text:
Oncogenic activation of the Raf/MEK/ERK pathway
Effects of MAPK pathway activation on Bcl-2 family members
Enhancing the effects of upregulated Bim
Questions and future perspectives
Commentary Free access | 10.1172/JCI37553
Anticancer therapy: boosting the bang of Bim
Andrea Wahner Hendrickson, Xue Wei Meng, and Scott H. Kaufmann
Department of Oncology and Department of Molecular Pharmacology, Mayo Clinic, Rochester, Minnesota, USA.
Address correspondence to: Scott H. Kaufmann, Division of Oncology Research, Guggenheim 1342C, Mayo Clinic, 200 First St. SW, Rochester, Minnesota 55905, USA. Phone: (507) 284-8950; Fax: (507) 284-3906; E-mail: kaufmann.scott@mayo.edu.
Andrea Wahner Hendrickson and Xue Wei Meng contributed equally to this work.
Find articles by Hendrickson, A. in: JCI | PubMed | Google Scholar
Find articles by Meng, X. in: JCI | PubMed | Google Scholar
Find articles by Kaufmann, S. in: JCI | PubMed | Google Scholar
First published October 23, 2008 - More info
Published in Volume 118, Issue 11 on November 3, 2008
First published October 23, 2008 - Version history
Treatment of B-RAF mutant human tumor cells with a MEK inhibitor requires Bim and is enhanced by a BH3 mimetic
Mark S. Cragg, … , Andreas Strasser, Clare L. Scott
B-RAF is frequently mutated in solid tumors, resulting in activation of the MEK/ERK signaling pathway and ultimately tumor cell growth and survival. MEK inhibition in these cells results in cell cycle arrest and cytostasis. Here, we have shown that MEK inhibition also triggers limited apoptosis of human tumor cell lines with B-RAF mutations and that this effect was dependent on upregulation and dephosphorylation of the proapoptotic, Bcl-2 homology 3–only (BH3-only) Bcl-2 family member Bim. However, upregulation of Bim was insufficient for extensive apoptosis and was countered by overexpression of Bcl-2. To overcome apoptotic resistance, we treated the B-RAF mutant cells both with MEK inhibitors and with the BH3 mimetic ABT-737, resulting in profound synergism and extensive tumor cell death. This treatment was successful because of both efficient antagonism of the prosurvival Bcl-2 family member Mcl-1 by Bim and inhibition of Bcl-2 and Bcl-xL by ABT-737. Critically, addition of ABT-737 converted the predominantly cytostatic effect of MEK inhibition to a cytotoxic effect, causing long-term tumor regression in mice xenografted with human tumor cell lines. Thus, the therapeutic efficacy of MEK inhibition requires concurrent unleashing of apoptosis by a BH3 mimetic and represents a potent combination treatment for tumors harboring B-RAF mutations.
Mark S. Cragg, Elisa S. Jansen, Michele Cook, Claire Harris, Andreas Strasser, Clare L. Scott
Even though activating mutations of B-Raf, a kinase atop the MAPK signaling cascade, reportedly sensitize tumor cells to MEK inhibitors, Raf and MEK inhibitors have exhibited limited clinical activity. In this issue of the JCI, Cragg et al. report that MEK inhibition upregulates the proapoptotic Bcl-2 family member Bim but induces little regression of human melanoma xenografts in mice unless the Bcl-2 antagonist ABT-737 is added (see the related article beginning on page 3651). These findings illustrate the potential benefit of simultaneously inhibiting oncogenic kinases and inhibiting Bcl-2 action in solid tumors.
Over the past decade, an increasingly detailed understanding of the molecular pathogenesis of cancer has led to identification of a variety of new targets for anticancer drugs. Two of the best-studied signaling pathways that are activated by oncogenic kinase mutations are the MAPK pathway and the PI3K/Akt pathway (Figure 1). According to current understanding, the former pathway involves signaling from a variety of receptor tyrosine kinases through adaptor molecules that activate the small GTPase Ras. Upon activation, Ras binds and activates members of the Raf serine/threonine protein kinase family, thereby triggering sequential phosphorylation and activation of the MEK kinases and their downstream targets ERK1 and ERK2. Upon activation, ERK1 and ERK2 phosphorylate a number of cytoplasmic and nuclear substrates involved in cell survival and proliferation. In the nucleus, ERK-mediated phosphorylation of c-myc, ELK1, and other transcription factors leads to increased expression of genes involved in cell cycle progression (1). In the cytoplasm, ERK-induced phosphorylation of Bcl-2 family members has been reported to inhibit apoptosis, as described below.
Overview of signaling pathways affected by MEK inhibitor/ABT-737 combination therapy. In healthy cells, mitogenic growth factors signaling through the MAPK pathway trigger sequential phosphorylation and activation of MEK and ERK kinases, which in turn leads to stabilization of Mcl-1, activation of Bcl-2, and degradation of Bim, thereby promoting cell survival. In tumors with B-RAF mutations, B-Raf causes pathway activation independent of upstream signaling by either directly activating MEK1/2 or activating c-Raf, depending on the B-Raf variant present. In this issue of the JCI, Cragg et al. show that MEK inhibitors such as U0126, PD098059, and PD325901 upregulate Bim but do not induce regressions of tumors harboring B-RAF mutations (17). The authors also propose that Bcl-2 and Bcl-xL neutralize the increased Bim, thereby diminishing the potential apoptotic effect of the MEK inhibitors. Consistent with this model, the authors show that addition of the Bcl-2/Bcl-xL antagonist ABT-737 enhances the apoptotic effect of MEK inhibition. When Bcl-2 and Bcl-xL are antagonized, the upregulated Bim binds to Mcl-1, causing it to release Bak and/or Bax, leading to cytochrome c release and subsequent apoptosis. Because tumors with B-RAF mutations are dependent on the MAPK pathway rather than the Akt pathway for survival, combining a MEK inhibitor and a Bcl-2/Bcl-xL antagonist appears to be a promising strategy for treating these tumors. c-FLIP, cellular FLICE (caspase 8) inhibitory protein; Grb, growth factor receptor–bound protein 2; GSK, glycogen synthase kinase; mTOR, mammalian target of rapamycin; PDK1, phosphoinositide-dependent kinase 1; PH, pleckstrin homology domain; PIP2, phosphoinositol-4,5-bisphosphate; PIP3, phosphoinositol-3,4,5-trisphosphate; PTEN, phosphatase and tensin homolog; SOS, son of sevenless; XIAP, X-linked inhibitor of apoptosis protein.
In addition to the MAPK pathway, receptor tyrosine kinases and Ras activate PI3K, which generates the lipid second messenger phosphatidylinositol-3,4,5-trisphospate (PIP3), again setting into motion a protein kinase signaling cascade. PIP3 activates the serine/threonine kinase phosphoinositide-dependent kinase 1, which catalyzes the activating phosphorylation of Akt. Akt in turn phosphorylates a number of proteins (e.g., the cyclin-dependent kinase inhibitor p27Kip1) that regulate cell cycle progression as well as transcription factors (e.g., NF-κB, Foxo3a) and other molecules that limit susceptibility of cells to apoptosis.
Studies performed over the past decade have revealed many ways in which one or both of these pathways are activated in tumors. Signaling is initiated not only by mutations that lock Ras in its GTP-bound (i.e., activated) state, but also by mutations of receptor tyrosine kinases such as EGFR and the EGFR family member HER2/Neu. Particularly pertinent to the present discussion are the more recently described activating mutations of B-RAF, which occur in almost 70% of melanomas, 30% of thyroid cancers, 15% of ovarian cancers, and 10% of colorectal cancers (2, 3). Whereas activating mutations of EGFR confer hypersensitivity to EGFR tyrosine kinase inhibitors such as gefitinib (4), B-RAF mutations have been reported to uniquely confer sensitivity to MEK inhibitors (5). Despite these observations, clinical studies of MEK and Raf inhibitors have yielded relatively disappointing results, even in patients with mutations that activate the MAPK pathway (3, 6, 7). While it is clearly possible for MEK inhibitors to inhibit growth of xenografts with activating B-RAF mutations (5), tumor regressions have been the exception rather than the rule in preclinical models and in the clinical setting, raising concern that some other pathway also needs to be modulated in order to facilitate tumor shrinkage.
In addition to enhancing cell proliferation, the MAPK pathway also regulates the mitochondrial pathway of apoptosis, a pathway in which the oncoprotein Bcl-2 and related proteins play a prominent role (8–10). Based on structural and functional criteria, members of this protein family can be subdivided into 3 classes. The first class, which contains Bcl-2, Bcl-xL, Mcl-1, Bcl-w, and A1, inhibits apoptosis by binding to proapoptotic Bcl-2 family members. The second class includes Bax and Bak, which are involved in releasing proapoptotic proteins from mitochondria, possibly by forming pores in the outer mitochondrial membrane. The third class, called Bcl-2 homology 3–only (BH3-only) proteins, includes Bim, Bad, Puma, Noxa, Bmf, and several other family members, all of which contain a 9– to 15–amino acid BH3 domain that is thought to be important in binding and neutralizing antiapoptotic Bcl-2 family members.
The BH3-only proteins appear to serve as molecular stress sensors within cells (9). Two of the family members, Noxa and Puma, are transcriptionally upregulated in response to DNA damage and other stimuli. Other family members such as Bim are constitutively expressed but sequestered by binding to polypeptides in various cellular compartments. In response to various stresses (e.g., cytoskeletal disruption or loss of growth signals), specific BH3-only proteins are released and activated. At least 2 models have been proposed to explain the subsequent induction of apoptosis (8–10). One model focuses on the purported ability of some of these polypeptides to directly activate Bax and Bak, thereby causing release of cytochrome c from mitochondria (10). The other focuses exclusively on the ability of all of these family members to bind and inactivate antiapoptotic Bcl-2 molecules (8).
The activities of Bcl-2 family members are regulated, in part, by posttranslational modifications. Antiapoptotic kinases, for example, catalyze activating phosphorylations of Bcl-2 (11, 12) and Mcl-1 (13, 14) as well as inactivating phosphorylations of Bad and Bim (15, 16). While some of these phosphorylations are mediated through the Akt pathway, others clearly involve ERK1/2 or their immediate downstream target p90 ribosomal S6 kinase.
Building on previous reports showing that ERK-mediated Bim phosphorylation leads to proteasome-mediated Bim degradation (15, 16), Cragg et al. report in the current issue of the JCI that MEK inhibition leads to Bim upregulation in a variety of B-RAF mutant human melanoma and colon cancer cell lines (17). Interestingly, however, the MEK inhibitors induce modest apoptosis in vitro and exhibit little antitumor effect on melanoma xenografts in mice in vivo. Results of further experiments suggest that the upregulated Bim is bound and presumably neutralized by Bcl-2 and Bcl-xL (Figure 1). Consistent with this interpretation, Cragg et al. show that the BH3 mimetic ABT-737, which binds to and inhibits Bcl-2 and Bcl-xL, increases MEK inhibitor–induced apoptosis in vitro and slows tumor growth — sometimes dramatically — in vivo.
The present study by Cragg et al. (17) represents an elegant step forward in translating current understanding of apoptotic pathways into potentially improved therapies. Nonetheless, important questions remain. The mechanistic basis for the apparent synergy of MEK inhibitors and a BH3 mimetic remains incompletely understood. While the results reported by Cragg et al. show that Bim shRNA protects cells from MEK inhibitor–induced death at early time points (17), Bim shRNA is much less protective with extended treatment. These observations raise the possibility that a second cytotoxic mechanism might be triggered during prolonged MEK inhibition. Earlier observations that the Raf/MEK/ERK pathway regulates stability of the antiapoptotic protein Mcl-1 (14, 18), as well as antiapoptotic activity of Bcl-2 itself (11, 12), raise the possibility that Mcl-1 downregulation and/or Bcl-2 dephosphorylation might also contribute to the cytotoxic effects of MEK inhibition. A possible contribution from interruption of ERK-mediated phosphorylation of other Bcl-2 family members also remains to be investigated. Finally, the effects of these agents on normal cells require further study. Although it is convenient to invoke the idea that selectivity comes from the phenomenon of oncogene addiction (19), i.e., the dependence of a cancer cell on one overactive gene or pathway for its survival and growth, the apoptosis resulting from drug-induced Bim upregulation combined with Bcl-2 inhibition described by Cragg et al. might be predicted to cause substantial toxicity in normal cells as well.
Compared with certain other attempts to alter Bcl-2 family members for therapeutic benefit (20), the effects of combined MEK inhibitor/BH3 mimetic therapy appear particularly promising. However, the ability to translate these findings into the clinic will depend on the toxicities encountered. The dose-limiting toxicities of MEK inhibition appear to be rash and hypoxia (1), but the dose-limiting toxicities of BH3 mimetics in humans have not yet been reported. Although the toxicities of this therapeutic combination in mice were reportedly tolerable in the current study (17), it remains to be seen whether these classes of agents can be combined at therapeutic doses and without toxic side effects in the clinic.
In view of the potential benefit of simultaneously inhibiting the MAPK pathway and antagonizing Bcl-2 in tumors with B-RAF mutations, it is reasonable to ask whether this approach will also work in tumors driven by other oncogenic kinases. Additional studies from the same research group indicate that the BCR/ABL kinase inhibitor imatinib and the EGFR tyrosine kinase inhibitor gefitinib also induce apoptosis, at least in part, through Bim upregulation (ref. 17 and references therein). Because BCR/ABL and EGFR activate signaling through the Akt pathway as well as the MAPK pathway (Figure 1), it is slightly surprising that Bim upregulation is the only prominent change in Bcl-2 family members observed with MEK, BCR/ABL, and EGFR inhibitors. In all cases, however, ABT-737 enhances the effect of the kinase inhibitor. Accordingly, one wonders whether the MEK inhibitor/BH3 mimetic therapy would also be active in other tumors that exhibit MAPK activation in the absence of B-RAF mutations.
Finally, while there is some evidence that MEK might represent a better target than Raf (3), the Raf inhibitor sorafenib is in fact approved for certain therapeutic indications, raising the question of what would happen if tumors harboring B-RAF mutations were treated with ABT-737 plus sorafenib rather than experimental MEK inhibitors. Answers to all of these questions are awaited with interest.
We thank members of the Kaufmann laboratory for stimulating discussions and Deb Strauss for editorial assistance. Work in the authors' laboratory is supported in part by NIH grant R01 CA69008.
Nonstandard abbreviations used: BH3, Bcl-2 homology 3.
Reference information: J. Clin. Invest.118:3582–3584 (2008). doi:10.1172/JCI37553.
See the related article at Treatment of B-RAF mutant human tumor cells with a MEK inhibitor requires Bim and is enhanced by a BH3 mimetic.
Wang, J.Y., Wilcoxen, K.M., Nomoto, K., Wu, S. 2007. Recent advances of MEK inhibitors and their clinical progress. Curr. Top. Med. Chem. 7:1364-1378.
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I am trying to insert a repeatable jpeg as a background image for the left sidebar. How can I insert it? Would it help to convert to another format?
Thnx. I have tried it but can't seem to get it to work. I am assuming this goes into the style.css under left sidebar. I am running WAMP to work on it off line. Could this be part of the issue or I am in the wrong ballpark?


By admin in Writing Authentic African-American Characters on April 18, 2017 .
The Sapphire is one of the most enduring black stereotypes in literature, film and television. A black woman with a strong will and a strong back. She always speaks the truth – especially to the white people. She gets laughs and inspires courage. Yet her humor masks her truth telling. We love her because she is strong, courageous even, while being heartwarming. Today we see her as an equal (which is a good thing,).
So, what's wrong with this trope and how can we fix it?
Here are the top four things wrong with the Sapphire trope and the two things we, as writers, can do to fix it.
1.) The Sapphire loves the white family – a little too much.
She cooks amazing meals, is there early and stays late & helps raise the little white children. The sapphire is more than a maid or housekeeper, she is a surrogate mother – and that is the problem.
She does everything for the white children. Literally everything. Doesn't this woman have a family of her own? What about h er kids? What about her husband & family? Yet she is always there for her white employers. Yes, it's her hard work and nurturing that gives her the moral authority to teach wisdom to the children and her employers. However, what is her status?
The Sapphire is in some kind of limbo where the white children are concerned. Her authority comes from her white employer and not because of her own moral authority or relationships with the child.
Her authority of Scout is only because Atticus takes her side, as the white male and head of the household. The Sapphire is in a kind of limbo because she's doing the job of a mother – without the job title.
2.) The Sapphire emasculates the black man.
Her strength, whether its moral, physical or emotional, is unquestioned. She speaks truth to power. She is a courageous woman. However, in order for the Sapphire character to shine, she has to knock some sense into somebody. In shows like Nell Carter's Gimme a Break, it was always the white kids who got the lessons about life from the sassy housekeeper. In shows like Good Times, it was Florida's own children who got the brunt of it.
The character of JJ Evans on Good Times was a clown of the highest order. While later seasons showed him taking his art more seriously, becoming more of a productive citizen, the character could easily be confused with a minstrel show performing jive artists. While the rest of the family struggles, JJ was shiftless, sexually obsessed, lazy and a potential con artist. He always had a plan or a scheme that his mother, Florida Evans (or his father, to be fair,) had to stop.
In many ways, you can't have a Sapphire without emasculating a black man around him. Go back and watch Mammy and Pork from Gone with the Wind. They don't have many scenes together, but it's clear who's in charge.
3.) The Sapphire is a neutered woman.
The Sapphire's strength is unparalleled. She is virtuous and is the soft spot everyone can lean on. All great story telling. Except, who does the Sapphire lean on? Who's shoulder does she cry on?
In addition, is the Sapphire heterosexual? Is she a lesbian? We don't know. Where is her husband? Her wife? Her par amour? Her lover?
Because her presentation to us, as reader, usually involved her being older, with copious amounts of fat on her, she is never presented as an object of sexual desire. Her romantic desires are never discussed.
And, while there are people who show no desire to form romantic relationships out there, the Sapphire is continuously portrayed as strong enough not to need a man – or anybody.
The Sapphire is righteousness personified. She has no time for foolishness or crap while she tells it like it is. While she speaks the truth her emotions range from irritated to full blown rage. From Hattie McDaniel's Mammy in Gone with the Wind, to Nell Carter's Nellie in Gimmie a Break, this woman is angry.
A good example of this is Oprah Winfrey's character Sofia in the Color Purple. She is all rage and indignation and truth telling. Oprah gives a beautiful monologue about her abuse growing up to Whoopie Goldberg's character Celie. It is a moving and heart wrenching scene. To Spielberg's credit, he pushes Sofia to her natural conclusion and has her curse a white woman and slug a white man, which gets her sent to prison.
How do we avoid these stereotypes? How do we fix them?
As I have said at conferences before, fixing the stereotypes of black characters involves one major step: show agency.
No one will have a problem with this decision because it's human.
Show the Sapphire as an object of desire. Have her talk about her lover, or husband or wife.
Let an older Sapphire have an opportunity to wax poetic about her lovers when she was younger. Let her brag about her figure and bust.
Let her break down and cry. Have her lean on her friends and get a hug. Allow people wait on her. Show her being vulnerable. Show her laughing, good naturedly. Let her have a passionate kiss.
Here is the incomparable Esther Rolle in Good Times showing a strong black woman being vulnerable.


text:
LESSWRONG
"Giftedness" and Genius, Crucial Differences
byArthurLidia6mo28th Jan 2019No comments
Other Personality Correlates
Characteristics of Genius: Some Conclusions
Educational Implications
This essay by Arthur Jensen is from an old book .
The genius has limits. A simple answer, and undoubtedly true. But my
assignment here is to reflect on the much more complex difference
between intellectual giftedness and genius, using the latter term in its
original sense, as socially recognized, outstandingly creative achievement. In
this think-piece (which is just that, rather than a comprehensive review of the
literature), I will focus on factors, many intriguing in and of themselves, that
are characteristic of genius. My primary thesis is that the emergence of genius is
best described using a multiplicative model.
I will argue that exceptional achievement is a multiplicative function of a
number of different traits, each of which is normally distributed, but which in
combination are so synergistic as to skew the resulting distribution of achieve
ment. An extremely extended upper tail is thus produced, and it is within this
tail that genius can be found. An interesting two-part question then arises: how
many different traits are involved in producing extraordinary achievement, and
what are they? The musings that follow provide some conjectures that can be
drawn on to answer this critical question.
As a subject for scientific study, the topic of genius, although immensely
fascinating, is about as far from ideal as any phenom enon one can find. The
literature on real genius can claim little besides biographical anecdotes and
speculation, with this chapter contributing only more of the same. Whether the
study of genius will ever evolve from a literary art form into a systematic science
is itself highly speculative. The most promising efforts in this direction are
those by Simonton (198 8 ) and Eysenck (1 9 9 5 ), with Eysenck's monograph
leaving little of potential scientific value that can be added to the subject at
present, pending new empirical evidence.
Earlier I stated that genius has limits. But its upper limit, at least in some fields,
seems to be astronomically higher than its lower limit. Moreover, the upper
lim it of genius cannot be described as characterized by precocity, high intel
ligence, knowledge and problem -solving skills being learned with speed and
ease, outstanding academic achievement, honors and awards, or even intellec
tual productivity. Although such attributes are commonly found at all levels of
genius, they are not discriminating in the realm of genius.
My point is perhaps most clearly illustrated by the contrast between two
famous mathematicians who became closely associated with one another as
"teacher" and "student." T he reason for the quotation marks here will soon be
obvious, because the teacher later claimed that he learned more from the
student than the student had learned from him . G. H. Hardy was England's
leading mathematician, a professor at Cambridge University, a Fellow of the
Royal Society, and the recipient of an honorary degree from Harvard. Rem ark
ably precocious in early childhood, especially in m athem atics, he became an exceptionally brilliant student, winning a scholarship after another acknowledged the star graduate in mathematics at Cambridge, where he remained to become a professor of m athem atics. He also became a world-class
mathematician. His longtime friend C. R Snow relates that Hardy, at the peak
of his career, ranked himself fifth among the most important mathematicians
of his day, and it should be pointed out that Hardy's colleagues regarded him as
an overly modest man (Snow, 1967). If the Study of Mathematically Precocious
Youth (SMPY) had been in existence when Hardy was a schoolboy, he would
have been a most prized and promising student in the program.
One day Hardy received a strange-looking letter from Madras, India. It
was full of mathematical formulations written in a quite unconventional—one
might even say bizarre—form . The writer seemed almost mathematically illiter
by Cambridge standards. It was signed "Srinivasa Ramanujan." At first
glance, Hardy thought it might even be some kind of fraud. Puzzling over this
letter with its abstruse formulations, he surmised it was written either by some
trickster or by someone sincere but poorly educated in m athem atics. Hardy
sought the opinion of his most highly esteemed colleague, J. E. Littlewood, the
other famous mathematician at Cambridge. After the two of them had spent
several hours studying the strange letter, they finally realized, with excitement
and absolute certainty, that they had "discovered" a major mathematical ge
nius. The weird-looking formulas, it turned out, revealed profound m athe
matical insights of a kind that are never created by ordinarily gifted mathematics.
Hardy regarded this "discovery" as the single most important event in his
life. Here was the prospect of fulfilling what, until then, had been for him only
an improbable dream: of ever knowing in person a mathematician possibly of
Gauss's caliber.
A colleague in Hardy's department then traveled to India and persuaded
Ramanujan to go to Cambridge, with all his expenses and a salary paid by the
university. When the youth arrived from India, it was evident that, by ordinary
standards, his educational background was meager and his almost entirely self
taught knowledge of math was full of gaps. He had not been at all successful in
school, from which he had flunked out twice, and was never graduated. To say,
however, that he was obsessed by m athem atics is an understatement. As a boy in
Madras, he was too poor to buy paper on which to work out his math prob
lems. He did his prodigious mathematical work on a slate, copying his final
results with red ink on old, discarded newspapers.
While in high school, he thought he had made a stunning mathematical
discovery, but he later learned, to his great dismay, that his discovery had
already been made 150 years earlier by the great mathematician Euler. R am anu
jan felt extraordinary shame for having "discovered" something that was not
original, never considering that only a real genius could have created or even re
created that discovery.
At Cambridge, Ramanujan was not required to take courses or exams.
That would have been almost an insult and a sure waste of time. He learned some essential things from Hardy, but what excited Hardy the most had nothing to do with Ramanujan's great facility in learning the most advanced concepts and technical skills of mathematical analysis. Hardy himself had that kind of facility. What so impressed him was Ramanujan's
uncanny mathematical intuition and capacity for inventing incredibly original and profound theorems. That, of course, is what real mathematical genius is all about. Facility in resolving textbook problem s and in passing difficult tests is utterly trivial when
discussing genius. Although working out the proof of a theorem, unlike discovering a theorem , may take immense technical skill and assiduous effort, it is
not itself a hallmark of genius. Indeed, Ramanujan seldom bothered to prove
his own theorem s; proof was a technical feat that could be left to lesser geniuses.
Moreover, in some cases, because of his spotty mathematical education, he
probably would have been unable to produce a formal proof even if he had
wanted to. But a great many important theorems were generated in his ob
passively active brain. Often he seemed to be in another world. One might say
that the difference between Ram anujan creating a theorem and a professional
mathematician solving a complex problem with standard techniques of analysis
is like the difference between St. Francis in ecstasy and a sleepy vicar reciting the
morning order of prayer.
After his experience with Ramanujan, Hardy told Snow that if the word
genius meant anything, he (Hardy) was not really a genius at all (Snow, 1967, p.
27). Hardy had his own hundred-point rating scale of his estimates of the
"natural ability" of eminent mathematicians. Though regarding himself at the
tim e as one of the world's five best pure mathematicians, he gave himself a
rating of only 25. The greatest mathematician of that period, David Hilbert,
was rated 80. But Hardy rated Ramanujan 100, the same rating as he gave Carl
Friedrich Gauss, who is generally considered the greatest mathematical genius
the world has known. On the importance of their total contributions to mathematics, however, Hardy rated himself 35, Ramanujan 85, and Gauss 100. By this
reckoning Hardy was seemingly an overachiever and Ramanujan an under
achiever. Yet one must keep in mind that Ramanujan died at age thirty, Hardy at
seventy, and Gauss at seventy-eight.
of course, all geniuses are by definition extrem e overachievers, in the
statistical sense. Nothing else that we could have known about them besides the
monumental contributions we ascribe to their genius would have predicted
such extraordinary achievement. In discussing Ramanujan's work, the Polish
mathematician Mark Kac was forced to make a distinction between the "ordi
nary genius" and the "magician." He wrote:
An ordinary genius is a fellow that you and I would be just as good as, if we were
only many times better. There is no mystery as to how his mind works. Once we
understand what he has done, we feel certain that we, too, could have done it. It is
different with the magicians. They are, to use mathematical jargon , in the orthogonal complement of where we are and the working of their minds is for all intents
and purposes incomprehensible. Even after we understand what they have done,
the process by which they have done it is completely dark. (Quoted in Kanigel,
1991, p. 28 1 ; Kanigel's splendid biography of Ramanujan is highly recommended)
To come back to earth and the point of my meandering, genius requires
giftedness (consisting essentially of g, often along with some special aptitude or
talent, such as mathematical, spatial, musical, or artistic talent). But obviously
there are other antecedents (to the magic of Ramanujan's "thinking processes")
that are elusive to us. Nonetheless, we do know of at least two key attributes,
beyond ability, that appear to function as catalysts for the creation of that
special class of behavioral products specifically indicative of genius. They are
productivity and creativity.
Although we can recognize creative acts and even quantify them after a fashion
(MacKinnon, 1962), our understanding of them in any explanatory sense is
practically nil. Yet one prominent hypothesis concerning creativity (by which I
mean the bringing into being of something that has not previously existed)
seems to me not only unpromising, but extremely implausible and probably
wrong. It is also inherently unfalsifiable and hence fails Popper's criterion for a
useful scientific theory. I doubt that it will survive a truly critical examination.
Because ruling out one explanation does further our understanding of creative
ity, I will focus on this theory.
I am referring here to what has been termed the ch an ce configuration
theory of creativity (well explicated by Simonton, 1988, ch. 1). Essentially, it
amounts to expecting that a computer that perpetually generates strictly ran
dom sequences of all the letters of the alphabet, punctuation signs, and spaces
will eventually produce Hamlet or some other work of creative genius. The
theory insists that blind chance acting in the processes of m em ory searches for
elements with which to form random combinations and permutations, from
which finally there emerges some product or solution that the world considers
original or creative. It is also essential that, although this generating process
is operating entirely by blind chance, the random permutations produced
thereby are subjected to a critical rejection/selection screening, with selective
retention of the more promising products. This theory seems implausible,
partly because of the sheer numerical explosion of the possible combinations
and permutations when there are more than just a few elements. For example,
the letters in the word permutation have 11! = 3 9 ,916,800 possible perm uta
tions. To discover the "right" one by randomly permuting the letters at a
continuous rate of one permutation per second could take anywhere from one
second (if one were extremely lucky) up to one year, three thirty-day months,
and seven days (if one were equally unlucky). Even then, these calculations
assume that the random generating mechanism never repeated a particular
permutation; otherwise it would take much longer.
The combinatorial and permutation explosion resulting from an in
crease in the number of elements to be mentally manipulated and the exponen
tially increased processing time are not, however, the worst problem s for this
theory. The far greater problem is that, just as "nature abhors a vacuum," the
human mind abhors random ness. I recall a lecture by the statistician Helen M.
Walker in which she described a variety of experiments showing that intelligent
people, no matter how sophisticated they are about statistics or how well they
understand the meaning of randomness, and while putting forth their best
conscious efforts, are simply incapable of selecting, combining, or permutation
numbers, letters, words, or anything else in a truly random fashion. For exam
ple, when subjects are asked to generate a series of random numbers, or repeat
edly to make a random selection of N items from among a much larger number
of different objects spread out on a table, or take a random walk, it turns out no
one can do it. This has been verified by statistical tests of randomness applied to
their performance. People even have difficulty simply reading aloud from a
table of random numbers without involuntarily and nonrandom ly inserting
other numbers. (Examples of this phenomenon are given in Kendall, 1948.)
Thus, random ness (o r blind chance, to use the favored term in chance
configuration theory) seems an unlikely explanation of creative thinking. This
theory seems to have originated from what may be deemed an inappropriate
analogy, namely the theory of biological evolution creating new living forms.
According to the latter theory, a great variety of genetic effects is produced by
random mutations and the screening out of all variations except those best
adapted to the environment—that is, natural selection. But a genetic mutation,
produced perhaps by a radioactive particle hitting a single molecule in the DNA
at random and altering its genetic code, is an unfitting analogy for the neces
sarily integrated action of the myriad neurons involved in the mental manip
ulation of ideas.
The Creative Process
The implausibility of randomness, however, in no way implies that creative
thinking does not involve a great deal of "trial-and -error" mental manipula
tion, though it is not at all random . The products that emerge are then critically
sifted in light of the creator's aim. The individuals in whom this mental manipulation process turns out to be truly creative most often are those who
are relatively rich in each of three sources of variance in creativity: (1) ideational
flu en cy, or the capacity to tap a flow of relevant ideas, them es, or images, and to
play with them , also known as "brainstorming"; (2) what Eysenck (1995) has
termed the individuals' relevance horizon ; that is, the range or variety of ele
m ents, ideas, and associations that seem relevant to the problem (creativity
involves a wide relevance horizon); and (3) suspension of critical ju d g m en t.
Creative persons are intellectually high risk takers. They are not afraid of
zany ideas and can hold the inhibitions of self-criticism temporarily in abey
ance. Both Darwin and Freud mentioned their gullibility and receptiveness to
highly speculative ideas and believed that these traits were probably charac
teristic of creative thinkers in general. Darwin occasionally performed what
he called "fool's experiments," trying out improbable ideas that most people
would have instantly dismissed as foolish. Francis Crick once told me that Linus
Pauling's scientific ideas turned out to be wrong about 80 percent of the time,
but the other 20 percent finally proved to be so important that it would be a
mistake to ignore any of his hunches.
I once asked another Nobel Prize winner, William Shockley, whose cre
activity resulted in about a hundred patented inventions in electronics, what he
considered the main factors involved in his success. He said there were two: (1)
he had an ability to generate, with respect to any given problem , a good many
hypotheses, with little initial constraint by previous knowledge as to their
plausibility or feasibility; and (2) he worked much harder than most people
would at trying to figure out how a zany idea might be shaped into something
technically feasible. Some of the ideas that eventually proved most fruitful, he
said, were even a physical impossibility in their initial conception. For that
very reason, most knowledgeable people would have dismissed such unrealistic
ideas immediately, before searching their imaginations for transformations
that might make them feasible.
Some creative geniuses, at least in the arts, seem to work in the opposite
direction from that described by Shockley. That is, they begin by producing
something fairly conventional, or even trite, and then set about to impose novel
distortions, reshaping it in ways deemed creative. I recall a demonstration of
this by Leonard Bernstein, in which he compared the early drafts of Beethoven's
Fifth Symphony with the final version we know today. The first draft was a
remarkably routine-sounding piece, scarcely suggesting the familiar qualities of
Beethoven's genius. It was more on a par with the works com posed by his
mediocre contemporaries, now long forgotten. But then two processes took
hold: (1) a lot of "doctoring," which introduced what for that time were sur
prising twists and turns in the harmonies and rhythms, along with an ascetic
purification, and (2) a drastic pruning and simplification of the orchestral score
to rid it completely of all the "unessential" notes in the harmonic texture, all the
"elegant variations" of rhythm , and any suggestion of the kind of filigree orna
mentation that was so common in the works of his contemporaries. This
resulted in a starkly powerful, taut, and uniquely inevitable-sounding master
piece, which, people now say, only Beethoven could have written. But when
Beethoven's symphonies were first performed, they sounded so shockingly
deviant from the prevailing aesthetic standards that leading critics declared him
ripe for a madhouse.
One can see a similar process of artistic distortion in a fascinating motion
picture using time-lapse photography of Picasso at work ( The Picasso Mystery).
He usually begin by sketching something quite ordinary—for example, a com
pletely realistic horse. Then he would begin distorting the figure this way and
that, repeatedly painting over what he had just painted and imposing further,
often fantastic, distortions. In one instance, this process resulted in such an
utterly hopeless mess that Picasso Finally tossed the canvas aside, with a remark
to the effect of "Now I see how it should go." Then, taking a clean canvas, he
worked quickly, with bold, deft strokes of his paintbrush, and there suddenly
took shape the strangely distorted figure Picasso apparently had been striving
for. Thus he achieved the startling aesthetic impact typical of Picasso's art.
It is exactly this kind of artistic distortion of perception that is never seen
in the productions of the most extremely gifted idiot savants, whose drawings
often are incredibly photographic, yet are never considered works of artistic
genius. The greatest artists probably have a comparable gift for realistic draw
ing, but their genius leads them well beyond such photographic perception.
Other examples of distortion are found in the recorded performances of
the greatest conductors and instrumentalists, the re-creative geniuses, such as
Toscanini and Furtwangler, Paderewski and Kreisler. Such artists are not primarily distinguished from routine practitioners by their technical skill or virtuosity (though these are indeed impressive), but by the subtle distortions,
within fairly narrow limits, of rhythm , pitch, phrasing, and the like, that they
impose, consciously or unconsciously, on the works they perform . Differences
between the greatest performers are easily recognizable by these "signatures."
But others' attempts to imitate these idiosyncratic distortions are never subtle
enough or consistent enough to escape detection as inauthentic; in fact, they
usually amount to caricatures.
What is the wellspring of the basic elements of creativity listed above—idea
tional fluency, a wide relevance horizon, the suspension of inhibiting self
criticism , and the novel distortion of ordinary perception and thought? All of
these features, when taken to an extreme degree, are characteristic of psychosis.
The mental and emotional disorganization of clinical psychosis is, however,
generally too disabling to perm it genuinely creative or productive work, espe
cially in the uncompensated individual. Eysenck, however, has identified a trait,
or dimension of personality, term ed psychoticism , which can be assessed by
means of the Eysenck Personality Questionnaire (Eysenck & Eysenck, 1991).
Trait psychoticism , it must be emphasized, does not imply the psychiatric
diagnosis of psychosis, but only the predisposition or potential for the develop
m ent of psychosis (Eysenck & Eysenck, 1976). In many creative geniuses, this
potential for actual psychosis is usually buffered and held in check by certain
other traits, such as a high degree of ego strength. Trait psychoticism is a
constellation of characteristics that persons may show to varying degrees; such
persons may be aggressive, cold, egocentric, im personal, impulsive, antisocial,
unempathetic, tough-minded, and creative. This is not a charm ing picture of
genius, perhaps, but a reading of the biographies of some of the world's most
famous geniuses attests to its veracity.
By and large, geniuses are quite an odd lot by ordinary standards. Their
spouses, children, and close friends are usually not generous in their personal
recollections, aside from marveling at the accomplishments for which the per
son is acclaimed a genius. Often the personal eccentricities rem ain long hidden
from the public. Beethoven's first biographer, for example, is known to have
destroyed some of Beethoven's letters and conversation books, presumably
because they revealed a pettiness and meanness of character that seemed utterly
inconsistent with the sublime nobility of Beethoven's music. Richard Wagner's
horrendous character is legendary. He displayed virtually all of the aforemen
tioned features of trait psychoticism to a high degree and, to make matters
worse, was also neurotic.
Trait psychoticism is hypothesized as a key condition in Eysenck's (1995)
theory of creativity. Various theorists have also mentioned other characteristics,
but some of these, such as self-confidence, independence, originality, and n o n
conformity, to name a few, might well stem from trait psychoticism. (See
Jackson & Rushton, 1987, for reviews of the personality origins of productivity
and creativity.)
A startling corollary of the multiplicative model of exceptional achievement is
best stated in the form of a general law. This is Price's Law, which says that if K
persons have made a total of N countable contributions in a particular field,
then N /2 of the contributions will be attributable to
(Price, 1963). Hence,
as the total number of workers ( K ) in a discipline increases, the ratio VTc/ K
shrinks, increasing the elitism of the major contributors. This law, like any
other, only holds true within certain limits. But within fairly homogeneous
disciplines, Price's Law seems to hold up quite well for indices of productivity—
for example, in math, the empirical sciences, musical composition, and the
frequency of performance of musical works. Moreover, there is a high rank-
order relationship between sheer productivity and various indices of the im
portance of a contributor's work, such as the frequency and half-life of scien
tific citations, and the frequency of performance and staying power of musical
com positions in the concert repertoire. (Consider such contrasting famous
contemporaries as Mozart and Salieri; Beethoven and Hummel; and Wagner
and Meyerbeer.)
If productivity and importance could be suitably scaled, however, I would
imagine that the correlation between them would show a scatter-diagram of the
"twisted pear" variety (Fisher, 1959). That is, high productivity and triviality
are more frequently associated than low productivity and high importance. As
a rule, the greatest creative geniuses in every field are astoundingly prolific,
although, without exception, they have also produced their share of trivia.
(Consider Beethoven's King Stephen Overture and Wagner's "United States
Centennial M arch," to say nothing of his ten published volumes of largely triv
ial prose writings—all incredible contrasts to these composers' greatest works.)
But such seemingly unnecessary trivia from such geniuses is probably the
inevitable effluvia of the mental energy without which their greatest works
would not have come into being. On the other hand, high productivity is
probably much more common than great importance, and high productivity
per se is no guarantee of the importance of what is produced. The "twisted
pear" relationship suggests that high productivity is a necessary but not suffi
cient condition for making contributions of importance in any field. The im
portance factor, however, depends on creativity—certainly an elusive attribute.
What might be the basis of individual differences in productivity? The
word motivation immediately comes to mind, but it explains little and also
seems too intentional and self-willed to fill the bill. When one reads about
famous creative geniuses one finds that, although they may occasionally have to
force themselves to work, they cannot will themselves to be obsessed by the
subject of their work. Their obsessive-compulsive mental activity in a particular
sphere is virtually beyond conscious control. I can recall three amusing exam
ples of this, and they all involve dinner parties. Isaac Newton went down to the
cellar to fetch some wine for his guests and, while filling a flagon, wrote a
mathematical equation with his finger on the dust of the wine keg. After quite a
long tim e had passed, his guests began to worry that he might have had an
accident, and they went down to the cellar. There was Newton, engrossed in his
mathematical formulas, having completely forgotten that he was hosting a
dinner party.
My second example involves Richard Wagner. Wagner, while his guests as
sembled for dinner, suddenly took leave of them and dashed upstairs. Alarmed
that something was wrong, his wife rushed to his room . Wagner exclaimed,
"I'm doing it!"—their agreed signal that she was not to disturb him under any
circumstances because some new musical idea was flooding his brain and
would have to work itself out before he could be sociable again. He had a
phenomenal m em ory for musical ideas that spontaneously surfaced, and could
postpone writing them down until it was convenient, a tedious task he referred
to not as com posing but as merely "copying" the music in his mind's ear.
Then there is the story of Arturo Toscanini hosting a dinner party at which
he was inexplicably morose and taciturn, just as he had been all that day and the
day before. Suddenly he got up from the dinner table and hurried to his study;
he returned after several minutes beam ing joyfully and holding up the score of
Brahms's First Symphony (which he was rehearsing that week for the N BC
Symphony broadcast the following Sunday). Pointing to a passage in the first
movement that had never pleased him in past performances, he exclaimed that
it had suddenly dawned on him precisely what Brahm s had intended at this
troublesome point. In this passage, which never sounds "clean" when played
exactly as written, Toscanini slightly altered the score to clarify the orchestral
texture. He always insisted that his alterations were only the composer's true
intention. But few would complain about his "delusions"; as Puccini once
remarked, "Toscanini doesn't play my music as I wrote it, but as I dreamed it."
Mental Energy
Productivity implies actual production or objective achievement. For the psychological basis of intellectual productivity in the broadest sense, we need a
construct that could be labeled m en tal energy. This term should not be co n
fused with Spearman's g (for general intelligence). Spearman's theory of psy
chom etric g as "mental energy" is a failed hypothesis and has been supplanted
by better explanations of g based on the concept of neural efficiency (Jensen,
1993). The energy construct I have in mind refers to something quite different
from cognitive ability. It is more akin to cortical arousal or activation, as if by a
stimulant drug, but in this case an endogenous stimulant. Precisely what it
consists of is unknown, but it might well involve brain and body chemistry.
One clue was suggested by Havelock Ellis (1 904) in A Study of British
Genius. Ellis noted a much higher than average rate of gout in the eminent
subjects of his study; gout is associated with high levels of uric acid in the blood.
So later investigators began looking for behavioral correlates of serum urate
level (SU L), and there are now dozens of studies on this topic (reviewed in
Jensen & Sinha, 1993). They show that SUL is only slightly correlated with IQ,
but is more highly correlated with achievement and productivity. For instance,
among high school students there is a relation between scholastic achievement
and SUL, even controlling for IQ (Kasl, Brooks, & Rodgers, 1970). The "over
achievers" had higher SUL ratings, on average. Another study found a correla
tion of + .3 7 between SUL ratings and the publication rates of university pro
fessors (Mueller & French, 1974).
Why should there be such a relationship? The most plausible explanation
seems to be that the molecular structure of uric acid is nearly the same as that of
caffeine, and therefore it acts as a brain stimulant. Its more or less constant
presence in the brain, although affecting measured ability only slightly, consid
erably heightens cortical arousal and increases mental activity. There are proba
bly a number of other endogenous stimulants and reinforcers of productive
behavior (such as the endorphins) whose synergistic effects are the basis of
what is here called mental energy. I suggest that this energy, combined with very
high f o r an exceptional talent, results in high intellectual or artistic productiv
ity. Include trait psychoticism with its creative component in this synergistic
mixture and you have the essential makings of genius.
Genius = High Ability X High Productivity AND High Creativity.
The theoretical underpinnings of these three ingredients are:
—Ability = g = efficiency of information processing
—Productivity = endogenous cortical stim u lation
—Creativity = trait psychoticism
There are undoubtedly other personality correlates of genius, although some of
them may only reflect the more fundamental variables in the formula given
above. The biographies of m any geniuses indicate that, from an early age, they
are characterized by great sensitivity to their experiences (especially those of a
cognitive nature), the development of unusually strong and long-term interests
(often manifested as unusual or idiosyncratic hobbies or projects), curiosity
and exploratory behavior, a strong desire to excel in their own pursuits, th eo
retical and aesthetic values, and a high degree of self-discipline in acquiring
necessary skills (MacKinnon, 1962).
The development of expert-level knowledge and skill is essential for any
important achievement (Rabinowitz & Glaser, 1985). A high level of expertise
involves the automatization of a host of special skills and cognitive routines.
Automatization com es about only as a result of an immense amount of prac
tice (Jensen, 1990; Walberg, 1988). Most people can scarcely imagine (and
are probably incapable of) the extraordinary amount of practice that is re
quired for genius-quality performance, even for such a prodigious genius as
Mozart.
In their self-assigned tasks, geniuses are not only persistent but also re
markably able learners. Ramanujan, for example, disliked school and played
truant to work on math problems beyond the level of anything he was offered at
school. Wagner frequently played truant so he could devote his whole day to
studying the orchestral scores of Beethoven. Francis Galton, with an estimated
childhood IQ of around 200 and an acknowledged genius in adulthood, abso
lutely hated the frustrations of school and pleaded with his parents to let him
quit. Similar examples are legion in the accounts of geniuses.
In reading about geniuses, I consistently find one other important factor
that must be added to the composite I have described so far. It is a factor related
to the direction of personal ambition and the persistence of effort. This factor
channels and focuses the individual's mental energy; it might be described best
as personal ideals or values. These may be artistic, aesthetic, scientific, theoret
ical, philosophical, religious, political, social, economic, or moral values, or
something idiosyncratic. In persons of genius, especially, this "value factor"
seems absolutely to dominate their self-concept, and it is not mundane. People
are often puzzled by what they perceive as the genius's self-sacrifice and often
egocentric indifference to the needs of others. But the genius's value system, at
the core of his or her self-concept, is hardly ever sacrificed for the kind of
mundane pleasures and unimaginative goals com m only valued by ordinary
persons. Acting on their own values—perhaps one should say acting out their
self-images—is a notable feature of famous geniuses.
Although this chapter is not meant to provide an exhaustive review of the
literature on geniuses and highly creative individuals, it has raised some consis
tent them es that might be worthy of scientific study. I propose that genius is
a multiplicative effect of high ability, productivity, and creativity. Moreover,
many of the personality traits associated with genius can be captured by the
label "psychoticism." Although geniuses may have a predisposition toward such
a disorder, they are buffered by a high degree of ego strength and intelligence. A
number of the remaining personality correlates of genius may best be captured
by the idea that genius represents an acting-out of its very essence.
Giftedness and Genius: Important Differences
Although giftedness (exceptional mental ability or outstanding talent) is a
threshold trait for the emergence of genius, giftedness and genius do seem to be
crucially different phenomena, not simply different points on a continuum . It
has even been suggested that giftedness is in the orthogonal plane to genius.
Thomas Mann (1 9 4 7 ), in his penetrating and insightful study of Richard Wag
ner's genius, for instance, makes the startling point that Wagner was not a
musical prodigy and did not even seem particularly talented, in music or in
anything else for that matter, compared to many lesser composers and poets.
He was never skilled at playing any musical instrument, and his seriously
focused interest in music began much later than it does for most musicians. Yet
M ann is awed by Wagner's achievements as one of the world's stupendous
creative geniuses, whose extraordinarily innovative masterpieces and their ines
capable influence on later composers place him among the surpassing elite in
the history of music, in the class with Bach, Mozart, and Beethoven.
It is interesting to note the words used by M ann in explaining what he calls
Wagner's "vast genius"; they are not "giftedness" or "talent," but "intelligence"
and "will." It is the second word here that strikes m e as most telling. After all, a
high level of intelligence is what we mean by "gifted," and Wagner was indeed
most probably gifted in that sense. His childhood IQ was around 140, as
estimated by Catherine Cox (1 9 2 6 ) in her classic, although somewhat flawed,
study of three hundred historic geniuses. Yet that level of IQ is fairly com
m on place on university campuses.
We do not have to discuss such an awesome level of genius as Wagner's,
however, to recognize that garden-variety outstanding achievement, to which
giftedness is generally an accompaniment, is not so highly correlated with the
psychometric and scholastic indices of giftedness as many people, even psychol
ogists, might expect. At another symposium related to this topic, conducted
more than twenty years ago, one of the speakers, who apparently had never
heard of statistical regression, expressed fire alarm at the observation that far
too many students who scored above the 99th percentile on IQ tests did not
turn out, as adults, among those at the top of the distribution of recognized
intellectual achievements. He was dismayed at many of the rather ordinary
occupations and respectable but hardly impressive accomplishments displayed
in midlife by the majority of the highly gifted students in his survey. A signifi
can't number of students who had tested considerably lower, only in the top
quartile, did about as well in life as many of the gifted. The speaker said the
educational system was to blame for not properly cultivating gifted students. If
they were so bright, should they not have been high achievers? After all, their
IQs were well within the range of the estimated childhood IQs of the three
hundred historically eminent geniuses in C ox's (1 9 2 6 ) study. Although educa
tion is discussed in more detail below, the point here is that giftedness does not
assure exceptional achievement; it is only a necessary condition.
To reinforce this point, I offer an additional example that occurred on the
very day I sat down to write this chapter. O n that day I received a letter from
someone I had never met, though I knew he was an eminent professor of
biophysics. He had read something I wrote concerning IQ as a predictor of
achievement, but he was totally unaware of the present work. The coincidence
is that my correspondent posed the very question that is central to my theme.
He wrote;
I have felt for a long time that IQ , however defined, is only loosely related to men
tal achievement. Over the years I have bumped into a fair nu m ber of MENSA
people. As a group, they seem to be dilettantes seeking titillation bu t seem unable
to think critically or deeply. They have a lot of motivation for intellectual play but
little for doing anything worthwhile. One gets the feeling that brains were wasted
on them . So, what is it that makes an intelligently productive person?
This is not an uncom m on observation, and I have even heard it expressed by
m em bers of MENSA. It is one of their self-perceived problem s, one for which
some have offered theories or rationalizations. The most typical is that they are
so gifted that too many subjects attract their intellectual interest and they can
never commit themselves to any particular interest. It could also be that indi
viduals drawn toward m em bership in M ENSA are a selective subset of the
gifted population, individuals lacking in focus. After all, most highly gifted
individuals do not join MENSA.
We must, then, consider some of the ways in which achieved em en t contrasts
with ability if we are to make any headway in understanding the distinction
between giftedness (i.e., mainly high g or special abilities) and genius. Genius
involves actual achievement and creativity. Each of these characteristics is a
quantitative variable. The concept of genius generally applies only when both of
these variables characterize accomplishments at some extraordinary socially
recognized level. Individual differences in countable units of achievement, un
like measures of ability, are not normally distributed, but have a very positively
skewed distribution, resembling the so-called J-curve. For example, the num
ber of publications of members of the American Psychological Association, of
research scientists, and of academicians in general, the number of patents
of inventors, the number of compositions of composers, or the frequency of
composers' works in the concert repertoire all show the same J-curve. M ore
over, in every case, the J-curve can be normalized by a logarithmic transform a
tion. This striking phenomenon is consistent with a multiplicative model of
achievement, as developed and discussed above. That is, exceptional achieve
m ent is a multiplicative function of a number of different traits, each of which
may be normally distributed, but which in combination are so synergistic as to
skew the resulting distribution of achievement. Thereby, an extremely extended
upper tail of exceptional achievement is produced. Most geniuses are found far
out in this tail.
The multiplication of several normally distributed variables yields, there
fore, a highly skewed distribution. In such a distribution, the mean is close to
the bottom and the mode generally is the bottom . For any variable measured on
a ratio scale, therefore, the distance between the median and the 99th percentile
is much smaller for a normally distributed variable, such as ability, than for a
markedly skewed variable, such as productivity. Indeed, this accords well with
subjective impressions: the range of individual differences in ability (g or fluid
intelligence) above the median level does not seem nearly so astounding as the
above-median range of productivity or achievement.
In conclusion, giftedness, a normally distributed variable, is a prerequisite
for the development of genius. When it interacts with a number of other critical
characteristics, which also are normally distributed, exceptional achievement is
produced. Exceptional achievement, however, is a variable that is no longer
norm al; it is highly skewed, with genius found at the tip of the tail.
At this point in my highly speculative groping to understand the nature of
genius as differentiated from giftedness, I should like to make some practical
recommendations. First, I would not consider trying to select gifted youngsters
explicitly with the aim of discovering and cultivating future geniuses. Julian
Stanley's decision (Stanley, 1977) to select explicitly for mathematical gifted
ness—to choose youths who, in Stanley's words, "reason exceptionally well
mathematically"—was an admirably sound and wise decision from a practical
and socially productive standpoint. The latent traits involved in exceptional
mathematical reasoning ability are mainly high g plus high math talent (inde
pendent of g). These traits are no guarantee of high productivity, much less of
genius. But the threshold nature of g and m ath talent is so crucial to excelling in
math and the quantitative sciences that we can be fairly certain that most of the
productive mathematicians and scientists, as well as the inevitably few geniuses,
will com e from that segment of the population of which the SM PY students are
a sample. Indeed, in Donald MacKinnon's (1962) well-known study of large
numbers of creative writers, mathematicians, and architects (certainly none of
them a Shakespeare, Gauss, or Michelangelo), the very bottom of the range of
intelligence-test scores in the whole sample was at about the 75th percentile
of the general population, and the mean was at the 98th percentile (MacKinnon
8c Hall, 1972).
However, it might eventually be profitable for researchers to consider
searching beyond high ability per se and identify personality indices that also
will aid in the prediction of exceptional achievement. The proportion of those
gifted youths selected for special opportunities who are most apt to be productive professionals in their later careers would thereby be increased. Assuming
that high achievement and productivity can be predicted at all, over and above
what our usual tests of ability can predict, it would take extensive research
indeed to discover sufficiently valid predictors to justify their use in this way.
Lubinski and Benbow (1992) have presented evidence that a "theoretical orien
tation," as measured by the Allport, Vernon, and Lindzey Study of Values,
might be just such a variable for scientific disciplines.
Certainly, the education and cultivation of intellectually gifted youths has never
been more important than it is today, and its importance will continue to grow
as we move into the next century. The preservation and advancement of civi
lized society will require that an increasing proportion of the population have a
high level of educated intelligence in science, engineering, and technology.
Superior intellectual talent will be at a premium . Probably there will always be
only relatively few geniuses, even among all persons identified as gifted. Yet this
is not cause for concern. For any society to benefit from the fruits of genius
requires the efforts of a great many gifted persons who have acquired high levels
of knowledge and skill. For example, it takes about three hundred exceptionally
talented and highly accomplished musicians, singers, set designers, artists,
lighting directors, and stage directors, besides many stagehands, to put on a
production of The Ring of the Nibelung, an artistic creation of surpassing
genius. Were it not for the concerted efforts of these performers, the score of
Wagner's colossal work would lie idle. The same is true, but on a much larger
scale, in modern science and technology. The instigating creative ideas are
seldom actualized for the benefit of society without the backup and follow through endeavors of a great many gifted and accomplished persons. Thus, a nation's most important resource is the level of educated intelligence in its
population; it determines the quality of life. It is imperative for society to
cultivate all the high ability that can possibly be found, wherever it can be
Cohn, S. J., Carlson, J. S., & Jensen, A. R. (1985). Speed of information processing in academically
gifted youths. Personality and Individual Differences 6:621 -629.
Cox, C. M. ( 1926). The early mental traits of three hundred geniuses. Stanford: Stanford University
Ellis, H. ( 1904). A study of British genius. London: Hurst & Blackett.
Eysenck, H. J. (1995). Genius: The natural history of creativity. Cambridge: Cambridge University
Eysenck, H. J., 8c Eysenck, S. B. G. (1976). Psychoticism as a dimension of personality. London:
Hodder & Stoughton.
Eysenck, H. J., & Eysenck, S. B. G. (1991). Manual of the Eysenck Personality Scales (EPS Adult).
London: Hodder & Stoughton.
Fisher, J. ( 1959). The twisted pear and the prediction of behavior. Journal of Consulting Psychology
23:400-405.
Jackson, D. N., 8c Rushton, J. P. (Eds.). (1987). Scientific excellence: Origins and assessment. Beverly
Hills: Sage Publications.
Jensen, A. R. (1990). Speed of information processing in a calculating prodigy. Intelligence 14:259
Jensen, A. R. (1992a). The importance of intraindividual variability in reaction time. Personality
and Individual Differences 13:869-882.
Jensen, A. R. (1992b). Understanding gin terms of information processing. Educational Psychology
Review 4:271-308.
Jensen, A. R. (1993). Spearman's g: From psychometrics to biology. In F. M. Crinella 8c J. Yu (Eds.),
Brain mechanisms and behavior. New York: New York Academy of Sciences.
Jensen, A. R., Cohn, S. J., & Cohn, C. M. G. (1989). Speed of information processing in academy
ically gifted youths and their siblings. Personality and Individual Differences 10:29-34.
Jensen, A. R., & Sinha, S. N. (1993). Physical correlates of human intelligence. In P. A. Vernon (Ed.),
Biological approaches to the study of human intelligence. Norwood, N.J.: Ablex.
Kanigel, R. (1991). The man who knew infinity: A life of the genius Ramanujan. New York: Scribner's.
Kasl, S. V., Brooks, G. W., 8; Rodgers, W. L. (1970). Serum uric acid and cholesterol in achievement
behaviour and motivation: 1. The relationship to ability, grades, test performance, and motiva
tion. Journal of the American Medical Association 213:1158-1164.
Kendall, M. G. (1948). The advanced theory of statistics (Vol. 1). London: Charles Griffin.
Lubinski, D., & Benbow, C. P. (1992). Gender differences in abilities and preferences among the
gifted: Implications for the math-science pipeline. Current Directions in Psychological Science
1:61-66.
MacKinnon, D. W. (1962). The nature and nurture of creative talent. American Psychologist 17:
484-495.
MacKinnon, D. W., 8c Hall, W. B. (1972). Intelligence and creativity. In H. W. Peter, Colloquium 17:
The measurement of creativity. Proceedings, Seventeenth International Congress of Applied Psychol
ogy, Liege, Belgium, 2 5 -3 0 July, 1971 (Vol. 2, pp. 1883-1888). Brussels: Editest.
Mann, T. (1947). Sufferings and greatness of Richard Wagner. In T. Mann, Essays of three decades
(H. T. Low-Porter, Trans., pp. 307-352). New York: Knopf.
Mueller, E. F., 8c French, J. R" Jr. (1974). Uric acid and achievement. Journal of Personality and
Social Psychology 30:336-340.
Price, D. J. ( 1963). Little science, big science. New York: Columbia University Press.
Rabinowitz, M., 8c Glaser, R. (1985). Cognitive structure and process in highly competent perfor
mance. In F. D. Horowitz & M. O'Brien (Eds.), The gifted and talented: Developmental perspec
tives (pp. 7 5 -9 8 ). Washington, D.C.: American Psychological Association.
Simonton, D. K. (1988). Scientific genius: A psychology of science. New York: Cambridge University
Snow, C. P. (1967). Variety of men. London: Macmillan.
Stanley, J. C. (1977). Rationale of the Study of Mathematically Precocious Youth (SMPY) during its
first five years of promoting educational acceleration. In J. C. Stanley, W. C. George, & C. H.
Solano (Eds.), The gifted and the creative: A fifty-year perspective (pp. 75-112). Baltimore: Johns
Hopkins University Press.
Walberg, H. J. (1988). Creativity and talent as learning. In R. J. Sternberg (Ed.), The nature of
creativity: Contemporary psychological perspectives (pp. 340-361). Cambridge: Cambridge Uni
versity Press.

redpajama_set_name: RedPajamaCommonCrawl


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Free on-line banking with invoice pay to regulate funds 24/7. As if that weren't sufficient, in July Governor Snyder signed an executive order abolishing the Board of Overview (unemployment compensation appeals board) and moving the function to a brand new appeals body combining workers compensation and unemployment compensation appeals.\n\nHowtostart, actually its very good information about mobile phone retailer. Claimants hoping to get data on the telephone are similarly out of luck, the auditor common discovered. That awkward second if you realise you've got stored talking after the call dropped out.\n\nAccount Analysis service charges are charged to your account within the present month for the prior calendar month's exercise and embody however should not limited to charges for superior payments and receivables companies, some business online banking companies, excess account exercise, and money/coin processing.\n\nThe idea that every time you apply for employment, and every potential employer has a file of your credit score historical past, (particularly those who've declined you) is sickening! Orders are cancelled and people start dropping their jobs. It's occurred to tons of of hundreds of Individuals who believed that banks don't make funds obtainable unless the checks they've deposited are real.\n\nLike Social Security, Unemployment Compensation was established throughout the Nice Melancholy in the 1930s, and like Social Security, it has turn into accepted and, by and enormous, accomplishes its mission of providing income to assist unemployed employees and provide a boost to the economy throughout recessions.\n\nThe rule in Michigan and most states is that a reasonable particular person will discover another job before quitting the one she or he has. I believe the only reason that an employer ought to verify a credit rating is if the individual is a potential candidate for a delicate job, similar to being a spy.


Sheila Gujrathi is the CEO of Gossamer Bio, which got caught up in the government shutdown freezing the initial public offering market.
With the government shutdown over, Gossamer Bio is expected to take a traditional path to an initial public offering, abandoning a plan to sidestep the U.S. Securities and Exchange Commission.
On Jan. 30, Gossamer canceled a risky workaround, in which its IPO registration statement would have automatically taken effect Feb. 12, without SEC signoff. That maneuver, announced Jan. 23, was a response to the government shutdown freezing public market debuts.
The company first filed for an IPO in late December, right before the shutdown began. SEC employees who review IPO filings came back to work Jan. 28.
Gossamer plans to raise $230 million through its IPO to advance its oncology, asthma, hypertension and bowel disease drugs. With the large public offering, the company raising $330 million in venture capital last year and a team led by ex-Receptos executives, Gossamer has been pegged as the next big thing in San Diego biotech.
But it's unclear when Gossamer will go public. The company on Jan. 30 said it would ask the SEC to approve its IPO registration statement prior to Feb. 12.
The company declined a request to comment.
Jay Ritter, a professor at University of Florida and IPO expert, said with the SEC returning, it's uncertain whether IPO filings will be prioritized.
For the SEC, the pressure is on to review paperwork, because the government is expected to close again if Congress and President Donald Trump don't reach a deal by Feb. 15.
Gossamer's earlier plan to circumvent the SEC came with risk, including potential litigation, the company noted in paperwork. But the company at that time gave itself an out, saying it would reevaluate if the agency resumed normal operations prior to Feb. 12.
Biotechs are often in a hurry to go public because of funding. Without drugs on the market, biotechs need investor capital so development and business operations continue unabated. Then again, Gossamer last year raised $330 million through Series A and B rounds.
Gossamer's IPO terms remain unchanged from Jan. 23 paperwork. The company plans to sell up to 14.4 million shares at $16 per share and trade on the Nasdaq stock exchange.
While Gossamer reversed course, on Jan. 24 Nasdaq in a statement said companies could list without the final green light from the SEC if they had completed much of the review process.
Ritter loosely likened the shutdown's IPO drought to when China in 2015 slapped a yearlong moratorium on IPOs.
In San Diego biotech, Poseida and Cibus also filed IPOs but have yet to list shares.


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E-Source Home > + Arts & Music
Magazines and Databases Online Targets (Click on the arrow to expand the description)
Alexander Street's Music Online (ProQuest)
Alexander Street's Music Online: Classical Music Library offers tens of thousands of classical music recordings online in streaming audio. Browse lists of titles, instruments, performers/ensembles, publishers, composers, genres, and people from the Medieval period through the 21st century. Adobe Flash Player may be required.
Available from home to Tompkins County patrons. Funded by a charitable donation to the Tompkins County Public Library Foundation
Art Museum Image Gallery (EBSCO) (Login required - click here)
Art Museum Image Gallery contains thousands of high quality images of artwork that span the cultures of Africa, Asia, Europe, and the Americas, including Native American and Meso-American peoples with entries from 3000 BC to modern day. It includes historical photographs and artifacts. Provenance and curatorial data accompany the images.
Available from home. Funded with RBDB funds through the South Central Regional Library Council
Fine Arts and Music Collection (Gale Cengage Learning)
Fine Arts and Music Collection provides access to scholarly journals and magazines that support research in areas including drama, music, art history, and filmmaking. The database emphasizes full-text content for publications included in the Wilson Art Index and RILM bibliography.
Available from home. Funded by NOVEL, an electronic resource access project that enables libraries across New York State to give their communities online access to the full text of hundreds of journals, newspapers and other references.


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Qualification report for Daytona Supercross
By Dan BeaverMar 9, 2019, 4:31 PM EST
SupercrossLIVE.com
With time off the clock, Marvin Musquin topped the leaderboard in 450 Group A qualifying at 1 minute, 07.725 seconds to beat Ken Roczen (1:08.638) by nearly a second and points leader Cooper Webb (1:08.744).
"The practice went good. I just needed to have a clear lap and put everything together and that's what I did," Musquin told Race Day Live's Will Christian on NBC Sports Gold.
Eli Tomac (1:09.295) was fourth on the board, showing why these four riders are battling for the championship.
Dean Wilson (1:09.425) rounded out the top five.
Making his first 450 start of the season, Shane McElrath posted the 12th fastest time of 1:11.213.
Click here for combined qualifying results
MORE: Daytona could be season's turning point
In the 250 class:
With a lap of 1:09.719, Chase Sexton showed a little more speed in qualification than points leader Austin Forkner (1:09.771).
Justin Cooper (1:10.161), Mitchell Oldenburg (1:10.935) and Brandon Hartranft (1:111.076) rounded out the top five.
In eighth overall, Jace Owens (1:111.962) was the best rider from Group B.
Qualification each week can be seen live with NBC's Sport Gold Supercross / Motocross season pass, which can be purchased at https://www.nbcsports.com/gold.
Follow Dan Beaver on Twitter


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EU Talks Tough on Trump Tariffs
Trade war risk remains alive; EU won't engage with U.S. on trade until it gets a permanent exemption from "pure protectionism" of tariffs.
By Jonathan Stearns | April 18, 2018 at 07:10 PM
European Union (EU) Trade Commissioner Cecilia Malmstrom says the U.S. has offered no signal it'll prolong a waiver for the bloc from controversial metal tariffs, highlighting the persistent risk of a trans-Atlantic trade war.
Malmstrom said she's still pressing U.S. Commerce Secretary Wilbur Ross for a permanent EU exemption from the levies on foreign steel and aluminum that President Donald Trump imposed last month on national-security grounds. He granted a waiver to the 28-nation bloc until May 1 and left open the possibility of a longer exclusion.
"I think the decision will be taken by the president personally," Malmstrom said in an interview on Wednesday in Strasbourg, France. "Secretary Ross will make a recommendation, and I hope he will recommend that we are excluded."
Growth for China's Fledgling Cross-Border Payments System
Bloomberg News | September 23, 2021
CIPS is becoming increasingly convenient for global businesses; some see it eventually competing with SWIFT.


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nasm src/bootsectors/pxestart.asm -o pxestart.sys
cd src
nasm pure64.asm -o ../pure64.sys
cd ..

redpajama_set_name: RedPajamaGithub


"Known events" one of those insurance buzz words that comes up again and again, but what on earth does it mean?
You might hear your travel insurer say that they are no longer covering for a volcanic eruption for example, as the event is now "known".
A known event, is something that has been reported in the media that may affect your travel plans- these are typically things like natural disasters; earthquakes, volcanic eruptions, floods, transport meltdowns like airport closures, or civil unrest and terror attacks. Policies do not cover claims for losses caused by an event that you were aware of at the time of purchasing your policy.
In the same way that you can't buy car insurance to cover you for a crash you had yesterday, a travel insurer won't cover you for a volcano, snowstorm or heavy fog that has already happened. So, if you've just heard about something in the news and you've not yet bought cover - it's probably too late.
Cancellations before you leave: If your pre-booked travel arrangements are cancelled, delayed or rescheduled as a result of an unforeseen natural disaster (for example) and you have not yet departed, you may have provision to claim for any non-refundable costs that you cannot recoup, or rearrangement of your journey - whichever is the lesser. If your travel arrangements are affected, it's a good idea to contact your travel agent or travel provider regarding the best option in altering your trip. Some companies may provide penalty free options to amend your travel arrangements in the event of delays or cancellations.
Cancellations when already abroad: If you have started your journey and your transport is delayed or cancelled, or your accommodation is affected, there may be provision to claim for reasonable additional travel, accommodation and meal expenses depending upon the policy purchased. Depending on the event, provided you are within the designated disaster area, you would be able to claim for the funds required to find you alternative accommodation in a safe area. If your flights have been cancelled you would also be covered for any additional accommodation and meal costs your incur.
Medical costs: Your medical costs are always covered, even on our most basic plan. Any injuries you incur as a direct result of a natural disaster for example would make for a legitimate claim, provided you had not invalidated your policy in any way. Emergency medical evacuation is also included.
Not following travel warnings: If you are specifically advised not to travel due to a severe weather warning or civil unrest for example, and you chose to go anyway, you may not be covered should your trip turn south.
When the event is "known": If a storm is being reported and you have not bought travel insurance, it's not too late to buy cover, however any claims made in relation to the storm may not be paid out. Travel insurance exists to protect against 'unforeseen' events, as opposed to those already happening that are being reported in the media. Whilst claims from the known event won't be covered, you can still get all the normal benefits for medical, cancellation, luggage and more.
Insufficient cover: It's not enough just to have travel insurance; rather your policy needs to be comprehensive enough to cover you for cancellation and delay expenses. Basic travel insurance will cover you for medical bills only, leaving you unable to claim for non-medical losses in the event of a natural disaster.
WHAT IS MY TRIP IS AFFECTED?
Hold on to everything: Take a record of every expense you encounter and get documented evidence or confirmation from airlines, local authorities, hotels or other businesses.
Stay in touch: After you initially let us know of any events, be sure to stay in touch! Resist any large payments until you receive confirmation that you will be covered for any major costs. Keep a record of your communications and we'll be sure to do the same.
Mitigate your out of pocket expenses,: Take all reasonable steps to keep costs down, particularly when altering your trip arrangements. By reasonable we mean appropriate and consistent—for example if you have been using two star or budget accommodation on your trip to date, then we advise that the replacement accommodation you seek should be of a similar standard.
Stay safe: It's a good idea to plan accordingly, and follow current government travel advice and register your travel details with SafeTravel.
WHEN ARE KNOWN EVENTS COVERED AGAIN?
Some event are excluded from cover for some time. The Mt Agung volcano in Bali being a prime example. This is because it keeps on erupting. So while it might not have erupted in a few weeks or months, unless your insurer tells you they've lifted the ban, don't assume it's covered!
buy early to beat the bans!
Whilst you can't get around travel bans from known events, buying travel insurance as soon as you've starting paying for your trip means you can get coverage before another event happens. As soon as you've book your flights and accommodation it's time to book your travel insurance. That way if another event gets in the way, you're covered if you need to cancel or delay your trip.


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Trained Interpreters For Patients With Limited English Can Help Avoid Medical Mishaps
By Michelle Andrews	 May 21, 2012
A visit to the emergency department or a physician's office can be confusing and even frightening when you're trying to digest complicated medical information, perhaps while you're feeling pain or discomfort. For the 25 million people in the United States with limited English proficiency, the potential for medical mishaps is multiplied.
A trained medical interpreter can make all the difference. Too often, however, interpreter services at hospitals and other medical settings are inadequate. Family members, including children, often step in, or the task falls to medical staff members who speak the required language with varying degrees of fluency.
According to a study published in March, such ad hoc interpreters make nearly twice as many potentially clinically significant interpreting errors as do trained interpreters.
The study, published online in the Annals of Emergency Medicine, examined 57 interactions at two large pediatric emergency departments in Massachusetts. These encounters involved patients who spoke Spanish at home and had limited proficiency in English.
Researchers analyzed audiotapes of the visits, looking for five types of errors, including word omissions, additions and substitutions as well as editorial comments and instances of false fluency (making up a term, such as calling an ear an "ear-o" instead of an "oreja")
More From This Series Insuring Your Health
They recorded 1,884 errors, of which 18 percent had potential clinical consequences.
For professionally trained interpreters with at least 100 hours of training, the proportion of errors with potential clinical significance was 2 percent. For professional interpreters with less training, the figure was 12 percent. Ad hoc interpreter errors were potentially clinically significant in nearly twice as many instances — 22 percent. The figure was actually slightly lower — 20 percent — for people with no interpreter at all.
A Civil Rights Issue
It makes sense that trained interpreters, especially those with more experience, would make fewer errors, says Glenn Flores, a professor and director of the division of general pediatrics at UT Southwestern Medical Center and Children's Medical Center of Dallas, who was the study's lead author. Experienced interpreters "know the medical terminology, ethics, and have experience in key situations where you need a knowledge base to draw on," he says.
Title VI of the Civil Rights Act of 1964 prohibits discrimination based on race, color or national origin. Courts have interpreted that to mean that all health-care providers that accept federal funds — because they serve Medicare and Medicaid recipients, for example — must take steps to ensure that their services are accessible to people who don't speak English well, according to the National Health Law Program, a nonprofit that advocates for low-income and underserved people. (Doctors whose only federal payments are through Medicare Part B are exempt from this requirement, however.)
The Census Bureau estimates that nearly 9 percent of the population age 5 or older has limited English proficiency, which the bureau defines as people who describe themselves as speaking English less than "very well."
Hospitals and other medical providers are in a tough spot, say experts. The law prohibits them from asking patients to pay for translation services, and they may not receive adequate or in some cases any other reimbursement.
"It's a civil rights law, not a funding law," says Mara Youdelman, managing attorney in the Washington office of the National Health Law Program.
A dozen states and the District reimburse hospitals, doctors and other providers for giving language services to enrollees in Medicaid, the joint federal-state program for low income people, and in CHIP, a federal-state health program for children, according to Youdelman.
A 2008 survey by America's Health Insurance Plans, an industry trade group, found that 98 percent of health insurers provide access to interpreter services, but providers and policy experts question that figure. According to a survey by the Health Research and Educational Trust, in partnership with the American Hospital Association, 3 percent of hospitals received direct reimbursement for interpreter services, most of that from the Medicaid program.
"Most hospitals that make this a priority make it a budget item," says Youdelman.
Hospitals and other providers realize that providing competent interpreter services can help ensure that they don't miss or misdiagnose a condition that results in serious injury or death, say experts. Trained interpreters can also help providers save money by avoiding unnecessary tests and procedures.
Youdelman cites the example of a Russian-speaking patient in Upstate New York who arrived at an emergency department saying a word that sounded like "angina." The emergency staff ran thousands of dollars' worth of tests, thinking he might be having a heart attack. The real reason for his visit: a bad sore throat.
Like many hospitals, Children's Medical Center of Dallas provides interpreter services around the clock via varying modes of communication — face-to-face, telephone and video — delivered by a mix of trained staff interpreters and outside contractors.
When Nadia Compean, 23, was six months pregnant, her doctor in Odessa, Texas, told her that her baby had spina bifida, a condition in which the spinal cord doesn't close properly, leading to permanent nerve and other damage.
The local hospital wasn't equipped to handle the birth and subsequent surgery that her daughter would require, so Nadia and the child's father traveled to Dallas, about 350 miles away.
Neither speaks much English, but at Children's Medical Center of Dallas, interpreters helped them understand what to expect, Nadia said (through an interpreter).
Nadia says she learned that her daughter, Eva, would be born with a lump on her back and would require immediate surgery. She also learned about problems that Eva may experience walking and using the toilet, she says.
Eva was born on March 6. Because of her medical needs and the lack of adequate interpreter services in Odessa, the couple is considering relocating to Dallas, where the father hopes he can find construction work.
Please send comments or ideas for future topics for the Insuring Your Health column to questions@kaiserhealthnews.org.
Michelle Andrews: andrews.khn@gmail.com,	@mandrews110
Health Industry Insuring Your Health
Michelle Andrews


All classes are gratuity-based and we are happy for you to donate what you feel the class is worth. We rely completely on the generosity of our students to continue making yoga accessible for all.
Bookings essential. We recommend arriving 15 minutes before class to check in, set up your mat, talk with the teacher if need be and prepare yourself for practice. If you are not at the studio at least 5 minutes before class starts, your spot may be given to a wait-listed or walk-in student.
Mat hire is available for a gold coin donation.
Private Sessions available by appointment only. Please contact us directly to discuss further.


as long as we make sense to each other.
the spark to a new flame.
as long as you promise to keep the skies lit up for me.
we'd never be easy to swallow.
Let them call it crazy!
is not being part of it in the first place.
I am continuously breaking, why do you continue to break me?