In the intensive care unit, compassionate and caring behaviors on the part of the clinical team result in better outcomes for critically ill patients and their families. However, studies have demonstrated deficiencies in delivering compassionate health care. Evidence suggests that physicians may miss up to 90 percent of opportunities to respond to patients with compassion.

To determine which factors drive and enhance compassionate care in the ICU and which factors drain and negate it, Shahla Siddiqui and a colleague conducted an observational, qualitative study of an international panel of intensive and critical care providers. The researcher-clinicians report in PLOS ONE that while ICU physicians and nurses feel a deep moral imperative to deliver the highest level of compassionate care, capacity strain, lack of staff and training, and a heavy emphasis on electronic health record maintenance present significant hurdles to achieving that goal.

“Studies done on physician compassion from a patient perspective emphasize listening and awareness of the patient’s emotional state, which not only builds trust within the patient-physician relationship but also enhances resilience amongst the care team and prevents burnout,” said Siddiqui, an anesthesiologist at Beth Israel Deaconess Medical Center. “Our aim was to describe compassionate behaviors in the ICU, study the factors that enhance and those that drain such behaviors with an aim to enable recommendations for practice and training.”

Siddiqui and co-author Christiane Hartog of Charité Universitätsmedizin, Berlin, showed two scripted video vignettes to 25 participants (24 physicians and one ICU nurse) in three virtual focus groups conducted over an online platform.

The two videos chronicled fictional interactions around end-of-life care of a Black patient who had expressed the desire not to receive life-prolonging measures. In one video, the attending physician was portrayed as compassionate, inclusive, and kind; in the second, he was shown as distracted and dismissive, and did not appear to care about the patient’s wishes and preferences.

The participants, divided into three focus groups, were interviewed by the principal investigators. When Siddiqui and Hartog analyzed the focus groups’ transcripts, strong trends emerged.

“Most clinicians felt the moral imperative to ‘do good,’ and to spend time forming important human connections with patients and families,” said Siddiqui, who is also an assistant professor of anesthesia at Harvard Medical School. “However, participants recognized that the health care system, with its inherent transactional demands, undermines these ideals, which can lead to alienation and burnout. Many lamented they had changed, or had been made to change, in order to become more efficient.”

For example, clinicians cited the need to pay attention to electronic health records as a major barrier to making eye contact and connecting with patients on a human level. They also recognized capacity strain, time pressures, and burnout as other factors hampering compassionate behaviors. Caregivers also emphasized the ongoing need for cultural and gender-appropriate behavior training to eliminate microaggressions.

“Our participants agreed that compassionate care requires some elements that can be taught and learned,” Siddiqui said. “The COVID-19 pandemic highlighted the existing structural deficits and lack of work-life balance, which produced unprecedented levels of burnout and stress borne by ICU staff. The current moment in health care with this increased awareness can provide an unprecedented opportunity to shift the working environment and training to comply with the patient and provider demand for compassionate care. In addition to enhancing outcomes for patients and families, these improvements could provide a more satisfying and fulfilling experience for physicians and nurses.”

This work was supported by the John Hedley-Whyte grant. There were no competing interests for the authors.

Can political discourse survive the culture wars — or is any discussion of the public good doomed to be “canceled” by one side or the other? The philosopher Agnes Callard addressed this dilemma and others, including ideas around free speech, during a lecture Thursday at Harvard’s Edmond & Lily Safra Center for Ethics.

Opening her talk with an examination of the “liberal concept of free speech,” Callard zeroed in on the decision by the science journal Nature to endorse Joe Biden in the 2020 U.S. presidential election. While the journal claimed to be speaking out for science — and for the free and open dissemination of knowledge — the University of Chicago scholar argued that its endorsement was just as likely to sow suspicion, increasing “distrust of science as political.”

One barrier to more honest and constructive discourse, Callard continued, is that voices on the left have adopted the tactics of those on the right. “We bully people without knowing it,” she said. “Not bullying is harder than it appears. And freely defending free speech is harder than it appears.”

As an alternative, Callard offered the clarity of classical philosophy. Distinguishing between persuasion that is coercive and persuasion that teaches or illuminates a subject, she explained how a Socratic argument relies on refutation, which pushes the other person to delve deeper and explain their argument, rather than on simply convincing a passive audience. “Socrates found a way to peel away the symbolism that everyone else feels compelled to layer on a conversation,” said Callard. “He’s not trying to win. He’s trying to find out.”

In its purest sense, Callard said, politics is about how we communally decide to live together, and political argument should focus on how we can best do this, an objective at odds with our current climate of politicization. In the U.S. today, even if a conversation is superficially about immigration or the minimum wage, she said, it’s really “set against the backdrop of a standing conflict,” in which each argument simply signifies a stance in an ideological dispute.

Lamenting how far our discourse has fallen, Callard circled back to arguments that, while apparently defending free speech, may instead undermine it. “Self-politicization itself is the far greater danger because it is an internal obstacle of political speech,” she said. “It restricts communication by shackling itself. So the key idea of Socratic politics is the depoliticization of arguments. If successful, this frees our speech.”

Socrates himself, Callard pointed out, held to these principles even in the face of the ultimate “cancel culture.” Although he was condemned to death for supposed impiety, the philosopher refused to give up his teaching and turned down help that may have saved his life. Holding true to the idea that “the unexamined life is not worth living,” he accepted his fate, said Callard. “An examined life at risk of poverty or death is going to be preferred over an unexamined life of security,” she said.

In the philosopher’s teachings, and even in his death, Callard sees a warning. “There’s something tragic about people who are in a context where they don’t have freedom to inquire, proclaiming their commitment to free speech or free expression or science or truth or nonconformism,” she said. “They may be applauding and speaking out and raising their voices, but they’re not able to mean what they say.”

Following her talk, Callard fielded questions. One participant asked if she saw a “floor” to American political debate. Rather than a floor, she responded, “We need to be thinking of the ceiling. Often having a sense of the ideal — what it is we’re aiming for — can be more useful.”

Harvard President Larry Bacow and his counterparts at six universities in Jordan, Israel, and the West Bank discussed the importance of international collaboration among higher education institutions and the role of universities in dealing with challenges of our time, such as pandemics and climate change, in a series of meetings and events last week. They also discussed the important role that universities play in their local communities.

Bacow also met with Harvard alumni in the region as well as students at each of the universities at events that included a presentation on climate and sustainability from students at the University of Jordan, a gathering of Ph.D. students at the Bloom School of Graduate Studies at the University of Haifa, a discussion with student diversity ambassadors at Hebrew University, and a tour of a clinical lab where he met life sciences students at Al-Quds University. In addition, he visited Tel Aviv University and met with the president of Birzeit University in Ramallah, Palestine.

The visit had been originally scheduled for 2021 but was postponed due to the COVID pandemic. It was to coincide with awarding an honorary degree to Bacow by Haifa University, which eventually took place virtually.

Harvard Medical School neurobiologist Michael Greenberg has won The Brain Prize 2023 for his lifelong research into brain plasticity: the ability of the organ to change, adapt, and learn over time.

Greenberg, who is the Nathan Marsh Pusey Professor of Neurobiology in the Blavatnik Institute at HMS, shares the award with Christine Holt, professor of developmental neuroscience at the University of Cambridge, and with Erin Schuman, director of the Max Planck Institute for Brain Research.

Collectively, the three scientists have made significant advances in unveiling the cellular and molecular mechanisms that enable the brain to restructure itself in response to external stimuli as it adapts, learns, and even recovers from injury.

The Brain Prize, considered the world’s most significant prize for brain research, includes approximately €1.3 million to be shared by the three recipients. The prize is awarded annually by the Danish Lundbeck Foundation to researchers who have made highly original and influential discoveries in brain research.

Greenberg’s research focuses on understanding how the brain responds to signals from the outside world to modulate the activity of genes that make proteins essential for brain plasticity. Throughout his career, Greenberg has delved into the details of this process, elucidating the identities, roles, and relationships of the various genes, proteins, and molecules involved.

“That our sensory experiences shape the structure and function of the brain is one of the profound discoveries in the field of neuroscience in the 20th century,” said David Ginty, chair of neurobiology at HMS. “Mike’s work, which has extended into the 21st century, has explained how this fundamental feature of brain function is achieved at a molecular, cellular, and circuit level.”

Brain plasticity, or the brain’s ability to rewire itself in response to new information throughout life, is a hallmark of the brain; central to the organ’s ability to function over many decades and to recover or regain function after damage.

To achieve this feat, the brain must continuously create new neural circuits and modify existing ones as it encounters information from the environment. This highly complex and dynamic process requires the brain to carefully orchestrate a multitude of molecules that communicate in signaling pathways and form the cellular basis of learning and memory.

Throughout his career, Greenberg has explored the role of genes in this process — how they work together with life experiences and external signals to support brain development and to ensure that the brain remains adaptable, or plastic, over time.

“Mike’s elegant research highlights the power of basic discovery as the most essential fuel for scientific progress. His impressive accomplishments, which now include this wonderful accolade, show just how much is possible when researchers unwaveringly follow their curiosity and scientific passions,” said HMS Dean George Q. Daley.

A convergence of insights

Greenberg and co-recipients Holt and Schuman are each studying different aspects of protein production within the context of brain plasticity.

Holt’s research focuses on the vertebrate visual system — specifically, the neurons that extend from the eye to the brain — to understand how neural connections in the brain form and are maintained over time. She has shown that proteins must be made and degraded locally to guide the growth of cone cells needed for vision. A continuous supply of locally made proteins is also required to maintain axons — the long fibers that transmit information down neurons. Holt’s work sheds light on how neural connections are established and how axons are sustained throughout life.

Schuman is interested in the processes that control how proteins are made and degraded in neuron structures that are distant from the cell body, including axons and branching dendrites that extend into synapses. She has shown that neurons have localized cellular machinery — namely, ribosomes and proteasomes — in axons and dendrites. She has also established that proteins made in dendrites are needed for synaptic plasticity and revealed molecular details of the mRNA and ribosomes involved. Her lab has developed new tools to label, purify, identify, and visualize newly made proteins in neurons and other cells.

“Together, the Brain Prize 2023 winners have made groundbreaking discoveries by showing how the synthesis of new proteins is triggered in different neuronal compartments, thereby guiding brain development and plasticity in ways that impact our behavior for a lifetime,” said Richard Morris, a professor of neuroscience at the University of Edinburgh and chair of the selection committee.

Of proteins and plasticity

As a postdoctoral researcher in the lab of Edward Ziff, a professor of biochemistry and neural science at New York University School of Medicine, Greenberg began studying the genetic changes that occur inside a mammalian cell when it is stimulated from the outside. He discovered that within minutes of stimulation, the cell begins to express a gene called c-fos, which, in turn, boosts the production of the associated Fos protein.

This turned out to be a milestone discovery.

“The idea that gene expression changes could be induced on such a rapid timescale was a paradigm shift that ushered in a new era for neuroscience,” wrote Emily Osterweil, a professor of molecular neuroscience at the University of Edinburgh, in a commentary about the work of the three winners.

Greenberg continued this line of research as an assistant professor at HMS. Notably, he established a connection between neurotransmitters — chemical messengers that flow from one neuron to the next — and changes in the activity of genes. He described a signaling cascade that starts with the release of neurotransmitters and leads to a spike in calcium in the neuron receiving the message. This influx of calcium induces the neuron to activate c-fos and other genes that make proteins, which, in turn, initiate downstream signaling.

Greenberg went on to more fully define the signaling pathways that neurotransmitters use to activate genes and identify the specific proteins involved. The work of other labs suggests that one of these proteins, CREB, is an important mediator of long-term memory. Building on Greenberg’s work, scientists have also identified hundreds of stimuli that induce Fos production in the brain during different behaviors, thus demonstrating the protein’s ubiquity and importance for brain function.

Greenberg is now working to further characterize the products of genes controlled by neural activity, including how these gene products interact. For example, he learned that Fos works with another protein, NPAS4, to regulate the expression of certain genes by modulating the on-off signals in neurons in response to stimuli. His findings offer a new possible mechanism for long-lasting brain plasticity that may underlie associative learning and spatial navigation. He also established that Fos plays a role in remodeling genetic material inside cells in conjunction with a protein complex called BAF, which has been implicated in neurodevelopmental disorders such as autism.

Greenberg’s efforts have provided insight into the mechanisms by which activity-related genes control the maturation, pruning, and stability of synapses — the small gaps where neurons connect and communicate. Greenberg has linked the gene transcription programs he is studying to key aspects of experience-dependent brain maturation and plasticity, including the formation of context-dependent memories and the plasticity of the visual system during development. His work sheds light on the origins of disorders in which mechanisms of neural plasticity are disrupted.

Greenberg’s research has also yielded important technical advances. His discovery of Fos induction provided researchers with a tool that is now widely used to identify the neurons and neural circuits that mediate behavior. His discoveries have also led to innovative ways of trapping these neurons to assess their function in neural circuits, and new strategies for making detailed observations about the molecules and mechanisms that mediate learning, memory, and behavior.

“For me, this is the culmination of a 40-year odyssey aimed at understanding how our sensory experiences impinge on the neuronal genome to orchestrate brain maturation and the plasticity that underlies long-term memory and how these processes go awry in disorders of the nervous system,” Greenberg said.

Greenberg earned a bachelor’s degree in chemistry from Wesleyan University and completed his PhD at Rockefeller University. Following his postdoctoral research at NYU, he became an assistant professor in the Department of Microbiology and Molecular Genetics at HMS, and later, director of the F.M. Kirby Neurobiology Center at Boston Children’s Hospital. In 2008, he became the chair of neurobiology at HMS, a position he held for 14 years.

Greenberg is a member of the American Academy of Arts and Sciences, the National Academy of Sciences, and the National Academy of Medicine. He has received numerous other awards, including a McKnight award for technological advances in neuroscience, the 2015 Gruber Prize in Neuroscience, the 2019 Ralph W. Gerard Prize in Neuroscience, and the 2022 Edward M. Scolnick Prize in Neuroscience.

The Lundbeck Foundation has awarded The Brain Prize annually since 2011. Winners are selected by a committee of nine leading neuroscientists from around the world who have expertise in diverse neuroscience disciplines.

For Steven Wofsy, the satellite is worth sticking around for.

Wofsy, an atmospheric scientist who spent decades investigating climate change, could be enjoying retired life at age 76, but he still has an active lab. Admittedly most projects there are winding down, with one exception: MethaneSAT, which could prove to be something of a game changer.

“The reason I’m not retired is that this is obviously way too important — and way too much fun,” said Wofsy, Harvard’s Abbott Lawrence Rotch Professor of Atmospheric and Environmental Science. “I’m not taking students in other areas, even though there are some things still going on. This is the focus, and it’s extremely challenging, but in a good way.”

More precise than other methane-sensing satellites that came before, MethaneSAT will allow scientists to track emissions to their sources and provide key data for reduction efforts. It’s important because it could buy the world critical time in the climate change battle. And, most hopefully, it appears particularly do-able in part because saving wasted methane provides a financial incentive for timely corporate cooperation in halting leaks.

MethaneSAT is scheduled to launch early next year, and Wofsy is its principal investigator. The project is the result of a unique collaboration led by the nonprofit Environmental Defense Fund and involves academic scientists, environmental activists, the private space industry, and philanthropic pockets deep enough to fund the design, construction, and launch of a satellite, which is traditionally the reserve of government and big business.

Wofsy and EDF chief scientist Steven Hamburg said the project was born partly out of frustration with years of government inaction on climate but also from a growing realization that curbing methane emissions can have important short-term effects on climate change. In fact, it has the potential to provide a decades-long bridge, slowing the near-term rate of warming and reducing the damage as the world transitions to the low-carbon energy sources that are a longer-term solution.

And perhaps the most important part: It appears actually do-able as it includes an incentive for timely corporate cooperation.

Methane is a potent greenhouse gas — 84 times as powerful as carbon dioxide on a 20-year time scale — but has been in CO₂’s shadow for two reasons. Carbon dioxide is emitted in much greater quantities and hangs around until removed by natural processes that can take centuries to millennia. That means the effects of the gas emitted today pile on top of those released over the last century, and the emissions of decades to come will only make the pile higher. Without steps to remove it, CO₂’s cumulative effect will drive warming upward inexorably and, on a human time frame, irreversibly.

While methane drives just about 30 percent of the warming occurring today, what’s gotten everyone’s attention is its lifetime in the atmosphere: decades rather than centuries. Ironically, that brief lifespan is part of the reason why it has been overlooked. The year 2100 emerged early on as a climate-change milepost, a common marker by which to gauge progress toward solving the problem. But when impacts are considered over a century, short-lived methane and its impacts come and go while effects from the buildup of carbon dioxide grow larger and larger.

“Methane is a short-lived climate pollutant,” Hamburg said. “If you look at a pulse of emissions of something that doesn’t last very long, at its impacts over 100 years, you’re going to have a lower number. But if you ask what’s its impact over 20 years, you’re going to have a much higher number.”

With stronger storms, hotter heat waves, longer droughts, and other climate-related impacts already growing apparent, Hamburg said there’s a growing appreciation that what’s important is not just how much the world warms, but also how fast. An abrupt heating over 20 or 30 years will have impacts very different from those of a long slow warmup over 70 or 80, even if they ultimately reach the same temperature. The rapid increase allows little time for either nature or human societies to adapt. And methane, with its potent warming power and short lifetime, has the potential to act as a toggle between the two futures, Hamburg said.

“If we don’t do anything for 50 years and then radically reduce our methane, the amount of warming in 2100 won’t be different, but the rate of warming will be much higher if you delay, which will have big impacts — and even feedbacks — on the climate,” Hamburg said.

A landmark study

 Wofsy has been keeping an eye on methane for decades. He has used everything from airplanes to balloons to a tower among Harvard Forest trees to better understand how greenhouse gases are changing the atmosphere. He has driven methane-sensing equipment around Boston searching for leaks in the area’s aging natural gas infrastructure, mounted instruments on rooftops and flown them from balloons to measure gases in the atmosphere.

The Federal Reserve Board is walking a tightrope. The central bank has been on a campaign to raise interest rates in an effort to lower surging inflation. But the higher rates also contributed to the recent collapses of Silicon Valley Bank, and several other financial institutions.

The Fed opted to keep raising rates Wednesday, but by only a modest 0.25 percentage point, as expected. In a statement, the Federal Open Market Committee (FOMC), which sets the rates, said the U.S. banking system is sound and resilient but the recent failures will likely make borrowing harder and more expensive for businesses and consumers, and impact economic activity, hiring, and inflation.

How far reaching the effects of all of this will be remains uncertain, Fed chair Jerome Powell said. He also said that there might still be a path that will allow the nation to rein in inflation without falling into a recession, a so-called soft landing, but the central bank is still searching for it.

Kenneth Rogoff is the Maurits C. Boas Chair of International Economics and a professor of economics at Harvard. An expert on global financial crises, Rogoff spoke with the Gazette about his views on how the Fed is doing and what it might do next.

Q&A

Kenneth Rogoff

GAZETTE: Interest rates went up by just a quarter of a percentage point. However, the FOMC did consider a rate pause, and there was a strong consensus to do so, according to Powell. Was this the right move or did last week’s bank failures force the committee’s hand?

ROGOFF: They’re sort of caught between a rock and a hard place. It could look in six months like they made a horrible mistake, either because we have a banking crisis and they wished they hadn’t raised rates, or because inflation is still out of control and they wished they’d raised rates more. Core inflation, which is perhaps the most meaningful number for looking at where things stand, is still very high. Wage growth is still very high as well. At the same time, we’re in a banking crisis, albeit not yet a systemic crisis. Still, even if no more banks fail near-term, lending conditions are surely going to tighten, partly because money is moving out of small banks and into larger ones, partly because banks are needing to pay higher deposit rates, partly because banks realize that tighter regulation is inevitable, even for smaller and mid-size banks. Tighter credit conditions mean that banks are going to pull back on lending, on mortgage lending, auto lending, and business lending. The Fed and the Treasury stemmed the panic, but only by issuing such a broad, sweeping guarantee that they’ve de facto guaranteed every deposit in America regardless of its size — completely the opposite of what they said they were going to do next time in the aftermath of the 2008 financial crisis. But if the taxpayer is going to be asked to take on so much bank risk, the Fed and the Treasury are going to have regulate more intensely, and that’s going to tighten lending conditions.

What do the ancient Romans have in common with the Korean rapper behind the 2012 dance hit “Gangnam Style”? How about an Indian king and an Egyptian queen separated by 1,000 years? All have been stewards of culture — creating it and spreading it across time and distance.

In his new book, “Culture: The Story of Us, From Cave Art to K-Pop,” Martin Puchner, the Byron and Anita Wien Professor of Drama and of English and Comparative Literature, guides readers across thousands of years of human history, highlighting turning points in language, art, and music. At the same time, he foregrounds the constancy through time of cultural borrowing — or, as many view it, theft. We talked to him about the genesis of “Culture,” the perils of pride, the future of the humanities, and more. The interview has been edited for clarity and length.

Q&A

Martin Puchner

GAZETTE: What made you want to write “Culture”?

PUCHNER: A few years ago, I was sitting around the dinner table with colleagues after new numbers had come in showing that only 7 percent of the incoming first-year class had expressed an interest in any humanities — a shockingly low number. Even a decade ago, those numbers were in the low 20s. And so, we were sitting around bemoaning the decline of the humanities, as one does these days. In the middle of the conversation, I stopped and realized that even though I’d been teaching arts and humanities for decades, I’d never really asked myself how culture works and how it develops — these fundamental questions.

What is the big arc of culture? Why do humans produce these things? Why do we spend considerable resources on things that don’t have an immediate use? The goal was to give some kind of answer to these questions. And, as I have been doing the past 15 years or so, do that not for just for a specialized audience — because it’s very clear that the decline in the humanities touches not only universities but society at large. We in the humanities need to get better at communicating what’s exciting about the field, what’s important about it.

GAZETTE: You make that case throughout the book in different ways. One question I found myself asking — what’s lost when we turn away from the humanities?

PUCHNER: You could describe the book as a sort of species history — a history of humans as a culture-making species, which is why I begin some 37,000 years ago. What we’re losing is the deep history of this activity. That deep history matters because we talk a lot about culture these days, but if you Google culture, you’re more likely to get a term like culture war, cancel culture, or cultural appropriation. It’s clear we’re living in a very contentious moment when it comes to culture. That’s not a bad thing on the face of it, because it means that people care, but these debates take place very much in a present mindset — what’s happened in the last two decades or the last two centuries, at most. I felt like it was important to bring a deeper sense of cultural history to this debate. I do take some positions, but the idea was not to say this person is right or this person is wrong, but to say, “Let’s not look at just this present cultural world and get caught up in in positions around that. Let’s look at a global history of culture and have that inform how we think and argue.”

GAZETTE: Can you walk me through some key moments?

PUCHNER: There are certain takeaways I wanted to highlight. The first is that culture is not natural, cultural objects are not automatically transmitted like DNA to the next generation — we have to store them somewhere or transmit them; we have to evolve storage media and institutions. I started to think about institutions where that transmission happens, and some of the earliest institutions, so to speak, were prehistorical caves like the Chauvet Cave, where people worked for thousands of years, continually. So that that’s one through-line — this focus on storage and institutions. And from caves I go to libraries and museums and universities.

Then there was a takeaway that I would describe as an emphasis on latecomers. I think our culture tends to favor originality and the new, who invented what first. There’s a kind of pride associated with that, and I increasingly felt that that’s misplaced — that in culture there’s always someone who came before you. And something similar is true of borrowing. Almost all episodes in the book have to do with one form of borrowing or another.

The last takeaway has to do with a kind of humility — that so many of the heroes in the book deal with culture of the past, even though that past is very different, a different world with different values and priorities. But they honored that, and even found it interesting to deal with something that was different from them. That includes Arabic translators who were interested in Greek philosophy, even though these Greeks weren’t believers of Islam; Christian scribes of the Middle Ages who were interested in the pagan past, even though these pagans weren’t Christians; and so on and so forth. And this is why I end with the Future Library, where authors agree to write something that won’t be published for 100 years, with the hope that people will be interested in our stuff even though they almost certainly look down on us for all kinds of reasons.

GAZETTE: The book critiques elitist attitudes, especially in the context of colonialism. Thinking about our era, how do we avoid some of those pitfalls when exploring and mixing with other cultures?

PUCHNER: It’s been my experience that if you, especially if you’re a professor, raise your finger and say “Everyone should do this” — people don’t like that. I don’t like that, either. My strategy is to show how culture works, and how these dynamics work, and be compelling about it, and create a certain excitement around that. There are implicit positions that emerge on colonialism, or ethno-nationalism, but also, to a lesser extent, I argue that certain leftist positions that have to do with cultural appropriation sometimes go off in the wrong direction. I’m very sympathetic in many ways, but I also think that being too worried about cultural appropriation can leave everyone impoverished in a certain way.

A few years ago, I started the Theater, Dance & Media program here, and I do have students come to me, future artists and theater-makers, who feel very uncertain about what they are allowed to do — or not. I wanted to unsettle that a little bit with history, which may or may not work.

GAZETTE: You also write that we should be careful about applying present-day standards to the past. How do we reflect on the past without negative judgment?

PUCHNER: I would never say that we should only study the past for its own sake, or that it should be put it in a glass case. Nor do I think that we need to worship the past and everything it stands for. When I am confronted with this distant past, and these figures who themselves confront the distant past, I don’t throw my beliefs overboard, but somehow my convictions and opinions become a little less urgent. You just realize the incredible variety of ways humans have lived and what they’ve thought. And yes, I wouldn’t want to live in all of these places, because I’m a child of my own time, as we all are. But studying history instills in me a sense of humility. Which brings me back to Future Library — and the idea that the future is going to have the same problem with us. And once you put yourself in that great chain of being, so to speak, I think that you find yourself less quick to dismiss something out of hand or consider it not worth engaging at all.

Sviatlana Tsikhanouskaya’s political career began when her husband, Siarhei Tsikhanouski, was jailed after announcing plans to challenge Belarus President Aliaksandr Lukashenko in 2020. The political newcomer ran in her husband’s place, and after Lukashenko was declared the winner in a contest widely viewed as fraudulent, mass protests broke out in Belarus for months.

Tsikhanouskaya, fearing for her safety, fled to Lithuania, where she leads the Belarusian opposition, which includes partisans who are working against the Russians in their attempt to take over Ukraine. Tsikhanouskaya’s group views their support of Ukraine as part of a larger pro-democracy battle pitting that nation and their own against Lukashenko and his ally, Russian leader Vladimir Putin, who seeks to reassert Moscow’s control in the region.

Tsikhanouskaya will be a keynote speaker at the John F. Kennedy Jr. Forum at the Institute of Politics on Friday and share the stage with European Parliament President Roberta Metsola. This event is part of the student-led European Conference at Harvard on Friday and Saturday and co-sponsored by the Minda de Gunzburg Center for European Studies, the Weatherhead Center for International Affairs, and the Davis Center for Russian and Eurasian Studies.

This interview was edited for length and clarity.

Q&A

Sviatlana Tsikhanouskaya

GAZETTE: What are some of the key issues and policy debates in Europe you’re planning to speak about during your address at the Institute of Politics? How does Belarus play a role in Europe’s security?

TSIKHANOUSKAYA:  The people of Belarus and the Ukrainians are facing the same enemy. Russia wants to return our countries to the sphere of Russian influence. We have always felt ourselves to be European, and we don’t want to be connected with Russia. Russia now is synonymous with war and poverty, and Europe is democracy and peace, and we want the same for our country. We want to break the perception that Belarus is part of Russia or a post-Soviet Union country. While Lukashenko is in power with the help of violence and criminal support, he will always obey Putin and fulfill his orders, and there will be a constant threat to the security of the region.

GAZETTE: What measures can the European Union take to support the pro-democratic movement in Belarus?

TSIKHANOUSKAYA: Consistency is powerful. If the European Union doesn’t recognize Lukashenko as president, it should not meet with representatives of the [Belarusian] regime. If it knows that Lukashenko is guilty of crimes against humanity and war crimes, then it should hold him accountable and start an investigation. The European Union can apply pressure on the regime through sanctions and political isolation. It can also support civil society. A huge number of people fighting the regime had to flee the country, and they need financial support. So do the families of political prisoners. We fully support the Ukrainians, but the war will not be over until Belarus is free too.

GAZETTE: What is your perspective on the United States’ foreign policy toward Russia, Ukraine, and Belarus?

TSIKHANOUSKAYA: [The United States] should unite in implementing measures against Lukashenko together with the European Union. Joint positions will be more effective. It should also support the Belarusian people and punish the regime. The U.S. needs to understand that Belarus and Ukraine are intertwined. Lukashenko is a full collaborator with Russia in the war in Ukraine.

I would also ask the American government to pay attention to the criminal occupation of Belarus because now we are seeing the presence of Russian troops in Belarus. We see how Russia is step by step occupying our cultural, economic, and military spheres, and we want to hear a clear message that any attempts to occupy Belarus will not be tolerated. There should be a wide range of personal sanctions placed on those serving the [Lukashenko] regime: work with democratic forces, NGOs, support cultural institutions, assist political prisoners, and offer scholarships to students.

GAZETTE: Do you still believe that the peaceful transition of power in Belarus is possible by limiting the number of presidential terms, as you have called for?

TSIKHANOUSKAYA: From the beginning we have believed that nonviolence can create change in our country because we know that peaceful change is more sustainable. When Belarusian anti-war regiments formed in Ukraine, we saw some cautiousness from our democratic partners. These regiments are defending Ukraine now, and there was some concern that one day they would come to Belarus and get rid of the regime through violent means. Where is the neat golden middle? In this battle to win peacefully we need to put the regime under constant stress.

We don’t want any violence. Belarusian anti-war partisans committed nonviolent acts of sabotage when they damaged the railway lines in Belarus so that Russia could not deliver new forces, weapons, shells, equipment, and other military supplies to the front and disrupted the Russian offensive on Kyiv. The same goes for the recent explosion of a Russian aircraft at a Belarusian airfield, which provided guidance for missile strikes on Ukraine. These actions are nonviolent, because they did not harm the life and health of people. On the contrary, in both of these cases, equipment is damaged that can be used to kill many people in Ukraine.

GAZETTE: Does fear ever stop you or momentarily paralyze you? How do you keep moving forward as a wife, mother, and political leader?

TSIKHANOUSKAYA: Since 2020, there wasn’t a day when I didn’t feel fear. I’m afraid for my husband and other political prisoners. I know how they are treated in prison. The fact that they sacrificed their freedom and chance to build a normal life is what makes me continue to fight. Sometimes I don’t want to get out of bed, but then I think about my husband, who doesn’t have the chance to say a word publicly and is humiliated physically and morally in prison. Then I tell myself to stand up and get to work.

When my husband is allowed to send a letter to our children, and my daughter, who is now 7 years old, is reading his words and crying, I understand that I don’t have a choice. When a woman is faced with obstacles, she will show her internal power, and she should not underestimate herself.

My son is a child with special needs who was born with deafness. He underwent an operation as a toddler and had to receive daily therapy to learn to speak. I didn’t know if there would ever be a full rehabilitation. I didn’t see the light at the end of the tunnel, but I knew I had to work with him every day. Eventually, he was able to join his classmates at school.

Maybe that personal experience is helping to sustain me now. I don’t know when the light at the end of the tunnel will appear for Belarusians either, but I do know that you have to find the strength in yourself to fight every day because you hope for a victory.

Our country doesn’t belong to just one person who thinks that Belarus is his private backyard. This is our country, and we are responsible for its future. People in the diaspora have taken so many creative initiatives, like forming the People’s Embassies of Belarus, and it’s really inspiring to realize you’re not alone. You stand shoulder to shoulder with others.

Mikhail Lukin, a pioneer and leader in quantum science and quantum computing, has been named a University Professor, Harvard’s highest honor for faculty.

Beginning July 1, Lukin will hold the University Professorship established by Joshua Friedman ’76, M.B.A. ’80, J.D. ’82, and Beth Friedman in 2017. The chair supports a tenured faculty member who has shown both extraordinary academic accomplishment and leadership within the University community.

“A pioneer in applying quantum optics for quantum computing purposes, Professor Lukin is central to the University’s ambitions in quantum science and engineering,” Harvard President Larry Bacow said. “As co-director of both the Harvard-MIT Center for Ultracold Atoms and the Harvard Quantum Initiative in Science and Engineering, he produces work that is not only elegant and beautiful, but also enormously promising in its capacity to create innovations that are likely to change many of our lives. It is a pleasure to welcome one of the best quantum information scientists in the world into the ranks of the University Professor.”

Lukin’s work in quantum science and engineering aims to use quantum superposition and quantum entanglement — the fundamental phenomena governing the interactions between photons, atoms, molecules, and electrons — to create new devices and applications, including quantum computers.

Classical computers, such as smartphones and laptops, depend on binary bits of data denoted as 1s and 0s. Quantum computers use quantum bits, or qubits. Due to quantum superposition, which is the ability of something at the quantum level to be in multiple states at one time, qubits can be 1s, 0s, or both simultaneously. Because of qubits’ properties, quantum computers can solve highly complex computations in a few hundred minutes that would take a classical computer more than 10,000 years.

According to Lukin, quantum computing has a potential to transform science and society, and the current era is akin to the early days of transistors and conventional computers, with many exciting opportunities that cut across physics, chemistry, biology, engineering, and computer science.

“Quantum is a unique field, truly interdisciplinary, originating from physics, chemistry, and mathematics, with implications to philosophy, and more recently connections to engineering, computer science, business, global security, and public policy. At Harvard we have a truly extraordinary community that includes an exceptional group of students, postdocs, and faculty that closely collaborate across many departments and Schools, making it a very special place to do this work,” said Lukin, who is currently the George Vasmer Leverett Professor of Physics. “This group’s collaborative efforts have already transformed the cutting-edge frontier in this field, and with this professorship, I hope to be able to help elevate this work even further by bringing together scientists and engineers to explore new scientific directions, make new discoveries, and realize applications that address the biggest challenges facing the world.”

Lukin grew up in Russia at the end of the Cold War. He has said that those formative years were an unusual time that was extremely challenging, but he was fortunate to be taught by dedicated individuals who piqued his interest in physics and solving scientific problems while he earned his master’s degree from the Moscow Institute of Physics and Technology.

When he arrived in the early 1990s at Texas A&M University in College Station, where he received his doctorate, and later when he came to Harvard’s Institute for Theoretical Atomic and Molecular Physics as a postdoc, Lukin said that he was very lucky to work with a remarkable group of mentors and peers who took him seriously as a researcher, but also helped him to mature and develop both as a scientist and a member of his community.

Inspired by the influence of his mentors, Lukin has advised or sponsored more than 150 graduate students and postdoctoral fellows. He has also published more than 450 papers and has received several of the top awards in his field, including the I.I. Rabi Prize of American Physical Society (2009), the Willis E. Lamb Award for Quantum Optics and Laser Science (2017), the Charles Hard Townes Award of the Optical Society of America (2021), and the Norman F. Ramsey Prize of American Physical Society (2022).

The first University Professorships were created in 1935 as a means to recognize “individuals of distinction … working on the frontiers of knowledge, and in such a way as to cross the conventional boundaries of the specialties.” With the addition of Lukin, 25 Harvard faculty members across the University currently hold this honor.

The scene was spare. Two men sat in armchairs on stage, a squat café table with two bottles of water between them. Cultural historian Harvey Young remarked to playwright Branden Jacobs-Jenkins on how rare the moment felt — an in-person gathering of the Rita E. Hauser Forum for the Arts. “Over the last three years we’ve had theaters that were shut down,” he said. “Life changed.”

Young, dean of the College of Fine Arts at Boston University, then asked Jacobs-Jenkins, an Obie winner and two-time Pulitzer finalist, how the arts had changed and what the state of the arts are now, the central focus of a recent Farkas Hall event.

“We’re coming out of a period of having to abandon liveness as a modality of receiving expression. There’s a desire and a need to reteach ourselves how to be in the present, and receive in the present, and communicate in the present,” said Jacobs-Jenkins, who is also creator of FX’s hit TV drama series “Kindred” and a former MacArthur fellow. “I’m curious about how the arts will assert its importance again.”

Jacobs-Jenkins described a pre-COVID world of stage frenzy in 2019, when interest in the field of theater and theater studies was expanding. With a sense of humor and also of humility, he recalled his own upbringing imbued with early art experiences, and talked about how the power of resources and money help shape the theater profession. Specifically, Jacobs-Jenkins spoke about the difficulties that artists face when they attempt to survive off their work alone, how awards can help, and how funding and resources can often influence how a play is imagined on the stage.

Harvey drew on the historical beginnings of theater’s funding since the Great Depression and the investment that continued through the early 1970s. He commented on how Jacobs-Jenkins has, in many ways, shifted perspectives about the state of theater through his success. Though the “theater is dying” mentality remains prevalent in the industry, Jacobs-Jenkins promotes a counterbalancing view personally and in his teaching at Yale.

“No one buys into a notion of success that lasts. You hope you make the thing that cuts through, or does what you intended to do for the community you are writing for at that moment,” said Jacobs-Jenkins. “Creativity, for me, always comes with an active asking of a question and a pursuit of it. I’m constantly asking questions about why we accept the things we accept.”

Importantly, Jacobs-Jenkins and Harvey discussed an area of inquiry they share: race in theater.

“I think of race as a big theater game — the biggest, longest-running theater game in the history of mankind. I never sit down to write about race. I write with race,” said Jacobs-Jenkins. As a self-identified “experimental artist,” Jacobs-Jenkins has strived to answer questions about representation and questions about accepting false truths.

After his play “Neighbors” — about a loud and raucous family of Black entertainers — received both positive and critical reviews, Jacobs-Jenkins produced “Appropriate,” an award-winning examination of a dysfunctional white Arkansas family, born out of his desire to understand and experiment with how to write an American family drama. He described “Neighbors,” “Appropriate,” and “An Octoroon” (an adaptation of a popular 19th-century melodrama) not as a trilogy but linked together.

When the conversation opened to a live Q&A, Jacobs-Jenkins advised younger members of the audience to write frequently. Though he described playwriting as a literary experience, he noted that writing a play is a means to providing the blueprint for a live event.

“Theater is alive,” said Jacobs-Jenkins. The audience applauded.

Patients who access test results through an online portal account overwhelmingly supported receiving the results immediately, even if their provider had not yet reviewed them, according to a survey conducted by Beth Israel Deaconess Medical Center and colleagues.

Published in JAMA Network Open, the findings included a small subset of patients who reported experiencing additional worry after receiving abnormal test results. However, pre-counseling by the health care team before tests were ordered was linked to reduced worry among patients with abnormal results.

“Online patient portals have emerged as important tools for increasing patient engagement,” said co-senior author Catherine M. DesRoches, executive director of OpenNotes, the international movement based at BIDMC focused on increasing information transparency in health care. “They enable patients to access information, participate in medical decision-making and to communicate with clinicians.

“Prior studies performed by OpenNotes investigators established immediate release of clinical notes as a recommended best practice. However, releasing test results to patients immediately, often before a clinician can provide counseling and context, was yet to be studied widely and remains controversial,” said DesRoches, who is also an associate professor of medicine at Harvard Medical School.

To assess patient and caregiver attitudes and preferences related to receiving test results through the patient portal, DesRoches and colleagues delivered surveys to more than 43,000 patients and care partners who accessed their test results via an online patient portal account between April 2021 and April 2022.

Of the 8,139 survey respondents:

• 80 percent reported reviewing at least one test result in the past month.
• 57 percent reported normal findings.
• 90 percent of respondents with normal results indicated they would prefer receiving their result via the patient portal.
• 96 percent indicated a preference for receiving results through the patient portal as soon as they are available, even if their provider had not yet reviewed them.
• Less than 8 percent reported being more worried after viewing test results.
• Among respondents who reviewed a result before being contacted by a provider, almost half reported feeling less worried after reviewing their results through the portal.
• Among those reporting not normal results, 84 percent reported less or no change in their level of worry.

The survey results suggest that patients receiving not normal results are indeed at increased risk for worry. Nevertheless, more than 95 percent of participants who received abnormal test results reported preferring to continue to receive immediately released results through the portal.

“Respondents overwhelmingly preferred to receive test results through the patient portal, even if it meant viewing results prior to discussing them with a health care professional,” said co-author Liz Salmi, communications and patient initiatives director of OpenNotes at BIDMC. “As health care systems continue to navigate this new era of health information transparency, balancing patients’ expectation of immediate access to their information with the need to manage increased worry is important. Additional research is necessary to better understand the nuance of worry from receiving abnormal test results, especially as it relates to revealing information about a newly diagnosed condition such as Huntington’s disease or cancer.”

The survey was fielded in four geographically diverse medical centers; University of California, Davis Health, University of Colorado Anschutz Medical Center, University of Texas Southwestern Medical Center, and Vanderbilt University Medical Center. The 29-question survey covered topics including test result information, result review behavior, education and follow-up by providers, the effect of reviewing results on health and well-being, and user preferences for receiving future test results.

Using mechanical forces — including massage — to stimulate tissue healing has been a form of physical therapy for decades. However, the biological basis and optimal settings for noninvasive mechanotherapies are still poorly understood, especially with respect to elderly patients.

A new multidisciplinary study has investigated whether elderly patients can benefit from tailored mechanotherapy for severely injured muscles the same way that young patients can.

The study was performed by researchers at the Wyss Institute for Biologically Inspired Engineering and the Harvard John A. Paulson School of Engineering and Applied Sciences (SEAS), led by Wyss core faculty member David Mooney in collaboration with associate faculty member and Paul A. Maeder Professor of Engineering and Applied Sciences Conor Walsh. In previous work, the collaborators used Walsh’s lab to develop a robotic mechanotherapy device that functions like a highly advanced massage gun. This technology enabled precise delivery of mechanotherapy to injured muscles in mice, allowing the team to measure its biological effects.

In young animals, the researchers found mechanotherapy accelerated muscle healing by mitigating inflammation. However, on aged muscle, the researchers found that the same treatment actually had the opposite effect — the settings that promoted healing in young muscle exacerbated injury in old muscle.

Searching for an explanation, the team found that mechanotherapy amplified inflammation in aged muscle, hindering the normal healing process by disrupting the behavior of muscle stem cells, a subset of cells responsible for replacing damaged muscle tissue.

The researchers next asked if controlling inflammation along with delivering mechanotherapy could help heal aged muscles. They found that this was indeed the case: combining mechanotherapy with anti-inflammatory treatment significantly improved healing in aged muscles and was superior to anti-inflammatory treatment alone. This work, published in Science Robotics, opens an exciting, noninvasive therapeutic avenue for elderly patients.

“Our study highlights critical differences in how muscle stem cells and immune cells respond to mechanical forces in the context of age, and how upregulated inflammation additionally compromises the function of aged stem cells needed for the regeneration of old muscles,” said Mooney who also is the Robert P. Pinkas Family Professor of Bioengineering at SEAS. “Muscle mechanotherapies likely thus won’t be a ‘one-size-fits-all.’ To realize their benefits, they will have to be tailored to patient populations, and specifically for aged individuals, it will be key to modulate inflammation.”

Earlier today, Harvard Provost Alan Garber released new and amended University policies and guidelines on non-discrimination and anti-bullying. Each has been approved by the Harvard Corporation and comes after a nearly yearlong community review period that took input from students, faculty, staff, and researchers across the University. The changes will go into effect on Sept. 1 and will be implemented by a working group led by Sherri Charleston, Harvard’s chief diversity and inclusion officer.

To learn more about the new policies and what changes the Harvard community will see, the Gazette spoke with Charleston and Peggy Newell, the University’s deputy provost.

Q&A

Sherri Charleston and Peggy Newell

GAZETTE: The policies and policy updates released today are a culmination of a process that started in January 2021 with the provost’s creation of a Steering Committee for University Discrimination and Bullying Policies and three related working groups. Can you share a little about why the University has focused on policies in these areas and how the committee arrived where we are today?

NEWELL: It’s important to remember that the University already prohibits illegal forms of discrimination, so that piece isn’t new. What is completely new today, though, is a University-wide policy on bullying. There have been mechanisms by which severe forms of bad behavior could be punished, but there has never been an explicit policy on bullying.

We started this process because members of our community — particularly students — expressed that they felt we did not have a well-defined pathway for addressing concerns, and if they had a concern, did not know where to go with it. It was largely prompted by the Harvard Graduate Student Union (HGSU-UAW) asking us to establish University-wide policies in these areas, in addition to other existing policies. In part, the release of the policies today stems from the commitment we made to HGSU-UAW.

The process to get us to today was extensive, largely because we knew it had to be inclusive. These are policies that apply to faculty, staff, undergraduate and graduate students, and other academic workers, across every one of our Schools. We had to have a process that considered and engaged all those constituencies. It also had to have a generous amount of time for community input, and we received a fair amount of community engagement on this.

Part of this process was also a focused review of the existing policies on sexual harassment and other sexual misconduct. Though the changes that were agreed on in the review process were approved by the Corporation for implementation in September, we anticipate that  updates to Title IX regulations from the U.S. Department of Education, expected to be released in May, will require that we make additional changes to our policies and procedures to ensure we are compliant with federal requirements. To avoid confusion, we will not be releasing the updated Title IX and sexual misconduct policies and procedures until any additional changes required under the anticipated new Title IX regulations are incorporated and approved.

CHARLESTON: I would just underscore something that Peggy mentioned, which was the desire to make sure there was transparency in this process. When I arrived in 2020, and considerations related to these policies were already well underway, what I was hearing from members of the community was a desire to understand more clearly how these policies would be developed and how the community would be involved in shaping them. The University recognized this need and was responsive to it with robust community engagement.

GAZETTE: The policies that were released today will be implemented starting on Sept. 1. Can you give us a window into what the next few months will look like as you prepare for implementation, and then what the community can expect starting in the fall?

CHARLESTON: In the cross-University working group that we’ve assembled, we’ll spend the better part of this current semester examining various structures across the University and trying to figure out how the policies on nondiscrimination and bullying intersect with local policies within the Schools. It will be up to each School and unit to develop the local structures to undergird the policy and adapt it to be responsive to the unique cultures within each of their local environments. By September, we expect to have a structure developed that can support the policies’ implementation. Members of the community interested in checking on our progress can go to the Office for Equity, Diversity, Inclusion, and Belonging website to see the policies, frequently asked questions, and periodic updates.

NEWELL: There are a lot of things that still need to be done in a relatively short amount of time. People are going to need to be hired and trained, handbooks and other materials need to be updated, and websites need to be created and changed to ensure we are meeting the need for clarity and understanding around the policies and the supporting procedures. None of that work could have been done before these policies were approved.

CHARLESTON: As Peggy alluded to, we will need to spend considerable time thinking about how we engage the broader community in learning what is and is not covered under the policies. Educating the community on the policies and clarifying and creating a shared understanding of what is meant by terms such as bullying and discrimination will be ongoing work.

An important thing to keep in mind is that this will be a progressive implementation, and it’s going to take a few years of refinement. To that end, we want to make sure a constant cycle of quality improvement is embedded into the rollout process, so that as we refine it, we’ll really figure out how to maximize our efficiency and awareness of resources and procedures. What we see on Sept. 1 will not be the final product; it will be the beginning of a cycle of continuous improvement.

GAZETTE: The provost’s message talked about not just implementing these policies, but also culture change. How can these policies and the work in the coming months be instrumental in changing culture?

CHARLESTON: When we think about culture change, we’re talking about creating better structures and better habits. How do we create better structures that enable us to have better habits? That’s what it means to develop a healthy culture.

OEDIB leads our University-wide efforts to create a culture where everyone can thrive. The soon-to-be created office that will support these policies will be focused on developing the structures that will undergird our efforts as a community to maintain strong and inclusive habits. As we implement these policies and policy updates, this new office will support the Schools and units in establishing local structures. It will also lead the development of the educational tools and data-tracking systems we’ll rely on as we implement the policy across campus.

NEWELL: People focus a lot of their energy and their attention on policies. Policies can put you on notice about what kinds of behaviors are not allowed and can possibly deter some people who fear the consequences of violating policy — but they don’t by themselves create a culture. The things that Sherri just described are critical to that. But every one of us is critical to that as well. If we want a community in which everybody can flourish, we all must try to contribute to that culture.

GAZETTE: Is it significant that these are University-wide policies? Why is that important, and how will Schools and units play a role?

NEWELL: Students and faculty increasingly work across Schools at Harvard. A student in a classroom could be sitting next to a student from another School, and the professor could be from a third School. When this was coming together, I think everybody agreed that there should be one set of overarching University-level policies, in addition to the local standards that many Schools have.

CHARLESTON: There are very few University-wide policies, and these are University-wide policies that went through extensive community review and community comment, and extensive review at every level of the organization from the deans all the way up to approval by the Corporation. That is incredibly significant and demonstrates the commitment of this institution to thinking about how we maintain a healthy culture. So, I think, both for its symbolic and functional significance, this is an incredibly important step for our institution.

Over the past few years, we have all seen the importance of public health approaches in helping to keep whole populations healthier. I think that these approaches can also help inform how we can create a healthier culture. A public health approach focuses on the well-being of entire communities, regardless of their individual backgrounds. It requires input and contributions from across disciplines and depends on collective action. Similarly, if we want to create a healthy culture where everyone can thrive, everyone benefits, then everyone must have a part.

We have different cultures within the Schools across the Harvard community, and each has its own unique cultural undercurrents. But I think it’s significant that we’re all committed to the same values, which means ensuring that we have a community where everyone feels respected. I think that these policies give us the tools that we need to make that process a little bit more tangible, and much clearer for members of our community.

Going to work is a heroic act for Mario Luna Romero. A spokesman for the Yaqui (Yoeme) tribe in the Mexican state of Sonora, Luna Romero has been leading the struggle of his community to protect the Yaqui River, which the Yaqui consider sacred, and preserve their rights to its water. Several such activists, including one of Luna Romero’s colleagues, have been harassed by government officials or killed by criminals.

Luna Romero will be a guest speaker at the “Mexico + H2O = Challenges, Reckonings, and Opportunities” conference scheduled for Thursday and Friday and sponsored by the David Rockefeller Center for Latin American Studies, Harvard Graduate School of Design, and the Department of History of Science.

The Gazette spoke to Luna Romero via WhatsApp. He spoke in Spanish from Vícam, one of eight Yaqui towns in Sonora. The interview has been edited for length and clarity.

Q&A

Mario Luna Romero

GAZETTE: What is the significance of the Yaqui River for your community?

LUNA ROMERO: The Yaqui River is essential to the lives of our community not only because it provides water for our farmlands and our own consumption, but also because it is part of our creation myths and our ancestral culture. Without the Yaqui River there are no Yaqui people. Our history tells us that the Yaqui people came out of the Yaqui River, and that our mythical ancestors, the Surems, inhabit the river. For us, the fight to preserve the rights to use the Yaqui River goes beyond economic survival; it is part of our culture and history. For us, this fight is a call to preserve our right to exist in the world.

GAZETTE: People said that the Yaqui tribe has led a historical struggle for water. Can you explain?

LUNA ROMERO: Studies show that our community has been around for 2,000 years inhabiting our ancestral lands in Sonora, northwest Mexico, near the Yaqui River — hence our name. The Yaqui people are the original inhabitants of this region. Sonora is a semi-desert, and the Yaqui River is the largest river system in the state.

The Yaqui tribe led a rebellion against the Spaniards, who took our lands and access to the river, in 1740. In the first years of the Mexican Republic, our tribe also fought against landowners who wanted to take our water to irrigate their farmlands. There were many conflicts throughout the 1800s as state and government officials, colluding with landowners, led a policy of extermination against the Yaqui tribe. Many of our people were killed by state and federal forces, and many others were captured and sent to southern Mexico as indentured servants, but the Yaqui tribe has always fought for our rights to land and water.

In 1937, the government restored, via presidential decree, ownership of our traditional lands, and in 1939, another presidential decree granted us the right to half of the water in La Angostura reservoir, the only one at the time on the Yaqui River. Later, two other dams were built, and in 2010, the state decided to build the Independencia Aqueduct, to draw water from the Yaqui River to supply Hermosillo, Sonora’s state capital.

GAZETTE: How did the aqueduct’s construction set off tensions over the Yaqui’s water rights?

LUNA ROMERO: When the Sonora state government decided to build the aqueduct in Yaqui territory, they did not consult us even though the project puts our livelihoods and existence at risk. We fought against the construction by protesting, blocking highways, and going to court. The courts sided with us, but the authorities didn’t comply with the judicial orders to stop construction, and they did not respect the presidential decrees that grant us rights to land and water.

The Mexican government has launched a campaign to show that they respect the Yaqui tribe’s water rights, but in reality, they are violating our rights and judicial rulings that have confirmed our water rights. They portray us as backward people who are against modernization.

At some point, the Yaqui numbered 60,000, but due to the policies of extermination against us, we now are between 40,000 and 45,000. To justify the construction of the aqueduct, state officials said, “You’re only 40,000, and there are 800,000 people in Hermosillo.” We think that the Mexican government has missed a historic opportunity to solve the Yaqui water struggle, but we are still here, fighting for our rights and our duty to take care of our land.

GAZETTE: What is the current status of the Yaqui struggle for water?

LUNA ROMERO: As of now, we feel besieged by economic and political forces that want to push us away from our ancestral lands. There are many big companies that want to take advantage of the strategic location of our territory, close to the U.S.-Mexico border. They want to make of Sonora a giant industrial corridor for low-cost maquiladoras.

For big businesses, Sonora’s location is strategic and beneficial; they want to capitalize on cheap labor and closer supply chains. Mining companies and automotive industries are looking to open plants in Sonora, and those industries consume a lot of water, not to mention agribusiness. We are in the middle of a struggle against economic interests that want to grab our territory because it is rich in resources and water, but also because of its location.

Those big companies want us to sell our water rights to them as if this is about money, but for us, it’s more than that. They don’t understand our world vision. Our vision, which we have learned from our elders, is that we all are passengers in the world, and we have a mission to take care of our land to pass it on to the future generations. In a way, it’s a confrontation between two different visions of the world.

GAZETTE: How did you become a water activist?

LUNA ROMERO: I live in Vícam, and I am the director and anchor at Namakasia Radio, an independent community radio station. Our goal is to promote our culture and help solidify the Yaqui’s cultural identity among young people. In 2010, in response to the state plan to build the Independencia Aqueduct, the traditional authorities of the Yaqui tribe chose me and Tomas Rojo Valencia as spokesmen for the Yaqui tribe’s water rights. The position of being a spokesperson has put us in the spotlight, in front of television cameras, which is something we were not looking for, and has put us in the eye of the hurricane. [Rojo Valencia was reported missing May 27, 2021, and weeks later his body was found near Vícam, a victim of murder, according to authorities.]

GAZETTE: Several Yaqui water activists have been killed. Why is this activity so risky?

LUNA ROMERO: There are big economic interests at play. They are eyeing our territory and our water, and anyone who opposes them is their enemy. It’s a mix of big agribusiness companies, automotive factories, and now that with the recent discovery of huge lithium deposits in our region, mining companies are also involved. We are aware of the risks, but we also worry about our lives because organized crime is active in Sonora. We don’t know who is doing the dirty work and for whom.

GAZETTE: What do you hope to gain from your visit to Harvard?

LUNA ROMERO: We’d like the audience to be aware of the Yaqui’s precarious situation and the threats to our livelihoods we are confronting. It is hard for a small community like ours to draw attention to our plight. That lack of interest and attention benefits the big companies that want to grab our land. Harvard is a very important forum for us to let people know what is at stake and stir interest among researchers. We have always resisted and fought against attempts to push us out of our land and take our water rights away from us. They haven’t been able to exterminate us. We’ll continue our resistance movement. Our belief is that both the nation’s laws and the country’s economic interests must harmonize with the Yaqui tribe’s right to exist as the original people of these lands.

New research reveals elevated suicide rates among adults undergoing surgery for cancer, with half of the suicides occurring during the first three postoperative years.

The study, led by a team of researchers from Harvard-affiliated Massachusetts General Hospital, was published in JAMA Oncology and highlights the need for regular screening for distress and assessment for suicide among such patients.

“Several studies have now shown that the incidence of psychiatric morbidity among patients undergoing cancer operations is high — an estimated 6 to 38 percent of patients develop major depressive symptoms after surgical treatment. However, the risk of suicide among patients undergoing cancer operations remains largely unknown,” says senior author Chi-Fu Jeffrey Yang, a thoracic surgeon at MGH and an assistant professor of surgery at Harvard Medical School.

“Additionally, there are currently no organized programs in place to implement regular screening for distress among this patient population.”

“Many patients who undergo cancer operations — particularly those diagnosed with early-stage disease — achieve excellent long-term survival rates. Most patients undergo these operations with the intent that surgery will provide them with the best prognosis possible,” says first author Alexandra Potter, a researcher at MGH.

“However, cancer surgery can be stressful, and patients can face long and complicated postoperative recoveries. These factors, combined with the high rate of psychiatric morbidity among patients undergoing cancer operations, may contribute to an increased risk of suicide in this patient population.”

To better understand the incidence, timing, and factors associated with suicide among patients undergoing cancer operations, Yang and his colleagues examined data from the Surveillance, Epidemiology, and End Results Program — which provides information on U.S. cancer statistics — for patients undergoing surgery for the 15 deadliest cancers.

The investigators found that from 2000-2016, suicides occurred in 1,494 of 1,811,397 patients (0.08 percent) who underwent cancer operations.

The incidence of suicide, compared with the general U.S. population, was significantly higher among patients undergoing surgery for cancers of the larynx, oral cavity and pharynx, esophagus, bladder, pancreas, lung, stomach, ovary, brain, and colon and rectum.

Approximately 3 percent, 21 percent, and 50 percent of suicides were committed within the first month, first year, and first three years after surgery, respectively. Patients who were male, white, and divorced or single faced the greatest risk of suicide.

“The incidence of suicide, compared with the general population, was significantly higher for patients undergoing surgery for 10 of the 15 cancers evaluated,” says Yang. “Also, approximately half of suicides occurred during the first three years after surgery, which is a time when many patients are often still regularly following up with their health care team.”

“Thus, this period is an opportunity to potentially develop and implement programs to regularly screen patients for distress and ensure that patients have access to the appropriate support and treatment if needed.”

Yang notes that screening for psychosocial distress is recommended by several major medical professional societies for all cancer patients, regardless of their treatment, but efforts to implement screening in clinical practice have mostly focused on integrating screening in medical oncology practices and not surgical oncology practices.

“Many early-stage cancer patients who undergo cancer surgery receive their primary cancer care through their surgeon and many do not ever see a medical oncologist,” says Yang.

“Because distress screening implemented in medical oncology practices may never reach patients who undergo cancer operations, further work is needed to develop and implement distress screening programs in surgical oncology practices.”

The researchers are hopeful that their findings will spur efforts to develop effective strategies for suicide screening, assessment, and treatment for these patients.

An accompanying editorial stresses the importance of considering how many suicide cases in the study were terminal, meaning that the patients’ deaths were expected to occur within six months. (Indeed, patients undergoing surgery for cancers with lower five-year survival rates had higher suicide rates.)

“Research aimed at understanding the similarities and differences between suicidal states, as classically defined, and end-of-life considerations among patients with terminal illness warrants further attention,” the editorial’s authors wrote. “Such research could advance the understanding of suicide and how to best prevent it across patient populations and to reveal clues for delivering compassionate and effective care for patients with cancer.”

Additional study co-authors include Alexandra L. Potter, Chinmay Haridas, Krista Neumann, Mathew V. Kiang,
Zhi Ven Fong, Corinne A. Riddell, and Harrison G. Pope Jr.

Is all the doomsaying on Social Security and Medicare a bit premature? A number of experts say yes, but the issue is complex. Both programs are often portrayed as standing on financially unstable ground. The population of those 65 and older is surging, and it’s raising concerns about whether proceeds from payroll taxes paid by younger workers will be able to keep pace. Financial projections from the Congressional Budget Office show the programs flirting with peril as reserves dwindle in the near future.

But they are just that: projections. To get a little more context on the issue, the Gazette spoke with Louise Sheiner, who received her undergraduate degree from Harvard in ’82 and a Ph.D. in economics in ’93. She’s also a senior fellow and policy director for the Hutchins Center on Fiscal and Monetary Policy at the Brookings Institution. This interview has been edited for length and clarity.

Q&A

Louise Sheiner

GAZETTE: There are a lot of people out there talking about the unsustainability of Social Security. What are we seeing right now that leads them to that conclusion?

SHEINER: The Social Security Administration and the Congressional Budget Office do projections of both sides of the Social Security balance, which is 1) what money is coming in, and 2) what money is going out. The money that comes in mostly comes from payroll taxes. The money coming out is set by a formula based on how many people are eligible and what their wages were, among other things. So the fundamental driver of the issues we’re seeing in the projections is population aging. What’s happening is that workers — the ones paying the taxes — are a generation younger than the beneficiaries. Because the Baby Boomers are a big generation, followed by smaller generations, it means that for any given payroll tax, there’s not enough revenue to pay the benefits. This gets the system into financial difficulty. It’s not coming from the fact that Social Security benefits have gotten really generous. It’s really a structural change in the economy that makes it difficult to sustain. Now, there is something called the Trust Fund, which creates some cushion. But that’s what’s expected to be depleted, based on current projections, after 2034.

GAZETTE: What happens then?

SHEINER: Does it mean that Social Security goes belly-up? No. It’s actually not clear what happens. There are two laws that are in conflict with each other. One law is that you get your Social Security benefits based on your top 35 years of earnings. But then the other law says if the money is not available, it can’t be paid out. So what happens? Let’s say the amount coming in is enough to pay 75 percent. Does everybody get 75 percent, or just a few? Nobody really knows. Most people think Congress will do something to address this. But there’s a big question about what to do when you’ve had a structural change in the economy, coming from population aging. Baby Boomers are retiring, and some people are acting like it’s a one-time thing. But so many factors will affect the future: fertility rates, life expectancy, how many kids someone has, how many old to middle to young workers there are. It’s always a projection, but trends are not going in the direction of going back to three kids, right? So we think it’s going to be a permanently older economy.

GAZETTE: How could that be addressed?

SHEINER: There are a number of things we could do: If people live longer, they can work longer; you could cut benefits; or you could raise taxes, which wouldn’t have to be a massive change. And obviously, the Democrats are on the side of raising taxes, and the Republicans are on the side of cutting benefits. Eventually, some combination is likely to result.

GAZETTE: Having worked in this space for a long time, did going through the pandemic change your thinking on this issue?

SHEINER: One of the things that happened at the beginning of the pandemic is that people were worried that [the economic and employment fallout] were going to accelerate the depletion of the Social Security Trust Funds. That didn’t happen. The economy did a lot better than people thought it would. There was a lot of mortality, which, unfortunately, helped shore up Social Security. But people did recognize that we are in a situation now where it’s precarious. The more the Social Security Trust Fund gets withdrawn, the more we’re worried about having to do something that won’t put these benefits at risk. We don’t want to get to a point where we suddenly have to act quickly, and people aren’t sure if they’re going to get their benefits.

GAZETTE: Some people think that programs like Social Security and Medicare should be totally gutted or at least reformed heavily. Does it seem inevitable that this is going to happen?

SHEINER: I don’t think it’s inevitable. It’s not the case for Social Security that spending has grown because of inefficiencies. The social credit benefits are not hugely generous. They’re helpful, but it’s not a case of spending gone wild. The problem is a structural change in the economy. Now, Medicare is a whole different issue, because Medicare is not just a provision of money, but the provision of health services. And we know that we’ve had very rapid growth in health spending for decades in this country. We spend a lot of money relative to other countries on health. Some people would say we should just gut Medicare and go through universal health care and completely revamp the system. But we’re not anywhere close to doing that, and how to get from here to there is really uncertain. I do think there will be reforms to Medicare, as there have been decade after decade after decade. In fact, Medicare spending growth has really been quite moderate in recent decades, to some extent, because of reforms that have happened.

GAZETTE: I recently read an opinion piece by Paul Krugman which suggested that Medicare and Social Security are not as unsustainable as people think. Do you think the projections put a gloomier spin on the situation than necessary?

SHEINER: I think the people who do the projections are trying to be balanced. Things may not be as bad as they predict, but they may be worse, right? I think a hard question is: What do you do when your policy has a lot of uncertainty? And people have different views on that. One approach is you should prepare for the worst-case scenario. Another is, no, let’s not cut benefits just because we think we might be in trouble in the future. I think I’m somewhere in between, which is: There’s a lot of uncertainty, so I would like to protect benefits, especially for lower-income people. I think there’s a lot we can do on the tax side. And figuring out a way to make the health system more efficient would have huge benefits all around. It would help people; it would help the budget; it’s a big deal. That should be a high priority.

GAZETTE: A Brookings article talked about how seniors are actually “the wealthiest age cohort in the world.” How does that affect the need for programs like Social Security?

SHEINER: You could make a decent argument that for higher-income people, they don’t need Social Security, they don’t need Medicare, or they could pay more for it. But one of the things that people have liked about Social Security and Medicare is that they’re universal programs. Everybody has a stake in it. But that’s not an economic argument. It’s a political argument: Do you want to preserve this program that everybody has, or do you want to make it more of a safety-net program?

GAZETTE: What should we be looking to do to shore things up right now as well as in the longer term?

SHEINER: For the long term, at least with Medicare, we need to continue experimenting with different reforms and try to increase the efficiency. That’s something we should be doing regardless of whether or not we had any kind of sustainability issue. If we can save money and make something more efficient, it’s clearly worth it. In terms of now versus later, I think it comes back to politics. Personally, I think we have bigger problems in our country than the sustainability of Social Security and Medicare. I think we can raise taxes for now and worry about the other things a little bit later. I would rather not focus on cutting benefits and raising taxes. I would like to focus on improving equality by investing in kids.

GAZETTE: If I’m someone who’s approaching retirement or thinking about retirement, what are practical steps I could take to set myself up or my family for success?

SHEINER: The best thing you can do is not retire too early. Delaying retirement has very big benefits. You get extra work in and increase your savings; you get bigger Social Security benefits to make up for the fact that you didn’t get it earlier. To the extent you can delay retirement, it really is the best thing that you can do.

GAZETTE: Are there areas of political common ground that give you hope?

SHEINER: Social Security and Medicare are popular programs, which makes me think that we will come around to solutions like raising taxes, shaving benefits a little bit here and there. But we won’t completely gut the programs. We’ll kick the can down the road a little, and I think that’s OK. I think we will eventually make that progress.

The class starts in the dark. One student, swathed in white cloth, reclines against a mirrored wall. She is soon surrounded by a half-circle of peers, while another classmate begins reciting The Lord’s Prayer. Soon after, all hell breaks loose — metaphorically — as the seated student begins writhing and speaking in tongues. The scene, a reinterpretation of one from the 1973 horror film “The Exorcist,” then disbands, and the students regroup, preparing for a seminar-style discussion with a professor from the Divinity School. Another weekly installment of English 90ex, “The Exorcist,” is underway.

New this semester, English 90ex is the brainchild of David Levine, M.A. ’96. The course bridges social commentary, popular culture, psychology, and religion; explores the influence of the 1973 classic; and reflects Levine’s interest in cross-genre studies of theater, performance, video, and photography.

“For the first month, students do presentations on topics that are directly or obliquely related to ‘The Exorcist,’” explained Levine, a professor of the practice of performance in Theater, Dance & Media. Playing on themes raised by the film, which helped make Linda Blair, then 14, a star, those topics have ranged from the performance of dissociative identity disorder to horror and queerness and the Satanic panic of the 1980s. Following these presentations, students apply their newfound knowledge to crafting a theater piece.

Actor, writer, filmmaker, humanitarian, and typewriter enthusiast Tom Hanks will be the principal speaker at Harvard’s 372nd Commencement on May 25.

“A true master of his craft, Tom Hanks has given life to some of the most compelling, beloved, and iconic characters on the screen,” said Harvard President Larry Bacow. “Over five decades, he has entertained, enlightened, and befriended us. He has made us laugh, cry, question, and think. In addition to his brilliance as an actor, Tom has demonstrated both an innate empathy and a deep understanding of the human condition. He has contributed to our national culture and expanded our ability to appreciate stories and histories that have been previously unexamined. I very much look forward to his address in May.”

On March 20, 2003, a U.S.-led military coalition invaded Iraq, toppling the government of Saddam Hussein before a fierce insurgency rose up to oppose Western forces. As the fighting unfolded over eight years, more than a million U.S. service members deployed to the region, and many returned with complex physical and mental wounds no single treatment can erase. To mark the 20th anniversary of the invasion, the Gazette spoke with Ron Hirschberg, an assistant professor of physical medicine and rehabilitation at Harvard Medical School and a traumatic brain injury expert at Massachusetts General Hospital and Spaulding Rehabilitation Hospital. Hirschberg is also senior director of health and wellness for the veterans-focused nonprofit Home Base, where he hosts a podcast about military service and mental health. The interview has been edited for clarity and length.

Q&A

Ron Hirschberg

GAZETTE: Is there still a lot of pain among veterans who served in Iraq and are dealing with traumatic brain injury, post-traumatic stress, depression, and other conditions?

HIRSCHBERG: When the war stops and the coverage of Iraq and Afghanistan stops, the people who served there — whether it’s one deployment or 10, whether they were there 20 years ago or two years ago before Kabul fell — those wounds are not like bones that break and heal in 12 weeks. They can resurface months to years later, and then it’s a matter of dampening the symptoms and providing the right care so that they can live their lives. In fact, we can expect even more need as time passes — as service members try to re-engage with civilian life and those who have difficulty doing it become isolated. Part of what triggers post-traumatic stress and exacerbates these wounds is not feeling connected to a group anymore.

GAZETTE: We’re marking the anniversary of the start of the Iraq War. Is it possible and/or necessary to separate Iraq service from Afghanistan service when talking about these injuries?

HIRSCHBERG: More than 1.8 million Iraq and Afghanistan veterans returned home with a permanent disability, with close to 1 million of these linked to mental health and traumatic brain injuries, not to mention the moral injuries and complicated survivor guilt that present their own unique and complex challenges. When it comes to Afghanistan, there’s a feeling you left with loose ends, and feelings of guilt with no ability to help. Many of our veterans developed strong bonds with families and translators, and many of these people continued to face grave threats after our withdrawal from Kabul.

GAZETTE: You mentioned that these conditions can endure forever. What is the proportion of those who recover?

HIRSCHBERG: Recovery is a process. My job at MGH is to see people with moderate to severe traumatic brain injury. When you see someone come in after a car accident, during day two to day four, they’re getting stabilized. The next week, they start to heal. They will recover for not just days to weeks, but really months to years. In six months to one year, you’re going to see a lot of that recovery. People can heal such that they can live their lives, have good family relationships. They might get back to work, travel, and live functional lives. I would use an analogy of chronic medical conditions like diabetes or cancer in remission. You are not going to fix them, but you can manage people with more diagnostic understanding and treatment.

When we look at Vietnam, at the veterans who are now 50 years post-deployment, we see folks who have had post-traumatic stress and other symptoms rear their head decades out. A classic situation is retirement or going on to the next chapter in life. Then there’s a loss of purpose and maybe isolation that bring on those symptoms. Even watching what’s going on in Ukraine can be a trigger.

GAZETTE: So there are people who may not have suffered initially and are now experiencing symptoms many years later?

HIRSCHBERG: It’s possible that some were treated and did well for many years and then one day they find themselves in trouble. We know that, among all veterans, there are 20 suicides a day, and between 2015 and 2020 there was about a 40 percent increase in suicides among active-duty service members. Thirty thousand veterans have died by suicide in just the Operation Iraqi Freedom and Operation Enduring Freedom conflicts over 20 years. Since 9/11, there have been more than 125,000 deaths by suicide of all-era veterans.

GAZETTE: When we talk about these invisible wounds of war, are they dependent on the specific type of injury or do they depend heavily on factors related to the individual?

HIRSCHBERG: Who you are — your medical history, social factors, psychiatric factors — matters. Then there’s the injury itself and post-injury. Rehab and recovery are very much affected by society and can be affected by belonging or lack of belonging. It’s like a tribe, really, of folks who have not only a sense of belonging but also a real sense of purpose. Part of the management of these invisible wounds is about finding new connections and new purpose.

GAZETTE: Has there been progress in the science of understanding and treating these conditions?

HIRSCHBERG: Home Base has a standard of care at its core, like insulin for diabetes or chemotherapy for cancer. The standard includes prolonged exposure therapy, cognitive processing therapy, and cognitive behavioral therapy. For traumatic brain injury, it’s cognitive rehab therapy and vestibular/physical therapy. Data indicates that these therapies work. But colleagues at Spaulding, Mass General Brigham, and Home Base are looking to improve them, trying to find biomarkers of post-traumatic stress and traumatic brain injury and how they may impact treatment. We’re doing work in psychedelics and have a partnership with MGH’s Center for the Neuroscience of Psychedelics and we’ve done some work in virtual reality for PTS. We are proud of our wellness efforts, getting people together in the kitchen with dietitians and in the gym with strength and conditioning coaches. We also incorporate art therapy and music, which tap into more creative spaces and have been shown to help with stress and depression.

GAZETTE: Why do you do this work?

HIRSCHBERG: I have not served in the military and every day that I’m there, I’m reminded that our job is to take care of the folks who have raised their hand to take care of us. Julian Kitching, a Green Beret, and his brother, an Army Ranger, came through our program. Julian said at the Run to Home Base last year that service members sign up to go to combat to keep us safe. The last thing anyone wants is to go to war, but when you have to, that’s what they’re there to do. The other end of the equation is simple: We take care of them when they’re back.