As the current Presidential campaign/circus proceeds with unheard of antics on a daily basis, I have become reminded over and over again of the importance of the modern phenomenon of narcissism. As a tongue in cheek pictorial example to set the tone for this series of posts in the few weeks before the national election, I have chosen the famous but perhaps forgotten by many of our younger generations of the prototypical fashion dandy of Britain in the early 1800’s, Beau Brummel. In a way, he could be the male forerunner of the phenomenon of fame seekers such as the ubiquitous Kardashians.
In spite of the now rampant, free-wheeling, arm chair psychologizing and analyzing of the Republican nominee for the Presidency Donald Trump, there persists in the blather and smoke of the nondebate political exchanges among the candidates, an issue that still is important. This is the somewhat famous “Goldwater Rule,” formulated and made part of the American Medical Association’s section of Psychiatric Ethics in 1973. It basically stated that psychiatrists were being unethical if they held forth on diagnosing, attaching specific psychiatric labels and such to Senator Barry Goldwater of Arizona who was in 1964 the Republican nominee for the Presidency. A magazine published for approximately 3 years by Ralph Ginsburg, a prominent counter-culture writer in the 1960’s.
Section 7.3, which appeared if the first edition of the APA’s code of ethics in 1973 and is still in effect as of 2016, says:
On occasion psychiatrists are asked for an opinion about an individual who is in the light of public attention or who has disclosed information about himself/herself through public media. In such circumstances, a psychiatrist may share with the public his or her expertise about psychiatric issues in general. However, it is unethical for a psychiatrist to offer a professional opinion unless he or she has conducted an examination and has been granted proper authorization for such a statement. [From Wikipedia
Mass shootings have become such a “fact of life” in the Western world, that there are now website “trackers” of these awful events. This seems to have started with the question of whether mass shootings “have always been with us,” or whether they are indeed, becoming more frequent. Writers, observers, political figures, journalists, and others have been opinionating on this question now for several years. The positions that various public pronouncements have taken, have been all over the map on this vexing question. Persons of a traditionalist point of view have not given en masse the perhaps expected response that we should worry so much publicly about this supposedly new mass phenomenon. Persons who have been publicly sanguine about this issue have been social conservatives who often react with a “don’t rock the boat,” view and can be those from the Conservative Right, or those from the often worry-wart Socially Left. Political persuasions have interestingly enough, not seemed to have shaped persons’ opinions as much stereotypical thinking might have trained one to expect.
Just days ago, August 1, was the 50th anniversary of the gruesome 1966 University of Texas at Austin Tower sniping murders in which Charles Whitman, a 25 year old student shot 16 people to death and wounded 30 others. It took three brave police who forced their way onto the walkway on the tower, to shoot him to death with their pistols to end the massacre. Since as a psychiatrist, long interested in this kind of phenomenon since early unsettling forensic contact with a few shooters, I came across through my trust ever roving “search bots,” this article from NPR news on one of their blogs, recounting this fateful incident, “Gun Violence and Mental Laws, 50 Years After Texas Tower Sniper,” by Lauren Silverman.
I was quite young then, but my father’s entire extended family was from Texas and we were riveted to the television as the “tapes” of the scene were played over and over on the evening news for a few days. I had been to the mall/quad/courtyard in front of the Tower before and since the incident, but watching the scene, especially the scene of the young man covering the body of a friend with his own in the open and being shot at, was literally unbelievable in that day and time. The entire nation stopped for a few days as the horrors of the event were absorbed and the trauma processed as best one could. I recall that it was one of those events that one who lived through it, would remember the rest of their lives, where they were when they heard the news and recalls the shattering effect of the evening television news scenes. It ranked in “trauma impact” up there with the assassination of President Kennedy, the Cuban Missile Crisis, the landing of Apollo 11 on the moon during that night in 1969 and other such indelible events that our brains cannot expunge.
I have witnessed and thought long and hard on the medical marijuana issue and debate for decades. I was a too young college student, precocious and underage for a college student but more worldly wise than my “Doogie Houser” like age and circumstances would convey. I had lived in nearly half the states in the Union and over a dozen foreign countries and had many experiences than the usual late middle school aged youngster growing up in a well educated professional, college emphasizing family of my time. I had lived in countries that even in the 1960’s were paralyzed by national endemic drug use to such an extent that my father, a mining engineer had trouble finding sober, not stoned underground miners for his projects; those drugs were opiates, pot/hashish and khat. I went to college and medical school in one of the hot spots of the latter hippie years and centers of the drug revolution, Ann Arbor at the University of Michigan. I saw people all around me smoking dope, dropping acid, and experimenting with the early designer drugs, DMT etc. I was curious and observed all this just like I did the radical, anarchist white student power movements of those times, attending SDS and Weathermen meetings, hearing Tom Hayden, Rene Davis, Eric Chester, Abbie Hoffman and other lesser known student radicals of that tumultuous era give speeches at rallies and in small groups, talking about “kidnapping Kissinger,” and other idiotic things. Sitting in on some of the small group meeting-cabals, given that I came from a military family, I could look around the room, and silently count the FBI agents in disguise in attendance, chuckling and thinking to myself ‘how dumb can these people be?’ I became so interested in the student radical movements that enveloped my world in Ann Arbor, I did the scholarly thing, and did a dissertation that compared them to the radical anarchist movements in Russia before the Bolshevist Revolution of 1917 that brought Vladimir Lenin, Trotsky and the Communists to power, and have looked at radicals in those terms ever since.
This past week, for this health care provider, the unthinkable happened: a hospital rebelled, and refused further accreditation review by the long-dominant and supremely influential arbiter of hospitals and their national rankings. The Joint Commission for the Accreditation of Healthcare Organizations is, as far as I know, an independent organization that has been around since before I ever dreamed of becoming a physician. To say any more about its history, development, and evolution would reveal my ignorance unless I scurried off during the writing of this post and did some hours of Internet search engine based research…
The story line is that the state of South Dakota has taken the unprecedented stand of declining having the Joint Commission to review and help the state reinstate the accreditation for the state psychiatric hospital of South Dakota! Continue reading →