the glory and the horror

Who needs the MMPI?

first time through:

Wackiness: 18/100
Rationality: 50/100
Constructiveness: 36/100
Leadership: 44/100

You are an SEDF–Sober Emotional Destructive Follower. This makes you an evil genius. You are extremely focused and difficult to distract from your tasks. With luck, you have learned to channel your energies into improving your intellect, rather than destroying the weak and unsuspecting.

Your friends may find you remote and a hard nut to crack. Few of your peers know you very well–even those you have known a long time–because you have expert control of the face you put forth to the world. You prefer to observe, calculate, discern and decide. Your decisions are final, and your desire to be right is impenetrable.

You are not to be messed with. You may explode.

2nd time through:

Basically the same.

Wackiness: 34/100
Rationality: 50/100
Constructiveness: 48/100
Leadership: 50/100

So I guess I’m basically an S-D-, which leaves me as a Mob boss, fountain of knowledge, dictator, or evil genius. Don’t mess with me, or I’ll blow your head off.

Seen today in the Dallas Morning News from New York Times columnist and author of China Wakes, Nicholas Kristof:

Jesus and Jihad
By NICHOLAS D. KRISTOF

So I’m in violation of copyright by posting the entire article, so you’ll have to hit the link and register at these newspapers for free.

**********************

And the rebuttal from Robert Spencer, the author of “Onward, Muslim Soldiers” and publisher of jihadwatch.org:
Are Left Behind books dangerous?

NO: Novels aren’t Scripture

Robert Spencer is the author of “Onward, Muslim Soldiers” (Regnery) and publisher of jihadwatch.org. His e-mail address is director@jihadwatch.org.

**********

Personally, I think Spencer shredded Kristof. Waiting for Jesus Christ to bring down wrath and judgment is quite different from militant Islam’s “jihad.”

So last night I took Phil out for his treat.  He had earned this treat by being such a stud and great help while I’ve been on my internal medicine rotation.  For example, he drove me into school at 4:30 one morning.  Then when I called him a few minutes later, he came back to bring me my stethoscope that I had forgotten in my own car.  Also, he brought up some ice-cream one day when I called him and asked him to do so.  On top of all that, he often comes to eat dinner with me at the cafeteria at the children’s hospital when I’m on call (i.e. I’m spending the night at the hospital).  So for his treat, he wanted to go to the movies and see I-Robot.  I suggested dinner and a movie and we ended up doing dinner and renting a movie.  I took him to a great place on Greenville called The Grape.  I first learned of this place my freshman year of college when my RA had a list of “best places to be kissed” posted on her door.  The Grape was one of them.  We had a fishy-fun time.  We had calamari for an appetizer and we both ordered some fish.  We sat outside and enjoyed having some fun time together.  J  It was certainly a treat for me too!

Isn’t she cute?
 

Derek Webb Message Board: Yes, I wouldn’t mind giving up some of those free meals and free pens and highlighters if it meant lower drug costs. I’d be the first to support that. However, given that the pens and meals are relatively cheap compared to the way other countries refuse to pay more, I’d say that there are a lot of places to ‘reclaim’ money. If other countries would not see the drugs as entitlements for their people, and if we spent less money on end of life care, and if drug companies didn’t give me free breakfast, lunch, pens, pads of sticky notes, dinner, etc., if execs didn’t take 120 million dollar salaries, yes, there are lots of places to cut costs.

And there’s also a lot of drugs given away free to people who need it. Ivermectin by Merck in Africa.

It’s a lot more complicated than just ‘they should be willing to charge less.’

Walmart and Starbucks are both all over China now. Interesting.

The AMA emailed me back and informed me that:

“There are 853,187 MDs in the U.S., which 248,300 are AMA members.”

The breakdown of those numbers are:

Students 47,899
Residents 26,643
Regular Dues paying Physicians, 87,007
Seniors 86,751

Which means that just under 30% of all medical students and doctors are in the AMA.

They definitely do not represent the whole of American medicine, and honestly, I don’t think I will renew my membership after I graduate.

It’s quite odd to think of myself that way, but that’s what I am. I’m sure Kathleen feels more of it, since she’s on her internal (eternal?) medicine rotation. The joke is quite apt in her situation, since she’s been QUITE busy, especially compared to me. I’m on inpatient psychiatry for the next 6 weeks, and it has been particularly low key lately – all the 3 days that I’ve been on this rotation.

I have really enjoyed this rotation, and I think I will continue to like it. Not just because of the schedule, but because the schedule and experience is just the right balance, I think, so that there is time to both see patients and be real to them, and because I get to think and write, as well.

There have been a number of interesting questions brought up in my mind.

1) Assuming a spiritual reality, which I do believe in, and assuming that that spiritual reality affects the physical reality, how much of psychiatric disorders is a result of actions in that spiritual reality? For example, could some of the voices that schizophrenics hear really be the voices of demons? Many, if not most, of those voices are often of a persecutory or depressive type – someone is out to get them, or that they’re not worth anything, or something to that effect. Modern American medicine does not take that into consideration at all, since it assumes that anything in the realm of the spiritual is untestable, and therefore not valid for consideration within the confines of the modern scientific method.

I’m not trying to say that all psychiatric illnesses are totally and completely spiritual in nature. That would be an extreme oversimplification. At the same time, we have little idea as to what some of these things are “caused” by. What leads someone to have grandiose delusions, to think that they are god? What leads people to simply stop listening to the world around them, and ascribe greater authority and validity to the voices in their head? On some level, beyond original sin, I would imagine that there’s something going on that may very well be the work of demons. As most of you readers ought to know, I’m definitely NOT of the charismatic or pentecostal tradition, but as a believer in a very active spiritual reality, I can’t ignore that. I also can’t ignore that our present treatment of these things is not going to begin to address that spiritual reality.

So if modern medicine doesn’t allow for the possibility of a spiritual reality when looking at patient treatment, where does that leave those who DO believe in a spiritual reality? There are a handful of books on Amazon.com, but none of them seem to have been read/reviewed adequately. There are some more focused books on Christianity and depression, or things like that, but little written on the fundamentals of being a psychiatrist applying the belief of a spiritual reality. If anyone knows a Christian psychiatrist, I’d like to pick their brain.

2) I am reminded of Thomas Szasz and his thoughts on the nature of psychiatry and the goals of the field. What is the purpose of having these classifications of various “illnesses?” He argues that they are little more than subjective ways to separate out those who are socially disruptive and only rarely, actually dangerous. After all, normal is just what most people define it to be, right? And so when someone hears voices in their head, they’re not “normal” because the rest of us don’t hear those voices.

If so, why do we involuntarily hospitalize these people and get court orders to force them to take their medication? Just about every other field in medicine allows patients to leave against medical advice, refuse treatment, and generally not listen to anything their treatment team says. After all, it’s a natural extension of autonomy.

I have read some rebuttals to Szasz, but am not convinced, given the great weight that autonomy is given in today’s culture and day-to-day medical practice.

Most people around here never comment, so if you have any ideas or thoughts, I REALLY want to know what you think. Comment like mad. Or even better, maybe post something over at Rasheed.

More to come later as I ponder and stew on stuff.

Rock Paper Saddam

Pleasantly amusing.

Fifty-nine deceits in Fahrenheit 911

I have not seen the movie, although this seemed like an interesting article someone pointed out to me. This is written by a journalist who voted for Nader last time around.

Third year started today. I am ambivalent about the orientation we received today. I am still processing some of the things they told me, and there are a couple of things I am profoundly disturbed by. I am wondering what is the role of depersonalization in patient care, and how that affects the health care provider’s ability to empathize and show concern for the patient and the patient’s family. I agree that we should not become too entangled so as to not be able to make decisions, but at the same time, I see no reason to totally wall off all emotion in regard to a specific situation or patient. I can imagine more than a couple situations where it would be beneficial and helpful in showing a patient and his/her family that you care by showing some real emotion.

If you were to completely hold back all emotion, does that include having an emotional motivation for practicing medicine? Is this an attempt to completely split the “rational” and the “emotional” as motivations and things that we “show” our patients? Granted, medical decisions should not be made based on emotional responses. But is good patient care devoid of emotional displays by the caregiver(s)?

A Letter to the American People from the Iraq-America Freedom Alliance