Homeopathy and Rabid Dogs

By Dr David Laing Dawson

I grew up in Victoria, B.C. It was then a sleepy mostly white collar town, home to the B.C. Legislative Buildings, the Empress Hotel, a strong English heritage, and excellent educational institutions.

It is now 2018, and I read that a Victoria Homeopath/Naturopath, one Anke Zimmermann has prescribed for a child some derivative of the saliva from a rabid dog. This hit the news because of the “saliva from a Rabid Dog” part, although, like all homeopathic “remedies” it is unlikely to have anything in it that is either harmful or helpful. And like many homeopathic remedies it is based on some cockamamie theory of memory. That is that water that once had a particular substance in it, but no longer does, retains a “memory” of that substance. (Pity the tub of water that was once my bath. Come to think of it, given that those water molecules have existed for eons, sometimes as vapour, sometimes as liquid, sometimes as ice, they could have an encyclopaedia of memories). The theory continues that the memory that resides in that small vial of water, when ingested by a sufferer would….. but then I get lost with the impossibility of their reasoning.

How can this be happening in 2018?

But I visited a Family Health Team recently. The waiting area was simple and clean. Nothing was promised, but a few posters and a couple of screens promoted some very basic ideas about keeping healthy. My name was called and I met the young doctor who led me through the rabbitwarren corridor to a tiny office. He said to just call him Michael. The minuscule examining room was filled with a partial desk with keyboard and computer screen, a stool for him and a stool for me and one examining table covered with white paper. The walls were bare save for the blood pressure and eye, ear instruments. A little cupboard held a few medical tools such as the rubber headed reflex hammer.

There was NO magic to be found. No mystery, no history, no spooky artifacts. No body diagrams, graphics of the actual physiology of the human body, no skeletons in the corner. The doc wasn’t even wearing a lab coat.

No magic. Just evidence based medicine. All scientific, except for the clear evidence that we all crave magic, hope, reassurance, belief.

2018. My patient tells me his homeopath put him on lithium. I am about to say, “What?” with incredulity, when I remember that this means he was prescribed water that remembered it once contained lithium or a tablet that contains less lithium than your average radish.

And another tells me his acupuncturist stuck needles in his right knee to help the osteoarthritis in his left knee. “I guess it’s all connected,” he says.

My impression is that more people are turning to various kinds of fraudulent health care, to ideas formulated three hundred and even 1300 years ago than did in the years I grew up in Victoria. And again more than I remember in 1980 or 1990.

So either our educational systems have failed to produce a population that understands, at least in a rudimentary sense, why we can now prevent measles, treat cancer and survive AIDS, or doctors of real medicine have underestimated our human need for magic, false hope, easy solutions.

And now Michael will send me for Xrays and remind me that some regular back and leg exercise, some weight loss, and taking some ibuprophen now and then is the best treatment for the osteoarthritis in my knees, short of titanium replacements.

Both my knees are in bad shape. I wonder if I could have the acupuncturist stick needles in my left knee to help my right knee and vice versa, or maybe if I bathed in water that remembers the knees of a young athlete….Maybe if I had saved my bathwater from 1960….But would I have to drink it for the full effect?

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The Failure in Police Reactions to Emergencies – Amended After Toronto

By Dr David Laing Dawson

Within the span of a few days the Hamilton Police demonstrated good judgment and remarkable restraint keeping two unruly mobs apart on Locke Street, saved a little girl’s life with quick compassionate action, and killed a teenager, a boy obviously in the throes of some kind of psychotic episode.

Why do they perform so well, even heroically, in some circumstances, and so poorly, tragically, in others?

I am not asking the question rhetorically, for the question may be worth serious consideration.

The first of these three situations was the most dangerous. It could easily have erupted into violence followed by five years of lawsuits.

The second required quick, focused action despite the horrifying sight of a child being caught under a moving train.

The third required a calm assessment of imminent danger (there was none) and then a calm slow approach.

In the rush to arrive at an unfolding situation each officer will develop heightened arousal. Stress hormones, adrenalin, breathing pattern, heart rate, blood pressure will all be aroused. This is commonly called the fight / flight response, but it is a complex system of brain/body arousal that allows for increased awareness of danger, heightened ability to focus, increased startle response, decreased pain sensation, decreased attention to ‘unimportant’ internal and external stimuli (e.g. time, hunger, thirst, chirping birds, other people), and heightened reflexes.

For the little girl with the severed limb this served her well. The officer reacted quickly and with full focus and efficiency without external distraction.

For the containment of the two mobs there had been enough planning, preparation, structure, and organization that each officer was able to quell or override their fight/flight response and diffuse the potential for violence.

Not so in the third example. The officers arrived in fully aroused state and entered the situation with heightened reflexes and heightened fear. Guns were drawn, triggers pulled.

Each circumstance is different. But in all the unnecessary police shootings of the past few years there has been one consistency: Police arrive in a rush on a call labeled as dangerous in some way. They are in a state of heightened arousal. They do not pause. They do not collect their thoughts or information. They do not pause in safety to slow heart rate, breathing, to scan the environment. They are hyper focused. They push forward. There is no thought of backing up.

In this state a cell phone can be seen as a gun. Awkward movements and slow response to commands can feel dangerous and threatening. The fact that no third party is at imminent risk does not register.

In a recent police shooting in the U.S. you can hear the heightened arousal, the full fight/flight response in the voices and breathing of the officers.

I have to conclude that some things are missing from police training. The first would be a pause upon arrival at the scene to determine if there is indeed a truly imminent threat to a third party. (Not a suicide threat, refusals, waving of arms, bizarre behavior, bad language, verbal threats – but a truly imminent threat to a third party. Is there anyone else on the street car, in the back yard, nearby in the field, nearby in the park, in the arrival lounge?). The second is the option to hold, rest, backup, breathe, take the time to dampen the state of arousal one is in at that moment, and then and only then proceed in a sane, calm, safe fashion.

And all that I suggest was done by the Toronto police officer when he confronted the driver of the van that had just wreaked havoc on Yonge St killing 10 and injuring many others. When the officer arrived, no one was in imminent danger. He even had the presence of mind to return to his cruiser and turn off the siren as it was distracting and preventing the officer and the subject from hearing one another. That also gave  him time to calm his nerves. At times, he backed away and, presumably when he realized that he was not in danger himself, he advanced and the suspect gave up.

We can only hope that this incident will serve as a training tool for others who might find themselves in a similar situation.

The Disease Model Simplified

By Dr David Laing Dawson

“I’m still coughing and sneezing,” one person says. “I caught what’s going around this winter.”

“Yeah,” replies the other. “Everybody in the office got it. And it lingers and lingers.”

It has been a long winter and I have overheard variations of that conversation a dozen times. And I wonder if they know they are applying both the disease model or concept plus some simple epidemiology to their observations of dis-ease, ailment, illness.

Disease model:

Symptoms: “coughing and sneezing”

Natural course: “lingers and lingers”

Same symptoms and course for many leading to assumption of this being the same thing: “I caught what’s going around this winter.”

And probably having the same necessary etiology. “I caught what’s going around.”

And epidemiology:

“Everybody in the office got it.”

It is the same reasoning that John Snow used when he traced the outbreak of Cholera to the Broad Street Pump in Soho, London, in 1854.

But Snow didn’t know much about bacteria let alone viruses, so he would not have said, “I caught what’s going around.” Instead, observing the distribution of the illness, reasoning out the source, all he could conclude was that the cause (hypothesized from this scientific approach to be the same for all sufferers) behaved as if it were a living thing in the water from the Broad Street Pump.

And there we have it. The modern western scientific medical concept of disease. If the symptoms are the same; if the natural course of the illness is the same; if the demographics are similar, then perhaps the cause is the same for each person afflicted. And while we look for that cause, can we see if there is some definable treatment that works for all or most?

It is instructive to know that we can be as ignorant as John Snow was about bacteria and still, applying the disease concept and basic epidemiology, come up with treatments that work ninety percent of the time. For cholera it is sanitation, basic public health measures, clean water, re-hydration and replenishing electrolytes.

Of course to complete the modern medical disease concept, we must then ask the most scientific question of all: “How do we know that to be true?” In the case of treatment this question is framed as “How do we know that it works?” That is, we must test the hypothesis and our otherwise very subjective observations.

For one hundred years psychiatrists have argued about the relevance of the disease model (described above as succinctly as I can) to mental illness. It doesn’t seem to work well with, or help our understanding of, day to day woes on one hand and major social upheavals on the other. But when applied to serious mental illness it is the only concept so far that has lead to treatments that work, and that have been scientifically shown to work.

We are all different. We have different experiences, levels of well-being, social support, education, intelligence, occupations, relationships, resilience. Some, without treatment, quickly die from cholera. Others survive. Yet we know it is the same disease afflicting each and every sufferer.

Same with mental illness. There are hundreds of factors apart from the disease itself, its causes, and our scientific treatment, that affect outcome.

But today, in 2018, why in God’s name would anybody want to throw away the western medical scientific disease concept? It is the one and only concept/model of severe mental illness that has lead to treatment that has been scientifically, objectively, proven to work.

More on The Continuing Proof of the Efficacy of Anti-Psychotics

By Dr David Laing Dawson

The narratives from the proponents of Open Dialogue remind me of the narratives arising from the psychoanalysts working in private psychiatric hospitals in the United States in the 1950’s and 1960’s. Many case studies were available and even books written on the subject.

In the late 1960’s we were unlocking the doors of the mental hospital in Vancouver and applying therapeutic community principles. The principles and ideas of the therapeutic community can be found in the activities of the Open Dialogue program. And before that they can be found in the practices of small hospitals from the Moral Treatment Era of the 1850’s to 1890’s, and again, briefly, in some mental hospital reforms shortly after WW1 and before the Great Depression, albeit, in each case, within the language and pervasive philosophies of the time.

In the late 1960’s we had already discovered how wonderfully effective chlorpromazine could be in containing mania and reducing the psychotic symptoms of schizophrenia.

So in this context, knowing the evidence, the clear evidence of chlorpromazine being the first and only actually effective treatment for psychosis, and lithium for mania (beyond containment, sedation, shelter, kindness, protection, food, routine grounding activities, time and care) it behooved us to look closely at the claims of the psychotherapists who were writing such elegant and positive case studies from the American private hospitals.

So I read them.

They were interesting reading, detailing the relationship of therapist and psychotic patient, interpreting the content of the psychosis, and the painstaking time consuming process of building a relationship, working to help the patient view the world in a different manner, and always, through the pages of these reports, it was said great progress was being made. And they all ended with something like (this is the one I remember best) “Unfortunately, despite showing so much progress, patient X assaulted a nurse and had to be transferred to the State facility.” Curiously, as with many “studies” I read today, despite the obviously bad outcome, a paragraph is added at the end extolling the progress made (before the unfortunate outcome) and recommending we stay the course.

There are many interesting explanations for the continuing anti-medication (for mental illness) philosophies. (Note that almost nobody objects to taking medication for other kinds of suffering and illness). Marvin and I have written about a few – the preciousness of the sense of self, the wish that there be an immortal mind that can outlive a brain, the fear of being controlled, distrust of Big Pharma, professional jealousies, and turf wars. But writing the above reminds me of another reason this irrationality persists.

It was clearer to me then (1960’s/1970’s) than it is now, because we really wanted to find ways of helping without medication: It is much more ego gratifying to mental health workers of all stripes when our patients get better simply because of our presence, our words, our care, ourselves, than if we just happen to prescribe the right medication.

I remember well a patient, a professional, a few years ago, thanking me for helping him overcome a severe depression. “Nah,” I said, “I just managed to prescribe the right medication for you.” “No, no,” he said. “It was more than that.”

All right. There are a few moments when I can be attentive, thoughtful, kind, and even find the right words. But to try doing that alone while withholding medication for severe mental illness would be malpractice, cruel, egotistical, even sadistic.

 

The Continuing Proof of the Efficacy of Anti-Psychotics

By Marvin Ross

Despite the protestation from the anti-psychiatry advocates, medication for schizophrenia works and another study has just been published to support that position. A new study based on a nationwide data of all patients hospitalized for schizophrenia in Finland from 1972 to 2014 found that the lowest risk of rehospitalization or death was lowest for those who remained on medication for the full length of time.

The risk of death was 174% to 214% higher among patients who never started taking antipsychotics or stopped using them within one year of their first hospitalization in comparison with patients who consistently took medications for up to 16.4 years.

It should be pointed out that this is real life data rather than a clinical trial involving a total of 8,738 people.

What is particularly significant for me in this study is that it is from Finland which is the home in one isolated part of that country (Lapland) to the alternative Open Dialogue espoused by the anti-psychiatry folks including journalist Robert Whitaker of Mad In America fame. Whitaker claims that 80% of those treated with Open Dialogue are cured without need for drugs.

I wrote about Open Dialogue very critically back in 2013 in Huffington Post and pointed out that there is very little research to demonstrate its efficacy. I actually asked a Finish psychiatrist, Kristian Wahlbeck who is a Research Professor at the National Institute for Health and Welfare, Mental Health and Substance Abuse Services, in Helsinki about Open Dialogue.

This was his answer:

“I am familiar with the Open Dialogue programme. It is an attractive approach, but regrettably there has been virtually no high-quality evaluation of the programme. Figures like “80 per cent do well without antipsychotics” are derived from studies which lack control group, blinding and independent assessment of outcomes.”

He went on to say that:

“most mental health professionals in Finland would agree with your view that Open Dialogue has not been proven to be better than standard treatment for schizophrenia. However, it is also a widespread view that the programme is attractive due to its client-centredness and empowerment of the service user, and that good studies are urgently needed to establish the effectiveness of the programme. Before it has been established to be effective, it should be seen as an experimental treatment that should not (yet?) be clinical practise.”

As for the claim that psychiatric hospital beds in Finland have been emptied, he said “in our official statistics, the use of hospital beds for schizophrenia do not differ between the area with the Open Dialogue approach and the rest of the country.”

My blogging associate, Dr David Laing Dawson also wrote about Open Dialogue in this forum with very skeptical view. He stated that the director of the program admitted that about 30% of the patients in Open Dialogue are prescribed medication so arguing that medication is not used is not correct.

At the time my article appeared in Huffington Post, someone on Mad In America agreed with me that there was insufficient evidence on the efficacy of Open Dialogue and said that a US study was set to begin in, I think, Boston. I did find a completed study on Open Dialogue done by Dr Christopher Gordon. His study involved 16 patients and he states at the outset that

“Since this was not a randomized clinical trial and there was no control group, we cannot say that these outcomes were better than standard care, but we can assert that they were solidly in line with what is hoped for and expected in standard care.”

In the paper that is in a legitimate psychiatric publication, he states that of the 16, two dropped out and a further 3 had disappeared at the end of the study so no data is available for them. This is a study of 11 people who completed the one year term.

He then points out that:

“Of note, four individuals had six short-term psychiatric hospitalizations (two involuntary).”

and that:

“three of the six individuals who were not on antipsychotics at program entry started antipsychotics. Of the eight already on antipsychotics, four had no change in their medication, and four elected to stop during the year. Both groups of four had similar outcomes and continued to be followed in treatment. Shared decision making and toleration of uncertainty contributed to these choices.

Hardly the success he suggests if the goal was to help them get well without medication.

But, coming up at the end of May in Toronto we have a conference with Robert Whitaker and others on Shifting the Narrative on Mental Health from the psychiatric disease model to the relational/recovery model, and on the challenges that are stacked against that eventuality.

Now I would say that the challenges against that shift are science but they define it as “The challenges and resistances to progressive change are of an ideological, macro-economic nature guaranteeing a protracted and difficult struggle for recovery advocates.”

Dwayne Johnson and Heroic Narratives

By Dr David Laing Dawson

Within the same time frame I was reading Marvin’s blog on the Mental Health Commission and the associated commentary, Dwayne Johnson’s story of depression popped up on multiple news sites. None of the sites gave much detail and I remain unsure if he suffered bouts of what we used to call “clinical depression”, and before that “endogenous depression” or if he simply suffered some difficult discouraging periods in life when his football career and a relationship ended.

In these brief news items Dwayne’s story is shaped as the narrative of an “heroic struggle”.

And I realized that most such stories are shaped and told in that form. It is a classic narrative form, and one we all want to hear.

Facing great odds, our hero, perhaps after learning some life lesson (humility, confession, love, trust, openness) battles his way through to success, health, and happiness. His weapons are will power, strength, hope, perseverance, and a little help from his friends.

It is the narrative form in the story of A Beautiful Mind’s John Nash. And it is the narrative form when the story is told about a victim of cancer.

The difference is that when we read the story and see the pictures of someone’s struggle with cancer, we know he or she has undergone one or many courses of radiation or chemotherapy, that he or she is still undergoing treatment.

The focus of the story may be on the courage and optimism of the patient, their loving  family, a special group of supportive friends, a cancer support group, or all that the patient is able to accomplish despite their illness – but we never lose sight of the fact of medical treatment for cancer.

It is good to bring mental illness out of the shadows. It is good to tell our stories. But we need to drop the euphemisms of mental health issues, and (a new one for me) mental health “situations”, and we need to include the fact of medical treatment for serious mental illness, because we don’t assume it as we do with cancer narratives. In fact, a very popular heroic struggle narrative is “I overcame my (illness, depression) without resorting to medication.”

This heroic struggle narrative has shaped the recovery movement; it has clearly influenced members of the mental health commission.

And who would bother watching a show, or reading a story with a tagline of: “A man develops depression, goes to his doctor; the doctor treats his depression and he gets better.”

This is not to denigrate the role of courage, optimism, hope, and support required to live with a chronic illness, or recover from an acute illness. But…

Update:

Another day, April 5 to be exact, and it seems it is OCD Day with several news items and videos appearing. Much is shared in these articles and videos, distinguishing crippling OCD symptoms from mild everyday forms of compulsions and obsessions. Psychological treatment is also explained, exposure and desensitization therapy. But not once, not once in the articles and videos I watched was it explained that there are medical pharmacological treatments that work with great success for about 90% of sufferers. Not once is this mentioned.

One of these medications has been around since the 1960’s, though at the time we didn’t know how effective it was for OCD and psychological/psychoanalytic thinking about the illness dominated.

I am not sure who or what is to blame for this. But for the psychologists who were interviewed to not mention this readily available medical treatment is akin to naturopaths not mentioning antibiotics when discussing the treatment of pneumonia.

Paradoxically, Jack Nicholson starred as a novelist with OCD in “As Good as it Gets” 20 years ago. At the end of the movie Nicholson’s character decides to be a better man and go back on his medication. Critics were not happy with that ending, and it did ruin the “heroic struggle” narrative. It was, as the third act of a story, very unsatisfying. “What? To quell his OCD all he had to do was take his medication?”  Well, yes.

 

Is This The End of the Mental Health Commission?

By Marvin Ross

In December, I wrote a blog pointing out that the Mental Health Commission of Canada should be disbanded. Those of you who follow my writing on Huffington Post know that this has been a constant theme of mine over the past few years. Last Fall, the Federal Health Minister set up an inquiry into what they called Pan Canadian Health Organizations (PCHOs). These are federally mandated groups established to carry out specific tasks in health across the country when, in fact, health care comes under provincial rather than  federal jurisdiction.

The review was to evaluate the role and relevance of these groups in advancing federal health policy objectives and meeting national goals. One of the PCHOs is the Mental Health Commission and my advocacy colleague Lembi Buchanan and I submitted a brief on the Commission through the Best Medicines Coalition.

With amazing speed for a government report, the findings were just released. Much to our delight, the Commission recommended that the Mental Health Commission either be ended or radically altered.

The basic premise for health care in the 21st Century as outlined by the World Health Organization and endorsed by most countries including Canada is that it be people centred. “It puts people at the centre of the health system and promotes care that is universal, equitable, and integrated. The framework emphasizes a seamless connection to other sectors, notably those focused on the social determinants of health. This framework also promotes providing a continuum of care that requires high-performing primary care.”

The conclusion the reviewers reached about the Mental Health Commission of Canada is that “Mental health is now “out of the shadows”. The integration of mental health care services into the core of Canadian health systems requires a different type of leadership, capable of driving a bottom-up approach in which patients and families, providers, researchers, and the broader mental health community come together to break down silos.”

As a positive, the report states that “The MHCC has been particularly effective in developing strategies around mental health, along with initiatives and campaigns to increase awareness and reduce stigma. It has made great strides in delivering on its objectives and helped to bring mental health “out of the shadows at last.” It has also created valuable contacts and built trust among its closest stakeholders.”

It did develop a mental health strategy mostly ignored and it did help to raise the awareness of mental illness. However, the report states that:

“The need to build greater capacity in Canada on mental health is still as pressing today as it was when the MHCC was established. What has changed, however, partly as a result of the advocacy work undertaken by the Commission, is the overarching policy goal. What Canada needs today is the complete and seamless integration of mental health into the continuum of public health care. What Canadians want is public coverage of proven mental health services and treatments, beyond physicians and hospitals. To be successful, those services must be integrated with primary care and supports for physical health, rather than isolated from them. We came to the conclusion that MHCC, in its present form and with its current orientation, is not the best instrument to achieve the objective of integrating mental health into Medicare.

They then state that these goals might be achievable if the MHCC changed itself but suggest that to accomplish this they would have to engage “health leaders at provincial and territorial levels in joint decision-making over service funding and quality standards; a different “knowledge base” in support of evidence-informed advice and performance evaluation; and a different, more flexible, and less centralized structure.”

This, in fact, is one of the many criticisms I’ve made over the years. The MHCC churns out papers but has zero influence in decision making and that is exactly what is needed. Policy papers are fine but they need to be implemented and the MHCC has yet to accomplish that from what I’ve seen. The report concludes in its section on the MHCC that “It is because mental health is so critically important to Canadians- and their governments- that a new approach is now needed.”

I was impressed with the team tasked with this job and I’m impressed with the speed in which it produced its report (October 2017 to March 2018). Let us hope that the Health Minister implements the recommendations.

And, a documentary we did on schizophrenia

Update on Jagmeet Singh and Cultural Inclusion

By Dr David Laing Dawson

A comment on my last blog asked what the question to Jagmeet Singh was and wondered about the relevance of his turban.  Well, the question posed to him by the CBC was if there were any circumstances in which he would support violence. The background to this was his equivocation regarding the Air India mass murder, and his attendance at gatherings alongside Sikh extremists.

Canada is a wonderful experiment. So far one hundred and fifty-one years of a gradually evolving, gradually improving liberal democracy of inclusion. The world needs to watch Toronto: People from a hundred different cultures speaking dozens of different languages living and working within one large metropolis and (as a friend put it with a tone of incredulity) they are not killing one another. This is unique in our world.

There has been a recent increase in gun violence in Toronto but usually it’s young men killing other young men from the same tribe (or gang).

We struggle with, argue about, but make accommodation for religious practice and the wearing of religious and tribal symbols. As long as it does not conflict with the laws of Canada and the rights of others we usually accommodate.

These symbols (dress, hair cutting or covering, metal adornments, tattoos, markings, face coverings) are statements of separation, exclusion, and speak of membership in a specific tribe, religion or cult that may or may not want to adhere to our evolved Canadian social contract. Hence we need to be vigilant and ensure that the practices within these cults do not contravene our laws and our charter of rights and freedoms.

But there is another unspoken but clear message declared by these symbols. And it is the very message we are trying to eliminate in Canada. And that is the message of superiority, of tribal superiority.

These symbols (wearing a cross, a turban, a ceremonial dagger, ringlets and yarmulkes) are statements of membership, but also of superiority. For the unspoken, subtle message is that “I am righteous and you are not; I am going to heaven and you are not; I am favoured by God and you are not.”

I trust that by living in Canada, attending our public schools, and finding life here not too bad, after a couple of generations most will relegate the wearing of these symbols to celebrations and yearly rituals, and think of them only as historical reminders, connections to a past of struggle and sacrifice.

The Way of Politicians

By Dr David Laing Dawson

The other day I listened to Jagmeet Singh being interviewed by the CBC. He was asked a very specific question. He danced, avoided, interrupted, distracted for a good ten minutes. His performance reminded me of Marco Rubio when asked a direct question by a student: “In the future will you accept donations from the NRA?”

Marco danced around this question like a verbal Nureyev. “I’m glad you asked that question.” is always the first response of faux sincerity. Often followed by “That is a very important question.”

I wondered then if politicians all go to the same politician school.
The one that teaches you how to avoid a question and still sound smart, knowledgeable, reasonable, thoughtful, and absolutely of a firm opinion that something or other is the morally right position. And that “something or other” will be sufficiently vague to offend no one.

Or, slowly but surely, everyone.

No wonder we don’t trust politicians. No wonder we are willing to elect a bullshit artist like Donald Trump, or a Ford brother, because they are, if no more honest than the rest, at least more entertaining. It is almost refreshing to hear Donald Trump lie rather than avoid acknowledging a fact, a truth. He even boasts that he was making it up all along. And then denies that as well. In a funny way, we know where he stands. But not Singh or Rubio.

Politicians. Agggghhh.

But let me keep this close to home. Mr. Singh, you seem smart and modern. Perhaps you are ready to participate in our liberal democracy and lead one of our three political parties. I accept that you practice some clothing and hair worship that dates to the seventeenth century. Every cult leader invents some magical interpretations and incantations to keep his flock in line.

But please leave these historical tribal grievances on the continents from which they sprang and continue to be fertilized. Do not. I repeat, do not bring them here.

And a one act play from David Laing Dawson

Is Science Fiction Becoming Reality?

By Dr David Laing Dawson

Good Science Fiction takes contemporary science, knowledge and theory, and extrapolates, sometimes getting it dead on, or at least exploring in very imaginative ways the moral and ethical issues, the comfort and dangers that might arise from our “progress”. But two common themes have puzzled me over the years: While the heroes and villains zip around in space, or toil on ships, or cross inhospitable planets, the political structure imagined is often feudal, or fascist, or at least Imperial. Not an extrapolation of better and better liberal democracies but usually a dystopian vision of medieval governance with high tech means of citizen control.

The second oddity is private enterprise. In these imagined futures big and often evil corporations own the spaceships, orbiting platforms and planetary settlements.

And I thought neither of these two imagined futures was likely. Surely our democracies will win out, improve, flourish. And surely space exploration will always be the purview of governments and alliances of governments, ideally of the United Nations of this planet.

But I am naïve as usual. Once again the Sci Fi writers may be prophetic. It seems they already imagined the Elon Musks and Donald Trumps of this century. Space exploration may devolve into competing profit-driven private corporations. Our current space station, if Donald gets his way, may become a Disney World/Jurassic Park for well heeled adventurers. And our forms of governance in the 22nd and 23rd century? Who knows?

I watched an old science fiction film the other day. I remembered the first time I saw it it’s impact was minimal, a forgettable entertainment. This time it seemed more closely allied to a horror film. The questions it posed about robots and AI are now upon us. When they, bots, are doing all the work, what will we be doing? When will AI become simply I? And might it turn on us?

It even seemed to me, reading Huxley’s Brave New World, that it was unlikely in our future that some of us humans would be living lives of leisure with our magic technologies in protected cities while thousands of other humans would be living in primitive squalor outside these cities, a step away from being Soylent Green. But now this seems all too possible as well.

Many of these science fiction writers imagined a future in which Big Brother, the Overlords, the Government, the Oligarchy could watch us, listen to us, and then manipulate us with messages designed to fit our psychological profiles. In these stories we are already there; it is already fully developed. Few of them explore the early phases and try to explain how we got there.

Well, now we know. Social Media plus Cambridge Analytica plus Robert Mercer plus his useful idiots. The future is upon us and we need to move quickly to not let it become the dystopias imagined by Huxley,  Wells, Asimov, Dick, and Ursula Le Guin.

And now, for your enjoyment, David Laing Dawson’s musical MacBush – Macbeth done as Bush: