Tuesday, June 06, 2006

Fields of screams, fields of dreams

Hey, let’s make up another disease. We haven’t done that in a while. Why are you throwing that chair?--The psychiatric community has discovered another disease. They do so every couple of weeks. It means they have something else to treat and the drug companies love it: they get to sell more drugs. This disease is called intermittent explosive disorder, or IED. It is defined as uncontrollable anger attacks often leading to violence, things like spousal abuse and road rage. Naturally, they have found it is not as rare as one might think--4-5% of the people in a study at Harvard and the University of Chicago, have it. See Archives of General Psychiatry here. They have physically assaulted someone, threatened bodily harm or trashed something. We’re not talking simply being pissed off here, we’re talking repeated acts of violence. Since the psychiatric community discovers “an unrecognized major mental health problem” regularly, it should be taken with a grain of salt. If 4 to 5% of people really had such a thing, I’d stay home every day. And don’t bother me there. I’m warning you. I'm working! I’m getting really steamed. Now GET OUT.

Sorry.

But if we drug the little bastards early, we can stop IED--I’m sure this makes the world a safer place. Psychiatrists [their day in the barrel, apparently] are prescribing anti-psychotic drugs to children five times in the years between 1993 and 2002. In a report in the Archives of General Psychiatry [they are having a busy month], researchers said that these medications were prescribed at a rate of 1,438 per 100,000 children, up from 275 in the period from 1993-1995. In part, one suspects, it is because there are more anti-psychotic drugs out there and if you make it they will prescribe it. Another reason is that children and adolescents now have problems given new psychiatric labels and as new labels are invented, why more patients show up. See above. It needs to be pointed out there is very little data on what those drugs do to children as such studies are simply--and happily--not done. Except that’s what we are doing now, isn't it, one giant experiment to see if the drugs do any harm.

“I didn’t realize that that was the only day”--This story is only tangentially about medicine, but it is too sad to pass up. In Phil Robinson’s screenplay to W.P. Kinsella’s book Shoeless Joe, "Field of Dreams," a fictional Ray Kinsella goes searching for a baseball player who appeared only once in a major league game, Archibald “Moonlight” Graham, played by Burt Lancaster. [The screenplay was better than the novel, by the way]. There was such a player, who played for the New York Giants in one game in 1905. See page 275 of the Baseball Encyclopedia. He was called up to play the outfield against the Brooklyn Dodgers but never got an at-bat. He was in the batting circle when the game ended and he never played again. His entry contains nothing but zeros. “Back then, I thought, ‘Well, there’ll be other days,’” he says in the film. “I didn’t realize that that was the only day.” There is a contemporary counterpart to Graham. Meet Adam Greenberg, who has yet to appear in the Baseball Encyclopedia. Last year, Greenberg, 24, was called up from the minors by the Chicago Cubs. Last July 9, Greenberg went to bat against Valerio de Los Santos of the Florida Marlins, his first at-bat in the “Bigs.” De Los Santo’s first pitch hit him on the batting helmet and knocked him down. In the days before batting helmets, he might have been killed. For months he suffered from dizziness, benign paroxysmal positional vertigo. The dizzy spells have gone away, but he hasn’t played since. The Cubs released him last week at his request. He is looking for a team. The real Moonlight Graham did indeed become a doctor in Minnesota, as Kinsella wrote, but probably never met “Shoeless Joe” Jackson, or played with ghosts in an Iowa corn field. Robinson pays no attention to dates in the film and scrambles chronology. Graham died in 1965 at the age of 88. By the way, both Graham and Greenberg graduated from the University of North Carolina. For a really splendid story, see Mike Downey’s piece in the Chicago Tribune here. [Registration required].

[Greenberg picture from the Chicago Tribune]

1 comment:

Daniel Haszard said...

Well said,i applaud your blog, mental health consumers are the least capable of self advocacy,my doctors made me take zyprexa for 4 years which was ineffective for my symptoms.I now have a victims support page against Eli Lilly for it's Zyprexa product causing my diabetes.--Daniel Haszard www.zyprexa-victims.com