Archive by Author | CaffeineCrush

Five Somewhat Amusing Facts About Epidemiology

An introduction to epidemiology. Please ask any questions you have about starting a career in epidemiology. Enjoy!


The Woodcarver’s Home: A Climate Change Fairytale


Little Red Riding Hood Illustration by Margaret W. Tarrant Image source:

One essential feature of any good fairytale is a lesson. Originally written for adults, many of these stories persist as warnings to children to behave properly lest some terrible monster eat them (Paton, 2011). Now, let me tell you a story.

There was once a poor woodcarver named Silva. After being abandoned as a young boy, Silva spent his life in solitude, living off the land around him. His only amusement was the figures he crafted from trees around his home. He may not have understood the lavish indulgences of a well-endowed supper table but he was happy. One day his peaceful seclusion came to an end, for Silva encountered Morus.

Morus, unlike Silva, had spent his entire life surrounded by the push and pull of other people. His family, crowded and destitute, had sent him out to seek new lands and great fortunes. Upon stumbling onto Silva’s forest home, he was fascinated by this simple, peaceful life. Morus wanted to know how to replicate the prosperity he saw in Silva’s existence. For such land with so many opportunities must be a boon for any man.

Silva, amazed yet frightened by this revelation of mankind, accommodated Morus’ inquiries. Silva showed how he chose the right tree for carving, caught his game and built his home with stones. Morus began to understand Silva’s livelihood, albeit with difficulty, but also saw a way to improve it.

“Why cut just one tree at a time?” Morus enquired, while he followed Silva one day. “Why take just one grouse, when there are so many more to partake in?”

Silva, confused, asked, “Why would I take something I do not need and eat when my stomach is filled?”

“Because you can, when so many can’t!” Morus replied.

“But what would I do with it?”

“Enjoy it, sell the bounty and live a better life!”

Silva returned to silence wondering how one could sell what one did not own? His cycles and patterns were not just his but also the forest’s, he followed its will as surely as he did his own. Morus realized the only way to show Silva the potential of his schemes was a demonstration.

One morning, weeks and days later, Silva awoke to the sound of several voices. Startled, he rushed outside to the late morning light. Morus stood with several other men around a large mound in the distance. As he approached it became clear this pile contained the corpses of hundreds of birds. Morus turned towards him, a broad grin on his face.

“You are up, good, I have a great fortune to show you!”

Silva could not speak; his heart beat with a staccato rhythm. These birds could have fed him for years and at once were gone.

“What have you done?” He whispered as he reached the gruesome reaping.

“What do you mean? I have sold this fair game for several gold coins.”

“Gold coins? What would I do with gold coins?”

“Spend them!”

“What do I want with money when there will be no game for years, you have slaughtered my life!”

“I have improved your life! You no longer need this small house or your meager meals!”

Silva turned away in anguish.

“What use is man’s wealth when what I truly need is gone?”

Morus did not understand his misery, there were trees to spare and land to cultivate. One only needed to move forward, to expand. Morus and Silva parted ways that day, one back to his family to report of this wealth, the other to despair in his lost peace.

Over the years the forest disappeared, the rough stone house weathered to nothing. Silva, though long forgotten, saw the true result of his encounter with Morus. For when you destroy what cannot be replaced, you may gain wealth but will lose life. What is at one time taken away, can never be given back.

The End


Image source:

Morus is hopefully, obviously a representation of humanity’s effect upon the earth. Silva is the earth, willing to accommodate us at first but unable to stop our destruction. The single, greatest concern for population health is climate change. Public health requires living populations and thus a habitable earth to be of any use. We need to rebrand climate change as this message (Subramanian, 2013). Hopefully my overdramatic fairytale provided some small moral lesson, treat our earth well and we can survive.


Paton, G. (2011 Mar 14). Parents who shun fairytales ‘miss chance to teach children morality’. Retrieved from

Subramanian, C. (2013, August 08). Rebranding Climate Change as a Public Health Issue. Retrieved from

Locked in the Ivory Tower: Am I trapped, stuck or merely biding my time?


Image source:

Sometimes it feels like my entire life has been spent behind a computer. From studying to writing essays to working on my research, I spend a lot of time on my own staring at a blinking cursor. As much as this is a reality of my studies in biostatistics and epidemiology, I cannot help but feel I am missing an integral part of the health sciences academic experience. That is collecting data and interacting with the subjects of my research. I rarely encounter people who are not either fellow academics or students. I am beginning to wonder what it is like in that big, bright world outside the ivory tower?

I recently had the opportunity to glimpse at this world when I shadowed a fellow graduate student and former clinical lead with the Portland Hotel Society in the Downtown Eastside (DTES) of Vancouver. His work involved a project on which my supervisor and research lab had done the statistical analysis. It was a unique opportunity for me to see the neighbourhood and people behind the de-identified statistical IDs I use for modeling. His responsibilities included running an arm of the study that provided housing interventions, including both managerial and counseling work, for homeless residents of the DTES.

He worked with these people on a one-to-one basis, planning treatment regimes for both mental and health services using a strong, team-based approach. This, ultimately, could not be more different than what I do. The world of collecting data, which is a rather cold way of saying providing services and working with participants, is the entire basis of my work. I could not run a statistical analysis without that data, yet I rarely get the chance to understand the circumstances of how it is collected. More importantly, I have few opportunities to understand the people the data represents. I keenly felt this reality during my shadowing time.


 A far more interesting looking tower than my own metaphorical one. © emilyrempel 2013

As I discovered, working with the participants could be a nine-to-five job but with the added caveat of extended hours for emergencies. The stark reality is that you need to be available when people die, often not within normal working hours. I have no concept of this type of stress. When I asked what that felt like, I received the expected response, not at all pleasant. There are however mental health strategies in place for this type of work including flexible hours, staff activities and vacation time. I realize, as typing this, that these emergencies faced by clinical staff are the very same numbers I see in a statistical database as censoring dates, or time of leaving the cohort. That is something I will take away from the experience with a slightly heavy heart. As I walked around the DTES during my shadowing, several people stopped us whether to catch up, chat or request help. It was amazing, the connections I saw, this work is definitely not done while staring at a blinking cursor.

As I reflect on this experience my most central question is how important is it that I know these “real-world” realities? Does it matter for statistical modeling? I hope that the answer is yes. It brings me back to the idea of multidisciplinarity. We need to understand more than our own training to develop effective multidisciplinary teams (Choi & Pak, 2006). I try to represent real-world health phenomena with biostatistical models. I must know the context of the problem in order to create reliable analyses. As well, understanding the inequities of our world is important to me personally. I work in this field because I care about health at the population level, particularly for those most vulnerable to poor health. I am sure as I progress in my career I will have more opportunities to work outside of a computer lab. To extend my initial metaphor, I wonder in the meantime what champion will release me from this locked tower? Luckily no actual chains exist and that champion, I imagine, will be my own ardent effort to fight against the idea that I am only a “numbers person”. Escape from the tower requires that I simply push through the door.


Please enjoy this clichéd photo of a literal unbarred door. © emilyrempel 2013


  • Choi, B.C.K. & Pak A.W.P. (2006). “Multidisciplinarity, interdisciplinarity, and transdisciplinarity in health research, services, education and policy:  1.  Definitions, objectives, and evidence of effectiveness.” Clinical and Investigative Medicine, 29, 351-364.
  • Holton, S.A. (2002). “Why an ivory tower?” The National Teaching & Learning Forum. 11(3), 1-12.

Being a Renaissance Wo/man: Modern education, interdisciplinary research and a multidisciplinary life



An engineer-scientist-painter-sculptor-inventor? That is an impressive, if disparate combination and of course describes Leonardo Da Vinci. From religious art to human anatomy to bicycles, Da Vinci had rather multidisciplinary interests. He is the eponymous Renaissance man. Merriam-Webster defines a renaissance man, sadly with no equivalent definition for a renaissance woman but let’s assume they are one in the same, as someone who has “wide interests and is expert in several areas”. In Renaissance Europe, being an academic was not the sole propriety of the scientific discipline. Rather a rounded education resulted in great inventors also being master artists. Fast forward 500 years and this archetype is virtually unknown, what would such a rare creature even look like in today’s academic world?



in modern education…

The modern Renaissance person would learn about a variety of subjects, equally applying their interests in various scientific and artistic pursuits. Transferring this concept to North American post-secondary education, students would study sciences like chemistry, mathematics, biology but also perhaps theatre, art history and English literature. Not to mention the numerous other disciplines ranging from beer brewing to environmental archaeology. Though I would argue that one would be infinitely more interesting while consuming the products of the other. Basically this person would acquire at least a base knowledge in several different disciplines. This can happen, especially in universities like my own with a focus on interdisciplinarity, but is not the rule for the majority of academics (Castán Broto, Gislason & Ehlers, 2009).



…in academic research…

In academic research, there is a special application of the Renaissance perspective, namely interdisciplinary research. Defined, varyingly in sources, as collaborative examination of a research problem from two or more disciplines (Choi & Pak, 2006). In this concept the researchers are not themselves Renaissance men but rather they take a Renaissance-like perspective on the problem at hand. The goal is to understand the research question in a more holistic way (Choi & Pak, 2006). The problem with applying Renaissance ideals to research is it clashes directly with university structure. We become increasingly specialized through Masters and Doctorate degrees, limiting our perspectives but becoming experts in one particular field (Castán Broto, Gislason & Ehlers, 2009). In this current structure, understanding where another discipline may add to our research is complicated. Science has greatly evolved since the 16th century; modern technology is difficult to keep up with within my own field, let alone understanding the context of another discipline. Therefore to examine an issue from multiple perspectives requires immense time and effort (Lélé & Norgaard, 2005). Interdisciplinary research teams are just beginning to chip away at the possibilities.



…in academic life…

What about beyond the doors of the university? What does a “true” Renaissance man or woman look like? A quick Google search for modern renaissance men and women produces many actors and a few academics. The criteria seems a bit confusing as I think many would agree Justin Timberlake wouldn’t be their first choice. According to this quiz I am “Totally Renaissance”, I must be doing something right. In this category being a Renaissance person is, well, personal. What we consider to be different and interesting is up to the individual. Someone who loves jazz and molecular biology is as much “Renaissance” as someone who studies anthropology and has an active interest in feminist literature. In the classical sense, your interests should include some kind of art as well as science (“Renaissance man”, n.d.). Where those lines are drawn is up to you, no pun intended.



…as an ideal.

In the end, what ideal are we working towards by being Renaissance? Da Vinci was no doubt a genius, but is being a Renaissance wo/man a goal in itself? What inherent value is there in having multidisciplinary interests? With research the benefit is clear, we can see a question in new and potentially more accurate ways. From a personal perspective, having an interest in theatre, sociology and chemistry may help you approach your research in innovative ways and perhaps improve your life.

-Emily Rempel-

A self-described epidemiologist-pianist-film fan-amateur archaeologist-photographer-travel enthusiast-home cook-general geek-voracious reader-graduate student.



  • Choi, B.C.K. & Pak A.W.P. (2006). “Multidisciplinarity, interdisciplinarity, and transdisciplinarity in health research, services, education and policy:  1.  Definitions, objectives, and evidence of effectiveness.” Clinical and Investigative Medicine, 29, 351-364.
  • Lélé, S. & Norgaard, R.B. (2005). Practicing interdisciplinarity.  BioScience, 55(11), 967-975.
  • Renaissance man. (n.d.) In Merriam-Webster online. Retrieved from
  • Castán Broto, V., Gislason, M. & Ehlers, M.-H. (2009). Practising interdisciplinarity in the interplay between disciplines: experiences of established researchers. Environmental Science and Policy, 12(7), 922-933.
  • Leonardo da Vinci (1452 -1519). (n.d.) Retrieved February 2, 2014 from

Selective Mutism: How I Learned to Stop Worrying and Love the Impact Factor

There is an unwritten rule in academia that good research, however you may define it, is less important than published research.  This does not preclude good research being the backbone of the academic world, but rather suggests the priorities of science, as a paradigm, have shifted.  Specifically, to the rule of publishing as much as you can (Elizabeth & Grant, 2013).   This trend has roots both in the audit culture and modern political structure, particularly in Canada.

An increasing focus on ‘numbers’ outside of the academic world has bled in to the most hallowed halls of higher thinking.  A major component of evaluating researcher’s quality is quantity of publications, the dreaded impact factor (Burrows, 2012).  The more you publish, the better your evaluation.  This audit culture forces researchers to, as Burrows (2012) says, either “’play’ or ‘be played’” (p. 369).  The implication is an increasing number of academics publishing to add a line on their CV, rather than to solve or study some novel question (“The cost of salami slicing”, 2005).  Either you keep publishing or you drop out of the race.

This is arguably an even bigger concern for new researchers, who have the added challenges of navigating both an unknown world and limited resources.  The poor student cliché exists for a reason.  Articles describing quick tips on how to boost your resume in graduate school and the need for social income services  after graduating, demonstrate the necessity of playing by the rules to increase your chances of paying rent (Keslky, 2012; Patton, 2012; Utell, 2011).  Publish as much as you can, as early as you can. Science for the sake of science seems to be an antiquated concept.  As Scott (2007) states, in his article on peer review processes, being published relies heavily on having conclusive results and complex problems rarely have conclusive answers.  Supervisors may need to push students to research simpler concepts, those that minimize political, temporal and financial burdens, in order to publish.

A key phrase in that last sentence, political burdens, is a concern for both new and experienced academics.  Being funded, and therefore producing any form of publications, relies increasingly on government approval, especially for those researchers working in the public sector.  The recent documentary on the Canadian government’s disregard for academia, “The Silence of the Labs”, demonstrates the danger of this influence (Rumak, 2014).  Not just in social arenas like public health, but archaeological and environmental fields. If research even slightly contradicts the message the Harper government wants to put forward, large-scale cuts and eventual job loss may result (Rumak, 2014).  The mantra should be ‘get published not political’.  Researchers have to operate under some assumption of topical, selective mutism.

The question comes down to this, at a personal level, is ‘doing’ science our job?  Are we just working at our chosen employment or are we attempting to understand and help the world?  If the former, the pressure to publish is still a personal challenge but not a systemic problem.  If the latter, there is a much greater barrier.  Your core ideals about what you think you are doing  do not match up with the day-to-day realities of your work.  Even a blending of both views of science can lead one to disenchantment (Elizabeth & Grant, 2013).

In conclusion, I do not want to suggest that academia is in a constant state of dredging up simple and repetitive research, but that as we allow the influence of audit culture and political preferences to seep in to the academic world, we lose what makes us important.  That is our ability to objectively examine and answer questions about the world around us.  It may be naïve to suggest that science should help people or the world, but I hope at the very least we do not end up ignoring what needs to be researched in favour of what is easy to research and ultimately publish.



Burrows, R. (2012). Living  with the h-index? Metric assemblages in the contemporary academy. The Sociological Review, 60(2), 355-372.

Elizabeth, V. & Grant, B.M.(2013). ‘The spirit of research has changed’: reverberations from researcher identities in managerial times. Higher Education Research & Development, 32( 1), 122–135.

Kelsky, K. (2012, March 27). Graduate school is a means to a job – manage your career. The Chronicle of Higher Education. Retrieved from

Patton, S. (2012, May 6). The PhD now comes with food stamps. The Chronicle of Higher Education. Retrieved from

Rumak, O.J. (Producer & Director). (2014, January 10). Silence of the Labs [Motion picture]. Canada: Canadian Broadcasting Company.

Scott, A. (2007). Peer Review and the Relevance of Science. Futures, 39(7), 827–845.

“The cost of salami slicing.” Editorial. (2005). Nature materials, 4(1), 1.

Utell, J. (2011, February 25). Practical wisdom and professional life. The Chronicle of Higher Education. Retrieved from