Monthly Archives: April 2017

Conscious Thought is Slow.

By Dr David Laing Dawson

My plasma screen big TV refreshes each and every pixel 200 times per second. Or is that every other pixel? And is there a formula that allows some of those pixels to rest in their current state for the full second? And this occurs after information has traveled from God knows where at close to the speed of light through copper wire and fiber optic cable.

My conscious mind cannot keep up.

But there are parts of our brain that must work almost as quickly. My optic nerve for instance. Or the message from burned finger to brain and then to muscle. Or from retina, to brain, to amygdaloid, to pineal to adrenal to heart and stomach so I might feel revulsion or delight or anger before my conscious brain manages to explain this.

Which is why most conscious thought occurs after the fact, after the action, after the experience, after the event. Which is why most conscious thought is rationalization, the explaining and organizing of an action already taken or a feeling already felt.

I am (slowly) thinking about this because I am trying to understand how it is so many cheered when Trump let fly those 59 missiles. The images of dead children on my plasma TV caused that very fast electrochemical chain reaction from retina to neuron to experiences of revulsion and anger. But how about we spend some time thinking and talking about how this civil war might be ended.

And every time I see Kim Jong Un on my plasma TV I want to slap him or deflate him. He, his terrified and sycophantic generals, and his strutting robot men, cause that same fast electrochemical reaction in my brain to produce hormones of disgust, of anger, and no small amount of incredulity.

And I know when I listen to the politicians and “experts” on CNN, I am hearing the thought processes that slowly justify the more instant wish to deflate this man. And then we cheer the armada, the threats, the bombast, and, God help us, we may soon be cheering the preemptive strike, or the overwhelming retaliation.

Please know this. Know this about our instant reactions and the slower thought processes that justify them. Know it is time to calm down, step back, and figure out how best to deal with such a man as Kim Jong Un and North Korea’s 25 million people to ensure we all have a future.

Opioid Epidemic and Childhood Trauma – NO!

By Dr David Laing Dawson

Social worker, Alexander Polgar, writing in the Hamilton Spectator suggests that the current opioid epidemic and death by overdose can be traced to “adverse childhood events”. This of course is patent nonsense. Some children do suffer terrible things that affect them their entire lives. But, from a statistical view point, the children growing up in the last 30 years (in Canada) will have experienced the fewest adverse events than any generation in history before them. (prenatal care, safe childbirth, child protection laws, diminishing physical punishment, plentiful food, no measles, mumps, smallpox, polio, pertussis, fewer sibling deaths, available medical care, safe toys, safe playgrounds, safe pools, safe beaches and lakes, accommodation in schools, organized play, sports, new safety rules for everything, child labour laws…). Sure, the parents may be more likely to divorce, but they are much less likely to die.

In the late 40’s and early 50’s my classes of 35 or so always had one kid with scars from a boiling water accident or a fire, another not coming back to school after a summer of polio, one on a cane or crutches or with a withered arm, another pockmarked from some communicable disease or other, and another two or three undernourished, lice ridden and dirty. Not to mention the shaming and physical punishment some teachers used to control behaviour. And in those decades many children grew up without fathers who had been lost to them in the war.

While one might be able to trace a specific addict’s misery to childhood trauma, to blame the current epidemic on an epidemic of childhood trauma is nonsense.

I could make a case for the problem being the opposite.

Clinically I have many discussions about “motivation”, as in “my child is not motivated.” or the teenager saying “I’m just not motivated” with respect to going to school, getting a part time job, joining anything. With some I joke that I don’t have a pill for motivation. With many of course I look for the anxiety or depression or circumstances underlying the apparent lack of motivation, now redefined as avoidance. With others I engage in a longer discourse about the nature of “motivation”.

Now, it is pretty clear to me that the prime motivator for humans and human children throughout history has been necessity. Without necessity we fall back on, I suppose, pleasing our parents, keeping up with our social group, plain old curiosity, immediate sensory gratification, the pleasure of an adrenaline rush, and perhaps, occasionally, finding an inner flame of ambition or artistic seeking or even altruism.

The other day I had a quite interesting conversation with a very bright, self educated, articulate 15 year old. Not in school, and as he said himself, not motivated to do anything. He rationalized that any “motivation” was pointless because life itself was pointless. He could talk about existentialism, absurdity, about the expanding universe, even the nature of consciousness.

So with him I engaged in a rather intellectual discussion about the nature of “motivation”. Of course from a social perspective, a “lack of motivation” equates to “not being willing to do what someone else thinks you should do.” But when we talked of the prime motivator for most humans being necessity (to avoid being cold, starving, hurting, wet and banished) he agreed, and pointed out that he faced no such necessity. Nor did most of his peers. They dressed as they liked from a selection of clothes in their closets; they always had a roof and a bed in a heated home; food in the refrigerator; much more than a penny in their pockets; and no one who could “make them go to school, or work”.

He was “motivated” to seek a few days a week of instant pleasure from weed, MDMA, mushrooms or acid, the chemical compositions and history of which he knew at least as well as I.

Now I may also get the opportunity to treat this young man’s depression, once he has done his own research on SSRI medication, but, thinking of this generation as a whole, I can go back to my main point. Which is that we have removed necessity as a motivator for many of our children and teenagers and young adults.

They are not experiencing more adverse events but fewer, and they are always ensured of their basic needs being met without any effort on their part, and, with the safety and esteem building tone of today’s parenting and pedagogical methods, coupled with the proliferation of things and activities that offer instant gratification (Good boy, wonderful picture, nobody fails, every child is special, dress as you want, here is an Iphone and a laptop, video games, information by clicking a mouse, substances that eliminate anxiety and stimulate the pleasure centers of the brain), the necessity of an extended period of work and discomfort to achieve something seems almost anachronistic.

I have said at times to some of the teen boys refusing to go to school, “But that’s where the girls are.” only to realize that, no, today, naked women reside 24/7 on the laptop in his bedroom. So even the vaguely formed wish and longing hope of sexual gratification after a lot of struggle, social embarrassment, attending school, joining the drama club, staring at, avoiding, talking to, asking on a date…. has been replaced by no-effort instant gratification without having to shower, brush your teeth and get dressed.

Blaming a 21st century problem on a 19th century scourge is not helpful.

It is very hard to understand and assess the vectors and forces that affect one’s own time, but the causes of teenagers doing stupid and dangerous things, and the causes of adults injecting themselves with something that offers equal odds of a pleasurable few hours or death, probably lie elsewhere.

Psychosis impairs brain function beyond the apparent symptoms. Depression impairs brain function, the scanning, filtering, perceiving functions. Depression eliminates perspective. Similarly, once addicted, the addiction impairs brain function. It seems to eliminate any sense of time and perspective, any way of thinking about long and short term priorities; it clearly impairs the brain’s ability to assess risk; it impairs the brain’s ability to consider short term pain for long term gain. It wipes out empathy. Once addicted the human brain becomes as if a shark’s brain with a solitary single purpose.

So we must treat addiction itself as an illness, offer detoxification and rehabilitation services and reduction-of-harm care. And this includes safe injection sites, and maintenance programs.

Secondary prevention of relapse should be another focus, and we know of several groups we could target for this: recently discharged from hospital, psychiatric hospital, drug treatment centers, jail, or prison.

Primary prevention is much more complicated. But there are some factors that could be addressed:

  1. Physician over-prescription of Opioids, both in dosage and length of time.
  2. Illegal availability of these drugs from a variety of sources, including the internet.
  3. Self medicating for something better treated by professionals in other ways: anxiety, depression, PTSD
  4. The simple fact that this is a very profitable business for many in the chain of supply.

Which means:

1.Education, guidelines, controls for physicians, pharmacists.

2. Taking a look at ways to stem the flow of drugs across borders (other than another “war” on drugs).

3. More readily available mental health treatment, sensible pain management.

4. And perhaps consider removing the profit motive by legalizing and providing opioids for addicts in a controlled fashion. Is this approach working in Portugal?

And then teenagers, early twenties. Though they have newly acquired logical thought processes and information at their fingertips, they do not have perspective, experience, and fully developed frontal lobes. They take risks uninhibited by the knowledge of a 10 or 20  or even 40%  probability of a disastrous outcome. They often respond to warnings in a paradoxical fashion. They still need parents, and parents who are willing to intervene in a strategic fashion and not give up.

 

 

 

Please Stop Listening to Donald Trump

By Dr David Laing Dawson

There was a point in my mother’s dementia when she could engage in a ten minute conversation with an acquaintance or stranger without the person discovering that she, my mother, could not tell you her address, age, the date or day of the week. She was adept at the speechisms, the smiles, the nods, the all-purpose declarations of pleasantness, of good weather, of well being, of the “So nice to see you again”, “lovely weather we’re having” kind of remark.

In a perverse sort of way it reminds me of Donald. Though his fill-ins, rather than being pleasantries, are a rather random assortment of extreme declarations: bad, very bad, terrible, horrible, disastrous, disgraceful to wonderful, terrific, great, best, like you’ve never seen before.

Note that both “lovely weather we’re having” and “like you’ve never seen before” work adequately no matter the reality.

Donald probably knows his addresses (they are easy to remember), the date, his handicap, the names of his children, but he clearly knows little else. His throwaway statements of “big league” and “disaster” stir his audience, but they also hide a chasm of knowledge and a lack of any detailed understanding.

We can be sure that when he rants about the dairy industry, Canada, and NAFTA, he knows nothing about these subjects. When he tells Fox News interviewer Maria Bartiromo about the “most beautiful piece of chocolate cake you’ve ever seen” and how he leaned across and told the President of China that he had just launched 59 missiles “at Iraq”, it wasn’t a slip of the tongue in a rapid conversation. Maria corrected him, simply saying, “You mean Syria?” He repeated her “Syria” without blinking, and went back to talking about dessert.

But he is POTUS and so the pundits, politicians, reporters, experts, panel members all try to find meaning, thought, policy, and direction in his utterances. Beside my own mother’s dementia it conjures images of courtiers, earls, and nobles trying to find wisdom in an idiot king’s sighs and passing of gas.

I think Trudeau and Merkel understand this. Let’s hope Kim, Xi, and Vladimir do as well.

Parenting Kim Jong Un and Donald J Trump

By Dr David Laing Dawson

As every parent knows for a threat to be effective the child must believe his father or mother will make good the threat if he does not comply. The child also knows that when the threat is outrageous (“you will be banned from all electronics for life.”) it is also hollow. Still, some children do not listen to threats even when they are consistently followed by reasonable consequences. This is often true of ADHD children, and those for whom the compulsion is too great (OCD) or the aversion to change too strong (ASD).

By the time children are teens the plot thickens. Now they are watching themselves through the eyes of their peers, not just their parents. Now they are clinging to new visions of themselves as capable, independent sentient beings with newly formed logical thinking processes. They are more apt to defy the threat if to comply would undermine this developing sense of self.

And then we have adults. And now for a threat to work it must overcome all the above plus pride if this all occurs privately and secretly, and much more if the threat occurs publicly (shame and loss of face), and more so still if the threatened figure is a man or woman whose sense of self, if not his very existence, depends on the adulation of the crowd.

There are public figures in this world whose behaviour we would like to change. Perhaps there are some of these whose sanity, whose internal stability and strength is sufficient to bring about a good response to threat.

Kim Jong Un is not one of them.

Please do not threaten this man. Never publicly threaten him. He will not respond as you wish him to.

Actually, Donald Trump may just be the right President for the task of soothing North Korea. He could invite Kim to Mar a Lago for a Korean BBQ and treat him like royalty. Let him expound. Set up a private communication system. Help him be more of a hero to his people by feeding and housing them better. Then privately discuss reducing his nuclear arsenal for something in return.

Of course this would require Donald to keep his own ego in check. Vain hope.

Could it be time for Canada to step in here. Are you listening Justin? Making Kim look weak and foolish before his own people could get millions killed. We need a Mike Pearson way of intervening now.

And all of you, including Pence and others saying that your patience is at an end, pay heed to the words of a much smarter man than yourself:

“Talk, talk, talk is better than war, war, war.” – Winston Churchill.

I am Distressed to Hear the War Drums

By Dr David Laing Dawson

I am distressed to hear the war drums. I am distressed listening to the talking heads, the panel of retired generals, pundits, and experts on CNN talk of war with North Korea. I am distressed by their matter-of-factness, by their strategic and political ponderings, all so devoid of horror.

How do we remain so inured to the real consequences of war?

My grandfather died in 1972. I had long thought he fought at Vimy, and on a visit there, to see the trenches and the monument, I wrote in the guest book, “I came to see where my grandfather fought.” In the trenches and the bomb craters one can smell the fear, sense the horror, see the threat of opposing trenches a stone’s throw away. At the monument, awe and pride intrude. My grandfather was here.

But it turns out he wasn’t.

Thanks to the wonders of the digital age I now have 93 adobe pages of my grandfather’s military record from the moment he enlisted until his discharge and the time of his death.

He enlisted in January of 1915 and joined the Canadian Expeditionary Force when it was still necessary for a married man to have his wife’s permission. His wife and my grandmother was Irene Alice who he left behind in Victoria with three children. A fourth would arrive, at least by my calculations, after the war.

On the enlistment form, just above a final declaration, is a curious question: “Do you understand the nature and terms of your engagement?” He answered “yes” and then completed the form with a signature much like my father’s and my own. He was 28 years old and five foot nine. He was assigned to the 30th battalion and sent overseas in the spring of 1915. From January 1915 until March 31, 1916 my grandmother received between 30 and 40 dollars per month.

He spent the summer training at Shorncliffe, on the Kentish coast of England, and then, in September, he was shipped to the front. The front being the trenches of France, and then Belgium and the second battle of Ypres.

Twice in France he was taken from the trenches to a field hospital suffering from influenza. He was promoted to Sergeant by late September 1915, and then to Sergeant Major. Upon discharge he was awarded the Distinguished Service Medal.

On June 3, 1916, at the Battle of Mont Sorrel, within the second battle of Ypres, my grandfather rose from the trench at the call to charge. A bullet pierced his right bicep and shrapnel hit him in the right side of his face. He was evacuated to the Graylingwell War Hospital with “wounds to his right arm and scalp”.

In the documents I have the army is more detailed and thorough in its descriptions of the pay records than either combat or medical experiences, but I do have terse notes by doctors and digitized versions of the original x-rays.

My grandfather’s right arm healed quickly. The x-rays show a piece of shrapnel behind the right eye lodged in bone. They did not attempt to remove this. He is transferred to a convalescent hospital with his arm healed and almost fully functional but suffering from poor sleep (nightmares of his time in the trenches), headaches and dizzy spells. The dizzy spells cause him to black out and fall frequently. Specialists cannot find a physical cause to explain these latter symptoms and they diagnose the etiology as, in part, “nervous”.

By August of that year he is declared medically unfit to return to duty and then formally discharged from the army in January, 1917. The monthly pay to my grandmother ceases two months later.

So he did fight in the trenches; he was wounded, and he was furloughed to London as I knew, but he didn’t fight at Vimy as I had come to believe. And it is 30 to 40 years later that I formed my first memories of my grandfather and he never spoke of the war and I had no idea of the questions I might ask.

But now my medical curiosity has kicked in. Initially his symptoms might have been concussive, or post concussive. Next he certainly suffered from what they called “nerves” and would soon refer to as “shell shock” and now PTSD. He did suffer the living hell of the cold muddy trenches in France and Belgium through the winter of 1916. He watched men dying suddenly. He watched men dying slowly. He watched men throw themselves into battle to relieve their growing terror.

But it is also possible that he continued to report dizzy spells and he continued to fall down at the convalescent hospital because he did not want to go back to those trenches.

Perhaps he had come to know that in war there is no glory to be had.

Birds and Squirrels

By Dr David Laing Dawson

I woke up this morning and saw through the window that a mid size but rather colorless bird was pecking at a dead branch. Down, peck, peck, up, look around, down, peck, peck. Was it eating grubs, termites, ants?

A black squirrel scampered along the top of the fence. And I wondered, “Do squirrels ever stroll?”

These observations and the queries they evoked sparked a small pleasure, a small sense of well being.

They also tell me that I am not depressed, that is, depression is not impairing the scanning, inquisitive function of my brain. Nor is my brain under the kind of threat that forces a dramatic reduction in its field of awareness.

I also know that unless I rear up and threaten both the bird and the squirrel I am nothing to them. I do not exist at this moment within their sphere of awareness. And this means, at least with respect to the squirrel and the bird, I am not psychotic. My brain has not created a false narrative regarding my relationship with squirrel and bird.

Do squirrels ever stroll? Do birds ever eat leisurely?

Depression impairs the ability of the brain to scan, focus, inquire, be concerned about, all but itself, its sense of dread, and the unwellness of its own body.

Psychosis impairs the ability of the brain to fathom its boundaries and relationships with others and then, because it is an imperative that we do so, because it is a primitive imperative that the brain find a way of organizing data to determine friend from foe, kin from stranger, threat from security, it applies the band aid of a simple false narrative.

Do squirrels ever stroll? Do birds ever eat leisurely?

The Brain, Cognition and Illness

By Dr David Laing Dawson

The aware, receiving, perceiving, organizing, planning brain.

Two recent writings got me thinking about this. The first was a comment from Mr. Summerville, in support of the absolute discharge of Mr. Vince Li, that Mr. Li showed “no signs of cognitive impairment”. The second was the raw honesty of Mr. Bowers when he writes that when he took a shotgun upstairs with the intention of killing his grandmother he was “bat shit crazy”.

I suffered one of those nasty strains of flu this winter. At the time it seemed to affect every organ in my body. Including my brain. That is my brain was aware this state of body sickness was impairing some of its functions as well.

I guess it’s tricky. We are aware when our stomachs aren’t working as we would wish them, when our prostates and kidneys are not quite right, when perhaps our livers are acting up, our eyes, our inner and middle ears, our calf muscles are balking. Well, really, it is our brain noticing these things. But when the brain is acting up, not quite functioning smoothly in one of its functions, there is no one left to tell us. That is, no other organ in the body is prepared to tell us that the brain is a little off. “Liver here. Brain, your thinking is off.” or “Brain, your medulla oblongata is a little sluggish this morning. Your perceptions are clouded.”

I have also suffered, by my own count, three depressions of clinical severity so far in my life. Perhaps the cause of these can be traced to my circumstances each time, perhaps my genetics, perhaps to my childhood, probably a combination of genetics and circumstances. But each time it happened I know my brain was impaired, not functioning well, not scanning, perceiving, reviewing, interpreting as it normally does.

You can find a list of the symptoms of “depression” in the DSM and on many a website not to mention TV advertisements for the latest antidepressant. But of course the organ experiencing these symptoms is the same one reading and hearing about them.

It is often family members and close friends who notice first. You are not yourself, they say. Or “the spark has gone from your eyes.” And always when I treat someone for depression and they improve, it is family members who notice the improvement first. The patient tells me they don’t notice any change, though I see his or her eyes are livelier, his face a little less strained, and the corners of his mouth more agile. And the mother or wife points out he came down for dinner, engaged in conversation, laughed at a joke. The brain of the patient hasn’t noticed these changes yet, because… well because its perceptual, interpreting, responding, scanning apparatus is still partially impaired.

Liver illness impairs the functioning of the liver. Mental illness impairs the functioning of the brain, and that can be some or many of its functions. Mental illness is a brain illness.

So let’s go back to Vince Li. His brain was absolutely definitely impaired at the time of his crime. And at this point if he is not terrified of relapsing, and thus wanting help for the rest of his life to keep himself from relapsing, if he does not himself (his brain) understand and want all safeguards in place to keep himself from relapsing, if he thinks he can just change his name and move on, then his brain is still impaired in some of its functions. If this is the case then his perceptual, cognitive, judgmental processes are still impaired.

Contrast that with the Blog written by Mr. Bowers. He has fully recovered from being “bat shit crazy” and he is fully aware he never wants to go there again, and he is fully aware (the perceptual, organizing, planning, monitoring, cognitive processes of his brain are functioning well) that he needs help and vigilance to never go back to that place again.

Mini Quiz – Are you Prone to Populism?

By Dr David Laing Dawson

The men (I don’t think I can accurately say men and women) who came up with our Canadian Senate (the house of sober second thought) and the complex set of checks and balances of the American Republic knew we humans were, at least quite often, drunken, impulsive, short-sighted, and stupid. They knew we often react emotionally, that we throw logic to the wind, that we forget history. They knew that we, like mice, despite hearing the snap of a trap to our left or right,  still go for the cheese. We still buy the snake oil. We still go along with the mob and chant whatever the mob is chanting.

Below is a small test to prove this point. Please answer quickly according to that first impulse, the one Populist leaders count on.

1. A lane jumper on the three lane highway pulls in front of you, slams on his brakes causing you to do the same and spill your medium regular Tim Horton’s coffee in your lap.

He should be:

A. Taken out and shot

B. Bitch slapped

C. Have his driver’s license revoked forever

D. Given a small admonishing toot of your horn.

2. A man is convicted of killing a child.

He should be:

A. Taken out and shot

B. Castrated, put in a rat infested cell, and then taken out and shot.

C. Allowed to appeal on a technicality.

D. Sentenced to life with no chance of parole for 10 years.

3. For the fourth time this summer your neighbour has dumped his tree trimmings on your side of the fence.

He should be:

A. Taken out and shot

B. The recipient of three of your bags of garbage.

C. Cursed at under your breath.

D. Forgiven because, after all, the rather dirty Mulberry tree is yours.

4.  A young man has broken into your house, stolen your jewelry, smashed your crockery, and swilled your 20 year old Scotch. He should be:

A. Taken out and shot.

B. Sent back to Jamaica.

C. Offered a community recreation center.

D. Face due process like everyone else.

5. A salesman talks your aging mother into buying  a very expensive furnace she does not need.

He should be:

A. Taken out and shot

B. Tied in a gerry chair and left in the corner of a dementia ward.

C. Arrested for fraud

D. Be reported to the Chamber of Commerce and receive a letter from your lawyer.

6. Illegal immigrants

Should be:

A. Taken out and shot

B. Rounded up and dumped in some other country.

C. Put in detention cells for 2 years and then dumped in some other country.

D. Offered a specific monitored pathway to achieve citizenship within a reasonable time frame.

7. Hillary is just a little too smug and prissy in her boxy white pant suit.

She should be:

A. Taken out and shot.

B. Locked up for life

C: Given I.T. and fashion advice

D. Elected anyway because she is actually competent

8. Those uppity Germans and Snooty French are having too big a say in how we live in England.

They should be:

A. Taken out and shot.

B. Delivered divorce papers

C. Asked to accommodate our peculiarities a little more in the E.U. parliament.

D. Asked to remind us why we organized the common market and E.U. in the first place.

Analyzing Trump Gibberish

By Dr David Laing Dawson

When speaking to someone, perhaps answering a question, most of us occasionally go off on a tangent, we find the first clause of our thought and sentence has triggered a parallel thought. Many of us find at times that the thought, the idea we were expressing, requires a change of format, a change of sentence structure in the middle of the utterance in order that it make sense. At that point we pause, and then either find a link such as “about which” that will work, or we start over and restructure from the beginning. Sometimes we realize what we said was not clear, and then reformulate the thought with, “What I am trying to say is…”. Sometimes the whole sentence is verbalized before we realize that it doesn’t quite work as a logical thought.

But always, or almost always, we notice this ourselves, during the time we are talking or immediately after. That is, we listen to ourselves.

And this is one of the things perplexing about Donald J. Trump. He either doesn’t listen to himself or he doesn’t care what comes out of his mouth.

A recent New York Times article called it gibberish and indicative of some sort of derangement.

We are all capable of gibberish at times. What worries me is that Donald Trump does not seem to notice he is speaking gibberish. This may explain the ease with which he lies and contradicts himself.

I don’t really understand this. His narcissism, yes. His short attention span, yes. His lazy grandiosity, yes. But what does it mean when the President of the United States does not listen to himself when he speaks? What does it mean when he does not listen to himself and notice the inconsistencies and contradictions in his speech, when he loses his way mid-sentence? Apart from being dangerous for the rest of us?

In a state of mania a rapid stream of consciousness occurs, a flight of tangential thinking, “pressured speech” as we call it, random thoughts and exhortations, sometimes linked only by rhythm and rhyme. But President Trump is not manic.

I have spent many years listening to delusions. Clear, simple, “fixed” delusions (as we call them) contain an inner logic. Trump’s speech patterns do not contain an inner logic. By inner logic I mean that if one accepts the hypothesis that the Martians are controlling me, then all else that I assert on this subject is plausible, if I can logically link it to the central idea.

Fractured, unsettled, probing, scanning, disorganized delusional thinking is different. It is a brain frantically looking for an organizing principle. This comes closer to Trump speak, but he does not appear in any other way to be psychotic.

Sprinkling random observations into the middle of an exchange and then forgetting you have done this can be a sign of dementia.

“The snow is on the ground.”

“Mother, it’s July.”

“I know that.”

“Then why did you mention snow?”

“I didn’t say anything about snow.”

This is probably not the problem afflicting Donald Trump, but time will tell. If it is some form of dementia it will get worse.

And then, just recently in the Oval Office while holding a conference with some members of Congress, he announced, in relation to the battle for Mosul, and specifically the involvement of American troops, “they are fighting like they’ve never fought before.” He said this with a particular tone and prosody, and a smile of pleasure, of good news and high expectations.

It is an interesting phrase in that context, rather meaningless and perhaps somewhat insulting to the veterans of the Iraq war and many other wars. Except if you take the phrase and the contextual information together, the unspoken portion of this thought ends with, “because I am an inspiration to them.”

It is similar to other favorite phrases of his, such as “like you’ve never seen before”. “It will make your head spin.”

It is empty salesmanship, a promise of nothing really, and a way of taking credit if something good happens, a way of congratulating himself in advance.

And it shows a paucity of complex thought beyond that of a 14 year old.

Linguists point out that the ability to compose and utter a sentence consisting of several clauses, with a premise supported by observations, leading to a logical conclusion, is a product of reading. Prior to written language all we required was something like, “Lion come, run.” But Trump’s performance with the teleprompter demonstrates that he can read, he just doesn’t read much. This leads some pundits and scholars to point out that we are in a post-print age. That much of Mr. Trump’s base do not read either.

Still, one would think Mr. Trump would notice when he is talking gibberish. And I would think it is the moral duty of all those who get to interview him, to point it out.

We live in a new age, when the spoken words (and tweets) of one man are instantly shared with the world, and because of his position of power, they have impact, they have weight. But while the world is listening to this man, he is not listening to himself.

The silver lining to this is, I think, that the Merkels, Mays, Trudeaus of this world have figured it out: that all his utterances, lies, contradictions, illogical constructions, and gibberish, can be translated as, simply, “I am great and you are not.”

But this also means he can be easily manipulated by the Putins and Bannons of this same world.