To Avoid Fuel Limits, Subaru Is Turning a Sedan Into a Truck: “Subaru’s strategy highlights what environmentalists, consumer groups and some politicians say is a loophole in the fuel economy regulations that has undermined the government’s ability to actually cut gas consumption. The average fuel economy for new vehicles is lower now than it was two decades ago, despite advances in fuel-saving technology.” —New York Times

“A new effort appears to be developing to expand the use of sleeping pills, which because of their potential for abuse have long had a reputation as being in some ways more dangerous than the insomnia they are meant to treat…

But part of the new push is driven by drug company marketing. Two new sleeping pills are expected to be available by the end of next year and their manufacturers hope to have them approved for broader and longer-term use than recommended for previous pills. And the companies are expected to advertise their products, and the problem of insomnia, heavily.” —New York Times

“For some women, especially those with a history of significant depression, the risks of abandoning antidepressants during pregnancy may be far greater to the mother and the fetus than taking the drugs themselves.

Those who abruptly stop taking their medications, often on the advice of their obstetricians, put themselves in danger of a relapse. Others who switch to lower dosages may still suffer depressive symptoms.” —New York Times

Washington’s Park Police bombed on a terrorism test on the second anniversary of 9-11 when the Office of Inspector General planted a mock dirty bomb at the Washington Monument. After it went undetected, they even moved it from the rear of the obelisk to be closer to a security checkpoint where tourists line up to enter the attraction. —Washington Post . I also heard a radio report about Immigration and Nationalization batting a perfect .000 recently in detecting a significant number of mock infiltrators from the OIG presenting at various ports of U.S. entry with clumsy home-PC forged identity documents. [Oh, but it must have been before they instituted the fantastic and much-heralded fingerprinting-and-photographing regimen!] But, predictably, reaction will lean in the direction of finger-pointing at the culprits in INS, the National Park Service, or whatever agency du jour has been embarrassed, rather than examining the essential futility of our paranoiac approach to ‘homeland security’.

“We get the conspiracies we deserve.” —Independent.UK

“French law enforcement authorities have made Vice President Dick Cheney the target of a criminal investigation for his role in a massive bribery scandal during his time as CEO of Halliburton. Le Figaro, one of France’s biggest (and most conservative) newspapers, reports ‘an investigative judge is looking into allegations of corruption during construction of a natural gas complex in Nigeria by Halliburton and a French oil company.'” Yet this story is virtually ignored in the American press, the author writes. —AlterNet. “The investigation is the first of its kind in France under laws introduced as part of an international convention on cross-border corruption signed in 1997 by some 35 countries, including the US.” —Guardian.UK

People are saying terrible things about George W. Bush. ”

With Paul O’Neill joining the ranks, the credentials of the Bush critics just keep getting better.”

I was one of the few commentators who didn’t celebrate Paul O’Neill’s appointment as Treasury secretary. And I couldn’t understand why, if Mr. O’Neill was the principled man his friends described, he didn’t resign early from an administration that was clearly anything but honest.

But now he’s showing the courage I missed back then, by giving us an invaluable, scathing insider’s picture of the Bush administration. —Paul Krugman, New York Times op-ed

A reader sent me this story from a Florida news outlet about a candidate for the Darwin Awards who, allegedly guided by voices, climbed into a lion’s cage in a Buenos Aires zoo and tried to ‘bullfight’ with a lion [thanks, Adam]. Mucking around at the site, I got to this slideshow format which has twenty-seven ‘news’ items. Clicking from one to the next, you cannot believe you go to ever more twisted, absurd and shameful displays of folly and perfidy. I do not know if it should be taken as more of a comment on human depravity or the sorry state of what passes for news on your average local station.

Why can’t Homeland Security tell the difference between a terrorist and Mark Frauenfelder’s six-year-old daughter? —Boing Boing

“…By the 1950’s fewer composers were writing for the string quartet, which had been overshadowed by more exotic ensembles. It began to seem as quaint as a Sunday afternoon chamber concert at the local church. It might have continued to languish but for the advocacy of two ensembles: the San Francisco-based Kronos Quartet, founded in 1973 by David Harrington, its first violinist; and the London-based Arditti Quartet, founded a year later by Irvine Arditti, the violinist involved in the Boulez exchange.

Passionate, unflagging champions of new music, the two groups have, between them, commissioned nearly a thousand works; that achievement alone should earn them a lasting place in music history. They have also inspired a wave of young string quartets that specialize in contemporary music, including Ethel and the Meridian and Flux Quartets in America, and the Brodsky, Keller and Balanescu Quartets in Europe. Not to mention the salutary impact they have had on the classical music scene as a whole, which has become a little less staid and a little more open.” —New York Times

The world’s largest book: “Last month, MIT professor Michael Hawley set a new Guinness World Record for largest book with the publication of Bhutan: A Visual Odyssey Across the Last Himalayan Kingdom, a 114-page photographic picture book recording four of his visits to the tiny country.

Opening to 1.5 by 2 metres and weighing more than 60 kilograms, the book is so big it needs its own Sherpa. The price? A cool $10,000 (U.S.), 17 times what the average Bhutanese earns in a year, although the books only cost $1,000 each to produce, with the remaining $9,000 benefiting the Bhutanese ministry of education as a charitable donation”

“Adobe Systems Inc. acknowledged yesterday it had added technology to its popular Photoshop graphics software at the request of government regulators and bankers to prevent consumers from making copies of the world’s major currencies…

Rival graphics software by Taiwan-based Ulead Systems Inc. also blocks customers from making copies of currency.

Experts said the decision by Adobe represents one of the rare occasions when the U.S. technology industry has agreed to include third-party software code into commercial products at the request of government and finance officials.” —Washington Post

Neal Stephenson: “Superficially, this site looks like a set of FAQs about a novel that I wrote entitled Quicksilver. As time goes on, we hope that it will develop into something a little more than that. We don’t know how it will come out. It’s an experiment.

Why put the information on such a complicated system, when a simple FAQ is easier? Because we are hoping that the annotations of the book on this site will seed a body of knowledge called the Metaweb, which will eventually be something more generally useful than a list of FAQs about one and only one novel. The idea of the Metaweb was originated by Danny Hillis.”

Having just finished reading Quicksilver (FmH readers will have noted my references to it during the past few months), I found myself reluctant to return* from an immersion in late 17th century European politics, science and philosophy. Because of Stephenson’s erudition (about nearly everything), the length of the book did not make it at all ponderous, despite the fact that much of the plotting is less than compelling and things are left unsatisfyingly unresolved for the main characters (of course, as it is the first volume of a projected ‘Baroque trilogy’). From a review:

The weight of Quicksilver, just less than four pounds, is a jail. Deep inside the 900 pages of Neal Stephenson’s vast new novel can be discerned, pacing the prison yard, a small slim underlit curtain-raiser of a tale whose task it is to warm us up for the real performance to come, the massive drama Stephenson is presumably planning to unfold in stages two and three of what he is calling The Baroque Cycle.

*Does anyone have any recommendations of good historical fiction set in 17th century Europe? Has anyone read Dark Matter, by the (underrated? under-performing?) novelist Philip Kerr?

Paul O’Neill is one disgruntled former employee, to be sure!

“Former Treasury Secretary Paul H. O’Neill charged in remarks released Saturday that President Bush began planning to oust Saddam Hussein within days of taking office and before the attacks of Sept. 11, 2001.

Providing firsthand testimony bolstering a longtime contention of White House critics, O’Neill told Lesley Stahl of CBS News for a segment to be broadcast on ’60 Minutes’ Sunday night that preparations to oust Hussein long predated Bush’s articulation of his preemption doctrine in June 2002, when he said the United States must strike looming enemies before the worst threats emerge.” —Washington Post

It is not his contentions that are surprising — I have long believed that the dysadministration was looking for a pretext to go into Iraq from the time they took power — but his gutsiness in spilling the beans. I will be curious to see what is unleashed upon him, in the way of character assassination or worse, in response.

No Guardian for a Fetus: “A Florida appeals court panel ruled on Friday that the state could not appoint a guardian for the fetus of a retarded rape victim, dismissing what civil-liberties groups complained was an attack by Gov. Jeb Bush against abortion rights.

The ruling does not affect the woman because she gave birth in August. But lawyers who fought the state’s effort said the decision would have a far-reaching impact, because it would keep the state from establishing legal protection for fetuses in the future.” —New York Times

Neal Stephenson: “Superficially, this site looks like a set of FAQs about a novel that I wrote entitled Quicksilver. As time goes on, we hope that it will develop into something a little more than that. We don’t know how it will come out. It’s an experiment.

Why put the information on such a complicated system, when a simple FAQ is easier? Because we are hoping that the annotations of the book on this site will seed a body of knowledge called the Metaweb, which will eventually be something more generally useful than a list of FAQs about one and only one novel. The idea of the Metaweb was originated by Danny Hillis.”

Having just finished reading Quicksilver (FmH readers will have noted my references to it during the past few months), I found myself reluctant to return* from an immersion in late 17th century European politics, science and philosophy. Because of Stephenson’s erudition (about nearly everything), the length of the book did not make it at all ponderous, despite the fact that much of the plotting is less than compelling and things are left unsatisfyingly unresolved for the main characters (of course, as it is the first volume of a projected ‘Baroque trilogy’). From a review:

The weight of Quicksilver, just less than four pounds, is a jail. Deep inside the 900 pages of Neal Stephenson’s vast new novel can be discerned, pacing the prison yard, a small slim underlit curtain-raiser of a tale whose task it is to warm us up for the real performance to come, the massive drama Stephenson is presumably planning to unfold in stages two and three of what he is calling The Baroque Cycle.

*Does anyone have any recommendations of good historical fiction set in 17th century Europe? Has anyone read Dark Matter, by the (underrated? under-performing?) novelist Philip Kerr?

Not that you would even consider doing such a thing, but “forty-five percent of the executable files downloaded through Kazaa, the most popular file-sharing program, contain malicious code like viruses and Trojan horses, according to a new study.” — Wired

Warning to UK readers: Keep tap water away from your face if you wear contact lenses. Seriously. —New Scientist

“Historical figures including Socrates, Charles Darwin, and Andy Warhol probably had a form of autism, says a leading specialist.

Professor Michael Fitzgerald, of Dublin’s Trinity College believes they showed signs of Asperger’s syndrome.” — BBC.

You owe it to yourself to read Steve Silberman’s fascinating Wired exploration of the savant phenomenon and the neurology of creativity, of related interest. I have previously linked to that piece. Silberman has also covered the so-called ‘Geek Syndrome’ observations that suggest Silicon Valley has been built on Asperger’s.

How Vermeer’s paintings translate to film: “Jan Vermeer’s works aren’t paintings – they’re frozen films, cinematic dramas in paint and canvas. Jonathan Jones looks at how his enigmatic masterpieces translate to the big screen.” — Guardian.UK I am transported by Vermeer, and look forward very much to this film, although I share puzzlement at how it will live and breathe on the big screen.

“At one time it was rare to find US citizens, in the safest and most prosperous country in the world, jumping at their own shadows. Now we only note how high.”

“A mother’s enquiry about buying Microsoft Flight Simulator for her ten-year-old son prompted a night-time visit to her home from a state trooper…So alarmed was the Staples clerk at the prospect of the ten year old learning to fly, that he informed the police, the Greenfield Recorder reports. The authorities moved into action, leaving nothing to chance. A few days later, (she) was alarmed to discover a state trooper flashing a torch into to her home through a sliding glass door at 8:30 pm on a rainy night.” — The Register (UK)

“Communitarian’ philosopher Amitai Etzioni has a weblog, I discovered by accident in someone else’s blogroll. Recently, for example, he has written a couple of posts lauding the Second Circuit Court of Appeals decision denying the Bush administration the right to detain U.S. citizen Jose Padilla an “enemy combatant” without benefit of constitutional protections.

Forgetting Isn’t a Simple Process:

“Do you recall the last time you actively tried to forget something unpleasant? Maybe it was an embarrassing moment, or Britney Spears’ weekend wedding that wasn’t.

New research suggests your brain is quite busy when you take on the task of un-remembering. The process, in fact, is similar to the mental effort required to stop your arm or leg from moving.” —Yahoo! News

Related: Research reveals brain has biological mechanism to block unwanted memories:

“For the first time, researchers at Stanford University and the University of Oregon have shown that a biological mechanism exists in the human brain to block unwanted memories.

The findings, to be published Jan. 9 in the journal Science, reinforce Sigmund Freud’s controversial century-old thesis about the existence of voluntary memory suppression.

“The big news is that we’ve shown how the human brain blocks an unwanted memory, that there is such a mechanism and it has a biological basis,” said Stanford psychology Professor John Gabrieli, a co-author of the paper titled “Neural Systems Underlying the Suppression of Unwanted Memories.” “It gets you past the possibility that there’s nothing in the brain that would suppress a memory – that it was all a misunderstood fiction.”

The experiment showed that people are capable of repeatedly blocking thoughts of experiences they don’t want to remember until they can no longer retrieve the memory, even if they want to, Gabrieli explained. ” —EurekAlerts

Also: Unmaking Memories: “In the sci-fi thriller Paycheck, an engineer has his memory erased after completing a sensitive job. Scientific American.com spoke with leading neurobiologist James McGaugh to find out just how close scientists are to controlling recall.”

National Zoo Admits Mistakes in Animal Care: “The National Zoo has filed a formal response that disputes the claims of a former staff pathologist who said he uncovered a pattern of poor animal care, but the zoo acknowledges making numerous mistakes in treatment and record-keeping…

While presenting a detailed response to Nichols’s allegations of veterinary mistakes in 21 animal deaths, the zoo acknowledged a range of staff errors in caring for 15 animals that died. The mistakes included failure to keep complete and accurate veterinary records; failure to examine some animals in a timely manner; failure to perform tests that would have more accurately diagnosed some ailments; and failure to closely monitor the care of some animals.” —Washington Post

Bush to Announce Ventures to Mars and the Moon, Officials Say:

“…(An) administration official cautioned that the proposal could be broad and open-ended, more in the nature of “a mission statement” rather than a detailed road map and schedule….

(T)he announcement, combined with Mr. Bush’s call this week to revamp laws regarding immigration, would signal the second major policy initiative put forward by the White House at the beginning of an election year. Both new policy directives would allow the president to be portrayed as an inspirational leader whose vision goes beyond terrorism and tax cuts.

They also would have the added political benefit of diverting attention from the Democratic presidential candidates trudging through the retail politics of the Iowa caucuses.” —New York Times

“No two ways about it, 2003 was a demoralizing year for those of us working for peace and justice. With George Bush in the White House, Arnold Schwarzenegger in the California State House, and Paul Bremer ruling Iraq, it was a chore just to get out of bed each morning. But get out of bed we did…” —AlterNet

Adam mentioned he has run across other reports of animals mourning their dead. This Google search has more to say about animal grieving (although, because of the syntax I used, you will have to filter out a couple of entries about grieving for animals as opposed to grieving by animals). By the way, I have to react to the anthropocentric phrasing of the USA Today headline and the slant of the story. In this case, because Babs was euthanized, of course they had to make deliberate provisions to bring her body back into the gorilla enclosure for the wake, but should it really be up to their human keepers to decide whether to allow the animals the opportunitiy to grieve?

And:

In another challenge to anthropocentrism:

Fear of new things shortens life: “Animals with an innate phobia of novelty have higher levels of stress hormones after a new experience and die significantly younger than their braver kin, new research has found. The work suggests that a lifetime of fearful stress can take an accumulated toll on health.” —New Scientist Evolutionarily, though, would it not make sense that tolerating higher levels of stress better would be selected for, given the obvious survival value it confers? It is not clear that the health effects of stress on a lab animal bred specifically to be stress- or novelty-intolerant can be generalized to “a lifetime of fearful stress” in an evolutionarily equipped organism. Furthermore, might the study results be turned on their head — one might imagine that it may not be that fearful animals die younger than braver kin, but rather that animals who (for some undiscovered constitutional reason) are going to die younger are more fearful than their kin. As usual, correlation is not necessarily causation. In any case, go out there and try a new thing or two…

I thought from reading the headline that researchers were claiming that nonhuman animals might approach having a ‘theory of mind’, the implications of which would be earthshattering. But it turns out they use ‘thinking about thought’ to mean something different and far less momentous. They give nonverbal memory tasks to animals like dolphins and rhesus monkeys but the study design gives the subject the option of declining to complete a task they assess as too difficult, which the researchers take to mean that the animal knows when it doesn’t know. —Guardian.UK. I have not read the study but it strikes me that there are probably behavioral explanations for the subjects’ behavior in the test that do not require us to infer self-reflective abilities. On the other hand, why not? I don’t know. [Now where’s my fish?]

“At a congressional briefing in September, a panel of psychologists reviewed new psychological research with battlefield implications.

They presented research across diverse psychology subfields, but with one major commonality: all of the findings apply to improving U.S. military operations at home and abroad. Their presentations spanned human factors, training, recruitment and retention.” —APA Monitor The article does not mention one of the most insidious trends in Pentagon-commissioned psychological research, about which I have previously written here — efforts to subvert the natural human response (‘post-traumatic stress disorder’) to exposure to stress beyond the pale of the human organism’s design capabilities in order to preserve the shellshocked soldier’s efficiency as a warfighting machine on the battlefield.

Patients recovering from depression with talk therapy show a ‘distinct’ pattern of brain changes: “An imaging study by neuroscientists in Canada has found that patients who recover from depression with Cognitive Behavioral Therapy (CBT) show a pattern of brain changes that is distinct from patients who recover with drug therapy.

It’s an important finding because it shows — for the first time with definitive imaging evidence — that the depressed brain responds ‘differently’ to different treatments. It may also help doctors better understand why a particular treatment might work for one patient and not another.” —EurekAlerts! I have a problem with framing the talking cure and medication treatment of depression as separate but equal treatments. I have often said to my patients that medication is like a bicycle; it will get you somewhere you need to go, but you still need to do the pedaling. It is just a very efficient way to use your energy. In contrast, therapy is like learning how to ride, how to plan where you want to go, how to navigate, obey the rules of the road and learn how to keep your injuries minimal if you ever fall… to push the metaphor. Of course, brainscan patterns of beneficiaries of the two treatments would show they affect different parts of the brain!

Book Review: Human Nature in Utopia: Zamyatin’s We: “Human Nature in Utopia argues a startling hypothesis about utopian systems. Building a society on a completely rational model is not just a political mistake but a scientific and philosophical one. A rational society is just not what we are evolved for, so the critique of hyperrationalist societies in Brave New World (Huxley), 1984 (Orwell), and Evgenii Zamyatin’s We can be understood anew from the viewpoint of evolutionary science.” —Human Nature Review I recall being scared out of my wits by Zamyatin’s little-known dystopian novel as a high school student with, of course, no inkling of evolutionary biology.

“Net multimedia company RealNetworks announced a sweeping overhaul of its digital audio and video software Wednesday, along with a digital song store aimed to compete with Apple Computer’s leading iTunes service.

Real is betting that the flexibility of its RealPlayer 10 music-playing software–the latest entry in an increasingly crowded digital-download market–will distinguish it from rival stores and software packages.

To this end, the company has created a jukebox that will play all the media formats used by its own and other song stores–including secure downloads from the iTunes store.” —CNET News

“Shameless self-promotion” is alleged in the lawsuit by the estate of George Harrison against a seemingly scummy New York oncologist who treated him in his final days in 2001. The suit alleges that the doctor, who has been promoting himself with national media publicity for caring for the dying Beatle and has already been sanctioned by medical authorities for professional misconduct, coerced the enfeebled Harrison into signing deathbed autographs for his children over his objections. —New York Times

An edited extract of a January, 2004 recording believed to have been made by Osama bin Laden, reacting to the US occupation of Iraq, transmitted by al-Jazeera and published in The Guardian.

A guest columnist in the Seattle Post-Intelligencer is frank (and brave) enough to call an S-word an S-word.

No Mark of Distinction: “Some publishers and scholars want to purge the colon from book titles; the only thing that’s worse: semicolons.” —The Chronicle of Higher Education [via dangerousmeta]

I seriously raised at least one FmH reader’s hackles last week in passing on Rafe Coburn‘s proposal about their lack of empathic capability being one of the defining characteristics of rabid conservatives. Now, with delight, I’m reproducing another of his comments of a similar ilk, but this time he casts his lot, and thus in turn I do, with a consummate curmudgeon:

“I’m currently reading a collection of H L Mencken’s essays, The Vintage Mencken. In one essay, ‘The National Letters,’ Mencken describes George W Bush (err, the American plutocracy circa 1920), thusly:

It is badly educated, it is stupid, it is full of low-caste superstitions and indignations, it is without decent traditions or informing vision; above all it is extraordinarily lacking in the most elemental independence and courage. Out of this class comes the grotesque fashionable society of our big towns, already described. Imagine a horde of peasants incredibly enriched and with almost infinite power thrust into their hands, and you will have a fair picture of its habitual state of mind. It shows all the stigmata of inferiority–moral certainty, cruelty, suspicion of ideas, fear.

Mencken’s argument is that what’s needed is a real aristocracy. I’m not sure I buy into that necessarily, but his description of the American plutocracy then and now is dead on.” [thanks to walker]

. . . into your local supermarket: “Hippie cuisine has come of age and, ironically, has become very big business. The past 10 years have witnessed an explosion in the organic and natural foods marketplace with sales of organic food growing five times faster than food sales in general, according to the Organic Trade Association. With national standards in place, organic producers will continue to supply a hungry market that is expected to continue growing up to 25 percent a year. Most surprisingly, a recent survey conducted by Prevention magazine and the Food and Marketing Institute (FMI) found that 53 percent of all organic food is now purchased at conventional supermarkets.” —Chicago Tribune

Rules bar telling which stores, restaurants had tainted meat: 10,000 lbs. of recalled beef from the Washington slaughterhouse where the BSE-tainted cow was rendered may have been distributed to as many as nine California counties and has been tracked to the retailers who sold it to the public. The state has shared the information with county health officials but they’re not telling you if you may have been exposed to any. They will say, however, that eleven restaurants and a market ended up with the beef.

“We are prohibited from releasing information that companies would consider proprietary,” (a USDA spkoesperson) explained. “If you are concerned whether you may have purchased the product, you can call your retail store. They would know. .. . The only way to know for sure is to contact stores.”

The USDA stresses that it considers the recalled meat safe because none of it contains the brain and spinal cord tissue thought to be the locus of infection with prions, the transmissible agents that cause BSE and its human equivalent, vCJD (which, by my reading of the literature, is what the exact same disease is called when it has crossed to infect a human). Then why is it being recalled? The answer may lie in the fact that scientists dispute whether prions can be transmitted via blood as well. SF Chronicle

“For the last three years, President Bush’s policies have ransacked the environment, put our national security at risk, damaged our economy, and redistributed wealth from the middle class to the very wealthiest Americans. Yet thanks to a complacent media, the President has managed to hide behind a carefully constructed ‘compassionate’ image. As the 2004 election nears, it’s crucial that voters understand what President Bush’s policies really mean for our country. And to do that, we need creative new ads that clearly show what’s at stake.

That’s why we decided to launch Bush in 30 Seconds, an ad contest that’s intended to bring new talent and new messages into the world of mainstream political advertising. We’re looking for the ad that best explains what this President and his policies are really about — in only 30 seconds.”

I especially like “Desktop” and “What Are We Teaching Our Children?”

“Charity Navigator, America’s premiere independent charity evaluator, works to advance a more efficient and responsive philanthropic marketplace by evaluating the financial health of America’s largest charities.” [via rebecca blood]. I am sorry I didn’t get to post this before you did your year-end giving. It bears pointing out, though, that if you are interested in maximum philanthropic impact of your dollars you might want to go beyond the large charities to smaller niche organizations without the inevitable layers of bureaucratic overhead.

One man’s perspective on Dean from Melbourne (the null device): “The fact that a machine-man from the lesser of two evils is seen as an almost messianic figure (an American Gough Whitlam, as it were) is testament to how loathed the Bush administration is in the more liberal, cosmopolitan parts of America. Mind you, with the US political system, Dean is as good as it gets; last election around, the best Ralph Nader could do was to bleed votes away from the Lesser Evil towards the Greater…”

Walker sent me this New Yorker Talk of the Town piece reflecting the question, which (with my affection for year-end “best” lists) I have been noticing increasingly on the critics’ lips this season, of why exactly we need the lists at all. Louis Menand’s answer, here, is that the year would “not make sense” without the lists:

You need, you realize, a list, and in exactly the same way that a drowning sailor needs a life preserver. The people who make these annual lists, the daily or weekly reviewers, have crossed the great sea of packaged amusement, pathos, and distraction for us, and they have emerged, clutching in their hands just ten plastic jewel cases. Here, they say; these are the best. We can imagine the nausea and entertainment fatigue they must have suffered during their twelve-month ordeal. We admire their grit and their pluck, and we salute them.

I thought it was just that, as I have grown up and become otherwise preoccupied, I am less au courant with new cultural developments, in pop music especially. But Menand shares my experience:

It’s not just that you don’t recognize ninety per cent of the stuff for sale. You don’t even recognize the categories. Electronica, Techno-House, Alternative Country, IDM (it stands for Intelligent Dance Music, as opposed, evidently, to the other kind). There are rows of bins containing Christian-rap CDs, and people are actually looking through them.

This being established, he goes on to explore the skill and care that must be taken in crafting these lists (in the process, condemning those who list their ten picks in alphabetical order as cheating us of needed further distinction…). Not only must the choices on the list be good; the list itself must be a work of art itself, it is as if he is saying.

If the lists function to help us indulge wisely in a world of increasingly limited leisure time and a bewildering multiplicity of choices, how alarming to find that different critics have different films, or recordings, on their lists. First, this is a reflection of the increasing fragmentation of culture into, as Menand nicely puts it, “thinner and thinner demographic slices,” so that a responsible media outlet must be pluralistic. Menand closes his essay a bit abruptly for my taste; his way of coping with his anxiety about not being given a clear dictate about what was the year’s best is merely to emphatically state his disapproval of such pluralism and democracy.

So Menand’s reflections go a long way to address the question of why we need the lists. Metaquestion, not addressed: why is it now, this year, that the question is being asked?

Walker sent me this New Yorker Talk of the Town piece reflecting the question, which (with my affection for year-end “best” lists) I have been noticing increasingly on the critics’ lips this season, of why exactly we need the lists at all. Louis Menand’s answer, here, is that the year would “not make sense” without the lists:

You need, you realize, a list, and in exactly the same way that a drowning sailor needs a life preserver. The people who make these annual lists, the daily or weekly reviewers, have crossed the great sea of packaged amusement, pathos, and distraction for us, and they have emerged, clutching in their hands just ten plastic jewel cases. Here, they say; these are the best. We can imagine the nausea and entertainment fatigue they must have suffered during their twelve-month ordeal. We admire their grit and their pluck, and we salute them.

I thought it was just that, as I have grown up and become otherwise preoccupied, I am less au courant with new cultural developments, in pop music especially. But Menand shares my experience:

It’s not just that you don’t recognize ninety per cent of the stuff for sale. You don’t even recognize the categories. Electronica, Techno-House, Alternative Country, IDM (it stands for Intelligent Dance Music, as opposed, evidently, to the other kind). There are rows of bins containing Christian-rap CDs, and people are actually looking through them.

This being established, he goes on to explore the skill and care that must be taken in crafting these lists (in the process, condemning those who list their ten picks in alphabetical order as cheating us of needed further distinction…). Not only must the choices on the list be good; the list itself must be a work of art itself, it is as if he is saying.

If the lists function to help us indulge wisely in a world of increasingly limited leisure time and a bewildering multiplicity of choices, how alarming to find that different critics have different films, or recordings, on their lists. First, this is a reflection of the increasing fragmentation of culture into, as Menand nicely puts it, “thinner and thinner demographic slices,” so that a responsible media outlet must be pluralistic. Menand closes his essay a bit abruptly for my taste; his way of coping with his anxiety about not being given a clear dictate about what was the year’s best is merely to emphatically state his disapproval of such pluralism and democracy.

So Menand’s reflections go a long way to address the question of why we need the lists. Metaquestion, not addressed: why is it now, this year, that the question is being asked?

“How you react to stress influences how easily you resist or succumb to disease, including viruses like HIV, discovered UCLA AIDS Institute scientists. Reported in the Dec.15 edition of Biological Psychiatry, the new findings identify the immune mechanism that makes shy people more susceptible to infection than outgoing people.” —EurekAlert!

More than unpleasant, chronic pain shrinks the brain —Scientific American

“We perceive space and time to be continuous, but if the amazing theory of loop quantum gravity is correct, they actually come in discrete pieces.” —Lee Smolin, Scientific American

Whatever doesn’t kill you might make you stronger: “If dioxin and ionizing radiation cause cancer, then it stands to reason that less exposure to them should improve public health. If mercury, lead and PCBs impair intellectual development, then less should be more. But a growing body of data suggests that environmental contaminants may not always be poisonous–they may actually be good for you at low levels.

Called hormesis, this phenomenon appears to be primarily an adaptive response to stress, says toxicologist Edward J. Calabrese of the University of Massachusetts at Amherst. The stress triggers cellular repair and maintenance systems. A modest amount of overcompensation then produces the low-dose effect, which is often beneficial.” —Scientific American

A fuller understanding of signaling in the brain of people with this disorder offers new hope for improved therapy: “An inadequate arsenal of medications is only one of the obstacles to treating this tragic disorder effectively. Another is the theories guiding drug therapy. Brain cells (neurons) communicate by releasing chemicals called neurotransmitters that either excite or inhibit other neurons. For decades, theories of schizophrenia have focused on a single neurotransmitter: dopamine. In the past few years, though, it has become clear that a disturbance in dopamine levels is just a part of the story and that, for many, the main abnormalities lie elsewhere. In particular, suspicion has fallen on deficiencies in the neurotransmitter glutamate. Scientists now realize that schizophrenia affects virtually all parts of the brain and that, unlike dopamine, which plays an important role only in isolated regions, glutamate is critical virtually everywhere. As a result, investigators are searching for treatments that can reverse the underlying glutamate deficit.” —Scientific American The treatment of schizophrenia, to put it another way, has been constrained by the serendipitous discovery of dopamine blockers that ameliorate its symptoms; that is why the disease has for so long been conceptualized as a disorder of dopamine. I have written about an analogous problem, most recently, in my critique of a misguided critique of the biogenic amine theory of depression. However, I wonder if glutamate is not just the next great thing in schizophrenia theory, much as, in that essay, I discussed the last decade’s focus on serotonin in depression. Glutamate-modulating drugs may not address the ‘underlying deficit’ any more than serotonin-modulating ones addressed an ‘underlying deficit’ in depression; in fact, they are, as I assert, less robust antidepressants than those that work by other mechanisms. Over and over again in psychiatry, when you have a new improved hammer, it pays to start seeing more and more nails everywhere [if you will forgive me for how often I overuse that metaphor…]

There is yet another problem, which this article touches upon only in its ultimate paragraph (“…because schizophrenia’s symptoms vary so greatly, many investigators believe that multiple factors probably cause the syndrome. What physicians diagnose as schizophrenia today may prove to be a cluster of different illnesses, with similar and overlapping symptoms.”), giving the briefest of nods to what I think of as a core issue in conceptualizing schizophrenia. It may not be only that other neurotransmitters beyond dopamine are affected, to varying extents, in different patients with the disease, provoking its varied presentations. I, and a number of those who treat schizophrenia, including a number of psychiatric luminaries, are convinced that our current diagnostic concept of schizophrenia lumps together patients with diverse and heterogeneous disease processes. While controversial, a strong case may be made that in some schizophrenics, it is not necessarily a disorder of intercellular signalling (neurotransmitters) at all, but more gross “organic” disruption in the architecture of the brain as a result of perinatal insult or developmental disturbance. Schizophrenics may sort roughly into two categories, those with (a) genetic history of the disease in relatives, fair to good medication response, more normal premorbid cognitive abilities (although sometimes having shown premorbid social-interactional abnormalities), less cognitive deficiency, absence of environmental insult history, and absence of findings on brain scans or autopsy; as opposed to those with (b) no family history; poorer medication response; evidence of poorer premorbid cognitive functioning; more deficits on neurocognitive testing; evidence of environmental insults such as season-of-birth effect, antibody levels indicative of exposure to infection, or other metabolic abnormalities; and abnormal brain scans and postmortem findings. The two types of schizophrenics also have contrasting symptom patterns; the former are more paranoid and delusional (the type Javitt and Coyle are writing about) and the latter more disorganized and confused.

Goodbye sunshine: “Each year less light reaches the surface of the Earth. No one is sure what’s causing ‘global dimming’ – or what it means for the future. In fact most scientists have never heard of it.” —Guardian.UK

Related? String Theory — A weak sun may have sweetened the Stradivarius:

“Myriad proposals have surfaced in the past several centuries to explain how Antonio Stradivari imbued his now priceless wares with transcendental sound. Some have suggested that Stradivari used beams from ancient cathedrals; others argued that he gave his wood a good urine soaking. The latest theory proposes that the craftsman should thank the sun’s rays–or lack thereof.

Stradivari could not have known that his lifetime coincided almost exactly with the Maunder Minimum–the 70-year period (from 1645 to 1715) of reduced solar activity that contributed to colder temperatures throughout western Europe during what is called the Little Ice Age.” —Scientific American

This is a reprise and an amplification of a New Year’s Day post from FmH in years past:

Years ago, the Boston Globe ran a January 1st article compiling folkloric beliefs about what to do, what to eat, etc. on New Year’s Day to bring good fortune for the year to come. I’ve regretted since — I usually think of it around once a year (grin) — not clipping out and saving the article; especially since we’ve had children, I’m interested in enduring traditions that go beyond getting drunk [although some comment that this is a profound enactment of the interdigitation of chaos and order appropriate to the New Year’s celebration — FmH], watching the bowl games and making resolutions. A web search brought me this, less elaborate than what I recall from the Globe but to the same point:

“Traditionally, it was thought that one could affect the luck they would have throughout the coming year by what they did or ate on the first day of the year. For that reason, it has become common for folks to celebrate the first few minutes of a brand new year in the company of family and friends. Parties often last into the middle of the night after the ringing in of a new year. It was once believed that the first visitor on New Year’s Day would bring either good luck or bad luck the rest of the year. It was particularly lucky if that visitor happened to be a tall dark-haired man.

“Traditional New Year foods are also thought to bring luck. Many cultures believe that anything in the shape of a ring is good luck, because it symbolizes “coming full circle,” completing a year’s cycle. For that reason, the Dutch believe that eating donuts on New Year’s Day will bring good fortune.

“Many parts of the U.S. celebrate the new year by consuming black-eyed peas. These legumes are typically accompanied by either hog jowls or ham. Black-eyed peas and other legumes have been considered good luck in many cultures. The hog, and thus its meat, is considered lucky because it symbolizes prosperity. Cabbage is another ‘good luck’ vegetable that is consumed on New Year’s Day by many. Cabbage leaves are also considered a sign of prosperity, being representative of paper currency. In some regions, rice is a lucky food that is eaten on New Year’s Day.”

The further north one travels in the British Isles, the more the year-end festivities focus on New Year’s. The Scottish observance of Hogmanay has many elements of warming heart and hearth, welcoming strangers and making a good beginning:

“Three cornered biscuits called hogmanays are eaten. Other special foods are: wine, ginger cordial, cheese, bread, shortbread, oatcake, carol or carl cake, currant loaf, and a pastry called scones. After sunset people collect juniper and water to purify the home. Divining rituals are done according to the directions of the winds, which are assigned their own colors. First Footing:The first person who comes to the door on midnight New Year’s Eve should be a dark-haired or dark-complected man with gifts for luck. Seeing a cat, dog, woman, red-head or beggar is unlucky. The person brings a gift (handsel) of coal or whiskey to ensure prosperity in the New Year. Mummer’s Plays are also performed. The actors called the White Boys of Yule are all dressed in white, except for one dressed as the devil in black. It is bad luck to engage in marriage proposals, break glass, spin flax, sweep or carry out rubbish on New Year’s Eve.”

Here’s why we clink our glasses when we drink our New Year’s toasts, no matter where we are. Of course, sometimes the midnight cacophony is louder than just clinking glassware, to create a ‘devil-chasing din’.

In Georgia, eat black eyed peas and turnip greens on New Year’s Day for luck and prosperity in the year to come, supposedly because they symbolize coppers and currency. Hoppin’ John, a concoction of peas, onion, bacon and rice, is also a southern New Year’s tradition, as is wearing yellow to find true love (in Peru, yellow underwear, apparently!) or carrying silver for prosperity. In some instances, a dollar bill is thrown in with the other ingredients of the New Year’s meal to bring prosperity. A similar New Year’s meal in Norway also includes dried cod, “lutefisk.” The Pennsylvania Dutch make sure to include sauerkraut in their holiday meal, also for prosperity.

In Spain, you would cram twelve grapes in your mouth at midnight, one each time the clock chimed, for good luck for the twelve months to come. The U. S. version of this custom, for some reason, involves standing on a chair as you pop the grapes. In Denmark, jumping off a chair at the stroke of midnight signifies leaping into the New Year. In Rio, you would be plunging into the sea en masse at midnight, wearing white and bearing offerings.

In China, papercuttings of red paper are hung in the windows to scare away evil spirits who might enter the house and bring misfortune.

Elsewhere: pancakes for the New Year’s breakfast in France; banging on friends’ doors in Denmark to “smash in” the New Year; going in the front door and out the back door at midnight in Ireland; making sure the first person through your door in the New Year in Scotland is a tall dark haired visitor. Water out the window at midnight in Puerto Rico rids the home of evil spirits. Cleanse your soul in Japan at the New Year by listening to a gong tolling 108 times, one for every sin. It is Swiss good luck to let a drop of cream fall on the floor on New Year’s Day.

However you’re going to celebrate, my warmest wishes for the year to come!

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.

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.]

There is a new British edition of The Devil’s Dictionary by Ambrose Bierce, one of my favorite books, from Bloomsbury. Illustrated by Ralph Steadman, no less. Reading Bierce, I know I have more than met my match in cynicism and misanthropy. A belated Christmas present?

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…

—

Disclaimer:

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

number of electrons were inconvenienced.

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…”??

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.”

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.

“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

“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]

“The great digital music giveaway is about to begin. In the new year, some of the world’s biggest brands will promote their products and services by doling out millions of free downloads through alliances with digital music services.” —CNN

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

“A trial starting on Wednesday will allow thousands of Japanese mobile phone owners to use their phones as a swipe card to pay for purchases, as travel passes, and as concert and movie tickets.” —New Scientist

“The first images from NASA’s new infrared space telescope reveal the drama and beauty of the infrared Universe.” —New Scientist

“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

“Why are humans nearly hairless? And why do some wish to become more so?” —The Economist

“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.

The dire consequences of species loss and the Bush dysadministration’s culpability in its acceleration. —Mother Jones

“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

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.

“Once a curmudgeonly champion of ‘usable’ design, cognitive scientist Donald A. Norman argues that future machines will need emotions to be truly dependable” —Scientific American

“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.

A compilation of links to the-year-in-arts reviews —Arts Journal

All the progressive punditry in one simple compilation: “Every pundit, blogger, correspondent, presidential candidate, reporter, scam artist, and all of their mothers, have something to say about Saddam. Here’s our roundup of what they’re spouting: from capture to trial to conspiracy theories, it’s all here (well, a lot of it anyway).” —Utne Reader

“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

“Jailed former Yugoslav President Slobodan Milosevic and another accused war criminal could become members of Serbia’s parliament after their extreme nationalist allies swept weekend elections, according to results released Monday.” —SF Chronicle

“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

…in Battle Over Next DVD Format —New York Times

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.

Thank heavens the Plame affair hasn’t been entirely been swept under the rug as I had feared. Washington Post

“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.

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

“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

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.

“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

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.

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 .

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 .

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

“Downloading copyrighted music from peer-to-peer networks is legal in Canada, although uploading files is not, Canadian copyright regulators said in a ruling released Friday.” —CNET News.com

“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

Anti-war, or pro-peace, children’s books [via wood s lot; thanks!]

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).

“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.

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.”

(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

Renowned, outspoken contrarian psychiatrist E. Fuller Torey says the report of President Bush’s Commission on Mental Health was a near-total waste and its nineteen recommendations “a hodgepodge of boilerplate and evasion.” —City Journal

James K. Galbraith: “In 1963, JFK ordered a complete withdrawal from Vietnam.” —Boston Review That is, exit without victory. Galbraith supports the much-maligned Vietnam analogy, with which punctilious historians quibble but which I have argued here is too important to be left to the academics.