The Medical History of Speech Disorders

microphone-1716069_1920Dr Marjore Lorch from Birkbeck’s Department of Applied Linguistics and Communication talks to us about her recent investigation into the first recorded case of spasmodic dysphonia (SD) – a condition in which  involuntary spasms in the tiny muscles of the larynx cause the voice to break up, or sound strained, tight, strangled, breathy, or whispery. The below interview is adapted from an interview given to the National Spasmodic Dysphonia Association and published in their newsletter Our Voice, 2016, 26 (1) 14-15.

What did this piece of research entail?

Together with Dr Renata Whurr, I investigated the very first case of spasmodic dysphonia that is regularly cited in the current research literature. We found that the picture presented by this patient, translated from German in the 1870s, was not what it seemed. The clinical description was not consistent with our current view and it is likely that the patient didn’t actually have SD. Subsequently, we discovered that research by a British clinician, writing at the same time, contained observations very similar to our current characterization.

How did you get involved in historical research?

I was fortunate to have teachers throughout my training who stressed that the way to understand neurogenic disorders, observed clinically, was to go back and read earlier descriptions to understand how syndromes were characterized by the perspective of the observers which changed over time.

Can you explain how historical research impacts current and future research?

I believe that applied medical history can contribute important insights into current clinical issues. This method puts a spotlight on understanding the way assumptions, concerns and questions change over time and how that influences the types of answers that are pursued. This kind of approach may be particularly useful in making progress on points that have been debated over the years by analyzing the types of symptoms that have been considered central to different formulations in the past. For example, whether clinicians considered SD to be psychogenic or neurogenic has changed over time. To develop a more nuanced and detailed picture to drive forward future avenues of research, it is valuable to go back and review historical observations. It can be a source of inspiration to revisit previous hypotheses and characterizations. The benefit is that it may produce a reassessment of things that were held as unquestioned assumptions.

What drew you to spasmodic dysphonia research?

I began my involvement with spasmodic dysphonia research in the early 1990s through my work with Dr Renata Whurr who was head of Speech and Language Therapy at the National Hospital for Neurology and Neurosurgery at Queen Square London. Over the years we have collaborated on a variety of aspects regarding SD. Initially, this was focused on treatment. However, I later became interested in the linguistics aspects of the problem. We investigated how the vocal cord movement disorder interacted with the articulatory properties of different languages. One important finding drew attention to the fact that speakers with SD will have different vocal symptoms depending on what language they speak. For example, the diagnostic features of SD for English will not adequately describe the characteristics of French SD speakers. Put more simply, if you have SD, your symptoms will be slightly different depending on the language you speak.

What has surprised you the most about researching the history of spasmodic dysphonia?

When my colleague, Dr Whurr, and I went back to the original case of SD reported in the 1870s that is still cited today, we were amazed to find that the individual didn’t have a voice disorder that we would recognize as SD. This research revealed the common practice of perpetuating a reference to historical literature without necessarily going back to the source. The selection of emblematic cases is also influenced by the assumptions held by the researcher. Our work highlighted how a particular view of the past may be colored by present day biases. In this instance, a strong belief in Freudian psychology in the mid-20th century may have played a part in choosing a historical case that was formulated as “hysterical”. It also highlighted how more significant and worthwhile observations may not be promoted, because of social rather than scientific reasons. By reading the 19th century literature, we recovered important observations about SD that had been lost to posterity.

How do you think this research will help people with SD?

Our research has highlighted the contribution of the 19th-century clinician, Morell Mackenzie, who described the particular sound of a person’s voice, which will lead directly to the diagnosis of SD. This is of vital importance as there is often a long delay in diagnosing SD. It is important to recognize that changes in voice may be the only symptom of this neurogenic disorder.

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Peace-making in Colombia beyond the ratification of the peace agreement: political or market solutions to peace-making?

This post was contributed by Dr Olivier Sibai, lecturer in marketing in Birkbeck’s Department of Management. Dr Sibai recently published a paper entitled ‘Marketing as a Means to Transformative Social Conflict Resolution: Lessons from Transitioning War Economies and the Colombian Coffee Marketing System‘ in the Journal of Public Policy and Marketing

Colombian peace agreement: is it really the end of the longest civil war?

After four years of negotiations, the Colombian government and the representatives of the FARC signed a historical peace deal this summer. The deal was ratified by the house of representative on the 30th November, officially ending 52 years of a civil war which has left up to 250 000 people dead and over 5 million people displaced. The peace deal was hailed by the international community as a major achievement. High Commissioner for Peace Sergio Jaramillo described it as a miracle and the country’s President, Juan Manuel Santos, received the Nobel Peace Prize for his role.

While the peace agreement is clearly a great achievement, voices are already raising concerns about the risks of ex-fighters joining criminal gangs. Clearly, the agreement is only the first step of a long peace-building process. As long standing civil war deeply changed Colombian society, peace-building will be a challenging process, necessitating the overcoming of many hurdles over many years.

Peace-making: a political challenge with a political solution?

Peace-making in Colombia is clearly a political challenge. Civil wars developed because, 50 years ago, the state was dysfunctional to the extent that it failed to provide certain public goods required for societal well-being. In particular, security manifested as physical safety, wealth, and welfare was limited to small segments of society – typically affiliated with the ruling party or class. In the wake of this situation, rebel parties emerged, fighting the state to implement a different political order.

Peace-making, therefore, typically involves achieving three objectives: restoring the ability of the state to provide public good,  undermining the ability of the rebel parties to challenge the state through war-making, and facilitating reintegration of the actors actively engaged in the war in a state-centered society. The peace agreement ratified in Colombia addresses those three political issues through political solutions. The Colombian state will redistribute land and invest in rural development, set up of a transitional justice system to judge and formally reintegrate the former rebels, and guarantee the FARC a place in democratic debates as a political party. International political organisations will also be involved, with, for example, the United Nations overlooking disarmament in the coming months. Civil society is already contributing to peace-making, facilitating community dialogue and communicating the benefits of citizenship and law-obedience within sensitive communities.

Peace-making: a market problem – with political or market-based solutions?

While political issues must undoubtedly lead the peace-making process, markets will also necessarily play a significant role in turning the peace-making initiative into a long-term success or a failure. As the civil war continued, the Colombian economy transformed into a war economy – an economic system adapted to the context of violent conflicts and functioning largely outside the rule of law. As the war economy itself continued, it stabilized itself as the new economic order, making it difficult to return to a peace economy. The markets of the war economy became institutionalized and business actors became dependent on the continuation of war to sustain their livelihood, producing short-term economic interest in perpetuating the war economy. The actors of the combat market accumulate their wealth from trade activities that directly fund the war (e.g. trade of money, arms, equipment, and fuel; taxation of licit and illicit economic activities). The actors of the shadow markets accumulate theirs from lucrative entrepreneurial activities on the margin of it (e.g. drug trafficking, smuggling, mass extraction of natural resources, currency exchange, and manipulation of aid resources). The actors of the coping markets (e.g. wage labor, petty trade) depend on the combat and shadow markets to eke out a living and reimburse their loans.

As business actors are embedded in the war economy, they are often viewed as a significant force working against peace-making. Typical approaches to fostering the transition from a war economy to a peace economy are therefore political, involving policies and interventions aimed at controlling market actors. The peace agreement for example foresees the states collaborating with the international community to crack down on narco-traffickers.

Yet, in the past 15 years, governmental institutions in countries afflicted by civil wars have been criticized as kleptocracies manipulated by elites embedded in the war economy to retain power and wealth. Markets, by contrast, have increasingly been recognized as including the potential to be the pro-social forces contributing to peace-making in such contexts, promoting cooperation, inclusion, security, social justice, and sustainable prosperity. Some have argued that business people have more interest in building a deeper peace than transitory international peacebuilding officials as they have a long-term personal investment in the country. Others have depicted business sites, such as plantations or large mines which remained “islands of civility” in times of war, as representing spaces in which trust and hope can redevelop in post-war periods.

Envisioning market-based solutions to peace-making

If market-based solutions can complement political solutions to peace-making in Colombia, we still need to understand how markets can contribute to stabilizing Colombia into peace rather than destabilize it back into war. And today, we still know very little about that.
My colleagues and I argue that, for markets to contribute to transforming the war economy into a peace economy, marketers need to shift their perspective. They need to view themselves not solely as economic agents guided by profit but as policy agents or corporate diplomats, equally interested in promoting social wellbeing through the market. From this perspective they must design peace-making markets rather than just design marketing tactics in existing war markets.

Now, what would a peace-making market look like? To get a first picture of this, we investigated the fair-trade coffee market system in the Colombian civil war. Overall our analysis shows that promoting individual empowerment, communication, community building, and regulation within markets represented useful anchors for marketers to design a peace-making markets, contributing altogether to legitimizing the government as a provider of public good, weakening rebel forces and helping market actors from the war economy to transition to a peace economy. Let us look at each anchor in turn.

  • First, the Colombian fair-trade coffee market system has empowered individual actors from the shadow markets engaged in illegal entrepreneurial activities on the margin of the war, providing them with the necessary resources and capabilities to reintegrate into the peace economy. For example, it has given farmers a viable “way out” of cocaine production.
  • Second, it has fostered the development of resourceful communities that incentivize actors from the coping markets, struggling to eke a living, to embrace the peace economy. For example, fair-trade coffee certification came along with training, increasing poor farming communities’ knowledge and expertise and the provision of education and health care for communities.
  • Third, the marketing system promoted communication between/among market actors and government bodies, enhancing the legitimacy of the state. For example, governmental methods to eradicate cocaine fields which damaged crops pitted the government against coffee farmers suffering from it, breaking ties between them. The democratic requirements of decision-making in fair trade coffee cooperatives motivated negotiations with the governments which successfully led to developing less destructive ways of eradicating cocaine plantations, relegitimizing governmental activities.
  • Finally, the fair trade coffee marketing system promoted the development of self-imposed market regulations that promote the view that prosperity can be attained through the peace economy. Governmental support of such regulations further legitimized the state as a provider of public good.

We do not contend that the anchors identified will necessary be the same in different contexts as there is no one-size-fits-all approach to peace-making. We do not contend either that market-based solutions to peace-making are alternatives to political solutions to peace-making. However, they represent a useful and necessary complementary approach. Markets will play an important role in the actual long-term pacification of Colombia and it seems unlikely that the war economy will transition in a peace economy without peace-making initiatives from market actors themselves. It is therefore essential that the Colombian government and the international communities consider carefully how they can promote and leverage market-based peace-making initiatives when working towards peace-making.

 

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Mars rover testing in the Utah desert

This article was contributed by Dr Jennifer Harris from Birkbeck’s Department of Earth and Planetary Sciences

Over the last week of October and first week of November 2016 a group of UK-based scientists and engineers carried out the first (of hopefully many) mission simulations of the ExoMars rover.

The Utah desert and site of the MURFI field trail (image credit: Jennifer Harris)

The Utah desert and site of the MURFI field trail (image credit: Jennifer Harris)

The ExoMars Rover

The ExoMars rover is the second half of the ESA/Roscosmos ExoMars programme to investigate the surface and atmospheric composition of Mars, looking for signs of life. The first half, the Trace Gas Orbiter, successfully reached Mars in November 2016 and is now preparing to begin its mission.  The second half, the rover, is due to be launched in 2020 and will be going to some of the oldest terrains on Mars. There it will drill up to two metres into the surface to look for any evidence of ancient life.

Before we send over €1 billion worth of technology all the way to Mars, trials using prototypes of the rover and its instruments are necessary to ensure useful and correct data will be returned, and that the scientists who will be involved in the mission operations know how to interpret these data and use them to guide the rover in its exploration. Numerous UK scientists, including myself and some of my colleagues in the Department of Earth and Planetary Science, are involved in the ExoMars program and were subsequently thrilled to take part in MURFI, a UKSA-funded field simulation of the ExoMars rover mission.

MURFI – the Mars Utah Rover Field Investigation

MURFI was a collaboration between a number of institutions including RAL Space, UCL, Birkbeck, University of Leicester, University of Oxford, Open University, University of St Andrews, Aberystwyth University, Natural History Museum and Joanneum Research in Austria. With over 60 people involved two core groups were formed.  One group set up camp in the Utah desert near to the Mars Desert Research Station and the Canadian Space Agency team (who were conducting their own rover field trials at the same time). With them were the rover supplied by the robotics group at the University of Oxford and various prototypes of the instruments that are currently being built for the ExoMars rover.  It was this field team who would be operating the rover and instruments, collecting the data requested. A second group gathered in the Satellite Catapult Centre in Harwell where a Mission Operations Centre (MOC) was established. This MOC would command the rover, sending detailed daily instructions to the field team.

MURFI Mission Operations Centre in full swing (Image credit: Pete Grindrod)

MURFI Mission Operations Centre in full swing (Image credit: Pete Grindrod)

Mission Operations – a daily race

Each day the mission operations team downloaded the data (primarily images) collected by the field team the previous day, analysed these and made a decision as to what we wanted the rover to do next. This was a constant race against the clock as these commands had to be sent to Utah by 2pm UK time, 7am Utah time, to give them a full day to complete our requests. Our primary aim in these decisions each day was to identify a patch of ground to drill into that is (a) drillable with the equipment available and (b) likely to hold evidence of past life. This will also be one of the major goals of the ExoMars rover operations team. Identifying the type of geological environment you are in when all you have are a handful of images to look at is significantly harder than if you are able to walk around the area yourself. However, it is exactly this challenge that we face with robotic exploration and thus learning this skill through field trials such as MURFI is a vital part of mission preparation.

Trial outcomes

The final pieces of data are still being analysed and mission debriefing is still to come but it’s safe to say everyone involved learnt a lot about being part of a rover driving team, and in the case of some, being part of a rover! With approximately five years to go before the ExoMars rover begins its mission this was an important step towards ensuring the UK’s planetary science community are prepared for the heavy work of searching for life on Mars.

MURFI rover and instruments (image credit: Pete Grindrod/MURFI field team)

MURFI rover and instruments (image credit: Pete Grindrod/MURFI field team)

Further details

The BBC came to visit us at Harwell one day to film a section for the Sky at Night which can be found at the end of this episode.

More in depth details of the field trial rationale and daily activities can be found at the MURFI blog and via the #MURFI hashtag on twitter.

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Speculative Aesthetics: Freeports as the Art Caves of High Finance

This article was written by Neil Fitzgerald, winner of the inaugural Verso Prize for Cultural and Critical Studies. Speculative Aesthetics: Freeports as the Art Caves of High Finance is a selection from the winning dissertation and was originally published on the Verso Books blog.


Fig. 1. Cave art from Lascaux

In a lecture given on January 18, 1955 in Orléans, the French writer and anthropologist Georges Bataille suggested that the paintings discovered at the Lascaux caves in France in 1940 announce the presence of man on earth –  man ‘appeared on earth with art’. The paintings are figurative – ibex, bison, mammoth rhinos, often in the process of being hunted by arrows (Fig. 1) – and Bataille suggests they reveal a magic-oriented desire for ‘assuring miraculous hunts’. He acknowledges the irony of how this discovery of ‘our birth’ is being made at a time when ‘the notion of our death appears to us’ in the guise of atomic experiments in the atolls of the Pacific.

What Bataille repeatedly stresses in this lecture is the relation of these prehistoric artworks to a form of ‘wealth’. One problematic he addresses is the inability of the contemporary visitor to discover these primitive artworks without the ‘present-day world’ following the viewer into the ancient cave. He highlights the parallels between the cave entrance at Lascaux and a Paris subway station, complete with admission tickets, bookstore and postcards. Bataille retraces the moment three 15-year-old boys re-discovered the cave network and art in September 1940.  He quotes one of the boys describing their discovery in terms of discovering treasure – ‘a casket of diamonds or a cascade of precious gems’; they thought that their fortune had been made. Bataille continues: ‘If we suddenly enter this world, the oldest one that man has created, we are seized by a feeling of fabulous wealth’. Their translation of this stupefying event into this language, Bataille argues, is because the feeling of personal wealth is the strongest feeling a human can have: ‘Lascaux is…rich to the point of dazzling us.’ In contrast to such riches is the poverty of his contemporaneous world, wherein everything is submitted to the control of profitability with one exception: ‘the engineering and materials of destruction, works that today threaten to exterminate the species.’ Bataille suggests that if we see ourselves in the beings who created the cave art, it is because they offer us this feeling of wealth, a feeling undermined by the poverty of the present-day which accompanies the latter-day visitor. Linking the marvellous with material wealth, Bataille posits the connection between art and economics lies in the fact that a work of art requires labour to be produced: ‘the work of art is wealth expended without utility.’ ‘The feeling of richness’ and the fact of ‘being dazzled’ are symbiotically entangled.

Since Bataille’s lecture, the interrelationship between art and ‘feelings of wealth’ has taken on a substantively different meaning. In 2012, global sales of art were estimated at more than £40 billion. The richness of this symbiosis is usefully demonstrated by the rise of the Freeport (Fig. 2), secure warehouse complexes which are said to house millions of works of art, although the confidentiality afforded by these locations means precise numbers and their value are impossible to come by.


Fig. 2. Le Freeport, Luxembourg

Freeports have garnered a reputation as ‘fortresses of art’ and ‘bunkers of the super-rich’ which operate as speculative safe-houses and galleries for the wealthy to shop in. It is noticeable how a martial figurative language is used to describe them as protection against potential attack. The website of Le FREEPORT in Luxembourg suggests clients choose their warehouse complex ‘to best preserve goods from theft, depredations, and climatic aggressions’. It is telling, however, that the locations of these warehouse complexes – Geneva, Luxembourg – are all in financial tax havens, suggesting that what they really offer protection against is an attack by the taxman. The key here is that the goods are technically in transit, and as such, are exempt from a raft of customs duties. The ‘port’ location ensures confidentiality, ‘not much scrutiny, the ability to hide behind nominees, and an array of tax advantages’, ultimately transfiguring these zones of transit into ‘permanent homes of accumulated wealth’. Tony Reynard, the chairman of a freeport in Singapore, believes the 2008 financial crash triggered a demand for physical assets such as art. These ‘physical assets’, however, are invisible assets, artworks carefully concealed from the view of thieves and taxation in high-security environments such as Le FREEPORT. Like death and extinction, these artworks are not part of human experience. Hidden from view, entirely withdrawn as phenomena, they move into the philosophical category of ‘non-existent objects’ – something that does not exist in reality, like unicorns or Sherlock Holmes, and yet can still be spoken about. Yet they still function as tradable commodities in a shadow market whose opaque transactions are legally sanctioned. The notion of ‘cave art’ has been inverted in freeports: these highly-secure climate-controlled structures now function as ‘art caves’, as places of un-seeing.

Within the Freeport art cave, artworks become objects of financial speculation – a tax-free safety-deposit box for off-shore assets. The ‘art object’ is wholly withdrawn, its historical ‘truth’ concealed in the logics of finance. Its existence becomes purely nominal, whatever value its title and artist can create on the market. The ‘feeling of richness’ or ‘wealth’ that Bataille spoke of in relation to the Lascaux cave art here becomes an economic investment – a feeling at once buried behind bureaucratic layers of confidentiality and secrecy deep inside the art cave’s security complex, and at the same time exterior to it – abstracted as an asset, a ‘feeling of richness’ revealing itself as a row of numbers on a balance sheet in another country. As Heidegger asked at the beginning of his essay The Origin of the Work of Art (1950-60), how does a painting go from a thing to a work? As a thing it can hang on a wall or be transported like coal. It becomes a work by doing the work of alēthia, disclosing a truth for a historical people. But today works are concealed behind concrete walls in art caves so that the concealing Freeport itself does this unconcealing, revealing the thingliness of works as speculative commodities, reified by an elite as mere financial resource.

Heidegger would perhaps see this as the culmination of the objectification of the aesthetic experience, of the art-object as mere resource. The ‘work’ of the art work is now done by money on the art market and by the artist’s name. A different version of Van Gogh’s A Pair of Shoes (1887) was sold at auction for $8.9 million in 2006 and now resides in a private collection. Heidegger’s pure notion of art also abstracts it from the logics of capitalism which the artist himself worked within. In 1888, Van Gogh writes about making his pictures have some ‘market value’; in 1883, he writes about not paying his taxes, demonstrating his poverty to the ‘assessors’ in his ‘four kitchen chairs’ and lack of ‘rugs, pianos, antiques’. In this conspicuous poverty, his house-cum-studio might be said to serve as a form of tax haven.

What brings the cave art and the art cave together are their susceptibility to the elements, including human observers. Both caves – prehistoric and contemporary – require a constant ambient temperature for the art to endure. Despite the vast temporal differences, the brute materiality of the art and its precariousness remain constant. Heidegger suggests that the art work creates a historical people who preserve the work and the truth it discloses in time, until it is displaced by a new disclosure. But now we find that later historical people are preserving earlier artworks. For example, the Chauvet cave art has been reconstructed using concrete-resin walls to preserve the originals from being damaged through human body temperatures disturbing the cave’s micro-climate. The simulacrum uses 3D scans, sculptures, and photos projected onto the rocks. Even the cool subterranean temperature of the original is replicated, as these atmospheric factors – darkness, humidity – are seen as integral to the ‘feeling of emotion’ generated by the original art.  The website boasts that visitors entering the replica cavern ‘will discover the world as it appeared to men and women 36 000 years ago’. Thus, in spite of Heidegger’s critique of the aesthetic experience of artworks, it is this very quality which engenders the preserving of the cave art. How such simulacra, be it the replica cave, Werner Herzog’s documentary film, or photographs, transfigure the original work of art, is an important question. The German Critical Theorist Walter Benjamin’s ‘The Work of Art in the Age of Mechanical Reproduction’ or Jean Baudrillard’s work on simulacra could provide intriguing frameworks for answering such questions.

In Heidegger’s essay, the earth is seen as the ontological horizon of all human being, which is now being threatened by the worlding of Late Capitalism, a system which benefits from concealing the truth of its destruction of its foundational earth. The Marxist philosopher Slavoj Žižek has suggested humanity’s ‘collective ideology’ is ‘mobilising mechanisms of dissimulation and self-deception’ rather than facing up to the climate catastrophe at hand and the necessary economic shift needed to counter it.[1] Are these freeports, then, one such mechanism of dissimulation and self-deception, seeking to conceal rather than unconceal the increasingly uneven strife between earth and world?


[1] Slavoj Žižek, Living in the End Times (Verso, 2011), p. 327.

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