Posts Tagged ‘illness’

Who Let Us Down?

June 12th, 2009

Recent news:

WASHINGTON, DC James von Brunn, the white supremacist who allegedly opened fire Wednesday at the U.S. Holocaust Memorial Museum in Washington, D.C., suggest that a lifetime of hatred had reached a critical mass. The 88-year-old is charged with murdering a security guard at the building.

LITTLE ROCK, Ark.  —  A Muslim convert charged with fatally shooting an American soldier at a military recruiting center said Tuesday that he doesn’t consider the killing a murder because U.S. military action in the Middle East made the killing justified.

NBC News is reporting that at Camp Liberty, the main U.S. military base in Iraq, which is located near the Baghdad International Airport, a yet unnamed serviceman walked into a “stress clinic” in the camp, opened first, killing at least five. Contrary to earlier reports, the soldier did not kill himself but is now in custody.

When things like this happen, we all stop and ask what went wrong?  In two of the three situations, we had relatives or friends nearby.  My daughter-in-law’s friend was working at the museum, and my son-in-law is stationed beside the stress clinic at Camp Liberty.

I’ll never forget when the Reagan administration began the movement to close down  mental hospitals.  A friend worked at the mental hospital nearby.  We had had a rash of threatening letters, some very upsetting encounters, and a several other incidents in the community when this friend said to me, “You know, we had 2,000 inpatients and 500 outpatients at the mental hospital.  Now we have 2,500 outpatients. Nobody’s left town, and when they don’t take their meds, there can be problems.”

Pfc. Joe Dwyer carried a young Iraqi boy who was injured during a heavy battle between the U.S. Army's 7th Cavalry Regiment and Iraqi forces near the village of Al Faysaliyah, Iraq, on March 25, 2003. Dwyer died of an apparent overdose at his home in North Carolina on June 29, 2008. Photo credit: Warren Zinn / Military Times file
Pfc. Joe Dwyer carried a young Iraqi boy injured during a heavy battle between the U.S. Army’s 7th Cavalry Regiment and Iraqi forces near the village of Al Faysaliyah, Iraq, on March 25, 2003. Dwyer died of an apparent overdose at his home in North Carolina on June 29, 2008. Photo credit: Warren Zinn / Military Times file

When you consider that there are about 6.5 billion people in the world, if only 5% of the total people living on this planet are suffering from some type of mental illness, we’re potentially talking about the equivalent of the entire population of the United States with some mental health issues. ( Sorry if  my math is slightly off.)  Point is, that’s a lot of people.  So, what are we doing for them?

The Rand Corp. released a study of returning service members and is estimating nearly 20 percent of the 1.6 million who have served since this war began will develop Post-Traumatic Stress Disorder (PTSD). That is nearly 320,000 PTSD sufferers – more than the population of Pittsburgh.

White supremacists are such old news.  We have had to hear about their beliefs over and over during the past sixty years or so.  Maybe when they are arrested,  as James von Brunn had been more than once, it would help them to serve their time doing community service as tour guides at Auschwitz?

Our soldiers, however, are an entirely different story.  We have spent the past several years meeting with experts in mental health who do know what to do for them.  That’s the good news.  The bad news is that this care is not being rendered.    The military has strict guidelines on the treatment of PTSD, but, if you ask our returning soldiers how faithfully these guidelines are implemented, the general answer is that “There’s not enough money to provide this care for our Guardsmen and women.”

We don’t pay our school bus drivers a living wage, and they are in charge of our most precious loved ones.  We couldn’t afford to send armour with our early troops deployed to Iraq and have had more amputees than in any war since the Civil War, and now we don’t have enough money to treat PTSD.

That type of rationalization makes me tired.  We have enough money, we just don’t have our priorities and incentives in line.

depression female young woman african american black mental health Nick Jacobs

Did anyone notice that James was boiling over with insanity?  How about Mohammed?  Our PTSD patient in Iraq knew that he was in troble, but we busted him, and then put him beside a driver with a gun on his hip.  That weapon became his killing tool.

This blog was not intended to be depressing.  It is intended to reemphasize that we in healthcare should be about caring. It is about teaching caring, love and respect.  It is about helping those who need help, and detaining those who won’t accept that help.   We have drugs, but, as the Virginia Tech shootings demonstrated, in certain phenotypes the receptors are not there to allow those drugs to be absorbed into the body.

Mental health help has a long way to go, and we all need to be part of that journey.  Telepsychiatry, PTSD clinics, screenings for radicals?  Surely someone cares.

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A Different Kind of Saturday Night Fever for Some

April 25th, 2009

In August 2006, I was inspired to write a disconcerting blog post regarding the potential outbreak of the avian flu.  It was a disturbing post not only because it contained potentially negative statistical mortality outcomes on an international basis, but also because, as a relative insider, it was clear to me that we were not ready at all for this type of pandemic.

Churchgoers in Mexico City | Photo Credit: AP

Churchgoers in Mexico City Sunday | Photo Credit: AP

With new grandbaby Zoey safely here on earth less than a week ago as the youngest member of the family,  today’s opening story of a potential influenza pandemic made my blood run cold.  The rate and speed with which this type of pandemic could overtake our world is almost immeasurable, and, having flown from San Francisco, to San Diego, to Richmond to Pittsburgh in the last week, it was clear that,  if I had been a carrier, literally hundreds of people could have been infected simply by my presence.

Those who are realists or pragmatists will simply say, it is Mother Nature’s way of “thinning the herd,” but herd thinning in our case is something that is uncomfortable, especially in such a random way.  During the pandemic of 1917/1918, mass graves were dug not ten miles from my home, and undertakers were not even permitted to prepare the bodies for burial.

My previous blog focused on the avian virus, but this morphed virus that appeared in Mexico, not China, not the Far East as originally predicted, is a combination of human, swine, and avian viruses.  No one has ever seen or found cures for this type of radical new flu yet.


View H1N1 Swine Flu in a larger map

The World Health Organization came out today with only a level three warning, but when they described this level of warning, they indicated that it was simply because they did not yet have enough information to take it to level six.  There are confirmed cases in San Antonio, San Diego, and one report even indicated that New York had two cases, and over 68 are known dead in Mexico.  Fever, sore throat, coughing, nausea, body aches, headaches, chills and fever are some of the symptoms presenting with this flu that can result in pneumonia and respiratory failure.

Mexico City closed it schools on Friday, and more such initiatives are expected as this powerful force of nature begins to take on a life of its own.

How can you avoid getting this flu?  Wash your hands, stay away from infected people, cover your nose and mouth.

In children, emergency warning signs that need urgent medical attention include:

  • Fast breathing or trouble breathing
  • Bluish skin color
  • Not drinking enough fluids
  • Not waking up or not interacting
  • Being so irritable that the child does not want to be held
  • Flu-like symptoms improve but then return with fever and worse cough
  • Fever with a rash

In adults, emergency warning signs that need urgent medical attention include:

  • Difficulty breathing or shortness of breath
  • Pain or pressure in the chest or abdomen
  • Sudden dizziness
  • Confusion
  • Severe or persistent vomiting

Let’s all hope that this never gets any worse than it did in the 1976/77 cycle when only a very few people died at that time…mortality rate was low with swine, but this is swine, avian and  human combination.

Tonight, say a little prayer.

Also by Nick Jacobs:

Are We Ready for the Avian Flu?
Hospital Impact
August 8th, 2006

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