Bob Schwartz

Category: Health

American Pandemic: “There’s a way to lose more slowly.”

Out of the Past (1947) is the best of all American film noir movies. It contains dozens of lines memorable and quotable, dialogue suffused with fatalistic wisdom.

Jeff and Kathie are at a roulette table. She is losing.

JEFF: That isn’t the way to play it.

KATHIE: Why not?

JEFF: Because it isn’t the way to win.

KATHIE: Is there a way to win?

JEFF: Well, there’s a way to lose more slowly.

The lives of Americans are in the hands of a loser. At this point in response to the pandemic, it isn’t clear exactly what “winning” means, but it is for the moment out of reach. What remains is for the man at the roulette table to figure out is how to lose more slowly.

Spoiler alert: At the end of Out of the Past, both Jeff and Kathie are dead. It is after all film noir.

Do not inject chicken soup to cure COVID-19, even though it does ease symptoms of a cold

Scientists don’t believe that chicken soup can cure a cold. But they admit that chicken soup can help ease the symptoms, including congestion. Plus, it’s delicious. So it couldn’t hurt to eat it.

But that in no way suggests that injecting chicken soup is recommended as a cure or preventative for COVID-19. It should not be necessary to say this, but given the dangerous misinformation that is current:

Do not inject chicken soup, for COVID-19 or for any other reason.

After the Virus: To seek a newer world

We do not and should not like paying the tragic price the Virus is demanding. But the current catastrophe, so far from over, does offer an opportunity to review, revise and, in some areas and in some ways, to begin again.

I’ve written before about the leaders I miss. No one more than Bobby Kennedy. He was a hard-nosed pragmatist and an idealist, a lover of literature and poetry. He frequently quoted the poem Ulysses by Alfred, Lord Tennyson. It is the tale of an old warrior who fights the urge for ease and comfort, and sets out one more time to pursue a dream. The poem closes:

…Come, my friends,
‘T is not too late to seek a newer world.
Push off, and sitting well in order smite
The sounding furrows; for my purpose holds
To sail beyond the sunset, and the baths
Of all the western stars, until I die.
It may be that the gulfs will wash us down:
It may be we shall touch the Happy Isles,
And see the great Achilles, whom we knew.
Tho’ much is taken, much abides; and tho’
We are not now that strength which in old days
Moved earth and heaven, that which we are, we are;
One equal temper of heroic hearts,
Made weak by time and fate, but strong in will
To strive, to seek, to find, and not to yield.

You don’t miss your water till your well runs dry: Learning the need for personal contact in a social media world

Social media began as a supplement to other media and social life. Social media came in some domains to dominate.

Some have observed that social media are out of balance, supplanting personal face-to-face. An emblematic modern picture shows people sitting around the same dining table, each one with a phone in front of them, busily “talking” to someone else not present.

Right now, in large parts of America and the world, that gathering of friends and family is a memory. Social media is the primary, to some extent only, means of mingling and gathering, whether for personal relations or for business.

At least for some isolated people, there may be a sense that they took live and in-person socializing for granted, just a little bit.

They say you don’t miss your water till your well runs dry. In the next chapter of this unprecedented novel, people will get back to getting together, gathering around that table. Maybe a little balance will return, and the phones will be put down.

If You Pray, Pray for Dr. Fauci

In her New York Times column today, Maureen Dowd interviews Dr. Anthony Fauci.

If you have been paying attention, you know that 79-year-old Dr. Fauci has been the trusted national voice of fact and reason in response to the pandemic. He is currently director of the National Institute of Allergy and Infectious Diseases, and has served six presidents.

In the interview, we learn that Dr. Fauci has been working 18-hour days, and at one point worked four or five days on three hours sleep each day. Because as a doctor, scientist and public servant he wants us to understand, wants us to behave appropriately, and wants as few Americans as possible to suffer and maybe die.

Part of that interview:


Thank God the Doctor Is In

By Maureen Dowd

March 21, 2020

WASHINGTON — It’s not easy being a national treasure.

“I’m exhausted,” confessed Tony Fauci when I reached him Thursday evening in the middle of another 18-hour workday.

“I have changed my tune a bit, probably thanks to my wife,” said the 79-year-old director of the National Institute of Allergy and Infectious Diseases. “About a week ago, I was going about four or five days in a row on about three hours of sleep, which is completely crazy, ’cause then I’ll be going on fumes. The last couple of nights, I’ve gotten five hours’ sleep, so I feel much better.”

He said he misses the endorphins of power walking, and he is wracked when he gets home at midnight and it’s too late to answer calls and emails.

“I gotta get rid of this guilt feeling,” he murmured about that moment’s 727 emails.

He said he has not been tested for the coronavirus but takes his temperature every day and usually has it taken another couple times before White House press conferences and meetings in the Oval.

When I spoke with him, he had been missing from the White House briefing for two days and Twitter blew a gasket, with everyone from Susan Rice to Laurence Tribe seeking an answer to the urgent query, “Where is Dr. Fauci?”

Donald Trump, the ultimate “me” guy, is in a “we” crisis and it isn’t pretty. The president is so consumed by his desire to get back his binky, a soaring stock market, that he continues to taffy-twist the facts, leaving us to look elsewhere — to Dr. Fauci and governors like Andrew Cuomo and Gavin Newsom — for leadership during this grim odyssey.

Dr. Fauci chuckled at speculation that he was banished due to his habit of pushing back on Trump’s hyperbolic and self-serving ad-libbing.

“That’s kind of funny but understandable that people said, ‘What the hell’s the matter with Fauci?’ because I had been walking a fine line; I’ve been telling the president things he doesn’t want to hear,” he said. “I have publicly had to say something different with what he states.

“It’s a risky business. But that’s my style, Maureen. You know me for many years. I say it the way it is, and if he’s gonna get pissed off, he’s gonna get pissed off. Thankfully, he is not. Interestingly.”

The first time I talked to Dr. Fauci was during a panic in the mid-80s about stopping another virus, the cause of the heartbreaking AIDs crisis. Then, as now, he was honest, brave and innovative. He told me that he tries to be diplomatic when he has to contradict the president about what “game-changer” cures might be on the horizon and whether everyone who wants to be tested can get tested.

“I don’t want to embarrass him,” the immunologist says, in his gravelly Brooklyn accent. “I don’t want to act like a tough guy, like I stood up to the president. I just want to get the facts out. And instead of saying, ‘You’re wrong,’ all you need to do is continually talk about what the data are and what the evidence is.

“And he gets that. He’s a smart guy. He’s not a dummy. So he doesn’t take it — certainly up to now — he doesn’t take it in a way that I’m confronting him in any way. He takes it in a good way.”

On Friday, a trigger-happy Trump was so quick to talk up the fabulous possibilities of an antimalarial drug in combating the virus that Dr. Fauci had to pump the brakes, taking the microphone to explain that we do not know yet because controlled testing is needed.

The president returned to the lectern to press his unscientific case and compliment himself: “I’m a smart guy,” he said. “I feel good about it. And we’re going to see. You’re going to see soon enough.”

Probably thinking about all his government staffers working round-the-clock, Dr. Fauci could not help rubbing his forehead and cheek — going against his own advice to the public — when Trump cracked a joke about the “Deep State Department.”

Though the scientist listens respectfully when the president and the vice president are talking, he somehow manages to emit an “Oh my God, please don’t say that” vibe when the two men scamper over the line. When Mike Pence went into false-hope overdrive, saying, “I just can’t emphasize enough about the incredible progress that we have made on testing,” Dr. Fauci and Dr. Deborah Birx, the administration’s virus response coordinator, exchanged a whispered aside that sent the internet into a frenzy.

Dr. Fauci assured me that, despite their crosscurrents and an early overconfidence about how easy it would be to control the path of the virus, the president “absolutely” now gets the threat of “the invisible enemy,” as Trump calls the virus.

Music: O-o-h Child (things are gonna get easier), The Five Stairsteps

O-o-h Child

Ooh child
Things are gonna get easier
Ooh child
Things’ll get brighter
Ooh child
Things are gonna get easier
Ooh child
Things’ll get brighter

Some day
We’ll put it together and we’ll get it undone
Some day
When your head is much lighter
Some day
We’ll walk in the rays of a beautiful sun
Some day
When the world is much brighter

DSM-5: Antagonism and Narcissistic Personality Disorder

 

DSM-5

This post was first published more than two years ago. It refers to no individual by name, but since it is regularly viewed by dozens of people each week, I am confident the message got through. Now that the issue of this personality disorder is finally at the top of the news, here it is again for those who may have missed it. Still no name mentioned, but there is no doubt what it suggests.

Mental health is a serious matter and mental health practitioners are serious professionals. These are not to be treated lightly and off-handedly.

The Diagnostic and Statistical Manual of Mental Disorders, Fifth Edition (DSM-5) is the “bible” of the mental health profession: “a classification of mental disorders with associated criteria designed to facilitate more reliable diagnoses of these disorders.” It is not a reference to be thrown around and used casually by non-professionals.

The DSM can nonetheless be fascinating, especially when certain strong behavioral traits observed in others seem to closely match the traits and possible related disorders referenced in the DSM.

With the above caution and caveat, here are selections from DSM-5 about the Personality Trait Domain of Antagonism. More from the DSM about the way this may or may not relate to Narcissistic Personality Disorder will follow in a subsequent post.

Personality trait: A tendency to behave, feel, perceive, and think in relatively consistent ways across time and across situations in which the trait may be manifest.

Personality trait facets: Specific personality components that make up the five broad personality trait domains in the dimensional taxonomy of Section III “Alternative DSM-5 Model for Personality Disorders.” For example, the broad domain Antagonism has the following component facets: Manipulativeness, Deceitfulness, Grandiosity, Attention Seeking, Callousness, and Hostility.

Antagonism: Behaviors that put an individual at odds with other people, such as an exaggerated sense of self-importance with a concomitant expectation of special treatment, as well as a callous antipathy toward others, encompassing both unawareness of others’ needs and feelings, and a readiness to use others in the service of self-enhancement. Antagonism is one of the five broad personality trait domains defined in Section III “Alternative DSM-5 Model for Personality Disorders.”

Manipulativeness: Use of subterfuge to influence or control others; use of seduction, charm, glibness, or ingratiation to achieve one’s ends. Manipulativeness is a facet of the broad personality trait domain Antagonism.

Grandiosity: Believing that one is superior to others and deserves special treatment; self-centeredness; feelings of entitlement; condescension toward others. Grandiosity is a facet of the broad personality trait domain Antagonism.

Deceitfulness: Dishonesty and fraudulence; misrepresentation of self; embellishment or fabrication when relating events. Deceitfulness is a facet of the broad personality trait domain Antagonism.

Attention seeking: Engaging in behavior designed to attract notice and to make oneself the focus of others’ attention and admiration. Attention seeking is a facet of the broad personality trait domain Antagonism.

Callousness: Lack of concern for the feelings or problems of others; lack of guilt or remorse about the negative or harmful effects of one’s actions on others. Callousness is a facet of the broad personality trait domain Antagonism.

Hostility: Persistent or frequent angry feelings; anger or irritability in response to minor slights and insults; mean, nasty, or vengeful behavior. Hostility is a facet of the broad personality trait domain Antagonism.

Dylan Thomas for Big Pharma

The Pharmaceutical Research and Manufacturers of America have a new public relations campaign. It is no secret that Big Pharma is not wildly popular, given the perception that pricing is surreal and marketing is out of control.

The inarguable point of the ad is that pharmaceuticals save and extend lives. To make that point, it uses the most moving poem of Dylan Thomas, one of the great modern poets:

Do not go gentle into that good night,
Old age should burn and rave at close of day;
Rage, rage against the dying of the light.

Though wise men at their end know dark is right,
Because their words had forked no lightning they
Do not go gentle into that good night.

Good men, the last wave by, crying how bright
Their frail deeds might have danced in a green bay,
Rage, rage against the dying of the light.

Wild men who caught and sang the sun in flight,
And learn, too late, they grieved it on its way,
Do not go gentle into that good night.

Grave men, near death, who see with blinding sight
Blind eyes could blaze like meteors and be gay,
Rage, rage against the dying of the light.

And you, my father, there on that sad height,
Curse, bless, me now with your fierce tears, I pray.
Do not go gentle into that good night.
Rage, rage against the dying of the light.

My request is emphatic and simple. Whatever the merits or demerits of Big Pharma, find some other way to make your case, and please leave Dylan Thomas out of it. He is way out of your league.

DSM-5: Paranoia

DSM-5

I did not think that I would be returning to the DSM quite so soon after my recent post.

The caveat in my last post about the DSM bears repeating. Mental health is a serious issue. Using diagnostic tools and terminology merely for entertainment and “pop psychology” can be careless. On the other hand, these tools can help provide insights that may be useful, particularly when the subject and the subject matter are very important or even critical.

Non-professionals talk loosely and colloquially about paranoia. The DSM approaches this clinically and scientifically:

Paranoid Personality Disorder

Diagnostic Criteria

A pervasive distrust and suspiciousness of others such that their motives are interpreted as malevolent, beginning by early adulthood and present in a variety of contexts, as indicated by four (or more) of the following:

  1. Suspects, without sufficient basis, that others are exploiting, harming, or deceiving him or her.
  2. Is preoccupied with unjustified doubts about the loyalty or trustworthiness of friends or associates.
  3. Is reluctant to confide in others because of unwarranted fear that the information will be used maliciously against him or her.
  4. Reads hidden demeaning or threatening meanings into benign remarks or events.
  5. Persistently bears grudges (i.e., is unforgiving of insults, injuries, or slights).
  6. Perceives attacks on his or her character or reputation that are not apparent to others and is quick to react angrily or to counterattack.
  7. Has recurrent suspicions, without justification, regarding fidelity of spouse or sexual partner.

Diagnostic Features [selected]

They suspect on the basis of little or no evidence that others are plotting against them and may attack them suddenly, at any time and without reason.

They are preoccupied with unjustified doubts about the loyalty or trustworthiness of their friends and associates, whose actions are minutely scrutinized for evidence of hostile intentions.

They may refuse to answer personal questions, saying that the information is “nobody’s business.”

They read hidden meanings that are demeaning and threatening into benign remarks or events. For example, an individual with this disorder may misinterpret an honest mistake by a store clerk as a deliberate attempt to shortchange, or view a casual humorous remark by a co-worker as a serious character attack.

They may view an offer of help as a criticism that they are not doing well enough on their own.

Individuals with this disorder persistently bear grudges and are unwilling to forgive the insults, injuries, or slights that they think they have received.

Minor slights arouse major hostility, and the hostile feelings persist for a long time.

Because they are constantly vigilant to the harmful intentions of others, they very often feel that their character or reputation has been attacked or that they have been slighted in some other way.

They are quick to counterattack and react with anger to perceived insults.

DSM-5: Antagonism and Narcissistic Personality Disorder

 

DSM-5

Mental health is a serious matter and mental health practitioners are serious professionals. These are not to be treated lightly and off-handedly.

The Diagnostic and Statistical Manual of Mental Disorders, Fifth Edition (DSM-5) is the “bible” of the mental health profession: “a classification of mental disorders with associated criteria designed to facilitate more reliable diagnoses of these disorders.” It is not a reference to be thrown around and used casually by non-professionals.

The DSM can nonetheless be fascinating, especially when certain strong behavioral traits observed in others seem to closely match the traits and possible related disorders referenced in the DSM.

With the above caution and caveat, here are selections from DSM-5 about the Personality Trait Domain of Antagonism. More from the DSM about the way this may or may not relate to Narcissistic Personality Disorder will follow in a subsequent post.

Personality trait: A tendency to behave, feel, perceive, and think in relatively consistent ways across time and across situations in which the trait may be manifest.

Personality trait facets: Specific personality components that make up the five broad personality trait domains in the dimensional taxonomy of Section III “Alternative DSM-5 Model for Personality Disorders.” For example, the broad domain Antagonism has the following component facets: Manipulativeness, Deceitfulness, Grandiosity, Attention Seeking, Callousness, and Hostility.

Antagonism: Behaviors that put an individual at odds with other people, such as an exaggerated sense of self-importance with a concomitant expectation of special treatment, as well as a callous antipathy toward others, encompassing both unawareness of others’ needs and feelings, and a readiness to use others in the service of self-enhancement. Antagonism is one of the five broad personality trait domains defined in Section III “Alternative DSM-5 Model for Personality Disorders.”

Manipulativeness: Use of subterfuge to influence or control others; use of seduction, charm, glibness, or ingratiation to achieve one’s ends. Manipulativeness is a facet of the broad personality trait domain Antagonism.

Grandiosity: Believing that one is superior to others and deserves special treatment; self-centeredness; feelings of entitlement; condescension toward others. Grandiosity is a facet of the broad personality trait domain Antagonism.

Deceitfulness: Dishonesty and fraudulence; misrepresentation of self; embellishment or fabrication when relating events. Deceitfulness is a facet of the broad personality trait domain Antagonism.

Attention seeking: Engaging in behavior designed to attract notice and to make oneself the focus of others’ attention and admiration. Attention seeking is a facet of the broad personality trait domain Antagonism.

Callousness: Lack of concern for the feelings or problems of others; lack of guilt or remorse about the negative or harmful effects of one’s actions on others. Callousness is a facet of the broad personality trait domain Antagonism.

Hostility: Persistent or frequent angry feelings; anger or irritability in response to minor slights and insults; mean, nasty, or vengeful behavior. Hostility is a facet of the broad personality trait domain Antagonism.