On Empathy and Appeasement

In an effort to complicate the commonplace understanding of empathy as an uncomplicated good, the author draws on her experience of sibling abuse to distinguish between empathy and appeasement. Because both rely on perspective-taking, empathy and appeasement are often conflated, but this essay demonstrates the importance of recognizing that empathy originates in courage and appeasement in fear. Abuse victims will recognize this important difference quickly enough; we need others espousing the value of empathy to recognize the difference as well

Telling the Truth About Sibling Abuse: Domestic Violence in Julie Barton\u27s Dog Medicine and Tara Westover\u27s Educated

Cultural conversations about two recent memoirs, Julie Barton’s Dog Medicine and Tara Westover’s Educated, miss an opportunity to address the most common form of domestic violence—sibling abuse—in favor, instead, of more palatable cultural narrative about depression and education. I argue that the memoirs themselves provide ample opportunity for such a conversation

On Narrative Collapse: Dementia, Depression, and the Significance of Narrative Resources

Drawing on scholarship in illness narrative, this article argues for the significance of Arthur Frank’s concept of narrative resources to an understanding of narrative collapse. Dependent on the belief that stories need other stories and that all humans need to narrate their lives, the concept of narrative resources draws our attention to the kinds of stories that are sanctioned by our culture and asks us to consider those that are not. The author herself draws on a number of narrative resources to consider what happens when our life narratives collapse. Driven by a desire to understand her mother’s dementia, the author examines the narrative resources available for narrating dementia and depression. The author proposes Judith Butler’s concept of precariousness as a new framework for understanding the work of narrative

Clinical and Lifestyle-Related Prognostic Indicators among Esophageal Adenocarcinoma Patients Receiving Treatment at a Comprehensive Cancer Center

Purpose: The incidence of esophageal adenocarcinoma (EAC) has risen substantially in recent decades, while the average 5-year survival remains only ~20%. Disease stage and treatment are the strongest prognostic factors. The role of lifestyle factors in relation to survival remains uncertain, with a handful of studies to date investigating associations with obesity, smoking, physical activity, diet, or medications. Methods: This study included patients diagnosed with primary adenocarcinoma of the esophagus, gastroesophageal junction, or cardia (N = 371) at Roswell Park Comprehensive Cancer Center between 2003 and 2019. Leveraging extensive data abstracted from electronic medical records, epidemiologic questionnaires, and a tumor registry, we analyzed clinical, behavioral, and environmental exposures and evaluated stage-specific associations with survival. Survival distributions were visualized using Kaplan–Meier curves. Cox proportional hazards regression models adjusted for age, sex, stage, treatment, and comorbidities were used to estimate the association between each exposure and all-cause or cancer-specific mortality. Results: Among patients presenting with localized/regional tumors (stages I–III), current smoking was associated with increased overall mortality risk (HR = 2.5 [1.42–4.53], p = 0.002), while current physical activity was linked to reduced risk (HR = 0.58 [0.35–0.96], p = 0.035). Among patients with stage IV disease, individuals reporting pre-diagnostic use of statins (HR = 0.62 [0.42–0.92], p = 0.018) or NSAIDs (HR = 0.61 [0.42–0.91], p = 0.016) had improved overall survival. Exploratory analyses suggested that high pre-diagnostic dietary consumption of broccoli, carrots, and fiber correlated with prolonged overall survival in patients with localized/regional disease. Conclusion: Our data suggest that lifestyle exposures may be differentially associated with EAC survival based on disease stage. Future investigation of larger, diverse patient cohorts is essential to validate these findings. Our results may help inform the development of lifestyle-based interventions to improve EAC prognosis and quality of life