If one searches for the term “Halloween” in Pubmed, the database for the National Library of Medicine and the National Institutes of Health, a few articles (out of 53) are related to psychiatry:
- Halloween psychosis. (No abstract! Feh.)
- Halloween, the 50-Megaton Bomb, and the Cuban Missile Crisis. (From the Journal of Analytical Psychology. No further comment.)
Quite a few are related to insects, usually in reference to Halloween genes.
There are also a couple of articles related to a specific breed of pumpkin. (”Pumpkin” is such a cute word!)
Some of the most interesting are related to emergency medicine:
- Eye injuries from eggs (or, more precisely, “blunt ocular trauma resulting from thrown eggs“; the authors conclude that the press should not condone the throwing of eggs)
- Some depraved souls apparently still insert needles into apples.
- Still other nefarious characters taint pastries: The case of the slandered Halloween cupcake
The radiologists opine, too: Should we X-ray Halloween candy?
The CDC published two pieces:
- Childhood pedestrian deaths during Halloween - United States, 1975-1996 (”The findings indicate that the number of childhood pedestrian deaths increased fourfold among children on Halloween evenings when compared with all other evenings.”)
- Urban community intervention to prevent Halloween arson - Detroit, Michigan, 1985-1996. (”By 1984, October 30 became known as “Devil’s Night” and had evolved to 3 consecutive nights of arson on October 29-31….”)
And some seem fairly random: ‘Halloween diarrhea’. An unexpected trick of sorbitol-containing candy.
For non-medical Halloween literature, here are some spooky stories.
Enjoy your Halloween and be safe: Don’t throw eggs, wear goggles, don’t accept any caramel apples, but don’t bother to X-ray your candy, and don’t eat too much candy, either. Don’t set things on fire, avoid crossing streets if you can, but if you must, look both ways before doing so, and keep your id in check.
30 Oct 2007 | 4 comments.
Psychiatric Link-o-Rama!
>> Someone left an article for me: “How ‘Objective’ are Psychiatric Diagnoses?” The photocopied pages were cool to the touch and a yellow Post-it note, with nothing written on it, was stuck on page three. I was not entirely sure that the article was meant for me, though I suspected this was the case: I recently delivered a presentation at a conference and discussed the problems with validity and reliability in psychiatric diagnosis. There was some mild protesting.
The article (available in its entirety in the above link—it’s short) argues that there exists reliability in psychiatric diagnosis (though the question of validity remains unanswered) that is comparable to or perhaps exceeds medical diagnosis. The author concedes that he did not conduct a thorough review of the literature (psychiatric or otherwise), but, to be fair, what information he does present did capture my attention (his examples include cancer and arthritis). The anonymous donor of this article must have anticipated this.
>> I received a copy of New York Presbyterian Psychiatry in the mail today. I find this curious for three reasons:
- I didn’t even know New York Presbyterian Hospital produced a psychiatric newsletter.
- I don’t live in New York City. I live in Seattle. How does the hospital know anything about me? (To be clear, New York Presbyterian Hospital is not affiliated with a consult-liaison psychiatry fellowship, though the two institutions affiliated with that hospital do offer fellowships. I shan’t write anything further.)
- Why would they start sending me this newsletter now?
Omen? (!)
The cover story of this newsletter is “Borderline Personality Disorder: Researchers Advocate Transference-Focused Therapy”.
Ah ha, I mused. New York City wants to compete with Seattle.
Dialectical behavior therapy (a behavioral intervention for borderline personality disorder) was developed in Seattle. Transference-focused therapy (a psychodynamic intervention) was developed in New York City. It’s not just a transcontinental clash (okay, maybe “clash” is too strong of a word); it’s also a theoretical debate. Let the behaviorists and analysts have at it!
This is interesting. You betcha I’ll be presenting the paper on transference-focused therapy for borderline personality disorder at the next journal club—it’s amusing (…) to point out and poke fun at the potential polarization, particularly since dialectical behavior therapy is all about dialectics!
>> There is a proposal in to fund mental health services in King County. The plan suggests a 0.1% increase in sales tax to fund services to decrease incarceration, increase resources for youth, and provide more assistance for the mentally ill who are homeless.
As someone who is currently working with homeless, chronically mentally ill individuals who frequently end up in jail (usually for criminal trespass, failure to appear, and the occasional assault 4) in Seattle, I can (grossly) see how the extra funding could be extraordinarily helpful. However, I can also see how voters would rather spend the money elsewhere: It’s more bureaucracy and more money doesn’t necessarily equate to positive change. (Just how much of the money will translate into concrete services that the chronically mentally ill can access? etc.) For those who endorse the opinion that people who are homeless and indigent “deserve” that fate due to character flaws (laziness, substance use, stupidity, etc.), it certainly doesn’t make sense to give earned riches to the poor. (”Robin Hood was totally overrated!”)
Meritocracy doesn’t apply to everyone, despite the fact that it is ingrained in American culture.
There are 29 pages in the proposal. I need to start reading.
29 Oct 2007 | 3 comments.
More on Running.
>> I’ve been running regularly for almost six months now. I would have never anticipated that I would one day identify myself as a “runner”. And while I do support cardiovascular fitness, I support even more the way my body now looks. (Allow me to indulge in my vanity, please.) I have not lost any weight, but I have lost girth—and have subsequently gained complimentary commentary from friends. I like to look fetching.
>> The cumulative distance I have run over the past six months is over 100 miles (about 160 kilometers)! That’s like running from Sacramento to San Francisco! From Anaheim (Disneyland) to (the) San Diego (Zoo)! From Baltimore to Philadelphia! From Philadelphia to New York City! (What? I’m not preoccupied with New York City—what are you talking about?) Realizing the distance I have covered is rewarding—the measurable accomplishment brings me a sense of pride.
>> Running has helped me to chase buses with greater efficiency. Not only can I chase them farther, but I can also sprint faster after them. I’m more likely to catch them, particularly if they are of the double-length variety. (Not that I routinely chase buses, of course. I value punctuality.)
>> The cardiovascular fitness I have gained from running has helped my dancing, too. I no longer gasp for breath during (and after) faster songs. The limiting factor is now the (lack of) speed of my footwork, not my heart. (And, as a corollary, dancing has helped my running because I am more aware of the location of my center of gravity when I run up and down hills. I still get a little freaked out when I am dashing down hills when it is raining, but I have more confidence as to how I would fall—not on my face or head—if I stumble.)
>> It’s difficult to get out of the door these days. It’s not the cool, crisp mornings that increase my reluctance (though, admittedly, that does contribute to it—cold ears are uncomfortable): It’s the darkness. I miss the mornings when the sky was already aglow with light by 5:30am. Now, it is dark when I start running… and remains dark while I am running… and is still dark when I am done. Hooray for dorky-looking reflective vests!
>> There is something to be said about experiencing the early morning on a consistent basis, and this “something” is this: I have a greater appreciation for how the world changes with time. I’ve watched the light gradually fade from the morning sky as autumn descends upon us. I’ve watched the fog quietly slither down the hills as the day unfolds. I’ve felt a variety of rain against my skin, from soft, misty caresses to insistent, annoying spitwads. I’ve noticed the leaves collecting in mounds along the gutters and the way the sidewalks look brighter as a result of unobstructed street lamps. There’s the way the air feels on those mornings when it will rain, but hasn’t yet. The same windows in the same houses are consistently illuminated with light.
These are the reasons why running indoors seems like a terrible idea.
>> My most prized reason for running, though, is probably the stress relief and the “cognitive processing”. Ideas trickle through the folds of my brain while I run: I consider, ponder, contemplate, ruminate, deconstruct, reconstruct, and reflect. Sometimes, thinking about anxiety-provoking things while my heart rate is high makes me feel that much more subjectively uncomfortable, though that, in of itself, reminds me to be mindful of my (loud) breath. When I run East, I imagine that I am running towards New York City (me? preoccupied?)… and running helps me deal with the fact that I can’t do anything about that situation right now (except wait). That I have added another three-plus miles to my ongoing tally, though, is personally satisfying, and somewhat compensates for my current impotence in regards to my future next year. (Though my initial goal was to simply be in New York City for the fellowship, I am now smitten with a particular institution—and (im)patiently wait with bated breath.)
A good friend of mine (who also runs) insisted that I commit to an agreement: If When I end up in New York City next year, I must purchase a running skirt.
“But why?” I protested. It is a rare occasion that I wear a skirt as it is.
“Because, that way, you’ll look cute when you’re running in Central Park,” she teased.
We shall see!
28 Oct 2007 | 9 comments.
Three Scenes.
He was walking ahead of her in the crosswalk. The red hand was already flashing and, to the right of the scarlet palm, the number was steadily approaching zero.
“Come on!” he yelled. He didn’t even deign to look over his shoulder. “Why you gotta walk so slow? Walk faster!”
He finally turned his head and glared at her. The red hand had stopped flashing. The traffic lights overhead glowed green.
“Hurry up!” he irritably remarked as he stepped onto the curb. She was trailing about five feet behind him and, taking little steps, eventually joined him in the safety of the sidewalk.
He was probably in his early 30s. She was no more than three years of age.
I rarely have the opportunity to mill through Pike Place Market during the week. An unexpected free afternoon allowed me to anonymously wander along the waterfront.
Falafel sandwich in hand, I strolled through the Market as the breeze from the bay gently tossed the ends of my scarf into my face. It was surprisingly empty; the usual hordes of people who ogle the fish mongers, cram around the florists, and smell the bright fruits were absent. I walked with ease and did not feel the need to protect my sandwich from offending others.
The buskers were busy, performing passionately for their invisible audiences. A young man with hair covering most of his head and face howled along with his banjo. A blind woman, her arthritic fingers cradling the signature red-and-white cane, sang a quiet lullaby outside of Starbucks. An older fellow, hunched over on a beat up stool, strummed his tired guitar while humming.
The fragrance of the falafel sandwich wafted to my nose and I felt the saliva pooling in my mouth. The melodies from the buskers floated through the air and as one faded, another one swelled into full volume. I walked the entire length of the market with music in my ears.
Aren’t we all singing songs about our lives? I wondered. Some people just sing louder than others.
She looks terrible.
Yes, it is a judgment, but she looks terrible.
Her face is misshapen. Distorted. Asymmetrical. Wrinkled. Her mouth contains maybe five teeth, at most—and those that remain are dark and craggly, like abused blocks of concrete. Her hair is thin and stringy, her body is lumpy and sags, and her clothes are unclean and oversized. She looks twenty years older than she actually is.
She stands on a traffic island and holds a sign. In block letters, she advertises that she has no food and no money. She doesn’t smile; she doesn’t frown. She simply stands there and she looks terrible.
People assume things about her. Some people avert their eyes. Some people scrutinize her. Some people give her a spare dollar or loose change. Some people give her bags of food.
Everyone drives by.
Some of the assumptions people have about her are true: She is homeless. She doesn’t have the skills right now to hold a steady job. She does imbibe in large volumes of alcohol from time to time.
But there are the things that people don’t know about her: A man forces her to stand on the island and panhandle for him. He hits her if she refuses. Sometimes he asks her to do more than just panhandle.
He takes all the money she collects. He tells her what her name is, where she is from, and what her problems are.
She is scared of him. She wants to leave him; she doesn’t feel safe around him anymore. She only meets with the outreach worker and psychiatrist when she is alone; the man has already warned her to avoid them.
She wants to leave, but she has yet to do so.
I saw her on the traffic island tonight on my way home from work. She still looked terrible. After scrutinizing her, I averted my eyes.
And then I drove by.
25 Oct 2007 | 3 comments.
Gentleman.
Stories begin and end on Third Avenue.
Tourists wander past on their way to Pike Place Market, the Seattle Art Museum, and Pioneer Square. Buses roll past in roaring caravans along this arterial route. Men in dark suits and women in heels and with highlights in their hair hurry past towards the skyscrapers. Delivery men push carts carrying towers of boxes.
Men solicit women for sex. Women solicit men for cigarettes. People solicit other people for crack cocaine.
Men push over trash cans and punch the buses at the bus stop. Women scream obscenities at passing cars.
We were walking in opposite directions along Third Avenue. After I called his name, he looked up and saw me smiling at him.
“Oh… hi,” he mumbled, slowing down. He scratched his auburn beard with the long, dirty fingernails of his hand. He wasn’t wearing the same clothes he wore when I last saw him two weeks prior; now an oversized grey tee shirt hung on his stocky frame and tattered (but clean) blue jeans covered his legs. His shoes were white and loosely laced. A faded green sweatshirt was tied around his waist.
His diagnosis is schizophrenia. His name is Robert.
Robert is about my age. We have known each other for about three months. He likes Corn Nuts and orange soda. He prefers his coffee without cream and sugar. He was born in Idaho and spent part of his life in Montana. Before coming to Seattle, he lived in Nevada. He said he has two older sisters, though he doesn’t keep in touch with them anymore.
“We don’t have much in common,” he simply remarked.
Robert and I don’t actually communicate well with each other. I don’t understand over half of what he says to me:
“How are you, Robert?”
“Oh! I’m fine. Apples! You know about the apples, right?”
“The apples?”
“Red apples. Only the red apples.” He looked at me, an expression of curiosity on his face. He then burst out laughing, slapping his knee in amusement. I couldn’t help but smile.
“Oh… it’s just apples. But yeah! I like orange soda. Burritos, too. And macaroni and cheese. The cheese is good,” he continued. He stopped talking and looked at me quizzically.
“Did you eat breakfast this morning?” I offered, concerned that he was hungry.
He looked at me. Five seconds passed. Then ten. He finally rubbed his face and replied, “Yeah. Yeah! I ate.”
Robert tolerates my company. I like him.
He and I stood on Third Avenue while the morning crowd milled past us. He was mumbling.
“I can’t hear you,” I said.
“I like the sun,” he answered.
“I’ll follow you,” I answered, pointing towards a swath of sunlit sidewalk. He continued to mumble and began to walk. I hurried my pace and joined him at his side. I craned my neck to hear his murmurs, but the bus engines drowned him out. He was looking at the ground and making small gestures with his hands. Though he was still talking, I wasn’t certain that he was talking to me.
A crowd of people engaged in animated conversation approached us. They were clearly engrossed in their conversation and did not seem aware that Robert and I were heading towards them. I was already calculating how I would walk around them—
—when suddenly, I felt Robert’s hand gingerly touching my arm. He gently pulled me out of the way of the oncoming crowd moments before they brushed past. By the time I realized what had happened, he had already released his hand and I saw his arm drifting back to his side.
He then resumed mumbling to himself, his eyes downcast. When we reached the section of sunlit sidewalk, he hesitated and slowed down. He made one last small gesture and asked a quiet question to the ground.
Robert then looked up, squinted at the glowing morning orb, and, looking at me, said, “I don’t know. Where do you want to go?”
23 Oct 2007 | 4 comments.