August 11th, 2009 by GruntDoc in Better Health Network, Opinion
No Comments »
One of the joys of having a blog with 10 readers is that a bunch of them actually add content. From the comments to this post (about the Collier Township, PA mass shooting) by CHenry:
Sadly a recurring pattern of tragedy. A mentally ill person: depressed, angry, frustrated and paranoid, socially isolated largely due to the behavioral features of his disordered personality (I say “his” particularly because it is true, most of these mass-killer-suicides are men) and then some event that triggers the lethal cataclysm of violence. It doesn’t even have to be something most people would think would trigger someone to break, maybe the failure of a brief relationship, or something more significant like a job loss.
U. Texas at Austin, Port Arthur, Tasmania, San Ysidro, California, Ecole Polytechnique, Quebec, Kileen, Texas, Dunblane, Scotland, Virginia Tech. All very similar, and there have been many more.
The gun control activists point to the weapons of choice. They have a point: semiautomatic firearms give an assailant a huge advantage of speed in making a body count when turned on unarmed and trapped victims. But even in places where gun ownership is tightly controlled, those with the determination to kill have found weapons of their choice.
We live in a society where it is startlingly easy to be alienated and alone, even in a crowd. For whatever reasons, the ties that bind us to one another, community, family, church, friendship and work are much more tenuous than ever before. People with thought disorders and violent tendencies have probably never been freer, both of the laws that once gave a society powers to confine them and of the observation and social controls that a world of smaller communities once imposed on their behaviors.
The lonely berserk stranger, hell-bent on wreaking as much destruction as possible before his own destruction has become the dark meme of modern living. Going postal.
I don’t see a practical answer to this problem. Good comment.
*This blog post was originally published at GruntDoc*
August 10th, 2009 by Berci in Better Health Network, News
2 Comments »
The Rorschach test is used for examining the personality characteristics and emotional functioning of patients as their perceptions of inkblots are recorded and then analyzed.
New York Times had a report about Dr. James Heilman who posted all 10 pictures on the site, along with research about the most popular responses to each. Of course, it led to a heated debate whether this information should be accessed on Wikipedia or not.
The article is protected from editing until 6, August but there are serious debates on the talk page. One example:
All of the pictures of the Inkblot Cards need to be removed. Posting them contaminates this tool, The Rorschach Test. Posting the popular responses further contaminates this test. It is a simple case of scuppering a professional clinical tool and needs to be stopped. – Comment of Edith Meyers who has PhD in Neuroscience and Clinical Psychology.
It has recently been suggested to use the hide template that would hide the word associations, so only those who want to read them would be motivated to click “show”.
As a medical student and Wikipedia administrator, I believe such things happen. It’s impossible to hide that kind of information, but revealing these possible answers can really ruin the test itself. Solution? A hide template with a clear warning for possible patients might be one of them. What do you think?
*This blog post was originally published at ScienceRoll*
July 26th, 2009 by Joseph Banken, Ph.D. in Better Health Network
1 Comment »
Two very interesting articles were published recently on the health effects of job loss and on-the-job rejection.
The first article looks at the health of people who have been fired. They limited their study to previously healthy adults who got sick after they lost their jobs. It didn’t seem to matter why they were let go or how quickly they found a new job. Kate Stully, an assistant professor in sociology at the State University of New York at Albany and author of “Job Loss Can Make You Sick” found that losing a job is linked to a higher risk for high blood pressure, heart disease, heart attack, diabetes or depression. I would also add an increased risk of suicide to this list.
The second article looks at what happens when you’ve been left out (or just think you’ve been left out) of the loop at work. Purdue University’s professor of psychological sciences, Kipling D. Williams, reported that hurt feelings for a perceived slight can affect morale, hurt job performance and productivity, and can even hurt the company financially in his article, “Avoid the Dark About Effects of Leaving Others Out of the Loop”.
The first article looks at how we define ourselves and our place in society by our jobs. The second looks at how damaging a perceived slight can be to productivity. Now these two articles on the surface seem to be talking about two different things. But if we take a closer look, aren’t both of these articles talking about the effects of rejection?
No matter how much we would like to say we don’t care what other people think, we really do care much more so than we might think. And it hurts when we feel left out or feel unwanted. According to the first article, it can even make us physically sick. It matters that we feel needed and accepted by those who play a large part in our lives. And let’s face it; we spend a lot of time with our coworkers so it would naturally follow that these people would have some influence over how we feel about ourselves.
The second article explains how just a small amount of the cold shoulder can have a significant impact on how we feel about ourselves and how we perceive others feel about us.
So how do we cope with feelings of rejection in the workplace? Most of us spend more time with coworkers than we do our families, so they often become our second family. In some cases, our work family may be the only one we’ve got. And family rejection is often the most devastating to our self-worth.
The first step in dealing with any rejection is a critical look at the rejecter as well as the rejected. Is she really rejecting me by talking with another coworker? Sure, we were a team in the meeting, but after the meeting she talked to someone else in the hall. Does this mean rejection, or does this mean she had a follow-up comment to something that person said in the meeting? Is my being fired from my job a reflection on my job performance or downsizing of the company? If it is my performance, was the job really a good fit to begin with? How could I have changed the outcome to better serve me? Could I have stepped up my performance, or changed jobs to one that I liked better? How will I deal with this in the future? Do I really want to be a part of this group in the first place? Is my desire for alliance with this group solely based on popularity? Does this group fit with my own morals and ideals? We all want to fit in, but not at the expense of losing ourselves in the process.
The second step is to realize that in order to feel rejection we must first give someone else the power to do so. Am I setting myself up for rejection? According to psychiatrist, Karen Horney, we tend to move toward, away from, or against others. Am I open and meeting others half way? Am I waiting for others to come to me or making others work harder to approach me? Or am I mistakenly pushing others away from me by rubbing them the wrong way or coming on too strong when all I really want to do is connect? Am I trying to alienate others before they get the chance to alienate or reject me?
The third step is to understand that rejection is a negative experience just like any other and that the hurt lessens when shared with others. Sometimes we can “feel” rejection when we are not being rejected at all. If I was cheated on by a loved one, or a family member raked me over the coals for showing up late for dinner, I would find a sympathetic ear to talk it out with. By discussing rejection, we find that we are not alone. We may even find that our story is not so bad when others share their horror stories of rejection. And don’t worry about fearing that we’ve blown the situation out of proportion. Maybe we have not been rejected at all. Our true friends will be the first to tell us when we are full of hot air. Our fake friends will be the last to tell us when we are wearing our underwear on our heads!
I’ll leave you with a couple of quotes on fitting in:
“I refuse to join any club that would have me as a member” Groucho Marx
“I want my individuality, so why can’t I get a tattoo? Everyone else is.” My neighbor’s teenager
The floor is now open for your comments. Please join in.
*This blog post was originally published at eDocAmerica*
July 16th, 2009 by Joseph Banken, Ph.D. in Better Health Network, Opinion
No Comments »
Since the publication of Norman Vincent Peale’s 1952 book called The Power of Positive Thinking, the world has been bombarded with a plethora of self-help books guaranteed to show us the way to happiness. But is there a down-side to these suggestions?
If we do as instructed, by a multitude of sources, to push away the negative, or bad thoughts and focus only on the positive, or good thoughts, how do we prepare for the bad times of reality?
Come with me, if you will, on a journey through the cluttered half-baked theories of my mind, but watch your step, there’s no liability insurance in here. If you trip into the corpus callosum, you’re on your own.
Part one of the half-baked journey begins with the extreme outcome of pure positive thinking. If I am truly thinking positively, then nothing at all could possibly go wrong, I have nothing to worry about, I am perfect just the way I am, and the world exists just so that I might gain pleasure from it.
If nothing could go wrong, why should I plan for a rainy day? My job will last forever, the roof will never leak, and my kids will remain perfectly healthy. There is only sunshine in my world.
If there is nothing to worry about, then I can count my life savings while walking down a dark alley without fear, my car will last forever- that banging under the hood means nothing and adds an interesting beat to the music playing on the radio, and I will never grow old. Throw away the botox; there are no wrinkles here.
If I am perfect just the way I am, why should I exercise to take off that extra ten pounds, why should I try to improve my mind with literature, the theater, or a higher degree. Why should I get off the couch?
If I buy into this extreme sport of pure positive thinking, why would I work like a dog to get ahead? Wouldn’t I be perfect enough for everything to be given to me?
Now for part two of the half-baked journey; are you still with me? We are getting really deep in the frontal lobes now.
If I remain in a positive thinking mode until I gain a serene, carefree state, does that mean my brain is unstimulated? And in turn, does that mean that the firing of neurons has diminished so much that if danger were to occur, I would not be able to act quickly enough for self-preservation? Would I react at all if I were a true positive thinker? What could happen if I stayed on the couch?
Let’s go back to the unstimulated idea. If I continue to not stimulate my brain, will my brain begin to deteriorate? After all, the old adage “Use it or Lose it” has been around longer than “Think Positively”. Let’s throw in another adage: Necessity is the Mother of Invention. That being said, if we have no necessity because we are positively thinking about everything and therefore need nothing new, why would we trouble ourselves to invent new things?
If I remain unstimulated for an extended period of time, what will happen to my mood? If there are no highs or lows, no release of adrenaline to handle excitement or danger, no need for the release of serotonin or dopamine to stimulate my brain, will these receptors be decommissioned as no longer needed? Will my mood sink into depression?
Now for the flip side of this saga.
What if I experienced continual negative thoughts? Would my life mirror the same lack of moving forward I found while hanging out on the couch with positive thinking? I may have more supplies stored in the basement with negative thinking and the door would be locked, but would my life be any more interesting? Would it be just as flat, but in a negative way?
If danger startled me off of the couch, would I be too paralyzed by negativity to react in time? If I think nothing good will ever happen, have I made this come true simply by closing the door to the possibility?
This leaves us with the good old fence straddlers.
Ordinarily, sitting on the fence is thought of as a bad thing. We are urged to choose a side, be decisive and stick with our convictions. What if I had a mixture of positive and negative thinking tempered with a good dose of reality thinking? Would my life attain a better balance necessary to survival? Would I have happy little neurons firing quickly and efficiently because they were getting a healthy dose of exercise and rest? If I use reality thinking with a mixture of both positive and negative thinking, will I be better prepared to weather hard times?
If I have a huge project due at work, would I be more effective if I used a dose of negative thinking that I don’t have enough time to complete this project, mixed in a little anxiety that if I don’t finish then my job may be finished, added some positive thinking that all I can do is my best, and stirred it around with reality thinking that I’ve proven myself by meeting hard deadlines in the past and have the ability to do so again. My project will most likely be completed on time because I have made this mixture of positive, negative, anxiety and reality work for me instead of against me. Too much positive thinking and I won’t push myself hard enough to make the deadline. Too much negative and I will give up before really trying.
The fence straddlers can enjoy a healthy mixture of both positive and negative thoughts, knowing each has its own value if kept in balance. And the view from the fence is not bad either.
Thank you for coming along on this trip through the half-baked theory region of my mind.
Now that I’ve shared some of my thoughts, feel free to share some of your own.
*This blog post was originally published at eDocAmerica*
July 9th, 2009 by DrRob in Better Health Network, True Stories
No Comments »
My worst night as a doctor was during my residency. I was working the pediatric ICU and admitted a young teenager who had tried to kill herself. Well, she didn’t really try to kill herself; she took a handful of Tylenol (acetaminophen) because some other girls had teased her.
On that night I watched as she went from a frightened girl who carried on a conversation, through agitation and into coma, and finally to death by morning. We did everything we could to keep her alive, but without a liver there is no chance of survival.
Over ten years later, I was called to the emergency room for a girl who was nauseated and a little confused, with elevated liver tests. I told the ER doctor to check an acetaminophen level and, sadly, it was elevated. She too had taken a handful of acetaminophen at an earlier time. She too was lucid and scared at the start of the evening. The last I saw of her was on the next day before she was sent to a specialty hospital for a liver transplant. I got the call later that next day with the bad news: she died.
The saddest thing about both of these kids is that they both thought they were safe. The handful of pills was a gesture, not meant to harm themselves. They were like most people; they didn’t know that this medication that is ubiquitous and reportedly safe can be so deadly. But when they finally learned this, it was too late. They are both dead. Suicides? Technically, but not in reality.
For these children the problem was that symptoms of toxicity may not show up until it is too late. People often get nausea and vomiting with acute overdose, but if the treatment isn’t initiated within 8-10 hours, the risk of going to liver failure is high. Once enough time passes, it is rare that the person can be cured without liver transplant.
Acetaminophen overdose is the #1 cause of liver failure in the US. According to a Reuters article, there are 1600 cases of liver failure from this drug per year (2007). This is a huge number. In comparison consider that the cholesterol drug Cerivastatin (Baycol) was withdrawn from the market when there were 31 deaths from rhabdomyalysis (severe muscle break-down, which is far more common than liver failure in these drugs). These happened mainly when the drug was used in combination with another cholesterol drug.
Should the drug be pulled from the market? No, it is safe when used properly. The toxic dose is generally 10 times the therapeutic dose. My complaint is not that they have dangerous drugs available; ALL drugs should be considered dangerous. Aspirin, decongestants, anti-inflammatories, and even antacids can be toxic if taken in high dose. The problems with acetaminophen stem from several factors:
- Most people don’t realize the danger.
- There has been very little public education and no significant warning labels on the packages.
- The drug is often hidden in combination with other drugs, including prescription narcotics and over-the-counter cold medications. This means that a person can take excess medication without knowing it.
I would advocate putting warning labels on medications containing this drug. I am sure this doesn’t thrill the drug manufacturers, but the goal is not to make them happy. I have thought this since that terrible night during residency. If there was such a warning, perhaps she wouldn’t have died.
It seems a bit silly that this action by the FDA is coming after their pulling of children’s cough/cold medications. Those drugs have very small numbers of true harmful overdoses. The reason they were pulled was probably more that they didn’t do anything over the fact that they were dangerous. Acetaminophen, on the other hand, can be deadly.
Just ask the parents of my two patients.
*This blog post was originally published at Musings of a Distractible Mind*
