Tag Archives: psychiatry

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.

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 “Health Care Industry” is Sick

THOUGHTS ON THE HEALTH SCARE-SNARE RACKET

Saturday, March 25, 2017—Trumpcare, the Republicans’ answer to Obamacare, failed this week.  Predictions abound about what the government will do next.  It appears Obamacare is imploding, and the media expects it to be saved or replaced.  My right-wing conservative friends declare government control of health care is unconstitutional.  My left-wing friends believe Obamacare needs to be fixed, not replaced.

I’ve been opposed to government and insurance-controlled medicine since graduating from medical school and psychiatry residency.  Back then, it was Hillarycare, which was trounced initially.  During Bill Clinton’s presidency, Hillarycare began being implemented piecemeal through bureaucracy.

For me, the issue then and now was freedom, including freedom of choice about everything from practitioners to types of treatment.  Government-controlled health care translates into a guaranteed captive market for insurance companies, in which the healthy subsidize everyone else, especially the “industry” itself.  Doctors and patients must kowtow to government and insurance rules.  Out the window go confidentiality, honesty, and compassion, since symptoms must fit a diagnosis code to insure payment for treatment.  In psychiatry, this means the psychiatrist must come up with a diagnosis which goes forever on the patient’s record and can interfere with everything from self-esteem to employment.

AND, SEVEN YEARS AGO THIS MONTH . . .

CURRENT EVENTS:  OBAMACARE

Wednesday, March 24, 2010—Everyone is talking about Obamacare, which passed over the weekend.  Everyone knew it would, but nobody knows what it means except more taxes.  The boat is sinking, but we’re afraid to rock it.

VIGNETTE:  OBAMACARE

Friday, March 26, 2010—I met a 35ish guy in line at Starbucks yesterday.  I was standing at the cash register when Sean mentioned something about Obamacare.  I said Dr.Obama needs to write his own prescriptions.  The guy behind me, a big, burly fella with motorcycle helmet and a completely tattooed right arm but untouched left arm, thick dark hair two-three inches long, eyes brown and intense, said something about economics, bankers, the Fed, or a related subject that tipped me off.

I realized he is an awakened soul, sees things as I do, and so we stood there agreeing with each other until both got coffee and moved out of the way.

Tee hee.  I had told the boyfriends the other day there is no gold in Fort Knox, and the levels of security exist to protect the void.  My new friend, whose name I didn’t ask, agrees there’s no gold in Fort Knox, but for fools’ gold, hahaha.  I told him his generation is much smarter than my generation and got a laugh out of someone behind me in line.

On the way out, my new friend mentioned the book, Creature from Jekyll Island, and said he learned on the net that the US has been selling gold-plated tungsten bars to China and I think France as if they were gold, and the deception has recently been discovered.  Apparently it began during the Clinton years, and the cost was something like $50,000 per bar to produce.

Later, Sean said we were two peas in a pod, an unlikely pair, the two of us, but what the hey.  These younger folks are expected to cater to all these old coots who were gullible enough to trust the Woodrow Wilsons, FDRs, Lyndon Johnsons, and other paternalistic exploiters, and I don’t blame the younger set if they believe Boomers are dispensable.  Why should they support us?  I told my friend he is under no obligation to make good on the government’s promises.

TEN YEARS AGO THIS MONTH:

MEDICAL SCHOOL ATTITUDES

Monday, March 26, 2007 – I’ve been thinking about my medical career.  Starting in medical school, I was appalled by the attitudes, and they got worse in the hospital in our third year.  M. was a good study companion the first two years, but his old girlfriend and the vicious, cut-throat, warfare in the hospital in our third year edged me out.  He played the politics and kissed up to the residents, but he also loved doing the procedures, and was like the rest of them, eager to compete for opportunities to do lumbar punctures, draw blood, drain fluid from lungs and peritoneal cavities, deliver babies, run codes.  While I wanted the experience, too, I wasn’t willing to elbow my way into the situations that offered them, and the rush-rush mentality rattled my confidence and made me afraid to touch the patients.

I was horrified at the frenzy of my classmates when it came to procedures, and the careless disregard for the patients they were so eager to practice on.  I wasn’t willing to follow residents around, hoping for chances to draw blood or run errands or otherwise do their bidding.  They perceived my attitude as insolence, and the OB-gyn boys took it more personally than the others. No one ever told me directly, so I was flabbergasted when Dr. S said they complained and almost failed me for the OB rotation.  I only remembered they wouldn’t let us do much, because they wanted to do it, and they kept medical students in a room together entire afternoons while they saw the patients alone.  I spent my time studying, so made the highest grade in the class on the written test.  I thought the OB-gyn material was the easiest.  Everyone else was bragging about how many babies they were “catching,” as if it were a disease.  I only “caught” one baby, that the chief OB resident helped me with, but he was the first baby with congenital syphilis the attending physicians had seen in ten years.

THE MD ROLE

Monday, March 26, 2007 – My no-frills trappings and simple, ascetic life – which it is – runs counter to the doctor stereotype, into which other doctors pour money and pride.  I’ve never felt comfortable in the doctor role.  It belongs to someone else, a non-being, a stereotype formed by others’ expectations, divorced from my self-perceived style.

But I’m good at it, among the best I know, which makes it all the stranger, because it comes so easily.  That I don’t put much faith in the pills I prescribe, the system I represent, the beliefs believed “normal” by today’s standards, ekes out in passing references.

No, I don’t believe in war, competition, health care insurance, the federal government, marriage, or that churches should be property tax-exempt, unless everyone is property tax-exempt.  If I pray directly to god, without need for a priest or rabbi to intercede, why should I pay property taxes when they don’t?  Who’s to say god listens more to them than me, and why should that give them a material advantage?

DRUG AND ALCOHOL LAWS

Saturday, March 3, 2007 – Drug and alcohol laws represent a major human rights violation–as the 1794 Whiskey Rebellion foretold–and should be abolished.  No one has the right to restrict another’s access to her own body.  The key to better health is better education and a free range of choices.  No one feels my pain like I do.

I believe drug laws set the frame for the sadomasochistic power struggles we call addiction. Drug laws are a means by which government seeks control over taxpayers.  Laws put government in a moralistic, paternalistic, top-dog position over the taxpayers who pay its way.

Laws and other social engineering tactics restrict the productivity of the very individuals who support them, and the entire society loses.

CHILD AND ADOLESCENT PRESCRIPTIONS

Monday, March 12, 2007 – Doing child and adolescent psychiatry means prescribing drugs I don’t approve of, because the teachers dictate medical care for unruly kids.

No, we won’t give them physical education, home economics, shop, or any incentive to behave, nothing that will interest them during the long hours they must sit, while some harried, bored, and boring teacher parrots an agenda designed to stifle curiosity and make children hate education.

No, we will diagnose them as Attention Deficit Hyperactivity Disorder (ADHD), and put them on amphetamines to control their behavior, because what we’re really doing is cultivating the next generation of slave labor for the imperialists who formerly were industrialists but no longer even produce meaningful industry.  They produce paperwork, insurance, stocks, cash, and debt, using their forebears’ reputations as collateral, generating paper profits on Wall Street, while product quality and workplace safety plummet.

 

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.

 

 

 

 

Psyche and Cupid Revisited

Dancer, by Carol O. Cole

Dancer, by Carol O. Cole

by Katharine C. Otto

Here’s a myth written by a man.

Venus, Roman goddess of love, sends son Cupid to skewer beautiful, mortal Psyche with one of his famous love arrows, so she will fall in love with some ugly old coot and age quickly. Unfortunately, Cupid botches the job, ends up sticking himself with one of his own arrows, and falls in love with his mother’s rival.

Next, he abuses his immortal power by lying to Psyche and her family. He has the oracle say her destined mate is a monster. She resigns herself to her fate, and her family abandons her on a mountainside.

Cupid marries Psyche and whisks her off to his mountaintop estate, far away from everyone she knows and loves, except him. She isn’t allowed to see his face. He buys her anything she wants, but he is not there for her. He comes home only at night, after she’s asleep, spends the night, and is gone by morning.

She’s unhappy with this arrangement. She communicates she is lonely, so he agrees to bring her sisters up for a visit. They fill her mind full of doubts and remind her of the oracle.

So, Psyche lights a lamp in the middle of the night and looks at him. Shocked by his beauty, her hand falters, and she spills a drop of hot oil on him.  He wakes up, is offended by her audacity, and runs home to Mama to have his burn cared for.

“Love cannot live where suspicion lies,” he moans, as he flies out the window, thereby getting the last word. Psyche is expelled from the mountaintop estate and must work for a living.

Venus takes advantage of the marital conflict and sets Psyche to work. She orders her to perform a number of inane tasks, but Psyche, being mortal, knows her limitations and is not afraid to ask for help. Even the ants pity her and help her sort a pile of small seeds, one of the endless meaningless tasks Venus inflicts. Finally, after ten years, Cupid rescues his wife from his mother.

Now, the testosterone-poisoned would have us believe that Psyche did something wrong by looking at her husband. You’re supposed to believe she didn’t trust him enough, so she ended up having to prove her love.

This is a con.

It wasn’t Psyche’s fault Cupid was a bad aim, abducted her under false pretenses, set unreasonable rules for her behavior, and wasn’t there for her except at night and on his terms. A lesser woman would have used that lamp to set fire to his bed.

Psyche knew this was Cupid’s way of saying “I love you,” but she was fed up with the lies, discovered the truth, and paid the consequences. Psyche was ultimately granted immortality too, so she and Cupid can live happily ever after.

Fortunately for her, she gets more freedom. We must suppose she is now allowed to see her husband in broad daylight, perhaps even have breakfast with him, and enjoy his company outside the bedroom. The myth doesn’t say how often Venus comes around, but Psyche’s mother-in-law issues are another story.

The point is that Psyche does the only thing she can do to avoid becoming a bitter old woman. She breaks the rules before they break her. She pays the price to earn fulfillment, happiness, and love. Good thing, too, since the alternative would make for a miserable eternity.

This is good for humanity as well, since the word “psyche” has come to stand for the human soul, the mind, and mental life. It is the basis of the words “psychiatry,” “psychology,” “psychic,” and others.

Psyche did us all a favor by daring to challenge the gods’ authority. She pushed the envelope, and pierced the veil of mortality. Her experience offers promise of light beyond the darkness, for those who have the courage to persist.