docpark’s Nice Tea! and my picks

Football playoffs and lazy Sundays mix wonderfully in this iced tea creation. I make a typical Southern sweet tea using double density of P&G Tips tea bags, steeped extra long for that extra bite of tannins. I add a tablespoon of sugar for every two cups (may add more for more traditionally sweet tea) and if I have them, I crush and muddle in spearmint leaves. At this point, this drink is fine for drinking after mowing lawns, but if you want a super smooth Nice Tea -you add a shot of Amaretto and a half shot of Grand Marnier along with a dash of Angostura Bitters. The result is a very smooth concoction that makes you think about spring -sunny, cool, and stirring to the spirit.

I won’t talk about the Vikings because it may curse them. I will root for the Jets in the same way I would root for the drunk Irish guy on St. Patrick’s Day who picks a fight with a bunch of yobby out of town college kids from an SEC school. He may go down, but he’ll be defending the honor of New York in his own special way.

Dawn of the Dead -is all about us.

I recently watched the remake of Dawn of the Dead on Hulu while on call. In general, I find the horror genre either to be a thinly veiled subcategory of Chick Lit or generally too scary to watch. The first category, the horror Chick Lit or Chick Flick, are all the romantic vampire stories and beauty with beast fables. They are dreck even when an auteur like Joss Whedon labors to make them watchable. Something dark lies in the feminine psyche for fantasies about blood sucking, pasty faced, pretty boy immortals sells. The latter, the truly scary horror, deals in the supernatural. In the heart of all rational people, there is a primitive spot that wonders if there is good and evil and not just cause and effect. When a film taps this, and reveals the frightening voids and yawning chasms presented by contemplation and imagining of evil, even this fairly rational and educated surgeon can get a twee scared watching The Grudge in the dark (she looks like an ex-girlfriend).

But zombie movies? Not so! For some reason, I love them because I’m a doctor. The slow zombie era of Cesar Romero came to an end with the fast zombies of 28 Days Later (and its sequel, 28 Weeks Later). Zombie movies appeal to my inner infectious disease expert. In some way, I deal with the necrosis and suppuration every week, and seeing hordes of diseased people doesn’t seem too scary. It then boils down to how the undiseased people react in these circumstances which entertains me: by denying, by panicking, by getting armed, by having sex (more denial), and by getting oddly rational. When HIV began killing people in the late 80’s, the response was not unlike the plot of a zombie movie. There was fatal ignorance and denial, followed by panic, then calls for concentration camps, followed a neurotic mix of hedonism, consumerism, prudishness, and rampant heterosexualism. The collective sigh of relief was the announcement by Dr. Ho of multidrug therapy, as conceptualized by the not-gay and not down-low Magic Johnson just staying alive.

The most recent remake of Dawn of the Dead makes great fun with these concepts. The survivors of the plague hole up in a shopping mall, and all the zombies congregate there and mill about outside the locked entrances. And its the same now in the time of the economic plague that I see hordes milling about at our local mall. Despite the recession, the place is always full. I think people go there because going to the mall and shopping is a talisman of normalcy. After the horrible events of 9/11, President Bush told everyone to go shopping. Shopping! And that is what I see going on, the continued shopping for a little slice of happiness, is not unlike the zombies congregating at the mall in Dawn of the Dead. “I think its some retained memory they have that brings them here,” says one of the characters.

As a medical student, I was assigned patients and was their intern, responsible for their health. Never mind that most of them had HIV and were crack abusers, making them somewhat unstable. I learned to have a conversation with them, those who in another era would have been called possessed and unclean. I took the lessons of the plaque dedicated to the twenty medical students who died in the influenza pandemic of 1918, and understood implicitly the bargain I had to make. To be a good physician, I would have to take good care of all people. I performed central lines and spinal taps in poorly lit rooms on patients whose viral titres made them frankly toxic to be around with a needle, a scalpel, or broken glass (from lidocaine vials). I learned equanimity in the face of really horrible things like the gal who hid a roll of dollar bills in her abscess (pocket of pus) cavity on her lower abdomen. She’d pay for crack with those filthy bills and earned them by doing who knows what. If that trumps zombies, I don’t know what. I always wash my hands after touching money.

Eddie Murphy had a claymation animation sit-com in the 90’s called the PJ’s. It featured a crack addict who was spot on and completely true. Ironically, he was the straight man, and dished wisdom while eying the pigeons for a possible meal. The great tragedy in the AIDs/Crack epidemic of the 90’s was its victims who made to the hospital after living on the streets for years were incredible specimens. They had to be to survive for as long as they did. They were all tall, lean, and if you looked past the insanity, wear, tear, and grime, were usually good looking with good bone structure -think Na’Vi, twenty years after the aliens from Earth returns to Pandora, colonize them, and put them on reservations with their sensory pony tails cut and cauterized at the stump.

We forget that the heroes of the Zombie movies are in fact, the Zombies. Once infected and left to wander around for fresh brain, they are the perfect citizenry. Their behavior is predictable, and their intentions are true. They offer no political resistance by asking no questions, and their happiness lies in fresh brains. Substitute fresh brains for fresh fruit out of season, perfectly-red meat packed in styrofoam and plastic, and giant homes in the suburbs, and you have it. The real monsters in Zombie movies are the protagonists, they with their guns and fire, keeping the thronging mobs from their happiness and fulfillment.

So stop being a wet noodle! Go, run out and buy yourself some Zombie pickle and get happy! A good place to start: On January 27th, Apple will present their next great thing, by the way, you happy Zombie.

The Personality Disorder -Which One Do You Have?

Girl Interrupted, or Bucket O' Borderlines

When I went to P&S, one of the great features of its curriculum was its Psychiatry requirement which spanned a full two and a half years of our time there. It was among my favorite experiences from medical school. In that first year, among other things, we discovered how really crazy we all were, each of us, in our own special way. It was then I discovered the DSM Personality Disorders, which is kind of an “interesting personalities” index. Rather like a Zodiac sign, my pals and I immediately set about viewing those around us through the lens of their particular personality disorder. People rubbing shoulders in large cities brings out these personality disorders like rubbing oregano brings out its spicy aroma.
According to the DSM-IV-TR Axis II (the 4th edition of the Diagnostic and Statistical Manual of Mental Disorders), the person with the personality disorder has to meet first the general criteria of having “an enduring pattern of inner experience and behavior deviating markedly from the expectations of the individual’s culture.” This is a very interesting criteria because it implies the existence of whole cultures that are crazy and where that flavor of crazy is normative (think Klingons before the Khitomer Accords). It also implies that whole families may be crazy, but within the confines of that family, one’s crazy behavior may seem “normal,” and children from such families only realize how abnormal their families are once they leave for college. This is not a personality disorder if the individual realizes that yelling their frustrations is not normative and corrects that behavior. This is an important feature of the general diagnostic criteria -that  two out of four deviations go unrecognized in terms of cognition (self perception and interpretation of others and events), affect (range, intensity, lability and appropriateness of emotional response), interpersonal functioning, and impulse control.
Also in this definition, this personality pattern is inflexible and persists along a broad range of personal and social situations, leading to distress or impairment in personal, social, and occupational functioning. This pattern is persistent and present for a long period of time, and not secondary to another primary mental disorder, substance abuse or medical condition. It means the person affected by a personality disorder may or may not be aware of their “deviation from the norm.”
The personality disorder list is then grouped into three clusters with subcategories.
Cluster A (odd or eccentric disorders)
-Paranoid personality disorder
-Schizoid personality disorder
-Schizotypal personality disorder
Cluster B (dramatic, emotional, or erratic disorders)
-Antisocial personality disorder
-Borderline personality disorder
-Histrionic personality disorder
-Narcissistic personality disorder
Cluster C (anxious or fearful disorder)
-Avoidant personality disorder
-Dependent personality disorder
-Obsessive-compulsive personality disorder
Appendix B -for further study
-Depressive personality disorder
-Passive-aggressive personality disorder
Deleted from DSM IV but present in DSM III-R
-Sadistic personality disorder
-Self-defeating (masochistic) personality disorder
The key point in personality disorders is that their conditions are considered out of the norm but not completely incapacitating. Most people have some degree of the above characteristics, and the differences in the ingredients results in the person. The PD-afflicted individual has one of the above characteristics in superabundance, resulting in flawed social interaction. Through this year, we’ll go through the personality disorders and figure out why some people behave the way they do.

I.D.D. -Irony Deficit Disorder, Unwanted Connectedness, and the Importance of Defending the Modern

The Greatest American

As a middle school student, we were assigned Jonathan Swift’s A Modest Proposal. I laughed my guts out, but soon realized that many were appalled by the idea that Irish babies should be used to feed the poor. As I grew up, I read Vonnegut with the avidity that presaged the kind of fandom that we see kids have nowadays for video games, and for it, I was a bit of an outsider. The word I learned in medical school was concrete -most of the world is concrete. They can process black and white, but are blind to shades of gray. A pie in the face is funny, but a pie made of Irish babies, not so much.

You can see this in the audience for comedy -in the 90’s, it was fans of Leno versus Letterman (and now  O’Brien), Jeff Foxworthy versus Jerry Seinfeld, and Britney Spears versus Lady Gaga. It’s the divide that separates America into Walmart and Target. There are people who take Sarah Palin seriously and those who see a cosmic joke. It is with utmost seriousness that I propose a new DSM personality disorder -the Irony Deficit Disorder or IDD.

IDD is marked by a lack of curiosity of the world beyond the experience offered by life within earshot and immediate view. People with IDD have limited affect and rarely express themselves with their hands. They hew to orthodoxy and are great believers of world views constructed by dead people. They are suspicious of the new and generally feel uncomfortable around people who don’t share their background. IDD is found across the political and socioeconomic spectrum. People with IDD are easily offended. They will likely be offended by this piece. These people find change distressful and uncomfortable. At first, new things are regarded with disdain and suspicion, and the ethical and moral dimensions are weighed from the viewpoint of their particular flavor of orthodoxy. When change threatens to intrude, they usually have been able to withdraw from it and the world, but not anymore. The internet, which back in the halcyon days of the nineties offered a utopian view of world connectedness -a New World Order, functions as both the irritant and the balm to those with IDD.

Every country now has its native Taliban fighting the bare-legged, ochre-skinned, breast implanted, spangly-pole dancing march to progress. It is the loss of tribe, social norms, and social status to barbarian invaders talking, looking, and thinking differently and dictating change while secretly sneering at the rubes, or so it seems to the bitter IDD person. They look at their internet in shock and awe – How can it be not wrong for a man to kiss a man and marry a man? How can it be not wrong for a white girl to kiss a black man? Why are they trying to get me to eat that horrible looking food? Why do I have to look at that person dressed that way? Why are those signs not in my native language? Why do I have to pronounce that name the way they want to? How can it be not wrong to assert that America is a country whose only mention of God in the Constitution is in the separation of church and state? Their fears are straightforward -They are trying to change my core values and by extension, denigrate them.

Now, having IDD in no way handicaps that individual. These people buy Toyotas and GM cars, use Windows, and wear red Christmas sweaters embroidered with reindeer. They pay taxes and abide the law. In fact, they are the majority, and their concerns have to be respected up to the point where someone else’s rights are infringed. Those of us endowed with the third eye of irony and rationalism have a difficult position because we will always be in the minority and vulnerable (see Qin Dynasty -burying of the scholars and burning of the books, Spanish Inquisition, Nazi Gleichshaltung, McCarthy Hearings, the Cultural Revolution, the Gulag, Taliban Kabul Soccer Stadium activities, the Iranian Election of 2009, The Glen Beck Show). A candle is mostly wax with a fine evanescent flame, easily blown out.

The bright lights of our world have to make a stand. Rather than retreat to Starbucks to grope out discontented tweets for a limited audience, we have to reach out and actively defend ourselves and our civilization which is the Modern Civilization. Rather than sneer behind our Kindle’s, we have to speak clearly for our Constitution and rule of law. We have to make our votes count and work with our like minded brethren in the opposing camp to come to rationale, workable solutions rather than digging trenches festooned with figures hung in effigy. The rational center must hold true to the convictions of Franklin, Washington, Jefferson, Hamilton, and Adams.

You now have the tee box.

The Return Customer

The return customer is earned with every interaction. Amazon has earned my business every year with amazing responsiveness and promptness. I have shifted most of my shopping to Amazon purely for the convenience of not having to drive around town looking for things. The Kindle 2, shown above, was purchased with an extended warranty. Normally, wear an tear is not covered, but I felt that it should have weathered a fall from the bed to a carpeted floor. This crack was not only unpleasant to look at, but created instability in the cover and would eventually fall apart in jagged, carotid artery scything shards.

The kind fellow at Amazon has a replacement in the mail! I am now fully Amazoned.

This contrasts with the terribly shabby way I was treated at Dell a few months ago when they lost my on-line order but took my money. It took three days of calling to eventually get them to cough up my netbook.  Their awful customer service and delays in delivery brought them to the attention of the NY Times.

Escape from the Uncanny Valley -why Avatar is groundbreaking

The uncanny valley is the revulsion caused by robots and computer generated images that try to mimic human faces. It was coined in the 1970’s by Masahiro Mori (link) and is the reason why watching Polar Express makes me jump up and down like a rabid chimpanzee. CGI movies that maintain their cartoony-ness avoid this problem.

So it was with a bit of suspicion that I went to see Avatar, expecting to jump up and down like a rabid chimp as soon as those blue goat people got on screen. I was wrong. James Cameron understood this implicitly and created an image capture system that follows actors facial movements and maps it directly to the blue Navi’s. The actors are really acting and the computer generated animatronics are imbued with emotion that greatly exceeds that of the actual human actors.

Avatar is great in the way that Titanic was great. The main character in Titanic was the ship, and in Avatar, it’s the escape from uncanny valley. The script is a Disney princess movie on steroids, but the real reason you should see Avatar is this entirely new way of experiencing the world.

I have to add, I have always felt virtual reality won’t work until all five senses are involved and Cameron seems to understand it as well -to access the avatars, the characters lay down in an MRI machine -it is through electromagnetic manipulation of nerves that true telepresence will be achieved.

Elvis, by Wowee, straight from the Uncanny Valley