Tutor profile: Arielle H.
Subject: Health and Medicine
Why do you want to be a doctor?
My mother’s due date was the day of my father’s first space shuttle launch. I was born into an extended family where some of the world’s most ambitious men and women became my role models. It seemed almost inevitable, biological even, that I would pursue a career in aeronautics or astrophysics. The Johnson Space Center was more or less my nursery. To my family’s surprise, I toddled right past the world-famous astronauts, mesmerized by those dressed in long white coats. I could not take my eyes off the flight surgeons. Who were these men and women, charged not with launching rockets, but with caring for their cargo? The medical routine at the space center was a super-charged version of standard practice. Between the diagnostics, pre-flight checklists, some of the most advanced equipment on the planet, and the constant stretching of the human body’s limits, I was hooked. The magic of it all captivated me. As years passed, nothing else gave me the same sense of wonderment. I knew I had found my calling in medicine. After a short decade-and-half of showering NASA’s flight surgeons with my constant questions, I decided to become a Certified Nursing Assistant (CNA). I completed my CNA certification while still in high school and was hired by a long-term care facility while a freshman in college. I was young, naïve, and the nursing home was quite a shock compared to my experiences in NASA’s clinic. However, I could never have foreseen how much this job would teach me. On my first day as a CNA, I experienced death for the first time. A woman was in the final stages of her life when my rounds brought me to her room. I imagined myself as the woman lying in bed, and the fear of dying alone rushed over me in one fleeting moment. She coughed, and her eyes met mine, connecting us in a way I never expected. Her eyes seemingly begged me to stay by her side for just a little longer. It did not matter that I was unaware of her story, values, hopes, or dreams. In her final moments, we were just humans, and she seemingly needed me. As I left the room that day, my mind was dizzy. I did not have the time to contemplate this sobering experience, as the many demands of work pushed me forward. Soon after, though, I remember helping a man practice walking after his surgery, and working with a stroke patient who was struggling to eat on her own. I recognized that, even on difficult days, these small victories make serving in healthcare worthwhile. From the medical utopia of the Johnson Space Center to the quiet, noble, unheralded work of the care center staff, I experienced a substantial dichotomy; yet, I loved them both. Conducting medical tests on astronauts during space flights is cutting edge, but no astronaut’s smile is as beautiful as an 85-year-old grandmother just learning she has visitors! The NASA community provided me with world-class mentoring, but predisposed me to develop a somewhat narrowed world view. As a young college student, I held science as a sort of perfect religion that gave me black-and-white answers to absolutely everything. Honestly, I had a false sense of my cultural awareness. The challenges of my new college environment, combined with the rigors of my first honors course, humbled me with the lowest grade I ever received. Discouraged, I learned to work harder. I shifted from passionately arguing for my beliefs and opinions to actively listening to other’s ideas. As I paid closer attention to ideas that differed from my own, I began to see the world in shades of gray. I still revel in the empiricism of science, but I now realize that answers come in different ways, people matter more than proofs, and the real world does not parallel the glitz of my interstellar playground. With a more nuanced mindset, I set out to gain experiences beyond my comfort zone. The Gabriel Project, a confidential outreach program for women with unplanned pregnancies, provided me with this opportunity. These women are marginalized and vulnerable; many of those served are immigrants and refugees. Almost every woman had been, at the very least, abandoned, or at worst, severely abused. Despite their diverse backgrounds, their pregnancies united them. Although I know I helped many women during my time there, I know my role did not compare to how these women helped each other. Given the awful things we are capable of, humans have an amazing ability to unite and care. Science has its triumphs, NASA may soon set foot on Mars, but these women are the real rock stars. My volunteer commitment quickly evolved into a passion. Between working with the women in their homes, accompanying them to doctor appointments, and sharing in their anticipation of a new arrival, I soon realized how similar we were. We shared likes, dislikes, goals, and dreams. In time, we even became friends. Their life experiences taught me more about adversity than I ever obtained from a textbook or course lecture. The Gabriel Project exposed me to the disparities that exist in healthcare and has ignited a fire in me to advocate for underprivileged populations in the medical field. Reflecting on my experiences thus far, leaves me no doubt that I will bring a unique perspective to medical school and to the care of my future patients.
What role does the media play in criminality?
The Violent Media as an Immoral Role Model The influence of modern technology on human life is an irrefutable present condition. With this seemingly exponential technological evolution comes the increasing societal presence of the media; this modern form of communication and story-telling is quickly expanding as technology becomes more readily accessible. Moreover, there is an upward trend in the prevalence of media violence. Considered together, these two factors have sparked an ongoing debate regarding the media’s potential to influence criminal behavior. Some, such as Brad Bushman, a human aggression psychologist, and Craig Anderson, a psychologist specializing in media violence, argue that media violence is a causal factor in aggressive behavior. Conversely, individuals such as Johnathan Freedman, an English professor at Yale, argue that media violence does not affect criminal behavior. With this debate lies the question: What role, if any, does the media play in social learning as it relates to the moral development of children? The media’s influence on violent and aggressive criminal behavior is evident, this exposure may result in an adverse behavioral outcome, arising from social learning and catalytic media influences. Christopher Ferguson, an American psychologist, introduces potential causal links between violent media exposure and future criminal behavior. Ferguson cites the theories of social learning, catalysis, and catharsis to explain the relationship between violence in the media and its influence on viewers. Supporting evidence for each of the three theories surfaces through the examination of work by Bandura, Akers, and Kohlberg for the social learning platform, Eysenck and Raine offering confirmation for the catalysis model. Conversely, Freud’s ideas support the catharsis counter-argument. Through analysis of Ferguson’s theories, as supported by the social learning and catalysis models, through Foucault’s concept of punishment as a spectacle, the role of violent media in criminal outcome becomes indisputable. Counter to this, evaluation of Ferguson’s catharsis proposition under a Freudian framework negates a relationship between media violence and criminal behavior. Ferguson introduces three plausible causes of criminality (or lack thereof) due to media influence. In his paper, Media Violence Effects and Violent Crime, he presents the methodologies of social learning, catharsis, and catalysis. Ferguson cites the social learning model where “individuals are likely to imitate what they see” (Ferguson, 42), while he outlines exposure to media violence under the catharsis model as “provid[ing] an outlet or release for aggressive drives... [P]eople who consume violent media would be expected to become less aggressive” (Ferguson, 42). Additionally, he delineates an alternate theory of catalysis where, “media violence neither is a cause of violent crime nor stimulates it, but may act as a stylistic catalyst” (Ferguson, 45). These three media influences are classifiable as behavioral mirroring, a deterrence mechanism, and a potential criminal primer. Michel Foucault, a twentieth-century French philosopher, provides a basis from which to conceptualize the shift of spectacle—from punishment as a criminal deterrent to the media’s glorification of violence. Extrapolated from a Foucauldian framework, violent media content now presents the possibility of influencing one’s behavior. In Discipline and Punish: The Birth of the Prison, Foucault suggests that punishment as a spectacle no longer exists; therefore punishment is no longer an effective means of preventing violent behavior (Foucault, 9). On the contrary, when evaluating Foucault’s work in the context of Ferguson’s proposed behavioral frameworks, the spectacle has undergone a conversion to exalting violence. That is, where the spectacle of punishment once deterred violence, now violence itself is the spectacle—prompting more violence from media spectators. This resulting violent behavior, when considered with catalysis and social learning, is typically unfavorable in society. Ideas introduced by Albert Bandura, a contemporary social scientist, and Ronald Akers, a present-day American criminologist, provide evidence for Ferguson’s social learning model of violent media influence on behavior. For Bandura, people learn violent behavior by observing the behavior of the individuals surrounding them. He contends that “[m]ost of the participants in the controversy over the determinants of behavioral variation eventually adopted the view that behavior results from the interactions of persons and situations, rather than from either factor alone” (Bandura, 9). From this, Bandura posits that the social learning theory is a constant interaction between the personality of the individual, the environment where the modeling takes place and the situation. Akers adds to this social learning model through his interdisciplinary connection of learning theories and their symbolic relationship to media violence. He proposes that, "The probability that persons will engage in criminal and deviant behavior is increased and the probability of their conforming to the norm is decreased when they differentially associate with others who commit criminal behavior and espouse definitions favorable to it, are relatively more exposed in-person or symbolically to salient criminal/deviant models, define it as desirable or justified in a situation discriminative for the behavior, and have received in the past and anticipate in the current or future situation relatively greater reward than punishment for behavior". (Akers, 50) Under the framework set forth by Bandura and Akers, the media’s symbolic role-model effect on its viewers is palpable. In their development, children see and observe these positive and negative role models—both well-behaved and violent—and learn behaviors in this fashion rather than solely by their own behaviors. Through Ferguson’s social learning model of violent media’s influence on behavioral outcome, as supported by Bandura and Akers, the media is a role model. The increase in violent media content only increases the probability of the media as a violent role model rather than as a respectable role model. Lawrence Kohlberg, a 20th-century American psychologist, adds to Ferguson’s proposed social learning model, as supported by the ideas of Bandura and Akers, through his theory of moral development. In this theory, he extrapolates the connections between the media, learned morality, and acts of criminality. According to Kohlberg, children progress through stages of morality as they develop in their abilities to decipher right from wrong. Under this moral development theory, Kohlberg states “moral and social development is defined as the direct internalization of external norms of a given culture” (Kohlberg, 105) from this definition, the role of the media falls within the scope of an “external norm” in American culture. The question of whether children are gleaning moral insight from the family unit or from the media becomes imperative. Kohlberg agrees with Akers and Bandura that the effect of violent media exposure on a child’s moral compass and behavioral outcome hinges on their relative “expos[ure] in- person or symbolically to salient criminal/deviant models” and if behavioral acts are presented to them as “desirable or justified in a situation discriminative for the behavior” (Akers, 50). With the increasing prevalence of children’s access and exposure to violence in the media, under Kohlberg’s theory of moral development, the type of behavior children are most commonly exposed to is what becomes reinforced under their developing moral framework. In this way, as endorsed by Akers’ and Bandura’s contentions, when children are presented with violent behavior more often than with non-violent behavior, violence becomes normalized. Similarly to the social learning model, Ferguson’s catalytic framework of violent media influence, as supported by Hans Eysenck, a 20th-century German-born psychologist, and Adrian Raine, a contemporary British criminologist, lends itself to a similar behavioral outcome. Under Ferguson’s catalysis model, violent media exposure acts as a “trigger” due to an individual’s pre-existing circumstances and vulnerability to commit criminal acts. While some individuals are able to control their behavior, others are unable to. Outside factors may contribute to the complex pathway introduced by Eysenck and Raine of genetics as it results in brain formation, resulting in personality (impulse control abilities/psychoticism). Devices that play a role in differentiating whether a person acts in one way or another are environmental catalysts and the strength of the individuals’ impulse control. Although there are a variety of factors that contribute to one’s eventual act of violent behavior, exposure to violent media may act as a factor catalyzing the shift from non-violent to violent behavior. The characters in Bobcat Goldthwait’s movie, God Bless America well exemplify Ferguson’s theories of social learning and catalysis, as discussed previously. The film’s main character, Frank, is terminally ill and has recently lost his job, among other discouraging life events. Frank is continually exposed to media violence at the beginning of the film, prompting him—through the social learning and catalysis models—to set out on a killing spree. For Frank, the media plays a dual role: as a social learning model it shows him how to use a gun and as a catalyst by prompting his murder rampage. While the violent media “shows” him the technique and the “how to,” the media as a catalyst predicts the emotional response of why he did this— based on his current, depressing life circumstances. Frank’s level of tolerance for violent stimuli was lowered, thus his impulse control device did not deflect his eventual violent behavior; his brain was not wired to tolerate and further violent stimuli— he “snapped”. Furthermore, a young teenager named Roxy is an unexpected assailant to Frank in his violent actions. As she accompanies him, Frank is a model for Roxy’s behavior (as a killer) through the social learning model. Throughout the film, Frank shapes Roxy’s values and her moral development through the authorization of her violent behaviors. Similarly, the role of the media in shaping Roxy’s morality is evident when she sees herself on the news as a wanted person. Although she is wanted for killing, she becomes excited when she sees herself on TV because the news recognizes her actions on a massive scale—even if this recognition is not “good.” From this example, the media has taught Roxy that one should work towards recognition, and the basis for recognition are: dysfunctional families, family fighting, and violence. Acting in a violent manner gleans media attention, and since Roxy wants attention, she continues to act out violently. In this example, there is overwhelming support for the role of violent media prompting violent actions via social learning and catalysis. Counter to both Ferguson’s social learning and catalysis methods is the catharsis model. While the social learning and catalysis frameworks, both depict media violence as an enabling factor in real-life violent behavior, the catharsis approach claims that media violence mitigates violent acts. The drive reduction theory, put forth by Sigmund Freud, a nineteenth-twentieth century Austrian neurologist and psychologist, supports Ferguson’s catharsis notion. Freud, in Civilization and its Discontents, introduces the idea of “death drive” which states that one has a natural drive toward their own death and destruction. Although this “death drive” is innate, individuals must channel this drive appropriately. In order to exist in a civilized society, one must find socially acceptable ways in which to channel this anger and aggression (Freud, 94-96). Methods by which one may accomplish this are by running, playing violent video games, watching horror movies, etc.; the possibilities are endless and differ amongst the population. Applying this theory to media violence exposure, people will become less aggressive as aggressive tendencies are released through exposure to violent content; violent media may act as an outlet for the drives that civilization represses. While this argument seems valid, it relies too heavily on the responsibility of the individual to acceptably resolve violent inclinations in the presence of violent stimuli. Nevertheless, regardless of the accuracy of catharsis in the face of media violence, this ideology still reveals media’s influence on human behavior—in resolving aggressive and violent behavior rather than facilitating it. Violent media presents itself as a fairly uncharted problem, as it is a recent introduction to modern society. The exponential media growth and proportional expansion of media violence require attention from researchers, psychologists, sociologists, parents, teachers, and all other parties responsible for the growth and development of societies’ youth. While many argue there is no link between adverse behavior and violent media exposure, evidence proposed by Bandura, Akers, Kohlberg, Foucault, Ferguson, Eysenck, and Raine suggest otherwise. Violence should not act as the role model for the moral development of future generations; with this in mind, society would be wise to take a cautionary approach to finding a balance between banning violent media and encouraging its expansion. The moral outcome of subsequent generations hinges on individuals such as policymakers, parents, scientists, and the like; a new approach is necessary if there is to be a resolution to this societal issue. References Bushman & Anderson v. Freedman. PDF. Akers, Ronald. Akers. PDF. Anderson, Craig A, and Brad J. Bushman. Anderson & Bushman 2002. PDF. Bandura, Albert. Bandura (short). PDF. Eysenck, Hans J. Eysenck 1996. PDF. Ferguson, Christopher J. Media Violence Effects. PDF. Foucault, Michel. Foucault Ch.1. New York: Random House, Inc., PDF. Foucault, Michel. Foucault Ch.3. New York: Random House, Inc., PDF. Freud, Sigmund. Civilization and its Discontents. New York: W.W. Norton & Company, 2010. Print. God Bless America. Dir. Bobcat Goldthwait. Perf. Joel Murray and Tara Lynne Barr. Potemkine Films, 2012. Netflix. Kohlberg, Lawrence. Kohlberg (short). New York: Harper & Row, 1981. PDF. Raine, Adrian. Raine 2008. PDF.
Explain the sequence of blood flow through the heart from deoxygenated to oxygenated. Specify how this differs from fetal blood flow in-utero and what 3 reminants of fetal blood flow are found in Adults.
Typical Adult Blood Flow: Vena Cava --> Right Atrium --> Tricuspid Valve --> Right Ventricle --> Pulmonary Semilunar Valve --> Pulmonary Artery --> Lungs --> Pulmonary Vein --> Left Atrium --> Bicuspid Valve --> Left Ventricle --> Aortic Semilunar Valve --> Aorta --> Blood goes to the rest of the body Fetal Blood Flow: Intervillous Space --> Fetal Villous --> Umbilical Vein --> Ductus Venosus (through Liver) --> Inferior Vena Cava --> Right Atrium --> Foramen Ovale --> Left Atrium --> Left Ventricle --> Aorta --> Brain/Body --> Umbilical Artery (Some of the blood also goes from the Right Atrium --> Right Ventricle and then continues to the Pulmonary Artery where it is shunted to the Aorta by the Ductus Arteriosus to mostly bypass the fetal lungs) Remnants: 1. Foramen Ovale 2. Ligamentum Arteriosum 3. Ligamentum Venosum