Maggie's Farm

America continues to take the subject of abortion seriously. That's a good thing, because it means we are morally and ethically still alive.

Hard cases make for bad law. Abortion is a mare's nest of conflicing considerations and motives: a Mom's right to control her fate vs. a baby human's right to life; individual freedom vs. group moral norms; a woman's instinctive striving for maternity vs. her wish for "freedom;" the human's (understandable) desire for consequence-free pleasure vs. the human and natural fact of moral limits, and others. 

I don't know about other countries, but I have never seen a woman who did not carry some guilt about her abortion(s). I consider myself lucky in never having had one, because I did some dumb things when I was young.

The pro-abortion movement has done its best, for 30 years, to try to normalize abortion. They have done this with language, by de-humanizing the "fetus" (nobody is "with child" any more); by speaking of "choice," by speaking of a woman's ownership of her womb as if a child were a homeless squatter on her property, by terming it a "d and c," and so forth.

Despite their efforts, the inner voice still speaks: the inner voice of our Judeo-Christian foundation and conscience which considers human life to be the property of God and which deplores the taking of innocent life.

People hate to feel guilt - it's painful. And people hate to feel inner conflict - it's uncomfortably confusing. Our brains struggle to suppress one side of a conflict to relieve us of these discomforts.

I do not really want to tell anybody else that they shouldn't have one done, but I wouldn't perform one (I doubt whether it is consistent with the Hippocratic oath) and I sure wouldn't have one. However, I wouldn't be surprised if I would have if I had gotten myself knocked up at 18 - when I was a selfish and frivolous person.

Thus my views lack moral and intellectual consistency. And that makes for a headache.

This post was prompted by Dr. Clouthier's America's Abortion Headache.

So asks Newsweek. (I resent the "we" in the question, because I hardly ever do those things.)

The article discusses how thin the science is of Evolutionary Psychology. It is. Whenever the issue of nature/nurture comes up, I find people making arguments which ignore two of the most basic aspects of human nature: 1. mankind's ability to adapt to almost anything and to create his own environment, and 2. mankind's obligatory social and culture-creating impulses.

It is innate to man to create cultures which reflect at least some aspects of human nature, but no culture can eliminate the beast in him. Thank goodness for that.

Thanks to Insty for letting me know about my old colleague Dr. Michael Stone's new book, Anatomy of Evil. Quote from the Amazon site:

What do psychology, psychiatry, and neuroscience tell us about the minds of those whose actions could be described as evil? And what will that mean for the rest of us? Stone discusses how an increased understanding of the causes of evil will affect the justice system. He predicts a day when certain persons can safely be declared salvageable and restored to society and when early signs of violence in children may be corrected before potentially dangerous patterns become entrenched.

Pretty to think so, but that day will never come, Dr. Stone.

Revisiting Klavan's brief video message to new college grads from a couple of weeks ago, with the great quote above.

It explains why I believe that any shrink, psychologist (or anyone in the social sciences) should be of a Conservative bent unless they have no faith whatsoever in the human spirit (in which case they should have no faith in their own, either).

It would be stupid of pharma companies not to market their new products. They have bills to pay and investors to pay. You cannot fault them for it.

As a shrink (who does not have a primarily pharmacology practice, but uses meds whenever needed), I never use the newest medicines. I let other docs find out whether they have any advantages first, or any repellent side effects.

For Bipolar, I still think good old Lithium, a salt dug out of the ground which costs pennies, is the best, safest medicine. It works.

From the NYT: New Drugs Have Allure, Not Track Record

I majored in Statistics in college (with a minor in English Lit), but my stats sophistication is a bit rusty now. But it's not so rusty that I do not raise my brow at any latest stats reported in medicine, or especially in Psychiatry - and especially genetic studies.

As Gene Expressions points out, it's partly because a p-value of 0.05, commonly used in such studies, is unrealistic for these things. It's straight out of How to Lie with Statistics, which is essential reading for all high school students.

As the man says, if there is a genetic serotonin link with trauma and depression, it has yet to be proven.

In his second post on the topic, Why are most genetic associations found through candidate gene studies wrong? he makes the key point:

For nearly all diseases, reproducible associations have small effect size and are only detectable when one has sample sizes in the thousands or tens of thousands (for many psychiatric phenotypes, even studies with these sample sizes don't seem to find much). The vast majority of candidate gene association studies had sample sizes in the low hundreds, and thus had essentially zero power to detect the true associations. By the argument above, in this situation the probability that a "significant" association is real approaches zero. The problem with candidate gene association studies is not that they were only targeting candidate genes, per se, but rather that they tended to have small sample sizes and were woefully underpowered to detect true associations.

While I find the field of behavioral genetics to be as fascinating as anything else in this world, I always read the latest gene-behavior studies with the highest skepticism. (Do I think real Bipolar Disorder has some provable genetic underpinning? Yes, I do, even though I do not think it has been adequately proven yet. But not much else genetic in Psychiatry has been adequately proven in my view. Schizophrenia maybe, IQ almost certainly, but possibly not homosexuality, or depression, or alcoholism.

The trick to getting papers published is to run your numbers so they show something. It's not rocket science if you know how to do it: just look at the climate studies. (Even Einstein fudged his math. He happened to turn out to be right, though, as far as we know today.) Science is about hypotheses, not Truth.

Many of us here have discussed how much can be learned from failure, and how relatively little can be learned from success.

Thus it is gratifying to see the child of Memphis and legendary hedge fund owner Paul Tudor Jones delivering a 9th Grade graduation address to the "Buckley Boys" in which he declined to discuss the recommended sanctimonious topic of "service" and instead spoke about the value of failure.

Good on him. Almost all of my wisdom has come from my errors and failures - whether personal or professional. Read his speech, and invite your kids to read it too.

No good deed goes unpunished.

Well, that is surely not always true, but with the economic downturn, the charity medical clinic at which I volunteer one day per week has seen a sharp upturn in lawsuits against us Docs and the clinic this year.

The medical defence lawyer we have now engaged (we have had no complaints or suits for 10 years until January 2009) tells us that we should now regard each patient as a potential enemy. (Our clinic's founding Christian philosophy is to regard every patient as a friend and neighbor.) 

He tells us that our notes must be guided by the principle of CYA (your notes are legal documents, not medical reminders as we had thought) and that every decision a doc makes contains some basis for a suit in the hands of a hungry lawyer because all medical decisions are judgement calls and every situation is unique.

He also told us that recessions tend to see more suits against doctors because more folks are looking for cash, and much more so in charity settings. Plus the tort lawyers are hungry too - but they always are. He also advised us to refuse to treat any patients with substance abuse histories for our protection - other than alcohol.

He actually said "Do not be kind. They will screw you whenever they decide to." He has been around the block a few times.

I do not like this at all. A Psychiatrist/Psychoanalyst cannot do the job under such conditions. Furthermore, I can not and will not endure any relationship in my life without mutual trust. I am considering resigning (even though I was one of the founders of the place) and finding some other outlet for my charity. Maybe prison work, where you can safely begin with the assumption that everybody is a liar and cheater and working the system - and take it from there.

My position on the Board, plus my volunteer time (all unpaid) doubles my legal liability. I just want to do my best, tithe and double-tithe my time, and avoid hassles that do not fit into my life - and legal fees that I cannot comfortably afford.

And no, I would never work for ObamaCare. Never. I did not go into medicine to be a government employee. I went into medicine to work for my patients, doing my best, with no intention of looking out for lawyers.

It's tough for doctors because we are often held responsible for people who either do not want, or do not accept, our help and advice. But, as long as their name remains on our rolls and as long as we persist in trying to be constructive, the lawyers can get us.

I have been burned several times by keeping them on the rolls in the charity clinic, only to be sued by them eventually for not doing a better job "taking care of them." What? I am not a professional mother and I do not "take care of" anybody. I am a doctor, not a caretaker and, despite the modern lingo, not a "care-giver" either.

Like all doctors,  I try to work with my patients - and do not take care of them, or I to try to bring them around to where I can work with them.

If I were more self-protective, I would not even try and would just say "I cannot help you. Good bye," but that is not my medical tradition. My medical tradition is that you are a friend to your patients, whoever they are.

Novalis presents such a case. More practical docs than I am would just throw them out of the office. However, after being punished and hassled legally several times by going the extra mile, my heart grows harder. 

Indeed, good deeds often are punished and yes, it does lead to some bitterness especially when it is performed on a charity basis. I have never been sued or hassled by a private, self-paying patient. 

Mnemosyne was impregnated by Zeus for nine consecutive nights, thus producing the nine muses. Among other things, she was a goddess of memory.

The number of muses increased over time from the original three. Poetic license and creeping specialization. I had been looking up Euterpe, the muse of music and of lyric poetry, called "the giver of delight." The muse of song, but got sidetracked on the general topic of the Muses.

I posted briefly on inspiration the other day, and we had "Sing, Goddess..." recently. It remains fascinating to me that our mental creations seem to come from "elsewhere," to the extent that we can imagine that they come from a supernatural source.

In my line of work, we say that such things come from the "preconscious" or the "unconscious," but that's not much different from saying they are gifts of a Muse.

Whenever a preacher says "May the words of my mouth, and the thoughts and meditations of my heart, be acceptable to You," he or she is echoing the classical plea to the Muses. Our civilization remains a Greek one.

This site tries to personalize the Muses.

Image is Dante Gabriel Rossetti's Mnemosyne (1881)

Kealey's talk which we posted yesterday is a wonderful revelation. It confirmed much of what I suspected in the back of my mind but never focused on or thought through. I would like to read his book.

Many things become sacred cows without any evidence for their benefit. Most famous example: the incredibly expensive Head Start program, whose benefits disappear after a year. The rug rats would be better off banging around the neighborhood or the fields and swamps, learning how to educate and entertain themselves. Just get rid of the damn TV.

These "programs" become sacred cows via their income constituencies and their penumbra of virtuousness - not their effectiveness.

The infantile fantasy of government as source of virtue is an insidious one because government is only about one thing: power, and the mediocrities who seek it and the money that accrues to it to maintain that power.

Is government funding for research little more than welfare for PhDs? Possibly. In my field, you would be amazed by the stupidity of most of the government research grants which are paid for by the taxes of modest, hard-working folks who would rather worry about their families than seek power over others. Must be fun to appear benevolent with OPM.

Cui bono?

In the Q&A, Kealey astutely points out that people seek ways to proclaim "I am a good person," and that being concerned about global warming is (or was?) today's fashionable version, just as eugenics was at the turn of the century, socialism in the 1930s, being a Dem during Reagan, and flag pins and bumper stickers after 9-11. Symbols and attitudes as effortless, non-sacrificial fashion statements.

Althouse posting at Insty on Internet Addiction.

That's the stupidest thing I have heard of yet today - so dumb it makes my hair hurt, as Imus would say. So dumb I won't even waste any virtual ink to bother to explain why.

I prefer this piece in NY Mag: In Defence of Distraction.

Editor's Note: Dr. Helen covers this "addiction" nonsense.

Shrinks debate putting Bipolar Disorder into the Psychosis category.

It's all a tempest in a teapot for me. All of our diagnoses in Psychiatry are of dubious validity. They have two purposes: 1) Something to write on an insurance form and 2) a starting point for research to find out if they make any sense.

I do not even think that Schizophrenia is a "disease" per se. It's a handle for a lot of different strange things that we understand poorly.

I hate studies of happiness because 1) I think happiness is fleeting 2) Everybody's happiness is different 3) I think good cheer and happiness come from within and from a clean conscience - not from without and, 4) I don't think life is or should be all about happiness anyway: I think it is meant to be made of sterner stuff than that...but that's me.

Therefore, I believe that "the good life" is not a one-size-fits-all shoe. For some, it's about being half in the bag on a mountaintop. For some, it's struggling with impossible math problems; for some, it's exerting minimal effort. For some, it's about having good relationships, but many folks don't give a darn about that. "Happiness" is a useless concept and, to me, a "good life" means nothing more than an honorable, responsible Christian life, with minimal jail time, and some golf and tennis and a good man in it but, again, that's just me.

Joshua Shenk has a piece in The Atlantic on the now-72 year-old Harvard longitudinal study.  He begins:

Last fall, I spent about a month in the file room of the Harvard Study of Adult Development, hoping to learn the secrets of the good life. The project is one of the longest-running—and probably the most exhaustive—longitudinal studies of mental and physical well-being in history. Begun in 1937 as a study of healthy, well-adjusted Harvard sophomores (all male), it has followed its subjects for more than 70 years.

Read Shenk's piece, and tell me what you think. David Brooks wrote a commentary on the Shenks piece, in which he says:

The study had produced a stream of suggestive correlations. The men were able to cope with problems better as they aged. The ones who suffered from depression by 50 were much more likely to die by 63. The men with close relationships with their siblings were much healthier in old age than those without them.

But it's the baffling variety of their lives that strikes one the most. It is as if we all contain a multitude of characters and patterns of behavior, and these characters and patterns are bidden by cues we don't even hear. They take center stage in consciousness and decision-making in ways we can't even fathom. The man who is careful and meticulous in one stage of life is unrecognizable in another context.

Shenk's treatment is superb because he weaves in the life of George Vaillant, the man who for 42 years has overseen this work. Vaillant's overall conclusion is familiar and profound. Relationships are the key to happiness. "Happiness is love. Full Stop," he says in a video.

In his professional life, he has lived out that creed. He has been an admired and beloved colleague and mentor. But the story is more problematic at home. When he was 10, his father, an apparently happy and accomplished man, went out by the pool of their Main Line home and shot himself. His mother shrouded the episode. They never attended a memorial service nor saw the house again.

He has been through three marriages and returned to his second wife. His children tell Shenk of a "civil war" at home and describe long periods when they wouldn't speak to him. His oldest friend says he has a problem with intimacy.

Even when we know something, it is hard to make it so. Reading this essay, I had the same sense I had while reading Christopher Buckley's description of his parents in the New York Times Magazine not long ago. There is a complexity to human affairs before which science and analysis simply stands mute.

Ed: Related, see some of our previous posts on the topic:

Are we happy yet?

The Aristocracy of the Human Spirit: Freedom vs Happiness

Money and Happiness

Huxley's Brave New World at 75

 Do Americans expect too much of marriage?

Happiness for Sale! No brain, no pain.

Grumpy. Are Americans hard to please, or do we just love to bitch?

One of us quoted Dylan recently, who said something like "You got to take your inspiration wherever you can get it."

And we recently posted the lines which begin "Sing, Goddess...." Thus acknowledging that the Goddess is the author, not the man. The man is the messenger.

It reminds me of what my pastor once said to me when I asked where the preaching came from: "I stand up there, and the Holy Spirit uses me. It just flows out. I have nothing to do with it."

The definition of "inspiration" is "the immediate effect of God or gods." How wonderful is it that the word doubles as the medical term for inhaling, and that "expiration" doubles for exhaling and for death?

Recently stumbled upon Furious Seasons. It's a shrinkology-related but far from shrinks-only site. Provocative.

The guy is a patient and a journalist, not a shrink.

I have posted numerous times here about the role that infantile wishes and hopes can play in the lives of those who are otherwise adults. We all must have hopes and dreams, and we all must have many of them dashed to become real, serious adults.

Real serious adults know all about the futility of wishful thinking, Santa, the Tooth Fairy, the Easter Bunny - and the free lunch.

Hoven at American Thinker has a post up about Wishful Thinking in politics. As salesmen, politicians are all about appealing or pandering to wishful thinking. He begins:

There's the old joke about an economist's plan to get out of a pit he was thrown into: "First, we assume a ladder."  There has been a whole lot of assuming going on, from alternate energy to non-harsh interrogations.