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.
Sunday, November 16, 2008
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.
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?
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.
"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...
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.
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.
_______________
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.
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.
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
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.
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.
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.
Thanks,
Comrade Kevin.
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.
Thanks,
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.
"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.
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 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.
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.
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