Off Course, Hard Aground, and Sinking Fast
This past week, 2 major events captured my attention from different parts of the world..But extremely
important to me as an avid sailor and a clinical psychiatrist in independent practice for many decades.
As for the practice of psychiatry, a landmark court hearing took place in Austin, Texas and I relied heavily on a brilliant psychiatrist who attended the court hearing and maintains a powerful psychiatric blog with daily posts. Directly from his post at www.1boringoldman.com is an article that I am in complete agreement related to the “Selling of Psychiatry”
The Selling of Psychiatry from 1boringoldman blog
I also rely on so many other profession journalists and blogger advocates, but specifically – Ed Silverman of the Pharmalot.com post explains the court case in Forbes Magazine. General area of concern for me for years has been use of psychotropic medications in children without FDA clearance.
Ed Silverman's post on the Risperdal Trial in Austin, Texas Jan 2012
Perhaps it is far too great of a stretch, but the sinking of the Concorde and the current state of Psychiatry seem to have much in common, in my opinion.
Both are off course, bother utilize supposedly “State of the Art” techniques that are believed to be safe to the public, both lack competent leadership (APA Presidents, Ship Captains, etc) In the field of Psychiatry, Huge Managed Care Companies essentially restrict the psychiatrist to quick, 15 minute medication checks and totally overlook the need for a therapeutic alliance and talk therapy between patient and doctor. Far too much emphasis on medication, rather than time tested common sense and meaningful communication. With the Ship Wreck, I will wonder if too much attention was given to high tech navigation and so called “Dead Reckoning” was not utilized at all. “Dead Reckoning” in Psychiatry is a lost art, I fear…but was once the primary method of talking with patients – face to face -listening thoroughly to the patient’s story, and not depending on “high tech” scales and Pharma-Industry Developed screening techniques to determine which medication should be given.
On a positive note, in keeping with the hope that there will continue to be independent clinicians, I was greatly relieved to learn of the successful circumnavigation of a very determined teenager’s solo journey yesterday via Abbey Sunderland’s Blog. Several Years ago, I had followed Abbey’s posts as she began to solo her sailboat ‘Wild Eyes” around the World, but was dismasted by a rogue wave in the Indian Ocean..as her family and followers often expected the worst – until so many days later she was safely rescued. Much criticism was placed on the parents of both these girls for allowing them to be in extreme harm’s way….and many a post claiming the parents were simply exploiting the children for book and movie profits in the future. I see the girls as brave and using extremely good judgement, as they set out to Sea.Unfortunately, I see so much more danger for adolescents right here in the States with drug abuse, being victimized, abducted, teenage prostitution trafficking, and anti-psychotic medications for behavioral control, rather than for acute psychosis
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The cruise vessels are way “over teched” and no doubt the bridge warnings went off all over the place that they were off course. As for their procedures, I don’t know what propulsion they had left but grounding the vessel close to shore is the safest thing to do. It was interesting that Fox News asked this question “what if this accident happened in the middle of the ocean? ” Duh! there are very few rocks in the middle of an ocean that is 2.5 miles deep. I think they will find that once the ship was aground and listing there was little they could do and in the dark I suspect that the Captain couldn’t get back on the ship. In fact, the best course of action for all of the people would have been to stay with the grounded ship and wait until daylight for rescue. So what if the wall is now the floor and vice versa. As we teach in canoeing merit badge “stay with the boat”. The dramatics of the Titanic are so vivid that folks think you will get sucked under by a sinking ship (urban legend). Plus the Titanic was in cold north Atlantic waters and survival in that water was only a few minutes anyway. The water temp there is 40 F. The water in the Med is 70 F and you can survive hours there.
I guess cruise ships will take their lifeboat drills very seriously from now on. Plus an interesting feature of this accident was that 1/2 of the lifeboats were useless once the ship list was too great. If you don’t evacuate the ship immediately, it is almost impossible to do once it is listing. The ship should have called an emergency immediately and gotten folks to their lifeboat stations. (Oh and it would be nice if the crew really knew how to use the lifeboats. I guess they will take that seriously now.)
Next lifeboat you see, look at the instructions and see if you can follow them. I noticed a ferry on a recent trip that had all sorts of complex graphics but they were too cluttered to tell what to do.
Grab a life jacket and jump in. The Med ain’t that cold.
Your Feedback so greatly appreciated & makes so much sense. Thank you !
Thanks for the utpdae on these teen female sailors. Teens are notorious rish-takers. In this world made ever safer by inventions, conventions, awareness and laws, informed adventure and calculated risk are more important than ever to the soul of the individual. I would rather my teenaged granddaughter attempt to sail around the world alone than engage in other irresponsible risky behaviors, like drinking, drugs, reckless driving, premature sex.
Oh and as for the sell of Psychiatry — the bean counters have taken over. If you can put it on a spreadsheet, it must have meaning. We are putting education on a spreadsheet now and if a department doesn’t make money, it will be eased out. Once we are all middle managers (ie, Business Majors), there will be nothing left to manage. We had a student come back after graduate school (Yale) and she was the only American in the Mathematics graduate school!!!!. All the rest are Chinese. I tell my students, don’t worry about studying, there are 10 Chinese who will take your place!
Far too true ! My older brother John is a professor at U Wash Seattle and spends so much of his time across the Pacific in Singapore, China, Thailand, etc.
http://en.wikipedia.org/wiki/John_D._Bransford Seems to love his consulting over there
with many motivated students. dlb