shrinkette

lonegunmen100 said...

Freeman, wait until my book comes out.... we are currently writing the outline

Howard Dully
howarddully@comcast.net

...the goal is to discharge patients who repeatedly engage in self-harm behaviors (stabbing or slashing themselves, etc.) as soon as possible because, unfortunately, some people reap great rewards from hospitalization (three meals; a bed; warm attention from other human beings; etc.) and thus may continue to physically hurt themselves so they will emotionally feel better. Ultimately, these people benefit greatly from consistent outpatient care where, in the non-crisis situation, they can learn how to obtain these emotional rewards without resorting to these dangerous (and potentially lethal) methods.

These outpatient providers thus ask us to not be warm to them so that, in comparison, the outpatient providers are more appealing and amiable than those cold-hearted, aloof, and seemingly unkind hospital psychiatrist bastards. (It is honestly difficult to act like a jerk, though, because we’ve been trained to exude warmth and that is what we usually do.)

So I put forth my best efforts in not being warm today and it worked. Which totally sucked for the patient and it wasn’t fun for me, either. Ultimately, perhaps, it was the best thing I could have done for the patient, but I just don’t enjoy being an Ice Queen...

"SANTA FE, New Mexico (AP) -- A state judge has lifted a restraining order granted to a Santa Fe woman who accused talk-show host David Letterman of using coded words to show that he wanted to marry her and train her as his co-host...

Nestler's application for a restraining order was accompanied by a six-page typed letter in which she said Letterman used code words, gestures and 'eye expressions' to convey his desires for her.

She wrote that she began sending Letterman 'thoughts of love' after his show began in 1993, and that he responded in code words and gestures, asking her to come east.

Nestler said Letterman asked her to be his wife during a televised 'teaser' for his show by saying, 'Marry me, Oprah.' Her letter said Oprah was the first of many code names for her and that the coded vocabulary increased and changed with time."

The quick definition of a delusion is a fixed false belief. It’s fixed because the person can’t be convinced otherwise, even though it’s obviously false to others...Delusions, while untrue, may be entirely plausible or they may be quite bizarre.

Some people have particular types of delusions, such as paranoid, persecutory, religious, or grandiose. People may believe that others control their thoughts and actions or that everyone around them can hear their thoughts.

Delusions, along with hallucinations and disorganized speech, are a psychotic symptom characteristic of schizophrenia and related psychiatric disorders. Usually, these symptoms are transient or are controlled with medications."

Arguing with a delusion only leads to further mistrust or anger. The beliefs are tenaciously held, against all reason, & they are characteristically not shared beliefs. They are held only by the person himself & by no one else.

Families & friends must first realize that delusions are a result of illness & not stubbornness or stupidity. Although fixed delusions can be irritating, emotional reactions should be avoided, as should taunts or threats...

We of the AMA are concerned over the current wild proliferation of doctors in America today. There are simply more than enough physicians to serve our society efficiently already, yet increasing numbers of students think they want to plan for a career in medicine...

A doctor cares for, maintains, and treats the human body. They cure diseases that have names they can barely pronounce. They tell people that they are going to die of cancer. They spend all of their time either in their too-small, suffocating office–where the brats scream at the sight of a tongue depressor–or, worse, in a hospital—where the halls are full of the dying and the dead, and everybody and his brother is throwing up. On you, yes, doctor, on you and your nice white slacks...

Begin with four years in college: you must take biology courses (where you will most certainly dissect frogs, pigs, and Christ knows what else) and chemistry courses (where you will inhale things unknown in hell itself). Then if you are accepted, you will go to medical school. For four years. I say “if you are accepted’’ because you will not be accepted. Nobody is accepted, and those who experience rejection undergo permanent damage to their self-esteem...

“This is Mr. X. I need to know something very important. Did you make sure my mother was dead?”
“Excuse me?”
“Her doctor told me she had a pacemaker, and that it would work for over ten years.”
“Yes, those batteries run a long time.”
“Well, if the pacemaker was working, that means she was still alive, so I buried her when she was still alive. Did you check that she was dead?”
I look at the phone. Take a deep breath. Always tell the truth.
“We don’t make a diagnosis of death here at the Coroner’s Office, sir. They’re pronounced somewhere else.”
“Do they ever wake up?”
Another look at the phone. I explained that people are examined before they arrive, and they are put on a cold metal tray in a freezer. If they were asleep, they’d wake up.
He wasn’t convinced...

He’s still upset and can’t sleep. He still thinks his mother is buried alive. As it’s been three months since his mother’s funeral, she’s not alive anymore—even if she was buried alive, which she wasn’t...

This conversation takes another hour. Logic is not helpful; his fear is neither logical nor rational. Finally, I refer him to my boss. I take his number, and tell him the boss will call.

I go to the boss’s office to brief her. She looks at me like I’ve grown a third head.

“Does he think a pacemaker makes his mother immortal?”
“I made that point boss.”
“A pacemaker won’t work on a dead heart, William.”
“I told him that, too.”

There is an upside to neurosis in that the true neurotic also enjoys the gift of prophecy. Worry enough about any problem and you can make it happen, no matter how highly the odds seem stacked against it. The healthy individual thinks herself thin or rich, the hand-wringing worrymonger thinks herself into a 102-degree fever, accompanied by a vile chafing cough, on Christmas Day.

It’s amazing the power of negative thinking. You can do it too, merely by spending hours picturing yourself laid out in bed, martyr-like, while the rest of the family tucks merrily into the Christmas goose downstairs. You can achieve this goal despite logic or major obstacles such as spending the month leading up to the big day mainlining carrot juice...

Bethlehem, Judea - Authorities were today alerted by a concerned citizen who noticed a family living in a barn. Upon arrival, Family Protective Service personnel, accompanied by police, took into protective care an infant child named Jesus, who had been wrapped in strips of cloth and placed in a feeding trough by his 14-year old mother, Mary of Nazareth.

During the confrontation, a man identified as Joseph, also of Nazareth, attempted to stop the social workers...

Also being held for questioning are three foreigners who allege to be wise men from an eastern country. The INS and Homeland Security officials are seeking information about these who may be in the country illegally. A source with the INS states that they had no passports, but were in possession of gold and other possibly illegal substances...The chemical substances in their possession will be tested.

Jobless sits, wretched, upon a curbstone. Everything he possessed has been taken from him. His accounts have been closed, house sold for taxes, warranties voided, policies cancelled, back wages garnisheed. His wife has left him for a vintner. His children have run away. He has become afflicted with piles, boils, and scours. Creditors give him no peace...

Then the Lord answered Jobless out of the whirlwind of hot-dog wrappers and plastic drink tops with straws still stuck through them, saying, “Who is this that darkens counsel with poorly researched statements? Suck up your insides into yourself like a man, and hear me, and answer what I will ask...

Three Sisters, originally uploaded by L. A. Price.

One reason, from L.A. Price.

"On behalf of the greedy rapacious pharmaceutical industry, I'm glad to be hosting this week. Unfortunately for everyone, the research end of the G.R.P.I. is not immersed in the ceaseless flow of promotional swag that the medical community has come to know us for. So for you practitioners dropping by today, enjoy a rare chance to interact with the drug industry with no free samples, pens, calendars, or trips to Martinique. Never been there, myself. . . (gazing at ice-covered yard). . . OK! Where were we?"

I do! I'm a psychiatrist in Eugene, Oregon. I don't post my name, because I have concerns about confidentiality. I wish I had chosen a different name for this blog! (One commenter says it sounds like "an inept laundromat.") We must think of a better one...

Blogspot blogs are free. I have no ads.

There's no simple answer. It's commentary. It's an online diary. It's ego, it's an escape, it's a a game. It's a wish to connect with others. Why shouldn't doctors join the fun of blogging?

Truthfully, it's not that different from what I've always done. I've been writing since I was very young. I also took writing and journalism courses (before and during pre-med). I chased news stories. I wrote features, interviews, and puzzles for school papers. I wrote fake horoscopes that told readers where to park, what to wear, and to "circle B on all multiple-choice tests today." (One year, I gave the editor so many ramblings that he got fed up. He said, "Look, why don't you get your own magazine?")

I look for specific stories: patients and doctors talking about their experiences, trying to communicate. Readers send "blog fodder." I link to mainstream media, to other blogs (see blogroll), and to anything that looks interesting.

It should be clear from the links. Or, it should be clear that it's my own voice. But no medical advice is given on this blog! (Except "talk to your doctor" and "take a CPR class.")

Ah, the creative process! If it's not in the headlines (or in another blog), then it's something that might have occurred to me at home or on the job.

This should be clear from the links. Note: when I say, "I saw this at work today," you can be sure that it was, actually, a totally different day. (Confidentiality!)

See above. I also have a mental representation of what is "appropriate." This involves some combination of: (a) Can colleagues and superiors read this? (b) Will a patient read this and say, "hey, that's me?" and (c) Can mom read this?

Sitemeter tells us a little about who's visiting and what they're reading. But we can't really identify anyone. (I am fairly sure, however, that the hits from the Chinese coast are from my husband.)

Comments are welcome! I haven't had to delete a comment in a long, long time. If a comment doesn't meet criteria a, b, and c (above), out it goes.

"Beer For Dogs."

"If you have a diagnostic category that fits 100 percent of people, it's not a diagnostic category."

"Once in the hospital, I was given another patient's medications by accident. I was angry when I found out. I didn't suffer any serious problems because of it, but I wanted to know if the person even cared that this had happened. I will tell you that when the nurse came into my room soley to apologize to me, my anger was gone. I just needed to know that the person was sorry and that they recognized the magnitude of it. I told the nurse how much I appreciated that he told me the truth and that I thought it took a lot of guts to do that. If I had never received an apology I still would not have sued, but I might have reported it. I needed to know someone took that seriously. Mistakes happen, doctors make mistakes, nurses make mistakes, and patients make mistakes. But showing sincere regret when a mistake occurs is so important."

"...by about 15 I was in full meltdown. I was really searching for a father figure and I hooked up with a really bad crowd. My parents realised I was in trouble, so they pulled me out of high school and put me in this school where there were, like, 20 pupils and a therapist."

Your parents? Didn't you just say that you were searching for a father figure? Wasn't your dad around back then?

For the first and only time in the course of our conversation, Black - who could ramble on about most subjects until you stopped him - is lost for words. This is exactly how he replies: "There is dad. I don't know why he wasn't, er ... Yeah. I don't know why he wasn't, er ... but he was there. Er, my dad was a good dad but he, um, I'm just sort of ... For some reason I wished that I had a Harley-Davidson-riding heavy-metal dad, and that's what I went to find."

Did you try the therapy on offer to you at this point? "Some of the more intense kids were going in every day and I was, like, what happens in there? So I went in one day and said, 'Can I have therapy?' and he said, 'Sure, sit down.' "

Black recounts the experience as if looking back on a day at the spa: "I don't remember exactly how it went down, but I started confessing - 'cos as a Jew you don't have confessional, so I had years of guilt - and I told him about how I stole money from my mom to get coke, and I just cried and cried and cried my eyes out. Came out a different guy one hour later. Soooooo good."

And is he still the guy who came out, cleansed and purged, from that room? "I don't know," he admits. "I like to think that I'm not at odds with myself but I know that I still hide things..."

"'Across countries and cultures, I am amazed by the resilience of people who have mental disorders. [They are] Living with illnesses that are difficult to understand and which affect the very core of our sense of self; battling on a daily basis to live ordinary lives like you and me; trying to live a normal life in a society that will not try to understand their reality and views them with fear and suspicion.'

'I am saddened when I hear and see how mental health services fail to understand the simple desire to work and live a normal life in the community with friends and family. It is highly disappointing to see many mental health services do not perceive their primary role as facilitating the fulfillment of this desire.'

'We (the professionals) frequently fail to understand their need to be in control of their lives and their bodies, just like any of us would want to. We are quick to prescribe solutions but not keen to listen to their voices. We frequently refuse to acknowledge their identity – I hate it when people say so and so is a schizophrenic – as if the illness is their identity.'

'You might wonder why I continue to remain in this profession. Because I also have some memories that I cherish a lot. Seeing the smile and the excitement on the face of a person standing in the checkout queue at the supermarket. For the first time. Someone who had spent the greater part of their adult life in a mental asylum but was now living in their own home. I am proud to have been part of a mental health service that made this smile possible.'

'Mental illness affects people like you and me. Its time we realized this is about us, not about them.'

Witnesses aboard an American Airlines jetliner say that Rigoberto Alpizar's wife pursued him, saying he was mentally ill, just before federal marshals shot and killed him. Air marshals said Alpizar had announced he was carrying a bomb.

Later, no explosives were found. The incident remains under investigation.

"She was chasing after him," said fellow passenger Alan Tirpak. "She was just saying her husband was sick, her husband was sick." When the woman returned, "she just kept saying the same thing over and over, and that's when we heard the shots."

You Know You're on Peds Rotation When ...
-- Your stethoscope covers 3/4 of your patient’s chest.

The resident on call with you has a flashing stethoscope.

You decide that your name badge is boring, so at the solemn advice of one of your patients, you decorate it with a little glittery nail polish....

Remember the man she saw on the street? It turns out he did not have any legs and was floating in the air. Yet, she insisted he was real.

I was lost for words. I had spent the last hour talking to her and had missed the main points altogether. I was so obsessed with her leg pain that I left everything else unnoticed. I was beginning to feel depressed myself. I have to admit, examining the mind is a very complicated challenge...

"For his daughter's coming-of-age celebration last weekend, multimillionaire Long Island defense contractor David H. Brooks booked two floors of the Rainbow Room, hauled in concert-ready equipment, built a stage, installed special carpeting, outfitted the space with Jumbotrons and arranged command performances by everyone from 50 Cent to Tom Petty to Aerosmith.

"...The party cost an estimated $10 million, including the price of corporate jets to ferry the performers to and from. Also on the bill were The Eagles' Don Henley and Joe Walsh performing with Fleetwood Mac's Stevie Nicks; DJ AM (Nicole Richie's fiance); rap diva Ciara and, sadly perhaps (except that he received an estimated $250,000 for the job), Kenny G blowing on his soprano sax as more than 300 guests strolled and chatted into their pre-dinner cocktails.

"Hey, that guy looks like Kenny G," a disbelieving grownup was overheard remarking - though the 150 kids in attendance seemed more impressed by their $1,000 gift bags, complete with digital cameras and the latest video iPod...

"I'm told that Petty's performance - on acoustic guitar - was fabulous, as was the 45-minute set by Perry and Tyler, who was virtuosic on drums when they took the stage at 2:45 a.m. Sunday.

"Henley, I hear, was grumpy at the realization that he'd agreed to play a kids' party..."

Yesterday, I watched pieces of what one would have to characterize as a 'humorous, human-interest story' which, of all things, was related to the partial facial transplant that happened in France.

It started out with allusions to the movie Face Off and then the movie in which Hannibal Lector wears the face of a man after cutting it off his head (cut to video clip of this). All this delivered by the perpetually beautiful anchorpersons, female and male, with wisecracks. Then we go to interviewing people on the street, with the question being, 'Would you donate your face to someone?' At the end, Mr. Cute anchor jokes about maybe having a different face for every day of the week(?).

I'm sorry, I just find this sickening. Maybe they should in their off-work hours visit some people who have had their faces torn to shreds by a dog or in an accident, or had very extensive surgery for cancer of the face. What's it like to go through life without a face? That is what facial reconstruction is about...

Dr. Stephen Nimer, my mother's principal doctor, heads the division of hematologic oncology at Memorial Sloan-Kettering and is also one of America's foremost researchers in the fundamental biology of leukemia. As he explained it to me: "The fact is that people are never as educated as the doctor. You have to figure out something about the patient" - by which he meant something that takes both patient and physician beyond the profound, frustrating and often infantilizing asymmetry between the patient's ability to comprehend the choices to be made and the doctor's.

...the ethical challenge, vital for a doctor to recognize and impossible (and ethically undesirable) to deal with formulaically, comes not with the 30 percent of patients Nimer estimates know for certain whether they want aggressive treatment or not, but with the "undecided" 70 percent in the middle. As Nimer told me somewhat ruefully, the doctor's power to influence these patients, one way or the other, is virtually complete. "There are ways to say things," he said. "'This is your only hope.' Or you could say, 'Some doctors will say it's your only hope, but it has a 20 times better chance of harming you than helping you.' So I'm pretty confident I can persuade people." Groopman, in his clinical practice with patients like my mother, patients for whom, statistically, the prognosis is terrible, at times begins by saying, "There is a very small chance, but it comes with tremendous cost..."

"Something must've blown in on the wind night before last, because when I woke up yesterday, every cell in my body was poisonous to every other cell. It felt like a hangover without the alcohol.

Add one patient who seemed determined to seize, code, and die. Before 8 am...

1) Find someone else who has the same label as the person you're arguing with. Find a ridiculous opinion of theirs. Argue about that...

2) Answer each half-sentence separately, especially sentences using the word "but". Don't bother trying to fit the context; just find a way to interpret the half-sentence that's false and argue against it. Bonus points if you can get away with grouping half-sentences talking about totally different things together.

3) Bring up the opinion of a Known Idiot. When your opponent says that person is an idiot, ask why they've "suddenly" decided to distance themselves from the person...

6) Tell your opponent (who is clearly quite happy) that you're sorry they got upset, and that you'll stop arguing because you don't want to anger them any more. If they respond by saying they're not angry, tell them you're glad they calmed down, but you still don't want them to get angry. Keep doing this until they flame you, and leave their angry response as the last word.

PRODUCTION on two new Pirates of the Caribbean films, starring Keira Knightley, has been halted because of raids by real-life brigands, according to reports from the Bahamas.

Two cast members have been forced to flee for their lives after a series of robberies at the Grand Bahama island location, producers of the Disney film said...

“They [the robbers] were able to get into the room with a key and stole everything from laptops, passports, cheques and other equipment. The money they stole was actually the actors’ pay cheques.”

Some actors and crew members have been robbed four times in a month. The last incident happened on November 11. It is claimed that $20,000 (£11,500) in cash and equipment was taken.

Mr Kakebeen, chief executive of Jemini Seven Entertainment, declined to say whether any of the film’s stars had been targeted. But he said that two actors had left the island in fear of their lives as a result of the robberies. The equipment and cast losses have brought production to a standstill.

The Pirates shoot ran into controversy earlier this year when members of the Carib tribe on the island of Dominica accused Disney of perpetuating the myth that locals were cannibals. A scene in which Depp’s Captain Sparrow is tied to a skewer with vegetables and roasted on a spit “like a shish kebab” provoked calls for local people working as extras to boycott the filming. Nevertheless, hundreds of Grand Bahama residents have signed up to work as £50-a-day extras, answering a call for “sailors, pirates and Asian seamen”...

If you are new to the Internet, allow me to explain how to debate in this medium. When one person makes any kind of statement, all you need to do is apply one of these methods to make it sound stupid. Then go on the offensive.

1. Turn someone’s generality into an absolute. For example, if someone makes a general statement that Americans celebrate Christmas, point out that some people are Jewish and so anyone who thinks that ALL Americans celebrate Christmas is stupid. (Bonus points for accusing the person of being anti-Semitic.)

2. Turn someone’s factual statements into implied preferences. For example, if someone mentions that not all Catholic priests are pedophiles, accuse the person who said it of siding with pedophiles.

3. Turn factual statements into implied equivalents. For example, if someone says that Ghandi didn’t eat cows, accuse the person of stupidly implying that cows deserve equal billing with Gandhi.

4. Omit key words. For example, if someone says that people can’t eat rocks, accuse the person of being stupid for suggesting that people can’t eat. Bonus points for arguing that some people CAN eat pebbles if they try hard enough.

5. Assume the dumbest interpretation. For example, if someone says that he can run a mile in 12 minutes, assume he means it happens underwater and argue that no one can hold his breath that long.

6. Hallucinate entirely different points. For example, if someone says apples grow on trees, accuse him of saying snakes have arms and then point out how stupid that is.

7. Use the intellectual laziness card. For example, if someone says that ice is cold, recommend that he take graduate courses in chemistry and meteorology before jumping to stupid conclusions that display a complete ignorance of the complexity of ice...

Weirdly enough, if you substituted "doctor" for "lawyer" in most of that article, you'd pretty much have the reaction of non-medical people to dealing with illness, or even a simple doctor's visit.

Or just about any other stressful issue.

No one wants to be sued wrongfully or maliciously, of course. And no doubt doctors by the nature of their practices are in danger of such suits more than the rest of us. There medical folks have my sympathy.

But I'm not sure why these reactions or feelings about being sued for malpractice should surprise anyone in any way.

I completely agree with the anonymous person who said that you can substitute any of the physician's feelings listed above for the patient's feelings or the feelings of the patient's lawyer---surprise, shock, outrage, anxiety, dread, etc. I was at this point in the late 1990's because of an incompetent neurosurgeon I had. Due to my family, (none of whom have ever been employed in the medical profession), taking me to a completely different hospital in a completely different geographical area, I am fully functional today. But I lost an extremely good job I had recently acquired while I was waiting for the clown to diagnose me properly, and I've never been able to get another job as good since then...(And, yes, the condition I have is a neurological condition that he should easily figured out.)

Jeepers Sleepers, originally uploaded by judge_mental.

Judge Mental sends word that the Third Infantry Serotonin Reuptake Inhibitory Battalion has taken up positions for the "forthcoming Battle of Christmas Shopping."

"Troops working out of a field hopital set up in British Home Stores will distribute emergency supplies of antidepressants to parents and children while maintaining crowd control operations..."

The reaction to being sued often is prefaced by a period of emotional turmoil following the catastrophic event or negative outcome. The physician may feel unduly responsible or guilty, genuine sorrow for the persons involved, dread, anxiety, and fear of being sued. These feelings may not resolve in any way until the statute of limitations expires or a suit is filed.

More than 95% of physicians react to being sued by experiencing periods of emotional distress during all or portions of the lengthy process of litigation. This may begin immediately on being served with the complaint by a sense of outrage, shock, or dread about the personal and financial effects of the eventual outcome. This is the first reaction in a series that is similar to those that accompany any major life event...Feelings of intense anger, frustration, inner tension, and insomnia are frequent throughout this period.

Symptoms of major depressive disorder (prevalence, 27%-39%), adjustment disorder (20%-53%), and the onset or exacerbation of a physical illness (2%-15%) occur, although fewer than 2% acknowledge drug or alcohol misuse. A general internist, for example, described awakening with his first episode of atrial fibrillation after being served with his first malpractice suit the previous afternoon. This generated emergency medical consultation accompanied by profound psychological effects on the physician. Some 2 years later, it figured prominently in his decision to settle and to retire earlier than he had originally planned...

The complaint is served: initial feelings of surprise, shock, outrage, anxiety, or dread

Consultation with lawyer: depending on the initial assessment of the case, reactions of anger, denial, concern, reassurance, panic

Lengthy period of denials and intrusions: active attempts to erase thoughts about the case, followed by automatic reminders and intrusive thoughts about it; becoming preoccupied by ruminating excessively—exacerbated whenever case-related activity increases, such as before the deposition, when experts testify, and before and during the trial

Working through the lengthy process, during which physicians psychologically and intellectually “process” the meaning of the case, their role in it, and their approach to their own defense...

Randolph Nesse, University of Michigan: 'I'm pretty sure that people gain a selective advantage from believing in things they can't prove. Those who are occasionally consumed by false beliefs do better in life than those who insist on evidence before they believe and act.'

Stanislas Dehaene, Institut National de la Sant, Paris: 'We vastly underestimate the differences that set the human brain apart from the brains of other primates.''

Carlo Rovelli, Centre de Physique Thorique, Marseille: 'Time does not exist.'

Seth Lloyd, Massachusetts Institute of Technology: 'I believe in science. Unlike mathematical theorems, scientific results can't be proved. They can only be tested again and again, until only a fool would refuse to believe in them.'

Daniel Hillis, chairman, Applied Minds Inc: 'I know that it sounds corny, but I believe that people are getting better. In other words, I believe in moral progress.'

Craig Venter, president, J Craig Venter Science Foundation: 'Life is ubiquitous in the universe.'

Janna Levin, Columbia University: 'I believe that there is an external reality, and you are not all figments of my imagination.'"

Du Yu, the engineer who works for our distributor here in China, is always translating for me: that girl says you look like Karl Marx. It happens wherever we go. It means, he says, that you are an amiable person, not to mention that you really look like him. Chinese people learn in grade school that Karl Marx is the “real” Santa Claus. So, I bask in the glow of the masses, they warm to my gaze like dumplings in a bamboo steamer. I probably could take advantage of this...

The waitresses wanted to put the cork back in the bottle after I poured myself a glass of the Cal Red and taken a sip. I tried to tell them that no, you don’t put the cork back in. They just did not understand what I was telling them. So, I pointed to the bottle and tried to pantomime that the wine needed to breathe.

Well, they thought I was telling them that the wine was causing me to suffer an attack of hyperventilation. They became quite serious, concluding that I didn’t like it, that it was killing me. They wanted to take it away! I had to keep repeating “that’s okay” as I grasped the neck of the bottle reassuringly. Then they went to get someone in uniform, who stood in front of my table silently for a while, then blurted out “ice?” -jerking her finger at my glass. “No, no ice, that’s okay, that’s okay”.

I could tell at that point they had concluded that I was crazy. Not putting ice in the Cal Red, not putting the cork back in the bottle to preserve its essence, pretending to hyperventilate for no apparent reason. After that, they left me alone, but I was observed from a distance with fairly unrelenting interest.

It’s around 10:45 pm now. We fly to Xi’an tomorrow afternoon, where the entombed warriors await us. Hainan Airlines, flight 7862, departing 14:45. KFC is going out of business in China. No one is eating chicken because of bird flu.

There is less emphasis on careful observation. The fundamental point is that the individual patient and his or her uniqueness should form the centrepiece of clinical practice...There is an increased tendency to make diagnosis through checklists, with less emphasis on the interesting uniqueness of each individual patient and on the humanism that lay at the heart of early psychiatry. We tend to over-biologise, we oversimplify the mechanisms of mental illness: in a reductionist framework, depression is a serotonin disease, schizophrenia a dopamine disease. But if we look only at brains, we fail to recognise the important role that personal life experiences may play in losing our minds.

It's useful for psychiatrists to remember that the word comes from the Greek psyche, which means breath, life, animating principle or spirit. Contrast that with the Greek word for mind, which is nous, or the word for brain, which is encephalon. Literally, a psychiatrist is a healer of the spirit, not of the mind or brain.

Does that explain why patients are prescribed so many drugs?

Doctors and patients began to think that most problems could be solved by popping a pill. In the US, at least, we have had some serious over-prescribing for conditions such as attention deficit disorders, anxiety and depression. Sometimes people see medicines as cosmetic surgery for the mind.

And some of those drugs can be a very mixed blessing?

Almost all medications have some side effects. The art of medicine, so to speak, is finding the right balance of dose and side effect. Some of the older antipsychotics did have side effects to do with the motor system: tremors, shuffling gait, restlessness. Newer antipsychotics have fewer of those side effects but have a tendency to produce weight gain. Some believe that modern antidepressants can cause suicide.

What's the solution to the problem of modern psychiatry?

What we need to do is collect data from all levels: molecules, cells, tissues, organs, cognitive and emotional systems, behaviour, exposure to environmental influences. This is going to require rather a lot of data. I love psychiatry because when we do it right, it is the only speciality that emphasises the understanding of individual human beings within the context of a unique environment and personal life history.

Fingernails scraping down a blackboard…the scream of a baby…your neighbour’s dog barking: what’s the worst sound in the world?

BadVibes is a new science project from Salford University that aims to find out just that. People can log on to the BadVibes website at www.sound101.org where they listen and vote on a collection of awful sounds, use the horrible sound mixer and even download horrible sound effects as ringtones.

But as Professor Trevor Cox from the University’s Acoustics Research Centre explained, there’s a serious side to the research as well.

"The idea behind the project is to get people thinking about the complex way we listen to and interpret sounds. For instance, you can find out why we find the sound of retching horrible.

By examining people’s voting patterns we will learn more about people's perception of horrible sounds. We hope to learn about what is the worst sound in the world, and maybe why it is the worst sound...

Schedel - Blue, originally uploaded by Pettefletpluk.

Today is the "Great American Smoke-out." Evy's line-and-gouache portrait sends a perfect message, don't you think?

Medical Necessities:
If the person has stopped breathing, administer CPR, including chest compressions if there is no pulse. This is the top priority!
Common Sense:
Make the person as comfortable as possible.

ENERGY METHODS to support the heart (presented in the suggested order, but like all energy medicine interventions, use with an experimental attitude—they won’t hurt, they probably will help, energy test your results when appropriate, stay attuned to your intuition, not every technique listed will be necessary, innovate):

1. Do a "hook-up" (one hand in navel, one hand on third eye, push in and pull up).
2. Strengthen the heart meridian by tracing it forward. As you come to the end of the meridian, rapidly twist the ends of the little fingers back and forth with some pressure.
3. Deeply and vigorously massage the heart neurolymphatic points between the 2nd and 3rd ribs, just below where the collarbone and breastbone meet, especially if the person is unconscious. Do not do this massage for more than 10 to 15 seconds.
4. Hold one hand over the heart area and press deeply into the top of the pubic bone with the other hand for about 30 to 60 seconds (re-establishes electrical energy in the body and stimulates the penetrating flow)
5. Hold the triple warmer strengthening points (TW3 & GB41, then TW2 & BL66) if the person appears to be leaving the body. Speak calmly and ask the person to stay with you. If you have help available, have another person pulse the K1 points on the bottom of the feet.
6. Hold the spleen meridian strengthening points (Sp2 & H8, then Sp1 & Lv1).
7. If the heartbeat is erratic or if the heart is beating too strong, hold the small intestine meridian strengthening points (GB41 & SI3, then B66 & SI2)...
8. If the person is conscious, stable and resting comfortably, hold the frontal neurovascular points to offer comfort until help arrives...

...The person may enter an altered state of consciousness and, rarely, appear to have left the body. Initially, if the person is in an altered state but conversant, ask if help or assistance is desired. Sometimes a productive and even precious inner journey is underway...

Australians have been told there is no need to panic after a recent "glow-in-the-dark pork chop" scare.

A caller to a Sydney radio talk show sparked fears of radioactive contamination in the meat supply.

The New South Wales Food Authority said the glow was caused by the harmless Pseudomonas fluorescens bacteria.

Food authority head George Davey said he understood people would be "shocked" to see their meat glowing in the fridge but said the bacteria were safe.

"It is important to remember that the micro organism responsible for the glow is not known to cause food poisoning," he said.

The bacteria are naturally present in meat and fish but they multiply quickly if food is not stored at the correct temperature.

So the glowing can be a sign that the food is starting to go off and Mr Davey recommends consumers throw any luminous pork chops - or other cuts of meat - straight into the dustbin.

It's impossible to discern whether this is a true trend or just a New York Times trend. That is, an editor or reporter has a friend or aquaintance who does something or believes something and then writes a whole front page story on the 'trend' based on interviews of the friend and the friend's friends. I suspect the latter, but it's disturbing nonetheless...

They possess two of the worst possible traits that when combined are often fatal - arrogance and stupidity. (Or, as one of my uncles used to say, 'It's not a crime to be stupid, but it is to abuse the privilege.')

If you were searching for the path to lasting happiness, Slough probably wouldn’t be the place you’d start. But for Richard Stevens, a leading psychologist, the Berkshire town proved the ideal location for a pioneering experiment: take all the theory and speculation about what makes human beings happy and test it over ten weeks on people in an ordinary British town. He believes he now knows what works.

Poor old Slough: it was the running gag in The Office; John Bunyan linked it irrevocably with “despond” in The Pilgrim’s Progress; and Betjeman famously pleaded: “Come, friendly bombs and fall on Slough/It isn’t fit for humans now.” Stuck under a Heathrow flightpath and beset by roundabouts and soulless concrete buildings, it is an emblem of the sadder aspects of modern Britain. But Stevens, along with a team of shrinks, counsellors, an economist and a film crew, found it fertile ground for emotional uplifts.

The team recruited 50 local volunteers, aged from 17 to 78, spanning the racial spectrum, and with occupations from housewives to local councillors and university tutors. The mission: Make Slough Happy. With a four-part BBC television series on the completed project starting next week, Stevens, the avuncular chair of the Open University’s social psychology course, claims to have found the path to happiness in everyday modern life . . . and it isn’t more money.

His formula splits into four general categories: physical, relationships, work and community. But if there is a keyword, it is connectedness...

Plant something and keep it alive.
Count your blessings — think of at least five — at the end of every day.
Have an hour-long uninterrupted conversation with your partner each week.
Telephone a friend.
Give yourself a regular treat.
Have a good laugh each day.
Take regular exercise.
Smile at strangers, or talk to them.
Cut your television viewing by half.
Perform an act of kindness every day.

Dr. David Healy, a psychiatrist at the University of Cardiff and a vocal critic of his profession's overselling of psychiatric drugs, has achieved a rare kind of scientific celebrity: he is internationally known as both a scholar and a pariah.

In 1997 he established himself as a leading historian of modern psychiatry with the book "The Antidepressant Era." Around the same time, he became more prominent for insisting in news media interviews and scientific papers that antidepressants could increase the risk of suicide, an unpopular position among his psychiatric colleagues, most of whom denied any link. By 2004, British and American drug regulators, responding in part to Dr. Healy and other critics, issued strong warnings that the drugs could cause suicidal thinking and behavior in some children and adolescents.

But Dr. Healy went still further, accusing academic psychiatry of being complicit, wittingly or not, with the pharmaceutical industry in portraying many drugs as more effective and safer than the data showed.

He regularly gets invitations to lecture around the world. But virtually none of his colleagues publicly take his side, at least not in North America.

"It's strange. I don't even know about friends, what they think about me," Dr. Healy said in New York, as he waited for a flight after giving a lecture at Columbia. "You don't really know who you can trust."

Because of his controversial views, Dr. Healy has lost at least one job opportunity, at the University of Toronto in 2001. In some circles, his name has become so radioactive that it shuts down discussion altogether.

"People have called it the Healy effect," said Dr. Jane Garland, chief of the Mood and Anxiety Disorders Clinic at British Columbia Children's Hospital in Vancouver, who shares some of Dr. Healy's concerns about drug risks. "If you even raise the same issues he does, you're classified as being with David Healy and that makes people very reluctant to talk. He has become very isolated."

Some colleagues have called him reckless, a false martyr whose grandstanding in the news media has driven away patients who need help. But they cannot dismiss him entirely. And for those who wish to understand what it takes to defy a scientific fraternity without entirely losing one's standing - or nerve - he has become a case study...

"You'd probably never know what happened to me if I didn't tell you,'' Dully said in an interview. "But I felt I was not who I was supposed to be anymore. You can't put your finger on it, but something's been taken away. Something's been altered or changed. It's very frustrating.''

"My file has everything -- a photo of me with the ice-picks in my eyes, medical bills,'' Dully says on the broadcast. ``But all I care about are the notes. I want to understand why this was done to me.''

He reads one of the entries. It's from his birthday, Nov. 30, 1960: ``Mrs. Dully came in for a talk about Howard. Things have gotten much worse and she can barely endure it. I explained to Mrs. Dully that the family should consider the possibility of changing Howard's personality by means of transorbital lobotomy. Mrs. Dully said it was up to her husband, that I would have to talk with him and make it stick.''

At the archives Dully also found a pair of leucotomes, the instruments that had been driven into his eye sockets.

The lobotomy was introduced in 1936 by a Portuguese physician, Dr. Egas Moniz. It won him the 1949 Nobel Prize in Medicine. Some 50,000 lobotomies were performed in the United States from the 1930s to the 1970s.

The original method, called prefrontal lobotomy, involved boring open the patient's skull to cut the connection between the prefrontal region -- an area concerned with emotion, learning, memory and social behavior -- and the rest of the brain. While it often relieved symptoms of severe mental illness, it also blunted emotion, leaving patients listless, apathetic and childlike.

Freeman invented an easier way, the transorbital or ``jiffy'' lobotomy, which left no obvious scars. It could be done in a few minutes as an outpatient procedure.

He traveled the country promoting the technique, performing up to 25 lobotomies per day -- some 3,400 of them in the course of his career, according to Jack El-Hai, whose biography of Freeman came out this year...

I don't know what was wrong with me: a case of ill fit with the world, I guess. I suddenly kept being confronted by the fact of my own mortality, like a glacier in my path, and seizing up with panic.

I told my doctor and, as luck would have it, he was branching into hypnotherapy and wanted to try it out on me. He was quite the evangelist for the treatment. Hypnosis was no mere stage trick, he insisted: A patient of his had recently had major dental surgery -- I imagined pile drivers and a building site -- solely anesthetized by the doctor's suggestion. As for quitting smoking, why, the cigarettes virtually extinguished themselves. My panic attacks should likewise succumb to the powers of his mind.

On my next appointment, he led me to a room where he gestured for me to lie down on a very purple, soft leather couch while he took the armchair opposite. He put a CD of New Age mood music on the stereo -- some sort of ode to aquatic life-forms, I noticed by the cover -- and told me to focus on a psychedelic spiral pattern inscribed on a small piece of paper attached to the ceiling, while simultaneously concentrating on the sound of his voice...

The hypnosis was a course of treatment and was supposed to proceed through several stages. Its goal was to get my everyday, humdrum, conscious mind off guard and sleepy, and thus penetrate to the real, traumatized meat of my unconscious to apply the salve of suggestion.

That is its proponents' explanation. An alternative, uncharitable view is that hypnotherapy, if it works at all, does so by appealing to people's deep-seated slavishness, such that they will deny -- including to themselves -- great pain or even, placebo-like, achieve some kind of recovery in order to please the authority figure of the doctor. It is supposedly this same mechanism that causes the subjects of stage hypnotism to go along with pretending to be Elvis or a teapot, or whatever -- just in order not to rock the boat. A third view has it that hypnotherapy has no place other than on the traveling huckster's hoarding, next to snake oil...

"I thought this would interest you. The McMartin preschool case was notorious."

http://tinyurl.com/arxy3

"Twenty-one years ago, a child then known as Kyle Sapp told police that he had been the victim of sexual abuse at the McMartin Pre-School in Manhattan Beach. Sapp, who attended the preschool from 1979 to 1980, was 8 when he first talked to authorities in 1984. He and hundreds of other South Bay children made allegations against the family who ran McMartin and against the employees who worked there. School administrator Peggy McMartin Buckey, her son Ray, daughter Peggy Ann, mother Virginia McMartin and three female teachers were accused of fondling and raping youngsters over a period of years, and of threatening them with death if they told. The scandal eventually resulted in criminal trials against Ray and his mother. By the time the trials came to an end in 1990—with acquittals and hung juries—"McMartin" was a household word. The case had turned into one of the longest and costliest criminal proceedings in U.S. history."

http://tinyurl.com/djuul

McMartin Pre-Schooler: 'I Lied'
# A long-delayed apology from one of the accusers in the notorious McMartin Pre-School molestation case

By Kyle Zirpolo, as told to Debbie Nathan

"I remember them asking extremely uncomfortable questions about whether Ray touched me and about all the teachers and what they did—and I remember telling them nothing happened to me. I remember them almost giggling and laughing, saying, "Oh, we know these things happened to you. Why don't you just go ahead and tell us? Use these dolls if you're scared."

Anytime I would give them an answer that they didn't like, they would ask again and encourage me to give them the answer they were looking for. It was really obvious what they wanted. I know the types of language they used on me: things like I was smart, or I could help the other kids who were scared.

I felt uncomfortable and a little ashamed that I was being dishonest. But at the same time, being the type of person I was, whatever my parents wanted me to do, I would do. And I thought they wanted me to help protect my little brother and sister who went to McMartin."

**********
Liz Ditz

"Ray Buckey and his sister, Peggy Ann, as well as a former McMartin teacher, Babette Spitler, declined to meet with Zirpolo. They've always staunchly proclaimed their innocence, and say they don't need apologies from former students, who were children and couldn't help themselves. Peggy Ann has said that they would rather hear from the police, social workers, therapists, prosecutors, doctors and parents who fueled the case."

I was, in English terms, very good at drinking. Too good. I had a substantial capacity for absorbing the stuff and had worked out the Dumb Crambo of moving around when your internal gyroscope has fallen over. I learnt to enunciate when my mouth felt like it was made out of putty and my teeth had all changed places and I had the tongue of the dog whose hair I’d consumed.

I drank steadily, with a steely determination. I drank on and through peripheral neuritis, alcoholic gastritis, an atrophied brain, an enlarged liver, a damaged pancreas, blackouts, suicidal depression, anonymous bloody sores and DTs so severe that I would have to take the first drink of the morning using a towel hooked round my neck as a pulley, because I was frightened of knocking my teeth out with the glass.

I went for help one April and the doctor said that I’d better be serious about stopping, because if I didn’t I was unlikely to see another Christmas. Incredulous friends said they couldn’t believe I had a problem as they’d never seen me drunk. The truth was, they’d never seen me sober, I’d just woven drink into the fabric of who I was and I had to unpick it...

I am trying to choose a new therapist. One has good qualifications, but I'm concerned because she is very overweight. Please, don't take this as criticizing anyone overweight. I have troubles with that myself. But does it indicate the therapist has issues and I should avoid her? you may blog this

"No matter what you do or where you go, you're always going to be yourself. And Panexa knows this. Your lifestyle is one of the biggest factors in choosing how to live. Why trust it to anything less? Panexa is proven to provide more medication to those who take it than any other comparable solution. Panexa is the right choice, the safe choice. The only choice..."

WHEN PANEXA SHOULD NOT BE USED

There are no known medical circumstances (based on extensive internal testing) in which PANEXA cannot be used. However, PANEXA is not quite as aggressively recommended in the following circumstances:

* PANEXA should not be used as a physical aid to set a broken bone, as in the case of a splint;
* PANEXA should not be used as a substitute for real human relationships; the tablets (and gel-coated caplets) are incapable of displaying any real emotion, and would prove to be dissatisfying friends or mates;
* PANEXA should not be used to soak up spills or remove stains. This is disrespectful to PANEXA;
* PANEXA should not be resold with the intent of generating a personal profit;
* PANEXA should not be used a form of motive transport, as it lacks the government regulated (US DOT 1445/88-4557) safety lights and reflectors;
* Women with uteruses should consider avoiding PANEXA or moving to a state or province where the concentration of PANEXA is lesser;
* Do not taunt PANEXA.

"Michael O'Leary, the founder of Ryanair, yesterday announced plans to introduce in-flight gambling by 2007 and said it could eventually help the airline to offer free tickets for all. He admitted it could change the image of airlines but insisted it could only be for the better as the traditional industry appeared to be built around high-cost tickets and terrible food."

Removing all flagpoles, streetlights, power lines, branches, and anything else that could be used as a perch

Warning nation's children to stay away from any and all flu pandemics

If roasted chicken becomes infected, instructing families to build mashed-potato wall to prevent contamination of peas..."

"I'm not telling you to make the world better, because I don't think that progress is necessarily part of the package," she said. "I'm just telling you to live in it. Not just to endure it, not just to suffer it, not just to pass through it, but to live in it. To look at it. To try to get the picture. To live recklessly. To take chances. To make your own work and take pride in it. To seize the moment. And if you ask me why you should bother to do that, I could tell you that the grave's a fine and private place, but none I think do there embrace. Nor do they sing there, or write, or argue, or see the tidal bore on the Amazon, or touch their children. And that's what there is to do and get it while you can and good luck at it."

"Within a couple of months of getting the new seat in late 2003, a sharp, electrifying pain shot through my upper left arm whenever I raised it, picked something up, rolled over on my left side in bed or even tried to brush my hair..."

"Yet it's hard for my colleagues and my friends to understand how debilitating it is, since it is an invisible pain -- without cast or sling or conspicuous impairment.

At my annual physical in August, my internist urged me to go on disability until the shoulder heals. That's not a viable option. I've now turned to the rehabilitation specialist as the lead doctor to deal with the pain. If and when the pain diminishes, then I have to decide what to do to get the shoulder to work again..."

"Perhaps few persons who are not physicians can realize the influence which long-continued and unendurable pain may have on both body and mind," he wrote. "Under such torments the temper changes, the most amiable grow irritable, the bravest soldier becomes a coward, and the strongest man is scarcely less nervous than the most hysterical girl."

If you live in the United States, has this ever happened to you?

You call a psychologist, social worker of psychiatrist who is "on your plan" only to find out that they "are not" on your plan?"

Have you found yourself feeling disgusted and exhausted from this experience, and deciding not to go further with finding a therapist?

Consider yourself haunted... By a Ghost Network.

...A smile broke across her face when she completed her recollection. She turned to me, her dark eyes glistening with tears.

“Thank you for listening,” she said. “I really appreciate it. I will miss you.”

“I will miss you, too,” I said, almost trying to mask the fondness in my voice—God forbid I actually sound like I actually care for my patients. “I hope that you will do well and get out of the hospital soon.”

“So do I,” she continued.

We looked at each other, sitting in that moment when something warm and meaningful and touching and perfect should be said, but the words are lacking...