2023 Accepted Projects

The Indiana University Department of Pathology displays collections of various formalin-fixed human tissue specimens. Over time, this formalin breaks down into formic acid and evaporates as a gas if the jar is not completely sealed. This breakdown causes tissue degradation and discoloration. Because they may be used for morphological, ecological, and educational purposes, these rare and valuable specimens required maintenance every few years to be kept in a presentable state. Many of these specimens have had their formalin replaced with ethanol because of safety reasons. The recent restoration in the summer of 2021 went from 10% NBF to 70% ethanol. Most jars were restored in the summer of 2022 to replace other formalin jars with ethanol and previously ethanolized jars with fresh ethanol. To determine long-term efficacy of ethanol preservation, restoration rates comparing formalin longevity versus ethanol longevity were compared to identify which preservative better prevents tissue breakdown. Approximately 41% of specimens in ethanol required re-ethanolization after 1 year with nearly 75% of jars requiring re-ethanolization within two years. Conversely, 61% of specimens in formalin required maintenance after 5-7 years, with the remaining percentage lasting for years later, showing that specimens in ethanol require significantly more frequent preservative maintenance compared to specimens in formalin. It is necessary to assess the quality of preservatives to ensure specimen longevity to teach future generations about past illnesses, medical history, and medical ethics.

Critical limb threatening ischemia (CLTI) is the most severe form of peripheral arterial disease (PAD) and is caused by atherosclerotic occlusion of blood vessels to lower extremities. It is highly associated with excruciating pain as well as the development of skin ulcers or gangrene for those affected. However, there are currently no accepted non-surgical therapies that improve circulation to extremities for people with CLTI. The current standard of care for CLTI is to improve blood flow to the leg with either a surgical bypass or angioplasty with stents to open existing blockages. Unfortunately, about 30 percent of patients with CLTI will not be candidates for a surgical bypass or angioplasty and amputation is the only treatment available to remove a painful or infected leg. It presents an even more significant risk for lower limb amputation in diabetic patients with poor options for revascularization. A survey of this population was conducted to assess patient quality of life and additional factors revealed that all the participants had been in pain for months to years because of downstream effects of their disease like toe or foot ulcers. Most patients have stated that they were motivated to amputate their limb due to the amount of pain they experience because of infection or ulcers. The decision that these patients have come to, has come after years of suffering and a shared story of pain that they could no longer fathom bearing. The PAD/CLTI experience is also marked by disparities by sex, race, and socioeconomic status resulting in lower outcomes for women, black patients, and those of a lower socioeconomic status. This project aims to address this patient narrative through disease development and treatment with the compounding factors that contribute to their vulnerability and the experiences that unify them.

The stress we experience day to day causes biological consequences and over time these consequences change the way we think and act. The more technical aspects involve how our immune system and its proteins respond to this stress and cause damage. I want to also touch upon how those more likely to live under this chronic stress, the disadvantaged and discriminated, have a higher risk of experiencing worse health as a result. Psychiatry as we know it today can be a very subjective practice. This subjectivity in diagnosis and treatment can cost lives and result in prolonged suffering. As our understanding of the human body and its physiology progresses, new questions may be raised about the relationship between seemingly unrelated biological processes. My paper is a meta-analysis that discusses the immune connection to mental illness. Major depressive disorder and suicidality are the focus, but during my research other illnesses such as PTSD, CTE, and Alzheimer's are implicated as well. Minimizing the subjectivity in psychiatry has the potential to save lives, validate suffering, destigmatize mental illness, and unlock new models of care. For this presentation, I will discuss the aforementioned subjectivity and its consequences, the immune connection, and the future implications of a more accurate and humanistic practice.

On September 16th 2022, a 22-year-old woman named Mahsa Amini was arrested in Iran for wearing her hijab incorrectly. While in official custody, she was beaten and sustained life ending injuries. In a matter of hours following her death, the people of Iran sparked a revolutionary movement for women all over the world by engaging in peaceful protests in an effort to finally obtain the freedom that was taken from them many decades ago. In Iran, there is a tradition known as “Chehelom” where family members and friends gather on the 40th day after a loved one’s death to honor their life. On October 26th 2022, exactly 40 days following the death of Mahsa Amini, medical students from the Central Michigan University College of Medicine and its Student Diversity Committee recognized this tradition by organizing a march in Mt. Pleasant, Michigan to honor Mahsa Amini’s life as well as the lives of all the women in Iran. More than 150 students and faculty members across the undergraduate, graduate, and medical campuses of Central Michigan University came together to participate in this march with a sea of white coats leading the way. This march not only achieved its goal of honoring Mahsa Amini and raising awareness for the movement that her death sparked, but it has also spread a message to future physicians regarding the influential power that their white coat carries with them. As future physicians, we must understand that there is more to saving lives than the medical knowledge that we gain from medical school. We must master a skill that cannot be taught within the four walls of any medical school. We must learn to use our powerful voices in instances like these to bring people together, and to save lives in ways that traditional medicine cannot.

This past November, New York City Mayor, Eric Adams, announced a new plan to “remove people with severe, untreated mental illness from the city’s streets and subways,” and instead commit them to psychiatric hospitals. This announcement was met with understandable backlash, but Adams’ proposal has destructive implications that go beyond the current moment. New York City is not innocent in America’s long history of eugenicist, disablist policies that have defined mental health care for vulnerable populations. This decision will not only overwhelm our hospital systems that have already been pushed beyond their limits, but it is a direct violation of the least restrictive option approach that has been critical to MHL and progress in the Disability Rights movement. As an interdisciplinary team of Columbia University graduate students studying Human Rights and Narrative Medicine, our collaborative, multi-modal poster presentation will explore the destructive implications of Mayor Adams’ decision through the lens of Disability Justice. We will approach this analysis via an Oral History interview. Historically, institutionalization, medical experimentation, and abuse of individuals with intellectual, developmental, and mental disabilities have been a common occurrence across hospitals and ‘training schools’ in the state of NY. In investigating these historical contexts alongside current litigation that protects the rights of persons with disabilities, we aim to uncover how Adams’ proposal violates the rights of people with mental disabilities and encourages regressive policies to manifest.

While the birth of a child is often one of the most joyous moments in a mother’s life, some mothers are unable to celebrate this occasion due to drug testing, often, taken without informed consent during labor. Additionally, this drug testing is documented to disproportionately impact Black mothers, as they and their newborns are 1.5 times more likely to be tested for illicit drugs compared to non-Black women, despite similar positivity rates (Kunins et al. 2007). Once a positive drug test is reported by the medical provider, familial separation and criminalization often occurs and these mothers must fight to regain custody of their child from the child welfare system in addition to fighting criminal charges. This paper examines the ethics of drug testing Black mothers and their newborns through an intersectional lens, by arguing how illicit drug testing disproportionately impacts women at the intersections of gender, race, and class. First, I define intersectionality and explain how intersectionality assists in better understanding the ways mother and infant drug testing is racialized, gendered, and classed. Next, I discuss how this unethical practice has a disproportionate impact on Black women and leads to unnecessary familial separations involving the child welfare system. Finally, I argue for appropriate, immediate steps that should be taken to reduce the separation of newborns from their mothers and why these matters should be removed from the criminal-legal system. Even though Black mothers are regularly drug tested at the hands of our healthcare system, the impact it has on these families remains largely under-studied. This paper shines light on this seldom studied issue by advocating for much needed change. Mothers should not worry about having their child removed from their care because of drug tests often ordered without their informed consent.