Sunday, December 28, 2014

Run Your Own Science Writing Group

Amanda Gefter and I have been co-directing NeuWrite Boston since September 2013, after I inherited the group from Molly Birnbaum and Judith Vick. NeuWrite is a workshop for scientists, science writers, and everything in between. While we're still figuring out how to do this with scientists and science writers from different disciplines and at different points in their career, I think we've got a good thing going with NeuWrite Boston.

Some people have been asking us how we got our group going and how we run the group, so I've decided to write this post. It's adapted from a couple of emails I've sent explaining how our group works. I hope this gives you enough information to go off and build your own group! (Brief note about me: I'm a late-stage PhD student in computer science at MIT. I've been interested in science communication for a while.)

How Amanda and I came to run the group. NeuWrite and Amanda both entered into my life pretty serendipitously. I had gone to college with Carl Schoonover, who started NeuWrite with his Columbia neuroscience PhD classmate Tim Requarth. In May 2013 I came across his profile as #3 on this list of 50 sexiest scientists and discovered that he had written a book (Portraits of the Mind, a gorgeous coffee table book of neuroscience images), started NeuWrite, and was doing all the science communication activities I always said I wanted to do but never did. I invited Carl, Tim, and their colleague Rebecca Brachman (who currently runs NeuWrite NYC) up to MIT to give a talk about science communication. Around this time both of the co-directors of NeuWrite Boston were leaving, so I somehow inherited the group. I was told to find a writer to run the group with me, so I started asking around. I met Amanda, a Knight Fellow at MIT and who just published her first book (Trespassing on Einstein's Lawn), through another Knight Fellow, Rochelle Sharpe, who I had met in a class. We met for coffee, hit it off, and have been running the group together ever since.

Membership. My favorite part about NeuWrite is the people. At every meeting I think to myself, "This is what it would be like if I took the most interesting people out of a party and made them all discuss something I cared about."

Our group has about 30 members, 10-15 of whom show up each time. There are a few members we inherited from before, but we recruited most of the current members. We've been trying to keep a balance between professional writers and professional scientists. A few people stayed in the group from when Judith and Molly ran it, but most of our members are new. I recruited the scientists mostly from my circle of friends and people who had shown up when Carl, Tim, and Rebecca same to speak. Amanda recruited the initial group of writers, some of whom were so successful they had long outgrown the need for such a group. We found a couple of more through other members in the group and through people finding us.

When recruiting, Carl, Tim, and Rebecca had recommended that we get people who are starting out in their careers--who need the group--rather than senior famous people. This has proven to be good advice: the junior people who get a lot out of workshopping in the group tend to be the best at showing up. Judith also told us to emphasize dedication--this is important for building a community where there is enough trust for people to be honest with constructive criticism.

Meetings. Our meetings have been surprisingly enjoyable for how productive they are. As Carl/Tim/Rebecca suggested, we meet once every three weeks for three hours. The first hour is social and the second two are for workshopping or discussion. We've workshopped not just specific pieces but also pitches for articles and books, scripts for educational videos, concepts for blogs, and proposals for magazines. (Read about some of what we did in 2014 here!) We've also workshopped a couple of the professional writers' pieces after publication and had them talk to us about their process. We've had discussion both about our favorite writing and our favorite science writing.

As for logistics, we host the meeting at one of our members' homes each time. The host cooks or orders out and we each chip in $10, plus optional drinks and desserts. (This is different from the original NeuWrite, which meets at a professor's house each time. I believe they also have departmental funding.) We have a Google spreadsheet where people can sign up to host, workshop, and send meeting notes (abbreviated minutes). I send out a Doodle RSVP for each meeting with people's food preference (omnivore/vegetarian/no food). Whoever is supposed to take the notes (usually Diana Crow or me) follows up afterward with a summary. If no one is signed up to workshop, I will email the list and/or ping individual people at least two weeks in advance. If no one wants to workshop, the group is pretty good about coming up with alternate activity.

A note on funding: it has been difficult for us to get funding when we first started because our members were spread across Harvard, MIT, and BU--and professional science writers. We haven't tried again since then.

Collaborations. The New York group seems to do a good amount of co-writing; we have yet to figure out how to get this going. People do help each other out on ideas, but there haven't yet been any collaborative products. One time, Tim De Chant, an editor at Nova, picked up a piece that Alison Hill, a biophysicist modelling HIV, wrote explaining why HIV has no "cure" yet. This past spring Amanda and I tried to pair people up to do projects together, but that didn't seem to really go anywhere. I have brainstormed with people about potentially collaborations--and the group model has made me much more open to co-writing. (For instance, I wrote this Wired opinion piece about how gender matters with two fellow MIT CS PhD students, Elena Glassman and Neha Narula, following our Reddit Ask Me Anything session.)

Some things we're working on in terms of group dynamics. Even though we've been having fun and doing things, we're still a work in progress. One thing we've struggled with is that since everyone seems to work in a different area of science, there aren't natural pairings between the writers and the scientists. Initially this made it unclear what the writers could get out of the group, especially if they are established and end up spending a lot of time mentoring scientists on their writing. For a while we tried to have the scientists spend an hour presenting their field to give the writers a deeper look, but I think everyone who wanted to go has already gone, so we've gone back to workshopping. We realized this issue at a meeting we had last January where we asked for feedback about what was working and what was not. This reflections/hopes-and-dreams meeting was incredibly helpful last year. It will be our first meeting of January 2015.

Social events and community things. One of the best parts of the group seems to be the network we have created of people interested in science communication. It is good for brainstorming and good for making the non-professional writers feel accountable for their science communication projects. People also trade notes on science news and good examples of science communication.

Because good things seem to come out of people talking to each other, we've been trying to provide more opportunities for this. So far we've had one official social event, a BBQ, that seemed to be a lot of fun. People sometimes email across the list about readings and events that they're going to. I'm not actually sure if people go to that, since I haven't been able to make it to any of them. There are some other fun things that go on: for instance Ash Jogalekar has a ton of books and gives them away every time he hosts. Inspired by this, we've talked about doing a NeuWrite Boston book exchange.

Summary of advice/what worked. I caution against taking too much advice from other people, but if I had to give advice about what worked this is what it would be:
  • Find people who need the group as much as the group needs them! For most members, unless they came highly recommended, I would do coffee with them and emphasize the importance of commitment to the group.
  • Allow the group to grow based on what the members want. A lot of cool things have come out of the members deciding they wanted certain things to happen, which would probably not have happened if they were waiting for Amanda and me to decide what was going to happen. Also, what works for another group and their members might not work for your members!
  • Try hard to balance out the group. We've noticed that when there is a good mix of writer/scientist backgrounds and a good mix of people in general, the discussion is better.
  • Make a website! (And do other things to increase feelings of legitimacy and community!) People seemed to feel our group was more legitimate after we had a website. It was good for morale and for our sense of community.
  • Spend time thinking about what your group needs to feel a sense of community. This is what keeps our members coming back to meetings.
Running NeuWrite has been one of my favorite extracurricular activities in graduate school. I have met many brilliant people from whom I've gotten such inspiration about the kinds of science communication projects I would like to do. tl;dr highly recommend; would do again. Good luck and have fun!

NeuWrite Boston 2014: Year in Review

This New Year's marks the end of the first full calendar year that Amanda Gefter and I have been co-directing  NeuWrite Boston. For those of you who don't know, NeuWrite is a workshop for scientists, science writers, and everything in between. I think of NeuWrite as a fun tri-weekly dinner party with some of my most interesting science-inclined friends, where we also happen to do some work (my other favorite thing besides dinner).

Here are some pieces we've workshopped in 2014:
And this is just a subset of what's passed through our meetings--pieces we've workshopped include a documentary about psychologist and human-computer interaction researcher Cathy Wolf (who has lived with ALS for almost two decades), an essay about the economics of rationality, and a couple of essays about the beauty, art, and craft of chemistry. Our members have also been doing lots of incredible their outside the group. (Amanda's first book, Trespassing on Einstein's Lawn--a fascinating physics memoir about nothing and the origin of everything, came out earlier this year! And she managed to keep running the workshops despite flying around and writing related articles.)

Amanda and I feel incredibly privileged to organize a group of such talented and fascinating people! We look forward to seeing what 2015 has in store. We look forward to seeing all the cool things we'll do in the upcoming year!

P.S. For those of you interested in starting your own similar group, I have a forthcoming blog post!

Sunday, April 27, 2014

Mazda 6 Recall: Is it True that Spiders Like the Smell of Gasoline?

A few weeks ago, my Facebook newsfeed prodded me with this rather distracting headline: 

“Mazda 6 recalled over spider invasion!”

Wait, spiders are invading our cars?

I clicked on the link, and learned that a common species of spider, call the yellow sac spider, just loves the smell of gasoline, and this passion for gas leads it to build its home within the Mazda 6 fuel tank. The webs it weaves disrupt the pressure regulation system within the fuel tank, causing it to crack. Gasoline leaks onto hot engine components, and boom! The engine catches on fire.

Engines spontaneously catching on fire? Seems like a good reason to issue a recall.

But as for the reasoning - is it really true that spiders are attracted to the smell of gasoline?

I took a peek into the scientific literature. Gasoline is composed of hydrocarbons, a class of molecules that are built from only hydrogen and carbon atoms (hence the name: hydro-carbon). I searched for any reference that linked spiders to hydrocarbons, and found only one: the East African jumping spider is attracted to the smell of specific species of plants whose nectar is favored by mosquitos; presumably hanging out on the plants gives them greater access to these mosquitos, one of their favorite forms of prey. Some of the compounds that determine the tree’s “smell” are indeed hydrocarbons; however, none of the hydrocarbons produced by the tree match those that would be found in standard gasoline.

Christopher Buddle, entomologist and blogger over at SciLog’s Expiscor blog, was also skeptical of the "gas-loving" spider story. He did his own literature search, and found that some spiders might be attracted to the smell of specific hydrocarbons found in the exoskeletons of bugs - but, once again, none of these hydrocarbons match those in gasoline.

It is a huge leap to say that the yellow sac spider loves the smell of gasoline just because certain other spiders like the smell of certain other hydrocarbons. Buddle believes he has found the source of the story, a 2011 Reuter’s piece in which automotive journalist Mitsuhiro Kunisawa is quoted as saying, “This spider's distinguishing characteristic is that it likes the smell of gasoline, caused by the hydrogen oxide.” As a chemist, I can tell you that “hydrogen oxide” could refer to molecules that are built from hydrogen and oxygen, none of which should be found in standard gasoline.

Perhaps, on the scale of scientific errors, the gas-loving spider story is a relatively inconsequential one: how much does it really matter if a few people believe that spiders enjoy the smell of gasoline? (Though I must say, I have this image in my mind of some future dad, lecturing his sixteen-year old son about a new car : “Now, son, after getting the oil changed, remember to check the engines for spiders! You know how those buggers just love the smell of gasoline.”)

But whatever the consequences, as a scientist and writer it still disturbs me when scientific inaccuracies are hyped and spread. Here is a sampling of some of the headlines I found:


Luckily, many of the larger news organizations (such as CNN) have avoided the “gas-loving spider” story.

Christopher Buddle has attempted to contact Mitsuhiro Kunisawa to see if he has any evidence for this story. For updates, follow Buddle’s blog at http://www.scilogs.com/expiscor/

Sunday, April 13, 2014

Is It Solipsistic In Here, Or Is It Just Me?

This post by NeuWrite co-director Amanda Gefter has also appeared here.

I’m sure every freshly published author struggles with the ungainly demands of self-promotion. It’s taxing and embarrassing— shouting your title from the rooftops of social media, groveling for favors, trying desperately to be heard. And then, if you’re me, there’s an additional level of awkwardness that taints the whole effort when it suddenly dawns on you that you’ve been out in the world trying to promote a book about solipsism.

The book, Trespassing on Einstein’s Lawn, is the story of my 17-year journey with my father to figure out the nature of ultimate reality and what we discovered, quite frankly, is not what any marketing team wants to hear. Quantum mechanics, relativity, black hole physics, cosmology and string theory all point to the same radical, paradigm-shifting conclusion: every observer’s reference frame defines its own universe, singular and complete, and even though any reference frame is as good as any other, we can only speak about one at a time. Me? I’ve got my reference frame – namely, “author.” And that puts me in the rather uncomfortable position of having to deny the existence of another reference frame – namely, “reader.” So when it comes to promoting my book, I’m kind of at a loss. If the universe is solipsistic, I’m pretty sure the twitterverse is, too.

My belief in this cosmic solipsism is a sad lesson in irony, really, because this whole thing – my career, my universe, my book—began with a conversation. I was fifteen years old, having dinner in a Chinese restaurant, when my father leaned over and asked, “How would you define nothing?” He told me that he was trying to understand how you can get something from nothing, how a universe could be born. Over plates of cashew chicken, we vowed to figure it out.

At first it was just sort of a hobby, teaching ourselves theoretical physics and cosmology, and we didn’t realize how far out of control it had spun until we found ourselves impersonating journalists and crashing a physics conference in Princeton, New Jersey. It was after the conference, as we were trespassing on Einstein’s front lawn, two bogus press passes still hanging round our necks, that I realized our hobby had become something more like a mission – a joint, covert quest to figure out the nature of reality. I conjured up a journalism career as a front and my father and I spent the next decade traipsing around the country, meeting with brilliant physicists and discussing the deep mysteries of existence.

Our first major breakthrough came when we realized that physics can pin down what’s real and what isn’t. It’s one of those things that’s somehow stupidly obvious and yet deeply profound: something is real if it’s invariant. That is, something is real if it remains unchanged from one reference frame to the next. Just look at a rainbow. You’ll see one in the sky if you’re in just the right reference frame with the Sun shining in from behind you, and droplets of water in the atmosphere refracting the light. It’s pretty, but good luck trying to grab it. A rainbow is not a physical object stapled to the sky. It’s a product of your reference frame. Which is to say, it’s not real.

Ok, so what is real? Space? Time? Particles? Forces? Well Einstein showed that space and time aren’t real– they change from one reference frame to another. However, something remains invariant in the process: a unified, four-dimensional spacetime. “Space by itself and time by itself are doomed to fade away into mere shadows, and only a kind of union of the two will preserve an independent reality,” the mathematician Hermann Minkowski declared.

And the thing my father and I learned is that ever since Einstein, theoretical physics has been one long death march for invariants. With his infamous discovery that black holes radiate, Stephen Hawking declared particles observer-dependent (along with fields and the quantum vacuum to boot). String theory did away with the invariance of dimensions and M-theory did away with the invariance of strings. By studying what happens when stuff falls into a black hole, Leonard Susskind discovered that the unified spacetime Einstein had left unscathed is itself observer-dependent. As for nature’s four fundamental forces, Einstein did away with gravity (“We are able to ‘produce’ a gravitational field merely by changing the system of coordinates,” he wrote) while the development of gauge theory took care of the other three. Every last one of the so-called fundamental ingredients of nature has turned out to be a shadow. Unreal.

When I look back on that spring day on Einstein’s lawn, the day when our journey took a turn for the crazy, I see my father and I operating under the rosy-cheeked premise that there was a single reality we both shared, a Kumbaya universe, a mutual home, a world “out there,” independent of our viewpoints. Sure, there are things like shadows and rainbows that only exist in a given reference frame, we thought, but there also other things, real things, like tables and chairs, stars and galaxies, things that exist out there, in the universe, the ontological furniture in the common room of existence. Only now we’ve discovered that the common room is empty. There’s nothing out there. The common room—the universe—doesn’t exist. You’re left with a splintered, illusory, solipsistic reality and when it comes time to do PR for your book, you find yourself in a bit of an existential dilemma.

Given this whole situation, you might ask why I bothered to write a book in the first place. It’s a fair question. I remember early in the process my editor asked me who was the intended audience for the book. “Me,” I replied. I knew it wasn’t exactly what someone interested in book sales wanted to hear – after all, there’s only one of me, and I get a free copy. But it was the truth. I tried to write the book that I wanted to read. More to the point, I couldn’t speak for anyone else’s ontology. At the scale of publishing, quantum gravity effects are probably pretty negligible. But still.

The death of the last remaining invariants is a new development in physics, but the specter of solipsism has been looming for decades, ever since the first generation of quantum physicists struggled to understand what the theory meant. “It is conceivable we must give up on any ‘one-world’ view of physics,” the legendary physicist John Archibald Wheeler scrawled in his journal as he wrestled with the mystery of the quantum. Quantum theory seems to go haywire when you assume that multiple observers occupy the same universe. I might open Schrodinger’s box to find a dead cat, but what if the cat, the box, and I are sitting inside an even bigger box, one that some other observer—my father, perhaps— hasn’t opened yet? To me, that cat is dead, but to my father it’s simultaneously dead and alive, and so am I. If there’s only one reality, which one is it? Quantum mechanics is just boxes within boxes – unless you stipulate that there’s only one box, in which case the whole issue of writing books becomes a little thorny.

Hugh Everett knew what I’m talking about. In his famous 1955 dissertation, the founder of the “many worlds” interpretation wrote, “The interpretation of quantum mechanics…is untenable if we are to consider a universe containing more than one observer.” A possible escape route, Everett suggested, is “to postulate the existence of only one observer in the universe. This is the solipsist position, in which each of us must hold that he alone is the only valid observer...This view is quite consistent, but one must feel uneasy when, for example, writing textbooks on quantum mechanics…for the consumption of other persons to whom it does not apply.”

Despite all this, here I am, holding a freshly printed copy of my new book. Maybe I wrote it so I could feel less lonely, so that my thoughts could take physical form, so that they could become this object that can worm its way into other reference frames I myself could never visit and yet there they are, carrying a little piece of me with them. Look: there’s my mind, sitting on someone’s nightstand beside the red-framed glasses. And over there – my mind has a coffee ring stain and a leather bookmark with tattered fringes peeking out the top. There’s my mind tossed on a chair, half obscured by a sweater. There it is being used a doorstop; there it is snuggled up with a stranger in bed. That person is reading my mind and she’s laughing. She’s crying, she’s writing in my margins, she’s rolling her eyes. My mind is splintered, duplicated, repeated, cast out into universe after universe where it will live all these invisible lives, lives I will never know, a silent echo, and I’ll just be sitting here, in my own solitary world, straining to hear.

Friday, January 10, 2014

Guest Post: Just resolving to “get well” doesn’t cut it. What does?

This post by guest blogger Jennifer Crystal has also appeared here. Jennifer is an alum of NeuWrite Boston.

Last year at this time, I wrote a post about New Year’s being a sort of mockery for patients with chronic illness: each day of suffering is much like the one before, and we cannot simply resolve to get well with the change of the calendar, the way we can resolve to lose weight or drink less coffee. So much of our convalescence is arbitrary.

For Lymies especially, we often can’t say how our energy will be one day to the next; even taking all of our medication correctly can make us feel worse before better. Spirochetes, like cancer cells, can replicate and burrow deep within our bodies and brains, despite our best efforts to fight them. Despite our will to stop them. One of the most frustrating aspects of living with chronic illness is not being able to control what is happening to your own body.

When I first got sick, I vacillated between the classic fight or flight responses to my situation. At first I thought I could ward off reality with a “mind-over-matter” mentality. I insisted on working at summer camp despite the fact that I had a serious case of mono; I drove back to Colorado after camp, willing myself to be well enough to ski that season; years later, after long-term treatment for tick-borne diseases, I moved to Vermont as soon as I got my PICC line out, sure that my determination would be enough to see me through any hiccups I encountered.

Each of these decisions landed me back in bed, sicker than before. Resolve and will and determination and a positive attitude were not enough to combat an aggressive physical infection.

Other times, when frustration got the best of me, I’d throw up my hands and think, what does it matter anyway? Why not stay up so late that I become too agitated to sleep, read and write so much that my neurological symptoms flare with electric intensity, skip my nap to have a bleary-eyed visit with a friend? I remember telling one friend, “Sometimes I feel like my life is a movie. What will happen next?” I figured that even if I didn’t take care of myself, even if I pushed myself beyond my limits, eventually it would have to work out, right?

Wrong. There was no script calling for someone or something to swoop in and save me. My life was not scheduled to get better in a neat little 120-minute package. I was the one writing the script. It was up to me to decide if eventually things would work out.

Of course, there were parts of my illness that I could not control; there were the actual bacterial and parasitic infections that could only be treated with intense antibiotic, anti-malarial and adjunct therapies.

But there was another part that was up to me. After my serious relapse in 2007—following the failed move to Vermont—a friend told me that he was concerned about a pattern he’d noticed since we were in college: a pattern of me pushing myself past my limits, not giving myself adequate time to rest, ignoring or perhaps not seeing warning signs until I had already crashed. “Going back to Vermont—or anywhere—without dealing with these issues would be a mistake,” he cautioned.

That was enough of a wake up call for me to really think about they way I treated myself. For so long, I’d fought my body when it couldn’t do what I wanted it to do. I got angry and frustrated when I wanted to ski or climb a flight of stairs or sit up for a meal but couldn’t. I berated myself for not getting better fast enough. My mind and body were forever battling each other. If I intended to win the war, I had to stop that pattern.

Two members of my medical team introduced me to the concept of cognitive behavioral therapy: recognizing patterns and behaviors that were causing myself harm, and training or retraining myself to act differently in those situations. For example, to help combat my insomnia, my sleep doctor recommended that I start going to bed at exactly the same time each night; that I use my bed only for sleep, so my brain would not associate it with activities like reading or watching TV; that I spend the hour before bed away from screens, listening to quiet music and doing deep breathing exercises to help myself relax. I could not control the neurological firestorm that Lyme was causing in my brain, but I could reinforce with good behavior the medications and treatments that were targeting that physical problem.

The same theory applied for the way I scheduled my day, the way I handled stress, and the way I set limits and boundaries for myself. It wasn’t easy. There were setbacks and slip-ups. It took a great deal of discipline to politely excuse myself for a nap at the same time each afternoon; to set time limits for talking on the phone; to walk away from my favorite TV show because it was making my neurological symptoms flare. I didn’t want to do any of those things, but I started to understand that I had to do them if I wanted to get well.

Over time, the new habits I created became routine. Taking proper care of myself became my top priority, and giving my health that significance made it easy to keep up the practice. Soon my body and brain were not arguing, but working as a team to get well. I started to get better much faster once my body realized that I was going to care for it properly, that I was in this fight with it, not against it.

We Lymies can’t control the spirochetes, but we can control ourselves. We can control the decisions we make and the habits we create that can help move us towards health. We can’t resolve to get well in the new year, but we can promise to take the best care of ourselves possible, to help achieve that end goal of restored health.

Lyme survivor Jennifer Crystal is pursuing a Masters in Creative Writing at Emerson College, in Boston. Her website is jennifercrystal.com. Email her at jencrystal5678@gmail.com.

Wednesday, January 8, 2014

Simple Science: The Neuroscience of Memories

This post is the first in our Simple Science Descriptions series of pieces written with the Up-Goer Five Text Editor restricting writers to the ten hundred most used words in English. It's harder than you might think! Send your entries (preferably under 350 words) to jeanyang [at] mit [dot] edu.

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I study the brain. When you think about it, the brain has made possible everything ever--from music to computers to hospitals, from kisses to high-fives to tears.

However, to me, there is one thing that the brain does that is the most amazing act in the world, and yet it happens every single day just in between your ears: the art of memory. When you think back to your first date, what you had for lunch today, or who you were as a child, you're actually cutting through time and feeling everything that makes memory so important, so story-like. It is who you are and what gives you a sense of "you" as the days and months and years go by. It is what goes away when some brain pieces break down and become broken thoughts.

Your brain is actually very much like the brain of other animals, such as the small, cat-hating, fast-moving animals that so often come out to eat at night and scare people to jump onto their chairs. To study the tiny pieces of the brain that make memory possible, I put on a clean, white, almost dress-like long-armed shirt and play with these animals each day. While doing so, I also can make their brain cells to respond light. Send some light into the brain and, as if part of a movie that you know was a lot of money to make, you can now control thoughts with flashes of light. My work can also take this a step further: it is now possible to find out which brain cells are holding on to a single memory, to make only those cells respond to light, and then to use the very same light to turn memories on or off, or even make new ones! Imagine being able to turn off memories that sometimes force people into a never-ending, deep-blue state of pain on the inside, or to turn on the kind of memories that remind us how happy of a thing life can be. So far, this is only in animals but, after all, we are animals too, just ones with bigger brains that know how to read and write and reason.

This is my work, and the age of memory control is here.

- Steve Ramirez, Ph.D. student in Neuroscience

Tuesday, January 7, 2014

Simple Science: Busy Doctors Make Less Money for Their Hospital

This post is the first in our Simple Science Descriptions series of pieces written with the Up-Goer Five Text Editor restricting writers to the ten hundred most used words in English. It's harder than you might think! Send your entries (preferably under 350 words) to jeanyang [at] mit [dot] edu.

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Being sick can cause you to spend a lot of money on the doctor and the hospital. The money you spend is not completely set by how sick you are. When your doctor is not tired, you may need to spend more money than if your doctor is tired. A tired doctor often writes less. When a doctor writes more, you often must spend more. This is because the stuff that a doctor writes is used to figure out how much you must spend. If doctors look at the stuff they did when they were tired at a time at which they are not tired, their hospitals may make more money. So, when a doctor has a lot of work, the hospital may get less money from each person that the doctor sees that day.

- Adam Powell, Ph.D.
President, Payer+Provider Syndicate

This is based on Dr. Powell's article, Physician Workload and Hospital Reimbursement: Overworked Physicians Generate Less Revenue per Patient.