I don't post much any more, I could blame being busy, but I'm not that much more busy than before. I just haven't had much to say lately. As always I have been reading a lot.
In any case, the reason I decided to post today was to beseech y'all to read this:
The Madness of SPC Weichel.
30 March 2012
14 November 2011
The Vets Are Alright (The Rest of Us Are the Problem)
This post is cross posted over at the wonderful Gunpowder & Lead blog. They're the same post.
As I read through recent stories about military veterans one thing has crystallized for me: the relentless focus on injuries, PTSD, TBI and the soldier's and veteran's general distress.
Based solely on the media's portrayal of returning soldiers and veterans one would believe them all to be fragile individuals whose lives may shatter at the slightest additional trauma. However, the vast majority of soldiers return healthy and capable, even if they are forever changed by their experience serving. That is to say, we seem to live in a world where the afflictions of soldiers are covered in the media like airplane crashes, rather than car accidents:
While the media's predilection for rare and extraordinary stories has been well documented what's more important than the coverage itself is the nature of the coverage. For example: this October 2010 Washington Post article, Traumatic brain injury leaves an often-invisible, life-altering wound. This article is typical for its genre, coming in at nearly 3,000 words, yet devoting only a few sentences to any sort of wider context. We are told the raw number of diagnoses of TBI since 2000, then given another, larger, number from a RAND corporation study. Completely missing is any sense of scale. Do those 180,000 (or is it 300,000?) soldiers represent 1%, 10%, or 90% of individuals at-risk for TBI?
As I read through recent stories about military veterans one thing has crystallized for me: the relentless focus on injuries, PTSD, TBI and the soldier's and veteran's general distress.
Based solely on the media's portrayal of returning soldiers and veterans one would believe them all to be fragile individuals whose lives may shatter at the slightest additional trauma. However, the vast majority of soldiers return healthy and capable, even if they are forever changed by their experience serving. That is to say, we seem to live in a world where the afflictions of soldiers are covered in the media like airplane crashes, rather than car accidents:
Page-one coverage of airplane accidents was sixty times greater than reporting on HIV/AIDs; fifteen hundred times greater than auto hazards; and six thousand times greater than cancer, the second leading killer in America after heart disease.To be sure, PTSD, TBI, amputations, automobile accidents, plane crashes, and cancer deaths are all very real and very tragic but it's long past due that we consider the consequences of our relentless focus on the those afflicted by war because they are real as well.
While the media's predilection for rare and extraordinary stories has been well documented what's more important than the coverage itself is the nature of the coverage. For example: this October 2010 Washington Post article, Traumatic brain injury leaves an often-invisible, life-altering wound. This article is typical for its genre, coming in at nearly 3,000 words, yet devoting only a few sentences to any sort of wider context. We are told the raw number of diagnoses of TBI since 2000, then given another, larger, number from a RAND corporation study. Completely missing is any sense of scale. Do those 180,000 (or is it 300,000?) soldiers represent 1%, 10%, or 90% of individuals at-risk for TBI?
03 October 2011
Misdirection by euphemism
As I watched the news a few weeks ago waiting to see if, and then when, the state of Georgia would execute Troy Davis—a man wrongly convicted at worst, or unjustly sentenced at best—something about the images from outside the prison struck me: The innocuous and anodyne name of the prison, the Georgia Diagnostic and Classification Prison.
Naming the prison this way asserts that the public should know that this facility is where diagnosing and classifying occur. While it's undeniably true that those terms do accurately convey some of the actions that the Georgia Department of Corrections carries out there, it begs the question: Why are these functions of this prison so vital as to claim space in its very name?
George Orwell, in his famous 1946 essay Politics and the English Language said, "In our time, political speech and writing are largely the defense of the indefensible." It is a coincidence of history that only a year later the United States would consolidate the belligerently named Departments of War and Navy into the comparatively docile Department of Defense.
The labels a culture applies to its institutions serve a purpose beyond mere identification: they signal the purpose and expectations by which we should judge them. This is why those two superfluous words in the Georgia prison's name are so important. They were not chosen lightly, nor were they included in the prison's title carelessly.
Let's examine the word diagnostic closely (classification's particulars ought to be self evident afterward). Beyond its definition, the verb diagnose is notable because it is overwhelmingly used to indicates a label applied by an authority. To wit: the OED's first usage example for diagnose is, "doctors diagnosed a rare and fatal liver disease." One can easily construct other common usages, e.g., "the mechanic diagnosed the problem with the car."
No matter the usage example, they all refer to situations where higher-information individuals (or professions, or institutions) apply a label to something. To put it more simply, diagnosis is an act of profound authoritarianism. While the authoritarian implications of both diagnosis and classification are important, the more subtle endorsement is toward the medical usage. It is no accident that diagnose's usage example invokes the medical profession.
Naming the prison this way asserts that the public should know that this facility is where diagnosing and classifying occur. While it's undeniably true that those terms do accurately convey some of the actions that the Georgia Department of Corrections carries out there, it begs the question: Why are these functions of this prison so vital as to claim space in its very name?
George Orwell, in his famous 1946 essay Politics and the English Language said, "In our time, political speech and writing are largely the defense of the indefensible." It is a coincidence of history that only a year later the United States would consolidate the belligerently named Departments of War and Navy into the comparatively docile Department of Defense.
The labels a culture applies to its institutions serve a purpose beyond mere identification: they signal the purpose and expectations by which we should judge them. This is why those two superfluous words in the Georgia prison's name are so important. They were not chosen lightly, nor were they included in the prison's title carelessly.
Let's examine the word diagnostic closely (classification's particulars ought to be self evident afterward). Beyond its definition, the verb diagnose is notable because it is overwhelmingly used to indicates a label applied by an authority. To wit: the OED's first usage example for diagnose is, "doctors diagnosed a rare and fatal liver disease." One can easily construct other common usages, e.g., "the mechanic diagnosed the problem with the car."
No matter the usage example, they all refer to situations where higher-information individuals (or professions, or institutions) apply a label to something. To put it more simply, diagnosis is an act of profound authoritarianism. While the authoritarian implications of both diagnosis and classification are important, the more subtle endorsement is toward the medical usage. It is no accident that diagnose's usage example invokes the medical profession.
14 September 2011
One thousand and seventy words about mental healthcare
I'm currently doing a psychiatry rotation at an outpatient behavioral health clinic which primarily serves the substantial indigent population here. I've tried to sit down and write about the experience but all that comes out is a structureless jeremiad about the tragedy of a shredded safety net and those with psychiatric problems.
Rather than subject you to that I'd rather just present this chart by Bernard Harcourt (much more here):
03 August 2011
JAMA and the NYT don't understand PTSD
The New York Times has a new article about a recent study examining the adjunctive use of Risperdal in treating PTSD. Specifically, patients who were already taking a serotonin reuptake inhibitor either were, or were not, given Risperdal as well. Via a variety of metrics they were then assessed after six months to see if the Risperdal made a difference.
Let's begin where the article does, with its headline, "Drugs Found Ineffective for Veterans’ Stress". First of all, the study only examined one drug (granted, it did so in conjunction with a myriad of others, but its findings all relate to one drug), making the Times' use of the plural deeply wrong. In case you want to excuse the writer (Benedict Carey) and just blame the editor for a careless headline, here's the first sentence, which abuses the plural as well, "Drugs widely prescribed to treat severe post-traumatic stress symptoms for veterans are no more effective than placebos and come with serious side effects, including weight gain and fatigue, researchers reported on Tuesday."
Not only does the sentence abuse its subject to over sensationalize the story, the entire second half exaggerates the research findings upon which this article is based. The research author's only comments on the side effects of Risperdal were, "Adverse events associated with risperidone were not serious."
Let's begin where the article does, with its headline, "Drugs Found Ineffective for Veterans’ Stress". First of all, the study only examined one drug (granted, it did so in conjunction with a myriad of others, but its findings all relate to one drug), making the Times' use of the plural deeply wrong. In case you want to excuse the writer (Benedict Carey) and just blame the editor for a careless headline, here's the first sentence, which abuses the plural as well, "Drugs widely prescribed to treat severe post-traumatic stress symptoms for veterans are no more effective than placebos and come with serious side effects, including weight gain and fatigue, researchers reported on Tuesday."
Not only does the sentence abuse its subject to over sensationalize the story, the entire second half exaggerates the research findings upon which this article is based. The research author's only comments on the side effects of Risperdal were, "Adverse events associated with risperidone were not serious."
30 July 2011
On pseudonymity
Back when I wrote this post explaining why I blog under a pseudonym I promised a second post about some of the credibility issues surrounding it.
While I've been busy and a mostly written version of that post has languished, Kee Hinckley wrote an excellent piece examining pseudonymity, anonymity, credibility and everything else I would have mentioned. Her's takes on the topic through the lens of Google+, but nearly everything she writes is equally applicable to bloggers, so I encourage you to read it.
On Pseudonymity, Privacy and Responsibility on Google+ | Kee Hinckley | Technosocial | 27 July 2011
While I've been busy and a mostly written version of that post has languished, Kee Hinckley wrote an excellent piece examining pseudonymity, anonymity, credibility and everything else I would have mentioned. Her's takes on the topic through the lens of Google+, but nearly everything she writes is equally applicable to bloggers, so I encourage you to read it.
On Pseudonymity, Privacy and Responsibility on Google+ | Kee Hinckley | Technosocial | 27 July 2011
15 July 2011
Another note on posting frequency
It occurs to me that I may have mistakenly given the impression awhile ago that I would return to my old, prolific posting frequency after I took my board exam a few weeks ago. In any case, it'll probably be another month or more before I get back to that sort of frequency. This month, and August I'm on surgery rotations which, while very interesting, are hugely time consuming.
I've got plenty of grist for material in the future (especially some interesting looking research using β-blockers to treat PTSD), but won't really have time to write well thought out posts for awhile.
I may throw up some shorter posts in the near future, but no promises.
I've got plenty of grist for material in the future (especially some interesting looking research using β-blockers to treat PTSD), but won't really have time to write well thought out posts for awhile.
I may throw up some shorter posts in the near future, but no promises.
02 July 2011
Novartis made a mistake which no one will learn from
The Last Psychiatrist has a post over at Partial Objects pointing out, and musing on some recent…revisions…to the psychiatric drug Fanapt's marketing materials. The short of it is that they have been mistakenly advertising the drug's affinity for a particular receptor type as 100x less than it actually is (this would lead to the impression among clinicians reading such material that the drug is unlikely to bind to and impair its function). His post isn't long, and if you don't read it I can't guarantee that my post will make sense to you. Though I can't guarantee that it will make sense after you read his post either.
I did a bit of looking and it doesn't appear that Novartis has actually updated the FDA approved drug label for Fanapt (at least not the one on DailyMed). Whether they're updating their marketing material while the new label languishes in approval limbo, I don't know.
I did a bit of looking and it doesn't appear that Novartis has actually updated the FDA approved drug label for Fanapt (at least not the one on DailyMed). Whether they're updating their marketing material while the new label languishes in approval limbo, I don't know.
Subscribe to:
Posts (Atom)