Art and Science Mingle in Baltimore

This was originally posted on the SciLogs Science Extracted blog on May 19th, 2016. 

When I took a poetry class as a science major in college, my professor advised me to use my science background as an asset, in the vein of Walt Whitman – doctor and poet– or Mary Borden – poet and nurse. But this was way beyond my scope and I haven’t been able to merge my scientific and artistic sides in any sort of conscious way.

Representation of Lapointe's microbiome in red and a bat's in yellow. Top: the separate microbiomes before the meal. Below: Lapointe's microbiome after his tasty meal. Image taken at Culture as Medium exhibit.

Which makes me appreciate those who do so much more. A few weeks ago I stopped by the Baltimore Underground Science Space to check out the exhibit Culture as Medium. Quick plug: the closing reception is tomorrow, May 20^th, from 7 – 9 pm.

Of the exhibits, I was particularly struck by the work of Francois-Joseph Lapointe, professor of biological sciences at the University of Montreal. He holds a PhD in biological sciences as well as in art studies and practice – and uses this unique background to combine performance art and science.
At the exhibit, there was a video of him in an African village which eats bats. He took a sample from the bat and swabbed his tongue before and after eating the bat and sequenced the microbiomes to show that what we eat becomes incorporated into who we are – or at least that’s how I interpreted it.


While he was in Baltimore he shook hands with people all over the city as part of his 1000 Handshakes project to show how microbiomes “mingle” when you meet people. Every 50 handshakes his lab-coated assistants swabbed his hands for later sequencing of the microbiome. As he shook people’s hands he chatted with them about what he was doing.

Apparently the locals at the Lexington Market were friendlier than the tourists in the Inner Harbor, which I appreciated since I used to live nearby the market.

Scientists often complain that the public doesn’t care about science. On the flip-side, the public has an idea of scientists cloistered within the ivory tower. And this is not far from the truth, since most research buildings have security or swipe badges to prevent theft of dangerous chemicals or bioagents, as well as scary-looking radioactive signs everywhere. Even an exhibit like at BUGSS requires the public to know the event is happening and then come inside – no small feat.

Performance art with a science element sprung upon unsuspecting citizens seems likea revolutionary way to bridge the divide between science and the public. And Lapointe uses it as a way to gather data on how our microbiome is influenced by our environment and those around us.

Is there a way to take even greater advantage of this “method” to gather samples, information, and spread science to the public? Only as long as there are enough people like Lapointe who break the stereotype of the shy and antisocial scientist.

Dysfunctional pipelines and other insights from NIH conference on women in biomedical careers

Earlier this month I attended a conference at the National Institutes of Health (NIH) on new interventions to help support women in biomedical research careers. You can view the webcast here.

A reoccurring theme was that a critical mass of women going into research careers is not enough. Women make up roughly half of STEM Ph.D.s but just 20% of full professors.  I’ve heard the justification that women are dropping out of the pipeline to raise children. While this might be the case, research presented at the conference indicated women also left research because of lack of satisfaction. A large component of satisfaction was institutional culture – whether there was a perceived “old boys club” – and perceptions of fairness.

Additionally, women are not the only ones who want work/life balance. Reshma Jagsi’s, M.D., D.Phil., associate professor at University of Michigan Health System, survey or junior faculty found the vast majority of men and women reported a strong preference for work/life balance. In fact the top 3 or so career priorities were the same for both sexes. Still, women expressed a slightly stronger preference than men for work/life balance, which makes sense since Dr. Jagsi also found women had a higher burden of domestic chores and child-care responsibilities.

Even those women who stayed in academic research – the so-called survivors – don’t advance at the same rate as men. Phyllis Carr, M.D., FACP, associate physician at Massachusetts General Hospital, followed up on a 17-year faculty survey which spanned 24 U.S. medical schools. Though men and women stayed in academia at the same rate, men were more likely to have achieved senior rank. This difference could mostly be explained by men publishing more – the main measure of productivity in academia. However, men were still more than two times more likely to hold a senior leadership position, such as dean or chair, even when accounting for productivity.

It is figures like these that led Dr. Jagsi to posit if this was not just a leaky pipeline, but a dysfunctional one. Deborah Helitzer, Sc.D, dean of the college of population health at University of New Mexico, found women were more likely to hold positions such as vice dean, which fulfil housekeeping roles and are not as likely to lead to dean positions.

As the academic research community makes progress in certain measures, it becomes clearer that there are problems in other areas. For example, explicit sexism has decreased substantially over the decades, but research – some presented at the conference – shows implicit bias is still going strong.
So what’s the solution? Many types of interventions were presented. Many centered on supporting individual women through career development programs and mentoring networks. Others suggested ways to increase women in leadership positions such as implicit bias training for search committees and implementation of the Rooney rule, which requires a certain number of women and minorities on the short-list.

Others, still, called for an overhaul of the academic system, including eliminating tenure and emphasizing shorter, more flexible work hours with more administrative support from institutions. As a scientist-in-training I was advised to have children during graduate school by some, during my postdoc by others, and not until after tenure by others. But why should women try to bend their lives into a system created decades ago by men? Of course it continues to better serve men than women.
Some argue however that the current system isn’t serving anyone. I highly recommend Robin Ely and Irene Padavic’s article in the Huffington Post “Work-Family Conflict is Not the Problem. Overwork Is.” This is supported by Dr. Jagsi’s finding that both men and women want work/life balance, but as Ely and Padavic say in their article, men suffer in silence or reduce their hours under the radar. Which brings me to another point of the conference: men need to champion these types of solution, which benefit both sexes and science as a whole and women need to do a better job engaging men in their efforts.

Serendipity in science shows need for global disease - and basic - research

One gets the impressions that scientists are fighting tooth and nail for research grants and that – in this atmosphere – more funding for research on global problems like malaria is a hard sell. Right now, the NIH spends $170 million of its $30 billion budget on malaria research. That’s $170 million for a disease at which half the world is at risk.

Map of malaria risk (in red). Licensed under Public Domain via Wikimedia Commons

Somewhere between a half to 1 million people die from malaria every year and most of these deaths are in children. I am well acquainted with these statistics as I wrote them in the introduction of three first-author papers, several grants, and countless presentations. The numbers served as a plea for the audience to care about my research and a justification for the federal money spent on a disease that doesn’t really affect Westerners.

Apparently the fact that the malaria parasite is really freakin cool is not justification enough. I mean Ebola – c’mon – it only has seven proteins! But the malaria parasite encodes over 5,000 proteins, many of which have no similarity to any known protein in other organisms and many of which are highly specialized for invading cells inside your body and hiding from your immune system.

Malaria parasites (stained dark purple) inside red blood cells. By Department of Pathology, Calicut Medical College, via Wikimedia Commons.

But researchers at the University of Copenhagen (UC) and University of British Columbia (UBC) published exciting new findings last month in Cancer Cell that will hopefully bolster the argument for why global disease research can pay off!

When the malaria parasite invades red blood cells inside the human body, it secretes hundreds of its own proteins, leading to drastic remodeling of the red blood cell: picture a saggy water balloon transforming into a rubber ball with protrusions, or knobs. These knobs stick to molecules on the host’s endothelial wall, sequestering the infected red blood cells and making it easier to acquire nutrients while also avoiding clearance in the spleen.

One of the malaria proteins in the knob, VAR2CSA, binds to highly complex chains of sugars on the placenta of pregnant women, latching the infected red blood cells onto the placenta and endangering both the mother and unborn child. It was while trying to develop a vaccine against malaria for pregnant women, that Dr. Ali Salanti of UC had an idea.

"For decades, scientists have been searching for similarities between the growth of a placenta and a tumor. The placenta is an organ, which within a few months grows from only few cells into an organ weighing approx. two pounds, and it provides the embryo with oxygen and nourishment in a relatively foreign environment. In a manner of speaking, tumors do much the same, they grow aggressively in a relatively foreign environment," Salanti said in a statement to the university last month.

It turned out the complex sugar chain, chondroitin sulfate A (CSA), which the parasite binds to, is found only on the placenta and many types of tumors but not on other healthy cells. Salanti tested whether the malaria protein could be exploited as a way to selectively deliver cancer drugs to tumors.

Working with Dr. Mads Dausgaard at UBC, a prostate cancer researcher, he found that fluorescently labeled VAR2CSA protein, produced in the lab, not only bound tumor cells but was also internalized by the cancerous cells. The researchers attached the protein to a toxin and found that the fusion killed many types of tumor cells but not healthy cells, which lacked the receptor for the VAR2CSA protein.

They next tested the toxin-VAR2 fusion on mice with different types of tumors transplanted. Treatment with the fusion drug essentially halted tumor growth in mice with non-Hodgkin’s lymphoma, while tumors in mice treated with the toxin not fused to the malaria protein grew four times the size. In mice transplanted with prostate cancer cells, treatment reduced tumor size by over 50% compared to the control and two of the six mice were even in remission 32 days after treatment. Finally, all mice with highly aggressive metastatic breast cancer died when untreated or receiving the toxin alone. In contrast five of the six mice that received the fusion drug survived with no spreading of the cancer more than 50 days after drug treatment. Other organs in the mice appeared normal and even high concentrations of toxin-VAR2 didn’t affect healthy mice.

The University of Copenhagen, in collaboration with Salanti and Dausgaard, has launched a biotech company to pursue their work further, with hopes to test it in humans in the next four years. “The biggest questions are whether it'll work in the human body, and if the human body can tolerate the doses needed without developing side effects. But we're optimistic because the protein appears to only attach itself to a carbohydrate that is only found in the placenta and in cancer tumors in humans," Salanti concluded in his statement.

Reference:

Salanti, A. et al. Targeting Human Cancer by a Glycosaminoglycan Binding Malaria Protein. Cancer Cell, 2015; 28 (4): 500-514. DOI: 10.1016/j.ccell.2015.09.003.

Adjusting to life at the desk vs. life at the bench

I hoped to avoid what seems like the inevitable downward trend in posting rate for blogs like these, but nevertheless, it has been over a month since my last post. As I previously mentioned, I also have a blog on SciLogs, but I hoped to save this site as a more personal and perhaps experimental forum for science writing. If anything it would at least let me re-hone my active voice after years of “The solution was stirred for 10 minutes before calcium chloride was added.”

However, my perfectionist qualities tend to get in the way. If I don’t have anything interesting to say –and can’t say it using the perfect language – why contribute to the ever increasing internet content? One idiosyncratic anxiety of mine is the seemingly endless amount of content and content-producers on the internet versus the amount and desire for content by content consumers. If a Science story has already been covered by major news sources, and the likes of Carl Zimmer, what possibly could I have to contribute?

So how about an update on my career transition?

Something I didn’t expect when I left the bench was a re-ignition in my interest, and dare I say, passion for science. No longer is it work since I haven’t had a single paying science writing gig; I get to pursue science questions that interest me. With the competition for both publication and grants, I always felt I should be reading more about potential techniques or papers in my field – reading about science was a means to an end. Therefore I couldn’t help but perceive any time spent on science outside my field as inversely related to my productivity and chance for success. I am sure this isn’t the case for scientists who truly love what they do. In retrospect, it is just one more reason why research was not the career for me.

However, I lately have less time to pursue these interests – hence the gap in posting – as I am a month into a science policy fellowship with a nonprofit science advocacy organization in D.C. Coming into politics with little knowledge, I have enjoyed the demystification process immensely. I am forced to trade in the academic and scientific jargon of “noncanonical”, “ubiquitous”, and “aliquot” for the language of the beltway:  “taps”, “stopgaps”, and “markups”. I get to look for scientifically inaccurate statements from politicians. This election cycle appears to be especially ripe with Mike Huckabee’s “proof” of life at conception in the form of the “DNA schedule”, which scientists all over the internet have lambasted as both incorrect and a very weird phrase better suited for “a band, an app, or maybe an erectile dysfunction drug."

While it has been an adjustment to have fixed schedule and sit at a computer all day, I appreciate that there is a large creative component, such as writing material for the website, coming up with messaging for worthy issues like stem cell research or comparative effectiveness research, and digging through all that content on the website to find tangible examples backed with solid numbers on how science has improved the lives of American citizens…and why the world will end if we don’t increase NIH’s budget.

Traveling galvinists and armchair travelers: review of the “Fantastic Worlds” exhibit at the Smithsonian

Yesterday I visited the “Fantastic Worlds: Science and Fiction, 1780-1910” exhibit at the National Museum of American History, which opened on July 1st. 

 

Scene from the 1902 silent film "A Trip to the Moon" 

Improvements in printing technology in the 18^th century afforded the general public greater access to information about science, igniting their curiosity, as well as the imagination of writers such as Rudyard Kipling, Edgar Allen Poe, and Mary Shelley.

The exhibit shows how science found its way into popular fiction in the 19^th century, displaying early edition works, including The Origin of Species from the Smithsonian Libraries.

I tend to enjoy small museums and exhibitions whose scopes aren’t too broad, so I found this one, nestled within a small corridor to the Library Gallery pleasant.

I also appreciated that unlike some of the other exhibitions in the museum this one was geared towards adults. Indeed parents seemed to enjoy it, with one dad exclaiming “I loved Twenty Thousand Leagues Under the Seas when I was your age,” shortly before his kid asked if they could leave yet. 

Its housing in the American History Museum is strange as the exhibit mainly features authors and scientists from Britain, Sweden, and France. I am very willing to overlook this though, as it was very nicely organized with six separated subjects, ranging from exploration into the deep sea, Africa, and the Arctic and early studies in man-controlled flight to the more bizarre, such as the re-animation of human bodies with electricity and men on the moon.

In the 19^th century ballooning was used for travel, with aspirations of even travelling to the Arctic, and as a means to study the atmosphere. During one study by meteorologist James Glaisher in 1862, the balloon ascended to 36,000 feet causing him to pass out and his test pigeon to freeze to death. Fiction of the time reflects the great hope placed on ballooning to revolutionize travel, depicting a London sky dominated by aircraft used for everyday errands.

To find out more about ballooning craze of the 18^th century, listen to a podcast about Sophie Blanchard or about a ballooning expedition to the North Pole.

Depiction of man bats as part of The Great Moon hoax, printed in The Sun, 1835.

Of particular interest was information on “The Great Moon hoax”. In 1835 a newspaper in New York published several accounts of the discovery of life on the moon. The discoveries, falsely attributed to the renowned astronomer, Sir Jon Herschel, were published as a series and became increasingly incredible, culminating in the description of man bats.

Listen to this podcast to find out more about The Great Moon hoax.

What I learned from the exhibit was that Edgar Allen Poe was upset at the author of this flimflam for stealing his idea. It turns out that Poe was quite the trickster, also publishing a fake article about a transatlantic hot air balloon ride achieved in 75 hours, setting precedence for the  “War of the Worlds” radio program in the 1960’s.

Though I’ve long been turned off by pulp science fiction, I find the science fiction genre as a whole fascinating. Particularly I am interested in how the genre enables writers to expose societal problems, that otherwise are taboo to discuss, but because set in an alternate world, are more disarming to the general public. In addition, science fiction exposes the anxieties of the day and even in some cases, has predicted the future.

Along these lines, I was interested to learn at the exhibition that the term robot first appeared in a play in 1921. It’s derived from the word robota, Czech for “forced labor,” foreshadowing ideas of both the replacement of human labor by machines and the possibility of artificial intelligence and rebellion by a robot workforce. I can see why people were worried; look how creepy this automaton is from 1870’s.

Patent model of creeping baby doll, 1871

Other interesting facts from the exhibit:

Deptiction of fossils found in the 1800's, including an illustration based on the finding of the ichthyosaur, an extinct marine reptile, found by a then 12-year old Mary Anning. She went on find more fossils in her long career as a paleontolongist.

People once thought that the deep sea was devoid of life. Britain’s Challenger expedition changed this, recording 4,500 new species, in 1873. What drove the exploration of the deep sea in the mid-1800s was the laying of a transatlantic telegraph cable, completed in 1866.

Depiction of Galvani's experiments.

In the late 18^th century Luigi Galvani discovered that an electrical current applied to dissected animals caused their muscles to twitch. This field, a precursor to electrophysiology, was termed galvanism. A fair amount of spectacle surrounded the field as in 1803 a public demonstration was held where an executed criminal was “re-animated” with electro-stimulation.

Mary Shelley was inspired by these accounts, writing Frankenstein, which is prime example of science fiction used as a philosophical study on society and what it means to be human.

Medical induction coils, ca 1850, used for wide array of medical treatments in 1800s.

While Galvani thought he was observing a new form of electricity, termed animal electricity, the physicist Alessandro Volta repeated the experiment and concluded that fluids within the body conducted the electric current derived from the metal. This led to the development of the first battery. 

From Pipettes to Pens

Writing my thesis was one of the most enjoyable experiences in graduate school and during my postdoc I found myself wishing for more time to work on my blog rather than doing bench science. I’ve always liked writing but never considered it a viable career option because of the uncertainty and competition…but research isn’t exactly an easy career either. Shouldn’t I focus the only capitol I have, my passion, on the career I want?

So a little less than a month ago I left my postdoctoral fellowship to pursue a career in science communication. This is the broad term I am use to encompass a career that could be anything from science writing for Scientific American (perhaps a pipe dream) to being a public information officer at a university (promoting their research through press releases and blogs) to being an editor at a scientific journal.

I wrote about getting over my feelings that I disappointed my scientific advisors in Science Extracted. Since then, I moved to Washington DC and am still trying to figure out how to get into any of the above careers, as well careers related to reviewing literature and translating science into plain language for nonprofit or governmental organizations. 

What I have encountered after two hopeful but ultimately dead-end phone interviews is that

many of these jobs want working experience doing the very things I am trying to transition my career towards. Many are also looking for applicants with a Masters in Science Communication or Journalism, however I think this wouldn’t be a problem if I had the work experience.

This does not in any way seem unique to science writing. It appears to me that companies do not want to spend the time to train employees anymore. But where are people supposed to get this experience?

There are always internships – however many of the internships are targeted towards students at either the undergraduate or graduate level. I had already applied and been rejected by the AAAS Mass Media Fellowship, often seen on the resumes of science PhDs cum successful science writers.

I am not writing this to say that I am discouraged, as I did not expect pursuing my dream job would be easy, and it has only been a month. Graduate school taught me, among other things, persistence. But I wanted to write about my career trajectory for other science PhDs looking to transition to writing…and perhaps get feedback/suggestions?

Clearly it would have been better to do more career exploration during my PhD. I can’t help but feel regret that I didn’t take advantage of the science writing certification program at Johns Hopkins while it would have been free. But I also recognize that I didn’t have much free time in graduate school. The time I did have I used to train for several half marathons, travel to several countries, hang out and commiserate with my friends (i.e. networking) and spend time with my husband.

Currently, I am continuing to build my portfolio through blog writing, doing a bit of freelance writing and editing on Upwork, which right now consists of answering health questions on the Internet for a $3-5 an answer, and of course, apply to jobs.

I have also tried to get better about networking (I have business cards) both online and off. At the suggestion of a successful science writer I started a twitter account and actually enjoy the social media aspect. What I am still working on is being comfortable with the schmoozy aspect of self-promotion – I am from the Midwest after all. I hate the idea of just connecting with someone for what they can do for me.

But maybe that’s not the right way to look at it. Maybe somebody else helped that person out once. After all, all I need is for someone to give me a chance and get me that initial experience in science journalism.

Already, I fell lucky to be where I am: a volunteer experience with the UIC press office led me to a science blogger who got me connected with SciLogs, which has been a great, supportive community of bloggers from diverse areas, all passionate about the importance for clear, non-overhyped, and trustworthy science communication.

Science and Poetry, 2nd edition: William Carlos Williams’ The Doctor Stories

Many years ago I picked up a crumbling copy of The Doctor Stories at the Baltimore book festival. Fast forward six years and a cross-country move and it remained in its dilapidated state, unread. Its light weight, and the promise of a future blog post topic, induced me to bring it along on a recent vacation to Greece.

"William Carlos Williams passport photograph 1921" by Unknown - Beinecke Rare Book & Manuscript Library, Yale University. Licensed under Public Domain via Wikipedia.

I was only familiar with William Carlos William (WCW), having read his poem “The Red Wheelbarrow” in high school.

so much depends

upon

a red wheel

barrow

glazed with rain

water

beside the white

chickens

The poem was refreshing in its seeming simplicity, lack of abstraction, and briefness, especially in contrast to more European-style and traditionalist poets I was studying at the time. Still I didn’t give the poem much thought despite growing up in a farming community which was not so far removed from being dependent on the wheelbarrow (but more so the John Deere tracker).

I gained a greater appreciation for WCW’s work after reading The Doctor Stories, which were compiled by his protégé Robert Coyles. Not a protégé poet, but a physician; WCW made his living as a pediatrician in the rural town of Rutherford, New Jersey.

The book is composed mainly of short vignettes of WCW’s encounters with and observations about his patients. While I was hoping for more poetry inspired by medicine and science, the depictions of life and the state of medicine in the 1930s were fascinating.

WCW spent much of his time treating the working class, including immigrants. His writing is full of honesty and a mix of compassion and judgment towards his patients. He made many house calls, allowing him access to the most intimate moments of people’s lives. He would describe their houses, demeanor, and family dynamics in vivid detail.

The candid and unsentimental nature of his narratives is exemplified in one story, where WCW is trying to examine a child’s throat, suspecting diphtheria. But the child resisted and fought WCW, overpowering her father who was trying to restrain her.

I could have torn the child apart in my own fury and enjoyed it. It was a pleasure to attack her. My face was burning with it. The damned little brat must be protected against her own idiocy, one says to one’s self at such times. Others must be protected against her. It is a social necessity. And all these things are true. But a blind fury, a feeling of adult shame, bred of a longing for muscular release are the operatives. One goes on to the end. –pg 60.

His more sentimental side does come through in such stories as “Ancient Gentility” where he is called to see an old woman who lives in a remote and poor Italian immigrant community. He goes, knowing that they will be unable to pay him for his services. He describes meeting the husband:

He was wonderful. A gentle, kindly creature, big as the house itself, almost, with long pure white hair and big white moustache. Every movement he made showed a sort of ancient gentility. Finally he said a few words as if to let me know he was sorry he couldn’t talk English and pointed upstairs again.

He quickly examined the woman after it was clear she wasn’t sick and went back downstairs. The husband, in lieu of payment, offers him a small silver box.

Why snuff! Of course. I was delighted. As he whiffed the powder into one generous nostril and then the other, he handed the box back to me – in all, one of the most gracious, kindly proceedings I had ever taken part in.

Imitating him as best I could, I shared his snuff with him, and that was about the end of me for a moment or two. I couldn’t stop sneezing. I suppose I had gone at it a little too vigorously. Finally, with tears in my eyes, I felt the old man standing there, smiling, an experience the like of which I shall never, in all probability, have again in my life on this mundane sphere. –pg 101.

Mundane sphere? He is a friend of Ezra Pound and other poets who are meeting in cafes in Montmartre. But it appears that WCW found something rejuvenating in his medical work, writing:

“How do you do it? How can you carry on an active business like that and at the same time find time to write?” But they do not grasp that one occupation complements the other, that they are two parts of a whole, that it is not two jobs at all, that one rests the man when the other fatigues him. –pg 122. 

The book also delves into moral and ethical questions in medicine and the way doctors are held up as gods. In “Old Doc Rivers” he considers the case of a doctor who was an addict and a contradiction of coldness and kindness. But WCW is more interested in “What kind of doctor was he, really?” (–pg 16). WCW knew Rivers, having assisted him with several surgeries and even spending a summer in Rivers' home in his younger years.

Still he takes up the investigation without bias, visiting clinics Rivers worked at to examine medical records and talking with people who knew Rivers.

Although very talented at diagnosing patients and a steady and thorough surgeon, Rivers became sloppier with drugs and age. WCW’s wife asks, “If you know he is killing people, why do you doctors not get together and have his license taken away from him?”As to why no one ever did, WCW writes:

In reality, it was a population in despair, out of hand, out of discipline, driven about by each other blindly, believing in the miraculous, the drunken, as it may be. Here was, to many, though they are diminishing fast, something before which they could worship, a local shrine, all there was left, a measure of the poverty which surrounded them. They believed in him: Rivers, drunk or sober. It is a plaintive, failing story. –pg 40.

There are also the sought after poems about medicine, which, when I finally came upon them towards the end of the book, were somehow unsatisfying. I wanted to know more about the characters in the poems and craved the detail abundant in the previous narratives. An exception is “A Cold Front:”

            This woman with a dead face

            has seven foster children

            and a new baby of her own in

            spite of that. She wants pills

            for an abortion and says,

            Un hum, in reply to me while

            her blanketed infact makes

            unrelated grunts of salutation.

            She looks at me with her mouth

            open and blinks her expressionless

            carved eyes, like a cat

            on a limb too tired to go higher

            from its tormentors. And still

            the baby chortles in its spit

            and there is a dull flush

            almost of beauty to the woman’s face

            as she says, looking at me

            quietly, I won’t have any more.

            In a case like this I know

            quick action is the main thing.

The double entendre “A Cold Front” both refers to the weather, which WCW had to trudge through to get to his patients, and to the demeanor of his patient, with her “expressionless carved eyes.” It is also a commentary on how society perceives women who have abortions or don’t show the proper maternal instincts. But WCW seems to be sympathetic to the woman’s situation and the lack of choice and agency women possessed over their lives.

Still, “I won’t have any more” is a declaration, despite the fact it is the doctors choice as to whether to give her the pills, abortion being illegal at the time. WCW implies that not doing so would be a death sentence, referring to the woman as a cat too tired to escape her tormentors and referring to her face as dead in the first line.

The stories are generally funny with feisty patients, but at times can be graphic in its detail or heartbreaking in its misery. I would recommend The Doctor Stories to anyone interested in the history of medicine or wanting to know more about William Carlos William’s life.