That’s all, folks

I’ve scoured the interwebs and continue to come up empty.  Suffice to say that the US is a predatory, brutal place with a societal culture that promotes predation.  As someone who was committed to patient advocacy, and yet failing miserably when I needed and sought help, I don’t want to lead others on a wild goose chase predicated on false hope and foolish optimism.  Those lead to betrayal, failure and more suffering.

That, in all of this medical mecca town, not a single psychiatrist, psychologist, psychiatric social worker or academic program offers any effective care and treatment to reduce unbearable psychological distress, nor is interested in doing so, speaks for itself.

That no one is interested on this blog or any other in discussing approaches or treatment alternatives sends a clear message.

Only I can find a place on the interwebs where no one else resides and Google turns up no results. WordPress putting all of my blog posts and comments on other WP blogs into spam was also a large factor in stopping.

In how many ways can one be ostracized?  I’ve lost count.  But I also just don’t give a damn anymore. They’ve got me where they want me – disappeared so as not to ugly up the place.

For the all one person (annalaw, that would be you) who read and commented, I am very grateful and appreciative.  I wish you the best in your quest for minimally acceptable care.

The reading list will remain in its messy, disorganized place.

And I will remain in this living hell until I can get myself euthanized and catch up to the social death.

Poverty of Thought

Steve Balt wrote a post about some of his take-away thoughts from the American Psychiatric Association conference.

Commenters responded with thoughtful, illuminating insights about the gestalt of extant American psychiatry.  I was gratified to read that David Healy‘s Pharmageddon book is being cited as important.  He emphasized understanding the history of how capitalistic forces have emerged as the predominant force in shaping psychiatry and in shaping policies and practices which directly affect patient treatment (I refuse to use the word, care, relative to psychiatry and mental illness treatment, because it has specific meaning in the helping professions, and it is absent here.) and patient outcomes.

Steve’s post and your response, along with Emily Deans’ highlights a type of “poverty of thought” rampant in organized psychiatry. One cannot successfully treat people without the people. The old adage, “the surgery was successful but the patient died,” is apt for this field, too.

From assessment – how do you know you’re asking the right, germane, and appropriate questions? (glaring example: asking patients about suicide plans instead of about intolerable psychache and unbearable distressors. The first results in patients’ loss of civil rights and incarceration/observation, etc., the second SHOULD result in an urgent/emergent treatment intervention to lower the levels of immediate distress and to devise a treatment plan to reduce/eliminate the causative distressors. But that would mean knowing the patient, his living conditions and intervening where social justice is required. Ew. Messy. Takes longer than writing a prescription.)

To patient relationships – currently based on legal coercion, deception, and adverserial threat

To treatment – psychotropic medication, invasive surgery, inducing seizures and electrical stimulation, plus a dollop of who-knows-what talk therapy

To outcome goals – treatment adherence (do patients name their goals of being that of treatment adherence? /derisive snorting) which are unrelated to patients’ perceptions and functions in quality of life

Everything. Everything is oriented toward the psychiatrist. These are psychiatrists‘ interests at work. Patients are simply objects upon which to act, and are the means toward psychiatrists’ rewards: professional reimbursement, the source of research funds, the means to publication, and fodder for career recognition and success.

It’s Alice down the rabbit hole or through the looking glass.

It’s wrong.

But that it’s making more psychiatrists increasingly uneasy and uncomfortable is a good thing.  Eventually, that uneasiness will increase until it becomes an unbearable, distressing force, and action will become inevitable, if not impulsive. (Yes, I’m making a sarcastic swipe at extant suicide risk assessment, but I’m not going to advocate for incarcerating the poor psychiatric victims – in this case, the psychiatrists.  Maybe a little cognitive behavioral therapy so that they can recognize their distorted thoughts, and a round of ECT to jolt them out of their depression about their situation…)

Intentional Complications

Empty suit

Because THAT helps to explain this:  the fundamental devolution of the practice of medicine, psychiatry and nursing with the concomitant declining health and welfare of the citizenry in the US.

Truth?  Whose truth?

Branding?

Market share?

Global leadership?

Cui bono?

Harvard.

Substitutions

I follow food and nutrition science to some extent.  This caught my attention:

It’s been a profitable venture for the drug companies, as well as for the professors and their universities. Agriculture schools increasingly depend on the industry for research grants, a sizable portion of which cover overhead and administrative costs. And many professors now add to their personal bank accounts by working for the companies as consultants and speakers. More than two-thirds of animal scientists reported in a 2005 survey that they had received money from industry in the previous five years.

Yet unlike a growing number of medical schools around the country, where administrators have recently tightened rules to better police their faculty’s ties to pharmaceutical companies, the schools of agriculture have largely rejected critics’ concerns about industry cash. Administrators have set few limits on how much corporate money agricultural professors can accept. Faculty work with industry is governed by confidentiality rules that veil it from public view.

In certain ways, the close relationship between animal scientists and pharmaceutical companies has never served the public well. Few animal scientists have been interested in looking at what harm the livestock drugs may be causing to the cattle, the environment, or the people eating the meat. They’ve left most of that work to scientists outside of agriculture, consumer groups, and others who take interest.

But with the introduction of Zilmax, the situation may have reached a tipping point. Critics say some academic animal scientists have become so closely tied to the drug companies that they may be working more in the companies’ interests than in those of farmers and ranchers—the very groups that land-grant universities were created to serve.

Substitute patient for beef cattle and psychiatrist/primary care physician for animal scientist and voila! Patients growing enormous and iatrogenically ill and diseased on second generation antipsychotics, and their physicians so entangled with pharma and medical device industries that they fail to serve patients’ interests.

The Chronicle of Higher Education isn’t usually where I find in depth whistle-blower investigative reporting.  Read the entire article.  It will (or should) make your hair stand on end.

Ethics and malfeasance, anyone?

Social contract. In pieces.

“The only one.”

English: Consequences of whistleblowing, from ...

Update:  NPR just published a compelling story about Mr. Boisjoly, and it includes two audio interviews- one about his whistleblowing and one with his perspective after the fact. Listening to NPR’s Howard Berkes talking With Roger Boisjoly In 1987 is incredibly heartbreaking.

I am ashamed that I have not always intervened to stand with those who stand alone.  Now I am a liability to others.  A pariah is not a help, but just more weight dragging the person farther down the rabbit hole.

Read the NYTimes’ activist obituary, if there is such a thing, and feel just a bit of what this man experienced.

Six months before the space shuttle Challenger exploded over Florida on Jan. 28, 1986, Roger Boisjoly wrote a portentous   memo. He warned that if the weather was too cold, seals connecting sections of the shuttle’s huge rocket boosters could fail. “The result could be a catastrophe of the highest order, loss of human life,” he wrote.

Mr. Boisjoly’s memo was soon made public. He became widely known as a whistle-blower in a federal investigation of the disaster. And though he was hailed for his action by many, he was also made to suffer for it.

Mr. Boisjoly … died in Nephi, Utah, near Provo, on Jan. 6. He was 73. His death was reported only locally at the time. He lived in southwest Utah, in St. George. His wife, Roberta, said he recently learned he had cancer in his colon, kidneys and liver.

But before then he had paid the stiff price often exacted of whistle-blowers. Thiokol cut him off from space work, and he was shunned by colleagues and managers. A former friend warned him, “If you wreck this company, I’m going to put my kids on your doorstep,” Mr. Boisjoly told The Los Angeles Times in 1987.

He had headaches, double-vision and depression, he said. He yelled at his dog and his daughters and skipped church to avoid people. He filed two suits against Thiokol; both were dismissed.

He later said he was sustained by a single gesture of support. Sally Ride, the first American woman in space, hugged him after his appearance before the commission.

“She was the only one,” he said in a whisper to a Newsday reporter in 1988. “The only one.”

His obituary lists family.  I hope they brought him solace and comfort.  Families mostly don’t survive intact. He was only 73.

The sole study (small, Australian) that looked at the health effects of whistle blowing listed 17 of 35 people admitting to suicidality.  The suicide rate couldn’t be ascertained because the study was done in questionnaire format and only used a single sampling. But adverse significant health effects were 100%.

100%

I know – you don’t believe me because you are a GOOD person, and you live in a society with safety nets for this type of thing. But here’s the gist of it:

OBJECTIVE–To examine the response of organizations to “whistleblowing” and the effects on individual whistleblowers. DESIGN–Questionnaire survey of whistleblowers who contacted Whistleblowers Australia after its publicity campaign. SETTING–Australia. SUBJECTS–25 men and 10 women from various occupations who had exposed corruption or danger to the public, or both, from a few months to over 20 years before. RESULTS–All subjects in this non-random sample had suffered adverse consequences. For 29 victimization had started immediately after their first, internal, complaint. Only 17 approached the media. Victimization at work was extensive: dismissal (eight subjects), demotion (10), and resignation or early retirement because of ill health related to victimization (10) were common. Only 10 had a full time job. Long term relationships broke up in seven cases, and 60 of the 77 children of 30 subjects were adversely affected. Twenty nine subjects had a mean of 5.3 stress related symptoms initially, with a mean of 3.6 still present. Fifteen were prescribed long term treatment with drugs which they had not been prescribed before. Seventeen had considered suicide. Income had been reduced by three quarters or more for 14 subjects. Total financial loss was estimated in hundreds of thousands of Australian dollars in 17. Whistleblowers received little or no help from statutory authorities and only a modest amount from workmates. In most cases the corruption and malpractice continued unchanged. CONCLUSION–Although whistleblowing is important in protecting society, the typical organisational response causes severe and longlasting health, financial, and personal problems for whistleblowers and their families. (emphasis throughout is mine)

I know how difficult it is to stand alone and support a person who has been ostracized.  There is real risk to do that.  So like other whistle-blowers, I don’t ask, and I never expect it. Moreover, people will not TOUCH whistle-blowers.  Whistle-blowers are literally toxic. That is why Mr. Boisjoly was so profoundly TOUCHED by Dr. Ride’s gesture.

But, hot damn, Sally Ride stood there and HUGGED him.  In public. If that isn’t a meeting of heroes, I don’t know what is. Funny thing is that she retired from NASA later that year, and in 2002, she was appointed to the Space Shuttle Columbia Accident Investigation Board. Accidents still happened.  Same old boring story – multiple Swiss cheese systems failures because the people advocating for time out and caution were over-ridden by those who gun always for the shareholders’ (lobbyists/politicians and their corporate overlord shareholders) bottom lines.  Sacrifices always have to be made by those who will never come into contact with the bottom feeders liners.

Professor Liam Donaldson, the chief medical officer for England’s National Health System, wrote,

We should “applaud heroes, and hope they are among us, but to base our hope of remedy in ordinary systems on the existence of extraordinary courage is insufficient.”

I’ve pretty much scoured the literature, and no one addresses whistle-blowing, ostracism and suicide.  No one addresses the life ruination, the total and complete losses, and the resultant world goes on while leaving the whistle-blower (and surviving family, if any) in literal limbo.

And really, it’s the perfect crime.  Because it’s like Holmes’ dog that didn’t bark.  No one notices the absence of whistle-blowers.  No one sees them missing in group photos, nor misses their names in employee recognition events, nor has any notion at all about their well-being. Much better than Jimmy Hoffa’s demise with that pesky media and all keeping his name alive and the issues addressed.

Whistle-blowers are disappeared much more cleanly and completely than any CIA black site prison. The torture leaves no mark.

Retaliation against whistleblowers at all time high

English: A woman protesting weak protections f...

Image via Wikipedia

It would be more humane to just kill them instead of the slow excruciating social death that they inflict.

While reporting of the wrongdoing was at an all-time high, so too was the backlash against those employees who blew the whistle, the research revealed. More than 1 in 5 employees who reported misconduct experienced some form of retaliation, which ERC President Patricia J. Harned said spells trouble.

“Retaliation against whistleblowers and pressure on employees to compromise their ethics standards are at or near all-time highs,” Harned said. “These are factors that historically indicate that American business may be on the cusp of a large downward shift in ethical conduct.”

 

Overall, the strength of corporate ethics cultures is at its weakest since 2000, the report said.

Hobbes and the Holidays

Rough Collie named Jack[N.B. This is an old post from a defunct blog whose title I had forgotten.]

Hobbes and I found each other when he was just a large puppy.

At that awkward age – adolescence –  when puppies look like dogs but definitely act like puppies; Hobbes had been given up by his owners. A new baby, and a new apartment, and Hobbes landed with a breed rescue group.

He was produced by an anonymous backyard breeder. You know, the ones looking to make a quick buck with any old dam and sire. You see their ads in the newspaper classifieds and now on the Internet. “Collies, tris and sables, AKC Reg. $150 Parents on premises.”

Translated that means, “I bred the first male I could find to the first female I could find. The American Kennel Club doesn’t care – all that the registration papers mean is that the family tree is known. Not that I give a hoot if it’s a good line of breeding. Vet care? That costs too much. Blind? How would I know? I need some extra cash for the holidays. And people always love puppies. What happens if they don’t get them altered? Why should I care what they do with them after they’re sold. Pet overpopulation? Not MY problem. I have RIGHTS, you know. This is AMERICA!”

And so Hobbes, his extra long collie muzzle ducking toward his tail, shyly allowed me to hoist him into my car and off for the ride home.

He was so shy, this tall, dark and handsome collie. I didn’t know that collies came in colors other than the TV issue “Lassie sable and white with a white stripe on the face.” But Hobbes had a rich dark brown coat with subtle highlights of sable eyebrows and sable legs and white stockings on his elegant and incredibly nimble feet.

By the time we arrived home from the foster family‘s house, Hobbes had crawled into the front seat and was leaning against my side very politely. We were fast friends as he bounded out of the car.

I learned of the official collie burp. It’s produced solemnly and with dignified presence. It’s subtle, yet distinctive, to purebred collies.

I learned of the fondness of a collie for a cool floor on which to luxuriate. Collies stretch from their noses to their tail tips, and Hobbes was masterful at his stretching.

And I learned of the collie’s absolute love and enjoyment of all things snow-related. Want to throw snowballs? Call a collie to be your partner. Snow Angels? Make that snow collies, too! Call a collie in from the snow, and you will find a collie with a large ball of snow attached to his nose. His face will have an open smile exuberance about it, or perhaps a hint of a pout for curtailing such wonderful fun!

Hobbes had an affinity to watch over his very own herd of cats, most of which were older and sedate. In the first Spring we were together, I have several pictures of Hobbes posing before newly blossoming daffodils, when in each subsequent picture; a tabby cat face a la the Cheshire Cat emerges from the yellow conga line of swaying daffodils. And then Sir Cedric Cecilwycke Tabby Cat (pronounce that with a “Thufferin’ Thuccotash” lisp), approaches the posing Hobbes for first a friendly nose to nose sniff, and then on the last frame, a very friendly full body cat rub on Hobbes, to which Hobbes is bent over Sir Cedric looking for all the world to be his biggest best friend and protector.

Later, when it became clear that a retriever Hobbes was not, the veterinarian checked his eyes and with alarming directness, instructed us to make an urgent appointment to see a referring veterinary specialist at once. He thought Hobbes was developing a large brain tumor at age two. I had visions of dealing with a very untimely demise of a much-loved dog.

At the visit with Dr. Wyman, the nation’s foremost canine ophthalmologist, I nervously held a calm and polite Hobbes during the eye examination. As he gently supported Hobbes’ long muzzle, Dr. Wyman, without anything other than sincerity, soothed to Hobbes, “You are SUCH a fine gentleman.” And I knew exactly what he meant.

There was good news and not so good news. Hobbes had not a brain tumor, but he was blind. And he had been since birth. In collies, there is a condition where the cells that hold the retina in place fail, that in mammals turn wavelengths into vision; Hobbes had failed to develop the supporting structure. And so with the retina fallen flat into the eye orbit, there was nothing on which the wavelengths to convert to vision. Dr. Wyman stated that categorically, Hobbes was blind and always had been.

I was giddy with relief. For this dog had already been through obedience classes and had passed with flying colors. Hobbes was titled as a CGC – Canine Good Citizen, and that, he was! How he knew where to place his feet and his body, I could never tell. But until his last day, he was unerring in his footing. He ran with the horses, avoided the goofy goats, and herded the chickens and rabbits, all without a single misstep.

Hobbes was such a gentle and sensitive soul, and he served as a greeter and big brother to uncounted animals who came into rescue and later the animal sanctuary that was founded in his honor. He was directly responsible for the rescue, retirement and rehoming of many animals that had been deemed unadoptable and un-savable.

Early on, Hobbes enjoyed car rides, and he went with me everywhere. As he gradually became more of a homebody, I often had to seek him out, as he stayed out of the general hubbub of younger and more energetic animals.

Over the past month, the other two eldest collies – both rescued from awful abuse situations and taken to high kill shelters, died after fading. Hobbes had been very connected with them, and I held my breath to see if he would survive his grieving for them.

We – the rescued dogs and I – celebrated his 13th birthday on December 22, and I knew that he hadn’t much time left with me here. Without much hearing left and with increasingly unsteady legs, he still enjoyed rooting for a passing bicyclist, but he was slowing a bit more each day.

On Christmas Eve, I insisted that he sleep inside, rather than on the three-season porch, as was his wont.

On Christmas Day, his gaze was unfocused, and his breathing was shallow and rapid. I knew that he was quickly leaving.

So with plenty of hugs and a liberal dose of tears, I released him to travel on and join his friends, Toby and Dumpling and Napoleon, as memories of exquisitely beautiful and sensitive souls. And on Christmas night, I buried his body next to his other collie buddies and planted daffodil bulbs to remind me of other times and gentle breezes and young collie cavorting.

I miss my dear friend terribly, and I am so grateful that I had such a wonderful collie friend in Hobbes, the throwaway blind collie. But how I long for just one more time to find a long collie muzzle resting on my leg, demanding a pat and a smooch.