Monthly Archives: April 2020

For the First time – The Inside Story of Trump’s UV Light and Disinfectant Theory

By Dr David Laing Dawson

The amazing Donald was right this time when he said the “lamestream media” got it wrong, with respect to his supposed recommendation of UV light and disinfectants administered orally and by injection to treat COVID 19.

This moment in the White House daily briefings spawned hundreds of very clever satirical comments, cartoons and memes, my favourite of which is, I think, the comment by a doctor that “Yes, injecting disinfectants directly into the body is a well established medical procedure. We call it embalming.”

But listening to and watching carefully the press conference in question here is what I think happened:

Previously Donald had attended, as he should, a meeting of scientists and doctors discussing the latest findings from research into this particular virus. This included experiments showing that COVID 19 could survive on different surfaces from hours to days, and that disinfecting with substances like Clorox were close to 100 percent effective killing the virus on those surfaces, while UV light and heat were partially successful, or limited the survival period of the virus.

And then Donald spoke up and asked the scientists if it might then be possible to infuse such disinfectants into the body directly to kill this virus, by “mouth or some other means”, and similarly if it were possible to get UV light or “strong light” directly into the body to kill the virus.

The scientists, and by looking at Donald’s reporting of this moment in the briefing, specifically Dr.Birx, told him they would “look into this.”

They humoured him.

And at the briefing Donald, as Donald does, is simply telling us he sat down with a bunch of medical experts and one-upped them with his ideas, because, though he is not a doctor, he has (and here he fumbled with words and gestured to his skull) a great brain.

At the briefing Dr. Birx and the others said nothing, though they did grimace a little.

So Donald was just boasting about his clever performance at a meeting with experts, that’s all.

In a way it is the experts who let us down. The whole world knows about Trump’s ignorance and grandiosity and fragile narcissism. Surely at the meeting one of them could have told Donald his ideas were stupid and he should not repeat them at the press conference.

He is not the KING, as the pundits remind. Surely it is the duty of those scientists to tell Donald when he is out to lunch.

And then I thought of the fable of the child saying out loud, “The emperor is not wearing any clothes.” Not one of the adults watching the parade, but one of the kids.

So, I think maybe we need a kid at every meeting, perhaps about age 12 to 16, ideally very smart and on the autistic spectrum. And he or she can call out bullshit whenever and wherever it happens without concern for social consequences.

No One Cares About the Disabled (or the Elderly)

By Marvin Ross

Those with disabilities are not treated well by society. I’m not just talking about those with serious mental illnesses but all disabilities. The Canadian government has done an excellent job responding to the needs of Canadians during the pandemic. Those who have lost jobs or been laid off are getting $2000 a month for 4 months to help them get by. Businesses are getting help with payrolls and, everyday, Trudeau announces another benefit for some group or other to help them. Nothing is offered to the disabled.

As I argued in an op ed published on April 19 online and print on April 20, financial support for the disabled is a provincial responsibility and Ontario is failing badly going back to 1995 when the newly elected right wing government came in and slashed rates by 21.6%. Payments have never caught up. I’m pleased to report that on April 22, Ontario did send out $100 to the disabled to help them and even if my article was not responsible for that, I’m going to take credit for it.

But that $100 increase is still a drop in the bucket for those in Ontario and for those in the rest of the country. The monthly payment for a single disabled person in Ontario is all of $1169 a month.

These are the rates in the rest of the country:

Alberta $1685

BC $1183.42

Saskatchewan $931.00 to $1064 depending on where the person lives

Manitoba $1036.00

Quebec $962.00

New Brunswick $819.92

Nova Scotia $810.00

PEI $900.00

Nfld and Labrador $754.00

These amounts may be a bit off as it was difficult finding the amounts for the current year so, in some cases, the allowances may be for 2018 or 2019. Regardless, they are disgustingly low universally. In my article, I cited the poverty level as $1767.00 a month. That is the least amount of money someone would need to not be considered impoverished. In Ontario, a disabled person must live on two-thirds of the income considered the minimum. Compare the monthly stipend in each of the provinces to that. It is worse if you live in a high cost of living community like Toronto or Vancouver where the rents are very high.

How can any just society allow citizens who are disabled for no fault of their own to live in such poverty? There is a petition circulating in Ontario at the moment calling for a minimum payment to the disabled of $2000 a month to be on par with the emergency funds given to those who are out of work because of the pandemic. What we do need, however, is a guaranteed minimum income for all at say $2000 a month. No means test, just give it to everyone like all over 65 get the Old Age Allowance in Canada. If people are working and have high incomes, that amount will be taxed back when they file their income tax. That is how old age pensions work. It saves the need to have a bureaucracy to administer this and it would eliminate the staff who now administer unemployment insurance benefits and disability and welfare benefits.

As we do not have pharmacare, we would still need staff to ensure that the disabled who only get the $2000 a month income can also get their medical benefits that they presently receive (prescriptions, dental care and vision care). Spain has announced that they plan to implement a minimum wage once this crisis is over. There is no reason we cannot as well.

Our other shame in all this is the deaths among the elderly in care homes in both Ontario and Quebec. This is another shameful situation that is only happening because of our treatment of the elderly. I am not familiar with Quebec but I do know that Ontario under a conservative government allowed for profit nursing homes to exist. Our present conservative government then, to save money, decided to end quality inspections of these institutions and only inspected when they received a complaint. They also attempted to slash financial support for public health.

We can only hope that the lessons learned will result in improvements for the most vulnerable among us.

Sanity in the time of COVID-19 – Part Two

By Dr David Laing Dawson

Our brains are open systems and organizing machines. Without any external input at all they malfunction, and they do this within not that many hours. Ordinarily our brains are confronted by nano bits of information every (waking) second. They dramatically screen for the useful bits, ignore, discard, do not see, the useless bits. The bits and patterns they are looking for (so to speak) are the bits and patterns that conform to expectations and can be added to, or reinforce, an internal map that will guide behaviour through and past threat/danger to achievement of needs and impulses. Those needs and impulses are quite basic and many of them are social in nature (“my relationship to others”).

With total sensory deprivation, our brains, being organizing machines, develop internal maps of the world from fears and primal needs rather than external reality. And these are just the kinds of delusions and hallucinations one would expect. They answer questions of power, control, danger, threat, love, hate, worth, competence, social status.

On a daily basis most of us rely on multiple interactions with others to feed and replenish that map and ensure our brains can organize an internal world that matches, roughly or functionally at least, the reality of the external world and that will therefore keep us safe and successful. We want life to be predictable, at least our brains want this, even if occasionally we enjoy surprises, or go exploring.  (enjoying surprises really means the rush of arousal hormones/adrenalin is experienced as pleasurable because of the social context, the smiling faces, the rewards, tangible or not)

There are those among us who tend to socially isolate to varying degrees, from school refusal to hermitage. The more isolated we are the more our brains are apt to form/organize internal social maps that are creatively eccentric at best, delusional and dangerous at worst. But most isolates get by with the input of other information sources and become just a little autistic in nature, or develop some obsessive compulsive behaviours to compensate, rituals that satisfy that organizational need.

The forced isolation of this pandemic has, from my observation, brought about some interesting behaviours:

Most of us are using various creative means, and technologies, to keep the flow of social information coming, albeit in reduced form, and often virtual. Still, it may not be enough to maintain that internal map, that internal sense of organization and predictability, without some fissures. Indeed that comfortable map most of us rely on no longer (temporarily?) fits the external reality. We are all having to adjust that internal map, that set of assumptions and expectations about the world and our place in it. And, generally speaking, our brains do not like having to do that. Anxiety increases, alcohol and Ativan use increases, conspiracy theories abound.

The people who perpetually self-isolated long before this pandemic seem to be doing okay. Some I know are chuckling about the rest of the world now behaving as they do. The kids who hate school (usually from social/peer anxiety) are displaying less anxiety. The gamers are less conflicted about their hours of gaming. No one is telling them to get off their computers and play soccer instead. Will this last? Part of their experience before included others always encouraging them to socialize, to come outside and join in.

But there is a large group whose “sanity” (I will finally try giving sanity a definition: the person’s internal organized neural map of the world they live in is maintained as a close representation of the real external world, and thus adequately and successfully guides thought and behaviour) depends on daily routines, the input of others, the adjusting of thinking by experience, the persuasion of others. These are the people with unstable or vulnerable psychiatric illnesses – bipolar, schizophrenia…

This last group is in trouble. My voice on the phone advising to take your pills, go to bed at night, exercise and find routine during the day, is not nearly as effective as it is within a face to face office visit. And the daily routines with others, (needed to reinforce and maintain a relatively sane internal map),  whether that be Tim Hortons, work, volunteer work, friendships, extended family, rec and rehab programs, A.A., drop in centers, ….are lost.  That sane but tenuous mental map can be quickly replaced by simpler versions, simpler conclusions, and delusions.

I think most of us will find ways of coping with this forced idleness and detachment, by finding alternate ways of socially engaging and by accepting some (temporary?) changes in our internal map of self and others, some different expectations and assumptions. For some it will simply relieve pressure and guilt. But for those with an infirm grasp of reality to begin with, much slippage can occur.

Musings On Sanity – Part One

By Dr David Laing Dawson

There can be no concept of sane without a concept of insane, as there can be no on without an off.

We use words to communicate and to express our emotions and reactions.

Sane/insane is a judgement we make of others, specifically the behaviour of others. Sane in common usage and in law is a default position, assumed, unless demonstrated otherwise.

When we ask how people usually make that judgement we find that we use two parameters: The first is the application of logic. We consider the goal, the purpose of the person’s actions, and then ask if that action could, logically, achieve that goal. The well known Einstein definition of insanity is of someone doing the same thing over and over while expecting different results. This fails the logic test, though we all might empathize a little.

The second is the application of empathy. We ask ourselves if we would or could behave in the same manner in the same circumstances.

In common use we deem a human behaviour as insane when it fails both tests.

The example often quoted is the observation of a man of age dressed in a business suit climbing a tree. We note that he is fleeing a bear and thus we judge, by logic and empathy, the action to be sane. On the other hand, he tells us he is avoiding a flea, we judge by logic and empathy the action to be insane, or perhaps there is a stage between the two we think of as simply, “not sane.”

In a similar vein, though the linguists and philosophers and psychologists can discuss many possible parameters that can be used for the distinction between normal and abnormal (statistical, actuarial, ideal, moral judgement, function…) in common use we tend to equate normal with predictable, and abnormal with unpredictable.

In the village old Joe is usually seen sitting on the bench in the square talking to himself. This becomes accepted as normal, and only when he doesn’t show up is the absence of Joe on the park bench perceived as abnormal.

In medicine the words normal and abnormal are used often (physical findings, tests). The parameter here is statistical or actuarial, with some element of predictability.

In psychiatry these two words (normal and abnormal), like “sane” or “insane”, are avoided, and replaced with such words as ‘usual’ and ‘unusual’, ‘functional’ or ‘dysfunctional’, which require an individual or social context and/or known history. i.e usual for this individual, or in this culture, or context. Or unusual and dysfunctional for this person to behave this way.

There is a paradox about sanity, or being sane, voiced before, and that is that someone truly sane occasionally doubts or questions his or her sanity (“am I really perceiving things as they are and coming to a logical, rational conclusion?”) while the truly insane person never doubts his sanity.

In my office the manic or psychotic patient has no doubts about the mental map he has drawn, his conclusions about the way the world works, and his place in it, be it messenger of God, or victim of the Deep State, but I, as a sane person, always do have doubts. As a sane person I do not need reminders by the the anti-psychiatry folks that my conclusions, my diagnoses, the advice and potions I prescribe may not be perfectly sound, exactly right, but I will watch over time and learn if they, flawed though they be, at least helped.

—-

Language lives and evolves, and “insane” has, in youthful usage, become synonymous with extreme, exciting, and “I wouldn’t try that myself.” In essence the behaviour being described as “insane” has failed the empathy test and perhaps the logic test but might still be admirable, even heroic. “Sane” on the other hand, in youth speak, can denote something rather dreary and common place.

While sane and insane are words, today, avoided by psychiatrists (formally at least), these words do have a place and definition in law.

Actually the supreme court of the USA just passed a judgement that allows the state of Kansas the right to continue rejecting the concept of “Not guilty by reason of insanity”. Kansas along with Utah, Idaho, Vermont and Montana do not allow this in their criminal codes. It is allowed in all other US States plus the UK, Canada, Australia, Hong Kong, India, Ireland, New Zealand and Norway.

Our culture has assumed for centuries, that for one to be culpable or guilty of a crime committed, a bad act, one must have a “guilty mind”.

The first time this was codified was at the M’Naughten trial in mid 1800’s.
The findings at this trial are the foundation for the Not Guilty by Reason of Insanity judgment for the succeeding 150 years. At the time, and still considered in court today, are two underlying questions to determine insanity, or at least, not guilty by reason of insanity. They are, in simple language:

Did the accused have the capacity to know right from wrong?

Did the accused have the capacity to appreciate the nature and consequence of his actions?

Sanity is the default position, assumed, with insanity having to be proved or argued convincingly.

Though guilt in our culture (and law) has always implied a “guilty mind”, a moral component, in common and careless usage it can simply mean “he done it”.

Canada, to bypass this common confusion, changed the “not guilty by reason of insanity” clause to a finding of “Guilty but Not Criminally Responsible due to mental illness”, (NCR) using the same underlying concepts.

The American Supreme Court decision is significant, not just for those before the court, but because it undermines a legal and formal acceptance of the idea that we should not be held responsible/punished for some behaviours that are beyond our conscious will and driven by brain illness/disease/defect. At the time of M’naughten, this was a mid 19th century shift away from judgements of human behaviour based on notions of goodness/evil/free will/possession/invitation to the devil/moral failure…

 

On Preserving Volunteer Advocacy Groups – A Negative Case Example

By Marvin Ross

Our last two blog posts on the new pet food mental health replacement for the Schizophrenia Society of Ontario (IAM) and what is essential in an advocacy list in mental illness have struck a nerve with readers. We received a number of very thoughtful comments on the nature of voluntary groups. What is striking is the transformation that comes about when exhausted volunteers begin turning over control to professionals.

Schizophrenia advocacy in Ontario began when families realized the need to do more for their family members. In 1979, Bill Jefferies began calling together other family members in a church basement in Oakville, Ontario and the Friends of Schizophrenics was born. This was long before my time but the group expanded across Ontario and chapters sprung up all over. In 1995, the name was changed to the Schizophrenia Society of Ontario. I did not get involved until the late 1990s with the Hamilton, Ontario chapter.

By that time, we had a couple of staff people and an office in the damp basement of a private art dealer down the street from a hospital. Active chapters existed in Burlington, Oakville, Toronto, Kingston, Ottawa, London, Windsor and Thunder Bay and elsewhere representing the needs of their local communities. There was a central office but the bulk of the work was carried out locally and by families.

In Hamilton, there were regular monthly support meetings for families with a lending library and a buddy program. Family members new to the disease would be hooked up with volunteers who they could call for advice and support. We had a regular lecture series with various experts with attendances at times over 100 people. There was an annual general meeting with dinner at the Sons of Italy Hall complete with speaker. Attendance was often around 100 people.

One thing that the chapter did was to hold a mental health fair probably every couple of years. All the agencies that provided service to those with mental illness paid a small fee to have a booth. The public came and had an opportunity to meet all the players involved in providing services and we then had a lecture that evening. One year we messed up and planned the event for a Thursday evening that happened to be the night of the first seder for Passover and the eve of Good Friday. It was also unbearably hot but despite all that, we were crowded and again we had over 100 people at the evening lecture. The speaker that night was the psychiatrist for the early intervention program at the Centre for Addiction and Mental Health in Toronto.

We were also very active in advocating with the hospital for service improvements. I don’t think we were much liked but they did know us and we were able to bring about some change. We also did a lot of fundraising and received grants from some of the local charities. Our main source of funds was the annual golf tournament put on for us by the National Hockey League Oldtimers. I will never forget the dedication of one older mother at the tournament. It was a very hot day but she stationed herself at the first hole and before a foursome could tee off, they had to listen to her spiel on schizophrenia and its impact on families and take her literature. They all listened intently and she stood there all day without taking a break.

The last tournament was Sept 10, 2001 and I remember driving back from it with something like $15,000 cash in a bag on the backseat just from the donations we got that day. Fortunately, I had cut myself off the wine early during dinner because we got stopped in a police impaired driving check. Bobby Hull was the guest speaker and Michael Burgess of Les Mis fame sung Danny Boy – a favourite of the hockey players.

All of this was accomplished by dedicated family member volunteers led by our main employee, the overworked and underpaid executive director, the late Richard Russell. Some of the volunteers had lost children to the disease through suicide or other misadventure but they still came out. That is not something that I could have ever done and their dedication is to be commended.

But, about this time, the central office decided that the chapters had too much control and independence. In its history, IAM mentions that starting in 2000 they began centralizing community supports and taking over from the local chapters. As I recall, they had some justification for doing this but it was handled very badly and chapters found themselves under attack. The chapters fought back at the provincial AGM but we were no match for all the proxy votes the central organization held. And I should mention that those provincial AGMs were all day affairs attended by 100s of people. There was always a lecture by prominent speakers. As the years went by after the centralization, the AGMs were very brief events attended by very few from what I had been told.

As a result of the battle, the Hamilton executive resigned and similar defections occurred most notably in Ottawa.

Hamilton still runs the family support group meetings but from their calendar, the last one was in September 2019. Their last strengthening families course was in March 2019. Nothing is scheduled for the future on the Hamilton section but they do list a virtual family course for April on the main event listing. The new office we opened on the first floor of a building next to the art gallery is long gone. The last I heard, they had an office at the Canadian Mental Health Association building.

Not to be totally negative, SSO before it became IAM did do some good and advocated for improvements but they have pushed CBT and held yogathons. I don’t see much hands on by family members and their board of directors is a mystery. IAM does not list who they are and what they do. There was a requirement that the majority of directors had to have  family experience with schizophrenia but I’m not sure that is still the case. Their old website had their audited financial statements and their contract with the government for the money they received. None of this is on the new website.

The organization Charity Intelligence Canadarates charities and the last rating they did of SSO was in 2017. Based on their financial reports for 2014/15/16, they received a rating of 2 out of 4. Their analysis stated that “Administrative costs were 25% of revenues and fundraising costs were 36% of donations. As such, for every $1 donated, 39 cents went to the cause. This falls below what Charity Intelligence considers a reasonable range for overhead spending.”

One of the comments on the original post stated that:

“I am not surprised that this new organization has been created as it just seems more of the same. I am on the e-list for the Schizophrenia Society of Ontario and have been a volunteer but was not consulted in anyway about the development of this new organization. What else is new? By not consulting stakeholders, they are like all the rest in the mental health system, or should I call it “the mental health industry”.

The bottom line in all this is that volunteers must always ensure that they retain control of their organization when involving professional administrators/bureaucrats to run it.

The Eight Commandments for Successful Mental Illness Advocacy

By Dr David Laing Dawson

Serious mental illness requires:

  1. Treatment. That treatment is primarily pharmacological. Treatment controls symptoms and prevents relapse. But as human beings people with mental illness also need:
  2. Adequate stable housing
  3. Adequate nutrition
  4.  Regular activity that provides a sense of purpose and value
  5.  At least one relationship that approaches intimacy
  6. Membership in a group providing a sense of belonging/acceptance
  7. Currency (money, skill, knowledge, literacy…)
  8.  Meaning (a way of thinking about existence/purpose/being/self/others)

Having an untreated mental illness puts all other seven of those essential needs at risk.

Without treatment it is almost impossible to regain even one of them.

There are many good people and organizations in this world that would like to improve the lives of the mentally ill. Please stop the nonsense of opposing pharmacological treatment and replacing it with big words and false promises drawn from current new age and corporate lexicon.

Instead pick one or more on my list  and work on it, as an individual, an advocate, a service provider, a fund raiser, an organization, a politician…….

The categories in my list are not in precise order but achievement of each is generally dependent on achievement of the ones above.

(note: large artistic installations of solar spectrum light in urban malls is not on the list, apart from satisfying numbers 4,6,7 and 8 for the artist himself)

Ontario’s Schizophrenia Society is No Longer – And it is a Shame

By Marvin Ross

Since 1979, families of people diagnosed with schizophrenia in Ontario have had an organization dedicated to offering support and advocacy. No longer!

The Schizophrenia Society of Ontario has now become the Institute for Advancements in Mental Health (IAM). Instead of providing support to the families of people with schizophrenia and advocating for better services, they are now “Innovating, Supporting, Driving Change with people impacted by mental illness”.

I have no idea what that means but this is one of their projects:

“Working with MOCA, IAM evaluated a light therapy installation by artist Apolonija Šušteršič, the first of its kind in North America. In particular, it looks at the effect on museum patrons to determine whether such spaces can help people with seasonal affective disorder (SAD), or other related depressive symptoms. This is the first large scale light installation used as a wellness intervention, with evidence helping to better understand the potential for scaling in other public spaces, such as retail or recreational centers.” (sic this is Canada)

They don’t define MOCA but in exploring their website, I think it might be the Museum of Contemporary Art in Toronto.

As one person I showed the website to said of the web write-up:

“The most egregious use of $20 words strung together in a totally meaningless way.”

This is how they describe their mandate:

“we are committed to community engagement, empowerment and system change that directly draws upon the strengths of those affected by mental illness.

Working closely with a diverse portfolio of stakeholders including government officials across several ministries and jurisdictions, IAM has the expertise and the flexibility to bring innovative models into traditional spaces, disrupting the existing systems that have not led to widespread progress, and creating sustainable and effective change for people now, and in the future.”

These goals are nothing more than institutional gobbleygook. It is all utter nonsense – better grammatically than Trump but along the same lines: illusions sold as fact.

So, who are the people doing this? No idea. They do not tell us who their staff are let alone what their qualifications are. Nor do they list the members of their board. They do list numerous people who they call advisors. That list includes a director of airport operations, someone from the aerospace industry, artists, and one psychiatrist plus someone from big pharma and other organizations. Their partners do, however,  include some in mental health.

They are strong believers in cognitive behavioural therapy (CBT) for psychosis along with increased community based supports and supports for families. CBT may have its place but it is not the main treatment for someone with a serious mental illness. As families will tell you, what is needed is more beds in hospital and longer stays in hospital to stabilize patients.  We then need more community supports for those discharged including affordable housing. In Ontario, we need a revised mental health act that makes it easier to hospitalize patients when they do not understand they are ill and that does not discriminate against family by hiding behind outdated privacy legislation.

Those issues have been at the centre of family advocacy in Ontario (and other jurisdictions) for as long as I can remember. Those are the issues they should be fighting for and did in the earlier days of the Schizophrenia Society.

Before giving a little history of where they came from, I would like to comment on another advocacy issue they consider key. They say:

Mental illness is commonly treated with pharmaceutical interventions that often involve a lengthy process of trial and error to find the best-suited medication(s) to address symptoms. Yet, consistent access to affordable and effective medications can be challenging due to costs associated with filling a prescription and the complex system of public and private drug plans.

The first sentence is OK. Finding the right drug and the right dose is difficult and time consuming but most of the time, the drugs will work to alleviate many of the symptoms. The second sentence sounds like it may have been influenced by big pharma. People who have a disability including a psychiatric disability and cannot work are given government support payments. In addition to a monthly amount (still too low and below the poverty line), their drugs (and all their medical needs) are paid for by the province. Not all drugs are covered but the important ones are and the new drugs may be slow to get listed but they do get listed.

If they want to advocate for prescriptions, then they could push for Clozapine to be used more frequently than it is as I argued in an earlier post.

They do say that they have evolved from the Schizophrenia Society of Ontario which was begun when a group of families in Oakville Ontario came together and formed the Friends of Schizophrenics in 1979. The name was changed to Schizophrenia Society in 1995 and the organization goal was to support families and to advocate for some of the key issues I mentioned above.

That support and that advocacy is still desperately needed. Do we really need a new organization with mostly incoherent  goals.  What they are doing now is nothing but a betrayal of the legacy of those families who founded the original Friends of Schizophrenics. And they use a name (IAM) that sounds like a pet food company (IAMS).

Time to Social Distance From the United States

By Dr David Laing Dawson

Can we move Canada? I’m thinking we could incorporate New Zealand and settle in next to Australia in the South Pacific.

This wish comes from watching yet another white house coronavirus task force briefing. I am tired of hearing, watching, listening to a most incredible (Trump managed to use that word nine times in the first few minutes) melange of failure, lies and boasting. His other favourite (and lazy) superlative is some variation of “Like the world has never seen before.”

On the other hand, along with lessons in virology, the history of infections and epidemics, the manner in which (scientifically) medicines are developed and tested, how vaccines work, some human biology and ecology, we also are all watching the persistence of a personality disorder.

Donald Trump’s voracious narcissism and psychopathy served him well during his campaign, and then in the first three years of his presidency as he bluffed his way through. The lying, boasting, bragging, the blaming of others in a persistent child-like manner, the “all about me” and “l’etat c’est moi”, all worked for him. The fact he knew little, cared less, and said whatever came to mind, worked for him, astonishing most of us. Even when saying something a little less provocative or narcissistic should have been an easy and strategic choice, he persisted in the same vein. And still it worked for him.

Along comes the pandemic, COVID -19. Now while big lies, inaccuracies, non-sequiturs, nonsense, ignorance, exaggerations, blaming others, boasting of fantasy successes – while, to not make too fine a point of it – absolute bullshit – is apparently a successful way of stick handling through economics, immigration, health care, wars, climate change, trade, military matters and foreign policy, I thought a pandemic would require some actual knowledge and selfless consideration from a leader.

But the reason certain traits and persistent ways of behaving become labeled “personality disorders” is precisely because the pattern of behaviour persists even when, to any other sane observer, this particular context requires, demands a different response, if only for self-preservation.

And in Trump’s case the pattern persists even in the face of a world pandemic.

Some thought that this would be his undoing, that his display of ignorance coupled with his grandiosity and narcissism in the face of this global threat would cause an unraveling, or, at the very least, expose him for the fraud that he is.

But maybe even here he has stumbled onto a formula that will work for him: He steps to the microphone, brags and lies randomly (his popularity, his saving of a million lives, his brilliance, his fine leadership, his poll numbers, his TV  ratings, even going back to his election win, the “Russia hoax”, the sacrifice of his billions to become president), lashes out at any criticism, repeatedly compares himself favorably with all others, displays a petulance worthy of a 13 year old,  even tries to sell a little snake oil and usurp medical science, and then steps aside to let the experts (and a couple of sketchy choices) do the actual work, most of whom know well enough to praise and thank him every step of the way, while he waits impatiently to take the microphone again.

Unfortunately there are many in his country who listen to Dr. Trump rather than the experts, the sane, the sensible, the compassionate.

And hence my wish to move Canada to the South Pacific. Please. I suppose we’d have to flip it to maintain our melting ice fields.