Sunday, November 30, 2008

True Enough

Lest we need reminding.

The Sunday Update

I found out yesterday that my medication taper off of Seroquel will proceed much more quickly then was originally scheduled. The doctor assigned to me for the first month I was here left last week for another job, and my case was transferred to another resident on staff. She intends to start the medication protocol about two or three weeks sooner. Since I have had difficulty sleeping without taking a sedating drug first, the theory in starting a much more robust titration schedule is that if sleep becomes difficult to attain (which it almost certainly will) I won't have to suffer quite as long with sleep deprivation before the med trial starts.

The Ketamine IV infusions were supposed to proceed around third week of January. Now they will begin around the first of the year. If I'm able, I intend to post at some length about the effects of the infusions. However, do be aware that there may be a fairly extensive period where I'll have minimal sleep wherein I likely won't feel anything like posting or be able to leave comments at other peoples' sites. For some reason, I didn't sleep well last night even with medication, which doesn't bode well for the next few weeks.

If I can't tolerate a lack of sleep I'll be placed back on Seroquel and then promptly sent home much sooner than anticipated. This is not what I want since the reason I am up here is to find treatment options not available to me on an outpatient basis in Alabama. Instead of borrowing trouble, however, it's probably wisest to focus on the present and not obsess about what may or may not go wrong at some nebulous point in the future. That's a tall order for me though, as I do worry constantly about the future.

The doctors worry most about a particularly virulent bout of insomnia triggering a manic episode. Since I'm still on Lithium as a mood stabilizer (and excellent anti-manic drug) this is not a huge concern for me. Still, what has been determined conclusively is that for every manic episode a person has throughout the course of their life, the more likely it is that the one which follows it will be worse and will be achieved far easier than the one which came before. Bipolar is an illness of degrees and the window between depression and mania narrows considerably with age. I don't wish to be fifty and hit a period of rapid cycling because I've had so very many manic or hypomanic episodes.

After meeting, today I visited the open-air market which is held in the immediate block or so outside the Dupont Circle Metro stop. The Q street exit side is home to organic produce, cheese, vegetables, homebaked bread, and just about every food product imaginable. I bought a loaf of white bread and a half gallon of milk produced by grass-fed cattle. Both are delicious.

Saturday, November 29, 2008

Saturday Video

The opening single from the largely forgotten masterpiece, Odessey and Oracle, "Care of Cell 44" is the unique story of a boyfriend awaiting his girlfriend's release from prison. The melodies and harmonies are gorgeous, as is the mellotron-heavy arrangement. Enjoy.

Friday, November 28, 2008

The Impact of the Internet

This story, which has been resting on the back burner in the attention of the public and the media, shows how intense a force the internet can be. Particularly it reveals how much of an addictive social outlet cyberspace is and how it creates a vast emotional response in those who use it. Most people who I count among my blogging friends are a generation or so older than me but even so they too know both the numerous positive factors and numerous negative factors that go hand in hand with an active social life online. I'm largely familiar with the interface between 21st century technology and human emotions since I have had many experiences and much experience perusing this juxtaposition in depth. The advent of bloggers and blogging is just another continuation in a phenomenon I've been accustomed to for a decade and a half.

The internet since its inception has become a forum for bored, lonely teenagers and now everyone sees just how easily the medium can be exploited for hurtful intentions. It's easy to be condemnatory of the woman who tormented this poor girl and drove her to suicide without fully understanding the context. I admit freely that ten or fifteen years removed I might have been a victim myself. My saving grace was that in those days, so-called adults weren't as aware of the vast scope of technology and additionally the social networking sites like MySpace and Facebook that are ubiquitious now simply didn't exist then. When I was cyberbullied (and it did occasionally occur) it was by people in my own age group. My parents simply weren't aware of what a world unto itself the internet can be. I'd rather not go into a litany of cruelty here---suffice to say I was periodically treated pretty nastily by anonymous strangers.

For many years I was homebound and either too sick to travel out of the house or too fearful of social interaction in general due to an anxiety disorder. The internet was my solace, though it often times was a source of torment and pain. All of the cruelty that exists in human nature shines through in personal contact over the internet, and if anything, the de-personalization and relative anonymity mean that people can be much crueler and much harsher to others then they'd ever dare to be in person. I'm not sure what that says about us, that we're so cowardly and non-confrontational that our evil side shows most plainly when we can hide our true identities and not have to face the people we hurt or insult.

As I said, I was a teenager when the internet came to prominence. Though it would be years before an effective high-speed internet access point would be invented and then made cheap enough for the average person to afford, the technical limitations of the medium didn't prevent me from making lots of friends. Even to this day, I still maintain a few close friendships with people I met online and I've even met face to face with several of them. Though I don't often speak about this element of it, I admit as well that I found several sexual partners online, too. Sex was never my intent up front, but combine two people desperate for companionship and lacking in social skills with a mutual attraction for each other and this sort of thing is bound to transpire. I also admit that I took some risks and wasn't as cautious, nor as careful as I probably should have been in those days.

For a generation of socially awkward teenagers the internet provided us with a world of like-minded peers. It expanded my horizons and gave me an expansive view of the world that many people would never achieve within their lifetime. At seventeen, I had accumulated so much knowledge from all of my contacts then many people would realize at age forty or fifty. In that regard, the internet was very helpful. And in that spirit, the fellow bloggers whose sites I visit on a nearly daily basis give me insight that in another age to which I would never be privy. Thanks to those online friends who enrich my life and also, may I be careful to avoid those unfortunate creatures whose only desire is to bring others down to make themselves feel better.

Thursday, November 27, 2008


This is the first Thanksgiving Day I have been away from home. When I was a child, I remember walking downstairs into the den about this time of the morning and smelling the smell of five dishes cooking simultaneously. My Grandmother was over and helping my mother with the meal. Some families ate closer to dinner, but we always eat around noon. As I was rubbing the sleep out of the eyes, I would awake to find the Macy's Parade playing on the television in the den. Like many, we kept the distinctly American custom of putting something on television but not even feigning much to watch it. I think the parade is everyone's background visual/white noise for the morning, kind of like that Yule Log film one sees around Christmas time.

If it were up to me, everyone would be off on Thanksgiving Day to spend time with their families. I feel sorry for the nurses who have to work today and take care of us, though I have been told they are getting holiday pay. I'm tempted not not to travel off of the ward today so that I am one less person on the streets that someone has to contend with on a holiday. Some places are open, but many are not. Everyone here has been jumping up and down about going to Old Navy to shop but I'd rather be caught dead than actively support child labor. Still, the fact that they've kept their doors open does insinuate that they are in financial trouble and so far as I'm concerned, they can go under for all I care.

I will also be observing this timely holiday tomorrow in lieu of Black Friday. Anyone wish to join me? In addition to being socially conscious, you'll also not have to worry about finding a place to park. Nor will you have to fight your way through the crowds.

When I was in college and working in a shopping mall, if only people had followed this advice on the Day after Thanksgiving.

Wednesday, November 26, 2008

Prophet 15

I'm lost in a cloud and I can't get out
There's no other way
So don't try

I'm caught in a car and I can't get out
I can't explain
I can't drive

Oscar Wilde and Peter Cook
Are close by
Che' Guevara and Steve McQueen

Are right there

I'm lost in a cloud and I can't get out
Floating away

I can't fly
I'm caught in a car and I can't get out

I can't explain
I can't drive

John Belushi and Lady Day
Are close by

Joe the Lion and Marvin Gaye
Are right there

Davy Crockett and Joan of Arc
Are close by

David Banner and Roger Moore
Are all there

Daily Images

1. While on the metro, a doting father sang a sotto voice version of "With or Without You" by U2 in a pronounced Jamaican accent to his baby son, seated before him a stroller.

2. The poverty of Anacostia, a working class neighborhood turned extreme urban blight. All white until the 1950s, it has now has one of the highest crime rates in the entire city. They measure progress there by the fact that the district now has merely half the homicides it did in the early 1990's. Condemned buildings, decay, run down churches, a lack of much infrastructure, and almost no places to eat or shop is the reality of the entire area. The one restaurant, a fast food fried fish joint that is as worn out as everything else advertises that it is black owned and black operated.

As you arrive on the Green Line metro, you walk out of the station and are promptly dumped out onto Martin Luther King. It reminds me of that Chris Rock routine. "If you find yourself on 'Martin Luther King Boulevard', run!"

Stepping off the stop and walking out into the neighborhood, I knew I was traveling out into the H-O-O-D. I have, however, learned a few things along the way and enough knew not to make eye contact with any of the passer byes. When I was in college I dated a woman who lived in a rough part of Birmingham. Her grandparents had owned the house when it was a reasonably safe working class neighborhood. Along with white flight outward in all directions from the city center, the area turned into a ghetto. I can't say I ever felt completely safe when I'd visit her, but at least I know how to minimize the likelihood of being the victim of a crime.

My destination was the Frederick Douglass house, about a ten minute walk away. While having a Harlem Experience (i.e. noticing I was the only white person within a six block area) I followed the signs to the house, which was the residence for the last few years of the life of the noted African-American abolitionist and social reformer. Apparently they don't get many Caucasian visitors to the site and to his great credit the tour guide was nice make a point to accommodate me, though it makes me a little nervous when someone points out race in any context to make a point. Cedar Hill is well maintained and stands out in great contrast to the rest of Anacostia. It's the highest point in the area and one can see the Capitol building, the Washington Monument, and the Navy Yard across the Anacostia River in the background.

3. Embassy Row, right off of Dupont Circle. The Irish Ambassador used to throw massive street parties to celebrate St. Patrick's Day. He even went to the trouble to have six Port a John's set up in front of the Embassy for use by visitors. That's hardcore. Unfortunately, he was replaced by a much stodgier representative and the parties are no more. Alas.

4. Sex Stores off Dupont Circle. Most underwhelming, unless you are into leather or like dressing in skimpy negligée. I didn't go into the gay male themed store which was completely BDSM and/or bondage oriented.

Tuesday, November 25, 2008

Early Morning Cold Taxi

While sipping my morning coffee and attempting heavily to wake up completely I am writing this post to you. This morning I was awakened around 7:15 to have blood drawn in order to check my lithium level. Lithium levels cannot be measured except by that method. Lithum has a relatively narrow window of efficacy (that is, a blood concentrate level) which must be within .6 and 1.2. If too low, then the positive effects are practically null. If too high, then one gets toxic, which means nausea and vomiting. My last level was at .8, well within the limits. They normally get the results in pretty quickly, within an hour. By the time I finish writing this, I expect to know the results.

I have to say that being jabbed with needles early in the morning is not particularly one of my favorite things. Still, the little man whose job it is to collect everyone's blood work is efficient in what he does and has never yet required more than one needle stick to do it. Some technicians stick you like they enjoy it. By contrast, he has a command of what he is doing and is quite efficient. The whole process takes less than five minutes. After everything was finished and I had a flexible band wrapped around my left forearm to stop the bleeding, I rolled over and went back to sleep for another half of a an hour.

As I've mentioned before, I intend to go on as many day passes as I can, since I might very well not feel like leaving the hospital when the treatment starts. Today I'm going to be visiting the Woodrow Wilson house, which was the President and his wife, Edith's, residence for the remaining years of his life. The Wilsons moved in shortly after his second term in office had expired. Woodrow Wilson died there in 1924. Edith outlived him by nearly three decades and then turned the house over to the National Trust for Historic Preservation upon her death. I meant to go yesterday, but discovered before I intended to leave the unit that the place is closed on Mondays. I stumbled across it on Sunday because it's on the way to the Quaker meeting I have been attending, right off the Dupont Circle metro stop.

In other news, until Obama is sworn in, I'm kind of taking a break from politics. I'd rather not critique or second guess the President-Elect's cabinet posts or economic plan. Much energy and analysis was expended on studying the minutia of the election and now that it is concluded I am taking the time to sort of catch my breath. What I will say, briefly, is that I hold out a tremendous amount of hope that our newest President will be a much better Chief Executive then what we've had for eight long years. Contrary to what some commentators might think, I never enjoyed feeling righteously indignant at everything W did wrong. Left-wing bloggers, liberals, and Democrats alike found common purpose and common indignity in the act of speaking out against the Bush Administration, but I didn't get a sense of satisfaction in doing so. I've found it a frequently exasperating and lonely experience being the Loyal Opposition. Maybe we'll all get a chance to set aside our communal griping and observe what it's like when government is properly and efficiently run.

Monday, November 24, 2008

No! Not Teh Gays!

Run! Don't let them take over your community!

* (I can't believe this is real)


In case you are bored, you can watch this instead.

Wrong, Wrong, Wrong


And to think some young women scour these sites for "diet tips". News like this infuriates me, especially since I have a sister and a very good friend who have both struggled with eating disorders. This kind of dysfunction needs a treatment, not a enabler masquerading as a support group. Again, I am reminded of how this culture's singular obsession with body image and perfection creates major problems like these.

Sunday, November 23, 2008

A Late Update from Headquarters

After two eventful days which constituted the first part of my weekend, today was a rather sedate affair by contrast. It's good to have a break from constant stimulation and memorable anecdotes, even if they at times border on the prosaic. Tomorrow I'll keep to the unit and not trudge out again until Tuesday. I've had my fun for a few days.

Meeting this morning was very powerful and spiritually grounding. I spoke first on the subject of spiritual perfection, thoughts which had been running through my head for most of half a week and had even found my way onto my political-oriented blog. Nine other people rose to speaking during worship, three of which in particular were very instructive and quite memorable to me. One man's testimony was itself a one part spiritual reflection and two parts Quaker history lesson, and as a recently Convinced Friend I had not heard the precise story before. It was very interesting. As I have mentioned before, I enjoy a vocal service, since silence by itself is so less rich than when fellow Quakers raise and layer their voices upon the testimonies of others--in, of course, the spirit of seeking greater meaning.

I engaged a woman my own age in conversation, mostly on the subject of unremarkable small talk. The conversation was polite and obligatory, but I wouldn't call it spirited in the least. Have you spoken to a stranger and had nothing unpleasant to say about them or about what was said, but also acknowledged at the same time that the crucial spark that separates a good conversation from a perfunctory one was severely lacking? I was a little disappointed, personally. Sometimes it's difficult to draw extremely introverted people out and as I've mentioned before, Quaker meetings are overwhelmingly comprised of introverts. Someone someday will do a study about the introversion spectrum and I'll be the first to read it.

Yesterday I prided myself on finding a Target not far from a metro stop and purchased a wool knit hat (Southerners call it a "toboggan") and gloves. DC winter started early this season. I also shopped three places for a heavy coat, which I am going to need ever more so as winter chill increases daily. A pea coat ranges anywhere from $250 at a department store to nearly $100 at Target. I'm going to look a few more places before I shell out the cash. One of the patients on the unit says she knows a place where I can get a good quality coat for even less than that.

Then I will look exactly like everyone else.

To conclude, the food at the diner at White Flint was fantastic, though I wish I'd known the milk shakes cost five dollars a piece. In complaining about the milkshakes, I felt like John Travolta's character in Pulp Fiction.

The Blogger Album Project


1. Post your list of the seven best albums, the seven bloggers you will tag, a copy of these rules, and a link back to this page.
2. Each person tagged will put a URL to their Blogger Album Project post along with a list of the seven best albums in the comment section HERE.
3. Feel free to post the “I Contributed to the Blogger Album Project” Award Graphic on your sidebar, along with a link back to this page.
4. Post a link back to the blogger who tagged you.


1. Posted below are my seven best albums of all time. I don't tag people on principle, but those who wish to participate may do so over their own accord. Liberality tagged me.



1. Sly and the Family Stone- There's A Riot Goin' On

In comparison with Sly Stone's earlier, more optimistic work, There's A Riot Goin' On is a muddy, sloppy, pessimistic, occasionally presumptuous masterpiece. Never was the death of the hippie dream and resulting demise of 60's idealism better articulated than this batch of songs. The narcotic grooves and lethargic beat suck you in despite yourself. Sly Stone's drug use and internal tension within the group would eventually lead to its demise and here one sees the beginning stages of that fragmentation.

2. Sloan- One Chord to Another

This Canadian group started out sounding like a poppier version of My Bloody Valentine at the beginning of the 90's, then quickly reverted to the perfect power pop they should have been producing all along. One Chord to Another, ironically enough, was cobbled together in piecemeal fashion, since many of the tracks were written solo by each member without any collaboration at all from the other bandmates. Sloan had been more or less broken up at the time of recording and were beginning to engage in solo projects, but decided to reform to attempt to make a much better group effort. The resulting album was a triumph---successful both critically and commercially in indie circles.

3. Radiohead- OK Computer

Over a decade since its release, Radiohead's third and best album has never been matched by any subsequent group. Released at the end of the Britpop era when alternative music as a whole was waning in popularity, OK Computer is a gloomy, brooding masterpiece. Never bettered, even by Radiohead itself, no single release in all of popular music since then has come close to topping it. Later Radiohead releases eshewed guitar rock in favor of more experimental, electronic sonic textures, but here the results are still conventional enough to reach a huge audience.

4. The Velvet Underground- Loaded

Switching to Atlantic Records, Lou Reed was asked by label brass to write an album "loaded with hits." He complied, writing one radio-friendly song after another. The resulting album was the group's most successful release, though Reed left the band well before Loaded reached its apex of popularity. In comparison with more avante-garde experimental releases which came before it, Loaded was designed for chart success. This is why many Velvet Underground fans find it among their least favorite album, but I happen to believe it otherwise.

5. John Lennon/Plastic Ono Band

Raw, angry, and exposed in a way few album had dared to be before, Plastic Ono Band is one of the best examples of the seventies singer/songwriter genre. At times a painfully harrowing listen, one has to admire the boldness and bravery of its composer, even if one is horrified at the emotional intensity. Lennon made no pretenses at concealing his true feelings on a variety of controversial subjects. While retaining a rather minimalist sound during the sessions, he experimented with a variety of different styles ranging from chug-a-lug rock to protest folk to piano-driven ballads.

A modest commercial success, Plastic Ono Band is nonetheless the best Beatles solo album of all the four. Lennon would never brave being this introspective and shockingly graphic again.

6. The Zombies- Odessey and Oracle

The Zombies started as a successful British Invasion group with two top ten singles, then released a series of disasterous flop 45s. After three frustrating years with minimal chart success and lessening popular appeal, the group decided to call it quits, but not before releasing a final album. With nothing to lose, The Zombies decided to make a album precisely the way they'd always wanted. They were limited slightly during the recording by a modest budget and as a result used a mellotron in place of strings and a live orchestra. One thing can be sure---this album doesn't sound like anything else. Odessey and Oracle was released to almost no notice until Al Kooper, a member of the American group The Electric Flag used his weight and connections to publicize just how good the LP was.

A single "Time of the Season" was pulled from the album and released. It became a monster hit and one of the most popular singles of the 1960's. The Zombies were urged to reform and tour on the strength of the chart success, but they refused. The album still speaks for itself.

7. The Kinks-
Arthur (Or The Decline and Fall of the British Empire)

The Kinks had been very popular at the dawning of the British Invasion, but then morphed from a loud, four power chords band ("You Really Got Me", "All Day and All of the Night") sound not so dissimilar to The Who to an album oriented group with unique arrangements and softer elements. The wistful, literate, melancholic rock of The Kinks in late sixties and early seventies fell upon deaf ears in the UK and in America.

Ray Davies wrote an entire album which was meant to be the soundtrack to a British TV drama. When the TV show fell through, Davies released the album anyway. Full of social criticism, scathing commentary, and uniformly strong songwriting, Arthur arguably showcases Davies most cohesive batch of songs. A modest success in the UK, the album didn't make much of an impression on American audiences. The Kinks returned to the good graces of the record buying public by releasing the single "Lola" two years later, which returned the group to the top of the charts yet again.

Saturday, November 22, 2008

Last Night

1. Good company was in great supply last night at the dinner party. I enjoyed meeting Norah's mother, who is quite an oversized gregarious personality indeed. I couldn't help noticing how she has much more pronounced a upper midwestern nasal quality to her voice than her daughter. Television, movies, and the internet have muted and restrained everyone's accent, no matter what the area of origin. Each of us eats the same food, shops at the same stores, focuses on the same pop culture tidbits, and grows ever more similar to the generation before us.

Yet again I was the Deep South representative to the gathering. Interestingly enough, the attendees were overwhelmingly comprised of people from Wisconsin and Minnesota. Dinner was fixed and then consumed, drinks were poured and then drank. Conversation began with pleasantries and shifted quickly to politics, religion, and philosophy. I was in an amazing good mood and feeling humorous. When I'm not feeling well, humor is the first thing to go. At the end, I hated to have to leave when I did, just as the conversation was getting good, but I have to be back here on the unit every night by 10, officially, though if you call and say you're going to be late, and get back in a reasonable hour, then that's forgiven.

2. The Red Line metro back here to NIMH is a fifty minute trip all told from Tacoma Park. Normally I try to pass the time by staring into space or end up people watching in spite of myself. About halfway home four soccer jock girls stepped onto the train and sat down in front of me. Ordinarily I would have ignored them, but I was distracted by their horseplay. In a silly kind of way they were taking their shoes off to show each other the callouses and rough skin of their feet. Having been to a lively, humorous dinner party immediately I was in a jovial mood; when I am in a good mood, I don't mind taking a risk and initiating conversation with random strangers on the metro.

Two of them were shy, shooting me smiles and interested looks, though they were too inhibited to utter a word in my direction. One of them stared directly at my crotch for an extended period of time. Each of them had played soccer in college and made a decent living coaching twelve and thirteen year old private school girls. Though they had been rivals in college, they were now very close. What struck me most is that they were reasonably intelligent. In the south, there is no overlap. Everyone is thrust into a caste system where overlap in impossible. Cheerleaders are ditzy, athletes, regardless of sport are stupid, and as such breaking out of these exacting stereotypes is futile. Though clearly athletes, these girls were capable of speaking a coherent sentence by themselves without a tutor and I'm not accustomed to that where I live.

Meanwhile, the most attractive one, a streetwise blonde from NYC with an understandably slender athletic build and an eyebrow piercing, got off at a stop before the other three. Before exiting the car she gave each of her friends a deliberate, theatrical peck against the cheek, then, her hands wrapped around the aluminum pole of the car like a dancer, flirtatiously and quite deliberately swung her body past me on her way off the car. She wished me a safe journey and a good night. The next step was mine.

3. Someone tried to sell me drugs last night. To get to street level on my stop, one must ride or walk up a very large escalator. I was unconsciously gesticulating with my right hand, imploring a man to move aside so that I could walk by. The unwritten rule in the Metro is that those who wish to ride the escalator stay to the right and those wishing to walk it stay to the left. He was blocking the left hand side, wearing a khaki-colored trench coat. A woman was blocking my path on the right, so that my way was totally blocked. In retrospect I realize he was doing this to hand over the drugs to a buyer, who was standing to the right.

He interpreted my gesture to mean, Oh, so you'd like to buy something as well?

And, realizing this, and looking at the joint he was offering me, I nodded my head vigorously sideways, pushing past him as quickly as I could. I made large strides to the top of the escalator, and it wasn't until I had arrived on ground level and was walking quickly back to this building that I understood precisely what had transpired.

Saturday Video

Sly and the Family made their reputation as the creator of high energy, upbeat, optimistic, singalongs. Fusing funk and soul with elements like Broadway and Hollywood soundtracks, their sound was thoroughly commercial but just edgy enough not to be categorized as throwaway AM radio pap. The first racially integrated major group, Sly and the Family Stone also featured several female members; ironically, the rock music scene of the time, while it preached gender equality, was also severely sexist and overwhelmingly comprised of men. This is what made the group ever more remarkable in an era of macho posturing and male domination.

By 1970, however, the band encountered some severe tensions, from leader Sly Stone's descent into drug addiction, over infighting over the direction the group would be headed, and from the bitter death of the starry-eyed idealism that characterized the late 1960's. The resulting album, There's a Riot Goin' On, was as muddied and worn as the times, due to frequent overdubbing and the erasing of key tracks on the original master tapes. The leadoff single pulled from this album, "Family Affair", was Sly and the Family Stone's last number one single. Though Riot was the most critically successful album the band would ever record, it represents also the group's apex. It was all downhill from there.

Friday, November 21, 2008

I've Got My Philosophy

As I survey the world around me, I discover that we're all seeking to make this world perfect, or at least more perfect than it was before we were alive. I recognize that few among us wish to halt progress to a standstill or to reverse its effects altogether. Liberal or conservative, Republican or Democrat, we look to the future as a time of hope and innovation. Though some may disagree with us about the means and methods, nevertheless each of us strives to reverse the problems of humankind and improve conditions for every living soul on earth. This doesn't mean that we don't have substantive difference of opinion as to how to achieve this, but we ought to pause and examine that though our theories may differ our ultimate aim is the same.

And as I further reflect, a large part of myself harbors deep cynicism. The convention wisdom asserts that humans are imperfect creatures and that, as such, seeking perfection is a recipe for disaster. Why bother to frustrate oneself in the end, knowing that the results will always fall short of the expectations? Why entertain grandiose notions that may never prove to be workable, no matter when they are enacted? Why dream large when smaller goals might be more attainable? Why let our hopes exceed our capacity to achieve?

I think it might do us a large amount of good to think of progress in terms of the process, rather than the conclusion. Perhaps if we were more zen in our thinking we'd delight in the process of creating, discovering, and solving. Too often we base everything upon the final step, rushing through the craft, desperate to find a breakthrough. Sometimes our own pet causes and our own crusades blind us to the joy of living in the moment or at least enjoying the process of discovery.

Thursday, November 20, 2008

Finalizing Dates/ Upon Further Review

Yesterday I was informed as to the exact day I will begin the ketamine infusions---6 January. By the point the protocol begins and the tapering of most of my other medication ends, I'll only be on lithium as a mood stabilizer. I hope that's enough to keep me from becoming too depressed. The option of going home for Christmas is available to me but my concern is that by that point I will be feeling in no condition whatsoever to undertake a forty minute metro ride, twenty minute bus ride, two hour wait in the airport, and two hour flight back to Birmingham. Might as well play it by ear.

In this entry, I meant to talk about the wonderment that was today's visit to the National Portrait Gallery and the Smithsonian Museum of Art. I also meant to talk about how ridiculous it is that any necklace should be upwards of $200 and more and especially how no artist has absolutely any right to charge over $400 for a creation that, despite the practical application, will end up becoming an overpriced paperweight. I was going to conclude with a brief, snarky diatribe that a fifty year old television, set prominently in a gallery, placed on a wooden petard is NOT art. No matter how much bullshit is provided on the placard proclaiming its merits as a genuine, bonafide precious work--it's still a fifty year old television. Period.

Instead, allow me to enlighten those of you about my crush. Doomed it may be, but it does keep me feeling decidedly and daily invigorated. She who shall remain nameless (the blonde) did not immediately strike my fancy, but a man's ego can easily be stimulated by needlessly in depth conversation and flagrant eye contact. Allow me my fantasy, please, and pray do not tell me I am being delusional or reading too much into the situation.

It took me back. Odd where one's memories will take you against your will.

When I was in seventh grade I remember harboring a crush upon a girl in gym class. Since I was far much shy than I was today I was never quite sure that my feelings for her were reciprocal and I would have never been so bold as to ask directly. After six months of ten minute conversations while seated Indian-style on a rubbery floor, one memorable day we met quite unexpectedly in a computer lab. As you might recall, before the advent of internet, labs were places to create presentations or type madly away into a word processing program. I was doing one or the other that day, engrossed very much in what I was doing.

Working on something, typing away, I was lost in space. I noticed how she walked behind me, facing the monitor in the same direction as I was. Quite unconsciously, it seems, her fingers began to vigorously rub my shoulders. Enjoying the tactile sensation, I wasn't sure what this behavior connoted exactly (friendly or romantic) until I turned around to see a guilty look. She stopped suddenly. The look on her face said it all: I can't do this. I have a boyfriend.

And it was true. She did have a boyfriend, a guy two years older was who attended another school---one whom she saw with regularity every weekend. Our friendship returned with a minimum of awkwardness, but I was always left wondering what might have happened had she not been so faithful to this distant boy. I wonder where she is now. Her name was Blair.

Another Award!

I'm not worthy! I'm not worthy!

Thanks are in order to Mauigirl for this one.

Wednesday, November 19, 2008

Team of Responsiveness

The potential appointment of Hillary Clinton to head the State Department, lack of malicious reproach towards wayward nominal Democrat Joe Lieberman, and utilization of notable Washington insiders to fill crucial posts within the Obama Administration does not upset me. As has been noted in many corners of the media, Obama is seeking to emulate Lincoln by putting to together a cabinet comprised of a "Team of Rivals". Having read that particular book recently, I see its influence upon the President-Elect. Lincoln himself drew frequent criticism for every policy decision he made---especially in the editorial boards and pages of the multitude of newspapers existent in his day, which were as hyper-partisan, if not more so, than the voices of the blogsophere today.

It's a tendency of human nature to seek blood justice and harsh punishment for offenders but this is a temptation we must fight. Lincoln learned quickly that if he wished to obtain the support and advice of fellow politicians he ought to favor tact over bloodletting. Restraint is a quality often in short supply in politics and the blogsophere alike. The "gotcha" style politics that have been practiced recently may seem satisfying and cleansing in the short term, but in the long term they create resentment and factionalism which is to no one's benefit in the end. Lincoln knew that forgiveness and a refusal to hold a grudge went farther than public punishment, no matter how justified it might seem at the time. Many people are fickle and uncomprehending of the process, eager to second guess their leaders, wishing the world could be a perpetual heavyweight, bare knuckle prize fight. Desiring retribution whenever possible and believing that consensus to be little more than a naive fantasy, they hold any elected representative to a standard of perfection that is impossible to attain in reality.

Obama also is aware of the problems Jimmy Carter created for himself when he packed his inner circle full of inexperienced Washington outsiders, whose incompetence and insularity created one black eye after another for the Carter Administration. The ravenous critics who will parse, lament, critique, knash teeth, and otherwise resort to indignation would be wise to shelve these knee-jerk reactions. I feel much more confident in the judgment of President Obama than I ever have or ever will about the capabilities of President Bush. No candidate needs a free pass---that would be irresponsible and shirk the responsibility of citizenship, but neither does a candidate need to be lambasted and raked over the coals for ever decision he or she makes, no matter the circumstances. That being said, if we could seek a happy medium within ourselves that is similar to the happy medium President-Elect Obama is searching to find in his own staff, how much more content and happy we would all be.

Tuesday, November 18, 2008


Being here on the ward is not an unpleasant experience, but at times it's isolating. Though we all have a shared illness in common, that in and of itself is a rather loose and unsubstantial common thread. Ever since I can remember I've known that I was a very different person from the norm and here I very plainly recognize it again. In this society we have a kind of ambivalent attitude towards the intelligent---on one hand we envy those who have gifts most do not possess, but the other side of it is that our whole system is geared towards the average and pedestrian. We give lip service towards self-improvement and education, while in the same breath espousing anti-intellectual propaganda, much of which is motivated purely from envy and jealousy.

The things I read, the things I view, the things I appreciate are far from typical. Forgive me for saying that I fail to see the pleasure that other people derive from reading bad fiction, watching television, or shopping for trivialities. In my younger years I talked derisively about both these proletariat distractions and the unfortunate people who stuffed themselves full of these banalities. Though less inclined now to seem so haughty and presumptuous--like before I am left with many questions that may never be answered to my satisfaction. If I could ask God any question, I think I'd ask why he created most people with average intelligence and so few people, proportionally speaking, with of above-average intelligence. As somewhat of an idealist, I look at the numerous problems we have in the world and recognize how many of them would either not exist or be easily fixed if everyone was smart.

It's easy to be elitist when one contemplates that intelligence is, as I've said above, a commodity that is simultaneously desired and decried. It's easy to be a snob when you've lived your whole life feeling thoroughly misunderstood and under-appreciated. It's easy to feel a sense of profound angst when you look around yourself and realize how easy it is for those middling folks to find companionship and camaraderie. Every thinking person has a bit of a complex for all these reasons and for the rest of my life I suppose I'll be asking why it has to be that way.

Though we are created equal in theory, we are not created equal in reality. As such, one wonders if hierarchies should be treated as an inevitability rather than a construct in need of reform. How can we be equal if we are not equal in skills, talent, or intellect? This, too, is a matter that no amount of study or consultation can answer to my satisfaction.

Monday, November 17, 2008

The More Things Change...

The Huntsville (Alabama) Times ponders why Alabama overwhelmingly voted for John McCain in this past Presidential election. The conclusions drawn in this article are that race was a factor in voting patterns and that although racial dynamics came into play, racism played a much smaller part of the whole scheme of things. I point this out because I get very tired of self-righteous people stating with self-satisfied smugness that the South has a monopoly over racism. In my travels north, I've found racism in greater quantity in some places in the North.

Much of the south has remained insular and removed from the more cosmopolitan elements of Northern cities, meaning that in the case of Birmingham, where I live, everything becomes a black versus white issue. Black politicians have kept their power base by inflaming racial tensions to get themselves elected and white politicians have done the very same to their bloc of voters. Sadly, a state of mutual paranoia exists where we would be better served by forgetting the historical stalemate and substantial violence of the past by simply moving past it. Unlike many observers, I don't take sides in this Pyrrhic battle---I think everyone involved, regardless of skin color has proved themselves equally ridiculous in the proceedings.

I've had conversations with small town Alabama residents and recognized quite quickly in the discussion that their viewpoints have never been challenged. They hold fast to a few well-worn talking points and leitmotifs, but at no point has anyone given them reason doubt their time-honored positions. By contrast, since I've been up here in DC, which is a solidly Democratic, solidly liberal area with a tremendous amount of wealth, opportunity, and education I recognize all that the intersection of wealth, opportunity, and education in a concentrated area can produce. While the benefits are thrilling, I think at times people who have so very much forget, in their desire to point fingers and condemn those who do not think as they do, how much they have in comparison to so many others.

Even in times of economic recession, they have more than many other regions of the country (and certainly many nations of the world) combined. If each of us had the same opportunities afforded to us, then what a different world this would be. When Jesus said, "the poor will always be with you", I don't think he meant that somehow this was the way things were supposed to be, always. Indeed, if all people lived a virtuous life, there would be no poverty in the world whatsoever. This goes well beyond advocacy work on behalf of the poor. That in and of itself is good, but is insufficient. What is called for is a total change in mindset and mentality. Those around us are poor in many ways beyond having no money: poor in spirit, poor in morality, poor in ignorance, poor in judgment. I maintain, and I maintain strongly, if we saw to these problems as we should, how much better everyone's lifestyle would be in the process.

Sunday, November 16, 2008


One of my shirts (not pictured) has shrunk considerably in the wash.

What was an overshirt has now become closer to a halter top. This would be great if I had a flat stomach and wanted to go to the gay bar and pick up men, but I'm not really inclined in that direction.

Observances While at Meeting

After having breakfast on the unit, my pass out into the outside was signed and away I went. I arrived at Friends Meeting of Washington, D.C, about forty-five minutes early. Quaker meetings I have found over the years to be disproportionally comprised of introverts and people as socially awkward as I, if not more so. This creates problems, since one socially awkward person in isolation is bad enough, but fifty in the same room trying desperately to make small talk is something else altogether. So it was that until First Hour worship I had several conversations that would likely be hilarious to observe from an outsider's perspective---especially if I had brought along a camera to provide visual evidence of said fact.

Worship began after ten minutes or so of silence with a woman expressing grief that a close family relative had passed away. I contemplated this for five minutes or so according to protocol. Quaker etiquette holds that it's rude to immediately rise to speak after someone else has finished talking. The point is to contemplate and find inner meaning with what has just been said. I make a habit of frequently speaking in meeting, but since it's such an effort to psych myself up enough to gather my courage, I often get impatient with waiting when I know my ability to talk in front of people quickly leaves me when I have time to obsess about my outward appearance to the rest of the world. My nerves have often betrayed me. Fortunately, today was not one of those instances.

I gave an eloquent, passionate talk. Though inside I was on the border between so nervous that my voice quavered and determined to speak my heart in spite of it, I gave the best message I had managed in my life. Anyone with a fear of public speaking knows what a chore it is to fight with one's own neuroses and stay afloat in the process. Yet, I kept these forces at bay and finished my talk. The satisfaction of a job well done flooded through me as I took my seat and tried my best to embrace serenity and inner calm.

A tired-looking blonde-haired girl with circles under her eyes and bad bangs spoke next. Earlier, as the service was beginning, she entered from my right and sat a bench behind me. My eyes fell upon her threadbare stockings, which were full of holes. She looked unbathed, exhausted, depressed, and demoralized. Her voice was fearful and resigned.

Sometimes it is so easy to see the Light within other people (referring to me), but there are times when I can't even see it within myself.

I know what she meant. Sometimes God seems far away, leaving you wondering where he is and why he departed for other destinations. The reality, of course, is that God is always there but for mysterious reasons direct revelation can seem at times both elusive and fickle. Sometimes he is revealed in the person of a stranger sitting next to you. Sometimes it appears as though his hand is present in the life of everyone you encounter with, the notable exception of you yourself. My own personal belief is that this perception involves freedom of choice. I firmly believe that since we are granted Free Will and can choose between good and evil, God works subliminally rather than overtly. The times in which he seems to have deserted us, he may simply be wishing to not interfere with our freedom to choose light or darkness, good or evil. If everyone was blessed with constant revelation, all of us would easily and eagerly choose good.

I treasure these times, where I feel the Light reflecting from within me out to everyone else in meeting when I speak. Today was one of those fortunate mornings where even my introversion, performance anxiety, and fear of public speaking fall away. The credit, of course, goes to God. I know there's no way I could do it by myself.

Saturday, November 15, 2008

Minor Annoyances

I headed to the Corcoran Gallery of Art today during the late morning and early afternoon. The trip underscored two key elements of my taste in art. They are as follows:

a) I'm tired of people using 11 September 2001 as a springboard for found art. It was a big deal at the time, it's over, and I could easily go another lifetime before having to see this dedication or that dedication to it. It seems like these days any momentous event, no matter what it is gets over-analyzed, parsed, deconstructed, and picked apart to death, rendering us all by the end exhausted with the very idea of it.

Here's the skinny of the exhibit---A female artist had lived next door to the World Trade Center and when towers collapsed, the resulting force blew out her windows, in the process thrusting a collection of discarded papers from offices into her living room. She glued each of them to a large strand of linen which reached from one end of the exhibition room to the other. That was it. I found myself somewhat interested, but much more fascinated by portraits and paintings.

b) I think minimalism is great, until, of course, it isn't. In literature, being deliberately sparse is much more palatable, but as I approach the beginning of the modern era, I find my attention and enthusiasm lessening. With landscapes, in particular, I much prefer the 17th and 18th century varieties to the modern ones, which look so faceless and wholly unremarkable that one wonders why they're not being sold for display to grace the walls of homes instead of housed in a gallery.

Question to the Peanut Gallery

At which point does completely out of fashion become retro and thus making a statement?

Or does it depend on who's wearing it and how and when and where?

Saturday Video

Alice in Chains secured widespread popularity as part of the famed Seattle grunge scene of the early nineties. Unlike many Seattle groups of the time, their music incorporated elements of both heavy metal and acoustic rock. Compared with the electric guitar heavy, punk-influenced bands of the time, Alice in Chains pulled in influences from bombastic arena rock to mellower styles of music. Part of the compendium of Seattle groups which rode on Nirvana's coattails into massive public attention--each seeming to catch fire simultaneously---Alice in Chains still hold the record for the largest selling EP of all time,1993's Dirt, on which this song is located.

"Rooster" is dedicated to guitarist Jerry Cantrell's father, who served in Vietnam. A powerful anti-war track, revealing the horror and fear of combat, the song reached number seven in the mainstream rock tracks. "Rooster" was a fan favorite and made its way into frequent MTV rotation.

Friday, November 14, 2008

Coming Up for Air

Last night began a slow tapering off of most of my medication. For the next month and a half I will be removed from almost all of them, with the notable exception of lithium. To participate in the study, one must stay on a mood stabilizer, either Lithium or Depakote. The first infusion of ketamine will take place around the first of next year. This means, of course, that I have a lengthy wait ahead of me before the trial begins. When it does, I'll receive an infusion a day for two weeks, then two weeks of nothing. Two weeks on, two weeks off, two weeks on, two weeks off---for roughly two months. As part of the study, at least some of the time I'll receive a placebo. It will be double-blind: neither I, nor the nurse administering the IV infusion, will know whether I'm receiving ketamine or placebo. I'll blog about the results, provided I am feeling stable and responsive enough to type.

Meanwhile, as I mentioned before, I am on the waiting list with one of my Senators and my local Representative to Congress regarding Inauguration tickets. As was reported in the local media, yesterday every Senator and Representative simply stopped taking requests for the ceremony altogether. Only 240,000 tickets will be granted to lucky constituents, and most congresspeople will get no more than 500 tickets to disperse. With demand at an all-time high, getting into the proceedings is by no means a slam dunk. Demand exceeds supply around 5 to 1. If I do get a ticket, I'll consider myself very fortunate indeed. The price of tickets have been bid up to ridiculously high levels---although technically free, on an online site I found, people have put in bids for any available passes to the event---and as such one ticket has been priced as much as $500 to $40,000 a piece.

They're expecting over a million people to be here for Obama's formal swearing in and Inaugural address, which is much more than the crowds that annually throng this area for the Fourth of July proceedings and fireworks on the mall. Hotel and motels in the area have just about been booked solid, too. It almost goes with saying that this is a historic event and everyone wants to say that they were there in person to see it. I do, too, but if I get tickets then I'll be tempted to make several hundred dollars profit by selling them to someone else. Still, being there would be the culmination of a dream I had beginning nearly two years ago and one that I honestly never thought I'd ever see in reality. I had this pleasant reverie wherein I saw Obama dressed warmly in a long black coat, reverently proclaiming, in his familiar baritone---I, Barack Hussein Obama, do solemnly swear...

Thursday, November 13, 2008

Stopping to Reflect

YouTube allows me the ability to browse the music videos of my early teens, the beginning of the so-called Alternative Revolution. They haven't dated as much as my perception of them has dated, and I realize now how many of them weren't nearly as awesome or as groundbreaking to the whole scheme of things as I thought they were at the time. That is to say, the sacred cows of a prior age are not nearly as sacred these days. Still, there are a handful which retain their staying power with me--albums and groups which I've always kept around and listened to periodically over the years. Those are relatively rare, though, and in watching the songs now a decade and a half old I often fail to see what the fuss was about. That era is in some ways closely related to these times, but in subtler ways they are also light-years away from us.

With age, tastes evolve, shift, and change. The people I worry about are the ones who live in a state of perpetual adolescence, neither moving forward, nor backwards. I also know that this one paragraph's worth of realization is far from uncommon. When you strip away hype and hyperbole and youthful exuberance and effectively demystify your past, you don't have much left afterward. What I have noticed is that the 1990's, led forward by grunge and post-punk were at times a pretty dark, dismal period in popular music--one teeming full of heroin-addicted musicians, ego posturing, preciousness, angst, and social defectives masquerading as tragically romantic, fashionably fallen demigods.

Case in point.

Now Entering Protocol

This entry is going to be a little heavy on medical terminology, so those who enjoy reading about the advances and exploits of psychiatric medication will delight while others less inclined might find this a touch boring. You know who you are, so read accordingly. With the election behind us and a lack of actual political news yet to arrive in this transition period between Presidential administrations, I'd much rather talk about treatment. Treatment is, of course, the whole reason I'm up here.

Today is a bit of a momentous occasion. This morning at ten o'clock I sign the paperwork officially beginning the protocol, or medication trial. Everything will be explained to me in great detail and later today or tomorrow I'll post more about what was said and what transpired. By noon I'll know exactly how long this trial will take, how much I'll be paid for it, and what sort of positive benefit I should expect to receive from it. Of course, every medication has a different result for every human being who takes it, which is part of the challenge in treating mental illness. The brain is poorly understood, and since bipolar disorder is a brain disease, therein lies the challenge.

What I do know is this: Ketamine injections will be administered via IV drip for forty minutes a day. During that point I will be surrounded by two nurses and a staff member, asked several questions as to my mood at the time, and after the infusion stops I'll be immediately walked over an expensive imaging scanner, and asked to lie still while a PET scan is performed. Each dosage of ketamine is rather low, since the drug was designed specifically to be an anesthetic, and the patient losing consciousness is not the desired result of this study. In talking to several fellow patients, each had a completely different reaction. Some patients felt nothing at all. Some hallucinated with fluctuating degrees of intensity. One woman giggled for hours afterward.

As for therapeutic results, yet again the results were severely mixed. One patient received much benefit from the drug for two weeks solid. Another patient only felt significantly less depressed for three days, then felt nothing at all afterward. I wonder where my result will fall. In the meantime, I will be slowly tapered off of my Seroquel. Since they want to have as tight as control as possible on the results, I'll be taken off all of my medication except for a moderate dose of lithium. Everyone in the ketamine protocol is kept on either Lithium or Depakote, though just high enough to have a mood stabilizing impact and no higher. For example, I take 1500 mg of Lithium a day, and I might be reduced to 1200 mg, since anything below that dosage would not give me any significant leveling effect.

I'm cautiously optimistic as to the overall results and will continue to post every latest development as it occurs. For those who wish to know a few blurbs more in depth about this precise study, I've tacked a few paragraphs onto the end of this entry.


The National Institute of Health News reports that a study of 18 patients has found that ketamine significantly improved treatment-resistant major depression within hours of injection.[25] The improvement lasted up to one week after the single dose.[26] The patients in the study were previously treatment resistant, having tried an average of six other treatments that failed. NIMH director Dr. Thomas Insel said in the paper:

"To my knowledge, this is the first report of any medication or other treatment that results in such a pronounced, rapid, prolonged response with a single dose. These were very treatment-resistant patients."

The researchers apparently attribute the effect to ketamine being an NMDA receptor antagonist.[27] Those findings of Zarate et al corroborate earlier findings by Berman et al.[28] However Zarate et al do raise some concerns about their results due to a possible lack of blinding, because of the inebriating effects of low dose ketamine infusion, and it is recommended that future studies include an active placebo.

The findings by Zarate et al. are confirmed by Liebrenz et al, who substantially, according to an attending doctor, helped a 55-year-old male subject with a treatment-resistant major depression and a co-occurring alcohol and benzodiazepine dependence by giving an intravenous infusion of 0.5 mg/kg ketamine over a period of 50 minutes and Goforth et al who helped a patient with severe, recurrent major depressive disorder that demonstrated marked improvement within 8 hours of receiving a preoperative dose of ketamine and one treatment of electroconvulsive therapy with bitemporal electrode placement.[29]<[30]

However, a new study in mice by Zarate et al. shows that blocking the NMDA receptor is an intermediate step. According to this study, blocking NMDA increases the activity of another receptor, AMPA, and this boost in AMPA activity is crucial for ketamine’s rapid antidepressant actions. NMDA and AMPA are receptors for the neurotransmitter glutamate. The glutamate system has been implicated in depression recently. This is a departure from previous thinking, which had focused on serotonin and norepinephrine. The glutamate system may represent a new avenue for treatment and research.[31]

Krystal et al. retrospectively compared the seizure duration, ictal EEG, and cognitive side effects of ketamine and methohexital anesthesia with ECT in 36 patients.[32] Ketamine was well tolerated and prolonged seizure duration overall, but particularly in those who had a seizure duration shorter than 25 seconds with methohexital at the maximum available stimulus intensity. Ketamine also increased midictal EEG slow-wave amplitude. Thus, a switch to ketamine may be useful when it is difficult to elicit a robust seizure. Faster post-treatment reorientation with ketamine may suggest a lower level of associated cognitive side effects.

Kudoh et al. investigated whether ketamine is suitable for depressed patients who had undergone orthopedic surgery.[33] They studied 70 patients with major depression and 25 patients as the control (Group C). The depressed patients were divided randomly into two groups; patients in Group A, initial HAMD 12,7 (n = 35) were induced with propofol, fentanyl, and ketamine and patients in Group B, initial HAMD 12,3 (n = 35) were induced with propofol and fentanyl. Depressed mood, suicidal tendencies, somatic anxiety, and hypochondriasis significantly decreased in Group A as compared with Group B. The group receiving ketamine also had significantly lower postoperative pain.

Acute administration of ketamine at the higher dose, but not imipramine, increased BDNF protein levels in the rat hippocampus. The increase of hippocampal BDNF protein levels induced by ketamine might be necessary to produce a rapid onset of antidepressant action.[34]

Wednesday, November 12, 2008

Ob-la-di, Ob-la-da

I'm going to call a halt to trips out for a little while. Though fun, they are frequently expensive and have drained my bank account. This hiatus won't be for very long, since you're paid reasonably well to participate in studies. The first check I received was for $440 and if I participate in two protocols, I stand to make around $2000 to $3000 all told. I may need to wire home for money just to be on the safe side. While Washington DC isn't the most expensive city I've ever visited, then again the cost of living and price of even the most routine things is significantly more than home. Blue states and blue cities are substantially more costly.

Meanwhile, the powers that be are waiting for records from all of the six other hospitals to which I have been admitted over the years. I wrote them all down in the first batch of paperwork I received, which was promptly filled out and mailed back four months ago, but apparently the staff didn't receive everything they requested. The culprit behind this delay is one of the hospitals in Atlanta where I spent three days recovering from minor bout of mania, which is so badly managed and averse to doing even the most basic of tasks that I know it'll be a while before NIMH receive its records. It's a little sobering that this is the sixteenth time I've been on a psychiatric ward but I try not to let the sheer number of hospitalizations make me depressed.

I've been promised a decision as to which medication I'll start receiving by the end of the week. Since things move rather slowly here, two events will lengthen my stay beyond what I was initially anticipating. a) My primary doctor is leaving at the end of the month for another job, meaning that it will take a while to assign me to another doctor on staff b) As mentioned before, waiting on the records from the Atlanta hospital will delay the decision as to which medication they believe will be the best fit for me.

Today will be a reasonably nondescript day which I will take to read, exercise, listen to music, and generally stare into space.

Tuesday, November 11, 2008

Journey to Mount Vernon

Mount Vernon is an absolutely beautiful place. At $13 a ticket for adults, it's a little on the pricey side. Most of the museums in the area are government run and government subsidized, meaning the fare to get in is usually free. Not Mount Vernon. The famous home of George Washington is privately owned and operated, meaning of course that dragging a family through the gates is not an inexpensive endeavor. Pricey, yes, but well worth the money.

I spent several minutes seated on a rocking chair painted green, looking out over the Potomac River, sitting on the south portico facing outward towards the riverbank. I wish I'd had a camera to document the event. Virginia, unlike Alabama, has very few pine trees. The result is a mostly deciduous forest that has now completely changed with the seasons. The yellows, reds, and browns make for a memorable visual image. The last time I visited it was early June and in the beginning of summer, so I didn't get the chance to see the autumn leaves.

When I was around fourteen or fifteen, the family took a trip to Washington, DC, whereby we stayed for close to a week. After an eleven hour drive from Alabama, we settled into a motel in the District, and after getting ready and eating breakfast, took one whole morning to browse the plantation of our country's fabled first President. Much had changed in fifteen years. The increased ticket price is due in large part to the addition of a brand new building on site, featuring a food court, new museum, visitor's center, and extensive gift shop. That was certainly not around when I last visited. Back then, the place had an air of well-worn charm, and although the grounds were well-maintained, the attraction was certainly showing its age. No longer. New walking trails have been established as have newly constructed farming equipment common to the period, a new walking bridge down to the riverside, a distillery, and a simulated slave quarter such as would have existed in Washington's day.

The trip was only slightly marred by a phalanx of three foolish people. Had I not had to wait in line next to them for most of an hour, I probably wouldn't have cared as much. However, I did, and having brought along an mp3 player I attempted to drown them out as best I could, which wasn't well enough. In addition to sporting annoyingly nasal Midwestern accents, talking loudly, and not bothering to do much in the way of minding a four year old boy (their son), they were all wearing sandals. I knew immediately these were the sort of people who would wear sandals even if it was -17 outside and as I peered down, showing through their sockless feet were a multitude of unbelievably ugly tattoos.

For starters, they had named the child Paxsan, which they had shortened to Pax. I really hope he doesn't come to hate them at some later date in his development. This also means that I had to hear PAX! screamed loudly up and down the pebble lined entryway to Washington's house. The boy fell flat on his face twice and it is a wonder he didn't run away altogether. I know little kids are fidgety, but had it been my kid, I'd have kept him close at hand and not in danger of seriously hurting himself. The threesome decided that having an extremely graphic sexual conversation around small children and critiquing the relative merits of Family Guy episodes was the best alternative to actually resort to such an uncouth occupation as say, parenting. I then listened to the father of two talk about all the ways he managed to con his way into places because he had been, at some point, active duty military.

Armistice Day

Today is formerly named Veteran's Day, but the Eleventh day of the Eleventh Month was originally designed to commemorate the end of the first catastrophic, widely sweeping conflict of the modern era: World War I. The Central Powers and the Allied powers agreed to stop fighting at the eleventh hour of the eleventh of November, concluding what had been four years of mechanized slaughter, the likes of which had never been seen before in the field of battle. Eight million died, methodically and chillingly killed by advanced weaponry: machine guns, poison gas, long range artillery, and tanks. The first total war of the modern era, World War I destroyed the economies and emptied the coffers of many Western European countries---in blowing each other sky high, each proved to be its own undoing.

Though seldom remembered these days, I think it would do us well to give pause today to that conflict. World War I drew a second-rate, reluctant, isolationist nation into the life-or-death struggles of Europe. While the major nations of the world emerged from the protracted, bloody conflict decidedly worse for wear, America gained a toehold and an industrial base that would within the next two to three decades make it the most powerful nation on the face of the earth. As the former world players crumbled, we took supreme advantage. It would take another World War to firmly establish the United States of America as a superpower, but the seeds of that assumption of authority would be planted immediately after what at the time was dubbed The Great War.

The aftermath of the conflict spawned the Lost Generation, a compendium of writers, artists, musicians, and bohemians with a sour, pessimistic outlook. Having experienced the horror of war and its impact on the soldier and civilian alike, they threw romanticism and optimism aside in forming their own conception of a fallen world. Wishing to forget the visceral and emotional toil of World War I, artists and regular people alike embraced a new era of loosened mores and permissiveness---which would last for a decade until the Great Depression thrust the entire world into a period of intense poverty it would take another World War to eviscerate, though some nations emerged from that war in much worse shape than they had during the previous one.

Do remember today those who gave their lives or at minimum their sanity in war, but don't forget the lessons of 1918, either. Though I am a Quaker and officially opposed to warfare of any kind, on Armistice Day day I take a moment to acknowledge the huge toil of the battle and how it punishes everyone: soldier, wife, husband, sister, brother, mother, father, son, daughter, uncle, aunt, grandmother, grandfather, friend---alike.

Monday, November 10, 2008


(Click to embiggen)


Thanks be to Westcoast Walker for this one.

I sincerely appreciate it. I scribble, therefore I am.

Breaking News (And an Anecdote)

I've called all three of my U.S. representatives. Two of them have put me on a waiting list and one rude woman at Senator Pissant's office claims that all the tickets to the Inauguration have been given out. This seems a little bit strange since I was told in no uncertain terms that not even a single ticket has been even printed yet; as such, no Senator or Representative will know his/her allotted quota until the end of the month. Either his office is lying to me, or they have some kind of backroom, old boy network way of dispersing tickets.

It really annoys me when I try to small talk a little for the sake of being social and end up speaking with someone who acts as though taking my call is a huge imposition. After five seconds on the phone it was obvious she couldn't wait to hang up. Maybe she's mad that a Democrat won the Presidency? No matter.


While out at the Alabama game, Norah got a brief glimpse of what life in a conservative state is like. In between commercials, Obama appeared on the television screen, giving a speech, apparently some kind of promo for a news show. A small, but nonetheless very vocal group of five people sitting in the front of the bar began booing. He'll be their President, too, and I hope Obama can win over even his detractors.

Tickets, Rounds, and Raw Nerves

Today during rounds I should find out specifically when the protocols are to begin and how the tapering regimen will proceed. One of the more confounding elements of being here is that I am told only a little bit by little bit at a time how the trial will be run. Hardly ever am I provided with the big picture of any decision. I wonder whether this is due to some strategy or clinical theory which I am largely ignorant, or rather that the doctors in charge simply don't want patients to know the majority of the intimate decisions they make. It makes for frustratingly insufficient conversation when people ask how precisely I am to be treated---I simply can't answer their question in more than surface generalities.

Yesterday I returned from an overnight pass out with a friend having not slept well the night before. This is why I was too tired to post anything much of substance upon my arrival back on the ward. I'll be honest. After the election, I find myself with not nearly as much to talk about as before. No worries, though, things will pick up again, particularly when Obama is sworn in at the end of January and the fabled 100 Days begin. I normally don't talk about myself on this blog nearly as much as I have since I've been up here, but I figure that documenting my progress while in treatment is worth noting.

This morning, shortly before rounds, I have been attempting to call my Congressman to obtain two tickets to Obama's inauguration. My friend is a native of Wisconsin, a solidly blue state, and as such likely to have already allocated its share of tickets. Alabama is a red state with a majority of representatives being Republican, and as such I know demand will be much less than it would have been had McCain won. Still, this time around, according the online news, even in Alabama there have been many requests for tickets to the proceedings and the multitude of formal balls and galas that bookend every Presidential Inaugural. In a way, this surprises me, due to how conservative a state it is. Yet, in a way it doesn't, considering how liberal most of the big cities tend to be and that the idea of the so-called Solid South conceals the fact that there are a sizable number of Democrats in every Southern state.


Next, a rundown of part of my weekend.

When I stepped off of the metro platform and rode the escalators up to the top of the Convention Center stop, I knew I was in a fairly rough part of town. The burglar bars on every window, the decay, and that faint but perceptible sense of tension in the faces of the people I passed by made that clear enough. But as my eyes adjusted to urban blight and decay, I noticed that gentrification had begun, or at least was trying to take root. Ten to fifteen years of reclaiming a ghetto means that a three block perimeter around the focal point of the attraction was full of trendy eateries, coffee shops, and bars. Ten to fifteen years of reclaiming a ghetto means that once one strays very far from the scene, one sees the hand of poverty on everything, shivers, and leaves immediately.

The Convention Center was fairly new and designed specifically with reviving the area, which had been a working class neighborhood in the early part of the twentieth century, then a largely African-American ghetto, then marked for urban renewal, then home to a major riot after the assassination of Martin Luther King, Jr., then targeted by urban pioneers. Even so, a trip to a hard-scrabble grocery store provided me the opportunity to be the only white person waiting in line.

Heading back to a safer part of the area, two groups bumped elbows at all the eateries and tourist attractions. Both of them met at the Conventional hall simultaneously: young black women in identical black muslin dresses, participating in a meeting sponsored by Essence magazine---combined with a gathering of largely young environmentalists. Towards the end of the afternoon, there were a copious number of Alabama fans awaiting the football game, which was why I happened to be in the area too.

I was glad Norah came with me since it would have been a little lonely to have been there on my own. Games are social events and one craves social connection when one's chosen team wins. Of all the games this season, she happened to be around for the best.

Sunday, November 09, 2008

Saturday, November 08, 2008

A Grievance in Brief

Dear Celebrities,

Don't try to make political statements. You're not as informed, nor as insightful, nor as articulate as you think you are. Instead, you just end up sounding foolish.


Comrade Kevin.

Saturday Video

A splinter group formed as a collaboration between two early members of krautrock pioneers Kraftwerk, Neu! produced some of the most experimental, most innovative, most all-out weird proto-electronica ever recorded. Drummer Klaus Dinger and guitarist Michael Rother would greatly influence a generation of techno and ambient musicians who followed their lead, but they were much too willfully strange to find much of an audience back in 1972, when their debut album was released to a largely uncomprehending West German record-buying public. Neu!'s three studio albums were re-released on CD at the beginning of the 2000's, reaching in the process a worldwide audience which had been up until that point entirely ignorant of the group's existence-- which transpired during a brief three-year-period running from the early to the mid 70's.

"Negativland" is ugliness personified, married to a robotic, metronomic beat and a distorted electric guitar that sounds not unlike an electrocuted seagull. This is music designed to be listened to whilst driving in a car, hence the reason Neu!'s sound is often described by means of the German adjective motorik, a turn of phrase coined specifically for the band's unique sound.

Friday, November 07, 2008

A Treatment Update

I've been trying to get out as much as I can because once protocols start, I might not feel up to getting off the ward. "Protocols" mean medication trials and in my case it means an injection a day of ketamine for several weeks. The dosage is low enough that it doesn't foster hallucinations or sedation, but it does make one feel fairly weird for thirty minutes to an hour afterward. Mostly I'm picturing both of my arms turning slightly black and blue and bruised from frequent needle punctures. The visual image that comes to mind is Sylvia Plath's description of her daily injections of insulin while she was hospitalized for depression in the early 1950's---noting her purple-tinged buttocks discolored and sore from months of shots.

One only receives actual relief from the shots for a maximum of one week. One woman here on the ward said that it made an impact on her depression for only three days, then she ceased to feel any effect at all. The neurotransmitter in question here is the amino acid glutamate. Up until this point, neuropathways explored to treat mental illness have been serotonin, dopamine, and norepinephrine. Glutamate has shown some promise and a recent drug trial in Russia which involved a much more aggressive exploration of the pathway worked well enough in stage II trials that I would not be surprised if it were FDA approved within the next few months.

I've been trying to get as much done as I can now, anticipating that once the trial starts I might potentially feel ill from the side effects. Ketamine protocal will take two or three months and then I might qualify to take another drug, Riluzole, which up until this point has been used exclusively to treat ALS, also known as Lou Gehrig's Disease. A correlation between ALS and bipolar has been established, though no one is completely sure how they are related. For example, lithium, which I take as a mood stabilizer, has also showed some promise in treating ALS. If one contemplates and studies much about psychiatry and psychopharmacology, invariably the same conclusions are drawn across the board---we know a little but nowhere near a lot about why medications work.

Thursday, November 06, 2008

A Reminder to Myself and Anyone Who Needs to Hear It

A Potentially Cranky Post

I understand the point of field trips, I really do. Show kids the momentous, the important, the laudable, the fantastical events which have transpired in history. Call attention to the triumphs and give children a sense of what they too might accomplish when they are adults.

That's the theory, anyway. The reality is that field trips become a break from the daily routine and/or monotony of the school day, meaning they quickly become social outings at the expense of everything else. Without guidance or the presence of a tour guide, field trips quickly degenerate into everything they're not supposed to be. Children are severely bored, totally unwilling to take the outing seriously, and don't make much of an effort to seriously contemplate the exhibits. Instead of measured reverence and a gradual sense of pacing they instead rush through scene after scene, barely focusing on anything other than their friends, and in turn completely missing the point of everything.

This is my second museum trip whose impact has been muted, if not ruined altogether by bratty children. And I'm not necessarily down on the kids themselves. I'm more frustrated with the adults in charge who have never taught these kids why they should care and care deeply about what it is they should have been viewing. I too remember being that age and feeling freed from the constrains of a 8 to 3 school day, but I also was a studious, serious child who had a good time at museums and historical sites because I got the point.

It doesn't have to be this way. I'm not sure whether to call for more discipline or studiousness in the part of teachers and administrators, but in any case, something needs to change.

Wednesday, November 05, 2008


This Newsweek synopsis, an insider's view of the 2008 campaign is a fascinating read, if you haven't done so already.

A kind of survival-of-the-fittest ethos permeates this extended explanation for why Obama won, McCain lost, and Hillary Clinton didn't become the Democratic nominee. In short, Obama surrounded himself with the best people and didn't fall prey to ego wars, pettiness, unnecessary expenses, and counter-productive backbiting. Reading it makes me even more glad that neither McCain nor Clinton became President, because if they didn't have the judgment necessary to run their own campaigns, what makes anyone think they could have run the country?

The idea of a Hillary Clinton or John McCain administration was a frightening concept to me, which I why I cast my votes both in the primary and in the general election for neither of them. Personal favoritism aside, having either of them as President would be a grave disservice to all Americans. As painted by this expose, Obama is not perfect, but he is certainly more competent then others with whom we might have been otherwise saddled. W proved how base incompetence can doom us all. I feel much more hopeful today.

*I'm also reminded of how often we elect slightly geeky loners to high elective office in this land. If I didn't have such a rotten medical history I'd have at least tried to get involved in politics as a candidate for some position.