My Daughter Rachel's Essay: Women’s Role and Representation in the Media By Rachel Raps Second Place Oratorical Speech

Turn on the TV, look at the walls of young teenage girls, or open up a magazine and what do you see? In this day and age, movies, television, advertisements, books, and basically anything else pertaining to the media, is compiled with images of women as either completely and unrealistically idealized or just portrayed in a demeaning and stereotypical matter. For example, think of any low-fat food (e.g. yogurt, salad) commercial you’ve ever seen. More often than not, women are flashed across the screen eating the product being promoted and not men. Why? The answer to that question is simple: That’s what sells.

90% of women in the United States are unhappy with at least one aspect of their physical appearance. Statistics show that over 50% of ads in women’s magazines relate to improving appearance with makeup or dietary products. Seeing someone on TV who is considered to be an “ideal” woman, someone with straight teeth, thin, fit, nice skin, etc., motivates or taunts women who feel as if they are incompetent at assuming the idealistic physical appearance that women sought after to buy the product being promoted. This is causing a serious issue, especially amongst adolescent women. The ratio of women with disordered eating attitudes to men is 5:1. Every year, approximately 1,000 women die due to eating disorders. My main point here is the idealized portrayal of women has become all but routine and is literally killing girls due to the pressure of aspiring to be just like the models and celebrities they’ve been surrounded with since birth, which leads me to my next point.

Now, you may want to ask me, “Who’s to blame for this?” Well, it’s not just one single group of people or one single gender; it’s a mixture of the two. Female celebrities in the current media are objectifying themselves and their bodies. For example, have you seen the music video to the song entitled Anaconda by female rapper Nicki Minaj? If so, you would know that is basically a three-minute video of Minaj in little to no clothing on. This isn’t sending a positive message to young girls about the steps necessary to achieve fame of any kind. Their basic understanding is that they need to take their clothes off to make it anywhere in life. Other celebrities such as Miley Cyrus, Selena Gomez, Rihanna, Lady Gaga etc. prove the same point. Two of the celebrities listed above, Miley Cyrus and Selena Gomez, were previously Disney stars, which make them more accessible to young children, having seen them on television themselves.

Stepping away from body image, I want to talk about another unforeseen aspect of women in the media. Ever since the 1800s, women have been fighting for their rights to perform and participate in the same daily activities as men. In modern society, it is perfectly normal to see a female doctor or lawyer working alongside male colleagues. They achieve the same amount of work, shouldn’t they earn the same salary? Not the case. Every year, studies show shocking statistics in the gap between male and female earnings. In 2012 the median salary for women working year-round, full-time jobs was $37,791. The median salary for men was $49,398. Another example of the gap between women and men’s salaries is shown with celebrities Angelina Jolie and Robert Downey Jr., the two top-paid movie actors/actresses of all time. Robert Downey Jr. earned a mind-boggling $75 million for the role of Iron Man in the super-hero action film Iron Man 3. For the action-thriller film Salt, Angelina Jolie earned $33 million; the average amount earned for male celebrities Denzel Washington and Liam Neeson per movie.

This behavior isn’t only being displayed on the big screen. For another example, women’s representation in the newsroom hasn’t improved since the 90s. In the year 1999, the amount of females editing and writing for the newsroom was 36.9% of the total staff. Today, that statistic has remained essentially stationary at 36.3%. Following this, in the early months of 2013, women were quoted in less than 20% of news articles, making men over 3.4 times more likely to be quoted on the front cover of The New York Times than women.

These statistics are shocking, if not flat out startling. This goes to show that women indeed are being portrayed unfairly and unequally. Hopefully, in the near future, these numbers will level out, and the unrealistic portrayals of women will be changed to a more sensible and attainable image. I encourage you to resist these representations and instead address the ongoing issue that is weakening the self-esteem of women and girls all over the world.

Rachel Raps
11/19/14
English 8BOratorical Speech

A COMMUNE WITH NATURE By Arlyn Valencia, M.D.

The diagonally-directed rain started hard
The tumultuous ocean was fighting the rain back.
Did I just perceive it as a fight,
Or it's just their way of relating with might?

The wind, albeit strong and erratic,
Served as the conduit for the dense scent of the tropics.
And A-Ha, I was alone,
Was it only me getting the sea's invitation ?

And how could I really refuse,
This invite of nature that I might soon lose?
I ran on the now alive warm sand,
And soon enough I reached the ocean...

Oh, I swam as near as the ocean floor,
Then I rose up above and perceived a big open door...
A door between my very soul,
And the generous nature but most of all:

A DOOR BETWEEN MYSELF AND ME...
I REALIZED  I JUST HAVE TO LET ME BE.      

MY TAKE ON THE DOCTOR SHOW PHENOMENON: An Open Letter by Arlyn Valencia, M.D.

I enjoyed the article " An Injection Of Hard Science Boosts TV Shows' Prognosis" although I think ER is not believable as far as the physician's general attitude and behavior are concerned. (I will not even comment on the inferior doctor shows. ) Now, there may be rare physicians, medical professionals and paramedical personnel who have that kind of a make-up, and this may be obvious in certain situations. But not all situations. If that kind of drama is what prevails in emergency rooms (ER's) and wards, then patients' care and prognosis will definitely be compromised.

Don't get me wrong. I value Michael Crichton's works or whatever work he may be involved in. Read all his books, admired his honesty, adored his wit, "sided" with his no-side, agenda-less take on the global warming issue. In this e-mail, I would just like to blurt out my humble opinion on the doctor show phenomenon.

As far as medical facts are concerned, I salute the consultants/researchers with coming up with the most esoteric, zebras of a diagnosis that even clinical experts would have a hard time blurting them out just like that. Although there may be the "ideal" ER's/wards manned by clinicians who are also academicians, rarely, would there be such a situation like that. This is more apparent in the series House, which I just happened to watch last night. Not only is this attending and residents not neurologists, rheumatologists, neuroradiologists,or endocrinologists (I still don't know what medical specialties they practice, or maybe I missed a very important episode when they revealed what they are, especially House), but the way they talk, argue, manage patients, and even perform the procedures they do, made me conclude they're specialists (and even subspecialists in some fields) in all the above mentioned disciplines. And all these in a community hospital setting.

This overlooked yet to-your-face aberration, may be due to the fact that a significant number of the show's consultants are researchers and "technically- minded" , and the necessary input from a long-time, experienced clinician is lacking. Or it may have been that if too much of a real clinician's input is considered, the over-all effect might be that the show would lack appeal and drama. If it would help soften the above comment, Dr. House's effect on me is, and I know the majority of the House-watching populace would agree: I, myself, wouldn't mind being assessed (but maybe not admitted) by the Dr.House. He reminds me so much of the brilliant Sherlock Holmes.

Don't get me wrong; House is the only doctor show I really enjoy. But the episode I saw last night made me cringe. Not just because of the blurting of a mouthful of diagnoses that are "interconnected" but also concluding that there may already be a complication (vasculitic) that is confounding the over-all problematic picture. These only from plain deduction.

There's one aspect that I cherish, though, not just in that episode I recently watched but in almost all of House's episodes, and that is at the end it makes it all clear that the physicians' virtues of "looking" at the patient, at the entire picture and addressing every aspect of patient care are the real "stars" of the show.

Sincerely,

Arlyn M. Valencia, M.D.

SAVING THE BRAIN DURING A STROKE By Arlyn Valencia, M.D.

When Joe woke up that chilly night, he knew something was terribly wrong. He tried to stand up but instead, he suddenly slid to the floor as if his right body pulled him down. That’s when he realized the right side of his body had gone “dead” on him. He tried to verbalize, orient himself to his surroundings. He concluded his mind was still working. He tried “shaking off” the problem on his right side but it would not go away. “Maybe”, he sighed, “I’ll sleep it off. It should be OK by tomorrow.”

Joe just had a stroke which affected solely the motor pathway in his left brain. He got lucky that the speech center, which is also on the left side (on right-handed individuals) was spared, thus, his ability to talk and comprehend remained intact.

Stroke is a too-familiar word for everyone. It is unfortunate, however, that the majority of Americans do not know the symptoms of stroke or those who knew do not know the significance of early medical evaluation and intervention.

Stroke affects 750,000 Americans each year. It is the fourth leading cause of death and the leading cause of serious long-term disability. The cost of care for stroke victims approximates $43 billion a year and a significant proportion of this is spent on long-term rehabilitation and nursing home care.

A stroke occurs when the blood flow to a part of the brain is impeded due to sudden blockage of an artery supplying that area of the brain. The needed glucose and oxygen will not reach that particular brain tissue which eventually will suffer and die if the blood flow is not immediately restored. The result will be loss of function of the part of the body which that part of the brain controls. This is called ischemic stroke.

Another cause of stroke is sudden bleeding into the brain substance when a weakened wall of an artery ruptures. This is called a hemorrhagic stroke.

Stroke is also called “brain attack” to connote the necessity of seeking immediate medical attention, that is as soon as the symptoms occur. However, compared to heart attack in which the symptom seems universal (chest pain), a stroke can have different manifestations, depending on what part of the brain is ailing or dying. For example, if the verbal speech area on the dominant side of the brain (which is left on right-handed individuals) loses blood supply causing death to the brain cells, the patient will suddenly lose the ability to talk .

Some of the more common warning signs of stroke are: sudden weakness or numbness of the face, arm and leg on one side of the body, sudden blurring of vision or blindness in one or both eyes, sudden incoordination, trouble walking, dizziness, sudden confusion, trouble speaking or understanding or sudden severe headache with no known cause. Of course there are other less obvious signs of stroke like sudden-onset double vision, difficulty with swallowing, nausea and vomiting. These latter signs are more commonly seen in brainstem strokes.

There is a nationwide campaign to improve stroke awareness. Every stroke must be treated as a life-threatening emergency. The available stroke treatment modalities can only be administered if the patient is brought for evaluation and treatment within four and a half  hours of stroke onset for the intravenous clot-buster (tissue plasminogen activator, tPA) and within six hours of stroke onset for the intra-arterial clot-buster. At comprehensive stroke centers, a procedure called thrombectomy/clot retrieval can be done or the stenosed artery can be stented to restore blood flow.  Recent data, however, have to be taken into account that these invasive procedure may not have statistically significant benefits compared to intravenous (IV) clot buster alone, during acute management, AND aggressive medical management later, towards stroke prevention.

Not all stroke patients are candidates for these treatments. It is very important that the emergency room (ER) physician and the neurologist adhere to the protocol and weigh the risk versus benefit. If given appropriately to eligible patients, the treatment can decrease or even reverse the neurologic deficits that the patient had at the onset.

Better understanding of the causes of stroke and the changes that happen in the brain before, during and after stroke has led to better over-all patient management. Even if the patient is not a candidate for the clot-buster therapy, emergent medical intervention can easily be started that may protect or save the ailing brain. It may be as simple as maintaining a good diastolic blood pressure, controlling fever, treating concomitant infections as soon as recognized (the latter is considered a risk factor for stroke), normalizing the blood sugar, improving oxygenation especially on those with pre-existing lung conditions. These measures may help “protect the ailing brain cells”. If these cells are not rescued, they will eventually die resulting in increased-neurologic deficits, thereby, increased disability.

Control of other risk factors should also be started acutely, such as treatment for high cholesterol, diabetes and homocysteinemia. Cessation of smoking, controlling other risk factors and compliance to stroke prevention treatment (taking the appropriate antiplatelet medications and blood thinners), can not be overemphasized. Healthy lifestyle, and consumption of food rich in antioxidants have a role in stroke prevention.

Young people who suffered from a stroke should be worked up for clotting disorders (hypercoagulable state), congenital or acquired heart problems or connective tissue disorders as well as blood vessel inflammation (vasculitis). Drug abuse especially methamphetamine and cocaine, especially the alkaloidal form (crack) CAN cause strokes. Another important cause of stroke for young people is dissection of the arteries supplying the brain either from trauma or from an inborn defect of the wall of the arteries. 

Each stroke patient is different. Joe, the patient I mentioned earlier, is my father. He improved dramatically. It could be that the ailing part of the brain got rescued by blood supply from other territories.

Our brain, although gifted with the power to autoregulate its own blood flow, can be chronically challenged by several medical insults like hypertension, diabetes, heart disease, cigarette smoking. This power of the brain can get exhausted. We still have time to correct such things before our brain gives up on us.

Take care of our brain. Control the risk factors, help in disseminating information to improve awareness. And at the first sign of stroke, seek immediate medical attention (call 911). The faster we act the better chance we have of saving or protecting the brain from the effects of stroke.

UPDATE: My father passed away. He initially survived a massive cerebral hemorrhage , then after recovering some functions, succumbed to rupture of aortic aneurysm.

Arlyn M. Valencia, M.D. is  Neurologist,  Stroke Subspecialist.  She is a Diplomate of the American Board of Psychiatry and Neurology,  a Fellowship-trained Stroke Neurologist.