Coming of Age
It is 1928 when Hanno Buchwald is born in the only hospital in Linton, Indiana. As he grows up on an isolated one-hundred-acre farm far from gravel roads and playmates, Hanno helps care for his ailing grandfather, works in the fields and kitchen, and daydreams atop his family’s grape arbor.
Like almost every farm boy, Hanno learns how to kill a chicken, churn butter, and milk a cow. Left to his own devices for playing, Hanno attaches special importance to visitors that include his brothers’ and parents’ friends, relatives, neighbors, and salesmen. After he begins his education in a one-room schoolhouse, he learns all about life in the town of Linton from his adventurous aunt, who is among the first to have a phone and car. But just as Hanno enters adolescence, World War II begins, sending him on a new path that will test his inner-strength, convictions, and spirit in ways he never imagined.
THIS diary is more important now than when it was written. It is about a time in China when relations with Americans were at a peak. It was during the period after the Cultural Revolution and before the Tiananmen Square massacre.
This period provided a clear lens by which to see a level of civilization not often exposed. Our exposure to another country, sometimes even when we are there, occurs greatly through the news media and through major political transactions. News media, for profit and survival, must focus upon the sensational. People who are political representatives must act from premises of policy that serve the best interest of their country and ward off threat. The people we met on the street and in the clinical conference rooms had no such motives. The opportunity to meet a person face to face from the other side of the world and deal with common interest is rare. One Chinese person we met put it this way. Governments come and go, whether in China, America, or elsewhere. The Chinese culture continues on and on. When a Chinese person and an American person get together with no political or newsworthy mandate, they are free to be who they are.
Our perspectives change with time. For this reason the words in this diary and in the concluding comment were as written in 1981. Only spell checking and correction of sentence structure have been made. An updating would contaminate this picture of a time in China.
Acknowledgement is offered to the People-too-People Citizen Ambassador organization that sponsored the trip. Appreciation is given to the various people who assisted in picture taking and in discussing the events as they were occurring.
The findings of this project addressed the following questions. During coronary unit or ward care, how much should a coronary patient be told about the severity of his illness? How much diversional stimulation should be provided? To what extent should a patient participate in self-treatment as opposed to passive rest? During a mild experimentally induced stress situation, how do MI (coronary) and non-MI patients differ in corticosteroid response within the context of natural circadian rhythm? What predicts a recurrence and/or death within 90 days following the initial coronary attack?
Multivariate analysis revealed that the question of how much to tell the patient about illness severity has no answer unless nursing care climate is specified. If patients are assigned controlled exercise and self-treatment chores, then highly informative severity feedback led to the highest survival rate of all MI groups. On the other hand, if patients are asked to do “nothing but passive rest” after receiving the extensive severity information, then the highest rehospitalization and death rate resulted. In other words, the coupling of severity information with the patient taking action is the crucial issue. Some combinations are toxic and should be avoided.
With the mildly stressful task MI patients (compared to non-MI) had a suppressed immediate corticosteroid elevation but indeed a marked elevation later in the day.
The strongest predictor of death was the level of social affection on the day of departure from the coronary unit. For example, the customary positive mood and tokens of appreciation to nurses and staff were absent among those destined to succumb soon. Elevated NEFA (non-esterized, or free, fatty acid level) following stress was also associated with death.
Rehospitalization with another coronary attack within 90 days was best predicted by psychological rather than electrocardiographic, blood enzyme, or other physical symptoms. Patients with high rates of scanning information, high anxiety or depression, low peak blood pressure, were more likely to have recurrence.
In a single snapshot comparison of MI and non-MI patients (rather than predicting outcome), the acute MI patients were characterized by greater external locus of control orientation, depression, and denial of hostility.
Nonfiction. For information or Purchase, click on name of book (in red).
What does it mean to be human? This book presents the view that we are still in the Dark Ages with this question. Various knowledge domains, such as religion, philosophy, scientific psychology, economics, and law, have their own perspectives. Indeed, they are built each to address different purposes: predictive utility (and the understanding it affords) in science, just decision making in law, and faith in religion. People have little difficulty sorting out the purposes of a hammer, screwdriver, or cell phone. Yet, they make outrageous transgressions when forcing one domain to meet the purposes of another.
In psychology a pot pourri of theories lack any common structure. As a contrasting example, the physical and biological sciences have the periodic table of elements. This organized set of findings applies widely to questions in nuclear physic s, engineering, chemistry, physiology, genetics, and other areas. The social and behavioral sciences have no such commonly shared tool.
Where would one start to build a primitive prototype of value for both molar and molecular ways to describe human functioning? We can agree that an event has occurred when a sinusoidal (cyclic) pattern of electroencephalic (EEG) activity is recordable. The same event that provided the electrical activity can also be described in terms of the cycle of resolution of information. The input is received by the retina or other sensory source. The next step determines if the input matches with things previously remembered (or if the input is novel). This initial segment, often called arousal, creates two initial pathways of event resolution: one with familiar and one with unfamiliar input.
The familiar input pathway then undergoes another discrimination based upon whether the remembered action and outcome centered upon goal approach or avoidance of harm or embarrassment. In either case the evoked match (recall) is linked to sequences of thought and action. They continue from the time of this start point to a termination signal that indicates that the sequence has been validated. This second segment of the cycle is often called activation. If the arousal segment indicates that something is to be done, this activation segment involves doing it.
The familiar input pathway then reaches the third segment of the cycle: appraisal and reset. It centers upon the anticipated signal to indicate that the thought/action sequence has either done its work or has achieved a significant step. Different options of outcome occur. In the not too frequent but nevertheless ultimate option, the activation sequence is completed. Information processing activity is returned to a resting state. Alpha waves are restored. The system becomes ready for another input event.
More frequently, the appraisal indicates that further steps are yet to be achieved. Otherwise, a correction of course may be needed, with modified action sequences or even outcomes. Failure to reach anticipated end point and goal extinction may occur. This is often called “burn out.”
Returning to consider the novel input pathway beginning in the initial segment, the failure of match launches both a transient assessment system and an alarm system. The assessment of novelty is sometimes weak or missing. A distinction is made between novel events that are worthy of approach (novelty attraction, sensation-seeking) and novelty that is potentially harmful or embarrassing. This transient step involves wildness vs. domesticity or tameness. An alarm system with innate activation sequences is the more potent alternative of the assessment.
A hyperalert state is accelerated or dispelled with various anticipations of danger or embarrassment. The options of taking to fight or flight are witnessed or dispelled with life experience, and a harm-avoidance (defensive) system is developed for skilled escape. Unlike the approach pathways, where satisfaction is both predicted and validated, these pathways often do not provide knowledge that a threat has successfully been avoided. One’s efforts may be only temporary. Thus a residue of unconsummated avoidance sequences may be retained as anxiety or other psychopathology.
Along with microelectric tracing, the cycle of resolving information, and other cycles, the input event may be describe on a biochemical neurotransmission level. The input arousal segment is driven by epinephrine. The activation segment is driven by dopamine. The appraisal/reset segment is driven by serotonin.
The single event with multiple levels of description is offered as a potential template around which questions may be addressed. Many flaws and imprecisions are yet to be identified and removed. Some of these are as follows.
Sometimes people assume that the moment that some new event has met with the retina or other sensory site the person is instantly aware of the event. They overlook the time needed for the impulse to travel the afferent pathways to brain processing centers and then along efferent pathways to allow awareness to be reported. By the time they are aware or can report, the event is already in the past. Much of what it means to be human transpired before awareness can occur. Thus, consciousness is a cumbersome organizing template.
People fail to distinguish between the empirical event and the various arbitrary descriptions of that event. The event itself is identified by consensual agreement among observers. One misunderstanding is that the level of description is the event. Another is that a given level of description causes the event. A third is that one level of description causes another level of description. The three (or more or less) levels of description may be judged by the kinds of questions about the event that they help answer.
Sometimes an event is hypothesized as related to another event outside the realm of observation or inference. Sometimes it is said to be caused by another event described in molecular terms. A “rubber band” hypothesis is one that can never be disconfirmed. Negative results can be accounted for.
When these flaws are removed, the distinction between the physical/biological and the social/behavioral sciences may wither. With the dots connected across disciplines it is evident that science is an ongoing human product.