I had posted in the past about locked-in syndrome and about how to communicate with the brain of people who cannot communicate. This neat little report details the creation of a brain computer interface that allowed a woman with locked-in syndrome to compose and play music. It seems an obvious leap to wonder about other ways a brain computer interface could be useful. Psychokinesis, anyone?
Brain Computer Interface
March 22nd, 2011On Being a Dinosaur
March 15th, 2011There has been a lot of media coverage recently about psychiatrists no longer doing talk therapy (psychotherapy). It seems that the NYT article about Dr. Donald Levin was the trigger. My patients as well as friends and family have been asking me about it. The primary force behind the abandonment of psychotherapy by psychiatrists has been the pressure from poor insurance reimbursement rates. Simply put, we psychiatrists can make a better living by just seeing people for medication visits, and by doing a lot of these briefer appointments in an hour. The insurance pressure shifts the talk therapy work to social workers and psychologists because they cost less. There has also been a shift in the training programs for psychiatrists away from talk therapy and towards more biological treatments like medications. So in a few years, as we older docs retire, there will be few psychiatrists with enough training in psychotherapy to provide this treatment in skillful way.
When I changed my practice eight years ago, I got off all the insurance networks. A main reason for this was to eliminate the pressure that made it difficult for me to do psychotherapy. Now, without the insurance company as a middleman, the patient and I negotiate the treatment plan directly between us. The discussion of cost and budgeting is a integral part of the start of treatment. I recognize that not all patients have the financial flexibilty to undertake treatment outside their insurance network. One of the many surprises I have had in making this practice change is how many patients receive significant reimbursement from their insurance companies for out-of-network care. I have enjoyed being able to do psychotherapy again. It gives me the time to be interested in the whole person, not just in their symptoms, side-effects and dose changes. The NYT article says that only 11% of psychiatrist do talk therapy these days. Combined with the decreased emphasis on this form of treatment in residency training programs, I do end up feeling like a dinosaur. But a dinosaur that has the awareness of being one of the last of her kind.
I hate House!
February 25th, 2011There are several reasons why the TV series “House” drives me crazy. In some ways it is very accurate about some diseases or conditions. On the other hand, it is very unrealistic. I know that my readers are thinking “lighten up already; it’s just a TV show!” But this is my blog and I get to rant when the need arises. The show is unrealistic in portraying the team doing everything themselves, from running highly sophisticated lab tests and MRIs to performing cardiac catheterizations or even brain surgery. No one doctor comes close to knowing how to do all those things. No one doctor could have the time to amass the experience to being able to do all those things safely. That aspect of the show plays up the doctor as a superior god-like being. Don’t like that for sure. Doctors have enough trouble with their egos without this kind of press. The next unrealistic thing is all the shenanigans the doctors get away with, from breaking and entering into patient’s homes, to lying to patients and families, to saying they are giving one medicine and then giving another. That is without even counting the sexual harassment, bullying, theft and vandalism that House indulges in. I object because maybe people believe that this is what their doctors are really doing when out of their sight. More bad press. No doubt about it, House is an SOB. It’s weird, the portrayal of the brilliant doctor as an immature, addicted, self-indulgent, impulsive guy with a mean streak a mile wide. It’s shocking how House’s co-workers, patients and the hospital accept all his bad behavior. He needs an intervention! But let’s face it. It is a popular series. Even I have been watching and I don’t even like it. It is kind of habit-forming. Does it mean we believe in the bad guy with a brilliant mind and a well-hidden heart of gold? Are we subscribing to the view that the end justifies the means? As long as the diagnosis is made and the patient saved, the transgressions don’t matter. I don’t believe the end justifies the means. Maybe the show is saying that if it were my life on the line, maybe I would feel differently.
Genetic Social Networks?
January 27th, 2011I watched the film “The Social Network” earlier this week. I was struck by the irony that the main founder of Facebook who had so many social deficits himself ended up creating a global system for connecting with others. It’s a system for a virtual connection that is different than a real world relationship but is unrivaled in its scope and lightning-fast speed. There is a clear generation gap in how connecting through the internet is perceived. Older folks like me see engaging through the internet as a less real connection. It certainly eliminates the possible pheromone connections that I posted about. Now this study I am posting about today attempts to establish genetic linkages in social networks. If you read through the summary you will see that the data is far from a slam dunk. Maybe there are genetic similarities in social networks, and maybe there are not. But if there are, the questions are why we would aggregate with people who share a bit of DNA with us and how we could possibly perceive who shares these little pieces of DNA and who doesn’t.
Another Thought About Tears
January 26th, 2011Thinking about the question in the prior post about why people cry. Do we release some chemicals in our tears that are somehow “toxic” to our minds? Is that why people report that after a good cry they feel so much better?
Why Cry?
January 13th, 2011Pheromones play a role in communication in other species, so why not in humans too? This study looked for pheromones in women’s tears and asked what their possible function could be. The summary of the study states that tears shed emotionally have a different chemical composition from tears in reaction to an irritant (like cutting on an onion). They didn’t teach that to us in medical school so it caught my attention immediately. Why would that be? It implies that emotional tears have a mysterious function and started me wondering why people cry when they are upset anyway. Notably infants cry a lot but don’t shed tears with their crying until they are several weeks or even months old. But I digress.
The study in question measured the effect of smelling a woman’s tears on sexual arousal in men. I can’t imagine why they thought of asking this question, but they did. The control substance for the study was some saline that had been trickled down the cheeks of the women to pick up the scent of any perfume or skin cream etc. They measured sexual arousal by physiological factors such as heart rate, testosterone level and skin temperature. They also inferred it from how the men rated the attractiveness of pictures of women’s faces which seems like a rather indirect measure of arousal. The best measure that they used was looking at how intensely brain regions lit up in a specialized brain scan when the men were shown erotic images. There was a distinct decrease if the men had been exposed to the tears first.
What possible role could there be for this unidentified substance in a woman’s tears that decreases the tendency for men to be sexually aroused? I am stumped. Ideas, anyone?
The Beauty of Science
December 21st, 2010I love these annual collections of the best scientific photos of the year. This time my favorite is number 8, the butterfly egg on the flower.
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Puzzling over Puzzles
December 16th, 2010I have finally found some justification for my occasional lapse into playing puzzle games on the computer. According to this article, playing games that tweak your creative side by engaging you in problem solving can put you into a more productive mind state afterwards. The article has some links to some fun interactive games like a timed online jigsaw puzzle or a timed pattern recognition task. Wonder if I have time in my schedule today for a quick round of Minesweeper?
For the Love of the Maraschino Cherry
December 3rd, 2010A friend forwarded this NYT piece to me and I loved it. It’s a story about urban bees turning red and producing bright red honey and about the efforts of the beekeepers to figure out what is going on. The detective work leads to the conclusion that the bees are flying a long distance to binge on the sweet red waste from a factory that makes maraschino cherries. The bees prefer this “junk food” to the nectar from local fields of nutritious blossoms that are directly outside their hives. Wow. I often wonder why people like things that are bad for them and now I can wonder the same about bees. I am of course assuming that a diet so rich in maraschino cherry juice that it turns their bodies a neon glowing red is bad for the bees. Scientifically speaking this assumption has not been proven. I have had a lifelong appreciation for the occasional maraschino cherry, despite my mother’s stern warnings that they were poisonous in high doses. She must have used this extreme tactic because I was overly enthusiastic about the maraschino cherries. They seem like the epitome of junk food….unnaturally colored, cloyingly sweet and with a shelf life that seems like decades. Really they look and taste plastic, don’t they? I don’t know whether to feel better or worse about my secret affection for maraschino cherries in light of the bee’s apparent addiction to them. It’s strange when nature is so unnatural.
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Pessimism in Dogs
November 24th, 2010I have been thinking about pessimism more lately after reading this study of dog personality. The study tries to sort the dogs according to their measured “pessimism” and relates pessimism to separation anxiety behaviors. The relationship would be something like…”oh, no, they are gone and will NEVER come back!” The test for pessimism used in the study was whether the dog would go to investigate a bowl that may or may not hold a treat. I am presuming that all the dogs were well-fed; otherwise the study just separates hungry from not very hungry dogs. Dogs that were less likely to go searching for the treat had a higher percentage of observed separation problems (measured in a different phase of the study).
Pessimistic people often justify their attitude by stating that it is better to expect the worst and be pleasantly surprised if something better happens. This defense of pessimism presumes it will be a protection against disappointment, but I don’t think it really works this way. Like the dogs in the experiment, pessimistic people often do not strive for hard to reach goals. They would be thinking something like “why bother…I’ll never succeed.” In that way, pessimism can be a self-fulfilling prophecy.
To be fair to pessimists everywhere, there have been studies showing that in some cases pessimists are more realistic than optimists. These studies compared depressed people who are profoundly pessimistic with non-depressed people with normal levels of optimism. The experiment evaluated the person’s ability to estimate the probability of winning in a game of chance. The non-depressed optimists over-estimated their chances of winning and the pessimists were pretty accurate.
