PRIME Winter 2020

WINTER 2020

FROM THE DAILY BRUIN

BEYOND THE TEAR GAS The body snatchers The billion-dollar patent PRIME | WINTER 2020

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PRIME CONTENTS

PERSONAL CHRONICLE

WINTER 2020

WORLD

6 Miraculous catch of fish written by PAULINE ORDONEZ

At Mass, a gospel prompts Ordonez to reflect on her faith, lost in one father and found in another.

COMMENTARY

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Beyond the tear gas written by LAUREN MAN

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Measles is on the rise UCLA is vulnerable written by OMAR SAID

Why the university is woefully unpreapred for another infectious disease.

An orientation, a protest, a global movement.

One student’s account of the Hong Kong protests.

HEALTH

20 When CAPS fails written by ALISSA EVANS

“I was suicidal. ... Can I just have help, like, immediately?”

On the cover photo by TESS HOROWITZ photo illustration by LIZ KETCHAM & LAUREN MAN

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PRIME FEATURES/WORLD

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The billion-dollar patent A new cancer treatment drug let dying patients in India live longer and with a higher quality of life. Then, UCLA waged a patent war.

HEALTH

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When UCLA sold its soul written by KESHAV TADIMETI

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More precious than gold

written by TEDDY ROSENBLUTH

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The body snatchers written by SUSAN MONAGHAN

How a scandal of black-market body parts changed the country’s oldest willed-body program.

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LETTER FROM THE EDITORS

Dear reader, Welcome back to campus and thank you for picking up the winter issue of PRIME! Our reporters have traveled near and far – from Delhi to Hong Kong – to bring you the stories in this issue.

Many of the topics touched on in this magazine are well-known – we have seen videos of recent protests in Hong Hong and countless memes about the UCLA measles outbreak. But in this issue, we aim to put a face to the problems to understand the true human impact of the headlines in the news. In “When CAPs fails” we see students who, even on the verge of a breakdown, are denied mental health counseling services. In “The billion-dollar patent,” we see the unintended victims of a UCLA patent war – Indian men who may not be able to afford their prostate cancer medication in the coming months.

Also in this issue: a look back at a scandal of illegally sold body parts – how pieces of bodies donated to UCLA ended up in the hands of private corporations, and how a once prominent doctor descended to a four-year jail sentence. Susan Monaghan explores what UCLA has done 10 years later to insure a scandal-ridden donated bodies program never repeats its mistakes. Pauline Ordonez also gives a personal account of her relationship with Catholicism, her father and an unlikely common thread between them – fishing. And, we get a glimpse into the Hong Kong protests as explained by a UCLA student who has grown up amid political tension.

We hope you enjoy the issue!

Teddy Rosenbluth PRIME director

Anushka Jain PRIME content editor

Nicole Anisgard Parra PRIME art director

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Miraculous Catch of Fish

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written by PAULINE ORDONEZ

designed & illustrated by NICOLE ANISGARD PARRA

t’s my father’s birthday, Feb. 10, 2019. A Sunday. The Lord’s day.

After my three years away at college, my family no longer wakes up on Sundays with the expectation of my father pulling us from our sleep with his booming voice, a countdown to church. Nowadays, before my siblings and I attempt to untangle ourselves from our warm comforters, my father is gone, humming and laughing with his fishing buddies as the wind whips at his face out on the ocean.

While my father plays games with the fish miles below – luring, pulling, rarely losing – we can sleep in.

It’s a Sunday, but I wake to the familiar sound of my father’s car racing into our driveway, resounding in the street outside my window. He’s back several hours early –

the boat must not have gone out today. So, he picks another venture: Mass.

Nowadays, he slips away on Saturdays to vigil Mass, with or without us. But today is his birthday, so we don’t protest, we don’t hesitate. We are ushered silently by my mother onto the leather seats of the car, then onto the wooden pews of the church. I easily fall into the rhythm of the service – sit up, stand up, kneel, recite this prayer, sing this psalm – only stirring out of my automation during the second reading from the book of Luke, the story of the miraculous catch of fish. In the story, Jesus instructs four fishermen to recast their nets. Incredulous, one fisherman answers, “We have toiled all night and caught nothing; nevertheless at Your word I will let down the net.”

The fishermen are rewarded for their faith. While the person reading voices the fishermen’s astonishment at the sight of their overflowing nets, I think about another fisherman at my side – my father – attempting to reconcile his lost fishing trip with a visit to Mass. I realize this religion was always about some sort of comfort to my dad, who returned to the high ceilings of the church for solace. We no longer go to Mass weekly as a family, but we went for my sister’s last Mass before moving away or for my baby cousin’s safe delivery. Not even a month after I was born, my parents returned to church to have me bathed in holy water. This early baptism was not only customary – it was reassurance. As my grandmother explained to me, to have the baby baptized as early as possible was to protect them.

I am not that baby anymore. Nor am I Catholic, despite my parents’ pledge at my baptism. I was baptized because my father inherited his Catholicism from his pious parents and reasoned his children would too. My baptism was a great precursor to my journey through the church; I cried through most of it, feeling perpetually young and vulnerable as the waters of faith engulfed me.

Teachings began when I was in kindergarten, every Sunday, with gentle women in long skirts and– wrinkles softening their faces. Weekly catechism continued into elementary school and junior high. The teachers were still warm, welcoming, but the instruction gradually became cold, damning.

Scripture was no longer just impressive tales of God’s power, but foretellings of my punishment. I dreaded catechism – sessions that reasserted my fear of being unworthy. Along with my classmates, I read passages of small script on thin, delicate pages, intimidated by the volume of God’s word. For reconciliation, my first sacrament since baptism, I sat ashamed in front of the priest, confessing my sins in whispers. For my first Holy Communion, I ate the body and drank the blood, my guilt festering as I swallowed. In high school, during the two years it took to be confirmed, I often clung to rosary beads, anxious for my repetition to be heard.

All those years, my father was the one to drive me to and from church. In the passenger seat, I felt my resentment grow for him as the driver, intent on delivering me to this place I found stifling. Perhaps I could have voiced my reluctance, stopped my bitterness from festering for so long.

But my father was at the wheel, grip unwavering, and I was just the passenger. So I stayed quiet.

I was doubtful. I can admit that. I felt like the penance was never enough. I was told I would be forgiven, was told I would be heard, was told I was fortunate to be loved despite all my sins. I was told during every Mass, every

class. But I was never able to overcome my doubts, never able to embrace the faith I saw my father so ardently return to again and again. In my sophomore year of high school, I completed my confirmation – what would be my final sacrament in the church. I felt relief, not because the sacrament flushed away all my culpability as intended, but because my father was happy.

After confirmation, my faith was my responsibility.

Without my father driving me to weekly catechism, my Bible remained closed. All the intimidation, the shame, the guilt stayed tucked away on a bookshelf.

I told myself that I was forgiven, heard and loved – but by a father nearer than I thought.

For too long, I clenched my fist around this grudge against my father, holding him responsible for my unhappiness in this religion. But I can sit in the pew and sing hymns with him because I am his daughter, participating in this custom for the family, not the church. I can trust now that he intended to impress on us morals and discipline by putting us through all those years in catechism. If only I had relented my bitterness earlier, shed my reluctance quickly like those fishermen in the story, I would have been able to relish in the fruits of that trust, the fish, sooner.

Trade the net for a fishing rod, and the story aligns; my father is a skilled and blessed fisherman, so our refrigerator overflows with filets and whole fish. I, not Catholic but still a daughter, take my communion at the dinner table at home, over the shared meal of fish. ♦

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MEASLES IS ON THE RISE UCLA is vulnerable. written by OMAR SAID illustrated by EMILY DEMBINSKI designed by CLAIRE SHEN

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U

Five cases of measles broke out in Los Angeles County in April.

rgent messages were sent to 125 UCLA students, asking them to submit to being quarantined.

Students were shuffled into a building with metal panels sealing the doors. In the middle of UCLA’s midterm exam season, students hunched over their computers, frantically searching for medical documents.

Measles isn’t like most diseases. It lingers in the air for up to two hours after a person who is infected leaves a room, potentially exposing anyone who breathes the same air, according to the Centers for Disease Control and Prevention. The symptoms start with a red blotchy rash and high fever, but can morph into pneumonia and brain swelling, both of which can be fatal. Add the fact that individuals are contagious for four days before the appearance of a rash, and it’s easy to understand why the disease is so dangerous.

April’s outbreak affected more than just UCLA. Of Los Angeles’ five measles cases, only one was a UCLA student.

Ultimately, LA County had 20 measles cases in 2019, with 2,500 potentially exposed to the disease.

Ultimately, the spread of measles was quelled, but the outbreak showed cracks in UCLA’s immunization policies and emergency response to life-threatening outbreaks.

Officially, 843 students were potentially exposed to measles in April.

UCLA officials examined students’ schedules to find who would have been in the building on the days the student who was infected came to campus. While UCLA eventually

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determined that 718 of the 843 exposed students were vaccinated, the university didn’t have records for the rest.

But those numbers don’t account for casual passersby.

Boelter Hall, one of the buildings that was infected, is home to the popular SEAS Café, a coffeehouse that, given its cash-only nature, doesn’t keep records of its clientele.

Any one of those customers could have been infected, becoming an unofficial and unlogged host for the disease to continue spreading throughout UCLA’s population.

Franz Hall, the other building that was infected, is home to UCLA’s psychology department, where volunteer test subjects frequently come to participate in studies. Any one of those subjects – many of whom aren’t necessarily students and don’t have vaccination requirements – could have been unvaccinated against measles.

The students who lived in the dorms and were exposed to the virus were quarantined in Bradley Hall, and separated into two groups based only on gender, but not sequestered individually – potentially exposing students to measles a second time.

Additionally, while student accommodations included mattresses, food and televisions, the university sent proctors to the quarantined area so students could continue to take exams – because the only thing better than being thrown into a room with lingering measles virus is getting to take a midterm while it happens.

For the remaining students who lived off campus, Dean of Students Maria Blandizzi sent out a cryptic text message.

It was vague and rife with contradictions – it told students they couldn’t leave their apartments, but also requested they make the trek to the Arthur Ashe Student Health and

Wellness Center for a blood test.

Students were forced to choose their own interpretation of the message – either isolating themselves or leaving their apartments to walk through one of the busiest parts of campus to reach the Ashe Center. The cherry on top?

The Ashe Center was closed when the message was sent.

Blandizzi’s original text message was additionally unclear regarding what students with roommates should do. The text told students they couldn’t stay in their apartments if they had roommates, but that was all. There was no clarification whether sharing an apartment but not a room with someone qualified, nor did the message indicate how long the quarantine would last. More importantly, it didn’t tell those students who felt they couldn’t isolate themselves in their apartments where to go, what to do or who to call for answers.

A student who misunderstood the order could have spread the disease further if they had just walked into their kitchen for water or answered the door to accept a package.

Ricardo Vazquez, a UCLA spokesperson, said at the time, off-campus students were directed to isolate themselves and if they couldn’t, they were invited to come to the official campus quarantine facility.

But Blandizzi’s original message contained no such invitation, and the order to isolate was a directive no one was enforcing. Students’ apartments weren’t sealed, and they could come and go as they pleased.

The university ultimately required only 39 of the 125 students – those who were living in the dorms – to quarantine themselves in UCLA’s designated isolation center.

It turns out the vaccination forms UCLA students once meticulously filled out aren’t as binding as they seemed.

The university made it clear through emails and explanations on its website that students who didn’t submit their vaccination records may be subject to enrollment holds, preventing them from registering for classes. But the university didn’t actually place any holds – the vaccination requirement wasn’t being enforced.

The University of California passed new systemwide vaccination requirements in 2015, following a series of measles outbreaks throughout the country. The policies themselves make sense. By requiring vaccination of all students except those with medical exceptions, the UC could guarantee herd immunity – stopping a disease’s spread by decreasing the number of vulnerable potential hosts – at each of its 10 campuses.

Because vaccinating and collecting records from

hundreds of thousands of students is such a large undertaking, the requirements were designed to be gradually implemented over three years, starting with education in 2015, then requiring students to upload vaccination records in 2016 before finally enforcing the regulation on students entering the UC in fall 2017. Amid backlash from those who felt the policy infringed their rights, UC delayed the enforcement for a year, to 2018.

Students who arrived at UCLA before fall 2018 didn’t have to fill out their vaccination records to attend. The policy encouraged students to upload those records, and students were made to think that uploading those records was mandatory.

Meanwhile, those who didn’t realize or ignored the requirements were allowed to remain as students and register for classes, without having holds placed on their accounts. According to Vazquez, this is because the policy took time to enact – a poor excuse for a university system boasting some of the country’s best health care systems.

As of fall 2018, incoming unvaccinated students have enrollment holds placed on their accounts, Vazquez said.

But that still means that as it stands now, over half of UCLA’s undergraduates – effectively UCLA’s third and fourth years – may still be missing vaccinations.

To make matters worse, with the exception of a few types of staff, like health care and preschool workers, UCLA employees do not have any vaccination requirements, Vazquez said. An unvaccinated professor could easily have contracted measles by being in the same lecture hall as a student who was infected. That professor could go on to infect other students in each of their classes, who would go on to infect even more people.

That’s the problem with measles. It’s intensely contagious, and the tightly packed nature of a college campus only amplifies its ability to spread, given the shared use of so many spaces. UCLA’s campus is 419 acres – the smallest of any undergraduate-serving UC – and it is home to about 46,000 graduate and undergraduate students. Add UCLA’s approximately 36,000 nonstudent staff members, and the campus population is near 82,000 people – the largest of any UC. Despite the high number of potential carriers, Vazquez said the majority of UCLA’s students are vaccinated, which is why the April outbreak didn’t spread past the original student.

But, unfortunately, it turns out that when it comes to vaccination, anything less than near perfection just isn’t enough. Timothy Brewer, a professor of medicine at the

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Unfortunately, it turns out that when it comes to vaccination, anything less than near perfection just isn’t enough.

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UCLA Fielding School of Public Health, said in order for a population to have herd immunity to measles, 95% of it must be vaccinated.

“Because measles is so contagious, it can spread so easily that you really need to consistently keep people vaccinated at rates higher than 95%,” Brewer said. “You fall much below that, you’re at risk for measles outbreak.”

Even vaccinating 80% of a population’s members is too low – no more than 5% can be unvaccinated at maximum, Brewer said.

Once those details are in the Ashe Center’s system, the university can sort students by vaccination status and produce reports. This should give UCLA the ability to determine how many students are currently unvaccinated against measles, but UCLA could not provide the exact number of students without their measles vaccines as of Oct. 25.

While UCLA still doesn’t have the exact numbers months later, about 7,500 students were missing vaccination records for measles in May after the outbreak.

These students who were missing vaccination records aren’t 5% of UCLA’s total population – they account for around 9%.

The real vaccination rates are likely even more drastic, considering UCLA employees’ lack of vaccination

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requirements. Looking only at undergraduate students, those 7,500 are about 24% of the population, an even more alarming statistic that shows UCLA’s herd immunity is basically nonexistent.

Despite what it might think, UCLA doesn’t qualify as a largely vaccinated campus.

Protecting a population from disease isn’t easy, especially when some members of that population feel like vaccines are inherently dangerous. Brewer said despite 10% to 15% of the population doubting vaccines’ safety, there are large amounts of evidence showing vaccines are safe, and that the consequences of getting a vaccine-preventable disease are far worse than the risks of vaccination.

Choosing not to get vaccinated decreases herd immunity and puts people who have medical exemptions – such as allergies to vaccines or conditions that prevent them from receiving it – at further risk of exposure than they already are.

This is an increasing issue, as infectious diseases might be back on the rise in America. Diseases are now stronger, with increased antibiotic resistance, and they persist for longer, such as in the case of the 2018 to 2019 flu season, which was the longest in a decade, according to the CDC’s annual report.

UCLA’s response may have been effective this time in keeping the disease from spreading past the first host. But if just a few more things had gone wrong, the outcome might have been completely different.

Perfection is undoubtedly difficult on such a large scale, but with the lives of around 80,000 people in its hands, UCLA should be up to the task. ♦

Perfection is undoubtedly difficult on such a large scale, but with the lives of around 80,000 people in its hands, UCLA should be up to the task.

Measles: TL;DR - With limited exceptions, UCLA employees are not required to submit vaccination records or have specific vaccinations.

- As of May, UCLA’s vaccination records suggest the university has not achieved herd immunity.

Vaccines

- UCLA still doesn’t know who is and isn’t immunized. It doesn’t have the numbers of vaccinated and unvaccinated students available.

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- The grace period in enforcing the University of California’s new immunization requirements allowed students to remain at UCLA with unvaccinated or missing records.

SOURCES: NPR, UCLA Office of Academic Planning and Budget, UCLA Media Relations, University of California. Graphic reporting by Omar Said, Daily Bruin senior staff. Graphic by Ben Brill, Daily Bruin contributor.

BEYOND THE written & photographed by LAUREN MAN designed by SOPHIE MARENCIK

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stepped into the carpeted room full of light, Mandarin Chinese chatter. To my left was a girl covered in immaculate masklike makeup, dressed as if she had just come from high tea. To my right was a girl draped in trendy clothing, docked in expensive streetwear from head to toe.

“I forgot how much mainlanders care about appearance,” my dad loudly said in Cantonese.

Bare-faced and in a simple T-shirt, jeans and scuffed Vans sneakers, I was painfully aware of the fact that I didn’t fit in.

I crossed the border from my hometown, Hong Kong, to mainland China to attend the UCLA information session held in Shenzhen, the neighboring mainland city, the

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summer before my freshman year. The event was held by the UCLA Chinese Students and Scholars Association rather than UCLA, meaning the entire session would be held in Mandarin instead of English.

I lowered myself into a chair, feeling conspicuous in my casual attire, and listened for any conservation I could join. Familiar phrases of Mandarin flew by, yet I could not comprehend the words in between. My Mandarin class exercises enunciated everything with perfect textbook pronunciation, speed and volume. The dialogue from the mainland students around me was quick and interspersed with slang. My attention drained as I tried to make sense of their words.

The room felt increasingly suffocating – the overbearing mass of white-gold decor loomed over me. I stared at the PowerPoint on the screen, written in simplified Chinese instead of the traditional script used in Hong Kong.

I was 34 miles from my home, yet everything was so alien to me. Shenzhen, geographically separated from Hong Kong only by a river, pressed its gleaming skyscrapers and residential tower blocks up our hilly, rural border, which is inhabited only by a few indigenous villagers. My dad has always joked that the city wanted to get closer to us, whereas we wanted to get as far away from it as possible.

The hordes of mainland tourists and our forced, gradual economic integration with the surrounding Chinese cities in recent years made us wary of the mainland. Regardless of what both parties wanted, it seemed undeniable that Shenzhen, and by extension the entirety of mainland China, was intrinsically different from Hong Kong.

This distinction isn’t clear to everybody. Many UCLA students assume Hong Kong is like any other Chinese city, or part of other countries such as Taiwan or Japan.

Let me get the facts straight.

Hong Kong Island was a tiny fishing village ruled by China when it was ceded to Britain in 1842 after China’s defeat in the Opium War. Over the next 56 years, China lost all three main regions of Hong Kong to Britain, including the haphazard spatter of islands near the city’s coastlines. It remained a British colony until 1997 – except for a brief period of Japanese occupation during World War II – when it was handed back over to China.

With more than 150 years of colonization under its belt, Hong Kong welcomed huge waves of immigrants from China whenever they faced crises, such as the Japanese occupation of China during WWII and the Cultural Revolution from 1966 to 1976.

Otherwise, the city remained mostly free of Chinese influence in the colonial era. When China standardized the language across the provinces to Mandarin, Hong Kongers continued speaking Cantonese. When they simplified the Chinese script, we kept our traditional Chinese characters. When Hong Kong was handed over to China in 1997, we were classified as a “Special Administrative Region,” a status that grants a certain degree of autonomy until 2047.

We are technically a part of China, but constantly rocking between assimilation and rejection of its authority.

Stretching 22 miles across and 14 miles vertically, Hong Kong has always felt too small. I wanted to belong to a larger cultural or natural identity. As much as I loved Hong Kong, I felt like I was just a bead in those doctor’s waiting room toys, trapped whizzing around the same cramped streets over and over again.

Traveling around mainland China, I thought, could help me discover a sense of belonging. I had always thought of China as more of a neighboring tourist destination than somewhere I actually belonged to, as both my parents and I have lived in Hong Kong all our lives.

My paternal grandfather, however, hailed from a village in

the neighboring Guangdong province, so my “heung ha” – place of origin – is technically in China. Perhaps going to China could help me get in touch with my roots?

I quickly realized I didn’t have much to latch on to in China either. Even though my “heung ha” was in China, I had never visited it and had no personal connection to it whatsoever.

Even though the majority of Hong Kong’s population is ethnically Chinese, including myself, I could never completely adhere to the broader Chinese culture. Sure, Chinese food tastes great. I was amazed at the beauty of Huangyao Ancient Town in a nearby province. Most of the people we interacted with while on the road were kind and friendly.

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But when I got down to the crux of China’s complex history and culture, I found myself uncomfortable with some of the more controlling aspects – the heavy online censorship and the concentration camps of the Uighurs in Xinjiang.

The Confucian texts I had to recite in Chinese class told me that to be a noble person was to “not violate” the rules of propriety. I was supposed to love my country and obey the head of state – so much as to die willingly if my monarch commanded me to.

But I didn’t – so I started to distance myself from my Chinese identity.

Hong Kong and China are distinguished by the “one country, two systems” policy.

While China only has the Chinese Communist Party controlling all three government powers, we have a multitude of parties across the political spectrum and a separation of powers.

“One country, two systems” seemed to mean that whatever happened on the mainland was none of my business. But the line was getting blurry, and China was creeping into our system.

In late 2015, a Hong Kong publisher who had been selling banned books disappeared. Although he appeared on Chinese state TV a couple of months later, insisting he wasn’t kidnapped, many suspected the Chinese government abducted him – a witness claims to have seen him forced into a car, and he wasn’t the first bookseller to disappear.

Then, four years later, politicians proposed a policy change that would allow China to detain and sentence any Hong Kongers suspected of committing a crime in the mainland.

To many, this bill seemed to corrode the line between the two systems even further. A 2019 New York Times Opinion article said the extradition bill “seemed to pave the way for China to target anyone in Hong Kong on almost any pretense and try them on the mainland.”

Protesters took to the streets in increasingly large numbers to oppose the bill. Even though we were still 28 years away from the end of the “one country, two systems” agreement, and even though we were still a special administrative region, we already had to fight – literally fight – for our autonomy and freedom.

Tear-gas-filled, black-clad protesters, international news kind of fighting.

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We already had to fight – literally fight – for our autonomy and freedom. Tear-gas-filled, black-clad protesters, international news kind of fighting.

The first time I heard the sound of a tear gas canister being shot into the air, it sounded surprisingly comical, like Buzz Lightyear’s laser gun sound effects at Disneyland. I was a hundred meters away, sitting on the ledge of a pedestrian footbridge above the protester-occupied road, feeling surprisingly calm.

I had spent so many nights gripped with anxiety. I had read about the arrests of kids younger than me, numerous reports of sexual assault by the police and the neighborhoods infiltrated with tear gas. Yet, I felt much more at ease when the action was happening in front of me because I realized that tear gas, as terrible as it must be for those in its proximity, was only a miniscule portion of the protests. That day, my attention diverted to the protesters themselves.

“Those without gear – stay back. Let those with gear go,” a protester shouted, preparing to put on a full-face respirator gas mask.

“The frontlines need more salt water!”

Someone ran up from the tear-gas-filled haze, carrying salt water to alleviate the burning.

“Give way!”

The crowds parted like the Red Sea, as a group of geardonned protesters charged toward the police, pushing an elaborate structure of metal railings bound together by zip ties to create a barricade.

These Call-of-Duty-esque features are usually the focus of news stories, but I was focused elsewhere – the silent cooperation and community of the Hong Kongers behind all the tear-gassed frontlines, a huge mass working toward a common goal.

It sounds cliché, but we were all in it together.

I first noticed this solidarity in 2012, when I accompanied my parents to a sit-in protest outside the Legislative Council of Hong Kong. The government wanted to pass a bill for the implementation of mandatory moral and national education in all local primary schools, aiming to instill a sense of patriotism in students. My dad bought me a huge piece of cardboard, on which I scrawled my opinion in teal capital letters, and I held it up proudly as I sat cross-legged with the other protesters.

Surrounded by a sea of adults, the only other young teenager around caught my eye. She smiled at me, pointed at my banner and gave me a thumbs-up. My heart stayed warm throughout all the protest songs, when all the Hong Kongers around me – often a cold and unexpressive demographic – poured their hearts out with the melody.

I felt the same way during the Umbrella Movement in 2014, when I went to Admiralty, an occupied site around the government headquarters. An impromptu little town had sprung up, with protest banners hanging from pedestrian bridges and tents where the occupiers resided. The centerpiece of the occupied zone was a woodblock statue of someone holding out a yellow umbrella.

The figure represented the instruments protesters used to ward off police pepper spray and later became a symbol of the movement. It felt like a grand monument in a country’s capital city, even if it was just a statue designed by a 22-year old artist and created by a modest 10-person team. I felt like we had reclaimed this city, like it was actually ours – until the movement died and the city seemed to fall in a nadir of political apathy.

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The protests are no longer solely composed of sweet solidarity and cool grassroots art. Some bemoan that protesters are tearing the city apart, that they are mindless rioters brainwashed by foreign powers, and they do nothing but immobilize transit, smash windows and attack police.

But the protests didn’t start out radical. During finals week of spring quarter my freshman year, I marvelled as 2 million of our 7 million population took to the streets in a peaceful mass protest against the extradition bill. I looked at aerial photos of protesters flooding every crevice of familiar city streets, as though they were liquid instead of human flesh.

Such a united display of our demands was only met with endless hails of tear gas Such a united display and pepper spray from the police. I started to lose hope. How far of our demands would we have to go for was only met with our voices to be taken seriously? endless hails of tear As the protests gas and pepper spray continued, the police committed more from the police. atrocities, firing expired tear gas near elderly homes and into closed railway stations where it couldn’t disperse. There were multiple reports of random arrests of nonprotesting citizens simply taking the subway, of sexual assault and gang collusion by our law enforcement.

What started as a simple demonstration against the extradition bill blossomed into Hong Kong’s five demands, which included the creation of an independent commission of inquiry into the police force and the implementation of true universal suffrage. Throughout the chaos, there was a brief moment of respite when the government formally withdrew the extradition bill. But too much had happened for that alone to satisfy us.

Our world had flipped. I looked at the protesters around

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me, many of them high school students. I, too, was stressed when I was their age, but over trivial matters like examination scores, not the collapse of all our freedoms.

We are all so young – why was this thrust upon us?

Why had the police, previously kind officers who gave me concerned warnings against jaywalking, turned into these unrecognizable trigger-happy soldiers, running around in camouflage riot gear? I watched recordings of our chief executive’s speeches at press releases. Why did she seem so robotic and uncaring with her empty condemnations of protest violence, as though she was reading from a script given to her?

Among all of the doom and gloom, Hong Kongers always found ways to counter oppressive measures and boost morale. My mother, homebound because of her foot injury, continued her display of support. One night, we opened the windows of our apartment and yelled protest slogans, a daily routine practiced by other nonprotesting citizens to engage with the movement.

“Liberate Hong Kong! Revolution of our times! Five demands, not one fewer!”

More than 20 stories high, we could hear others shout back from the ground and neighboring apartment buildings. It felt like we were connecting with different Hong Kongers through our catharsis.

One evening in August, I was working a night shift at my summer job when my coworker ushered me to peek out of the office window. We had a view of one of Hong Kong’s most iconic mountains, Lion Rock, and we could see a glimmering line tracing along its rugged peek. Hong Kongers had formed human chains across districts, inspired by the anti-Soviet ‘Baltic Way’ in 1989. Not only were the chains stretching along the pedestrian walkways in our commercial areas, they were also making their way into our countryside.

To some, this might eerily represent Jordan Peele’s “Us,” but I felt so touched that I could have cried. Hong Kongers,

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who I have always thought of as dismissive and standoffish group were holding hands with complete strangers? I was so proud.

When I returned to UCLA in mid-September, I went to an anti-totalitarianism rally in Hong Kong remains 22 Monterey Park in support of Hong Kong. I felt like I was home when I heard the protest miles wide and 14 miles chants and Cantonese songs. Without long, but our movement the threat of arrest, protesters displayed infographics and satirical art criticizing the and the values we stand Chinese regime. for are unlimited by our While this was a pivotal moment for Hong Kongers, I realized it was also a crucial geography. moment for many other cultures who have faced oppression. I saw Tibetan flag-bearers, men and women in traditional Uighur dress, protesting China’s Uighur concentration camps and the oppression of religious freedom.

In our midlife years as a special administrative region, we have forged a new facet of our identity through our struggle. Hong Kong remains 22 miles wide and 14 miles long, but our movement and the values we stand for are unlimited by our geography.

We started out fighting for our own future, but now we have also caused a ripple effect, empowering others who have suffered from Chinese totalitarianism. Hong Kong is one of the only Chinese places that still has freedom of speech, and we are going to shout on everyone’s behalf.

“Free Hong Kong!” we yell, but also, “Free Tibet! Free the Uighurs!” ♦

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When CAPS Fails

written by ALISSA EVANS photographed by XUXIN ZHANG designed by WINNIE LIU

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uring an alumna’s second year at UCLA, she was sexually assaulted.

The recent graduate, who requested to be anonymous for this story, had a midterm the next day, but the incident absorbed all her attention – she struggled to focus and couldn’t retain information like she could before.

Over time, she avoided leaving her apartment – she couldn’t risk seeing any male who resembled the person who assaulted her. If she did see a man who looked even vaguely similar, it would trigger panic, tears and vomiting.

So she resorted to practically hiding in her room for the remainder of the school year.

She knew the deep, emotional impact of the assault on her psyche meant she needed to take action. After calling a nurse hotline, she decided to seek help from UCLA’s Counseling and Psychological Services. With more midterms approaching, she was desperate for a psychiatrist to sign the Center for Accessible Education forms that would grant her disability-based accommodation, which can extend assignment deadlines and grant students breaks during exams.

When she went to CAPS for her prescreening, the waiting room felt daunting. She was afraid she would see someone she knew that and they would ask her questions about her trauma.

After her name was called and the prescreening was complete, the CAPS staff told her she would have to wait a month and a half for an appointment. In the meantime, they suggested off-campus resources. But the assault took place outside UCLA, and she was too frightened to venture off campus again.

“I could barely get myself to leave my apartment to go to class, let alone go outside of campus,” she said. “I was not able to physically bring myself to get anywhere outside of like Ralphs, which was pushing it.”

She expressed these concerns to the CAPS staff, but they didn’t offer a solution, she said. When she was finally able to see a therapist at CAPS nearly two months later, midterm season was long gone.

This alumna’s experience is not isolated – CAPS is notorious among students for lengthy wait times and limited resources.

CAPS’ infamous reputation reaches as far as the UCLA meme page on Facebook, on which a recent meme about the long wait times garnered over a thousand likes and nearly a hundred comments including “These are the actual facts” and “CAPS = 100% trash.”

UCLA’s student body is in the midst of a mental health crisis. On the Monday of zero week of the fall quarter, 90 students came into the counseling facility, said CAPS Executive Director Nicole Green. On average, CAPS sees about 1,550 students per quarter, Green said.

“The crisis that we’re in is ... worldwide,” Green said.

“We’re looking at mental health being so underserved for so long and so much stigma attached, and now that people

are raising issues, we’re just bombarded. The demand for services is just far outpaced.”

And while CAPS’ limited resources play a significant role in the crisis at UCLA, decreasing stigma and increasing pressure on students have heightened the demand for mental health services nationally. A recent study found that 35% of first-year college students from eight different countries including the United States reported symptoms indicative of a mental health disorder. Moreover, the rate of individuals aged 18 to 25 who reported symptoms in line with major depression in the last year increased by 63% from 2009-2017.

There is no single explanation for such findings, said Dori

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Now that people are raising issues, we’re just bombarded. The demand for services is just far outpaced.

- NICOLE GREEN

Hutchinson, the director of services and an associate clinical professor at Sargent College of Health & Rehabilitation Sciences at Boston University. But one contributing factor, Hutchinson said, is the academic pressure on students, which gives rise to the mentality that straight A’s are the only path to success later in life.

“The academic culture is high stakes, ... and we’ve made it all about the grades because that’s a good business model for the school,” Hutchinson said. “The more competitive you are, the more people apply, the more you charge, the higher your rankings.”

With an understaffed department and increasing demand for its services, CAPS has struggled to keep up. Green said the program has had difficulty hiring and maintaining mental health professionals largely because of the high volume of cases with an at-risk population.

In 2014, Green said CAPS adopted a triage system, in which the wait times for each student were based on the severity of their symptoms. The triage team was originally comprised of three triage clinicians, but has since expanded to seven members, Green said. The average wait time to receive a routine intake appointment has dropped from fall 2018’s average of five weeks to two and a half weeks this year, she said. Green credits the improvement to the department being fully staffed.

CAPS hired seven new full-time therapists over the summer. From 2018 to 2019, the number of staff clinicians increased from between 24 and 27 to 33, which allowed CAPS to increase the number of intake appointments per week from 2018’s average of 100 to about 140, Green said.

Nevertheless, Green said CAPS still gets backed up, as do the off-campus facilities CAPS refers people to.

CAPS has a large triage team compared to other University of California schools, Green said, but it is still not enough to eliminate wait times for students. Even if CAPS had the

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funds to double its staff, Green said she thinks more people would feel encouraged to seek treatment, and the wait times would be largely unimproved.

Triage is intended to reduce wait times, but without sufficient staffing and resources, it can lead to significant wait times for people who require less urgent treatment, said Alexa Wesley, an associate director for research and policy at the National Association of Student Personnel Administrators – Student Affairs Administrators in Higher Education.

Further, while providing small improvements, it doesn’t directly address the issue of limited sessions. While it largely depends on the individual, Raphael Rose, the associate director of UCLA’s Anxiety and Depression Research Center, said the effects of cognitive behavioral therapy are generally assessed after 12 weekly sessions. CBT is a common technique employed by therapists at CAPS, but the sixsession limit prevents it from being carried out to its full potential.

Glynnis McNamara, a third-year global jazz studies student, said her anxiety and depression led her to seek help from CAPS in late November 2018. She had not been to therapy since she struggled with similar mental health issues in high school, and she hoped CAPS would provide

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some novel solutions and coping mechanisms. But when the CAPS staff said the soonest a therapist could see her was February, she broke down in tears on the spot.

After her CAPS prescreening, McNamara said her emotions and mood swings became increasingly difficult to manage.

Once her scheduled session rolled around nearly three months later, she said she missed the appointment because she was too depressed to get out of bed.

“You’re trying to address issues before they worsen,” McNamara said. “The longer your mental health issues go on, your baseline and your tolerance for coping with things gets lower and lower, and eventually you’re scraping rock bottom.”

Even if she had gone to her appointment, McNamara didn’t have the UC Student Health Insurance Plan, so she would only be offered three appointments. McNamara said she thought the touch-and-go treatment that CAPS offers would ultimately not be worth her time.

Similarly to McNamara, the recent graduate said the three-session limit prevented effective care and led to less individualized therapy. The graduate felt dehumanized after her assault, she said, and was hoping the sessions with CAPS would be tailored to her feelings and trauma. But during her appointments, her therapist gave her general advice rather than a personalized perspective.

The graduate said she wanted her therapist to validate her feelings, to tell her it’s normal to lose the ability to focus

after being raped, to tell her she had PTSD and was not and intense sleep deprivation culminated her having a overreacting. panic attack on the floor of her dorm room. The episode Instead, her therapist reiterated empty statements about prompted Vasquez, a fourth-year cognitive science student, how hard it must be for her. She resorted to reading people’s to seek help from CAPS. She has UC SHIP and therefore has stories through online forums like Reddit to find comfort, access to six sessions per year. the graduate said.

After the notoriously long wait before her intake, Vasquez Her GPA also took a major hit after the assault, and the said her therapist helped her address her anxiety, including competitive environment of UCLA gave rise to feelings of the many “what if” concerns about how people might inadequacy. She had to seek out perceive her. But despite the articles online to understand how sessions’ positive effects, she The longer your mental health common it is for rape victims to wishes the resources were issues go on, your baseline and your struggle academically following their more accessible on a weekly assaults. basis. She said the two- to tolerance for coping with things At such a large, reputable gets lower and lower, and eventually three-week waits in between university like UCLA, a robust appointments made you’re scraping rock bottom. counseling center seems like a consistent help virtually necessity. But McNamara said UCLA impossible.

- G LY N N I S M C N A M A R A advertises other, more outwardly The resources are even appealing assets of the school, rather than putting full less accessible to those without UC SHIP, with appointments emphasis on its lacking mental health resources. at Westwood mental health clinic Acacia Counseling Publically, UCLA is investing in movements like its and Wellness costing up to $150 for people with out-ofDepression Grand Challenge, a series of research studies network insurance. But, in addition to the cost of therapy, aimed at cutting the burden of depression in half by 2050.

Hutchinson said the overall price of education also plays But despite UCLA’s efforts to improve mental health 30 years a role in the increasing amount of mental health issues from now, McNamara said UCLA needs to make an effort to college students experienced. Hutchinson said steep tuition provide more immediate mental health resources today. costs often force students to take out thousands of dollars in “Other things are more attractive to UCLA,” McNamara loans. And when students don’t rely on loans, their families said. “I think (athletics and research) are critical to UCLA’s carry the financial burden, Hutchinson said. existence and the student body, but, ultimately, you’re not B. Janet Hibbs, psychologist and co-author of “The Stressed going to have a student body unless you take care of them.”

Years of Their Lives: Helping Your Kid Survive and Thrive Even when students are allotted the full six sessions, CAPS During Their College Years,” said the cost of college pressures still comes up short. During Alexxa Vasquez’s first year of students to be perfect in school to avoid wasting their college at UCLA, the combination of high-pressure classes parents’ money.

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People in the late adolescence to early adulthood age better publicized. range are at the highest risk for the onset of many mental Hibbs said even parents could potentially be a crucial disorders, said Danielle Keenan-Miller, director of the UCLA part of prevention. Parents can encourage their children Psychology Clinic. But since many students experience these to speak about mental health before it feels like too big issues for the first time, they don’t know when or how to a burden to address and provide a safety net of support, seek help, and ultimately do not get treatment.

Hibbs said. Green added that staff from the RISE center gave Ultimately, Green said CAPS is a short-term therapy presentations to emphasize the importance of monitoring provider. The best course of action for the 20% to 30% of mental health in the same way we monitor students who want physical health. long-term therapy “Students ... is to get a referral are expected to to an off-campus manage their facility, she said. physical health Hibbs said mental health disorders are nearly as But for students on a daily basis,” prevalent as the common cold – and with the help of like the recent Green said. “Are graduate, an offstudents sleeping? parents, peers and faculty, the crisis can be solved. campus referral is Are students not enough. Even if drinking a whole she had been able to lot of energy leave campus, she said the expensive Uber cost from UCLA drinks? Are they binging on the weekends? Are they really to the Rape Treatment Center at UCLA Medical Center, engaged in things that are going to take care of their Santa Monica, which CAPS referred her to, wasn’t feasible. mental health?”

With CAPS’ current funding, Green said longer-term But as students learn to track their mental health, therapy would only create longer wait times. But Wesley campuses must find a way to facilitate access to mental said transparency is crucial to an effective mental health health resources. Hibbs said some schools like University resource, so college counseling centers like CAPS should be of Florida have implemented 24/7 teletherapy – a cheaper upfront about the limitations of their services. alternative to face-to-face therapy – which would be Green said UCLA as a university is making an effort to a potentially cost-effective way for CAPS to treat more better publicize the mental health resources available and students and reduce wait times. respond to student concerns. Staff from the Resilience Another option is online do-it-yourself therapy, with in Your Student Experience hub – which was created educational videos to help those with less pressing issues in response to student feedback – gave a 30-minute cope, Rose said. Data-driven measures like how often a presentation at orientation this year, Green said. student is missing class, or even how often they’re not using RISE offers group meditation, yoga and educational their dining hall swipes, might also help identify which presentations among other resources beyond the scope of students need help, Hibbs said.

CAPS, she said. CAPS also created a community relations Ultimately, Hutchinson said there is still an enormous and outreach coordinator to help students with community amount of cultural shame, prejudice and discrimination referrals, and brought the copay of outside services from $25 that surrounds mental health issues in today’s society. But down in past years to $5 this year.

Hibbs said mental health disorders are nearly as prevalent But students are constantly – and understandably – as the common cold – and with the help of parents, peers asking for more effective mental health services, Green said. and faculty, the crisis can be solved.

With CAPS’ current funding and physical size, she said its Both CAPS and UCLA have a long way to go before they’re goal is to utilize as many resources from the surrounding part of the solution. And in the meantime, students like the community as possible to assist those with mental health recent graduate are forced to seek outside sources to bridge issues nationwide. the treatment gap.

For college campuses, there’s no one-size-fits-all The alumna said she was finally able to travel far enough treatment for mental health, Keenan-Miller said. Moving off campus for outside treatment spring quarter of her forward, an interdisciplinary approach is necessary to fourth year. Her best friend accompanied her for support, holistically address the issue. but she said it was still an extremely difficult process that Although clinical services are a major part of mental she couldn’t imagine doing any sooner. The staff at the health treatment, mental health education also plays a Rape Treatment Center – which she said offered 10 free significant role, said Sara Abelson, a co-investigator and lead sessions – were more understanding of her trauma and the for Diversity, Equity and Inclusion projects with the Healthy sessions were more personalized than those at CAPS, she Minds Network. said.

At Boston University, Hutchinson said the school has But by this point, two years had elapsed since her assault. begun training upperclassmen who identify as having a She said CAPS needs to find a way to make its services more mental health condition to serve as peer mentors, a method available, perhaps by hiring more staff clinicians, so that it she said has been validated by research. Although UCLA is not a last-resort resource for students in crisis. has a similar peer mentoring program to that of Boston “I was suicidal,” she said. “I don’t really need an outside University, its resources should, with the help of CAPS, be place right now. Can I just have help, like, immediately?” ♦

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THE BILLIONDOLLAR PATENT A new cancer treatment drug let dying patients in India live longer and with a higher quality of life.

Then, UCLA waged a patent war. written by KESHAV TADIMETI & TEDDY ROSENBLUTH additional reporting by KRITIKA SONY photographed by LIZ KETCHAM designed by LAUREN HO & CALLISTA WU

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WHEN WHEN UCLA UCLA SOLD SOLD ITS ITS SOUL SOUL written by KESHAV TADIMETI photographed by LIZ KETCHAM designed by LAUREN HO

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early 8,000 miles from the polished offices of Murphy Hall sits a black stone slab the size of Chancellor Gene Block’s office bookshelf.

Maroon, white and orange flowers dress the upper surface in ornate polygonal patterns. A bronze lamp stands at the slab’s head, a small flame burning inside the rectangular glass casing. Pristine green grass surrounds the site and sandstone-colored tiles snake around the exterior to form a walking path.

Mahatma Gandhi was cremated at that site 71 years ago.

The champion of “satyagraha,” or peaceful political resistance, is celebrated worldwide for his nonviolent advocacy against the British colonial empire. Be it in the hallowed rooms of Moore, Bunche and Dodd halls or the open air of Bruin Walk, Block and his counterparts have touted the freedom fighter’s virtues as the foundation of civil rights movements in the United States and abroad.

But those remarks ring hollow in a courthouse just 3 miles southwest of Gandhi’s memorial grounds.

In that pale brownish-white building, decked with numerous pillars and countless clay planter pots, lawyers representing UCLA have argued with Indian officials about how it should be able to increase the cost of a potentially lifesaving medicine by more than eightfold, rendering it outrageously out-of-budget for many.

Thousands of Gandhi’s heirs struggle every day to treat their ailing loved ones, shoving tinted currency slips stamped with his smiling face – their life savings – into pharmacists’ hands in exchange for treatments. Hundreds more die in the streets of New Delhi, outside brimming hospitals. Millions die each year across the subcontinent because of treatable conditions.

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Chief among those illnesses is prostate cancer, an insidious disease with growing prevalence among Indian men. More than 25,000 new cases popped up in 2018, with more than 17,000 people dying and nearly 48,000 having lived with the disease for upward of half a decade. Curative treatments are few and far between, and the available market demands that family members abandon their financial futures to keep their loved ones alive. Countless resort to simply letting their relatives die, and doctors can only sit idly by.

That prospect seemed to change in 2005, when UCLA researchers partnered with a pharmaceutical company to manufacture a compound called enzalutamide that

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If UCLA gets its way, it’s going to have blood on its hands.

could help treat late-stage prostate cancer. U.S. regulatory agencies fast-tracked clinical trials, claiming it was a miracle medicine.

In a cruel twist of fate, though, that compound will be dangled outside the reach of nearly 1.4 billion people because the university is fighting a legal battle to monopolize the drug’s production in India.

Indians are upset and the university hardly seems to care. It stands to make billions in other pharmaceutical deals if it wins.

But if UCLA gets its way, it’s going to have blood on its hands.

A subcontinent’s worth.

Enzalutamide should have been the quintessential story of scientific discovery.

The compound came about from a conversation in 2003.

Michael Jung, then a 55-year-old distinguished professor in the Department of Chemistry & Biochemistry at UCLA, was asked by his wife one day whether he was content doing more of the same for the rest of his life. The New Orleans native pondered the idea of continuing his theoretical research into synthesizing organic compounds.

He wanted to do more, though, and set out to somehow pursue something else: creating compounds to cure human diseases.

That dream turned into a plan when, according to a UCLA Newsroom account, Charles Sawyers, a professor of medicine and molecular pharmacology at UCLA, approached Jung with an ambitious idea.

“Let’s stop prostate cancer,” Sawyers said.

Two years later, UCLA – on behalf of the duo – licensed enzalutamide to a San Francisco-based company called Medivation Inc. The resulting drug, Xtandi, was a pill meant to treat castration-resistant prostate cancer, a latestage form of the disease with few treatments.

Xtandi didn’t disappoint. The compound was so effective, the Food and Drug Administration cut short clinical trials and offered the medicine to all participants. Xtandi quickly became a popular drug on the market because it allows patients to resume a number of their daily activities – walking in the park, taking care of grandkids, attending family gatherings – during their treatment. Medivation was eventually bought over and the drug’s licensing agreement began being managed by Pfizer Inc. and Astellas Pharma Inc., two massive pharmaceutical corporations.

The companies made ​nearly $1.9 billion off Xtandi in 2015 alone. UCLA sold its royalty interest in the drug for $1.14 billion and has invested a portion of that amount in its other research endeavors. Jung now researches antitumor and antiviral treatments at UCLA, while Sawyers studies cancer pathways at the Memorial Sloan Kettering Cancer Center.

And that’s about all the university’s idealistic PR account will include.

The reality is that a patient takes about four Xtandi pills daily for 28 days, each pill costing more than $100 by some estimates. Depending on insurance coverage, patients can cough up copayments ranging from $3,300 to the full price of more than $12,000 a month. Even with Medicare, the typical Xtandi patient can end up spending upward of $12,000 a year on the drug – almost a fifth of the median U.S. household income.

Oh, and the companies’ plan only got worse.

Pfizer and Astellas sought to patent enzalutamide in India and charge the same obscene prices to one of the poorest countries in the world. When the Indian Patent Office rejected their application in 2016 on the grounds that it wasn’t inventive, considering generic versions of enzalutamide exist on the Indian market, the companies called on UCLA to appeal the rejection.

The bastion of public higher education and research responded in true form: by taking California taxpayer

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That’s the crux of this tale: how a scientific breakthrough now has one of the nation’s top public universities selling out to a pair of multibilliondollar companies.

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dollars almost 8,000 miles overseas to the High Court of Delhi to patent a compound already patented in the U.S., so Pfizer and Astellas could bankrupt millions in a nation rank with poverty, starvation and inequities. The university has enlisted the help of everyone from corporate savvy Indian lawyers to an ex-minister now in jail for corruption charges.

And that’s the crux of this tale: how a scientific breakthrough now has one of the nation’s top public universities selling out to a pair of multibillion-dollar companies.

“I’ve always associated academic institutions with some kind of principals, so it’s shocking to see they’re so commercialized,” said Leena Menghaney, the South Asia head for Doctors Without Borders’ Access Campaign.

“It shows that academic institutions have lost their independence.”

That kind of characterization flies in the face of the University of California’s mission of public research.

“Just as we are doctors without borders, scientists should be without borders as well,” Menghaney said. “Your science should cross boundaries and should be able to benefit people.”

Jung and Sawyers’ science now stands to kill hundreds.

India’s medical market largely consists of generic medicines, mass-produced at significantly cheaper prices than their branded counterparts across the world. This system came into place because many Indians lack medical insurance and are forced to pay costs upfront and out-ofpocket. Xtandi, for example, has at least four competing generic products roughly priced between 30,000 and 40,000 rupees – between $429 and $572 per packet of 120 tablets.

Granting the Xtandi patent would illegalize these existing drugs and replace them with the same medicine priced at around 825% more. In effect, Pfizer and Astellas would monopolize an already expensive market and get

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away with charging Indians more than 30 times their average salary.

The results of that could be devastating. Indian doctors are already forced to consider patients’ financial statuses when prescribing drugs and advising treatments, said Rajeev Kumar, associate dean of the All India Institute of Medical Sciences in New Delhi, the nation’s premier government-run medical facility. Kumar, a urologist, said he almost never prescribes Xtandi because it is much more expensive than its generics and even more so than chemotherapy.

But enzalutamide has shown promising results when introduced earlier in prostate cancer treatments. And per oncologists, like Sainath Bhethanabhotla of the Krishna Institute of Medical Sciences in Hyderabad, India, enzalutamide has fewer side effects than chemotherapy and other prostate cancer treatments on the market.

UCLA’s legal win would force Indian doctors to make the impossible choice between offering patients Xtandi at the risk of plunging them into financial ruin and pursuing other treatments knowing they may not be as effective.

So much for stopping prostate cancer.

Before my colleagues and I traveled to New Delhi this summer, I spent a month in Hyderabad laying the groundwork for our reporting trip.

While reaching out to oncologists and pharmacists, I ran into a relative of my mom’s colleague: a fourth-year computer science student preparing to take the GRE. The student knew some local medical professionals and offered to help me visit them. One day, while his suspensionless minivan creaked along the congested road, I asked him what he wanted to do after graduating.

He answered, almost instinctively, that he wanted

to pursue a master’s degree at UCLA. He told me about the name recognition of the university and how its groundbreaking research is something many Indians and national institutions look up to. UCLA, as he saw it, was an authority on science and public education.

He’s not wrong. Be it doubling down on the need for an egalitarian, open access to research or assembling hundreds of scientists across the globe to discover a cure for depression, UCLA is an academic authority worldwide.

But the university is using that same amassed status to also demand that Indian patients pay two multinational pharmaceutical companies they hardly know of. Some of those patients could be relatives of students or professors.

The dichotomy only dismantles UCLA’s image as an international research stalwart. And that doesn’t just hurt faculty and administrators – it hurts students and alumni, too.

Enzalutamide was hailed as a grand medical achievement in treating cancer and restoring patients’ quality of life. Now it has become such a fraught compound that Jung and Sawyers didn’t even respond when the Daily Bruin reached out for comment.

That’s understandable, given the antics UCLA has resorted to when defending itself. The Union for Affordable Cancer Treatment wrote an open letter in 2017 – signed by 56 academics and civil society organizations, including Menghaney, Third World Network, the All India Drug Action Network and Yale Global Health Justice Partnership – requesting UCLA and the UC Board of Regents withdraw their patent litigation in New Delhi.

John Mazziotta, CEO of UCLA Health, responded in a letter, asserting that while UCLA held the patent, it ceded numerous legal rights to Medivation because the company – now owned by Pfizer – agreed to take up the full cost of producing enzalutamide.

“Importantly, this life-saving drug would not currently be available for patients at all were it not for Medivation’s significant investment and diligent efforts,” Mazziotta wrote, italics included.

It takes some gall to justify using taxpayer dollars to sue a foreign government.

UACT isn’t the only one speaking up, though. The Universities Allied for Essential Medicines and the American Medical Student Association have lobbied the UC for nearly two years, sending a petition with nearly 3,500 signatures to UC President Janet Napolitano and meeting with UCLA administrators to convince them to drop their lawsuit against the Indian Patent Office.

In addition, Knowledge Ecology International, a nonprofit that advocates for, among other things, accessible medicine, submitted a proposal in February to make enzalutamide part of the World Health Organization’s Essential Medicines List to pressure Pfizer and Astellas into allowing for generics of the drug.

There’s a reason for all this opposition: UCLA’s patent battle is fundamentally a show of superiority.

That a public university can partner with pharmaceutical giants, hire multiple lawyers familiar with India’s patent system, secure a spot on a higher court’s docket and sue the world’s largest democracy to

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charge debilitatingly high prices for a lifesaving drug is only possible because Block and his fellow administrators are blessed with financial and administrative power few Indians – and even Americans – have.

Instead of using that authority for the public good, UCLA has sold its soul for a couple of Ben Franklins.

“Why don’t you just leave the developing world out of your licenses? ... What are you going to earn out of us?”

Menghaney said. “You didn’t create this drug for us. How many Indians can buy it at Pfizer’s price?”

According to KEI, it costs between 50 cents and $1 per milligram to produce enzalutamide in most countries.

Pfizer and Astellas are charging nearly triple that. And lawyers representing the UC were fighting in the High Court of Delhi as recently as May. Administrators have couched these actions as a contractual obligation. We’re supposed to believe the university is incapable of persuading its pharmaceutical partners to not make some chump change off India – or, dare we say, lower their prices.

That’s remarkably elitist – blaming inaccess for millions on a bad contract.

Enzalutamide was discovered in a lab funded by taxpayer dollars, made possible by grant money from the National Cancer Institute at the National Institutes of Health and the U.S. Army Prostate Cancer Research Program, in a university founded by the state of California to advance the public’s interest. Yet millions – in India and the U.S. – will be expected to fork over their life savings to share in this collective medical achievement.

UCLA succeeded, all right. Its authority is being heard loud and clear.

What surprised me most about my reporting wasn’t how upset Indians were with UCLA. Rather, it was how many threw their hands up and ruefully accepted their fate.

Inaccessible medical treatments aren’t a novelty for them. Dozens of families sit on the ground outside the AIIMS facility, waiting in the unrelenting sun and smog for their minuteslong doctor consultations. Patients toil in hourslong outdoor lines in front of the pharmacy just to

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What surprised me most about my reporting wasn’t how upset Indians were with UCLA. Rather, it was how many threw their hands up and ruefully accepted their fate. get their medicines, clamoring for space under the sparse ceiling fans. Some sleep on dusty sidewalks, with children beside them.

Xtandi is just another inaccessible brand name to millions of Indians. Prostate cancer is just another ill-fated condition they hope to not contract. And UCLA’s patent battle is just another obscure piece of trivia. Western powers colonized the nation for nearly a century, so the exploitation – now from multinational companies – isn’t new.

“You can’t take any action on these companies. It’s not that irregular. ... It’s something of business as usual,” Bhethanabhotla said. “As a doctor you can’t do anything, ... it’s not something where you can act. So you just go with the flow.”

And many Indians do. Horns blow in the distance outside the AIIMS campus and yellow, three-wheeler rickshaws speed by. Grainy brown smoke clouds the air, while pedestrians trudge over the dirt edges of the road, their leather slip-ons navigating the dusty terrain.

India will tread on, as it always has. The nation that produced the likes of Gandhi and boasts a population of nearly 1.4 billion can surely produce a handful of decisive challengers to its colonial powers.

Be they a western empire or a bankrolled university. ♦

PRECIOUS GOLD written by TEDDY ROSENBLUTH photographed by LIZ KETCHAM designed by CALLISTA WU

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S RUPAM HIS FATHER IS NOT THE TYPE TO

arat Kumar Borah had been taking enzalutamide for six weeks when he told his son he wanted to give up the medication.

It was helping a little with his prostate cancer symptoms – his headaches were milder, some days he had more energy – but he became livid whenever he thought about the price of the drug.

“I’m drying up your funds,” he told his son. “I am old. What is the point of me living any longer if it’s going to finish everyone’s reserves?”

Without insurance to cover the cost of the medication, Sarat Kumar had heavily relied on his son, Rupam, to help pay for the drugs. Even with the leftover box of medicine the doctor gave him, Rupam estimates he spent around 25,000 rupees on different treatments, nearly a quarter of the average annual salary in India.

Rupam insisted his father is not the type to give up.

“I’m going to fight this damn thing out,” his father had joked just weeks earlier. “Who do you think you’re dealing with?”

But now it’s different.

Although he owns a successful design business, Rupam has stopped eating out, going on vacations and dipped well into his youngest daughter’s college fund, leaving him up most nights trying to piece together a plan to send her to university.

“I’m just trying to tell her, ‘Finish your (12th grade) and hold on. Let’s see how we do,’” he said. “I can’t break her heart.”

Even if the medicine were to be just a little less expensive, it would help, he said. But, in the next couple of months, the price of enzalutamide could dramatically increase.

In 2016, the patent for enzalutamide, a “wonder drug” for late-stage prostate cancer discovered by UCLA, was rejected by the Indian Patent Office – a decision many saw as a step toward affordable medication.

Generic versions of the drug flooded the market, offering enzalutamide at a fraction of the cost of the name-brand drug, Xtandi. Though it still wasn’t as cheap as chemotherapy, consumer advocacy group Knowledge Ecology International estimated the cost of a pill could be driven down to 50 cents as more generic companies joined the market.

Then, in May, UCLA appealed the decision to the Delhi High Court and won. The court sent the patent back to the Indian Patent Office to evaluate anew.

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We will have to live by the reality that he will have to pass away sooner. That’s it.

What else can we do?

- R U PA M B O R A H

”

If the office approves the patent, the decision would outlaw the generic brands of enzalutamide, leaving only Xtandi, a medication with a daily dose that is up to 70% more expensive than that of the generic brands.

In 2007, the University of California and 11 other universities signed onto a set of ethical licensing guidelines that emphasized the “consideration of the needs of people in developing countries,’’ according to the document.

But to most critics, their pledge was little more than a PR stunt.

As it was signing its goodwill gesture, UCLA was wrapping up the licensing agreement for Xtandi, with no provisions to insure patients in developing countries would be able to afford the drug.

Rupam and countless others would not be able to afford the medication if the patent were approved. Spending a quarter of his salary on medicine was unaffordable – spending 40 times his salary was impossible.

“We will have to live by the reality that he will have to pass away sooner,” he said. “That’s it. What else can we do?”

In a small lab on the south end of UCLA’s campus, chemistry professor Michael Jung spent most of his career as an organic chemist, developing new ways to synthesize chemicals.

For 45 years, he was content tinkering away at basic research questions and publishing results in journals like

36

Tetrahedron Letters. Then, on his 55th birthday, his wife pulled him aside.

“What do you want to do for the rest of your life,” she asked. “More of the same?”

Jung said he always dreamed of finding a cure for a human disease but never had the guts to try it. Some researchers worked years on developing a medication with nothing to show for it.

The day after his birthday, a colleague asked if he wanted to join a project dedicated to creating a prostate cancer drug. He took it as a sign.

He knew almost nothing about prostate cancer, but thought he’d give it a try anyway. At worst, people would just think he decided to take an early retirement, he said.

A couple of years later, in 2009, he published a paper in Science, introducing two new molecules that could drastically alter the way prostate cancer was treated.

While chemotherapy moves through the body quickly and indiscriminately, wiping out cancer cells and any other quickly dividing cells, like bone marrow, enzalutamide clicks into receptors on the surface of prostate cancer cells, blocking the hormones that cause them to grow.

Stephen Freedland, a urologist at Cedars-Sinai Medical Center remembers the excitement around enzalutamide and other similar drugs.

“There weren’t a lot of options for men. It’s kind of like, ‘Sorry life sucks,’” Freedland said. “Then, all of a sudden, we had a drug that could salvage a lot of these guys and just

buy them time, a good quality of life.”

Chemotherapy often leaves patients bedridden with nausea. In contrast, patients on enzalutamide can usually maintain their normal lifestyles – many of Freedland’s patients only complain about occasionally feeling foggy.

In early clinical trials, for late-stage prostate cancer patients who had already exhausted hormone therapies and chemotherapy, enzalutamide extended their lives by five months. In oncologist circles, the result was promising – usually treatments that work for late-stage cancer patients work even better for early-stage patients.

Two years later, the medicine proved so successful that scientists stopped the clinical trial short, after it significantly reduced death rates in patients before they started chemotherapy, which has traditionally been given to patients as a last course of treatment. Then, in August, the Food and Drug Administration approved enzalutamide for patients before they even started hormone therapy, one of the first lines of defense against prostate cancer.

Freedland thinks enzalutamide could eventually turn prostate cancer into a chronic illness – something you can live with for years, like diabetes or asthma.

“We are in a Renaissance period in the medical therapy of prostate cancer,” said Thomas Flaig, lead doctor in an enzalutamide clinical trial. “Even at this early stage, enzalutamide is a game changer.”

By weight, Xtandi is 65 times more expensive than gold.

In the United States, that is 2.5 times the annual per capita income. In India, the name-brand drug costs more than 38 times the per capita income.

Rajeev Kumar, a urologist at a public hospital in Delhi, said if the patent were approved, almost none of his patients would be able to afford the medication. His patients already struggle to afford the generic brands, he said.

Many of them run out of money a couple weeks into the treatment plan and stop taking the pills. Others, aware they will inevitably exhaust their resources, refuse the

“

We are in a Renaissance period in the medical therapy of prostate cancer. ... Even at this early stage, enzalutamide is a game changer.

- THOMAS FLAIG

prescription from the beginning.

With the patent, even his wealthiest patients would be unable to afford the medicine.

In the United States, 80% of patients with insurance have a copay of less than $25 a month for Xtandi. In India, Kumar estimates less than 20% of his patients have insurance.

If they do, their insurance policies usually cover a fixed amount of medical expenses for the entire family, which Xtandi would quickly deplete.

Rupam has seen the worst of it in the hospital, as he waits for his father’s appointments – children, mothers and wives sobbing next to him, coming to terms with the

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”

EXCEPT TO MANY, IT DIDN’T SEEM AS IF THE WAS TRYING TO SERVE THE

fact that they can’t afford medication.

“I’ve seen those kinds of people in hospitals,” he said.

“I’ve seen them. I mean, they just cry. They are completely helpless.”

Most of the men he has talked to in the hospital can scrape together enough for about a quarter of the cost of one box of enzalutamide. Sometimes he gives money to other patients at the hospital.

Stretch it for as long as you can, he tells them.

If the pills were to become more expensive, Kumar isn’t sure he would even prescribe enzalutamide to his patients anymore. A couple of months of life is only worth so much financial stress.

“I know if I offered it to (a patient), he would take it, and that’ll end up destroying his family,” he said. “The next generation (will be) in debt for the next 10 years.”

Even as an established doctor and professor at a widely respected hospital in Delhi, one box of Xtandi would cost Kumar an entire month’s salary.

“Would I give it all up to extend (my life by) a couple of months?” he said. “Probably not.”

Enzalutamide ultimately made the University of California more than a billion dollars.

Even for the UC, which owns the most patents out of any American university, the drug generated more money for the University than any other patent sale.

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“We are strategically supporting one of our essential missions – funding and generating research with practical applications that serve the public good,” said UCLA Chancellor Gene Block in a university press release following the deal.

Except to many, it didn’t seem as if the university was trying to serve the public good.

First, there was the $1.14 billion dollars, which sat in a portfolio, generating $60 million dollars for UCLA every year.

To R. Joseph Trojan, a pharmaceutical patent lawyer based in Los Angeles, it was simple economics – the more the UC charged for the patent, the more pharmaceutical companies would have to increase the price of the medicine to recover what they had spent.

“Where does it think the money was going to come from?” he said. “It was coming out of the pockets of people who need the drug. Why are you driving up the cost of these drugs by demanding a billion-dollar licensing fee upfront? That makes no sense at all.”

Furthermore, although researchers used public funding from the National Institutes of Health and the U.S. Army’s prostate cancer research programs to discover Xtandi, UCLA was actively pursuing a patent that would make it inaccessible to the public.

“It wasn’t even your money you were investing, and still you demand a billion dollars for the effort,” Trojan said.

Then there was the language in the licensing agreement.

With no clause to protect developing countries, the

agreement seemed to directly contradict its own licensing guidelines, which say the University “should consider such public benefit and broad societal needs when developing licensing strategies.”

John Mazziotta, the vice chancellor of UCLA Health Sciences and CEO of UCLA Health, said these ethical licensing guidelines are not always prescriptive, explaining there are a “variety of complex and potentially contradictory issues” that need to be taken into account when drafting licensing agreements.

Producing and testing medicines are expensive, he argued. A pharmaceutical company might not agree to produce the medicine at all if there was a clause limiting the sales in developing countries.

Still, advocates have long been skeptical of that argument given other companies, such as the French NGO responsible for a successful gene therapy, have included reasonable pricing clauses and have still been able to license the patent for millions.

Other institutions, such as Harvard University, have been able to include global access provisions for about half of their pharmaceutical licensing agreements. The clauses allow generic companies in developing countries to produce their patented medications. They also allow Harvard to refuse to prosecute a patent in a developing country.

Although the UC created a committee to oversee the inclusion of similar clauses in 2009, there have been no concrete changes or a timeline to implement these changes.

Without those provisions, if Medivation, a biopharmaceutical company that helped manufacture Xtandi, wanted the UC to prosecute a patent that could take medicine away from

thousands, the University has no legal avenue to refuse.

The UC ultimately appealed the patent decision on a technicality – it claimed the patent office hadn’t taken into account a piece of evidence.

To argue its case, it hired P. Chidambaram, the former Union Minister of Finance in India, who had been accused of money laundering as early as 2013 and spent 14 days in September in jail with his son on corruption and money laundering charges.

The Delhi High Court ruled with the University, sending the patent back to be reevaluated.

Neda Ashtari, a second-year medical student at UCLA, stood on the stairs of Powell Library wearing all black.

In front of her were dozens of white paper bags, each with a small plastic candle inside and a name scribbled on the front in colored marker. Students sprinkled plastic rose petals in between the bags, a sort of vigil for what they called the “lives lost as a result of UCLA’s inaction to drop the patent on Xtandi.”

Ashtari protested the patent appeal in India for years. In a UC Regents meeting, she stood in front of the UC leadership and demanded change.

“For one moment can you just step outside yourselves and imagine having to choose between the roof over your head and the (medicine) you needed to stay alive?” she asked. “Can you imagine the guilt you would feel if all of your family’s income went to your (medical) bills? Would you even want to live at that point?”

Students sprinkled plastic rose petals in between the bags, a sort of vigil for what they called the ‘lives lost as a result of UCLA’s inaction to drop the patent on Xtandi.’

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But now, standing in front of the bags of names, she seemed quieter – more defeated than angry.

The pleading at regents meetings, the public protests and the letters to the UC president’s office – the first one signed by 56 civil society organizations and doctors, and then another with 3,500 signatures – had been mostly ignored.

To her, UCLA’s choice to defend the Xtandi patent was personal.

Her mother was diagnosed with breast cancer when she was 4 years old. For 12 years, as her mother’s primary caregiver, she fought with insurance companies to get medication. She had lost her house, her father, who had left under the mounting stress over the cost of treatments, and eventually her mother.

She said the worst part wasn’t saying goodbye to her mom, it was knowing the same financial nightmare would happen over and over again.

“They say time heals all wounds, but it hasn’t,” she said, her voice breaking up. “I still live with the consequences of these policies every day.”

In a small coffee shop on the outskirts of New Delhi, Rupam flipped through pictures of his dogs on his phone.

He showed, Bella, affectionately called “Bella the Beautiful,” whom he found badly beaten on the side of the road, Phi Phi, whom he rescued on the way back from his vacation in Thailand, and Coco, whose paw was run over by a car.

He has a soft spot for stray dogs. He fosters stray puppies, pays to neuter dogs and even puts out bowls of dog food on the street in front of his house.

Feeding the dogs is getting harder. Paying for everything is getting harder.

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Rupam’s business had been slowly declining for months.

When the economy is bad, the last thing people want to do is redecorate their houses, he said. Worried about the future of his company, he started teaching his employees the skills they would need to start their own businesses.

Regardless, he tries to stay positive, especially around his father – he’s seen too many children turn cold and resentful toward their parents under the financial strain of treatment.

He cooed and zoomed in on the well-groomed hounds as he went through tens of photos, occasionally stopping to take a sip from a clay cup of chai. In one, a dog with short white fur and pink ears flashes a soft, squinty smile at the camera. In another, Rupam is nuzzled into the dog’s fur as the brown and white mutt playfully nibbles at the hand wrapped around him.

When he tells his story, he speaks calmly and matterof-factly. If his mother had been at the table, though, he wouldn’t be able to keep it together, he said.

He’s wracked with guilt over the whole situation – that his oldest daughter walks dogs to help pay for her sister’s tuition, that he had to take back money from his mother to cover the cost of medication.

Rupam doesn’t blame his father for having wanted the medicine, but he wouldn’t choose enzalutamide for himself.

“I would opt for euthanasia any day,” he said. ♦

THE BODY SNATCHERS written by SUSAN MONAGHAN illustrated by CLARA VAMVULESCU designed by CALLISTA WU PRIME | FALL 2019 PRIME | WINTER 2020

41 41

Two prison sentences.

Multiple lawsuits from horrified family members.

A bag of unidentified body parts.

T

he downfall of the UCLA Willed Body Program, the country’s first program to accept dead bodies for medical research, began when the director of the program, Henry Reid, sold hundreds of cadavers from the university’s morgue.

For five years, middleman “body broker” Ernest Nelson paid Reid in cash and cashier’s checks for cadaver parts. Nelson visited UCLA’s medical center two times a week to take saw off pieces of the bodies, store them in coolers and cart them to a rented warehouse until he could find a buyer.

Reid had a constant stream of revenue – an average of 175 people had been donating their bodies to UCLA annually around the time of the scandal. Pieces of those people were shipped out to more than 20 private research corporations – most notably, multinational company Johnson & Johnson – for hundreds of thousands of dollars.

At the end of a three-year investigation, the program could not account for hundreds of bodies and had bags of unidentified appendages, like hands and feet. Nelson had netted more than $1 million.

Reid and Nelson were arrested in March 2004. Reid pled guilty to the charges and was sentenced to four years and four months. Nelson was sentenced to 10 years.

When the illegal activities became public, the news made national headlines and the body donation program, which had accepted bodies since the 1950s, shut down for more than a year.

Donating your body to science is a relatively new concept. Until recently, having your corpse splayed out for medical students was considered punishment, not a gift.

An English law titled the Murder Act of 1752 made it possible to punish high crimes by dissection.

The United States later adopted a similar law as a provision of the Crimes Act of 1790, allowing judges to add dissection onto a death sentence.

While the execution was a threat to one’s life, dissection was an assault to one’s soul.

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Pieces of those people were shipped out to more than 20 private research corporations.

The need for cadavers quickly outpaced the number of executed criminals after universities started offering anatomy classes. Many resorted to buying bodies from grave robbers – sometimes, medical students and doctors dug up the bodies themselves.

This practice ended after the public started seeing familiar faces on the surgery table. Once, at the Ohio Medical College, visitors found the body of a U.S. senator. The public became so angry at anatomists that, in 1788, a mob ran into New York Hospital and beat medical students, according to a piece by the Albert Einstein College of Medicine.

The protest ultimately ended in the death of three rioters and three militiamen. Shortly after, New York passed a law against grave-robbing.

Over time, the stigma against postmortem dissection decreased, and some prominent physicians and wealthy individuals made it a point to donate their bodies, such as the wealthy horse dealer Thomas Orne, who donated his body in 1899.

In the 1950s, UCLA established the first willed-body program in the world.

Horace Magoun, the chair of the anatomy department at the UCLA School of Medicine at the time, made an announcement in the Daily Bruin: More than 100 people had donated their bodies to the university.

Though most people would not be able to gift large sums of money to the medical school, which had opened just prior to the program, the donation of bodies for teaching and research was a splendid

contribution to medical progress, he wrote.

By signing a statement provided by the anatomy department, anyone 18 years or older could donate their body for use after death.

Two years later, Magoun said UCLA had received almost 300 bequests, and about 80% of the bodies used to teach medical students were willed. By 1955, the program had received enough will forms to fill the

�

school’s needs for 30 years and temporarily stopped taking bequests.

Other universities followed suit and established their own body donation programs – today, almost every major research university has one.

But the body program that revolutionized cadaver practices has been riddled with scandal.

In 1993, a funeral-at-sea director in Santa Monica

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Bay, who was contracted by UCLA, found a mix of gauze, glass vials and a rubber glove in the ashes of a container for cremated remains. The revelation occurred amid investigations by a local environmental group into allegations UCLA had been illegally dumping into the bay for 22 years, according to the Daily Bruin.

A man who brought UCLA cadavers to the crematorium in the mid-1990s testified that when bodies couldn’t be cremated because they weren’t identified, UCLA employees simply cut off their heads, according to the Los Angeles Times. Bodies without heads are exempt from being identified.

Soon after, families of cadaver donors sued UCLA for throwing their loved ones’ ashes in dumpsters and landfills.

UCLA settled with the California Department of Health Services in 1994 and agreed to rework its policies for handling donated bodies, according to the LA Times.

Then, 10 years later, the news broke that Reid was selling

44

body parts.

While Reid and Nelson were both convicted by grand juries and sentenced to prison time, the state Supreme Court ruled in 2010 the university had no legal obligation to the families of the deceased whose remains were abused.

The dozens of family members who had filed suits against the UC Regents were left without restitution.

In the year following the scandal, stakeholders in the program, attorneys and risk specialists held a series of meetings to discuss policies that would prevent abuses, like the ones committed by Reid and Nelson, of the program in the future.

Brandi Schmitt, the former interim director of UCLA’s Donated Body Program and the current director of anatomical services for the University of California Office of the President, was hired by UCOP about a year after UCLA’s willed-body program shut its doors.

Schmitt said the mood across the UC system’s programs after the news broke was heartwrenching.

“People who work in the donor program have dedicated their careers and their professional reputations to running a

Soon after, families of cadaver donors sued UCLA for throwing their loved ones’ ashes in dumpsters and landfills.

body donation program, where people in the community are gifting their bodies to us,” she said.

Throughout the following year, each body donation program in the UC system was audited by an internal auditing service, and a consulting agency was hired to personally oversee the body donation process, Schmitt said.

The meetings included a large leadership group, including a former governor of California, who met with staff members to talk through the specifics of the program.

The staff members were tasked with explaining their roles in the body donation process, down to their day-to-day

“

For now, the insensitivity that allowed the pair to take advantage of the trust invested in the program by hundreds of willing donors is a mystery not likely to be solved. obligations.

Schmitt suggested implementing a standardized system for tagging and tracking bodies and body parts for donors.

This system exists in the donation process at UCLA today, according to the Anatomical Donation/Materials Programs policy guide.

The Digital Donor Library, or the Anatomical Materials Registry, manages and tracks “anatomical preparation, handling, inventory management, allocation, and disposal of anatomical materials,” according to the guide.

The actual mechanisms of the library’s tracking system – what materials are used to track the bodies, what details fall under which stage of the bodies’ preparation or who records what information – are not specified.

Schmitt said employees who stayed on after the program’s policy changes are extremely dedicated to the work they do. The technical aspects of the job, the dayto-day handling and sorting of cadavers, are not easily divorced from the lives of the bodies themselves.

“Working in a body donation program, I’ll say, is not a job suited for everybody. It’s not the kind of job where you go to work and you can just leave it behind,” Schmitt said.

“You deal with people’s loved ones, people’s grief, people’s medical histories and all sorts of very personal issues, and so it really takes someone who’s dedicated.”

Of course, UCLA’s program knows the body donation field suits some people better than others.

While it is easy to talk about how emotionally draining

the job can be, it’s hard to account for Reid and Nelson’s overt apathy. For now, the insensitivity that allowed the pair to take advantage of the trust invested in the program by hundreds of willing donors is a mystery not likely to be solved.

The scandal has not deterred everyone from donating their bodies, though.

William Grisham, a behavioral neuroscientist and adjunct professor at UCLA, said he plans on donating his body to the university. “(I’m) beyond interested,” he said. “I’ve already done the paperwork.”

He sees donating his body as a sort of symbolic gesture – a fitting end to a career filled with cadavers.

“Someone did this great act for me to give me the privilege of studying their body,” he said. “I want to pass it on to future students.”

He said he hopes his brain ends up back in the psychology department, where he uses donated human brains to teach neuroanatomy in his behavioral neuroscience laboratory class.

Grisham has three brains on loan from the UCLA Donated Body Program. He keeps them in containers with preservatives and takes the formaldehyde-scented organs out for demonstrations during class or exams.

Despite their smell, the brains, Grisham said, are priceless, and while artists do a wonderful job making models and drawings, nothing can beat seeing the real thing.

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“

It’s an abomination that should have never happened.

- WILLIAM GRISHAM

On models, the grooves are deep and obvious, while on a real brain the big central sulcus might blend right in with all of the other folds. On a model, the artery that brings blood into the brain is usually red and exaggerated. On a real brain, one can hardly see it.

Grisham is careful to treat each brain with the utmost respect. Each brain has to stay with a brass label that identifies it. While students can take pictures of sheep brains to study the anatomy, taking pictures of the human brains is strictly forbidden.

“You can’t do things like take a selfie with the human brain,” Grisham said. “It’s somebody’s remains and you have to be respectful.”

Grisham said he doesn’t believe he’ll have any consciousness after he has died. Still, the body-selling scandal in 2004 deeply disturbs him.

“It’s an abomination that should have never happened,” Grisham said. “It was disturbing, very disturbing to hear.”

Jay Phelan, an academic administrator in life sciences who also plans to donate his body to UCLA,

46

is less concerned about his body parts being misused.

He said he doesn’t attach any particular significance to his body once he’s dead.

He’s more concerned that, because of the size of the classes he teaches, some of his former students will see him as a cadaver. Because of his excessive sun exposure, Phelan says he’s fairly confident he would be used as an example of damaged skin for medical students.

“That might be weird if I donate my body (and a student) was like, ‘Oh no, this is Professor Phelan,’” he said.

Rhonda Murotake, a laboratory administrator in the life sciences department who helped Phelan purchase a human brain for his class, said it is nearly impossible to get human remains because of the new strict regulations on the treatment of bodies.

Murotake said the brains she uses are kept locked somewhere on campus.

“And I’m not going to tell you where that is,” she added. ♦

STAFF prime.dailybruin.com Teddy Rosenbluth [PRIME director] Anushka Jain [PRIME content editor] Nicole Anisgard Parra [PRIME art director]

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Pauline Ordonez, Omar Said, Lauren Man, Alissa Evans, Keshav Tadimeti, Teddy Rosenbluth, Susan Monaghan

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