The Mentally Ill in Prison – A Reply to the Centre For Addiction and Mental Health

By Marvin Ross

The chief of forensic psychiatry at Toronto’s Centre for Addiction and Mental Health (CAMH) , Dr Sandy Simpson, gave his explanation as to why so many people with mental illness are in the correctional system in a blog earlier in December. I learned of it because a number of people contacted me upset by what he had to say.

He gave three main reasons for this phenomenon which you can read for yourselves. His first reason is the one that people found the most upsetting as he claims that “broken families, poverty, substance abuse in the home, physical and emotional abuse experience” are “problems that increase the risk of suffering a serious mental illness. Therefore people with problems of criminal behaviour may well also have problems of mental illness, but the illness is not the cause of their criminality.”

This sounded like family blaming to those who contacted me and it does. I asked him on Twitter if he was suggesting that mental illness is caused by bad families? And I added, “Your point 1. MI in jail because of lack of services and beds”. His Twitter reply was “Agreed to last point esp in US. Family one of many relevant factors for crime generally Family problems often social context driven”. I then asked if he thought that serious mental illnesses were caused by families and he replied “no” but he did not reply to my tweet that his blog could be taken the wrong way.

His suggestion that the lack of beds might be a problem but that it is worse in the US is an interesting comment. That may be the case but so what? Is our negligence mitigated because someone else might be even more negligent? Imagine an accused murderer saying to the judge, “but your honour, I only murdered one person. Joe Blow murdered three people”.

Now Doc Simpson works at CAMH and CAMH is notorious in my mind for refusing a court order to treat a mentally ill patient. In fact, they won a legal battle that prevents judges from ordering mentally ill offenders to be taken to a hospital for treatment. In 2010, Toronto judge Mary Hogan, was faced with a schizophrenic defendant before her on a minor offence. She ordered CAMH to stabilize him as she knew that the standard policy was that these individuals were rerouted to jail rather than hospital.

CAMH left him in the hall because they had no beds and initiated legal proceedings to prevent such orders. They won. Can anyone imagine refusing treatment to someone injured in a traumatic car crash because the hospital is busy? It would not happen.

Lack of adequate mental health services and beds is the main reason that so many with mental illness are in jail. According to a thesis submitted in 2011 to the University of Manitoba by Richard Mahé, it has been known since the 1970’s that the lack of community resources resulted in the criminal justice system replacing the psychiatric hospital. The Canadian Institute for Health Information reported that the shortage of psychiatric hospital beds is resulting in people being squeezed out of hospital too early.

This closing of beds was decried by the Schizophrenia Society of Canada. And the Public Health Agency of Canada pointed out that “the rise in the proportion of prison inmates with mental illness suggests that some have exchanged the psychiatric ward for the prison ward.”

Howard Sapers, the investigator for Corrections Canada, told the Tyee that “We’ve seen a big increase in the number of men and women being sent to federal penitentiaries with a mental health issue and many of them end up with diagnosed mental illnesses such as schizophrenia.” And, he added, it is difficult to even find qualified staff willing to work in the prison system.

In fact, a state of the art infirmary and 26 bed mental health unit in the Toronto South Detention Centre has never opened due to a staff shortage. Inmates are being held in solitary confinement instead. Andre Morin, Ontario’s Ombudsman, has threatened to intervene if the situation is not rectified.

So, Dr Simpson, there is a lot to talk about on the subject of mentally ill in jail that is a lot more crucial than speculating on the adequacy of families. And we have a lot of work to do to rectify that sad reality.

On Prancer, on Dancer…A Blog Post for Christmas Eve

By Dr David Laing Dawson

Danny was a short stocky young man who had suffered a head injury and was intellectually challenged. He was impulsive, talkative, and socially intrusive. And he passed through phases that were either hypomanic in origin or perhaps simply derived from child-like exuberance. He could also be helpful and endearing.

He did not have sufficient skills to live independently, at least not without getting into some kind of trouble, and he had been expelled from his most recent group home. Rather than readmit him we opted to put him up in a local motel while we looked for a better solution. It was close to Christmas after all, and he did not want to come back into the mental hospital. He viewed that as something of a failure.

I promised to visit on Christmas Eve, and to bring him some clothes and food on my way home from the hospital. The weather was good that day, the sky clear but cold, and it was dusk when I drove to the motel with the promised clothing and food. This was, of course, a cheap motel, a single floor designed as a U around the parking area, an office and entrance at the front.

And there I found Danny and another man, standing, posturing in the parking area, threatening one another, shouting insults and promises of violence above the very loud music coming from the open door to Danny’s unit.

I got out of my car and approached them. They were in shirtsleeves, the other man clearly a customer of the same motel. The issue seemed to be Danny’s very loud music.

I summoned up my best school principal voice and shouted at the second man. “Sir,” I said. “Go back to your own room or you will be spending the night in jail.”

He stopped and looked at me, and for a second hesitated. It was in that second that I realized, that I had a clear vision, of being in a brawl in the parking lot of a cheap motel on Christmas Eve. Perhaps spending the night in jail myself, or the emergency department.

But the man stopped, muttered a final insult or two, and proceeded back to his own unit.

I carried Danny’s clothing and food and followed him into his room. I convinced him he didn’t have to play his music that loudly, that he should keep his door closed. I shared a drink of something with him, and watched the pleasure in his eyes, the smile on his face, to be visited by “Docker” Dawson on a Christmas Eve.

The pleasure was mine.

Sony, North Korea and the Role of Satire

By Dr David Laing Dawson

News item: Sony suspends release of “The Interview”.

By all accounts this film is a satirical comedy targeting one of Hollywood’s favorite demographics: teenage boys. It is probably lame and stupid and crude. So is this important news, this response to threats presumably originating in North Korea?

Well, yes, I think so, for this reason: Of all the freedoms we have in our western democracies, the one we should prize the most is our freedom to poke fun at, to satirize, to lampoon, (and to seriously criticize) our leaders and our deities. It is by this freedom that all the others are protected. And so it is this freedom that deserves the most vociferous protection, the most careful vigilance, the strongest defense. It is this freedom that every would-be dictator first erodes (e.g. Russia, Turkey), and it is this freedom that allows us to become more than vassals, serfs, slaves, and supplicants.

I think we instinctively know this. For when we can laugh at our Queen, our President, our Prime Minister, our Religious Leaders, and especially when we see they are smiling with us, we know we need not fear them.

The freedom to lampoon and satirize may be even more important than the freedom to seriously criticize, for satire is surely the most effective way to burst the bubble of tyranny, of autocracy, and of stupid fables masquerading as truth.

We need George Carlin parsing the ten commandments. We need Charlie Chaplin lampooning Adolf Hitler. We need Seth Rogen making fun of The Supreme Beloved Leader. We need Danish cartoons of Allah. We need “The Life of Brian”. We need our cartoons of mayors and premiers and prime ministers doing stupid things. This is the freedom of expression that guards all other freedoms and protects us from our own cowardice, stupidity and vanity. And more importantly, it protects us from the nefarious ambitions of those among us who love to tell everybody else how to live.

On the Difficulty of Comprehending the Mind and the Body in Mental Illness.

By Dr David Laing Dawson

I have trouble getting my head around infinity, the ever-expanding universe. Eternity troubles me as well. And the speed of light. One tiny copper telephone wire brings me moving images on my big screen TV, and surround sound at the same time. I understand this copper wire is transmitting simple binary code, zeros and ones, but think of the speed required to refresh 1080 pixels per inch every two hundredths of a second. (or whatever that calculation might be). I just don’t have the capacity to imagine, to picture these things in my “mind”. Perhaps Stephen Hawking can. I can’t.

And then we have the problem of duality, mind and body, or mind and brain. How can one imagine the brain constituting the I, without a homunculus inside it, a spirit, a ghost, an identity, a me? As difficult as it is to imagine infinity and eternity, it is equally difficult to imagine the “I” as simply a product of the brain. We don’t want to think of ourselves as simply biological beings with limited lifespan, and our consciousness being merely an expanded version of the self-awareness of a lobster.

Hence the struggle many of us have to accept that something gone wrong with the brain, the biological information machine we call the brain, can affect the “I”. And the corollary to this, that some medicines, some psychiatric drugs, can alter the biochemistry of this broken brain and affect the “I”, and perhaps return it to a more usual state. And that this can be a good thing.

Thus the battle lines are drawn. Mental illness can’t be an illness affecting the brain, the neurotransmitters and receivers of the brain, improved with pharmaceuticals that alter perception and cognition because this would imply that there is no “I” separate from the brain. And we don’t want to imagine that. At the very least we want to imagine that the “I” can influence the biological brain, rather than vice versa. (To say nothing of those who want to believe that the “I”, our attitudes and beliefs, can influence the course of cancer).

Curiously, with recreational drugs we have no problem thinking that they work on the brain and yet alter our perception, our cognition, our awareness, our sense of time, our sense of humour, our sense of urgency, our volition, and our interpretations of reality. Though even here there are those among us who think cannabis, mescaline, peyote, LSD, can cause the “I” to experience an alternative, more spiritual reality. No. They are simply altering the chemistry of our electrochemical transmitters and receivers, and thus altering the manner in which our brain processes information coming to it through our sensory organs and from our memory banks.

I think those are the struggles behind what seems obvious to the rest of us: The best treatment of severe mental illness combines medication(s) that work, and a good, compassionate person “working with” the sufferer over time. That person can be the same one prescribing the medication, or someone else on the team. And I say “working with” that person, meaning being there for him or her, meeting regularly, talking and supporting, counseling and instructing, accepting and directing.

Many would like to define that part, “working with”, in such specific terms that it can be patented, marketed, and promoted, and even promoted as something more wholesome and natural than medicine. So we have a proliferation of mindfulness therapies, CBT, DBT, and onward. In fact, if you check Wikipedia you will find there are, on average, about 5 kinds of psychotherapies per letter of the alphabet.

We need to get past this dichotomous thinking, once and for all. I have been listening to these arguments now for about 50 years.

Someone who is ill, be it of the body, brain, or “mind”, can be helped with medications that work, proven scientifically to work, and by having someone in his or her corner.

Peers are not Medical Professionals

By Marvin Ross

When it comes to people with illnesses helping and providing support for those newly diagnosed with the same illness, I am supportive. It makes perfect sense for people to have a support network of their peers. Many disease groups have some variation of this. When I was involved with the local chapter of the schizophrenia society, there was an excellent buddy program. Family members with newly diagnosed offspring were matched with an experienced family member who could give advice, support and comfort.

It is only in mental illness where lay peer support people are becoming quasi professionals and involved with all aspects of the illness. This, despite the research that shows that their therapeutic role is of little value. The Mental Elf Blog reported on the most recent evaluation of these programs and found that:

“there is currently little evidence to support the clinical effectiveness of this intervention for people with severe mental illness.”

So, imagine my surprise to find that there is a social worker from Quebec described as a psychiatric survivor who has developed a program called  Gaining Autonomy & Medication Management (GAM) Training for Peer Support Workers. This program was held in Toronto on December 11 but it has been given in a number of other locales throughout North America.

According to a paper written on GAM, “the approach was developed to take into account the many perspectives and relationships that users have with their medication, their knowledge and practices, their experience of mental health workers, and a thorough analysis of the current knowledge of psychotropic medications both in the field of biomedical research and in the human and social sciences.”

GAM also “recognize(s) the symbolic aspects of medication and require(s) recognition of its multiple, and at times contradictory, meanings in the lives of users and various individuals involved in psychiatric treatment.”

Now I have no idea what this means, particularly the symbolism medication may have. If you have a headache, you take an analgesic. Is that symbolic?

The only paper that I could find on Pub Med or on the internet is the one that I quoted from above. It is claimed that this strategy qualifies as best practices in Quebec but the reference link is dead. Many of the references are not there. They did mention research with 26 people with serious mental illnesses and provided a table to demonstrate the results of their research. That table shows that there was a decline in the number of medications taken at the end of the program. Is that good or bad? No idea. They may think so.

If you have a serious mental illness, your doctor will prescribe medication. That doctor is usually a psychiatrist who has six years of medical school, one year of internship, and five years of residency training to qualify as a psychiatrist. He or she should be well aware of what to expect from what is prescribed and should discuss the effects of that medication on you including side effects. The prescription will be dispensed by a licensed pharmacist with five years of university training who will pick up any drug-drug interactions that the doc may have missed.

Both the doctor and the pharmacist have ethical obligations and responsibilities to you as well as legal responsibilities dictated by their regulatory colleges. Your buddy, the peer, has none of the above education, ethical or legal responsibilities. They might say by way of support, “that sounds like a side effect. I had something similar but it went away in a few days. If it doesn’t, better see the doctor or talk to your pharmacist”. Perfectly legitimate. But you really should not be talking to him about the legitimacy of the prescription or whether you should even take it. To be perfectly pragmatic, you can sue your doc for malpractice and/or report him to his regulatory body, but what of your lay peer?

If you had diabetes, would you learn from a peer how to manage it or would you work with your endocrinologist, dietician and other regulated health professionals?

Why, when it comes to mental illness, is it considered alright to get your pharmaceutical and treatment advice from a lay person?

Homegrown Terrorism

By Dr David Laing Dawson

A reasonably articulate and educated young man from Ottawa stands beside a ruined village exhorting others to violence against those who provided him with a comfortable childhood.

How can we explain this? And how can we explain the angry response stirring in my own brain?

Young men. Males of the species. Biology. Evolution.

We humans have come so far because we are the most adaptable of species. The traits and instincts we have inherited come with wide variability. Most other species play out a single program when challenged, or threatened, or frightened, or hungry, or fed, or stroked. Our reactions can be far more nuanced, far more context driven. Our reactions are sometimes even preceded by thoughtful consideration of outcome. And, after a certain age, even thoughtful consideration of long-term outcome and effect on others.

But the extreme possibilities remain in our atavistic human brain, those extremes that served us well in the jungle, in hostile environments, in times of scarce food, when survival of the species, of the family, required intense competition for territory and mating. When survival required the banding together of brothers, intense loyalty to the Alpha male, and the willingness to kill.

We learn through play, through the socialization of family, sports, music, school and work to suppress those primitive instincts. We have developed healthier outlets for them: the hockey arena, the football field, the rock concert, extreme sports, the racetrack, even the hunting party, and perhaps, we hope, video games.  And, for better or worse, we can vicariously experience the flowering of these traits, these behaviours, this banding together of brothers, this adrenalin rush, this possibility of righteous killing, of revenge and conquest, as we ride alongside Bruce Willis, Liam Neeson and Colin Farrell.

God help us, the instinct is there, the trait is there, lying dormant in most young men, usually only trotted out in safe and playful circumstances. But it is there.

And to release it, to let it flourish, for some young men, requires but a little indoctrination by a charismatic psychopath with an ancient text under his arm.

How do we prevent this happening? Mostly by doing what we have been doing: becoming more educated, more aware, more sensitive to the feelings and rights of others, to the stupidity of war. By, if you’ll pardon the word, “allowing” women to become equal partners in this evolutionary struggle. By sharing. By treating the ill among us. By developing a good, just, liberal, inclusive, and secular form of governance.

But, I also think our ongoing reliance on ancient texts remains a problem. There are moderate people in our midst, good people, who believe in and promulgate ancient texts. The most progressive among them even ask us to believe in only the nice parts of these texts, the love and kindness parts, and they ask us to ignore the homophobic, misogynist, racist, vengeful, violent, and very stupid fanciful bits of these same ancient texts.

But still they are conditioning another generation to believe, without question, the teaching of an older, ordained man, with an ancient text under his arm, a text written before we knew the world was round and not the center of the universe. Usually a good man I am sure.

But at a certain low and troubled time in his life, how is a young man to know that this charismatic ordained bearded father with an ancient text under his arm, promising brotherhood, glory, certainty — is really a murderous psychopath?

On Mental Illness – Let’s Not Wring Our Hands But Actually Do Something

By Dr David Laing Dawson

The last few days, thanks to our local newspaper and the television, I have been bombarded with mental health news. This could be a good thing. Heightened awareness, increased sensitivity, decreased stigma, having a public conversation about it, making politicians and lawmakers aware.

But it has almost all been over-inclusive wringing of hands, bemoaning the state of the nation, the suicidality of our youth, the stresses of modern life, the bad behavior and instability of our classrooms, the internet vulnerability of our children, the dramatically increased use of marijuana which is now, they say, ten times more powerful than the stuff we toked in the 60’s while singing “Puff the Magic Dragon.”

As is so often the case these days the words and phrases “mental health”, “mental health issues”, “addictions”, “behavioural issues”, “stress”, “anxiety”, “mental illness”, “addiction issues”, are used interchangeably.

The most egregious of these misnomers often comes in the form of “He is known to suffer from mental health.”

Am I too concerned with semantics here? I don’t think so. Because I think all this fraught hand wringing, vague euphemisms, contradictory word usage, broad generalizations, and statistically implied causal relationships can only lead to two kinds of unhelpful responses:

1. The news itself, defined so broadly, so all inclusively, so vaguely, and with such a sense of urgency, becomes just another stress to bear.
2. Money is found, a program is announced, some general response that will allow the politicians to appear to be doing something to “solve the problem” and boast in the legislature or town council, while knowing it will do nothing to help specific individuals who actually suffer from specific mental illnesses.

At least response number two will help alleviate the damage of response number one. But response number two is all too often some general manipulation of optics, some appearance of action to “eliminate crime”, or to provide a telephone number to call for those who are stressed or “experiencing suicidal thoughts.”

Okay. There are social, political, and economic factors that contribute to mental illness and disability. And we could and should gradually ameliorate these through social and political programs that reduce poverty (minimum wage, disability pension, and social assistance increases), increase the availability of affordable housing, make day care more affordable and accessible, ensure we have an educated population, help youth transition from childhood to full independence (support, training, internships, money management programs), stop sending young men and women to war and trauma, ensure some of the profits from alcohol and gambling go to alleviate the damage done by alcohol and gambling, fund and evaluate specific targeted programs to reduce the social cost of addictions, and to counter the misogynist messages our young men are now acquiring through social media, pervasively available pornography, and hateful song lyrics.

But there are a number of specifically identifiable and specifically treatable mental illnesses that we could target in a far more specific and effective way. These are:

Anxiety Disorder

Obsessive Compulsive Disorder

Depression

Bi-Polar Disorder

Schizophrenia.

These specific disorders (not withstanding the researchers’ and clinicians’ ongoing search for more clarity, specificity, and causality) can be very specific causes of disability, distress, failure, and suicide.

But we can identify them; we have the tools to detect them; and we have the tools to treat them. And doing this, providing funds and creating programs to do this, would be far more effective than hand wringing.

Take suicide for instance. There are a large number of social factors (loss, divorce, alcoholism, poverty, unemployment, debilitating illness, aging, trauma) that increase the risk of suicide. Some of these we can do nothing about. We can chip away at others through legislation and social programs.

But there are some specific causes of suicide (actual suicide, not threats and thoughts) for which we do have the tools to detect, intervene, and treat.  And these are the mental illnesses listed above.

(I think I must point out here that the proliferation of hot lines, crisis lines, help lines, phone numbers to call over the past twenty years, has NOT changed the actual completed suicide rate in any jurisdiction I know of.  But there have been studies demonstrating that helping and teaching family doctors in the detection and treatment of depression has lowered the rate of actual suicide.)

So what we should focus on are specific programs for early detection and comprehensive treatment of the mental illnesses listed above. Or better targeted funding for the services that do that now, and the linkages between them.  These linkages are crucial in order to move from suspicion, to detection, through assessment, to expert treatment: Parent and teacher to counselor and social worker to family doctor and pediatrician to mental health program with psychologists and psychiatrists.

Editor’s Note Dr David Laing Dawson has been practicing psychiatry for many years. He is a former professor of psychiatry in the Faculty of Health Sciences at McMaster University in Hamilton, ON and the former chief of psychiatry  at the Hamilton Psychiatric Hospital. He is the author of Schizophrenia in Focus, Relationship Management of the Borderline Patient and The Adolescent Owner’s Manual. He has also written and directed a number of films on mental illness.

Science, Quackery, Received Wisdom, Cherished Belief.

By Dr David Laing Dawson

Are these just competing yet equally valid ways of understanding our world and our selves, our health and our illnesses, treatments and cures?

There are two moments of clarity in my education that stand out in my mind. The first occurred during, I think, my second year of medical school. The second during a last year of residency training. I will talk about the second moment first because it reveals something very fundamental about science, perhaps the most important characteristic of a scientific way of thinking about things.

A wise colleague, a born teacher and storyteller, a scholar who always conversed in thoughtful sentences and paragraphs, told a story about a German physician who lived in a small village hundreds of years ago. This historic physician had, according to my teacher, the first recorded scientific thought in Western Medicine. Now, I have no way of knowing if this is true or not, and in what year it happened, and so because of the very nature of this discussion, I will present this story as apocryphal.

The story is that in this man’s village there was a girl who lived but did not eat. To live and yet not eat is clearly a miracle. The mother told the priest, the priest told the bishop, and soon people came from far and wide to behold the miracle of the girl who lived but did not eat. The village doctor asked himself this question: “How do we know she does not eat?”

He invited himself into this family’s home to observe for 24, perhaps it was 48 hours. And what he observed, of course, was the young woman, though not eating during the day, would come down to the pantry to eat after midnight.

This is the question we need to put to every bit of quackery, miracle cure, exotic treatment, cherished belief, and story told to us. “How do we know this to be true?” “How do we know this wheatgrass diet cures cancer?” “How to we know that house is haunted.” “How do we know that insanity increases when the moon is full?”

Sometimes it is easy to answer that question and sometimes not so easy, especially when money and prestige are at stake. But it is the important question. “How do we know pulling the goalie in the last two minutes of a hockey game helps more often than it hurts.” Curiously, even here with an abundance of statistics to support pulling the goalie early in a tie game, coaches remain reluctant.  Whatever we are being told – how do we know it to be true?

The first moment occurred in Medical School. The professor of psychiatry was giving a lecture to the class of 60. Only ten minutes into his lecture one of the yahoos in the class, to the amusement of his buddies, challenged the professor of psychiatry. “Sir,” he inquired, “Psychiatry is not really scientific, is it?” They bantered a bit, the student grinning at his friends, the professor developing his own wry smile. Then the professor said, “Perhaps Mr. Jones would like to explain to the class the nature and philosophy of science?” Of course Mr. Jones could not do this. Whereupon the professor closed his lecture notes and proceeded to deliver an hour talk on science, the history of science, the philosophy of science, the methods and methodologies of science. And I realized, at that moment, that though I had studied chemistry, physics, biology, and physiology at advanced levels, no one had ever explained actual science to me. What it is.

And from this I must assume that few others have ever attended such a lecture, and that it must be a very small segment of the population that actually understands the fundamental ideas of a scientific way of thinking.  Which are, if put very succinctly:

Observe (a phenomenon, a claim)

Hypothesize (an explanation, a cause, a mechanism, a likely result)

Test (design an experiment to test this hypothesis)

Repeat.

There are caveats to this of course. Observation should be as objective as possible, while understanding objectivity is not a common human trait. One should formulate one’s hypothesis based on current scientific knowledge of the universe and leave any leaps past this to the Einsteins and Hawkings in our midst. Testing can range from  mind experiments (based on current scientific knowledge of how things work), observation of outcome, to particle accelerators to double-blind large population outcome studies. And repeat (replication) to rule out compounding variables and observer bias.

For example, the claim that a diet of raw carrots,  wheat grass and a positive attitude cures leukemia is contrary to all we know to date scientifically about leukemia; a hypothesis of how it would work requires new laws of physiology and cell growth, and testing such a hypothesis would require a (probably unethical) large comparison study of three populations: no treatment vs. current medical treatment vs. a wheatgrass diet.

On the other hand, those placebos you are taking to ward off colds and flu viruses are probably doing no harm.

Harmless Homeopathy?

By Dr David Laing Dawson

It is not uncommon for some of my patients to tell me they have seen a homeopath or a naturopath. Sometimes they tell me this a little sheepishly; sometimes they go to homeopaths with the same attitude I have when I’ve been talked into letting someone read my tealeaves. I certainly don’t believe any of it for a second but when my aunt peers intently at the dregs at the bottom of my cup and says that, “soon a little money will be coming your way” I can’t help but feel a twinge of pleasure. Or when someone points out that the life-line on my palm predicts a long and prosperous life. Very nice.

Occasionally when a patient tells me of the homeopathic advice she has been given for her child, I try to assert a little twentieth century knowledge into the discourse, but often I pass. One person told me she had been prescribed lithium by her homeopath, because of an obvious deficiency in this substance, determined by – who knows – the colour of her eyes? I was about to let loose a rant about this when I paused to consider two probabilities:

1. The substance that was prescribed for this woman had a 50% chance of having no lithium in it at all, and,

2. A 50% chance that it had no more lithium than a bowl of vichyssoise. In the end I made no comment on the subject.

Another took her three hyperactive boys to a special homeopathic clinic, where, apparently, they took blood samples and examined them under a microscope. Then the mother was told, and she related this to me, that all three of her children had parasites in their blood causing their ADHD.

An outraged rant about this formed in the back of my head, this ridiculous notion, this proclamation or diagnosis that, if actually true, would constitute a life-threatening emergency. I quelled my outrage in favour of asking what the homeopath had prescribed for her boys. Apparently what he had recommended, for the expunging of these parasites, was a healthy diet, exercise, and sufficient sleep. Again I smiled and let it pass.

But I watched CBC’s marketplace Friday night, and I have several grandchildren. The opening images of the documentary are quite striking: a group of very healthy children playing on Granville Island in Vancouver, and then very healthy mothers with very healthy robust babies. The mothers were not wearing black as they would be if they were mourning the deaths of two out their five children. The children could see and hear and run on two legs and catch with two hands. None of them had suffered through an epidemic of polio, measles, whooping cough, diphtheria, cholera, meningitis, or the bubonic plague. None of them. These diseases were not even part of their consciousness. I tried to imagine the same group of children and mothers in a park during the polio years of the 1950’s, and then the early 1900’s, and again perhaps on the commons of a village in the early 1800’s. The early 1900’s would be the time an uncle-to-be of mine died from diphtheria, the 1950’s when a classmate of mine disappeared from school and into an iron lung at the hospital.

They had homeopathic remedies in those days too, a hundred and two hundred years ago, and they didn’t work then and they don’t work now. The difference in those images, the healthy children and healthy mothers today, vs. the images from a century ago, has been brought to us by medicine and public health: clean water, good nutrition, good prenatal care, antibiotics, and vaccination.

These homeopaths are not just endangering the lives of the children they see as clients, but my grandchildren as well. I actually think a class action lawsuit is in order.