In Defense of Carbon

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Carbon is the basic building block of life.  It is an element, indestructible.  We have the same amount of carbon on earth now as always.  It goes through a cycle.  Because it is so versatile, it can join with numerous other atoms to create complex structures.

I’m a climate change agnostic.  I know the climate changes every day and every season.  Whether human beings are changing the climate in a significant way is the subject of heated debate.  I do know humans are poisoning the environment, but the most dangerous chemicals involved are not carbon dioxide or methane.  These two are naturally occurring substances that are intimately involved in the cycles of life and death.

Organic chemistry is based on whether the compounds under study contain carbon.  Photosynthesis is the means by which plants use energy from light to convert water and carbon dioxide to food for the plant.  In this process, water is hydrolyzed (meaning broken down into its constituent atoms) with the hydrogen joining with carbon to form sugars, such as glucose and sucrose.  The sugars contain energy that fuels plant growth, maintenance and manufactures the substance of the plant itself, like cellulose.

That plants can make their own food from light, carbon dioxide and water is a marvel of solar technology, because all food ultimately comes from plants.  The mechanism of photosynthesis, according to my botany text (Botany:  An Introduction to Plant Biology, 6th edition, T., Elliot Weier, et al., 1982) took almost 200 years to be understood, and it still contains undiscovered secrets.  Researchers are now working on harnessing the 100% efficiency of plants to make electricity.  In contrast, solar panels are only between 15-20% efficient.

According to Botany, a series of discoveries beginning in 1700 led to the eventual understanding of how photosynthesis works.  In 1700, a Flemish physician and chemist Jan van Helmont grew a willow branch in measured soil and water.  It grew from five to 169 pounds in five years, but used only two ounces of soil.  In 1772, Joseph Fleming noted a sprig of mint could restore confined air that had been made impure by burning a candle, but in 1779 Jan Ingen-House noticed air was only revitalized when the green portion of the plant was exposed to light.  In 1782, Jean Sonebier discovered carbon dioxide was necessary in the “fixed air” supply of the green plant, and in 1796 Ingen-House determined the carbon went into the nutrition and structure of the plant.  In 1804, Nicholas Th. de Saussure observed water was also involved in the photosynthetic process, and in 1800 chemists discovered that carbohydrates were formed.  Experiments using “heavy oxygen” (oxygen with atomic weight of 18 rather than the usual 16) proved the oxygen liberated in photosynthesis came from water rather than CO2.

The basic chemical reaction for converting carbon dioxide and water to glucose is:

6CO2 + 6H20 +686 kcal –> C6 H12 O6 + 6O2

The oxygen is released into the atmosphere.  Plants also release water vapor through evaporation, and this induces liquids and nutrients to move upward through the xylem (the plant’s substance, including transportation “vessels”).

The glucose produced is used directly, or stored as insoluble starch.  It’s used to make cellulose and other structural components, or is combined with nitrogen, sulfur or phosphorus to make proteins.

When a plant or any life form dies, the stored carbon is either consumed by another life form or it is released as CO2 and methane (CH4), among other substances.

Igniting the hydrocarbon molecules reverses the photosynthetic process in a one-to-one ratio.  CO2 and water are re-created, and the energy bound up in the molecule is released as heat or used to do work.

The chemical reaction when the simplest hydrocarbon, methane (natural gas), is burned is:

CH4 + 2O2 –>  CO2 + 2H2O

Natural gas, oil, coal, ethanol, and plastic, to name a few, have the same carbon and hydrogen building blocks, in different combinations.  All have high energy contents and produce CO2 and water when burned.

Ethanol—which is now a federally mandated gasoline additive—has a lower energy content than gasoline so lowers gasoline efficiency. Ethanol, also called “ethyl alcohol,” is old-fashioned grain alcohol, the same substance distilled by farmers in Revolutionary War days, and the stuff that led to the Whiskey Rebellion when the whiskey tax was passed in 1791.

Plastic has a high energy content and burns hot.  Plastic waste is accumulating around the planet, in huge ocean “gyres,” as well as other bodies of water, sewage and drainage systems.  Its breakdown products are associated with endocrine (hormonal) changes in people and animals.

The main weakness of the climate change initiative is that the focus on “greenhouse gases” diverts attention from more immediate and ongoing threats to the planet.  The use of single-use packaging, for instance, uses valuable natural resources, such as paper, and environmentally harmful industrial products, such as plastic, that end up in landfill or in rivers, lakes, and oceans.

The ethanol mandate, passed in 2007, is a particularly toxic piece of legislation.  Under this scenario, farmland is used to produce corn, soy, or other carbon-containing plant matter, to be distilled into alcohol for burning in cars.  Not only does this deplete soil that might otherwise be used to grow food, but it requires massive amounts of water, time and money, so is a pox on the planet and on the engines that use it. It is particularly harmful in small engines, like lawnmowers, so conscientious users must use ethanol-free gas to protect their engines.  That Archer Daniels Midland, the main corporate beneficiary of the ethanol mandate, is set up to distill ethanol for cars as well as ethanol for drinking, should provide clues as to how regressive this mandate is.

In summary, I contend that, “climate change” includes changing the political climate to recognize that growing trees is better for the planet than giving corporations “carbon credits” not to cut them down.

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Opiates: Crisis du Jour

Opiate abuse is the crisis du jour in the medical and psychiatric world.  I’ve seen reference to it in the psychiatric journals, in the New York Times, and in the Summer, 2017 issue of Utne magazine.  There are Continuing Medical Education credits available for it.

Do I believe opiate abuse is a new problem, or that it has suddenly grown into the gigantic epidemic the “authorities” claim?  I know there is a push for funding for substance abuse treatment.  Other than that, I believe the “crisis” is fueled by enablers who need to be needed.

First, the literature I read makes no distinction between heroin, which is an absolutely illegal drug in the US, and the other opiates.  There’s a vague claim that the heroin is coming in from Mexico, but I wonder if it’s coming home with troops from Afghanistan, too.  No one has asked that question.

The legal-with-a-prescription opiates are presumed to be used for pain, and apparently there is a growing trend to abuse prescription opiates.  Doctors who prescribe too many of them fall under the DEA’s watchful eye, so I wonder how many doctors are willing to risk their licenses to support an abuse habit.  There are pain clinics sprouting up around the country, specialty clinics in which opiate use is standard.  These are carefully monitored by the DEA, as are pharmacy records that show which docs are prescribing controlled substances.

A large number and variety of substance abuse treatment methods and facilities exist, but effectiveness over the long term is poor.  Most studies into substance abuse treatment only follow patients for a year.  Long term studies are rare.  Alcoholics Anonymous (AA) and its spin-offs, like Narcotics Anonymous and Cocaine Anonymous—with their reliance on the 12-Step Program—have remained the standard since 1935.  These are free programs, peer supported, in which names and paperwork are not required.

My questions about this new “crisis” stems from my cynicism about our current drug-centered world.  The difference between “good” drugs and “bad” drugs is only a matter of legality, according to me.  Drug laws confuse the issue and create problems that needn’t exist.  Even the Psychiatric Times is beginning to take a fresh look at substances such as marijuana, looking to explore its potentially therapeutic effects.  There was a recent article suggesting hallucinogens like LSD and psilocybin might deserve more attention as therapeutic agents, under controlled conditions.

Unintentional injury from accidents and drug overdoses, according to one Continuing Medical Education (CME) course I took, is now in the top five causes of death.  The course didn’t distinguish how the overdoses occurred, but my experience tells me a surprisingly large number of people take ten or more medications, don’t know what they are taking, how to take them, or what they are for.  They don’t know about side effects, and their doctors don’t explain.  They take them “when I feel like I need them.”  or don’t take them at all if they can’t afford the cost.

Direct-to-consumer advertising by pharmaceutical companies has grown exponentially since it was approved by the FDA in 1997.  Pharma spent less than $800 million/year on advertising in 1996, but by 2000, that sum grew to $2.5 billion.  Of that, 20 percent was for psychiatric medications, and these constituted 10 percent of the top 100 selling drugs.

Obviously, there is a great demand for “feel-good” drugs, either over the counter or under the counter, and I have to wonder why.  From what I’ve seen, none of these drugs satisfies the long-term cravings of those who have lost their way.  The psychiatric drugs, like antidepressants, are not proving themselves over time, so there is a constant turnover of medications used to treat depression.  Yet advertising, the “health care industry,” and the world at large seems to believe there is a quick fix to problems, lifestyle problems, relationship problems, financial problems, employment problems, health problems, loneliness problems, and all the problems people’s fantasies tell them should respond to drugs.

As long as people put faith in solutions outside themselves, they will be disappointed, I believe.  Maybe a pill can help, temporarily, but there is no pill for financial problems, unless you’re selling it on the street.

That, in summary, may be the underlying impetus behind the “opiate crisis.”

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.

 

 

 

 

 

It’s About Time: Bud, Beon, and the Bots

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Sunday, July 2, 2017—This is a scene from my novel, a decades-old perpetual work in progress.  Superficially sci-fi, it is based on a philosophy that life is immortal, everything has consciousness, and everything runs its course then evolves into something else.  Time and space are illusions within a “spacious present.”  Death is like a phase change–like water converting to steam–while retaining the essential qualities of water.  From this perspective, there is no end point, and the process is the goal.

The purpose of the novel is to make you smile.  Let me know if you want more.

CHAPTER 4

CAUSE AND EFFECT

The sun, shining through dingy, crocheted curtains, cast a mosaic of light and shadow across the worn rug. By the angle of the light and content of the shadows, Joe knew it was at least 11 AM.

His head throbbed with an intensity of 200 on a one-to-ten scale.  The light hurt his eyes, but he didn’t have the courage to move.  He remained curled stiff, eyes clenched shut, until his bladder forced him to attempt the impossible and get out of bed.

He moaned, then winced.  He eased to a slouching position at the edge of the bed, resting his aching forehead between tender hands.  Slowly, ever so slowly, he stood and staggered to the bathroom, carefully shielding his eyes from the light.  He downed two aspirin and then a third, to abort the stroke he must be having.  It was at least a stroke. Maybe an aneurysm had burst.  He stared into the mirror.  Images of his certain, agonizing, and imminent death spread like acrid black goo across his quivering brain.

“I’m dying,” he told his haggard face. It stared back at him—coldly critical, his appearance substandard today, even for him.  He and his reflection eyed each other.  He noted the dark eye sockets, red eyes, fuzzy vision, chin stubble, wrinkles, and greasy hair.  He didn’t smell too good, either.  Let the embalmer handle it, he decided.  That’s what he’s paid for.

He trod a wobbly path through the living room to the kitchen, where the percolator was full of yesterday’s grounds.  His stomach wasn’t feeling much like coffee, but his head told him he was in caffeine withdrawal.  He cursed Marian for getting him so drunk that he forgot to prepare the coffee pot.  He imagined her boiling in a vat of coffee, begging for mercy.

Suddenly, Beon’s face loomed across Joe’s inner screens.  The balding, round visage grinned like the Buddha, his eyes innocuous, his portent ominous.  Joe’s head pounded harder, and his knees felt weak.  An image of lab rats, pinned to boards and randomly shocked, blotted out Beon’s face.  Then, the lab rats became little Joes, with Beon delivering the shocks.

Joe listed the objective, measurable reasons for his agony.  Unendurable pain. Undetectable caffeine levels. Betrayal by his only friend.  Violation of sacred coffee ritual, and death without absolution.  Beon.  He threw fresh coffee in the pot, spilling half the grounds on the counter, creating yet another reason to feel miserable.

Percolator finally started, Joe turned to face new trouble.  He opened the freezer and scowled at empty ice trays.  The little Joes in his head jumped and slumped.

He dragged his failing carcass to the couch. He imagined the pain in his head could power a small city, if he could figure out how to harness the energy.  Not today, though.  And tomorrow wasn’t looking too good, either.

Beon’s face returned, and with it, thoughts of the healing machine.  Joe wondered if it could cure his headache.  “Yes,” said Beon’s image.

“Who asked you?”  Joe demanded, not realizing he spoke out loud.

“You did.”  Joe decided he was going crazy, too.  “DALE,” said the face.  “Diet-Associated Life Enhancer.”

Joe covered his ears, but it did no good.  Beon’s image swelled in his head, and dream pictures bombarded his brain, rocking his scientific foundations.  The throbbing and pounding got louder, clanging against his skull.  Joe closed his eyes and waited to die.  Through it all, Beon’s face smirked, as if he enjoyed Joe’s suffering.

But death defied him, and Beon continued to grin.  Joe glanced around the room.  A single picture, hung askew, showed a listing clipper ship, an artifact left by the previous tenant.  George White left a few pieces of tired furniture, too, good enough for Joe.  His mailbox in the foyer downstairs still bore White’s name.  When neighbors called him “George,” Joe didn’t bother to correct them.  It was as good a name as “Joe.”

Now Joe wondered for the first time what happened to George White.  His couch may not look great, but it had personality.  It was warm, comfortable, inviting.  It was friendly.  It was taking care of him, helping him feel better, as a friend would do.

“I have tangible evidence that you existed,” he told the former tenant, “even if we’ve never met.  I still get your mail.  Beon is only imaginary, but he’s torturing me, and I can’t get away from him.”

Joe’s eyes began to blur.  His stomach felt queasy.  Vague terrors swept over him, and sweat poured from his upper body.  He wiped his face with a dirty napkin and dropped it on the floor.  “This is only a hangover.  It clouds my perspective, makes me think crazy thoughts.  It was only a dream.  A machine like that is impossible, and Beon doesn’t exist.”

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.

 

 

 

 

 

 

 

Addictive Thinking

by Katharine C. Otto, M.D.
January, 2002

Loosely defined, addiction is any attachment that compromises free will.  Addictive compulsions become problematic when they take precedence over more important life concerns, in defiance of reason and good judgment.

Everyone can identify with some measure of addictive thinking. Understanding your own compulsions – whether eating, exercising, working, television, sex, lifestyle, or even a prevailing mood, like anger, sadness, or guilt – helps to appreciate that the difference between addicts and non-addicts is merely a matter of degree.

With addiction you feel powerless, victimized, or lacking in free will. Thus, the first of the 12 steps of Alcoholics Anonymous states, “We admitted we were powerless over alcohol – that our lives had become unmanageable.” The key words here are “powerless” and “unmanageable,” because the substance could just as easily be tobacco or food.

When your compulsion becomes your priority, affecting more important areas of your life, such as health, relationships, work, or society at large, you become diagnosable. At this point every choice you make is colored by your addiction. For this reason, addiction treatment and AA emphasize making recovery a priority – a concept hard to grasp by many addicts, who fight this step because it is so powerful. Making recovery a priority and “walking the walk” on a day-to-day basis requires conscious choice and confers over time confidence in your ability to change your life. This subtle change in thinking from “power over” to “power to” reflects a shift from the role of victim to that of a responsible, self-directed individual.

Recovery is a growth process, requiring time to mature.  Building a healthy sense of self within the context of the environment takes patience.   We live in an addictive society, and enablers abound. Our systems foster and perpetuate dependency. Mainstream assumptions that the answers are “out there” lead us to doubt our own inner wisdom, yet relying too heavily on external authority eventually results in disappointment, victimization, and power struggles. Power struggles with either internalized or external authority eventually must be balanced by a cooperative spirit.

Relapse is part of the disease of addiction. Addictive thinking includes a rigidly held set of rules, whether consciously acknowledged or not. When these perfectionistic – and frequently unrealistic – rules are violated, the addict will often give in to his underlying sense of powerlessness and intensify his self-destructive activity, becoming a victim once again. Here, the power struggle is within himself, but the whole self loses in the see-saw struggle between “absolute control” and “out of control.”

In the past, addiction treatment took a punitive approach to relapse, but the winds are shifting. The addict who relapses already feels like a failure, and the punitive approach reinforces his negative self-image. At this point he is likely to run from treatment, if he is not reassured about the relapsing nature of addiction and the importance of keeping the relapse short.

Addictive thinking presupposes boundary confusion, a lack of definition of where you end and the next person begins. This inability to establish and maintain appropriate boundaries contributes to the escapism of addiction, and this leads to physical and/or emotional isolation. The “higher power” of Alcoholics Anonymous can just as easily refer to society as it does to a god, because the group is stronger than the individual. It helps set boundaries when the addict is unwilling or unable to do so. It’s also good for supporting the recovering addict in his strengths. For this reason, addiction treatment relies heavily on group process.

Everyone is susceptible to negative attachments, to situations and circumstances that lead to unwise choices. Addictive belief systems perpetuate those attachments, employing such tactics as victimization, power struggles, perfectionism, impatience, and deception. As the recovering addict walks the walk, he learns through everyday experience how to avoid those pitfalls and live a more fulfilling life.

 

Involuntary Manslaughter?

Twenty-year-old Michelle Carter was convicted last week of “involuntary manslaughter” for encouraging the suicide of her friend Conrad Roy III, in July, 2014. While I’m not surprised by the outcome, I’ve always wondered if anyone should be held responsible for another person’s actions, up to and including suicide and murder.

The law says they should.  Psychiatrists, in particular, can be held liable if their patients–present or past–kill themselves or anyone else.  A mere hint of “suicidal ideation” in an emergency room is enough to get someone committed to psychiatric hospitalization, at least for an observation period of up to 72 hours.

That homeless people, alcoholics, drug addicts, and those escaping the law or outside enemies use this ploy to obtain “three hots and a cot” on cold or stormy winter nights is common knowledge in the medical world.  There are also the drug seekers, who hope to receive controlled substances to alleviate their pain.  While others want to blame the patients, I look to the crazy-making system itself. Those who learn to “work the system” are only doing what they believe is necessary for survival.

The professional’s challenge and dilemma is always to determine intent to act. Psychiatric evaluation is meant to assess the seriousness and immediacy of the threat.  It includes questions about access to weapons, past attempts, serious stressors (like medical diagnoses, relationship breakups, financial crises, for instance), level of intoxication (if any), mental stability (such as psychosis) and other possible contributing factors to the person’s distress.

In most cases, a 24-hour hospitalization is enough to alleviate the symptoms and allow a person to be discharged safely.  By morning, most people have changed their minds, at least until the next time.  Those who are truly suicidal can remain in the hospital for weeks, months, or even years, although this is becoming rarer. Psychiatric hospitals are so crowded that there’s constant pressure to discharge as soon as possible, or at least as soon as insurance coverage ends.

Bottom line is potential suicidality is taken very seriously in the medical and psychiatric world, and each case is different.  Although it is an ethical no-no for psychiatrists to diagnose or analyze people they have not personally examined, I deduce from news reports that there were a number of factors playing into the Carter case, including the un-examined belief that anyone can prevent anyone from doing what they intend to do.

News sources say Mr. Roy had attempted suicide four times in the past.  Ms. Carter met him in 2012, had emotional and mental problems of her own, and needed to be needed.  She fancied herself a helper, and up until the last two weeks of his life, she tried to convince him not to kill himself.  Then she suddenly changed tack and began encouraging him to act on his threats.  She even ordered him back into the carbon-monoxide filled vehicle when he became scared and got out.  Most of this was done long-distance, say the reports.

Witnesses for the prosecution claimed her motive was attention, as she was communicating various moves in this two-year dance to a variety of other people. It’s not clear whether anyone intervened or tried to break up this dangerously destructive dynamic.  Was this so-called need for attention a desperate cry for help by Ms. Carter herself?  Apparently Ms. Carter at one point encouraged Mr. Roy to seek professional help, but did she consult anyone herself about this problem? Chronically suicidal people can be exhausting, even for professionals, when they begin to manipulate for sympathy, attention, or to control the relationship.  At what point does the helper give up and say (or think), “Quit talking about it and just do it.”?

I don’t mean to excuse Ms. Carter for her actions.  She apparently gave a lot of bad advice over a long period of time, and she was way out of her depth.  Who can ascribe motive? For all anyone knows, Mr. Roy may have killed himself sooner if not for Ms. Carter’s friendship.  I happen to believe suicide is a personal choice.  I don’t recommend it, but I also believe we all choose our time to die, on some level.  We only differ in how we do it.