’An international team of experts argues that better care for people experiencing their first manic episode is urgently needed and that more research needs to go into treatment solutions for bipolar disorder.

In a new paper, published in The Lancet Psychiatry journal, the authors describe patchy and inconsistent care, widespread failure to detect bipolar disorder early enough, and a lack of guidance on how to treat people experiencing mania for the first time.…’

Via PsychCentral

As a practicing psychiatrist, I’d like to suggest that the approach of this ‘international team of experts’ may be faulty. This may have something to do with the divide between clinicians and the academic psychiatric pundits, who I would venture to say see far fewer real-world patients.

Bipolar disorder is a condition that can only be properly diagnosed by observing and understanding the longitudinal course of the patient’s presentation over time. Thinking you know what is going on when you take the snapshot view at a moment in time is immensely problematic. It may be clear at the time of a ‘first manic episode’ that a person’s condition declares itself as bipolar disorder but not necessarily. It is often not clear even when faced with the patient in front of you in the moment that what they are experiencing is a manic episode. The symptoms they might display, possibly suggestive of mania — increased energy, decreased sleep, loquaciousness, ambition and confidence, brightening of mood, irritability, agitation and raciness, perhaps some telltale psychotic symptoms — could also be indicative of a number of other illnesses or temperaments when taken in isolation.

‘Better care for people experiencing their first manic episode’ is often not possible precisely because it is not prudent or sometimes not even possible to diagnose it as mania. The mindset of the rapid rush to judgment embodied in the article has arguably played a large part in the epidemic over\diagnosis of bipolar disorder and concomitant rush to overtreatment, to the detriment of our patients.

Michelle Goldberg in Opinion: “We need to get past the trauma of Hillary Clinton’s defeat.”

’Several things can be true at once. Without the handicap of sexism, Clinton probably would have won a race that was essentially decided by a rounding error. Misogyny will work against the next female presidential candidate. And yet the people best positioned to lead the Democratic Party are women.

After all, every candidate will have something to overcome. Sanders would have to deal with widespread fear of socialism. Biden demonstrated again on Thursday that he’s ill-equipped to justify much of his long record in public life. Sexism is a disadvantage but it’s not the only one.…’

Via New York Times

Opinion by Gary J. Bass:

’…even by Mr. Trump’s dismal standards, his performance this week before the G-20 summit in Osaka, Japan, should take everyone’s breath away. More than yet another demonstration of his erratic behavior, this was also an object lesson in the dangers of his context-free hostility to the world beyond the United States.

Before arriving in Japan, Mr. Trump had reportedly been musing about withdrawing the United States from the security treaty with Japan signed in 1951 and revised in 1960 — the cornerstone of the alliance between the United States and Japan and a pillar of American foreign policy. On Wednesday, asked about the treaty on Fox News, Mr. Trump sneered, “If Japan is attacked, we will fight World War III.” Then he added: “But if we’re attacked, Japan doesn’t have to help us at all. They can watch it on a Sony television.”

Mr. Trump’s comment demonstrates a strategic cluelessness and historical ignorance that would disqualify a person from even a modest desk job at the State Department.

Though Mr. Trump implied that the security treaty favors Japan, it was largely dictated by the United States.…’

Via New York Times

‘It’s a nightmare scenario: His defeat was “fake news,” and Trump tries to stay in power. Would democracy survive?…’
— Read on Salon

With a whimsical, irregular trunk and flat-topped evergreen leaves, the Monterey cypress in La Jolla, California, that may have inspired the trees in 7he Lorax fatally fell over last week.
— Read on Atlas Obscura

What even more smarmy condescending pitiful bald faced liar waits in the wings?

‘Sarah Huckabee Sanders, the White House press secretary, is leaving the Trump administration after a turbulent tenure marked by attacks on the media, dissemination of false information, and the near-disappearance of the daily press briefing…’

— Read at Boston Globe

‘President Trump’s latest comments, during an ABC News interview, indicating that he would consider accepting negative material on political opponents from foreign governments, and that he wouldn’t necessarily report the contact to the FBI, are just the latest in a long line of counterintelligence red flags. Trump said, “There isn’t anything wrong with listening.”…’

— Read on CNN

Those of you with more common family names, or with appreciable extended families, may have a hard time seeing the point of this post. But, as I’ve noted before, there are very very few Gelwans. I have always wondered, or you might even say obsessed about, how/if those people with the Gelwan surname I do find are related to me. I have very little in the way of extended family; I envy those who do and thirst for deeper family connection, especially so that my children might come to feel embedded in a broader web. It becomes poignant each year around the holidays, which I imagine you all celebrate with enormous extended family gatherings while we have the four of us around the dinner table.

I subscribe to a Google alert for new ‘Gelwan’ references on the web, and once received a link to this page  (gendrevo.ru). Alas, the page is now gone from the web. It appeared to me to be from a Russian genealogy site in which survivors post remembrance pages for their relatives who died in the Holocaust. On my paternal side, the generation of immigrants were my grandparents, in the early 20th century; my father’s older siblings and he were born in the U.S. between 1910-1915. I have always assumed that Gelwan was an Ellis Island anglicization of something else and thus that researching my family’s roots would become squirrelly because the family name of anyone related to me might not have precisely the same pronunciation or spelling. As the part of the world from which my ancestors emigrated shifted back and forth between Slavic and Germanic dominance, between Cyrillic and Roman alphabets, so too did the rendering of family names. I would have to pursue the Gelvans, the Gelmans, and even the Hellmans and who knows what else for relatives. [I may have made this up, but I think I learned somewhere along the way that we are actually distantly related to the Hellman’s mayonnaise family…]

The flip side of that coin is of course that literal ‘Gelwans’ might not be related to me. For example, I found through Googling traces of a Deborah Gelwan who was in the public relations industry in Sao Paulo, Brazil who is referred to on the web. Deborah now lives in Orlando FL and runs a couple of businesses. Maybe I’ll get to see her someday.

When I was a child, a Brazilian tourist with the last name Gelwan, possibly from the same family as Deborah, arrived on our doorstep, having looked up Gelwan in the phonebooks on arriving in New York City. It appears that my parents and the visitor determined that it was unlikely we were related (although I cannot imagine how they did this, as my parents spoke no Portugese and rumor has it this visitor spoke no English). Deborah and I are now Facebook friends but we have not established a family relationship. And there are traces of other Gelwans in Brazil as well. I would at least love to figure out if these South American Gelwans descended from Eastern European immigrants. I am aware that eastern European Jews did go to South America in the diasporas, but I am not sure about Brazil per se.

Similarly, I have reached out to Gelwans in Lebanon — a Claude Gelwan was there but apparently now lives in France —  and Iraq but I doubt we are related. It appears to me that Gelwan is a transliteration of a first name, not a family name, in Iraq.

I have discovered several other Gelwans in the New York area where I grew up. Interestingly enough I have long been aware of two brothers, physicians as I am: Jeffrey, a gastroenterologist and Mark, an ophthalmologist. In years past we spoke by phone but cannot establish a common background. I assumed that it might merely be an accident that we share our name, that Gelwan might be a final common pathway of anglicization from diverse unrelated family names in eastern Europe.

Similarly, there is a pharmacist in Brooklyn named Steven Gelwan, who never answered an email from me. Maya Gambarin-Gelwan, I think Steven’s spouse, is yet another New York area physician, at Memorial Sloan-Kettering, with a number of scholarly publications. Never heard from her either. There is a Rebecca Gelwan (my late mother’s name by marriage) who studies, or studied, law in Pennsylvania and posts alot of photos and videos of her new baby (congratulations on the newest Gelwan!) but, again, I can’t figure that we are direct relatives. Along with my brother, that’s two Gelwan attorneys. Elise Gelwan, I learn, graduated from medical school at the University of Connecticut. Yet another physician Gelwan! There is a Sam or Sami Gelwan (I think they are the same person) in the New York area as well. If I mention all these names in this post, they may get hits when people vanity-search themselves, and they may get in touch, I hope.

LinkedIn, from which I resigned long ago, has thirteen ‘Gelwan’ profiles, including some of the aforementioned but also a Brazilian photographer Jacob Gelwan, and a Miriam Gelwan in Argentina. A Samantha Gelwan is/was a student at Indiana University in Bloomington. A Mohammed Gelwan is an engineer in Egypt.

From time to time I see passenger manifests listing Gelwans who disembarked at Ellis Island in the late 19th or early 20th centuries. I have found the arrival records of my grandfather’s two sisters and alot of other mysterious Gelwans. But where do I go from there? Some 19th century records show Gelwans emigrating from Ireland to Manitoba, but I cannot find Canadian Gelwans today.

I was told that my family originated in Riga, Latvia. Given that, I’ve written to Vladimir, or Wladimir, Gelwan, who I learned was the principal dancer in the Latvian National Ballet and who now runs a ballet school in Berlin, suggesting that we may be related, but have never gotten a reply back. I have seen a picture of Vladimir Gelwan on the web and can even imagine a certain family resemblance, although he’s certainly got the dancer’s grace that I do not. I’m determined to try and drop in on him when next in Berlin. [Do I have any readers in or near Berlin?]

What is it, by the way, with these nonresponses? I don’t know, maybe it’s just me, but a message from afar suggesting the writer might be my relative, with such a rare name, would immediately pique my interest and would surely get a response. Do you think recipients might have worried that my messages represented some kind of con? I don’t want anything from them except connectedness. Is that the problem right there?

Given the waves of upheaval that repeatedly washed over eastern Europe in the 20th century, with ever-changing political hegemony over various regions, large scale displacement of populations, the Holocaust, the destruction of records, the changing of names, etc., conventional genealogical research is not possible. It is not as if there is an established family tree, with records waiting around for the taking, as is the case for many families with western European origins. My father’s older brother, now deceased, once returned to eastern Europe to try to find some of our roots. Despite a reputation for being extremely resourceful, he apparently had no success at all. Lamentably, I cannot find any notes from his research; otherwise I (acknowledged as someone with no lack of resourcefulness myself!) might pick up the trail where he left off, despite the passage of time having added fifty further years of obfuscation.

It has been a little (not much) easier to find information about my mother’s ancestors. She herself, as a young child, emigrated with her family in the 1920’s from Eastern Europe. Several years ago, my son and I visited the small out-of-the-way town of her origin looking for indications of her family, armed with notes from a maternal uncle of mine who had made a similar trip decades before and retracing his steps. Unfortunately (probably because they were a Jewish family), the town hall and the burial grounds held no traces; the Nazis had razed the Jewish cemetery. I discovered when I visited the site that my uncle had been the one to fund the reassembly of the smashed fragments of gravestones into a monument there. There were no Jews left but a non-Jew who lived adjacent to the site of the burial ground kept the key, tended the grounds and let Jewish visitors into the site to see the monument.

My son and I did see the house where my mother had been born; eerily, we had by coincidence parked our rental car right in front of it when we had entered the town center.

We learned that, because of their persecution, the entire family hid from the authorities behind a falsified family name for several generations. Interestingly, that was the same name as a boss of mine, whose family I knew originated from the same region. Instead of being intrigued when I mentioned my discovery to him when I returned from my Eastern European trip, he scoffed. (I think he was appalled at the possibility that we were related.)

I am on Ancestry.com (here is a link to what I know so far of my family tree) and Ancestry keeps notifying me that they’ve discovered someone who is probably a third or fourth cousin. None of the family trees I’ve been directed to seem to intermesh so far. (I wonder how many third or fourth cousins a person has, on average…)

If you have a complicated heritage that will not be easy to trace on a geneology research site, my advice is to embark on a project of tracking down and documenting what you can, as soon as you can. It only disappears over time. Your children and their children may appreciate it if information about their mysterious family origins might one day help them find their place in the world in the face of the increasing rootlessness of modern life.

Perhaps one day someone googling their family name will be linked to this post and wonder how they might be related to Eliot Gelwan. Hurry up, Google, crawl this post and index it!

Trump’s history-mimicking, incremental assaults on democracy

’Trump hasn’t made a blatant lunge for dictatorial power. But his intermittent impulses toward autocracy have made it necessary for advisers, Congress and courts to contain him.

He argued during his campaign for the efficacy of torture and prosecuting his opponent, Hillary Clinton. He has threatened media whose coverage he found insufficiently admiring, and tried to suppress the Trump-damning book “Fire and Fury.”

He proposed an un-American religious test for immigrants and refugees to ban Muslims; infected the body politic with nepotistic and business-crony appointees; shrugs off Russian meddling in our elections; and discussed a mass roundup-cum-deportation of illegal immigrants…

To top it off, the president plays fawning footsie with real dictators.…’

Via WBUR Cognoscenti

Related: How America could become a dictatorship (Google search)

Ravens get bummed out if they see a feathered friend who’s in a bad mood, according to a study published on Monday in the Proceedings of the National Academy of Sciences.

The adoption of feelings expressed by others is known as “emotional contagion,” and while it’s familiar to humans, it’s not as well understood in other social animals. Examining the phenomenon across species could shed light on the evolution of important abilities such as empathy, according to the study, which was led by Jessie Adriaense, a PhD student at the University of Vienna.…’

Via VICE

’A new paper just published in the Journal of Geology puts forth a new idea: A pair of supernovae ionized our atmosphere to such an extend that lightning became exceptionally common, and burned down the trees in which our ancestors lived.

The paper’s lead author, physicist and astronomer Adrian Melott of the University of Kansas, says, “It is thought there was already some tendency for hominins to walk on two legs, even before this event. But they were mainly adapted for climbing around in trees. After this conversion to savanna, they would much more often have to walk from one tree to another across the grassland, and so they become better at walking upright. They could see over the tops of grass and watch for predators. It’s thought this conversion to savanna contributed to bipedalism as it became more and more dominant in human ancestors.”…’

Via Big Think