Today, from a distance, I saw you

walking away, and without a sound

the glittering face of a glacier

slid into the sea. An ancient oak

fell in the Cumberlands, holding only

a handful of leaves, and an old woman

scattering corn to her chickens looked up

for an instant. At the other side

of the galaxy, a star thirty-five times

the size of our own sun exploded

and vanished, leaving a small green spot

on the astronomer’s retina

as he stood on the great open dome

of my heart with no one to tell.

— Ted Kooser

These are difficult to believe but they are real. Read more about them here and here. [thanks to rebecca blood]

“The Book Review recently asked a handful of poets and critics to respond to this question: What book of poetry, published in the last 25 years, has meant the most to you personally — the book you have found yourself returning to again and again? We asked them not to select reissues, or volumes of a poet’s ”selected” or ”collected” work. Here are their responses…” (New York Times [thanks to wood s lot])

While, as my posts reacting to the election defeat indicate, I agree that this is a time for, figuratively if not literally, street-fighting, I hope that stridency like this does not herald a return to the rhetoric of certain segments of the ’60’s movement who were intent on being radicaler-than-thou and dismissive of anyone who did not conform their activities to their notion of what was to be done. I personally think, in contradistinction to the lead-in above, that writing a weblog is a valid part of ‘taking action on the pressing issues of our day’ and may even qualify as ‘street fighting.’ Of course, it can also be simply intellectual masturbation. The danger is that empty lip service to being a change agent may actually help bolster the status quo. Please help me to maintain an honest distinction.

“BloggerCorps matches bloggers with activists and non-profit groups who want to blog and need help getting started….

The authors (a wide-ranging group comprised mainly of bloggers, activists, and tech organizations who work with non-profits) will post announcements on behalf of organizations who need help starting blogs or building blogging communities. The posts will be categorized according to the organization’s geographical location, and in some cases its main focus issue. Bloggers interested in helping that particular organization can express their interest in the comments section attached to that post. The organization will then decide which of the volunteers it wants to follow up with. All arrangements will be made directly between organizations and bloggers. Bloggercorps will not mediate. We are not raising money to put people on planes so in most cases the idea is to match organizations located in a particular place with bloggers living in the same place. If situations arise in which organizations cannot find volunteers living in their area, we may be able to point them to foundations or philanthropic organizations who might be in a position to help fund travel for blogger-volunteers. But we won’t do your fundraising work for you.

Sounds like a wonderful idea; count me in. Although FmH is primitive from a coding standpoint, I have been doing this for long enough to understand the mechanics.

I still wonder why there has been no serious discussion of the possibility that the tape was a Bush administration concoction given its convenient timing, its anonymous origins, and its congruence with the Republican fear-based campaign techniques. I raised the possibility that it was the often-touted ‘October surprise’ in my initial reactions to its appearance.

Oliver Willis’ Brand Democrat project

“Scientific experiments claiming that distant intercessory prayer produces salubrious effects are deeply flawed…” — Michael Shermer (Scientific American) Whenever I link to one of Shermer’s profoundly skeptical observations, I get at least several angry responses from readers who dismiss my thinking as being hopelessly limited. I don’t mind; I think that this is an especially important time to subject faith to reasonable examination. Readers of FmH will know that I hardly limit myself to what is “scientifically” proven; I think scientific knowlege is a socially conditioned belief system like any other, producing important distortions and limitations in our understanding of reality. There are many sources of light that project the flickering shadows on the wall of the cave.

I tend to believe most paranormal phenomena involve a balance of a basis in fact and a basis in human credulousness. I agree with Shermer that distance prayer is one of the more in-credible claims from a scientific perspective, but also with the claims of adherents that such phenomena may not be amenable to scientific examination. However, I think most paranormal phenomena are ultimately comprehensible as manifestations of intuition. We have ways of knowing things about which we know very little, yet they are ultimately comprehensible mental faculties. Empathic resonance and mind-body connectivity go a long way to understanding “extrasensory” perceptions. My difficulty with fitting distance healing into this perspective is that the recipient does not know s/he has been prayed for. I have the same difficulty with the studies several decades ago that claimed to show that therapeutic touch made a difference to plant growth.

And, as a reader commented to me in a private email (entitled “not an angry response”), distance prayer may be more beneficial for the sender than the recipient, but that it is nothing to scoff at because it increases the sender’s compassion. Most of the most meaningful spiritual practice is dedicated to cultivating compassion, no matter in which system it is embedded. And that, by the way, is why Bush’s brand of faith-based evangelism is not by any stretch of the imagingation a valid spiritual position.

“Will the inevitable decrease in prescriptions ultimately lead to more teenage suicides?” asks The New York Times Magazine. Readers of FmH know I have covered the controversy over antidepressants and suicide in detail. I won’t belabor the points I have already made, except to summarize that, even though they do sometimes make their users more uncomfortable, any excess suicidality in users of the antidepressants should not be attributed to the drugs but to the way they are prescribed. Part of the art of prescribing is monitoring and managing side effects; we do not restrict ourselves only to medications that are trouble-free, but weigh the relative risks and benefits with our patients in making the decision to prescribe a given medication and following the patient once they are taking it. All well and good, if everyone has access to accurate data on the effects of a medication, but drug company minimization and concealing adverse information from both consumers and prescribers has made that impossible. The pharmaceutical manufacturers sitting on top of this cash cow have marketed the drugs as trouble-free and persuaded prescribers that little care was necessary to follow those taking the drugs under their supervision. Over the past two decades, this marketing strategy succeeded by shifting the bulk of SSRI prescribing from the psychiatrists who have traditionally followed depressed patients, have the training to assess the subtleties of antidepressant side effects and the subtleties of assessing suicidality, and the time to do so in their patient visits, to generalists, internists and primary care clinicians who have none of those assets.

The ‘black box’ warning about suicide risk in pediatric use of these medications was premature and unwarranted. Most data shows that antidepressants not only do not enhance suicide risk but that they decrease it. Here is a Google Scholar search into whose citations you can drill down if you have further interest. One of the effects of the cavalier attitude about prescribing the new generation of antidepressants has been a tremendous expansion of the indications for which they are used and a lowering of the threshold for using them, especially in children. Many speculate that the adverse publicity will make many parents skittish about having their children on antidepressants. With any luck, this reluctance will take its toll primarily on the more dubious uses of the medications and not on the most severe childhood depressions for which the medications remain urgently necessary, justifying any added risk if used carefully, and without which use there would be an expansion of childhood and teenage suicides. While I am not a child psychiatrist, given my strong interest in this issue I have had many conversations with my child-psychiatrist colleagues, including some of the most authoritative and well-respected pediatric psychopharmacologists in the Boston area, with whom I am privileged to collaborate at times. The good news is that they are not seeing the feared chilling effect; parents seem no more reluctant to approve antidepressant therapy for their children in need than before the furor began. Of course, they may not be a representative sample of antidepressant prescribers. By and large, the child psychiatrists I have queried are not the ones who would be prone to prescribe in a cavalier manner, with inadequate followup, or for dubious indications. But the premise of the Times Magazine‘s article — that there will inevitably be a decline in antidepressant prescribing since the FDA warnings — is not at all a given, as I see it.

“Will the inevitable decrease in prescriptions ultimately lead to more teenage suicides?” asks The New York Times Magazine. Readers of FmH know I have covered the controversy over antidepressants and suicide in detail. I won’t belabor the points I have already made, except to summarize that, even though they do sometimes make their users more uncomfortable, any excess suicidality in users of the antidepressants should not be attributed to the drugs but to the way they are prescribed. Part of the art of prescribing is monitoring and managing side effects; we do not restrict ourselves only to medications that are trouble-free, but weigh the relative risks and benefits with our patients in making the decision to prescribe a given medication and following the patient once they are taking it. All well and good, if everyone has access to accurate data on the effects of a medication, but drug company minimization and concealing adverse information from both consumers and prescribers has made that impossible. The pharmaceutical manufacturers sitting on top of this cash cow have marketed the drugs as trouble-free and persuaded prescribers that little care was necessary to follow those taking the drugs under their supervision. Over the past two decades, this marketing strategy succeeded by shifting the bulk of SSRI prescribing from the psychiatrists who have traditionally followed depressed patients, have the training to assess the subtleties of antidepressant side effects and the subtleties of assessing suicidality, and the time to do so in their patient visits, to generalists, internists and primary care clinicians who have none of those assets.

The ‘black box’ warning about suicide risk in pediatric use of these medications was premature and unwarranted. Most data shows that antidepressants not only do not enhance suicide risk but that they decrease it. Here is a Google Scholar search into whose citations you can drill down if you have further interest. One of the effects of the cavalier attitude about prescribing the new generation of antidepressants has been a tremendous expansion of the indications for which they are used and a lowering of the threshold for using them, especially in children. Many speculate that the adverse publicity will make many parents skittish about having their children on antidepressants. With any luck, this reluctance will take its toll primarily on the more dubious uses of the medications and not on the most severe childhood depressions for which the medications remain urgently necessary, justifying any added risk if used carefully, and without which use there would be an expansion of childhood and teenage suicides. While I am not a child psychiatrist, given my strong interest in this issue I have had many conversations with my child-psychiatrist colleagues, including some of the most authoritative and well-respected pediatric psychopharmacologists in the Boston area, with whom I am privileged to collaborate at times. The good news is that they are not seeing the feared chilling effect; parents seem no more reluctant to approve antidepressant therapy for their children in need than before the furor began. Of course, they may not be a representative sample of antidepressant prescribers. By and large, the child psychiatrists I have queried are not the ones who would be prone to prescribe in a cavalier manner, with inadequate followup, or for dubious indications. But the premise of the Times Magazine‘s article — that there will inevitably be a decline in antidepressant prescribing since the FDA warnings — is not at all a given, as I see it.