Wednesday, July 25, 2012

Off the shelf...

On the strength of the recommendation of dozens of blog commenters over the years, I got George MacDonald Fraser's WWII memoir, Quartered Safe Out Here, to read on my Kindle on the trip. Thank you to all who recommended it; it is right up there with With The Old Breed.

That was followed up on my return with Deadly Kingdom: The Book of Dangerous Animals because face-eating monkeys.

Recent events have me currently reading Clayton Cramer's My Brother Ron: A Personal and Social History of the Deinstitutionalization of the Mentally Ill. (Which is fascinating thus far for its study of the treatment of the mentally ill in American history.) It's a knotty problem: How do you deal with the non compost mental in a free society that respects individual liberty and human dignity? Life was simpler when I had glib answers to that question*...


*"Lock 'em up!" as a young conservative and "Everybody's got a right to be crazy!" as an adult wookie-suiter. Is pre-crime incarceration, a la Minority Report, okay if the diagnosis comes from a psychiatrist rather than a psychic? Is a crazy person, like a minor, not entitled to the full range of liberties and rights of citizenship?

29 comments:

Anonymous said...

More to the point: "Crazy" covers a lot of ground in an America where:

1) Practically every quirk of human nature has been redefined as evidence of some sort of mental syndrome and hey, they've got a pill for that!

and 2) every six months or so liberals release "studies" that "prove" that people who hold conservative and/or libertarian beliefs, and are suspicious of government officials, are "unstable."

So just as they're groping all of us at the boarding gates to make a show of keeping terrorists off airplanes, why wouldn't "crazy" be defined down to the point that just about anybody would qualify (and especially if they disagreed with Democrats on the issues of the day)?

--Wes S.

akornzombie said...

My two cents worth: If someone is mentally unstable, crazy, whatever, they still have the rights and duties o a citizen.

It's when they are no longer able to control themselves and become a threat to the populace at large is where I draw the line.

Emphasis on control themselves.

Anonymous said...

Tam some of the mentally ill cannot function in society while others do just fine. The key is the medication and making sure they stay on it, some of them would rather not have that routine be part of their lives.
Mental illness has two victims-the patient and their family. Just as the patient has the right to liberty and rights of citizenship, the family also retains those rights. They however labor under tremendous encumbrances and the medical and judicial system quite frankly is at best indifferent and at worst hostile towards helping them live a life that has some sense of normalcy. The old system was not perfect, but it at least acknowledged that the damage needed to be minimized to society and families.

Bubblehead Les. said...

Re: Reading Material. Just a Heads Up. Baen is finally going to release some new Larry Corriea and Kratman and others in a few days. (Of course, some of us wish that they had done so 2 months ago, so we could have some Summer Reading as we sit in our backyard kiddie pools trying to cool off from all of the Global Warming).

As for the Mentally Ill, you got me. I'm old enough to remember when they were Warehoused in those Big State KooKoo Nests. Nowadays, I can chat with them any day of the week as they push their Shopping Carts down the Street.

At least we've advanced enough in our Culture that Military Veterans aren't being seen as Travis Bickels every time we go out the Door.

Mikael said...

Crazy is normal, there's not a person in this world who does not suffer from some sort of mental syndrome. Case in point, everyone has delusions about something or other. The difference is how dangerous/damaging those delusions are.

You can be stable and still have psychological disorders. The problem are those that aren't stable.

It doesn't help that several disorders are genetic, and heretitary, and often selected FOR, not against. One of the most telling is schizophrenia, which aided the chance of survival and reproduction for the afflicted back in our primitive past because they were 'godtouched', prophets, shamans, etc.

og said...

Mental illness in all it's forms is possibly mostly deliberately misunderstood. My cousin is a board certified psychiatrist who left his practice once he found out that the profession was lousy with hand holders anxious to develop enough patients to pad out thier calendar and keep them in a good lifestyle. He was disgusted with the lack of real science being done.

Psychiatric treatment, chemical deficiency/dependancy will always be a way for a certain portion of the industry to make a handsome living. Why fix it when treatment is so much more lucrative? So long as there are a number of "Cures" on a regular basis to make the profession look like it is doing it's job, the rest of the time they can sit back and let Blue Cross/blue Shield make thier Maybach payments.

Lewis said...

I've liked everything by George Macdonald Fraser that I've read. My introduction, as I suppose is usually the case, came through the Flashman books, and then the MacAuslan series, then QSOH and Light's On At Signpost. Sure doesn't hurt that he wrote the screenplays to The Three (and then Four) Musketeers.

jetaz said...

Generally, I think that the position society should take is to presume that any person who reaches their majority is competent to make their own decisions.

Societally we have very little cost to letting the mentally ill, or the developmentally disabled, wander around free. However, we have a huge societal cost if we create a process by which the noncriminal mentally ill may be incarcerated.

Robin said...

jetaz, very little cost? I think you don't understand the immense contribution that mental illness makes to our crime problem.

Anonymous said...

"It's a knotty problem."

Ain't it though. Among so many other problems for which there just is no simple solution that is not totally subjective or skewed by vested interest.

Og's observation about crazy is applicable to most of the others too; taxation, national/personal defense, and politics itself among them.

As usual, follow the money.

PB

Merl said...

My mother works in a residential facility for the mentally retarded and every weekday they go to "day program" where they perform menial tasks, mostly envelope stuffing. They go willingly but by definition the retarded aren't capable of consent. Is that immoral? It obviously is "slavery nor involuntary servitude, except as a punishment for crime whereof the party shall have been duly convicted"?

Peter said...

Another book recommendation: "Measuring America" and its sequel "The Fabric of America" by Andro Linklater. Fascinating background on how the USA came to exist in its present form, including much that I'd never heard about before reading these books.

John Stephens said...

There are no good solutions, only least worst. With that in mind, I propose to abolish the concept of "legally insane". Anyone who can't confine their behavior within legally established margins, FOR WHATEVER REASON, gets locked up. Whether they go to a hospital or a prison is up to the authorities after the trial. Yeah, it'll suck for the crazies. Guess what? Life sucks. Deal with it, or get dealt with.

PhilaBOR said...

I think the alternative we are talking about is many or very large institutions, filled with the mentally ill. They are run by the government or contractors. Managed as well as the VA or the Post Office. Presumably that is what we had before the great de-institutionalization.

Anonymous said...

My son has Autistic spectrum disorder.

What works with him is being very clear, in words about actions, and consequences. He has virtually no ability to learn by example, or to fit in. He routinely has conflicts with his siblings because they have not the words to explain why they are unhappy with him.

So much of our learning is connecting action with reward or punishment. He misses that. Reward seems random. Punishment seems capricious to him.

What will happen when he is grown? He will forever be unable to drive a car, as he will be unable to look at the flow of traffic and intuit that there is a block a head, so he should slow down.

I can't expect his siblings to take him over. That would be horribly unfair to them.

I guess I just have to live forever.

Drang said...

RE: G.M. Fraser: Have you read The Steel Bonnets? History of the Borderers, and available in Kindle format.

Re: Mentally handicapped. I dunno. The easy answer is "If they are a threat to themselves or others, lock 'em up", but how to define "threat to themselves or others"-especially others, and how to measure at what point they become such a threat--is nowhere near as easy an answer. Nor is the question of how to pay for warehousing them, or who is to pay.

Not sure if this is what prevents me being a full-blown wookie-suiter or not.

Anonymous said...

"The Steel Bonnets? History of the Borderers"

Yes! Great book!

What's the line repeated in the book about some poor sod arriving at a keep in the middle of the winter night in the miserable cold and wet, and asking for shelter and being told to f-off. He answers plaintively "Be ye not Christians?" And from battlements the answer: "Nay, we be Percy's"

As the insane and incapable, somehow we managed to warehouse them for decades without too many sane people getting caught up...

Moriarty said...

Taking away someone's civil rights is always a big deal.

On the one hand, you can invoke a "Two Doc Hold" which can result in involuntary admission for up to 3 days (in my state.) It requires independent evaluation by two physicians and a determination that the patient is represents an imminent threat to themselves or others. A hold has to be renewed, by independent evaluation, every 72 hours.

FWIW, physicians hate this sort of thing not only because of the paperwork involved, but because of the liability exposure over depriving someone of their liberty. (You don't want to be defending yourself on the witness stand after being second-guessed by some hired gun academic psychiatrist with a publication list twice as long as your CV.)

Beyond that, you get into questions of competency, which is another legal furball. I've been dragged into court several times to testify on the competency of patients. (Once over our neighbor, whom I've known since childhood. The plaintiff, defendant, plaintiff's council, our neighbor and the bailiff were all my patients. Such is small-town medicine.) Competency usually turns on whether a power-of-attorney should be granted or revoked over financial or medical matters.

Again, you have to be exceedingly cautious: Malpractice liability coverage does not extend to your potential role in unjustly denying someone their civil rights. Physicians state their opinions at their peril.

There is no simple answer to what to do with an incompetent patient who has not appointed someone to speak for them. Everyone should have a "living will" of some fashion, designating a decision-maker, but often this defaults to the next-of-kin. I've seen some gut wrenching displays of family dysfunction when Dad decides to let Mom die with dignity and the adult children maintain that Jesus is going to have her up and walking in a day or so if everyone just prays harder. (They literally told their father that if she had her extubated, they'd consider him a murderer.)

There's also the problem of what to do if no next-of-kin exist. In training, we had a patient who was floridly schizophrenic and unable to care for himself. He was incompetent and we treated him with antipsychotics under implied consent.

His symptoms abated and he became competent. The first thing he did was refuse further treatment. His symptoms promptly recurred and he became incompetent again. (On the second cycle of lucidity, he appointed a friend to carry his power-of-attorney and we discharged him into adult foster care.)

Rob Reed said...

Have you read Don Burgett's books about his experiences with the 101st in WWII?

Currahee is the first book, and Seven Roads to Hell is about Bastonge. I can't recall the name of the third.

They are very, very, much worth reading.

Rob Reed (Trebor)

Ancient Woodsman said...

Thank you for the review of Fraser. I have read E.B. Sledge many times over. I'll now have to get the Fraser memoir.

On the other thing, over my career it seems that the less socially able folks are just as likely an accuser as an actor of an unacceptable deed, so I do not have a pat, Internet-acceptable answer for that part of the conversation.

Drang said...

@Rob Reed: Amazon.com: don burgett
I'm guessing "Beyond The Rhine" is #3.

Another interesting one: Amazon.com: The Simple Sounds of Freedom : The True Story of the Only Soldier to Fight for Both America and the Soviet Union in World War II (9780375507861): Thomas H. Taylor: Books

Tim Ellwood said...

Just finished "soft Target" by Stephen Hunter ( strange book to be in the middle of last friday night). Now to reread the Peter Capstick books, "death in the tall grass, etc.
Have to add the deadly kingdom to my list. Also need to reread the Jerry Ahern books, may he rest in peace.
The "Survivalist" series may not be high literature, but it made me buy a lot of guns and Alessi holsters

Rob Reed said...

@Drang,

Joe Beyrle's story is definitely worth reading. Actually, he wasn't the "only" U.S. soldier to serve with Soviet troops after being freed from a German POW camp, but that's not important.

Here's my funny "brush w/greatness" story. Beryle was local tome. I read an newspaper interview with him years ago and tracked him down and called him.

I talked to him about his war experiences for awhile and said he should write a book. I let him know that if he ever wanted a co-writer/editor I was very interested. He said he'd just started working with "a guy" and thought they were working out well.

Turns out his co-writter, Taylor, is WWII 101st Gen. Maxwell Taylor's son and a 101st vet himself. I couldn't think of a bettre person to write that book with him!

It's well worth reading for anyone who's a WWII buff.

Rob (Trebor)

Borepatch said...

The situation with mental health is even more complicated. A lot of these folks do very well so long as they keep on their medication. As a matter of fact, you meet them every day without knowing it.

So what should society do about controlling these people when they're on their meds? After all, they might stop. But they might not.

I'm afraid that I lack the confidence in the overall intelligence of our Philosopher Kings, and so default more to the Wookie Suit end of the spectrum. Could something constructive actually be done? In theory, yes. But in practice - with the politicization that is inherent in how laws get passed - confidence is not high.

Matt G said...

I think of all the times that I've run into people who were not just kinda weird, but actively crazy, and either nothing could be done, or available services were not utilized.

Heck, I even wrote about a crazy guy with a gun who walked free about 9 hours after chasing a cop with a gun.

That wasn't a case that I heard about; I was there.

Anonymous said...

Dealing with the mentally ill is and always will be a morass in any semblance of a free society. (That is all we are now, a semblance!).

I see them every day in my small town practice, I see where they need referrals to specialists, and where there are no specialists to refer them to.

We all do our best, but the only way to really do this right is with more manpower and evaluation than we can afford. Depriving someone of their freedom BEFORE they commit a crime is wrong, and surely more damaging than allowing the crime, at least to society as a whole.

So far as the Aurora shooter, I'm not convinced that he was/is insane. There are those within whom the ability to do great evil resides, and insanity is not necessarily a co-present issue.

While normal people may look at that horror and protest that surely he was insane, I look at it and say, "What about Mao, and Stalin, and Hitler, the Japanese war generals, and Saddam, and Gaddafi, and Osama, and so many others, were they insane as well?"

Because the act would demonstrate insanity if WE were to commit it, because it would mean we had left all our sane compunctions behind, it does not mean that it was an act of insanity by someone who had no such compunctions in the first place.

Great evil exists, and in some, it does not co-exist with insanity!

Bill

Clayton said...

Thanks for mentioning my book.

About 18% of murderers in one recent survey were mentally ill--much of it schizophrenics. Worse, the spectacular murders that scare the wits out of the general public enough to get them listening to assault weapon bans, are the random mass murders--and these are overwhelmingly people with significant mental illness problems. Many have long histories of contact with police, or are known to family and friends as severely ill.

The difficulty is that while you don't want people locked up for being a bit eccentric, the evidence that I can find suggests that such improper commitment were pretty pretty in the bad old days. I am sure that they happened, but the severe overcrowding of mental hospitals meant that there were strong incentives to release people who did not belong there, and no incentive to hold them.

While there is only a little evidence so far about the Aurora shooter, he fits the pattern of schizophrenic breakdown: very, very smart; late teens or 20s; shy, loner; goes from apparently fine to "I'm the Joker" in a few months. Other recent incidents, such as the Cafe Racer killings, are well established to be the sort who would have been hospitalized in 1960 without any question at all, not to protect society, but for his own good.

Wookie-suiters can take pleasure in their ideological purity, but something is going to give on this, and other paranoid schizophrenics, such as Patrick Purdy, tend to make the system give on gun control instead.

Crotalus said...

"Deadly Kingdom" "This book is for anyone even remotely thinking od getting a monkey, a sea lion, or heaven forbid, a dog."

Or for that matter, getting married. Man (both sexes) is by far the most dangerous animal on the planet. Wonder if we're mentioned in that book?

Earl said...

Thank you for the Fraser title, it fit my mind, memory and mood. I have the Steel Bonnets and another on order of his. Might have read deeper into Flashman if I had read this first, but since I am not jumping up to get one, probably not. Thanks again.