Medicine's Subjective Parasites: Psychiatry and The Fifth and Sixth Vital Signs

When visiting a doctor, whether in an office or hospital, nurses will take vital signs. The four objective signs are heart rate, temperature, blood pressure and respiration rate. However, two new subjective vital signs are level of pain, and self-described depression. "On a scale of zero to 10, ten being the most severe, what is your level of pain?" the nurse may ask. That question, simple as it seems, opens the door to opiate prescriptions that may not be needed, and such self-diagnosis leads to prescriptions -- paid for by the government or private insurance -- of high-demand drugs.

Coincident with the addition of the fifth vital sign, death by prescription overdose has overtaken automobile crashes as the leading cause of accidental death, and the heavy narcotics sitting in home medicine cabinets are an attractive lure for illicit use by others in the family, or can end up for sale on the Internet or out front of the local high school. An 80 Mg pill of Oxycodone, for example, has a street value of around $40. The price is driven by the demand for a cheap high, not any excape from physical pain. In Florida, pain clinics operate largely unregulated, and getting a prescription for narcotic pain relievers is as simple as going in, describing some fake pain, and walking out with a prescription for a dangerous narcotic.

Now, "depression" is being added as the "sixth vital sign." Recently, I was hospitalized for a motorcycle accident. At home, recuperating, a deep wound on my foot was slow to heal, got infected, etc. I got pain medications to help me sleep, and the home health nurse asked me if I had experienced any depression. Well of course. I had visited the basement of emotional reactions: I was angry that somene had rear-ended me in traffic, destroyed my motorcycle, put me into surgery and then the hospital, made me miss work, having to use a walker or crutches and lay on the table in the doctor's office while he did "Sharp debriesment" of the open wound. I was dizzy at times from a concussion and the drugs, and my broken ribs hurt. Having to have my wife help me with simple tasks, on and on. Of course I had experienced some depression, I think anyone would. But it was related to something I was dealing with and was as natural as getting wet goes with rain. But had I said yes I had experienced depression, I would have been prescribed a phychopharmaceutical to cheer me up. A happy pill that -- according to the black box warnings -- could cause me to go into a rage or kill myself. I said no, no depression, because I know a lot about happy pills and there was no way in hell that I wanted to walk down that road.

Today in the waiting room of my primary care doctor, I saw a poster asking about depression. There were three levels. "Normal," "Worn Down" and "Overwhelmed," each accompanied by the appropriate bored or less happy or really unhappy face. Many of the people in the waiting room were in walkers on crutches, or had some physical problem. They were in a doctor's office, they had a right to be depressed without some self test leading to a very expensive happy pill that most likely would be paid for by Medicare or Medicaid, and carried a black box warning about potential suicide or uncontrollable rage.

These heavy pain killers were originally intended for people in incredible pain, going through the last stages of cancer, for example. Now, anybody can obtain them with the "right answer" to the fifth vital sign.

These fifth and sixth vital signs will become more and more significant as the Affordable Care Act (ACA) covers all Americans with insurance, and there will be millions of homeless and unemployed people with insurance to cover narcotics for the fifth vital sign and anti depressants for the sixth. If you had to pay for these drugs, you might not want them unless they were critical to your well being. But now, answer "8" to the pain question, or "yes" to the "worn down"or "overwhelmed" question, and bingo you have ready access to addictive dangerous and highly unpredictable drug paid for by the taxpayers of America.

This adding on of subjective measures to an objective science is not unprecedented. While the practice of medicine is built on objective study of anatomy and objective measurement of indicators such as heart rate, temperature and blood pressure, psychiatry has become a subjective parasite on the good name of medical practice and the help it has brought to people around the globe.

Psychiatry's ailments, however, have no objective measures and are voted on by psychiatrists and entered into a book called the "Diagnostic and Statistical Manual" which is now going through its latest revision. The link to medicine is the theory that chemical imbalances in the brain cause such things as depression, mania, and other mental problems, but no scientific evidence exists that this is true -- it is a convenient lie to cloak psychiatric voodoo in the robes of medical legitimacy. Over time, we've dispensed with other phony sciences like phrenology (head bump diagnosis) chanting and banging on gourds, appealing to Zeus and so forth, even though those practices had some limited success in curing psychosomatic ills. But psychiatry has so far managed to blend in with the medical sciences, perhaps because psychiatrists must have a medical degree and know something at least about anatomy.

The combination of the ACA and the fifth and sixth vital signs are a perfect storm of no responsibility and will lead to a society even more drugged and asleep than it is today. A human being, hooked on heroin, meth, Oxycodone, Methodone, Prozac, Zoloft, or any one of hundreds of such potions and pills is a slave very much like the slaves of the pre-Civil War South. They are owned by the drug companies, they can be sexually abused, beaten, starved, forced into prostitution or crime by the pushers that profit from their servitude. The society tolerates their servitude and in fact profits from it as pharmaceutical stocks rise and more and more human slaves are added to the rolls. And finally, they are punished by withdrawal if they attempt to excape their servitude, and death if they overdose in an ever-increasing need for relief from their plunge into the depths of despair and addiction.

When asked for the fifth and sixth vital signs, beware. Your answer could make you a slave for the rest of your life. If you need help for a problem in your life, find a friend, priest, minister, rabbi -- someone who will listen to you. Beware the psychiatrist or physician who would slap a label and a bar code on you, hand you a prescription and call out "next."

Waving Pop Tarts and Other Offenses

A seven year old, waving a pop tart and saying "bang bang" was a very serious matter to Maryland school officials who suspended the boy. This is a lesson in seriousness, the kind of seriousness brought about by school shootings or drugs in schools. When confronted with seriousness, we often throw out deliberation and good sense and substitute "zero tolerance" measures that get pop-tart-waving children or those with Tylenol in their backpacks expelled from school.

Zero tolerance measures may begin with good intentions -- after all, they are designed to counter drugs, guns and other dangerous things -- but we know what the road to hell is paved with. There is a kind of lazy relief in not confronting a problem, in not making a decision based on the "greatest good" for the situation. And there's risk in making decisions, "what if it doesn't work out and I get in trouble?" It's easier and less stressful to just follow verbatim some rigid policy.

True, computers operate that way, they follow their programming, their rules exactly. But our lazy relief at doing the same thing is a kind of apathy and every time an individual fails to act in a rational manner, the door opens for some new legislation to "solve" that new problem, and puts everyone under a structure that dictates what actions may or may not be taken under such and such conditions. We get frustrated at kids using drugs so any drug, even an aspirin gets a kid booted from school. We are so revolted at school shootings that we boot a 7 year old for waving around -- as his father termed it -- "a danish."

Human beings -- in spite of the success of our digital technologies that basically operate on yes/no switches -- can weigh intangibles in an analog fashion to come to a decision that sits somewhere on a scale between "a really bad idea" and "Nobel Prize-winner." A word to the kid that he should eat his pastry pistol or lose it would probably have sufficed. But no, suspension is the only choice because we've got a zero tolerance policy for guns -- and gun shaped pastry -- in schools. It only makes sense to a computer, or a legislator or somebody who is afraid to lose their job if they don't adhere to the policy.

Human beings make mistakes when they launch into making decisions on their own, and those mistakes become the motive for some really bad legislation. "Activist judges" don't follow the law and so more laws are passed to further restrict the decisions they can make. On and on, a gradual calcification, a smaller and smaller window of actual decision-making that can be left to individuals.

There is a decent purpose for laws and rules, however. They are the generally agreed-upon rules of conduct that a society has found to be useful in promoting survival, and so those laws and rules are enforced for the good of the society. That process -- justice -- is applied to members of the society who make personal choices that cause harm to themselves or others.

Ethics, however, has to do with those personal choices. Someone turns in a watch they found in the dressing room, not because they will be arrested if they don't, but because they feel it is the right thing to do. They take care of their families, pay their bills, tithe to their church, work hard, etc. They most often don't need justice, and are not motivated by fear of it. These are the people you never hear about in the news. "Man pays bills on time," is not a news item. "Couple married 50 years" is on the back pages, "Kid cleans up schoolyard," might be noted in passing. And there are millions upon millions of those "non-stories," every day in this country that are never reported. "Nothing Stolen During Street Fair," "Millions of Americans Never Arrested."

But if we get lazy and our ethical decisions flabby, plenty of people are willing to take the job of telling us what to do. "If it feels good, do it," was the mantra of a generation that went off the ethical rails with drugs and promiscuity and American society is still paying for it, still trying to solve the problems it created, 50 years later. Now, if you don't feel good, you need an anti-depressant, but shrinks and pharmacists are the dealers and it's all legal. The government even pays for it. And it's not your fault.

Our new mantra is: "It's not your fault, you have a chemical imbalance." In this society, you are seen as a sort of consuming computer, a stimulus-response machine driven by your chemicals, marketing and advertising, incapable of reasoning. You are seen as a product of your environment, an expression of your body's DNA, the effect of your parent's mistakes and the chemicals in your brain. You have no ability to make good decisions, and must be protected from yourself by a benevolent government that knows what's best. Protected against obesity, trans fats, soda, evil businesses, stress, sports injuries, accidents on and on. Everything is OK, you no longer have to take risks or make difficult decisions -- those create stress, which increase the drain on our national health system. So take a pill will you?

OK, way too serious! I do have some bad news however -- It is your fault! You are ultimately responsible for the good things and the bad that result from your actions. If your kid is suspended from school for waving a loaded pop tart, you can raise hell and should. If you feel stress, it's not your chemicals, it's something that you need to deal with and are avoiding. If you are obese it's not McDonald's fault for making stuff taste good, it's you being a pig. Go get some exercise like you know you should, and stop feeding your face. And if you feel like you really are a stimulus-response machine driven here and there by wind and chance, get religion. It's about you as a spiritual being, not a body full of chemicals and trans fats rolling downhill to the cemetery. That should cheer you up some.

From the Monkey to the Democrat

The way I see it is that we have at least two well-developed views of America. The first is a direct descendent of the Founders where government was the enemy, they thought they were in charge and they told us what to do. They wore red coats and wouldn't go away so we had to shoot them. We were the militia, those farmers with guns who did the shooting.

Once the redcoats left, we got together in groups and argued about who was in charge, but not much shooting, except for a few duels to honor the French who helped us. We keep guns to let people know we haven't forgotten and that we are still a force to be reckoned with. We watch Fox news and we'll give up our guns when you pry them from our cold dead fingers.

The second major view is that we have evolved, from the monkey to the union member to the Democrat, and we are all kind of sophisticated now, live in big cities, believe that global warming means we should live in the park, heat with compost and listen to National Public Radio.

Having evolved, we look down on the gun-toting monkeys as cretins, whatever those are, and define the word "militia" as "the military." To continue our sophisticating ways, we take from the rich and give to the poor. We tax sinful activities -- like smoking, drinking, gambling, burning gasoline and being productive -- to send a message of disapproval and to pay for our beneficence -- whatever that is -- to the poor, the dispirited, the depressed, the gender bent, the addicted, the many victims of a cruel fate meted out by the most wealthy and productive and fair-minded country in the history of the world.

The first view excludes those who don't share the first view. They just want to be left alone with plenty of space around them so someone with the second view won't move in next door or walk on their lawn.

First view parents say "tough it out," and "rub dirt on it," to their children's troubles, maybe take them to boxing or martial arts classes, while second view parents take kids to get medication and hire lawyers to sue bullies.

The second view warmly embraces the poor the broken, the dispirited, the criminal, the unemployed, the shiftless, the addicts, the criminals, the crazies, and those with a propensity to the many vices the flesh is heir to.

The first view sees that as completely unfair, because all those losers vote Democratic and the ranks of loserhood are growing. The second feel it is our burden to shoulder, and drag them from their TV sets down to the polls to vote, because after all, they are just poor weak creatures who need good examples, and in exchange we get tons of votes.

Both first and second views spend money like drunken sailors, no matter what they say. The first view spends like crazy on the military because we want to keep bad people from moving in next door to America. And the first view wants to hammer the dictators, the terrorists, the redcoats, the drug dealers and other bad people.

The second view believe we must make the wealthy and productive shoulder the burden of the losers, and so invent programs that provide food, pharmaceuticals, housing, abortions, caring, sharing, and other necessities of life to their charges. We believe we must all get along, and pass hundreds of laws to force us to do that. Cumbaya.

The first view folk see the country as swerving to the left, closer and closer to the socialist state with the red flag. "From each according to his ability, to each according to his need," which -- while camouflaged as warm and fuzzy, requires a heavy government fist to enforce -- penalizes the productive and rewards the unproductive, and was the idea that gutted the USSR, Cuba and all such warm and fuzzy and broke economies.

The second view folks disagree, citing Euro-socialism as workable and dignified and very very sophisticated. Nothing as sophisticated as an English accent or Greek bailouts. The first view folk put stickers on pickup bumpers that say "Socialism is great until you run out of other people's money."

Can we all get along? No. The views are too different. The second view media do not understand the first view reality, and denigrate it, calling for compromise or partial surrender, or just waiting for the old white guys like Clint Eastwood to die off, for the dawning of a glorious socialist spring where the government tells you what to do, but everything is free.

It's too late for good manners. The first view is angry and itching for a fight. The second view is in charge for now and, smiling indulgently from Mt. Supermajority, will plunge leftward ignoring the first view perspective. They think they are in charge and they tell us what to do, and as in olden times, we're having us a Tea Party.