“The Hot Zone” and the mythos of Ebola

The Hot Zone was first released in 1994, the year I graduated high school. Like many readers, that book and Laurie Garrett’s The Coming Plague* really sparked my interest in infectious diseases. In some sense, I have those books to thank (or blame?) for my career.

But I’m still going to criticize The Hot Zone, because as a mature infectious disease epidemiologist and a science communicator in the midst of the biggest Ebola outbreak in history, The Hot Zone is now one of the banes of my existence. A recent article noted that the book is back on the bestseller list, going as high as #7 on the New York Times list recently, and #23 on Amazon. It’s sold over 3.5 million copies, and it’s reported as “a terrifying true story.” Many people have gotten almost all of their Ebola education from just The Hot Zone (as they’ve told me over, and over, and over in the comments to this blog and other sites).

Here’s why The Hot Zone is infuriating to so many of us in epidemiology and  infectious diseases.

First–the description of symptoms.Preston himself admits that these were exaggerated. Over and over, he uses words like “dissolving,” “liquefy,” “bleeding out” to describe patient pathology. (If I had been playing a drinking game while reading and did a shot every time Preston uses “liquefy” in the book, I’d be dead right now).

Of a Marburg patient, pseudonymously named Charles Monet, he describes him as

“…holding an airsickness bag over his mouth. He coughs a deep cough and regurgitates something into the bag. The bag swells up….you see that his lips are smeared with something slippery and red, mixed with black specks, as if he has been chewing coffee grounds. His eyes are the color of rubies, and his face is an expressionless mask of bruises. The red spots…have expanded and merged into huge, spontaneous purple shadows; his whole head is turning black-and-blue…The connective tissue of his face is dissolving, and his face appears to hang from the underlying bone, as if the face is detaching itself from the skull…The airsickness bag fills up to the brim with a substance known as the vomito negro, or black vomit. The black vomit is not really black; it is a speckled liquid of two colors, black and red, a stew of tarry granules mixed with fresh red arterial blood. It is hemorrhage, and smells like a slaughterhouse….It is highly infective, lethally hot, a liquid that would scare the daylights out of a military biohazard specialist…The airsickness bag is brimming with black vomit, so Monet closes the bag and rolls up the top. The bag is bulging and softening, threatening to leak, and he hands it to a flight attendant.

“…the body is partly transformed into virus particles…The transformation is not entirely successful, however, and the end result is a great deal of liquefying flesh mixed with virus…The intestinal muscles are beginning to die, and the intestines are starting to go slack…His personality is being wiped away by brain damage…He is becoming an automaton. Tiny spots in his brain are liquefying…Monet has been transformed into a human virus bomb.

“…The human virus bomb explodes…The victim has “crashed and bled out.”…He becomes dizzy and utterly weak, and his spine goes limp and nerveless and he loses all sense of balance….He leans over, head on his knees, and brings up an incredible quantity of blood from his stomach and spills it onto the floor with a gasping groan. He loses consciousness and pitches forward onto the floor. The only sound is a choking in his throat as he continues to vomit while unconscious. Then comes a sound like a bedsheet being torn in half, which is the sound of his bowels opening and venting blood from the anus. The blood is mixed with intestinal lining. He has sloughed his gut. The linings of his intestines have come off and are being expelled along with huge amounts of blood. Monet has crashed and is bleeding out.”

And later, at autopsy:

“His liver…was yellow, and parts of it had liquefied–it looked like the liver of a three-day-old cadaver. It was as if Monet had become a corpse before his death…Everything had gone wrong inside this man, absolutely everything, any one of which could have been fatal: the clotting, the massive hemorrhages, the liver turned into pudding, the intestines full of blood.”

And I didn’t even get to what Preston says about Ebola and testicles. Or pregnant women. Seriously, there’s pages upon pages upon pages of this stuff.

Throughout the book, Preston presents these types of symptoms as typical of Ebola. Not “in worst case, this is what Ebola could do,” but simply, “here’s what happens to you when you get Ebola.” It’s even beyond a worst case scenario, as he notes in part: “In the original ‘Hot Zone,’ I have a description of a nurse weeping tears of blood. That almost certainly didn’t happen.”

Compare that to just about any blog post by actual workers with Médecins Sans Frontières, healthcare workers on the front lines of this and many previous Ebola outbreaks. Stories are scary enough when the reality of the virus is exposed, and with it the dual affliction of poverty and the terrible health system conditions of affected countries. I interviewed MSF’s Armand Sprecher a few years back during a different Ebola outbreak, and he noted this about symptoms–quite different from the picture Preston paints:

The patients mostly look sick and weak. If there is blood, it is not a lot, usually in the vomit or diarrhea, occasionally from the gums or nose.

The clinical picture of Ebola that people take away from The Hot Zone just isn’t accurate, and with 3.5 million copies sold, is certainly driving some (much? most?) of the fear about this virus.

Second, airborne Ebola. Though this trope is often traced back to “Outbreak,” Preston clearly suggests that both Zaire Ebolavirus and Reston Ebolavirus can be airborne. What he never discusses nor clarifies is that the “evidence” for this potential airborne spread is really thin, and not even indicative of animal-to-animal or animal-to-person transmission.

Rather, it’s much more likely that if airborne spread was involved, it was aerosols generated by husbandry (such as spraying while cleaning cages), rather than ones which would have been generated by infected primate lungs (a necessary step for primate-to-primate transmission via a respiratory route). Indeed, this is the paper that Nancy Jaax et al. published on the findings Preston talks to Jaax about, 13 years after the fact (the experiment is marked as 1986 in The Hot Zone), and noting that transmission due to husbandry practices could not be completely ruled out. It’s unclear also that the Reston strain moved through the primate facility via air, rather than via spread due to caretakers, equipment, or husbandry. Nevertheless,  it’s frequently cited as fact and without any qualification that Reston is an airborne type of Ebola.

Instead, here is what Preston says about it:

“If a healthy person were placed on the other side of a room from a person who was sick with AIDS, the AIDS virus would not be able to drift across the room through the air and infect the healthy person. But Ebola had drifted across a room. It had moved quickly, decisively, and by an unknown route. Most likely the control monkeys inhaled it into their lungs. ‘It got there somehow,’ Nancy Jaax would say to me as she told me the story some years later. ‘Monkeys spit and throw stuff. An when the caretakers wash the cages down with water hoses, that can create an aerosol of droplets. It probably traveled through the air in aerosolized secretions. That was when I knew that Ebola can travel through the air.'”

He then comes back to “airborne Ebola” several times, based in part on this idea.

But here’s the thing. Just about any virus or bacterium could be aerosolized this way–via high pressure washing of cages, for example. If it can bind to lung cells and replicate there, as we already know Ebola can, it can cause an active infection.

But that’s not the same as saying “Ebola can drift across the room” from one sick person to a healthy person and cause an active infection, as Preston tries to parallel with HIV in the above paragraph. Even in Jaax’s experiment and others like it, there’s zero evidence that primates are expelling Ebola from their lungs in a high enough concentration to actively infect someone else. And that is the key to effective airborne transmission. Think of anthrax–if it’s released into the air, we can inhale it into our lungs. It can replicate and cause a deadly pneumonia. But anthrax isn’t spread person-to-person because we don’t exhale the bacteria–we’re dead ends when we breathe it in. This is what happens with primates as well who are experimentally infected with Ebola in a respiratory route, but Preston implies the opposite.

Third, if it wasn’t for points one and two, The Hot Zone really could be read as a “damn, Ebola really isn’t that dangerous or contagious so I have little to worry about” narrative. Preston describes many “near misses”–people who were exposed to huge amounts of “lethally hot” Ebola-laden body fluids, but never get sick–but doesn’t really bother to expose them as such. All 35 or so people on the little commuter plane Monet flies on between his plantation in western Kenya and Nairobi, deathly ill, vomiting his coffee grounds and dripping nasal blood into the airsickness bag he handed to a flight attendant–none of them come down with the disease.

The single secondary infection Monet causes is in a physician at the hospital where he’s treated, after his bowels “ripped open” like a bedsheet. That physician, Shem Musoke, not only swept out Monet’s mouth until “his hands became greasy with black curd” but also was “showered” with black vomit, striking him in the eyes and mouth. Monet’s blood covered Musoke’s “hands, wrists, and forearms,” because “he was not wearing rubber gloves.” Musoke developed Marburg virus disease, but survived–one of the few secondary cases of infection described in the book.

Another “close call” was that of Nurse Mayinga N. She had been caring for one of the Ebola-infected nuns at Ngaliema Hospital in Kinshasa during the 1976 outbreak in Zaire, the first detected entry of Zaire Ebolavirus into the human population. Beginning to feel ill herself, she ditched her job and disappeared into the city for two days. She took a taxi to a different, larger, hospital in the city, but was sent away with a malaria shot. She’s examined at a third hospital and sent away. Finally she returns to Ngaliema hospital and is admitted, but by that time, had caused a panic. Preston says:

“When the story reached the offices of the World Health Organization in Geneva, the place went into full-scale alert…Nurse Mayinga seemed to be a vector for an explosive chain of lethal transmission in a crowded third-world city with a population of two million people. Officials at WHO began to fear that Nurse Mayinga would become the vector for a world-wide plague. European governments contemplated blocking flights from Kinshasa. The fact that one infected person had wandered around the city for two days when she should have been isolated in a hospital room began to look like a species-threatening event.”

How many secondary cases were the result of Mayinga N’s wanderings? That possibly “species-threatening” event? Preston again devotes several paragraphs to Mayinga’s gruesome illness and death, and notes that 37 people were identified as contacts of hers during her time wandering Kinshasa. He tells us they were quarantined “for a couple of weeks.”

The fact that exactly zero people were infected because of Mayinga’s time in Kinshasa merits half a paragraph, and not dramatic or memorable. “She had shared a bottle of soda pop with someone, and not even that person became ill. The crisis passed.” <–Yes, that is a direct quote and the end of the chapter on Mayinga. Contrast that to Preston’s language above.

Finally, beyond the science and the fear-mongering about Ebola, beyond everything and everyone in the story “liquefying” and “dissolving” and “bleeding out,” reading this book again as an adult, as a woman in a science career with a partner and kids, I was also left annoyed at the portrayal of the scientists. All of the major characters except one, Nancy Jaax, are men of course, ranging in age from late 20s to 50s-60sish. Understandable since this is in a mostly-male military institution and in a BLS4 setting to boot, but the one Preston focuses on for much of the narrative is Jaax.

While Preston may have been trying to portray Jaax as the having-it-all, tough-as-nails woman scientist, the fact that she’s the only one with any kind of home life is telling–mostly because he devotes more paragraphs to how she neglects both her children and her dying father than any success she has in her life outside of work. She is told early on by one of her colonels that “This work is not for a married female. You are either going to neglect your work or neglect your family.” This thought comes up repeatedly for Jaax, and in the end, while she was accepted and even honored by her colleagues and bosses, we hear over and over again how her children are left on their own to microwave meals and tend to their homework. How they desperately wait up for her to get home after work, often eventually falling asleep in her bed before she arrives. How she tells her father, dying of cancer back in Kansas and both knowing he only has a few hours to days to live, good-bye and “I’ll see you at Christmas” over the phone. How she barely arrives on time for his funeral after he passes.

We hear one paragraph about how another colleague, Thomas Geisbert, had a crumbling marriage with two small children, and how he left the children at his parents’ house for a weekend. Other than that, the personal lives of any other characters are practically absent, save for Jerry Jaax, Nancy’s husband. Even with him, much of the character development revolves around his fears of his wife working in a BSL4 lab.

The Hot Zone, for me, is unfortunately one of those books that you read as a young person and think is amazing, only to revisit years later and see it as much more shallow and contrived, the characters one-dimensional and the plot predictable. The problem is that The Hot Zone is not just a young adult novel–it’s still presented and defended as an absolutely true story, especially by huge Preston fans who seem to populate comment threads everywhere. And now it looks like there will be a sequel. At least it should be good for a drinking game.

 

*I’ll note that The Coming Plague is much more measured when it comes to Ebola–the two were grouped together because temporally, they were released close together, not because they display the same type of hype regarding the virus.

Baby on board–in a BSL4 lab

I’m happy to welcome Dr. Heather Lander to the blogosphere and Twitterverse. She’s a virologist who has done work with some of the world’s deadliest pathogens in a high-security biosafety level 4 laboratory. This is the type of lab where one must wear “space suits” to work with organisms. You’ve probably seen in dramatized in various movies and TV shows (such as The Walking Dead). Heather describes what it’s really like to work in one–even while pregnant.

Heather 9 months pregnant in BSL4
Dr. Lander, 9 months pregnant in a BSL4 lab

 

TS: Can you tell readers a bit about your background and research? How did you get interested in studying viruses, especially some of the deadliest on earth that require BSL4 containment?

HL: I began my college career as a music major but I also loved science so I enrolled in many science classes, weighing my options. When I took a molecular cell bio class I was hooked. I changed majors and didn’t look any farther ahead than my Bachelor’s degree. But then the news exploded with tale of deadly virus outbreaks, and books and movies started coming out. I was fascinated, as are most people, so with permission from the professor I enrolled in a graduate level molecular virology course. Turns out viruses are beyond interesting. They blew my mind: microscopic, consist of hardly anything and can take us down in a matter of days. I wanted to know what was going on. At this point I thought all viruses were insanely interesting, but I found myself drawn to those that cause hemorrhagic fevers (HFV), and not only because of the media attention. I started reading the literature and these viruses were pretty different than the more familiar ones. They were confounding and I wanted to help figure them out.

Because I hadn’t planned ahead, I wasn’t ready to apply to grad school. So to improve my chances of working with these viruses, I got a job as a technician in a very highly regarded lab that worked on angiogenesis; basically the biology of blood vessels. Because HFVs either damage blood vessels or make them leaky, I thought it would be a good knowledge base. From there I got into the University of Texas Medical Branch as a PhD student and ended up working with CJ Peters, one of the premier experts in HFVs. Our interests aligned and he was great at listening to and encouraging the ideas of a neophyte.

We wanted to investigate viral infection of the cells that line the blood vessels, endothelial cells, and UTMB was getting ready to open their new BSL4 facility – The Robert E. Shope, MD Laboratory – the first of its kind at a U.S. university. In deciding which virus to work with, we took Ebola off the table because it was pretty clear that Ebola caused blood vessel leakiness through overt damage. Other HFVs did not, so the mechanisms of vessel leakiness were still unknown. Of these viruses, the arenaviruses were good options for me. One in particular, Junín virus, which causes Argentine hemorrhagic fever,  was a nice model because we had access to virulent and attenuated strains. I could work with the attenuated BSL2 virus, to get my model and systems up and working, and then repeat the experiments with the virulent BSL4 virus. So I researched the effects of  Junín virus infection on human endothelial cells.

TS: For readers who aren’t familiar with what working in a BSL4 entails, can you describe what it’s like to work in such a laboratory? 

HL: Working in a BSL4 lab adds a lot of steps to any lab work so everything takes longer. Before you can even go inside you are required to have extensive training, health and psychological assessments and be granted Department of Justice security clearance – many BSL4 organisms are Select Agents. After training at all other levels: BSL2 and 3, you are required to complete 100 hours of mentored, supervised BSL4 training, and assessment by the mentor, before being granted independent access. So, BSL4 research is only done if you can’t answer the scientific questions another way. Now, UTMB has the Galveston National Lab, a second BSL4 lab that is much larger, but the Shope lab is relatively small, only a few people can be in there at the same time. This means you have to plan ahead and schedule. Do you have all the supplies you need? You can only carry so much in at one time and you can’t go in and out, it’s too time consuming. So you have to make sure you know what you’ll need and I would often go in a day ahead of time, just to take supplies and make sure I would be ready to go.

During training you do a lot of practice. One of the most important things to practice initially is how to safely hold and open cryovials while wearing bulky rubber gloves. You also learn all safety and decontamination protocols as well as some practical things like moving around the lab safely. Seems silly, but in the lab, you are connected to an air supply through a hose that is attached to the air supply system on the ceiling. Those hoses don’t move with you. They stretch only so far and then you have to disconnect, move to where you need to be and connect a hose at that location. The suits are positive pressure with a constant inflow of air, with ports for air exhaust, otherwise they’d pop like a balloon. The air-flow is wonderful. The suits are cool and relatively comfortable, much more so than the stuff you wear for BSL3. Another important thing to learn and practice is how to enter and exit the lab. Seems simple but there are many steps involved. Here’s a description of what is is like to enter and exit the UTMB Shope Lab. Other labs are different, so this description isn’t meant to apply to all BSL4 labs in general, although the principles would be the same.

One of the best things about working in BSL4 is that, once you’re inside no one bothers you, no one interrupts you. There is a phone, but you don’t use it unless you have to.  So there are no annoying deliveries, phone calls or bored people stopping by to chat. It’s great. Though there was one very important thing I learned early: if you’re disconnect from the air hose, don’t bend over! When you do, you force the air that’s in the suit, out through the exhaust valves, so when you stand back up, the suit is sucked to you like a vacuum sealed bag with no air. Yeah, I did it. They laughed. It only happened once.

TS: Did you or your husband have any reservations about you continuing to work while pregnant? What convinced you that it was safe?

HL: We never had any reservations, and I’ll explain why. When I started working in the BSL4, I made sure I explained the work and the risks, to my family and my husband. So when I got pregnant, I had been working in the lab for a couple of years and he was very familiar with what I did. We had many long conversations about it and, as a couple, sat down with CJ and also our environmental health safety officer, the go-to person at UTMB for Select Agent biosafety, and member of the ASBA council. CJ had been head of USAMRIID’s containment lab and then he was Chief of Special Pathogens at the CDC. CJ and out EHS officer both know their stuff and were very helpful. I never felt pressured to continue working in the BSL4. It was my decision, with input from my husband of course, but he let me make the call. He trusted me and knew I wouldn’t be foolish. Aside from the obvious, the concern with Junín virus is that the case fatality rate is much higher than normal for pregnant women and fetuses, so it was not a cavalier decision by any means.

The bottom line, was that the entire time I worked in the BSL4, I valued my life and I was exacting and followed protocols to the letter. BSL4 protocols are designed to prevent any chance of contamination or infection and if they are followed, then the lab is clean. It’s the cleanest lab I’ve ever been in. I think a big misconception is that there are viruses floating around everywhere in the BSL4 and that’s why you wear the suit, but that’s just not true. The BSL4 protocols prevent contamination and infection. The suits are back-up – meant more to prevent exposure in the event of an accident than as a first line of defense. If someone in the BSL4 goes into cardiac arrest, we would remove the suit and administer first aid. This of course depends completely on each scientist adhering to protocols, and they do. And they are watched to make sure they do. The director’s office has cameras so he can see who is working and what they are doing. Every action is documented. And the people working in there are highly trained. I trusted those people and I trusted myself. I never deviated from the protocols, and I knew that. I was already being as careful and exacting as I could be, so there was no way for me to be more careful because I was pregnant. In addition, I wasn’t working with animals at that point, so the risks were lower. I was never worried and neither was my husband.

TS: How did your superiors take it when you first met with them to discuss continuing to do such work while pregnant? Was there anything you had to sell them on to allow you to work in there during your pregnancy?

HL: This was hard. I was terrified that they would make me stop working. No pregnant woman had ever been knowingly allowed to work in a BSL4 lab in the U.S. prior to this. I say “knowingly” because CJ pointed out that it’s possible that there were women at the CDC or USAMRIID who went into the BSL4 while pregnant and either didn’t know it yet, or they knew but waited as long as they thought they could before telling their supervisor, because they knew they would be told to stop. And here I was, a student at a university.

I broke the news in a committee meeting, my last powerpoint slide was an ultrasound photo. The reactions were mixed, to say the least, but CJ was my advisor so they deferred to him. I didn’t have to sell it to CJ, or to our EHS officer. They were very supportive and seemed to welcome the opportunity to advance the rights of pregnant women in biosafety, in a safe way. We discussed the risks and my work and when my husband and I decided to go ahead and push for me to be allowed to keep working, consulting with the Director of the Shope Lab, and the safety experts at USAMRIID and the CDC.

We also involved my physician, who really advocates to prevent unneeded limitations of pregnant women. It took about 3 months for these negotiations, during which time, I did not go into the BSL4. With the help of my doctor we came up with a plan that would allow me to work in the BSL4, with limitations designed specifically to mitigate any difficulties that the pregnancy itself might cause. We drafted a contract and everyone signed it and it went into my UTMB file along with my OBGYN medical records.

Because sometimes unexpected things can happen during pregnancy, some limitations imposed included that I would not be allowed to go into the BSL4 alone. We also decided I would not stay in the lab for more than 3 hours at a time. This was to prevent me from getting both too tired, or dehydrated.  Turns out this one really didn’t need to be written down, my bladder was always screaming at me before the three hours were up and that meant exiting the lab. I also couldn’t work with animals, which wasn’t something I was doing anyway. When all was said and done, USAMRIID, the CDC, my Physician and UTMB were all on board and I went back in. After I paved the way, others have done it. You’re welcome. 😉

Heather in BSL4 with first successful Junin Romero plaque assay!
Dr. Lander displays her Junin Romero plaque assay.

 

TS: How was it, logistically, working in there while pregnant? I know I always felt huge and clumsy while pregnant and I wasn’t working with anything above BSL2 level and wearing a normal lab coat.

HL: Because the suits are cool, it was still pretty comfortable. It slowed me down for sure, especially the last couple of months. Moving with deliberation was already ingrained in me so that didn’t change, but I definitely moved more slowly. And I was huge, and the suit was definitely cumbersome. My belly pushed against the suit near the end but it wasn’t painful or even uncomfortable, I just had to give myself enough clearance when moving around tables and things. I also had to ask for help when doing normal everyday housekeeping kinds of things in the lab like emptying a trash bin or lifting autoclave pans. Everyone I worked with was very helpful and kind, so it was not a problem. I had the normal aches and tiredness, but if I ever felt too tired to go in, and there were a few times I did, I would cancel my time for that day and reschedule. I knew my limits and respected them.

TS: Any good stories?

Oh boy do I. Unfortunately I can’t share the best ones. When I was still in the 100-hours-of-mentored-training segment of my BSL4 experience, I was in the lab with a professor and we were working with Rift Valley Fever inmice. We had finished the work and had already put the animals away and cleaned up. We were just getting ready to exit the animal room, to go into the main section of the lab, and the air hose connection valve on my suit broke. Without the air hose, there’s no air, not to mention the suit had a hole in it. The professor realized what happened before I did and grabbed the air hose and shoved it against the broken valve, allowing air to get inside the suit. He and I took turns holding air hoses in place while we showered and exited. Because of the incident we had to fill out paperwork and I had to go to the university hospital’s BSL4 exposure unit for a potential exposure. Because we hadn’t been working with anything when the valve broke, I wasn’t actually exposed to anything, but it was standard protocol. I was released fairly quickly and have a story to tell. The experience taught me a lot about how to handle those situations and even though those kinds of things are REALLY rare, the BSL4 director made changes to specifically prevent anything like that from ever happening again, and it hasn’t happened since.

TS:  What are you working on now and what are your longer-term career goals?

HL: I want to put my expertise to good use and I’ve come to realize that I love writing so I’m hoping to find something that can incorporate that. In the meantime, I have a really interesting job doing grant development for faculty at UTMB. This involves high-level assessment of the science, grantsmanship and presentation/writing of proposals, in an effort to help make faculty more competitive. To get my pathogen fix and dispel some emerging disease misconceptions, I recently started the blog and I’m really enjoying it. I also have ideas for a novel (don’t we all?), so…who knows?

Many thanks to Heather for participating! Be sure to check her out at Pathogen Perspectives or Twitter

Unpacking a bit more

Yesterday’s post was frustrating. However, if anything good came out of it, it was some sharing of stories and mutual affirmations on the Twitters that yes, this happens to women all too frequently; yes, it’s obnoxious; and that hopefully some people viewing it thought about their own internalized biases, and how those may reflect in behavior toward women. I’m reminded at times like these how important social media networks have been to me, both in introducing me to new people (I’ve already found many new scientists to follow because of this) and in having an outlet to discuss and commiserate. So, some thoughts.

1) I hadn’t considered this in the beginning (because it’s my life and all), but from the write-up alone, I probably sound like “just a mom,” especially with my baby’s picture within the post. I mention at one point my colleague and link to a fellow scientist, but let’s be honest–people don’t always read these posts carefully or all the way through. So I was an easy target. Many studies have shown that people still describe scientists as old, white men–the Einstein stereotype. Just google “scientist” and check out the images: a bunch of nerdy, older white guys for the most part, and a handful of women (some scantily dressed, cause that’s exactly how we science, amirite ladies?). I got this type of attitude just the other day, as the driver who picked me up at the Philadelphia airport (a driver who routinely transports scientists!) was still surprised that I was a young woman and doing the work that I do. I’ve gotten that response previously at conferences as well. Women just aren’t accepted as scientists, even at times by other people working in the field.

2) I think many people (especially men) may underestimate or not understand just how frustrating this type of behavior/attitude is to women. Or worse, minimize it or not accept that this happens. I’ve been gaslighted previously by male (and female!) colleagues, telling me that surely my perception of a situation or event was incorrect. I accepted that they were right at the time (this was long before #ripplesofdoubt or other such support and story-sharing). No way would I stand for that now.

3) Blowback. The current situation involved a pseudonymous man on the internet, but all too often in these types of situations where women are dismissed and their expertise minimized people are involved who are more difficult to ignore. They may be senior colleagues in one’s own department or college. People in the field who could be reviewers of your papers or grant applications. Even collaborators who, in theory, should respect your training and value your expertise can try to appropriate your work because they see themselves as more important. (Thankfully this has not happened to me, but it has to several of my female colleagues, with mixed results in the end as far as credit, authorship, etc.)

In the end, much of this type of sexism is not conscious on the part of the one initiating it. I’m sure that people who told me I don’t look like a scientist meant it as a compliment and truly believed it was–because after all, scientists aren’t supposed to be young, or female, or particularly attractive. I’m sure that those that may have assumed I’m “just a mom” and didn’t bother to pay any attention to my professional accomplishments before explaining my field to me don’t think they’re particularly biased against women. Outright, blatant bias against women is much tougher to get away with today (in theory, anyhow), but the more subtle, “everyday” sexist behaviors are still very much amongst us. If it hurts people’s feelings that they get called out on these, well, tough. The only way things change is by shedding light on them. I have a bright spotlight and I’m not afraid to use it.

Twitter-splained

Just wrapped up a meeting sponsored by the Center for Disease Dynamics, Economics, and Policy and Princeton University’s Department of Ecology and Evolutionary Biology and Environmental Institute on the topic of antibiotic resistance at the animal-human interface. While I was there, I hopped on Twitter at a break after mingling and pumping–and got my ass Twitter-splained. I should note that i have no idea who Doc Ricky is–or if said Doc is a man or a woman, but either gender can be susceptible to doubting the expertise of women and relying on men to “set them straight” as it appears happened here. Storify follows (link here).

The world’s foremost Proust scholar

The world’s foremost Proust scholar

Twitter-splained!

  1. Another article using “superbugs”  http://aetiologyblog.com/2014/05/13/superbugs-rising/  – and calling to action blaming antibiotic use on farms. #kneejerk
  2. @drricky That’s by @aetiology who has done her homework and may well know a lot more than you about this. Your hashtag may apply you.
  3. @SavorTooth Not going with the argument from authority fallacy. Article ends with a call to action that isn’t well thought out.
  4. @SavorTooth I have been looking at the data. Go past the false equivalence of the antibiotic classifications.
  5. @drricky Yeah, and she studies the data professionally at Iowa State. Hardly knee jerk.
  6. OK, so I know not everyone knows me or what I do. And my name is pretty common, so sometimes Google-fu is tough. Maybe linking to my website would help clear things up…
  7. .@SavorTooth @drricky Every post I write isn’t going 2 b science-heavy. Search my blog or pubs, plenty science there.  http://taracsmith.com 
  8. @aetiology @SavorTooth I call to question this particular post because it alludes to certain scientifically dubious premises.
  9. I also pointed out that even in the post, I don't put blame only on ag antibiotics. Even at the "Superbugs" meeting, we discussed human-use antibiotics. One of the speakers was Dan Uslan (@dan_uslan), an infectious disease doctor at UCLA. No one is dismissing this as a cause of resistance.
  10. @drricky I call in farms and clinics–note I described what docs/hospitals are doing. Any antibiotic use -> resistance.
  11. @aetiology @SavorTooth been combing pubmed for “smoking gun” articles for years.
  12. @aetiology yes – all antibiotics are of finite usage. But not all equivalent.
  13. @aetiology @SavorTooth Yes, indeed, I agree re: totality of evidence. But also indictment without sufficient evidence is unjust too.
  14. At this point, lunch at my meeting had ended and I went back to work–listening to other speakers talk about their work on antibiotic resistance. (My talk was yesterday). Meanwhile, all of these popped up:
  15. @aetiology @SavorTooth (btw – impt premise – I am going to keep this as academically neutral as possible) #discussionmode
  16. @aetiology consider the “call to action” ending of the article links to the pewtrusts advocacy. But it doesn’t detail what will be done.
  17. @aetiology @SavorTooth The WHO report doesn’t directly finger farm usage, but the pew trusts action pushes the 70% figure.
  18. @aetiology @SavorTooth The casual appearance of false equivalence in discussion antibiotics is problematic.
  19. @aetiology Abx resistance is a complex topic  http://mmbr.asm.org/content/74/3/417.full  impt to consider that resistance pbly evolved w the antibiotic
  20. @aetiology And the Davies review took care to define “superbug” in their paper  http://mmbr.asm.org/content/74/3/417.full  but this may not be the vernacular
  21. @aetiology @SavorTooth empiric antibiotic prescription in clinics as well as unsupervised used and disposal may be bigger problem.
  22. Obviously, he hadn't checked out my website!
  23. .@drricky @SavorTooth Are you really explaining antibiotic resistance to me?
  24. I didn't pull the "DO YOU KNOW WHO I AM?" card directly.
  25. .@drricky I’m currently at a small meeting @ Princeton w/ world’s experts on topic of antibiotic resistance. Guess what? I’m one of them.
  26. Willem van Schaik is another microbiologist (in the Netherlands). He affirmed that I know my shit.
  27. @aetiology @drricky I’ve read the blog-post and there is absolutely nothing wrong with it.
  28. @aetiology @drricky ‘possibly reducing antibiotic use on farms, though optimism is mixed regarding how much that will actually help things’
  29. @aetiology @drricky is a very fair assessment of the current situation
  30. There may have been some snark.
  31. @aetiology @drricky this is pretty funny, actually. Like explaining to LeBron what a jump shot is.
  32. Best mansplaining thread ever MT “@aetiology: @drricky I’m at a mtg w/ world’s experts on topic of abx resistance. Guess what? Im one of em”
  33. Apparently this affirmation appeased Doc Ricky, who earlier "was not going with the argument from authority fallacy." Guess it's different when the authority is a guy?
  34. @cmyeaton @chenghlee @aetiology @drricky always a good move to back down once a white dude shows up to back a woman up. #gross

Promoting women in STEM–what do we discuss?

While I loved Jeanne Garbarino’s recent post, “Want to promote women in STEM? Leave home life out of the discussion“, and agree with probably 90% of it, I think it unfortunately goes from one extreme to another with some of her recommendations.

Garbarino notes several reasons why she thinks it’s counter-productive to discuss home life issues when trying to promote women in STEM careers: 1) it is rare that home life situations for men in STEM are discussed; 2) not everyone shares the same home life experiences or goals; 3) it doesn’t move the conversation forward. Very true for 1 and 2 (though I’d argue that rather than shutting down this conversation for women, perhaps we open it up more to men, who are increasingly worried about work/life balance as well), but 3 is where my disagreement centers. She writes:

As someone who frequently moderates panel discussions on careers in STEM, I have come to realize and value the types of information that truly move the conversation forward. Let’s face it – finding a job in STEM is not easy, and having a PhD no longer equates to job security (at least, job security in one’s area of research). I’d be happy to discuss my tactics for finding quality time with my children as part of a parenting forum. But ask me to talk about this when the focus is on securing a job, and I will no longer do it – it just doesn’t seem relevant.

Instead of discussing home life, I think it is better to talk about individual strategies for networking, recognizing opportunity, being your own advocate, and negotiating skills. These are the types of anecdotes that are the most valuable.

And while I support that, the reality for many of us is that finding a job necessarily includes a discussion of family life within that search (again, noting #2 above that clearly, for any panel such as this there will be people for whom that doesn’t fit). Personally, I had a secure job, was tenured, loved where I was, but *because* of family issues, it just wasn’t working out, so back on the market I went. For women in particular, we’re much more likely to have a partner who’s also in academia or a similar career. From NSF, note that women in STEM are much more likely to have a spouse working full-time, and to be married to another scientist or engineer. Thus, even when looking for jobs, women are more likely than men to have to deal with dual hire situations, or to need to look for some kind of accommodation for a partner.

Admittedly, I don’t have data for those Garbarino points out may feel alienated by husband/wife language, such as lesbian couples, but that brings up other issues of knowing whether a campus/town/area is LGBT-friendly, or can also find a position for their spouse/partner. And for those with children or planning to have them, knowing how to find out about childcare arrangements, for example, isn’t just theoretical, and can again be a factor in securing a job and may come up during  job negotiations. These *are* family issues, but also critical ones when “the focus is on securing a job,” or at least one where you and/or your partner won’t be miserable–and they shouldn’t be relegated to just a “parenting” or “family” panel in my opinion.

I think that instead of steering women-in-STEM panels away from topics such as partners and children (which she notes that certainly aren’t goals for everyone), it’s important to note that some kind of support system is important for *anyone* in academia. That may be husbands and wives, it may be a circle of friends you can vent to and troubleshoot problems (personal or professional), it may be other family or relatives in the area. Truth is, it’s very hard to go it alone in STEM, but it’s true that a spouse/partner isn’t the ideal solution for everyone. Similarly with the child issue: we all want balance. Just because one chooses to be child-free doesn’t mean s/he still wants to work 80 hours every week and have no kind of life outside of science. So perhaps rather than referring to balance in only a child-centric manner, it would be better to open that up to a bigger variety of ways that one has a life outside of work.

Finally, while I love the “Finkbeiner test” cited, I’m not sure this is appropriate for many *discussions* of women in STEM, rather than write-ups of such as intended. Coverage of women STEM figures in the media is quite different from an advice panel on job-seeking or tenure strategies, in which cases participants or audience members may be seeking just the information that Garbarino suggests leaving out.

Overall, this is a tough and touchy topic. No one wants “women in STEM” to equate to “must always discuss family issues and cheesecake recipes,” but at the same time we have to be realistic that women, even in academia, still generally are doing the lion’s share of family work, and that these are legitimate questions and concerns for many of us, especially for those heading toward the job market. We also know that many women still are turned off STEM careers because they’re seen as incompatible with having some kind of a life outside work, spouse/children or not. I’m not convinced that limiting discussion of these is any better than having the focus solely be on these types of topics–either strategy is bound to be alienating to one group or another. Personally, I can only emphasize what has worked for me. Your mileage may vary.

You’re also too pretty for math

I wasn’t going to raise this comment en blogge, but with Dr. Isis’ new post, it becomes more relevant. From Rick Fletcher on the “you’re too pretty” post:

It’s a major issue if your department won’t hire your or promote you because you are a woman. It’s no surprise that a retail clerk at a small shop in a downtown area is not the smoothest operator.

25 years ago it was a common response when I was introduced as a PhD chemist: “You don’t seem like a scientist.” Now it’s a common response when introduced, “Why are you single?” People say some dumb things. Not exactly the news.

But again, it’s an issue if the people who matter to your career hold you back because of your gender or appearance. Is that the case? No?

You can’t tweet the science but you can blog your indignation over getting hit on. Check your issues bag, it might be time for spring cleaning.

I already responded in the thread so I won’t rehash here, but via Isis comes this lovely reminder of why it’s more than just the people who hold my career back who matter–it’s an all-too-pervasive attitude, and it’s not just about me. Isis caught this screenshot from the store Forever21 (a store that I think we have in our mall here; I’ll have to see if they carry this particular product):

Yes, for less than $4, you too can tell the girls in your life that they’re too attractive for math. As Dr. Isis notes:

This is the kind of nonsense that frightens me. Washed up old fucks like Harvey Mansfield don’t worry me. I worry more about the small messages that pervade popular culture. The messages that we have to defend our girls against when we take them to the mall or the market.

Things like this make me realize just how far we have to go.

Bingo. *This* is why comments like that matter and aren’t just some kind of harmless flirty pick-up line, or just my “issues” that I need to “spring clean.” It affects all of us, and we all need to be aware of it and respond, rather than sweep it under the rug and dismiss it.

You’re too [pretty/young/female, take your pick] to be a microbiologist!

This wasn’t the post I wanted to write about the ASM conference. There’s been lots of great science discussed (I’ve tried to tweet some of it, but the wifi in both the conference center and my hotel have been spotty, so I’ve not had a chance to write anything comprehensive). Instead, I’m ticked off and venting via dashed-off blog rant.

[Me, trying to make a purchase]: Do you have any of these in a box that doesn’t say “from someone in New Orleans who loves you”? I was going to get them for my lab and that might be kind of creepy.

[Retail salesguy]: Your lab? I’m not sure those are good for dogs.

[Me]: No, not the dog lab. A science lab. My laboratory. The people who work for me.

[RSG]: Oh, you’re here for the science conference?

[Me]: Yes, microbiology. I study germs.

[RSG]: But you can’t be a scientist!

[Me]: I can’t?

[RSG]: No, you don’t look like a microbiologist.

[Me]: Um, what exactly does a microbiologist look like, then?

[RSG]: Uh…

[Me]: Because I’m pretty sure that I am one. (Rummaging through bag, digging out ASM nametag). Yep, that’s my name, and that’s the microbiology conference logo right there.

[RSG]: But you’re too pretty! You should be in Hollywood.

[Me]: (picking up bag, leaving unpurchased boxes on counter) I bet you’ve had dozens of scientists just like me through your store today, and never even realized it because of the stereotypes you hold. Conference runs through tomorrow, so I hope you’ll say hello to a few of them.

I know Mr. Salesguy was trying to be nice and probably thought he was flattering me, but fer chrissakes, that is NOT the way to go about it. Women in science already frequently feel like “The Other,” that we’re “too XX” to be good at what we do, that our possession of breasts surely must mean that we’re too much of a fragile flower to be able to handle the “man’s work” involved in science and academia, and that we need to go above and beyond what our male colleagues do just to feel the same level of acceptance and appreciation. I’m sure Mr. Salesguy has never thought about the plight of women in science before tonight (and I doubt that my conversation really made him think about it for more than a few fleeting seconds), but it really dragged down what had otherwise been a very nice few days of unadulterated sciencey goodness.

Of course, it’s not only science meetings or clueless salespeople; atheist meetings have their unthinking men too, as was recently demonstrated yet again. From now on, maybe I’ll print out this post and keep a copy in my bag, just for situations like today.

Margulis does it again

We all know of once-respected scientists who ended up going off the deep end, adhering to an unproven idea despite massive evidence to the contrary. Linus Pauling and his advocacy of megadoses of Vitamin C, or Peter Duesberg’s descent into HIV denial. It’s all the more disappointing when the one taking a dive is a woman, since there are, compared to men, relatively fewer female “big names” in the sciences. So when one goes from views that were, perhaps, outside of the mainstream (but later proven largely correct) to complete science denialism, it makes it all the more depressing. Even worse, mainstream popular science magazines like Scientific American (with this article by Peter Duesberg) and Discover (Duesberg again) give these ideas reputable press. And now Discover has done it again by giving “maverick” biologist Lynn Margulis a profile in their latest issue. More after the jump.
Continue reading “Margulis does it again”

Rock Stars of Science, part deux: coming to a GQ near you

The second edition of the Rock Stars of Science is now out online, and in the November 23rd (“Men of the Year”) edition of GQ magazine. As Chris Mooney notes, this is a campaign funded by the Geoffery Beene Foundation, working to raise recognition of scientists’ work (and scientists, period, since roughly half of the American population can’t name a single living scientist). Part of the campaign is to make science noticeable and “cool;” I’ll quote from the press release:

ROCK S.O.S™ aims to bridge a serious recognition gap for science, observes journalist Chris Mooney, co-author of the recent book, Unscientific America, and a partner of the campaign.

“The current gap between science and our popular culture,” says Mooney, “keeps Americans from recognizing the centrality of science to their daily lives. They think science is some strange activity performed by slightly geeky others in white coats. In fact, science fuels our economy and is our great hope for cures to diseases that affect all of us.”

“The RSOS™ campaign shines the spotlight on this critical national issue,” says G. Thompson Hutton, CEO and Trustee of the Geoffrey Beene Foundation, supported by the designer menswear brand Geoffrey Beene, LLC, which dedicates 100 percent of net profits to philanthropic causes. “If we invest in research, we will save lives now and trillions of dollars later.”

So, I think it’s a great cause, and a unique way to spread the word. From that side of things, I’m all for it.

But… (there has to be a “but,” right?)

The first campaign didn’t exactly knock my socks off. Chris gives an update on the participants at The Intersection; if you read through it, you may notice the 2009 participants had many things in common: they were universally older, white men. To be sure, they include older white men doing great things (Tony Fauci, head of the National Institute of Allergy and Infectious Diseases, NIAID, was one of those featured)–but they promoted the stereotype of scientists as, well, old white guys.

This time around, the lineup is more diverse, featuring 17 scientists–including 4 (white) women and 2 men of color (though still, mostly older). The scientists chosen include notables such as Nobel prize winner Elizabeth Blackburn and physician/astronaut Bernard Harris. The lineup is also heavy on cancer researchers and other biomedical types; understandable, since they are focused on disease and cures. I realize these are easier to “sell” to the public, because we all know someone who has experienced cancer–but if the foundation does a round 3, perhaps some more physical scientists could be included? Even if they maintained the focus on health, climate change, for instance, has the potential for huge impacts on health–and many engineers, physicists, and chemists work on health-related problems.

They also have a cutesy Q&A with each scientist, providing them all the same questions. Some I find to be fairly lame (“What was your worst part-time job?” “Alternate career choice?” “Longest med school study session” [!? why the emphasis on med school?]), along with some that I think make a better impact, like discussing misconceptions of their work, or their best moment in science/research. I realize the “lame” ones are to help the audience see that scientists are just like them, and spent time in crummy jobs, but diversity in the questions would be nice to shake things up a bit. Then they have a portion where the scientist’s research is described…which is terrible. I don’t know if this made it into the print version or is only online, but in many cases, these descriptions are lifted right off the scientist’s professional website. Look at Catriona Jamieson’s, for instance (taken verbatim from her lab website):

Dr. Jamieson specializes in myeloproliferative disorders (MPDs) and leukemia. Myeloproliferative neoplasms are a family of uncommon but not rare degenerative disorders in which the body overproduces blood cells. Myeloproliferative neoplasms can cause many forms of blood clotting including heart attack, stroke, deep venous thrombosis, and pulmonary emboli and can develop into acute myelogenous leukemia. Although some effective treatments are available, they are laden with serious side effects. In addition, individuals can become resistant to the treatments. Dr. Jamieson studies the mutant stem cells and progenitor cells in myeloproliferative neoplasms. These cells can give rise to cancer stem cells. Cancer stem cells may lie low to evade chemotherapy and then activate again later, causing disease progression and resistance to treatment. Her goal is to find more selective, less toxic therapies. In the past two years, Dr. Jamieson’s stem-cell research studies have taken a great leap: from identifying a promising treatment in the laboratory to opening and completing the first clinical trial to target cancer stem cells in humans. This trial is the result of teamwork that has brought together her discoveries in myeloproliferative neoplasms and a local pharmaceutical company’s drug development track.

I mean, really?? I’m a scientist, and just reading that even made *my* eyes glaze over. If one thing they’re trying to convey is the importance and relevance of the scientist’s research to GQ readers, what percentage of the readers are really going to walk away with a deeper understanding of what Dr. Jamieson does by reading that description? It would have been a small thing to ask each participant to submit a layman-friendly version of their research (their “elevator talk” description, for example) for GQ to include.

Finally–one of the “scientists” is Dr. Oz. What is he doing in there? One, I would think he’s already well-known enough; why not save that spot for another scientist? Two, yes, I know he’s actually done research and published, and is on the faculty at Columbia. Fantastic. He’s also a serious woo peddler, who has even featured everyone’s favorite “alternative” doc, Joseph Mercola, on his talk show, and discussed how vaccines may be playing a role in autism and allergies (despite mounds of evidence to the contrary). This seems to completely contradict their goal of “research funding as a national priority,” since Oz is often (and Mercola is always) highly critical of “mainstream medicine.” I really don’t understand his inclusion, and think it’s to the detriment of the rest of the campaign.

I know, this is quite a lot of complaining (isn’t that what bloggers *do*?), but I’m sincere in hoping that this campaign does raise awareness. I hope they expand it beyond GQ–why not do something similar in magazines with a larger female readership, such as Good Housekeeping or even People magazine? Women are the ones who make many of the healthcare decisions, after all. We’re often advocates for health and healthcare research–and if more funding is what they’re ultimately looking for, we vote too.

[Edited to add: Science has an article on the campaign as well.]

The science boys’ club strikes again

Recently, a bit of a kerfuffle has sprung up around the choice of entries included in The Oxford Book of Modern Science Writing, edited by Richard Dawkins. The book contains 83 examples of the “finest writing by scientists.” However, DrHGG noted:

Of 83 texts Professor D has selected 3 written by women. That’s about 3.6%. How hard could it be to find a handful more? Like 10%? It would still be a wiener fest.

She also notes that of those 3, one is even left out of the “Featured Writers” section, as it was co-written with her husband (who received all the credit).

Sheril brought this up on her blog, and Dawkins replied, noting that “it is a regrettable fact that the great majority of distinguished scientists of the past 100 years, as measured by Nobel Prizes, Fellowships of the Royal Society, numbers of science publications, etc, have been male. That imbalance, and not an imbalance in my preference or my choice, is what is reflected in the anthology.”

I call shenanigans. First, Dawkins also claims that he is “…not one of those who thinks men are genetically better equipped than women to become distinguished scientists.” Therefore, he must know that it’s other factors that have led to larger numbers of men than women in the top ranks of the scientific enterprise–one of these factors being a nasty feedback loop. Women lack role models in the upper echelons of science, leading more of us to think that perhaps this isn’t the place for us, which is reinforced by examples such as this anthology. While Dawkins may not support such an attitude, his incredibly male-dominated collection, and his “too bad, so sad, that’s just the way it is” response to this criticism reinforces this conclusion.

Other comments in the thread are also depressing. Dave24 notes:

The author of the material doesn’t matter. The substance does. Dawkins created a collection of works that he personally found relevant and important. Taking into account the sex of each author is completely pointless. Find something else to complain about.

This is exactly the wrong attitude for anyone who’s concerned about the future of U.S. science to have. Yes Dave, I’m sure we’re all well aware these are Dawkins’ personal preferences. The question is *why* are those choices so “weiner-centric,” as DrHGG notes? Really, only 2 solely female authored essays? Even granting that science has been exceedingly male-dominated in the past 100 years, surely something could have been included by some of the female “big names,” such as scientist, Nobelist, and writer Christiane Nüsslein-Volhard to give one recent example?

This isn’t just “pointless.” It’s yet one more example of women being overlooked and dismissed. This was a subjective collection–surely, if Dawkins had put some thought into it and realized how unbalanced it was, he could have included some additional essays by scientists who also happen to be women. You can argue that maybe he just didn’t know of any (which I find quite unlikely), but even if this is the case, why not throw out a net, asking friends and colleagues for some suggestions of great essays by female scientists in order to be more inclusive and take one small step toward breaking that nasty feedback loop?

PZ recently put up a post asking about the invisibility of female atheists, and noted:

The problem isn’t dismissal. It’s casual disregard. It’s being just enough pro-feminist that we lose sight of the real problems that women and people of color face.

Bingo. And even when called on it, Dawkins remained dismissive. *This* is why women still feel like outsiders in the atheist community, and in many parts of the scientific community, and Dawkins’ collection reinforces that it’s a boys’ club that we’re unlikely to crack, despite the call for change. Find something else to complain about, indeed.

[Edited to add: Mike Dunford also weighs in]