Category: Uncategorized

By Margaret Zendzian

1875-1896: Life Before Einstein

Everyone knows who Albert Einstein was, from his wacky tongue photo to his famous equation E=mc². But were his achievements entirely his own? Opinion is divided on the history of Einstein’s work. Many say Mileva Marić, his lesser-known first wife, could have played a large role in his physics and mathematics papers. Others say she did not help and was just a housewife who took care of their children. However, you can’t deny Mileva’s intelligence: she was just as gifted as Albert, raising the question of whether her brilliance helped shape some of his greatest ideas.Mileva Marić was born in 1875 in Titel, Austria-Hungary, to an affluent family of Serbian descent. From a young age, she was a bright girl¹. As a teenager, she was allowed to attend an all-boys school in Zagreb¹. Throughout her education, she continued to excel in mathematics and physics¹. Mileva’s father played an influential part in her continuing her educational journey, pushing her to travel to Switzerland to continue her studies¹. After finishing her secondary studies in 1896, she enrolled at the University of Zurich, which was the first university in Central Europe to admit women as matriculated students (unlike Austrian and German universities, which didn’t do so until around the turn of the 20th century²). She briefly studied medicine before transferring to the Polytechnic Institute of Zurich to study mathematics and physics. However, it’s interesting to note that the official student statistics of the Polytechnic do not show any enrolled women before 1917³. Therefore, women like Mileva were likely enlisted as Gasthörer– auditors- meaning much of their student life during this period was without academic credit.³

1896-1919: Life with Einstein

Both Mileva and Albert were admitted into the physics-mathematics section of the Polytechnic Institute of Zurich in 1896, and they soon became inseparable⁴. As a student, Mileva was meticulous in her studies, always organized and on top of everything, while Albert attended only a few lectures and was very disorganized⁴. During university, Mileva constantly helped Albert to channel his energy and guide his studies⁴.

From October 1897 to the following April, Mileva spent a semester abroad at Heidelberg University, where she audited mathematics and physics classes¹. Upon arriving back at the Polytechnic Institute of Zurich, she took classes in differential and integral calculus, descriptive and projective geometry, mechanics, theoretical physics, applied physics, experimental physics, and astronomy³. In 1899, she took her intermediate diploma examinations, and her results placed her fifth out of the six students who took the exams that year. While her physics grades were the same as Albert’s, she scored higher than him in Applied Physics.³ A year later she took her final exam, but failed^5,6. While many stories reiterate Mileva’s academic failure, very little is mentioned about the tutor who scored her exam^5,6. Interestingly, all the other students in her small group (all male) obtained at least 5.5 in this subject. It was only Mileva who was assigned such a low grade^5,6. At the time, Wilhelm Fiedler, a professor at Polytechnic who taught the geometry that comprised the Theory of Functions course, was also a member of the Prussian Academy of Sciences^5,6. Some members of that body felt there was no place for women in science, let alone physics, and Professor Fiedler may have shared that belief along with his colleagues ^5,6.

During this time, Albert and Mileva had been working together on a research article on capillarity. On December 13, 1900, they submitted their paper titled “Conclusions Drawn from the Phenomena of Capillarity,” which explored the surface tensions between a liquid and its vapor using a phenomenological theory based on two-body forces between molecules⁷. However, only Albert’s name ended up on the submitted final draft. This erasure of Mileva’s contribution reflects a broader pattern of the era, in which women scientists were often denied recognition for their work due to prevailing societal and institutional biases. As the historical record shows, women were frequently barred from formal scientific education and excluded from publishing under their own names, leading to their discoveries being overlooked or attributed to their male colleagues⁸.

Albert’s family strongly opposed his relationship with Mileva. She was neither Jewish nor German, and she had a lifelong limp⁴. According to Albert’s mother, Mileva was far too intellectual. In a letter from Albert to Mileva dated July 27, 1900, he stated that his mother told him:

“By the time you’re 30, she’ll already be an old hag!” and “She cannot enter a respectable family”⁴

In the early spring of 1901, the two went on a vacation together to Lake Como in Italy⁴. There, Mileva’s destiny changed abruptly. She became pregnant, but Albert still refused to marry her.⁴ They left their lover’s retreat, and Mileva sat in for her second and final attempt on her diploma exam while three months pregnant⁹. Again, she did not pass her Theory of Functions examination, and her marks in Theoretical and Experimental Physics came in lower than her previous attempt.⁹ Mileva, pregnant and unmarried, was forced to abandon her studies and return to Serbia⁴. There, she gave birth to a girl in January of 1902.⁴ No one knows what happened to the baby after she was born, as there are no birth or death certificates.⁴ Some accounts suggest that the child died soon after contracting scarlet fever, while others believe she was put up for adoption.⁴

In June of 1902, Albert received a job offer at a patent office, and his father finally granted him permission to marry Mileva⁴. The two married on January 6, 1903 and  they settled into life together: while Albert worked, Mileva assumed all the domestic duties⁴. However, during the evenings, the pair worked together on mathematics and physics. On May 14, 1904, their son Hans-Albert was born.⁴ In 1905- also known as Albert’s ‘miracle year’- the couple traveled to Serbia, where they met numerous of Mileva’s relatives and friends, who described how they collaborated together.⁴ Zarko Marić, a cousin of Mileva’s father, lived in the countryside property where the Einsteins stayed during their visit. He told Krstić (a former physics professor at Ljubljana University) how Mileva calculated, wrote, and worked with Albert.⁴ The couple often sat in the garden to discuss physics. Harmony and mutual respect prevailed. During an evening gathering of young intellectuals hosted by Mileva’s brother, Albert declared:

“I need my wife. She solves for me all my mathematical problems.”⁴

While working in the patent office, Albert also gave unpaid lectures in Bern until he was offered his first academic position in Zurich in 1909⁴. At this time, documents show that Mileva was still assisting him. Eight pages of Albert’s first lecture notes are in her handwriting, as is a letter drafted in 1910 in reply to Max Planck, who had sought Albert’s opinion.⁴ As Albert’s groundbreaking papers began to gain significant recognition within the scientific community, his reputation grew rapidly, and he soon became a celebrated figure among physicists⁶. He traveled across Europe delivering lectures and enjoying the professional esteem that came with his rising prominence in the field. His recognition remained largely within academic circles until he was awarded the Nobel Prize in 1921. While Albert was traveling, Mileva stayed behind in Prague with their children to take care of them⁶. Mileva hated Prague and soon became depressed because she was no longer a part of the scientific community⁶. Albert started to resent Mileva’s demands for attention, as he was far too busy to occupy himself with family life. Further indicating Albert’s and Mileva’s estrangement: On a trip to Berlin in 1912, Albert became reacquainted with a cousin, Elsa Löwenthal, whom he had known as a child¹⁰. The two started a romantic correspondence, and in 1914, Albert moved to Berlin, where Elsa lived¹⁰.

1919-1948: Life after Einstein

After years of living apart, Albert Einstein and Mileva Marić officially divorced in 1919¹¹. Their marriage had been strained for years, marked by emotional distance and financial struggles. Albert moved forward with his personal life, marrying his cousin Elsa just months after the divorce was finalized. Mileva was left to care for their two sons, Hans Albert and Eduard, with only sporadic financial support from Albert⁴. Raising two sons alone was no easy task, especially as their younger son, Eduard, suffered from severe mental illness. He was later diagnosed with schizophrenia and required extensive care, placing an even greater financial strain on Mileva⁴. Mileva found herself in an increasingly difficult position, and the correspondence between Mileva and Albert reveals a relationship that had become transactional, with Mileva frequently writing to Albert about the inadequacy of the money he sent⁴. The only moments of warmth between them appeared when discussing their children, a rare shared concern amidst years of growing resentment. Despite her own struggles, Mileva remained devoted to her children, particularly Eduard, ensuring he received medical attention and support⁴. Meanwhile, Hans Albert pursued a career in engineering, eventually moving to the United States⁴.

Mileva’s later life was burdened by both financial and personal hardships. She lived a modest and often difficult life in Zurich, overshadowed by the immense fame of her former husband. She continued to rely on Albert’s financial assistance, but the payments often were inconsistent, leading to constant disputes. While Albert was celebrated as one of the greatest minds of the 20th century, Mileva’s contributions, both in the early years of his scientific work and in raising their children, remained largely unrecognized. She passed away in 1948, far from the spotlight that had once surrounded her, leaving behind a legacy that remains debated by historians and scholars to this day¹.

Afterword: Did Mileva Contribute?

While Mileva Marić’s contributions to Albert’s work remain a matter of speculation, there is sufficient evidence to suggest that she was more than just a supportive wife. Mileva was a talented physicist and mathematician in her own right whose potential was stifled by societal norms and systemic biases. While Albert legally owed her financial compensation through their divorce, history may owe her something more: acknowledgment of the role she played in shaping one of the greatest scientific minds of the 20th century. I believe that Mileva truly did help Albert write some of his papers. However, because of the era in which she lived, Mileva didn’t get the credit she deserved. 

Many continue to raise the question of whether Mileva deserves formal recognition for Albert’s work. Unfortunately, no official documents list her as a co-author, and there is no direct proof that she contributed substantial original ideas to his major theories. However, circumstantial evidence, including Albert’s own words and family accounts, suggests she played an essential role in his development as a scientist. Albert himself wrote to Mileva on March 27, 1901, strongly implying collaboration, stating:

“How happy and proud I will be when the two of us together will have brought our work on relative motion to a victorious conclusion.”⁴

Additional support for Mileva’s role in Albert’s research comes from modern gender bias research, which highlights a consistent pattern of women in research teams being significantly less likely than men to be credited with authorship¹². One study found that women are 13.24% less likely to be named in academic articles and 58.40% less likely to be listed on patents produced by their teams¹². The reasons for this underrepresentation include their work being overlooked, unappreciated, or ignored¹². While direct data from the early 1900s is scarce, these trends suggest that Mileva’s contributions may have suffered the same fate, especially considering that she was one of the only women in her class studying physics and mathematics.

At the very least, Marić’s story underscores the broader issue of women’s erasure from scientific history. She was a gifted physicist who, under different circumstances, might have had her own distinguished career.

Sources

Mileva Einstein-Maric – Facts, Husband & Life. Biography. Published July 15, 2020. https://www.biography.com/history-culture/mileva-einstein-maric

Higher Education in Central Europe. Jewish Women’s Archive. https://jwa.org/encyclopedia/article/higher-education-in-central-europe

Asmodelle E. The Collaboration of Mileva Maric and Albert Einstein. Published March 27, 2015. https://www.researchgate.net/publication/274263348_The_Collaboration_of_Mileva_Maric_and_Albert_Einstein

Gagnon P. The Forgotten Life of Einstein’s First Wife. Scientific American. Published December 19, 2016. https://www.scientificamerican.com/blog/guest-blog/the-forgotten-life-of-einsteins-first-wife/

Stachel J., Cassidy D.C., & Schulmann R., The Collected Papers of Albert Einstein, Volume 1: The Early Years, 1879-1902, Princeton University Press, 1987.

Calaprice A. & Lipscombe T., Albert Einstein: a biography, Westport: Greenwood Press, 2005.

Stauffer D. Einstein’s theory of surface tension. Annalen der Physik. 2001;10(9). doi:https://doi.org/10.1002/1521-3889(200109)10:9%3C731::AID-ANDP731%3E3.0.CO;2-Z

The Long Silencing of Women in Science Continues Today. Literary Hub. Published March 5, 2021. https://lithub.com/the-long-silencing-of-women-in-science-continues-today/

Krstić D., Mileva & Albert Einstein: their love and scientific collaboration, Radovljica: Didakta, 2004.

Elsa Einstein – Death, Husband & Facts. Biography. Published November 1, 2021. https://www.biography.com/history-culture/elsa-einstein

Volume 9: The Berlin Years: Correspondence, January 1919-April 1920 (English translation supplement) page 5. Princeton.edu. Published 2025. Accessed April 14, 2025. https://einsteinpapers.press.princeton.edu/vol9-trans/27

Ross MB, Glennon BM, Murciano-Goroff R, Berkes EG, Weinberg BA, Lane JI. Women Are Credited Less in Science than Are Men. Nature. 2022;608:135-145. doi:https://doi.org/10.1038/s41586-022-04966-w

Image Sources

“Mileva Marić.” Author Unknown. 1896. http://www.bhm.ch/en/news_04a.cfm?bid=4&jahr=2006. Accessed April 19, 2025. Public Domain.

“Mileva Marić Einstein and husband Albert.” Author Unknown. 1912. http://ba.e-pics.ethz.ch/latelogin.jspx?records=:33805&r=1448594392396#1448594400592_1 ETH Zurich Archives. CC BY-SA 4.0.

“Mileva and Albert Einstein with their son Hans Albert in the garden: postcard.” Author Unknown. 1904-1905. ETH Library Zurich, Image Archive / Hs_1457-72. https://www.redalyc.org/journal/5117/511767145014/html/ Public Domain.

“Einstein Family Correspondence, including Albert Einstein-Mileva Marie[sic] love letters, surround a portrait of the couple, before going under the hammer at Christie’s in New York on November 25, 1996.” 1996. David Cheskin. PA Images/Getty Images. https://www.gettyimages.com/detail/news-photo/einstein-family-correspondence-including-albert-einstein-news-photo/829881250. Used under License. 

“Mileva Reading a Book.” Author Unknown. Date Unknown. https://rinconeducativo.org/en/anniversaries/august-7-1948-death-mileva-maric-how-much-contribute-einsteins-discoveries/. Public domain. 

“#nobelformileva.” Li Xinmo https://li-xinmo.com/. 2021. Public Domain.

By Lillian Mergen

It is the stem cell’s ability to become any other type of cell that makes it unique, controversial, and full of opportunity – The Mayo Clinic

Imagine you are a painter. In front of you, there is a blank canvas and all the materials and skills you need to create something new. What would you create?

Now, imagine yourself to be a scientist. Your canvas is now a stem cell. Your materials are the genetic machinery, and your skills are technologies like molecular cloning and gene editing. Your “something new” has become a treatment for a debilitating disease.

Cells are the basic building blocks of the body. Stem cells are the most fundamental version of a cell – they are the cell type from which all other cell types arise. When a stem cell divides, the two new cells are called daughter cells, which can either remain as a stem cell or they can change (i.e. “differentiate”), into new cell types. As a baby grows in its mother’s womb, the daughter stem cells will differentiate into every specific type of cell found in the body, like blood, brain, or muscle cells. Starting from a single fertilized egg, stem cells eventually form all 1,250,000,000,000 cells in the newborn.¹

There is a lot of controversy regarding stem cells, mostly surrounding the use of embryonic stem cells. According to the Mayo Clinic, human embryonic stem cells are isolated during one of the earliest stages of embryonic growth, when they are around three to five days old and consist of approximately 150 cells.² Embryonic stem cells are categorized as “pluripotent” stem cells (see details below), which are the stem cell type that can become nearly any other type of cell, making them extremely versatile.² The opportunity that stem cells represent is that if you can program them to become other cells, you could replace cancerous bone marrow, grow new skin for burn victims, create a working pancreas for diabetics, and cure genetic diseases.

In order to create a new pancreas or replace bone marrow, research must be conducted on stem cells. To work with stem cells, they need to be developed into stem cell lines, which are groups of stem cells that are grown from the same original cell, and therefore are identical.⁴ Once a stem cell line is established, the stem cells can be grown in relatively large quantities, frozen for storage, and shared with the scientific research community.⁴

So, you may be wondering, how many stem cell lines are there now? As of this writing, there are about 400 human embryonic stem cell lines that are approved to be used in the US for biomedical research.⁶ This number of stem cell lines is much higher than during the period between 2001 and 2008.⁶ In 2001, a bill was passed that limited scientists to using only the 60 stem cell lines that were in existence at that time, with only 21 of them being viable.⁶

Totipotent – The most powerful type of stem cell, as they can differentiate into any cell type. They are found during the very beginning of embryonic development at the 2-4 cell stage. When they divide, they produce pluripotent stem cells.³

Pluripotent – This type of stem cell is slightly less “powerful” than totipotent stem cells, as they are restricted to becoming cells that form the three different germ layers in the embryo: the ectoderm, the mesoderm, and the endoderm. When they divide, they produce multipotent stem cells.³

Multipotent – This type of stem cell is the most restricted. These are committed to making cells from only one of the three germ layers. They can still develop into numerous types of cells, but the cells are all part of the same germ layer. When they divide, they produce the specialized cell types that we think of in our body, such as cardiac muscle cells or bone cells.³

What happened with stem cells in August of 2001?

In August 2001, President George W. Bush announced that federal funding would only be available for research on stem cells that had already been isolated and turned into stem cell lines.⁷ Bush further stated that moving forward, the destruction of human embryos and the development of new stem cell lines would not be supported by the federal government and its funds.⁷ In his announcement, President Bush said, “I have concluded that we should allow federal funds to be used for research on these existing stem cell lines, where the life or death decision has already been made.”⁷ He further described his decision as a compromise, in that taxpayers would support stem cell research while not drifting further into questions of morality involving the human embryo.⁷

 In enacting this stem cell policy, President Bush did two things. First, he set a precedent that the federal government can hold an opinion on the morality, or ethical responsibility regarding embryonic stem cells.⁸ Second, he set a precedent at the same time that the federal government supported stem cell research and recognized its potential benefits.⁸ As a result of President Bush’s decision, all federally funded stem cell research was immediately limited to the 60 stem cells lines that already existed at that time.⁶

The new policy and resulting cuts in federal funding were not popular amongst most researchers. The stem cell ban led to many embryonic stem cell researchers laboriously separating their research environments based on whether or not the “staff, equipment, and lab space” was paid for via federal or private funding.⁹ Embryonic stem cell researchers who had been working with international researchers had their collaborations stifled due to the funding cuts and work limitations.⁹ The elite universities, which had more significant economic resources, were able to bounce back from the initial ban much faster than lower-tier and/or less endowed universities.⁹ The wealthier universities were able to develop alternative funding mechanisms to continue their contributions to human embryonic stem cell research.¹⁰

The scientific and technical limitations of the few stem cells lines approved for use aggravated many embryonic stem cell researchers. The approved stem cell lines were not incredibly diverse, either genetically or ethnically.⁹ This meant that certain diseases with a strong genetic component such as Parkinson’s “… could no longer be studied in embryonic stem cells.”⁹ The existing stem cell lines also were limited to certain ethnicities (primarily White, North American or European), which left “… uncertainty with regard to cellular processes in minority groups.”⁹

The scientific community responds strategically to the institutional and policy conditions affecting science.¹⁰

In 2006, researchers at Kyoto University, Drs. Kazutoshi Takahashi and Shinya Yamanaka developed the first successful method to make pluripotent stem cells from adult mouse skin cells.¹¹ The Kyoto researchers did this by “de-differentiating” adult stem cells, reverting them back to an embryonic state, thus restoring pluripotency.¹¹ Takahashi and Yamanaka figured out the exact combination of genes to turn on and off to make the cells “forget” they were skin cells, resetting them to the pluripotent stem cell identity.¹¹ This innovation started with mouse cells, but the human version of these induced pluripotent stem cells, or iPS cells, were produced at the same university only one year later. In 2012, Dr. Yamanaka went on to win the Nobel Prize in Physiology or Medicine, along with Dr. John Gurdon of the University of Oxford.¹²

“Following the discovery, the White House noted that by ‘supporting alternative approaches, President Bush is encouraging scientific advancement within ethical Boundaries’. Subsequent U.S. progress in iPS cell research may have well enjoyed unique encouragement under Bush’s policies.”⁹

So, what are iPS cells and why are they so revolutionary?

iPS cells are normal adult cells, which are fully differentiated and specialized, that have been reverted back to their pluripotent state.¹³ Human iPS cell technology offers many advantages: they are pluripotent, created from human adult cells, and are highly accessible.¹³ The development of iPS cells has opened the door to numerous possibilities for scientists when it comes to disease modeling, drug discovery, and regenerative medicine.¹⁴ To date, iPS cells have been used for modeling human disease, and for assessing the efficiency and potential toxicity of different drugs.¹⁴ Most exciting is that iPS cell technology enables the ability to create patient-specific treatments using pluripotent stem cells created from the patients’ own cells.¹⁴

Finally, I want you to think back to that blank canvas. Embryonic stem cells are the blank canvas that can become just about anything with the right tools. With iPS cells, you can take an already finished painting and do something new. You can paint the canvas white and start over again to paint the right picture, a better picture, a new picture of health.

© kaneez / Adobe Stock (AI generated Image)

Works Cited

1. Number of cells in newborn infant. Number of cells in newborn infant – Human Homo sapiens – BNID 106413. Accessed May 6, 2024. https://bionumbers.hms.harvard.edu/bionumber.aspx?id=106413&ver=4. 

2. Answers to your questions about Stem Cell Research. Mayo Clinic. March 23, 2024. Accessed May 6, 2024. https://www.mayoclinic.org/tests-procedures/bone-marrow-transplant/in-depth/stem-cells/art-20048117. 

3. Facebook.com/bioinformantworldwide. Do you know the 5 types of stem cells? BioInformant. March 9, 2024. Accessed May 6, 2024. https://bioinformant.com/types-of-stem-cells/#:~:text=Totipotent%20(or%20Omnipotent)%20Stem%20Cells,Oligopotent%20Stem%20Cells. 

4. Creating new types of stem cells. CIRM. Accessed May 6, 2024. https://www.cirm.ca.gov/creating-new-types-stem-cells/. 

6. Ludwig TE, Kujak A, Rauti A, et al. 20 years of human pluripotent stem cell research: It all started with five lines. Cell Stem Cell. 2018;23(5):644-648. doi:10.1016/j.stem.2018.10.009 

​​7. Seelye KQ. Bush gives his backing for limited research on existing stem cells. The New York Times. August 10, 2001. Accessed May 6, 2024. https://www.nytimes.com/2001/08/10/us/president-s-decision-overview-bush-gives-his-backing-for-limited-research.html. 

8. The stem cell debate: Is it over? Learn.Genetics. Accessed May 6, 2024. https://learn.genetics.utah.edu/content/stemcells/scissues#:~:text=But%20when%20. 

9. Murugan V. Embryonic stem cell research: a decade of debate from Bush to Obama. Yale J Biol Med. 2009;82(3):101-103.

10. Furman JL, Murray F, Stern S. Growing stem cells: The impact of federal funding policy on the U.S. Scientific Frontier. Journal of Policy Analysis and Management. 2012;31(3):661-705. doi:10.1002/pam.21644 

11. Omole AE, Fakoya AO. Ten Years of progress and promise of induced pluripotent stem cells: Historical origins, characteristics, mechanisms, limitations, and potential applications. Published online October 26, 2017. doi:10.7287/peerj.preprints.3374v1 

12. The nobel prize in physiology or medicine 2012. NobelPrize.org. Accessed May 6, 2024. https://www.nobelprize.org/prizes/medicine/2012/press-release/. 

13. ​​Ye L, Swingen C, Zhang J. Induced pluripotent stem cells and their potential for basic and Clinical Sciences. Current Cardiology Reviews. 2013;9(1):63-72. doi:10.2174/1573403×11309010008 14. Mondal A, Talukdar A, Haque R. Unlocking the potential of induced pluripotent stem cells in revolutionizing cancer therapy. Current Stem Cell Research & Therapy. 2024;19. doi:10.2174/011574888×294791240408055222

Image Credits

“Embryonic stem cells colony under a microscope. Cellular therapy and research of regeneration and disease treatment in seamless 3D illustration. Biology and medicine of human body concept. 4K.” © Eduard Muzhevskyi / Adobe Stock

“Stem Cell Applications diagram” © brgfx / Adobe Stock

“Bush Stem Cells” AP Photo/Gerald Herbert

“Nobel Prize Yamanaka and Gurdon” The Yomiuri Shimbun via AP Images

“Moss Concrete Wall Background, Close up Dirty Cement Wall Texture,Old plaster surface old plastered wall wallpaper old,old damaged and dirty white wall with peeling paint – rough dirty texture” © kaneez / Adobe Stock (AI generated Image)

A new perspective on the risks of stealing a patient’s freedom to choose their own treatment and future.

By Piper Lin

Anna is your average college student. Like many students, she is heavily involved in her school work and extracurricular activities, both academic and leisure. One difference is that Anna suffers from severe mental illness. Her diagnoses range from major depressive disorder to borderline personality disorder. Despite this, she still manages her various responsibilities as a student, friend, and active community member. Like all those plagued with these disorders, she has moments where her disease takes control. Anna experiences suicidal thoughts but has no plans to carry through with them. Although, she does experience episodes of mild self-mutilation as a form of stress relief. For Anna, this coping mechanism converts her psychological pain to physical pain as a momentary distraction from reality. She takes her illness seriously by regularly attending therapy and taking several medications to cope. She is constantly trying to manage her disorders, so she can move ahead with her life and future plans.

The growing severity of the mental health crisis is taking the United States by storm, especially after the COVID-19 pandemic. In 2021, an estimated 22.8% of Americans experienced some kind of mental illness (6). Every day, the talk discussion around mental illness is becoming more and more prevalent, whether it be in regard to suicide rates, substance abuse, or other mental health-related issues. Along with the increased focus on mental health, discussions about treatment options, wellness, and self-care for sufferers are all the rage right now. However, one particular form of mental illness, “treatment,” has been identified to potentially cause more harm than good because it borders on the infringement of basic human rights: Involuntary hospitalization.

Significantly, the phrase constantly associated with all psychiatric treatment is: “Your privacy is protected unless your therapist or doctor believes you are a threat to yourself or another person.” What many do not think about or know is what occurs once those threat criteria are met, and the person’s privacy is revoked.

One particularly hard evening, Anna’s disease got the best of her, and she cut her arms while under the influence of alcohol. She quickly realized she needed medical assistance and rushed herself to the hospital for sutures. At the hospital emergency room, she was given stitches, and all seemed to be well. She had no idea about the experiences that awaited her. Soon after her stitches were finished, a nurse came in, handed her inpatient hospital attire, and instructed her to change. Anna was then stripped of all her belongings, including her phone. She was confused. No one was giving her information about what was going on, and no one would answer her questions. She was forced into a room and watched over by a hospital staff member and a police officer for her own “protection.” She was not permitted to contact anyone or talk directly to her parents, who were only given information by the hospital staff. After being told by hospital staff she would be released after talking to a therapist, she spent 12 grueling hours in that small room, alone, with little to no interaction with doctors or medical staff. After those 12 hours, she was not released. Instead, she was informed that she was being transferred via ambulance to a behavioral health hospital four hours away from her university.

The term “involuntary hospitalization” of a patient, or “civil commitment,” is defined by the United States Health and Human Services as the legal process by which a person is confined in a psychiatric hospital against his or her wishes because of a treatable mental disorder (1). In this process, a patient is stripped of their right to refuse treatment. Involuntary hospitalization often occurs as the result of a medical professional deeming a person a threat to themselves, a threat to others, or of grave disability to provide themselves with necessities such as food and housing due to mental illness (1).

Anna knew her actions were worrisome, but she believed she had the right to know what was going on and to explain her case. She especially believed she had the right to contact her own parents and a doctor to decide on a plan to move forward. She did not feel that she needed to be hospitalized.

The idea of psychiatric commitment dates back to the 4th century B.C. when Hippocrates, known as the father of medicine, believed that sufferers of mental illness should be secluded in a comforting environment (1). The first official psychiatric commitments did not occur until 1752 and, at that time, were characterized by long stays in psychiatric institutions. In colonial America, treatments for mental illness were barbaric, including physical pain, social isolation, and emotional torment (7). In the 1950s, deinstitutionalization began with the discovery of the first antipsychotic medicine, chlorpromazine, and the Civil Rights Movement. Deinstitutionalization reduced these long stays in institutions and promoted the alternative of less isolated, community-based treatment plans for the mentally ill (1).

In the United States, there are several variations of an involuntary hold that are defined in the Welfare and Institution Code. A 5150, more commonly known as the 72-hour hold, allows a mentally ill patient to be hospitalized in a psychiatric institution against their will for 72 hours. If, after 72 hours, the doctor or therapist decides the patient continues to show one or more of the three criteria previously stated, then the patient is subjected to a 5250 code, which extends the involuntary hold up to 14 days, a time determined by a Certification Review Hearing or Probable Cause Hearing (2).

The involuntary hold is meant to protect patients suffering from mental illness, but the legally mandatory nature of it warrants a discussion about an involuntary hold’s infringement upon human rights. In reality, it pits patient autonomy versus beneficence. Patient autonomy is about personhood, about the right of a patient to make decisions about their medical care without being influenced by a healthcare provider. Beneficence is the intention of doing good. In the case of mental health sufferers, beneficence is not only about the good of the patient but also relates to the concept of parens patriae, Latin for the “parent of the country.” The concept of parens patriae holds that the state or court has an obligation to protect its citizens, even from themselves). So, in this case, beneficence is also about the good of the community.

Second, involuntary holds may contribute to additional trauma to a patient from the loss of agency, freedom, and control over their own treatment. When subjected to an involuntary hold, patients often are stripped of their personal belongings, as well as their control over communication with the outside world. This has a dehumanizing effect on many patients and causes a sense of shame (4). This added trauma might reduce the motivation of patients to better themselves and, instead, cause them to revert to their original patterns. While an involuntary hold may be a short-term protective solution for patients, it can contribute to or even exacerbate their long-term trauma.

Entombment of Christ, 1672, in Saint-Martin Church in Arc-en-Barrois (Haute-Marne, France) by Vassil

Once admitted to the behavioral hospital, Anna was finally given a chance to speak with a therapist, who would have complete control over her release. She begged and pleaded about how she was missing classes and that being locked up was putting her academic standing in jeopardy. Anna’s concerns were not prioritized in any way, although she tried time and time again to explain her case. One hour a day, Anna was given access to a phone that she had to share with several other patients. With almost no contact with the outside world, Anna felt she had completely lost control over her own life. She did not trust the physicians or anyone around her. She fell into a deeply depressed state that she was forced to hide in order to get into good standing with the staff so that they would release her quickly.

The final negative impact of an involuntary hold is that it also can contribute to the future pursuit of care. Traumatized patients may have difficulty admitting suicidal thoughts because they worry that sharing this information may result in future unwanted treatment and more involuntary hospitalization. This contributes to a disconnect between patients and caregivers. Dainius Pūras, a professor of psychiatry who was recently appointed by the United Nations as an independent expert on the right to mental health, stated, “Forced treatment is ineffective and perpetuates power imbalances in care relationships, causes mistrust, exacerbates stigma and discrimination and has made many turn away, fearful of seeking help within mainstream mental health services.” (5)

After four days, Anna convinced the therapist that she was well enough to leave. In reality, Anna had never felt worse. She had been stripped of her right to choose, missed several days of classes, and lost many aspects of her identity. She was robbed of her voice and ability to communicate with the outside world. Worst of all, Anna lost all trust in the healthcare system. She now believed they cared not for her well-being but only about protecting themselves and following overgeneralized codes and regulations put in place by organizations that did not understand their impact. Anna left the behavioral health hospital riddled with confusion, stress, and a worse mental state than what sent her to the hospital. Still, Anna was glad to return to her own life, and she focused on getting better. But now, she was instilled with the belief that from then on, avoiding a repeat of this nightmare was the number one thing she would care about, even over reaching out for help again. She would get better on her own.

In sum, the practice of involuntary holds raises many ethical concerns because it interferes with patients’ right to choose a care option for themselves, and it can cause more harm than benefit. While involuntary holds can be a short-term solution for the potential protection of the patient from themselves, they should be imposed with great caution and care. The benefits and disadvantages of this course of treatment should always be called into question first to determine which truly outweighs the other.

References

1. Fariba K, Gupta V. Involuntary commitment – statpearls – NCBI bookshelf. National Library of Medicine. https://www.ncbi.nlm.nih.gov/books/NBK557377/. Published April 28, 2022. Accessed October 9, 2022. 
2. 7. Hickman D. Mental health in colonial America. The Hospitalist. December 19, 2021. Accessed September 10, 2023. https://www.the-hospitalist.org/hospitalist/article/123117/mental-health-colonial-america#:~:text=Insanity%20in%20colonial%20America%20was,them%20were%20fueled%20by%20cruelty. 
3. Involuntary holds . Family Education and Resource Center. https://ferc.org/uploads/docs/resources/5150_5250.pdf. Accessed October 9, 2022. 
4. Mental illness. National Institute of Mental Health. March 2023. Accessed September 10, 2023.https://www.nimh.nih.gov/health/statistics/mental-illness#:~:text=Prevalence%20of%20Any%20Mental%20Illness%20(AMI),-Figure%201%20shows&text=In%202021%2C%20there%20were%20an,%25)%20than%20males%20(18.1%25). 
5. Morris NP, Kleinman RA. Involuntary commitments: Billing patients for forced Psychiatric Care. American Journal of Psychiatry. https://ajp.psychiatryonline.org/doi/10.1176/appi.ajp.2020.20030319. Published December 1, 2020. Accessed October 9, 2022. 
6. Rüsch N, Müller M, Lay B, et al. Emotional reactions to involuntary psychiatric hospitalization and stigma-related stress among people with mental illness. Eur Arch Psychiatry Clin Neurosci. 2014;264(1):35-43. doi:10.1007/s00406-013-0412-5x
7. Simons P, By, -. Involuntary hospitalization increases risk of suicide. Mad In America. https://www.madinamerica.com/2019/06/involuntary-hospitalization-increases-risk-suicide-study-finds/. Published May 7, 2022. Accessed October 9, 2022.

Image References

1. “Prisoner of the Heart” by qthomasbower is licensed under CC BY-SA 2.0.
2. Entombment of Christ, 1672, in Saint-Martin Church in Arc-en-Barrois (Haute-Marne, France) by Vassil is licensed under CC BY 3.0 DEED.

By Halee Lott

The Count of Monte Cristo and The Three Musketeers are two books you are probably familiar with. But what most people don’t know is that the author of these two very famous books, published in 1846 and 1844, respectively, is Black. If you gasped, then you were not the only one. I didn’t even know until a couple of months ago.  

The author of these books, plus a whole collection, is Alexandre Dumas. ¹He was a man of African descent who grew up in the aristocracy of France. Most French people did not know who he was until he was transported into the Pantheon de Paris in 2002 during a televised funeral. Why was Dumas’ identity hidden for so many years? The answer may never be clear, but one historian, ²Claude Schopp, revived Dumas’s legacy by uncovering archives from his life. Alexandre Dumas’s tale was like many other French aristocrats of the time, filled with infidelity, dozens of mistresses, illegitimate children, and money. The most surprising thing about digging into Dumas’s past was not the multiple women and bastard children, but his father, who has a forgotten tale of his own. 

³Thomas-Alexandre left San Domingo at eighteen in 1780 with his father to visit France. Thomas-Alexandre’s father was an important member of the Normandy family and held many positions in the French court. The people he associated with were curious about the “tan giant” that walked among them. Here are first-hand accounts of the French seeing Thomas-Alexandre Dumas for the first time, “…this five feet nine giant with tan complexion, with velvety brown eyes, with white teeth, and whose hands and feet have a feminine slenderness which reveal his aristocratic origin, walks always in the front and makes quite an impression…”. Apparently, Thomas-Alexandre’s appearance was alluring and mysterious to the French. I mean, who wouldn’t be intrigued? 

In 1786, Thomas-Alexandre joined the army using the name Alexandre Dumas, taking the name of his deceased mother. While men with a noble rank usually entered as an officer, Thomas-Alexandre entered at the lowly rank of a private. ⁴Even though Dumas was a mixed-race individual in colonial France, and wanted nothing to do with his aristocratic heritage, he never needed an edge. In September of 1792, Thomas-Alexandre became second Lieutenant. The day after that he was promoted to First Lieutenant. In February of 1793, he became a Lieutenant Colonel, and then in July of that year, he was appointed Brigadier-General of the Army of the North. Then in September of 1793, he was promoted again to General of a Division of the army. Five days later, he was commissioned General Commander-in-Chief of the Army of the Western Pyrenees. In case you weren’t counting, that’s six promotions in a little over a year! Why isn’t this guy in the history books again? And I haven’t even gotten to the most jaw-dropping part of the story yet. In the fall of 1796, Dumas met a young general from Corsica, Napoleon Bonaparte. This started Dumas’ journey to becoming one of Napoleon’s most trusted generals. 

After the two generals met for the first time, there was tension between them. General Dumas stood taller than General Bonaparte, and many people thought Dumas was the commander in charge. Dumas really proved his worth to Napoleon Bonaparte the next year when he “single-handedly” drove back a squadron of Austrian troops in northern Italy. The French began to call him “the Horatius Cocles of the Tyrol”, after a hero who saved ancient Rome. While Dumas was Napoleon’s greatest general, the pair never got along. So much so, that when Thomas-Alexandre died, 3-year-old Alexandre and his mother were left with nothing because of Napoleon’s spite. Thomas-Alexandre was a great general in the French military, and his adventures were the inspiration for some of his son’s writings. With a story like Thomas-Alexandre’s, it would be hard not to be an inspiration.

By Noelle Shorter

You jolt out of sleep in the middle of the night with severe back pain. You feel your abdomen tightening and aching and remember, “I’m almost 9 months pregnant. I must be going into labor!” You frantically wake up your partner, grab the hospital bag you prepared 5 months ago, and rush to the hospital. There, the nurse congratulates you, realizes you are quite far along in labor, and rushes you both to a delivery room. After 2 hours of walking, stretching, breathing, and pushing, you have a beautiful baby boy. You and your partner then stay at the hospital for two days, being monitored and meeting your child, meeting a lactation consultant, and finally getting to go home as a happy family.

Now picture this: you jolt out of sleep, feeling contractions, and think, “Oh no, I didn’t want this to happen here.” You crawl out of your bottom bunk, trying not to disturb the person sleeping above you. You get the attention of the correctional officer on duty and tell them that you think you’re going into labor. She rolls her eyes at you, puts you in a transfer cell, and says someone will be back later to take you to the hospital. After hours of breathing through contractions in the tiny room, another correctional officer comes in, handcuffs you, and takes you to the ambulance, where they shackle your ankles for good measure.⁵ After finally making it to the hospital room, one of the healthcare workers has the kindness to call your mother, who arrives quickly. However, the correctional officer standing guard at the door says it is against state policy to let her into the delivery room.⁵ After hours of laboring alone, one ankle shackled to the bed, you finally give birth to a daughter, who is whisked away for extensive tests before you can hold her. When the tests come back clear, you can finally hold her and awkwardly try to breastfeed, still shacked to the bed, in front of the correctional officers.

The second story seems like a nightmare. However, it is a reality for thousands of women every year. Many facilities require handcuffs, leg irons, and belly chains or belts on incarcerated women while they are transported to the hospital, even if they are in active labor.⁵ Many facilities keep at least some of these restraints on during the entire labor, despite the United Nations ruling that “instruments of restraint shall never be used on women during labor, during birth and immediately after birth.”⁷ Correctional officers are also required to be in the room, but in many facilities they are not required to be female.⁵ Unfortunately, this maltreatment does not start or end with labor. It begins during pregnancy, with lack of care and appropriate nutrition, and extends to postpartum treatment and separation of mother and child.

Approximately 2,000 women give birth in prisons annually, and 5-10% of women enter prison or jail pregnant.⁴ That is approximately 58,000 incarcerated pregnant women who need access to specialized care, prenatal diet, and accommodated living conditions.¹⁰ One study revealed that women who were given high-quality food experienced fewer complications during pregnancy and labor.¹¹ Despite this, there are limits in jails and prisons on foods like fruits, vegetables, and milk; and multivitamins are not commonly prescribed.⁵ There are “no federal regulations on the minimum standards for nutrition in state prisons,” so the lack of quality food and prenatal vitamins for incarcerated pregnant women can be swept under the rug.¹²

For pregnancy-related accommodations in living conditions, most facilities at least require a pregnant inmate to have a bottom bunk. However, in over-crowded facilities, pregnant women end up on top bunks, or even sleeping on the floor.¹ Pregnancy is already very physically demanding, so putting pregnant women in living conditions where their physical needs are not met could cause lifelong consequences for mother and child.

Beyond the women who are pregnant or give birth while incarcerated, one study indicated that 25% of incarcerated women are pregnant or gave birth less than a year before entering prison.⁸ Therefore, women who had a baby just before being incarcerated will most likely be separated from their newborn children. As for women who give birth while incarcerated, they are separated from their children only a few days after birth.² A mother wants to bond and find comfort in her newborn, especially after going through the traumatic experience of chained labor. They are often denied this experience. One study that interviewed several incarcerated women who were separated from their children reported the mothers saying things like “it feels empty without him/her in my belly,” and “I want to get on parole so I can be a mom.”³ Despite the fact that incarcerated pregnant women usually are not given adequate care, many women in the study said that “everything was fine until I gave birth,” which truly revealed how devastating this child separation is for the mother.³

I want to get on parole so I can be a mom.

Unsurprisingly, the mental health of most incarcerated pregnant women or mothers deteriorates. As many as 80% of pregnant women in a correctional facility experience depression at some point.⁹ More specifically, postpartum depression is very prevalent, likely aggravated by the isolation from family and friends in the correctional facilities. Increased stress during pregnancy and the postpartum period, a lack of support, transfers between correctional facilities and hospitals, and separation from their child all contribute to maternal depression.⁸  The mother is not the only affected party, as children of incarcerated mothers are more likely to be anxious, depressed, and withdrawn, especially if separated from their mother during infancy or toddlerhood.⁶

Despite all of this, there is hope for a change in these disparities that has started with the creation of nurseries for incarcerated mothers. Nine states now have these so-called “prison nurseries,” in which mothers are able to serve time while being with their newborns.⁴ Prison nurseries are special housing unit inside the prison, where a mother can parent her baby alongside other incarcerated new mothers.¹³ The states with these programs already built include California, Illinois, Indiana, Ohio, Nebraska, New York, South Dakota, Washington, and West Virginia.¹³ There are also Community-Based Residential Parenting (CBRP) programs in Alabama, California, Connecticut, Illinois, North Carolina, Massachusetts, and Vermont.¹³ Unlike prison nurseries, CBRP programs are not located inside prisons. Instead, CBRPs are separate facilities, usually run by non-profits, that allow mother and child to live together under supervision.¹³ Children who spent their first 1-18 months in a prison nursery, rather than being separated, had much lower anxiety/depression scores as preschoolers.⁶ On the opposite spectrum, children who were separated from their incarcerated mothers showed a higher prevalence of insecure attachment (mistrust, avoidance, and anxiety that arises due to past interactions) towards their temporary guardians and mothers.⁶ Therefore, studies show that both prison nurseries and CBRP programs have very positive impacts on both children and mothers. These programs have introduced humane changes that have helped the welfare of incarcerated mothers and their children. However, more needs to be done. Including states’ prison nurseries and CBRP programs, only 14 out of 50 states provide mother-child incarceration/CBRP. Because such clearly positive results are seen when mothers and children can remain together, these facilities are needed in every state in the US.

Works Cited