“Politicized science is an inevitable part of
the human condition, but society must strive to control it. Although history
shows that politicized science does much more damage in totalitarian societies
than in democracies, even democracies are sometimes stampeded into doing very
foolish and damaging things." – William Happer, Harmful Politicization of Science in Politicizing Science: The
Alchemy of Policymaking
When I was a kid, I walked five blocks a day back and forth
to primary school and kindergarten for the first seven years of my schooling. I
got to know the people along that route very well. In those days in a small
town people looked out for you when you were a kid. They offered you things to
eat and you knew it was safe to eat. You
got to know their problems. They told me
about being gassed in World War I and never getting over it or drinking a pint of gin a day for thirty years and then stopping. Some were engaged in behaviors that were
difficult to explain such as laughing uncontrollably or making statements that
seemed to be directed to you but that did not make any sense. Other people told me about their neighbors having alcoholism or having undergone shock treatments.
There were adults with developmental disabilities. I visited several families
with my parents and I can remember witnessing shocking behavior in those
private residences - shocking for a kid but not so much for a psychiatrist. Plenty of shocking events happened right at my own home. That was my neighborhood as a kid and I lived
there a long time.
Over the next four decades, I have thought a lot about my
old neighborhood from time to time. The most frequent thought I get is how
common psychiatric disorders are and how they are easily recognized by most
people in your neighborhood. The second
most frequent thought I get is how there was nearly a complete lack of professional help for
people with those problems. There was an extremely high threshold for
assistance and when that threshold was met people were often sent hundreds of
miles away to institutions until they recovered or remained in those
institutions on an indefinite basis. Some
of these institutions doubled as sanatoriums for the mentally ill and patients
with tuberculosis. My aunt was a nurse in one
of those places and was assaulted. I can
remember thinking: “Why would somebody with TB attack her?”
My mother had severe bipolar disorder, and was treated for
years with tricyclic antidepressants by her family physicians. She eventually
was able to see a psychiatrist and got more appropriate mood stabilization, but
only after decades of mood instability. My
father seemed very depressed and lethargic. He probably had obstructive sleep
apnea, a condition that psychiatrists routinely screen for these days but back
then it was unknown. I found him dead one morning when he was 42 years old. Medical treatment in general was pretty bad in those days. Treatment for mental illness and access to psychiatry was practically nonexistent.
There was no DSM when I was walking back and forth from
school. And yet the people with mental illnesses who were impaired were obvious to most people. That consensus was
necessary, because their neighbors knew that they had to be more patient and
kind based on those problems. They knew they had to keep children from teasing or ridiculing these folks and teach them how to treat the disabled. Some of
our neighbors who interacted with my mother were incredibly tolerant at all
hours of the day or night. I don't know where I would have ended up without that level of assistance and recognition that there was a huge problem. I think that level of common sense prevails
today and is the basis of studies that look at whether or not psychiatric
disorders are considered to be "diseases" by most people. Those survey
studies generally show that most people view severe mental illnesses and addictions as diseases. The idea that there is no such thing
as a psychiatric disorder, forms the basis of anti-psychiatry rhetoric, but it
is not rooted in reality or common sense. The average person on the street does not need a DSM to detect mental illness.
The reality of psychiatric disorders and their treatment is
really the focus of this blog. It is
something I have been focused on since before I became a psychiatrist. Psychiatry is the most politicized and
maligned medical specialty. It is rarely covered in an objective manner by the
media. It has been manipulated by businesses and the government for their
mutual advantage. It is the only specialty where there are significant profits made from continuously criticizing every aspect of the discipline. It has few rational and fewer effective advocates.
I continue this blog with those thoughts and the memories of
my old neighborhood in mind and wish any readers here a Happy New Year.
