ShrinkWrapped

Lies, Damn Lies, and Statistics

The front page of Drudge has a dramatic headline:

'1 IN 5' AMERICANS MENTALLY ILL

The story is on CNBC and is quite dramatic:

Nearly 1 in 5 Americans had mental illness in 2009

More than 45 million Americans, or 20 percent of U.S. adults, had some form of mental illness last year, and 11 million had a serious illness, U.S. government researchers reported on Thursday.

Young adults aged 18 to 25 had the highest level of mental illness at 30 percent, while those aged 50 and older had the lowest, with 13.7 percent, said the report by the Substance Abuse and Mental Health Services Administration or SAMHSA.

The rate, slightly higher than last year's 19.5 percent figure, reflected increasing depression, especially among the unemployed, SAMHSA, part of the National Institutes of Health, said.

Dr Helen picks up on the story:

"The survey also found that 23.8 percent of women had some form of mental illness, compared with 15.6 percent of men."

Since we are in a "Mancession" where more men are losing jobs than women, it's interesting that fewer men were found to be mentally ill, given that they are the majority losing jobs. However, it could be that men do not report their symptoms as much as women do, or it could be biological--that women are more susceptible to depression or mental illness under stress. What's your take?

When I looked at the story my first thought was: How many of these people were unhappy rather than ill?  How many were feeling terribly stressed rather than Psychiatrically disturbed?  Then I noticed where the report came from: the Substance Abuse and Mental Health Services Administration or SAMHSA.  I have no idea who they are but have two questions:

1) How do they define "Mental Illness"?  It has become a protean concept meaning everything and anything from unhappy to abusive of Alcohol to committed to violent Jihad.  Loose definitions of Mental Illness serve to decrease personal responsibility and justify expanded government intervention in order to ensure treatment to all these ill people.

2) Why do we have a SAMHSA?  I suspect a great many of these "mentally ill" people would do better if they could find support in their community rather than from a Psychiatrist.

Why don't we reserve the concept of Mental Illness for those who suffer from a serious definable Mental Disturbance that brings the person far out of the (wide) limits of normal human variability?  I know this would decrease the income of some Psychiatrists, Psychologists, Social Workers, and various Counselors, but to be human is to function less than optimally much of the time, worse during periods of high stress.  Pathologizing human variability and behavior is a sign of, dare I say, Mental Illness.

Its Their Nature: 1A

The discussion in the comments was particularly rich and informative.  I did not mean for the post to be primarily about George Soros, but he is certainly a worthy topic of discussion since so much of what he believes and supports is inimical to what many of us believe are the best values and principles upon which America is built.  There is an important point I would like to reinforce.  This is a principle that animates Psychoanalytic thinking and is useful to keep in mind; it is also one of the main reasons I try to avoid making Psychoanalytic interpretations of people I have not personally seen professionally.  To wit: All behavior, which is the result of multiple unconscious and conscious determinants, can have multiple explanations.

Consider a hypothetical wealthy Socialist, née Communist, who believes that a centrally planned and controlled society offers the best possibility for universal social justice.  Let us posit that this individual treats individuals who disagree with him as enemies and justifies all manner of cruelty in the service of his ideology.  He consciously believes that even the worst crimes are justified by the wonderful goals he has so clearly in mind; in fact, only through "breaking a few eggs" can the Socialist Utopian omelet be made.

Consider some of the kinds of unconscious organizations that might lead to such an outcome:

Our hypothetical, committed ideologue could be unconsciously quite sadistic.  His rationalization of torture and murder in the interest of his Utopian ideals could be based on an unconscious sadism, ie pleasure in the pain of others.  He may have been attracted to his ideology because he sensed that it would allow him to gain power over others, power which he could use to inflict pain.

On the other hand, he might be a Sociopath, simply lacking in fundamental empathy and uncaring about the lives of others.  Other people would exist as pawns for him to use for the furtherance of his own desires, often including sadistic desires, but not motivated primarily by sadistic wishes.

However, there are other explanations.

He could merely be extremely Narcissistic, perhaps even a Malignant Narcissist.  In this case he would derive no particular pleasure, unconscious or otherwise, from inflicting pain but rather, would value other people only in terms of how they affect his self worth and self esteem.  Idealized objects would be esteemed while those who have nothing to offer would be dismissed.  The true Malignant Narcissist in a position of power would use the most vile means to ensure that the adoring crowd remains an adoring crowd and thus what might look like sadism is actually not motivated by the gratification of pleasure in pain but rather the need to have object lessons for other potential opponents who fail to show the proper obeisance. 

Meanwhile the committed ideologue, who with his extra dollop of Narcissism arrives at his ideology via an intellectual process, may simply be someone who relates poorly to other people.  In his case, while he might love mankind, he doesnt have any particular connection to the individual man.  This is common in ideologues who love the people but despise (devalued) people. 

Finally, perhaps our hypothetical idealist has remained stuck in an adolescent Utopian position.  He truly cares deeply about people and wishes everyone to just get along without strife.  He is fearful of his own (and others') aggression and is committed to only doing good.  Perhaps he wants to save the planet and realizes that only by controlling other peoples' behavior can the world be saved.  His character is immature, poorly understanding of cause and effect, and thoughtlessly dangerous and controlling.

In reality, most people contain a mixture of elements from all sorts of unconscious determinants.  In the end, why they behave the way they do, as important as it would be to me if I were their Psychoanalyst, is minimally relevant to our current political straits, save when it can usefully help shape a way to undermine or attack them.  All of these people can be dangerous to others because they desire nothing less than to control others and should be opposed on their politics not their character.

NB: This does not mean that character doesnt count in our politicians; of course it does.  Character is probably the single most important element that determines whether or not we are safe placing our government in their hands.  However, although I may have some insights into the ways character forms and some ability to help people change, I have no more expertise in penetrating the public persona of the faux character too many of our politicians construct than anyone else.  In fact, most people today are experts in evaluating the character of others based on their public persona.  In 2008, a significant portion of the population got carried away with the projection of their own Utopian wishes onto a candidate who was purposely deceptive in his representations; we began to make amends two weeks ago.  Despite that, and my suspicions of his motives, I refuse to see Obama as an enemy.  He is an opponent and as such, I can oppose his policies without wishing to see him destroyed.

Its Their Nature

Character counts, whether we are talking about individuals or the characteristics which sum to form the base for a culture.  Character is the organization of defenses, identifications, and drive derivatives that define a person's identity; these traits and their organization are highly stable over long periods of time and are rarely consciously ego-dystonic (ie, people and cultures do not recognize such characteristics as self defeating or troubling.)  Character is the most difficult thing to change in an individual and changes only very slowly in a culture.  One way to change character is to find or develop a new Ego Ideal which then can be used to alter longstanding characteristics.  For example, an alcoholic, whose character has come to be dominated by his use of alcohol, can join Alcoholics Anonymous and exchange an Ego Ideal ("Life of the party", perhaps) for a new Ideal which includes Sobriety.  A "Loser" can exchange a failed Ego Ideal (to become a world famous soccer star, for example) for a more realistically available Ego Ideal (as a Shaheed for Islam, for instance) and shed his old character which was so wanting in exchange for becoming an esteemed warrior in his community. 

England is currently conducting the experiment to see if the character of the nation, forged over a thousand years, can be completely deformed in a single generation:

Britain on its knees, with a human rights noose round its neck

It is hard to overstate how much of a disaster for both Britain and the west is the British government’s decision – all but buried under yesterday’s Royal wedding media hysteria – to award an unspecified sum of compensation, estimated variously between £10 million and £30 million, to 16 former detainees of Guantánamo Bay to avoid running up a £50 million legal bill if their cases went to court, and to avoid the security service being forced to compromise its intelligence sources.

And what was the reason the British government faced this court case? Why, the ex-Guantanamo inmates claimed British complicity with torture. Not that the British committed torture, but that they were complicit with it. They claim that the UK fed information and questions to their interrogators, or gave information to the CIA so it could arrest British suspects overseas where they were tortured.

What was the torture to which they were subjected in Guantanamo and elsewhere? Well, there are a lot of claims but nothing, other than in three cases overall at Guantanamo, has ever been convincingly proved to be anything other than claims made by terrorist suspects. Those three were water-boarded.

In this case an idealized conception of Human Rights (equivalent to an individual's Ego Ideal), intolerant of anything less than a perfect application of the highest standards of legal jurisprudence, has replaced a more realistic set of standards that included, as part of the previously extant ideal, the protection of the English people and culture.  In effect, the Human Rights Lobby has been hijacked by the Left to use as a weapon against Western Civilization. 

The Left now argues in favor of such "liberating" cultural behavior as female genital mutilation and the treatment of women and children as chattel, a principle that the West abandoned long ago.  Being forced to wear a Burka and Niqab is now understood as granting women real freedom, not the faux freedom of women in the West who only think they are free.  In the United States a Left wing President and his courageous Attorney General have tried to bring their conception of Human Rights to the heart of New York but the results of the Ahmed Ghailani miscarriage has lead even the New York Times to understand that using the criminal justice system to punish Islamic terrorists may be problematic.

The character of the Left is nowhere better exemplified than in one of its most visible and prolific supporters.  Bookworm does a wonderful job of getting to the essence of the evil at his core:

George Soros: A missing moral compass

A lot of people have, through circumstances, been forced to do heinous things to survive.  As a child, I certainly met my fair share, since I grew up in a world of Holocaust and Killing Field survivors.  I knew people who worked dragging bodies out of the ovens; I knew people who sorted the teeth and hair removed from the dead bodies; I knew people who worked as slave labor in the factories, making weapons the Nazis used against the Allies; I knew Germans who survived Soviet concentration camps; and I knew people who survived the Killing Fields in ways that too terrible for them to describe.  I would’t dream of judging them.  I have no right to judge, and I have no will to judge them.  When one is completely brutalized and intentionally de-humanized, one does things that would be unthinkable in ordinary circumstances.

What distinguishes all the people I knew, though, when compared to George Soros is the fact that they judged themselves.  Without exception, each knew that, even though unwillingly, he or she had been complicit in deeply immoral acts, and each spent a lifetime seeking redemption.  All of them worked hard and were exemplary citizens, whether that simply meant avoiding doing harm or whether it involved more active engagement in altruistic acts.  Neither the absence of external judgment nor their own knowledge that they were responding to overwhelming external forces took that edge off.  They suffered twice, first in the doing and then in the ever-lasting guilt.  But it was the guilt that made them people of exceptional decency and humanity.

...

All of these stories, the ones I heard growing up, or the ones we read about in books such as The Road Out of Hell, have a clear message:  even the most horrific youthful experiences need not destroy a conscience.  Soros, however, seems to have no conscience whatsoever about his complicity with the Nazis.  Unlike the people I knew growing up, who lived with and worked daily to expiate their guilt, when he looks back, he’s good with it all.  When Soros was interviewed about his wartime experiences on 60 Minutes, he expressed no regret whatsoever (emphasis added):

KROFT: (Voiceover) And you watched lots of people get shipped off to the death camps.

Mr. SOROS: Right. I was 14 years old. And I would say that that’s when my character was made.

KROFT: In what way?

Mr. SOROS: That one should think ahead. One should understand and–and anticipate events and when–when one is threatened. It was a tremendous threat of evil. I mean, it was a–a very personal experience of evil.

KROFT: My understanding is that you went out with this protector of yours who swore that you were his adopted godson.

Mr. SOROS: Yes. Yes.

KROFT: Went out, in fact, and helped in the confiscation of property from the Jews.

Mr. SOROS: Yes. That’s right. Yes.

KROFT: I mean, that’s–that sounds like an experience that would send lots of people to the psychiatric couch for many, many years. Was it difficult?

Mr. SOROS: Not–not at all. Not at all. Maybe as a child you don’t–you don’t see the connection. But it was–it created no–no problem at all.

KROFT: No feeling of guilt?

Mr. SOROS: No.

KROFT: For example that, ‘I’m Jewish and here I am, watching these people go. I could just as easily be there. I should be there.’ None of that?

Mr. SOROS: Well, of course I c–I could be on the other side or I could be the one from whom the thing is being taken away. But there was no sense that I shouldn’t be there, because that was–well, actually, in a funny way, it’s just like in markets–that if I weren’t there–of course, I wasn’t doing it, but somebody else would–would–would be taking it away anyhow. And it was the–whether I was there or not, I was only a spectator, the property was being taken away. So the–I had no role in taking away that property. So I had no sense of guilt.

The only real question one is left with after reading the above is whether Soros was always a sociopath, or whether the war made him one.  As I said, I know people who went through worse than he did, and came out human.  He didn’t.  He came out a very intelligent animal, by which I mean that he lacks the moral compass that, to me, is the single most important distinction between humans and animals.

Please read her entire post; she includes an amazing story that I had never seen before, about a man who suffered and was complicit in terrible events as a child but became a "Good Man", a Mensch, when he escaped his prison.  The contrast with Soros is almost palpable.  I see people everyday who complain that their terrible backgrounds have left them in their current straits.  Their history of criminality, abuse, and other social pathology were the result of the mistreatment they suffered; this is a false narrative, a rationalization.  You can accept your poor treatment, eschew a moral compass, and perpetuate the evil, now as the active participant rather than the passive recipient, or you can exercise a moral choice and actively resolve to be and do better.  If it is true that 30% of people who were abused as children become abusive adults, it is more true that 70% do not.

These are examples of failures of character in the West.  What about the character of our enemies, the Death Eaters who seek nothing less than the destruction of our Civilization? 

This post is already long enough; Part II will follow.

The FDA Will Kill Us All*

* with the help of the Trial Lawyers.

[All posts in The FDA Will Kill Us All series are collected in the FDA archives.]

This post is less about the FDA than the entire Medical Treatment Liability Complex which makes Medical innovation more difficult and costly and threatens to destroy the Golden Goose completely by insisting upon a risk-free world.  The Precautionary Principle privileges an illusion of safety over every other consideration and in practice seems to be the animating principle of the litigation industry.

On Sunday the New York Times reported on an escalation of the fight against innovation, although it was certainly not discussed in such terms:

Investors Put Money on Lawsuits to Get Payouts

Large banks, hedge funds and private investors hungry for new and lucrative opportunities are bankrolling other people’s lawsuits, pumping hundreds of millions of dollars into medical malpractice claims, divorce battles and class actions against corporations — all in the hope of sharing in the potential winnings.

The loans are propelling large and prominent cases. Lenders including Counsel Financial, a Buffalo company financed by Citigroup, provided $35 million for the lawsuits brought by ground zero workers that were settled tentatively in June for $712.5 million. The lenders earned about $11 million.

Most investments are in the smaller cases that fill court dockets. Ardec Funding, a New York lender backed by a hedge fund, lent $45,000 in June to a Manhattan lawyer hired by the parents of a baby brain-damaged at birth. The lawyer hired two doctors, a physical therapist and an economist to testify at a July trial. The jury ordered the delivering doctor and hospital to pay the baby $510,000. Ardec is collecting interest at an annual rate of 24 percent, or $900 a month, until the award is paid.

It is a long article and you should read the whole thing to get the full flavor of the level to which modern ambulance chasers have stooped in the pursuit of immense sums of money which they can extract from the system.  I would like to point out that a large meta-analysis many years ago by the esteemed New England Journal of Medicine determined that most incidents of birth trauma which involved significant damage to the infant, in fact had nothing to do with the actual birth trauma but almost certainly had to do with pre-existing problems with the baby that precipitated premature birth or problematic births.  That did not stop people like John Edwards from making millions of dollars representing such damaged individuals and anyone who could object to the lottery winnings of such children and their families would have to have a heart of stone, but the damage to the greater medical system caused by such litigation is profound. 

We need to reorient our approach to risk assessment and tolerance in Health Care to more closely match the reality.  As I pointed out in Obamacare's Faulty Premise:

With the exception of some limited, mature, areas of medicine, all of modern medical practice represents a naturalistic experiment.

We have more proof of this in the news this week:

Docs Reassess Long-Term Use of Osteoporosis Drugs

Doctors are reassessing the long-term use of osteoporosis drugs because of the possible risk of side effects, including jaw necrosis and esophageal cancer, according to an article in the LA Times. The first osteoporosis drugs were launched about 15 years ago and are taken by millions to offset the bone-thinning disease. Doctors are recommending that some patients take a “drug holiday” by stopping their use for a period of time.

This is how Medicine works.  We identify a problem: Osteoporosis leads to premature morbidity and mortality, especially for women.  The much maligned Pharmaceutical industry invents or finds a wonder drug that can  treat Osteoporosis.  The FDA forces the Pharmaceutical industry to spend an average of $1.4 billion to show the drug is "safe and effective"; their findings are typically based on between 1000-3000 people using the drug for less than 3 months duration.  The findings of "safe and effective" are a mirage; $1.4 billion dollars later, we start the actual naturalistic experiment as first thousands and then millions begin to take the drug every day for years at a time.  Anywhere from 1-10 years down the road we discover that some subset of patients, unidentifiable by our current measures, can be severely damaged by the treatment.  Lawyers then sue, occasionally winning lottery settlements for themselves and a few "lucky" patients, many patients unnecessarily stop useful and life prolonging treatments out of fears promoted by the legal and media companies and their Doctors' worries about malpractice, and some patients find drugs that were uniquely valuable become no longer available (Vioxx.)  This is no way to run a health care system than is capable of amazing innovations.

[I don't watch much TV but over the last few weeks I have seen numerous commercials asking for Patients who have been harmed by Avandia or Chantix to contact some lawyers to sue for damages.  My "favorite" commercial was for patients or their families who have suffered Stevens-Johnson Syndrome to contact lawyers to sue for damages.  This is nearly the perfect example of the idiocy of our system.  Stevens-Johnson Syndrome is a very rare but potentially fatal skin reaction to any of a number of drugs.  I have seen one patient in the last 20 years develop Stevens-Johnson Syndrome and it is alarming.  After she failed a trial of an SSRI (Zoloft) I gave her Wellbutrin, an antidepressant that is almost unique in its mode of action and particularly helpful for certain kinds of major depression.  She had an initial excellent response and then over a weekend developed a rash near her mouth which then spread into her mouth; by the end of the weekend she was in the hospital; luckily she recovered uneventfully.  SJS is impossible to predict; there are no known tests for susceptibility, although perhaps soon we will be able to isolate the genetic variants that predispose one to developing the Syndrome.  Nonetheless, people are damaged by a treatment that is life saving for many more.  Now we have lawyers trolling for victims who they can leverage into a large class action suit against the makers of Wellbutrin and its generic offspring.  It will add to the cost of healthcare while doing nothing to increase the "safety and efficacy" of our treatments.]

We need tort reform and for the American people to demand to be treated like adults, capable of making their own risk assessments based on as much of the available data as they desire.  This does not mean that every drug should be available without any safety or efficacy testing; however, the FDA currently operates under the belief that the Precautionary Principle protects us whereas in reality it more often slows innovation and singularly fails to protect us from the rare terrible side effects of our treatments.  The belief that Medicine advances by exponential leaps rather than by incremental steps, underlies the FDA's faith int he Precautionary Principle.  Medicine rarely jumps by exponential leaps; it is rare for a new paradigm to sweep medicine and when new paradigms arise, for all the wonderful good they do, there are some who suffer:

Penicillin revolutionized how we treat life threatening infections yet some people still suffer and die from allergic prophylaxis from Penicillin.

Thorazine revolutionized the treatment of Schizophrenia, yet was eventually found to cause a terrible neurological condition, Tardive Dyskinesia, in as many as 30% of patients with long term use.

Meprobamate was the first effective medication treatment for anxiety yet it, and its offspring, the Benzodiazepines, were found to cause dependency and mental status changes in many who relied upon them long term.

Zyprexa was the first real anti-psychotic that helped with the negative symptoms of Schizophrenia (withdrawal, apathy) and was not dysthymic, yet with long term use as many as 30% who use Zyprexa, while no longer risking Tardive Dyskinesia, are at increased risk of developing Diabetes.

In Medicine when we attempt to manipulate our biochemistry, there is no free lunch.  We do not yet have the fine control of our proteome to pre-determine the best treatment for any particular patient or to guarantee a risk free treatment for any condition.  Let us deal with the reality of risk without the illusion, fostered by the FDA and leveraged by the Tort Bar, that we can live risk-free lives and that all medical care can be risk free.  All we are doing now is rewarding a few parasites and fewer unfortunates while preventing the majority from aging more slowly and gracefully.  It is past time for us to act like, and be treated like, adults.

Bob Herbert is a Closet Tea Party Supporter

He just doesnt realize it yet:

This Raging Fire

The terrible economic downturn has made it more difficult than ever to douse this raging fire that is consuming the life prospects of so many young blacks, and the growing sentiment in Washington is to do even less to help any Americans in need. It is inconceivable in this atmosphere that blacks themselves will not mobilize in a major way to save these young people. I see no other alternative.

The first and most important step would be a major effort to begin knitting the black family back together. There is no way to overstate the myriad risks faced by children whose parents have effectively abandoned them. It’s the family that protects the child against ignorance and physical harm, that offers emotional security and the foundation for a strong sense of self, that enables a child to believe — truly — that wonderful things are possible.

...

Dorothy Height, the longtime president of the National Council of Negro Women, who died in April at the age of 98, always insisted that blacks “have survived because of family.” And she counseled: “No one will do for you what you need to do for yourself.”

The Liberal welfare state has failed our Black citizens and neighbors horribly by infantilizing them and maintaining them as dependents of the "benevolent" government.  While Bob Herbert undoubtedly thinks that the economic downturn means that the money spigot is going to be turned off to the detriment of the Black community, in fact this could well be the only thing that saves them.  When people finally recognize that they must either take care of themselves or fail, some (hopefully most) will actually succeed.

The New Faces of Evil

Take a good look at these two faces.  They embody an evil at the heart of America that only Big Government can root out:

Although they are only 13, their crimes against the state must be nipped in the bud.  Their crimes against the Bureaucracy are heinous and chilling:  

THEY SOLD CUPCAKES WITHOUT A PERMIT!

When Andrew DeMarchis and Kevin Graff, two 13-year-olds from Chappaqua's Seven Bridges Middle School, set up shop at Gedney Park on a fall weekend last month, they were expecting a tidy profit.

Instead, the two wannabe entrepreneurs selling cupcakes, cookies, brownies and Rice Krispie treats baked by them for $1 apiece got a taste of cold, hard bureaucracy.

New Castle Councilman Michael Wolfensohn came upon the sale and called the cops on the kids for operating without a license.

Thank Gaea for Councilman Wolfensohn.  If these two criminals had not been caught, their plans could have undermined the entire corporate/bureaucratic structure of the state!  Notice how they had already corrupted two confederates! (/sarc)

DeMarchis and Graff, along with two other classmates, Zachary Bass and Daniel Katz, had a simple, if half-baked, business plan: sell their treats at Gedney Park for a couple of years and save up enough to open a restaurant.

Their first day was wildly successful, the boys said. They netted $120, of which they invested $60 to buy a cart from Target and added water and Gatorade to their offerings on their second day, the next Saturday, Oct. 9.

After about an hour of brisk business, during which DeMarchis and Graff — Bass and Katz were not with them — said they made $30, police arrived at their stand and asked them to shut it down.

This is the kind of petty idiocy that has grown in this country in the last 30 years as the State has grown larger and larger and its rules and regulations have metastasized and found their way into regulating more and more of our activities.  The Leviathan must have a purpose, and what purpose could be nobler than to tie down its citizens with more intrusive, and more petty, rules and regulations.  The result? Two 13 year olds have now been traumatized by the state:

"The police officer was extremely pleasant. He said he was sorry to have to do this, but that he was following up on a report filed over the phone by a Town Board member," said Suzanne DeMarchis, Andrew's mother, who was called to the scene. "Kevin was so upset, he was crying all the whole way home. He was worried if he was going to get arrested or have a criminal record."

In fairness, Wolfensohn may not be a bad guy; he might just be someone with a little power who has become so blinded by the forest of regulations he is charged with enforcing that he can no longer see what the role of government should be:

"All vendors selling on town property have to have a license, whether it's boys selling baked goods or a hot dog vendor," said Wolfensohn, who was elected to the board in 2007 after becoming well known in the community for leading a contentious, five-year effort to build a 9/11 memorial. The memorial ended up in Gedney Park after neighbors of the original location, the Duck Pond, sued.

Couldn't Wolfensohn have simply told the boys that they needed a license, the parents want to know, instead of calling the police?

"In hindsight, maybe I should have done that, but I wasn't sure if I was allowed to do that," he said. "The police are trained to deal with these sorts of issues."

These were a couple of bright kids trying to make a little money.  Their idea was pretty clever.  Perhaps the need for a permit could be justified, after all, lemonade stands have been closed for less, but the heavy hand of the bureaucratic state does not commonly tolerate reasonable interpretation of its regulations, its raisons d'etre.  The entire "zero tolerance" idiocy that allows petty satraps to avoid responsibility for their rigidity and inanity is all the illustration one needs of the stupidity which the system breeds.  Once the purpose of the Bureaucratic State has evolved to become primarily its own perpetuation and expansion, those caught up in its machinations lose all power of reason and reasonableness; laws and regulations increase exponentially and are never taken off the books.  We end up making any sign of independent thought, any creative enterprise, a threat to the system.

Allow one of the boys the last word:

For 13-year-old boys looking to make pocket money, there aren't many options, Suzanne DeMarchis said.

"I don't get too many offers for babysitting, and we live in a development, so shoveling snow is not an option either," said Andrew. "We were being entrepreneurs , but now I feel a little defeated."

The Future is Already Here

At HillBuzz, kevindujan01 asked a question and noted that behavior that was, literally, unthinkable because too far over the horizon 5 years go, is now commonplace and unremarkable:

QUESTION: What are the little moments that make you realize how much technology has changed, so fast?

Tonight, as my friends and I are out in Boystown I catch myself cruising every bar…for electrical sockets.

There is so much email that comes in for HB every day, including nonstop texts from people who somehow got my number, that my phone gets drained in just a few hours when we are out.

So, I now know where every electrical socket in every bar is located so I can plug in and recharge while seeing what everyone is up to in Boystown. It weirdly reminds me of the Decepticons obsessively searching for Energon cubes on the Transformers.

Never in a million years would I have imagined, as a kid in the 80s sitting on the floor watching cartoons, that I would be 33, writing columns on a pocket sized handheld computer, asking go-go boys if I could plug myself into their most convenient socket.

People who are not comfortable with technology have a sense of dislocation when contemplating such behavior.  The older a person is, the more estranged he is likely to be from technology.  On the other hand, if you are reading this blog, or watch video on Youtube, or live by your e-mail, you are involved in a project of hyper-connectivity that is redefining how human beings organize their relationships, from the most personal one to one relationships, to the ways in which we organize large groups.  There are implications of this hyper-connectivity, where everyone (who is connected) is potentially only one degree of separation from anyone else on the planet (who is connected.)

For the first time in human history there is a possibility that we will evolve toward a close approximation to a meritocracy.  Because of the internet and blogosphere, when the Emperors have no clothes, there will always be multiple voices pointing out that our Emperors are, in fact, naked.

It was the internet that exposed Dan Rather.  That was minor league however.  It was the internet that exposed the scam of AGW; that was a major league exposure of a potential power grab by international elites that would have been one more step toward the enslavement of the individual to the desire for power of our erstwhile Emperors.

The first comment to kevindujan01's post is from SFGoth:

This is exactly why, every chance I get, I berate people that say the gulf between rich and poor has never been greater. Are they nuts? It’s never been closer. Yeah, sure, most of us can’t afford to fly international first class, order $100 bottles of wine with dinner, or drive Maseratis, but holy great Caesar’s ghost Batman, we can still fly in fairly tolerable conditions, eat in restaurants to begin with, and drive cars. When has there ever been a better time to be the working poor? Are you nuts? When is the last time anyone adjusted the rabbit ears on their B&W, after waiting a few second for the vacuum tubes to warm up. Get real.

Gadgets is the new plastics. We’ve solved everything in life that materialism can solve. The rest is up to that metaphysical intersection of faith and love.

Not only are we changing in our relationships to each other, we are changing how our minds work.  I have always had a wonderful memory, however, now I no longer have to spend time and mental energy remembering the details of past information, (and since I am in my late 50's, not a moment too soon!)   All I need is a tiny piece of data, sometimes only a part of a word or an impression, and in no more than a few minutes of my time, I can find the information.  Song snippets that would once plague me for days trying to recall where I heard the line can now be clarified in mere moments.  It would require a currently impossible experiment (running an fMRI before the use of Google and comparing it to a post-Google fMRI after 3 months of use) but I am comfortable in believing that my brain's filing system has changed, becoming more streamlined and intuitive, because of the internet.  In the most prosaic sense, for many people such streamlining will simply leave them more time to follow the adventures of Paris Hilton or some other celebrity du jour, but for those who wish to be more productive, the less energy spent on maintaining historical connectivity with data, ie maintaining the archives, the more the ability to form associative connections will emerge.  Further as we out source our data base management to software, finding novel associative connections will become a skill that will reward its possessors in ways which will make an Eidetic memory seem like part of human prehistory.  In a small way, blogs like this one, as well as larger collaborative projects, are offloading and expanding our ability to create enhanced associative connectivity.

The upshot is that our relationships are being redefined moment to moment.  In the political sphere, we now see an old guard Republican party, soon to be extinct, coming into confrontation with the Tea Party Republicans.  The older, disconnected leaders do not understand that the world has changed.  At one  time they could operate under cover of darkness, make their money, make their friends and relatives more comfortable, and periodically appear before the public to tell us what great things they are doing for us.  This will not work anymore in an environment where handing off an earmark for one's friends and contributors shows up in an obscure blog the following day and then at Instapundit and Hot Air two days later. 

The Republicans who do not understand this will not remain in office for long.  We have already seen that the Democrat leadership misunderstands the environment in which they operate.  Operating under the belief that what the rubes don't know can't hurt their betters, Nancy Pelosi became the poster child for arrogance and disconnection.  She did not realize that, policy differences aside, a great many people facing economic straits would find noxious her need to use the Air Force as her personal private air line.

The hallmark of Homo sapiens is adaptability.  We are adapting to the age of hyper-connectivity as well as we adapted to every other technological advance, not without some serious dislocation, but with an admirable aplomb.  It will take more than the current pace of change to surprise people.  The Toflers were correct about Future Shock (though the evidence is that we, the people, are doing pretty well with the Future) but where they believed it would be disruptive for the individual, it is our institutions that are having the most trouble dealing with the future.

And the strangest changes are yet to come.  

The Future is already here: 

There Will Be Peace ...

When the Arab hatred of Jews diminishes; from Soccer Dad:

Mediterranean conference cancelled on account of cooties

When I read something like this Mediterranean summit canceled again due to Arab threat to boycott over Israel (via Daily Alert Blog)

An international summit of Mediterranean leaders has been canceled for the third time because Arab states threatened to boycott if Israel was invited.

I wonder how there's ever going to be peace.

So many in the media, along with diplomats and politicians fall all over themselves to criticize or condemn Israel for building in its own capital and yet not a single one seems concerned by this infantile hatred of the Jewish state.

And when the Arab hatred of Palestinians diminishes; from the Elder:

New Apartheid poster

Actually, I know full well that the Arab mistreatment of Palestinians is in the service of their dream of destroying Israel.  The Palestinians are simply the weapon most effective against Israel.  Perhaps someday the Arabs will learn to hate less; when that happens, Peace will come.

Some Difficult Truths About Supplemental Security Income

Yesterday The Last Psychiatrist wrote a rather impassioned denunciation of the use of SSI to promote social justice.  He made some interesting connections between Psychiatry and Sociology:

The Terrible, Awful Truth About Supplemental Security Income

I.  I need to write this and get it posted before the Fingermen come and black bag me.

So you want to file a psychiatric disability claim against your former employer?  Too bad. 

Say you're poor and have never worked.   You apply for Welfare/cash payments and state Medicaid. You are obligated to try and find work or be enrolled in a jobs program in order to receive these benefits.  But who needs that?   Have a doctor fill out a form saying you are Temporarily Incapacitated due to Medical Illness.  Yes, just like 3rd grade.  The doc will note the diagnosis, however, it doesn't matter what your diagnosis is, it only matters that a doctor says you are Temporarily Incapacitated.   So cancer and depression both get you the same benefits.

Nor does it matter if he medicates you, or even believes you, so long as he signs the form and writes "depression."(1) The doc can give you as much time off as he wants (6 months is typical) and you can return, repeatedly, to get another filled out. You can be on state medicaid and receive cash payments for up to 5 years. So as long as you show up to your psych appointments, you'll can receive benefits with no work obligation.

II.  "That's not how it works for me!"

...you might say, which brings us to the whole point: it's not for you. It is for the entire class of people we label as poor, about whom comic Greg Geraldo joked: "it's easy to forget there's so much poverty in the United States, because the poor people look just like black people." Include inner city whites and hispanics, and this is how the government fights the War On Poverty.

In the inner cities, the system is completely automated. Poor person rolls in to the clinic, fills out the paperwork (doc signs a stack of them at the end of the day), he sees a therapist therapist, a doctor, +/- medications, and gets his benefits.

There's no accountability, at all. I have never once been asked by the government whether the person deserved the money, the basis for my diagnosis-- they don't audit the charts, all that exists is my sig on a two page form.  The system just is.

III.   But what happens when your five years on the dole are up?

Enter SSI, Supplemental Security Income. You can earn lifetime SSI benefits (about $600/mo + medical insurance) if "you" can "show" you are "Permanently Disabled" due to a "medical illness."

"You"= your doc who fills out a packet with specific questions; and maybe a lawyer who processes the massive amounts of other paperwork, and argues your case, and charges about 20% of a year's award. 

"show" has a very specific legal definition: whatever the judge feels like that day.  I have been involved in thousands of these SSI cases, and to describe the system as arbitrary is to describe Blake Lively as "ordinary."

this non-sequitor here entirely for my own benefit.  Thank you for your patience

"Permanently disabled" means the illness prevents you from ever working.  "But what happens when you get cured?"  What is this, the future?  You can't cure bipolar.

"Medical illness" means anything.  The diagnosis doesn't matter, only that "you" show how the diagnosis makes it impossible for you to work. Some diagnoses are easier than others, but none are impossible.  "Unable to work" has specific meaning, and specific questions are asked: ability to concentrate, ability to complete a workweek, work around others, take criticism from supervisors, remember and execute simple/moderately difficult/complex requests and tasks, etc.

Fortunately, your chances of being awarded SSI are 100%. ("Not for me!"  Again, it's not for you.)  You may be awarded it on the first try; you may be denied and then get it on appeal; you may need a SSI hearing before the judge; or you may apply five or six times and finally get it after ten years.  But if you are persistent, you will get it. (2)

There is much more there and his writing is entertaining; go there to read the whole thing.  Essentially, TLP believes that what we have constructed with the system is to use the Medical, especially Psychiatric, system to pathologize poverty in order to pay poor people a minimal amount in order to keep them from resorting to more robust anti-social behavior.  In his terms:

Do you want riots in the streets? How much does it cost to prevent LA (your choice) from catching fire? Answer: $600/month, plus Medicaid.   Medicalizing social problems has the additional benefit of rendering society not responsible for those social ills. If it's a disease, it's nobody's fault. Yay empiricism.

Since I work at a clinic which serves predominantly disadvantaged new Yorkers, with a predominantly Black and Hispanic population, I can attest that TLP's post has some validity, though not as much as he might imply.  I have always considered the clinic at which I work to be fairly well run from an administrative point of view.  As a clinic policy (with rare exceptions) we do not fill out forms documenting our patients' inability to work and on the rare occasions when we see a patient who is so disturbed that work would indeed be impossible, we make such a determination time limited and expect that, except in the most extreme cases, decent treatment can render many of these people employable.  Admittedly this costs us patients since those who come to us expressly (if covertly) to acquire or continue to receive SSI and do not suffer from serious Psychiatric illness tend to find other clinics more amenable to their desires.  To run a clinic this way requires some extra work.  It is easier all around to fill out the forms, for us to pretend to offer therapy and medicine while the patients pretend to be sick, and for all to be happily paid by the system.  I suspect too many clinics operate under such a rubric.

[TLP is correct that for people who truly deserve SSI but want to work and fight against their disorder, obtaining SSI can be an ordeal; that could be the subject for another post.]

However, the more problematic patients, and the vast majority of the patients on SSI with "Depression", are those who have been so defeated by life, and have so little of the strengths and capabilities that are necessary for success in life and work that a successful life is simply beyond their horizons.  By the time these people are in their 40's the chances of them being able to become more functional members of society are minimal.  They tend to come to the clinic as products of all the social pathologies that define poverty; raised by single parents or grandmothers, raising children of their own from multiple "baby mamas" or "baby daddies", often with histories of drug and alcohol abuse (sometimes continuing but denied), and with all of the medical complications of personal neglect:  obesity, Diabetes, Hypertension, with elevated cholesterol and triglycerides, poor diets, no exercise, the list goes on.  Further, most did not finish school.  Their inability to succeed in life may be attributed to some combination of pathologic character flaws, limited intellectual abilities, dysfunctional upbringings, and dysfunctional culture.

The question is how to shift the incentives so such people, when caught in the system at a young age (before they have descended hopelessly into dependency) can recover enough agency to live a better life than they would on SSI, which after all, does not provide for much in the way of a "good life" despite the worries of the most Libertarian Social Darwinists.  Right now little attention is paid to these kinds of questions, however many interesting questions will arise when, sometime very soon, paying $600/month plus Medicaid becomes too expensive to carry the numbers of permanently disabled now on SSI. 

Veteran's Day 2010

There are no words that can covey the debt we owe to our Veterans.  They placed their lives on the line repeatedly to allow us to live the lives we have today.  Please consider celebrating Veteran's Day by donating to one of the many organizations devoted to taking care of all of our Veterans and their families who have sacrificed so much for the rest of us.  I am a supporter of Wounded Warriors.  They do excellent work.

Later on today, I plan on calling a couple of Veterans I know to personally thank them.  My Father served in WWII and was recalled for Korea and my Oldest Son served during Iraq War II.  Middle Son is currently serving in the Navy; not a Veteran yet but I'll call him anyway.  I admire and am humbled by all of them.