The Wild, Wild West
Some decades ago one would hear this take on an old saying and think only of a popular, if a bit corny, television Western. But after the (again) recent mass shootings here in the U.S. (and again, carried out with assault rifles by the shooters and in one case, body armor), outside observers have to wonder what is going on, not only in the "west" but throughout the United States. Our President and our Congress (well, our Senate at least) continues to blame mental illness as the cause, as noted in a day-old editorial by of all places, the business oriented Bloomberg: Maybe this time will be different. That’s the thought on the minds of many Americans now. Two mass shootings in 24 hours have left at least 31 people murdered and many dozens more wounded. This, just a few days after a shooter at a festival in California killed three and wounded a dozen — with shooting sprees in Brooklyn, Chicago and Mississippi that also left people dead, dozens wounded and communities shaken. President Donald Trump addressed the nation today but failed to mention the two most important words in this debate: background checks. While he said he supports a federal red-flag law, which allows law enforcement to remove guns from those who pose serious mental-health risks, he has yet to push for it. And he pinned more blame on video games and the internet than on our laws that enable such horrific violence — the usual dodge. Children killed with assault weapons at a grade school...nothing happened. Kids killed with assault weapons at a high school...nothing happened. Concert goers killed with assault weapons in Las Vegas...nothing happened. People killed in a mosque, church, and picnic, all with assault weapons...nothing happened, at least not here in the United States. Wait, I take it back, the sale of guns, even now with these recent incidents, spiked to new sales levels (kudos to New Zealand for taking action immediately, as in a few days, to change its gun ownership laws). Continued Bloomberg: The House of Representatives passed a hugely popular comprehensive background-check bill in February, along with legislation to close the loophole that let a racist mass murderer acquire the weapon he used in a church in Charleston, South Carolina, in 2015. Senate Republicans have failed to act on both those proposals. The recent shootings brought even more tragic stories, that of a mother diving over her baby daughter, then her husband diving over both of them (both were killed but the baby survived; they also leave another 6-year old daughter). One of the shooters cited in his "reasoning" the words of our president, words spoken during one of President Trump's election rallies. There are even sites where such would-be and actual shooters go to promote or detail their plans for such mass shootings (recently taken down but rapidly put back up by another server). Well the shooters are suffering mental illness say the pundits, but is there more going on behind the scenes, and exactly what sort of "mental illness" are we talking about?
The rather famous Framingham study done in the 1950s, one designed to study and follow for 20 years the possible factors that could lead to coronary disease, almost highlights the difficulty of trying to pin down a "reason" in a general way. In his book Heart: A History, author and cardiac surgeon Sandeep Jauhar tells of the study this way: The first study questionnaires included items about personal and family history, parents' age at the time of death, habits, mental state, and medication use. Government appointed doctors peered into subjects' eyes and palpated livers and lymph nodes. Blood and urine tests were taken; X-rays and electrocardiograms were performed... After a year, control of the study shifted to the newly established National Heart Institute. The NHI changed the character of the project, making its methodology more rigorous. Instead of enrolling volunteers, it now randomly selected subjects, eliminating a source of bias...the Framingham study, as it emerged in the 1950s, was "clinically narrow," as one researcher put it, "with little interest in investigating psychosomatic, constitutional, or sociological determinants of heart disease." This would turn out to be a major flaw. Stepping back a bit, the initial results over the 20 years looked good with Framingham researchers introducing the term "risk factor." Author Jauhar* continued: For example, a recent twelve-year study of 20,000 Swedish men showed that almost four out of five heart attacks could be prevented through Framingham-inspired lifestyle changes, such as a healthy diet, moderate alcohol consumption, no smoking, increased physical activity, and maintaining a normal body weight. Men who adopted all five changes were 86 percent less likely to have a heart attack than those who did not. An earlier study of about 88,000 young female nurses found that participants who followed a healthy lifestyle --didn't smoke, had normal body weight, exercised at least two and a half hours each week, had moderate alcohol consumption, followed a healthy diet, and watched little television-- had almost no heart disease after twenty years of follow-up. But to the initial point, as thorough as this study was, there was that "major flaw" of not incorporating a psychosocial side to the research. What I found even more striking was the study Dr. Jauhar mentions of Japanese immigrants, a simple move to Hawaii doubled their risk for coronary artery disease, and a move to the mainland U.S. tripled the risk. Was it the change in diet? Possibly, even though once that was factored in, the role diet played was minimized if immigrants retained close ties to their culture.
Jump to the mind of a shooter or a suicide bomber, or a proper gun owner, or a Senator against any changes to owning guns, or a person totally against guns in general, or a person leaving everything behind other than a handful of clothes and her children in order to flee the violence of guns, or those watching violent movies or playing violent video games, or those not at all concerned, or those feeling empowered, or those about to pull a trigger and end a life. Now imagine yourself a parent, having done all which you felt was right, and watching your child turn out as he or she has, right or wrong in your eyes, right or wrong in society's eyes. As the Framingham study seemed to point out, there will always be guidelines and parameters that will be missed. Why a person turns out that way he or she does is so varied and can go back so many generations that pinning a simple cause such as "mental illness" can be as erroneous as labelling what caused a person's actions as just a lapse or a lack of judgement. Some of these emotions may be buried so deep and from so far back that they become difficult to find or emerge. But as professor Hannah B. Harvey says in her lectures on storytelling: Storytelling forces self-reflection: It puts up a mirror to yourself and to culture. Your story gives you access to yourself; in other words, it’s how you get a handle on yourself—if you don’t recognize your story, you can’t change it. In some sense, that’s what therapy does: It helps you shape a narrative for a listener, and in hearing yourself tell your own story and having someone question it for missing or forgotten parts, you can listen to and change your story. Stories reveal human truths, which are different from facts. Facts are what happened; truths are about what those events meant to people.
And what did these recent events and assault weapon killings mean to Dr. Jauhar? As he Tweeted afterwards on his page: Committing gun violence, like committing suicide, is highly opportunistic, and the desire to do so is often reversible. We put railings in high places to discourage suicide. Time to adopt commonsense measures to #EndGunViolence NOW. They work. Look around the globe. And the first response he received was this: Ignorance in the med community regarding firearms=absurd. Guarantee >95% of MDs have never touched one. If u don’t know, don’t throw saline at it & hope for the best. Get a consult. Read Constitution & Federalist Papers. Which leads me to the topic of hope and horseshoe crabs, creatures (misnamed as crabs) quite likely among the oldest lineage of living things on earth spanning back some 450 million years, living fossils as noted by Wikipedia. And now, their reign may be coming to an end because of us humans. Said a piece in Audubon:** What happened? Fishermen kill some 600,000 crabs each year along the U.S. Eastern Seaboard to bait eel and whelk traps. Another 500,000 are captured along the same coast annually in order to produce an all-important medical test --known as LAL (Limulus amebocyte lysate)-- that detects endotoxin, a potentially life-threatening bacterial contamination in vaccines and intravenous medicines, as well as in joint replacements, pacemakers, and other implanted medical devices. In short, the prehistoric sea dwellers safeguard the health of almost every one of us (and our pets). Jay Bolden worked at a senior biologist at Eli Lilly and wondered why the already-developed alternative to the blue blood of the horseshoe crab wasn't being used. The mounting deaths of the ancient crabs, here long before man even began to form, bothered him and he began the painstakingly slow process of using his data to show Eli Lilly that the synthetic alternative was actually better and more effective than the blood of the horseshoe crabs. It is because of his efforts that Eli Lilly will reduce its use of the crabs' blood by 90% come next year.
When something horrific happens it is easy to look for the simplistic rationale, but there does seem to be an exposed wound in our country, and perhaps our world. As my friend is fond of saying, "a leader doesn't divide, a leader unites." But perhaps as we are seeing, a "leader" simply exposes that which is already there, and that might prove to be the bigger question. The rift in our country, the tribal divisions, the anger, the hate, surely these didn't just arrive overnight. But lumping it all together into a category of "mental illness" and sweeping it under the rug doesn't seem to be the right answer either. As biologist Jay Holden has shown, sometimes witnessing the horrific can lead to change, and it might be just a single person who makes that difference. And if one person can make a difference, imagine what two people, or two million, or two billion people can do. I like to fall back on the words of Dr. Jan Pol, that cantankerous country vet you see occasionally on National Geographic's channel. In an interview with AARP's magazine, Dr. Pol reflected on what "all creatures --even humans--need most." Animals accept people for who and what they are. If you treat an animal right, it will reward you with unconditional love. We come home and our pets (a Great Dane, a Saint Bernard, a Newfoundland, three cats, two Friesian horses, and a menagerie of peacocks, pheasants, turkeys, chickens, ducks and tropical fish) are happy to see us. Just like people are happy when they feel wanted. It feels good. That’s what people need in this world — a little more love, instead of hate.
*Sandeep Jauhar's book is fascinating even if only to satisfy your curiosity about an organ that beats inside of virtually every living thing. To note just some quick examples he cites about the heart: From birth until death, it beats nearly three billion times. The amount of work it performs is mind-boggling. Each heartbeat generates enough force to circulate blood through approximately 100,000 miles of vessels. The amount of blood that passes through an average adult heart in a week could fill a backyard swimming pool...cardiac cells --and the organ they create-- are social entities. The heart can continue to beat for days, even weeks, after an animal has died. In a laboratory, the French Nobel laureate Alexis Carrell showed that properly nourished chick heart tissue cultured on a medium of blood plasma and water will pulsate for months and can remain alive for more than twenty years, much longer that the normal life span of its host. This is a unique property of the heart. The brain and other vital organs cannot function without a beating heart, but a beating heart does not depend on a functioning brain, at least not in the short term. You may also find interesting his description of the sometimes gruesome history of developing what we today take for granted, that of the heart-lung machine. Take for granted? Added Dr. Jauhar: Today more that one million cardiac operations are performed annually worldwide --three thousand a day-- with the heart-lung machine.
**The online piece differs slightly from the printed version, likely due to space considerations. The text quoted in this post is from the printed version.
The rather famous Framingham study done in the 1950s, one designed to study and follow for 20 years the possible factors that could lead to coronary disease, almost highlights the difficulty of trying to pin down a "reason" in a general way. In his book Heart: A History, author and cardiac surgeon Sandeep Jauhar tells of the study this way: The first study questionnaires included items about personal and family history, parents' age at the time of death, habits, mental state, and medication use. Government appointed doctors peered into subjects' eyes and palpated livers and lymph nodes. Blood and urine tests were taken; X-rays and electrocardiograms were performed... After a year, control of the study shifted to the newly established National Heart Institute. The NHI changed the character of the project, making its methodology more rigorous. Instead of enrolling volunteers, it now randomly selected subjects, eliminating a source of bias...the Framingham study, as it emerged in the 1950s, was "clinically narrow," as one researcher put it, "with little interest in investigating psychosomatic, constitutional, or sociological determinants of heart disease." This would turn out to be a major flaw. Stepping back a bit, the initial results over the 20 years looked good with Framingham researchers introducing the term "risk factor." Author Jauhar* continued: For example, a recent twelve-year study of 20,000 Swedish men showed that almost four out of five heart attacks could be prevented through Framingham-inspired lifestyle changes, such as a healthy diet, moderate alcohol consumption, no smoking, increased physical activity, and maintaining a normal body weight. Men who adopted all five changes were 86 percent less likely to have a heart attack than those who did not. An earlier study of about 88,000 young female nurses found that participants who followed a healthy lifestyle --didn't smoke, had normal body weight, exercised at least two and a half hours each week, had moderate alcohol consumption, followed a healthy diet, and watched little television-- had almost no heart disease after twenty years of follow-up. But to the initial point, as thorough as this study was, there was that "major flaw" of not incorporating a psychosocial side to the research. What I found even more striking was the study Dr. Jauhar mentions of Japanese immigrants, a simple move to Hawaii doubled their risk for coronary artery disease, and a move to the mainland U.S. tripled the risk. Was it the change in diet? Possibly, even though once that was factored in, the role diet played was minimized if immigrants retained close ties to their culture.
Jump to the mind of a shooter or a suicide bomber, or a proper gun owner, or a Senator against any changes to owning guns, or a person totally against guns in general, or a person leaving everything behind other than a handful of clothes and her children in order to flee the violence of guns, or those watching violent movies or playing violent video games, or those not at all concerned, or those feeling empowered, or those about to pull a trigger and end a life. Now imagine yourself a parent, having done all which you felt was right, and watching your child turn out as he or she has, right or wrong in your eyes, right or wrong in society's eyes. As the Framingham study seemed to point out, there will always be guidelines and parameters that will be missed. Why a person turns out that way he or she does is so varied and can go back so many generations that pinning a simple cause such as "mental illness" can be as erroneous as labelling what caused a person's actions as just a lapse or a lack of judgement. Some of these emotions may be buried so deep and from so far back that they become difficult to find or emerge. But as professor Hannah B. Harvey says in her lectures on storytelling: Storytelling forces self-reflection: It puts up a mirror to yourself and to culture. Your story gives you access to yourself; in other words, it’s how you get a handle on yourself—if you don’t recognize your story, you can’t change it. In some sense, that’s what therapy does: It helps you shape a narrative for a listener, and in hearing yourself tell your own story and having someone question it for missing or forgotten parts, you can listen to and change your story. Stories reveal human truths, which are different from facts. Facts are what happened; truths are about what those events meant to people.
And what did these recent events and assault weapon killings mean to Dr. Jauhar? As he Tweeted afterwards on his page: Committing gun violence, like committing suicide, is highly opportunistic, and the desire to do so is often reversible. We put railings in high places to discourage suicide. Time to adopt commonsense measures to #EndGunViolence NOW. They work. Look around the globe. And the first response he received was this: Ignorance in the med community regarding firearms=absurd. Guarantee >95% of MDs have never touched one. If u don’t know, don’t throw saline at it & hope for the best. Get a consult. Read Constitution & Federalist Papers. Which leads me to the topic of hope and horseshoe crabs, creatures (misnamed as crabs) quite likely among the oldest lineage of living things on earth spanning back some 450 million years, living fossils as noted by Wikipedia. And now, their reign may be coming to an end because of us humans. Said a piece in Audubon:** What happened? Fishermen kill some 600,000 crabs each year along the U.S. Eastern Seaboard to bait eel and whelk traps. Another 500,000 are captured along the same coast annually in order to produce an all-important medical test --known as LAL (Limulus amebocyte lysate)-- that detects endotoxin, a potentially life-threatening bacterial contamination in vaccines and intravenous medicines, as well as in joint replacements, pacemakers, and other implanted medical devices. In short, the prehistoric sea dwellers safeguard the health of almost every one of us (and our pets). Jay Bolden worked at a senior biologist at Eli Lilly and wondered why the already-developed alternative to the blue blood of the horseshoe crab wasn't being used. The mounting deaths of the ancient crabs, here long before man even began to form, bothered him and he began the painstakingly slow process of using his data to show Eli Lilly that the synthetic alternative was actually better and more effective than the blood of the horseshoe crabs. It is because of his efforts that Eli Lilly will reduce its use of the crabs' blood by 90% come next year.
When something horrific happens it is easy to look for the simplistic rationale, but there does seem to be an exposed wound in our country, and perhaps our world. As my friend is fond of saying, "a leader doesn't divide, a leader unites." But perhaps as we are seeing, a "leader" simply exposes that which is already there, and that might prove to be the bigger question. The rift in our country, the tribal divisions, the anger, the hate, surely these didn't just arrive overnight. But lumping it all together into a category of "mental illness" and sweeping it under the rug doesn't seem to be the right answer either. As biologist Jay Holden has shown, sometimes witnessing the horrific can lead to change, and it might be just a single person who makes that difference. And if one person can make a difference, imagine what two people, or two million, or two billion people can do. I like to fall back on the words of Dr. Jan Pol, that cantankerous country vet you see occasionally on National Geographic's channel. In an interview with AARP's magazine, Dr. Pol reflected on what "all creatures --even humans--need most." Animals accept people for who and what they are. If you treat an animal right, it will reward you with unconditional love. We come home and our pets (a Great Dane, a Saint Bernard, a Newfoundland, three cats, two Friesian horses, and a menagerie of peacocks, pheasants, turkeys, chickens, ducks and tropical fish) are happy to see us. Just like people are happy when they feel wanted. It feels good. That’s what people need in this world — a little more love, instead of hate.
*Sandeep Jauhar's book is fascinating even if only to satisfy your curiosity about an organ that beats inside of virtually every living thing. To note just some quick examples he cites about the heart: From birth until death, it beats nearly three billion times. The amount of work it performs is mind-boggling. Each heartbeat generates enough force to circulate blood through approximately 100,000 miles of vessels. The amount of blood that passes through an average adult heart in a week could fill a backyard swimming pool...cardiac cells --and the organ they create-- are social entities. The heart can continue to beat for days, even weeks, after an animal has died. In a laboratory, the French Nobel laureate Alexis Carrell showed that properly nourished chick heart tissue cultured on a medium of blood plasma and water will pulsate for months and can remain alive for more than twenty years, much longer that the normal life span of its host. This is a unique property of the heart. The brain and other vital organs cannot function without a beating heart, but a beating heart does not depend on a functioning brain, at least not in the short term. You may also find interesting his description of the sometimes gruesome history of developing what we today take for granted, that of the heart-lung machine. Take for granted? Added Dr. Jauhar: Today more that one million cardiac operations are performed annually worldwide --three thousand a day-- with the heart-lung machine.
**The online piece differs slightly from the printed version, likely due to space considerations. The text quoted in this post is from the printed version.
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