Today’s horrific tragedy will undoubtedly spawn another round of news stories saying that this is the “Nth mass shooting,” or “it’s been N days since the last mass shooting in the U.S.” But many of them will give completely different numbers.

When it comes to mass shootings, it can be hard to find good data—in part because in 1996 congress essentially defunded the Center for Disease Control’s research into gun violence, and in part because there is no standard definition of a mass shooting. But that doesn’t stop people from keeping count—at least five organizations track mass shootings, and this attack would not qualify as a mass shooting according to Mother Jones, or USA Today’s records of Mass Shootings.

How is this possible? How can a doctor walking into a hospital with an AR-15 and shooting seven people then shooting himself not be counted as a “mass shooting?” In part, because it took place in a hospital.

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See, many of the organizations that track shootings only count shootings where 3-4 died from the shooting. So as the NY Times noted, “Some believed that the death toll would have been far higher had the shooting occurred anywhere but where it did — a hospital filled with state-of-the-art medical equipment, and with doctors and nurses who rushed to victims and performed triage where they fell, in staircases and hallways, even as the gunman was still at large.”

While deaths are clearly the most tragic outcome of a shooting, whether or not a shot was deadly does not change the motivation for the incident. In determining a mass shooting sn’t the number we care about the number that were shot at, not the number injured or dead? Why is it important shooter hit or missed their target when classifying a shooting as a mass shooting? In fact, some researchers suggest that improved treatment of gunshot wounds and the use of gun deaths as a metric has decreased our attention to the fact that gun violence appears to be rising.

But expedient medical care isn’t the only reason this shooting won’t be classified as a mass shooting according to some lists. For example it probably wouldn’t make the FBI Active Shooter Report, which only count shootings that occurred in public areas, since the victims were doctors and medical students it may be counted as a workplace dispute  as opposed to a mass shooting that occurred in a public space.

In fact the only two organizations I could find that would definitely count this incident as a mass shooting are both crowd-sourced projects that operate online: the Mass Shooting Tracker and Gun Violence Archive.

If one is concerned with general gun violence, the Mass Shooting Tracker, Gun Violence Archive, or USA Today’s mass shootings, which ignore location and motivation, may provide the most comprehensive data. However, many of the incidents they count such as gang fights or familial murder-suicides aren’t what we are typically referring to when we say ‘mass shooting.’ So if one is concerned with the seemingly random, public mass shootings other sources may be better better.

And how we classify these events is extremely important if we want to study them and figure out how to stop them.

Today’s story stands out more than normal to me, probably because the friends I entered medical school with just finished their first year of residency, and maybe a bit more because I’m living in New York.

Any shooting, mass shooting or not is tragic, and it’s important to remember that while guns are a major public health problem in America — particularly because of their use to commit suicide — mass shootings remain a rare cause of injury or death. How rare? Well, it all depends who you ask.


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James L. Madara, MD, CEO of the American Medical Association (AMA), began his letter to the United States Senate poetically:

“Medicine has long operated under the precept of Primum non nocere, or ‘first, do no harm.’ The draft legislation violates that standard on many levels.”

The letter concludes more concretely:

“We believe that Congress should be working to increase the number of Americans with access to quality, affordable health insurance instead of pursuing policies that have the opposite effect…”

Much of the debate over the ‘Trumpcare bill,’ also known as the American Health Care Act (AHCA), has come down to money: Republicans want the new bill to remove a tax on high-income individuals, and to raise prices of premiums and deductibles such that the Congressional Budget Office estimates would make 15 million more people uninsured next year compared with current law.

And Dr. Madara is worried about money as well, particularly per-capita-caps that would cut Federal Medicaid payments to states by 26% by 2026 :

“Per-capita-caps fail to take into account unanticipated costs of new medical innovations or the fiscal impact of public health epidemics, such as the crisis of opioid abuse currently ravaging our nation. The Senate proposal to artificially limit the growth of Medicaid expenditures below even the rate of medical inflation threatens to limit states’ ability to address the health care needs of their most vulnerable citizens.”

The AMA is a professional organization and lobbying group, which has historically looked out for the financial interests in doctors. In this case that interest aligns with that of patients: more health care for patients means more jobs and money for doctors.

But the AMA isn’t the only group of doctors to oppose the bill. The Americans College of Physicians, America’s second largest physician organization, which consists of internal medicine doctors, also opposes the bill. They released a statement in May, when the house passed the bill, saying the organization was “extremely disappointed” in the bill because it makes:

“… Coverage unaffordable for people with pre-existing conditions, allows insurers to opt-out of covering essential benefits like cancer screening, mental health, and maternity care, and cuts and caps the federal contribution to Medicaid while sunsetting Medicaid expansion. As a result, an estimated 24 million Americans will lose their coverage… we urge Congress to start over and seek agreement need a better source on bipartisan ways to make health care better, more accessible, and more affordable for patients rather than imposing great harm on them as the AHCA would do.”

Despite these groups opposition to the new bill, there is no denying the American healthcare system is in need of an overhaul. According to the OECD, the United States topped the list of healthcare spending in 2015, with 16.9% of the GDP spent in healthcare. Canada, with it’s single-payer system, on the other hand spent only 10.1%. And what are we getting for spending more than one and a half times as much on healthcare? Three years fewer life expectancy, according to the World Bank, with Canadians living to an average age of 82 compared to 79 in the US.

This February, A survey, published in the New England Journal of Medicine showed only half of Primary Care Physicians had a favorable viewed the Affordable Care Act (ACA), but 95.1% stated that regulations protecting the coverage of patients with pre-existing conditions were “very important” or “somewhat important” for improving the health of the U.S. population, a provision slated to be removed according to the house’s bill. Only 15% of those surveyed wanted the ACA repealed, but 73.8% favored making changes to the law.

So, yes, we need to reform healthcare in the United States, but if you ask doctors in the US, the AHCA is not the reform we need.

Loan words sometimes take on whole new meanings: for example the word ‘parka’ in Japan refers to a ‘hooded sweatshirt’ or ‘hoodie’ as opposed to the jacket commonly called a ‘parka’ in English:


I’d be really curious to dig into the etymology of these kinds of words, and it’s probably fairly easy to trace their emergence because they came into use so recently. Perhaps parka entered Japanese not from english but from another language where the term already had this different meaning? Or, perhaps it was originally used as a brandname for a hooded sweatshirt?

Or, perhaps it’s illustrative of the nature of loan words themselves, where their lack of history makes them especially malleable and prone to mistaken meanings shortly after they’re introduced.

Regardless, here is a list of ‘loan words gone wrong,’ which sound as if they’ve come from english, but who’s meaning may not be immediately apparent to english-speakers, and words that sound like loan words but are in fact neologisms:

  • Paper driver – Peipaa doraibaa – ペーパー ドライバー – someone who has their driver’s license but doesn’t actually drive or know how to drive well. 

Continue reading ‘Japanese English – Loan words gone wrong (with audio) – 和製英語 / 日本語英語’

The strong and simultaneous activation of both branches the autonomic nervous system, sympathetic and parasympathetic, is known as ‘autonomic conflict.’ In the cartoonish intro-biology view of the body, the sympathetic system fight or flight is an accelerator, the parasympathetic is pumping the breaks. (I always used to think parasympathetic = paramedics = ’rest and recover’.)

So you might think, that these effects would just cancel each other out, but slamming on the accelerator and breaks in the car at the same time, isn’t the same as letting your car cruise.

The specific effects of activating the sympathetic and parasympathetic nervous systems depend on the tissue, and the why is really gonna come down to the details, but let’s look at a couple examples first.

  1. Blood vessels are going to constrict. Because most blood vessels in the body receive sympathetic but not parasympathetic innervation. They’ve got an accelerator but no breaks.
  2. The heart. Alone, the sympathetic nervous system makes the heart beat faster and stronger. The parasympathetic nervous system while slow it’s rate and slightly decrease the strength of it’s contractions. But if you have high levels of both, things can get tricky: Paton et al. (2005) shows this can cause generate cardiac arrhythmias which have even rarely lead to sudden death in animals. This can also be studied in isolated hearts, shown in this figure:

a. Shows an isolated heart receiving adrenergic neurotransmitters. B-F different strange patterns of activity (arrhythmias) observed after adding parasympathetic neurotransmitters on top of sympathetic. From Shattock and Tipton, 2012.

Why is this? We have to look at what the sympathetic and parasympathetic nervous system are doing mechanistically. The parasympathetic post-ganglionic neurons (that are signaling to effector tissues) release acetylcholine. That acetylcholine can signal nicotinic and change ion concentrations, or stimulate muscarinic receptors and set of G-couple protein receptor cascades. Meanwhile, sympathetic is mostly adrenergic, though some tissues such as sweat glands are also activated using acetylcholine.

How those neurotransmitters affect the effector tissues on the specific receptors are on the effector tissues, and how the downstream pathways of those receptors interact. And because receptors activation is influenced by the concentration of neurotransmitter, ‘low equal’ levels of sympathetic and parasympathetic activation may not be the same as ‘high levels’ of parasympathetic activation.

This autonomic conflict occurs physiologically for example when you jump into cold water, which can activate both the ‘cold shock response’ and the ‘diving response’. An interesting article I found explores whether or not this response can generate the above-mentioned arrhythmias in people and may cause sudden cardiac arrest and death in vulnerable individuals (and which may be the true cause of deaths which are currently labeled as deaths due drowning or hypothermia).

One nuance of language that I hadn’t considered before spending a year in Japan is how words for expressing categories sometimes don’t quite line up. For example, in Japanese ‘juusu’ or juice refers not just to fruit and vegetable juices, but also soft-drinks. But what’s more, the line between fruits and vegetables itself is different, and, yes, melons are considered vegetables in Japanese.

To listen to a discussion about this, skip to minute 23:40.

In English the line is blurry (is a tomato a fruit)? And there are different definitions used commonly in ordinary language, by botanists, and even the supreme court. And while we’re here, is corn a vegetable or a grain? You can imagine that it must be quite confusing to learn the borders between these words. Somehow these objects and concepts are sorted and clustered based on various characteristics: are they sweet, are they seed-bearing, how closely do they resemble some prototypical fruit…

Colors in American English and Japanese

But, what is considered a cluster, and where the lines are drawn varies from language to language. Another classic example of this is colors. Colors lie on a spectrum of infinite minute variations, but linguistically we chop them up: yellow, green, blue, purple. But exactly where these lines are drawn, and how many basic categories there are varies between languages. For example, midori or green is a relatively late linguistic addition to Japanese and to this day fresh vegetables and traffic lights are describe as aoi which now means blue, but used to–and in these contexts, it still does–describe a set of clusters that encompassed both blue and green.

Clusters of ‘chromatic color categories in color space’ Kuriki et al., 2017

And while it’s easy to say, ‘wow, that’s so strange,’ are you bothered by the fact that we don’t really have a commonly used word for sky blue/light blue/cyan ? According to Kuriki et al., 2017, this color is now often described using the word ‘mizu’ (full text article) which literally means water. And here, I’d like to switch gears and dig into this study.

Continue reading ‘Watermelon isn’t a fruit in Japanese? And colors across languages.’

What are the Best Introductory Psychology textbooks, and are they telling us the truth? I looked up the Psychology textbooks used at the top programs across the US and talked to Professor Chris Ferguson, author of Education or Indoctrination? The Accuracy of Introductory Psychology Textbooks in Covering Controversial Topics and Urban Legends About Psychology, about his recommendations for the most accurate textbooks.

When Chris Ferguson, a professor at Stetson University, was trying to choose a textbook for his introductory psychology course, he realized his own field of study, videogame violence was being mis-portrayed in some textbooks:

“It’s an area that’s really controversial and the data isn’t consistent or clear, but at least some textbooks seemed to be trying to report it as if the research was more clear than it actually was.”

It intrigued Ferguson, so he decided to research it systematically and publish a paper on errors in textbooks. Errors went beyond over-simplifications that glossed over controversies in the field and murky data, sometimes text books including examples that were flat out wrong:

Continue reading ‘Psychology Textbooks Are Spreading Urban Legends. What are the best introductory psychology textbooks? (Plus how to buy them for cheap and even turn a profit.)’

As an intern at Gimlet Media’s Science Vs, I’ve learned a lot about making podcasts. The process of making a podcast can seem mysterious, if not impossible. And when it comes to tasks like finding the overall structuring of a story or selecting the very best audio from three-hour-long interviews, if you’re like me, you may be unsure where to even begin.

I have good news, it’s not magic, there is a method. Radio producers have been been making shows under the constraint of the hardest of deadlines (dead air, gasp!), so skilled producers have systematized the process of creating audio and written how-to guides, one even in comic book form! (And while learning that some of my co-workers had been immortalized in a graphic novel was probably not the best for my already shy interactions with them, I learned a ton from that book!)

Anyways, here’s my unofficial Gimlet reading lists: one of books the Gimlet office keeps on hand for newbies like me and then a second of books on nonfiction writing and journalism that Gimlet colleagues recommended to me. 

Books about audio storytelling / Books about making podcasts and radio stories:

  1. Out one the Wire: The Storytelling Secrets of the New Masters of Radio by Jessica Abel (with a foreword by Ira Glass)
    out on the wire cover
    Comic-book writer and illustrator Jessica Abel extends and updates her classic, Radio an Illustrated Guide, interviewing the hosts and staff that create the hits This American Life, The Moth, Radiolab, Planet Money, Snap Judgement, Serial, Invisibilia, and other narrative radio shows. This book starts from the very beginning, and teaches you every step of the process of creating a story from start to finish, what sorts of big picture questions and details producers think about, and all of the weird jargon like ‘bounces,’ ‘logging,’ and ‘selects.’ And abel shows as well as telling–using the same techniques that are described in this book to make it feel more like a narrative than a dry how-to guide. Plus, it’s funny, cheap, and you’ll learn a bit about the idiosyncratic personalities who create the shows you love.
  2. Sound Reporting: the NPR guide to audio Journalism and Production – by Jonathon Kern
    sound reporting
    What Out on the Wire does for Gimlet-style narrative stories, Sound Reporting does for more tradional NPR journalism. (Though, unfortunately, more traditional also means no pictures.) However, Sound Reporting is an audio journalism textbook written in clear conversational language by the Executive Producer for Training at NPR, and as such explains every step of making an audio news story. Not only reporting, producing, and editing, but also the ethical considerations of journalism–including examples of journalism gone terribly wrong! (For example, did you know some journalists erred and published in the 1980s that 2 million children were abducted each year, probably contributing to the long-lasting ‘stranger danger’ that still worries people today?) Sound Reporting is full of interesting, concrete examples like this, that illustrate Kern’s points and make it easy to read and understand.
  3. Reality Radio: Telling True Stories in Sound – Edited by John Biewen and Alexa Dilworth
    reality radio
    Reality Radio is a collection of 24 essays. The second edition is hot of the press (Feb., 2017) and includes up to date information about the rapidly changing world of radio: the ascendance of the podcast; greater cultural, racial, and topical variety; and the changing economics of radio itself.

    Contributors include many of the familiar faces from Out on the Wire, and a wider group including radio-makers from Canada, the United Kingdom, and Australia. The contributers are: Jad Abumrad, Daniel Alarcon, Jay Allison, damali ayo, John Biewen, Emily Botein, Chris Brookes, Scott Carrier, Katie Davis, Sherre DeLys, Ira Glass, Alan Hall, Dave Isay, Natalie Kestecher, Starlee Kine, The Kitchen Sisters, Sarah Koenig and Julie Snyder, Maria Martin, Karen Michel, Joe Richman, Dmae Roberts, Stephen Smith, Alix Spiegel, Sandy Tolan, and Glynn Washington.

Books about nonfiction writing and journalism more broadly:

  1. Follow the story : How to Write Successful Nonfiction – by James B Stewart
    follow the story
    I took the fact that Follow the Story’s Amazon page recommends it alongside my favorite style guide Zinsser’s On Writing Well as a very good omen. Stewart is a former editor of the Wall Street Journal’s front page, and draws heavily on examples from his own writing. This may irk some, but hey, write what you know, right? As much as this is a step-by-step guide for researching and writing a story, it is a philosophy about how to following your curiosity, and then leading the reader/listener down that same journey.
    I’m looking over the amazon reviews for this book and I don’t get them:
    Read this book if you want to be a journalist,” says Jen. Four Stars. I would have sworn a 5-star rating was coming after that unequivocal endorsement.
  2. Naked in Baghdad: The Iraq War and the Aftermath as Seen by NPR’s Correspondent Anne Garrels
    naked in baghdad
    A lot of times in radio and journalism there is no script–no one can tell you what you should be doing and that can be terrifying, and that’s without putting your life in danger. Naked in Baghdad is an example, of a journalist rising above the call of duty, who “as one of only sixteen non-embedded journalists who stayed in the now legendary Palestine Hotel throughout the American invasion she managed to deliver the most immediate, insightful and independent reports with unparalleled vividness and immediacy,” and the madness of Iraq are juxtaposed against  e-mails from her husband.
    Naked in Baghdad is an inspiring piece of work that illustrates the types of dramatic and impactful work you can do if you learn the skills of creating radio. As Ron Franscell points out in an Amazon Review, audio journalists can get access where others can’t: “She had no cameras… no bulky notebooks to mark her as a reporter in a crowd. Only a tape recorder the size of a cigarette pack … and the sounds of war. She traveled lightly and discreetly, just under the radar of the gatekeepers.”

So there’s the start of a reading list for the aspiring radio journalist, podcaster, or audio storyteller. What books have helped or inspired you that I’m missing from the list? Leave them in a comment below or tweet me @neuroamer. And let me know if you have other questions about making podcasts or working at Gimlet.

Learning a new language can seem impossible, especially later in life, but it’s not–in fact, language learning is something our brains specially evolved to do! In this post I’ll share why why language learning is fascinating from a neuroscience perspective, my experience learning Japanese from scratch at twenty-eight, and end with three tricks for self-study that I learned along the way.

Language is a miracle, where neurons signal between brains by vibrating throat flaps

Just imitating a word is amazing. Think about it, we hear a word and then somehow figure out how to vibrate flaps in our throat to produce the exact same sound–what?! And that word spans a wide space of sounds–it can be said at different pitches, with different intonations and accents–yet we can hear that word through the roar of a crowded cocktail party. But speech recognition and imitation are just the beginning–we learn to impute the meaning of so many other words, just be hearing them or seeing them in context, and then using grammar can combinatorially recombine words into an infinite number of sentences, which can by understood by the listener even if they have never been uttered before in history.

Part of why language feels so miraculous, is because it is a human super-power. While animals like songbirds have the vocal imitation part down, and we can teach commands to dogs and rudimentary sign language to apes, we seem to be the only species specially wired to learn language, particularly when we’re young. I regret that I didn’t take advantage of free language classes when I was younger, but as cliche as it sounds, it’s never too late. Let me introduce you to Sally.

Sally: grandmother, and my roommate
Continue reading ‘Learning Japanese (or any other language) – 3 tricks I learned during my year abroad’

First off, if you’re experiencing the worst headache of your life, please stop reading and head to an emergency room, especially if it’s onset was sudden.
Alright, moving on:

I’ll start with a personal story and get to the studies, below. Feel free to skip ahead.

I was thirteen, in English class and struggling to read. Don’t get me wrong, I knew how to read, but on this particular day, in this particular class, I couldn’t read at all. The center of my vision looked something like this:


“I’m going blind,” I thought, as I strained to read the blurred letters. I’m going fucking blind. I was too embarrassed to raise my hand and ask to go to the nurse. What exactly would I say, if I did? That I’m going blind? I decided to wait it out. Always a smart to wait things out when you’re convinced you’re becoming permanently disabled, right? So, I sat waiting until the end of the period, hoping I wouldn’t get called on to read something.

When the period ended, I bee-lined it for the nurse’s office. On the way, my head began to throb.

“I’m going blind” I told her, expecting her face to fill with worry.

Continue reading ‘What is a headache: The four most common types of headache. And, can you hurt your brain by thinking too much?’

Lab Wars Interview

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This is an unusual post for the blog because it’s primarily an audio interview  with charming Caezar Al-Jassar, Ph.D, co-creator of the game Lab Wars. The conversation goes into having a side project as a young academic and Caezar’s kickstarter success, but also touches on heavier topics such as the difficulties of imposter syndrome, and leaving the academic bubble and trying to make it in the real world. I haven’t gotten a chance to play Lab Wars yet, but it’s gotten good initial reviews on Board Game Geek.

Following are links to the games we discussed, and some musings on why board games are fun, why boardgames appeal to nerds, and whether playing games can make you smarter.

Other games we discussed in the interview audio (which might make a great gift for a nerd you love this holiday season, hint hint, Mom). [Mom, if you actually read this that was just a joke]


Dominion: the first deck-building game ever and one of my all-time favorites.


Evolution: Haven’t played this but it looks rad and has great ratings on Board Game Geek.


Viticulture: Same as above.


Pandemic: the best science-themed game I’ve played. You play as different scientists and public health officials at the Center for Disease Controls, working collaboratively to try to prevent a pandemic from wiping out humanity. If you’re looking to play an interesting and challenging game where you work together as opposed to fight against one another, this is my top recc.

Why Are Board Games Fun?

Continue reading ‘Lab Wars Interview and What Makes Board Games Fun, Why do Nerds Like them, and Can they Make you Smarter?’

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