The Code: 2011

Wednesday, September 14, 2011

5 Shocking But Real Medical Conditions Linked To Video Games (Retro Repost)

Note: This article was originally published as part of my time as an Associated Content Featured Contributor to the Video Games Section. Associated Content was later bought by Yahoo! and renamed Yahoo! Voices. Yahoo Voices shut down in July of 2014. This article is being republished here on The Code, backdated to its original date of publication to remain as a record of my writing.

From your parents scolding you not to play video games so close to the television, to opinion and editorial pieces in newspapers across the country calling video games the next harbinger of a violent society, video games are blamed for a host of maladies, both social and physical. Video game players might be forgiven as dismissing old wives' tales, or ignoring talking-head pundits blustering about video games. When medical experts begin to weigh in with conditions they have seen in patients, it might do well for even the most hardcore gamer to sit up and take notice. Here are 5 shocking but true medical conditions that have been linked to playing video games.

5. Acute Wiiitis

Dr. Julio Bonis, a practitioner of family medicine in Madrid, diagnosed and named a muscle injury he called "Acute wiiitis" in June 2007. He first noticed the condition, pronounced "wee-eye-tiss", when he awoke after a playing a few rounds of the Wii Tennis game the night before. While the injury was similar to the strain tennis players are at risk of, appropriately named "Tennis Elbow", his injury was in the wrist and forearm area. He noted that his colleagues had made similar observations or complaints of injury and muscle fatigue after playing Wii Sports. Luckily, the treatment, as outlined in the New England Journal of Medicine was fairly simple: take ibuprofen for one week, and abstain completely from playing any Wii video games.

Of course, this wasn't the first time playing games for a Nintendo console had sparked diagnosis of an injury. If one looks back a few generations to the heyday of the Nintendo Entertainment System, one will find doctors talking about a malaise affecting hardcore gamers of the 1980s called...

4. Nintendinitis

First discussed by Dr. Brazington in the May 17th 1990 issue of the New England Journal of Medicine, Nintendinitis (also called “Nintendo Thumb”) is a repetitive strain injury caused by overuse of the directional pad on the NES controller. The main symptoms of Nintendinitis are blistering, swelling and acute numbness of the digits. The extremity most commonly afflicted with Nintendinitis was the thumb, but any finger used to operate an NES controller was diagnosed as at risk for the affliction. Nintendinitis can also be a precursor to other repetitive strain injuries like carpal tunnel syndrome. The recommended treatment for Nintendinitis was usually a short regimen of anti-inflammatory medication, an over the counter pain reliever and strict time limits on the length of video game play sessions.

Nintendo isn’t the only video game console manufacturer to have its own ailment. The Sony Playstation alarmed some dentists with one malady dubbed…

3. Playstation Lip

First noted in the June 10th, 2000 issue of the British Dental Journal, “Playstation Lip” had two dentists, R. L. M. Inglis and R. R. Welbury quite concerned. They noted two separate patients that came to their office with severe lower lip trauma. When further questioned, the patients admitted to intensely chewing and sucking on their lower lips while concentrating on playing Playstation games. Other symptoms included jaw muscle fatigue and bleeding of the inside of the lower lip.

While the usual treatment recommended for Playstation Lip is a matter of relaxation techniques and learning to modify one’s beahavoir when concentrating, in these patients’ case the lowerlip trauma was so severe that they required to use of soft splints and mouthguard-like shields for the gums. Of course, while the conditions outlined so far are injurious but not life threatening, there can be more severe consequences.

2. Video Game Induced Epileptiform Seizures

The first case of an epileptiform seizure that was linked to playing video games was reported in 1981. Over the past 30 decades, hundreds of cases of eliptiform seizures triggered by video games were reported. Further study has shown that the risk of seizures are not for younger children with photosensitive epilepsy (where seizures are triggered by light), but also in children and adolescents with epilepsy that are not photosensitive at all. This increased risk is why most video game published place warnings about an epilepsy risk in video game manuals, and sometimes in the video games or console startup sequences themselves.

There currently is no known cure for photosensitive epileptic seizures, so most of the treament methods treat symptoms, along with a healthy dose of risk prevention. The most important steps for prevention of these seizures when playing video games: take a 15 minute break every hour, play in a well-lighted area, and to make sure you’re at least 6 to ten feet away from the television when playing video games.

One curious case went even further than the possibility of triggering seizures, when a teenager came down with a case of…

1. Traumatic Mental Detachment

In late 2008, 13 year old Lorenzo Amato was found by his father, curled up in a state of shock, and appearing as if in a stupor. Lorenzo did not talk, respond to questions, or even seem to know where he was. When he was rushed to the emergency room, doctors thought Lorenzo might have suffered a stroke or aneurysm. Later, they determined that this had happened after a marathon session in front of the Playstation. Antonio Buccoliero, a local politician, told reports that “…once [the doctors] understood that this was a strange kind of mental detachment connected to his PlayStation,” they were able to successfully treat Lorenzo. Lorenzo later told reporters that he asked his father to throw out his Playstation, saying “If I even think about it I want to throw up.”

While these conditions are strange but true, the key to continuing to enjoy playing video games without tying your muscles up in knots, harming your lips, or placing yourself at risk for light-induced seizures and eyestrain is moderation. According to the Mayo Clinic, taking breaks after every half hour, stopping when you get tired or feel fatigued, and resting your eyes if you feel sore, dizzy or nauseous will go a long way towards making sure you enjoy your favorite video games without taxing your body.

Sources:

http://www.reuters.com/article/idUSN0616721120070606

http://www.sportsscientists.com/2008/01/computer-games-continued.html

http://www.wired.com/culture/lifestyle/news/1998/12/16579

http://www.ncbi.nlm.nih.gov/pubmed/2330022

http://www.mja.com.au/public/issues/173_11_041200/koh/koh.html

http://www.ncbi.nlm.nih.gov/pubmed/14706041

http://iospress.metapress.com/content/nlw6et6ub0r13tmj/

http://www.qj.net/qjnet/playstation-3/playstation-addict-diagnosed-with-mental-detachment.html

http://www.mayoclinic.org/medical-edge-newspaper-2009/mar-13c.html

Tuesday, January 11, 2011

Retro Repost: Penny Arcade, Game Culture & Rape

On August 11, 2010, the web comic Penny Arcade presented a comic strip titled "The Sixth Slave". According to the news post for that comic, it was based on a real quest in an MMORPG, and intended to lampoon the sort of punch-clock morality introduced by having to repeat the same instance of a quest over and over for new players. In the first panel, an armor-clad hero strides past a ragged slave, who calls out, "Hero! Please, take me with you! Release me from this Hell unending!". The second panel is a close-up of the slave's haggard face as he continues, saying, "Every morning, we are roused by savage blows. Every night, we are raped to sleep by the dickwolves!". In the final panel, the hero replies, "I only needed to save five slaves. Alright? Quest complete." As the slave protests with a "But..." the hero interjects, "Hey. Pal. Don't make this weird."

The reaction to the comic from fans, writers, and rape survivors touched off a firestorm of controversy, and apparently took the creators by surprise. Commenter Sydera in a discussion thread on the feminist blog Shakesville theorized that "...the reason this cartoon thought a rape joke would be funny is the pervasive use of 'rape' among WoW players to mean something other than rape."

Others pointed out that since rape isn't an explicit part of most video games and was only part of the set-up to the joke, something else equally over-the-top and horrible could have been substituted for being "raped to sleep by dickwolves" without losing the humor of the punchline. Others wondered if the joke would have been as funny if it were a child or a woman instead of a man making the pleas. But the most common criticism leveled at the comic was that using rape as the set-up to a punchline was part of larger problem of both male-centric gaming culture and society at large: jokes about rape inadvertently reinforce a social climate where real pain from rape survivors is minimized. Shaker Milli A, in a guest post on Shakesville, said that this is especially damaging"...because rape survivors exist among us, and after being victimized by rapists, they are re-victimized by a society that treats even real rape like a joke, forced to live in a culture that actually has a lot of rape jokes... because people don't take rape seriously."

The creators of Penny Arcade, Mike Krahulik and Jerry Holkins, seemed surprised and even angry at the criticism. Kahulik responded on Twitter, saying "I don't feel like we made a mistake... Some people seem to work really hard so that they can be mad. Life is too short." When it was pointed out that rape jokes have the potential for triggering severe traumatic responses in survivors, Krahulik replied with "[T]he idea that our cartoon could cause 'significant trauma' is bat s*** f***ing insane."

The pair released a follow-up comic two days after "The Sixth Slave" that featured the comic's two main characters, Tycho and Gabe, directly facing the viewer. In the first panel, Tycho says "Hello, this is Tycho Brahe, of Penny Arcade. We recently made a comic strip where an imaginary person was raped imaginarily by a mythological creature whose every limb was an erect phallus. Some found that idea disturbing." Gabe chimes in with "We want to state in clear language, without ambiguity or room for interpretation: We hate rapers, and all the rapes they do. Seriously, though. Rapists are really the worst." In the final panel, Tycho, Tycho says, "It's possible you read our cartoon, and became a rapist as a direct result. If you're raping someone right now, stop. Apologize. And leave. Go, and rape no more!" In the comic's related news post, Kahulik said "Did the [previous] comics about bestiality, suicide, murder, pedophilia, and torture not bother them? Or how about the fruit f***er? I mean, we have a character who is a literal rapist. What comic strip have they been reading all these years?"

Melissa McEwan responded by pointing out that "No, one rape joke does not 'cause' someone to go out and commit a rape. But a single rape joke does not exist in a void. It exists in a culture rife with jokes that treat as a punchline a heinous, terrifying crime that leaves most of its survivors forever changed in some material way." According to the Community Counseling Centers of Chicago, a third of rape survivors can develop post-traumatic stress disorder. McEwan further explained that "...rape jokes trigger (some) survivors of sexual violence... A survivor of sexual violence who experiences a trigger is experiencing the same thing as a soldier who experiences a trigger, potentially even including flashbacks... [and] post-traumatic stress disorder". This is why I have chosen to place a trigger warning at the beginning of the article.

A charitable interpretation of the official response from Penny Arcade is that Krahulik and Holkins were upset and defensive. There was hope that the many posts from gamers and bloggers along with emails containing critical responses from fans in the wake of the "Sixth Slave" comic could help the duo realize that the bigger problem wasn't that the inclusion of a rape joke was unnecessary and potentially offensive, but that the joke and their response were potentially triggering. In the months after the controversy, they had the time to educate themselves about post-traumatic stress disorder and trigger warnings. However, on October 8th, Krahulik posted the following introduction to his podcast about Dungeons and Dragons: "Trigger Warning for attempts to coerce laughter through foul language, Dungeons, Dice rolling, contempt for Hydra's bodily autonomy, [and] Dragons". Immediately following this post, Holkins posted an announcement for one of two new shirts on sale: a "Penny Arcade Dickwolves" shirt, done in the manner of a sports team logo. Shortly thereafter, Penny Arcade also added a Dickwolves pennant.

I personally feel that with a news post mocking trigger warning and PTSD victims, followed by the sale of a "Penny Arcade Dickwolves" T-shirt, Mike Krahulik and Jerry Holkins progressed from being ignorant, insensitive and unintentionally offensive to outright deliberately cruel, all while trying to exploit the controversy and pain caused in the wake of the "Sixth Slave" comic and their response for a profit. Penny Arcade is a website that draws millions of views every single day. They run two separate video game conventions. MTV Online has called Krahulik and Holkins "...the closest the medium [of video games] has to leaders of a gamers' movement." They created the Child's Play charity originally to combat the negative stereotypes about people that play video games and have raised nearly 9 million USD for children's hospitals over 8 years. They were listed as part of the 2010 Time Magazine 100 people that "most affect our world". Yet they have offered the defense that the comic and the resultant merchandising is not supposed to be influential or taken seriously. Either they can influence their audience, or they can't.

When they published "The Sixth Slave", I was willing to give the duo the benefit of the doubt. I wanted to believe that Krahulik and Holkins were only being clueless out of ignorance, not being malicious on purpose. Of course, intent doesn't mitigate impact. If you're doing a funny dance for a bunch of people and you accidentally step on someone's foot, it's still going to hurt, even if you didn't mean to step on anyone's feet. When Penny Arcade published the follow-up comic after making several angry and defense responses, I could no longer willfully make an assumption of good faith. Mocking trigger warnings, and by extension PTSD, along with selling a Dickwolves t-shirt and pennant has led me to conclude that they are being malicious on purpose for their own satisfaction, and to make a quick buck.

The problem with using rape as part of punchline is that is adds more to the cultural waters where rape is not taken seriously. As mentioned before, recounting of rape can has the potential to trigger awful traumatic reactions in survivors. And the number of survivors of sexual violence is very large indeed. According to RAINN, 1 in 6 women and 1 in 33 men will be sexually assaulted in their lifetime. Despite the high percentage of women who are survivors of sexual violence, many people making rape jokes tend to think of rape as an abstract thing that is horrible and wrong but hasn't happened to them, nor to anyone they know. So they feel free to make jokes about a shocking subject, thinking that since they don't mean any harm, they won't be harming anyone. This adds to the pervasive attitude that rape is just some nebulous thing that happens to "other people" and a dismissive attitude has no real impact. That attitude, in turn, in turn leads to victims being less likely to tell someone who makes these jokes that they have been sexually assaulted.

According to RAINN, a little over 60 percent of incidents of sexual assault go unreported. This is partially attributed to the fact that prevalent attitudes regarding assault and rape make survivors reluctant to speak out. A critically-acclaimed video gives an example of this shame and silencing effect-- in Mass Effect 2, when Commander Shepard asks what the prison is like, one of the male prisoners answers makes lots of fidgeting and furtive glances and obliquely references the fact that other prisoners have stolen his clothes, his belongings and even his pride, and that he's been so afraid he hasn't showered in months. It is played for laughs. There is an entire category on TV Tropes about the use of prison rape as comedy. In the "Sixth Slave" comic strip, the slave begging to be saved from the fate of being "raped to sleep by the dickwolves" is a man. As a survivor of sexual assault myself, I can personally attest that constant jokes about male on male rape, casual use of rape jokes and rape as slang for losing (or winning) a video game by a wide margin have made me less likely to share my experiences, increased the level of humiliation and shame I have felt, as well as contributing to me feeling like an outsider at times in a community I wanted to belong to.

Krahulik wondered why this particular comic seemed to spark so much outrage when they have been doing offensive comics for years. Leaving aside the notion that people are allowed to chose what they devote their own mental energy to, as well as the fact that Penny Arcade is not an episodic strip with much in the way of continuity... the strip has been online since 1998. The number of people reading comics online has grown by leaps and bounds in the past 13 years. I personally think that the backlash might not be a matter of fans suddenly being upset with them, but instead reflect the first time that Krahulik and Holkins really couldn't ignore what they were being told.

The Dickwolves t-shirt doesn't turn gamers into rapists, but it does dismiss and trivialize a very real trauma. It can contribute to an atmosphere that can make victims of sexual assault-- of which women are the most likely-- feel unwelcome and ostracized from the gaming community, especially in light of the fact that there are two Penny Arcade conventions. An outfit isn't just something one uses to cover one's nakedness. As anyone giving job interview advice would tell you, your choice of outfit sends a message to the people around you. Many gamers or geeks will wear t-shirts that express a geeky side or love of video games. The Penny Arcade Dickwolves t-shirt looks like a team jersey of the kind typically worn by fans or supporters of their favorite sports team. So what sort of message are you sending when you wear a "team Dickwolves" shirt or display the Dickwolves pennant? I looked high and low for a "Sixth Slave" sports team t-shirt. Penny Arcade doesn't sell those.

One person who is, however, is producer and blogger Kirby Bits. Bits has responded by designing a shirt for the "Dickwolves Survivors Guild". The shirts are priced at a dollar over cost, Bits said, with 100 percent of the proceeds being donated to RAINN. When asked about his reasons for making the shirt, Bits said that "...the thing that motivated us into action was that if you're going to make a t-shirt... [the Dickwolves design] is about the laziest, most uncreative way to do that. And on top of that, they are literally profiting off of rape culture, which makes me sick to my stomach when I think about it for too long."

Even if you don't agree with the fact that placing rape and the trauma of rape survivors as part of a joke makes life worse, it is a demonstrated effect that these joke can trigger physical and severe mental trauma. Do you want to be a part of that? How can we, as members of the video game community, claim to be a part of the good that charities like Penny Arcade's Child's Play will do, but choose to ignore, dismiss or marginalize women gamers and survivors of sexual assault? Every single response from Penny Arcade-- a website that has proven to be enormously influential in both the effects it has on the video games industry and the audience it commands-- has sent the message that if you have been raped, if feel uncomfortable about rape jokes, or if you don't think that joking about rape is funny, then the video gaming community isn't really the place for you.

The official response from Penny Arcade to fans who emailed them, engaged them on twitter and pointed out the consequences of Penny Arcade's rape humor were mocked, insulted and ultimately ignored. The fact that Krahulik and Holkins now proudly sell t-shirts and pennants mocking the reaction and claiming allegiance via the "Penny Arcade Dickwolves" is a bitter irony when you consider that they used to sell a t-shirt with a drawing of geek icon Wil Wheaton emblazoned with the statement "Wil Says: Don't Be A Dick".

Sources: