When it Comes to Vaccinations, I Stand with Macron

By Marvin Ross

French president Macron upset many when he announced that he wants to “piss off” the unvaccinated by making life difficult for them and forcing them to vaccinate. He is so right as the statistics show at least in Ontario and likely elsewhere as well. Austria has made vaccines mandatory, Greece is fining the unvaccinated over age 60 $114 a month and Italy is planning to prevent the over 50 unvaccinated from going to work.

The Omicron variant is spreading rapidly while, in Ontario, 81.6% of those over the age of five have already had two doses. Our problem is with the 12.6% of people who do not even have one vaccination. Even though you need a vaccine passport to go out to dinner, to a movie or a play, all has been shut down to help prevent the collapse of our hospital system. All elective surgeries have been cancelled which will not hasten death but will increase the suffering for those whose procedures have been delayed.

The anti-vaxers point to the fact that both the vaccinated and the unvaccinated are getting Omicron but they ignore the crucial bits of data that tell a compelling story. According to the science table that has been advising the Ontario Government since the beginning, covid cases among the unvaccinated are 1600.9 per million versus 1292.0 per million among the vaccinated. The vaccinated with two doses are 19.3% less likely to get the virus which is a reduction but not that great a reduction.

The huge difference is in severity. Those who have not been vaccinated are 5 times more likely to be in hospital than the vaccinated (532.7 per million vs 105.9 per million). That differential becomes even greater when intensive care need is looked at. The rate for unvaccinated in the ICU is 135.6 per million compared to 9.2 per million for the vaccinated. That’s a reduction of 93.2%

These are the stats for January 5 from the Science Table

We are all being made to suffer because of a small element of people who value their personal freedom over the good of all society or because of their inability to grasp science. If we required people to show their vaccine passports for travel on public transit, shopping and even going to work in addition to the already required restaurant and other places of entertainment, they will either get vaccinated or sit at home alone.

The issue is the right to make decisions and choices about your own medical treatment (and to hell with everyone else) versus the impact that right has on the health and safety of others in society. It has been suggested to me that the case of Typhoid Mary is one that is comparable now. Mary Mallon was an Irish American cook who was an asymptomatic carrier of typhus. She denied being ill but, as a carrier, she infected many and some of those whom she infected died. She continually denied that she was ill and was twice quarantined to North Brother Island for a total of 26 years. Isolating people in quarantine to protect the majority of society is not something new but dates back to Biblical times when lepers were isolated in colonies.

Today, we are not suggesting the unvaccinated be quarantined on remote islands but that they simply accept a fairly benign injection. How terrible is that?

We should not be allowing this small minority to dictate to us and to clog up our hospitals. The other day, I saw Dr Paul Offit, an American pediatrician and expert in vaccines interviewed on BBC News. He stated that at his hospital, the Philadelphia Children’s Hospital, the Covid wards are full of kids whose families are not vaccinated. Watching families sob when he is forced to intubate their kids makes him want to go and shake some sense into them to vaccinate he told the BBC. He added that a parent’s job is to protect their kids and not vaccinating is not protecting them. Today, in Ontario, babies are ending up in hospital with covid acquired because many pregnant women are not vaccinating.

Maybe Macron’s strategy and the measures being taken in some European countries will work.

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Back in January – Our Final Blog of 2020

By Marvin Ross

This is our last blog for 2020 in what has been a horrible year . We will return in January when the roll out of vaccinations increases to slow the deaths from Covid-19. We can only hope that we can regain all that has been lost as we mourn the countless number of people who did not make it.

Science has shown that when it needs to, it can come up with a vaccine in less than a year in a process that normally takes 5-10 years if ever. There are still many infectious diseases that do not have a vaccine. Meanwhile, science is still a long way from unravelling the mysteries of serious mental illness let alone developing truly effective treatments.

We can all use a little laughter in our lives so I would like to present a one man show called Charly’s Piano for your entertainment. Charly Chiarelli is a retired social worker, and entertainer who plays a mean Blues harmonica. His show from 2019 which I saw live has just been made available on Youtube. As the description states, this is a “heartwarming true tale of how, in 1972, he was a young hippie looking for work in Toronto. He gets a job as a psychiatric assistant at the Clarke Institute of Psychiatry and organizes a fundraiser to buy a piano for the patients’ lounge. Some of his quirky patients help him….”

and “He returns years later with his daughter Selina, to find that things have changed in psychiatry.”

I knew the Clarke well as about that time, I had a friend who escaped from there regularly and showed up at my apartment not to far away. Charly is a graduate of McMaster University (and two others) and was inducted into the McMaster Hall of Fame along with its other grads – Martin Short, Dave Thomas and Eugene Levy.

Enjoy and have a safe and happy holiday. See you in January.

Can Donald Change His Spots

By Dr David Laing Dawson

As wrong as the anti-psychiatry folks are about psychosis and psychotic disorders and the application of biomedical science to understanding them, there is definitely much to quibble about with psychiatry’s category of personality disorders.

Should we even try to categorize them? Are they illnesses? Are they defined more by an oppressive capitalist hierarchy and social construct than by objective analysis?

And although psychiatry tends to define these disorders in non-contextual ways as if they exist within people themselves in a permanent fashion, “they” only really exist, objectively, within human interactions. It really does take at least two people to create a “personality disorder” even if the “disorder” leads to self-isolation in a cabin in the woods. Even a sociopath must have a society to act badly within in order to be defined as a sociopath.

Of course volumes have been written about these behavioural, philosophical, medical, and social conundrums.

But, as Joe Biden would say, “Here’s the deal.”

We are in the midst of a very public display of the harm that can be rendered by someone who does have a “personality disorder.”

We all have traits, and to some extent we each have our own repertoire of interactional and transactional patterns, the ways we deal with relationships, challenges, compliments, successes, failures, people. And most of us can alter or grow that repertoire as needed by changing realities, empathy, perception of better outcomes, even self interest.

But when we talk about a set of personality traits becoming a disorder we are really talking about someone with a fixed, immutable set of traits that do not adjust to changing realities, new experiences, new needs, new projections of outcomes.

Enter Donald.

I am writing this because there was actually an editorial in our newspaper indicating a hope that Donald would learn from his diagnosis/illness of COVID, just as a quite a few opined at the time of impeachment that maybe he learned a lesson.

Well no. He has a fixed repertoire of behaviours. We can describe them at length, and ponder what lies “beneath” them, as many have done. But the problem is they do not change, even when to do so would be easy, and in his own interest as well as that of his country.

So enough with the sympathy for his contraction of COVID. He cannot change and he remains a danger to himself and everyone around him.

Group Dementia, Anti-Science, Anti-Vax and Anti-Psychiatry

By Marvin Ross

An individual I look after who has Alzheimer’s and is in a dementia care home called because he can no longer tolerate the Covid-19 restrictions. He has been locked in since the beginning and can no longer go for his daily walks (with his Personal Support Worker) to various coffee shops in the area. The arguments he used were quite similar to the arguments used by the anti-lock down people in the US. They were:

• there is no pandemic
• people die all the time so what’s the big deal
• who are the public health officials and medical officers of health to tell me what I can and can’t do
• my freedom is curtailed and it is my business

He can be excused because he has dementia which trumps (no pun intended) his doctoral degree and his knowledge of science and medicine. But how can we account for those views in people who do not have dementia? The answer, I think, is our anti-science views that are not restricted to just the groups mentioned in the title and the conspiracy theories they breed. For example, someone in Quebec is torching cell towers because they believe that 5G technology is spreading the virus. The towers do not have 5G technology.

A doctor in France, for some reason, decided to do a small study of a malaria treatment drug called Hydroxychloroquine to see if it might help with Covid-19. Why, no one seems to know since the drug is used to prevent malaria and to help with the symptoms of lupus and rheumatoid arthritis. The study has few people in it and is badly designed but he claims some efficacy. Trump latched on to it, Huffington Post suggested, when he was influenced by a “philosopher who tweets anti-semitism, two bitcoin bros and right wing media” Suddenly, numerous universities around the world decide to conduct full scale clinical trials. Right now, there are 199 trials of this drug listed with the clinical trials registry.

The rationale for conducting a clinical trial is that there is a viable hypothesis to suggest the drug might be efficacious. I do not think there is one in this case so why are we wasting our resources?. The clinical trial process is lengthy and takes years to complete before a drug is finally approved. The steps are laid out in this article from the American Council on Science and Health .

Remdesivir, an anti-viral agent, may show some promise but the one study found no reduction in mortality from its use and a reduction of time to cure reduced by about 4 days from 15 days. Production is being ramped up despite a marginally positive result in one small trial. The American Council suggested that the one study with results is no cause for celebration.

As for vaccines, the fastest a vaccine has ever been developed is 5 years and yet there is tremendous hype for a vaccine with one small trial involving only 8 patients. The stock market response to this one very small trial added $29 billion to the value of Moderna stock.

“Several vaccine experts asked by STAT concluded that, based on the information made available by the Cambridge, Mass.-based company, there’s really no way to know how impressive —or not — the vaccine may be.”

There were 45 subjects in this trial but the company only released data on 8. What were the results for the other 37 subjects? No one knows and that is just one problem with the data.

The anti-science attitude is not new nor is it confined to certain segments of society like the uneducated. This attitude is surprising given that the last 50 or so years has seen incredible scientific advances that have enhanced our lives and allowed us to live longer than before. The anti-vax movement is as unscientific and stupid as can be and is not confined to those with little education. The same goes for the anti-psychiatry group as I have been writing for a number of years.

I still cannot get over the scholarship for anti-psychiatry studies established at my alma mater the University of Toronto a few years ago. I wrote about it here and here.

Just recently, a long list of supposedly respected people and disability groups wrote an open letter to the Public Broadcasting System (PBS) in the US because they showed a documentary on serious mental illness called Bedlam done by a psychiatrist. Unfortunately, I did not see the film because my local PBS station across Lake Ontario in Buffalo, New York did not show it. The letter demands that PBS give them airtime and criticized what they think are the fallacies in the film.

Unfortunately, those who oppose modern psychiatry and the treatment of serious mental illnesses are either ignorant or unaware of the advances in the neurosciences and in the treatment of these illnesses. Their letter decries the lack of discussion of such treatments as Open Dialogue from Finland, the Hearing Voices movement and Sorteria. As I wrote a few years ago, Open Dialogue has yet to be proven to be efficacious. My blogging partner, Dr Dawson covered this in this blog. Hearing Voices was discounted by me in the Huffington Post and by Dr Dawson in this blog as well. Sorteria, a drug free program founded years ago and abandoned years ago is getting a bit of a resurgence in a drug free treatment program in Norway.

Properly applied pharmaceutical therapy for serious illness saves lives. To ignore this is folly.

Given the extent that scientific advances since the mid 1950s have enhanced lives, it is surprising that anti-scientific views attract so many people.

Guest Blog Will the New Federal COVID Mental Health Funds Help Those With Serious Mental Illness?

By Home on the Hill

Prime Minister Trudeau has announced an investment of $240.5 million to develop, expand, and launch virtual care and mental health tools to support Canadians during the COVID Crisis. This action is laudable, however, will people with serious mental illness be helped with this money?

Many have symptoms such as “anosognosia” or lack insight that they are ill and will not reach out and ask for the help that they need. Home on the Hill has heard from a family where the telephone crisis service asked that the family member with schizophrenia, and in crisis, make the telephone call himself which he did not do.  When things became overwhelming, the family called the police which they had done many times in the past.. While the police do treat families with respect, their actions are not subtle and five police cars can land on your street which causes consternation and suspicious questions from neighbours.

Kathy Mochnacki, a family caregiver and Chair of Home on the Hill, attempted to communicate that  “anosognosia” prevented people from accessing care at the Service Coordination Council on Mental Health and Addictions of the Central Local Health Integration Network (LHIN) and felt uncomfortable with the response of some members who did not appear to understand this symptom. Over the three year span of this Council, she repeatedly asked that a psychiatrist attend the meetings but this request was disallowed even though psychiatrists play a significant role in a family member’s care.  This Council was to embed the patient and family voice and an Interim Report from the Centre for Excellence in Economic Analysis Research (CLEAR) evaluation group of St. Michael’s Hospital in Toronto recommended  “meaningfully engaging people with lived experience and their family members”.

Despite this, the family voice was not heard. Until it is, scenarios like the above described example will continue to happen.

Education to service providers about the symptoms of psychotic illness would help them understand anosognosia and other symptoms of psychotic illness which prevent the individual from reaching out.  Service providers would then understand that by not asking for help, the individual  is not expressing a choice but demonstrating a symptom of his or her illness. And families are not left with the only option of calling costly emergency services such as the police. (please see a training opportunity about anosognosia education by Dr. Xavier Amador)

The above mentioned family are grandparents with their own health issues whose grandson was finally taken to hospital by the police but was shortly discharged.  He walked all the way home from one city to another and arrived at the family home around midnight.  When we last checked, the grandparents said they are “practicing deep breathing and are saying prayers” and desperately scrambling for emergency housing.

Is this how our society should treat its most ill citizens and their families?

Is there a way that this new funding could lessen the burden of this family when the reason for their distress is systemic?  

And why does the current COVID pandemic garner a response of mental health funds, when the ONGOING PANDEMIC OF UNTREATED PEOPLE WITH SERIOUS MENTAL ILLNESS who lie abandoned on our streets, and in our jails continues to be ignored? 

Five thousand citizens live with a serious mental illness in the city of Richmond Hill alone. These citizens deserve appropriate hospital stays, education for them and their families about the illness, a psychiatrist, a family doctor for the many physical issues that they experience, rehabilitative supports, appropriate supportive housing and a mental health system which listens to them and their families with respect.

The COVID pandemic is an opportunity to draw the curtains back, and ask some hard questions. The family home, out of necessity, has replaced the asylum and until we get adequate and appropriate supportive housing, this will always be. Family caregivers perform most of the care tasks and ask that this fact be appreciated.. It is not a role that they chose. While families are included in meetings with the doctor when the patient has cancer, they are so often excluded  from the discussion if their loved one has a mental illness even when the patient has given permission.

Is it not time for mental health professionals to help mitigate the myriad of barriers that families experience like the unrealistic Ontario Mental Health Act and entrenched attitudinal barriers. Can we not streamline, enhance (like increase hospital beds) and coordinate services that work to make it easier for patients and families?. Is there an opportunity to evaluate services and not depend solely upon inputs like the number of visits or the length of the wait lists but study outcomes such as whether the youth suicide rate has gone down?.

Are there innovative ways to engage vulnerable people at risk as 50% of people with schizophrenia have the symptom of “anosognosia”.  Could service providers look at less stressful ways to deliver care such as the practice of visiting nurses who give injections now practiced by St. Joseph’s Hospital in Hamilton. Finally, many families who look after a vulnerable relative with no help from the system are bewildered at the costly bureaucracy which appears detached and totally removed from what they are experiencing.  Is there a way, instead, to spend our precious financial resources on these aforementioned much needed determinants of health for people with serious mental illness?

Home on the Hill is a supportive housing initiative in Richmond Hill, Ontario. For more information, visit http://www.home-on-the-hill.ca/

Addendum

A recent editorial in the Lancet points out that the one group that is not getting any consideration during this pandemic are those with serious mental illness. The authors suggest that:

Those who wish to build fairer societies and health systems after the pandemic ends must learn about and prioritise the needs of people living with severe mental illness as a matter of urgency.

Intimations of Mortality

By Dr David Laing Dawson

I’m sure I have not used the word “intimation”, nor read it, since a High School Poetry class. And over the years Wordsworth’s phrase has changed in my memory from “Intimations of Immortality” to “Intimations of Mortality”, making it finally a word and a phrase that exactly suits the moment.

For on another day the same as the last, checking the worldwide coronavirus numbers and then sitting by the window watching the leaves finally unfold in the colder than usual May, the word ‘intimation’ settles with full meaning in my mind. Not just a feeling; not just clues; not simple hints; not information exactly; not merely foreboding; not only an unsettling mood, but some combination of all these. Brought about I’m sure by the change in routine, the uncertainty, the threat of illness, the quiet in the streets, and the world encompassing information.

And there it sits; and I should allow it to sit; and I should live within it for a while to see what I learn.

But we run from it exchanging cartoons and memes and black humour with family and friends. We return to what we imagine was a simpler age and garden and bake and knit and build and paint and write. And we binge watch old series where people smoked and watched television in small boxes and phoned each other from heavy contraptions on a desk.

And I write a blog describing all the good things that might arise from this pandemic, the changes societies could make in response to the crisis. But there are other possibilities too: the rise of nationalism, polarization, a fatalistic view of climate change, the rise of tyrannies, a return to the status quo with more inequality, and less attention paid to the hidden population of mentally ill.

I watch CNN in the evening and ignore CBC though I am a fourth, maybe a fifth generation Canadian, and this because my intimations tell me to watch America. Canada is muddling through this without excess rancour and discord, as it is bound to, finding compromise where ever possible, its citizens obeying most cautions, laws and directives, sacrificing comfort and pleasure for the common good.

But the USA is where the action is, where the polarization increases under duress, where racism rears up, where the social contract is broken, where guns are carried to protests, where the selfish I openly struggles with the We, where each blames the other, where politicians regress to school yard taunts, where expedience trumps knowledge, and where this might all go the wrong way.

Intimations indeed.

Lessons Learned from Covid-19

By Dr David Laing Dawson

We humans seldom change our behaviour until and unless we have to. The counselling mantra is that we don’t change (go into rehab, drink less, exercise, stop smoking…) until we want to, decide to. But that’s not really true. We don’t do those things, that is make difficult changes in our routine behaviour, until we have to, as brought to us by a health scare, a threat from a loved one, an embarrassing experience, an overall shift in social attitude…

The same goes for corporate behaviour. Corporations don’t shift behaviour until they are fully in a crisis, or get caught.

So the good news about the current pandemic is that we are in a crisis and we did get caught.

So maybe, just maybe, some good things will come out of this. Here is my list:

1. True international cooperation and preparedness for the next virus, or bacterium that emerges.

2. Some measures taken to prevent the jump of pathogens from animals to humans.

3. Improving our long term care facilities and procedures. (It has always been known that influenzas and pneumonias, viral and bacterial, carry off this vulnerable population each season, but COVID- 19 is a wake up call)

4. Hospitals are paying some attention to antibiotic resistant bacteria but they are really Petrie dishes for these new evolving pathogens. Time to take it really seriously.

5. An overall increase in the awareness and acceptance of actual scientific medical information. e.g. vaccines

6. Improvement in our health care systems, COVID 19 having shown us the different gaps and problems and inequalities in each nation’s system.

7. I have always expected to acquire a minor virus or two when travelling any distance by air. Perhaps this crisis will show us how to travel by air/train without such an expectation.

8. This awakening to a problem that is world wide, that has an impact on every human on the planet, may help us expand our consciousness to the plight of all, and specifically to the developing crisis of climate change and global warming.

9. And finally, this may bring about a new understanding of what is referred to as “the economy”.

I was struck by the television reporting the past couple of nights of people in the USA lined up for food banks. “Not since the great depression” was the tag line, with some black and white images of long lines of unemployed and hungry families in the 1930’s. They are standing, clustered in threes and fours, in quarter mile lines, appearing gaunt, dressed in drab clothes, waiting their turn for the soup kitchen. In contrast the lines today were of cars and SUV’s lined up for blocks to enter the drive-through food bank, with boxes of food stuffs being loaded into the cargo space.

The great depression was preceded by the roaring twenties, with excess, excess in expectations, borrowing, crime, growth, debt, leading to a collapse of banks and the stock market.

It wasn’t until Roosevelt’s New Deal that it occurred to government that this man-made problem could have a man-made solution, that the problem of no jobs could be overcome by creating jobs, by getting money into the hands of ordinary people, that as much as jobs create money, money creates jobs. And money can be printed.

So now it has become common practice to spend our way out of recessions and depressions, to create or “borrow” money and “stimulate” the economy. Still we stumble from the good times to the bad and never learn.

While we are busy flattening the curve of COVID – 19, might we learn how to flatten the roller coaster ride of our “economy”?

Simple steps I think learned from 100 years of experience:

a. Bank, lending and market regulation and oversight. Corporations and people cannot be trusted.

b. Much more equitable distribution of wealth achieved through higher taxes on all forms of excess income.

c. Guaranteed annual income of at least, say, $20,000.

d. Simplify this by giving the annual income automatically to every adult, and have it replace unemployment insurance, welfare and disability pensions, old age pensions and all the bureaucracy that goes with these.

The time has come for this last idea. All it requires is a different way of thinking about “the economy” and about money itself.

The Trump Propaganda Machine Just Keeps Rolling Along

By Marvin Ross

Internationally syndicated columnist, Gwynne Dyer, recently wrote a column on how, during this pandemic, every country gets the government it deserves. He was specifically referring to the UK and to the US as both have severely botched their responses to this crisis. About the same time, Irish Times columnist, Fintan O’Toole, wrote that the attitude in the world today is to pity the United States.

“Trump’s mixed messaging and lack of leadership has made the U.S. the epicenter of the pandemic: “I don’t think we’ve ever seen… a leader who has been active spreading a deadly virus, which is really what Trump has been doing.”

And while all this is true, a great deal of the blame must go to the scientists as David Dawson wrote earlier,for not exposing his lies and BS. Yes, they are protecting their jobs and their asses but at the cost of tens of thousands of lives. Sure he can fire them but maybe, just maybe, the mass firings would get Americans to stop and think for a minute.

The other group that is enabling this BS are the journalists attending the White House press briefings. The role of the media in a democracy is to inform the public and to “act as watchdogs checking government actions.” That watchdog role should involve taking the statements that Trump and his press secretary make and doing some basic fact checking. Some US media groups are doing some of this but often not the ones sitting in DC listening to the press briefings.

The other day, I caught the new press secretary giving her briefing to the press. She was pointing out that because of all the hard work that had been done by the administration and by others, the US had one of the lowest rates of covid-19 and Covid-19 deaths in the world. So, as a result, we are now able to relax the lockdown rules and reopen the economy.

That is actually the opposite of what is happening. The US has one of the worst rates of infection and mortality in the world as can be seen here. With that as a response to a question, the proper response is for the journalist or others to ask a supplementary question. What evidence do you have for asserting that? No one did.

At that same press conference, she dismissed the need to mass test people and called it useless. However, it is reported that she, herself, and the inner White House Circle get tested twice a week.

By not challenging it, it then is considered to be fact. Now I realize that journalists might lose their accreditation to appear at the briefings but so what. If enough ask difficult questions and challenge the BS, most will be kicked out. And if they are, then the networks can refuse to broadcast it. By not going that route, they are simply enabling the lies and propaganda.

Trump’s newest press secretary is 32 year old, Harvard Law School grad Kayleigh McEnany. She is a life long Republican and an early supporter of Trump. In 2012 during the birther attack against Obama, she posted this on twitter “How I Met Your Brother — Never mind, forgot he’s still in that hut in Kenya.” Obama’s half brother, Malik, lives in Kenya and is a graduate in Accounting from the University of Nairobi.

The Trump propaganda machine has been busy and working from the very beginning. In 2017, Jeff Nesbit writing in the US News and World Report, compared Trump’s media policies to that of Joseph Goebbels and Hitler. He wrote:

“State-sanctioned propaganda – which works by destroying independent media credibility while simultaneously disseminating lies – is now lurking around every corner in America, and in the press briefing room at the White House itself, where the press secretary and administration officials offer demonstrably false statements as truth or “alternative facts.”

He ended with “The power of state-sanctioned propaganda, and its ability to destroy the credibility of independent media, is timeless for a simple reason: It works.”

It is time for the US media to stop enabling Trump and to take a stand.

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

By Dr David Laing Dawson

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

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

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

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

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

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

They humoured him.

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

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

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

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

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

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

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

Sanity in the time of COVID-19 – Part Two

By Dr David Laing Dawson

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

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

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

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

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

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

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

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

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

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