When The Going Gets Weird, The Weird Turn Pro

Hunter S. Thompson killed himself a year ago today. I was disappointed and crushed and went to a bar soon after I heard the news that evening. I drank whisky and came to understand why he did it. He'd been an outsized literary hero (an all-too rare thing in America), a journalist who changed journalism, a comic genius with a pen and a very shrewd observer of human character. And, then, he wasn't anymore. By the late-1990s, HST had become a hack. He had been a huge influence on me when I was young--for me, he's right up there with Hemingway, Rilke, Carver, Rimbaud and Henry Miller. A crazy motherfucker who was seriously after the truth and intent on finding it on his own terms and sending energy off in 16 directions at once. He was also funnier than all those other writers put together.

But something died in Hunter years before he put a gun to his head and pulled the trigger. He'd stopped doing any truly original work and pumped out an occasional column for ESPN.com. This was not pleasant to watch. His letters and assorted writings came out in various collections. He still did crazy shit with guns and drugs that got him into the news. But he was done as Dr. Thompson and he knew it. The guy who'd once shouted "I hate to advocate drugs, alcohol, violence or insanity to anyone, but they've always worked for me" was quickly becoming a dried-up old man. To go from large gifts to utter literary silence had to be too much.

His suicide is one of the few perfectly rational acts (there is evidence that he planned the business) of self-destruction that I know of. It was like he'd earned the right to off himself. As a pal of his put it:

"He told me 25 years ago that he would feel real trapped if he didn't know that he could commit suicide at any moment. I don't know if that is brave or stupid or what, but it was inevitable. I think that the truth of what rings through all his writing is that he meant what he said. If that is entertainment to you, well, that's OK. If you think that it enlightened you, well, that's even better. If you wonder if he's gone to Heaven or Hell--rest assured he will check out them both, find out which one Richard Milhous Nixon went to--and go there. He could never stand being bored."

He bought the ticket, he took the ride. Mahalo, buddy. Have fun with Nixon.

Love American Style: Men, Women And Narcissism

I know I am going to anger a lot of my readers by writing this, but sometimes things have just got to be said. So here goes.

Richard Friedman, a Cornell psychiatrist, pens one of those weird opinion pieces that the New York Times runs from time to time in its Health section. I think these pieces are supposed to pass for a blend of commentary on the human condition and medical advice all at once. Not sure what you'd call the form.

Anyhow, today Friedman takes up the yawningly familiar subject of the midlife crisis, pointing out that perhaps there is nothing natural at all about the dynamic and pegging it as a convenient excuse for misbehavior. He writes of two men in their 40s, both accomplished who both ditched their wives under the panic of a midlife crisis.

"[Y}ou have to admit that 'I’m having a midlife crisis' sounds a lot better than 'I’m a narcissistic jerk having a meltdown.'"

The guys do smell like narcissistic jerks in Friedman's telling, but what stopped me in my tracks wasn't that the doctor blamed "our youth-obsessed culture" for this dynamic, but that he only singled out men for criticism.

Does Friedman not have any insight into how disastrously and selfishly women behave in relationships? Has he never seen women unaccountably walk from an LTR to pursue a flavor of the month and try to somehow recapture something they feared they'd lost in the process of having a normal relationship (the one they'd presumably wanted at some point)? Has he never read of women lying about who they are and what they want out of life in order to tie a man down only to do an about face once the relationship gets comfortable? Are men always the culprits in the easy mythology of sex, relationship and gender as told to America in the pages of the Times or on "Oprah?"

The reason I ask is that, in recent months, I have watched as women in LTRs with men I know have ended or sabotaged relationships because of the same loose dynamic as what Friedman calls a mythic midlife crisis. I'm talking grown women behaving narcissistically here. In one case, I know a woman whose partner has been raising her daughter from a previous marriage for five years, has been paying the rent and so on the whole time. Now, the woman is doing everything she can do to force him out of the relationship because she's apparently bored. Wow, there's some gratitude.

The others involving friends I won't get into because they are too Seattle-centric and could result in a permanent downgrading of my social status in town (modest as it is already).

But here's a recent example from my own life, offered with much trepidation. This woman I know and I had always had an attraction for one another over several years. Thing was she was in an LTR and when she made a pass at me one evening at a social engagement a few years ago, I made it clear to her that I don't mess around with other men's girlfriends. Bad karma and honor and all that. The guy she was in a relationship with was a classic narcissistic jerk of the musician variety (women always seem to tolerate musician jerks more than other jerks, I've noticed, except wealthy jerks, of course) and pretty much everyone who knew the pair felt she deserved far better.

So a year or so ago, the guy starts cheating on her and she catches him and kicks him out of the house. They'd had an open relationship in the past but at that point it was supposed to be closed. She waits six months and officially ends the relationship. Not long after she and I go out for drinks, a friendly get-together (not a date) and wind up later at my apartment. It's obvious she's damn interested in me and I am in her, but I've gotten a bit timid about the headlong rush into affairs and dating and such over the years (too many awful experiences and misjudged characters and wasted money), so I take things carefully and leave her to pass out on my couch (she was drunk and so was I). In the morning, we agree to get together over the weekend. The weekend comes and I call (and call) but she won't answer her phone or return messages. Monday comes and I decide to shoot her an email.

She answers the email that Monday night. Turns out she'd spent the entire weekend all bummed out and locked up in her house (so typically Seattle that I cannot get into it), and now she was on the road at a business conference. "Ah, didn't know about that," I write back. "Have fun."

She replies that she will and, in fact, since it's 11 p.m. she's going to go to a liquor store, buy a fifth of vodka and drag whatever guy she can find from the conference in the hotel bar back up to her room and fuck the beejesus out of them. I figure she's kidding, so I email her back: "Funny joke."

She emails me back that it's no joke and indeed she's been doing this kind of thing at out-of-town conferences for years, sometimes behind her ex's back, sometimes not. She's an attractive woman and I guess she can get away with it, although in her email she whines that she's just hit 40 and isn't feeling very attractive and men don't understand her and support her and so on. In other words, complete narcissism, midlife crisis BS. She writes that she hopes I understand. The subtext of her messages was: While I'm getting laid on the road, I want you to be ready for me when I get back to town and we can have some fun.

I quickly write her back that not only do I not understand, but that I don't want her contacting me ever again. Seriously. I cut her off just like that because why would I even remotely be interested in having such a manipulative character in my intimate life (believe me, I knew none of this about her before). Over the next three days she writes me several emails claiming that she now feels guilty and begging me to be friends with her again.

I don't even bother replying because there is nothing to say, except that women in my generation (that'd be Gen X, more or less) have turned out to be an epic disappointment from where I sit. I'm a long way from being a member of the Tom Leykis women hating/abusing club (I had to listen to his show once for an assignment. Dumbest show ever), but I've really found that I've had to back the hell off from the dating world the last two years because it is a disaster out there and, in my opinion, there are some very damaged women running about who think they own men. And this isn't even remotely the fault of men, as some feminist theory and the Dr. Friedmans of the world would lead you to believe.

They don't own this cowboy.

Two years ago, I ran into a woman I'd gone out with a few times while walking in the neighborhood one afternoon. I was very interested in her. Anyway, we're talking and she hits me up with the proverbial, "Can I tell you something?" When those words come out of a woman's mouth, they either spell ecstasy or doom for the guy on the other end of the conversation.

"Sure," I answer, already sensing that it wasn't going to be the ecstasy version.

"Look, I'll just be honest," she says. "I'm not interested in you romantically or sexually. Can we just be friends?"

"Ummmmm," I say, fishing for an answer. "You don't want to date me?"

"Right," she says.

"You don't want to have sex with me?"

"Right."

"Do you have any single friends you plan to hook me up with?"

"No, I don't. I'm sorry."

"Then your utility to me as a friend is extremely limited."

I knew how things would play out had I decided to be "friends." There would be a string of irregular meetings for coffee and drinks and such where she would sit there and cry to me about how whomever she was dating or fucking at the moment was an idiot, and I'd be expected to do the friendly thing and just sit there and take it. I've been there before, and didn't like it. So I just walked off, knowing full well that what I'd just said and done was likely very narcissistic (I'm sure Friedman and Oprah would say so), but if knowing what one wants out of another human is narcissism, then I plead guilty. Hell, I'm 45-years-old, as midlife as it gets, so perhaps I am entitled.

I could offer many, many more examples of women being idiots in relationships, and in the even-dicier pre-relationship period. But my main point here isn't that women are bad or evil or whatever, it's that they are as big a disappointment to men as men are to women.

And from what I understand of human psychology and the DSM, they are just as narcissistic.

Pfizer Targets Cape Codders With Depression Mongering

A fascinating op-ed ran in the Boston Globe last week and I'll quote from it a bit and you'll get what's going on here. The gist is that Pfizer sponsored a survey of Cape Cod residents and found that 43 percent showed symptoms of depression, not depression as it's clinically understood which would've hit perhaps 7 percent to 10 percent of Cape residents. Pfizer makes Zoloft.

"This study was conducted only on the Cape, and it used a survey created by pharma giant Pfizer, which has a financial interest in the number of anti-depressant prescriptions being written. And in a break from usual medical protocol, it was handed out in waiting rooms to people who, for the most part, had come to the doctor for reasons having nothing to do with getting help for depression or its symptoms."That was the case last fall when I went to my doctor for a persistent chest bug. Without explanation, the receptionist handed me a survey that asked whether in the past two weeks I had "been bothered" by a list of symptoms, including "feeling down," "trouble falling asleep, or sleeping too much," "feeling tired," "poor appetite or overeating," and "feeling bad about yourself."
"Setting aside that my cough and fever had brought on most of these symptoms, I was startled by the aggressiveness of the inquiry, as well as the nonchalance of its administration. Unlike more typical medical forms that ask about diseases you've had in the past, this one seemed to be looking for a condition that hadn't yet been diagnosed, for which the patient was not necessarily seeking treatment. And, unlike an effort to prevent a contagious disease from threatening the public health, this one targeted an affliction of a highly personal nature, not known to spread through physical contact, or even propinquity.
"Now, all of a sudden, the nurse taking my blood pressure and weight was reviewing my completed survey and wondering if I should talk to the doctor about it, along with my nagging cough."

The upshot is that doctors thought this was a good way to start a "conversation" with patients about depression. Pfizer is perhaps the only party to the exchange who stood to benefit.

The only conversation docs ought to have is within their own profession about how they are trying to link depression with absolutely everything and about how they are becoming a wee bit too intrusive into every aspect of their patients' lives and about how they are getting to be the equivalent of bait-and-switch salespeople: "Came in to discuss a cold? Well have I got the SSRI for you?"

It's because of episodes such as this one that I openly lie on those little screening forms doctors give you these days each time I visit a doc.

Autism Experts Examine Vaccine-Related Case As Another One Becomes Public

I don't write about autism much on this site because it's a bit out of my wheelhouse and because making a statement in either direction on the vaccine connection/non-connection to the disorder invites a huge fight that is almost impossible to sort out. Anyway, there was an NIMH-sponsored meeting in Indianapolis yesterday to bring experts together to discuss a recently-publicized case where the government admits that a girl's autism was most likely related to being vaccinated. The apparent connection was driven by diseased mitochondria in the girl.

In advance of the meeting, the New York Times' excellent Gardiner Harris dug up records indicating a second apparent case, this time out involving a girl who took a FluMist vaccine earlier this year and a week later:

"'[B]ecame weak with multiple episodes of falling to ground' and 'difficulty walking,' according to a case report filed with federal health officials and obtained by The New York Times."The girl grew increasingly weak and feverish and 'became more limp, appears sleepy, acts as if drunk,' the report said. She was hospitalized and underwent surgery and was finally withdrawn from life support. She died on April 5, according to the report."

It wasn't clear if experts were going to discuss this case as well and I've seen no subsequent press coverage of the meeting so far. I pass all of this along for what it's worth to you.

My own view is that, since the Institute of Medicine declared that there was no scientific evidence of a vaccine-autism link in 2004, there has certainly been increasing noise around the disorder and the scientific consensus. And, it's enough to make me think that something very odd has gone on with all of these children that has little to do with what we think we already know. What it is, I don't know. Maybe no one does.

If you want to see how heated things can get, check this comment thread at Age of Autism where Harris is savaged for not being aggressive enough, even though he's just pushed some vital information out into the public sphere.

Schizophrenia, Violence, And Forced Treatment

There was an ironic intersection of various forces in the mental health world yesterday.

Fuller Torrey's Treatment Advocacy Center had a post trumpeting new forced treatment laws in Illinois, Louisiana and Idaho and the group made its usual argument that forced treatment for people with schizophrenia and bipolar disorder is a social good. "Progress" even. That's a dubious claim, since there are folks who are fully compliant with their meds who still go off and do crazy, regrettable things. In some cases, it's pretty clear that the meds may be intimately connected with the behavior and, of course, sometimes they aren't. The good folks at TAC will never be interested in having that sort of subtle conversation, however, because they are led by Fuller Torrey and he's a well-known "prophet." Or lying fearmonger, if you prefer.

Separately, Alaska attorney Jim Gottstein, who also heads the anti-forced treatment group Psych Rights, sent around an email letting people know that a very unique case he's working on in Alaska is marching forward in that state's supreme court (no link to offer). The basic story is that a man in that state is fighting the state's ability to force him to take antipsychotics in the state hospital and Gottstein has managed to stop the state for the time being from being able to force the man to take meds that the state cannot prove don't harm him. The court is going to hear more motions on this case soon. Like I said, this is a very unique case and you can read the various filings here.

Meanwhile, yet another paper from the unending CATIE study came out in the British Journal of Psychiatry yesterday. Itexamined the question of whether first or second generation antipsychotics work better at preventing violence occasionally associated with schizophrenia. I've not seen the full paper yet, so I can't get into how researchers measured "violence," but I can pass along the news that the new meds didn't outperform the old. I'll have more from the study when I see the entire paper.

Like I said, it's ironic that all of that popped up within hours of each other.