Category Archives: Health

Crazies ‘R’ Us

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One of my alter-egos, Kookie the Shrink, with New-Age, eco-friendly, portable, non-pharmaceutical, public domain feel-good idea that hasn’t been invented yet.

Everyone knows psychiatrists are crazy.  Just ask my deceased mother, who claimed psychiatrists enter the profession to solve their own problems.  Fact is, I only began having problems in medical school.  My problems got worse after psychiatry residency, when I started practicing psychiatry in a “health care industry” so saturated with sanctimonious hypocrisy that I was astounded.  No one seemed to notice or care that externally imposed rules and expectations were making a mockery of the principles I was taught in training.  While everyone in the “health care industry” claims to be acting in the patients’ and public’s best interest, the so-called “healers” have become passive tools in a tidal wave of co-dependency that cripples to control and calls it “care.”

While “health care” professionals across the board have succumbed to this debilitating delusion, I feel particularly betrayed by the leadership in my own chosen specialty, because psychiatrists should know better.  I believe the psychiatric establishment has abdicated its philosophical foundations.  Instead of promoting mental health and self-reliance, it is busy kissing up to the profiteers in government, pharmaceutical and insurance industries, and seeking ever new ways to bind patients and the public to its mind-numbing agenda.

Two concurrent trends show how the psychiatric establishment–which depends on pharmaceutical advertising for its numerous professional publications—is desperately seeking relevance in a drug-pushing world.

The first trend, toward “medication-assisted treatment” for “opioid use disorder,” has been heavily embraced by the psychiatric establishment and the mainstream media.  The Friday, August 11, 2017 issue of USA Today claims “Opioids to be declared a national emergency.”  Here, we learn that President Donald Trump “’is drawing documents now’ to officially label the crisis as a national emergency.”  Such a designation would trigger specific tools for federal and state governments, including grants from the Public Health Emergencies Fund, a suspension of some of the patient privacy provisions of the Health Insurance Portability and Accountability Act (HIPAA) of 1996, and waive Medicaid restrictions on federal funding for mental health hospital admissions.

The second trend is the ongoing fight by the American Psychiatric Association (APA) and its state-level affiliates to stop the push by psychologists for prescription privileges.  This is an ongoing turf battle, with bills for psychologist prescribing introduced in multiple state legislatures every year.

The common denominator in these trends is that they are turf battles over drugs.  They have nothing to do with caring for patients, mental health, or the mind’s intrinsic self-healing potential.  The professional contestants, however, all claim they have patients’ best interests in mind.

Contributing factors abound.  In psychiatry, the shift from psychotherapy to medication management has been particularly devastating to professional self-esteem.  Psychiatry, now more than ever, seeks to align with the “scientific” foundations of medicine. Meanwhile, insurance and government have delegated “talk therapy” to less expensive psychologists and social workers.  What used to be 45-minute psychiatric consultations have become 15-minute “med checks.” Freud has been replaced by Prozac.

This follows a general cultural trend toward quick-fix solutions, with pills becoming the treatment of choice in all specialties except surgery.  The rise in illegal drug use can’t compare with the explosion of drugs for medical conditions, vaccines, and pseudo-conditions.  Over-medication is a major cause of accidents, drug interactions, and overdoses.  Unintentional injuries from falls and overdoses from prescription and illegal drugs are now the fourth leading cause of death in the US, according to one study.  Another study cites medical error the third leading cause in hospitalized patients.

The “opioid crisis” is attributed in part to Purdue Pharma’s misrepresenting OxyContin in 1997, when it was introduced, as having low abuse potential.  That same year, the FDA approved direct-to-consumer advertising. Pharmaceutical DTC advertising took off at the turn of the century.

That prescription painkillers fall in a different category from heroin—which cannot be prescribed in the US—bears mention, but they are linked by their black market affiliation.  OxyContin’s introduction on the market, and its aggressive marketing campaign to specialists and family practitioners brought Purdue Pharma $45 million in sales the first year.  That increased to $3.1 billion by 2010, or 30 percent of the prescription painkiller market.  In 2007, Purdue pleaded guilty in a federal lawsuit claiming it intended to mislead doctors and patients about its addictive properties.  It paid $600 million in fines.  The state of Kentucky, the state most ravaged by prescription painkiller and heroin use, has made 12 claims against Purdue, including false advertising, Medicaid fraud, unjust enrichment, and punitive damages.  OxyContin costs up to $1/mg on the street, or up to $80 for an 80 mg tablet.

Other reports say fentanyl, a prescription opioid that can be synthesized by drug traffickers, dramatically increases the risk of fatal overdoses.  Its deadliest component, carfentanil, is five thousand times stronger than heroin.  Add this to the fact that multiple common drugs and alcohol also depress the respiratory center, with a cumulative effect.  Benzodiazepines, like Xanax, are often taken along with opiates.

The “opioid crisis,” is now being traced to pharmaceutical companies and to the FDA, according to The Guardian’s latest report.  (www.theguardian.com/commentisfree/2017/aug/13/dont-blame-addicts-for-americas-opoid-crisis-real-culprits)

The collusion between the psychiatric community and the pharmaceutical industry to push drugs on a gullible public smacks of a cronyism that few seem to recognize.  The FDA-approved “medication-assisted” treatment for opioid use disorder contains two opioids—methadone and buprenorphine—which are also abused.  However, the psychiatric establishment, which has sub-specialties in addiction, has a piss-poor success record with addiction treatment and virtually ignores Alcoholics Anonymous and its spin-offs, like Narcotics Anonymous.  These are peer run, free, and have a better track record than the “experts” can claim, despite their education and degrees.  The APA also ignores non-pharmaceutical treatments like acupuncture, which even the NIH has admitted has utility in chronic pain.  Auricular acupuncture for substance abuse has a long and under-appreciated track record.

Where does psychiatric officialdom stand on the mental health advantages of low-stress lifestyles, nutrition, physical therapy, and exercise?  Ask, and let me know what you find out.

Crazies ‘R’ Us indeed.  The psychiatrists need to get off the drugs and learn to use their minds to heal themselves first.

 

July, 2007 Retrospective

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Ten years ago this month, I was working in a public mental health outpatient clinic, preparing to retire my medical and DEA licenses the following month.  These journal notes give a profile of my reasoning at the time.

GOSSIP AND SECRETS

Sunday, July 1, 2007 – I have been victimized by gossip more than once.  I tell patients therapy wouldn’t be necessary if not for gossip.

I remember excluding myself from cliques – the lunchroom crowd at Duke, composed of several girls in my dorm, and the group in medical school who gathered at lunch – because I didn’t like the mean-spirited gossip and chit-chat that characterized the gatherings.  I couldn’t sit with them without judging and seeing sides of them they couldn’t be proud of.

So I have been naive about gossip’s power.  In a culture built on hearsay, I am an odd duck, indeed.

Of course, my way is better, because it’s more practical.  I like forming my own opinions and always wonder what the gossiper’s agenda is.  I agree with Anne Scott, my history professor at Duke, who insisted on primary sources.  I believe in getting my information from the individual in question.  What he or she doesn’t tell or show me is none of my business.

In theory.  When people are plotting behind my back, it becomes my business, because I end up being the victim of their gossip.  I have been blindsided too often by those I trusted too much.

FREEDOM

Monday, July 2, 2007 – My unconventionality surprises me more than anyone.  Rather, I’m surprised to be growing so confident in it.   Perhaps I always knew it was there – that I was “different” – but it was unexpressed until revealed by the contrasts with the groupthink.  I live what others profess to believe, yet I am castigated for it by those who claim the beliefs most strongly.

No one attacks me directly, but they use triangulation, hurting things and people close to me, such that no one is safe.  I believe at some point the winds will shift, and I won’t stand so alone.  I will not actually lead, except in ideas and methods, as I feel I am already doing when opportunities arise.  After the fact, everyone wants to claim credit.  I don’t care who or how many people get credit, because everyone who takes a stand on her own behalf deserves credit for it.  I do for myself what I hope others will do for themselves, in commitment to self-reliance and freedom from bondage.

A PATIENT-CHURNING, PRESCRIPTION-WRITING MACHINE

Tuesday, July 3, 2007 – The more I work as a patient-churning, prescription writing machine, the more I hate it.  If they want to hire me to do staff development, groups, lectures, or anything that doesn’t involve writing prescriptions, we can spin it as education, and I won’t need a license.  I think these drugs are overrated and/or do more harm than good.  I spend all my time reducing meds and warning about side effects.

ON DRUG REPS

Wednesday, July 11, 2007 – Drug reps were lurking in the halls again today.

I’m reducing people’s meds, and they are grateful.  These folks seem healthier than the system.  Politically manufactured diseases justify churning tax dollars.

As psychiatrists like Dr. W (who plans to be a stay-at-home mom) and me (who plans to be a stay-at-home survivor) leave the system, the exploiters wring their hands in agony, wondering how they can perpetuate the illusions when the docs won’t cooperate.

ON THE HEALTH SNARE RACKET

Friday, July 13, 2007 – I undermine the system with every patient.  A hip replacement?  I ask.  Surgeons like to cut, and they have overhead to pay.  You need a hip replacement?  If you lost weight and restored some flexibility to your joints, your hip pain may not be so bad.  You’re thinking about replacing something living with something dead.  A living hip joint is infinitely more capable of regenerating itself than a plastic substitute.  Do you know how bacteria-infested hospitals are?  And bone surgery is the most invasive of all.  Microbes can hide and fester best in bones.

Your drug rep says you need to up your Cymbalta from 20 mg to 60 mg because that’s the standard starting dose?  But you feel better on 20 mg, and you’re super sensitive to meds?  Your drug rep wants to sell drugs.  Listen to your body.

Turn off the television to alleviate depression.  Dance for exercise.  Journal for self-discovery.  Reduce meds.  People treat side effects with more meds.

The whole world is crazy, so if you’re crazy, you’re normal.

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FOOD

Thursday, July 19, 2007 – In the check-out line at the grocery store, the man in front of me, an elderly black man, had several chicken pot pies and orange juice in a plastic container.  I think about the cost of all that packaging.

Several patients have gained significant weight, so I’ve begun to talk with them about diet.  They spend lots of money on food at restaurants like Applebee’s, but don’t get takeout boxes.  I’m watching what people buy in grocery stores.  People are using food stamps for things like bottled water and soft drinks.

One patient told me her food stamps go farther since she started eating more vegetables.  She weighs close to 300 pounds.

PFIZER REPS AND DRUG CULTURE

Wednesday, July 25, 2007 – The Pfizer reps were blocking the halls yesterday, flirting with the head nurse, who was laughing and flirting back. As I squeezed past her to collect my next patient, she loudly mentioned that the other doctor was late.  She couldn’t much stop me, could she, considering I was generating money.  And no, I will not sign my name for samples of those poisons.

Fortunately for me, my patients all showed up, and I had a blast with them while avoiding Pfizer at every turn.

They even brought lunch.  There must have been 20 boxes of pizza in the break room, and everyone but me gravitated to the food.  I heard the other doctor’s voice, so the Pfizer rep had his fish.

I was too busy seeing patients until 12:30 p.m., so they knew not to stop me

I have said over and over the drug reps shouldn’t be allowed to hang out in the back.  It’s unprofessional.  But this is the way business is conducted these days, in these “public-private partnerships.”

The drug culture?  Here’s what I think of the drug culture.  Grow it, just like you do food.  If you can’t grow it, you don’t need it.  Tobacco, corn for ethanol, marijuana.

Here’s an idea.  Individuals should be allowed to have private ethanol plants, formerly known as stills, to fuel their personal energy needs.  Whatever they sell, they can pay taxes on, if they must.

Same with tobacco.

Individuals could grow corn for their energy needs and sell designer corn liquor by the side of the road.  This would give farmers more value for their ethanol and save taxpayers from the middlemen.

Why, if investment bankers and oil companies can get government mandates and subsidies to force commercial ethanol plants, individuals should have equal status under the law.  Corporations don’t vote.  Individuals do.  Corporations vote behind the scenes, with money and favors, but the public pays the taxes and other costs for the fat cats’ deals.

THE TRUTH ABOUT THE DRUG COMPANIES, MARCIA ANGELL, MD, 2004, 2005

Friday, July 27, 2007 – I’m on the last chapter of The Truth about the Drug Companies:  How they deceive us and what to do about it, by Marcia Angell, MD.  I read about how the Food and Drug Administration (FDA) basically works for the pharmaceutical companies.  Far from protecting the public, the FDA protects snake oils, since approved drugs are not required to show superiority over current drugs, only over placebo.

Monday, July 30, 2007 – Dr. Angell castigates drug companies and FDA throughout the book but at the end, she recommends more legislation and more money for the FDA.  Of course she’s part of the establishment and can’t rock the boat too much and expect to be published.  A Boston Yankee, liberal Harvard elitist in an ivory tower, she depends on government for funding so is ultimately a GoverCorp slave.

And, she doesn’t mention insurance.  How does insurance, which costs more for giving less, get away with being so transparent?  Like with cellophane, you don’t recognize the costs until you’ve been shrink-wrapped and can’t breathe.

Tuesday, July 31, 2007 – So Dr. Angell is sadly naive about government and Medicare, either that or she chose to focus on one problem at a time.

Not I.  The FDA, for instance.  Waste of money.  Have the drug companies market directly to patients, starting with FDA employees, and pay them to participate in clinical trials. This could constitute true consumer marketing, drug company accountability, earning opportunities for all, and publicly supported large scale scientific research.  Capitalism in a nutshell.  They already do it in third world countries, under the pretext of giving free medications and vaccines to the poor.

Secrecy is the problem, and regulations make secrecy necessary to survive.  The more rules, the less anyone knows about cooperation.  Communication plummets, except by hearsay, and this further tangles networks.

Perhaps the FDA should focus only on safety and leave the efficacy to market-based consumer trials.  Abolishing drug laws would give taxpayers direct access to drugs of choice, and MDs could assume advisory and educational support but not have to play middleman in the government’s war on taxpayers.

 

 

 

 

 

Memories, June, 2007

 

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Above:  The Department of Human Resources (DHR) building in Columbus, GA

In June, 2007, I was finishing a short term psychiatry contract in the public health system in Columbus, GA.  Columbus is one of Georgia’s largest cities, on the Alabama border, and home to Fort Benning, one of Georgia’s largest military bases.

In August, 2007, I would attempt to retire from psychiatry, by letting both Georgia medical licenses and federal DEA licenses expire.  The stress was literally ruining my health.  Seeing patients was my favorite part, but the system itself was so dysfunctional that I risked everything if I missed a call.

BUILDING DESIGN

Saturday, June 2, 2007 – I fantasize about taking a sledgehammer to the walls at work.  It’s a maze, inefficient, unnecessarily confusing, and downright dangerous, with too many blind alleys, locked doors, and long, narrow halls.  Everything is so disconnected from everything else that the entire organization functions like a mindless blob of quivering protoplasm.  Individual effort dies in situ, never achieving enough momentum to spread beyond the 12’ X 12’ walls of the private offices.

These offices all have the  latest electronic equipment and programs, though, upgraded too often to be useful.  But they have zero reference books, so I bring my own.   I had to retrieve my own DSM-IV from the 500-foot walk to my other office, because the computer only takes diagnosis numbers rather than words.  I have not memorized diagnosis codes and never intend to.   Of course, the intake office does not have a DSM-IV.

HEAVEN

Saturday, June 2, 2007 – Anybody ever consider that heaven is not having to pay taxes?

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WASTE OF TREES

Sunday, June 3, 2007 – Columbus is full of railroad tracks.  As I negotiated 15th Street and around a tangle of other streets, I went under a RR trestle where Norfolk-Southern cars filled with fresh wood chips, piled high, smelled the air of pine.

How sad for those trees, I thought.  Their chopped chips are probably going to make junk mail, paperwork, and packaging.  This while their fellows are burning in a hundred square miles of uncontained forest fire in southeast Georgia.

CURRENT EVENTS

Thursday, June 7, 2007 – I’m becoming bored with current events.  I’ve had fun on the internet message boards, but the columnists remain uninspired – from my perspective – and I battle basic assumptions, like the belief that competition is good.  So, I approach it with the cavalier feather stroke of playfulness.  I balance discussions about nuclear proliferation in Iran with questions about paranoid counter threat tactics by the US.  How much are taxpayers paying for nuclear proliferation under our noses at home?

Lah de dah  . . .

Another world, another opportunity to blow it up, or not, depending on your reference point.  Worlds split off from each other, I believe, and those who believe in nuclear holocaust may well travel along a world chain of events toward that outcome.

Moi?  I’ll let that car pass on by, to avoid being swept up in that drive chain.  I see myself as an illusion-popper, clarifying ambiguities, flipping coins, turning phrases, bringing a sense of hopefulness through flexible thinking and clever (to me) juxtapositions.

Slowly, I see others becoming more confident, more outspoken, more imaginative.  Less victims, more involved, responsive, and reflective.

GONNADOS

Friday, June 8, 2007 – The world is overrun with “gonnados” who expect others to pay huge up-front costs for questionable future rewards.  There was an online Washington Post column extolling the new president of Arizona State University, for his grand vision of developing better communications between Americans.  President Crow starts by firing 20 of 23 deans on the faculty.  This communicates clearly to me.

Next, he creates lots of programs – a biodiversity center, for one – in order to make Arizona State a bigger place, competitive with Harvard and the like.

Another empire builder, think I.  I post my view that he’s another “ivory tower elitist with more theories than sense, standing on a soapbox bought with other people’s money.”  Another megalo-maniacal world changer, think I.  Yawn.

He talks about “stovepipe” mentality, but if he has replaced most of the deans, he’s just creating a different stovepipe for those he’s indebted to, or who share his agenda.

PRESCRIPTION SNAFUS

Thursday, June 14, 2007—I discovered yesterday that writing a prescription for something like Geodon doesn’t necessarily mean the patient will get Geodon.  Yesterday’s patient got four days’ worth of samples because that’s all the pharmacy had, so by the time I saw her, she hadn’t taken it for over three weeks.  By then both she and I decided she didn’t need it.

I’m beginning to wonder if these meds work at all.  As Seth* says, your beliefs determine your reality.  Those who improve give the pills the credit, but I’m not so sure. Antidepressants like Prozac “change your brain chemistry,” they say, but so does any life experience, and the fact of going to the doctor may change it even more.  Perhaps pills are merely transitional objects, tools to link mind with body, as valid for relieving suffering as faith.

I wonder how many people would take antidepressants and the like if they were over the counter.  To hold the claim of potency to the measuring stick of free market capitalism would be an experiment worth trying.

SIMPLICITY

Saturday, June 16, 2007 – Everything has always seemed so simple and obvious to me, issues of right and wrong, justice, fairness.  As I have come to know myself, I’ve shed projections from others, thanking psychiatry for teaching about projections and projective identification.  Psychiatry supplies the words to describe confused feelings.  People’s lack of clarity leads them to assume way too much and act accordingly.

I grew up believing I was potentially a brutally violent person, in need of rigid self-control, yet I’ve learned the opposite is true.  My childhood question, “Why can’t people just love each other?” remains as valid today as ever, and I’ve yet to learn the answer.  My nature has been to look for things to like, and I can usually find something, especially if I’m in a situation not easy to leave.

I’ve always felt safe and protected, though, not only by parents – although they certainly helped – but by life.  Not flamboyantly psychic, I suppose, I’m merely supersensitive emotionally, although there is no objective standard to measure this.  I don’t even believe I’m supersensitive, merely more aware than others, and more trusting of my perceptions.

FOR THE LOVE OF GOD

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Sunday, June 17, 2007 – My desire for solitude stems from a wish to know myself apart from others’ projections and judgments.  I suppose even as a child I was trying to reconcile what I felt with what adults said, and with what I saw.  Basic truths boil down to one truth:  God is love, and I want to do god proud, I will aspire to demonstrate her love in every thought, word, and deed.

It sounds sappy, inconsistent with my tendency to scream things like “Back off, asshole!” to the gas guzzling red truck tail-gaters with mag wheels and attitudes.  This is innately loving, I figure, because if I didn’t yell or otherwise show him where his rights end and mine begin, how would he learn?  If he already knew, he wouldn’t be tailgating.  And just because he’s behaving like an asshole now, it’s not necessarily a character trait, especially if he backs off or passes.  The loving hand of God therefore works through me to teach such testosterone-poisoned creatures how to grow in grace, in terms they can understand.

I’ve found taking my foot off the gas works, too, if yelling doesn’t, and I’ve allowed many such a creature to rush ahead to a destiny too frenzied for me.

DEMOCRACY IN AMERICA, ALEXIS DE TOCQUEVILLE, 1835 AND 1840

Monday, June 18, 2007 – de Tocqueville cites the lawyer class in America as the equivalent of the aristocracy, and the jury as the means by which every citizen sits in judgment over every other.  It strikes me that we do have a society that looks to laws to solve social problems, and perhaps the preponderance of lawyers in government has distorted our national perspective.

DRUG LAWS

Thursday, June 21, 2007 – I flip flop from thinking the drugs I prescribe are dangerous to thinking they are useless, validating Seth’s* assertion that the belief determines the effectiveness.  I really do believe drug laws create an artificial mystique about their effects.  Everyone would claim this is doctor turf, the license to prescribe, but I contend that this is a front for the government and pharma to falsely inflate the price, as well as presumed benefits and risks.

 

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*Seth is the channeled entity who spoke through medium/author Jane Roberts.  There are several books in the Seth series.

 

 

 

 

 

 

 

The View from Below

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I shoveled the dock steps the other day.  This was part of my latest health initiative, with the purpose of swimming in the river.

Now, most people don’t have a dock or concrete steps to a polluted river where they can swim.  Most people haven’t grown up on said river and watched it change gradually over the past 60 or so years.  It is a blessing and a curse.

While doing this mundane labor, which with clean-up took about two hours, I had time to ponder many worldwide concerns.  First, I listened to the constant buzz of helicopters at Hunter Army Airfield, only a couple of miles–as the helicopter flies–from my house.  There were also military aircraft flying overhead, as I live only 28 degrees off Hunter’s flight paths, and those planes fly low, low, low over my head. This reminded me that the US is engaged in perpetual wars, and I live in a war zone, what with the strong military presence loud, clear, and constant.

Next, I thought about the Clean Water Act of 1972, when the Army Corps of Engineers got jurisdiction over all “wetlands” including the “hydrophytic” marsh that surrounds my small spit of land.  I wondered if the AC of E would fine me for taking mud off the steps and depositing it in the center of my land, which is mine but not mine in that I pay property taxes but can’t modify it.  This spit of land has been sliding into the river for years and now becomes flooded in spring and fall tides.  The channels in the area are also filling in, because no one dredges them anymore, even though the drainage ditches are perpetually clogged and contribute to frequent, severe flooding in Savannah.

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The local movers and shakers would prefer to dump poisonous malathion by helicopter on the entire ecosystem than drain the bogs where mosquitoes breed. That the Army Corps of Engineers pays Chatham County to control mosquitoes, yet operates the largest mosquito habitat in two states does not seem important to anyone but me.  That the dredge material from current harbor deepening project will increase the mosquito habitat at this international port presents no red flags to those who are developing vaccines for mosquito-borne disease but are blithely nonchalant about the cushy habitat they are creating.

This brings me home to the polluted river, which still has fish and shrimp, but not as many as in my childhood.  I figure if fish can swim in it, so can I.  I’ve been stomping around, crabbing, shrimping, boating, water skiing, and swimming in that water since I can remember, so know it well.  While shoveling, I thought about “climate change,” and the claim that the oceans are rising.  I also remembered reading about how land is washing into the oceans and wondered if the oceanic rise is relative to the land’s sinking, in a leveling out that would lead to the oceans’ getting shallower. Shallow water heats more quickly than deep water, as any swimmer knows, and holds more heat, so this could explain some of the climatic changes.

So then I thought about President Trump’s withdrawal from the Paris Accord and wondered whether it makes any difference in the long run.  I’ve never been a fan of government solutions to government-supported problems, like the fact that deforestation is a major contributor to climate change.  I don’t believe in paying corporations not to cut trees (as in “carbon credits”) and would prefer instead to reduce demand for paper, like junk mail and single-use packaging.  International Paper, the owner of primo rain forest in South America, and a huge polluter of the Savannah River and air, does not recycle paper.

That got me to thinking about the enormous amount of methane produced by the marsh, the fact that methane and natural gas are the same thing, and that Germany is the world’s leader in recycling (70%).  In addition, Germany has to import garbage to fuel its waste-to-energy plants that provide so much of its heat and electricity. There is also new technology to capture methane produced by landfill, but the US lags behind places like China in its adoption of these promising technologies.  No wonder Angela Merkel was frustrated by Trump’s withdrawal from the Paris Accord. Germany is the world leader in sustainability, and should be so acknowledged.

So, Donald Trump may believe coal gives the US a financial advantage, but this is short-sighted.  Apparently China is the largest purchaser of US coal exports, but China built 431 waste-to-energy plants in 2016, so it may not need our coal much longer.  With the reduced cost of solar, India is also going greener.  China is the biggest carbon-emission nation in the world, and the US is second.  Russia is third, and India fourth, according to Google 2011 data.  Americans probably generate the most waste, though, 4.5 pounds of garbage per person per day, and recycling has decreased, now down to about 30 percent.

So, while I solved my personal problem of how to swim without getting mud between my toes and oyster shell cuts on my feet, I also solved a lot of world problems, and I never had to leave home.

 

 

 

 

The Power of Life

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May 28, 2017—The following thoughts give an overview of my reasons for skepticism about Western, allopathic medicine and the paradigm it represents.  I claim the overriding belief in external agents for healing or symptomatic relief ignores the basic dignity of the individuals in question and the “vitality” that keeps us going.

The body is a marvelous homeostatic instrument, for which health is the natural state.  This understanding pervades Oriental medicine, which is based on the concept of “qi” (“chi”) or life force.

I’m an amateur student of Oriental medicine so can only describe it in general, simplified terms.  Essentially, it holds that there is a continuum between spiritual, mental, emotional, and physical levels.  Problems begin as spiritual.  If not resolved at that level, the problems become increasingly “dense” until they show up in the physical body.

In Chinese medicine, the idea of qi underlies and informs the entire system.  This sets Oriental medicine at odds with the Western, mechanistic viewpoint we Occidentals take for granted.  With the advent of the industrial age, the “scientific method,” and the requirement for “objectively verifiable” evidence, we’ve come to rely on instrumentation and a cause-and-effect sequence for assessment and treatment of any given condition.  The body is treated as though it’s a machine, with the resident human being largely a passive recipient of the diagnoses and treatments decided by the technician/physicians who administer them.

While the official stance of “science” receives almost religious devotion and some legitimate respect, it is exceedingly limited in what it can do.  “Science,” which relies on measurable “proof” has yet to prove that life exists.  Nor has it located the “mind,” although most believe the “mind” is in the brain.  The scientific method relies on studies that theorize causes, then set up conditions that limit variables to one, to determine whether there’s a significant correlation between cause and effect.

My unorthodox approach to life, health, and medicine stems from a fundamental belief in the power of the life force.  I call it “vitality,” but others may refer to “qi,” “quality of life” or use any number of terms to describe this battery that keeps us going.

Whether individuals survive physical death, and if so, in what capacity, is a question no one can answer, although religions and philosophers of all persuasions have tried.  What is life, anyway?  Is it a candle flame that can be extinguished?  Is it an essence, like “qi” that joins the “qi” of the cosmos, to be re-born in another place and time?

I won’t try to answer these questions but raise them simply to note that a belief in life beyond death strongly influences how I live mine.  Certainly others wrestle with the question, especially as they get older and wonder what lies ahead.

I became a psychiatrist partly to help make philosophy practical, but the profession—and Western medicine as a whole–is going in the opposite direction.

“How so?” a reasonable person may ask.  The most obvious answer is that it devalues the most basic principles that keep us healthy or make us sick.  Western medicine systematically undermines the individual’s faith in his or her own body’s self-correcting mechanisms.  It pits mind against body, which is deemed untrustworthy, a thing to be feared, unreliable.

The intangibles that formerly distinguished psychiatry from other medical specialties, the “quality of life” issues—now take a back seat to “evidence-based medicine” and the vain attempt of psychiatrists to align with the more “scientific” practitioners.

The antidepressant Prozac (fluoxetine) was introduced in 1989, two years before I graduated from medical school.  This began the separation of psychotherapy and other “talk therapy” from “medical management” of emotional problems.  While other antidepressants, anti-psychotics, anti-anxiety agents, and mood stabilizers had been on the market for decades, Prozac began the trend toward a raft of new, patented, drugs that could treat symptoms while ignoring the larger life pattern that led to the problems.  “Talk therapy” was shifted to psychologists and social workers, with the move heavily supported by government and insurance reimbursement criteria.

Since that time, the avalanche of patented drugs, technologies, diagnostic tests, and other interventions has made the “health care industry” one of the most profitable sectors in the United States.  Costs for the individual have skyrocketed, such that few can afford medical help without insurance.  Now, the government has made insurance mandatory.  No one seems to recognize that insurance does not equal health care.  In fact, insurance impedes, rations, and delays health care, and it raises the price for everyone.

Medical care costs twice as much in the US as anywhere else.  Medications are significantly more expensive.  A continuing medical education article I read says medical error is now the third leading cause of death in the US, after cardiovascular events and cancer.

That medicine and psychiatry seem obsessed with finding or creating problems already puts patients at a disadvantage, in a defensive position.  Psychiatrists don’t get reimbursed for “no diagnosis.” They must find or invent a diagnosis, a label, to justify the time they spend.

No wonder Oriental medicine has such appeal for me.  Here, diagnosis is based on patterns of disharmony within the body and mind.  The hands-on approach is individualized and personal.  The patients and the practitioners are partners, with the belief in the treatment’s effectiveness–“the placebo effect” in Western terms—a desirable component.  In short, it respects the dignity of the vital forces that medicine presumes to reinforce.

I hear people say that “health care is a right.”  We also have a right to refuse health care, especially when it’s forced on us by hostile, predatory forces.  We have the right to eat nutritious foods, life a balanced life, and keep stress levels low.  We have the right to maintain our vitality and health they best way we know and to choose who and what to trust for help when we need it.

 

I Couldn’t Make This Up: 2007

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Ten years ago this month I was working a short-term contract as a psychiatrist in a public mental health outpatient clinic.  At I was considering allowing my medical and DEA licenses to expire, simply because I felt like a hypocrite.  I entered psychiatry to set people free, not to enslave them to diagnoses and drugs, government and insurance, for the rest of their lives.

DEPRESSED ECONOMY

Sunday, April 1, 2007 – Driving around Columbus, GA shows how depressed the economy is.  It smacks of military people borrowing against an uncertain future. Independent businesses are so rare as to be non-existent. Otherwise, Columbus is clunking along on pawn and title pawn shops, government buildings, banks, insurance companies, and a variety of businesses dedicated to selling and maintaining vehicles and vehicle parts.  There is so much run down and empty commercial space – and the place looks generally devoid of life – that the only activity shows at the multiple traffic lights, where large trucks, vans, SUV’s and old clunkers congregate as if at a business meeting.

PET FOOD SCARE

Tuesday, April 3, 2007 – The pet food scare widens, and it appears the economic hit is on China’s wheat gluten.  I’m more convinced than ever that the thugs at DHS, CIA, FDA, CDC, or DEA are behind it, and they all answer to Bush and Cheney, the sadomasochistic side show in the world-wide butt fuck.

I believe the goons at DHS have made their point.  Melamine is a plastic, used in McDonalds’ forks, hahahaha, and the latest bullet in the war on pets, but the repercussions in the plastics industry should be interesting.  I’ve wondered about the buildup of plastic breakdown products in the environment, and the toxins they release.  Animals would be the most susceptible, of course.

No one has proved the wheat gluten is the cause.  No one has even proved what the toxic agent is.  The “scientists” are disagreeing with each other, thus to obscure the real issue (in my view) that this was inside sabotage by someone who had access to aminopterin, which was proven in the DHS-funded lab at Cornell, created for the purpose of protecting US tax revenues from foreign threats.

The media arm of the Police State blithely ignores the obvious, so eager is it to cozy up to the perpetrators.  I’ve noticed AP is particularly reprehensible along these lines.  No wonder it hides behind its image.  It took some research to discover where their corporate offices are.

FEAR

Wednesday, April 4, 2007 – The vague cloud of fear that hovers over me surrounds the planet, I suspect, and I am less afraid than most.  Unseen enemies are those who are reacting to their own fears, and I have to dance lightly to stay out of their way.  I try not to take insults personally, even if they are meant that way.  I get strong reactions from people, as on the ESLR message board, when I assess the state of the “economy.”  I don’t pander to the Wall Street-generated hype meant to reassure people of economic growth, despite evidence.  It’s a pack of lies and deserves to be so-called, because people aren’t as gullible as they once were, especially as they feel the “economic growth” like a cancer in their personal lives.

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Corn, Cochran, GA Supposedly 80% of corn sold in the United States is already genetically modified. It’s too late to label GM products.

CORN AND ETHANOL

Wednesday, April 4, 2007 – How much time does it take to grow an acre of corn, convert it to ethanol and burn it?  Has anyone calculated the cost of energy, soil depletion, and water for the process?

The environmental groups are quiet on this one, and so are the Agriculture Department, the economists, farmers, American Solar Energy Society, and scientists.  Isn’t anyone even curious?  Congress hasn’t asked, Bush certainly doesn’t want to know, and once again, I am the lone voice asking questions that should have been asked a long time ago, before the legislation, before the factories were built, before the farmers were seduced into following this government-created fad.

COLUMBUS, GA NOISE POLLUTION:  LOCUM TENENS ASSIGNMENT

Wednesday, April 4, 2007 – The noise makes constant assaults on my senses, and I’m afraid  I will explode from repressed fury.  The airplanes have been droning–along with machines, traffic, and sirens–but mostly constant airplanes since I got home to the camper, exhausted from a relentless day, seeking a little peace, not to be had here, where the very earth is vibrating from the din.

I, for one, will be glad if I live to see the world run out of oil.

Now, the train.  The trucks on the highways.  The last airplane is gone, finally.  Was air traffic stacked up over the airport?  The train whistle is constant.  Everybody is in a dizzy tizzy today, all except the one bird I hear twittering, and my cat, who is as serene as a placid pool, asleep.

That train has been whistling for five minutes.  Motorcycles, more trucks.  If I were home and could do it, I’d let out a primal scream by now, so furious am I.  A horn.  another motorcycle.  I can still hear the train.  More traffic.

I turn on music and dance awhile, as I encourage patients to do.  It helps my attitude a little.

Train still blowing the whistle – seven minutes or so.  Constant.

The work turns me into a zombie prescription writing machine.  In W’s office, where I work on the adult side, the computer is also loud, so I listen to that all day and wonder if that contributes to my headaches.  Or maybe it’s the coffee they have there, the creamer, the stress.

I just got up and closed the windows.  It helps a little, but my head is vibrating still.  I can feel it like a saw grinding though my skull.

I turn on the fan, now that the windows are closed.  I can still hear the traffic noise outside, even though the fan is only two feet away from my head and has its own noise.

How loud must it get before people wake up?  Now I know why people go deaf.  Not that it would protect anyone here, because the vibrations penetrate all walls, all protections.  You can hear it over the music, over the fan, over the air conditioning.  It rattles the ground, shakes the camper.  I might as well be in the center of a war, except this is a war on nerves, as in the nerve of them.  There is no defense against sound, except to leave or bury my head in  . . . what?  The earth transmits it, too.

You get what you focus on, says Seth, but how can I think of anything else?

Winston Smith, in George Orwell’s classic novel, 1984, had a horror of rats gnawing his face, so those who would convert him used rats in cages over his face, as I recall.  For me, relentless machine noise is the torture I most fear, but I am already being tortured, and my head hurts, and I think I will have a stroke or heart attack, and soon, if I don’t escape this hell hole in a healthier way.

 

USPS REORGANIZATION

Friday, April 13, 2007 – I discovered Richard Nixon re-organized the Postal Service in 1971, giving it over to a Board of Governors, and removing the Postmaster General from the Cabinet.  You don’t hear much about the Postmaster General or the Board of Governors, but the USPS affects every area of our lives.

Who exactly owns the USPS, which is so heavily saturated with garbage mail it can’t deliver a first class letter without losing it in the junk?  Why am I subsidizing these assaults on my money, attention, and all the trees on the planet?  I pay yet again for the destruction to the environment.  And these government goons are blaming taxpayers for global warming?  They are burning resources just as fast as they can get away with it, and their solution is to do more of the same?

Not at my expense, folks,  Use your own money to play stupid, because I don’t run my life that way.  Double rates on all sneaky mail (that is, all mail with rates they don’t want you to know).  How’s about publish ALL the rates everyone has to pay, like the slick paper flyers and unwanted medical journals, CME offerings, school and university solicitations, magazines, newspapers, non-profits, campaigners, sales pitches, fundraisers.  If they didn’t spend so much money on self-congratulatory propaganda, perhaps they could afford to do some good.  What exactly is pre-sorted first class?

MONEY MANAGEMENT

Saturday, April 14, 2007 – Money management is about keeping my money.  The more money I keep, the more money I save.

 

 

 

 

 

The More Things Change . . .

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Above:  The professional literature in Psychiatry remains funded primarily by pharmaceutical companies.  I get up to eight Psychiatry periodicals every month, all containing about 50% advertising, most of it by Pharma.  This junk enjoys a privileged postage rate, because it is “educational.”

April 12, 2017–Reading old journal entries helps me focus blogs and show the trend of my thinking over time.  In April, 2007, ten years ago this month, I was considering allowing my medical and DEA licenses to expire, because I felt used by a medical system that causes more disease and suffering than it alleviates.  As a psychiatrist, I was under a virtual mandate to prescribe drugs that promised more help than they delivered.  Not only that, but the system itself was so dysfunctional that it put everyone at risk.

ON MEDICINE AND PSYCHIATRY
Wednesday, April 18, 2007 – If I can get out of the business of medicine, I can enjoy the fun of medicine, when it’s done right.

It starts with honesty.  We have created a sado-masochistic society that feeds failure and punishes success.  In today’s climate, the individual doesn’t matter.  “Equality” means bringing everyone down to the lowest common denominator, statistically speaking, to save the “economy” from the individuals who take more than they give.

Our society has rendered them so dysfunctional that they are incapable of doing anything useful and resentful of those who expect them to make an honest living.
What kind of psychiatrist would I be if I didn’t point out the insanity of that?  I believe the individual matters, if only to herself.  I matter enough to stand my ground in the face of society’s power struggles and to comment on the process.

The US psyche is caught up in the emotional two-year-old anal stage of psycho-sexual development, the “terrible twos,” the year of potty training, the age in which life-long issues related to power and power struggles emerge.  The “self” vs. “not-self.”
As we play with the shit we have created, we are evolving, hopefully, toward a greater understanding of what it means to be free.  Demonizing and drugging the individual mind and spirit is society’s game, not mine.  I have evolved beyond the anal stage.  I quit.  Get ahead by slowing down.  Take time to smell the roses before you pave them over.

This patient-churning prescription writing machine throws the government credentials—the medical licenses—into the compost bin.  Thus relieved of the paper shield, I step from in front of the DEA’s guns to show them aiming at my back, to control invisibly every aspect of the prescription game.

They need me more than I need them, but only because they believe in drug laws.  If there were no drug laws, we wouldn’t need the DEA, but doctors would still have jobs.

“Doctor,” a word my absentee bosses don’t know, is derived from the Latin “docere” meaning “to teach.”  A doctor is fundamentally a teacher about health.  That’s what I do – teach people about health, especially mental health.

You know what I tell my patients?

“It really is them,” I say.  “They are the crazy ones.  Don’t put your life on hold waiting for the government.  You’ll grow old and die waiting.  Live it up while you still can.  Dance in the living room.  Turn off the television, for your sanity’s sake.  Shut off the mind and noise pollution so you can hear yourself think, and you’ll get back in touch with your common sense.”

ADHD (ATTENTION DEFICIT HYPERACTIVITY DISORDER)

Tuesday, April 3, 2007 – I enjoyed working with kids and parents yesterday.  I gave practical advice and supported them in their efforts.  A little six-year-old hugged me on the way out.

These aren’t bad kids.  In fact, I think many who are branded with ADHD are brighter and more creative than the rest, with skills and interests that reach beyond the classroom.  A 12-year-old girl who is about to fail sixth grade for the second time daydreams and draws during class.  Likes violin and reading Japanese books in English.

I reassure them school really is boring, and teachers are busy pleasing absentee bosses.  Moms nod vigorously, and the kids stare at me as if they are shocked I would express such heresy.

CME ON ADULT ADHD

Tuesday, April 3, 2007 – I read a Continuing Medical Education article on ADHD (Attention Deficit Hyperactivity Disorder).  Bottom line is there’s nothing new, except the diagnosis of adult ADHD.

Do you think anyone would consider causes pills won’t treat, like multi-sensory fatigue from the environment?  Machine noise from traffic and power tools, airplanes, blowers, coffee grinders, speakers in coffee shops, grocery stores, hardware stores, banks, blaring “I Died and Went to Hell” music and advertising at top volume?  The screeching, attention-starved voices from the halls of hell?  Who can attend to anything with all that noise?

No.

Think they might consider that the same drugs are used by drug addicts and schools to treat the same symptoms, but it’s okay if you have the correct diagnosis?

No.

Think the lack of physical education in the schools, or the fact that kids with too much energy are punished by depriving them of play time might contribute to their hyperactivity?

No.

It’s all in the brain chemistry, you know.  Hit ‘em up with a little Adderall or Ritalin and we’ll let ‘em come back to school.  Never mind that they have been suspended the last X days and are even further behind.  They shouldn’t have acted out.

The other two psychiatrists here, Child & Adolescent psychiatrists, indulge me in my one-to-two minutes of tirade.  Each says separately, unfortunately, the kids who come here need to be on meds.  Doctors have adapted to being prescription writing machines, drones in the endless grind of patient-churning status quo.  They see the hypocrisy, but they learn quickly to keep quiet, to show in behavior the repressed anger generated by power abuses.

Learned helplessness vies with identification with the aggressor, but do you think psychiatrists make the connection between abstract understanding and the evidence in front of them?

No.

Why learn psychiatry if nobody cares?  You could get a computer to write prescriptions faster and more legibly.

The inertia is as cloying as clear gelatin.  Perhaps this is the egg; the yolk, the planet, the albumin the atmosphere, with humans poised at the interface, possibly growing and possibly getting big enough to crack the shell.

 

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The Medicare Myth

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Introduction:  Friday, February 24, 2017–Back in 2005, when I cared about the health scare/snare racket from a practitioner’s point of view, I began research for a book.  The Medicare Myth  proposed a national health care system that would by-pass insurance and pharmaceutical companies to provide access directly to all comers.

Now I care from a patient’s point of view.  My original idea has grown and thrived under Obamacare.  In 2017, as Congressional Republicans move to re-configure Obamacare, the nation grits its teeth and bites its fingernails, contributing to stress and bad outcomes.  It doesn’t have to be this hard.

Obamacare is the talk of every town these days.  I refuse to call this the “Affordable Care Act,” because it is the opposite.  It steals from the poor to pay the rich–the pharmaceutical industry, the insurance industry, and the government–using criminally abusive scare tactics against a naïve and gullible public.

Sadly, the Republicans are hard-pressed to come up with a workable alternative.  Up to the plate I come, to offer a point of view others may appreciate.  Here we have an opportunity to guide the government toward win-win solutions, and no party can claim credit.

Where better to seek solutions than from the “private sector,” of which I consider myself a member?  I also have insider knowledge of how the system works, having been the daughter of a public health doctor as well as a psychiatrist myself, working in the public mental health system, including five VA facilities, in my time.

Consider this:  We already have public sector infrastructure for a comprehensive public health network.  For outpatient services, community public health departments already provide STD screenings, TB skin tests, birth and death certificates, and other services that benefit the community as a whole.  Accessibility is a huge advantage, otherwise not easily available except through emergency departments.  Another advantage is that direct patient care saves paperwork, time, and insurance costs.  It reduces overhead and restores quality to health care.

The Veteran’s Administration Hospital and outpatient system is already in place for vets, and I’ve enjoyed my time working at VAs.  However, I believe the families suffer as much as or more than the vets, as they are primary caretakers.  Why aren’t families covered in the VA system?  And, while we’re at it, why aren’t we all covered?  We all pay for war, one way or the other.

The slave-owner mentality of our mandated Western medical care paradigm is laughable.  While detractors want to blame Barack Obama for this travesty, let’s all remember that GW Bush-appointed John G. Roberts, Chief Justice of the Supreme Court, cast the deciding vote on Obamacare, declaring the mandate a “tax.”  So, this is bipartisan stupidity at work.

For one thing, I think it’s healthier to get an acupuncture treatment or massage, go dancing or bowling, than sit in doctor’s offices.  Yet, insurance steals money from truly healthy activities to feed the asset plunderers in Washington and money churners on Wall Street.

 

 

 

THE MEDICARE MYTH
Health Care Insurance, Not Health Care
by Katharine C. Otto,  MD
October, 2005

 PREMISE

Medicare was never intended to provide medical care.  It is a government-controlled insurance subsidy.  It guarantees income to insurance companies whether patients are served or not.  This allows for sweetheart deals between government and insurance companies.  Insurance companies profit by delaying and denying treatment.

With the new prescription drug benefit, the stage is set for sweetheart deals between government, insurance, and pharmaceutical companies.  Under these arrangements the aggressively intrusive middlemen profit by collecting payment before treatment and doing everything they can to keep the money.

He who holds the money calls the shots.

Government feeds off taxpayer productivity, exacting payment in advance for services it no longer has incentive to provide.  Are taxpayers getting value for their money?

The government/insurance scam exploits taxpayers under the guise of helping them.  This results in the de facto inaccessibility of timely diagnosis and treatment.

This proposal recommends scrapping the entire Medicare system in favor of public health departments and public hospitals under the Veteran’s Administration Hospital model.  The difference between this and socialized medicine is that it should be easily accessible to all, but voluntary.  Taxpayers are already subsidizing huge investments in Medicare and Medicaid insurance.  Why not spend those same dollars on diagnosis and treatment in a timely and direct manner?

As a citizen and taxpayer, I believe I have an obligation to help care for the community, and I’m happy to support public health, public works, public education, including public libraries, the public mail system, and public transportation.  These are legitimate government functions that provide the nuts and bolts of a smoothly functioning civilization.

America is ripe for the growth of the self-employed, the independent contractor, the small business owner, and those who provide basic, local services that no one can outsource.  The independent contractor could afford health care if he didn’t have to subsidize an insurance-controlled system that shifts costs to those who can least afford them.  A restructured public health system could provide basic accessibility to all and more efficient use of our tax dollars.

Advantages:

  • Public health departments deliver preventive medicine and health maintenance education to local communities. General responsibilities include screening for communicable diseases, providing school outreach, insuring sanitary conditions in public works, public facilities, restaurants, and other places where public health safety may be threatened.  Health departments also provide childhood immunizations, as well as other inoculations.
  • Veterans Administration hospitals already provide direct care to vets. The structure is in place.  VA hospitals are training grounds and essentially supervised apprenticeship programs for students in all health care professions.
  • Peer review and supervision are built into the system. Multiple layers of care provide a clear chain of command and accountability.
  • Reduction of bureaucracy and paperwork. Bureaucrats can be re-trained to serve practical services, like lifting, turning, bathing, and transporting patients.
  • These services could be made available to all but forced on no one. If it’s a good system, everyone wins.  Those who must go beyond what the public systems provide will have easier access to more specialized health care services.
  • Taxpaying citizens deserve better care for the money we spend. Super-inflated costs indicate the health snare system is hopelessly caught in its own trap.  As it increasingly cuts services to swell profits, it becomes even less accessible, more costly, and ultimately less relevant to those who support it.

 

The books pictured above:

  1. Medicare’s Midlife Crisis, Sue A. Blevins, Cato Institute publishers. 2001.
  2. Bellevue Literary Review. BLReview.org.  A literary magazine affiliated with the NYU Langone Medical Center, NYC.  Specializes in medical topics, memoirs, stories, etc.
  3. Two Days That Ruined Your Health Care (And How You Can Provide the Cure), William C. Waters III, MD, MACP, No pub date or copyright.
  4. Rats, Lice, and History: The Biography of a Bacillus. Hans Zinsser, 1934.  A charming story about how the microbes win every war, written before the widespread use of penicillin.  This book is a particular favorite of mine by the original author of medical microbiology texts still used today.
  5. Overdosed America: The Broken Promise of American Medicine.  “How the pharmaceutical companies are corrupting science, misleading doctors, and threatening your health.” John Abramson, MD, 2004.  This Harvard MD begins opening the can of worms about the sleazy pharmaceutical industry that thrives on patents.
  6. The Truth About the Drug Companies: How they Deceive Us and What To Do About It, Marcia Angell, MD, 2004, 2005.  This former editor of the New England Journal of Medicine  gives another perspective on the pill-pushing mentality of the health snare racket.
  7. (Not pictured)  Patient Power:  A Free-Enterprise Alternative to Clinton’s Health Plan.  John cv. Goodman and Gerald L. Musgrave,   The Cato Institute, publishers, 1994.  Remember in the 1990s, when Hillarycare was soundly rejected by the public?  Then First Lady Hillary Clinton implemented its main features through bureaucracy.  The updated and re-configured version eventually morphed into Obamacare.

 

The Mind-Body Connection

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From “The Foot Book: Healing the Body Through Reflexology,” by Devaki Berkson, 1977

Anyone who has a neck has a mind-body connection, assuming the mind is in the brain, which has not been proven.  In fact, with the medical mucky-mucks pontificating about “evidence-based” medicine, I have to ask what evidence do we have that the mind exists at all?  In fact, what evidence do we have that life exists?  We can’t measure either of these on our fancy instruments.

Albert Einstein, who sought in vain for a unified field theory to link the different universal forces, like gravity, and strong and weak nuclear forces, took life for granted, as Western medicine and science do.  Oriental philosophy does somewhat better, with its acceptance of “qi” or “chi,” loosely translated as “life force.”  Philosophically, I prefer the Oriental paradigm, which assumes a living cosmos, emanating from the inside out, like a holograph.  Embryos grow from the inside out, as do plants from seeds.

While people know the brain is in the head, they forget that nerves extend from the brain to almost every cell in the body, in a feedback loop that transmits information and directions back and forth with dazzling complexity.   Chemical messengers and neurotransmitters number in the thousands.   Only a few have been studied, and even these are poorly understood.

The so-called “scientific method,” a construct of the mechanized Western model, assumes cause and effect, yet it requires limiting any “scientific study” to one variable. This creates an artificial situation which attempts to control for confounding factors and leads to skewed results.  Alternatively, the Oriental model, which sees disease, for instance, as a pattern of dis-harmonies, is inclusive.  It presumes there are no single causes and that dis-harmonies create patterns of dis-equilibrium. Disciplines like acupuncture strive to re-balance “qi” to improve health and quality of life.

Ear acupuncture and reflexology are based on the idea that there are correspondences between points on the ears, hands, and feet and the various organs and structures in the body.

earacu

Acupuncture does not lend itself to the “scientific method.”  Because it is holistic, it cannot be reduced to “cause and effect” studies.  Also, studies into acupuncture can’t be double-blinded, as the acupuncturist presumably knows which points are the “real ones.”

However, as East and West develop more ties, acupuncture is receiving more attention and acceptance, especially for such conditions as pain and substance abuse.

Reflexology, which is a specific form of massage, does not get as much attention, but it has the advantage that anyone can do it.  I make no claims about its healing properties, but I can vouch for the fact that foot and hand massage feel good and constitute a safe form of touching in a skin-starved society.

 

If We’re So Smart, Why Aren’t We Sane?

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September 10, 2016

by Kookie the Shrink
an alter ego of katharineotto.wordpress.com
President, Chair, and CEO, Psychiatrists for Sanity
(and so far the only member)

The August, 2016 issue of Psychiatric Times has two good articles related to recent topics in my senior citizens’ discussion group.  One is on gun violence, and the other on physician-assisted suicide.

Gun Violence and Mental Illness

There’s a good interview with forensic psychiatrist Liza H. Gold, MD regarding her book, Gun Violence and Mental Illness.  She claims that most serious mental illness is only weakly associated with violence, and gun violence in particular.  There are 33,000 firearm deaths each year, and two-thirds of them are suicides.  Less than one percent occur in mass shootings.   Firearm violence by individuals with serious mental illness against strangers is one of the rarest forms in the US.  If seriously mentally ill people do become violent, it is usually against family members or in committing suicide.  Those with serious mental illness only commit 3-5% of all types of violence.

When Dr. Gold talks about legislation, she says only felons with a history of gun violence should be denied weapons.  Now, all felons are prevented from buying guns.  Psychiatrists and therapists should ask not only if the patient owns a gun but whether there is a gun in the household.  Better access to mental health care would perhaps prevent suicides (10th leading cause of death in the US and second among adolescents and young adults).  There are 40,000 suicides/year in the US with more than one-half using a gun.  As many as 90% of people who commit suicide have a history or current diagnosis of a psychiatric problem

We are the only nation in the world with this kind of gun violence problem.  Access to mental health treatment would not reduce homicide rates (11,000/year), which are usually interpersonal (domestic, gang wars, etc.)

The most dangerous time for a woman is in trying to leave an abusive relationship.  Temporary restraining orders do not prevent the perpetrator from having a firearm, but permanent ones do.  Gold says the temporary restraining order should also prohibit firearm possession for the perpetrator.

She says we should educate family members to remove firearms from the homes of those in crisis, such as depression, psychosis, substance abuse, dementia, recent trauma–such as loss of job or relationship–or has a recent diagnosis of serious medical illness.

Physician-Assisted Suicide

A commentary, “Physician-Assisted Suicide and the Rise of the Consumer Movement,” by Ronald W. Pies, MD, addresses the current status of so-called “physician-assisted suicide” movement and the ethical implications for psychiatrists.  While others refer to “death with dignity,” he likes to think in terms of “life with dignity,” and implies this is the main goal of psychiatry.

Dr. Pies says PAS is now legal in Oregon, Washington, Vermont and California.  They are considering a law in Canada that would allow for assisted suicide in mentally ill adult minors. He states the broad terms under which euthanasia is used in the Netherlands.

Dr. Pies correlated this with the growing “consumer rights” movement, which has replaced “physician” with “provider,” and “patient” with “consumer.” He hints that insurance companies–guided by numbers and statistics more than good care–are behind this language pollution.  He implies this subtle shift in terminology has dehumanized both parties and has undermined the therapeutic relationship between patient and physician.

My take is medical journals subsist on advertising, primarily from pharmaceutical companies.  Content usually reveals the medical bias toward expensive, patented medications and overtreatment for relatively minor problems.  The August issue of Psychiatric Times shows a heartening trend toward more clinically relevant information.  I commend this issue’s attempt to educate psychiatrists and the public about common sense solutions to common problems.