Month: July 2013

PTSD In The US vs UK

In American veterans, rates of post-traumatic stress typically range from 10 to 17 percent, but among British veterans, the rate is closer to 4 percent. David J. Morris explains how that discrepancy has little to do with a “stiff upper lip”:

P.T.S.D. cannot be reduced to a simple matter of differing cultural attitudes. Within the field of P.T.S.D. research, there is a concept known as “the dose-response curve.” In simple terms, the more horror and death you are exposed to, the more likely you are to experience post-traumatic stress. (This is not limited to shooting combat; it encapsulates exposure to any life-threatening danger.) And Americans have been exposed to a lot more horror and death than their British counterparts.

When I asked Matt Friedman, the director of the National Center for P.T.S.D., about the differing diagnosis rates and what this might mean for American psychiatry, he seemed to grow irritated. “The Brits were down in Basra. Ain’t nothing happening down in Basra,” he said. In a letter responding to the original Lancet study that compared P.T.S.D. rates of American and British veterans, Charles Hoge and Carl Castro, P.T.S.D. researchers at the Walter Reed Army Institute of Research, made this very point, writing that “only 17% of UK service members reported discharging their weapon, compared with 77-87% of US service members; 32% of UK service members reported coming under small arms fire, compared with more than 90% of US service members.”

Morris zooms out:

The growing criticism of our current understanding of P.T.S.D. suggests that what was once ignored or treated as a failure of character—the soldier’s weakness—has now been medicalized to the exclusion of discussing its moral and spiritual dimensions. “It feels to me as if the U.S. civilian population has pathologized the veteran experience,” Elliott Woods, an Iraq veteran-turned-reporter, told me not long ago. “One well-intentioned person said to me the other day, ‘I can’t see how anyone could go to Iraq and not come back with P.T.S.D.’ ” Yet our social mechanisms for dealing with that problem are weaker than they should be.

Previous Dish on PTSD here, here, and here.

Chart Of The Day

World Population

Africa’s population is projected to skyrocket:

Right now, with a couple of exceptions, Africa’s population density is relatively low; it’s a very big continent more sparsely populated than, say, Europe or East Asia. That’s changing very quickly. The continent’s overall population is expected to more than quadruple over just 90 years, an astonishingly rapid growth that will make Africa more important than ever. And it’s not just that there will four times the workforce, four times the resource burden, four times as many voters. The rapid growth itself will likely transform issues within African countries and thus their relationship with the rest of the world.

Nigeria is expected to become one of the world’s largest countries:

In just 100 years, maybe two or three generations, the population is expected to increase by a mind-boggling factor of eight. The country is already troubled by corruption, poverty and religious conflict. It’s difficult to imagine how a government that can barely serve its population right now will respond when the demand on resources, social services, schools and roads increases by a factor of eight. Still, if they pull it off – the country’s vast oil reserves could certainly help – the rapidly growing workforce could theoretically deliver an African miracle akin to, say, China’s.

Meanwhile, In Turkey …

Elif Batuman reminds us that “normalcy has not yet returned to Turkey”:

A TV personality who believes in telekinesis has been made Erdoğan’s chief adviser. Thousands of people, including doctors who treated protesters, have been detained by police. The man with the machete is now in Casablanca; as the owner of a small business, he may be entitled to government compensation for his sufferings as a terror victim.

It’s hard to get a coherent picture of what’s going on from reading the news, partly because so many editors and reporters have been intimidated into vagueness or retirement. It’s unclear what will become of all the out-of-work journalists. Some journalists tried to stage a march on Saturday, but the police blocked them before they could march anywhere. Chaos spread through Taksim. An ice-cream-parlor employee reportedly helped seven or eight civil policemen beat up a customer. I didn’t go out myself, but friends who did narrowly missed being hit on the head with gas cannisters or run over by reconnaissance vehicles. Terrifying images circulated on Twitter. One showed an art professor from Mimar Sinan University bleeding from the mouth being led into police custody.

Claire Sadar has more on the situation:

In response to the heavy-handed tactics of authorities, there has been a boom in creative passive-resistance protest in recent weeks including public standing, walking, festivals and even Ramadan Iftar dinners.  There have also been move made toward creating a solid political movement out of the diverse grievances of the protestors through the creation of community forums throughout Istanbul.

These forums are of course only baby steps toward Occupy Gezi having representatives in local or national government.  In the short term, as myself and others repeatedly predicted, Erdogan and the AKP are not going anywhere.  Indeed some, including anthropologist of Turkey Jenny White*, have begun to question whether Westerners and Turkish elites have over estimated the real impact Occupy Gezi has had and will have on Turkish politics.  I certainly don’t discount her observations and they mesh with my own impression that away from the protest centers there is little sympathy for the movement.  In this way the AKP’s base has been little effected by Gezi and the party is sure to remain a force to be reckoned with in the short term.  However, the very existence of the Gezi movement itself remains remarkable and bodes well for the political future of Turkey.

More Dish coverage of Turkey here, here and here.

Ask Ken Mehlman Anything

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[Re-posted from earlier today with many questions added by readers]

Ken Mehlman is a businessman, attorney, and political figure who held several national posts in the Republican Party and Bush administration. He managed Bush’s 2004 re-election campaign and subsequently chaired the RNC from 2005 to 2007. After that, Mehlman worked for the law firm Akin Gump Strauss Hauer & Feld, then became the Global Head of Public Affairs at Kohlberg Kravis Roberts, a multinational private equity firm. In 2010, Mehlman came out as gay, making him one of the most prominent openly gay figures in the Republican Party. Since coming out, he has been a major advocate for the recognition of same-sex marriage. He also serves on the board of the American Foundation for Equal Rights.

To submit a question for Ken, simply enter it into the Urtak survey after answering all of the existing questions (ignore the “YES or NO question” aspect and simply enter any open-ended question). To vote, click “Yes” if you have a strong interest in seeing him answer the question or “No” if you don’t particularly care.

The New Newsroom

After watching the first four episodes of The Newsroom’s second season, Marc Tracy concludes that creator Aaron Sorkin has become more self-aware:

[T]he most important change Sorkin has made is to the show’s structure, using its episodes to tell one ongoing story. And so the story—and the season—is told in flashback, as network lawyers interview various staffers at a gigantic conference-room table in preparation for a wrongful termination lawsuit surrounding a blockbuster story that the show-within-the-show, “News Night,” has had to retract. (The device would remind you of The Social Network even if you didn’t know Sorkin had written it.) The result is a cross between one of those six-hour BBC series—an association further suggested by the new, slicker opening credits—and a sitcom. The overarching storyline gradually unfolds, while the episode-specific subplots come fast and furious, and with a discipline that didn’t exist on the one actual sitcom Sorkin did, ABC’s “Sports Night.”

Making the season-long arc about a faked news story solves another of the haters’ complaints. It no longer seems so absurd to watch a show intimately tied to two-year-old current events when the dramatic weight is placed overwhelmingly on a fabrication and the actual news pegs are relegated to comedy or, at least, decidedly minor drama.

Nevertheless, Alyssa thinks the show remains flawed:

The problem with The Newsroom, I think, is that no one comes across as particularly competent, both by design and by accident. Women on the show tend to be dippy, impulsive, prone to attacks on their technology, rants on the street, or attacks of principle that are bad for ratings. But men can be high-handed, obsessive about conspiracy theories, stories without ratings draws, or their ex-girlfirends, or oddly naive, as is the case with Jim’s (or the show’s) lack of awareness that since outlets pay for seats on campaign buses, the Romney staff can’t actually kick him off. What the show identifies as moments of journalistic bravery are significantly driven by the fact that Will McAvoy is based on Keith Olbermann, and so a ranting answer to a question, or a special comment during a broadcast get more points than actual reporting, or driving new subjects into the news stream the way Rachel Maddow did with national security.

Alison Agosti hated the first season but feels compelled to see the show through:

In general, if a show starts to drag or if a character gets amnesia or something, I’m out. Yet Sorkin has created something perfectly infuriating, where I’m not sure that I’m enjoying it, but I am completely engrossed. I want to see what he going to do next, what new inanimate objects Maggie will trip over. Quite frankly, I’m really looking forward to rolling my eyes so hard I’m worried they’ll fall out of my head when Will and Mackenzie inevitably get back together.

Previous Dish coverage of The Newsroom here, here, here and here.

And If We Catch Snowden?

David Pozen imagines what it would be like if the NSA leaker were brought to trial in the US:

Snowden would no doubt obtain high-powered lawyers. Protesters would ring the courthouse. Journalists would camp out inside. As proceedings dragged on for months, the spotlight would remain on the N.S.A.’s spying and the administration’s pursuit of leakers. Instead of fading into obscurity, the Snowden affair would continue to grab headlines, and thus to undermine the White House’s ability to shape political discourse.

A trial could turn out to be much more than a distraction: It could be a focal point for domestic and international outrage. From the executive branch’s institutional perspective, the greatest danger posed by the Snowden case is not to any particular program. It is to the credibility of the secrecy system, and at one remove the ideal of our government as a force for good.

Marc Herman adds:

Though catching Snowden would likely help the White House’s effort to discourage future leakers, it’s not at all clear that prosecuting him wouldn’t shine light on the environment in which the incident occurred, more than on the incident itself. According to this useful report from NPR, the Zimmerman case could result in a Constitutional challenge to Florida’s so-called “stand your ground” law, despite a jury’s belief that George Zimmerman didn’t murder Trayvon Martin. Similarly, Snowden could be found guilty of leaking classified information—which he’s already admitted publicly that he did. Letting him explain his reasons for doing so from a witness stand, however, might be worse for the NSA than the leaks themselves have been, Pozen suggests.

Recent Dish on Snowden here and here.

“Even If You’re A 300-Lb Black Kid, You Still Wanna Be Calvin”

Scott Beggs is super-psyched about the upcoming documentary on the creator of Calvin and Hobbes:

To get an idea of how long Dear Mr. Watterson has been in the works, consider that its creator Joel Schroeder posted a teaser trailer for it three years ago. And that was years after he’d started working on it. Fortunately, it was the exact kind of thing that Kickstarter was built for, and after 2,083 backers representing over $120,000 chipped in, the film is finished. Now, according to Variety, the “Calvin & Hobbes” documentary will see theaters and VOD on November 15th.

As you can imagine, it chronicles Bill Watterson’s monumental creation and its influence — specifically by featuring conversations with the likes of Berkeley Breathed (“Bloom County”), Bill Amend (“Foxtrot”), Seth Green and more. … Awesome, awesome, awesome news. Times a million. I don’t even know what else to say.

A reader does:

Calvin & Hobbes is the best comic ever. There is such joy and adventure and heart and just enough mischief.

Bill Watterson’s complaints when he retired were that the newspapers wanted the comic in a set form and he hated when they shrunk the strip down too much. A website where he had complete creative control over how the subscribers saw his work would eliminate all of that. If Watterson ever wanted to create a site where one paid him directly for a weekly or even monthly strip, I’d sign up in an instant.

Racism And Richard Cohen’s Reality, Ctd

A reader writes:

Your comments struck a chord with me, because it really does seem that a lot of older white folks are stuck in the ’80s. I’m a young white guy living in DC, and every time I go home for the holidays or a party with extended family, after the usual small talk it always comes up: “How do you deal with the crime?” It’s honestly a question that drives me crazy. I’ve lived here five years and all I’ve ever witnessed is someone stealing something from CVS. I do know of friends of friends who have been mugged and such, but still … it’s far from a war zone. When I commented that I had recently moved to nearby Arlington, they said, “Well, of course – I mean, you can’t live in DC, really.” It’s apparent to me that despite my denials, my aunts and uncles are convinced that DC and other urban areas of the US are something akin to Baghdad. They just don’t seem to believe me when I tell them that, yes, there are a lot of black men around (“sketchy people”, in their words), and, no, they do not bother me. They are convinced there is mortal danger around every corner, just like Richard Cohen is.

Another DC resident:

Just this morning I reflected on the Metro that I hardly notice race anymore. I am trying not to sound like Stephen Colbert as I type that, but what I mean is that I am far less race-conscious than I used to be.

I am white, and I moved to DC several years ago, after living in smaller cities. It isn’t like I never interacted with minorities in other cities, but in a big city like DC it is harder to segregate oneself. In other cities, I lived in mostly white neighborhoods and so I mostly interacted with other white people when not at work. The people of color I worked with were well-educated professionals. I rarely ran into young black men in hoodies, but in DC, I see all kinds of people just on my commute before I even get to work or to lunch or whatever.

I promise I wasn’t an overt racist before moving to DC, but I would be lying if I said I didn’t have some unconscious prejudice before (and still now, of course). If I had been alone on the street with a young black man in a hoodie, I might have been suspicious for no good reason other than I didn’t recognize the guy. I am not proud of that, but it’s true.

It is different now. The increased interaction with all kinds of different people here in DC makes me able to recognize when to steer clear of a person or group, and race is really not a factor. A black guy in a hoodie isn’t notable. A guy eyeing my phone? Maybe. A guy walking back from 7/11 talking on his phone? Probably not a problem. Very few people commit robberies while on the phone.

I point this out only because for people like George Zimmerman who lived in a gated suburban community (and possibly Richard Cohen – not sure we’re he lives), the lack of exposure to black men in hoodies is what leads to the fear of a black man in a hoodie. I know this because I used to be much closer to their thinking than I am now, and I get where they’re coming from, to a degree. But what it reveals is not some “reality” of an intelligently honed fear of young black men as Cohen suggests. It reveals that we are still a segregated country in many ways and that Cohen doesn’t often interact with young black men.

Another Reason To Avoid The Hospital On The Weekend

Aaron Carroll analyzed hospital records for 23,000 babies diagnosed with “failure to thrive” and found that those admitted on weekends stayed longer and at greater expense. Drum summarizes:

If your baby is admitted on a weekday, the average length of stay is five days and the average cost is about $9,000. But if your baby is admitted on a weekend, the average length of stay is seven days and the average cost is about $13,000. For all practical purposes, it looks like the babies just sit around over the weekend and then start getting treated on Monday.

Carroll saw it coming:

What irked me [as a pediatrician] was that so many [babies] seemed to be admitted over the weekend. Almost all of the tests, and all of the consults, that we’d order would be unavailable then. So it seemed like these babies would just sit. They’d have longer admissions, and they’d cause me a lot of effort and paperwork. At least, this was my theory. … I’ve often kidded on the square that most of my research is spite based. In other words, something pisses me off, and I go on a mission to prove it’s wrong.

Previous Dish on weekend hospital care here.