frustration

Letter to a friend and former OSU medical school classmate. Asylums Anyone?

Note from Eshrink’s Editor: My father had a reunion with his classmates who graduated from the Ohio State University Medical School back in the 50s (1956 I think). Last month, one of the few classmates left in his class sent him and article from the Wall Street Journal. Here is the link to the article https://www.wsj.com/articles/its-time-to-bring-back-the-asylum-ec01fb2?reflink=desktopwebshare_permalink. I’ve included a PDF version at the end of this blog post.

This letter is my dad’s response.

July 31, 2023

Dear Jim, 

           Thanks for the WSJ article regarding asylums.  It resurrected memories of an incident which I wrote about previously (Passing the Torch) when during my residency my attending physician for whom I had a great deal of respect, invited me to share a cup of coffee with him.  This was a bit unusual, and my first thought was to wonder what I had screwed up.  Imagine my surprise when he announced that he would be retiring at the end of my rotation on his service and wanted me to be the first to know.  The casual observer would likely have seen Dr. Ristine as a tough old bird rather than as warm and fuzzy, yet patients warmed to him instantly.  He arrived daily at the hospital wearing a beret and driving a battered topless corvette which had lost the battle when he used it to pull out a stump on his farm. 

           Prior to his stint in academia, he had been assistant director of the department of mental health.  His face was flush with anger as he described his frustrations in that job.  He reported that he made occasional visits to the various state hospitals where he would often sit and cry as he witnessed what he saw in the “backwards.”  His efforts to secure more funding for their treatment went unheeded by the legislature, for as he said, “Severely mentally ill folks don’t vote,” and therein lies the problem.   It has oft been said that “you get what you pay for” and we pay very little considering the magnitude of the problem.  The National Institute of Mental Health reports 5.5% of Americans suffer from a serious mental illness.  Dr. Ristine seemed to be saying that it was now my turn to attempt to fix the problem, which was obviously way above my pay grade.  Nevertheless, I was touched by his openness and still fondly recall that coffee break.

           Surprise, surprise, more than a half century later, I must confess that I have also failed at fixing the problem, but Dr. Ristine had found the solution as had many more who had gone before.  As with most contemporary problems the solutions can be found by following the money or in this case the lack of it.  After the French Revolution Pinel unchained his patients, moved them out of the dungeons, and allowed them to exercise outside.  Unfortunately, such ideas which came to be called the Moral Treatment of Insanity, were rare, and it is estimated that more than 1,000 psychotic folks were burned at the stake. 

           The heroine of the movement was Dorothea Dix who became a tireless advocate for the mentally ill in the mid nineteenth century.  She addressed political bodies throughout the country and even convinced the Pope to launch an inquiry into hospital treatments of the mentally ill.  She was very successful and largely through her efforts a system of asylums was built.  These asylums were usually large attractive buildings with assurances that they would offer the latest in modern treatments.  Unfortunately, there was a lack of effective treatments for the more serious cases and most, if not all, became permanent residents.  It is difficult for us to imagine what it must have been like to deal with large groups of people so paranoid that they lived constantly in terror, and whose suspiciousness made it impossible for them to accept help.  Little wonder that caregivers were driven to try unproven and sometimes garish treatments out of desperation, and that the introduction of Thorazine was greeted with enthusiasm.  Within a year over 70% of psychiatric beds were emptied.  Finally, there was a medication with proven ability to affect delusions and hallucinations, and it was widely hailed as a possible cure for schizophrenia.  

           Mr. Oshinsky begins his piece with a series of instances of murders at the hands of mentally ill persons.   Such stories are real attention getters, especially the gorier ones, and will certainly get more press than articles about drunk drivers who kill.  They will also provide more grist for the NRA crowd’s message that it is the mentally ill not guns that are the problem and reminds us to be careful around those with psychiatric problems as you never know which one is a homicidal maniac.  In reality such assaults are rare and mentally ill folks are more likely to be victims rather than perpetrators of homicides.  Such attitudes do little to eliminate the biases suffered by the mentally ill.

           The author’s statement that our Mental Health system is a “mess” is accurate in my opinion, and it lacks provision for long term care, but the system has suffered mostly due to inadequate funding.  As his last official bill signing prior to his assassination in 1963, President Kennedy signed a bill authorizing the establishment of Comprehensive Mental Health Centers throughout the country.  The idea was to provide care in patients’ home communities.  Eligibility for funding required the provision of 5 essential services including: inpatient, outpatient, social services, medication management, and emergency services.  My hometown was the second in the nation to receive such a grant, and a decade later I was recruited to become its director.  I was exhilarated by a staff who were dedicated to the welfare of our patients, and frustrated by local politics, the difficulty of recruiting psychiatrists to a rural area, but most of all by the limitations of our budget.

           Kennedy’s bill was designed to provide operating expenses for a limited period of time, less than half the proposed facilities were ever built, Reagan eliminated the program as part of his budget squeeze, and now managed care pays for little more than crisis intervention with hospital stays averaging less than 2 days.  I agree that our laws regarding involuntary commitment need to be revised.  After all it is not unusual for such correcting laws to swing too far afield, and indeed in their zeal to “deinstitutionalize,” they failed to recognize there are still patients who require custodial care in spite of our best efforts.  It is also true that without corrective action abusers will find their way into the system and Nurse Ratchets, though rare, do exist, and a community-based system is likely to shed more light.  Which poses the question, without “One Flew Over the Cuckoo’s Nest” would we even be having this conversation. 

           The idea of asylums as he described them is attractive except for the fact that we already did that with poor results, and some would say to repeatedly do the same thing expecting a different result is the definition of insanity.  Many have also posited that the location of asylums for the insane have always been located in out of the way places with the idea that out of sight is out of mind while congratulating ourselves that they are not chained in a dungeon…but thousands are in jail. Though we no longer burn witches at the stake, the stigma of mental illness is alive and well.  I abhor the term behavioral health to describe mental illness which infers that behavior, not illness, is the problem.  Unfortunately, it is aberrant behavior which usually gets the public’s attention rather than its cause.  The term is widely used even by professionals including the mental health center where I last worked.  My efforts to convince the staff that although efforts to convince a psychotic person that a fireplug was not a urinal were laudable, it was unlikely to get to the root of the problem.   Medical insurance still offers minimal coverage for mental health problems.  Employers widely discriminate.  In many ways mental health problems are treated differently.  If mental illness is illness, why not treat it as we do other chronic diseases?  The answer of course remains the same as it was in Dr. Ristine’s day: it is too expensive. 

           The accomplishments of reformers back to the Middle Ages have always been short-lived by lack of adequate funding.  Bedlam, one of the earliest hospitals from the Middle Ages was designed by a famous French architect.  It was said to be a marvelous structure but eventually deteriorated due to lack of funds.  Understaffed and underfunded, their financial problems were solved by the sale of tickets to the townspeople to come watch the lunatics, and bedlam was added to our vocabulary as a word signifying chaos.

           Sorry about boring you with all that stuff, but sometimes when I get started it is hard to stop, and this diatribe will likely end up as a blog.  It was great to hear from you and reassuring that someone is beating the grim reaper.  I have no doubt that you will be around for another reunion.  Do you have any idea how many of us are still alive? It seems to me that almost all of the guys I really knew are gone.

We just returned from our family vacation at North Carolina Beach.  I think it might have been our 25th but the string was interrupted by the covid thing.  All the kids, grandkids and their significant others were there, and the trip was a gift to Barb and I from the kids in honor of our 70th anniversary.  We had a great time and I feel incredibly fortunate to have such a great bunch of people who actually care for a gimpy old fart.

           I agree that the world is a mess right now and I have grave concerns that our progeny may not experience many of the blessings we have enjoyed, but spending time with these kids gave me hope for I think they are smarter than we were and more capable of cleaning up the mess than were we.  Meanwhile, I see the buckeyes are rated #3.  I think it’s time for a national championship.

                                                       Love,

                                                       Smitty and Barb

Below is PDF of the WSJ article dad references.

Dads blog It’s Time to Bring Back Asylums – WSJ articleDownload

Best of ESHRINK for Father’s Day: Does anybody answer the damn phone?

Need a doctor? Have an emergency? Please hold and try not to die!

6.18.23: Introduction

For Father’s Day I decided one of Eshrink’s most popular posts–WITH AN UPDATE and EXPLANATION on his dereliction of duties as author of ESHRINK BLOG is appropriate for his fans.

EXPLANATION: Eshrink (my dad) has been head down working on his historical novel (DON’T call it a biography–he has that “Dutch” quality where one doesn’t make anything about “themselves”…I think he has a blog about learning from his mother that “one doesn’t brag” about their accomplishments OR the accomplishments of their children….dad, correct me if I’m wrong). Anyway, Eshrink’s progeny has requested that he use his interesting perspective with 92 years on this planet to write about how things were and how they’ve changed…he has certainly lived history. I understand creatives need time and space to create their masterpieces so I’m recycling some of his most popular blog posts from the archive to keep his fans updated.

THE UPDATE to “DOES ANYONE ANSWER THE DAMN PHONE?” I think dad sarcastically predicted this, but it actually came to fruition. Gregg, my S.O. (when you’re in your late 50s, the title “boyfriend” seems somewhat inaccurate…man friend? Partner? Dude? Significant Other works for this purpose) needed a direct flight to Las Vegas for a sales meeting. He decided to try SPIRIT Airline at my urging– I had a good experience last year when I flew direct to Vegas with the kids. When he found out the main meeting was actually starting a day later, he tried to change his flight and that’s when it happened (Spirit Airline was perfectly fine with you wanting to handle the situation via phone but they explained they would charge you $25 if you wanted to actually talk to a human being) Needless to say, he kept his flight (their online user interface for changing flights was quite dreadful…I’m sure intentionally so). I guess I’ve inherited my dad’s “CURMUDGEON” tendencies and sarcasm! Please enjoy this post from 2014.

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DOES ANYONE ANSWER THE DAMN PHONE?

One would think that anyone who has been on this planet as long as I would have “seen it all”.  Well not quite.  The other day I had occasion to call our local hospital and found myself listening to a recording.  After my initial shock, I decided that I must have called the wrong number, but redial confirmed my worst fears as the voice instructed me to call 911 if this were an emergency, but assured me the operator would be back on the line shortly (whenever she finished her coffee break?).  It left me wondering if the hospital was no longer in the emergency business.

Fortunately for my coronary arteries I was spared the indignity of hearing the ultimate contradiction of how important was my call.  Whenever I hear that message, I begin to salivate like Pavlov’s dog, and scream “if it is so important why don’t  you answer the damn phone”!  I was however subjected to the usual noises masquerading as music while I fumed and waited.  My record of listening to these awful sounds punctuated with that stupid lie about the importance of my call is forty three and one half minutes.  Fortunately the hospital operator answered in only a few minutes, but I was still in shock.  She assured me that she had been on the line talking to others, but I am still not convinced that she wasn’t taking a break.

Prior to the dawn of the technology age, the hospital operator served a very important function not only as a purveyer of all kinds of useful information about the hospital, but as a link to the outside world.  It was her/his responsibility to initiate procedures to mobilize crisis units in case of local disasters for example.  A more forward thinking person than myself would not have been surprised by this unthinkable event, for I should have known that when hospitals began to refer to their patients as customers that these so called not for profit organizations had set out to emulate their profit based cousins in the business world.  Perhaps an appropriate motto would be “if you like General Motors, you will love this hospital”.

Many accuse we old folks as being resistive  to change which is probably true; however we have been around long enough see what was promoted as progress to sometimes turn out to be regress.  I figure it must have been an old guy who coined the phrase, “if it ain’t broke don’t fix it”.  Now II realize this phone thing has been a boon doggle for many workers, as I can see how it provides them opportunity to goof off, socialize with coworkers, play video games, or take care of excretory functions, and I have always been in favor of fringe benefits for workers; however my forty three and a half minutes of time is gone forever and I don’t have much of that commodity left.   One of my Grandkids suggested that a solution might be to leave my phone on speaker, a novel idea (fight technology with more technology), but that interferes with my nap.  The bottom line (see even I have been corrupted by corporate influences) is that I will simply need to adjust, not easy for an old guy.

Though I realize that we will never go back to the days when a call was answered by a live human being who simply said hello, I feel there should be some punishment levied against the person who invented this tool designed to inflict such diabolical punishment.  In my last letter, I had suggested in a fit of anger that someone should be lynched.  I didn’t mean that as I am against capital punishment, mob violence, or torture.  However; I would be in favor of his being sent to the Haque to face charges of Crimes against Humanity.

Father’s Day Note from the Editor: I love you dad…that goes without saying…some of the qualities I admire most about you are your determination, your patience (not with technology but with humans), your compassion, your loyalty, passion for learning, and how you have always been there for us. I always felt heard…even as a child. When I say, “You’re the best dad on the planet,” it’s not hyperbole…it’s a FACT!

DOES ANYONE GIVE A DAMN?

Monday I tuned into the cable news to watch the John Lewis festivities.  I always thought the Bard had it wrong when he said: “The evil that men do lives after them,” for it seems to me that when people die, we usually give them a pass and tend to focus on all the good stuff they have done.  For example, it is unusual for an obituary or eulogy to say much about the deceased’s less endearing qualities.  In Lewis’s case there seems little doubt that he was a genuine American hero and that his stature as such is warranted.  Even his adversaries don’t question the worthiness of those accolades, although I am expecting a tweet from on high before the week is over!

I spent the day flipping between CNN and MSNBC hoping to see something other than a hearse either parked or proceeding at 2 miles per hour through the streets of DC while various anchor people tried to fill in the time.  I was so engrossed in the anticipation that something worth watching would happen that I forgot to check in with Fox News.  It would be interesting to know if they felt any of it newsworthy.

When I checked late that afternoon the temperature in Washington DC was 95 degrees, and as is usually the case in DC, the humidity level was high.  There had been a heat advisory issued earlier in the day.  I initially became concerned about that while I watched the honor guard at the airport standing at attention in their full-dress uniforms waiting to carry the casket from the plane to the hearse, but that phase was uneventful (although I was surprised they had survived standing motionless on the concrete at the mercy of an unrelenting sun).

Having spent some time in the military, I was aware of how standing rigidly motionless for long periods of time can result in a temporary loss of consciousness due to orthostatic hypotension which is usually caused by prolonged immobility or a decreased blood volume such as dehydration.  In this case, it seemed likely that both scenarios were in play, so that when the hearse finally arrived at the Capitol, the same or similar honor guard was standing at attention at the bottom of the steps of the Capitol building.  It was composed of 2 marines, 2 army, 2 navy, and 2 air force enlisted men along with a squad leader.

With the arrival of the hearse at the capital, I was hopeful that those guys would not be forced to stand there as long as they had at the airport, but as the commentators dragged on my hopes were dashed.  I commented to Barb that although those guys are trained to remain motionless in these kinds of ceremonial missions, there are limits to human tolerance, and I did not imagine they would be able to tolerate much more time standing at attention in that intolerable heat.

Those words had barely escaped when one of the sailors collapsed.  This was not one of those faints in which one gradually sinks to their knees and slides to the ground, but the sailor fell flat on his back much like a tree being felled.  The other members of the squad did not so much as twitch, and a capital policeman walked over to attend to the fallen one.  I was concerned as to the possibility of a head injury since he had fallen so hard with the point of impact appearing to be the back of his head.   To my surprise he was eventually able to walk away with some assistance, and finally the remaining 7 guys were able to carry the casket up the steps into the rotunda.

US Sailor collapses in heat during honor guard service Rep John Lewis funeral ceremony

Click here to watch video

When the sailor passed out, I was watching MSNBC.  They briefly followed the incident but with no follow-up.  When I toggled to CNN, they made no mention of it, and had panned away from the honor guard.  Through it all they continued their commentary as if nothing had happened.  I was appalled at the disregard exhibited by the media for an accident which could have or maybe did result in a fractured skull.  We will never know the extent if any of his injuries since the media giants did not deem it important enough to follow-up.

An even more important question is: why in the world were those poor guys left to suffer in what could in other situations be described as torture with risk of serious injury or illness.  I recall one of the broadcasters saying that the ceremony was running 20 minutes behind schedule, but I am certain those guys were out there longer than 20 minutes.  Even so, why would anyone order them out there knowing there was a delay.  Was anyone in charge?  Were they aware of the risk to the honor guard, If not, why not, and if they did know, did they care?

Did anyone give a damn?

 

Editor’s Note: Here is link to how the military press covered the sailor’s crash with concrete: Link to Article

 

 

 

 

 

 

 

 

Uncomfortable Hospital Bed

BED REST? ARE YOU SERIOUS?

 

For a lot of years, I routinely admitted patients to hospitals. Due to a recent brief sojourn in one, I now feel compelled to seek atonement for those sins.

As I am sure you are all aware, to be hospitalized means that during your stay, you will spend almost all of your time in a contraption the medical staff will refer to as a bed. My recent experience has enlightened me, for I naively thought that the word bed when used in medical parlance had the same meaning as it did in ordinary conversation, i.e., a place where one could rest or even sleep. In truth, it turns out that a hospital “bed” has little to do with such a concept, but is simply a workbench designed primarily for the comfort and convenience of the worker.

As such, today’s hospital beds are of course designed to perform all kinds of tasks with minimal effort on the part of the worker. The hand cranked mechanisms of past generations are now powered by electric motors, and with a push of a button, will raise or lower all or parts of the bed. They come equipped with a variety of connecting mechanisms that allow all kinds of accessories to be attached. All in all, as tools, they are marvelously engineered and do amazing things none of which have anything to do with patient comfort.

If you have the misfortune to find yourself in a hospital bed, you will find yourself lying on a thin, usually lumpy, mattress atop a metal slab. Such discomfort does not come cheap however for Modern Healthcare says the average cost for a hospital bed in 1998 was $15,627 while specialized Intensive care beds can cost $25,000 to $35,000.

Since these so-called beds are narrow enough that to roll over could land a patient on the floor resulting in a wrongful death lawsuit, they come equipped with side rails as standard equipment. The practices of shackling patients to their beds, euphemistically referred to as the use of soft restraints, has received a lot of bad press in recent years consequently; our always innovative design engineers have located the side rail lowering mechanisms in a place where they are inaccessible to the patient. The result is that one is virtually immobilized.

Such a strategy does have its limitations however. I recall a conversation from years ago with a patient of mine who sustained some rather serious injuries when he fell while attempting to climb over his bed rails. Following the time-honored tradition of blaming the victim, I asked him why he had done such a thing. He replied that he needed to use the bathroom. When I responded with the equally inane question as to why he didn’t wait for help, his answer was prophetic: “If you ever have a prostate like mine you will understand and not ask such a dumb-ass question.” Now, a few decades later I do understand.

When trapped in one of those cages, the patient’s lifeline is the “call light,” presumably so named from the days when the push of a button turned on a light in the nurse’s station. This would summon a nurse to the patient’s room. Now due to the miracles of modern science, that gadget has morphed into a 2-way radio, and your voice will probably be answered by the ward secretary in a businesslike fashion, but in a tone that suggests “what the hell do you want now?”. In the event you happen to reach a nurse who has been forced to work overtime after completing a 12-hour shift, prayer will be your best option.

Most of you are undoubtedly familiar with the aforementioned gadget which also has buttons to operate the TV and room lights. It is attached to a cable which is the umbilical cord to the outside world. This presents a hazard to a klutzy guy like me who tends to drop everything he touches. Consequently, panic set in when I dropped the thing on the floor in the middle of the night. There was urgent business which needed immediate attention and no way for me to escape containment. The feelings of helplessness engendered, rapidly progressed to an exacerbation of my latent claustrophobia.

Fortunately, I was saved from psychotic decompensation when someone who in other circumstances I would have cursed for awakening me at such an ungodly hour came in the room to check my vital signs. She turned out to be very helpful and I felt like kissing her for saving me. I have no idea who she was for it is difficult to distinguish the nursing staff from the cleaning crew these days for they are all dressed in scrubs. Gone are the days of starched white nurses uniforms with dainty white caps perched on their coiffured heads, which announced the school from which they trained. White oxfords and stockings have been traded in for sneakers. Dress codes long gone demanded that hair must never reach the collar.

It is not that I have ever been intrigued by formality, and I confess that I have not worn a necktie in the past couple of years. Nevertheless, I believe that some uniformity conveys a sense of pride in one’s profession and in medicine inspires confidence in the caregiver, which has been proven to be therapeutic, but that has been given up in the name of casual comfort for the caregiver.

 

Now that we have hospital beds doing most of the heavy lifting, could not engineers now engage all that superior intellect in an all out effort to design a bed with the comfort of the patient in mind?  Back in the dark ages when I was in medical school we were taught that rest was a powerful tool to aid in the healing process, a principle undoubtedly discovered by grandmothers thousands of years ago. Who knows? To be in a real bed might even allow us to catch a few winks in between assaults on our body.

‘TIS THE SEASON $$

Introduction from Eshrink Editor: I think all readers will relate to this blog post where Eshrink discusses the battle of the charities during the holidays. I told him about a website I use to evaluate charities and he wanted me to add it to the beginning of the post in hopes it might help people give to charities that maximize the amount of money that goes to the people the charity says it wants to help versus executive compensation and “administrative” costs. It’s charitynavigator.org. What I like about this non-profit is that they explain in simple terms the methodology they use to evaluate each charity. Take it away Eshrink with the latest installment of the Curmudgeon Series. This one is entitled ‘Tis the Season!

Now is the time to max out those credit cards. After all, you will have a year to pay them off, and be ready to do it all over again. Most people, even some non-Christians, follow the tradition of gift giving during the Christmas holidays. Some might say that in many instances it has become an obscene example of crass materialism. In any event it is said that we of the Christian faith are generous in general, with of course, many exceptions to that rule. This generosity presents many business opportunities particularly in the retail and the manufacture of stuff. This is confirmed by the long-held proposition that the period between Thanksgiving and Christmas is the only profitable time of the year for many retailers. There are also the delivery services, the credit card companies, the grocers, and the electricity providers that are among those who profit as a result of those millions of gaudily wrapped packages.

 

JOY TO THE WORLD
Ah, but those are not the only ones for whom the season is joyous. It is a great time for thieves who can follow UPS or Fed Ex trucks and collect a lot of stuff, not to mention the shoplifters and purse snatchers who find it easier to defeat the security cameras when stores are crowded. The “begging” business is also certain to have an uptick since there is a focus on family and children, and the contrast of opulence and poverty is apt to be dramatic–thus provoking feelings of guilt among those who go “ALL OUT” on the gift giving at Christmas.
TIME TO CASH IN: THE BUSINESS of GIVING
Those circumstances are not lost on various charitable organizations who go into high gear during the holiday season. The Society for the Prevention of Cruelty to Animals unleashes some real tear jerkers on television. The Shriner’s Hospital, and St. Jude Hospital for children likewise are not shy about showing children in wheelchairs or with prosthetic limbs. There seems to be an increase in the number of starving children seen on TV along with severely impaired veterans leading one to assume there must be considerable competition for all that Christmas “goodwill” money. Charitable giving is also enhanced by those who want to take advantage of deductions prior to the end of the year. It is fertile ground and must be the charitable organizations’ equivalent of the retailer’s Black Friday.

 

DISCLAIMER to IMPENDING COMPLAINT
All of this is simply a preamble to my most recent complaint. In my defense, I feel compelled to issue a disclaimer that I am not anti-charity in any sense of the word. As a matter of fact, I believe that it does good things not only for the beneficiaries but often times even more for the giver. In my own case when I am feeling particularly beneficent, and drop a whole dollar bill in the Salvation Army pot, which is obviously designed to only receive coins, I walk away with a bit of a spring in my step feeling very righteous.

 

NO ANONYMOUS DONORS
Although I do not profess to be even a minor league philanthropist, I do manage to cough up a few bucks on occasion for charities which I think worthwhile. In recent times, we as a society have chosen to forfeit privacy in return for convenience. Consequently; it should not come as a surprise when organizations sell our names to other organizations. In one case I noted a very small print notice in the bottom of a solicitation that reassured me that although they passed my name to other charities, such organizations were carefully vetted to ensure their legitimacy. Somehow, I did not feel motivated to thank them for deciding to put my name on someone else’s sucker list without my permission. Since this seems to be standard operating procedure for these charities, it is not surprising that our gift giving is rewarded with a barrage of requests for money.

 

GOOD STUFF for “FREE” – NEW TACTICS
In recent years I have noted a new technique designed to squeeze some green from our pocketbooks which I find to be especially repugnant. I first noticed this several years ago with a solicitation from the March of Dimes. Some of you young whippersnappers may not know that this charity had its beginning as a quest to find a cure for Polio, but with the eradication of that disease, they didn’t want a good bureaucracy to go to waste so they switched to birth defects. Those of you who are on their list may have noticed a dime is attached to their fundraising letters.
I do not mean to denigrate the March of Dimes organization for they were very much involved in financing Salk and Sabin who developed the vaccines which eliminated that horrible disease that left children crippled for life. It was developed in 1938 with the help of Franklin Roosevelt, himself a victim of the disease. I recall fund drives at our school when we kids brought in dimes to be used for the cause. Of course, this was back in the time when a dime had some value, a time when the dime stores flourished and you could actually buy something for 10 cents. In addition to the financing, it provided for research. I am certain it also had great value in allowing kids to feel good about giving.

 

NOT A PENNY FROM ME
Although the March of Dimes pioneered this type of fundraising, others have carried the idea of sending a gift with their solicitation to a ridiculous extreme–which is the basis of the weekly complaint from this old curmudgeon. The dime was merely a symbol, while all the stuff I see arriving along with an essay concerning the plight of those who suffer from some horrible malady or situation, is accompanied by greeting cards, return address labels, ball point pens, calendars, calculators, and even money. The latter are the ones that I find most irritating. They apparently think that if they send me a check for a couple of dollars, I will feel obligated to send them money, which of course makes even less sense.

If these fund raisers in their infinite wisdom believe such tactics stimulate me to contribute to whatever they are selling, they are sadly mistaken. Instead, I feel insulted that they think they must give me something in order to get something from me, or is it that if I get something for free I will feel guilty if don’t respond. In either event, response to such tactics is unlikely to put that spring in my step.

The whole “tactic” just puts a damper on that feeling of goodwill that should accompany generosity. What’s the answer? Well, you could write a blog post about it (or let these charities know what you think by writing them an email or strongly worded letter). Also, Eshrink editor Maggie provided you with that charitynavigator website at the beginning of this post. ‘Tis the Season of Giving. Give wisely!!

IS MY TIME WORTHLESS?

IS MY TIME WORTHLESS?
Ben Franklin said “Dost thou love life? Then do not squander time for that is the stuff life is made of.” I admit that I have not always followed his advice and that I have been a time squanderer of the first order at times in my life. Nevertheless, I strongly resent it when others take it upon themselves to squander a chunk of my time…my life!

 

IS MY CALL REALLY IMPORTANT TO YOU?
It seems to me that I am now surrounded by more time squanderers than any other time in life despite the conventional wisdom that we are now living in a time of unparalleled efficiency. We have all been subjected to the “your call is very important to us” mantra which is usually a prelude to an interminable time listening to some awful sounds masquerading as music. In most cases it would be much less frustrating to suffer in silence. Since such behavior surrounds us we have become inured to it, and in some cases have learned to find work-arounds. For example, whenever I call an organization that I expect will keep me waiting on the phone, I have learned to have reading material available so that I can put the phone on speaker and ignore the music and the automated voice which lies to me with reassurances that someone will be with me soon. Unfortunately, some such indignities cannot be so easily circumvented which brings up the issue of my complaint of the week.

 
MANNERS
My Mother once told me that good manners are simply a matter of showing respect for others. Then I married this woman who was a dyed-in-the-wool aficionado of Emily Post’s book of etiquette and who has devoted a lifetime to training me in such matters. Therefore, I feel such background qualifies me to judge this latest complaint to be near the top of the list of ill-mannered behaviors, and a significant squanderer of my time. As a matter of fact, it ranks right up there near CNN or blog writing as a significant waster of time. I must confess I do feel some ambivalence about ratting out my colleagues because this time I am complaining about the medical profession.

 
THE GATEKEEPERS
In the past I have lodged complaints about the inaccessibility of physicians and the barriers that have been erected to keep doctors isolated from their patients i.e. receptionist, to nurse, to nurse practitioner, or physician’s assistant, and if one’s concern is deemed serious enough, he/she may receive a return call from the nurse or even the great one himself/herself. However; this latest complaint was brought to the fore by a series of events over the last few weeks. It began with a routine visit to my doctor which began with hope that he was running nearly on time since there were only a couple of people in the waiting room.

 
They put the WAITING in the term Waiting Room
I settled in to read a dog-eared magazine of unknown vintage with all the latest (at that time) news about the royal family (not a major interest of mine). It did seem a better choice than the stack of Good Housekeeping magazines. Time passed and I realized that I had been waiting for well over an hour and a half which seemed like an even longer time than I had waited during previous visits. I risked the wrath of the receptionist who was busy chatting with a colleague to inquire if I had the wrong day. She calmly and unapologetically announced that the doctor had been called to the hospital to do an emergency procedure and she didn’t expect him back for another hour or so. When I suggested that if I had known this I could have found other ways to use the time, she shrugged, turned her back to me, and continued the conversation with her friend.

 
This was precisely the type of situation for which I had been trained all those years consequently; with great difficulty I withheld the stream of profanity which longed to stream out for all to hear. Instead, I decided to channel my anger into something useful much as I had been taught. My anger was not directed at the Doctor as I am well aware that emergencies do occur. I am also aware that physicians are not always in touch with what goes on in their outer office. I have been as guilty as the next guy in occasionally running behind, but to my credit I encouraged my receptionist to keep patients informed of probable delays. I also tried to remember to apologize for my tardiness.

 
THE TIME OF RECKONING
With all that in mind I decided to inform the good Doctor about what was going on in his waiting room in a very calm deliberative, hopefully constructive, manner. His response was underwhelming as he responded with: “those things happen sometimes.”

 

WHAT? THOSE THINGS HAPPEN SOMETIMES?
Naive little old me had expected at a minimum maybe an acknowledgement of my distress, an apology for having been held hostage for over two hours, or even a thank you for letting him know that the gum-smacker at the front desk was a screw-up. I did not respond with my usual sarcastic comment out of fear that he might decide I needed a rectal examination.

 
SAVING THE BEST FOR LAST
That experience pales however; compared to Barb’s recent run-in with the medical establishment of which I was an unwitting and unwilling participant. It all began with her visit to our internist for what seemed like a simple problem. When the problem was not resolved, he referred her to a super specialist, i.e., (a person who specializes in a specialty, as when a cancer doctor only treats one kind of cancer or an orthopedist limits his practice to the treatment of big toes). Barb had been forewarned that she should not plan any other activities on the day of her appointment, but little did she know how apt was her friend’s warning.
We arrived at the appointed time with a several page questionnaire filled out as per instructions. A real time saver, right?

Wrong!

We still waited and waited (plus, Barb said he didn’t even look at the questionnaire. Since I was forewarned by Barb’s buddy, I came armed with a boring book. Little did I know that I would finish it before we escaped. Our adventure began with a conventional 1½ hour waiting room experience, and although suffering minor frustration, I felt encouraged after the nurse called for Barb thinking that we would likely make it home in time for lunch after all.

Wrong again.

After another 40 minutes or so, a crotchety nurse came out to tell me that Barb had asked for me to come back to the treatment area where I found her shivering under a paper sheet. When I asked her what the Doctor said she replied that she had not seen him yet, but that she was feeling claustrophobic having been imprisoned and refrigerated in an examining room somewhat smaller than a San Quentin prison cell.

 

When I asked the crotchety nurse if the good Doctor was often late, she replied in the affirmative at the same time complaining that although she was supposed to work until 5 she rarely left before 7 or 8 PM. I assumed this had a great deal to do with her crotchety-ness. The rest of this visit is a bit hazy to me. Suffice it to say when the doctor arrived on the scene, he was very affable and impressed me with his knowledge of the problem at hand. He was unhurried as we chatted about a variety of topics. Our quest for health and happiness had begun at 10:30 AM and we were out the door by 1:45 PM.

 
Lest you think this concluded our dealings with Dr. P…… let me assure you this was not to be our last encounter for he decided that Barb needed a minor diagnostic procedure under anesthesia, and Ms. Crotchety scheduled it for the following week at 1:00 pm. I was not surprised by the time since such minor procedures are usually scheduled after the major surgeries are completed consequently; the schedules for the minor stuff are at best only estimates. With that in mind, I was heartened when we received a call on the day of her minor procedure a few minutes after 12 informing us that Dr. P…… was ahead of schedule and asking us if we could come in earlier. We were there in 15 minutes.

 

Certainly, to be ahead of schedule would virtually guarantee that the procedure could be finished before we caught some drug resistant hospital bug.

 

Wrong again.

 

Although we were promptly ushered into a refrigerated pre-op prep room (one would think the medical establishment would be aware that we old folks are susceptible to major problems from hypothermia), my hopes were dashed as another hour and a half of the stuff my life is made of was squandered. I could have used that time for an afternoon nap. There was a bright spot in the afternoon however when a cute young nurse witnessed Barb shivering in her backless gown and wrapped her in a heated blanket. This may have been the lifesaving act of the day. I have no idea what the mortality rate is in that room, but we survived and I live on to continue in my quest to become the most ardent complainer of our time.
It has turned out that I am not alone in my zeal to achieve the status of Olympic class complainer however; I would caution those so inclined to be robust in registering their complaints (manners be damned) lest their development be arrested at the level of whiner, which is likely to result in chronic emotional constipation. In the interest of full disclosure, I should mention that the foregone conclusion is based on anecdotal information and I know of no large-scale studies to validate my opinion. I also feel bound to issue the caveat that in this era of concealed carry permits one should whenever possible cleanse their complaints of personal insults.

Looking for trees? Check my mailbox.

Our mailman does not seem to like us although Barb and I both consider ourselves to be as likeable as the next guy. Whenever I meet him at our mailbox, he doesn’t respond to my characteristic jolly greeting, but simply hands me my mail, grunts, looks straight ahead and drives away. Old habits die hard and this old psychiatrist still tries to understand aberrant behaviors. Consequently, I have attempted to understand what may have precipitated his apparent animus.

 

The Investigation: Why does my mailman hate me?
It is true that I forgot to leave his traditional tip in the mailbox at Christmas time, but of course that was several months ago.

There was also the Floyd incident, but I wouldn’t anticipate his blaming me for my dog’s exuberant behavior. Floyd loves to ride in the car and isn’t choosy about the type of vehicle or driver. Consequently, when the mail truck pulled up to mailbox one summer day, Floyd seized the opportunity. He leaped into the mail truck with excitement with big plans to accompany our mailman on his route. Unfortunately, in the process Floyd was forced to run through a gauntlet of boxes and crates of mail resulting in the rearrangement of their contents. However, the mailman was remarkably calm throughout the incident and accepted my apology, although I did note that he was muttering to himself as he restored order to the crates of mail.

 

My Epiphany! It’s not me. It’s those damn catalogs.
After all of these deliberations, I have concluded that the ire exhibited by my mailman has the same genesis as my own.

You see, just yesterday he delivered 23 catalogs in addition to two magazines and multiple solicitations from organizations, some of whom I have never heard of, and this was only a routine day. If history is any guide, the volume will increase as the holiday season approaches. Instead of emptying my paper recycling bin once a month, I now must empty it every few days. No wonder my mailman becomes frustrated since he must stuff all that stuff in my mailbox daily.

 

Nothing unites like a common enemy.
His pain is my pain! I sympathize with my mailman’s frustration. I get angry each time I have to unload that mailbox, cursing as I sort the scams from the legitimate mail. As a bona fide card-carrying curmudgeon I must tell you that I remember the day when if one wanted a catalog they asked for it. Today, if you order something  from a catalog, you will soon be buried in an avalanche of slick pictures of beautiful people wearing cool clothes and hawking gadgets I’m sure I need but know I’ll never use. Not only do I resent their audacity of sending the catalog without me requesting it, I resent that they believe they can convince me that I look as cool in those duds as the suave handsome dude who models their stuff.
Some of these catalogs feature stuff way beyond my pay grade. For example, I do not ordinarily shop for $1500 leather jackets, $600 sweaters, or $750 shoes. One such high end catalog featured of all things a $250 pair of jeans faded in all the right places to make them look old. I do occasionally browse and sometimes find interesting inventory. For example, one which featured home health aides also had a two-page display of dildos. I was surprised to find they came in so many different sizes, shapes, and colors. Barb vigorously denies having ordered the catalog, but I have my suspicions.

 

The good ole’ days of face-to-face relationships
It is no secret that there is a flourishing market for names and addresses of potential customers and that these catalogers have no hesitation in selling us to the highest bidder. I recall the time of the mom and pop stores when the relationship between customer and seller was built on mutual trust and therefore personal. The storekeeper was more interested in customer loyalty than making a sale, trusting that if his customer was “treated right” he would come back. Likewise, the customer trusted the salesperson to give an honest representation of the product sold. In many cases shopping was as much of a social event as a series of business transactions. I suppose that now as even we former Sears catalog devotees fade-away, we will become even more depersonalized as we become numbers in Amazon’s super computer. Our computers will order from their computers, our orders will arrive untouched by human hands, and one more avenue of human interaction will close.
Shopping: Art, Science, Disease, or Therapy?
Enter my beautiful, charming, and aesthetically gifted wife. She is a former shopkeeper one of the last to conform to those qualities I mentioned, and whose store continues to receive rave reviews from former customers. Among her other talents she is a world class shopper. As our daughter Molly (now deceased) said regarding her Mother’s shopping prowess: “when Mom gets the scent, you better get out of her way.” For Barb, Christmas shopping is not a project, it is a mission. She scoffs at the idea that it would be much simpler for her to give the kids money and insists on finding a gift (or unfortunately–gifts…plural) which are perfect for each one whether they realize it or not. Things to be considered include: hair and eye color, stature, personality, and consideration of their known personal preferences unless those preferences are in extremely poor taste.
Within the past year the last department store as well as the last men’s store in our town closed their doors. I recall a time when our main street hosted three department stores and multiple specialty shops which have all folded as the big boxes took over. Having fought and lost the good fight with the big guys, and since she places online shopping in the same category as those big box adversaries, the best Barb can do is to reluctantly shop via catalogs even though she disapproved of the one featuring dildos. I presume this change in her shopping habits is responsible in large part for the appearance of our names on a few hundred mailing lists.

 

The List Contagion: It’s a real thing
It’s not only the merchandisers who will pursue you. Barb is a sucker for those tear-jerking ads on TV, which has resulted in reams of solicitations for real and non-existent charities. I wonder if they make more money selling my name and address than from my feeble contributions. In my zeal to become a good steward of my government, I once made the mistake of contributing to a political campaign online. Now, I start my day by deleting pleas to contribute to this or that political cause or candidate. They assure me that without my contribution a worldwide calamity is immanent or that I will be to blame for the extinction of the white rhino.

 

Privacy?
On a more serious note, it has been said that with a few key strokes one can know more about me than I do about myself. This is undoubtedly true e.g. I don’t know where I ate a year ago but that info is available somewhere. Our privacy is said to have been eroded, but it is probably more accurate to say it is gone. Now, as more DNA results are collected not only will more be known about your behavior but your body and your relatives. Nevertheless, the blatant disregard of our rights to privacy as this little essay illustrates is only one small example yet enough to piss me off big time.

 

Ground Zero
Maybe my overzealous anger about the catalogs goes beyond the senseless time spent sorting and recycling and even beyond the invasion of my privacy. Maybe it’s a symptom of something bigger that concerns me. A change in our society that is worrisome. While many say technological changes make it easier than ever to connect with one another, it seems we are more disconnected than ever. Less human interaction. More loneliness. Clicking the chat button as you order gifts on the internet, or even talking to a live person when you order from one of the thousand or so catalogs, is a poor substitute for the process of old-fashioned shopping at the aforementioned brick and mortar establishments where you talked to retail clerks, shop owners, and even fellow shoppers.

 

A little over 100 years ago, a sociologist name of Emile Durkheim coined the term Anomie which he used to describe situations where societies in large measure feel a sense of alienation because their only feeling of attachment is to the system in which they don’t believe or feel a part of. He thought this came about due to division of labor (this was in the midst of the industrial revolution) and rapid change from a traditional society to a modern society.

 

The pace of changes which Durkheim witnessed were trivial compared to the last 50 years, and it change continues to accelerate at a speed almost beyond our ability to comprehend. Yesterday, I awoke to hear news of the second mass shooting in less than two weeks. I believe it noteworthy that most of the perpetrators of these horrible acts were described as people with few if any acquaintances and no one who was willing to call them a friend. They were described as quiet and uninvolved in their communities, in short: alienated.

 

It also seems noteworthy that in spite of relatively good economic times, suicide rates in the U.S. have increased 24% from 1999 to 2014. Likewise, murders increased 8.6% in only one year (2016). According to the non-profit that tracks gun violence in the USA, (www.gunviolence.org) incidents have increased each year since they started tracking statistics in 2014. Conventional wisdom is that our current President was elected and continues to have widespread support from those who feel they have been “disenfranchised.”

 

Who is the patient?
This all suggests to me that we need to look farther than individuals with mental illness as the major factor in gun violence. It may be that it is our society that is ill, and in need of treatment. Human connection, kindness, and compassion might not help cure all of society’s mental illnesses, but it can’t hurt.

 

P.S. Catalog UPDATE
By the way, I just now picked up today’s mail and there were only 18 catalogs, but an armload of solicitations for money, some bills, and a letter from my only friend who still writes via snail mail.  Remember to be kind to your mailperson (especially this time of year).  There may be other Floyds out there and I’m sure there are even more catalog targets like me and Barb on every mail carrier’s route.  (Break for reminiscing): When I was in college a couple of centuries ago I worked as a mailman during Christmas breaks, and occasionally someone would invite me in for a cup of hot chocolate on the coldest days.  I wonder if that happens anymore.

Editors Note: While editing eshrink’s blog, I found this non-profit whose mission is to help us cancel unwanted catalogs: Catalog Choice . However, I haven’t told eshrink yet because I don’t want to rain on his curmudgeon complaint parade…he’s on a roll and I think it energizes him! Love you dad.

The Power of Belief

WHAT SHOULD I BELIEVE

          A few months ago in a blog about conspiracies (May 2017, Conspiracy Theories) I attempted to find answers to the question of why so many of us seem willing to subscribe to stuff even when it is far from the truth, or in some cases totally illogical.  The question has been of particular interest to me having seen many, many patients through the years with disordered thinking leading to false beliefs.  The extreme example of the phenomenon is seen in the paranoid psychotic person whose perceptions are so distorted that his interpretations of reality are far enough removed from that of the average person that he lacks credibility.  They are often so bizarre as to make others sufficiently uncomfortable that he may be shunned.  As a matter of fact, it is not a stretch to describe paranoia as conspiracy theories on steroids.

ARE WE ALL A LITTLE CRAZY?

We now realize that there are many conditions that can impair brain function resulting in paranoia, yet when comparing the paranoiac to the conspiracist, we see they have much in common, which begs the question as to whether the paranoid’s extreme suspiciousness rather than qualitatively different is merely an aggravation of the basic human condition.  After all, suspiciousness has been adaptive behavior for the human race.  It has contributed to our survival and those without suspicions are called gullible and looked down upon.  On the other hand, the conclusions arrived at by delusional thinking are rigidly held in spite of whatever logic or facts are presented.  In like manner, the political zealot’s ideas seem set in concrete, and he brushes off contradictory information as either irrelevant or untrue.

THAT TRUTH THING AGAIN?

If suspiciousness is not only protective but in search of truth, why do we so often believe stuff when there is no evidence that it is true.  Any good con man will tell you the best way to gain trust is to tell the mark what he wants to hear, and the best lies are those that confirm what he already believes.  As a personal example, there is the case of Donald Trump, who I thought was a jerk long before his TV show.  Granted, that opinion was based on feelings and maybe not even rational for obviously I didn’t really know him.  Nevertheless, I am now even more convinced that he is a jerk and moreover a bad President.  Consequently, I suck up what is said about Trump on MSNBC and reject what Fox News has to say as bullshit.  I find it difficult to understand how some of my friends can listen to the Fox News bullshit, and I am sure they feel the same way about me and MSNBC bullshit.  As a consequence, we rarely discuss politics, but I am sure that they talk politics to friends who are of like mind while I rap only with the anti-Trump contingent.  Perhaps this is not such a bad thing. One study indicated that groups with opposing beliefs actually became more extreme in those beliefs while discussing the issues with those who differed with them.  Thus, there may be wisdom in the maxim that “one should not discuss politics or religion in polite company.”

CATCH 22 AGAIN

Unfortunately, that policy presents us with another one of those unresolvable dilemmas, for if one assumes that it is impossible to resolve differences without discussion and discussion simply reinforces beliefs, compromise is unlikely to occur.  The phenomenon does offer a measure of security to politicians or political parties in that limited exposure of their base to contrary ideas will keep them in the fold.  With that, he can devote more resources to winning the independent vote.

When I was a kid we played a game called Follow the Leader in which participants were to follow the behaviors of the designated leader, and those who failed to mimic the leader were expelled until there were only two players remaining, at which point the one survivor would become the leader and the game would resume with the new leader.  There is ample evidence that similar behaviors are seen in nearly all aspects of human behavior, and that we are indeed herd animals.

SO YOU THINK YOU ARE A THINKER?

There is a famous British study in which a large group of volunteers were asked to walk aimlessly around a large hall without talking to anyone, while a few were secretly given instructions as to where to walk, and to appear confident of their destination.  95% of the crowd followed those who appeared to know where they were going, in much the same manner as would a flock of sheep follow a Judas goat.  This phenomenon, only one example of what has been called herd behavior or herd mentality, has received a great deal of study through the years by philosophers, psychologists, sociologists, economists, theologians, historians and even psychiatrists like Freud and Jung.

The principles of herd behavior, or tribalism, have been found to have great utility in influencing all manner of human behaviors.  Indeed, it is difficult to imagine any aspect of our lives that is not affected in some way by our tribal memberships.  Those of us who fancy ourselves to be independent thinkers have little awareness as to how these and other genetically ingrained behaviors unconsciously affect not only our behaviors, but our thought processes, opinions and beliefs.  To belong, one must conform and conform we do, often with little awareness of why we do so.

HERMITS NEVER MAKE IT

The importance of herd behavior is not lost on the world’s politicians and despots.  They know how to make use of our need to belong to a group or to use a shrink term to be “validated.”  In order to brainwash someone or start a cult, one must begin by isolating the prospective victims in order to deny them validation so they will eventually align themselves with their persecutors.  They make use of the fact that as herd animals, contact with other living things is essential, and they hope that their victims will eventually accept whatever relationship is made available to them.  Similar dynamics undoubtedly play a part in the development of the “Stockholm Syndrome” as in the case of Patty Hearst, who joined the cause of her anarchist kidnappers after having been isolated and abused by them.  As I mentioned in a previous blog, it has been shown in several studies that solitary confinement often results in the development of psychosis, further evidence of the importance of relationships.

JUST ONE OF THE GUYS

It is largely accepted as fact that negative political campaigning is more effective than merely focusing on issues.  In such cases the emphasis is not on issues, but rather on his/her opponent’s character and identity.  The candidate will set out to show that he is like his audience and thus is a member of their tribe while his opponent does not belong.  When addressing a blue-collar audience, he may shed his coat and tie and roll up his sleeves.  The recent election has demonstrated that a baseball cap can generate more votes than a resume in those rallies while more formal attire will be chosen for $1000-a-plate dinners.

HERDS GONE WILD

Nowhere is the herd concept better illustrated than at athletic events.  I have been an Ohio State fan all my life, which by the way is a long time.   Of course, football is the most raucous of all modern sports and one in which tribalism is on full display.  I paid significant sums of money for the privilege of sitting in crowded uncomfortable seats sometimes in rain or snow. Surrounded by 100,000 fellow tribe members all rooting for the enemy to be vanquished, I felt I truly belonged.  Fellow tribe members were readily identified by clothing adorned with the school colors.  We pledged our fidelity by singing the alma mater followed by the school “fight” song.  Seating was arranged so that the opposition fans were separate from us good guys, and the cheerleaders encouraged our totally uncivilized behavior.  The best seats are those on the 50-yard line not only providing a better view of the action but placing the fan in the center of the crowd much as other herd animals jockey for position to be in the center of their herd.  Our loyalties also affect our beliefs, e.g., questionable calls by the refs are bad if they favor the other team, and the boos of one are apt to be taken up by other fans.

In similar manner mob behavior can be initiated, and there have been instances where those officiating games have feared for their lives.  Soccer games seem especially prone to mob behaviors.  Political rallies can be orchestrated to take advantage of that same dynamic.  It is said that Hitler frequently placed plain-clothed SS agents in crowds when delivering his tirades. Their job was to stir up the crowds by cheering his every word thereby stimulating herd behavior, a technique not lost on modern day political organizers.  For example, it is clear that the “lock her up” chants during the last presidential campaign were not entirely spontaneous.

GOOD GUY, BAD GUY

Throughout history leaders have come into power by designating a person or group of people as enemies.  A prospective leader must be able to place blame for whatever widespread complaint exists, and convince his audience that they are under assault by the bad guy or a group of bad guys.  It is helpful if he can induce hatred, for passion increases voter turnout, and the resulting divisiveness is encouraged.  An opponent will feel compelled to respond in kind to the accusations and the campaign becomes a battle of personalities rather than ideas.  Charisma triumphs and meaningful debate never happens.

We are all under a great deal of pressure to believe as are our fellow tribesmen. Consequently, we are strongly influenced to share our beliefs with those who are sympatico, which often leaves us isolated from those who don’t share those beliefs.  In a previous blog, I referenced a study which demonstrated that people are more apt to believe information obtained from a friend than from conventional sources, another indication that belonging is enhanced by sharing beliefs.

IS INDEPENDENT THINKING A LOST CAUSE?

Although many of our beliefs are buttressed by facts, there is also a certain amount of volition involved.  We sometimes reject beliefs that we find objectionable in spite of significant corroboration, and readily adopt those we find appealing despite limited evidence of their validity.  Religions demand professions of belief if one is to enter into the fold, be eligible for an afterlife or in some cases even one’s mortal life.  Early Christians presented their captives with a choice of believing or dying.  Radical Muslims are reported as doing the same even today.

Today, there are powerful pressures brought to bare in efforts to channel our beliefs.  We are drowning in information, much of which is distorted or false.  We are affected by advertising so sophisticated that it is personalized to each of us.  News sources which we trusted to provide truths are under assault.  Then there is that whole internet thing which muddies the waters even more.  Perhaps it is understandable that in our search for a lifeline we should reach out to our tribe to tell us what to believe.

Addendum by eshrink’s offspring (Maggie)

So, what is the answer to this dilemma? Maybe recognition of our need to belong is the first step to evaluate our own ability to think rationally. Instead of convincing or attempting to persuade others, maybe more listening and less talking will lead to greater understanding. No matter our opinions and thoughts, greater understanding and close relationships are what define the human condition.

One of the primary teachings I learned while earning my journalism degree was one of neutrality and learned objective behavior. “A reader should never know what your opinion is. Save that for the editorial page,” a professor preached to our class. To counter the need to disagree, I was taught to ask why. There is always more value in understanding why someone believes something than trying to convince them why their thinking is flawed. To ask the question and learn about their thought process (if there is one) can lead to greater understanding for the person asking the question and sometimes illicit the process of critical thinking in the one whose opinion differs from your own.

At the end of the day, this life is about relationships. Humans connecting with one another. Maybe we can be an example for the pundits and the politicians who want to gain power by dividing rather than unifying. One can only hope.

 

 

 

 

 

 

 

 

 

 

 

 

 

 

HOW MUCH ARE KIDS WORTH?

Tragedies involving children always get a lot of press, and the most recent example concerned a school bus accident in Tennessee in which six children were killed. In such cases, there is usually a search to determine who was at fault, and this was no exception. If an act of human negligence is found to be the cause, we can add outrage to our feelings of sadness and horror. The headlines become larger, and blaming reassures us that there is someone out their more careless and uncaring than ourselves.

busblog

NOT MY FAULT
In such cases as this, we only need to look as far as the nearest mirror to see who is responsible. It is true that there were warnings about this driver, which should have been enough to prompt his removal from such an important job; however, no action was taken. In such cases, should responsibility not be shared by those who have the ability to prevent such a horrendous tragedy? We profess that these bus drivers carry our most precious cargo, so should they not receive the highest level of scrutiny? Qualifications for school bus drivers vary widely from state to state. Pennsylvania requires considerable classroom and on-the-road training, physical and mental evaluations, and extensive background checks, while my state (Ohio) requires only a commercial license with passenger designation. I suspect that Brink’s truck drivers may be more highly trained and investigated. After all, they are carrying money.

brink-s-truck
WHY?
There was a school bus accident in my county six years ago, and 7-year-old Kacey was killed. Video from the inboard surveillance seemed to show that the driver had lost consciousness. I was surprised to learn that in our state, school buses were not required to be equipped with seat belts. This made no sense to me then, nor does it now. Since 1968, I have been required by law to fasten my seat belt, yet our children are left to fend for themselves in a large, top-heavy, tin can mounted on a truck chassis. Following the accident, there was talk by our state legislators of requiring seat belts, but, as is often the case with politicians, they were long on talk but short on action. After reading that the bus in Tennessee did not have belts, I inquired at my local school board office to find out about the status of the seat belt issue and was told that our buses still do not have any physical restraints. When I asked why, I was told that the state had not mandated them yet (not an adequate answer in my opinion).

ARE YOU SERIOUS?
The latest information I could find on the subject was that only six states mandated seat belts on all school buses. The National Highway Traffic Safety Administration (NHTSA) does not require or recommend seat belts on all buses weighing more than 10,000 pounds. They concluded that “the crash forces experienced by occupants of (heavier) buses are much less than that experienced by occupants of cars, light trucks, or vans.” Could this mean that my 10th grade physics teacher was “full of it” when he gave us that force formula f=ma?

The NHTSA has initiated a concept they call “compartmentalization,” which they insist offers superior protection in crashes. Protection is offered by the use of high seatbacks which are highly padded, and designed to absorb the shock of a frontal crash. Crash tests confirm their effectiveness in head on crashes. NHTSA in 2002 testified in Congress that seat belts were unnecessary, pointing out that school bus travel was the safest form of ground transportation available. Indeed, their statistics are impressive when one considers 440,000 school buses travel 4.4 billion miles each year carrying 24 million kids with only six fatalities.

FOLLOW THE MONEY
Studies by the University of Alabama in collaboration with NHTSA concluded that “the cost of installing seat belts on every bus is prohibitive.” They estimated that it would cost $8,000 to $15,000 per bus. The studies also concluded that schools would need to increase their bus fleets by approximately 15% due to space requirements for belts with a total cost of $117 million per state. Their final opinion was “costs far exceed benefits.” That and similar statements undoubtedly lead a group like The National Coalition for School Bus Safety to say the issue is influenced by “an economically driven industry.” These statements also lead us to the question: how much are we willing to pay for a few kids’ lives?

DAD DESERVES A MEDAL
In December 2010, Today.com reported an accident in Texas similar to both the recent one in Chattanooga and the one that happened in my town. In 2006, a Texas school bus carried a high school girls’ soccer team when it was forced off the road into a ditch and rolled over. One girl was thrown through the window, and her arm was pinned under the bus, resulting in serious injury. Two other girls were killed, and there were other less serious injuries.

One of the fathers was convinced that a seat belt would have saved his daughter’s life, and he vowed to do all he could to see that all school buses would be equipped with seat belts by law. The Texas A&M Transportation Institute reached the same conclusions as had the University of Alabama, but, in spite of those objections, the law passed largely due to four years of continuous lobbying by the victim’s father. There must have been some buyer’s remorse, for the funds designated for the project were immediately cut by two thirds. I have no recent information about the status of the law’s implementation.

THEY ARE TOP HEAVY
The thing these nine children have in common is that they all died in a school bus that flipped. The design engineers who invented the “compartmentalization” strategy to prevent injury must realize that Ike Newton was right about that gravity thing; therefore, if a “compartment” does not have a lid on it, the contents are likely to fall out and scatter every which way when it is turned upside down.

0709prochoice06

We will never know if seat belts would have saved Kasey or any of those other kids, but we do know that compartmentalization did not work for them. There are instances recorded that imply lives would be saved with seat belts. School administrators in districts where seat belts are used also report fewer problems with driver distraction, bullying and disciplinary problems.

Another unanswered question is to what effect the addition of seatbelts could have on reducing non-fatal injuries. The Ohio Department of public safety reported 1,590 school bus accidents last year, resulting in 282 injuries. I could find no information as to the seriousness of those injuries.

SIX DEATHS TO SEE A PROBLEM?
The only good news resulting from the Tennessee tragedy is that it has reawakened the debate about school bus seat belts. The NHTSA has reversed their position and now favor seat belts for school busses. Administrator Mark Rosekind is quoted in an Associated Press release that, even though school busses are the safest means of transport to and from school, “they could be safer.” The good news is that he has strongly recommended a national initiative to require lap and shoulder seat belts since November 2015; the bad news is that no action has been taken in that regard.

The last directive by the NHTSA regarding seat belts was in 2013, when a policy was implemented requiring new buses be equipped with seat belts with two exceptions: namely, transit busses and, you guessed it, school buses. I, for one, was incensed to read that the powers that be prioritize the safety of passenger buses above that of children, but, in spite of the good words by Mr. Rosekind, that policy appears to still be in place.

MORE TALK
Just a few days ago Mr. Rosekind once again voiced his unequivocal support for seat belts. He was convinced that school bus seat belts had saved lives and that others could have been saved if protected by belts. He went on to estimate that 70% of school bus deaths could have been prevented by seat belts. Nevertheless, despite the mountains of data that have been collected, he declined to issue a directive and planned more study of the subject. A major concern was how to finance such a program, and he even suggested that some school districts might need to be exempted from the requirement for financial reasons. Once again, money appears to factor in to a life-or-death decision.

According to a report in the November 28 issue of People/Crime, five days before the Chattanooga accident, one of the elementary student survivors wrote the following: “the driver was doing sharp turns and he made me fly over the next seat. We need seat belts.”

Out of the mouths of babes!

Note from the editor:

I found this topic particularly interesting, so Eshrink and I compiled a list of some articles for further reading.

Data and Statistics of School Bus Fatalities Over Ten Years

USA Today Article

 

SEARCHING FOR PATRIOTS:

PEOPLE WHO LOVE, SUPPORT, AND DEFEND THEIR COUNTRY AND ITS INTERESTS

The fat lady has sung and it is finally over. Hillary won the battle (most votes) but lost the war. It’s time to wipe away the tears and take off the black arm band. The center of the universe has been relocated to the lobby of Trump tower, where supporters arrive hoping to take the elevator to the top and be rewarded by the great one. We were wrong about so many things. We expected this to be a landslide victory for the Democrats, but we were also wrong about Mr. Trump. From the very beginning of this crazy campaign, he had been telling us that he was the greatest, and now here he sits at the top of his tower dolling out goodies to the faithful as he becomes the most powerful person in the world. It doesn’t get much greater than that.

 

THE NASTIER THE BETTER
Conventional wisdom says that negative campaigning works, and this election has set new records for the use of that strategy with name calling, character assassination, unproven accusations, misquotes and even threats. In most any other situation, such discourse would be labeled slanderous. There has also been a great deal of scapegoating, divisiveness, and fear mongering. I, for one, can see no benefit to my country by the use of such tools by our leaders, which inspired me to ask the question: “Where are the Patriots?”

We hire our leaders in jobs all the way from school boards to presidents to run things and look out for us. We expect integrity, and we hope for wisdom. It seems to me that both are too often lacking. The size and complexity of the operations of the federal arm of our government must make for endless opportunities for corruption. When those we have hired make self-serving decisions rather than for the common good, we are betrayed. Rude and disrespectful behavior by our leaders cheapens us all. Those who promote hatred between groups of citizens weaken our country, for as one of our most famous Patriots said, “We must all hang together or we shall all hang separately.”

 

IF YOU CAN’T BREAK IT, GO AROUND IT
The separation of powers principal was wisely developed by the founders to hopefully eliminate the effect of the lust for power that is so common in many job seekers. Congress is charged with the making of laws, the Supreme Court with deciding on their legality, and the president with the power to veto. Initially those selected to govern considered it a sacrificial duty to serve, and there were not many clamoring to leave their farms to spend time in Washington. However, it was not long until debates in the halls became a bit rancorous, factions developed, and eventually the two party system evolved. Nevertheless, issues continued to be debated. Recently, however, congressional rules have been used to stifle debate, and the majority leader in the senate not only refused to bring up for vote bills unpopular with his party, but shamelessly announced in public that his first priority was to prevent the president from having a successful term. This was said without any apparent regard as to the effect such obstructionism would have on the country.

 

NAÏVE ME
This statement floored me, for, despite my inherent cynicism, I still believed that those whom we had employed were more concerned about their country than their political party, or their reelection. The idea that 250 or so people could all sit in the same room and have the same opinion about anything flies in the face of anything we know about people, yet the party proceeded to vote in lock step against every issue proposed by their congressional opponents, or the President. There were record numbers of filibusters. Compromise became a dirty word, analogous to the N word to describe our President. Of course, Democrats were not entirely blameless. The dislike each side had for the other reached an intensity bordering on outright hatred. I ask you, how could these guys call themselves patriots?

This level of dysfunction virtually guaranteed that little work would get done. There was more time and money spent on investigating each other than legislating. As a matter of fact, they passed fewer bills than at any time in recent history. People were fed up, and Congress’ approval ratings fell dramatically to record lows. Congress was judged to be even worse than the President, who was very near the bottom himself. Rather than having rational, adult discussions in search of solutions to the country’s problems, they chose to blame each other.  Much time was wasted, and there was little time to waste. After all, this had become a part time job. Some of these guys admitted that they spent more time raising money than on governing.

 

PARTY LOYALTY
The people were angry and were looking for someone different to run things, and they found such a person in Donald Trump. Oh was he different. In fact, many in his own party scoffed at him for entering the race. They refused to endorse him and cited a number of reasons why they judged him unfit to be president, yet, after he was nominated, they said they would vote for him. They gave no reason for their vote, and few indicated their opinion of his competence had changed. I was appalled at the thought that elected officials would vote for a leader who they were convinced was unfit. Anyone who believed Mr. Trump was unfit to be President would obviously believe that such a presidency would put our country at risk. How could anyone put party politics ahead of their country? I was also disappointed that no one seemed to take note of this behavior, which I thought was, if not treasonous, certainly unpatriotic in the extreme. I am sure that if questioned about this decision to vote, we would hear that the other choice was worse, but that doesn’t excuse it in my opinion.

 

IS ANYBODY OUT THERE?
It would be reasonable to expect to find a lot of patriots in the halls of our government, and I am sure there are many who satisfy the criteria as defined in the subtitle of this paper; although at times they are not very visible.  It seems to me that patriotism should be a requirement to be considered for the job and that applicants should understand what that word entails. An American flag behind a desk doesn’t guarantee its occupant is a patriot.  That can be known only by his deeds. Although this country screws up occasionally, we have much for which we can feel proud and grateful. One of such things is the freedom to say most anything, and even to be a jerk, but civility is probably more effective as a strategy to get things done. That freedom has been paid for with the blood of patriots. It demands our respect and should never be abused. Let’s hope patriots  prevail, and our leaders read their job descriptions carefully.