John Simpson '66's photos donated to PAW
Class notes features
John Simpson '66's photos donated to PAW
The late John W.H. Simpson '66 took this photograph of a European beech that until
recently stood at the northwest corner of Little Hall, diagonally across from
the University Store. This is one of some 10,000 images relating to Princeton
taken by Simpson, a professional photographer who often shot assignments for
PAW, between 1975 and his death from a heart attack, in 1993. Simpson's heirs -- his
son, Jamie, and daughter, Jebb -- recently donated their father's Princeton negatives
and contact sheets to paw. The collection is housed in the University Archives,
located in the Seeley G. Mudd Manuscript Library, where it is available to students, alumni,
and other researchers.
Paying attention to pain
Nelson Hendler '66 has developed standard criteria
Twenty years ago, psychiatrist Nelson H. Hendler '66 opened the Mensana Clinic in Stevenson, Maryland, to diagnose and treat patients suffering from chronic pain. Today, Hendler sees more than 500 patients a year and writes and lectures widely on Mensana's work. In 1992, Business Week included Mensana on a list of top pain clinics. A 29-question screening test Hendler developed is now used by the CNA insurance company to distinguish valid from invalid pain claims.
Q. Why did you open Mensana?
A. A lot of patients really weren't receiving what I thought were adequate evaluations and treatment for their chronic pain problems.
Q. Why were doctors misdiagnosing?
A. If they found it difficult to diagnose patients, they would just turn around and blame the patients, because there's a whole body of psychiatric literature which gives you permission to do so. It's talking about imaginary pain, or people who are depressed but can't express their depression, so they express it as a pain.
[Hendler's evaluations showed that many patients' symptoms didn't match the psychological disorders their doctors had diagnosed.]
Then the questions were, why were they angry and why were they depressed? The answer became pretty obvious: It was because they had pain that they got angry and depressed, not the other way around.
Take a perfectly well-adjusted individual and give him chronic and persistent pain that interferes with his sleeping, interferes with his sex life, interferes with his ability to earn, interferes with his ability to participate in hobbies, and the next thing you know, you've got a depressed patient. No magic there.
Q. Why did doctors have trouble seeing this?
A. Pain is a totally subjective experience. You can't take a picture of pain. The sine qua non of dealing with chronic-pain patients is to believe the patient. If a doctor tells you the pain is all in your head, get out of his office.
Q. Why did you devise your screening test?
A. The tests available just didn't make any sense. [The popular Minnesota Multiphasic Personality Inventory tends to classify chronic pain as imaginary or faked.] I said, "This is unfair." Schizophrenics get brain tumors and hysterics get disk disease. Just because you have a psychiatric disease doesn't confer upon you a medical immunity.
So I devised a test that, regardless of your preexisting or coexisting psychiatric problem, can tell you whether the complaint of pain was valid. If you score 17 points or less on my test, there is an 85 to 91 percent chance you'll have a moderate or severe abnormality on at least one objective measure of organic pathology [such as a CT scan]. If you score 21 points or greater, there's an 85 to 100 percent chance you will have a mild abnormality or none whatsoever. That's what we call an exaggerating pain patient. That's a patient who has real pain, but it's minimal; they use it for secondary gain.
The CNA insurance company found for $100 spent on this test, they would save an average of $1,654 per claim. Here we have an objective, quantifiable device that says, "Put the detective on this guy. Authorize the testing for that guy. Let's get the guy well."
The thing that's costing the insurance companies even more money is the 40 to 67 percent of the patients who are misdiagnosed. When you come up with an accurate diagnosis for someone who has languished in treatment because they have the wrong diagnosis -- and you're still paying him lost wages, and you're still paying for all the inappropriate care -- you can really make a difference.
-- Deborah Yaffe
Bringing theater to prisons and shelters
The ten thousand things are born of being.
Being is born of not being.
--Lao Tsu, Tao Te Ching
With these powerful, brief phrases, Lao Tsu, an ancient Chinese sage, addresses the tension between materialism ("the ten thousand things") and spirituality. With her Ten Thousand Things Theatre Company, Michelle Hensley '80 lives that tension every day as she and her fellow actors bring theatrical classics to juvenile prisons, reform schools, and homeless shelters in Minneapolis. The work is difficult, non-remunerative, and inspiring.
Hensley, an English major at Princeton, took classes in the university's theater program. She was hooked early on. "The artists from New York who taught in the program inspired me," she says. "Their integrity and dedication to their craft was extraordinary." After graduation, she moved to California, and eventually earned an M.F.A. in directing from UCLA.
"At that point, there were basically two ways to go," says Hensley. "I could either go the usual route, gradually working my way up, pleasing others, and making no money, or I could do what I believed in, and make no money."
Put that way, the choice seemed clear to Hensley. She started her own theater group, and persuaded actor-friends of hers to go to a homeless shelter to stage The Good Woman of Sichuan, by Bertolt Brecht, a study of the effects of receiving a divine gift of money on a poor, good-hearted woman. "We were very nervous about presenting this play to an audience composed of people in a homeless shelter. Would they care about it? Would it engage them? But they responded honestly and wonderfully."
That performance led to others in juvenile prisons in Los Angeles, and further performances of Electra, the tragedy by Sophocles. "They got that one right away. Their lives are like Greek tragedies, after all." In 1991, Hensley had a child with Frank Clancy '79, and they moved to Minneapolis, where there is a "vibrant theater community," notes Hensley. The community is also generous when it comes to donating money, a vital element in keeping this particular theater company running.
"We have no building, so our expenses are low," says Hensley, "but we're always looking for ways to sustain ourselves." In the meantime, Ten Thousand Things keeps bringing the classics of theater to nontraditional audiences. "We'll do Shakespeare this fall," she says, "And we've done everything from the Greeks to Albee's The Ballad of the Sad Café, about a love triangle involving an ex-con." In addition, Ten Thousand Things has put on Life Is a Dream, by the 17th-century Spanish playwright Pedro Calderón de la Barca; Mud, by 20th-century American playwright Irene Fornes; and a number of 17th-century farces.
"I've been thrilled by the willingness of great professional actors in the area to take part even though we use no lighting, minimal props, and usually a circle of folding chairs for the audience," notes Hensley. "The effect is very intimate, very close, very powerful. We all love the immediate, intense feedback. These people tell us what they think. They don't hold back."
-- Nicholas Morgan '75
On the Scene
For now, Hong Kong worries about the economy, not politics
I live in Hong Kong, and every time I talk to someone from America, I hear the same question: "Have there been many changes?"
The surmised "changes" refer to the handover of Hong Kong to the Chinese in July 1997. China's promise to leave the enclave's British-born free-market system unchanged for 50 years met with skepticism worldwide.
So have there been changes? Yes. Big ones. And but for the weather (more on this below), they have had nothing to do with the handover.
Like all other Asian economies, Hong Kong's is in a funk, but that's due to the area's currency crisis. Unemployment is at a 15-year high, the stock market is jittery, and the property market is down about 35 percent from last year. Also, as regional currencies lose their values, pressure mounts on the Hong Kong government to abolish the peg that officially ties the Hong Kong dollar to the U.S. dollar. The government doesn't want to because the peg advertises the city's economic stability to the world.
Chan Q. Public's biggest pre-handover concerns were economic, not political. Taxi drivers are often major stock-market investors, and they didn't seem to care when China's first official sovereign act disbanded the government that had been democratically elected in 1995. China proceeded to set up elections for last May under a system designed to prevent proponents of democracy from winning the same kind of landslide victory they had won three years ago. Far from being outraged, the public downright yawned.
But the residents of Hong Kong weren't yawning nine and a half years ago when more than a million of them rallied in May 1989 in support of students demonstrating for democracy in Beijing's Tiananmen Square. After the infamous massacre on June 4, they were understandably worried about the government that would soon rule them.
But, in general, Hong Kongers tend to let pragmatism, not idealism, dictate the way they live. Despite the fact that the Western press made a big deal of the 4,000 People's Liberation Army troops who entered Hong Kong during the handover, locals were unconcerned. And, for reference, the British used to station 10,000 soldiers here at any given time.
Everyday life has remained the same. Pundits' fears of capital flight aside, Hong Kong's 6 million people bet more money on the horse races every week than all of America bets on the Super Bowl and March Madness combined. Easter and Christmas are still holidays, though they're work days in mainland China. Cantonese, not Mandarin (the unifying Chinese dialect), remains the language of the streets.
Most importantly, social liberties have not been visibly curtailed. While government power to prevent demonstrations has been broadened, the police have allowed the city's frequent minor marches. The death penalty, used to excess in mainland China, has not been instituted in Hong Kong.
The local alternative newspaper, HK Magazine, continues to publish and skewer government toadies. The editor of the leading English-language newspaper says he has not been any more circumspect about criticizing the government. However, other media publications, run by people who don't have foreign passports, have been more cautious.
One change has been real. Tourism, which peaked during the handover frenzy, has dropped markedly and rapidly: 1997 arrivals were more than 11 percent below those in 1996, and tourists in 1997 spent 15 percent less money than they did the year before. The latter drop, more than any changes in civil rights laws, has worried Hong Kongers.
That leaves the rain. Hong Kong's rulers in Beijing probably smiled when the heavens opened up on election day in May. Downpours inhibit voting. Still, 53 percent of residents went to the polls. News crews focused on the record turnout as a vindication of democracy, but they missed the real story: the city's Beijing-appointed leader's power to unilaterally overrule 60 elected politicians renders the elections fairly meaningless. (China's precautions notwithstanding, democracy advocates garnered 63 percent of the vote.)
Then again on June 4, torrential rains auspiciously materialized for Beijing, restricting attendance at this year's Tiananmen Square rally, which was permitted to go on. Some 16,000 people -- about one-third as many as last year -- braved the weather to demand democracy in China.
To most Americans, the handover ended last year when 8,000 foreign journalists left the territory, hardly better informed than they had been when they swooped in. To people in Hong Kong, the change is just beginning. And everyone needs an umbrella.
-- Glenn Berkey '89
Glenn Berkey, who works for The Princeton Review, has lived in Hong Kong since 1991.