FDA approves drug for bipolar disorder

Beware a new/old pharmaceutical trend of which this is an egregious example! “Eli Lilly and Co. on Monday said it has won regulatory approval to sell its new drug Symbyax to treat the depressive phase of bipolar disorder.

The U.S. Food and Drug Administration approved the drug, which is a combination of the active ingredients in two other drugs _ the anti-depressant Prozac and the anti-psychotic Zyprexa, which is used for treating manic stages of bipolar disorder.” —Dallas-Ft Worth Star-Telegram

I have difficulty with referring to this as a ‘drug’, or referring to ‘the anti-depressant Prozac and the anti-psychotic Zyprexa’ as ‘drugs’. These are products; the ‘drugs’ or ‘medications’ are the ‘active ingredients’. I refuse to prescribe products, writing all my prescriptions by the generic names, i.e. the ‘active ingredients’, instead, and challenging all the nurses who take off my orders in the hospital to learn the generic names. (It is sort of like refusing to wear teeshirts that make me a walking billboard for a product name…) It may seem a foolish conceit or a merely semantic difference but it is a polemical point upon which I insist. In a case such as this, it clarifies the thinking and helps one see readily that there is no ‘new drug for bipolar disorder’ here, really just a new product which combines several existing drugs.

A generation ago in psychopharmacology, we got rid of such ‘fixed-dose combinations’, which have several problems. The obvious one is that I can already prescribe the two pertinent medications independently and in combination for the patient, and have much greater control over the two dosages independently. The only downside of the latter approach is that the patient will have to swallow twice the number of pills, or thereabouts, as in the new product. But I have rarely seen a patient in whom the advantages of that outweigh the disadvantages of the fixed-dose combination, although the drug company will try to sell the product to doctors by appealing to its convenience to their patients. If you grant me that there is no medical advantage to the fixed-dose combination, then it becomes clear that it is for drug company profit alone. For one thing, if they succeed in pushing this product, they retain the right to sell the ‘new drug’ at a high price even as generic versions of its constituent medications become available. Generic fluoxetine for far less than Prozac brand is already here, and in several years olanzapine will be off-patent and available for far less than Zyprexa brand as well. Furthermore, if I am a devotee of this product, whenever my patient on Lilly’s antipsychotic Zyprexa requires an antidepressant, I would be sure to be giving Lilly’s antidepressant, Prozac, rather than a competing and possibly superior one. Finally, the drug company hopes that some doctors will, carelessly, give in to the temptation to give the two-component medication to patients for whom one of the two alone would suffice, i.e. patients will receive an antipsychotic medication and an antidepressant together even if they are nonpsychotically depressed, or nondepressively psychotic. This will double the drug company’s profit on such patients in one fell swoop.

There is already a problem of ‘polypharmacy’ in modern psychopharmacology; I see patients, especially the chronically mentally ill whom I specialize in treating, arrive at the hospital with appallingly long lists of medications they are prescribed. Drugs are added readily for new twists or turns in their disease presentation, but rarely are others reduced or eliminated. Little thought is given to what might or might not be working. It is no wonder these patients cannot or will not comply with their medication regimens, given the bewildering complexity of their daily dosing schedules and the unmanageable side effects their medication combinations may be causing. Imagine how much more problematic this will become when, at every swipe of the pen, their doctors can add two new medications to their list!

If you are interested in the psychopharmacological treatment of bipolar disorder, there are several further problems with this product in particular, over and above my generic objections to ‘fixed-dose combinations’. The fluoxetine (antidepressant) component to this product may be largely unnecessary to begin with. Many psychiatrists feel that one of the advantages of the newer, so-called ‘atypical’, antipsychotic medications such as olanzapine (Zyprexa) is concomitant mood-stabilizing and antidepressant activity as well as the antipsychotic efficacy. If you read the article, you will see claims that this product may begin to work more rapidly than less novel approaches. Although I have heard this claim accompanying the introduction of every new psychopharmaceutical during my twenty-year career (and it never turns out to be borne out in practice; the drug companies’ marketing departments just know how to play on the heartstrings of those of us who have to wait for the onset of action of the medications we give to people while they are in agonizing distress), if it has any merit in this case it may be because most patients for whom it has been prescribed will heretofore have been on Zyprexa or another atypical antipsychotic and, as I stated above, therefore may have gotten a headstart on antidepressatn effects as well.

Furthermore, a bipolar or manic depressive patient can only benefit from an antidepressant during their (time-limited) depressive episodes. It is actually dangerous to keep them on an antidepressant when they are nondepressed, because the antidepressant can drive them to the other extreme, a manic ‘high’ (with eiher euphoria and self-destructive boundless energy and drive, or dramatic hyperirritability and ultimately psychosis). A physician who follows path-of-least-resistance prescribing may also be one who does not get around to changing the patient back from Symbyax to plain vanilla Zyprexa rapidly enough when they come out of their depressive phase. Bye bye mood stability…

So: if you or your loved one are prescribed a new medication (oops! product), be sure to ask the prescriber (a) if it is a ‘fixed-dose combination’; (b) if it is, whether both the medications are really necessary, or if one might suffice; and (c) why the two cannot be prescribed as separate pills rather than together.

By the way, I have previously noted the loony appeal of all the ‘q’s, ‘x’s, ‘y’s, and ‘z’s in the names of the newest psychopharmaceuticals. There is scarcely one without, especially among the most-recently developed antidepressant products: Prozac, Desyrel, Zoloft, Paxil, Luvox, Serzone, Celexa, Lexapro, Effexor and Zyban; now Symbyax. In the last fifteen years or so, only Remeron fails to meet the bill. Three of the six most-recently introduced antipsychotic products are: Clozaril, Zyprexa, and Seroquel. The product-naming consultants the industry uses show this brain-dead lack of creativity in their long-hackneyed approach, but they still, as far as I have heard, make enormous consulting fees for each of these crazy names. This xenophilic trend tends to strengthen the esoteric and occult flavor of the physician’s role and the inaccessibility of her knowledge to the layperson, I imagine.


Worried Pain Doctors Decry Prosecutions

Ascroft’s hounds of hell are demonstrating that they are unable to tell the difference between a racketeering conspiracy and legitimate medical practice, in the cases of several high-profile prosecutions of pain specialists for their volume of narcotics prescribing. The established medical use of opiates is, some doctors say, becoming criminalized, while Ashcroft crows about “our commitment to bring to justice all those who traffic in this very dangerous drug” (OxyContin). Obviously, Ashcroft has never suffered from one of the debilitating chronic pain conditions for which OxyContin and similar medication advances have been the only solution, and has no compunctions about throwing babies out with bathwater.

While there are certainly mendacious physicians who run “prescription mills” for quick profit, writing painkiller ‘scripts for all comers regardless of medical need, it seems these prosecutions are capturing mainly those unfortunate doctors whose only crime may have been choosing to specialize in a field of medicine, pain management, that makes them conspicuous to our ever-vigilant law enforcement bulldogs. Their names will appear on the radar screens simply due to the volume of ‘scripts they issue and the almost inevitable likelihood that, somewhere along the line, someone will divert some of their OxyContin to the extremely lucrative street trade. There are no certainties in managing pain, and doctors are at different points along the continuum of attention to (or paranoia about?) issues of diversion and addiction. While I am not a pain specialist and shy away from prescribing narcotics de novo, I certainly often maintain a narcotics-dependent patient on their preexisting prescriptions when they come into the hospital with psychiatric problems (which, as you realize, I’m sure, may be difficult to disentangle from substance-abuse difficulties). I do interpret my mandate to first do no harm to include not facilitating narcotics abuse and addiction, but I remind myself that I am not omniscient and, despite my skills, will be deceived from time to time as to the legitimacy of the pain complaints of a patient. I console myself with the reminder that these patients are primarily fooling themselves. I don’t take it personally, but then again I do not have Ashcroft’s thugs breathing down my neck either.

[It bears pointing out, in my continuing tirade about the irresponsibility of the pharmaceutical industry, that OxyContin could have been formulated in a manner that would prevent the pils from being processed for street users to shoot up, as is the case with other sustained-release narcotics preparations which are not diverted in a similar manner.]


Have an Inoffensive Holiday Season

A reader posted this to Dave Farber’s IP mailing list:

I wanted to send out some sort of holiday greeting to my friends, but it is

so difficult in today’s world to know exactly what to say without offending

someone. So I met with my attorney today, and on his advice (and after $299

in attorneys fees) I wish to say the following:

Please accept with no obligation, implied or implicit, my best wishes for an

environmentally conscious, socially responsible, low stress, nonaddictive

gender neutral, celebration of the winter solstice holiday, practiced within

the most enjoyable traditions of the religious persuasion of your choice, or

secular practices of your choice, with respect for the religious/secular

persuasions and/or traditions of others, or their choice not to practice

religious or secular traditions at all.

I also wish you a fiscally successful, personally fulfilling, and medically

uncomplicated recognition of the onset of the generally accepted calendar

year 2004, but not without due respect for the calendars of choice of other

cultures whose contributions to society have helped make America great (not

to imply that America is necessarily greater than any other country or is

the only “AMERICA” in the western hemisphere), and without regard to the

race, creed, color, age, physical ability, religious faith, or sexual

preference of the wishes.

By accepting this greeting, you are accepting these terms: This greeting is

subject to clarification or withdrawal. It is freely transferable with no

alteration to the original greeting. It implies no promise by the wisher to

actually implement any of the wishes for her/himself or others, and is void

where prohibited by law, and is revocable at the sole discretion of the

wisher. This wish is warranted to perform as expected within the usual

application of good tidings for a period of one year, or until the issuance

of a subsequent holiday greeting, whichever comes first, and warranty is

limited to replacement of this wish or issuance of a new wish at the sole

discretion of the wisher…


No trees were harmed in the sending of this message, however, a significant

number of electrons were inconvenienced.


Annus horribilis

Here is how the Guardian sums up 2003 (this is a review of its year-end summary book):

“Of course Iraq is central, sickeningly portrayed by Suzanne Goldenberg’s ‘Picture of Killing’ and Audrey Gillan’s ‘Death by Friendly Fire’ – though there’s too little about the aftermath or about Hutton’s inquiry into how we were duped.

But other themes flood in – Hamas’s ‘total war’ (omitting that it is because the Middle East peace map has been distorted by Sharon into a road to nowhere), and Sarah Boseley’s heart-rending picture of a soon-to-die mother in Malawi, illustrating the fate of 29 million people with Aids in sub-Saharan Africa.

Martin Kettle assesses the neocon hard-right assault on US affirmative action and pro-diversity laws. Raekha Prasad denounces the UN ‘protection areas’ for refugees that enable Britain to deport more asylum-seekers. Polly Toynbee dissects the growing trade of female trafficking, a modern variant of the slave transportation of past centuries, with 2 million women trafficked each year – a less remarked-on aspect of globalisation. Martin Jacques chronicles the jeering and booing at the Williams sisters and their father in middle-class, lily-white tennis. Racism is never far beneath the surface, and the accentuation of inequality in 2003 has served only to make it more pronounced.

The American imperium, with its unalloyed unilateralism, entered this year in full spate, and leaves it in deep disarray. But its workings are a great deal subtler and more pervasive than merely enforcing regime change. Ian Traynor recounts the brute diplomacy to secure war crimes immunity deals for Americans and the exercise of the aid card to bring vulnerable countries into compliance with US demands for exemption from the international criminal court. And George Monbiot admirably captures the new messianic order: America is not so much a project as a religion. It’s not just that Americans are God’s chosen people; America now perceives itself as on a divine mission for the liberation of mankind.”

The reviewer, a former MP, notes some omissions, however:

t would have been nice, but not essential, to have had an angle on the rise and rise of the corporate state, the first clear signs of the coming oil crunch, the collapse of party democracy, the plague of obesity, the neglect of global warming as the greatest threat to the planet, and the rebellion against spin … But you can’t have everything.

“…but not essential…”??


Mad Cow Disease

The killer illness for a new world order, a 2001 Slate piece by David Plotz, written in response to the European BSE scare and now resurrected in the face of the current spectre of American panic:

“Mad cow fits the classic profile of a disease likely to cause hysteria. Ebola, AIDS, and polio—three of the most flamboyant illnesses of the century—overshadowed deadlier but less flashy plagues, such as malaria, for several reasons. First, the hysteria-inducing illnesses usually affect young people and strike in particularly gruesome ways. Ebola causes massive bleeding from every orifice. AIDS is responsible for grotesque cancers and infections. Polio paralyzed young children.

Second, at the moment of the panic—before much is learned about the disease’s origin—everyone seems vulnerable, and it’s not clear that prevention is possible. Maybe an Ebola victim flew in from the Congo and breathed on you! Maybe your dentist is HIV-positive! And finally, the disease organism is new and weird and seems to have sprung from a dark, mysterious place. AIDS is a creepy mutating monkey virus. Ebola remains a riddle: The Hot Zone traces it to the bats in a spooky East African cave.

Mad cow is similarly vicious, unstoppable, and mysterious. It murders by driving its young victims insane, then melting their brains. It theoretically puts anyone who ever ate English beef at risk. It was spawned in the miasma of rendering plants and slaughterhouses, our own hell’s kitchens. And the disease organism is a mystery.”


Righting the Ship of Democracy

Presenting Deliberation Day: A radical proposal to help voters make better decisions, write Bruce Ackerman, Sterling Professor of Law and Political Science at Yale University, and James Fishkin, Janet M. Peck Chair in International Communication and Director of the Center for Deliberative Democracy at Stanford University.

“In our soon-to-be-released book, we offer a new way of thinking about democratic reform, proposing a new national holiday—Deliberation Day. It would replace Presidents’ Day, which does no service to the memories of Washington and Lincoln, and would be held two weeks before major national elections.

Registered voters would be called together in neighborhood meeting places, in small groups of 15 and larger groups of 500, to discuss the central issues raised by the campaign. Each deliberator would be paid $150 for the day’s work of citizenship. To allow the business of the world to carry on and as many as possible to participate, the holiday would be a two-day affair.”

They note that, while sustained public conversations about issues, particularly around political campaign seasons, do take place, the overall level of public ignorance is appalling. Here is an entertaining anecdote:

George Bishop and his colleagues at the University of Cincinnati dramatized this point in their study of attitudes toward the “Public Affairs Act of 1975.” Asked for their opinion of the act, large percentages of the public either supported or opposed it, even though no such act was ever passed. In 1995, The Washington Post celebrated the “twentieth unanniversary” of the nonexistent act by asking respondents about its “repeal.” Half the respondents were told that President Clinton wanted to repeal the act; the other half were informed that the “Republican Congress” favored its repeal. The respondents apparently used these cues to guide their answers, without recognizing the fictional character of the entire endeavor.

They suggest that it actually makes sense for the voters to remain ignorant; the acquisition and analysis of adequate information about public affairs is time-consuming and competes with other priorities, and if there is no payoff because your vote really doesn’t matter, why bother? This argument is based on the idea that, usually, one does not see a “direct cost for an ignorant decision” in the political sphere, in contrast to the personal penalties suffered if one does not make an informed decision when buying a car or a house, for example.

While I think that the idea of a Deliberation Day holiday is an absurd way to remedy the situation, I appreciate the analysis. It points to the simple fact that impressing the public with the direct costs to themselves of supporting the present dysadministration, for example, is the most efficient way to regime change in 2004. Of course, nothing in the authors’ examination of the value of deliberation in the political process appears to me to be relevant on a national scale, especially since their central premise that an informed electorate might have genuine, enfranchised power is a political fiction on that scale. I haven’t read their book, but it sounds like it will be a useful study on modern disenfranchisement even though not proposing a useful solution. This is not surprising, since no one really has any useful solutions to the powerlessness of the masses.


The ‘We’ Word And the Tyranny of the Majority

“False collectives — what Americans call ‘weasel words’ — poison the language we use to talk about public affairs by cobbling together spurious majorities”, writes Roger Kerr in Policy, the quarterly review from New Zealand’s The Centre for Independent Studies. I have never heard of the phrase ‘weasel word’, which Kerr attributes to anti-collectivist social philosopher Friedrich Hayek (The Fatal Conceit: The Errors of Socialism), who wrote:

. . . it has in fact become the most harmful instance of what, after Shakespeare’s ‘I can suck melancholy out of a song, as a weasel sucks eggs’ (As You Like It, II, 5), some Americans call a ‘weasel word’. As a weasel is alleged to be able to empty an egg without leaving a visible sign, so can these words deprive of content any term to which they are prefixed while seemingly leaving them untouched. A weasel word is used to draw the teeth from a concept one is obliged to employ, but from which one wishes to eliminate all implications that challenge one’s ideological premises.

While I was drawn to this article because I share its apparent bias against the tyranny of the majority and am interested in an analysis of how our language contributes to that tyranny, this is really a stalking horse for a tirade against big government. His biases are clearly Republican. For example, I was struck by this passage:

A good example comes from the United States in the mid-1990s. In 1994, a new Republican-dominated Congress thought it had a clear mandate to move towards a balanced budget. It duly put up proposals to reduce the growth rate of some welfare entitlement programmes. But no sooner had the proposals been passed than President Clinton vetoed them, invoking the support of a new majority opposing them. Which did US citizens want? A balanced budget or guaranteed entitlement levels? They wanted both. The ‘will of the people’ may be systematically ambiguous on the decisions that governments make on a daily basis.

He does not note that the dilemma he poses was only a dilemma within Republican ideology, and that Clinton’s administration did in fact balance the budget without gutting entitlements as drastically as Republicans called for (although Clinton was by no stretch of the imagination a friend of the welfare state, and his welfare ‘reform’ platform was designed to appeal to the Right).

In warning against the ‘we’ word, as Kerr concludes, because “despite its apparently communitarian connotations, it so often portends a weakening rather than a strengthening of social cohesion”, he is a bellwether of the increasingly fractious state of modern political discourse in the neo-con-dominated late-20th century US. One of the ongoing tactics of neo-con agit-prop is to accuse their opponents of disenfranchising them and threatening social cohesion. Essentially, the concept of a ‘spurious majority’ only makes sense if you do not accept the notion of an implicit ‘social contract’. However, Kerr, who is the executive director of the New Zealand Business Roundtable, may in fact be accurate if we take his argument to imply that the notion of the social contract is outmoded in a world in which corporations have more rights than individuals and governments exist mostly to protect their interests.

Related (maybe): A review of Death Sentence — the Decay of Public Speech by historian Don Watson: “A terrible thing is happening to the language, he believes, and at the end of the day, in a globalised world, it is not a positive communications outcome. In other words, there is a pox upon our public speech. ” —The Age


FBI Issues Alert Against Almanac Carriers

“The FBI is warning police nationwide to be alert for people carrying almanacs, cautioning that the popular reference books covering everything from abbreviations to weather trends could be used for terrorist planning.

In a bulletin sent Christmas Eve to about 18,000 police organizations, the FBI said terrorists may use almanacs ‘to assist with target selection and pre-operational planning.’

It urged officers to watch during searches, traffic stops and other investigations for anyone carrying almanacs, especially if the books are annotated in suspicious ways.” —New York Times [via IP]


Shadows are hardwired into the brain

The results confirm an intuitive bond people feel with their shady outlines. “Our brains instinctively view our shadows as an extension of our bodies, a new research has shown.

Subjects in the study reacted to stimuli near the shadow of one hand as if the stimuli were affecting the hand itself, found Francesco Pavani, at Royal Holloway University of London, UK, and Umberto Castiello, at the Università degli Studi di Trento, Italy.” —New Scientist


Lead Iraq weapons seeker ‘to quit’

“The man leading the US hunt for biological, chemical and nuclear weapons in Iraq is to resign, according to reports. The loss of David Kay is being interpreted by many analysts as signalling the end of the major effort to discover any hidden weapons.

A number of observers now believe it is unlikely that any weapons of mass destruction (WMD) existed. However, officials from the US administration maintain that if Kay does leave, it would have no impact on the ongoing work of the Iraq Study Group he heads.

According to The Washington Post, Kay has told administration officials that he plans to leave before the completion of the ISG’s final report, expected in autumn 2004. He may even leave before the next interim report in February.

Kay has cited personal reasons for resigning, the paper says. But in recent weeks he has softened his line on the probability of finding banned WMD. He is said to be frustrated that some of the ISG’s 1400 staff were reallocated to counter-insurgency duties in Iraq in October.” —New Scientist


Where Have You Gone, Isaac Newton?

“Today, physicists suppose that a particle can travel many different paths simultaneously, or travel backwards in time, or randomly pop into and out of existence from nothingness. They enjoy treating the entire universe as a ‘fluctuation of the vacuum,’ or as an insignificant member of an infinite ensemble of universes, or even as a hologram. The fabric of this strange universe is a non-entity called ‘spacetime,’ which expands, curves, attends yoga classes, and may have twenty-six dimensions.

In short, the recent literature on physics makes one nostalgic for anything as reasonable as a witch trial.

For the past decade many physicists have been wandering the streets with signs that read: ‘The End of Physics Is Near.’ They claim to be developing a final ‘theory of everything,’ which will leave future physicists with nothing to do but play computer games. We can dismiss their megalomania, yet still be tempted to agree with their message. The end that seems near, however, is not a climactic rise to omniscience but an embarrassing descent into pseudo-science.”

Although I don’t understand all that much of modern physics, I suspect that the author, David Harriman, despite his M.S. in Physics, is out of his depth in branding it pseudoscience. If his yearning for the naive simplicity of Newtonian science is not enough evidence, there is the fact that he is the editor of Journals of Ayn Rand and a senior writer for the Ayn Rand Institute in Irvine, Calif.


Noticeably Safer

“Silver cars are much less likely to be involved in a serious crash than cars of other colours, suggests a new study of over 1000 cars.

People driving in silver cars were 50 per cent less likely to suffer serious injury in a crash compared with drivers of white cars, the research in New Zealand found.

White, yellow, grey, red and blue cars carried about the same risk of injury. But those taking to the roads in black, brown or green cars were twice as likely to suffer a crash with serious injury.” —New Scientist


Dirty minds

Book Review: “Attention, parents: Now that you’ve seen your kids’ first report cards of the year, it’s time for a little homework of your own. No doubt you’re doing the best you can to ensure your little ones’ eventual membership in Mensa — promoting stimulating dinner conversation, reading a chapter together each night, maybe even playing Mozart during bath time. But wait — there’s more. You’ll find your next assignment in the pages of Colleen Moore’s Silent Scourge: Children, Pollution, and Why Scientists Disagree.

You probably already know that lead is not an appropriate component of any cerebral calisthenics program. But nor is it the only pollutant that can stunt intellectual development. In Silent Scourge, Moore, a developmental psychologist, reviews the case against lead and five additional types of pollutants — mercury, PCBs, pesticides, noise, and radioactive and chemical wastes.” —Grist As a psychiatrist, I have always paid attention to the subtle cerebral insults that create less-than-obvious impairments in intellectual and emotional functioning and behavior. I keep an environmental toxicology textbook on my desk at the hospital and like to think I see alot of influences on my patients to which psychiatrists without such an orientation might be less sensitive. I have often wondered why it is not plausible to think that the overall environmental assault our unaccustomed organisms suffer is not taking its toll, and especially on the critical stages of CNS development in childhood. This book is definitely on my reading list, as a parent as well as a mental health proessional.


The Internet in a Cup

“The coffee-houses that sprang up across Europe, starting around 1650, functioned as information exchanges for writers, politicians, businessmen and scientists. Like today’s websites, weblogs and discussion boards, coffee-houses were lively and often unreliable sources of information that typically specialised in a particular topic or political viewpoint.” —The Economist. Has anyone else noticed an explosion of attention to late-17th and early-18th century European intellectual life recently? I have, but I am not sure whether it is just because I have been engrossed in Neal Stephenson’s Quicksilver in recent weeks, in which, for example, Leibniz and Newton play major roles and the rise of the coffee house phenomenon receives more than passing attention.


Peace on Earth: The Prospects

“The sooner the United States starts behaving like one country among many, rather than a global bully, the better the prospects for peace on earth become. The irony is that the post-9/11 bellicosity of the Bush Administration has been so extreme that in the long run it may lead more directly to a world with a common aversion to wars and empires.

If we’re willing, much of the rest of the world is ready. It’s in our hands.” —Geov Parrish, AlterNet


At the Movies, It Was the Year of ‘Yes, But . . .’

“2003 gave us a lot to gripe about — overblown action pictures, witless sequels, pointless remakes, misbegotten literary adaptations, mopey little art films shot in headache-inducing digital video — but these failures reveal less about the state of cinema than about the fate of most creative endeavors, which is to land in the fat, mediocre middle of the artistic bell curve.

To look at the three top 10 film lists displayed in this section — and at the dozens more that sprout from nearly every printed publication and Web site in the land — is to be struck by the sheer variety and vitality of the movies, which, according to some historians, marked their centenary as a narrative art form this year. The number of good motion pictures released this year is less impressive — and harder to agree on — than their diversity.” —New York Times


There but the grace of God…

Not only did I miss several weeks’ worth of important developments, but in particular the clarity of thinking that the Christmas spirit brings. As Rafe Colburn observes:

“I’ve often said that the fundamental difference between most hardcore conservatives and the rest of us is a lack of appreciation for the old bromide, ‘There but for the grace of God go I.’ The inability to put yourself in the shoes of people worse off than yourself, or just different than you, period, is the enabler for what passes for modern conservatism.”

Rafe also has a cogent argument about why it doesn’t wash to claim that Libya’s renunciation of WMD is a consequence of the US invasion of Iraq, even though dysadministration propaganda crows about how it is our victory.

Another thing that may not be our victory to crow about is the apprehension of Saddam Hussein, who may actually have been taken into custody by the Kurdish opposition, hogtied and left for the US to claim.


Dean is secure in his view of Saddam

“In his interview with the Monitor, Howard Dean repeated his contention that Saddam Hussein’s recent capture had made America no safer.

‘My opponents spent the week criticizing me for that, which I think was to their detriment’ since the federal government had just increased the terror alert level to orange, indicating an elevated risk of an attack.

But he said two other recent events had benefited national security: the capture of a ship loaded with drugs in the Persian Gulf – ‘which is almost certainly how al-Qaida is partly financing their operations,’ Dean said – and Libya’s decision to declare its illegal weapons programs and get rid of them.” Concord (NH) Monitor

Dean doesn’t mention the unabated continuation of assassinations of US occupiers by insurgents, which has prompted an increased bounty on the heads of the remaining at-large Baathist most wanted.


Army Thin-Skinned Over Homemade Armor

A Missouri transportation unit headed for Iraq sought extra protection for non-combat vehicles. Local businesses donated the costs for a local steel fabricator to sheath their trucks and Humvees.

The 72 vehicles operated by the 428th are not designed for battle. They have thin metal floorboards and, in some cases, a canvas covering for doors. Iraqi guerrilla groups have been targeting all types of military vehicles with homemade bombs and small-caliber weapons.

E-mails from soldiers already deployed in Iraq urged the Missouri reservists to get extra armor if possible, said 1st Sgt. Tim Beydler, a member of the 428th.

Unfortunately, although official US Army add-on armor is still under development and not yet ready, the Pentagon will not allow this jury-rigging, since it has not been approved through official channels. [Oh, and because one of Cheney’s cronies has to be awarded the price-gouging contract to do the retrofits instead?] Washington Post


Tips for Traveling With Tech Gear

“While security checks have reached a certain consistency, it may not remain so for too long. Before you head for the airport, you may want to check a frequently updated list of everything that is and is not allowed on a flight. This information comes from the Transportation Security Administration, part of the Department of Homeland Security.

It’s presented in chart form, telling you what you’re allowed to carry on or check, and it may not always be what you think.” PCWorld


50 things we’d like to see less of in 2004

I admit to a guilty pleasure — I love those year-end ‘best this’ and ‘worst that’ lists. They are the modern equivalent of the memory palace artifice. I do alot of my CD shopping (although not my bookbuying, since I tend to keep up better with the latter throughout the year) after the music lists come out. Any links to quality year-end lists you send me will be gratefully appreciated and likely posted here. To start with, here’s what one Guardian observer wants to deep-six for the new year. Unless you are a devotee of English tabloid culture, you might miss some of the references, but you also might agree with many of them, as I do.

Addendum: and the suggestions start rolling in. Thanks to Sam for pointing to the compilation of year-in-review lists at Fimoculous.

And, thanks to walker, some top-10-words-of-the-year lists (top phrases, the top names, the best and worst product names, top Enron inspired words, top YouthSpeak words, and others….) which reveal how the mutable English language can be influenced even on the timescale of one year’s developments.


Bush Gets Serious About Killing Iraqis

“The United States doesn’t even pretend to respect the Geneva Conventions these days. Obviously, shooting unarmed demonstrators in the back as they flee is a war crime. But then neocons don’t do international law.

As Bush has repeatedly made clear, he believes international treaties are for wimps, appeasers, and the irrelevant. International law is for pantywaists such as the French, not intractable and self-righteous Americans engaged in a forever war against ‘terr’ism,’ otherwise known as the Islamic religion.” `–Kurt Nimmo, Counterpunch


There but the grace of God…

Not only did I miss several weeks’ worth of important developments, but in particular the clarity of thinking that the Christmas spirit brings. As Rafe Colburn observes:

“I’ve often said that the fundamental difference between most hardcore conservatives and the rest of us is a lack of appreciation for the old bromide, ‘There but for the grace of God go I.’ The inability to put yourself in the shoes of people worse off than yourself, or just different than you, period, is the enabler for what passes for modern conservatism.”

Rafe also has a cogent argument about why it doesn’t wash to claim that Libya’s renunciation of WMD is a consequence of the US invasion of Iraq, even though dysadministration propaganda crows about how it is our victory.

Another thing that may not be our victory to crow about is the apprehension of Saddam Hussein, who may actually have been taken into custody by the Kurdish opposition, hogtied and left for the US to claim.


Prescient About the Rhetoric

Just back from two weeks’ media cold turkey and, as in past years, you will have to endure an element of my getting back into the swing of things, catching up with developments I missed, and making observations that will probably already seem to you readers to be the obvious. To start with — the big fat bullseye painted on Howard Dean’s back, now he has solidified his frontrunner position, has emerged in earnest while I was gone, with barbed arrows headed in his direction as suggested in this prescient post from Atrios .


Prescient About the Rhetoric

Just back from two weeks’ media cold turkey and, as in past years, you will have to endure an element of my getting back into the swing of things, catching up with developments I missed, and making observations that will probably already seem to you readers to be the obvious. To start with — the big fat bullseye painted on Howard Dean’s back, now he has solidified his frontrunner position, has emerged in earnest while I was gone, with barbed arrows headed in his direction as suggested in this prescient post from Atrios .


…of the Season

My family and I will be away, and I will not be posting here, until after Christmas Day. My warmest wishes to you and those dear to you, that the joy of the season be yours now and for all the year to come.

I salute you.

There is nothing I can give you which you have not,

but there is much that while I cannot give,

you can take.

No heaven can come to us unless our hearts find rest in it today.

Take heaven.

No peace lies in the future which is not hidden in this present instant.

Take peace.

The gloom of the world is but a shadow. Behind it, yet within our reach, is joy.

Take joy.

And so at this Christmastime,

I greet you, with the prayer

that for you,

now and forever,

the day breaks

and the shadows

flee away.

— Fra Giovanni, 1513 AD

The court case that could reshape US democracy

“It bears the utterly uninformative title of Veith et al vs Jubelirer (docket number 02-1580). But the case, which the US Supreme Court heard yesterday, deals with the explosive political issue of gerrymandering – and its ruling next year could literally reshape America’s democracy.” Gerrymandering is so widespread and has become so effective that only four incumbent congresspeople were defeated in the last round of elections, and the number of districts in which the House race is a foregone conclusion is astounding. ‘ “Voters no longer choose members of the House, the people who draw the lines do,” says Samuel Issacharoff, professor at Columbia Law School.’ The precision with which databases full of demographic data can predict voting patterns by neighborhood, street or household is largely to blame. The threat to incumbents is often no longer the general election but the primary, which does not have the same intolerance of extremism. Hence, the political process is far more polarized with the ubiquity of gerrymandering. In the past, the Supreme Court has only heard challenges to the practice based on racial grounds, otherwise considering it a fact of life. Yet the Court decided to hear this case, for reasons as unclear as which way they will lean in ruling on it. —Independent.UK


A history of failure

Author and psychologist Bruce Levine, interviewed on Salon, pummels psychiatry, psychotropic drugs and the role both may have played in the case of Andrea Yates. “The theory that depression and other disorders are caused by ‘chemical imbalances’ in the body that can be remedied by psychotropic medication is, according to Levine, ‘just that: a theory.’ Not only does he believe that psychotropic medication is, at best, ineffective; he also claims that the rush to solve social problems by medicating individuals is blinding us to the ways in which people are rebelling against an ‘institutional society’ that doesn’t meet human needs.”

“One of the greatest marketing feats of the past 20 years is use of pharmaceutical companies’ dollars to convince the mass media that psychiatrists who prescribe these companies’ drugs are basing their treatment on anything resembling science.”

But Levine, a non-medically-trained psychologist, not an MD, is guilty of basic mistakes in his understanding of the psychiatric theory he criticizes. For example:

All these new antidepressants — Prozac, Paxil, Zoloft — are SSRIs [selective serotonin reuptake inhibitors]; they all increase the level of the neurotransmitter serotonin in the brain. The theory is that this increase fixes depression.

But they’ve changed their theory every five or 10 years of which neurotransmitter fixes depression. So if you look back 20 or 30 years, they were talking about norepinephrine and that’s why they were giving out things like Tofranil and Elevil [sic; I don’t know if it is his misspelling or Salon‘s].

Not so. If you look back twenty or thirty years, they were talking about a biogenic amine theory of depression, the amines in question being both norepinephrine and serotonin. “Things like Tofranil and Elavil”, which are tricyclic antidepressants, are thought to affect both of these chemicals. They are still talking about both chemicals. The SSRIs are “selective” for serotonin, but they were developed and relied upon not because the prevailing theory changed so that it was only serotonergic dysfunction that was thought to be involved in depression. Far from it; our knowledge of the interactions of serotonin and norepinephrine have become far more sophisticated. In certain regions of the brain, serotonergic neurons may be “upstream” of and modulate the activity of norepinephrine. Furthermore, medications that modulate serotonin selectively tend to be more tolerable and safer (and, yes, more marketable). Norepinephrine was never forgotten. Newer drugs like venlafaxine (Effexor) and mirtazepine (Remeron) are, in fact, not selective, but thought to be combined serotonin/norepinephrine reuptake inhibitors, or SNRIs, with broader and arguably more effective action against depression. Even when psychiatrists were trying to treat everything with serotonin-specific drugs, it was clear that resistant cases often needed the addition of augmenting medications that would work on the norepinephrine side of the equation. So the theory never changed. This is so profound a misunderstanding, or rhetorical misrepresentation, of psychiatric theory that Levine’s observations lose all authority for me.

Levine is also a pitiful reductionist. He criticizes treatments that alter serotonin because serotonin is not necessarily the cause of the syndrome. This betrays a massive misunderstanding that medications rarely do just one thing (there are even basic debates within psychiatry about whether some effects certain medications have are unwanted side effects or part of their therapeutic benefit!) and a massive misunderstanding about the unimaginably complex interactions between the actions of the various neurotransmitters and the various anatomical regions of the brain. To treat through serotonin does not mean one is affecting only serotonin. Far from it. My guess is that Levine played hookey during the day or two that his psychological training addressed neurotransmitter theory, or that he was so angry about that take on things that he could not effectively learn the material. Here’s a quiz question for you, Dr. Levine — through what neurochemicals might your anger affect your ability to attend to and learn salient facts?

The more profound sin of his broadside, which is shared with most of the other so-called radical critiques of modern psychopharmacology, is to assume that the fact that the theory — the biogenic amine theory or whatever — is inadequate, that we really do not understand how the brain works, is grounds to conclude that we should not use the medications. Psychiatrists will be the first to agree that we do not have anything like a complete theory of the actions of the medications we use. It is a deep misunderstanding of basic pharmacology to think we need to know precisely, to the molecular level, how a medication works before we can assert that it is effective. By that standard, there would be almost no therapeutics anywhere in medicine at all. We would not use aspirin, we would not use narcotics, we would not use insulin or any cardiac drugs. Think how absurd it would be, in other fields, to warn consumers not to buy technologies whose basic theory is not completely understood. Praxis and theory are dialectically related, not linearly…

The process of drug discovery, about which I would venture a guess Dr. Levine knows little, illustrates this. Often, it is serendipitous observation that first suggests a certain substance (in nature or in the laboratory) will control a certain symptom, to be later confirmed by clinical trials. The theory of how a drug works chemically often guides me in drug choice and understanding of side effects and results of combining it with other medications, but it is never lost to me that we discovered rather than invented the drug and its effectiveness (although we may be at the dawn of the often-promised era of ‘rational drug design’). Readers know that I often remind you that the CNS is a ‘black box’ whose inner workings are still largely opaque to us. It is in fact usually our investigation of the mechanism of action of a medication known to be effective that illuminates how the brain (at least in pathology) works, rather than an understanding of the brain that illuminates how the drug works. The process of drug development builds on the original serendipity to invent basically similar, if more refined, versions of the same compound by analogy.

This is a more serious critique of psychiatry; that the lens through which we understand the chemistry of a mental state has been determined by coincidence or accident, and that different ways of understanding (and different, potentially efficacious medications that work by novel mechanisms) are so much harder to discover. Substances with many modes of chemical action in the brain (or, for that matter, elsewhere in the body) might be effective against depression, for example, but we haven’t happened upon them yet, except for those that work on the familiar neurotransmitters serotonin and norepinephrine. Furthermore, it may only be by accident that we think they work on those neurotransmitters. That activity may be an epiphenomenon distant from the therapeutic effect (although probably correlated with it).

In fact, evidence is emerging that there may be totally different mechanisms of the known antidepressant drugs that contribute to their therapeutic effectiveness, such as modulation of nerve growth factors and neuroprotective benefits. Again, these discoveries about the actions of the molecules feed back to influence our understanding of the workings of the brain and the ‘lesion’ in depression; a new model is emerging involving damage to neurons probably mediated by stress hormones which neatly explains some aspects of depression (including its chronicity, its relationship to loss and stress, and some physical findings in depressed patients) and complementing the amine mechanisms.

The truth about investigating the workings of the brain is something like the parable of the blind men and the elephant. Just because the appreciation by each blind man in the parable of the true and complete essence of an elephant was incomplete and inaccurate does not mean that they should not interact with the beast. But I wouldn’t expect Levine to understand this…

It was a mixed blessing, but my stomach was strong enough to go on with the interview with Levine, because I was curious about what he had to say about Yates. Although I suspect he and I would differ greatly in the details, we probably actually agree that irresponsible psychiatric treatment should bear much of the culpability for the deaths of those five unfortunate children, I reasoned. Suddenly, I come upon this:

When people are taken off Haldol, they routinely become really agitated, they feel completely out of control. Sometimes people can’t even keep food down; if they haven’t eaten for a while, they often experience dry heaving.

This is absolutely inaccurate, thoroughly irresponsible grandstanding. Not only not “routinely”, but never, have I seen a reaction like this, and I have prescribed alot of haloperidol during my career. Honestly, I don’t know where he gets this stuff, although it makes good press and may sell books. And they want to give nonmedically-trained psychologists like him the right to prescribe?

But while he goes drastically wrong in his criticism of drug-based treatment, Levine makes a crucial point with which I agree. Focusing on brain disease has certainly put the blinders on the field of psychiatry. As a whole, it is as deeply reductionistic as I’ve just finished accusing Levine of being from the other side. While psychiatric disorders appear to be proliferating, it is not merely the pharmaceutical industry’s profit-hungry marketing pressures that are to blame, even though it is true that if the only tool you have is a hammer, you will tend to see nails everywhere. He says:

Psychiatry is part of the problem in that it is exploiting this situation, but it is also diverting people from taking a true look at what is happening in the culture to cause all of these problems. Our society is perhaps the most economically successful culture in the history of the world, materially. But in our one-dimensional quest for productivity, consumption and efficiency, we have forgotten about a whole bunch of things that people need to stay human — like community, autonomy, diversity. All of those things have shrunk.

Taken together, this may help to explain why so many kids are being diagnosed with attention deficit disorder and all these other various childhood disorders. The largest increases we have seen in new illnesses are the ones that affect children.

…We have created that. And that is what we, as a culture, don’t want to admit: We’ve created fewer and fewer places for different kinds of personalities to feel good about themselves and to make a living.

Stay with that thought, Dr. Levine; psychiatry needs to hear it (and be pummelled).


Drugs for depressed children banned in Britain

“Modern antidepressant drugs which have made billions for the pharmaceutical industry will be banned from use in children today because of evidence, suppressed for years, that they can cause young patients to become suicidal.

The Medicines and Healthcare Products Regulatory Agency (MHRA) told doctors last night not to prescribe all but one of the antidepressants known as selective serotonin reuptake inhibitors (SSRIs).

The exception is Prozac, which is licensed for use in depressed children in the US. But the MHRA will warn that, at best, it helps only one child in 10.” —Guardian.UK

I have written extensively about the thoughtful psychiatrist’s balancing act in the face of the rapacity of Big Pharma on the one hand and the somewhat histrionic overreaction on the other of those with sometimes good and sometimes bent intentions to protect psychopharmacological patients, sometimes from the care they need. This decision was prompted by public outcry and throws the baby out with the bathwater. Based on my own practice standards, I have said all along that the best antidote to adverse outcomes of drug treatment is prudent responsible doctoring, not regulation, but, I don’t know, I suppose I should not speak for the profession as a whole. It may serve society’s interests better to prevent harmful bad practice than rely on good. It is indicative of the sorry state of modern medical practice to be at the mercy of both market forces and hysteria and not steer through the currents with any authority or respect.

Two of the SSRI class of drugs have already been banned – or, technically, contra-indicated in children – by the agency.

The first, in June, was Seroxat, which goes by the generic name paroxetine (Paxil); the second, in September, was Efexor (venlafaxine) (Effexor); joining them now will be Lustral (sertraline) (Zoloft), Cipramil (citalopram) (Celexa), Cipralex (escitalopram) (Lexapro) and Faverin (fluvoxamine) (Luvox).

[I have added in italics the corresponding trade names of these drugs in the US. — FmH]

If this British pronouncement works anything like analogous decrees in the US, it is worth pointing out that it does not have the force so much of law as of recommendation (“technically, contraindicated”, rather than “banned”), and will serve to give prescribers but more importantly patients or parents, pause. It is just another eddy being introduced into the marketplace. When alarm in the US last year resulted in a recommendation that one SSRI, Zoloft (sertraline) not be prescribed for children, I am not sure it changed prescribing practices much. I would be interested in the data.

It may influence GPs more than psychiatrists. As you know, I feel that the proper source of consumer concern over adverse effects of psychiatric medications is the fact that they are mismanaged by poorly prepared general practitioners who have been the major targets of Pharma’s marketing efforts over the twenty years since the SSRIs were introduced. That shift in targeting strategy has been, I am convinced, the biggest cause of the change in the landscape of modern psychiatry during my practice, and I have fought bitterly against it. The single most helpful thing to do to insure maximal benefit from psychopharmacological treatment is to take your loved one, or yourself, to a reputable psychiatric specialist rather than allow your medication to be prescribed by your general practitioner.

Now, turning to the other claim, that antidepressants may not be very effective in children, that should rightly prompt profound consumer skepticism when a doctor reaches for a prescription pad, especially to treat a child. There is an epidemic of both overdiagnosis and overprescription for conditions in which medication may not be effective. However, I am dubious about the 1:10 claim. I am not a child psychiatrist but I know that my colleagues in that end of the field have far greater success rates than 10%, when diagnosis is properly performed and prescribing is targeted and prudent. A truly depressed child is at considerable risk of morbidity and mortality, and prudent antidepressant use has an invaluable role in ameliorating her/his suffering and preventing a dire outcome. It just has to be managed by someone properly trained, adequately experienced, well-intentioned, and not in the pockets of the drug companies.


"Way to go, Al"

Cobb says:

“Al Gore, that fundamentally quirky guy, has given the finger to Joe Lieberman. Good.

Let the Democrats be populist and leave Lieberman in the dirt. He needs to switch parties and quit kidding himself anyway. Liberals need to be radically populist and if Dean is the best they can do, fine. Even Hillary Clinton, whom I do not love to hate, is sounding hawkish, hardheaded and sensible these days. What’s up with that?

Message to Democrats. There is no triangulation left to do. It has been done. Get your cudgels, torches and pitchforks and bring your radical stuff to the streets. That’s what you do best, so get to it. What’s wrong with you people anyway? Where are your hemp handbags and Act Up antics? Where are your plastic inflatable rats and black balaclavas? Where are your effigies and misspelled picket signs? Where are your balls?

You’re not going to let a wimp like GWBush beat you again are you? Here’s a little secret. The first party to nominate a candidate with a beard will have my vote for life.”


America’s most wanted

(book, that is): “It’s Iraq. The Sunnis, Shias and Kurds are at each other’s throats, only cooperating long enough to attack the foreign army that is occupying their country. The army is tasked with nation-building, and is running into serious difficulty. The man in charge is… no, not America’s Paul Bremer, but General Sir Aylmer Haldane. The year is 1920.

Published in 1922, Haldane’s book, Insurrection in Mesopotamia 1920, long ago vanished into the dusty fastnesses of antiquarian booksellers. But not any more. We hear that Sir Aylmer is required reading in Washington these days. Evidently, the Pentagon and state department are snapping up all available copies – the price on the web has hit $250 and is rising. Why?” —Guardian.UK


More Than a ‘Scream’

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A blast felt ’round the world: “Since 1893, when ‘The Scream’ was rendered, various art historians have speculated about the nature of that event, and when it occurred. Now Dr. Donald Olson, an astronomer at Texas State University, and colleagues say these experts have overlooked an earth-shaking fact.

In the February 2004 issue of Sky & Telescope, the Texas group asserts that ‘The Scream’ was the direct consequence of a cataclysm half a world away from Norway: the volcanic explosion on the Indonesian island of Krakatoa.” —New York Times


Hailing Elvis

Seattle cab drivers are now free to dress up as their favourite public figures. “This is not just good news for taxi drivers but good news for journalists. If the taxi driver is dressed up as ‘a generally well known public figure’ then it could save the reporter all the bother of finding the public figure to interview. If the habit spreads from Seattle, then journalists will be able to fly from city to city interviewing ‘readily identifiable and generally well known public figures’ without ever having to track down the real thing.” —Guardian.UK


Glaxo Chief: Our Drugs Do Not Work on Most Patients

Senior Pharmaceutical Executive Goes Public with Industry Open Secret for First Time:

“Drugs for Alzheimer’s disease work in fewer than one in three patients, whereas those for cancer are only effective in a quarter of patients. Drugs for migraines, for osteoporosis, and arthritis work in about half the patients, Dr Roses said. Most drugs work in fewer than one in two patients mainly because the recipients carry genes that interfere in some way with the medicine, he said.

‘The vast majority of drugs – more than 90 per cent – only work in 30 or 50 per cent of the people,’ Dr Roses said. ‘I wouldn’t say that most drugs don’t work. I would say that most drugs work in 30 to 50 per cent of people. Drugs out there on the market work, but they don’t work in everybody.’

Some industry analysts said Dr Roses’s comments were reminiscent of the 1991 gaffe by Gerald Ratner, the jewelry boss, who famously said that his high street shops are successful because they sold ‘total crap’. But others believe Dr Roses deserves credit for being honest about a little-publicized fact known to the drugs industry for many years.” —CommonDreams


Jihad has Worked —

The World is Now Split in Two: “Osama bin Laden, two years and three months after the New York and Washington attacks that were part of his jihad against America, appears to be winning. He has lost his base in Afghanistan, as well as many colleagues and fighters, and his communications and finances have been disrupted. He may be buried under rubble in Afghanistan or, as Washington and London assume, be hiding in Pakistan’s tribal areas. But from Kandahar to Baghdad, from Istanbul to Riyadh, blood is being shed in the name of Bin Laden’s jihad.” — Ewan McAskill, diplomatic editor of The Guardian, CommonDreams


A Fire in the Brain

The difficulties of being James Joyce’s daughter; a review of Carol Loeb Shloss’ Lucia Joyce: To Dance in the Wake.

“Carol Shloss believes that Lucia’s case was cruelly mishandled. When Lucia fell ill, she at last captured her father’s sustained attention. He grieved over her incessantly. At the same time, he was in the middle of writing “Finnegans Wake,” and there were people around him—friends, patrons, assistants, on whom, since he was going blind, he was very dependent—who believed that the future of Western literature depended on his ability to finish this book. But he was not finishing it, because he was too busy worrying about Lucia. He was desperate to keep her at home. His friends—and also Nora, who bore the burden of caring for Lucia when she was at home, and who was the primary target of her fury—insisted that she be institutionalized. The entourage finally prevailed, and Joyce completed “Finnegans Wake.” In Shloss’s view, Lucia was the price paid for a book.

But, as Shloss tells it, the silencing of Lucia went further than that. Her story was erased. After Joyce’s death, many of his friends and relatives, in order to cover over this sad (and reputation-beclouding) episode, destroyed Lucia’s letters, together with Joyce’s letters to and about her…” —The New Yorker


Nursery rhymes produce warped view of dangers of head injuries

“So exactly what was that old man doing – and who was he doing it with? – when he went to bed and bumped his head and couldn’t get up in the morning?

How come no one called child protection authorities about the baby in that cradle in the tree top?

And why in the world did men on horseback attempt to restore Humpty Dumpty to health, when an Emergency Services crew with a cervical collar and a spinal board ought to have been on the scene?” —Canoe


"…principled stand by a man who’s changed profoundly since 2000…"

Joe Conason:

“Although Al Gore’s …endorsement of Howard Dean must be disturbing news for all of the front-runner’s rivals, it will strike most sharply at Joe Lieberman. John Kerry also badly wanted and needed the endorsement of Gore, who nearly selected the Massachusetts senator as his running mate in 2000.

…(S)omeone will probably ask Gore why he assured the nation three years ago that Lieberman was the Democrat best qualified to serve in the Oval Office should any exigency befall President Gore — but is today less worthy of voter support than the former governor of Vermont.

If the former vice president were to answer candidly, he might admit that his own politics have shifted since 2000, when the experience of losing the presidency he had won seems to have changed him radically. The most obvious evidence of this change during the past year came in his powerful speeches against the war in Iraq and the erosion of civil liberties. A related signal is his close and continuing cooperation with MoveOn.org, which sponsored those speeches.” —Salon


R.I.P. Ruben Gonzalez

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Buena Vista pianist dies at 84. Called by Ry Cooder “the greatest piano soloist I have ever heard” and “a Cuban cross between Thelonius Monk and Felix the Cat”, Gonzalez’ comeback in the ’90’s represented not only his own return from retirement but the reclamation of a musical style that the world had almost lost forever.


Hard Wired for God?

Carmelite nuns in Montrealbreak their vow of silence and venture out of the cloister, joining forces with science to seek a concrete sign of God inside the human brain. —The Globe and Mail

And: Humanity? Maybe It’s in the Wiring:

“Neuroscientists have given up looking for the seat of the soul, but they are still seeking what may be special about human brains, what it is that provides the basis for a level of self-awareness and complex emotions unlike those of other animals.

Most recently they have been investigating circuitry rather than specific locations, looking at pathways and connections that are central in creating social emotions, a moral sense, even the feeling of free will.” —New York Times


The Neurology of Personal Preferences

Selling Directly to the Mind:

“You see a sweater for sale and think, ‘I have to have that!’ Clint Kilts wants to know why.

Kilts, a professor of psychiatry and behavioral sciences at Emory University in Atlanta, is investigating the underlying neural organization that governs personal preferences and the decision-making process. Regarding a product, there’s not a lot of conscious deliberation, he says. People decide quickly whether they like something.” —The Scientist

Brain Area Identified That Weighs Rewards:

By studying how monkeys choose to look at lighted targets for juice rewards, neurobiologists have identified a still-mysterious region of the cerebral cortex as an area that judges the value of rewards, and adjusts that value as circumstances change.

The finding adds a significant piece to the puzzle of how the brain is wired to make judgments, perhaps even moral judgments, about the outside world, said the researchers. The findings may also have implications for understanding a number of neurological disorders, said the scientists. Damage to the area the researchers studied — called the posterior cingulate cortex — has been linked to cognitive decline in Alzheimer’s disease, as well as pathologies of stroke, obsessive-compulsive disorder, schizophrenia and spatial disorientation. —Duke Med News


Updated IQ tests can wreak havoc

“The year in which IQ is tested can make the difference between life and death for a death row inmate. It also can determine the eligibility of children for special services, adults’ Social Security benefits and recruits’ suitability for certain military careers, according to a new study by Cornell University researchers.

That’s because IQ scores tend to rise 5 to 25 points in a single generation. This so-called ‘Flynn effect’ is corrected by toughening up the test every 15 to 20 years to reset the mean score to 100. A score from a test taken at the end of one cycle can vary widely from a score derived from a test taken at the beginning of the next cycle, when the test is more difficult, says Stephen J. Ceci, professor of human development at Cornell.” A .pdf of Kanaya, Scullin and Ceci’s paper

is here.


Brother, can you spare the dime?

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Reagan image: new deal for the dime? “Some Republican members of Congress want to get Democratic President Franklin Delano Roosevelt off the dime, literally.

They have provoked a partisan battle by proposing to flip the left-facing image on America’s dime — getting rid of the face of FDR and replacing it with a man they hold in the same lofty regard: former Republican President Ronald Reagan.” —SF Chronicle

Nancy Reagan has weighed in
on the side of maintaining the Roosevelt homage on the dime. (Perhaps she is shooting for a larger denomination?) —New Zealand Herald


Tough New Tactics by U.S. Tighten Grip on Iraq Towns

“As the guerrilla war against Iraqi insurgents intensifies, American soldiers have begun wrapping entire villages in barbed wire.

In selective cases, American soldiers are demolishing buildings thought to be used by Iraqi attackers. They have begun imprisoning the relatives of suspected guerrillas, in hopes of pressing the insurgents to turn themselves in… The response they chose is beginning to echo the Israeli counterinsurgency campaign in the occupied territories.

So far, the new approach appears to be succeeding in diminishing the threat to American soldiers. But it appears to be coming at the cost of alienating many of the people the Americans are trying to win over.” —New York Times

…And, in the long run, it will have the same success the Israeli tactics have had.


Teacher sues over limits on history curriculum

“A seventh-grade social studies teacher in Presque Isle who said he was barred from teaching about non-Christian civilizations has sued his school district, claiming it violated his First Amendment right of free expression.

Gary Cole of Washburn, a teacher at Skyway Middle School, sued School Administrative District 1 in U.S. District Court in Bangor.

Cole alleged that complaints by ‘a small group of fundamentalist Christian individuals’ led to the creation of a curriculum ‘which never mentions religions other than Christianity and never teaches the history of civilizations other than Christian civilizations.’

‘He can’t even teach the history of anti-Semitism (or the) history of ancient Greece,’ said Cole’s lawyer, A.J. Greif of Bangor.” —Portland (ME) Press Herald This was the news item about which Rafe Coburn said, “The Taliban aren’t nearly as alien as most people would like to believe.”


Expletive Undeleted

“Struggling 2004 Democratic wannabe John Kerry fires an X-rated attack at President Bush over Iraq and uses the f-word – highly unusual language for a presidential contender – in a stunning new interview with Rolling Stone magazine.

Sen. Kerry (Mass.) used the undeleted expletive to express his frustration and anger over how the Iraq issue has hurt him because he voted for the war resolution while Democratic front-runner Howard Dean has soared by opposing it.

‘I voted for what I thought was best for the country. Did I expect Howard Dean to go off to the left and say, ‘I’m against everything’? Sure. Did I expect George Bush to fuck it up as badly as he did? I don’t think anybody did,’ Kerry told the youth-oriented magazine.” —New York Post

His unexpurgated anger, however, seems less directed against Bush and Iraq than it does his own freefalling chances to win the Presidency.


Examining the U.S.-Europe Cultural Gap

“Imagine a discussion about the cultural divide between the United States and Europe and not a word about Michael Jackson, 50 Cent, Tom Cruise or Paris Hilton.

Instead, prominent European and American writers mocked the Bush administration, lamented the rise of religious fundamentalism in the United States and squabbled about Israel at a forum Thursday night sponsored by PEN American Center and the Institute for the Humanities at New York University.

They also discussed more writerly concerns: why more translations of foreign-language books are not published in the United States, for instance, and why Americans do not seem to take their writers as seriously as the Europeans do theirs.” —New York Times


Web Webster Stir

Which Dictionary is Best?

“I restricted my testing to seven of the relatively affordable and frequently updated college dictionaries (the type of dictionary used not only in the most dormitory rooms but in the most homes and offices as well). To determine my rankings, I looked up seven times over words that I knew but wanted to understand better (like regret, jealous, and overdetermined); words with disputed usages (including aggravate, disinterested, fortuitous); words with potentially interesting etymologies (e.g., chauvinism, juggernaut, lagniappe); neologisms and slang (e.g., blogger, booty, yay); anything friends had looked up recently (e.g., Panglossian, condominium, alembic); as well as the words I didn’t know in the last book I read, J.M. Coetzee’s Elizabeth Costello.” —Slate


Medical Whoring Dept.

How drug firms ‘hoodwink’ medical journals:

“Hundreds of articles in medical journals claiming to be written by academics or doctors have been penned by ghostwriters in the pay of drug companies, an Observer inquiry reveals.

The journals, bibles of the profession, have huge influence on which drugs doctors prescribe and the treatment hospitals provide. But The Observer has uncovered evidence that many articles written by so-called independent academics may have been penned by writers working for agencies which receive huge sums from drug companies to plug their products.” —Observer.UK

I have previously written about this particular bit of medical whoring, but here it comes again.


Hidden Gotcha in Medicare Reform

New Bill Bars Extra Insurance for Drugs:

“Millions of Medicare beneficiaries have bought private insurance to fill gaps in Medicare. But a little-noticed provision of the legislation prohibits the sale of any Medigap policy that would help pay drug costs after Jan. 1, 2006, when the new Medicare drug benefit becomes available.

This is one of many surprises awaiting beneficiaries, who will find big gaps in the drug benefit and might want private insurance to plug the holes — just as they buy insurance to supplement Medicare coverage of doctors’ services and hospital care.” —New York Times

Congress’ supposed rationale is a curious one: “Health economists have long asserted that when beneficiaries are insulated from the costs, they tend to overuse medical services.” But, unless I have missed something in the practice of medicine, while sharing some of the cost of medical care may control overutilization, sharing the cost of prescription drugs will not help control overprescribing, since it is not the benificiary but the benificiary’s physician who decides what medications are necessary.


If Shoe Won’t Fit, Fix the Foot?

Popular Surgery Raises Concern:

“With vanity always in fashion and shoes reaching iconic cultural status, women are having parts of their toes lopped off to fit into the latest Manolo Blahniks or Jimmy Choos. Cheerful how-to stories about these operations have appeared in women’s magazines and major newspapers and on television news programs.

But the stories rarely note the perils of the procedures. For the sake of better “toe cleavage,” as it is known to the fashion-conscious, women are risking permanent disability, according to many orthopedists and podiatrists.” —New York Times


"…A Chance to be Brave…"

Ground Zero’s Only Hope: Elitism

“Ladies and gentlemen of the jury: now that everyone agrees that the ground zero memorial finalists are a disappointment, there’s only one thing to do.

Throw them all out.

You have the power to do so. Use it. This is in part a memorial to extreme bravery in the face of overwhelming force. Here’s a chance to be brave.” —New York Times


Hints of Wine?

Chocolate Enters the Tasting Room

‘ “Chocolate is the next coffee,” confided one importer.

“Chocolate is the new olive oil,” said a chocolatier.

“Chocolate now is where cheese was 10 years ago,” a pastry chef asserted.

In the beginning, there was wine. And there were wine tastings and wine snobs and wine-of-the-month clubs. Then olive oil, vinegar, cheese, coffee and butter followed into the American culinary consciousness. Now the appreciation of fine chocolate seems poised to become the next gastronomic parlor game.’ —New York Times


Country’s Gotta Eat…

Kebabing Along

“When I went to Afghanistan in August, I was prepared — sort of — for the acres of crashed airplane carcasses that greeted us upon arrival at the Kabul International Airport; I was prepared for the heat and the dust and the fact that much of the place is essentially a pile of rubble. I was even prepared for the traffic (just before I left, The Wall Street Journal pointed out that there were almost 200,000 registered vehicles in the city — and no traffic rules to speak of). What I was not prepared for was the food. It is delicious.” —New York Times Magazine


A New Era of Nuclear Weapons

Bush’s Buildup Begins with Little Debate in Congress: “Congress, with only a limited debate, has given the Bush administration a green light for the biggest revitalization of the country’s nuclear weapons program since the end of the Cold War, leaving many Democrats and even some hawkish Republicans seething.”


Just in case you thought I was blowing hard in my post last week about The Day After and nuclear numbing.


US child bombing account challenged

“Local villagers in Afghanistan have contradicted US reports that the target of an air strike that killed nine children also died in the raid.

The attack was carried out on Saturday in the village of Hutala, in a remote area of southern Ghazni province.

US officials said they were acting on extensive intelligence and had killed a former Taleban militant, Mullah Wazir.

But local Afghans told the BBC’s Crispin Thorold the intended target had left the village 10 days earlier.” —BBC


Hair on fire

“A hair stylist was pumping gas into her car when her hair burst into flames.

‘That scared me to death,’ said stylist Traci Marshall.

The fire was probably caused by static electricity from Marshall’s hair rubbing against her clothes, said her husband, Camilla firefighter Lt. Bill Marshall.” —Atlanta Journal-Constitution

I have recently noticed the proliferation of warning signs about static electricity precautions at the pumps — turn off your cell phone, ground yourself on some bare metal away from the pump, etc. — and classed them as among the absurd profusion of needless cautions with we are afflicted so that corporate lawyers can create the impression that they have earned their keep by advising their clients’ due caution around all manner of conceivable liability issues both realistic and outlandish. Now, maybe I will reassess at least this particular risk, although I don’t have a beehive hairdo…


The Look Of Abercrombie & Fitch

“Two ex-managers for a clothing chain accused of discrimination say corporate representatives of the chain, Abercrombie & Fitch, routinely had them reduce the hours of less attractive salespeople.

The two former managers – who say they were hired for their good looks – appear in a Morley Safer report on the trendy retail chain on 60 Minutes…” —CBS

Abercrombie and Fitch is at it again;

Clothing chain yanks its racy, sex-stuffed catalog:

“The national clothing chain Abercrombie and Fitch has pulled its Christmas catalog, which featured page after page of naked young models and extolled the virtues of group sex, after several groups launched consumer boycotts of the company.

The firm denied that its decision at the height of the holiday shopping season to stop selling the racy catalog — which advocated orgies and group masturbation — had anything to do with the protests. Instead, Abercrombie and Fitch said it needed to free precious shelf space for a new perfume and promised to return with a spring catalog offering more “butts” and other nudity.

Abercrombie & Fitch Seeing Consequences of Sleazy Marketing; Clothier’s Stock, Holiday Sales Plummeting in Wake of Boycott:

“…(A) story in today’s Wall Street Journal …noted A&F’s in-store sales had dropped 13 percent in November — and its stock has lost over 16 percent of its value since Focus on the Family and other pro-family groups urged Americans not to buy the retailer’s clothes. In addition, recent trading volume is more than twice normal.” —US NewsWire


Beat The Clock

“For both parties, next year’s presidential election is, in many ways, a race against the clock. For President Bush, the question is whether he peaks too early. For now, the economic news is good and the war news just barely tolerable.

But take a closer look at both fronts. On the economy, the ideal time for Bush’s reelection would be about now, when everything is on an upswing. Unfortunately, the election is next fall. Economic growth and the beginning of job growth have returned. However, both are built on a unsustainable degree of economic stimulus. The federal budget deficit is about 5 percent of GDP, and rising. Interest rates are at five-decade lows.

With that amount of stimulus, of course the economy grows. Even so, jobs are not yet growing fast enough to reduce unemployment much, and wages are still fairly flat. The problem is that you can’t sustain very high deficits and very low interest rates very long. Money markets look at the rising national debt, and start getting very nervous. That pushes up interest rates.

More ominously, huge budget deficits are linked to huge trade deficits. We finance our deficits and borrowing binge by absorbing capital from the rest of the world. That’s not sustainable either….

Over in the opposition camp, the Democrats have a very different timing problem. For 20 years, they have been tinkering with the nomination process in the hope of getting it done early, so that their standard bearer can be known early and the usual extended brawl avoided.

This year, however, the nomination process could drag on, leaving Democrats pounding on each other rather than honing their challenge to Bush. One of the Democrats’ rule changes requires delegates to be awarded proportionally. No more winning New York by a few votes and being awarded all of its delegates. Every state will now have a split delegation. This change, coupled with a large field of candidates, makes it much harder for any candidate to win half the delegates, and the nomination contest could go all the way to the convention for the first time since 1960…” — Robert Kuttner, TomPaine.com


Air Force Pursued Boeing Deal Despite Concerns of Rumsfeld

The New York Times details the collusion between Boeing and Air Force personnel in a proposed $20 billion contract for the acquision of 767’s. Even after the scandal led to this week’s resignation of Boeing’s CEO, the Air Force’s top acquisitions official distributed messages to the parties urging Boeing and the Pentago to close the deal “a.s.a.p.” before public opposition mounted. This official had earlier this year forwarded to Boeing copies of internal Pentagon memos detailing the Defense Dept’s planned negotiating strategy for the contract.

And Pentagon adviser Richard Perle came under fire on Friday for failing to disclose financial ties to Boeing Co., even while championing its bid for a controversial $20 billion-plus defense contract. —CommonDreams


Cellphone Number Transfer Hits a Snag

“…(M)obile phone users looking for improved phone reception and service have discovered a new problem: technical glitches and delays in making the number transfers.

Tens of thousands of customers have had to wait several days for their old numbers to work on their new phones and some have waited more than a week – even though switching a number is supposed to take only a few hours. In fact, according to people in the industry, the automated computer processes that are designed to carry out the number switching have been failing about 50 percent of the time – making it necessary for the wireless carriers to check the customer data manually, a time-consuming task.” —New York Times


Hundreds of U.S. Troops Infected by Parasite Borne by Sand Flies, Army Says

Cutaneous leishmaniasis, caused by a parasite spread by biting sand flies, has been diagnosed in more than 150 US military personnel in Iraq so far. It causes ugly ulcerated skin lesions which may take months to heal and can only be treated by 10-20 days of a 50-year old unapproved drug that can be administered only intravenously and which is toxic to the liver and pancreas. So far the life-threatening visceral form of leishmaniasis, in which the parasites infest the internal organs rather than the skin, has not been seen. The invasion of Iraq began during the hot season when the sand flies start biting, in contrast to the 1991 Gulf War conducted in the colder season and in which very few contracted the disease. In the current military action, many soldiers have scorned precautions, sleeping outside in their underwear because of the heat and eschewing insect repellent because the sand sticks to it. But even those who sleep under mosquito netting indoors are susceptible, because the Army’s mosquito netting has holes too large to stop the sand flies. Some GIs have presented with more than 200 bites per night. The disease has a long incubation period and hundreds of soldiers in each unit have been bitten and are in danger of developing the disease in coming months. Currently, more than 40 new cases a day are being diagnosed but we can expect that to skyrocket. Soldiers are sent back to the US for treatment, out of service for 30-40 days. Will the Army quietly stop sending infected soldiers for treatment as the numbers continue to mount? —New York Times


Hospitals Say They’re Penalized by Medicare for Improving Care

The article analyzes the failure of Medicare’s payment structure to provide incentives for better care, and the recently-passed Medicare reforms do nothing to address the effort despite calls from health funding specialists. Psychiatry is different from much of the rest of medicine with respect to Medicare reimbursement in several respects. First, there are few “procedures” in my field, so the situation the article describes in which a hospital gets paid much less for, say, a pneumonia patient if the patient gets better without needing to be placed on a respirator does not apply. Secondly, in other areas of medical care, other than paying for procedures, there is flat-rate reimbursement by the admission or the incident, whereas in psychiatry, Medicare pays by the day (and, unlike other insurers, Medicare is not ‘managed’, i.e. there are no reviewers pressuring the hospital to treat the patient and discharge sooner to save the insurer money). So there is an incentive for psychiatric hospitals, especially those in the for-profit sector, to fill their beds with Medicare patients rather than divert any who present, no matter how possible to send them home instead and stabilize them in the community and prevent a needless admission that would be disruptive and distressing. Furthermore, there is an incentive for the hospital to fill their beds with less sick patients, because sicker patients will cost more in manpower, medications and other resources while they are hospitalized despite fixed reimbursement. I see this at my hospital, where clinical input into the appropriateness of admissions decisions has been excluded by the non-clinical corporate fiscal administrators, and I am convinced inappropriate Medicare admissions become a covert bulwark of the hospital’s profitmaking strategy.


Reagan Reconsidered, Again

“This month, Americans will get a second chance to scrutinize the legacy of Ronald Reagan when HBO begins airing its two-part adaptation of Tony Kushner’s Pulitzer Prize-winning play, ‘Angels in America.’

The first opportunity to reconsider Reagan, of course, was scuttled in November, when CBS pulled the plug on the notorious, and now almost legendary, TV-movie, ‘The Reagans.’ At the time, conservatives decried the film as an exercise in character assassination, insisting that at best, it employed excessive artistic license in condemning the 40th President’s deplorable response to the AIDS crisis, and, at worst, was a fabricated hack job…

The HBO adaptation of Tony Kushner’s ‘Angels in America‘ is a far harsher indictment of Reagan’s handling of the AIDS. So why has the rightwing remained silent?” —AlterNet


Annals of Depravity (obviously):

‘If Armin Meiwes gets off on the insanity degree, I’ll eat my…’ On trial in Germany, cannibal says victim was willing. Meiwes says that being an only child yearning for a younger brother transmuted itself into an obsession with wishing to consume someone to incorporate them into him and bind them to him forever, according to his testimony. He says he got over four hundred responses to an ad he placed seeking someone for “slaughter and consumption.” When he met his victim, they apparently dined on his penis after Meiwes amputated it. Later, his victim was killed and dismembered, and Meiwes consumed various body parts over ensuing months. He was arrested after authorities were alerted to a subsequent ad he placed; buried human remains were found at his home. The case is legally complex, since cannibalism per se is not a crime, and since the victim was seemingly a willing accomplice in his own death.

A reader was reminded loosely of my two essays on apotemnophilia here and here. I share the sense of being challenged about how to conceptualize situations in which people collaborate in their own gruesome mutilation, disfigurement or death for inexplicable reasons. I am in a way more stupified by the four hundred people who responded to Meiwes’ ad than by his depravity.

Related? Victoria Van Dyke is the pseudonym of an artist who describes her work in this way:

My drawings and paintings of the past have been deeply personal and often of a sexual nature. It is only natural that my photography is deeply personal, sexual and sometimes confusing, even to me. I work with models in my photography because I am uncomfortable showing my own body…

I now identify myself as a cannibal, although I have never attacked or eaten anyone, nor do I feel the urge to do so at this time. I simply am a cannibal who due to social restrictions decides not to eat. Much like a vegetarian who decides not to eat meat. This overlap of my eating beliefs with my art is an intriguing one, because I feel it grabs people’s attention, and I like the attention that I get.

Perhaps I am only interested in being a cannibal because of the attention it gives me, but psychologically speaking, if I was ever given the opportunity to eat someone, and get away with it, I would.


Sharia & Europe

European Dishonor: “The Western world has grown accustomed to hearing about the brutalities of Islamic law. However, these primitive practices are no longer limited to the remote tribal areas of Pakistan, the backward kingdom of Saudi Arabia, or oppressive, mullah-dominated Iran. Today, thanks in large part to a massive flow of immigration from Muslim countries, sharia law and medieval customs are becoming increasingly common in the heart of Christian Europe.” —National Review [via walker]

The authors are head writer and attorney/terrorism analyst at the Investigative Project, “a Washington, D.C.-based counterterrorism think tank.” I have no way of assessing the veracity or gravity of this exposé and know nothing about the Investigative Project. But the article is full of gruesome detail (Walker sent me a highlight describing how amputations are done under sharia) and allows the anecdotal excesses it describes to stand for European Islam as a whole, without counterexamples. Its ethnocentric bias is apparent from the first paragraph’s use of ‘backward’ to refer to Saudi Arabia and ‘Christian’ to refer to Europe, and it is xenophobically anti-immigrant, anti-diversity and pro-assimilation. Those who think differently are tarred with the brush of “political correctness.” All of these are buzzwords; one can imagine, without knowing, the ideological orientation of the authors, or is it of the Investigative Project? The major intent of the article appears to be the indiscriminate demonisation of Islam as a whole.


Out of their Right Minds

Conservatism is Crazy, but Psychiatry is Here to Help: “For centuries, statesmen and philosophers have argued about just what modern political conservatism really is: aristocratic or meritocratic, orthodox or libertarian, reactionary or triumphalist. Finally, science has the answer: conservatism is madness. That, at least, is what four professors—Jack Glaser, Frank Sulloway, John Jost, and Arie Kruglanski—suggest in a study that got a great deal of attention in the last few months.” —The New Atlantis The paper attracted alot of attention in the lay press, headlined by campy histrionic comparisons of Bush with Hitler. Despite being more understated than that, the paper, whose authors are prominent enough in psychological academia to know better, had to be written more to be provocative than serious. It appers quite disingenuous of them to defend the paper on op-ed pages, as described in the article, with pained claims of innocence and surprise about pathologizing and, hence, offending anyone. While I believe that decreased cognitive complexity and flexibility, deep insecurity, and lagging moral development, make their bearers more suited to politically conservative thinking, and are characteristic of some conservatives (e.g. George W. Bush in spades), certainly the Right holds some appeal to some cognitively and emotionally sophisticated souls. Political psychology, which applies to populations or polities skills intended for and honed by analyzing individuals’ psyches, has always felt to me like a right shoe worn on a left foot. There is yet another false step, although I am not sure if it is that of Glaser et al or merely the New Atlantis rendition of their beliefs, in moving from inferring unconscious psychological roots of the political beliefs of subject such as Bush to labelling them as a variety of madness. In any case, call me crazy but I agree that “this stands as a powerful example of the misuse of science and the arrogance of expertise.”


The Bird Was Perfect But Not For Dinner

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Another example of Bush’s penchant for misleading us photographically:

“In the most widely published image from his Thanksgiving day trip to Baghdad, the beaming president is wearing an Army workout jacket and surrounded by soldiers as he cradles a huge platter laden with a golden-brown turkey.

The bird is so perfect it looks as if it came from a food magazine, with bunches of grapes and other trimmings completing a Norman Rockwell image that evokes bounty and security in one of the most dangerous parts of the world.

But as a small sign of the many ways the White House maximized the impact of the 21/2-hour stop at the Baghdad airport, administration officials said yesterday that Bush picked up a decoration, not a serving plate.” —Washington Post

The article also observes that Dubya’s pose was not visible to reporters covering the event. The photo was taken by a pool photographer and later distributed to news sources. This is the obvious way to do it if you are going to mislead.



The Builders Association/motiroti’s

, Bangalore–London–New York:

“…(T)he Alladeen project explores how we all function as “global souls” caught up in circuits of technology, how our voices and images travel from one culture to another, and the ways in which these cultures continually reinterpret each other’s signs and stories.

The Alladeen project encompasses three collaborative works: this web project, http://www.alladeen.com (directed by Ali Zaidi); a cross-media stage performance (directed by Marianne Weems); and a music video (directed by Ali Zaidi), featuring music by Shrikanth Sriram (Shri) and video by Peter Norrman. Although distinct, these three works have been created in tandem, drawing on a common pool of imagery and information, with material from each interwoven into the others.”


The Day After Tomorrow

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Coincident with the twentieth anniversary of The Day After comes the announcement of this big-budget film on apocalyptic global warming. However, it is certainly not the case that we need no longer worry about thermonuclear apocalypse either. If the Bush dysadministration has its way, we should all reacquaint ourselves with the 1983 film. As someone who was preoccupied back then with working on disarmament issues (whenever I wasn’t memorizing anatomical details for my medical school classes), the night I gathered wtih a group of like-minded friends to watch The Day After and consider that this event had the potential to break through the nuclear numbing (to use a phrase of my mentor, psychiatrist Robert J. Lifton) of millions of American viewers was a prodigious experience. It needs to happen for a new generation now too…


His Own Private Idaho

Rebecca Blood pointed us to this long thoughtful saga of the journey of an Idaho-bred conservative to a profound mistrust and disapproval of the current neo-conservative regime. An excerpt:

“There’s no doubt my feelings about the legitimacy of George W. Bush’s presidency affected my view of his behavior after the terrorist attacks. In fact, I was profoundly dismayed that someone as manifestly unfit for the office was occupying it at such a crucial moment in history. Now, had Bush gone about pursuing the war on terrorism seriously, building multinational coalitions; recognizing the myriad faces of terrorism, and the limits of the military response; perhaps even recognizing when a criminal-justice response is more warranted; and uniting the nation around a genuine consensus — well, then, I would have been forced to change my opinion of the man. I would have backed him as gladly as the Glenn Reynoldses and Andrew Sullivans are urging us to do now.

But Bush, of course, did not. Because he is so grotesquely shallow a leader, he has essentially allowed a cadre of genuine radicals — specifically, the ‘neoconservative’ ideologues from the Project for a New American Century — to take control of both our foreign policy and the entire direction of the ‘war on terrorism.’ The result has been that we have spit in the face of our traditional allies, as well as the United Nations (and then had the temerity to come back to them demanding help when it all turned sour); only limited recognition that terrorism has a home-grown face as well; embarked on an invasion of another country with the September 11 attacks as a pretext, while such claims have not proven to be well-grounded; and completely divided the nation by making out dissenters from the radical direction in which he has taken the nation as ‘unpatriotic.'”

But this is only a portal to the author’s ongoing and more broad-reaching work on incipient fascism in America.