Here is further ethnographic information. The Queen succeeded her grandmother, as her mother died before the grandmother’s reign ended. Usually, when a queen knows her time is near, she passes her crown on to her successor and then takes poison, it is said. And, it seems, the future queen’s liaisons were subjected to the same tabloid scrutiny as Diana’s, says The Guardian. The African National Congress, it turns out, has wooed the court of the Balobeda because of “its ability to deliver votes.”

In other news of exploitation, it would seem from this web site that South Africa is trying to capitalize on the tourist potential of the kingdom. And here, from the Worldwide Guide to Women in Leadership, is a run-down of other matriarchal South African sub-states past and present. And, finally, “the Balobedu people were regarded as an ideal study sample…” for this 2005 psychological study of the cross-cultural validity of Erik Erikson’s stages of child development “…because of their relatively unchanged lifestyle which still resembles the traditional African way of life.”

Bush’s Support on Major Issues Tumbles in Poll (New York Times )

The issue is heating up right now in the runoff toward the next edition of the American Psychiatric Association’s DSM (Diagnostic and Statistical Manual), due in 2010 or 2011. The DSM is the ‘bible’ which defines official mental disorders and their ‘official’ limits. There has been a tension ever since the beginnings of clinical psychiatry between lumpers and dividers. The former leads to contraction of the numbers of diagnoses, each of which has a broader scope, while the latter leads to the proliferation of narrow pigeonhole diagnoses. This also has some relationship to the tension between those who believe in qualitative differences between pathology and normalcy and those who believe in a continuum between more and less disturbed. Finally, this also maps to a difference between those who believe in treating psychiatric ‘diseases’ and those who target every symptom independently.

Diagnostic attitudes in modern psychiatry are, unfortunately, also strongly influenced by market pressures by psychopharmaceutical manufacturers, muddying the waters. As I am fond of saying, if the only tool you have is a hammer, it pays to see more and more nails around you everywhere. The Boston psychiatric establishment, where I practice, has a reputation of being at one extreme of the psychopharmacological continuum of disregarding diagnosis or putative disease process in favor of treating ‘target symptoms’, i.e. throwing a medication at every aspect of behavioral disturbance a patient demonstrates. The consequences are predictable. Patients come in with an obscenely lengthy roster of medications (and an obscenely weighty roster of side effects and complications!). New medications are usually added, and dosages of existing ones jacked up, as new distress emerges but the list is rarely pruned back when the patient is stable. The industry reaps the profits while the patient often suffers slowed and impaired thinking and activity; obesity and metabolic disturbance; sexual dysfunction and/or neurological damage. The intent of the DSM was supposed to be that clinically valid diagnosis would drive therapeutic decisions, not the other way around.

I have also written about another consequence of clumsy and slapdash diagnosis not driven by thoughtful clinical reasoning. Patients with personality styles, or personality disturbances, who are disinclined to accept responsibility for their behaviors, find it quite easy to obtain an ‘objective’ diagnosis of a disease to ‘explain’ their ills and let them off the hook for their behaviors or their recovery. Naive inexperienced clinicians (and let us not fool ourselves, a large majority of modern mental health treatment is delivered by trainees or therapists otherwise inexperienced!) ‘enable’ and collude with diagnosis-seeking by personality-disordered patients or, in some cases, push diagnoses on patients by their own initiative. The proliferation of the diagnosis of ADHD in adults is the most recent phenomenon of this sort. I have also written about the kneejerk, excessive labelling of patients with the diagnosis of PTSD (post-traumatic stress disorder). This is somewhat related to the phenomenon of ‘cosmetic psychopharmacology’, a term coined by psychiatrist Peter Kramer, atuhor of Listening to Prozac, who wrote of his concerns about the erosion of the boundaries betweeen the legitimate treatment of suffering and the more questionable practice of performance-tweaking with new-generation antidepressants. We should not necessarily use them in all cases where we might use them, where they are capable of having an effect, he might have said. If anything, the practice has only proliferated and the boundaries further eroded in the decade since Kramer raised the hue and cry. (Of course, there are now at least half-a-dozen new-generation antidepressants whose manufacturers are vying for market share, not just Prozac!)

Of course, when it comes to diagnostic practice, the converse is true as well, and I have written about this too. When a clinician who is not astute about his or her own reactions to the patients s/he treats (so-called “countertransference” feelings) takes a dislike to a patient s/he finds disagreeable or unruly, the patient is often given a pejorative personality disorder label, usually borderline personality disorder, while a legitimate mental illness they are suffering may consequently go unrecognized, undiagnosed and untreated.

Perhaps more important, then, than a consensus on the scope and number of official diagnoses would be the thoughtful, systematic application of existing diagnostic criteria to the process of labelling someone with a mental disorder. In fact, only accurate thoughtful diagnosis by experienced clinicians willing and able to avoid labelling someone on the basis of intuitive gut reactions (or other influences such as the marketing pressures from the pharmaceutical reps who visited them in the preceding week) will be the stepping stone on whose back we can begin to refine the diagnostic process and categories reasonably. I am at a loss as to how that might happen in time for the next edition of the DSM, which will guide at least the next decade of treatment (and funding of treatment) in mental health.

The memo itself can be read here (Times of London).

The Heretik has a round-up of those already writing about the issue here.

This year’s college graduates (except for those who, like myself, took time off during their undergraduate years… not a common thing any longer, I’m afraid) are the first to have gone through college in a post-9/11 world, as many commencement speakers are fond of pointing out. A friend, who sent me to this article, commented that what had in years past been one of his favorite New York Times features, once “a satisfying display of the broad spectrum of thought and idea and intellectual achievement in this country”, has become “a sad recap” of our sad state.

But there is this, from James McBride, an author and jazz musician who addressed Pratt University graduates, which my friend found to be the saving grace [thanks, abby]:

“If I were 21 I would walk the earth. I would go barefoot longer; I’d learn how to throw a Frisbee, I’d go braless if I were a woman and I would wear no underwear if I were a man. I’d play cards and wear the same pair of jeans until they were so stiff they could get up and strut around the room by themselves. … So don’t take the short road. Fool around. Have fun. … You’re not going to get this time back. Don’t panic and go to graduate school and law school. This nation has enough frightened, dissatisfied yuppies living in gated communities, driving S.U.V.’s and wondering where their youth went.

We need you to walk the earth, so that other nations can see the beauty of American youth, rather than seeing our young in combat fatigues behind the barrel of an M-16.”

Funny, just today I picked up and started reading Murakami’s Underground, about the 1995 sarin nerve gas attack on the Tokyo subway.

First Cream, now Pink Floyd. Now, if only the Bonzo Dog Band…

The memo itself can be read here (Times of London).

The Heretik has a round-up of those already writing about the issue here.

Page hits at FmH Wednesday and Thursday are down to about half the average daily numbers. Is my content more boring than usual or have readers had trouble accessing the site? or should I simply stop looking at the statistics? What-Me-Worry?

Spiked seems to have set itself up as the gainsayer par excellence on doom and gloom. I recall last year’s series of articles about how we worry too much about world affairs and the potential for disaster, and that it is a matter of changing cultural norms to reduce global angst. I thought this was the sort of ‘What-Me-Worry?’ sentiment that has been lampooned for decades. (It has taken on uncanny new significance given the remarkable resemblance of George W. Bush and Alfred E. Neuman…) Now a Spiked contributor is arguing that we should divert our eyes from the mass outbreaks of human tragedy, misery and atrocity of the past so as not to become too tainted or cynical about humanity. Of course I am one to bridle at that suggestion, since my cynicism is one of my strongest attributes. But when it comes to what I call the ‘ostrich mode’ (the notion that sticking one’s head in the sand and not seeing looming threats makes them go away) of historiography, who are you gonna believe, Tiffany Jenkins or George Santayana?

The problem I have with memorial museums is not so much that they keep our eyes open to the horrors of the past as that they glorify misery and solidify communities’ identities as victims, only victims and nothing more. As important as who is putting these museums up is who is going to them and what sentiments they indulge in.

As to the article’s criticism of the implied relationship between ordinary rudeness and the capacity to commit atrocities, I think that the everyday encounters with our capacity for hostility are precisely what civilizes us and holds our worst impulses in check. Emphasizing, not avoiding, that equation is uimmensely useful. The idea that “I couldn’t do that, not me” is a comforting and dangerous fiction, as we have known at least since the disturbing Stanley Milgram experiments illustrating how many would have made good Nazis given the circumstances. Certainly, cultural influences and the pronouncements of political and social leaders can shape a community’s aggressive urges in either permissive or restrictive ways. Just to cite two examples from my own recent experience:

• Yesterday, I asked an Israeli friend living in the US and just back from her annual visit home what effects she was seeing from the change in Palestinian leadership in comparison to last year. She observed that hopefulness is in a way a self-fulfilling prophecy with immediate effects. The intifada is ramping down, and she is seeing more efforts at fellowship between Arab and Jewish communities, a strengthening of the peace community, and, from her vantage point, immediate gains in the sense of safety of Jews in mixing with their Arab neighbors. (Of course, the proof of the the pudding is whether it works the other way as well.)
• In inpatient psychiatry, assaultive patients in need of physical control have often provoked a, shall we say, overly vigorous response from mental health staffs angered and frightened by assaults or threats against them. Some of us have been looking at what it takes to go to a “restraint-free” environment on inpatient units without commensurate losses in safety. If one compares psychiatric units that have successfully achieved the elimination of physical restraints which those that still utilize this tactic, one gets the impression that, more than anything else, the difference comes down to little more than having the political will to change the prevailing culture on the part of the leadership.

New study:

Fecal wastes contaminate mountain snows which are collected for drinking water… (New Scientist)

Woman Has Child After Receiving Twin’s Ovarian Tissue (New York Times )

And here’s the pitiful part:

As the article goes on to point out, most self-diagnosis is a waste of time. I am not so concerned with the objection that it ‘slows down consultations’ (since by far the greater fault of physicians is that they do not take enough time to address their patients’ concerns and educate them to the extent necessary to make them better informed healthcare consumers) but rather that would-be patients may easily become convinced they have conditions they do not. Even some of the best medically educated among us are prone to that; every medical student is cautioned about ‘medical student syndrome’, in which studying a disease convinces one that one has the disease. The lay public have no defense against that when the information, even if it is not egregious misinformation, comes from the net.

Alot of people are linking to this New York Times piece on erasing embarrassing evidence of your cyberspace presence because Anil Dash managed to get a picture of himself featuring a Goatse tee-shirt into the Paper of Record. (In case you are one of the few who do not have a clue about what Goatse is, here is the wikipedia explanation, with further links.) But the Times article is of merit from a content standpoint as well!

While doing a google search on an unrelated topic, I happened upon this long-forgotten evidence of my 1989 web presence. It’s a dump of a 1989 bulletin board discussion I got into, and I think got backed into a corner on, on issues of web censorship. I think yo might find it interesting. I probably wouldn’t get as bent out of shape about heil.zip these days, but I can’t be sure. Was the analogy I drew to swastika graffiti on a synagogue wall a reasonable one? It may be an even more pertinent question today than it was in 1989, because the internet is a much larger ‘virtual wall’ on which graffiti will be in a much greater number of people’s faces. I later got into a verbal tussle over similar censorship issues with renowned weblogger (and one of my initial boosters when FmH appeared) Jorn Barger, who was at one point a virtual pariah with a large number of netizens for the appearance of anti-Semitism.

An interactive feature about the U.S. military’s interrogation practices since Sept. 11 and the Bush administration policies that have informed them. (Slate)

Alot of people are linking to this New York Times piece on erasing embarrassing evidence of your cyberspace presence because Anil Dash managed to get a picture of himself featuring a Goatse tee-shirt into the Paper of Record. (In case you are one of the few who do not have a clue about what Goatse is, here is the wikipedia explanation, with further links.) But the Times article is of merit from a content standpoint as well!

“Please join us in sending Spine postcards to your Senators and members of Congress to let them know they should join the Inquiry into the Downing Steet Minutes/Memo. You can click here to download a pdf file that can be printed on cardstock or other paper and sent to you members of congress.”

“ADS is a coalition of veterans’ groups, peace groups, and political activist groups, which launched on May 26, 2005, a campaign to urge the U.S. Congress to begin a formal investigation into whether President Bush has committed impeachable offenses in connection with the Iraq war. “

Certainly, Tom, there’s nothing scientific about it if you think in simplistic terms like ‘chemical imbalance’. I guess s****tology has clarified his thinking to the point that it is entirely see-through. I don’t know why I should be surprised that Cruise’s comments seem so incoherent. It takes a great deal of tolerance for illogic and cognitive dissonance to adhere to s****tology in the first place. Cruise also doesn’t seem to know much about postpartum depression. Most mental health clinicians think of it as much more akin to bipolar psychosis than simple depression. I wonder if Cruise is familiar with the not insubstantial number of cases of women who, in the throes of their postpartum delusional thinking, come close to murdering their newborns? It goes without saying that you cannot treat this with vitamins.

It goes without saying that I am guilty as charged as well…

An eminently reasonable compendium of suggestions from New Scientist.

Many of the pundits commenting on the current recruitment situation comment somewhat fatuously that we are learning how difficult it is to fight a protracted war with an all-volunteer army. More properly, it is an issue of the difficulty of attracting volunteers to an unjust pointless war predicated entirely on Big Lies. Why is that distinction lost on them?

The season officially begins on June 1, and US forecasters predict a big 2005 Atlantic hurricane season (NOAA ); perhaps great news for surfers, surely dreadful for most others.

10,000 families in Florida are still in temporary housing from last year’s quadruple hit to the state over a five-week period, and officials worry about ‘hurricane fatigue’ — that inured residents may not take the forecasts seriously enough and take adequate precautions. (South Florida Sun-Sentinel)

At first I found W. Mark Felt’s revelation that he had been Woodward’s anonymous source somewhat anticlimactic, especially given the sense that, in failing health at 91, he had been persuaded by his daughter to uncover himself because there might be a book in it that could fund his grandchildren’s college educations. The flip side to that, of course, is the impression that he was never vainglorious, keeping the most sought-after secret in Washington for over thirty years with no apparent thought of personal fame. On the other hand, the impression grows that he decided to start providing the information because he was embittered that Nixon had passed him over for promotion to head the Bureau on Hoover’s retirement.

Lest we think he acted solely on principle, Felt himself was later convicted of allowing FBI agents to break into homes without warrants in pursuit of members of the Weather Underground, which I find somewhat in the same spirit as the Watergate offenses. I suppose this has something to do with the fact that these were not, or are not, so much aberrations but the normal way anyone involved in doing the government’s business, no matter what their position on an issue of the moment, inevitably does the job. In an eerie reflection of the current situation in which the zealots prosecuting the WoT® are doing far more damage than the supposed terrorists they pursue, Reagan pardoned Felt for “[acting] on high principle to bring an end to the terrorism that was threatening our nation.”

However, some of the jaded cynicism about this ‘Deep Throat’ revelation must come from the fact that, in the years since his role as an informant helped change history, the use of anonymous sources has become somewhat debased and come under attack. Consider the contrast to the recent Newsweek source who leaked information on the desecration of the Koran at Guantanamo but recanted under the subsequent firestorm of pressure even as independent corroboration of the abuses emerged. I am not sure the calumny for that and similar situations, however, belongs with the sources so much as the news media. The debasement may be in the lack of thoughtfulness in which relationships with informants are built and evaluated, and in the rather more fist-in-glove relationship the mainstream media have with the corporate and political oligarchs these days. And now major news outlets are in the midst of restricting the use of unnamed sources only to situations where they are, essentially, unavoidable. (Another way to read that: only those rare situations where the saleability of the news they would provide outweighs the potential liability to the news outlet?)

Contemplating Felt’s heroics anew ought to reinspire us, at a time when an administration at least as malignant as Nixon’s reigns, to speak truth to power, despite its having become a trickier proposition these days with the degradation and cowardice of the ‘free press’. On the other hand, although I have long said that the techniques the powers-that-be use to control and spin consensus reality become ever more subtle, refined, and difficult to recognize, the Bush administration bucks that trend, lying more openly and clumsily than any other administration in recent history. I don’t know if it is because they craftily espouse the philosophy that hiding things in plain sight is the best strategy, or if it is just that their avarice and contempt for the people they rule makes them inept and stupid at what they do. In either case, you really don’t need a weatherman to know which way the wind blows these days.

Ramachandran is an astounding neuroscience thinker. I have written before about his thinking about “mirror neurons” and the extraordinary significance he — quite rightly — affords them in understanding human experience. Most neurologists are quite skittish about thinking about the neurological functions I consider nontrivial, things like thinking and feeling. If you have an interest in the relationship between the brain and the mind, forget the Mind Wide Open and Brain Hacks hyperbole and head straight for Ramachandran’s A Brief Tour of Consciousness and Phantoms in the Brain for more insights per square inch of printed page than you can handle. For a quick and dirty introduction, look at his 2003 series of five BBC radio lectures, The Emerging Mind (audio links and transcripts), to which I blinked when they emerged then.

And:

Big jpg image [thanks to Magpie]

(Yahoo! News)

I know this is nothing to laugh about, but I was thinking that these must be the men who are using the Viagra for autoerotic activities, right? Maybe they are the men whose women partners take the pill:

Related:

Sanctity of All Life??

And:

Just Shut it Down

While I agree, I also question the premise that the ‘talented’ people — the term he repeatedly uses — are confined to those who have made the devil’s bargain he posits, or that the thoughtful and caring among us opting out of the high-powered jobs is necessarily a tragedy we should restructure society to strive to prevent.

Also:

Study Tying Longer Life to Extra Pounds Draws Fire

Michael Kinsley, who has Parkinson’s Disease, on the Korean stem cell breakthrough:

BTW, here is a page that will remind you of the many notables who have made their Parkinson’s Disease diagnoses public.

This shy 18 year-old Queens College (NY) student and his older sister were murdered last week by his sister’s ex-boyfriend, who was implicated in the crime by Ng’s last weblog entry, written on May 12th while his killer waited in the other room. “Hopefully he will leave soon…” Here is New York Daily News coverage. At Ng’s site, hundreds of readers left comments to the post expressing their condolences to him and his sister for their murder.

I have written about this provision of NCBA before. It is good to see someone organizing around it:

Not a promising beginning. The reason sufferers know that they are being irrational in this ‘form of psychosis’, Lisa, is that it is not a psychosis. And PANDAS does not represent a link between a bacterium and a mental illness, but rather between autoimmune-mediated brain damage and a mental illness. Despite the effort to sensationalize it as a ‘compelling breakthrough’, this is neither new news nor monumental if put in the proper context. It is often the case that injury to certain brain regions causes behavioral disturbance. The author goes on to posit a false dilemma — “do these children need penicillin or Prozac?” — although it might not be either-or but both. If the streptococcal connection is true and patients may benefit from antibiotics, they may also benefit from the medications that help control obsessional thoughts and the resultant compulsive behaviors. Besides, as I understand it, if the theory that PANDAS is mediated by an autoimmune reaction (in which antibodies raised to react against strep cross-react against some brain tissue that is misrecognized by these antibodies) is correct, it ought not respond to antibiotics at all, since the presence of the bacteria is no longer necessary to fuel the continuing immune response once the body has mistakenly recognized the brain tissue as foreign. It may be a coincidence that some cases have responded to antibiotics, continued use of which is not a benign treatment, and no one has been able to advance a consistent theory of why it should work. While I have an open mind, I think it is much more likely that, as with other psychiatric illnesses, preexisting symptoms are exacerbated by an illness. Kids with OCD symptoms frequently test positive for strep because, well, kids frequently test positive for strep. Belkin, although trying to impute ponderous import to this controversy by throwing in overblown comments about how science thrives on disagreement, etc., actually does better in the second half of the piece describing the dilemmas children, families and treaters face when premature conclusions are drawn as to whether a condition has a psychological or a physical cause. Where she should have gone with that, if she really wanted to draw ponderous conclusions, would have been to indicate that that distinction itself is a specious one.

Not a promising beginning. The reason sufferers know that they are being irrational in this ‘form of psychosis’, Lisa, is that it is not a psychosis. And PANDAS does not represent a link between a bacterium and a mental illness, but rather between autoimmune-mediated brain damage and a mental illness. Despite the effort to sensationalize it as a ‘compelling breakthrough’, this is neither new news nor monumental if put in the proper context. It is often the case that injury to certain brain regions causes behavioral disturbance. The author goes on to posit a false dilemma — “do these children need penicillin or Prozac?” — although it might not be either-or but both. If the streptococcal connection is true and patients may benefit from antibiotics, they may also benefit from the medications that help control obsessional thoughts and the resultant compulsive behaviors. Besides, as I understand it, if the theory that PANDAS is mediated by an autoimmune reaction (in which antibodies raised to react against strep cross-react against some brain tissue that is misrecognized by these antibodies) is correct, it ought not respond to antibiotics at all, since the presence of the bacteria is no longer necessary to fuel the continuing immune response once the body has mistakenly recognized the brain tissue as foreign. It may be a coincidence that some cases have responded to antibiotics, continued use of which is not a benign treatment, and no one has been able to advance a consistent theory of why it should work. While I have an open mind, I think it is much more likely that, as with other psychiatric illnesses, preexisting symptoms are exacerbated by an illness. Kids with OCD symptoms frequently test positive for strep because, well, kids frequently test positive for strep. Belkin, although trying to impute ponderous import to this controversy by throwing in overblown comments about how science thrives on disagreement, etc., actually does better in the second half of the piece describing the dilemmas children, families and treaters face when premature conclusions are drawn as to whether a condition has a psychological or a physical cause. Where she should have gone with that, if she really wanted to draw ponderous conclusions, would have been to indicate that that distinction itself is a specious one.

The Picture of Everything by Howard Hallis.

“So next time you decide to get a case of road rage, think twice about who you might be screaming and swearing at through the windows.”

It is actually not hard, if you already hold our government’s behavior suspect, to realize you are a suspect. I suppose that is why most of my commenters sign their posts with pseudonyms. Is it too late, do you suppose, or should you do something like join the ACLU? I have been a card-carrying member for a long time.

The new technique promises to make creation of a cloned line of stem cells efficient enough that it can be reliably developed for any patient who might have the need. (New York Times ) What is as interesting as the therapeutic advance is the tapdance around terminology and spin. This is “therapeutic cloning” but both “therapeutic” and “clone” are loaded buzzwords to be avoided.

…and thought Abu Ghraib was an isolated incident. (New York Times )

Sorry, but as an inveterate Palm and iPod user I find virtually nothing appealing on kottke’s list. An iPod makes a lousy information appliance, and a PDA is, compared to my iPod, a lousy mp3 player. Many of these suggestions thus end up being downright silly, and the potentially useful information-access exploits are handled far far better on my PDA and thus to utilize my iPod in these ways becomes an intolerable compromise when no compromise is needed. Until I can get one data-access appliance that does everything my Palm Tungsten does and more and has at least a 40-80 Gb micro-drive and a music player interface and performance at least as good as my iPod, I have no qualms about carrying around two four* small appliances. Besides, how much worse (oh, around twice as bad?) you would feel, if it were all in one package and you lost it, than if you just lost your iPod or your PDA?

*Let’s not forget about my cellphone and digital pocket camera, another two devices for which one will not do. And, hey, while we’re at it, there’s also my GPS.

“Pat Buchanan speaks of American conservatism in the past tense. ‘The conservative movement has passed into history,’ (he says).” (Washington Times) Great lead sentence. However, I don’t think people should take heart, because what, in Robertson’s term, passes for conservatism these days has an unprecedented stranglehold on American political theater these days, even if Buchanan’s wing is going to fade out of the picture. And if you had any doubts about that, wait and see who is left standing tomorrow after the shootout over the filibuster.

I thought, facetiously, to headline this post with something about how they had finally started to deal with the true juvenile delinquents, or something like that. But this is nothing to laugh about, and is an indication of the extent of the failure in our early education system rather than the fault of the children, of course. While it has been recognized that early group daycare and preschool help socialize children, the corollary is that entering preschoolers are still essentially unsocialized. You don’t expel them for their behavior, you teach them, competently, to behave differently. (We sometimes make the same mistake in my field, the treatment of the acutely mentally ill — demanding they change some troublesome behavioral symptom before we can treat them rather than remembering we must treat their illness before their behavior can change.)

If we are going to place more and more children sooner and sooner in childcare situations so their parent or parents can continue to work fulltime (to earn the money to afford childcare…), careers in early childhood education have to be socially valued, encouraged and supported rather than remaining a marginal afterthought. No disrespect, by the way, intended to the daycare workers and preschool teachers, who are usually dedicated and heroic and always undercompensated for what they do.

From The Independent, this fascinating story of a man in his 20’s or 30’s found five weeks ago in dripping wet evening wear from which all the labels had been removed wandering near the Kentish seashore. Psychiatrically hospitalized, he has not said a word since and cowers in fright upon anyone’s approach. Left with pencil and paper, he produced a detailed sketch of a grand piano and, given access to a piano, he has played exquisitely for hours on end, including long pieces that appear to be his own compositions.

It is not clear whether he understands English, and he has not responded to entreaties in various Eastern European languages. Ironically, even though his caregivers have noted that “if you put him in front of a piano, his whole demeanour changes. He completely relaxes and is oblivious to people around him,” he has been moved to a different ward where there is no piano. He avoids television and radio and continues to produce his sketches of grand pianos. There has been an overwhelming response (BBC )to publication of his picture with requests for assistance from anyone who could identify him. However, curiously, his caregivers say they have not had the time to follow up on the most promising leads, and that they are not sure they will ever know who he really is. What’s up with that??

A number of theories about who is is, how he came to be found, and the nature of his distress are discussed in the article. He is such an enigma that the assumptions of those speculating about him may at this stage say more about them than about him. The extent of his fright and silence suggests traumatic amnesia to some, but I wonder about acute paranoia as well. The detail about his avoidance of t.v.’s and radios is something I have often seen in patients who are suffering an acute paranoid psychotic episode, who may feel that they are receiving messages through the media or that the devices can pick up and broadcast their thoughts. Of course, they don’t tell you that at the time; all you notice is that they avoid the media. Elective muteness is seen in acute psychosis as well, and I consider the deliberate obliteration of evidence of his identity (such as the removal of his clothing labels) more characteristic of a psychotic break than a post-traumatic condition. Several outlandish theories as to how he came to be in the ocean — e.g. that he was an asylum-seeker dropped off near the shore — are discussed, but without mention of the obvious possibility that he had attempted to kill himself by drowning. I hope those caring for him have also considered the possibility that his mutism, his possible amnesia, his acute fearfulness, his wandering, etc. are sequelae of a neurological rather than a psychological condition. I have at least one neurologist reader of FmH; I wonder what he thinks of the case. There are some conditions that would affect the so-called ‘speech centers’ of the brain but leave musical expression intact. A neurological workup would require procedures he may yet be too frightened to undergo, such as cerebral imaging studies and bloodwork.

We are hearing from his social worker and other ward staff; has his attending psychiatrist made any public statements? And why in the world don’t they (a) continue to facilitate his access to a piano; (b) bring in some people who know music better; and (c) get on the stick following up on those leads about who he is?

Let’s get serious. ‘Lingweenie’ is far more clever than the other examples, involving a double entendre as it does. IMHO, neither ‘ginormous‘, ‘confuzzled’, or ‘whoot’ really adds anything to the lexicon, since — duh — conveying that something is bigger than ‘gigantic’ means it is also inevitably bigger than ‘enormous’; usually, someone who is confused may be said to be puzzled too; and most joyful exclamations are both somewhat whoop- and hoot-like. Lingweenies indeed; it doesn’t take a rocket scientist to just conflate two synonyms… which is why, I guess, these words are not only not in the dictionary but probably will never be. I have never heard any of these terms used in conversation either — have you?That is possibly because I don’t hang with the right crowd, but I do hear my children and their peers do use ‘bazillion’ and ‘gazillion’, I’ll grant you that. You want neologisms by the bazillion, most of which are similarly destined for obscurity? See here.

I have seen far more clever word coinage compilations in The Atlantic‘s language columns in years past, BTW.

On a related topic, I heard an attorney interviewed on a radio broadcast today refer to her client, whom she felt had been unjustly accused, as an ‘escape goat’, and it didn’t sound as if she was deliberately trying to be clever. It really is a ‘doggy dog world’ out there for legal practitioners these days, isn’t it?

Senate Defies Bush, Approves Highway Bill (Yahoo! News)

…to a number of my friends married here in Massachusetts one year ago today, when they could finally join the ranks of those legally entitled to love and commit to whomever they please. (Yahoo! News)