How a Dutch “Dementia Village” Improves Quality of Life with Intentional Design

Peo­ple suf­fer­ing from demen­tia lose their abil­i­ty to take an active part in con­ver­sa­tions, every­day activ­i­ties, and their own phys­i­cal upkeep.

They are prone to sud­den mood swings, irri­tabil­i­ty, depres­sion, and anx­i­ety.

They may be strick­en with delu­sions and wild hal­lu­ci­na­tions.

All of these things can be under­stand­ably upset­ting to friends and fam­i­lies. There’s a lot of stig­ma sur­round­ing this sit­u­a­tion.

Tak­ing care of a spouse or par­ent with demen­tia can be an over­whelm­ing­ly iso­lat­ing expe­ri­ence, though no one is more iso­lat­ed than the per­son expe­ri­enc­ing severe cog­ni­tive decline first­hand.

While many of us would do any­thing to stay out of them, the sad fact is res­i­den­tial mem­o­ry care facil­i­ties are often the end-of-the-line real­i­ty for those liv­ing with extreme demen­tia.

Dur­ing the first sum­mer of the COVID-19 pan­dem­ic, nurs­ing home deaths attrib­uted to Alzheimer’s dis­ease and demen­tia increased by more than 20 per­cent, owing to such fac­tors as chron­ic staffing short­ages and a ban on out­side vis­i­tors.

As DeAnn Wal­ters, direc­tor of clin­i­cal affairs for the Cal­i­for­nia Asso­ci­a­tion of Health Facil­i­ties, told Politi­co:

We’re try­ing to be sup­port­er, social work­er, care­giv­er, friend and house­keep­ing for the res­i­dent. It’s putting a lot of pres­sure on the care­givers and the oper­a­tion of the facil­i­ty to make sure every­one has what they need. Before the pan­dem­ic we couldn’t even get socks on peo­ple and you’d see them walk­ing around bare­foot.

Not the vision any of us would choose for our parent’s gold­en years, or our own.

The Hogeweyk, a planned vil­lage just out­side of Ams­ter­dam, offers a dif­fer­ent sort of future for those with severe demen­tia.

The above episode of By Design, Vox’s series about the inter­sec­tion of design and tech­nol­o­gy, explores the inno­va­tions that con­tribute to the Hogeweyk’s res­i­dents over­all hap­pi­ness and well­be­ing.

Rather than group­ing res­i­dents togeth­er in a sin­gle insti­tu­tion­al set­ting, they are placed in groups of six, with every­one inhab­it­ing a pri­vate room and shar­ing com­mon spaces as they see fit.

The com­mon spaces open onto out­door areas that can be freely enjoyed by all housed in that “neigh­bor­hood”. No need to wait until a staff mem­ber grants per­mis­sion or fin­ish­es some task.

Those wish­ing to ven­ture fur­ther afield can avail them­selves of such pleas­ant quo­tid­i­an des­ti­na­tions as a gro­cery, a restau­rant, a bar­ber­shop, or a the­ater.

These loca­tions are designed in accor­dance with cer­tain things proven to work well in insti­tu­tion­al set­tings —  for instance, avoid­ing dark floor tiles, which some peo­ple with demen­tia per­ceive as holes.

But oth­er design ele­ments reflect the choice to err on the side of qual­i­ty of life. Hand rails may help in pre­vent­ing falls, but so do rol­la­tors and walk­ers, which the res­i­dents use on their jaunts to the town squares, gar­dens and pub­lic ameni­ties.

The design­ers believe that equip­ping res­i­dents with a high lev­el of free­dom not only pro­motes phys­i­cal activ­i­ty, it min­i­mizes issues asso­ci­at­ed with demen­tia like aggres­sion, con­fu­sion, and wan­der­ing.

Co-founders Eloy van Hal and Jan­nette Spier­ing write that the Hogeweyk’s crit­ics com­pare it to the Tru­man Show, the 1998 film in which Jim Car­rey’s title char­ac­ter real­izes that his whole­some small town life, and his every inter­ac­tion with his pur­port­ed friends, neigh­bors, and loved ones, have been a set up for a high­ly rat­ed, hid­den cam­era real­i­ty TV show.

They describe The Hogeweyk as a stage for, “the rem­i­nis­cence world”, in which actors help the res­i­dents live in a fic­ti­tious world. Many Alzheimer’s experts have, how­ev­er, val­ued The Hogeweyk for what it real­ly is: a famil­iar and safe envi­ron­ment in which peo­ple with demen­tia live while retain­ing their own iden­ti­ty and auton­o­my as much as pos­si­ble. They live in a social com­mu­ni­ty with real streets and squares, a real restau­rant with real cus­tomers, a super­mar­ket for gro­ceries and a the­atre that hosts real per­for­mances. There is no fake bus stop or post office, there are no fake façades and sets. The restau­rant employ­ee, the handy­man, the care­tak­er, the nurse, the hair­dress­er, etc.—in short: every­one who works at The Hogeweyk uses their pro­fes­sion­al skills to actu­al­ly sup­port the res­i­dents and are, there­fore, cer­tain­ly not actors.

Pro­fes­sion­al care and sup­port goes on around the clock, but rarely takes cen­ter­stage. Nor­mal life is pri­or­i­tized.

A vis­i­tor describes a stroll through some of the Hogeweyk’s pub­lic areas:

In the shade of one of the large trees, a mar­ried cou­ple gazes hap­pi­ly at the activ­i­ty in the the­atre square. An elder­ly gen­tle­man, togeth­er with a young lady, intent­ly study the large chess board and take turns mov­ing the pieces. At the foun­tain, a group of women chat loud­ly on colour­ful gar­den chairs. The sto­ry is clear­ly audible—it is about a mem­o­ry of a vis­it to a park in Paris which had the same chairs. Passers-by, old and young, greet the women enthu­si­as­ti­cal­ly. A lit­tle fur­ther on, a woman is talk­ing to a man oppo­site her. She is ges­tur­ing wild­ly. After a while, anoth­er woman joins the con­ver­sa­tion. The two women then walk through the open front door of Boule­vard 15. 

The cov­ered pas­sage smells of fresh­ly-baked cook­ies. The scent is com­ing from De Bonte Hof. Amus­ing con­ver­sa­tions can be heard that pause for a moment when the oven beeps in the kitchen that has been dec­o­rat­ed in an old-fash­ioned style. A tray of fresh cook­ies is removed from the oven. Two women, one in a wheel­chair, enter the venue, obvi­ous­ly seduced by the smell. They sam­ple the cook­ies. 

The super­mar­ket across the street is very busy. Shop­ping trol­leys loaded with gro­ceries are pushed out of the shop. The rat­tle of a shop­ping trol­ley dis­si­pates into the dis­tance as it dis­ap­pears from view towards Grote Plein. A man reluc­tant­ly push­es the full trol­ley while two women fol­low behind him arm in arm. The trio dis­ap­pear behind the front door of Grote Plein 5.


A staffer’s account of a typ­i­cal morn­ing in one of Hogeweyk’s hous­es reveals more about the hands-on care that allows res­i­dents to con­tin­ue enjoy­ing their care­ful­ly designed home, and the autonomous lifestyle it makes pos­si­ble:

Mr Hen­dricks wakes up on the sofa. He unzips his fly. I jump up and escort him to the toi­let just in time. I grab a roll of med­ica­tion for him from the med­ica­tion trol­ley. He is now walk­ing to his room. We pick out clothes togeth­er and I lay them out on his bed. He wash­es him­self at the sink. I watch briefly before leav­ing. Fif­teen min­utes lat­er, I poke my head through the door. That’s not how elec­tric shav­ing works! I offer to help, but Mr. Hen­dricks is clear­ly a bit irri­tat­ed and grum­bles. He’ll be a lit­tle less shaven today. We’ll try again after break­fast…

We help Mrs Sti­j­nen into the show­er chair with the hoist. She is clear­ly not used to it. Dis­cussing her exten­sive Swarovs­ki col­lec­tion, dis­played in the glass case in her room, turns out to be an excel­lent dis­trac­tion. She proud­ly talks about the lat­est piece she acquired this year. On to the show­er. The two oth­er res­i­dents are still sleep­ing. Great, that gives me the chance to devote some extra time to Mrs Sti­j­nen today. 

The door­bell rings again and my col­league, Yas­min, walks in. She’s the famil­iar face that every­one can rely on. Always present at 8 a.m., 5 days a week. What a relief for res­i­dents and fam­i­ly. She, too, puts her coat and bag in the lock­er. The wash­ing machine is ready, and Yas­min loads up the dry­er. The table in the din­ing room is then set. Yas­min puts a flo­ral table­cloth from the cup­board on the table. Mr Hen­dricks lends a hand and, with some guid­ance, puts two plates in their place, but then walks away to the sofa and sits down. A Dutch break­fast with bread, cheese, cold cuts, jam, cof­fee, tea and milk is served. Yas­min is mak­ing por­ridge for Mrs Smit. As always, she has break­fast in bed. Yas­min helps Mrs Smit. It is now 08:45 and Mr Hen­dricks and Mrs Sti­j­nen are sit­ting at the din­ing table. Yas­min push­es the chairs in and sits down her­self. They chat about the weath­er, and Yas­min lends a help­ing hand when need­ed. 

Mr Hen­dricks is real­ly grumpy today and is cur­rent­ly grum­bling at Mrs Jansen. I’m won­der­ing if we’re over­look­ing some­thing?

Learn more about the Hogeweyk, the world’s first demen­tia vil­lage here.

Watch a playlist of Vox By Design episodes here.

Relat­ed Con­tent 

The Restau­rant of Mis­tak­en Orders: A Tokyo Restau­rant Where All the Servers Are Peo­ple Liv­ing with Demen­tia

How Music Can Awak­en Patients with Alzheimer’s and Demen­tia

Demen­tia Patients Find Some Eter­nal Youth in the Sounds of AC/DC

- Ayun Hal­l­i­day is the Chief Pri­ma­tol­o­gist of the East Vil­lage Inky zine and author, most recent­ly, of Cre­ative, Not Famous: The Small Pota­to Man­i­festo.  Fol­low her @AyunHalliday.

Dying from Overwork: Disturbing Looks Inside Japan’s Karoshi and China’s “996” Work System

By most mea­sures, Japan boasts the high­est life expectan­cy in the world. But that rank­ing, of course, does­n’t mean that every Japan­ese per­son sees old age. Though the coun­try’s rate of vio­lent crime is low enough to be the envy of most of the world, its sui­cide rate isn’t, and it says even more that the Japan­ese lan­guage has a word that refers specif­i­cal­ly to death by over­work. I first encoun­tered it near­ly thir­ty years ago in Dil­bert com­ic strip. “In Japan, employ­ees occa­sion­al­ly work them­selves to death. It’s called karōshi,” says Dil­bert’s pointy-haired boss. “I don’t want that to hap­pen to any­body in my depart­ment. The trick is to take a break as soon as you see a bright light and hear dead rel­a­tives beck­on.”

You can see the phe­nom­e­non of karōshi exam­ined more seri­ous­ly in the short Now­ness video at the top of the post. In it, a series of Japan­ese salary­men (a Japan­ese Eng­lish term now well-known around the world) speak to the exhaust­ing and unceas­ing rig­ors of their every­day work sched­ules — and, in some cas­es, to the empti­ness of the homes that await them each night.

The CNBC seg­ment just above inves­ti­gates what can be done about such labor con­di­tions, which even in white-col­lar work­places con­tribute to the heart attacks, strokes, and oth­er imme­di­ate caus­es of deaths ulti­mate­ly ascribed to karōshi. In a grim irony, Japan has the low­est pro­duc­tiv­i­ty among the G7 nations: its peo­ple work hard, yet their com­pa­nies are hard­ly work­ing.

Ini­tia­tives to put a stop to the ill effects of over­work, up to and includ­ing karōshi, include manda­to­ry vaca­tion days and office lights that switch off auto­mat­i­cal­ly at 10:00 p.m. Among the lat­est is “Pre­mi­um Fri­day,” a pro­gram explained in the Vice video above. Devel­oped by Kei­dan­ren, Japan’s old­est busi­ness lob­by, it was ini­tial­ly received as “a direct response to karōshi,” but it has its ori­gins in mar­ket­ing. “We want­ed to cre­ate a nation­al event that bol­stered con­sump­tion,” says the direc­tor of Kei­dan­ren’s indus­tri­al pol­i­cy bureau. By that log­ic, it made good sense to let work­ers out ear­ly on Fri­days — let them out to shop. But Pre­mi­um Fri­day has yet to catch on in most Japan­ese enter­pris­es, aware as they are that Japan’s eco­nom­ic might no longer intim­i­dates the world.

The afore­men­tioned low pro­duc­tiv­i­ty, along with a rapid­ly aging and even con­tract­ing pop­u­la­tion, con­tributed to Japan’s loss of its posi­tion as the world’s sec­ond-largest econ­o­my. It was over­tak­en in 2011 by Chi­na, a coun­try with over­work prob­lems of its own. The Vice report above cov­ers the “996” sys­tem, which stands for work­ing from 9:00 a.m. to 9:00 p.m, six days a week. Preva­lent in Chi­nese tech com­pa­nies, it has been blamed for stress, ill­ness, and death among employ­ees. Laws lim­it­ing work­ing hours have thus far proven inef­fec­tive, or at least cir­cum­ventable. Cer­tain pun­dits nev­er stop insist­ing that the future is Chi­nese; if they’re right, all this ought to give pause to the work­ers of the world, East­ern and West­ern alike.

Relat­ed con­tent:

“Inemuri,” the Japan­ese Art of Tak­ing Pow­er Naps at Work, on the Sub­way, and Oth­er Pub­lic Places

Why 1999 Was the Year of Dystopi­an Office Movies: What The Matrix, Fight Club, Amer­i­can Beau­ty, Office Space & Being John Malkovich Shared in Com­mon

“Tsun­doku,” the Japan­ese Word for the New Books That Pile Up on Our Shelves, Should Enter the Eng­lish Lan­guage

The Employ­ment: A Prize-Win­ning Ani­ma­tion About Why We’re So Dis­en­chant­ed with Work Today

What is the Secret to Liv­ing a Long, Hap­py & Cre­ative­ly Ful­fill­ing Life?: Dis­cov­er the Japan­ese Con­cept of Iki­gai

Charles Bukows­ki Rails Against 9‑to‑5 Jobs in a Bru­tal­ly Hon­est Let­ter (1986)

Based in Seoul, Col­in Mar­shall writes and broad­casts on cities, lan­guage, and cul­ture. His projects include the Sub­stack newslet­ter Books on Cities, the book The State­less City: a Walk through 21st-Cen­tu­ry Los Ange­les and the video series The City in Cin­e­ma. Fol­low him on Twit­ter at @colinmarshall, on Face­book, or on Insta­gram.

Jon Kabat-Zinn Presents an Introduction to Mindfulness (and Explains Why Our Lives Just Might Depend on It)

The prac­tice of cul­ti­vat­ing mind­ful­ness through med­i­ta­tion first took root in Europe and the U.S. in the 1960s, when Bud­dhist teach­ers from Japan, Tibet, Viet­nam, and else­where left home, often under great duress, and taught West­ern stu­dents hun­gry for alter­na­tive forms of spir­i­tu­al­i­ty. Though pop­u­lar­ized by coun­ter­cul­tur­al fig­ures like Alan Watts and Allen Gins­berg, the prac­tice did­n’t seem at first like it might reach those who seemed to need it most — stressed out denizens of the cor­po­rate world and mil­i­tary indus­tri­al com­plex who had­n’t changed their con­scious­ness with mind-alter­ing drugs, or left the cul­ture to become monas­tics.

Then pro­fes­sor of med­i­cine Jon Kabat-Zinn came along, stripped away reli­gious and new age con­texts, and began redesign­ing mind­ful­ness for the mass­es in 1979 with his mind­ful­ness-based stress reduc­tion (MBSR) pro­gram. Now every­one knows, or thinks they know, what mind­ful­ness is. As med­i­ta­tion teacher Lokad­hi Lloyd tells The Guardian, Kabat-Zinn is “Mr Mind­ful­ness in rela­tion to our sec­u­lar strand. With­out him, I don’t think mind­ful­ness would have risen to the promi­nence it has.”

His sec­u­lar­iza­tion of mind­ful­ness, how­ev­er, has not, in prac­ti­cal terms, tak­en it very far from its roots, which explains why Kabat-Zin­n’s ground­break­ing 1990 book Full Cat­a­stro­phe Liv­ing receives high praise from Bud­dhist teach­ers like Joseph Gold­stein, Sharon Salzburg, and Kabat-Zin­n’s own for­mer Zen teacher, Thich Nhat Hanh.

While Kabat-Zinn says he him­self is not (or is no longer) a Bud­dhist, his def­i­n­i­tions of mind­ful­ness might sound just close enough to those who study and prac­tice the reli­gion. As he says in the short seg­ment at the top: “It’s pay­ing atten­tion, on pur­pose, in the present moment, non-judg­men­tal­ly.” And then, “some­times,” he says, “I like to add, as if your life depend­ed on it.” The qual­i­ty of our lives, the clar­i­ty of our lives, and the depth and rich­ness of our lives depend on our abil­i­ty to be aware of what’s hap­pen­ing around and inside us. This abil­i­ty, Kabat-Zinn insists, is the inher­i­tance of all human beings. It can be found in spir­i­tu­al prac­tices around the world. No one owns a patent on aware­ness.

Nev­er­the­less, Kabat-Zinn is par­tic­u­lar­ly leery of what he calls McMind­ful­ness, the com­mod­i­ty-dri­ven indus­try sell­ing col­or­ing books, apps, puz­zles, t‑shirts, and nov­el­ties tout­ing mind­ful ben­e­fits. Mind­ful­ness based stress reduc­tion is “not a trick,” he says. It isn’t some­thing we buy and try out here and there. “MBSR is exceed­ing­ly chal­leng­ing,” Kabat-Zinn writes in Full Cat­a­stro­phe Liv­ing. “In many ways, being in the present moment with a spa­cious ori­en­ta­tion toward what is hap­pen­ing may real­ly be the hard­est work in the world for us humans. At the same time, it is also infi­nite­ly doable.” It can also be high­ly unpleas­ant, forc­ing us to sit with the things we’d rather ignore about our­selves. Why should we do it? We might con­sid­er the alter­na­tives.

MBSR began (“in the base­ment of the Uni­ver­si­ty of Mass­a­chu­setts Med­ical Cen­ter,” notes NPR) help­ing patients with chron­ic pain recov­er. It proved so effec­tive, Kabat-Zinn applied the insight more glob­al­ly — “using the wis­dom of your body and mind to face stress, pain, and ill­ness.” This is not a cure-all, but a way of liv­ing that reduces unnec­es­sary suf­fer­ing caused by over­ac­tive dis­cur­sive think­ing, which traps us in pat­terns of blame, shame, fear, regret, judg­ment, and self-crit­i­cism (illus­trat­ed in Scot­tish psy­chol­o­gist R.D. Laing’s book of neu­rot­ic nar­ra­tives, Knots) — traps us, that is, in sto­ries about the past and future, which affect our phys­i­cal and men­tal health, our work, and our rela­tion­ships.

The med­ical evi­dence for mind­ful­ness has only begun to catch up with Kabat-Zin­n’s work, yet it weighs heav­i­ly on the side of the out­comes he has seen for over 40 years. MBSR also comes high­ly rec­om­mend­ed by Har­vard neu­ro­sci­en­tist Sara Lazar and trau­ma expert Bessel Van Der Kok, among so many oth­ers who have done the research. The evi­dence is why, as you can see in the longer pre­sen­ta­tions above at Dart­mouth and Google, Kabat-Zinn has become some­thing of an evan­ge­list for mind­ful­ness. “If this is anoth­er fad, I don’t want to have any part of it,” he says. “If in the past 50 years I had found some­thing more mean­ing­ful, more heal­ing, more trans­for­ma­tive and with more poten­tial social impact, I would be doing that.”

As Kabat-Zin­n’s 2005 book, Wher­ev­er You Go, There You Are, shows, we can bring what hap­pens in med­i­ta­tion into our every­day life, let­ting assump­tions go, and “let­ting life become both the med­i­ta­tion teacher and the prac­tice, moment by moment, no mat­ter what aris­es,” he tells Mind­ful mag­a­zine. This isn’t about escap­ing into blissed out moments of Zen. It’s fos­ter­ing “deep con­nec­tions,” over and over again, with our­selves, fam­i­lies, friends, com­mu­ni­ties, the plan­et we live on, and, in turn, “the future that we’re bequeath­ing to our future gen­er­a­tions.”

Relat­ed Con­tent:

Dai­ly Med­i­ta­tion Boosts & Revi­tal­izes the Brain and Reduces Stress, Har­vard Study Finds

How Mind­ful­ness Makes Us Hap­pi­er & Bet­ter Able to Meet Life’s Chal­lenges: Two Ani­mat­ed Primers Explain

De-Mys­ti­fy­ing Mind­ful­ness: A Free Online Course by Lei­den Uni­ver­si­ty 

Stream 18 Hours of Free Guid­ed Med­i­ta­tions

Josh Jones is a writer and musi­cian based in Durham, NC. Fol­low him at @jdmagness

The History of Birth Control: From Alligator Dung to The Pill

The his­to­ry of birth con­trol is almost as old as the his­to­ry of the wheel.

Pes­saries dat­ing to Mesopotamia and ancient Egypt pro­vide the launch­ing pad for doc­u­men­tar­i­an Lind­say Hol­i­day’s overview of birth con­trol through­out the ages and around the world.

Holiday’s His­to­ry Tea Time series fre­quent­ly delves into women’s his­to­ry, and her pledge to donate a por­tion of the above video’s ad rev­enue to Pathfind­er Inter­na­tional serves as reminder that there are parts of the world where women still lack access to afford­able, effec­tive, and safe means of con­tra­cep­tion.

One goal of the World Health Organization’s End­ing Pre­ventable Mater­nal Mor­tal­i­ty ini­tia­tive is for 65% of women to be able to make informed and empow­ered deci­sions regard­ing sex­u­al rela­tions, con­tra­cep­tive use, and their repro­duc­tive health by 2025.

As Hol­i­day points out, expense, social stig­ma, and reli­gious edicts have impact­ed ease of access to birth con­trol for cen­turies.

The fur­ther back you go, you can be cer­tain that some meth­ods advo­cat­ed by mid­wives and med­i­cine women have been lost to his­to­ry, owing to unrecord­ed oral tra­di­tion and the sen­si­tive nature of the infor­ma­tion.

Hol­i­day still man­ages to truf­fle up a fas­ci­nat­ing array of prac­tices and prod­ucts that were thought — often erro­neous­ly — to ward off unwant­ed preg­nan­cy.

Some that worked and con­tin­ue to work to vary­ing degrees, include bar­ri­er meth­ods, con­doms, and more recent­ly the IUD and The Pill.

Def­i­nite­ly NOT rec­om­mend­ed: with­draw­al, hold­ing your breath dur­ing inter­course, a post-coital sneez­ing reg­i­men, douch­ing with Lysol or Coca-Cola, tox­ic cock­tails of lead, mer­cury or cop­per salt, any­thing involv­ing alli­ga­tor dung, and slug­ging back water that’s been used to wash a corpse.

As for sil­phi­um, an herb that like­ly did have some sort of sper­mi­ci­dal prop­er­ties, we’ll nev­er know for sure. By 1 CE, demand out­stripped sup­ply of this rem­e­dy, even­tu­al­ly wip­ing it off the face of the earth despite increas­ing­ly astro­nom­i­cal prices. Fun fact: sil­phi­um was also used to treat sore throat, snakebite, scor­pi­on stings, mange, gout, quin­sy, epilep­sy, and anal warts

The his­to­ry of birth con­trol can be con­sid­ered a semi-secret part of the his­to­ry of pros­ti­tu­tion, fem­i­nism, the mil­i­tary, obscen­i­ty laws, sex edu­ca­tion and atti­tudes toward pub­lic health.

From Mar­garet Sanger and the 60,000 women exe­cut­ed as witch­es in the 16th and 17th cen­turies, to econ­o­mist Thomas Malthus’ 1798 Essay on the Prin­ci­ple of Pop­u­la­tion and leg­endary adven­tur­er Gia­co­mo Casano­va’s satin rib­bon-trimmed jim­my hat, this episode of His­to­ry Tea Time with Lind­say Hol­i­day touch­es on it all.

- Ayun Hal­l­i­day is the Chief Pri­ma­tol­o­gist of the East Vil­lage Inky zine and author, most recent­ly, of Cre­ative, Not Famous: The Small Pota­to Man­i­festo.  Fol­low her @AyunHalliday.

Relat­ed Con­tent 

The Birth Con­trol Hand­book: The Under­ground Stu­dent Pub­li­ca­tion That Let Women Take Con­trol of Their Bod­ies (1968)

I’m Just a Pill: A School­house Rock Clas­sic Gets Reimag­ined to Defend Repro­duc­tive Rights in 2017

The Sto­ry Of Men­stru­a­tion: Watch Walt Disney’s Sex Ed Film from 1946

What Did People Do Before the Invention of Eyeglasses?

You remem­ber it — one of the most heart­break­ing scenes on TV. A man longs for noth­ing more than time to read, to be free of all those peo­ple Sartre told us make our hells. Final­ly grant­ed his wish by the H‑Bomb, he then acci­den­tal­ly break his glass­es, ren­der­ing him­self unable make out a word. Oh, cru­el irony! Not an optometrist or opti­cian in sight! Sure­ly, there are “Time Enough at Last” jokes at eye care con­ven­tions world­wide.

Moral­i­ty tales wrapped in sci­ence fic­tion might make us think about all sorts of things, but one of the most obvi­ous ques­tions when we wit­ness the fate of Mr. Hen­ry Bemis, “char­ter mem­ber in the fra­ter­ni­ty of dream­ers,” might be, but what did peo­ple do before cor­rec­tive lens­es? Were mil­lions forced to accept his fate, liv­ing out their lives with far­sight­ed­ness, near­sight­ed­ness, and oth­er defects that impede vision? How did ear­ly humans sur­vive in times much less hos­pitable to dis­abil­i­ties? At least there were oth­ers to read and describe things for them.…

In truth, the Twi­light Zone is not far off the mark. Or at least near­sight­ed­ness and read­ing are close­ly linked. “As long as pri­mates have been around, there’s prob­a­bly been myopia,” says pro­fes­sor of oph­thal­mol­o­gy Ivan Schwab. But Schwab argues in his book Evo­lu­tion’s Wit­ness: How Eyes Evolved that the rise of read­ing like­ly caused sky­rock­et­ing rates of myopia over the past three hun­dred years. “Though genes and nutri­tion may play a role in near­sight­ed­ness,” Natal­ie Jacewicz writes at NPR, “[Schwab] says edu­ca­tion and myopia seem to be linked, sug­gest­ing that when peo­ple do a lot of close work, their eyes grow longer.”

As the His­to­ry Dose video above explains, the old­est image of a pair of glass­es dates from a 1351 paint­ing of Car­di­nal Hugh of Saint-Cher. The paint­ing is an anachro­nism — spec­ta­cles, the nar­ra­tor tells us, were invent­ed 23 years ear­li­er in Pisa, after the car­di­nal’s death. They “grad­u­al­ly spread across Europe and trav­elled the Silk Road to Chi­na.” (The old­est sur­viv­ing pair of glass­es dates from around 1475). So what hap­pened before 1286? As you’ll learn, glass­es were not the only way to enlarge small items. In fact, humans have been using some form of mag­ni­fy­ing lens to read small print (or man­u­script or cuneiform or what-have-you) for thou­sands of years. Those lens­es, how­ev­er, cor­rect­ed pres­by­opia, or far-sight­ed­ness.

Those with myopia were most­ly out of luck until the inven­tion of sophis­ti­cat­ed lens-grind­ing tech­niques and improved vision tests. But for most of human his­to­ry, unless you were a sailor or a sol­dier, you “like­ly spent your day as an arti­san, smith, or farm work­er,” occu­pa­tions where dis­tance vision did­n’t mat­ter as much. In fact, arti­sans like medieval scribes and illu­mi­na­tors, says Neil Han­d­ley — muse­um cura­tor of the Col­lege of Optometrists, Lon­don — were “actu­al­ly encour­aged to remain in their myopic con­di­tion, because it was actu­al­ly ide­al for them doing this job.”

It was­n’t until well after the time of Guten­berg that wear­ing lens­es on one’s face became a thing — and hard­ly a pop­u­lar thing at first. Ear­ly glass­es were held up to the eyes, not worn. They were heavy, thick, and frag­ile. In the 15th cen­tu­ry, “because… they were unusu­al and rare,” says Han­d­ley, “they were seen as hav­ing mag­i­cal pow­ers” and their wear­ers viewed as “in league with the dev­il, immoral.” That stig­ma went away, even if glass­es picked up oth­er asso­ci­a­tions that some­times made their users the sub­ject of taunts. But by the nine­teenth cen­tu­ry, glass­es were com­mon around the world.

Giv­en that we all spend most of our time inter­act­ing with small text and images on hand­held screens, it seems maybe they haven’t spread wide­ly enough. “More than a bil­lion, and maybe as many as 2.5 bil­lion, peo­ple in the world need but don’t have glass­es to cor­rect for var­i­ous vision impair­ments,” notes Live­science, cit­ing fig­ures from The New York Times. For many peo­ple, espe­cial­ly in the devel­op­ing world, the ques­tion of how to get by in the world with­out eye­glass­es is still a very press­ing, present-day issue.

Relat­ed Con­tent:

The World’s Old­est Sur­viv­ing Pair of Glass­es (Cir­ca 1475)

James Joyce, With His Eye­sight Fail­ing, Draws a Sketch of Leopold Bloom (1926)

Oliv­er Sacks Explains the Biol­o­gy of Hal­lu­ci­na­tions: “We See with the Eyes, But with the Brain as Well”

Josh Jones is a writer and musi­cian based in Durham, NC. Fol­low him at @jdmagness

The Anti-Vaxxer Who Waged War Against Jonas Salk & His Polio Vaccine: When History Keeps Repeating

Almost imme­di­ate­ly after Scot­tish doc­tor Edward Jen­ner learned how to inoc­u­late humans against small­pox in 1796, mass move­ments sprang up in Eng­land and the U.S. to oppose the mea­sure. The rejec­tion of inoc­u­la­tion and vac­ci­na­tion gen­er­al­ly made its stand on “polit­i­cal grounds,” says Yale his­to­ri­an Frank Snow­den. For over two hun­dred years, peo­ple have “wide­ly con­sid­ered [vac­cines to be] anoth­er form of tyran­ny.” In the 19th cen­tu­ry, fears of gov­ern­ment con­trol mutat­ed into pseu­do­sci­en­tif­ic con­spir­a­cy the­o­ries claim­ing the small­pox vac­cine might cause, for exam­ple, the growth of hooves and horns or the birth of human/cow hybrid babies.

The push­back against the small­pox vac­cine, writes Slate’s Nick Kep­pler, occurred dur­ing a time “when argu­ments about bod­i­ly integri­ty and reli­gious objec­tion car­ried as much weight as sci­en­tif­ic evi­dence.” But vac­cine sci­ence pro­gressed nonethe­less, and sci­en­tif­ic insti­tu­tions – very much in league with gov­ern­ment by the mid-20th cen­tu­ry – shared their largesse in the form of med­ical break­throughs and con­sumer con­ve­niences. “The post­war era was a very trust-in-sci­ence-era,” says researcher sci­en­tist Jonathan M. Berman, author of Anti-Vaxxers: How to Chal­lenge a Mis­in­formed Move­ment. “The pub­lic not just accept­ed, but cheered, the head­line-mak­ing work of guys in white lab coats,” Kep­pler remarks.

Not every­one was cheer­ing for Jonas Salk, the March of Dimes, and the polio vac­cine, how­ev­er. While celebri­ties like Elvis Pres­ley legit­imized the vac­cine in the eyes of a pre­vi­ous­ly skep­ti­cal pub­lic, a few fer­vent anti-vaxxers rose to promi­nence, some using the same com­bi­na­tion of fear mon­ger­ing, pseu­do­sci­en­tif­ic spec­u­la­tion, and con­spir­a­to­r­i­al think­ing com­mon to the small­pox era – and com­mon, once again, in the time of COVID-19.

One of these fig­ures, Flori­da busi­ness­man Duon Miller, found­ed a cos­met­ics com­pa­ny, then invest­ed his own mon­ey and that of oth­ers into an orga­ni­za­tion called Polio Pre­ven­tion Inc., a one-man oper­a­tion that pur­port­ed to fight polio with infor­ma­tion about nutri­tion. Miller’s orga­ni­za­tion actu­al­ly served to under­mine the vac­cine with a host of out­ra­geous, log­i­cal­ly fal­la­cious claims about the caus­es of polio and the dan­gers of vac­ci­na­tion. As Kep­pler notes:

Like today’s COVID skep­tics, Miller cher­ry-picked physi­cians who were skep­ti­cal of polio as a virus and mis­rep­re­sent­ed facts. One mail­er was a rapid fire of out-of-con­text infor­ma­tion: Salk “isn’t entire­ly sat­is­fied with the vac­cine.” Some chil­dren still got polio after being vac­ci­nat­ed. And just as the “real” num­ber of COVID-19 deaths pales in com­par­i­son to vac­cine deaths in some dark cor­ners of the inter­net, so it was with polio in Miller’s world: “Polio ‘CRIPPLES’ and Polio ‘DEATHS’ are mere­ly ‘Sta­tis­tics’ to the ‘Char­i­ty-Bro­kers,’ whose record to date of ‘Crip­ples’ and ‘Deaths’ is TRULY DISGRACEFUL.”

Like many con­spir­a­cy the­o­rists today, Miller’s claims con­tained sev­er­al ker­nels of truth, mis­placed in the ser­vice of a bizarre cru­sade. Research now ties excess con­sump­tion of soft drinks, white flour, and refined sug­ar to an increase in can­cers and heart dis­ease. In this, Miller was pre­scient, giv­en that these are the some of the biggest killers in the coun­try. But this had noth­ing to do with the polio virus. Miller’s uncrit­i­cal think­ing, mis­tak­ing large-scale cor­re­la­tions for cau­sa­tion, typ­i­fies con­spir­a­cy the­o­ries. His appeal to the wel­fare of chil­dren also strikes a famil­iar chord, but it’s unsur­pris­ing in this case, giv­en that “polio was a dis­ease of chil­dren,” says René F. Najera, edi­tor of the Col­lege of Physi­cians of Philadelphia’s His­to­ry of Vac­cines project, “so peo­ple were already afraid for their chil­dren.” Com­par­a­tive­ly, COVID-19 “has large­ly left chil­dren alone … so we don’t mobi­lize as much.”

Kep­pler draws many oth­er par­al­lels between Miller’s per­son­al anti-polio vac­cine project and the efforts today to resist the COVID-19 vac­cine, all rep­re­sen­ta­tive of Amer­i­can anti-intel­lec­tu­al­ism and the well-fund­ed will to dis­be­lieve what the sci­ence clear­ly demon­strates. Miller dis­trib­uted mail­ers in schools around Flori­da, accept­ed hun­dreds in dona­tions, and print­ed thou­sands of pam­phlets for dis­tri­b­u­tion. He even offered to get inject­ed with the polio virus to show that it was harm­less. How­ev­er, “fed­er­al charges end­ed Miller’s cru­sade,” when he was charged with “send­ing ‘libel­lous, scur­rilous and defam­a­to­ry’ state­ments through the mail” in 1954, the year Salk read­ied nation­wide tri­als of the vac­cine. Five years lat­er, “U.S. polio cas­es were about 14 per­cent of what they were in 1952, thanks to vac­ci­na­tion,” not, as Miller would have the pub­lic believe, a change in diet. “Give us prop­er diets,” he con­tin­ued to write to news­pa­pers, “and we’ll solve the phys­i­cal imper­fec­tions of Amer­i­cans young and old.” He might have been on to a good argu­ment about nutri­tion just by chance, but the pub­lic had no rea­son to lis­ten to his opin­ions about polio sim­ply because he could afford to cir­cu­late them.

via Steve Sil­ber­man

Relat­ed Con­tent: 

Elvis Pres­ley Gets the Polio Vac­cine on The Ed Sul­li­van Show, Per­suad­ing Mil­lions to Get Vac­ci­nat­ed (1956)

How the World’s First Anti-Vax Move­ment Start­ed with the First Vac­cine for Small­pox in 1796, and Spread Fears of Peo­ple Get­ting Turned into Half-Cow Babies

How Do Vac­cines (Includ­ing the COVID-19 Vac­cines) Work?: Watch Ani­mat­ed Intro­duc­tions

Dying in the Name of Vac­cine Free­dom

Josh Jones is a writer and musi­cian based in Durham, NC. Fol­low him at @jdmagness

The Omicron Variant Explained by Neil deGrasse Tyson & Regeneron President George Yancopoulos

What is the Omi­cron Vari­ant? How do vac­cines work? And what about mon­o­clon­al anti­body ther­a­py? On this episode of StarTalk, Neil deGrasse Tyson has a wide-rang­ing and quite infor­ma­tive con­ver­sa­tion with George Yan­copou­los, pres­i­dent of Regen­eron, the com­pa­ny that cre­at­ed the mon­o­clon­al anti­body ther­a­py now being used in the fight against COVID-19. And there’s an inter­est­ing side note: Dur­ing the 1970s, Tyson and Yan­copou­los were high school class­mates togeth­er at Bronx Sci­ence. They’ve both come a long way, and now they re-unite to explain the sci­ence behind the lat­est phase of the pan­dem­ic.

If you would like to sign up for Open Culture’s free email newslet­ter, please find it here. Or fol­low our posts on Threads, Face­book, BlueSky or Mastodon.

If you would like to sup­port the mis­sion of Open Cul­ture, con­sid­er mak­ing a dona­tion to our site. It’s hard to rely 100% on ads, and your con­tri­bu­tions will help us con­tin­ue pro­vid­ing the best free cul­tur­al and edu­ca­tion­al mate­ri­als to learn­ers every­where. You can con­tribute through Pay­Pal, Patre­on, and Ven­mo (@openculture). Thanks!

Relat­ed Con­tent 

1,700 Free Online Cours­es from Top Uni­ver­si­ties.

Neil deGrasse Tyson Lists 8 (Free) Books Every Intel­li­gent Per­son Should Read

MIT Presents a Free Course on the COVID-19 Pan­dem­ic

How the COVID-19 Vac­cines Could Be Cre­at­ed So Quick­ly: Two Ani­mat­ed Videos Explain the How mRNA Vac­cines Were Devel­oped, and How They Work

How the World’s First Anti-Vax Movement Started with the First Vaccine for Smallpox in 1796, and Spread Fears of People Getting Turned into Half-Cow Babies

A car­toon from a Decem­ber 1894 anti-vac­ci­na­tion pub­li­ca­tion (Cour­tesy of The His­tor­i­cal Med­ical Library of The Col­lege of Physi­cians of Philadel­phia)

For well over a cen­tu­ry peo­ple have queued up to get vac­ci­nat­ed against polio, small­pox, measles, mumps, rubel­la, the flu or oth­er epi­dem­ic dis­eases. And they have done so because they were man­dat­ed by schools, work­places, armed forces, and oth­er insti­tu­tions com­mit­ted to using sci­ence to fight dis­ease. As a result, dead­ly viral epi­demics began to dis­ap­pear in the devel­oped world. Indeed, the vast major­i­ty of peo­ple now protest­ing manda­to­ry vac­ci­na­tions were them­selves vac­ci­nat­ed (by man­date) against polio, small­pox, measles, mumps, rubel­la, etc., and hard­ly any of them have con­tract­ed those once-com­mon dis­eases. The his­tor­i­cal argu­ment for vac­cines may not be the most sci­en­tif­ic (the sci­ence is read­i­ly avail­able online). But his­to­ry can act as a reli­able guide for under­stand­ing pat­terns of human behav­ior.

In 1796, Scot­tish physi­cian Edward Jen­ner dis­cov­ered how an injec­tion of cow­pox-infect­ed human bio­log­i­cal mate­r­i­al could make humans immune to small­pox. For the next 100 years after this break­through, resis­tance to inoc­u­la­tion grew into “an enor­mous mass move­ment,” says Yale his­to­ri­an of med­i­cine Frank Snow­den. “There was a rejec­tion of vac­ci­na­tion on polit­i­cal grounds that it was wide­ly con­sid­ered as anoth­er form of tyran­ny.”

Fears that injec­tions of cow­pox would turn peo­ple into mutants with cow-like growths were sat­i­rized as ear­ly as 1802 by car­toon­ist James Gilray (below). While the anti-vac­ci­na­tion move­ment may seem rel­a­tive­ly new, the resis­tance, refusal, and denial­ism are as old as vac­ci­na­tions to infec­tious dis­ease in the West.

Image via Wiki­me­dia Com­mons

“In the ear­ly 19th cen­tu­ry, British peo­ple final­ly had access to the first vac­cine in his­to­ry, one that promised to pro­tect them from small­pox, among the dead­liest dis­eases in the era,” writes Jess McHugh at The Wash­ing­ton Post. Small­pox killed around 4,000 peo­ple a year in the UK and left hun­dreds more dis­fig­ured or blind­ed. Nonethe­less, “many Britons were skep­ti­cal of the vac­cine.… The side effects they dread­ed were far more ter­ri­fy­ing: blind­ness, deaf­ness, ulcers, a grue­some skin con­di­tion called ‘cow­pox mange’ — even sprout­ing hoofs and horns.” Giv­ing a per­son one dis­ease to fright­en off anoth­er one prob­a­bly seemed just as absurd a notion as turn­ing into a human/cow hybrid.

Jen­ner’s method, called var­i­o­la­tion, was out­lawed in 1840 as safer vac­ci­na­tions replaced it. By 1867, all British chil­dren up to age 14 were required by law to be vac­ci­nat­ed against small­pox. Wide­spread out­rage result­ed, even among promi­nent physi­cians and sci­en­tists, and con­tin­ued for decades. “Every day the vac­ci­na­tion laws remain in force,” wrote sci­en­tist Alfred Rus­sel Wal­lace in 1898, “par­ents are being pun­ished, infants are being killed.” In fact, it was small­pox claim­ing lives, “more than 400,000 lives per year through­out the 19th cen­tu­ry, accord­ing to the World Health Orga­ni­za­tion,” writes Eliz­a­beth Earl at The Atlantic“Epi­dem­ic dis­ease was a fact of life at the time.” And so it is again. Covid has killed almost 800,000 peo­ple in the U.S. alone over the past two years.

 

Then as now, med­ical quack­ery played its part in vac­cine refusal — in this case a much larg­er part. “Nev­er was the lie of ‘the good old days’ more clear than in med­i­cine,” Greig Wat­son writes at BBC News. “The 1841 UK cen­sus sug­gest­ed a third of doc­tors were unqual­i­fied.” Com­mon caus­es of ill­ness in an 1848 med­ical text­book includ­ed “wet feet,” “pas­sion­ate fear or rage,” and “dis­eased par­ents.” Among the many fiery lec­tures, car­i­ca­tures, and pam­phlets issued by oppo­nents of vac­ci­na­tion, one 1805 tract by William Row­ley, a mem­ber of the Roy­al Col­lege of Physi­cians, alleged that the injec­tion of cow­pox could mar an entire blood­line. “Who would mar­ry into any fam­i­ly, at the risk of their off­spring hav­ing filthy beast­ly dis­eases?” it asked hys­ter­i­cal­ly.

Then, as now, reli­gion was a moti­vat­ing fac­tor. “One can see it in bib­li­cal terms as human beings cre­at­ed in the image of God,” says Snow­den. “The vac­ci­na­tion move­ment inject­ing into human bod­ies this mate­r­i­al from an infe­ri­or ani­mal was seen as irre­li­gious, blas­phe­mous and med­ical­ly wrong.” Grant­ed, those who vol­un­teered to get vac­ci­nat­ed had to place their faith in the insti­tu­tions of sci­ence and gov­ern­ment. After med­ical scan­dals of the recent past like the Tuskegee exper­i­ments or Thalido­mide, that can be a big ask. In the 19th cen­tu­ry, says med­ical his­to­ri­an Kristin Hussey, “peo­ple were ask­ing ques­tions about rights, espe­cial­ly work­ing-class rights. There was a sense the upper class were try­ing to take advan­tage, a feel­ing of dis­trust.”

The deep dis­trust of insti­tu­tions now seems intractable and ful­ly endem­ic in our cur­rent polit­i­cal cli­mate, and much of it may be ful­ly war­rant­ed. But no virus has evolved — since the time of the Jen­ner’s first small­pox inoc­u­la­tion — to care about our pol­i­tics, reli­gious beliefs, or feel­ings about author­i­ty or indi­vid­ual rights. With­out wide­spread vac­ci­na­tion, virus­es are more than hap­py to exploit our lack of immu­ni­ty, and they do so with­out pity or com­punc­tion.

via Wash­ing­ton Post

Relat­ed Con­tent: 

Dying in the Name of Vac­cine Free­dom

How Vac­cines Improved Our World In One Graph­ic

How Do Vac­cines (Includ­ing the COVID-19 Vac­cines) Work?: Watch Ani­mat­ed Intro­duc­tions

Elvis Pres­ley Gets the Polio Vac­cine on The Ed Sul­li­van Show, Per­suad­ing Mil­lions to Get Vac­ci­nat­ed (1956)

Josh Jones is a writer and musi­cian based in Durham, NC. Fol­low him at @jdmagness

« Go BackMore in this category... »
Quantcast
Open Culture was founded by Dan Colman.