All posts by mross109

Buck a Beer and Dented Tuna Tins

By Marvin Ross

The Buck a Beer campaign (opposed by many craft brewers) was first developed about 2002 by Lakeport Brewery in Hamilton Ontario as an attempt to gain market share. It worked and they went from a 1% market share to the top 10 in a very short period of time. But, Ontario raised the minimum price and Lakeport was bought out in 2007. The CEO of Lakeport, Teresa Cascioli, went on to become a major philanthropist in Hamilton donating over $4 million to various institutions in the city.

How it came into the mind of Doug Ford as something anyone wants is bizarre. Unlike the woman who used her wealth generated by the buck a beer, he is willing to spend tax dollars on this scheme while not only cutting the basic income pilot program but by cutting the increase in social assistance planned for September from 3% to 1.5% . He has also put on hold all other improvement to social assistance to come into effect on that date.

Doug, unfortunately, is a carryover from the last Conservative government Ontario had starting back in 1995 led by Mike Harris. Harris slashed welfare rates by 21.6% and despite modest increases during the Liberal regime, rates have not recovered from that slashing. It is important to remember that most of the people impacted by those cuts are disabled and cannot work or can only work part time.

Treating the disabled this way is cruel and smacks of Marie Antoinette. In fact, when the social services minister under Harris, David Tsubouchi, was challenged in the legislature, his suggestion was that the poor and disabled could buy dented tins of tuna at less than the usual price if they bargained with shop keepers. He then put out a proposed welfare diet that includes pasta without sauce, bread without butter, and the elusive 69-cent tuna can.

He even went further by telling single mothers on welfare that they had ample time to find jobs because they had a three-month warning. He also suggested welfare parents could just ask neighbours to look after their children, and accidentally ordered 115,000 disabled people and senior citizens to be cut off from their welfare benefits.

A report done in 2015 on the 20th anniversary of those cuts found that the consumer price index had gone up by 45% but the cost of the welfare diet had increased by 107%. The welfare rate has only gone up by 37% to 2015. Pathetic.

In an op ed in the Hamilton Spectator, Michael Taub a former speech writer for Stephen Harper, argued that the Progressive Conservative Party is not progressive and should not have progressive in its name. He argues that rather than being progressive they practice:

“compassionate conservatism. For instance, working with religious organizations and private charities to help out the poor and needy. Finding ways to use the free market as a means of getting people back to work and wealthier, such as reducing taxes and state involvement. Supporting public programs like health care and education, but ensuring the private sector has a greater role and/or influence in these sectors.”

He supports Ford’s cutting of the Basic Income Project and of social assistance rates. His argument:

Rather than a never-ending cycle of government handouts, the PCs will use other means, such as tax cuts (including the 10 cent reduction on gas prices) to accomplish the same goal. This will hopefully produce far better results and savings for Ontario families.

Right, let us reduce gasoline by 10 cents a litre to help people who cannot afford to buy a car and who have to use the food bank to eat in their substandard rental units.

The utter folly of this is that if people cannot afford to eat nutritious food which is more expensive, it will impact their health. They will end up getting costly medical treatment for the ill health caused by their poor diets. That will cost more than the money saved on social assistance cuts. And don’t think that the Liberals are any better. Despite being in office for 15 years, they failed to bring the social assistance rates back to where they were when they were slashed in 1995. Social activists found a loophole in the act that allowed for the poor to get an extra allowance if they needed more expensive food for health reasons. Doctors and nurses began signing the forms for their patients so they could eat better but the government put an end to that practice.

Going off on a tangent, I must point out that I knew David Tsubouchi and he was our lawyer until he went into cabinet. To this day, I do not understand how he could do what he did as he was a very nice, compassionate person. He was a poet and, because he was bored with the law, he acted in his spare time and played a Japanese salesman in David Cronenberg’s Videodrome and other shows.

But then, politicians do stupid things that run against their principles to be in power. A recent Toronto Star column asked where the grown ups are in Ford’s cabinet as they are all silent. I think the explanation for this was spelled out by the late journalist Heather Robertson. I’m just reading her book, More Than A Rose (1991) on the wives of Canadian Prime Ministers. She makes the point that politicians can make peace with anyone if it leads to power.

Power corrupts but the whiff of power corrupts just as easily.

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Buck a Beer Trumps Compassion for the Poor and Disabled

By Dr David Laing Dawson

“Buck-a-beer” as proposed by Ontario’s new Premier, Doug Ford (and brother of the infamous Rob) is simply a very silly adolescent political promise. With all that is going on in this world our premier comes up with “buck-a-beer”. I am embarrassed.

But now his government is discontinuing the basic income pilot project.

I have always been astonished by the gap between what we know of human behaviour and how our governments function. Especially, for example, how so many leaders think “punishment” in the form of sanctions will change the behaviour of dictators.

But back to the issue of basic income for all.

There are far too many variables to know how each and every recipient of a basic income will behave. For some, will a basic income simply make their lives better? Will their health improve? Will they develop more or less incentive to work? Will the cost to taxpayers be, ultimately, less or more? Will the increase in basic income be offset by a decrease in health care, social service and correctional system costs?

For those who could in theory work or be retrained for work would it be an incentive or a disincentive? And ultimately, for our economy, would that matter?

Surely in our society in 2018 it is simply cruel to force people to live on $700 a month. So the humanitarian argument is easily won. It is the other arguments that go on and on. Incentive, disincentive? Can we afford such a program? Will the taxpayers tolerate such a program costing them money? Can we prove to the taxpayers that it will cost them little?

I know the fear our inner Ayn Rand holds is that some of the recipients will take advantage of “the system”. They will pocket the money, buy booze and drugs with it, and continue in their sloth-like ways.

But we are, I like to think, a rich, modern, caring and scientific community. So, let us study the problem. Let us choose 4000 people to receive basic income and compare this to a matched sample of 4000 people who receive the usual services. Let’s give this a few years and then let’s study the results down to the penny. At all levels. Health care costs, trips to emergency, social service costs, police costs, alcohol and drug addiction, part-time and full time employment, effect on next generation, income tax paid, volunteer hours…

A difficult component to track I am sure (but maybe economists can) would be the effect on the broader economy. Every extra dollar a basic income recipient receives will be spent (note: in Canada, and not on a luxury yacht made in New England). The money will go round and round, and at each stop it will increase the income of others and shed a small percentage to taxes.

And I gather that is what we were doing, though I have little idea about the details of this pilot project and the extent of the evaluation. To stop it now is Trumpian, allowing ego, prejudice, ideology, and politics to Trump truth and compassion.

More to come

The Tiff with Saudi Arabia

By Dr David Laing Dawson

Usually in our relations with nation states that have poor human rights records, Canada officially protests in polite fashion, the offending state responds in some grumbling way, and life goes on. Strategic, political alliances, and economic forces trump the rights of minority religions, journalists, little girls and women. Fair enough. Canada is not in a position to do much more than raise the issue anyway, and continuing to be engaged may be the most productive thing we can do in most cases.

Those fifteen thousand Saudi students in Canada just might take some civilized values back to the Middle East. Or not.

But we now have an opportunity to go beyond that. The over-the-top school-yard reaction by the Saudis, complete with a jpeg showing an airliner heading for the CN Tower, cancelling the scholarships of those 15,000 students, cancelling all future business deals, and sending our ambassador home, actually allows us now to be a little more direct and specific, without worrying about geopolitics and economics.

Saudi Arabia is a slave state. The girls and women of Saudi Arabia have only marginally more rights and dignity than a “house nigga” in 1840’s Georgia. In fact, researching this it seems the only real difference may be the amount of leisure time and purchasing power afforded the Saudi women by the  oil wealth of many households.

So, Chrystia and Justin. Opportunity knocks. Make it clear what you think of the enslavement of women, the absence of free speech, the control of the press, and their medieval system of justice.

As far as I can see, we need no longer be constrained by the strategic alliance between the USA and Saudi Arabia. In fact, it is Donald Trump who has emboldened the dictators and potentates of this world. He will no doubt say something like, “There are good people on both sides”, or even favor the Saudis over Canada in this dispute.

While we watch the craziness south of our border unfold, we must remain independent and give clear voice to our liberal democratic principals.

 

Guns, Guns, Guns

By Dr David Laing Dawson

Some years ago I was awakened after midnight by the screech of tires and the unmistakable sound of a car smashing into a lamppost two stories beneath our bedroom window. I crawled out of bed and looked out the window down to the sidewalk. A car was curled against a lamppost, its doors open, steam rising from its hood, and two men were fighting on the sidewalk.

My first thought was that they probably deserve one another, whatever the story behind this event, and that I should go back to bed. But then it was clear that one man was down and the other was kicking him mercilessly.

I asked my wife to call 911, pulled on a pair of pants, grabbed the only weapon in the apartment and headed for the front door. That weapon was a hockey stick.

The building is on a hill with the front door opening on ground level one story above and around the corner from the men.

I rounded the corner and approached the men who were downhill and fifty feet away. They saw me coming, stopped fighting, and got to their feet.

(This allowed me to tell the story later as one of the thugs saying to the other, “Good God, it’s an old Canadian Geezer with a hockey stick. Run for it.”)

But their easy surrender may have been induced by the Police car they could see coming over the hill behind me.

I’m sure when I grabbed the hockey stick I thought of it as a symbol of authority and not a weapon I would actually use. Something to hold in my hands. There was no gun in our house and there never will be.

But I am writing this because the presence of a gun might have turned this farce into a tragedy.

And the absence of guns might have turned two local tragedies into farces, into stories of human folly and stupidity rather than tragedy. One event occurred recently with a boy from the Six Nations Reserve being killed by a shotgun blast while he attempted to steal an old truck. The other was a few years back and involved another boy from the same reserve being killed by a bullet from a handgun. In that story the boy (probably a little inebriated) was banging on the door of an isolated farm house seeking help for his car that wouldn’t start after he and his companion had pulled into the driveway to urinate in the bushes.

Much has been written about these events, the court cases that ensued, the verdict of innocence in the latest, the verdict of guilty in the earlier case, but later overturned. And of course much has been written about the possible racism that played a part in the tragic events in the first place, and then in the court cases that followed.

Perhaps racism played a role in these tragedies. But perhaps not. In both cases it is dark; the owners of the houses are awakened in the middle of the night. They find themselves confronting, in the recent case, a shadowy figure trying to steal his truck, in the older case, a (possibly inebriated) young man pounding on his door after midnight.

Had these home owners been armed with nothing but a hockey stick the story would have been a farce, worth telling to grandchildren around the fire pit; and perhaps the boy killed more recently would have decided there are better careers than grand theft auto, and the boy in the older case was already attending college, but, as young men are apt to do, had consumed some alcohol while parked with a friend at the Starlight Theater in an unreliable automobile.

The difference here, between farce and tragedy, was, as is so often the case, gun ownership.

All other factors, as usual, are questionable, of some interest, consuming of legal time, journalism. But without the presence of guns these two incidents could have ended as my story did.

It is the gun that turns folly and farce into tragedy.

Drugs and Violence

By Dr David Laing Dawson

In medicine, when we find something that works we overuse it. That is as true of antibiotics, anti-inflammatories, and blood pressure drugs as it is for psychiatric drugs.

And this means that some people who really didn’t need the drug in the first place may be suffering unnecessary side-effects. Over time medicine usually corrects with broad studies and new guidelines.

(Although it is as difficult for doctors to convince a patient that he needs to exercise rather than take Prozac, as it is to convince a mother that her child’s cold and earache will run its course with or without antibiotics.)

But to blame psychiatric drugs for violence and murder is patently ridiculous.

In fact, if one extrapolates from the murder rate trends around the world, or just within large Canadian cities, one could make a case for the wide prescription of anti-depressant and anti-psychotic medication being the source of less violence in our societies.

Murder rates in the middle ages were shockingly high by all estimates. Similarly throughout the 1800’s.

In Toronto and Montreal the murder rates climbed from 1900 into the 1960’s, peaking in the mid 70’s and then declining ever since.

The powerful psychiatric drugs were introduced in the 60’s but mostly used within hospitals and outpatient clinics of hospitals. Wider use developed in line with the reduction of psychiatric hospital beds and the introduction of newer drugs in the 1970’s and 1980’s: the so-called atypical anti-psychotics (Risperdal, Seroquel eg) and the SSRI’s for anxiety and depression (Prozac onward).

The increasing use of these drugs within the community and less ill population, when charted, is a reverse image of the declining murder/homicide rates.

Many other factors are at play as well, of course, so I cannot make a case for these drugs specifically being responsible for the declining rate of homicides, but I can from this data be confident that wide-spread use of these medications is NOT increasing the homicide rate.

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The first group of antidepressants were introduced in the 1950’s, again primarily in hospitals, outpatient clinics and for severe depression. (Imipramine, Amitriptyline)

Prozac, the first SSRI antidepressant was introduced in 1989. Currently 86 people per 1000 in Canada take an antidepressant, usually an SSRI or NSRI medication.

(note both the highest suicide rate and the lowest consumption of antidepressants falls to South Korea)

Similarly the first antipsychotics (Chlorpromazine etc.) were introduced in the late 1950’s/early 60’s and were used primarily within the mental hospital population. The second generation only became available in the 1980’s. Currently a little over 1% of the American population takes anti-psychotic medication.

If one considers the percentage of the population that suffers from severe mood disorders it is reasonable to say that the antidepressants are being somewhat over prescribed.

On the other hand if one considers the percentage of the population suffering from a psychotic disorder (schizophrenia, bipolar disorder, psychotic depression, autism with psychosis) the anti-psychotic medications are being underutilized.

But, either way, to blame these medications for violence or homicide in 2018 is ridiculous, as the data clearly demonstrate.

 

The Carbon Challenge

by Dr David Laing Dawson

Last year we humans and our livestock pumped 38 billion tons of carbon dioxide into the air we breathe. The earth’s ecosystems managed to reabsorb half of that. That leaves a net increase of 19 billion tons.

It would take a better mathematician than myself to calculate how much carbon we need to take out of the atmosphere each year to achieve some kind of fluctuating net neutrality. We would also have to know just how much carbon dioxide our earth will continue to absorb, and how much that is determined by saturation, ocean temperature etc.

But let’s say we humans need to remove, say, 10 billion tons of carbon dioxide per year from the atmosphere, while we try to reduce emissions, in order to staunch global warming.

Is it possible to do this?

If one gizmo can capture a billion tons in a year we would need only ten of them.

If one gizmo could capture 1 thousand tons we would need 10 million of them.

In the last couple of decades we have built, world wide, between 6 and 12 million cell towers (depending on the definition of a cell tower), and a hundred times that in substations.

For carbon capture there is “source capture” (power stations, oil fields etc) and general air capture. Then we have the problem of transportation and storage or transformation into a usable product.

Currently there are hundreds of experimental trials and actual implementations going on, plus grants and tax credits, in numerous parts of the world.

And if there were no urgency to the problem we could let this wind its complex course to fruition and see what happens, that course fashioned of course by economics and politics. and a little bit of science.

But parts of the world are rapidly becoming uninhabitable, especially for the poor.

In better times we might have expected America to take the lead, to pull together scientists, engineers, politicians and economists, create a Manhattan project for carbon capture, and then take this to the United Nations.

Our grand intention to reduce emissions by switching to alternative sources of energy world wide is pie in the sky.

It is time for someone, some country to take the lead. Justin? Canada?

The Danforth Shooting – Violence and Mental Illness

By Dr David Laing Dawson

In the wake of the Danforth shooting a couple of my colleagues have been quick to point out that the association between mental illness and violence is small, that most people suffering from mental illness are more likely to be victims of violence than perpetrators of violence. They are worried about the stigma of violence attaching itself to mental illness. And of course they are right. Though one of them goes on to use those horrible euphemisms of “mental health issues” and “mental health challenges”.

Language is important as are the questions we ask.

If we expand the problem to “mental health issues” then I am sure I can rightly say that all acts of physical violence by one human against another are the products of “mental health issues”. Otherwise we will have to expand our concepts of normal and healthy to include physical violence.

And the use of such ill defined euphemisms plus our worry about stigma cause us to ask the wrong questions. Did he suffer from “mental health challenges” and “issues”? Of course he did. Is a circle round?

These are the better questions to be asked:

1. Did treatable mental illness play a role in the Danforth shooting?

(I have just read that the man in question “repeatedly cut into his face with a pencil sharpener blade” and talked of hearing voices – both symptoms of a treatable mental illness, a psychosis, probably schizophrenia)

2. If he did have such an illness why was it not being adequately treated?

(Not “supported”, “counselled”, “accommodated”, but treated)

And finally, because question 2 will always lead to imperfect answers, 3. How did he get a gun?

I have to add that while many people suffering from delusions never act on those delusions, especially if they are being treated, a very specific sign that a psychotic and delusional person will act upon a delusion (that is, attack his imagined torturers) is self injury to face or genitals.

Delusional Narcissism and the Donald

By Dr David Laing Dawson

It is time to make a prediction, though, as a relatively sane person, I know we can never be one hundred percent sure of anything. Seldom over 70% for that matter.

But here it is:

Donald Trump’s pathology is becoming more and more evident in his off the prompter remarks, his lies and contradictions, his fractured adolescent English and his tweets.

If this simply continues, if the Republicans retain control of House and Senate, and Donald’s popularity does not drop precipitously within his base, then step by step, under cover of the Trump circus, the Trump distraction, America will become worse in all ways. Let me list some of them:

Racial intolerance, racial strife

Women’s reproductive rights, women’s equality, gone

Fascist application of laws

Good health care for fewer and fewer.

Distribution of Wealth even worse

Destruction of the environment

Increasing corruption.

Larger and larger debt

More and more poor and black in prisons

Fewer, poorer welfare programs

Poorer public education

More tribal isolation

More gun violence

Damaged reputation in the rest of the world.

(And the world will suffer because we need a sane and healthy America)

On the other hand Mueller may indict Trump and/or members of his family and inner circle, or we find the Russians do have something on him, or he fires Mueller and sets in motion a constitutional crisis. Whichever way Trump’s presidency comes to an end the problem remains his narcissism.

Each of us may suffer a narcissistic injury from time to time. (a rejection, a loss, a failure, a disappointment). The healthiest among us nurse our wounds, learn from the experience, and become kinder, gentler, more thoughtful people. The more narcissistic flail longer, hurt more, deny longer, blame others, before they give in and learn from the experience. With a little more narcissism they remain hurt for longer, and may develop unhealthy coping mechanisms, such as continuing the blame, seeking revenge, obsessing.

And then we have the supreme narcissist. Usually such a person will organize his or her world to be immune from challenge. Which is perhaps where Donald Trump would be if he hadn’t entered politics – surrounded by sycophants who support his illusion, be king of the resorts and golf courses he owns, print his name in bigger and bigger gold letters, make claims without challenge of being a stable genius who has written many books, and get his name in the news media as often as the Kardashians.

It was quite telling to hear Donald disrespect his own country at the Helsinki meeting. Some called this treasonous. But I think the explanation for this behaviour comes not just from his need to please Putin, but from his narcissism. By that I mean that another president would know that his or her power and status derived in fact from being the elected representative of the Country America and all it’s institutions. Not Trump. His sense of his greatness precedes and exceeds his conferred status as President. He is “Trump”. ( the pun in this is one of those quirks of history)

And that level of delusional narcissism does not suffer injury lightly. He will flail and explode in rage. He will disorganize. He will blame and obsess. He will not go quiet into that good night.

How Science Tries to Understand Mental Processes

By Dr David Laing Dawson

When science tries to understand human behaviour it can develop methodologies to look at multiple levels of our organization. These levels could range from subatomic particles to the behaviour of tribes, nations, the population of the entire world.

Within the medical sciences we are interested in the behaviour of cells, of neurochemistry, and, at the other end of this chain, the experiences and behaviour of individual humans.

Behaviour can be observed, and observed within different contexts, and under specified situations. Internal experiences require self reporting within a social context, and self reporting is notoriously unreliable. (Imagine asking Donald Trump what he is thinking and feeling, and why he is having these thoughts and feelings, and whether he has written many books.)

Until quite recently the behaviour of brain cells, of neurochemistry, could only be studied by measuring the rise and fall of various metabolites in blood and urine.

And between these extremes (human behaviour and the rise and fall of metabolites in blood and urine) there existed an enormous black box containing the interaction of chemistry, cells, neurons, organs within the brain, systems of arousal and perception, systems of neural organization, complex biochemical and electrical feedback systems….

With EEGs, CT Scans, MRI’s, Pet scans, molecular biology, genome mapping, our new ability to at least see which parts of the brain are active (metabolizing, using glucose and oxygen) and which are dormant when we talk, listen to music and/or hallucinate, that Black Box has shrunk. But it is still there.

Behaviour is a visible product of a long complex chain of events from cell activity, neurohormone production, arousal and filtering systems, inhibiting and stimulating feedback loops.

Ritalin is a stimulant. Yet when given to a boy with ADHD it usually slows him down. So my best guess here is that with ADHD our stimulant is stimulating an inhibitory mechanism.

Like many medications, the power of Chlorpromazine (Largactil) to quell psychosis was discovered by accident. This time in France. Heinz Lehmann brought it to Canada to use in a trial at The Douglas Hospital. It worked dramatically, but why and how it worked is another question. Following the methodologies mentioned above it was first determined that chlorpromazine and drugs developed within the same family affected the neurochemical, neurotransmitter, dopamine. From this arose the dopamine hypothesis of schizophrenia.

But we have since learned that each mental illness is the product of long, complicated pathways from neuron to dendrite to neuron to behaviour (sometimes through long chains and multiple pathways), and that different medications can affect the final behavioural outcome by affecting different parts of that chain, sometimes by stimulating production of a neurohormone, sometimes by emulating a neurohormone, sometimes by inhibiting a neurohormone, sometimes by blocking the transmission of a neurohormone, and sometimes by inhibiting the degradation of a neurohormone (hence the SSRI’s – Selective Serotonin Reuptake Inhibitors)

With the modern technologies we can describe with accuracy what exactly each drug does at a neuronal, biochemical level. But there remains a black box between that level and the actual observed behaviour. Though it is getting smaller and smaller and easily bridged with hypotheses.

But psychosis is not simply too much dopamine, nor depression inadequate serotonin. Although medically altering those two neurochemicals (neurotransmitters) does affect (usually) the chain of electrical/molecular events that leads to psychosis and depression.

RIP Dr Fred Frese

By Marvin Ross

The world just lost another advocate for serious mental illness. Dr Fred Frese was a psychologist with schizophrenia and an active promoter of better care for the seriously mentally ill. He had been a board member of the National Alliance on Mental Illness and one of the founders (along with Dr E Fuller Torrey) of the Treatment Advocacy Center.

I met Fred, and his wife Penny, when they gave a talk at the Hamilton Program for Schizophrenia in the late 1990s and did a profile of them for one of the medical papers that I wrote for. Both of them were incredible speakers. Fred first got sick when he was an officer in the US Marine Corps guarding the largest repository of nuclear weapons in the US.

He became quite paranoid and was eventually transferred to Walter Reed Hospital in Washington where, he said, may of his fellow psychiatric inmates were high ranking officers. While a patient there and elsewhere, he pursued his education and obtained a PhD in psychology. He joked that he went from being an involuntary patient in one hospital in Ohio to becoming its chief psychologist years later.

He commented that he continued to study because people with mental illness simply cannot find work. His sense of humour was evident when he talked about dating his wife. They had gone for a long walk in the woods and it was then that he decided to tell her that he had paranoid schizophrenia. Not the best place to do that, he commented. She did not run off screaming, they married and had four children.

Dr Frese has always been a strong supporter of involuntary treatment when it is necessary (as it often is) and for the fair treatment of those who are ill.

He explains his position in this presentation below:

As he said in the video clip below, he refuses to be ashamed of his illness and that he is not recovered (despite all his credentials) but is in recovery.

I should also mention that Fred was very generous with his time and was an active supporter of the late Dr Carolyn Dobbins (another psychologist with schizophrenia) and was gracious enough to write a very good blurb for Katherine Flannery Dering’s book, Shot in the Head.

Those of us who advocate for improved services for the mentally ill will have to step up our efforts to make up for Fred’s loss.