The Beat Goes On

31 May 2020

[Above photo: Boat traffic on the Yangon River is insanely busy these days.]

For some reason I receive an inordinate number of advertisements for massive, Chinese-made rock crushers. I’d think with all the advertising algorithms available they would know my preferences for vacant oceanfront land for sale in Maine and small sailboats capable of circumnavigating the globe. That’s what I tend to browse, when I’m not reading the NY Times, the WaPo, Science, or the New Yorker. Rock crushers. I’m not into highway construction, in particular.

I’ve been reading Barry Lopez’ Arctic Dreams.  He writes beautifully and it has memorable passages and insights into the adaptation of plant and animal life to a land of two seasons, one of which is very, very brief. Oh, the desperation plants and animals must feel to reproduce successfully in the tiny window available to them. I’m also finishing Spike Lee’s “When the Levees Broke”, a 4 part documentary about Hurricane Katrina and the inundation of New Orleans. The amazing thing about the documentary is that it shows so well the massive scale of devastation and the criminal stupidity and neglect of the Bush administration for the citizens, largely black, of that city. “You’re doin’ a heck of a job, Brownie.”, GW says to Michael Brown, the unqualified and inept head of FEMA; a hell of a (disastrous) job, it seems. Seeing Part I is probably adequate but it was good to be reminded of Barbara Bush’s—the apple doesn’t fall far from the tree—stingingly unfeeling analysis of those in the Superdome in Houston, her take on Marie Antoinette’s “Let them eat cake.”

When Susan Collins says, “I am very concerned.” with no subsequent action to demonstrate the same concern, as she does frequently in a curtsy to moderate never-Trump Republicans and Independents, we can conclude she isn’t very concerned.  I do hope that Sara Gideon steamrolls her, even though SC’s Super-Pac money keeps pouring in.

In class on Monday one of the students presented a paper she was given by Dr. Khin Maung Zaw, who teaches on Tuesdays. She had internet problems and couldn’t present it the previous week in his class. It was entitled “Current research in child and adolescent bipolar disorder”. The senior author was Robert Findling, MD, a well-known pharmaceutical shill and enthusiast for the concept of bipolar disorder in pre-pubertal children. I once went to my only drug-sponsored supper at Charles Phan’s Slanted Door in San Francisco, urged by some friends, at which Findling was speaking about the use of 2^nd generation antipsychotics. Someone in the audience questioned why he only showed studies of Risperdal, not the other 4 then in use. Someone else asked, “Who sponsored the supper?”  Janssen Pharmaceuticals, the maker of Risperdal, of course. Anyway, Findling has been paid by many different drug companies, despite having a good salary as an academic (currently Chief of Child Psychiatry and an endowed professorship at Johns Hopkins and previously at Case Western Reserve).

The paper was pure crap, trying to drum up business for Pediatric Bipolar Disorder. Take this convincing and informative sentence: “For instance, regions on chromosomes 2, 4, 6, 8, 11, 13, 16, 18, 21, 22, and X have been possibly linked to bipolar disorder.”  And, “Examination of neuroanatomical structure differences of children with bipolar disorder compared with children without psychiatric disorders have reported conflicting results.”

Basically, the diagnosis of Pediatric Bipolar Disorder is one of phenomenology since the DSM doesn’t consider causality or context.  A man is running past me down the street. Did he rob a bank? Is he delusional, imagining state security is after him? Is he late for his wedding? Has he won the lottery and he’s hightailing it to collect the winnings? Is he training for a half-marathon? Was he about to have a panic attack in a crowded market and he’s escaping from the scene? You get the point.

Happily, one of my students called the other one at 10PM one night last week, well before my rant of today, and said, “Look out for that Findling. I’ve looked him up and he’s getting money from so many drug companies.” It warmed my heart. I worry that my students will be naïve prey to drug manufacturers and their minions. They are not patsies, it seems.

We’ve “seen” on Zoom a 9yo boy in a village outside of Magway. His parents are concerned because he has become aggressive and oppositional. There is a complicated history.  His father’s farmland was on the east bank of the Ayeyarwaddy River and the bank collapsed, taking away the house and much of the farmland. He, his wife and son had to move in with his mother, brother, and sister. Complicating this further was the fact that his wife, the boy’s mother, had been a domestic worker for the father’s family, coming from another village. As such, she was always treated poorly, even after marrying the father. The boy developed lumps in his neck after the family moved in with his grandmother, was taken to Yangon Children’s hospital for 1 month and determined to have multidrug-resistant tuberculosis. The parents decided to try to stay in Yangon, since the home situation was so hostile. The father opened a mohinga stand and supported the family for several years. City life was too hard, however, and they moved back to his mother’s house. It has been difficult for the boy in the village because all the other parents won’t let their children play with him, fearing he is contagious. Plus, he struggles in math so doesn’t like school.

This was all described via Zoom at the first visit, using an uncle’s phone. The data charge was about $2 for an hour of Zooming; the therapist was able to send the money electronically to the uncle after each session. By the third session of merely telling their stories, the boy looked happy and had a couple of playmates, the father seemed relieved, and the mother was able to say she became aware she was displacing her anger toward her demeaning relatives onto her son. Reciting a dream in which her husband died and she didn’t know what she would do, she burst into tears. The uncle is leaving the village for work soon and his phone will accompany him, so we have one more appointment with the family unless they can find another phone to borrow or rent.

I want to underline the fragility of their existence and their resilience in the face of that. They have no steady income, no retirement savings, no shares of stock, virtually nothing of monetary value and yet their love for their son is strong enough to allow them to overcome the stigma of seeing a psychiatrist, to allow their personal vulnerability in the face of that, and to use their ingenuity to scrappily, but honestly, piece together their lives.

I had my first outing in 10 weeks two evenings ago. Clementina, a terrific Italian woman in our small poker group, is leaving in a week with her family. Olivier, her husband, will train prison observers in all of West Africa for the International Red Cross, based in Dakar, Senegal. He’s been doing the same here for the 46 prisons and 42 labor camps in Myanmar. They’ll visit her family in Milan first. They live at 8 Mile, which is just about that distance from my apartment. They are in a gated park, in a huge and lovely house. There are 4 other homes in the park, as well as a swimming pool and a tennis court. How the other half live. They have 3 children and each parent has led a full and interesting life. We consumed Parami Pizza—the truffle pizza is pretty darn good, although my crust is better—and Army beer at 8% alcohol. Wonder of wonders, I left the poker table with more than twice my buy-in. That has never happened to me before and in celebration I paid for all the cab fares home!

Our poor country is convulsing and DT is certainly withholding the diazepam. Rather, he’s injecting metrazole (A drug that induces seizures and was a predecessor to ECT). Racism is alive and well, kicking, one might say, despite John Roberts and the Supremes relieving southern states of some provisions of the Voting Rights Act. Of course, they all immediately began to institute measures of voter suppression.  People always get tribal when frightened; DT and others pouring gasoline on the fire certainly doesn’t help. If I were a young black man, I’d say “Up yours!” to all the laws of the land and loot and wreak havoc, I am sure. It isn’t helpful and will provoke a backlash, which is certainly what Trump seeks—those “Law and Order” votes— but the rage is understandable when the police, and other white men, continue to murder black men without cause.  Hateful whites certainly activate my hatred for them.  An endless, desperate, chaotic spiral downwards and, again, the “leadership” in DC at best mumbles platitudes, at worst incites the rage. He makes the current crop of generals in Myanmar look like choirboys.