Month: April 2007

Chemotherapy Fog Is No Longer Ignored as Illusion

“Chemo brain is part of the language now… [A]ttitudes are changing as a result of a flurry of research and new attention to the after-effects of life-saving treatment. There is now widespread acknowledgment that patients with cognitive symptoms are not imagining things, and a growing number of oncologists are rushing to offer remedies, including stimulants commonly used for attention-deficit disorder and acupuncture.

…Virtually all cancer survivors who have had toxic treatments like chemotherapy experience short-term memory loss and difficulty concentrating during and shortly afterward, experts say. But a vast majority improve. About 15 percent, or roughly 360,000 of the nation’s 2.4 million female breast cancer survivors, the group that has dominated research on cognitive side effects, remain distracted years later, according to some experts. And nobody knows what distinguishes this 15 percent.

… The central puzzle of chemo brain is that many of the symptoms can occur for reasons other than chemotherapy.

Abrupt menopause, which often follows treatment, also leaves many women fuzzy-headed in a more extreme way than natural menopause, which unfolds slowly. Those cognitive issues are also features of depression and anxiety, which often accompany a cancer diagnosis. Similar effects are also caused by medications for nausea and pain.

…’So many factors affect cognitive function, and the kinds of cognitive problems associated with cancer treatment can be caused by many other things than chemotherapy…’ ” (New York Times )

Paradoxical Undressing and Hide-and-Die Syndrome

Sources of Very Obscure Death Scenes in Lethal Hypothermia (abstract): “Hypothermia is a relatively rare cause of death in temperate climate zones. In most cases of lethal hypothermia, elderly and mentally ill persons are affected as well as persons under the influence of alcohol or other substances. Although most cases of death from hypothermia are accidental, they, more often than other types of death from environmental conditions, produce a death scene that is at first obscure and difficult to interpret. The reason for this frequent obscurity is mainly because of the phenomenon of the so-called paradoxical undressing as well as the hide-and-die syndrome. In many cases, the bodies are found partly or completely unclothed and abrasions and hematomas are found on the knees, elbows, feet, and hands. The reason for the paradoxical undressing is not yet clearly understood. There are two main theories discussed: one theory proposes that the reflex vasoconstriction, which happens in the first stage of hypothermia, leads to paralysis of the vasomotor center thus giving rise to the sensation that the body temperature is higher than it really is, and, in a paradoxical reaction, the person undresses. The other theory says that it seems to be the effect of a cold-induced paralysis of the nerves in the vessel walls that leads to a vasodilatation giving an absurd feeling of heat. In 20% of cases of lethal hypothermia, the phenomenon of the so-called hide-and-die syndrome also can be observed. Some of these bodies are situated in a kind of “hidden position,” for example, located under a bed or behind a wardrobe. Apparently, this finding is the result of a terminal primitive reaction pattern, which is probably an autonomous behavior triggered and controlled by the brain stem. It shows the characteristics of both an instinctive behavior and a congenital reflex.” (Forensic Pathology Reviews)

A Medline search on ‘paradoxical undressing’ leads to one citation from a 1979 Swedish paper.

Chemotherapy Fog Is No Longer Ignored as Illusion

“Chemo brain is part of the language now… [A]ttitudes are changing as a result of a flurry of research and new attention to the after-effects of life-saving treatment. There is now widespread acknowledgment that patients with cognitive symptoms are not imagining things, and a growing number of oncologists are rushing to offer remedies, including stimulants commonly used for attention-deficit disorder and acupuncture.

…Virtually all cancer survivors who have had toxic treatments like chemotherapy experience short-term memory loss and difficulty concentrating during and shortly afterward, experts say. But a vast majority improve. About 15 percent, or roughly 360,000 of the nation’s 2.4 million female breast cancer survivors, the group that has dominated research on cognitive side effects, remain distracted years later, according to some experts. And nobody knows what distinguishes this 15 percent.

… The central puzzle of chemo brain is that many of the symptoms can occur for reasons other than chemotherapy.

Abrupt menopause, which often follows treatment, also leaves many women fuzzy-headed in a more extreme way than natural menopause, which unfolds slowly. Those cognitive issues are also features of depression and anxiety, which often accompany a cancer diagnosis. Similar effects are also caused by medications for nausea and pain.

…’So many factors affect cognitive function, and the kinds of cognitive problems associated with cancer treatment can be caused by many other things than chemotherapy…’ ” (New York Times )

Lease Super Strength

Fight Crime With Rented Robotic Exoskeleton: “Need to move a piano? Picked on by bullies? Want to uproot trees in the backyard? Not to worry. Soon you’ll be able to RENT A HAL-5 EXOSKELETON for just $590 per month. The robotic suit gives its wearer super strength.” (The Raw Feed)

Into A Shadowy World

//graphics8.nytimes.com/images/2007/04/25/movies/25zoo600.jpg' cannot be displayed]
“The director Robinson Devor apparently would like viewers who watch his heavily reconstructed documentary, Zoo, to see it as a story of ineluctable desire and human dignity. Shot on Super 16-millimeter film, with many scenes steeped in a blue that would have made Yves Klein envious, Zoo is, to a large extent, about the rhetorical uses of beauty and metaphor and of certain filmmaking techniques like slow-motion photography. It is, rather more coyly, also about a man who died from a perforated colon after he arranged to have sex with a stallion.” (New York Times )

Putin to Suspend Pact With NATO

“President Vladimir V. Putin said Thursday that Russia would suspend its compliance with a treaty on conventional arms in Europe that was forged at the end of the cold war, opening a fresh and intense dispute in the souring relations between NATO and the Kremlin.

The announcement …underscored the Kremlin’s anger at the United States for proposing a new missile defense system in Europe, which the Bush administration insists is meant to counter potential threats from North Korea and Iran.” (New York Times )

I would quibble with the Times calling this an issue between NATO and Russia. It seems to me that Putin’s enmity, and the responsibility for potentially restarting the Cold War, should be laid squarely at the feet of our national-embarrassment-in-chief in Washington. This may well prove to be one of the most enduring facets of the Bush legacy, along with the destruction of Iraq, the squandering of most of the international community’s goodwill toward the US, the sabotaging of a consensus against climate change, irreparable domestic polarization, and the visitation of the burdens of his fiscal irresponsibility on a generation to come in the US. Am I forgetting anything?

Why Cho Was Not Committed

Psychologist Jonathan Kellerman writes a thoughtful Wall Street Journal op-ed piece , with which I largely agree, grappling with the ethical responsibility of the mental health profession with respect to violence:

“If the Virginia Tech shooter had been locked up for careful observation in a humane mental hospital, the worst-case scenario would’ve been a minor league civil liberties goof: an unpleasant semester break for an odd and hostile young misanthrope who might’ve even have learned to be more polite. Yes, it’s possible confinement would’ve been futile or even stoked his rage. But a third outcome is also possible: Simply getting a patient through a crisis point can prevent disaster, as happens with suicidal people restrained from self-destruction who lose their enthusiasm for repeat performances.”

Kellerman does, however, place too much responsibility at the feet of the “liberationists” and “libertarians”, exemplified by R.D. Laing and Thomas Szasz for the historic failure of the mental health system to effectively address such issues. Would that Laing’s thought had had more of an influence! Kellerman summarizes the Laingian perspective as the principle that “[not] only wasn’t psychosis a bad thing, it was evidence of a superior level of consciousness”. But Laing’s opposition to psychiatric medication and hospitalization were just the window dressing on his more essential contribution — an existential perspective which gives inroads into the inner world of our psychotic patients that inherently humanizes our care. This is not incompatible with the responsible mainstream practice of clinical psychiatry, IMHO, and I can cherish Laing’s influence on my psychiatric philosophy without cognitive dissonance even though I medicate and hospitalize patients. About Szasz I have less kind things to say, especially given his collaboration with the Scientologists.

Deinstitutionalization and the failure of the community mental health system were not driven nearly as much by such idealistic philosophical vision as they were by the fiscal betrayal of the severely mentally ill — a socially insignificant constituency without serious advocates, and one our society is all too ready to shun and stigmatize — in the service of budgetary constraint. As Kellerman observes, “this was baby-and-bathwater time.” The crux of the matter, he goes on to observe,

“…[the] basic premise of Community Psych–that severely mentally ill people could be depended on to show up for treatment voluntarily–never made sense to me. The core of the most common and debilitating psychosis, schizophrenia, is degradation of thought and reason. So the idea that people with fractured minds could and would make rational, often complex decisions about self-care seemed preposterous.”

I would amplify on that; schizophrenia (and other major mental illness) involves not only a general degradation of reasoning but also a specific loss of insight into the nature of one’s illness and recognition of the need for treatment, known as anosognosia, that can be understood both in terms of psychological denial and neurochemical dysfunction of particular brain regions, and which makes noncompliance with followup treatment and medication the single most important cause of deterioration and relapse.

While exercising due diligence in raising caveats, Kellerman infers that Cho had a serious mental illness and, unfortunately, all we will have is speculation:

“Diagnosis from afar is the purview of talk-shows hosts and other charlatans, and I will not attempt to detail the psyche of the Virginia Tech slaughterer. But I will hazard that much of what has been reported about his pre-massacre behavior–prolonged periods of asocial mutism and withdrawal, irrational anger and hatred, bizarre writing and speech–is not at odds with the picture of a fulminating, serious mental disease. And his age falls squarely within the most common period when psychosis blossoms.”

I would be the first to assert that psychiatry is a markedly imperfect tool at best for the prediction and prevention of violence, and that once on the slippery slope of preventive detention the dangers outweigh the benefits. But Kellerman’s conclusion, that

“Penning up and carefully scrutinizing the killer was never an option. Not in Virginia or California or any other state in the union. Because in our well-intentioned quest to maximize personal liberty, we’ve moved conceptual eons away from taking the concept of dangerousness seriously”

should give us pause.

Lamest Technology Mascots Ever

//www.wired.com/images/slideshow/2007/04/gallery_mascots/joker_RGB_medium.jpg' cannot be displayed]
“Creatures such as Tux the penguin have become bizarrely treasured icons, while others, such as recent roadside-autopsy subject Jeeves, are better off in the hereafter. And some, such as the freakishly terrifying jester touting Adobe’s new Creative Suite 3, are an indication that vector-based illustration software should probably come with consumer warning labels, just like those found on drugs, circular saws and guns. From the charmingly pixelated to the hideously misguided, join us on a tour of the good, the bad and the ridiculously lame of technology mascots.” (Wired)

Extrasolar planet may be able to support life

“European astronomers say they have found the first Earth-sized planet beyond this solar system with temperatures mild enough to allow liquid water — a crucial step toward answering whether our cradle of life is unique in the universe.

The planet circles the star Gliese 581, which at 20 light years away is among the 100 stars closest to Earth. Dubbed Gliese 581c, the planet orbits very close to its star — closer than Mercury is to our sun. But astronomers with the European Southern Observatory say the star is dim enough that average temperatures on the planet would fall in the range of an ordinary Chicago spring day.

Click here to find out more!
If the planet has water — a big unknown — its size and climate could make it habitable, experts said. The planet appears to be about 50 percent larger than Earth and has five times more mass, making it one of the smallest far-off planets ever detected.

The conditions look promising enough that officials with the California-based SETI Institute, which looks for signs of radio communication from alien civilizations, said they hope to give the planet a fresh look this summer. Previous radio observations of Gliese 581 in the 1990s turned up nothing unusual.” (Orlando Sentinel )

Support of Gonzales affirms power play

Boston Globe news analysis: “Since so much depends on favorable rulings from Justice, the administration can’t possibly look forward to having to justify its actions to a new team of lawyers. But that’s almost certain to happen if Gonzales is replaced by someone outside Bush’s inner circle. Bush would be very hard-pressed to get an inner-circle appointee confirmed by Democratic-controlled Senate. He or she would have had to withstand days of public grilling by Democratic senators, who would try to raise the curtain on any of the administration’s secret programs.

More likely, Bush would be obliged to choose an attorney general with a reputation for independence, such as a former Republican senator with credibility on Capitol Hill. But such a figure would almost certainly be more skeptical of the administration’s assertions of executive power than Gonzales, a close Bush associate from the president’s Texas days.”

Executed in US may be awake as they suffocate

“Some prisoners executed by lethal injection in the United States may die of suffocation while they are still conscious and in pain, University of Miami researchers said in a study that concluded the drugs do not work as intended.

The study, published in the Public Library of Science journal PLoS Medicine, raised new questions about whether the lethal cocktail violates the US constitutional ban on cruel and unusual punishment.” (Stuff.NZ)

Singer’s toilet paper musings leave Rove untouched

Sheryl Crow attempts to debate carbon credits: “As he turned to leave, Crow reached out to touch his arm. ‘Karl swung around and spat, ‘Don’t touch me’,’ recounted Crow and fellow eco-celebrity Laurie David in another blog.

‘How hardened and removed from reality must a person be to refuse to be touched by Sheryl Crow?’

But the singer was not deterred. ‘You can’t speak to us like that, you work for us,’ she thundered to the departing Mr Rove, who responded, ‘I don’t work for you, I work for the American people.’

‘We are the American people,’ the singer shot back.” (Guardian.UK)

Hallelujah Indeed

Debating Handel’s Anti-Semitism: “Scholars have too little investigated questions of religious meaning in Handel’s ‘Messiah,’ particularly the work’s manifest theological anti-Judaism. Previously unknown historical sources for the work’s libretto compiled and arranged by Charles Jennens (1700-73) reveal the text’s implicit designs against Jewish religion. Handel’s musical setting powerfully underscores these tendencies of Jennens’s libretto and adds to them, reaching a euphoric climax in the ‘Hallelujah’ chorus.” — Michael Marissen at the American Handel Festival (New York Times )

Soldier: Honor troops like Va. Tech dead

Deaths in Iraq and Afghanistan are ‘mere blips on the TV screen’: “An Army sergeant complained in a rare opinion article that the U.S. flag flew at half-staff last week at the largest U.S. base in Afghanistan for those killed at Virginia Tech but the same honor is not given to fallen U.S. troops here and in Iraq.” (Yahoo! News)

I have reacted to the lionization of the VT victims much as I did to those who died in the 9/11 attacks. These are victims, not heroes. To celebrate their heroism cheapens heroism. I am not saying their deaths are not tragic, but they did not come about, with rare exceptions, as a result of any exceptional display of courage. They were in the wrong place at the wrong time.

It would be tempting to think of this as a distinction between these victims and our casualties in Afghanistan and Iraq. Given that we have an all-volunteer military, the latter chose to put themselves in harm’s way for a greater cause and may in fact deserve more, not less, esteem when they fall, this line of reasoning goes. And I am not sure it is not correct.

But on the other hand, much as I believe Kerry intended in his much-ballyhooed bungled comments last year, many of those serving in the US occupation forces in Afghanistan and Iraq can be considered no less victims, virtually compelled — no less than they would be with conscription — to join the service by the lack of other opportunities in the inequitable American society. The old men who send our forces to war still exploit the least fortunate in our society, not the sons and daughters of privilege. I remind myself of that whenever I am tempted to get on my moral high horse and suggest that the troops should have the ethical sophistication to refuse to participate in an unjust war.

[While we are on the topic of courage, I am of course unambivalent about the courageous stance represented by war resistance. Ironically, this is often seen as its diametrical opposite, cowardice.]

Alcohol damages women’s brains faster than men’s

“The brain-damaging effects of alcohol strike women more quickly than men, a new study conducted in Russia confirms.

Female alcoholics performed worse on a number of tests of neurocognitive function compared with males, Dr. Barbara Flannery from RTI International in Baltimore and her colleagues found.

However, Flannery cautioned in an interview with Reuters Health, the findings aren’t good news for alcohol-dependent men. ‘Women are vulnerable to the extent to which they will experience the negative consequences of alcohol abuse and alcoholism more rapidly than men, but men will also experience it — the same kinds of effects,’ she said.

Other physiological effects of alcoholism, such as heart and liver damage, are known to occur more quickly in women than in men, a phenomenon known as ‘telescoping,’ Flannery and her team note in ournal Alcoholism: Clinical and Experimental Research.” (Yahoo! News)

San Francisco Doctors want Pap test for gay men

“The goal is to push back rising rates of anal cancer, a preventable disease that has increased 37 percent in the United States since a decade ago, when the total number of cancer cases increased only 1 percent.

Anal Pap smears would help doctors spot precancerous lesions and wipe them out before they have a chance to turn malignant, say supporters of widespread use of the exam among gay men. But nationwide, doctors have been reluctant to embrace the screening test, partly because there is disagreement over whether it’s effective or even necessary.” (SF Chronicle)

Colleges face surge of troubled students

“Reasons for the surge include the Americans with Disabilities Act, which gives mentally ill students the right to be at college, and increasingly sophisticated medications which enable them to function better than in the past. Recent surveys and studies underscore the scope of the increase…” (Seattle Post Intelligencer)

After Suicide, a Window on a Patient’s Other Self

A psychiatrist encounters her patient on MySpace after his death: “I had thought of him as struggling under the constant hold of hallucinations. But he had ignored his hallucinations long enough to write of a different yet equally true self here, and he had found friends who identified him not by psychiatric symptoms but by astrological sign. In this world, he was a Pisces, not a schizophrenic.” — Elissa Ely (New York Times )

Blogger and Podcaster

Are you an “aspiring new media titan”, as the cover says? Then this is the periodical for you! First issue of Blogger and Podcaster magazine. So “blogging” (as you know, I have always eschewed the term and insisted on calling this a weblog) has made it so big it has its own slick new ‘old media’-style rag. For better or worse, it seems to make its appeal to everything FmH is not. However, the user interface is interesting. Click on the upper right corner of the page to turn the page (‘old media’ style).

‘Devastating’ Moyers Probe of Press and Iraq Coming

“The most powerful indictment of the news media for falling down in its duties in the run-up to the war in Iraq will appear next Wednesday, a 90-minute PBS broadcast called ‘Buying the War,’ which marks the return of ‘Bill Moyers Journal.’ E&P was sent a preview DVD and a draft transcript for the program this week.

While much of the evidence of the media’s role as cheerleaders for the war presented here is not new, it is skillfully assembled, with many fresh quotes from interviews (with the likes of Tim Russert and Walter Pincus) along with numerous embarrassing examples of past statements by journalists and pundits that proved grossly misleading or wrong. Several prominent media figures, prodded by Moyers, admit the media failed miserably, though few take personal responsibility. ” (Editor and Publisher thanks to Micheline)

When a Brain Forgets Where Memory Is

New York Times psychology reporter Jane Brody on the fascinating phenomenon of dissociative fugue:

“People with this problem suddenly and unexpectedly take leave of their usual physical surroundings and embark on a journey that can last as little as a few hours or as long as several months. During the fugue state, individuals completely lose their identity, later assuming a new one. They don’t know their real names or anything about their former lives, and they do not recognize friends or family. They may not even remember how they got to where they are.

While loss of memory can occur for many reasons, dissociative fugue has no direct physical or medical cause. Rather, it is precipitated by a severe stress or emotionally traumatic event that is so painful the mind seems to shut down and erase everything, like a failed computer hard drive.”

Several years ago on FmH, I wrote with fascination of an apparent case of dissociative amnesia, a largely mute piano-playing young man institutionalized in a British mental hospital after apparently washing up on a beach. But, although they appear with regularity as literary or cinematographic devices, fugue states are encountered rarely if ever by clinical psychiatrists like myself in the course of our work. Of course, an exhaustive effort to rule out other, more neurologically based, causes of acute memory failure must be made. At the other end of the spectrum, so too it is at times difficult to distinguish fugue states from more consciously motivated attempts to deny one’s identity.

I am not alone in wondering if fugue is a disease of modernity, requiring an emphasis on the self and personal sense of identity to shape a subconsciously-motivated attempt to lose one’s self. I wonder what effect the modern challenges to identity, such as the influence of mass media on identity, the diffusion of the self through online presence, or the threat of identity theft, will do the the manifestations of dissociative fugue.

Kucinich to launch Cheney impeachment push on April 25

“Rep. Dennis Kucinich (D-OH), the former mayor of Cleveland who is seeking the 2008 Democratic nomination for president for the second time, has selected a date to introduce articles of impeachment against Vice President Dick Cheney.

A source who asked to remain anonymous told RAW STORY that the articles of impeachment would be introduced next week.” (Raw Story )

This may be seen as an audacious grandstanding move by Kucinich, with his indefatiguable Presidential aspirations. On the other hand, if successful it would remove the major stumbling block to the impeachment of George Bush.

Got nicotine?

Madam Fathom is the pseudonym of a neuroscience PhD student with a weblog about her (I assume it’s a her) field. This is an interesting post about the potential benefits of nicotine that offers a particularly lucid picture of brain function.

“There is a large body of research showing that nicotine, the ingredient that drives people to addiction, improves cognitive function in humans and laboratory animals. The most robust effect demonstrated in human smokers is an enhanced ability to sustain attention to a task for a prolonged period of time, an ability inextricably linked to learning and memory. Of course, learning and memory involve a number of processes (acquisition, encoding, storage, and retrieval), but the ability to concentrate on particular stimuli and screen out the rest is critical for the success of this operation.

Nicotine’s beneficial effects on these “higher” cognitive functions have prompted efforts to develop nicotinic treatments for diseases associated with cognitive impairment, such as Alzheimer’s disease, Parkinson’s disease, attention deficit/hyperactivity disorder, and schizophrenia. However, this area of drug development is impeded by the complexity of nicotine’s actions, including the observation that cognitive improvements have only been reliably detected in either smokers or the cognitively impaired. In contrast, nicotine tends to have deleterious effects on cognitive performance in “normal” non-smokers. (Another factor hampering the development of nicotine-based therapies is that they offer pharmaceutical companies little potential for financial gain, as nicotine sources are easy to come by.)…”

Violent, antisocial, beyond redemption?

“Whether you think of them as mad or bad, they are certainly dangerous to know. All societies contain a few extremely violent individuals, who are either psychopaths or have a related severe personality disorder. With no concern about the harm they inflict, little can be done to change their behaviour, psychiatrists say.

Now the UK government is challenging this dogma in the hope of protecting the public from these highly risky people. It has already altered criminal law to allow certain violent offenders to be given indefinite jail sentences. Over the coming weeks, parliament will debate legislation that could broaden the definition of mental disorders and increase existing powers to detain such people for treatment ” (New Scientist)

Benefits of Antidepressants Outweigh Risk of Suicidal Behavior in Adolescents

A new analysis adds to the evidence that antidepressants are effective in young people, prompting some to renew questions about a ‘black box’ warning required on the drugs since 2004.

The most comprehensive survey yet finds that the benefits of antidepressants outweigh the risks in children and teens during the first few months of treatment. The finding comes three years after the Food and Drug Administration (FDA) ordered pharmaceutical companies to put black warning labels—the strongest possible—on antidepressants cautioning that the drugs may increase the risk of suicidal behavior in kids.” (Scientific American)

The Question Mark in Harper Hall

“He seemed to be crying behind his sunglasses.. It was like talking to a hole sometimes…. Everything emptied out and seemed very dark when he entered.”

Nikki Giovanni, the feminist poet and teacher at Virginia Tech who stirred the campus convocation yesterday with a poem, had Cho in a poetry class two years ago — and it wasn’t long before she had him tossed out. “There was something mean about this boy,” she said. “Troubled kids get drunk and jump off buildings. It was the meanness that bothered me.” Giovanni recalled that Cho came to class in dark sunglasses and a hat. And every day, from very early in the semester, she would ask him to remove the one and then the other. “We would have this sort of ritual,” she said.

Giovanni recalled that Cho “was very intimidating to my other students.” Eventually, other kids began skipping class because of his behavior. The poet then wrote creative writing department boss Lucinda Roy a letter — in part to create a record — asking Roy to remove him from class. Giovanni said Cho turned in material that wasn’t poetry but just junk. “He was writing weird things,” she recalled. “It was terrible…. It was just intimidating.” (Time)

Bolton: US has no obligation to post-invasion Iraq

Andrew Sullivan comments on a BBC interview with John Bolton: “The BBC’s interviewers are not as deferent as some in America. Paxman is among the most aggressive. What staggers me about this clip is Bolton’s point-blank view that the US had no responsibility to impose order after the invasion, and no responsibility for security within the country. Bolton actually says that the only error Bush really made was not giving the Iraqis ‘a copy of the Federalist papers and saying, ‘Good luck.” Yes, he says he’s exaggerating for effect, but he is conveying the gist of the policy. The casual recklessness and arrogance of these people never cease to amaze. The world is theirs’ to play with – and the victims of predictable and predicted violence are left to help themselves.”

Are mobile phones wiping out our bees?

“It seems like the plot of a particularly far-fetched horror film. But some scientists suggest that our love of the mobile phone could cause massive food shortages, as the world’s harvests fail.

They are putting forward the theory that radiation given off by mobile phones and other hi-tech gadgets is a possible answer to one of the more bizarre mysteries ever to happen in the natural world – the abrupt disappearance of the bees that pollinate crops. Late last week, some bee-keepers claimed that the phenomenon – which started in the US, then spread to continental Europe – was beginning to hit Britain as well.

The theory is that radiation from mobile phones interferes with bees’ navigation systems, preventing the famously homeloving species from finding their way back to their hives. Improbable as it may seem, there is now evidence to back this up.” (Independent.UK)

There and Back Again

“Last year, Midas, the muffler company, in honor of its fiftieth anniversary, gave an award for America’s longest commute to an engineer at Cisco Systems, in California, who travels three hundred and seventy-two miles—seven hours—a day, from the Sierra foothills to San Jose and back. “It’s actually exhilarating,” the man said of his morning drive.” (New Yorker)

There and Back Again

“Last year, Midas, the muffler company, in honor of its fiftieth anniversary, gave an award for America’s longest commute to an engineer at Cisco Systems, in California, who travels three hundred and seventy-two miles—seven hours—a day, from the Sierra foothills to San Jose and back. “It’s actually exhilarating,” the man said of his morning drive.” (New Yorker)

Freeing a Locked-In Mind

“The idea is radical: we might soon be able to reach a number of people, including 250,000 Americans, who suffer from consciousness disorders–patients who, until now, had been considered beyond treatment.” (Scientific American)

World Bank staff to Wolfowitz: "Resign"

“World Bank President Paul Wolfowitz acknowledged Thursday that he erred in helping a close female friend get transferred to a high-paying job, and said he was sorry. His apology didn’t ease concerns among the bank’s staff association, which wants him to resign.” (Yahoo! News) The overt issue is Wolfowitz’s nepotistic promotion of a woman with whom he was romantically involved. However, he has been a disaster in his role heading the Bank, hiding himself behind a cadre of imported conservative advisors, unilaterally denying funding to projects that do not meet his priorities, and dissing European members’ priorities in particular to the point that some Western European countries are threatening to seriously decrease their level of funding for Bank projects. His campaign against corruption is, critics say, a thinly-veiled cover for spreading a neocon/neocolonial notion of “democracy.” Of course, Bush has recently expressed his fullest confidence in the job Wolfowitz is doing, bolstering concerns that the World Bank is becoming the development arm of the Pentagon (Guardian.UK). All of this is coming to a head on the eve of the World Bank/IMF’s spring meetings (NPR). Sparks should fly…

The Heroic Imagination

Edge interview with Philip Zimbardo, designer of the (in)famous Stanford Prison Experiment:

“As a social psychologist, I bring forth the power of situations to transform good people into evil, which is what I’ve been studying since my Stanford prison study way back in 1971. I argue that there are some features of special situations that can corrupt the best and brightest. Normal people, even good people. Not all, but most. And the ones who resist, the ones who somehow have the street-smarts – the situational sophistication – to resist are the exceptions. In fact, I’m going to call them heroes.

…My research really says several things. One, that we have to recognize that some situations, some social settings, some behavioral contexts, have an unrecognized power to transform the human character of most of us. Two, that the way to resist – the way to prevent a descent into Hell, if you will – is precisely by understanding what it is about those situations that gives them transformative power. It is by this understanding that you can change those situations, avoid those situations, challenge those situations. And it’s only by willfully ignoring them, by assuming individual nobility, individual rationality, or individual morality that we become most vulnerable to their insidious power to make good people do bad things. Those who sustain an illusion of invulnerability are the easiest touch for the con man, the cult recruiter, or the social psychologist ready to demonstrate who easy it is to twist such arrogance into submission.

One way of looking at the consequences of the Stanford Prison Study is as a cautionary tale of the many ways in which good people can be readily and easily seduced into evil. But there’s an equally important – maybe more important – consequence of the study, which is what it tells us about the flip side of human nature. The Stanford Prison Study was ended abruptly: it was supposed to run for two weeks and it ended – was terminated – after only six days because of a very heroic act…”

Zimbardo reveals that he ended the experiment because of the abhorrence his girlfriend, now his wife, expressed when she came down to observe. Zimbardo turns Hannah Arendt’s phrase on its head, talking about the “banality of heroism”:

“Most people in the world who engage in heroic acts are …individuals who find themselves in a particular situation – one in which other people are looking the other way or continuing to perpetrate an evil behavior – and who, for some reason we don’t know, take heroic action. They do something to stop it – blow the whistle or otherwise challenge it in a direct way. That action is “heroic,” even if the people are “ordinary.” My sense is that the typical notion we have of heroes as super-stars, as super heroes, as Superman, and Batman, and Wonder Woman, gives us a false impression that being a hero means being able to do thing that none of us can actually accomplish. I want to argue just the opposite: that what we have to be doing more and more is cultivating the “heroic imagination” – especially in our children.”

Zimbardo’s notion of a hero has alot to do with activism, empowering people to speak truth to powerful wrongdoing, both by “cultivating the heroic imagination” in individuals, largely through education, and by changing our institutions so they become “hero-engendering.” He calls for “a new revolution of making heroes more common”. Nothing really new in this except the phraseology; it has been the eternal preoccupation of social critics and revolutionaries. But how to get there…

Sex, Love, and SSRIs

“Doctors have been grappling with sexual dysfunction since SSRIs (selective serotonin reuptake inhibitors) were introduced in the 1980s. Approximately 70 percent of people taking SSRIs suffer from sexual side effects. But these drugs may also compromise the ability to feel love.

Rutgers University anthropologist Helen Fisher, for one, believes SSRIs are wreaking havoc on human courtship. SSRIs alleviate depression by upping the levels of serotonin in the brain and curbing the production of the neurotransmitter dopamine. Unfortunately, dopamine is also responsible for the feelings of elation and ecstasy that accompany falling in love. By suppressing dopamine, Fisher argues, drugs like Prozac block your ability to have these feelings, thus making it harder to fall in love and stay in love.

…Even if you’re one of the lucky ones who manage to find love while taking SSRIs, you still have some obstacles to overcome, says Fisher. …[You] may lose the ability to orgasm, and this could cause long-term relationship issues. Orgasms trigger the release of the hormone oxytocin—one that has been linked with pair bonding. Indeed, those who fail to orgasm, thanks to SSRIs, may be at a distinct disadvantage when it comes to mating and bonding.” (Psychology Today)

Of course, this becomes much more of a problem in an era of “cosmetic psychopharmacology” in which the distinction between tweaking a blue mood and treating a clinical depression has been lost. Those who are clinically depressed and truly require antidepressant treatment are usually in no position for love and bonding at this time in their lives in the first place. This issue highlights just one of my misgivings about the potential indiscriminate overuse of these medications.

Shell Shocked

A Shock Wave of Brain Injuries: “IEDs have added a new dimension to battlefield injuries: wounds and even deaths among troops who have no external signs of trauma but whose brains have been severely damaged. Iraq has brought back one of the worst afflictions of World War I trench warfare: shell shock. The brain of a soldier exposed to a roadside bomb is shocked, truly.

About 1,800 U.S. troops, according to the Department of Veterans Affairs, are now suffering from traumatic brain injuries (TBIs) caused by penetrating wounds. But neurologists worry that hundreds of thousands more — at least 30 percent of the troops who’ve engaged in active combat for four months or longer in Iraq and Afghanistan — are at risk of potentially disabling neurological disorders from the blast waves of IEDs and mortars, all without suffering a scratch.

For the first time, the U.S. military is treating more head injuries than chest or abdominal wounds, and it is ill-equipped to do so. According to a July 2005 estimate from Walter Reed Army Medical Center, two-thirds of all soldiers wounded in Iraq who don’t immediately return to duty have traumatic brain injuries.” (Washington Post 4/6/07)

Better Than Netflix!

DailyLit: Read books by email. “…[If] you are like us, you spend hours each day reading email but don’t find the time to read books. DailyLit brings books right into your inbox in convenient small messages that take less than 5 minutes to read. This works incredibly well not just on your computer but also on a Treo, Blackberry, Sidekick or whatever the PDA of your choice. In the words of Dr. Seuss: Try it, you might like it! ” [thanks, abby]

? I recall once I subscribed to email serialization of Finnegans Wake, but the mailing list died. I just checked; dailylit doesn’t have that, but they have everything else of Joyce’s. I might start with William James’ Varieties of Religious Experience, Henry James’ Turn of the Screw, or Boswell’s Life of Johnson, and that’s just from the ‘J’ page…

Autologous hematopoietic stem cell transplantation

Treatment shows promise against diabetes: “Thirteen young diabetics in Brazil have ditched their insulin shots and need no other medication thanks to a risky, but promising treatment with their own stem cells – apparently the first time such a feat has been accomplished.” (Seattle Post-Intelligencer)

Some of the recipients have been insulin-free for as long as three years, although the researchers do not claim this is a cure.

Plus Ca Change?

“On the surface, recent votes in Congress appear to signal a new Democratic determination to withdraw from Iraq. But the reality is otherwise. It is not only that the resolutions were drafted and adopted with the certain knowledge that they would be vetoed. More important, even if a future Democratic president did try to implement the new plans, the results would likely end up looking oddly similar to the Bush administration’s current strategy. In politics as in war, things are seldom what they seem.” — Noah Feldman (New York Times Magazine)

Depression or Just a Little Emotional Blow?

Many Diagnoses of Depression May Be Misguided, Study Says: “About one in four people who appear to be depressed are in fact struggling with the normal mental fallout from a recent emotional blow, like a ruptured marriage, the loss of a job or the collapse of an investment, a new study suggests. To avoid unnecessary diagnoses and stigma, the standard definition of depression should be redrawn to specifically exclude such cases, the authors argue.

The study, appearing today in The Archives of General Psychiatry, is based on survey data from more than 8,000 Americans; it did not analyze the number of people who had been misdiagnosed.

Psychiatrists and other doctors who take careful medical histories do so precisely to rule out such life blows, as well as the effects of physical illnesses, before making a diagnosis of depression.

But the American Psychiatric Association’s diagnostic manual does not specifically exclude people experiencing deep but normal feelings of sadness, unless they are bereaved by the death of a loved one. And an increasing number of school districts and health clinics use simple depression checklists, which do not take context into account, the authors said.” (New York Times )

The study compared 157 bereaved individuals and 710 who met the criteria for major depressive disorder whose episode had been triggered by another loss. Grief specifically precludes a diagnosis of major depression, but the investigators showed that those diagnosed with depression after other losses did not differ significantly from the bereavement group on a well-chosen spectrum of indicators of the severity and impact of their symptoms. They concluded that the data “do not support the validity of uniquely excluding uncomplicated bereavement but not uncomplicated reactions to other losses” from the diagnosis of major depressive disorder.

The researchers are a social worker, two sociologists and one psychiatrist — interestingly, a psychiatric epistemologist who participated in the formulation of the latest version of the Diagnostic and Statistical Manual (DSM-4), the official ‘bible’ of acceptable psychiatric diagnoses and their defining criteria. This should be a clue that the study should be interpreted in light of the perennial conflict within mental health care between the medical and social models; it is a shot across the bow aimed at biological psychiatry. When psychoanalysts dominated in shaping the psychiatric paradigms of diagnosis and treatment in the era before modern psychopharmacology, a crucial distinction was made between “endogenous” and “reactive” depression. One still hears vestiges of that outlook when healthcare personnel observe, “Wouldn’t you be depressed too if you had gone through what he/she did?”

With the ascendency of biological models and medication-based treatment, roughly since the ’60’s, however, the distinction was largely thrown out (with the exception of the exclusion for acute grief), and a generation of psychiatrists were trained to see it as quaint and archaic. The focus in diagnosing and treating has come more and more to be on the description, the symptoms, of an episode of emotional distress (such as can be captured in the symptom checklists the article mentions) to the exclusion of the meaning of that distress to the individual and its contextualization in an individual life. With the development of medications that can treat depressive symptoms, what has been lost has been the question of whether they should be treated in all instances. Recent dogma emphasizing that depressive episodes not be seen as self-contained but as manifestations of a lifelong relapsing condition mitigates for preventive treatment through indefinite antidepressant maintenance. Relapses are explained with disdain as the result of inadequately insightful patients failing to comply with that paradigm. I will leave it to my readers to draw their own conclusions as to whether this deserves to be seen as an aspect of the medicalization of everyday life driven by market pressures and the selling of healthcare down the river by the unholy alliance of Big Pharma and its handmaiden physicians.

On the other hand, I quibble with the implication of the article that this finding points to wholesale “misdiagnosis” of depression where it is unwarranted. That would be too simple, and I doubt it is what the authors intended. What is at stake is not just tidying up diagnostic criteria or diagnostic practices. There is no “true” definition of what depression is to aim for; it is a social construction that reflects dominant values and assumptions. We are in the midst of a full-fledged clash of conflicting paradigms, with a study such as this at its nidus. As Kuhn suggested in The Structure of Scientific Revolutions , evidence inconsistent with the dominant paradigm is explained away or ignored until a sufficient accumulation occurs.

What are the dangers of ignoring these challenges to the dominant conception of depression, markedly broadened from that of a generation ago and ignoring context almost entirely? One of our real social ills may be not the prevalence of depression but of the narcissistic expectation that we are entitled to have any depressive distress eradicated, and the parallel assumption that it is the fault of a ‘chemical imbalance’ rather than the way we make sense of the world, process our feelings or treat one another. What is at stake is something very basic about the parameters of the social construction of the self in modern society. There may be biological consequences as well. I have been troubled by the possibility — which I cannot get many of my colleagues to take seriously — that having too low a threshold for beginning or maintaining our patients on antidepressants may actually perpetuate or worsen depressive dysfunction of the brain. Although antidepressants are not, in a rigid sense, addictive, their use may cause a self-perpetuating necessity to continue to use them. I hope to have more to say about that in the future as I clarify and extend my thinking about this issue.

Depression or Just a Little Emotional Blow?

Many Diagnoses of Depression May Be Misguided, Study Says: “About one in four people who appear to be depressed are in fact struggling with the normal mental fallout from a recent emotional blow, like a ruptured marriage, the loss of a job or the collapse of an investment, a new study suggests. To avoid unnecessary diagnoses and stigma, the standard definition of depression should be redrawn to specifically exclude such cases, the authors argue.

The study, appearing today in The Archives of General Psychiatry, is based on survey data from more than 8,000 Americans; it did not analyze the number of people who had been misdiagnosed.

Psychiatrists and other doctors who take careful medical histories do so precisely to rule out such life blows, as well as the effects of physical illnesses, before making a diagnosis of depression.

But the American Psychiatric Association’s diagnostic manual does not specifically exclude people experiencing deep but normal feelings of sadness, unless they are bereaved by the death of a loved one. And an increasing number of school districts and health clinics use simple depression checklists, which do not take context into account, the authors said.” (New York Times )

The study compared 157 bereaved individuals and 710 who met the criteria for major depressive disorder whose episode had been triggered by another loss. Grief specifically precludes a diagnosis of major depression, but the investigators showed that those diagnosed with depression after other losses did not differ significantly from the bereavement group on a well-chosen spectrum of indicators of the severity and impact of their symptoms. They concluded that the data “do not support the validity of uniquely excluding uncomplicated bereavement but not uncomplicated reactions to other losses” from the diagnosis of major depressive disorder.

The researchers are a social worker, two sociologists and one psychiatrist — interestingly, a psychiatric epistemologist who participated in the formulation of the latest version of the Diagnostic and Statistical Manual (DSM-4), the official ‘bible’ of acceptable psychiatric diagnoses and their defining criteria. This should be a clue that the study should be interpreted in light of the perennial conflict within mental health care between the medical and social models; it is a shot across the bow aimed at biological psychiatry. When psychoanalysts dominated in shaping the psychiatric paradigms of diagnosis and treatment in the era before modern psychopharmacology, a crucial distinction was made between “endogenous” and “reactive” depression. One still hears vestiges of that outlook when healthcare personnel observe, “Wouldn’t you be depressed too if you had gone through what he/she did?”

With the ascendency of biological models and medication-based treatment, roughly since the ’60’s, however, the distinction was largely thrown out (with the exception of the exclusion for acute grief), and a generation of psychiatrists were trained to see it as quaint and archaic. The focus in diagnosing and treating has come more and more to be on the description, the symptoms, of an episode of emotional distress (such as can be captured in the symptom checklists the article mentions) to the exclusion of the meaning of that distress to the individual and its contextualization in an individual life. With the development of medications that can treat depressive symptoms, what has been lost has been the question of whether they should be treated in all instances. Recent dogma emphasizing that depressive episodes not be seen as self-contained but as manifestations of a lifelong relapsing condition mitigates for preventive treatment through indefinite antidepressant maintenance. Relapses are explained with disdain as the result of inadequately insightful patients failing to comply with that paradigm. I will leave it to my readers to draw their own conclusions as to whether this deserves to be seen as an aspect of the medicalization of everyday life driven by market pressures and the selling of healthcare down the river by the unholy alliance of Big Pharma and its handmaiden physicians.

On the other hand, I quibble with the implication of the article that this finding points to wholesale “misdiagnosis” of depression where it is unwarranted. That would be too simple, and I doubt it is what the authors intended. What is at stake is not just tidying up diagnostic criteria or diagnostic practices. There is no “true” definition of what depression is to aim for; it is a social construction that reflects dominant values and assumptions. We are in the midst of a full-fledged clash of conflicting paradigms, with a study such as this at its nidus. As Kuhn suggested in The Structure of Scientific Revolutions , evidence inconsistent with the dominant paradigm is explained away or ignored until a sufficient accumulation occurs.

What are the dangers of ignoring these challenges to the dominant conception of depression, markedly broadened from that of a generation ago and ignoring context almost entirely? One of our real social ills may be not the prevalence of depression but of the narcissistic expectation that we are entitled to have any depressive distress eradicated, and the parallel assumption that it is the fault of a ‘chemical imbalance’ rather than the way we make sense of the world, process our feelings or treat one another. What is at stake is something very basic about the parameters of the social construction of the self in modern society. There may be biological consequences as well. I have been troubled by the possibility — which I cannot get many of my colleagues to take seriously — that having too low a threshold for beginning or maintaining our patients on antidepressants may actually perpetuate or worsen depressive dysfunction of the brain. Although antidepressants are not, in a rigid sense, addictive, their use may cause a self-perpetuating necessity to continue to use them. I hope to have more to say about that in the future as I clarify and extend my thinking about this issue.

Will Vermont Secede from the Union?

“The winds of secession are blowing in the Green Mountain State. Vermont was once an independent republic, and it can be one again. We think the time to make that happen is now. Over the past 50 years, the U.S. government has grown too big, too corrupt and too aggressive toward the world, toward its own citizens and toward local democratic institutions. It has abandoned the democratic vision of its founders and eroded Americans’ fundamental freedoms.” (Washington Post via Alternet)

Will Vermont Secede from the Union?

“The winds of secession are blowing in the Green Mountain State. Vermont was once an independent republic, and it can be one again. We think the time to make that happen is now. Over the past 50 years, the U.S. government has grown too big, too corrupt and too aggressive toward the world, toward its own citizens and toward local democratic institutions. It has abandoned the democratic vision of its founders and eroded Americans’ fundamental freedoms.” (Washington Post via Alternet)