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War, Mental Disorder and Suicide

(Loncar et al. Coll. Antropol. 28 (2004) 1: 377–384, Zagreb)

“War as a human disaster of major significance has led to an increase in the number of suicides committed by people suffering from mental disorders. Considering the results of similar research, we were particularly interested in the effect that war has on the incidence of suicide among of people with mental disorders. The research included 16,362 patients with mental disorders, treated at the Clinic for Psychiatry at the Clinical Hospital Split during the nine-year timeframe which were divided into pre-war (April 6th 1988 – April 7th 1991), wartime (April 6th 1991 – April 7th 1994) and post-war (April 6th 1997 –  2000) periods… In our research, we found a statistically significant difference in suicide incidence between three observed periods …with the incidence being the highest during the wartime period …With this research we intended to offer a better understanding of the complexity of the suicide problem…”

During WWII the cherry blossom was a symbol of the beauty and transience of life used to motivate kamikaze pilots.   Fliers painted them on the sides of their planes or carried branches with them in their cockpits.

Here in Philadelphia for the past week, we have enjoyed tranquil, temperate weather and the blossoms have emerged in force.

These were taken at Morris Arboretum.

I recently received more good news concerning my film, “Astronaut Goes From Migrant Fields To Outer Space” which has now also been selected for screening at both the SENE Film, Music & Arts Festival in Pawtucket and Providence, Rhode Island (April 7-11, 2010), and the Imago Film Festival in Elgin, Illinois (April 5-9, 2010).

So based on this latest information, the film will actually premier at the SENE Festival’s Opening Night kickoff in Pawtucket on April 7th, rather than on the 10th in Delaware.

I’m excited about the recent selection of my short film “Astronaut Goes From Migrant Fields To Outer Space” for inclusion in the Hearts and Minds Film Festival in Delaware next month. This will be the film’s premier screening at a festival, and is in fact the first film that I have submitted for consideration.

Here is a synopsis/director’s statement:

“In the U.S., immigration is both proud and tragic legacy. Except for the original people from whom a continent was stolen, we are all immigrants or descendants of immigrants. Yet each new wave that arrives with few possessions and many dreams find they survive, not because of, but in spite of, what they find: the least rewarding and most dangerous work, and the contempt of those already here.

As a child, Jose M. Hernandez trekked from Mexico to the fields of California where he picked strawberries with his family under the tense and squalid conditions migrant laborers still experience. In the summer of 2009, he traveled into space as an astronaut on the Discovery space shuttle.

His story honors both the desperate struggle of immigrants and the greatness of which they are capable.

As a filmmaker and a poet, and someone of Latino descent, I feel I must contribute in some way to the search for justice.  Because as an issue, immigration is so contentious and sensitive, I have also been striving to find a perspective that rises above the standard arguments, that is positive as well as principled, in the hopes that I might reach those on all sides. In making a film about the astronaut Jose Hernandez, I believe I have found this point of view.”

Here are some details about the Hearts and Minds Festival and its artistic mission:

“JOIN US!

5th Annual Hearts & Minds Film Festival

Friday, April 9th, 2010 – Delaware State University Campus

Saturday, April 10th, 2010 – Schwartz Center for the Arts

DOVER, DELAWARE

Our festival showcases “super-independent” films from around the world – things you won’t see screening at just any movie theater or on TV.

Each entry was selected not only for its excellence, but for its focus on social issues and the human condition: from faith to homelessness to race and identity to disability culture. In an era of increasing social and economic challenges, these films herald a timely call to awareness and service. There will be something for everyone who enjoys media that features remarkable characters from many walks of life, fiction and non-fiction films of all kinds.”

“If a picture is indeed worth a thousand words, multiply that image by 24 or 30 frames per second and imagine the impact on an audience that a well crafted, issue-oriented film can have! In the best tradition of documentary film-making, independent artists today are lifting their “voices” by pointing their lenses at subjects critical to the health and sustainability of communities around the world. They draw attention. They celebrate. They rage. They entertain. And always, they create conversation.

People the world over love movies. Perhaps like no other art form, good films bring people from disparate backgrounds together, in one room, to share the entertainment experience. By selecting films that focus on topical subjects such as economics, crime, literacy, the environment, and themes that address the human condition like relationships, health, survival, legacy, Hearts and Minds Film seeks to acknowledge new works and to inform, inspire and empower diverse audiences in community-based settings.”

Alexander and his Doctor, about 1648-9, Eustache Le Sueur

According to classical anecdote, Alexander the Great suffered from mysterious maladies and from his own mystique. No one dared to treat him for fear that a bad outcome would doom the would-be healer to certain persecution by Alexander’s wildly solicitous minions. Finally, Phillip, Alexander’s physician, frustrated by the young king’s decline, offered care in the form of a salubrious potion. But a general had already impugned Philip in a letter to Alexander, which claimed Philip to be acting seditiously on behalf of Alexander’s Persian enemies, and not to be trusted. Despite this warning, Alexander boldly drank the medicine, as he did so, handing the letter to Philip to read.

In the painting, Philip stands above a recumbent Alexander, as the doctor-patient relationship would demand. But Alexander’s broad chest and raised eyes reveal his power, while Philip’s stooped posture and frown expose the frailty of his position. The painting reveals, perhaps unwittingly, the vital duality of the relationship, each risking himself, proffering his full commitment to the other. Here the physician assumes the role of servant rather than patriarch, though his experience and wisdom are evident.

Haus LebensWert is a philanthropically developed and supported facility in Cologne, Germany where patients may receive oncology services free of charge.  An integral part of Haus LebensWert’s vision and mission is to vigorously help cancer patients cope with life both during treatment and afterwards.  Another key component is the use of alternative and complimentary therapies.  These therapies are made available to patients in addition to traditional measures as part of a seamless whole.   Examples include psycho-oncology, art & music therapy, gymnastics and other exercise, voice instruction, Feldenkrais training, Nordic walking, dance therapy, massage and aroma massage, Tai-Qi, Qi-gong and acupuncture.   The Haus LebensWert, which complements a more traditional hospice, has been well received by both patients and practitioners, including those who refer their patients from outside (Hematology Am Soc Hematol Educ Program. 2009:320-5).

Critics of “complimentary and alternative medicine” (CAM) frequently complain of a double standard, and a lack of rigor in its evaluation.  Some feel this looseness encourages bloat and charlatanism, and risks distracting patients and practitioners from the path to “good outcome.”

“Academic medicine integrates three of the most honorable human activities: treating the ill, teaching, and research. The quality that all three share is persistent quest for truth. However, there is reluctance of academic medicine today to openly defend scientific truth by challenging the arguments and the very existence of “complementary and alternative medicine” (CAM). There is no sound proof of CAM effectiveness, no hypotheses on the mechanisms of their action, nor scientific reports testing them. The fact that patients are charged for these “healing” activities makes CAM a plain fraud. With these facts in mind, the name “complementary and alternative medicine” is undeserved and misleading. CAM advocates maintain that CAM should be recognized precisely because it is widely practiced and very promising, that it has a special holistic/human approach, and works at least as a placebo in situations where medicine can do nothing more. As it seems that the public interest in paramedicine will only grow stronger before it grows weaker, scientists must raise their voice and question the truthfulness of CAM more openly.”
Croat Med J. 2004 Dec;45(6):684-8.

While a truth-centered paradigm is difficult to dispute, there is more than scientific truth at stake in the quest for human understanding.  There is also existential truth.  While physician-scientists optimize therapeutic regimens by evaluating their effects on controlled trial populations, each individual patient attempts to grapple with his or her radically changed reality both in terms of life, and death.  Quantity—be it months of survival, tumor size, or fraction cured—can be measured with increasing accuracy and predictive value.  Quality can’t be so easily parameterized.  Moreover, even attempts made to evaluate “quality of life” tend to fall short because experience transcends subjective criteria when they are too rigidly circumscribed.  Patients exist within the larger communities of other patients, clinicians, family, and the omnibus of culture.  If society views the sick as mechanisms in need of repair, and devalues anything regarded as “touchy feely,” then those in charge will cut the funds that allow physicians to spend time talking with patients or considering the larger life outside the body, while adding to the already glutted ranks of surgi-centers and MRI scanners.  Certainly the possible advantages of reinvigorating the art of medicine, or even expanding it to include real art, such as expressive writing, or speaking, as therapy,will be viewed as unworthy of “serious” exploration.  This is what has happened so far.  The impersonal and alienating experience of illness is nearly a truism, at least in the U.S.

Hospitals, especially large referral centers, can be daunting and soulless places.  As we move necessarily towards more “cost-effective” healthcare it will be important not to lose sight of the fact that quality and quantity exist to a large degree as orthogonal axes.  Designing healthcare to have a more empirical and inclusive approach to alternative healing strategies assures a better chance at quality of life, and should be encouraged as long as these don’t induce patients to forego proven treatment.   A life of fear and despair may be nearly as much a lost life as for the patient who dies of his or her disease.

Haus LebensWert, by the way, means House for a Life Worth Living.

This will play right into Obama’s hands. Humanitarian, compassionate. They’ll use this
to, to burnish their, shall we say, credibility with the black community, the both
light-skinned and dark-skinned black community in, in this country. It’s made-to-order
for him. That’s why he couldn’t wait to get out there, could not wait to get out there.

                                                                                     –Rush Limbaugh

A man carries on in the ruins, carries an old woman
Clear of the broken stone, everything broken,
The world indescribable simply because it’s smashed
Beyond recognition. We talk
Of magnitude–well, on the scale of misery this weighs
More than everyone’s imagination. The world comes
Down to this, comes down like building blocks,
The camera closing in
Until you only see his face.

We keep expecting that other aftershock
We hope will cause the right stone to break
And with a softer resonance as from a body
Trembling joyfully, all by itself,
Because a black president
Is more an event than a man, belongs
To the simple facts we gather together
And call a world.
                                        We stand poised, greased and waiting
To leap headfirst into the waters
Of change, which are warm like the Caribbean
Though we know the help will be tepid,
Less than close to enough because of pictures
Like this, the people in them who didn’t choose to be,
Who lack the luxury to decide whether they care
For the color scheme.
                                                 But still they visit
The television that is our president,
Always alone or in groups still small enough
To distinguish those in them
Which is how survival happens, even triumph.

So he appears wretched and still humbly, oddly proud
Carrying his wounded neighbor
Like something essential, bond receipts, a television,
A pail of food, or water
As in that painting by Lois Mailou Jones
She called The Water Carriers,
Too few pipes after all, too little cultivation
On the little voodoo island
That bears the brunt of our curses
Because it freed itself. Jones carried herself
Like water, entered contests anonymous
As water so they wouldn’t know
She was black.
                                   Her painting doesn’t show you
The river, not even the little bit by her side,
Just a bright hat and a face that resembles hers
And ours. Some day there will be people like that
On Haiti, people whose misfortune will move
All of us like the earth. Everyone will act
Indifferent as a river, which can’t tell its own
Smooth stones from a hand or a mouth.

                                                          —David Moolten

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