#mclean hospital controversy

[night-wyld-system]

McLean Hospital & DID Stigmatization

We found someone going over the video from McLean hospital that also contains the parts of the speaker. In this post we will go over every instance of false claims, slander, and harm that Matthew A. Robinson has perpetuated in his video. This goes over numerous points and is made to make people aware that some of the information about this going around has been clearly false and done only to try and pretend that harm was not caused.

We are incredibly angered and upset to see someone has been posting about the video in the defense of the ableist man who made the speech and by that perpetuating the harm that he caused with his speech to our community. Anyone whatsoever who approves of his usage of the videos is someone we are not comfortable with.

Massive trigger warning: Ableism, fakeclaiming, stigmatization and demonization of DID, slander, and hatred towards endogenic systems, ableism towards complex systems and overt systems.

Claims About Switching

Switches only happen with or when experiencing flashbacks or being actively traumatized

Claims that in a fun video when a woman asks her partner if he can tell who’s fronting that there is no signs of confusion or distress about the switching- and implies that means they are lying and faking

Reaffirms that switches only happen because of trauma triggers to flashbacks

“Switching is actually quite rare in the way that it is portrayed online” proceeds to act like switching is rare and does not happen often in any cases

Claims switching only happens because of new traumas or flashbacks

Claimed that people describing switches in a way that would be understandable to those who do not understand and/or have the disorder was “dramatizing switches” and was harmful (again with no evidence) claims there is an uncharacteristic awareness of dissociation as if being diagnosed and in treatment is possible if you are unaware of having a disorder.

Again claims the only switches are subtle and not noticeable by observers. (Again claiming/making it seem like Overt systems do not exist)

Claims About Alters

Elaborate descriptions of alters are considered to be character like are not real alters

Changes in self state are often intrusive and unexpected (never talks about the alternative presentations)

Leaving notes for headmates/alters to communicate back with is somehow seen as a “tips for becoming plural”

Elaborations of parts/alters are somehow not possible and people are not actually apparently able to have creative expression.

Literally says having alters have different appearances is not possible and mentally viewing themselves as having specific appearances is a sign of faking

Claims that one cannot figure out who is fronting through questions about what they like and dislike and beliefs, etc.

Stigmatizing Claims

“People with DID are so afraid of their own thoughts feeling and memories that they displace them onto a personified aspect of themselves”

Claims that DID comes with unpredictability which does actively demonize systems and make them be seen as dangerous

Claims that you see no fear or conflict about someone receiving the diagnosis and that they are celebrating. (while implying being happy to learn what your disability is and know you can get help is bad)

“Requires capacity for hypnotization” in the trauma model of dissociation

Brings up the fantasy model and never mentions the current model, brings up some other generalized idea of the trauma formation of DID but does not address any theory whatsoever on that front.

“The DID narrative gives social gain” (paraphrase)

Conflates functional multiplicity with endogenic systems while demonizing and fake-claiming both

Make it out to be that people with "real DID" can only ever be sad and incapable and nothing else.

Claims DID can only be reluctant or ambivalent to their alters

People with DID would not be aware of "named parts" apparently.

Again claims that conflict and confusion with trauma history and symptoms is always necessary for DID.

Slander & Generalized Bigotry

This part is both to DID systems and endogenic systems.

“Do these content creators have DID, if they are not cases of genuine DID then what are they...” (directly implying or claiming they are lying) 

Claims that the normal gains from social media are incentive to lie, but brings forth no evidence or studies that prove that people are more likely to lie for social media fame than any other purposes, regardless of the validity of the statement, the lack of sources in concerning.

Claims someone is malingering off of a one minute video about one day out of their entire life. Also suggests it could be “factitious”

Claims that selling merchandise as part of your social media branding is a sign you are malingering or factitious. With no further reasoning.

“Commodification of DID” because a woman with DID makes hats… and mentions she has DID. She has a business and that is apparently commodifying her disorder because she has it. Having a hobby and selling products is apparently a sign of malingering or being factitious. 

“Imitative DID” in general is a whole can of worms we don’t want to touch. Basically claiming people can accidentally fake and demonizing being wrong about what you have if you later find out its something else (this harms people w/o DID) 

Claims that plurality is a form of “imitative DID” when non-disordered plurality is nothing like DID, he also mocks endogenic systems.

“I show this video to demonstrate the uncharacteristic way in which people with imitative DID…” (directly fakeclaims a person with diagnosed DID). THEN pulls up a slide saying Case Study: Imitative DID (to deny this is fakeclaiming is to be a liar)

Miscellaneous Claims

Many of the new patients who are asking if they may have DID to their doctors do not report a trauma history (implying in that claim that therefore they are faking, when that is the purpose of the whole disorder)

Can be interpreted to imply that overt DID does not exist. Claims that reluctance to allow changes is the norm (true) and implies allowing those changes alters make is not a thing that happens (not as true)

Amnesia isn’t about normal forgetting, it is about trauma information being compartmentalized and kept separate so that the person can get through their day to day life without getting inundated. (paraphrase)

Children… tell themselves they’re not the ones being harmed and the framing does make it sound like a choice.

Implies DID is only/always caused by abuse, and implies that it is caused by those who DO provide children with food and shelter (DID has many causes, additionally he ignore neglect as a possibility for children to experience and implies traumatized children would not be given food or aid if acting traumatized)

Survival depends on DID being hidden (this is categorically false some overt systems form because it has intimidated abusers, additionally in cases of purposeful dissociation caused by purposeful actions to do so is not hidden from the abusers but is chosen by them)

Does not seem to understand the way algorithms work nor understand how viewership of online platforms works either

He mentions online harassment to the influencers yet shows the exact people who have suffered this in his own video proving a lack of care for his own actions and their consequences to other individuals.

Claims its harmful to DID systems to run into people who are accused falsely of making up their symptoms while providing a lecture on why he thinks people are faking. 

Reinforces that the feelings of shame and confliction many systems have will be reinforced by running into fakeclaiming (while he is also fakeclaiming others to be clear).

Social media is leading to increased risks of non-genuine claims! Failing to acknowledge this is a normal consequence of any and all disorders becoming well known. It doesn’t take a rocket scientist to go through the list of every single disorder that has had movements of people pushing for stigmatization and see this happened with them. It would not be an issue if doctors were not incompetent and they actually helped these people figure out what they are experiencing.

Proclaims that not showing you’re distressed 24/7 is a sign of faking

We could not stomach the rest of the video, we watched this on some systems channel when they did a livestream response to it, they themselves were not supportive of endogenic systems which was also annoying but they did have the video play the full context of what this man has said. It is incredibly disgusting to see that anyone has tried to make it out to be better than it was. This speech was disgusting and objectively harmful to DID systems. It was also unnecessarily cruel to endogenic systems for not reason other than to drive the nail deeper and put salt into the wound of others.

The fact this man even brought up the fantasy model makes us see him as objectively a threat to us and our safety. Anyone who would perpetuate the idea that DID systems are delusional and their memories of trauma are fake is a disgusting sniveling coward who has something to hide. The only motivation that created the idea in the first place was someone trying to cover his own ass for being an abuser.

[circular-bircular]

Reviewing some of the McLean hospital video today, but getting this thought out now while it’s in my head:

My heart goes out to the systems that are suffering due to the public nature of the video.

However.

McLean Hospital did not fakeclaim any systems in the video. I’m certain that it was interpreted as such, but their interpretation =\= the facts of the video. And yes, I will be discussing the section of Imitation DID when I do get to actually write a full response.

[sophieinwonderland]

hey, sophie, regarding the recent controversy around the mclean hospital, would it be important enough to reach out to anti endogenic spaces to get attention on this?

If others want to, I won't stop them.

For myself, at this point, I think a lot of the big name anti-endos will support things specifically because I oppose them. That's been the pattern whether I'm saying "people with DID aren't broken," "headmates deserve to be treated as people," "yes, it's unethical to harm headmates" or "you shouldn't call traumagenic systems endogenic."

I fully suspect that if I made a post in the anti-endo tags about how terrible the video is McLean video is, a bunch of anti-endos would come out to support it out of sheer spite. 🙄

Actually, the best way to make every single anti-endo blog start posting about how terrible the video is would probably be for me to make a post praising it. /hj 😜

[reglux456]

Energy Drinks

With its rare and mystical parts, the symbol is engraved within the minds of its audience. Organizations use their logos to reach out to their customers on several mediums. To achieve this high quality, the designer of the monster energy emblem, McLean Design, opted for a clear layout. The effect is that the logo can scale on multiple advertising surfaces without compromising its quality. In January, a authorities report discovered the number of emergency room visits involving energy drinks doubled from 2007 to 2011, reaching more than 20,000.

This drink is ripe and juicy and has just the right quantity of carbonation. If it wasn’t in a gigantic can with that horror movie-looking M emblazoned on it, I wouldn’t even realize it was an energy drink in any respect. We cracked open 34 cans and bottles to find monster energy drink the best Monster energy drink flavors. Red Bull accommodates caffeine, taurine, B nutritional vitamins, and sugar — all of which can provide a short-term energy increase (1, 5).

Monster Energy accommodates 10.00 mg of caffeine per fl oz (33.eighty one mg per one hundred ml). The Monster Beverage Corporation has been concerned in some scandals and controversies. Each time these negative stories showed up, the stakeholders discovered revolutionary methods to neutralize them. They have mastered the art of turning adverse tales into advertising successes.

Hansen's fruit juice smoothies include roughly 25% juice and provide one hundred pc of the recommended daily grownup consumption of Vitamins A, C, and E. In 2009, Monster Beverage launched Hansen's Natural Lo-Cal 64-ounce juice cocktails, in 4 flavors. In November 2012, the agency announced a long-term partnership with the Professional Bull Riders,[48] and at present sponsors several riders including Jose Vitor Leme, Cody Teel, and Derek Kolbaba. Starting in 2018, they grew to become the title sponsor of the PBR's premiership tour, generally identified as the Unleash the Beast tour. The firm additionally doesn’t differentiate between massive and small companies when it presents a grievance.

Monster Beverage, the maker of energy drinks, is exploring a combination with Corona brewer Constellation Brands, in accordance with people familiar with the matter. Only a handful of cases pop up in the scientific literature, though it is potential that such deaths are under-reported. The massive question is how a lot rolex deepsea of the blame for going to hospital can be attributed to energy drinks alone. Between 2005 and 2009, ER visits related to energy drinks went up tenfold in the US. But a minimal of forty four per cent of those ER visits have been as a end result of mixing energy drinks and one other substance, similar to alcohol.

North Americans eat extra energy drinks than some other geographic market in the world, with the European market shut behind. Plus, research shows that the Asia-Pacific region is expected to be one of the fastest-growing markets for the business, with a CAGR development of 5.1% by 2026, due to a more modern lifestyle and changing demographics. Monster incorporates 28 grams of sugar per eight.4-ounce (248-ml) can, which is comparable to Red Bull. Drinking simply considered one of these energy drinks daily can cause you to eat an extreme amount of added sugar, which is unhealthy in your overall well being (2).

Although PepsiCo would not release monetary information about particular brands, we will make some dedication about how Rockstar is poised to place itself within the company. This one ranked a little lower as a result of it really, actually smells like cologne to me. But if you could get previous Axe physique spray stink, you’ll be rewarded with a extremely tasty glowing lemonade. Another can of one thing to deliver to the beach as an accompaniment to your excessive water sport of selection. It’s like if Hawaiian Punch went to a bunch of Orange County punk shows in the ’90s.

Smoothies, Rumba Energy Juice, Energade, and Energy Formula, are minor merchandise. Monster owns Blue Sky Beverage Company, which manufactures several gentle drinks. Pasco County Schools, a Florida district simply tiger woods nike north of Tampa, also provides Kickstart drinks to high school students in its vending machines.

But Stephen Hegarty, a spokesman for the district, noted that PepsiCo, which owns the brand, marketed the beverage as an “enhanced gentle drink,” not an “energy drink.” PepsiCo declined to remark. Noting that the college offered Mountain Dew’s version, Kickstart, Ms. Fitzgibbon stated students opted for the drink not just for the energy jolt but for the benefit of buying for it through their scholar accounts. Consider monitoring the amount of caffeine and sugar out of your energy drinks. It might help you avoid energy and the challenges from too much caffeine. Because of the caffeine, kids or teens shouldn't drink energy drinks, in accordance with the American Academy of Pediatrics.

Likewise, the stock of the beverage firm Monster Energy has elevated 31 percent prior to now year. If the talks are profitable, it would be the latest beverage deal since Coca-Cola agreed to accumulate the remaining stake that it doesn’t personal in sports-drink brand BodyArmor for $5.6 billion in cash earlier this month. Fournier suffered from Ehlers-Danlos syndrome, a genetic dysfunction that causes unfastened skin and joints, and easily broken blood vessels. Since caffeine dilates blood vessels, Fournier’s underlying situation could have made her much more delicate to the results of caffeine. Monster packs a strong punch however has a clean, easy-drinking taste you’ll dig. Monster is the parent company of Hansen Beverages who produce a line of pure delicate drinks.

[the-courage-to-heal]

Childhood:

The book Sybil and the subsequent 1976 movie in which Sally Field portrayed a girl with more than a dozen different personalities were the result of a collaboration between psychiatrist Cornelia Wilbur and author Flora Rheta Schreiber. The goal was to have people better understand a child abuse victim who developed alternative personalities as a coping mechanism.

While the book and movie raised the profile of what is now known as dissociative identity disorder (DID), they also created some significant misconceptions.

“Do people come into my office and switch personalities in a dramatic way, with different voices. Does their makeup suddenly change? No,” said Milissa Kaufman, MD, PhD, about the character Sybil. “It may feel like that to them internally, but there’s no dramatic thing that happens.”

Kaufman, director of the Dissociative Disorders and Trauma Research Program at McLean Hospital and medical director of McLean’s Hill Center for Women, said patients with DID, a form of post-traumatic stress disorder (PTSD), often carry on very normal, high-functioning lives. She pointed to Robert Oxnam, a China scholar and president emeritus of The Asia Society, who shared his life story in the 2005 book A Fractured Mind: My Life With Multiple Personality Disorder.

That is because DID is a coping mechanism, usually brought on by childhood abuse, and is a kind of ingenious, unconscious way of displacing situations onto other aspects of themselves.

“It’s the ‘not me’ phenomenon,” said Kaufman. “Little children have magical thinking. It’s at this age in development where you believe in Santa Claus, or where little children personify stuffed animals. There are displaced thoughts and feelings that are difficult for them, so they are put on these other entities. It’s a normal developmental stage that children go through.”

Where DID veers from “not me” is when abuse—physical, sexual, or emotional—is introduced into their young lives.

“If you’re being abused at night, you think to yourself that can’t possibly be happening. It has to be happening to some other little girl. It’s not me,” she said. “If a little girl is being abused at night and has to wake up the next morning and go to school and do sports and do homework and have to do as much as they can to not have people get angry at them, they displace it onto another aspect of themselves.”

“A child doesn’t have many other ways to cope. They can’t go to their parents, since that is the origin. They feel like there are other people inside of them, and they can’t tell anybody.”

Dissociation can be found in 1-3% of the general population and as high as 20-30% in psychiatric populations, about the same prevalence as schizophrenia, Kaufman said. A 1986 study by Frank W. Putman and others in the Journal of Clinical Psychiatry found the average patient with DID has been in the mental health delivery system for an average of 6.8 years and has received three other diagnoses. This reflected either misdiagnoses or occurrences of other diagnoses or symptoms that delayed an accurate diagnosis.

Dissociation occurs along a spectrum, from “spacing out” while driving and missing an exit to being hyper-focused on a topic. Along the range are memory issues, like gaps in recall, often associated with PTSD. Further along are depersonalization and derealization—which Kaufman described as a profound detachment from sense of self or sense of body, a sensation of being apart from one’s self, perhaps viewing what is happening from a distance.

The furthest end of the spectrum is fragmentation of identity, where “my feelings or my thoughts or my body feel like they don’t belong to me,” she said.

Richard Loewenstein, MD, a psychiatrist in the Trauma Disorders Program at the Sheppard Pratt Health System in Baltimore, noted in a 2018 paper in Dialogues in Clinical Neurosciencethat dissociative identity disorders are among the oldest reported psychiatric disorders, with case reports appearing at the end of the 18th century.In more recent times, DID was viewed as being “rare and exotic,” except during wartime. Yet, the diagnosis was not without controversy, even among mental health professionals, with a history going back to Freud and questions about what real memories are. That was rekindled in the 1980s cases involving child abuse at day care centers in many parts of the country. Among the models developed at the time, one suggested DID could be produced in highly hypnotized, suggestible patients.

Rather than simply reveal forgotten traumas, the theory went, hypnosis could be used to implant false memories.DID can also be wrongly connected to malingering (exaggerated) and factitious (inauthentic) disorders, where patients make claims either with or without a motivation for personal gain. The best-known example of factitious disorder is the severe form once known as Munchausen syndrome.“That’s not what it looks like,” said Kaufman. “It’s a very real, very well-studied psychiatric disorder.”“It most often is chronic,” she continued. “It typically is at the hands of a caretaker. It can be sexual abuse, it can be physical abuse, it can be emotional abuse. But generally, people who have DID have had many different types of abuse at the hands of multiple perpetrators.

The women she works with at the Hill Center usually arrive with histories of childhood abuse, PTSD, co-occurring disorders such as eating disorders, or substance abuse issues. While DID affects men, she believes many are less likely to come forward for help.“I think there’s even more of a stigma for men to talk,” she said. “It may be that, or a lot of mental health professionals are not trained to ask questions. They may not be on alert for it, because the media depicts women most often as having this disorder, so maybe they don’t even ask.

”DID is also treatable with a three-stage set of professional guidelines established through expert consensus.The initial stage focuses on stabilization and safety. The goal is to

“get things calmed down and life in order. It can take a while for someone to feel comfortable and safe. It can take years.”

Once that is achieved, clinicians move on to the second stage, where the patient begins to process the traumatic events that have affected them. In the final stage, the emphasis is on

”getting your life back, mourning what you have lost and moving on without dissociation, learning how to be in the world without dissociating.”At the same time, scientists are exploring potential biological or genetic links that could predispose a person to DID. Studies to date have shown that in the classic form of PTSD, the brain’s amygdala—which controls the “fight-or-flight” response—is overactive while the prefrontal cortex is not, generating a hyper-aroused state. But in the dissociative subtype of PTSD, Kaufman said, the prefrontal cortex is overactive to the point where a person can be numb and detached.In fact, she explained, both the amygdala and prefrontal cortex become overactive in patients with DID.

“The trauma state in DID looks like classic PTSD,” said Kaufman. “In a numbed state of mind, it looks more like the dissociative subtype, where, the brakes are on too tight.”Scientists are also looking at the brain’s attentional activation system, how a person concentrates.“People who are dissociative have a really refined ability to focus attention, particularly in multitasking,” she said, saying researchers are working to understand how the brains of people with DID have a different allocation of resources toward attentional systems.Finally, there are also studies on potential genetic links.“You aren’t born with DID, but you can have a genetic predisposition to dissociate, so we are also looking for genetic markers.”But Kaufman stressed that people with DID should not give up hope.“It’s treatable. It’s a pretty phenomenal coping mechanism when you are growing up, but it becomes disruptive when you don’t need it anymore.”

source

[aaknopf]

Today we present a preview of a major new biography of Sylvia Plath, Red Comet, coming this fall. Through committed investigative scholarship, Heather Clark is able to offer the most extensively researched and nuanced view yet of a poet whose influence grows with each new generation of readers. Clark is the first biographer to draw upon all of Plath's surviving letters, including fourteen newly discovered letters Plath sent to her psychiatrist in 1961-63, and to draw extensively on her unpublished diaries, calendars, and poetry manuscripts. She is also the first to have had full, unfettered access to Ted Hughes's unpublished diaries and poetry manuscripts, allowing her to present a balanced and humane view of this remarkable creative marriage (and its unravelling) from both sides. She is able to present significant new findings about Plath's whereabouts and her state of health on the weekend leading up to her death. With these and many other "firsts," Clark's approach to Plath is to chart the course of this brilliant poet's development, highlighting her literary and intellectual growth rather than her undoing. Here, we offer a passage from Clark's prologue to the biography, followed by lines from one of Plath's celebrated "bee poems."

from Red Comet: The Short Life and Blazing Art of Sylvia Plath

The Oxford professor Hermione Lee, Virginia Woolf’s biographer, has written, “Women writers whose lives involved abuse, mental-illness, self-harm, suicide, have often been treated, biographically, as victims or psychological case-histories first and as professional writers second.” This is especially true of Sylvia Plath, who has become cultural shorthand for female hysteria. When we see a female character reading The Bell Jar in a movie, we know she will make trouble. As the critic Maggie Nelson reminds us, “to be called the Sylvia Plath of anything is a bad thing.” Nelson reminds us, too, that a woman who explores depression in her art isn’t perceived as “a shamanistic voyager to the dark side, but a ‘madwoman in the attic,’ an abject spectacle.” Perhaps this is why Woody Allen teased Diane Keaton for reading Plath’s seminal collection Ariel in Annie Hall. Or why, in the 1980s, a prominent reviewer cracked his favorite Plath joke as he reviewed Plath’s Pulitzer Prize–winning Collected Poems: “ ‘Why did SP cross the road?’ ‘To be struck by an oncoming vehicle.’ ” Male writers who kill themselves are rarely subject to such black humor: there are no dinner-party jokes about David Foster Wallace.

Since her suicide in 1963, Sylvia Plath has become a paradoxical symbol of female power and helplessness whose life has been subsumed by her afterlife. Caught in the limbo between icon and cliché, she has been mythologized and pathologized in movies, television, and biographies as a high priestess of poetry, obsessed with death. These distortions gained momentum in the 1960s when Ariel was published. Most reviewers didn’t know what to make of the burning, pulsating metaphors in poems like “Lady Lazarus” or the chilly imagery of “Edge.” Time called the book a “jet of flame from a literary dragon who in the last months of her life breathed a burning river of bale across the literary landscape.” The Washington Post dubbed Plath a “snake lady of misery” in an article entitled “The Cult of Plath.” Robert Lowell, in his introduction to Ariel, characterized Plath as Medea, hurtling toward her own destruction.

Recent scholarship has deepened our understanding of Plath as a master of performance and irony. Yet the critical work done on Plath has not sufficiently altered her popular, clichéd image as the Marilyn Monroe of the literati. Melodramatic portraits of Plath as a crazed poetic priestess are still with us. Her most recent biographer called her “a sorceress who had the power to attract men with a flash of her intense eyes, a tortured soul whose only destiny was death by her own hand.” He wrote that she “aspired to transform herself into a psychotic deity.” These caricatures have calcified over time into the popular, reductive version of Sylvia Plath we all know: the suicidal writer of The Bell Jar whose cultish devotees are black-clad young women. (“Sylvia Plath: The Muse of Teen Angst,” reads the title of a 2003 article in Psychology Today.) Plath thought herself a different kind of “sorceress”: “I am a damn good high priestess of the intellect,” she wrote her friend Mel Woody in July 1954.

Elizabeth Hardwick once wrote of Sylvia Plath, “when the curtain goes down, it is her own dead body there on the stage, sacrificed to her own plot.” Yet to suggest that Plath’s suicide was some sort of grand finale only perpetuates the Plath myth that simplifies our understanding of her work and her life. Sylvia Plath was one of the most highly educated women of her generation, an academic superstar and perennial prizewinner. Even after a suicide attempt and several months at McLean Hospital, she still managed to graduate from Smith College summa cum laude. She was accepted to graduate programs in English at Columbia, Oxford, and Radcliffe and won a Fulbright Fellowship to Cambridge, where she graduated with high honors. She was so brilliant that Smith asked her to return to teach in their English department without a PhD. Her mastery of English literature’s past and present intimidated her students and even her fellow poets. In Robert Lowell’s 1959 creative writing seminar, Plath’s peers remembered how easily she picked up on obscure literary allusions. “ ‘It reminds me of Empson,’ Sylvia would say . . . ‘It reminds me of Herbert.’ ‘Perhaps the early Marianne Moore?’ ” Later, Plath made small talk with T. S. Eliot and Stephen Spender at London cocktail parties, where she was the model of wit and decorum.

Very few friends realized that she struggled with depression, which revealed itself episodically. In college, she aced her exams, drank in moderation, dressed sharply, and dated men from Yale and Amherst. She struck most as the proverbial golden girl. But when severe depression struck, she saw no way out. In 1953, a depressive episode led to botched electroshock therapy sessions at a notorious asylum. Plath told her friend Ellie Friedman that she had been led to the shock room and “electrocuted.” “She told me that it was like being murdered, it was the most horrific thing in the world for her. She said, ‘If this should ever happen to me again, I will kill myself.’ ” Plath attempted suicide rather than endure further tortures.

In 1963, the stressors were different. A looming divorce, single motherhood, loneliness, illness, and a brutally cold winter fueled the final depression that would take her life. Plath had been a victim of psychiatric mismanagement and negligence at age twenty, and she was terrified of depression’s “cures,” as she wrote in her last letter to her psychiatrist—shock treatment, insulin injections, institutionalization, “a mental hospital, lobotomies.” It is no accident that Plath killed herself on the day she was supposed to enter a British psychiatric ward.

Sylvia Plath did not think of herself as a depressive. She considered herself strong, passionate, intelligent, determined, and brave, like a character in a D. H. Lawrence novel. She was tough-minded and filled her journal with exhortations to work harder—evidence, others have said, of her pathological, neurotic perfectionism. Another interpretation is that she was—like many male writers—simply ambitious, eager to make her mark on the world. She knew that depression was her greatest adversary, the one thing that could hold her back. She distrusted psychiatry—especially male psychiatrists—and tried to understand her own depression intellectually through the work of Fyodor Dostoevsky, Sigmund Freud, Carl Jung, Virginia Woolf, Thomas Mann, Erich Fromm, and others. Self-medication, for Plath, meant analyzing the idea of a schizoid self in her honors thesis on The Brothers Karamazov.

Bitter experience taught her how to accommodate depression—exploit it, even—in her art. “There is an increasing market for mental-hospital stuff. I am a fool if I don’t relive, or recreate it,” she wrote in her journal. The remark sounds trite, but her writing on depression was profound. Her own immigrant family background and experience at McLean gave her insight into the lives of the outcast. Plath would fill her late work, sometimes controversially, with the disenfranchised—women, the mentally ill, refugees, political dissidents, Jews, prisoners, divorcées, mothers. As she matured, she became more determined to speak out on their behalf. In The Bell Jar, one of the greatest protest novels of the twentieth century, she probed the link between insanity and repression. Like Allen Ginsberg’s Howl, the novel exposed a repressive Cold War America that could drive even the “best minds” of a generation crazy. Are you really sick, Plath asks, or has your society made you so? She never romanticized depression and death; she did not swoon into darkness. Rather, she delineated the cold, blank atmospherics of depression, without flinching. Plath’s ability to resurface after her depressive episodes gave her courage to explore, as Ted Hughes put it, “psychological depth, very lucidly focused and lit.” The themes of rebirth and renewal are as central to her poems as depression, rage, and destruction.

“What happens to a dream deferred?” Langston Hughes asked in his poem “Harlem.” Did it “crust and sugar over—/ like a syrupy sweet?” For most women of Plath’s generation, it did. But Plath was determined to follow her literary vocation. She dreaded the condescending label of “lady poet,” and she had no intention of remaining unmarried and childless like Marianne Moore and Elizabeth Bishop. She wanted to be a wife, mother, and poet—a “triple-threat woman,” as she put it to a friend. These spheres hardly ever overlapped in the sexist era in which she was trapped, but for a time, she achieved all three goals.

They thought death was worth it, but I Have a self to recover, a queen. Is she dead, is she sleeping? Where has she been, With her lion-red body, her wings of glass?

Now she is flying More terrible than she ever was, red Scar in the sky, red comet Over the engine that killed her— The mausoleum, the wax house.

from “Stings” by Sylvia Plath

More on this book and author:

Learn more about Red Comet: The Short Life and Blazing Art of Sylvia Plath by Heather Clark

Learn more about Heather Clark

Share this poem and peruse other poems, audio recordings, and broadsides in the Knopf poem-a-day series

To share the poem-a-day experience with friends, pass along this link

[newsfact]

Virginia governor’s race: How to vote

Virginia’s gubernatorial election looms with less than two weeks left to vote for governor, lieutenant governor, attorney general, members on the House of Delegates, and some local office candidates.

Many Virginians will plan to line up on Nov. 2 to cast their vote, but if you can’t make it to the polls the first Tuesday in November, here’s how you can vote.

Early in-person voting

Early in-person voting began Sept. 17, 45 days before the general election. Virginians can look up their local registrar’s office to see where they can vote early.

Virginians do not have to provide a reason why they want to vote early and can show up anytime during the office’s designated hours. Voters are required to bring a valid form of identification or sign an ID Confirmation Statement. 

The last day to vote in person before Election Day is Saturday, Oct. 30. 

Curbside voting is also available upon request. 

RNC TARGETS MCAULIFFE FOR CONTROVERSIAL REMARKS REGARDING CHILDREN’S EDUCATION AS GOVERNOR’S RACE HEATS UP

Absentee Voting

Virginia voters can vote by mail so long as they have requested their mail-in ballot by Oct. 22. 

The state recommends voters check to see if their absentee application was received after they have submitted their request. 

In this combination photo, Virginia gubernatorial candidates, Democrat Terry McAuliffe left, and Republican Glenn Youngkin appear during the Virginia FREE leadership luncheon, in McLean, Va., on Sept. 1, 2021.  (AP Photo/Cliff Owen) (AP Photo/Cliff Owen)

Voters should then track whether their ballot has been sent to them or received by the home office by using Virginia’s Citizen Portal, though Fairfax County voters should track their ballots here.

Vote-by-mail ballots can be submitted through the U.S. Postal Service or by email or fax. 

Absentee ballots will be accepted by the state so long as they are postmarked by Nov. 2 and received no later than Nov. 5 by 5 p.m.

Emergency Absentee Voting

 In the case of hospitalization, illness or an emergency situation like the death of a spouse, child, or parent, that prevented an individual from meeting the Oct. 22 deadline to request an absentee ballot, Virginians can still vote by absentee ballot. 

An emergency absentee ballot can be requested so long as the request is submitted by 2 p.m. on Nov. 1.

If approved, a designated representative will provide the voter with their ballot. The ballot must then be marked in the presence of the designated representative. 

The ballot must be received prior to the close of the polls on Election Day.

TERRY MCAULIFFE ABRUPTLY ENDS INTERVIEW, TELLS LOCAL VIRGINIA REPORTER, ‘YOU SHOULD’VE ASKED BETTER QUESTIONS’

Military voting

If a registered Virginia voter is serving in the military or absent overseas they are eligible to vote electronically.

A Virginia DMV-issued ID will be required to submit their ballot electronically.

In the absence of a state-issued ID, the overseas Virginia voter can cast their ballot through the federal postcard application (FPCA) portal.

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Election Day   

For Virginia voters who choose to wait until Nov. 2 to vote in person, they will be required to provide an accepted form of identification or they will be required to sign an ID Confirmation Statement.

If the voter declines to sign the ID Confirmation Statement, they can complete a provisional ballot and will have until noon on Nov. 5 to provide a valid form of ID. 

Valid forms of identification include Virginia DMV-issued IDs, student ID, and U.S. government passports. 

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Play Lost consciousness officer had him in a chokehold and that paramedics injected him with a lethal amount of ketamine ABC's Marcus war as the latest news I'm coming 2 years after McLean who by the way was unarmed when he had that encounter with police and later died on days later at the hospital never regaining consciousness after receiving that that ketamine according to to prosecutors and authorities there and his family also alone New York and New Jersey were also now learning that the death toll from the storm has climbed to 22 people after five people were found dead in Elizabeth New Jersey and of course with all of these transportation issues many of us had a tough time getting to the office and getting on air this morning take a look at this video unfortunately just one of so many people looking at a picture like this he was actually unable to join us on the show today because of this and so we did want to give just a huge shout out to our team our nannies the caregivers the whole village that went in to getting us here today and getting us on the air and just sending out all of our hearts to all of those people struggling from the storm from the Gulf Coast all the way up to the Northeast caster for joining us here at the top of the hour but first much more in that controversial Texas abortion law here again teen Titans

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Excited Delirium: How Cops Invented a Disease

It might not be “real” in the conventional sense, but it’s still a deadly diagnosis in the hands of police.

Arjun Byju filed 13 April 2021 in Criminal Punishment

In March of 2020, Daniel Prude died in police custody in Rochester, New York. When body camera footage was released that fall—showing Prude as he lay unarmed and handcuffed, hooded and pinned to the asphalt, snowflakes melting on his naked skin—protests erupted across the country, and found common cause with an already roiling Black Lives Matter movement.

Prude’s death was, in many ways, depressingly similar to the litany of police killings that had inspired a year of dramatic demonstrations and calls for systematic reform. Documents later revealed how officials took over four months to release arrest footage to the victim’s family and refrained from disciplining police leadership in the face of mounting public pressure. That Prude’s death had so much in common with George Floyd’s, both men subdued and asphyxiated in the street, offered a symbolic reminder of the ubiquity of injustice. 

Yet, Daniel Prude’s demise was also distinct because among the causes of death listed at his autopsy was “excited delirium.”

As a medical student who had recently begun clinical clerkships, I was curious about this diagnosis, which I had never read about in my textbooks or heard on the wards. A quick internet search revealed a host of explanations. From the Seattle Police Department, excited delirium was: “A state of extreme mental and physiological excitement, characterized by extreme agitation, hyperthermia, hostility, exceptional strength and endurance without apparent fatigue.” Variously referred to as “agitated delirium,” “Bell’s mania,” “lethal catatonia,” and “acute exhaustive mania,” proponents of the syndrome defined it as a constellation of fear, panic, exaggerated strength, hyperthermia, respiratory arrest and death—chiefly in the context of drug use, physical restraint, and police custody.

Although excited delirium has been invoked to write-off dozens of deaths at the hands of police in the last decade—including, in another morbid parallel to the case of George Floyd, as a possible defense in the trial of Derek Chauvin—it is not recognized as a veritable clinical entity by the American Medical Association, the American Psychiatric Association, the World Health Organization’s International Classification of Diseases (ICD), or the Diagnostic and Statistical Manual of Mental Disorders (DSM-5).

Despite this lack of recognition, “excited delirium” helps police absolve themselves of deaths that occur during arrest. Outlets ranging from Mother Jones to Slate to NPR have reported on how this “questionable diagnosis” provides a medicolegal explanation for what otherwise might be considered murder. In the last few months alone, the controversy has gained broader coverage and has been featured on the television news program (and bulwark of mainstream, bourgeois journalism) 60 Minutes. Nearly simultaneously, the paragon New England Journal of Medicine published a critical (albeit guardedly so) editorial about Prude’s death and excited delirium—written by a Black neurosurgeon who works in Rochester and, remarkably, also happens to be a cousin of Daniel Prude.

While these recent critiques are laudable, I couldn’t help but think they still fell short. Focused on proving why excited delirium is not “real,” they missed a broader point: why are diseases like excited delirium manufactured in the first place, and how are cultural beliefs and stereotypes reflected in the process of categorizing, diagnosing, and treating illness? Put another way, surely something suspicious is going on when a bunch of young Black men die suddenly upon encountering the police—whether it’s a “legitimate” clinical syndrome or not. In fact, if excited delirium is, as advocates maintain, a sterile, biochemical process—which remains doubtful—then the phenomenon is still a tragedy. For here are sick people, receiving not a hospital bed and medication but a hogtie and electroshock. Even if we accept the (very) debatable idea that excited delirium is real, it requires compassion and a dedication to better outcomes. For every sickness—manmade or not—has its own narrative, a parable of suffering and diagnosis, and hopefully, triumph.

How Excited Delirium Became ‘Real’

Most histories of excited delirium begin with Luther Bell, a psychiatrist working at the McLean Hospital in Belmont, Massachusetts. During the mid-1800s Bell described what he believed to be a novel presentation of mania and delirium typified by “exceedingly great overactivity; marked sleeplessness…transient hallucinations that border on illusions” which frequently culminated in death of the patient. (The paper’s title, “On a form of disease resembling some advanced stages of mania and fever, but so contradistinguished from any ordinary observed or described combination of symptoms as to render it probable that it may be overlooked and hitherto unrecorded malady,” gives you a good sense of what 19th century science was like.)

It was not until roughly 130 years later, in the 1980s, that a medical examiner in Miami named Charles Wetli revived interest in excited delirium, and launched its modern association with drug use and police interactions. Wetli described a phenomenon of psychosis and hyperactivity, culminating in sudden death, among seven habitual cocaine users, five of whom died while in police custody. His syndromic description took hold and led a handful of researchers, including Deborah Mash, to seek to identify excited delirium’s pathophysiology—the biological and chemical explanation of how it arises. Mash and others posited “chaotic dopamine signalling” and aberrant quantities of proteins in the brain, like heat shock protein 70, as the cause of excited delirium. Although a singular theory has never been promulgated, Mash also proposed that excited delirium’s etiology was tied to changes in kappa opioid receptors as well as an over-expression of alpha-Synuclein, a protein linked to Parkinson’s, in the brain.

On the surface, these findings grant a veneer of scientific rigor and legitimacy to excited delirium. See, these people aren’t just killed by the police, there are distinct differences in their brains! But upon closer inspection, these justifications falter on multiple fronts. First, as Meabh O’Hare, Joseph Budhu, and Altaf Saadi of MGH and Harvard Medical School explain, delirium—which is a legitimate and commonplace diagnosis (just delirium, not the supposed “excited” type)—does not by itself cause rapid death. Delirious patients have a “fluctuating disturbance in attention and cognition, typically provoked by an underlying medical condition such as infection, drug intoxication, a medication’s adverse effects or organ failure” but their condition, crucially, “is not associated with sudden unexpected death.”

Moreover, the two neuropsychiatric conditions which proponents of excited delirium most commonly compare it to—Neuroleptic Malignant Syndrome (NMS) and Malignant Hyperthermia—both have identifiable triggers: antipsychotic medications and anesthetic drugs, respectively. By way of analogy, the only possible “trigger” for excited delirium would be confrontation by the police. And, as O’Hare, Budhu, and Saadi note, the proposed biomarkers of excited delirium are not specific to that condition, repudiating claims to a unique category of illness.

Dubious biochemistry aside, since its forensic debut, excited delirium has also proved diagnostically inaccurate. During the 1980s, over 30 women—all of them Black—were found dead in Miami. Most were sex workers and habitual cocaine users and even though evidence pointed to assault, Wetli, who was then working in Miami as a medical examiner, concluded that they all were killed by a variant of excited delirium relating to sex and cocaine use. As reported in the Miami New Times, Wetli told journalists that the women had died in relation to “a terminal event that follows chronic use of crack cocaine affecting the nerve receptors in the brain” and even more puzzlingly, that “the male of the species becomes psychotic [after chronic cocaine use] and the female of the species dies in relation to sex.”

Despite Wetli’s ludicrous implication that all 32 women had died in the heat of intercourse (!?), by 1992 police had identified a serial killer behind the gruesome murders, revealing the more obvious fact—that marginalized people like sex workers, drug users, and women of color are not only consistently disregarded by contemporary society, but are also routinely blamed for their own victimhood.

Remarkably, Wetli clung to his diagnosis and excited delirium continued to gain traction as industry influences bolstered the shaky diagnosis. As Reuters investigative journalists report in a fascinating series, research into excited delirium got a major boost from a dubious source: TASER International (now known innocuously as Axon Enterprise). In the last several decades, the company has spent millions of dollars on research to defend its eponymous electroshock gun in court, deliberately promoting a nexus of research, law enforcement, and medicine that establishes excited delirium—and not the company’s weapon—as a legitimate cause of death.

Reuters found that excited delirium was:

listed as a factor in autopsy reports, court records or other sources in at least 276 deaths that followed Taser use since 2000…in at least 30 of 128 lawsuits against the company, the condition was cited as a factor, either by Taser, its expert witnesses or municipalities whose police used the weapon. In all but one of those cases, Taser’s defense prevailed…with excited delirium often one plank in the winning legal argument.

It may come as no surprise to some, then, that Taser has paid both Wetli and Mash to appear as expert witnesses in various defense cases.

At this point, proponents of excited delirium like to proffer the condition’s recognition by the American College of Emergency Physicians (ACEP) and the National Association of Medical Examiners (NAME); both organizations, on this point, are in opposition to the other major professional groups in their insistence on excited delirium’s existence.

Yet, it’s now known that at least three of the authors of the ACEP white paper on excited delirium were paid Taser consultants, including Mash and an E.R. doctor named Jeffrey Ho—and that according to Reuters, the trio’s links to Taser were not revealed until two years after the paper’s publication. Ho, who is a physician and police officer in Minnesota, served for many years as Taser’s medical director. In this capacity he was paid hundreds of thousands of dollars to research and travel and teach about excited delirium and the relative safety of Taser guns. In June of 2019, facing sharp public backlash, Ho’s hospital finally terminated the contract that allowed him to serve as Taser’s medical director. As one local official bemoaned, “What hospital has a relationship with, you know, a gun manufacturer?”

As it turns out, the same hospital where George Floyd died.

But what about the medical examiners? Don’t they recognize excited delirium as a real clinical entity? In this specialty, too, Taser exerts its influence. According to Reuters, Taser has on its payroll at least one former president of NAME, and actively sues officials who link deaths to their guns, including an examiner in Indiana and another in Ohio. Accordingly, Amnesty International, in its review of over 300 cases of deaths following Taser use and subsequent industry challenges to autopsy findings, concludes that “medical examiners may be subject to pressure by companies or other entities with an interest in protecting a product or reducing their liability in potential lawsuits.”  

Nevertheless, several high-profile physicians have spoken out against excited delirium, including Werner Spitz, a forensic pathologist who investigated the deaths of JFK and MLK, as well as Paul Applebaum, former president of the American Psychiatric Association. As Applebaum states, excited delirium is a “a wastebasket phrase…a way of explaining what happened without necessarily bearing responsibility for it.” Homer Venters, former CMO of NYC Jails, gets even closer to the inherent frailty of excited delirium as a diagnosis when he notes that, “The most consistent feature of excited delirium deaths seems to be contact with law enforcement.”

Indeed, other than a Taser shock, physical restraint appears to be the only thread linking all excited delirium fatalities—the sine qua non, to borrow from medical parlance (where Latin likes to elevate all discourse.) As a student, I’m encouraged to remember the essential and indispensable condition for a disease, the sine qua non, without which it would not be. You can’t have the seizures of eclampsia without high blood pressure, nor are you likely to have the fevers of malaria without a mosquito bite. So, what about excited delirium? A meta-analysis from 2020 concludes that “there is no evidence to support ExDS (excited delirium syndrome) as a cause of death in the absence of restraint” (italics mine). Rather than an occult pathophysiologic process, the authors suggest “restraint-related asphyxia must be considered a likely cause of death.”

Why the Police Love Excited Delirium

While understanding excited delirium’s murky genesis is important, it is equally revealing to consider how the syndrome is conceived of by those who lean on it the most: law enforcement. Take for instance this description of a typical case of excited delirium, which comes from a police department in Indiana:

…the subjects will generally exhibit extreme strength and most likely will not respond to law enforcement efforts in the area of pain compliance techniques.  Law enforcement will commonly identify these behaviors as an attempt to defeat their efforts for a safe apprehension of the subject.  Eventually, a greater number of law enforcement personnel or a successful application of a CEW (Taser) will most likely allow for an apprehension.  Routinely, the subject might remain in the prone position or be secured in a transport vehicle for a few minutes while law enforcement continues gathering information for report purposes.  In most ExDS incidents, during transport or during the restraint process the individual will suddenly become calm, unconscious, or go into respiratory distress/cardiac arrest.  

In medical school, we are taught to recognize a multitude of “illness scripts:” an array of clinical signs and symptoms which, in concert with a patient’s history and risk factors, can lead us to a diagnosis. Some illness scripts are straightforward. A woman who went hiking in Connecticut and now has a bullseye rash? That’s Lyme disease. Others are a bit more opaque, and have a broad differential. A child with dull, aching bone pain? It depends. It could be an infection, avascular necrosis, perhaps cancer—or something completely benign, like “growing pains.” Such cases warrant further history-taking (When did the pain start? Does anything make it better?) as well as blood tests and imaging.

Unfortunately, such measured analysis doesn’t happen with excited delirium, a syndrome without clear diagnostic criteria or biomarkers, and whose sufferers often die in custody. And apart from the question of how accurate diagnostic constellations are—that is, what percentage of people with X symptoms actually have Y disease, and what percentage of people with Y disease don’t have X symptoms—is the question of what cultural messages our scripts impart.

Lexipol, a private company that provides training manuals and consulting services to thousands of police agencies across the country, offers a primer on excited delirium in which it explains that sufferers are likely to assault officers due to a lack of “remorse, normal fear or understanding of surroundings and rational thoughts of safety.” Lexipol adds that “pain compliance techniques are not likely to be effective as ExDS subjects are often impervious to pain.”

Authors of other descriptions of excited delirium seem to lack even more self-awareness in their role as peddlers of the script of intractable violence and danger. The Indiana police department mentioned above includes among the cardinal symptoms of excited delirium: “unfounded fear and panic…hyperactivity and thrashing (especially after being restrained)…unexplained strength/endurance.” Of course, exhibiting fear and panic in the face of violent arrest and struggling while being forcibly restrained seem to be natural responses, rather than evidence of pathology. And in the context of a literal life and death struggle—the adrenergic system ramped up in “flight or fight”—it is not unreasonable to expect individuals to demonstrate more than normal strength or endurance (e.g., people surviving in the wilderness despite amputation injuries or cases of parents lifting cars off their children—although evidence for such “hysterical strength” is admittedly scant).

The belief on the part of law enforcement that individuals afflicted by excited delirium have exaggerated strength and a diminished response to pain is one of the most striking features of the diagnosis, and perhaps predictably, can be traced to Wetli, who once proclaimed, “It’s as if they’re impervious to pain — to pepper spray, to batons, to numchucks [sic]. You spray them with pepper spray and they just sort of look at you.” It remains unclear why Wetli believed individuals with excited delirium would be impervious to nunchuks, an obscure oriental weapon that despite the increasing militarization of the police would appear to be reserved mainly for YouTube compilations and strip-mall martial artists. Oh wait, nevermind. The cops use them now, too.

Outlandish weaponry notwithstanding, it’s easy to appreciate how an illness script that highlights a supposed lack of response to traditional policing tactics paves the way for dangerous, and potentially fatal, escalations in force. Every disease narrative comes with a concomitant therapeutic repertoire. For the guy with the crushing left-sided chest pain radiating to the jaw—chew an aspirin and head to the E.R. For the kid with intermittent wheezing and shortness of breath—try an albuterol inhaler. Such directives have the ability to affirm the severity of illness (rush him to the cath lab, stat!) or dismiss it entirely (a 24-year old who normally drinks eight cups of coffee shows up on New Year’s Day with a splitting headache and a resolution to kick caffeine cold turkey. Rx: go to Starbucks).

The trouble with excited delirium—whether it’s “real” or not—is that its “therapeutic” directive is one of complete force that simultaneously lays culpability at the foot of the afflicted person. The Journal of Emergency Medical Services emphasizes this point in its description of excited delirium, creating a caricature of a violent, raving menace:

…excited delirium patients will, for no known reason, strike out at objects made of glass. They display what some describe as animalistic behavior by grunting, groaning and exhibiting strength that seems superhuman. They aren’t actually stronger; rather, they don’t recognize the implication of any painful stimulus. This includes CEDs, pepper spray and physical compliance holds.

Again, official descriptions of excited delirium prove unabashedly dehumanizing. And while Lexipol contends that those with excited delirium are “remorseless,” it is actually the officers, fed an overwhelming narrative of pain imperceptibility, who are empowered to feel no guilt. Don’t feel bad about shocking and body slamming that guy—he couldn’t even feel it.

Those who defend excited delirium’s clinical veracity—particularly within the medical profession—would be wise to consider the narrative they are peddling. If it is a real clinical syndrome, then why not treat it as such? With treatment comes compassion and a willingness to heal, to see people as patients rather than perpetrators, and the ability to refrain from vindictiveness and proactive strikes.

Here then I may break rank with some who criticize police brutality by contending that it is not the sadism of individual officers that enables episodes of extreme violence—at least, perhaps, not in the case of excited delirium—but the prevailing pseudo-medical rhetoric relating to pain. The sheer universality of the claim that those with excited delirium have a heightened if not infinite tolerance for pain, and the doggedness with which it is preached, from manuals to all manner of online police training videos, exposes, I believe, a subconscious discomfort with the tactics being used, and a need for a buffer on conscience.

Excited Delirium and the Question of Pain

In an episode of the popular Netflix series Black Mirror, a soldier discovers that the zombie-like humanoids that he has been hunting and killing (nicknamed “Roaches”) are actually human beings, their faces and voices transmogrified into grotesque monstrosities and awful howls by a neural implant placed surreptitiously in each soldier. If an analogy to pop culture is allowed, excited delirium—or rather, the medical mythology that surrounds it—serves in our society as the neural implant: a gimmick without which we would be unable to tolerate our own atrocity. As Mark Greif writes in his essay Seeing Through Police, “The restraints in civilization on attacking anyone, especially a citizen who portends no harm or threat, are fairly high. For most forms of violence that breach civilized norms, even if it is one’s art or profession, steps of habituation are needed.” Imbibing the legend of excited delirium, a narrative of irrevocable insanity and subhuman sensation, is for many, a first step in habituation to violence.

History offers examples, too numerous to count, of how (pseudo)science, with its connotations of impartiality and inevitability, permits extreme cruelty, namely by telling us, “That is how they are.” And in the case of excited delirium, “This is how they must be handled.”

At the same time, it doesn’t take a Ph.D. in critical race theory to appreciate the tropes at play in institutional descriptions of excited delirium. Emphasizing “superhuman strength” and the ability to “overcome multiple officers,” the literature around excited delirium hearkens back to the myth of the superpredator. Perpetually conflating drug use and violence feeds into the same moral panic that fueled the War on Drugs. In almost every way, the ritualized description, diagnosis, and management of excited delirium—the unpredictable, wild threat that needs to be forcefully subdued—evinces characteristic anxieties about Black bodies that have shaped American culture, politics, and criminal justice since our country’s inception.

In particular, the question of pain—who can and can not feel it—has a troubled history in medicine, which undoubtedly imbues the modern conception of excited delirium. As Linda Villarosa details in New York Times magazine, white physicians have long believed that Black people are not as capable of feeling pain, a conclusion which for many years supported not only slavery, but the practice of outright medical experimentation on people of color. Villarosa cites, among others, the work of Dr. Benjamin Moseley, a British physician who proudly described his experiments on racial discrepancies in perception of pain in 1787: “What would be the cause of insupportable pain to a white man, a Negro would almost disregard.” He continued, “I have amputated the legs of many Negroes who have held the upper part of the limb themselves.”

Moseley’s writing has disquieting parallels with Wetli’s, as both men describe with frank, almost cheerful prose, how individuals can tolerate what seems surely impossible—post-amputation stoicism or unflinching eyes in the wake of pepper spray. And though doctors might have (mostly) evolved beyond such insensitive pronouncements, the question of how to judge and treat pain remains particularly difficult for those in medicine, leaving plenty of room for implicit (and explicit) bias to run free [1]. As Villarosa and others have pointed out, Black patients’ descriptions of pain, in many medical contexts, are still rated less seriously and treated less meaningfully by providers. Most embarrassingly to me as a student, outdated beliefs in physical differences relating to pain perception—the same myths that were first proposed in the era of Moseley—continue to abound. A recent survey revealed that nearly 40 percent of first and second year medical students endorsed a false statement like “black people’s skin is thicker than white people’s” or “black people’s nerve endings are less sensitive than white people’s.”

Perhaps the most appropriate historical parallel for excited delirium, then, is Drapetomania—a once-proposed “mental illness” that sought to explain why Black slaves ran away from their masters. Initially described by Samuel Cartwright, a physician who practiced in the antebellum South, Drapetomania was suggested to be the mental derangement that led wayward slaves to seek liberation; for prophylaxis, Cartwright unironically suggested whipping [2].

Although Cartwright’s proposed clinical syndrome seems laughable today (someone runs for freedom and they called that Drapetomania?), I wonder whether future generations will look at contemporary defenses of excited delirium in the same light (someone was killed by the cops and they called that “excited delirium”?).

I’m cautious about disregarding a purported clinical entity like excited delirium just because it appears at first glance improbable and its pathophysiology may not be fully elucidated. We don’t know why exactly some people are stricken with inflammatory bowel diseases (IBD), although as anyone suffering from daily bouts of abdominal pain, cramping, or bloody diarrhea can attest—it is very much real.

However, when a disease category is unbelievable, has a murky explanation, and seems to exist to exculpate police officers and a shock gun company, we are warranted to raise our eyebrows. Some who take a critical stance toward the medical diagnostic schema contend that an increasing “medicalization” of life has been pushed to service the bottom line of pharmaceutical corporations (e.g., an explosion in the diagnosis of depression, or sleep problems, or even obesity—which now can all be treated with a pill, rather than say, talk therapy, better sleep hygiene, or more exercise). While there is undoubtedly some truth to this argument, in all of these cases there existed at least an a priori substrate for the pathology—some suffering on the part of people that brings them to their doctor. And even when they are sold pills, these potions have at least the intention of cure. No one comes to their doctor saying, “I’m agitated and unruly and violent, can you please choke me or taser me to death?”

Nosology—the field of medicine dedicated to categorizing disease—is like all other human enterprises in that it is informed by our virtues and vices, prejudices and stereotypes. And while Drapetomania and excited delirium represent the use of diagnosis as a means of oppression, it’s worth mentioning that withholding disease recognition can also adversely affect disenfranchised groups. For example, consider fibromyalgia and chronic fatigue syndrome, both of which are poorly understood conditions that predominantly affect women. It took significant effort and much too long for the medical establishment to recognize these disorders, although this is slowly starting to change. Similarly, posttraumatic stress disorder (PTSD) was only formally recognized by the medical community in 1980, despite having been described since at least the time of Gilgamesh.

While it’s doubtful that excited delirium is a “real” disease in the conventional sense, it would perhaps prove helpful to conceive of the social milieu from which it arises as one. Last year, many in my profession began to call systemic racism a “deep-rooted disease” and a “public health crisis.” The skeptic eyerolls at virtue signaling. Yet the optimist thinks that maybe this is the way to move forward, to make progress the only way we know how. If calling the structural forces that give rise to excited delirium a disease is what it takes to finally address them, then perhaps that’s a medicalization of everyday life we should be willing to accept.

When approached with benevolence, and not as a tool of oppression, formal recognition of illness can be incredibly salubrious for those suffering: it gives a name to their struggle, it provides a sense of relief in discovering others who share their burden, it opens doors to government and private research, and it begins the quest for an underlying etiology, treatment, and hopefully cure. Those who stand by the “diagnosis” of excited delirium, invoking a facade of science and biology—Tasers (and sometimes nunchuks) at the ready—would be wise to remember another bit of Latin that lies at the core of modern medicine: primum non nocere. First, do no harm.

[1] Leaving aside racial disparities, pain continues to be an inscrutable malady for the medical profession. Some of the most basic questions still remain, like, what exactly is pain anyway? For several decades, at least, it has been known that pain is not just based in anatomic derangements, but can be influenced and

exaggerated by stress, mental anguish, and sociocultural factors.

Importantly, given a general sentiment that pain had been “undertreated” for much of the 20th century, a

crusade

was begun in the beginning of the 21st to recognize and medicate pain—it became “the fifth vital sign.” Some people attribute an ensuing overzealousness in managing pain, particularly with potent narcotics, as a driving force behind what would become the opioid epidemic. Pendulums swing, back and forth.[2] Cartwright also mused on

Dysaesthesia aethiopica

, a supposed state of mental laziness or “rascality” that afflicted Black Americans and opposed the adoption of the germ theory of disease. Needless to say, none of his theories have aged well.

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'Loose Women' Sparks Backlash Over Comments During Trans Debate

‘Loose Women’ Sparks Backlash Over Comments During Trans Debate

‘Loose Women’ is facing a backlash after the panellists made a series of  controversial comments during a debate about trans people. 

Friday’s show saw Andrea McLean, Nadia Sawalha, Stacey Solomon and Gloria Hunniford discuss the recent NHS row that came after a Telegraph investigation revealed that those who self-identify as female have been allowed to stay on women-only hospital wards. 

Despi…

[integrativeaddiction]

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[night-wyld-system]

The thing is he should absolutely have his license revoked or at least get in major trouble because it’s a huge HIPPA violation

EXACTLY. Additionally it is scary to know somebody who is capable of violating the consent of others to that magnitude would be a doctor of any kind. Who's to say he would further violate the consent of his patients? I would be terrified if he was my therapist. Somebody who fails to recognize boundaries has no business in medicine and should not be involved with it. That man is actively a danger and I doubt any of his patients are getting proper treatment given he SHAMES signs of fucking healing.

- Blaize

Edit: Not HIPAA violation, but still fucking rebrehensible and disgusting and we wouldn't touch that creature with a ten foot pole. People like him and especially those who defend him are literally what caused me to split. Slanderers and those who support the slander and side with the slander. We will not budge, stop trying to fucking change our morals.

Nyx.

[the-end-of-art]

Ended loneliness

From Mary Karr Names Names by Nina Puro at The Fix

Karr teaches in the Creative Writing Program at Syracuse University, where I once took a memoir class with her. On the first day she got in a huge spat with the program director, who came in and told her she was in the wrong classroom. They traded some choice barbs and he walked out. Then she broke character and told us to write down everything that happened—it had all been an act. The class argued long and hard about whether he was wearing pants or long shorts, and the exact wording of the final insult. Our recollections of such a recent event, as well as our personal reactions, varied wildly. The exercise demonstrated how inaccurate memoir is. Karr gave The Fix a chance to see if interview can do any better.

The Paris Review called you “surprisingly diffident when it comes to talking about [your]self.” Have meetings and therapy helped you become more comfortable with that?

Everything I wanted people to know I’ve already presented, and in some ways I’m more candid in talking about myself than I was before. When you surrender, you get used to a certain level of candor—you know, the old thing, you’re only as sick as your secrets. You develop a confidence in truth-telling. Part of my drinking was so much about trying not to feel things, to not feel how I actually felt, and the terrible thing about being so hidden is if people tell you they love you…it kinda doesn’t sink in. You always think, if you’re hiding things, How could you know who I am? You don’t know who I am, so how could you love me? Saying who I am, and trying to be as candid as possible as part of practicing the principles, has permitted me to actually connect with people for the first time in my life. It’s ended lifelong exile.

They always say God is in the truth, and I’ve ended loneliness and been able to feel connected by saying who I am and how I feel. I’m sort of comfortable to the degree to which I’m an asshole. It’s not like I’m not an asshole—people know the ways I’m an asshole and it’s within the realm of acceptable asshole-ocity. Part of my drinking and depression was having a voice in my head that was constantly criticizing everybody. I was sort of brought up that way, hypercritical, and I feel like my spiritual practice is a constant correction out of judging everybody else. But I think I’m more critical of myself than anybody, strangely enough, as marvelous as I am.

It’s generally agreed that the enormous success of The Liars' Club spurred a lot more confessional memoirs. But since then, there’s also been a trend in other media to broadcast people’s deepest secrets in a way that’s often seen as exploitive. What do you think about shows like Intervention and so on?

I think the problem with visual media like TV is that they’re reductive. They don’t show the psychological complexity, the real struggle and practice of what it is to have to give up the substance. I think Dr. Drew should be shot. I really do. That guy...small wonder that everybody who’s on 'Celebrity Drug House' or whatever it is would like to blow their fucking brains out. He seems like the most malevolent—I’m sure he means well, I’m sure he has benevolent impulses—but he seems so insincere and exploitative. And also, being told, “Oh yes, you are special because you’re a celebrity and trying to get sober”… I think those shows, especially with celebrities, are awful, and that’s why anonymity is important: Nobody should be a spokesperson. I’m not an example of anything, and the best way to learn about how to quit drinking is to spend a lot of time talking one-on-one with people who have done it.

James Frey is another famous memoirist and addict—a highly controversial one. Do you want to share your opinion of him, or should I nix that question?

No, no, go ahead. He was the guy who wanted nothing to do with AA—and look how well you turned out, you lying sack of shit! I felt sorry for that guy for a while and then when he started that thing—let’s rip off young people and exploit them—that thing he’s doing is just...really reprehensible, I don’t quite understand it.

If we can talk about your relationship with David Foster Wallace in the early ‘90s—did you get sober together?

He was in rehab and we’d met through friends; he was in rehab down the street and I lived in Belmont, Mass., which is where McLean [Hospital] is. When he got kicked out of Harvard they slam-dunked him in McLean, where I’d eventually do a happy little stint. One of the Whiting fellows said, "Can you contact him?" So I brought him a batch of brownies. I thought it was super sweet that they did that. I was about a month clean; his sobriety date was about a month after mine. So we ran into each other a lot. He was in a halfway house where I did volunteer work. I would drive people to job interviews and stuff like that; there were a lot of disabled people, people who only had one hand or whatever. Everybody there had to have a job and I drove a lot of people around. So I saw him there quite a bit, and we had a lot of mutual friends, many of whom ended up in Infinite Jest in a way I thought was…I really thought was unkind.

I remember you saying how a lot of Infinite Jest was lifted straight from meetings, despite the anonymity tradition. But some would say storytelling is always plagiarism, and maybe his book did people good; where’s the line?

Yeah, I thought it was pretty awful. Another person who does that is Augusten Burroughs. Everybody I ever wrote about, including David, I talked with in advance and said, “This is what I wanna do.” I talked to David before… I wasn’t going to use his name, then after he died, I’d talked to him before he did it and included him enough that I was gonna give him a pseudonym—which he said he didn’t care about, but nonetheless…then he was dead before the book came out. Tragically, stupidly...moron. Moron.

How much do you think his addiction or sobriety had to do with his death [by suicide in 2008]?

David had tried to kill himself three times before that, so you can’t slap that on it. I think being sober kept him alive way longer than he would have made it otherwise. But he wasn’t exactly sober by my measure: He was taking lots of anti-anxiety meds and stuff I consider chemically no different, so I don’t know exactly. I wasn’t in touch with him the last six months of his life. Such a tragic thing. And you know, I don’t know his wife but it seems like such a nasty fucking thing to do. Here’s this woman who’s been trying to take care of you and…I guess I could’ve imagined myself in that situation too easily, and I wouldn’t have been as nice about it as she was. I was lucky I wasn’t, I guess, but damn.

I think we kept each other alive to some extent, for a period of time when we were trying to quit using and it was all but impossible for each of us to do that. And I think our friendship and sobriety was important to both of us. I told him a lot of things about how he was writing. Everybody was very in awe of him because he was so much smarter than everybody. I’d been living in Cambridge where everybody was smarter than everybody, and I’d sort of decided that smart wasn’t that big of a deal. Not that it’s not a great advantage, but in his case I think it was a great disadvantage.

There’s this idea of the tortured artist, or of a link between depression and creativity—is that true and necessary? If so, how do you make meaningful art after recovery, if you’re no longer tortured?

Well, I don’t know, maybe you don’t. I’ve been sober almost 25 years and anything anyone’s ever bought from me has been written when I was sober. If I hadn’t been, I would’ve been like David, swinging from a fucking noose. That really cuts down on your creativity. [Laughs]

When I was super depressed, I wasn’t working—I was always too depressed. Hemingway did his best work when he didn’t drink, then he drank himself to death and blew his head off with a shotgun. Someone asked John Cheever, “What’d you learn from Hemingway?” and he said “I learned not to blow my head off with a shotgun.” I remember going to the Michigan poetry festival, meeting Etheridge Knight there and Robert Creeley. Creeley was so drunk—he was reading and he only had one eye, of course, and had to hold his book like two inches from his face using his one good eye. But you look at somebody like George Saunders—I think he’s the best short story writer in English alive—that’s somebody who tries very hard to live a sane, alert life.

You’re present when you’re not drinking a fifth of Jack Daniel’s every day. It’s probably better for your writing career, you know? I think being tortured as a virtue is a kind of antiquated sense of what it is to be an artist. It comes out of that Symbolist idea, back to Rimbaud and all that disordering of the senses and all of that being some exalted state. When I’ve been that way, I’ve always been less exalted than I would have liked.

So in the beginning you said you weren’t going to talk about AA. I was planning to ask whether you still go to meetings or have a sponsor. Should I nix that?

Well, I guess what I would say is, I always talk to people who are trying to stay sober and trying to have some kind of connection or community. And I spend a lot of time talking to young women with little kids who were trying to quit drinking, because when I was a young woman with a little kid and I was trying to quit drinking and a single mom, it was so hard; I was so deranged. So I feel an obligation to be of service. And there were people who helped me and talked to me and talked to my kid, who made places in their lives when I was so isolated—I want to be available to them— to any woman I have time for who is raising a kid and trying to quit drinking, I want to be available to them. So I guess I’d talk to that with that amount of a fig leaf.

I’m going to Michigan this week to talk to women at an organization that runs domestic violence shelters for women who are in violent relationships and struggling with addiction, or their partners are.

Do you think some people have addictive tendencies that both precede and outlast active use: the “addictive personality”? I’m thinking, now, about your habit of coming into class with two giant Wegmans green teas, and the gregarious ferocity with which you approach your students, and any conversation, which kinda scares people sometimes...

Oh, yeah! I would snort all the coke and kiss all the boys—if I could live on Ho-Hos, Jack Daniel’s and pharmaceutical cocaine, I would (and not blow my brains out, ‘cause that’s exactly what I’d do). I have a completely addictive personality. Diet Coke is my last—God, I know people counting days off Diet Coke; I’m such a Diet Cokehead. Now I won’t let myself buy it. I’m sorta like the girl who only gets coke from boys—at parties I let myself have a Diet Coke with lime and it’s exactly like snorting a line. If a bomb goes off, I’m getting a carton of Marlboros.

There’s a notion of your being and celebrating the pistol-packing outlaw—a very Texan lack of adherence to convention—which addicts often resemble. But in recovery, the idea of surrender, of adherence to rules, is something people have to learn. How have you managed?

I used to think of it as an adherence to rules, and the really horrible thing about quitting drinking is, I think, inside my mind I was so divided against myself. Nobody really talks about what happens to you and your level of self-confidence when you tell yourself every fucking day you’re going to drink X, and then you drink 10 times that—or you’re not going to drink at all and you drink anyway. You become very split off against yourself. So there was a part of me that would yell and scream and say, “You stupid bitch, goddamnit, you said you weren’t gonna drink and you drank anyway.” And there was this other part that was like “Fuck those people! Fuck the rules!” you know, blah blah blah…

You assume that when you quit drinking, you’re surrendering to that kind of nasty schoolmarm rule-maker. But for me getting sober has been freedom—freedom from anxiety and freedom from…my head. What has kept me sober is not that strict rule-following schoolmarm. There’s more of a loving presence that you become aware of that is I think everyone’s real, actual self—who we really are.

Blake said, “...we are put on Earth a little space / That we might learn to bear the beams of love.” And I think, quote-unquote, “bearing the beams of love” is where the freedom is, actually. Every drunk is an outlaw, and certainly every artist is. Making amends, to me, is again about freedom. I do that to be free of the past, to not be haunted. That schoolmarm part of me—that hypercritical finger-wagging part of myself that I thought was gonna keep me sober—that was is actually what helped me stay drunk. What keeps you sober is love and connection to something bigger than yourself.

When I got sober, I thought giving up was saying goodbye to all the fun and all the sparkle, and it turned out to be just the opposite. That’s when the sparkle started for me.

(https://www.thefix.com/content/mary-karr-liars-sober91684?page=all)

[sophieinwonderland]

https://www.tumblr.com/sophieinwonderland/712975033767804928/hey-sophie-regarding-the-recent-controversy

could you put a /j for the ending paragraph? sorry, thanks!

Maybe an /hj?

Like, I have seen multiple posts I've made get twisted and attacked by anti-endos who then turn around and praise other anti-endos for saying the same exact things.

I really do get the feeling that a lot of anti-endos are so caught up in the hate of endogenic systems that their hate matters more to them than actually supporting traumagenic systems, and that the mainstream anti-endo blogs would feel more comfortable posting about the controversy if pro-endos were on the other side and they could get a "win" on us.

I don't think we could get them to sign this petition, for instance, if only because the petition is made by The Plural Association.

This should not be a pro-endo/anti-endo thing. Fakeclaiming systems like was done here shouldn't be okay or justifiable to anyone. But I don't think the anti-endo community has the maturity to divorce the message from the messenger, which is why I have zero intention of posting about this in any anti-endo tags or reaching out to their community, as it will most likely just cause blowback if it's coming from me. 🤷‍♀️

[thedeadshotnetwork]

10 things you need to know today: November 20, 2017 1. Charles Manson, the 1960s cult leader convicted in one of the most infamous murder sprees of the 20th century, died in a California hospital Sunday of natural causes. Manson, who was serving nine life sentences, was 83. Members of the so-called Manson Family started the bloody killings on Aug. 9, 1969, at the home of actress Sharon Tate and her husband, director Roman Polanski, who was out of the country. Tate, who was eight months pregnant, and four others were killed. The next night, Manson followers killed supermarket executive Leno LaBianca and his wife, Rosemary. The murderers wrote "death to pigs" and "Helter Skelter" on the walls in victims' blood. Manson, who wasn't present during the murders, was convicted as the mastermind. Prosecutors said he had hoped to start a race war. 2. Zimbabwe's longtime president, Robert Mugabe, unexpectedly refused in a Sunday night speech to say that he would resign, although CNN reported Monday that he had agreed to an exit deal . Mugabe, who was placed under house arrest along with his wife, Grace, last week, acknowledged problems under his 37-year rule, saying, "The era of victimization and arbitrary decisions" must end. He said, however, that he would preside over a governing party congress in a few weeks. Experts questioned whether he could do that. Hours before his address, leaders of his party, ZANU-PF, told him to resign by Monday or face impeachment by Parliament. The deadline passed with no announcement, although CNN said he had accepted the terms of his departure, including immunity for him and his wife. 3. A U.S. Customs and Border Protection agent died Sunday after he was injured while on duty in Texas , the agency said in a statement. Rogelio Martinez, a 36-year-old from El Paso, and his partner were injured after responding to activity in the Big Bend area. A Border Patrol spokesman said he could not disclose what happened to the agents, although an FBI agent said they were "not fired upon." Martinez died in the hospital, and his partner, whose name has not been released, remains in serious condition. Authorities are searching for suspects and witnesses. President Trump reacted with a tweet linking the incident to the need for tightening the border. "We will seek out and bring to justice those responsible," he wrote. "We will, and must, build the Wall!" 4. President Trump's budget director, Mick Mulvaney, said Sunday that the White House would not insist on repealing the ObamaCare health insurance mandate in the GOP's tax overhaul if opposition to the measure threatened to sink it. "If it becomes an impediment to getting the best tax bill we can, then we are OK with taking it out," Mulvaney said on CNN's State of the Union . The Senate version of the bill currently includes a provision repealing ObamaCare's individual mandate, but some Republicans object. "I don't think that provision should be in the bill," said Sen. Susan Collins (R-Maine). "I hope the Senate will follow the lead of the House and strike it." 5. The U.S. military banned all of its personnel in Japan from drinking after a Japanese driver was killed in a Sunday collision with a 21-year-old Marine whose blood-alcohol level reportedly measured three times the legal limit. Police on the southern Japanese island of Okinawa arrested the Marine, Nicholas James-McLean, on suspicion of negligent driving resulting in injury or death and driving under the influence of alcohol. The accident was expected to stoke opposition to the already-controversial presence of 25,000 American troops on Okinawa, where there have been previous complaints of crimes and crowding involving U.S. soldiers. All U.S. personnel on Okinawa were ordered to stay on base or in their homes. 6. Talks on forming a coalition government collapsed overnight in Germany, leaving Chancellor Angela Merkel struggling Monday to contain a potentially crippling crisis. Inconclusive elections had left Merkel's conservatives struggling to form an awkward and unprecedented coalition with the pro-business Free Democrats and the environmentalist Greens. The Free Democrats pulled out shortly before midnight, ending weeks of talks over immigration, tax, and environmental policies. Merkel now faces a menu of unappealing options, including new elections, forming a minority government with the Greens, or trying to persuade her partners in the last government, the center-left Social Democrats, to form a new coalition, something they have ruled out. 7. Former Chilean President Sebastián Piñera won the first round of the election to succeed President Michelle Bachelet on Sunday, but not with a margin big enough to avoid a run-off against center-left journalist Alejandro Guillier. Piñera, a 67-year-old conservative billionaire, received 36 percent of the vote, while Guillier got 22 percent. Another journalist, political newcomer Beatriz Sánchez, came in a close third with 20 percent representing the new leftist coalition Frente Amplio. Candidates from Frente Amplio also picked up a significant number of seats in Congress, signaling that the two major coalitions that have governed Chile since military rule ended in 1990 will have to share power with a new force starting next year. 8. The five-member Nebraska Public Service Commission is scheduled to decide Monday on whether to approve the final major permit for the proposed route for the Keystone XL pipeline through the state. The regulator's ruling could influence pipeline-operator TransCanada Corp.'s decision on whether to move ahead with construction of the long-delayed project. Some businesses and the Trump administration favor the project, calling it a job creator, but environmentalists and some landowners along the route oppose it. Commission members will not be able to consider last week's oil spill from the existing Keystone pipeline as they weigh the new pipeline route. 9. President Trump reacted sharply Sunday after the father of one of the three UCLA men's basketball players arrested for shoplifting in China suggested that Trump had overstated his role in getting them released. "Now that the three basketball players are out of China and saved from years in jail, LaVar Ball, the father of LiAngelo, is unaccepting of what I did for his son and that shoplifting is no big deal," Trump tweeted. "I should have left them in jail!" Trump has said he personally brought up the case to Chinese President Xi Jinping. LaVar Ball had rejected Trump's claim that he helped, telling ESPN, "What was he over there for? ... Everybody wants to make it seem like he helped me out." 10. Actor Jeffrey Tambor announced Sunday he will be leaving Amazon's Transparent , after two members of the show's crew said he sexually harassed them. "Playing Maura Pfefferman on Transparent has been one of the greatest privileges and creative experiences of my life," he told Deadline . Because of the "politicized atmosphere that seems to have afflicted our set," he added, "I don't see how I can return to Transparent ." Tambor said he apologizes if any of his actions were ever "misinterpreted by anyone as being aggressive," but called "the idea that I would deliberately harass anyone…simply and utterly untrue." Amazon is investigating the allegations. November 20, 2017 at 01:18PM

[lindamcsherry]

Heart Stents Do Not Ease Chest Pain, Study Warns

Although heart stents are widely used nationwide, new research suggests that they may not be effective in easing chest pain for heart patients who receive the devices for just that purpose. 

Researchers from the U.K. published a study in the medical journal The Lancet on November 2, which raises serious questions about the effectiveness of heart stent procedures, known as percutaneous coronary intervention (PCI).

The study found that, while the heart stents did help alleviate blockages and improve blood flow through clogged arteries, there was no difference in reports of pain relief between those who were given a heart stent and those who were not.

The research involved a blind-fed, multi-center randomized clinical trial involving 230 patients with angina. All were given six weeks of medication and then some were given a real stent and the others underwent part of the procedure but had no actual stent implanted. The researchers followed up with the patients for six weeks after the procedure.

According to the findings, those who received the heart stents showed significant improvements in the blockages. However, there was no significant difference in reports of pain and the ability for either group to exercise.

“In patients with medically treated angina and severe coronary stenosis, PCI did not increase excercise time by more than the effect of a placebo procedure,” the researchers concluded.

In an accompanying editorial, Dr. David L. Brown of Washington University School of Medicine and Dr. Rita F. Redberg of the University of California San Francisco questioned whether the study may bring an end to the use of heart stents for stable angina.

The editorial points out that a number of studies have questioned the effectiveness of heart stents in these types of patients, but that did not stop them from being aggressively marketed and implanted in patients who may not benefit.

“Despite numerous subsequent randomised trials and meta-analyses of these trials, which have shown no reduction in death or myocardial infarction, the use of percutaneous coronary intervention (PCI) has grown exponentially,” they noted.

Stent Profits May Lead to Abuses

Concerns have emerged in recent years over the increase in use of coronary stents, with many reports suggesting that doctors and medical providers may be putting their own financial interests before the interests of patients when recommending heart stent placement.

According to a 2011 study published in the Journal of the American Heart Association (JAMA), it was estimated that 15% of all stent operations were likely unnecessary.

The coronary stent business rakes in big bucks. From 2002 to 2012, the 7 million coronary stent operations in the U.S. cost about $110 billion.

Some say that the lucrative money linked to coronary stents have also led to illegal activity. A number of hospitals and doctors have been investigated, and in some cases fired or even jailed, for implanting unnecessary stents in unsuspecting patients, who were lied to and told their lives were at risk.

In late 2009 and early 2010, Maryland’s St. Joseph Medical Center sent letters to more than 600 former patients of Dr. Mark Midei, informing them that a review of their medical records demonstrated that they may have received a stent that was unnecessary. Midei was stripped of his license to practice medicine in Maryland, fired from the hospital and faced hundreds of lawsuits over unnecessary stents.

Stent procedures, which are designed to prop open arteries that are significantly blocked, can cost $10,000 or more. Typically, most experts agree that a patient should have at least a 70% artery blockage for a stent implant to be necessary, and many patients have reported being told that they had blockages over that amount, but a subsequent review of records from the procedure found blockages that were well under 50%, which is generally considered “insignificant.”

The investigation into Midei’s activities revealed that Abbott Laboratories, the makers of the coronary stents he was using, lavished him with gifts, including holding a pig roast at his house. When the controversy over his procedures broke, the company spirited him away to Japan in the hopes that he could keep on promoting their coronary heart stents while the investigation continued.

Another Maryland doctor, John R. McLean, was ultimately sentenced to eight years in prison for unnecessary coronary stent procedures in a case where the judge said greed clearly played a factor. A Louisiana doctor got 10 years in 2009 in a similar case. During his trial, attorneys argued that his crimes were actually the industry standard.

The post Heart Stents Do Not Ease Chest Pain, Study Warns appeared first on AboutLawsuits.com.