A Very Interesting Perspective

Like many Americans, I have had it up to here (my hand is by my forehead) with religious fanatics trying to impose their views on the public. It's a shame because it causes me to have knee-jerk reactions to their causes, owing to the fact that most of their causes are ridiculous. My favorite example is the "pro-life pharmacist movement" - these are licensed professionals who refuse fill birth control prescriptions because they are "abortifacient". Give me a freaking break already.

Then someone smart comes along (from Harvard - it figures) and makes you think:
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FOCUS: Bigotry and the Murder of Terri Schiavo
By JOE FORD

“Misery can only be removed from the world by painless extermination of the miserable.”

—a Nazi writer quoted by Robert J. Lifton in The Nazi Doctors: Medical Killing and the Psychology of Genocide

The case of Terri Schiavo has been framed by the media as the battle between the “right to die” and pro-life groups, with the latter often referred to as “right-wing Christians.” Little attention has been paid to the more than twenty major disability rights organizations firmly supporting Schiavo’s right to nutrition and hydration. Terri Schindler-Schiavo, a severely disabled woman, is being starved and dehydrated to death in the name of supposed “dignity.” Polls show that most Americans believe that her death is a private matter and that her removal from a feeding tube—a low-tech, simple and inexpensive device used to feed many sick and disabled people—is a reasonable solution to the conflict between her husband and her parents over her right to life.

<>The reason for this public support of removal from ordinary sustenance, I believe, is not that most people understand or care about Terri Schiavo. Like many others with disabilities, I believe that the American public, to one degree or another, holds that disabled people are better off dead. To put it in a simpler way, many Americans are bigots. A close examination of the facts of the Schiavo case reveals not a case of difficult decisions but a basic test of this country’s decency.
the whole article

Rest in peace, Terri.

Blog problems

I've been having blog problems for the last few days. Both blogger and my webhost were doing upgrades on the same day, so it was some job to get it all working again. Thanks for your patience.

Goodrum no longer facing court-martial

<> I promised to keep track of the case of First Lt. Jullian P. Goodrum, the soldier who was denied requested mental health treatment and forced into unwanted treatment all within a few months. It turns out he will not be dishonorably discharged after all as the military dropped the AWOL charges against him.

According to the Washington Post:

At his hearing next week before Jackman, Goodrum will defend himself against a charge of "conduct unbecoming an officer and a gentleman." This charge stems from Goodrum's refusal in November 2003 to obey a captain's admonishment to leave Knoxville and return to Fort Knox. The charge sheet does not mention his treatment in Knoxville for post-traumatic stress disorder.

Goodrum also is charged with fraternization with a female sergeant. This charge dates to Goodrum's prewar mobilization at Camp Atterbury in Indiana, when he allegedly kissed and embraced the woman. It also mentions alleged fraternization in Kuwait and Iraq in 2003.

Both Goodrum and the sergeant have denied the allegations. Some witnesses at his earlier court-martial -- where these charges first were aired -- debunked them as part of a vendetta against Goodrum.

If found guilty, Goodrum could face sanctions such as a forfeiture of pay or official reprimand.

However the case turns out, Goodrum will likely be leaving the military, Klimaski said. An Army medical board that already has examined his case is set to recommend that he be medically discharged.

PTSD - a collection of stories

Here are some interesting stories about Post Traumatic Stress Disorder:

Veterans tell Durbin of the toll post-traumatic stress

Seated at a table with emotional and angry veterans Monday, Sen. Dick Durbin (D-Ill.) announced he will introduce new legislation requiring the U.S. Department of Veterans Affairs to expand its treatment of post-traumatic stress disorder.

"Veterans hospitals are not equipped to do the job," said Durbin at an American Legion in Bucktown. "They don't have enough counselors and doctors to help these returning veterans and their families."

An estimated 15 percent to 30 percent of all returning soldiers from Iraq and Afghanistan will suffer from the disabling disorder characterized by violent flashbacks, nightmares and severe anxiety. Nationwide, the VA is treating 244,000 veterans from previous wars who have PTSD, but some experts fear the VA is not staffed to handle the influx of new soldiers.

Veterans from the Vietnam War and World War II, including one man who survived the Bataan Death March, explained to Durbin how their lives have been crippled by PTSD, which wasn't recognized by the VA until the early 1980s.
---------------------------------
S. Florida VA hospitals brace for a wave of post-traumatic stress cases

They may be home from the war in Iraq, yet they are not home free.

Replaying gory scenes of death and destruction, some combat veterans are unable to sleep for more than minutes at a time. Some fight anger and anxiety with alcohol and drugs. Depression is common. Almost all bear invisible scars.

Michael Culmer, 25, who manned a 120 mm mortar for the U.S. Army outside Ramadi, survived his tour of duty by becoming numb, feeling no emotion even when his commanding officer took a fatal shrapnel wound to the head. Now back in his hometown of Miami, "I just want to get off meds and feel like the person I was," he said.

As more soldiers return from the war zone, some from second tours of duty, mental-health counselors with the Veterans Affairs Department in Broward, Palm Beach and Miami-Dade counties are bracing for a growing tide of men and women suffering from post-traumatic stress disorder.
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Returning home from Iraq

Michael Torok didn't die while serving in Afghanistan, but his family believes the war still killed him.

The 23-year-old Kingston man spent 10 months in Afghanistan as a communications specialist for the U.S. Army. He returned to Kingston on Sept. 2.

On Sept. 5, he disappeared while on his way to visit a friend in Shabbona.

A deputy found his body Sept. 24 in his truck parked in an Ogle County cornfield. He had died from a single, self-inflicted stab-wound to the heart.

His family later learned the Army had given him Lariam, an anti-malaria drug that, in some people, causes depression, bad dreams and hallucinations. The family also learned he had been suffering from depression and possibly post-traumatic stress disorder, or PTSD.
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VA's ongoing post-traumatic stress study focuses on women

Department of Veterans Affairs researchers plan on completing their first-ever study focused solely on female post traumatic stress disorder by the end of the year.

But researchers hope the findings will help develop better treatment options for both men and women veterans.

The study, which began looking at patients in 2002, has monitored various PTSD treatments administered to 283 female veterans. Paula Schnurr, one of the lead researchers on the $5 million project, said the focus on women was largely driven by the fact that no such effort had been done before.

“A number of studies have shown this is more prevalent [percentage-wise] in women than it is in men,” she said. “And we’ve seen that women in the military world often have suffered some traumas before joining the military, and that can create additional problems later.”
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Coming home: Readjustment can be difficult for some returning soldiers

As he and his troops entered Baghdad in 2003, detachment commander Staff Sgt. Kirk Reese couldn't help but notice the body parts lining the streets.

<>Reese, a Mt. Pleasant native, is a member of the 1st and 2nd Platoon Truck Co., Headquarters Battalion, 4th Marine Division. In charge of hauling troops during combat operations, his battalion was the first soft vehicle company to go through An Nasiriyah.

About 65 percent of the 13 trucks and 10 trailers under his command were hit by indirect or direct fire <>. Day and night the soldiers were objects of mortar and rocket attacks; that was just during Reese's first deployment.<>

Child's death boosts parents' mental illness risk

In yet another blow to the idea that all mental illness is purely biologically based, we find a new study which states that:

In the year after the death [of a child], bereaved mothers were almost seven times as likely as their nongrieving peers to be hospitalized for a mood disorder, like depression; about four times as likely to be admitted for schizophrenia; and nearly three times as likely to be admitted for abusing drugs and alcohol.

Bereaved fathers were at lower risk than bereaved mothers during this first year, but compared with nongrieving fathers were still nearly six times as likely to be admitted for a mood disorder like depression, and more than twice as likely for schizophrenia.

With time, the difference in risk between the bereaved parents and their peers narrowed significantly, but after five years the bereaved group still had a higher rate of hospitalization for psychiatric problems -- about 40 percent higher in fathers, nearly 80 percent in mothers.

article here

Define "Insane"

According to Webster's the defintion of insanity is:

1 a : a deranged state of the mind usually occurring as a specific disorder (as schizophrenia) and usually excluding such states as mental retardation, psychoneurosis, and various character disorders b : a mental disorder

You'd think it would be easy to spot someone whose mind was deranged, and sometimes it really is obvious. Yet there are many cases over which we are left scratching our heads - is the person insane or just bad? The BTK serial killer is a good example.

For those who haven't followed the story, BTK stands for "Bind-Torture-Kill". It is the name that a serial killer who was at large for 30 years in the Wichita, Kansas area gave himself. The killer had taunted police and residents by sending mocking notes and trinkets to the media, and seemed to greatly enjoy his horrible vocation. When he was finally caught it turned out he was the "compliance officer" in Park City, Ks., the president of his church board, a long-time Boy Scout leader, and all around normal seeming person. For thirty long years he kept his thirst for murder a secret and no one knew.

His crimes were heinous - he like to suffocate women with plastic bags. He taunted the police by sending them dolls with plastic bags over the head. That seems to make him totally crazy by anyone's standards. But he lived right among us in our society. According to the Witchita Eagle, the people who knew him, "... are not stupid people. They are good parents, perceptive adults who trusted Rader to guide their sons in Scouts, come into their houses, meet their wives, help neighbors." How could he be insane, THAT insane, and no one noticed?

At one point the killer wrote of a "monster inside" that motivated him to murder and send his notes, but many experts have written that off as an attempt to create a ready excuse. Considering how well he hid his secret life from those around him, I'm inclined to agree.

It is hard to forget the spectacular Canadian murder/rape trial of Paul Bernardo during which he was asked why he smiled into the camera while he was assaulting his screaming victim. Bernardo's chilling answer was, "I was enjoying myself." Some people really are just bad. It seems to me that this is the case with the BTK murderer as well. You can be certain he'll claim to be insane at his trial, though. I hope he doesn't get away with it.

"... a duty to protect ..."

This morning Jeb Bush announced that:

"We in government have a duty to protect the weak, disabled and vulnerable," he said in a statement Monday. "I appreciate the efforts of state and federal lawmakers on both sides of the aisle who have taken this duty to heart."

Those of us who fret over the fate of the mentally ill and otherwise disabled on a daily basis stand in shock and awe of that sentence. It is a numbing slap in the face when you consider that it was only one month ago that this article ran in the NY Times:

"With little fanfare, the Bush administration is proposing to stop financing the construction of new housing for the mentally ill and physically handicapped as part of a 50 percent cut in its housing budget for people with disabilities."

Amazing. The article further states that:

"... the federal government would discontinue financing housing for people with spinal cord injuries or psychiatric illnesses who are not necessarily homeless but may live in nursing homes or psychiatric hospitals.

By relying exclusively on vouchers, the federal government would essentially be lumping these people with able-bodied Section 8 recipients in competing for some of the same apartments.

"What you have for disabled folks is you're getting a double whammy," said Jonathan Harwitz, director of public policy for the Corporation for Supportive Housing, which promotes housing for people with special needs. "You're looking at both the landlord making a decision, 'Do I even want to rely on Section 8?' and secondly, saying, 'Do I want a disabled person in here?' Because that's an additional issue."

I guess lawmakers only take their duty to vulnerable people seriously when it's politically expedient. When no one is looking they like to make the Terri Schaivos of the world compete with able-bodied welfare recipients (a.k.a Cadillac driving welfare queens, as Reagan preferred to call them) for housing funds.

And what would they want done with Terri Schiavo if she didn't have settlement money and willing family to care for her?

Carol Noell's Lobotomized Mother is Remembered

When Carol Noell first became a member of Psychosurgery.org she was seeking a way to have her mother's memory honored. Her mom deserved something good after such a troubled, often sad life. You see, Walter Freeman lobtomized her while she was pregnant in an attempt to "cure" her of her headaches. Her tale is yet another Freeman "success story" - after her lobotomy her husband left her because she was worse than ever and she lost her kids.

Anyway, I am pleased to tell you that Carol has achieved her goal, with thanks to reporter Rusty Marks. Her mother's story was published in her hometown newspaper. Congratulations Carol!
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Kanawha woman struggled for normalcy after lobotomy

By Rusty Marks Staff writer

Anna Ruth Noell could have been anything.

An intelligent young woman who grew up in Marmet, Anna Ruth had a natural gift for numbers. She might have become a scientist or mathematician. But all she wanted to be was a good wife and mother.

Because of Dr. Walter Freeman, she couldn’t even be that. In early 1950, Freeman performed a transorbital lobotomy on Anna Ruth Noell in an effort to cure her recurring headaches. The procedure left her screaming in pain for months, and would eventually cost her her husband, her children and her future.

“Anna Ruth needed to be taken care of, because Freeman took everything she had,” said Carol Noell Duncanson, Anna Ruth’s only surviving daughter. “She just walked up and down MacCorkle Avenue, pretty much. That’s how she spent the rest of her life.”

Anna Ruth was born Nov. 25, 1924, in Point Pleasant, the youngest of three children born to French and Lillian Gates Channels. As a child, she was hit by a car while getting off the school bus. The door handle of a passing Studebaker hit her in the head, piercing her skull.

Anna Ruth recovered, but the accident left her with severe and incessant headaches.

In 1947, following a whirlwind romance, 23-year-old Anna Ruth married Lowry Ward Noell, a dashing man 17 years her senior. Deeply in love, Noell recorded the couple’s first year of marriage on a scroll he fashioned out of brown paper lunch bags.

But trouble was brewing for the newlyweds. In March 1948, a baby daughter was born prematurely and died at an Alexandria, Va., hospital. Carol was born in 1949, a healthy but small baby, but Anna Ruth remained tormented by headaches and struggled with her newfound responsibilities as a mother.

Six weeks after Carol was born, Anna Ruth was pregnant again. A team of doctors suggested lobotomy as a cure for her debilitating headaches and anxieties. They recommended Dr. Freeman, then considered the leading expert on lobotomies in the United States.

Freeman had been performing lobotomies on patients since the 1930s, at first using a costly and time-consuming technique that entailed boring two holes in the skull and inserting a cutting device to sever the nerves between the frontal lobes and the rest of the brain. Lobotomy at the time was a last-resort treatment for all sorts of mental illness and brain injuries doctors couldn’t treat any other way.

While Anna Ruth was battling headaches and the rigors of motherhood, Dr. Freeman had been experimenting with a new kind of lobotomy. Using a stout metal probe that resembled an ice pick, Freeman found he could quickly and efficiently sever the frontal nerves.

Continued ...

Another "The Lobotomist" review

I don't really like the "lesson" people seem to be taking from El-Hai's book. The idea that lobotmy "cured" anyone is a load, and it's dangerous too. This paragraph from a review is totally and completely false:

"In the days before anti-depressants, lobotomy was often the last hope for those suffering from severe depression, anxiety, obsessive-compulsive disorders and even schizophrenia. Writer El-Hai, who had unprecedented access to Freeman's papers, shows how the gory procedure actually rendered some patients free of their anxieties and compulsions."

First of all lobotomy cured mental illness like the guillotine cured dandruff. It's technically true and that's about it.

Second, there were plenty of 'treatments' back then. There were electro-shock treatments, a "therapy" which is still used and vigorously defended by psychiatry to this day. There was insulin shock. There was metrozol shock too. There was talk therapy. There was hydrotherapy. This idea that they were sitting around without a treatment in sight is a myth.

Unfortunately I am very busy getting ready for the Graduate Record Exam which I will be taking in just over a week. When I am done I will finish and post the long-awaited review of "The Lobtomist".

"Mystery of Neurochemistry"

In today's issue of Salon.com writer Ayelet Waldman has published an article called "Living out loud -- online" (you have to subscribe or watch an ad to read it). In it she discusses her blog which she uses to chronicle her personal life including her bipolar disorder. Recently she published her intentions to kill herself on her blog, sparking quite a crisis. Her article describes the incident this way:

I informed my readers, among them my husband, that what I have, the milder form of the disease, has a 24 percent suicide rate. Then I wrote, "It does not help to know that one's mood is a mystery of neurochemistry when one is tallying the contents of the medicine cabinet and evaluating the neurotoxic effects of a Tylenol, topomax, SRRI and ambien cocktail.

It makes me sad to think that anyone regards themselves as hostage to their brain chemistry and some cold table of statistics. In my opinion it engenders an unhealthy helplessness that is counterproductive at best.

That doesn't mean that medication doesn't work or help. I think that everyone who finds themselves struggling with mental illness should seriously consider giving medication a try. It does help lots of folks. Some people's lives are saved by it. However, I liken psychiatric medication to aspirin - it can help stop the pain and symptoms long enough to treat the wound that initially caused the pain. And as we know, in the case of depression there is ample evidence that placebos work as well as the latest pharmaceutical concoction.

Of course, people started down this 'helpless to brain chemistry" path to combat the phenomenon of family members screaming at depressed loved ones, "You're just being lazy! Get up!" People are so extreme sometimes. While you can't blame it all on brain chemistry, you can't entirely blame the intentions of the ill person either, or their family. People and their lives are complicated. Aren't you complicated? I'm willing to bet that it takes years to truly understand who you are, what you're about, what causes your pain, how you got to where you are, and where you want to be one day. It is foolish to think that anyone's problems could be resolved with a simple pill.

Even though Waldman was under a psychiatrist's care and on his prescription when the incident happened, still she thinks the answer lies in medication alone. When her 7-year-old expresses fear that she might one day really kill herself, Waldman writes:

I sat him down and explained what had happened, that I had been taking the wrong pills and that my doctor had fixed my medicine. ... I hugged him, then I told him that I knew why he was afraid. I told him what a good doctor I had and how careful we were now to make sure nothing like this ever happened again.

At least she sounds somewhat less helpless when she concludes:

I promised him that I would never, ever hurt myself. A rash promise, perhaps, but I do my best not to break my promises to my children. And I don't intend to start with this one.

Unclaimed Ashes

I was disgusted that in some cases patient records were left in file cabinets in abandoned hospitals. It turns out that was only a small sign of the disregard in which mentally ill people are held.
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Ore. Seeks Burial Site for Unclaimed Ashes

Gustav Metzgus died in 1938 at the state psychiatric hospital where he was being treated for dementia, and his cremated remains were stored in a nameless metal canister alongside hundreds of others in a dank room.

Then his granddaughter, Roseann Ismert, learned about his whereabouts. She recently picked up his urn and took it to her pastor to give him a blessing.

"Before that he was just stacked on a shelf. There was no final prayer or send-off for him back then, so I felt something should be done," Ismert said.

Soon, the 3,500 other former patients whose remains have been cremated and stacked in a storage facility may also get a dignified final resting place.

Legislators, mental-health advocates and others are working to find a proper burial place for the remains and possibly a memorial. Because no state funds are available, private donations are being sought.

State Sen. Peter Courtney, who is leading the effort, said he became aware of the roomful of urns last fall when he took a tour of Oregon's crowded, run-down psychiatric hospital, where much of the 1975 movie "One Flew Over the Cuckoo's Nest" was filmed.

Courtney said he was shocked to see the canisters stored in an abandoned storage building that once served as the hospital's mortuary and crematorium.

"I found myself thinking 'This is like sacred ground,' and yet it isn't a proper place for these people; it isn't a respectful place," said Courtney.

Until the early 1900s, unclaimed hospital patients were buried in a cemetery. In 1913, the Legislature decided it needed the land and ordered the hospital to build a crematorium, exhume all bodies from the cemetery and incinerate them.

The remains were placed in the welded copper cans and stored in a hospital basement for more than six decades. They were moved to an underground vault in 1976, then transferred again four years ago to the abandoned storage building.

There are no names on the urns, only numbers that correspond to names in the hospital's records. As many as one-quarter of the 3,500 sets of remains can't be identified, hospital officials said.

The cremation policy at the hospital was halted in the 1970s. Unclaimed bodies are now sent to funeral homes for burial.

"We want to bring dignity and respect to these people," said Jason Renaud of the Mental Health Association of Portland. "People with mental illness have been disenfranchised and set aside throughout history."

Rats Are People Too

The only reason I'm not mocking the idea that rats act helpless when they're depressed (gotta love biological psychiatry, eh?) is because I would love dearly for this treatment to be real.

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MRI Scans Could Have Antidepressant Effect -Study

WASHINGTON (Reuters) - High-speed magnetic resonance imaging scans produce effects in rats similar to the use of antidepressants, confirming observations made in human patients, U.S. researchers reported on Thursday.
...

"We found that when we administered the magnetic stimulation to the rats, we saw an antidepressant-like effect, the same effect as seen after administration of standard antidepressant drugs," said William Carlezon, director of McLean's Behavioral Genetics Laboratory.

Writing in the journal Biological Psychiatry, Carlezon and colleagues said they tested the rats after another team at the hospital reported a new type of magnetic resonance imaging, called echo planar magnetic resonance spectroscopic imaging (EP-MRSI), had improved the mood of people in the depressed phase of bipolar disorder.

The new study was designed "to see if we could demonstrate in an animal model what the clinicians thought they were seeing in humans," Carlezon said.

When repeatedly stressed, rats develop helpless behavior, which may be their version of despair, the researchers said. But in the experiment, the rats that had been exposed to EP-MRSI showed less helplessness during the stress tests.
"They behaved as if they had received an antidepressant," said Dr. Bruce Cohen, psychiatrist in chief at McLean.

"It's a non-drug way to change the firing of nerve cells," Cohen said. "That's why the implications of this work have the potential to be so profound."

More

Jack El-Hai on NPR's Fresh Air Tonight

Jack El-Hai, author of The Lobotomist, just sent out this message:

Dear Friends:

I just learned from the producer of NPR's Fresh Air program that their segment on me and my book The Lobotomist will be included in tonight's (Thursday's) show. It was a last-minute decision to drop it in today. Details on the show will go up after noon eastern time at http://www.freshair.com. You can find information on the show's broadcast schedule in different markets at http://www.npr.org/wheretohear/index.php?prgId=13&selStates=AL

And if you haven't already, please check out the website of my book at http://lobotomist.com
Thanks!
Jack
---------------------------------------------------
Jack El-Haijack@el-hai.com
Author of The Lobotomist: A Maverick Medical Genius and His Tragic Quest to Rid the World of Mental Illness
Just published by John Wiley & Sons
http://lobotomist.com

"The Lobotomist" Reviews

Yes, I'm going to post my review in the next couple of days, but in the meantime here are a few articles on and reviews of Jack El-Hai's "The Lobotomist":

New book reconsiders 'icepick lobotomist' who did some surgeries in Athens hospital

TRANSORBITAL LOBOTOMY

Book portrays lobotomy pioneer, local hospital co-founder

"The Lobotomist" examines an infamous doctor

The man behind the lobotomy

To aid tortured minds, he cut the brain

I'd Advise Against It

Brain Stimulation May Curb Persistent Depression

Individuals with severe depression who do not respond to standard types of treatment may be helped with an experimental treatment called deep brain stimulation, Canadian investigators report.

Four of six severely depressed patients who underwent deep brain stimulation, which involves surgically implanting electrodes in a targeted area of the brain thought to be involved in depression, experienced a "striking and sustained" let-up in their depression, investigators report in the medical journal Neuron.
...
According to study investigator Dr. Helen S. Mayberg from Emory University in Atlanta, the four who improved, but not the other two, had "early onset depression with classic melancholic features."
...
"We need new treatments so that a patient does not go through 5 years of drug cocktails and every possible combination of pills and electroconvulsive therapy before coming to the conclusion that you need something else," she said. "Why should people suffer that long, when maybe we can do something that will give true relief?"
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Indeed, Dr. Mayberg. Why should they suffer when they could have you embed electrodes in their brains instead?

According to this next article, DBS is nothing short of a MIRACLE TREATMENT for intractable depression. Behold, the very first patient was instantly cured!

Jeanne Harris, 50, has battled the illness for the better part of a decade. About 10 per cent of people with chronic depression do not respond to treatment and Harris was among them. Despite taking a cocktail of drugs, she was incapable of working or even maintaining contact with friends.

In one six-month stretch, she travelled from bed to couch and back, bathing and changing her clothes only on the one day a week she was taken to see her doctor.

Nearly two years ago Harris became the first patient to undergo surgery to have two thin wires with electrode contacts threaded into the subgenual cingulate region deep within the frontal lobes of her brain. The ends of the wires were then tunnelled through to the lower neck area, where they were hooked up to a pacemaker-like device placed under the skin.

As the surgeon, Dr. Andres Lozano of Toronto Western Hospital, gentle probed different spots within the section, Harris - who was conscious throughout - was infused with an intense, almost forgotten, sense of serenity.

A few hours later, she was home clipping hedges. A minor task. A major miracle.

"It was absolutely unbelievable - to do it and to be feeling normal and enjoying it like I remember I used to feel," she recalled in an interview Monday.

Harris has had no side-effects from the surgery and raves about the procedure that gave her back her life.

"I see it as a major medical breakthrough. I see it as it saved my life because I was definitely headed towards suicide, because a person can only take so much."
--------------------------
Wow, you know, the tiny number of people treated, and the astonishing claims of cure remind me of another time and era, another miracle cure that involved brain surgery and the frontal lobes ...

Yes, I'm disgusted.

Lieutenant Julian Goodrum

USAToday has an article about PTSD in returning troops. It reads in part:

"Lt. Julian Goodrum, an Army reservist from Knoxville, Tenn., is being treated for PTSD with therapy and anti-anxiety drugs at Walter Reed Army Medical Center in Washington. He checked himself into a civilian psychiatric hospital after he was turned away from a military clinic, where he had sought attention for his mental problems at Fort Knox, Ky. He's facing a court-martial for being AWOL while in the civilian facility."

Wow, that really got me interested ... why isn't the military helping this man? Why couldn't he get care from them? Then I looked into it further and there is another side to this story. According to the military:

Lieutenant Goodrum conducted an affair with his platoon sergeant in Iraq. Following his redeployment to the U.S. in June 2003, an investigating officer recommended that he received an Article 15 (nonjudicial punishment, which creates a black mark on a soldier's record but cannot result in jail time).

The Army further accuses Goodrum of going AWOL from Fort Knox in November 2003, until he turned himself in at Walter Reed Army Medical Center in February of this year. The prosecutor, Captain Wright, summed it up in her closing statement this evening: an open and shut case, with serious charges -- AWOL, fraternization, and dereliction of duty.

So it appears that he was about to get into legal trouble and tried to pretend he was crazy to get out of it.

Not so fast! According to UPI, "Goodrum was named the 176th Maintenance Battalion's "Soldier of the Year" in 2001. He has received a host of awards, including the combat action ribbon, and positive reviews from superior officers.

"Lt. Goodrum is a truly outstanding junior officer," reads one performance evaluation from 2002. "In addition to his technical competence, he demonstrates great leadership potential. ... Promote to captain and select for advance military schooling."

Not only was he not the sort of man who would do something like fake a mental illness to get out of trouble, but it also turns out that the army had a grudge against him.

It seems that, for an earlier article, Goodrum gave a quote to UPI claiming that hundreds of Fort Knox soldiers had to wait weeks or months for medical treatment. This led to both Goodrum and the Fort Knox garrison commander being called before Congress to testify about the matter. This happened on October 29.

About ten days later Goodrum showed up at the very hospital he had disparaged and asked for treatment for a PTSD related breakdown. While it has not been proved, it seems likely that he was intentionally denied care by angry staff members. It was at this point that he stole away to a civilian psychiatrist who hospitalized him. This is where I had first picked up the story - at the denial of care/AWOL stage.

But wait - it gets even more interesting. As I dug further I learned that Goodrum eventually turned himself in to the military at Walter Reed and the story picks up with this item:

Army kept whistle-blower in locked ward

The Army kept a soldier whistle-blower in a locked psychiatric ward at its top medical center for nearly two weeks despite concern from some medical staff that he be released, according to medical records.

The Army then charged him nearly $6,000 for the stay at Walter Reed Army Medical Center in Washington, billing records show.

"They are definitely retaliating against me," said Army Reserve Lt. Julian Goodrum, a 16-year veteran of the Gulf War and Operation Iraqi Freedom.

Doctors say Goodrum suffers from post-traumatic stress disorder, or combat stress, from Iraq. Last summer Goodrum asked for an investigation into the death in Iraq of a 22-year-old soldier in his 212th Transportation Company. He was also quoted in a United Press International article about poor medical care at Fort Knox, Ky., that helped spark investigations in Congress.

"Walter Reed public affairs officer Beverly Chidel said privacy rules prohibit any comment on Goodrum's case specifically. But she said care at Walter Reed is dictated by patients' medical needs.

"Everything we do for a patient is based on their medical or clinical needs," Chidel said.

But some medical staff at Walter Reed expressed concern that Goodrum was being held for those reasons. "Several team members have discussed concern that he is (in the locked ward). Serial Mental Status exams have not revealed signs of psychosis, (suicidal thoughts) or (homicidal thoughts)," his records say on Feb. 26.

"As discussed previously, this inpatient hospitalization has been extended due to administrative concerns," the records say the next day. "This treatment could have taken place in an outpatient setting."

Walter Reed released Goodrum from the locked ward on March 2, one day after UPI published a story on allegations that Fort Knox refused to treat him."

Bravo to the Walter Reed medical staff who expressed their concerns about Goodrum's detention. It is vitally important that psychiatric care never be abused in that way and that psychiatrists themselves vigorously defend that ethical line.

As for his treatment at Fort Knox - again, we can't really know what happened, but it would be very human to be incensed with someone who disparaged your work and then asked for your help. But again, physicians in general have a heavy burden in this regard. Their Oath would require them to swallow those feelings and treat him anyway.

Goodrum is unique in that he has both been refused requested treatment and forced to get treatment he didn't want all within months. Right now he is awaiting Court Martial. It's an interesting case that this blog will follow.