Balls and Walnuts
more than you ever wanted to know
Category Archives: The Barbarous Craft
Life, meet Art. Art, Life.
Live blogging tonight!
Jake and I have been sharing yucks and generally having fun with the Sam and Max games. These retro mysteries are all about the wisecracks; the puzzles are usually trivial.
In the first game, Culture Shock, Sam and Max contend with a trio of former child stars who are roaming our protagonists’ neighborhood, promoting the mesmerizing video of cult-leader-wannabe Brady Culture. The video promises to teach viewers “Eye-Bo fitness,” eye exercises guaranteed to get you the girl/boy/job/foot massage of your dreams.
As if anyone would believe eye exercises could improve your life. Crazy, huh?
Meanwhile, purely in the interests of research (natch!), this afternoon I googled “psychology adults abused as children.” This search led me to this Amazon page for EMDR in the Treatment of Adults Abused as Children.
EMDR stands for Eye Movement Desensitization and Reprocessing — Eye-Bo by any other name. What’s the big idea? One reviewer writes,
EMDR helps you to integrate the two halves of your brain and to heal from trauma that is trapped in your nervous system. EMDR is a very effective treatment for post-traumatic stress disorder (PTSD). It isn’t quite as spectacular as the books make it seem, but it really can work.
Hmm. How does that work, again?
EMDR helps you to recognize that the abuse happened in the past, and is not happening in the present. Therefore it is easier for you to process your traumatic experiences because you don’t have to live as if the abuse is still happening.
I see. It’s that old right-brain/left-brain thingamobob. But are there any peer reviewed reports to support EMDR? After all, these are vulnerable patients who come to their therapist following a childhood of victimization. No one would take advantage of such folks by taking their money in exchange for unproven methods . . . would they?
As usual, Quackwatch has the dope:
Only one published study has directly compared EMDR with a no-treatment control group. Jensen (1994) randomly assigned Vietnam veterans with PTSD to either an EMDR group or a control group that was promised delayed treatment. EMDR produced lower within-session SUDs [Subjective Units of Distress] ratings compared with the control condition, but did not differ from the control session in its effect on PTSD symptoms. In fact, the level of interviewer-rated PTSD symptoms increased in the EMDR group following treatment.
The author concludes,
The proponents of EMDR have yet to demonstrate that EMDR represents a new advance in the treatment of anxiety disorders, or that the eye movements purportedly critical to this technique constitute anything more than pseudoscientific window dressing . . . .
Because of the limited number of controlled studies on EMDR, both practitioners and scientists should remain open to the possibility of its effectiveness. Nevertheless, the standard of proof required to use a new procedure clinically should be considerably higher than the standard of proof required to conduct research on its efficacy. This is particularly true in the case of such conditions as PTSD, for which existing treatments have already been shown to be effective. The continued widespread use of EMDR for therapeutic purposes in the absence of adequate evidence can be seen as only another example of the human mind’s willingness to sacrifice critical thinking for wishful thinking.
And now I get to kick back and watch. Will any EMDR fanatics come out of the woodwork to tear me a new one? Folks are always rarin’ to testify, it seems.
D.
Remedial Social Skills, 101
I had to share this with you. In the “President’s Message” of our local medical society’s Bulletin, our prezzy bemoans the way we’ve grown apart as a community. We couldn’t even pick each other out of a police lineup! That is bad.
After urging our society’s members to become more cohesive, the President concludes with suggestions for change, ending with this groaner:
. . . write a biographical sketch about yourself or a colleague and send it to the Medical Society. There are great stories out there about who we are and how we got here. If we receive your work with permission to publish, it could show up in the Bulletin soon.
But that’s not the good bit. Here’s the good bit:
At the least, it will come in handy when it is time to write the obituary!
That’s not even the last sentence . . .
And on some days, that need seems to be sooner than we might have thought.
Shorter version: “Dudes. It’s getting harder and harder to research your obits, so if you want something more detailed than ‘Dr. Hoffman was an otolaryngologist who served our community for X years,’ write your own damned obituary. You’ll be dead sooner than you think.”
And people think I’m exaggerating when I say us docs have the social skills of bonsai trees.
D.
Thirteen scenes from Gross Anatomy
Nothing says “medical school” like Gross Anatomy. Think about it: anyone can study microbiology, histology, or pathology. But how many people get to cut up dead bodies? How many people would want to?
Maybe in the future, cadaver dissection will be replaced by in computero practical exercises, but I doubt it. A big part of training is learning to violate taboos — getting close to people, asking them the most intimate of questions, touching them in ways even their spouses wouldn’t touch them, and hurting them. None of this comes naturally; all of it must be learned. Or, rather, unlearned. It’s all about breaking down internal barriers.
And that’s why Gross Anatomy will always play a role in medical education.
Follow me below the fold for thirteen memories. Sorry, no more pictures on this one; I doubt I would find anything palatable for mass consumption.
Lisa Nowak: a medical hypothesis
The television talking heads are trying their best to figure out Lisa Nowak, the diaper-wearing stalker/astronaut, but to my knowledge, no one has suggested the possibility of a medical explanation for her breakdown. The possibilities are endless — tumor, heavy metal intoxication, adverse drug reaction. Lots of things can tweak the mind. But here’s one idea.
This is the “butterfly rash” of systemic lupus erythematosus:
Older photos of Ms. Nowak show no rash:
But recent images of Ms. Nowak, particularly her mug shot, suggest a classic malar “butterfly rash”. Here’s another suggestive photo:
If Ms. Nowak has lupus, it raises the possibility of lupus cerebritis. Among the potential neuropsychiatric manifestations:
Mood disorders such as anxiety and depression are frequently reported.
Cognitive disorders may be variably apparent in patients with SLE. Formal neuropsychiatric testing reveals deficits in 21-67% of patients with SLE. Whether this represents true encephalopathy, neurological damage, medication effects, depression, or some other process is unclear.
Psychosis related to SLE may manifest as paranoia or hallucinations.
All I’m saying is there may be more to this story than a love triangle gone bad. When family, friends, and coworkers react the same way, remarking how vastly out of character her recent behavior has been, you have to entertain the medical hypothesis. News organizations are talking to PSYCHOLOGISTS, for heaven’s sake — no MDs.
Stay tuned.
D.
PS: In other news, The Aristocrats has the inside scoop on how the medical community healed Ted Haggard of his gayness.
Douche what?
And now, a public service announcement, because gaaaaah it’s late, I’m tired, and my brain has been topic-free all day.
That’s not entirely true. My brain kept feeding me Thursday Thirteen topics: Thirteen Yiddish insults and curses; Another Cosmo Thirteen (oh, this is going to be a good one); Thirteen Memories from Gross Anatomy. BUT IT AIN’T BLOODY THURSDAY, so thanks but no thanks, brain.
Anyway.
Let’s talk about nasal douching.
This is the product I hype to my patients: the NeilMed Sinus Rinse Kit. It’s simple. Combine the packet with the correct amount of water (distilled or filtered, ideally at body temperature), shove the nozzle up your nose, and squeeze. If it squirts out your mouth or your other nostril, you’re doing it right.
The idea — no, really, do I have to explain the benefits of douching? It’s like brushing your teeth, for the love of snot. Atomized saline may be better than nasal douching, but any wimp can put spray up their nose; it takes a REAL mensch to douche his nose. A mensch like Swami Ji:
This fellow uses a Neti pot to douche his nose. In one hole, out the other. If you click on the picture, you’ll learn that nasal douching is an ancient yogic practice — so it has to be good! From the same people who invented enemas (and if I’m not careful, I’ll spend the rest of the evening reading these enema testimonials).
Nothing wrong with Neti pots, but I prefer the forcefulness I can achieve with the NeilMed squeeze bottle. Booosh. I do it in the shower because it can be damned messy. And I only do it when my nose gives me fits; I’m not a habitual doucher.
Yes, I suppose I could call this nasal lavage or nasal irrigation, but then I wouldn’t be able to enjoy my patients’ baffled, disbelieving expressions.
He didn’t —
Did he just say . . . ?
My nose?
Yes, Miss. Your nose. What did you think I said?
D.
PS:
Did you mean to search for: Lesbian Bars and Walnuts
Don’t ask.