Friday, April 26, 2013

Nice work, Tony.

My amazement has grown over the way that journalists at the ABC's current affairs TV program Lateline have firmly challenged the inappropriate use of anti-psychotic drugs by Australian doctors and psychiatrists. In fact a very good argument could be made that there is no appropriate application of these dangerous and harmful drugs, but I think it would be too much to expect that this argument should be found on Australian TV.

In 2011 Tony Jones interviewed the powerful Irish-Australian psychiatrist Professor Patrick McGorry. At the time I thought this interview was informed but too soft, and the findings of research that has been done since this interview has shown that much of what McGorry claimed about the effectiveness and evidence-base of the interventions he has been advocating for many years was wrong. In 2012 Tony Jones appeared to be quite personally inflamed when he reported about elderly dementia patients having their lives shortened in Australian nursing homes because of the widespread over-prescription of anti-psychotic drugs.

The last couple of editions of Lateline have examined the issue of a 600 per cent increase in the use of the anti-psychotic drug Seroquel in just five years by Australia's Department of Defence, presumably for the treatment of post-traumatic stress disorder (PTSD) in soldiers. Allegations have been made that this drug is being used instead of proper and expensive psychological interventions, is being prescribed in dangerous high doses and is being prescribed inappropriately to treat insomnia symptoms of PTSD. Last night Tony Jones was steadfast in asking questions, recounting evidence and seeking answers in an interview with a clearly very irritated senior person in the Australian Defense Force, our Commander Joint Health and the ADF Surgeon General. The interview was a pleasure to watch. I am sure that there are heaps of journalists who would not have had the confidence to question the practices and administration of a qualified doctor and senior bureaucrat on an issue about the rights or wrongs of medical/psychiatric clinical practice. I am sure that many journalists would simply defer to authority, or be too intimidated to be seen questioning that great sacred cow of Australian popular culture; the "mental health" industry. Not Tony Jones. A good journalist should be hot on the inside, cool on the outside, filled to the brim with all the relevant facts, and able to recognize the truth beyond personal agendas. I think Mr Jones approaches that ideal. Nice work Tony.

Thursday, April 4, 2013

Another speculative thought about the interesting case of "Doc" Evatt

A couple of years ago I was amazed to be apparently the first person in the world to identify the fascinating, formidable and not bad looking for a pollie late Australian politician H. V. Evatt as a synaesthete, based on biographical information written by others but not previously analysed in terms of synaesthesia. Evatt was a controversial and enigmatic character, and his coloured days of the week synaesthesia was perhaps one of the least amazing of his characteristics. Synaesthesia certainly wasn't the only interesting thing going on inside the brain of the ALP leader. By all accounts he suffered from a dreadful mental decline for an unknown period of time before his death, which seems like an especially cruel fate for a man who displayed a powerhouse intellect since he was a school-boy. Biographers have put forward a number of theories about the cause of his death and decline. Some wrote of atherosclerosis, some offered convincing evidence that epilepsy was treated as a definite or speculative diagnosis by Evatt's doctor. As you'd expect, some who don't like his politics have asserted that he was simply crazy as a loon. Asperger syndrome has been offered as an explanation of his personality, which is really an empty assertion as that label is itself little more than a description of behaviour. Eccentric behaviour has been noted by a biographers and commentators - a terror of flying, stuffing newspapers under his clothes as insulation against hot weather, sloppy dressing accompanied by a "strine" accent, a cruel manner at times, sleeping few hours a day (as appears to be common among political leaders), and meeting guests fully dressed but lying in bed. In not sure exactly during which period in Evatt's life he liked to go nude, a behaviour admired by another colourful past ALP leader, Mark Latham. Our nation came that close to having a nudist PM, that long ago? That's something to consider. I could be accused of anti-intellectualism in my suspicion that there was something interesting behind Evatt's life-long habit of collecting achievements, but when I read in one biography pages upon pages of description of the academic prizes, positions and honours amassed by Evatt since his earliest school-days, I couldn't help wondering about the powerful driving forces and motivations.  Even his nick-name is an academic achievement. He had a doctorate in law. 

Perhaps the oddest behaviour noted by biographers is the being in bed fully clothed. Why? Sleeping in clothes? An odd attempt to hide physical collapse caused by absence seizures? Some other medical problem causing fainting? I was monkeying about on YouTube, as you do, viewing one of my favourite genres of videos - the medical freak-show, when I came across an episode of the TV series Mystery Diagnosis. There were two interesting medical cases in the episode, but it was the case of swallow syncope in long-suffering patient Martha Bryce that made me think of Evatt. If Evatt had this illness or something like it. it would explain a lot of his eccentricities and also the tragic mental decline. This rare medical condition as an explanation would encompass both the seizure-like and the circulatory symptoms that Evatt appeared to have. If he had it way back in the 1950's in Australia I think most likely it would have been misdiagnosed or not medically understood and not treated effectively. I imagine it would slowly but surely destroy the brain and the mind if untreated, and no one would understand what was happening. What a horrible fate. Could there be any link between synaesthesia and neurally-mediated syncopes? God only knows, but I do know that I, a multi-synaesthete, have experienced some memorable episodes of this type of fainting. 

Rare diseases and medical conditions deserve a greater share of research funding, recognition and donations. Individually these conditions are indeed rare, but as a group rare medical conditions and disorders are not rare at all - many people have one or more rare or uncommon medical issue, but it is the common deadly diseases that get all the attention.