Category Archives: Uncategorized

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.

Kudos to The Heroic Underpaid Health Care Workers

By Marvin Ross

Some of the most heroic figures in health care are the lowly personal support workers. They often tend to be the least well trained and the worst paid but they do a vital job day after day. I say some are less well trained because it is a job, in Canada at least, for recent immigrants. Some are nurses, technicians and even doctors from their country of origin who don’t qualify to practice here. Their country of origin changes depending upon the latest wave of immigration. Today, most are from the Philippines but when my mother was in a nursing home, they were from the West Indies and one was even a pediatrician from the Soviet Union.

My friend with Alzheimer’s is now confined to his dementia care home and cannot go out and cannot receive visitors and it is driving him to extreme frustration. He does not understand and keeps phoning me to complain and demand I end his isolation. He becomes quite agitated and borders on being violent. Other than dementia, he is in excellent physical health and his PSW’s routine is to take him out where he meets people in a coffee shop, goes for long walks, buys the New York Times and walks the streets and trails around the area.

That keeps him happy and, as I monitor his spending, I see in the course of a day debits from all of the coffee chains in the area along with the bookstores and food places in the area. It must be difficult enough for them to manage all that with him day after day but now they are locked in the home with him trying to keep him occupied. And for the most part, they do and with good cheer. Their efforts are amazing and to be applauded. I have no idea what they earn but they are worth double that.

During this current epidemic, their jobs are both more difficult and dangerous.

They are, as I said,  all from the Philippines but when my mom was in a nursing home, they were mostly West Indian. One day, I visited and this very large West Indian lady yelled at me. “Your mother needs brassieres”, she said. “Why do you not get them for her?” “ I didn’t know,” I replied, “but I will speak to the desk and have them ordered”.

“No that’s too expensive. I know her size so I will get them and you can pay me back.” I was totally amazed with her offer. She went out, bought them for my mom and I paid her back.

Another time, my mother was scheduled to go see an eye doctor but the disabled transport cancelled at the last moment so the appointment had to be postponed. The night before her next appointment, the night nurse called to say she was worried that the transport would not show up again so did she have my permission to send her by taxi. I approved but said I could not get her the money in time. “Not to worry. I’ll pay for it and you can pay me back when you visit next”.

Again I was dumbfounded and made sure to get there as soon as I could to reimburse her and to thank her in person.

So, lets’ hear it for the truly essential, brave and lowly paid medical staff who keep the system going.

More Perspective on the Year of the Plague

By Marvin Ross

I had hoped that the one benefit to come out of this pandemic would be the demise of the Donald. I fear that I am wrong. According to a recent poll conducted by ABC News and Ipsos 54% of Americans approve of Trump’s handling of the outbreak. Just last month, he claimed there was no problem and that covid-19 would be curtailed. It was, after all, a hoax and reports suggest that he ignored the warnings from his own intelligence officers. Now, he is defying science and proclaiming a cure in an untested medication for malaria.

Of course, the experts have debunked this idea and suggested that the evidence is “thin to nonexistent”. Public health is limited in the US and the office for pandemic services had been scrapped or severely curtailed by Trump when he came into office along with funding for the CDC..

I think the best description of Trump in this time of crisis was written on the blog Respectful Insolence penned by a surgical oncologist in Detroit. He said:

Meanwhile, under the “leadership” of an arrogant incompetent orange ignoramus with a massive ego that requires constant sycophancy and stroking, who spouts misinformation on an hourly basis and will never, ever try to relieve his black hole density ignorance with actual information that experts have been desperately trying to dangle in front of him to get his interest by coupling it with “Dear Leader”-style overblown praise of his awesomeness, the COVID-19 pandemic appears, by every measure, ready to explode out of control.

This is a golden opportunity, the doctor states, for quackery and outlined many of the absurd suggestions being made by the natural remedy proponents. That is not something unique to the US as we, in Canada, have our own scammers and nutbars.  This is an example:

Ontario merchant calls COVID-19 a ‘hoax’ and tells coughing customers to visit

Testing in the US is limited and even some politicians who have been symptomatic have refused to self isolate. Georgia Senator, Brandon Beach turned up at the office with symptoms before getting a positive test result and now the entire Georgia Senate is in quarantine as a result.

Despite the dangers of this virus, the value of a vaccine has not dented the thinking of the anti-vaxxers. The candidate for Governor of Vermont, David Zuckerman, is an active anti-vaxxer and opposed to mandated vaccinations. He is upset that his political opponents are using his opposition to vaccines to score political points during this crisis. Meanwhile, Texas anti-vaxxers are preparing to actively oppose any covid-19 vaccination. The Texas group is one of the largest in the US. One member suggested they hide their kids from forced vaccinations by hiding them under the floor boards like Jews were hidden under Nazi occupation.

With support for Trump increasing and the anti-science and anti-socialism attitude of so many Americans, I see little hope for them surviving this epidemic. When I say anti-socialism, I mean anti such things as a good safety net like universal health care. Projections are that if the US does not smarten up, there is the potential for up to 2.2 million of its citizens dying. What I feared is that Trump would use this disaster to consolidate his authoritarian powers and it is being attempted. There are reports that the Department of Justice is working on a plan to suspend the US Constitution  along with Habeus Corpus.

Thus far, Canada is faring better despite right wing governments like that of Ontario’s Doug Ford who tried to reduce funding for public health. As of today, Tuesday, the infection rate in Canada is 55 per million people while in the US, the rate is 139 per million. The silver lining might just be waking Americans up to the dangers of Trump and the value of  health care that is not based on making money but on serving its people. And for Canadian politicians to pay more attention to health care and public health.

The other potential might just be an increased awareness of the need for a minimum income for all. Most people live from check to check and the Canadian government is pouring billions into enhancing unemployment insurance for those laid off and other measures to help workers and small businesses. People are being encouraged to work at home where that is feasible which will help the environment and some grocery chains have raised wages for their staffs to reward them for the danger they are facing.

The concept of a guaranteed income has been proposed for years but is resisted by right wing politicians. Despite promising not to cancel the minimum income pilot project in Ontario if he won the election, Dough Ford did that as soon as he got in. He also reinstated the requirement for workers to have a doctor’s note if off sick but, because of the current crisis, he has rescinded that.

A guaranteed minimum income would ensure that everyone had an income above the poverty level and would wipe out the need for an unemployment insurance bureaucracy, and a welfare and disability support system. Given the shift to the gig economy, it would be very valuable. If you work, the amount of the minimum income is clawed back but if you lose your job because of times like this, you are still guaranteed a certain amount. The reduction in bureaucracy would partially pay for this.

Out of desperate times come innovations so let us hope that some positive innovations will come out of this..

Looking for Perspective and a Silver Lining During the Year of the Plague.

By Dr David Laing Dawson

I watch the panic, the drama, the anger, the boasting (no matter the subject or the dismal news, someone in the USA manages to boast about the USA) on CNN, then switch to the calmer, more nuanced and thoughtful news on CBC. The difference between our two countries is growing.  But we are all in this together and COVID-19 does appear to be more deadly than regular flu and more contagious.

Then for perspective I look for those statistics that are now at everybody’s fingertips:

In the USA 100 people are killed by gunfire per day. 300 in total are shot per day and most of those require treatment in Emergency wards and surgical units.

2.3 million people per year attend/are brought to emergency wards for serious injury from car accidents. 36,000 die in car accidents per year in the USA. That means about 200,000 people are being brought to emergency wards with serious injuries from car accidents per  month. Canadian stats on this are better: about 2000 killed and 10,000 seriously injured (250,000 total injuries) in traffic accidents per year, with a solid downward trend over the past 20 years.

In China car accident fatalities are over 65,000 per year. As of this day Covid-19 has caused 3,261 deaths in China. Their peak in active cases was reached in mid February.

The news from Italy is especially depressing with close to 1000 people per million infected with COVID-19, a death rate currently at 9%, many health care workers infected, and with still at least two weeks to go on the uphill side of their trajectory.

Now for COVID- 19 in the USA: As of this date there are 27,630 active cases in the USA with 700 listed as serious or critical. These numbers will be on a steep uphill trajectory for the next 2 to 6 weeks before leveling off and then dropping, or on a lower but longer curve if containment measures are moderately successful.

The difference in perception, attention, and anxiety, I suppose, comes from the fact that COVID-19 is new and invisible, we are all tracking it, and we have no control over its behaviour, while we all imagine (the operative word here) that we have control over the damage that guns and vehicles might cost ourselves, and seasonal influenza and measles have been with us a long time.

The world death toll from Covid – 19 is still a long way off that of measles, while the other types of flu in Canada infect about 40,000 people per year with a death rate between 500 and 1500 per year. So far Covid-19 accounts for 1385 cases and 20 deaths in Canada.

Now, my optimistic silver linings:

1. The action taken to “flatten the curve” of covid-19 means dramatically less traffic on the roads and, presumably, fewer car accidents.

2. Self-isolating, social distancing and bar closures should decrease gun violence.

3. These in turn will free up the emergency and ICU resources needed to deal with Covid-19 in the US and Canada (apart from  equipment shortages).

4. The lessons from Covid-19 may be learned, and in future the countries of the world, in concert, may be much better prepared for the next pandemic.

5. The USA may learn first hand the advantages of a universal health care system.

6. This may put a serious dent in the dangerous beliefs and rhetoric of the anti-vaxxers.

7. Which in turn may make it easier to turn back the resurgence of measles and polio and the continuing presence of many other infectious illnesses and their consequences.

8. We are are all getting lessons in biology, ecology, epidemiology,  the smallness and fragility of our planet, and of our interdependence.

9. Perhaps we will learn to save during the good times in anticipation of some bad times to come.

10. Perhaps this event will change our perspectives and behaviours with respect to international relationships, our own needs and consumption, our use and abuse of the internet, how our well being and “economy” is measured……

10. Perhaps after defeating COVID-19 we can turn our attention seriously to global warming. Although we really should have done that when our economies were strong and before  tanking and heading into a long recession, our RRSPs and RIFFs decimated, travel options suddenly limited, oil suddenly cheap, borders closed, jobs lost……

Nope, didn’t work, I’m still depressed. But at least our boxers are happy to have us home.

 

Eckhart Tolle, Global Warming, and the Coronavirus

By Dr David Laing Dawson

Someone asked Eckhart during one of his Youtube performances, “What is the purpose of mental illness?” Now to understand the question we first have to accept the guru’s premise that there is “purpose” in everything. And his answer was something to the effect that mental illnesses were aberrations in consciousness, blockages to achieving true consciousness. And to understand this we need to accept the premise of collective consciousness seeking to be both one and enlightened. But he couldn’t help himself from commenting that someone in India going through and achieving this level of consciousness might be revered as a spiritual teacher while the same person in the Western world might be locked up in a “Mental Home”. Then he back-tracked a little on that one, but continued his basic premise that all this suffering (he brought in the millions killed by other humans in the past hundred years) was, collectively, just part of the human struggle to full collective enlightened consciousness.

The news today and last night was all about the Coronavirus, Covid – 19. Calming words, frightening words, cautionary words, conspiracy words. And I am struck by the fact we know, can know, almost instantly, the number of new cases reported overnight in countries all over the world, along with the opinions of both the informed and uninformed. I am struck with the fact that this information being available to us, along with ice melting in Antarctica, deserted streets in Wuhan, Turkey unleashing killer drones in Syria, the words of the Ayatollah in Iran, in such breadth and volume, is a new thing. Not new to the kids born after 1990 perhaps but new within my life time, and very new in the evolution of Homo Sapiens.

My dogs and all other animals are programmed to recognize danger and to react. If they see, smell, or hear it coming, they can communicate this to their immediate pack. Perhaps a whale can warn distant pods, and birds pass the warning along.

But we humans are the only species that evolved to the point we can imagine and anticipate danger in the much larger environment, explain it in words, spend much time thinking about it, planning or worrying about it, and communicating these facts and fears widely and quickly. Obviously this has provided us with a great evolutionary advantage, as well as the tragic opportunity for those fears being exploited or misdirected.

And only in the last 50 years or so our imagination, our awareness, has expanded to the point of truly being conscious of our world as but a fragile ball orbiting a burning sun within a galaxy, within an unfathomable universe, and then suddenly this: – instant unfiltered communication between all humans on this planet no matter the distance.

I’m sitting in a clinic waiting room now and a large screen TV is scrolling stock market reports. But along with the market prices I count seven distinct areas of rapidly changing news being covered in separate boxes on this screen. These include the coronavirus and Super Tuesday.

Eckhart would have us give up the egoic mind as he calls it, to settle into a here and now collective, passive, and enlightened consciousness. And no doubt a little mindfulness practiced now and then can be a calming influence. But that is really not the problem.

Every advantage evolution has given us has come with a cost and a danger. The ability to imagine threat in our near and far environment has, along with our need for organization and predictability, in extreme, brought us anxiety disorders and schizophrenia. The ability to imagine threat combined with mass communication has brought us confusion, more anxiety, conspiracy, misplaced fears,  panic, and a petri dish for delusions. The ability to imagine threat combined with mass communication and an unscrupulous leader has brought us war and genocide.

So here’s the deal: Yes, Eckhart, it would be good for each of us to achieve the ability, now and again, to allow our minds to give up the worry narrative, the egoic as he calls it, and enjoy only the moment, the beauty of the sunset or a streetlamp and the person (or dog) by our side. To give up, for that moment at least, our striving to control.

Still, our greater task is to ensure our evolutionary advantages and our clever inventions are used, at least mostly, to improve our lives and the life of the small planet we share, with the occasional time-out to enjoy the sunset and the sunrise.

And then this moment in time: Our “new” ability to imagine the world as a single eco system, coupled with our evolved ability to imagine threat, coupled with our amazing scientific advances, coupled with instant mass communication, means we can follow the spread of a virus around the world in real time, do everything reasonable to prevent further spread and ameliorate the consequences, especially for the vulnerable, while waiting for this pandemic to run its course and waiting the requisite year or so to develop a vaccine, or, or, or, we can panic  and make matters much worse.  And this current pandemic could turn out to be an excellent wake-up call for global preparedness for the next one.

Something a Little Lighter

By Dr David Laing Dawson

I was walking a few blocks from my home when a man cycling by wheeled around and pulled up to me. “Hi Doctor Dawson,” he said, balanced astride his bicycle, “Wanna hear a joke?”

“Sure,” I said.

I was trying to remember his first name. His last name had come to mind, perhaps because it began with an unusual Vu. I had not seen him for a good ten years, when I had sometimes met him at a picnic table on the grounds of the hospital, in part because he was too paranoid to enter the building, and in part because once in he could be loud and threatening and was known to have destroyed a full block of parking meters early one morning.

“What’s the difference between a hippo and a zippo?” he asked.

“I don’t know. What is the difference?” I said.

“Well, one is really heavy,” he told me. “And the other’s a little lighter.”

I laughed and he laughed and then he was off, cycling north toward the lake. He looked healthy, complete with long wild black hair, and in good spirits, and I was not really surprised by the lack of small talk and pleasantries and catch-up one usually expects in such an encounter.

Now don’t expect a linkage here other than I, while reading Donald Trump’s tweets and the news, was thinking our Blog occasionally needed something a little lighter:

And first, I need a 12 step program to quell my habitual reading of Donald Trump’s twitter feed. I sit down for breakfast and there it is. My fingers go straight to @realdonaldtrump as my brain asks me obsessively, “What nutsy thing is he saying this morning.” I suppose the 12 steps would require me to acknowledge my addiction, and later to apologize to my wife for ignoring her crossword questions, but I think it should forgo the higher power part, for surely this is a human problem requiring a human solution.

And I wonder how it would play in Canada, so I try it out:

Justin Trudeau

@realJustinTrudeau

Stevey Del Duca is running for Premier of the great province of Ontario. Stevey was a terrific union leader for the Carpenters. He is a REAL LEADER who will never let TRUDEAU or our country down! Stevey will protect your right to own several guns…. …. (which is under siege), is strong on Crime and on the Border, and truly LOVES our Military and our Vets. He will be a great Premier for the people of Ontario. Leader Stevey Del Luca, a winner, has my Complete and Total Endorsement. I love Ontario!

The Covid-19 Blues

Sitting here all alone

Chewing on an empty bone

Toilet paper in the hall

Waiting for the man to call

Don’t trust the air I’m breathing

Don’t trust the news I’m reading

Now I have this tickle in my throat

Thinkin’ it’s time to build that boat

I got the Covid nineteen blues

I got the Covid nineteen blues

I’m busy searching for some clues

But I got the Covid nineteen blues

They’re rushing the Island shores

They’re rushing the grocery stores

This seems to be a time of dread

With a tiny virus in my head.

Just Got the Covid nineteen blues

Got the Covid nineteen blues.

I’m searching for some helpful clues

But I got the Covid nineteen blues.

Covid-19 and Guns

By Dr David Laing Dawson

This morning (March 7) the death toll from COVID – 19 in the USA has reached 17. Most contracted the virus off shore with a small number from “community spread”.

The last two nights I have watched specials on CNN, numerous experts speaking, the VP and the task force. All told an amazing amount of attention, argument, hype, and also diligence brought to bear on COVID – 19. I have also watched the somewhat calmer Canadian response to this new epidemic.

And of course we should do what we can to prevent spread, contain this epidemic, and then prevent, where possible, future transmission of animal pathogens to human hosts.

While the actual death rate from contracting this virus is not certain (.5 – 3 percent) we know the elderly with serious underlying illnesses are at greatest risk, and the overall cost of this pandemic and/or the panic it has caused is already huge.

But then I am struck by the attention, the money, the panic, the hype, the arguments, the number of experts, the immense resources brought to bear on this one little virus for which we will have a vaccine in a year or so.

And I contrast this with some other data:

Measles (for which we do have a vaccine): 413,308 reported cases in 2019, 140,000 deaths from measles in 2018 world wide.

And then back to the USA: while deaths from COVID – 19 have reached 17 within a few weeks, the number of people shot and killed by guns has averaged 103 per day. The total number shot is an average of 313 per day (average over three years), making the death rate 33 percent and I doubt there are any cases of mild or asymptomatic gun shot wounds. The total death rate per year from guns in the USA is an average of 37,603. Thirty-seven thousand.

(I am imagining a gunfight breaking out in WALMART over the last bottle of hand sanitizer)

We humans have the capacity to anticipate threat from afar, from the invisible, from the future. We also have an immense capacity to focus our anxieties and our resources on the wrong things, or at least, disproportionately.

Debunking Another Anti-Psych Myth and Worthwhile Anti-Stigma

 

By Marvin Ross

Another myth claimed by anti-psychiatry advocates is that people with serious mental illnesses like schizophrenia have significantly shortened lives because of the pharmaceutical treatment they get. There is no doubt that psychiatric medications have bad side effects that result in greater susceptibility to physical ailments like diabetes and cardiovascular disease but there is another explanation that is largely overlooked – stigma by medical professionals.

Over the years, there have been a number of studies demonstrating that those with serious mental illness do not receive adequate physical health care. A 2018 study pointed out that There is evidence of inequitable access to and/or uptake of physical and dental health care by those with schizophrenia”.

A 2011 study suggested that there is sufficient evidence that people with SMI are less likely to receive standard levels of care for most of these diseases (Nutritional and metabolic diseases, cardiovascular diseases, viral diseases, respiratory tract diseases, musculoskeletal diseases, sexual dysfunction, pregnancy complications, stomatognathic diseases, and possibly obesity-related cancers) .

A cross sectional survey in 27 countries found that More than 17% of patients experienced discrimination when treated for physical health care problems. More than 38% of participants felt disrespected by mental health staff.”

the latest study published in January comes from Sweden where there exists an impressive database of patients to draw upon. What researchers did was to compare 4536 patients (cases) and 44,949 controls. Cases included patients with reported preventable harm in primary health care and emergency departments from January 1st, 2011 until December 31st, 2016.

What they found was that Psychiatric disease, including all psychiatric diagnoses regardless of severity, nearly doubled the risk of being a reported case of preventable harm. The authors pointed out that a significant reason for this is what is called diagnostic overshadowing. This is a process whereby physical symptoms are misattributed to mental illness and therefore ignored.

Most of us (and I suspect mainly women) have been told that our complaints are all in our heads when doctors cannot find a cause for the symptoms. When someone with schizophrenia reports symptoms, they are often overlooked because of the schizophrenia.

The most egregious example of that took place at the ER at St Joseph’s Health Centre in Hamilton Ontario in 2002. Rusty Potter, a 40 year old man with schizophrenia and asthma was sent to the ER by his family doctor because he had pneumonia. Randy was known to the ER staff because he volunteered at the hospital and his address was a group home for people with schizophrenia. As a result, they assumed his problems were psychiatric despite what he told them. When he was having increased difficulty breathing, a nurse handed him a paper bag to breathe into assuming he was having a panic attack.

Randy arrested and died in the waiting room.

I wrote about this in my book Schizophrenia Medicine’s Mystery Society’s Shame and quoted one of the patient advisors who wrote to the local paper and said that:

persons with mental illness do not obtain appropriate medical treatment. All too often, our clients don’t get access to medical services or their concerns go unrecognized because the symptoms are viewed as part of their illness or they are attention seeking by asking for help.

Dr Miriam Schuchman wrote in another Canadian paper (The Globe and Mail), that medical staff in doctor’s offices or in ER’s may be uncomfortable treating these people.

There goes another anti-psychiatry myth and a stigma that does need to be corrected.

And on another note, the world recently lost one of its key anti-psychiatry advocates in Toronto’s Bonnie Burstow who began an anti-psychiatry scholarship. Ms Brstow received numerous obituaries including the New York Tines 

Happy Holidays – Back in 2020

By Marvin Ross

covermindyou

It has been an interesting year with far more going on than anyone would have expected so we’ve decided to take a short break over the Christmas season and return in early January 2020.

Since beginning this blog in October 2014, we have published 419 posts and had over 97,000 visitors. Our visitors are mostly from Canada and the US but visitors have come from a total of 163 different countries.

In the past week, there has been a considerable interest in a column that David Dawson did back in January 2015 on the Canadian murderer, Luke Magnotta. Turns out there is a Netflix docudrama on him which has resulted in new visitors finding us. Some of the most popular blogs, not surprising, have to do with David’s many evaluations of Donald Trump. They are available in our compilation Two Years of Trump on the Psychiatrist’s Couch which is available in print and in all e-book formats from whoever your favourite supplier is.

cover dawson trump

And don’t forget we also have a compilation of our other blogs in Mind You which is also available in print and e-book format.

Enjoy the holidays and we will be back next year

For Remembrance Day 2019

By Dr David Laing Dawson

single_red_poppy

I grew up thinking my grandfather fought at Vimy Ridge, though he never talked about his war experiences. I have a memory of one funny story he told of being on leave in London, and throwing his filthy underwear into the street from a hotel window, and another moment when he told his grandchildren that he had a metal plate in his head. But that is all. Years later I visited Vimy, saw the trenches, the killing grounds, and the Memorial, and signed the visitor book. Perhaps my memory told me he fought at Vimy because in my mind at that time Vimy Ridge and Canada and the First World War were conflated.

Now, with the wonders of digitization and the internet I have access to all my grandfather’s war records and his medical documents from the field hospital to the Canadian Forces Hospital in England to the Convalescent facility. I have the doctors’ notes and even an X-ray of his skull. I even know he enlisted in 1915 after three of his children were born and when the Canadian Government removed the requirement of spousal approval.

He trained in England with the Canadian Expeditionary Forces and then fought in Belgium, in the muck and mud and horror of the battles for Ypres. Twice he was taken from the front lines to the Field Hospital sick with fever and dehydration. He survived the charges, the bombardments, the cold wet trenches through the fall of 1915 and the winter of 1916. But on a spring morning in that year upon the whistle to charge he stepped up from the trench and was hit by both a bullet and the shrapnel of an exploding mortar. The bullet hit his left arm; the shrapnel struck the left side of his face and head.

He was carried to the Field hospital again, and then shipped to the Armed forces hospital in England.

The bullet wound in my Grandfather’s left arm healed quickly. The doctors cleaned his head wound and removed all but one piece of shrapnel still visible on the X-ray 100 years later. But in the hospital and the convalescent ward through the summer of 1916 he continued to suffer dizzy spells, and when he had these he usually fell to the ground. He was eventually given a medical discharge and sent home via troop ship to Halifax and then train and boat to arrive in Victoria in the winter of 1917.

In the hospital they had searched for an explanation for his dizzy spells and concluded, in the terse medical writing of the time, that the cause was mostly “functional”.

One would have to have practiced medicine and psychiatry in the 20th century to understand all the implications and nuances of the diagnosis “functional”. It meant no underlying structural or physiological mechanism has been detected. It also implies the symptoms may be goal directed, but the degree to which the patient is conscious or not conscious of the goal may be implied by the overall tone of the report. In black and white terms, malingering or conversion reaction.

With a little more knowledge today (I do mean little) I know my grandfather’s falling-down spells could have been caused by post concussion syndrome, by PTSD, by a conversion reaction, or by a very conscious decision to fake illness to avoid going back to the trenches.

I am writing this because I read an article in my local paper recently by Thomas Froese. I am sure Mr. Froese is a good Christian and a good person, but I would like to tell him he is wrong. There is no glory in war. There is no heroism. There are no lessons to be learned other than we must never let it happen again. Mr. Froese also says he “doesn’t believe in war” which makes as much sense as saying you don’t believe in rape and murder.

We do not need to teach children (as he recommends) about the moments of courage and spiritual awakening, and acceptance of mortality and powerlessness that can occur in war. At least not unless we are preparing them to enlist for the next conflagration.

I am posed with a dilemma now I have my grandfather’s war record. He was not a hero of Vimy Ridge. He was a decorated soldier who fought at Ypres. He arrived home before the battle of Vimy Ridge. And his medical discharge? How am I to think and feel about that? Well, I have concluded that I would be most happy, proud even, to think he faked his dizzy spells. It would mean that he was a sane man, not delusional, that he was rational and mature, that he simply said NO to returning to the horror and insanity of war, that it was more important to remain alive for his wife and children. That he had had enough. That he knew there was no heroism or enlightenment to be found in war, no grand purpose, just death and life long damage to body and mind. That he understood that he had enlisted because he had succumbed to the propaganda of heroism, duty, king and country, manliness, the great adventure. That he now had the courage, the real courage, to say, simply, “No more.”