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Hi, my name is Nicholas Christakis and I'm a physician and a social scientist and the
discipline I'm going to be speaking about to you today is sociology. Sociology is
the field in which you study human behavior and human experience and how it relates to
the fact that individuals are embedded within larger groups and collections of individuals.
When you see an individual as a member of a group or the collectivity you get a completely
different perspective on that person and on the groups of which they are a member and
in fact, in sociology we explore a fundamental tension and that tension arises because of
two facts. On the one hand you yourself have your own identity and your own agency
and your own ability to make choices that affect your life, but on the other hand there
is a collective responsibility for your life as well and it turns out that collective supra-individual
factors can have as much to do with all kinds of aspects of your life, including whether
you live or die as your own genes or your own choices and it turns out that supra-individual
collective factors can have as much to do with what happens to you in your life and
even with whether you live or die as things within you, your own genes or your own choices. Now
supra-individual factors such as where you live, what kind of networks you are a part
of, social interactions you are a part of, what kind of institutions are nearby, for
instance governments or hospitals, all of these are critical in shaping your life and
all of our lives and these supra-individual factors can include things like inequality,
culture and religion as well. Supra-individual factors like where you live or where you are
located in these vast face-to-face networks that we human beings assemble or what kinds
of formal institutions are near you like governments or hospitals for example can have as much
to do with what happens to you in your life as your own decisions and your own actions.
Other sorts of things are important too, like inequality or culture or religion and
those sorts of supra-individual factors have a similar importance. This is the difference
between what we want to understand as structure and agency between social constraints and
opportunities on the one hand and individual choices and actions on the other hand and
a second key idea beyond that first one- This the difference between structure and agency,
between collective constraints and opportunities that constrain and permit you to do certain
kinds of things in your life on the one hand and your own individual choices and actions
that permit you to do other sorts of things on the other hand. That is the first big
idea that I’d like to communicate today. The second big idea that sociology
explores and that I would like to communicate today is that collective phenomena are not
mere aggregations of individual phenomena. There is something different, something
special about groups of people, about collectivities that does not reside within the individuals
themselves, something that emerges, something that transcends, something that is above and
not a part of solely individual kinds of things that you might think of. A second
key idea in sociology is that collective phenomena are not mere aggregations of individual phenomena.
There is something special, something weird almost about groups of individuals, about
collectivities, something weird that you cannot see if you just study individuals, but that
you must study whole groups of people in order to really understand. So how did I become interested in these crazy ideas? Actually
I started my career as a physician and I went to medical school and at the time I wanted
to be a reconstructive surgeon and I wanted to operate on people who had cranial facial
abnormalities or people whose extremities had been cut off and reattach these extremities
and I used to cut class my first year of medical school and go operate with some of the surgeons
at Children’s Hospital in Boston and I did this for quite awhile and eventually as we
would operate on these kids they were primarily kids, one after another, day after day, I
came to the realization that the kind of healthcare that I wanted to practice was not the kind
that took care of people one at a time, but rather, the kind that tried to take care of
whole populations of people. I mean I wanted to understand why do groups of people become
sick, not just why do individuals become sick and how can we make groups become well, not
just individuals become well one at a time and part of this was prompted by my realization
that I was running around putting my fingers in the dike. One hole after another was
springing water and we were running around, all of us, trying to plug these holes and
I was interested in how can we make a better dike, how can make a situation in which fewer
people become sick to begin with, in which we spring fewer holes to begin with, in the
dike as it were and in fact I began to ask what I came eventually to see as sociological
questions about the origins of illness and disease and suffering and death in our society
and I wanted to understand how we could have a sociological response, a collective response
to these sorts of problems and in fact this dovetails to some extent with an interest
in public health, which can be contrasted with a kind of interest in clinical medicine
which takes care of patients one at
a time.
So let’s start by taking a look at a personal testament, a very seemingly individualistic
statement that a human being is making about their own life, about what would seem to be
a quintessentially private individualistic decision, namely whether to take your own
life and to commit suicide. This is Charlotte Perkin Gilman’s suicide note. She was
75 years-old when she took her life and the note says: “The time is approaching when
we shall consider it abhorrent to our civilization to allow a human being to die in prolonged
agony which we should mercifully end in any other creature. Believing this choice to
be of social service in promoting wiser views on this question, I have preferred chloroform
to cancer.” And the note said: The time is approaching when we shall consider
it abhorrent to our civilization to allow a human being to die in prolonged agony which
we should mercifully end in any other creature. Believing this choice to be a social service
in promoting wiser views on this question, I have preferred chloroform to cancer.”
So despite the fact that this woman is taking her life and despite the fact that
she is writing a suicide note notice that the note contains or eludes to kind of connections
to others even as she was ending her own life. She bemoans the fact that society is not
sensitive to her pain and even while dying she is trying to make a contribution to society.
She is trying to be connected to other individuals. Here is another note: “Dear God,
please have mercy on my soul. Please forgive me. I can’t stand the pain anymore.”
And that note was written by a 76 year-old grandmother who isolated by depression and
disability crawled into her basement freezer to kill herself by the cold and you might
ask what kind of a social system permits this to happen, permits one of its members to be
so alone, to feel so isolated that this is the choice that they would make and in fact
you might ask was this suicide truly an individual act, was it really purely an individual choice. Another
one, Ron Berst jumped off the Golden Gate Bridge and in his will he donated $10,000
to AIDS research. This is his note: “To the San Francisco Police Department or equivalent
jurisdiction. This is to state that I, Ron R. Burst did take my own life due to the fact
that I have the disease AIDS and it has progressed both rapidly and to the point where number,
I constantly feel ill and have almost no energy and number two, I very soon expect to become
a burden to my friends and family and I do not want to put any of them through such an
ordeal. I sincerely regret any inconvenience that this may have caused anyone involved.
I honestly believe that a fast end such as this while one is still able, yet ill enough
to justify it is easier on my close friends who have been so unbelievably supportive emotionally
for me and my family who have been no less so than to drag this out. I did not give
up.” So again in Mr. Berst’s note notice the social concern. His death is
not an individual act at all. First of all, it was public. He jumped off the Golden
Gate Bridge. People saw him. Second, it was guided by a concern for others. He is
worried about his friends and family and third, it is infused with the social ties that connect
him to his family and his friends. Now there is another way that suicide is social
as well. It is not just the connection the individual has to others. It is the responsibility
that others have to the individual. It is about how social and structural factors constrain
or permit individual acts even like suicide. For example, this is an image of the Golden
Gate Bridge from which Ron Berst jumped and this bridge is unusual in its design because
the sidewalk as you can see is directly next to the edge of the image. He walked along
the sidewalk and then just jumped over that railing, stood there and jumped right over. And
this is a picture of Kevin Hines who almost met the same fate as Mr. Berst. In September
of 2000 at the age of 19 suffering from depression he went to the Golden Gate Bridge and he stood
there for 40 minutes crying. No one approached him to ask what was wrong and then eventually
a tourist came up and asked him if he could take her photograph. Hines interpreted this
as a clear sign that no one cared. He took the picture and then when she walked away
he turned around and he jumped right over the railing, but instantly he says he realized
that he had made a mistake. He changed his mind. “Oh shit,” he thought, “I don’t
want to die.” “What am I going to do?” he later recalled. In midair he came up
with a plan to save his life as he described as follows: “It was simply this. “A;
God save me, B; throw your head back and C; hit feet first.” And it takes four seconds
to drop the 220 feet from the height of the Golden Gate Bridge to the water and you eventually
reach a speed of 75 miles per hour and among the over 1,200 people who have jumped off
the bridge since 1937 only 26 are believed to have survived and interestingly a large
percentage of those who attempt the jump when they are interviewed afterwards say that they
regretted the decision as soon as they jumped. For example, another jumper, Kevin
Baldwin was 28 and also severely depressed in August of 1985 when he jumped and he later
said the following thing: “I still see my hands coming off the railing. I instantly
realized that everything in my life that I thought was unfixable was totally fixable
except for having just jumped.” It is 220 feet from the deck of the bridge to
the water and it takes just four seconds to reach the bottom and by which point you are
traveling at 75 miles per hour. Even allowing for the fact that we cannot know
what all the successful suicides would have said had we been able to interview them these
kinds of reports by people who jumped and survived beg the question of how to prevent
these kinds of supposedly purely individual acts. What would happen to these people
if somehow society could have prevented them from jumping, if there somehow had been a
structure in place which had constrained the agency of these individuals? One landmark
study conducted in 1978 of 515 people who were removed from the Golden Gate Bridge before
they had jumped and followed them for an average of about 26 years afterwards found that 94%
were still alive or had died of natural causes many years later, so suicidal behavior is
acute and crisis driven and if the individual is prevented from acting on their suicidal
impulses by those around him it might not be repeated. There are quite a number of remarkable things about
such stories. No doubt these individuals and their illnesses are central actors in
the experience of the individual, but I want to highlight two other observations. One
is the role of the perceived indifference expressed by the person that Kevin encountered.
This point points to an important theme in sociology, the rule of social connection
in our personal experience and the role of our embededness in the lives of others. So
one thing I would like to highlight is the perceived indifference on the part of the
person that approached Kevin. One thing that I would like to highlight is the perceived
indifference on the part of the person, the tourist that approached Kevin because this
highlights an important theme or an important idea in sociology, namely the idea that we
are all connected to each other. The role of connection in our experience of the world
and the role of our embededness in others is in fact a key consideration or a key point
that sociologists are interested in. The other important thing to realize from these
stories is the importance of extra individual factors that help determine individual outcomes
as I alluded to the role of structure versus the role of agency. Now the Golden Gate