Category Archives: psychiatry

psychiatry, psychology, psychology/psychiatry

What Feminists Got Wrong

Julie has always been a feminist, and I have always believed that diversity is not only morally correct but also a benefit to society as a whole.  My opinion goes beyond gender and includes the rights of all people, regardless of race, religion, or sexual orientation. 

However, there is one thing that Julie does that bugs me; that is when she retorts that the woes in the world are due to our paternalistic society and the oppression of women by men. This post is meant to present a different perspective. You are invited to accept or reject my ideas.  However, please don’t condemn them without giving them a moment’s thought.

My wife is a very bright person.  She holds two Master’s Degrees and has two PhD degrees (Clinical Psychology and Social Psychology).  She works professionally and has helped countless clients.  She successfully runs her own business.  She is economically stable and lives in a wonderful community. She has no real wants. I do not see her oppressed or limited in any way. 

She could have accomplished all of these things on her own.  However, my unwavering financial, emotional, and physical support made those impressive accomplishments easier for her to reach.  I am her husband; that is the way it should be.  I am also a man.  Does my gender automatically make me an oppressor? To be fair, if you asked my wife this question, she would say I wasn’t.  However, blanket statements about paternalistic, oppressive men drag me into that category by default. Imagine if the reverse were true, if I generalized the actions of an individual and turned them into blanket gender statements about women.  “Women can’t think critically,” “Women can’t do math,” “Women are too emotional for leadership positions.”  Are there women who fit these generalizations?  Of course, but not all women.  Those statements would be considered inappropriate, but male-bashing, even when done innocently, is considered OK in our society.

I don’t have a million-dollar grant to survey the population. My dataset is limited to my experiences and observations.  Therefore, it is restricted.  However, that limitation does not make my arguments invalid. 

Am I a male outlier?  What about other males? Does my son have a bias against women?  Absolutely not.  How about my male friends?  No, they have all championed their wives ’ and daughters’ efforts.  What about the males in my family?  Here again, they have supported their wives and daughters to reach their life goals. My wife’s sister has two daughters and a son. Did their father (my brother-in-law)  raise his daughters to be inferior to their son?  The answer is no.  These are different groups of men from various backgrounds, religions, and generations.  All wanted the same for their spouses and children: to reach their goals and potential.

How about if I go back further in time to a much more conservative and constrained culture?  What if I go back to my parents’ generation? My parents were born early in the 20th century and married in the 1930s. Both come from large, conservative, ethnic families.  Both sets of grandparents immigrated to the US at the turn of the last century from conservative Eastern European countries.  Both sides were deeply religious and closely tied to the Catholic Church.

On the surface, they should represent the most traditional values and ideals, and in some ways, they did.  How did my parents, aunts, and uncles raise their children?  Was there a gender gap?

Both my grandfathers worked in back-breaking, labor-intensive jobs.  One fixed machines at a book bindery, the other was a machinist for International Harvester.  I don’t believe that either job was particularly rewarding or fulfilling. My grandmothers were housewives, which was also an extremely taxing job.  They did not live in a mechanized world; everything from doing laundry to making clothing was done manually. Both sides had large families, and my grandparents faced the mammoth task of raising many children. Money and labor were needed, which kept them very occupied.

All the older siblings in my mother’s family were boys, but the last three children, including my mother, were girls.  I know little about her older siblings beyond a few scattered facts. I know that many of her siblings became very successful.  A number of them were engineers; one founded a savings and loan; another owned a profitable manufacturing company. Pretty impressive considering that they came from nothing.  I have childhood memories of being in awe when visiting their houses.  I recall being in one huge house that had its own real library.  What was in that library beyond books?  An elevator to the upper floors!  Wow.

I knew more about my dad’s side of the family.  Here, there was a more traditional path to earning a living. Two of my uncles were electricians; two worked in factories; one owned a small furniture reupholstering business; and my dad was the chief operating engineer at one of Chicago’s largest high schools.   

My dad’s story illustrates the era’s expectations, which were very different than today’s. He left school after 8th grade to help support my uncle (his brother), who was attending college to become a priest.  I think such sacrifices were not that uncommon during that era, as you could still make a living with a limited education.  How did he feel about cutting his education short?  He often said he was glad to make the sacrifice; yet he attended night school for years, eventually winding up at the Armour Institute (now the Illinois Institute of Technology), so perhaps he did have a feeling or two.  Editor’s note: My uncle eventually left the seminary and married.  Fortunately for me, that union produced several of my cousins!

Both families were deeply ethnic and traditional, and they held high expectations for their children.  Everyone went to church.  Everyone was supposed to get married and have kids.  Everyone was expected to marry someone with a similar ethnic and religious background. However, these expectations were the same for both sexes. 

My mother worked in various jobs after she graduated from high school.  There were no restrictions on her working.  I’m not sure whether she worked after she married, but I do know there was a significant external push to have children. This pressure was on both my mother and father.   

What about my generation? Were there different rules for my sisters and female cousins than for their male counterparts? I don’t believe so.  We were all expected to live moral lives. There was an emphasis on showing respect to our elders. There were also religious rules; for instance, we couldn’t eat meat on Fridays. Those rules were the same for both boys and girls. 

During my generation, there was a strong emphasis on education. I have two sisters, and both hold advanced degrees beyond their bachelor’s degrees. My one sister didn’t want to go to college, but my father encouraged her to go. He bargained with her to try it for at least a year.  If she hated it, she was free to choose a different path. In the end, she earned a Bachelor’s degree, then a Master’s, and worked as both a teacher and a psychotherapist. There was no double standard in my family’s education.

How about my female cousins on my mom’s side?  I have limited knowledge, but I know one sang with the Lyric Opera and the other taught.  I know more about my female cousins on my dad’s side. Of those I know, all hold Bachelor’s degrees; in fact, I believe most have master’s degrees. Additionally, two hold PhDs and were university professors. Lastly, my male cousins’ wives held jobs, mostly in health care and the corporate world.  There were no restrictions on what they could do or become.

As far as societal norms were concerned, women were expected to run the house, and men to provide and protect. Generally, that is what happened in my family. But there were also many exceptions.  

In my conservative, religious extended family, societal restrictions on women were ignored.  In fact, the opposite was happening.  Women were being encouraged to succeed, to become educated, to move forward.  I don’t believe my family was an outlier; I saw other’s doing the same things. 

Have fringe religious groups used societal rules to control their members, including women?  Yes. Have abusive, manipulative men used societal norms to control their wives? Yes.  However, both genders can have members who are manipulative and abusive. 

When I was growing up, we had a family in our neighborhood consisting of a couple and their only child. The husband worked as a bus driver to support the family, and the wife was a stay-at-home mom.  She was dominant in every way. She and their daughter lived in the main part of the house, but her husband was required to live in their unfinished basement.  In fact, his wife made him eat off separate dishes, with meals left for him on a tray next to the basement stairs. 

How about societal norm outliers with my aunts and uncles?  These were individuals who came of age in the 1930s and 1940s, so you would think that their roles were set in stone.  On my dad’s side, my one uncle never married.  He supported my grandmother financially, and she provided him with a home, meals, and the like.  Per societal rules, he should have married.  He wasn’t shunned in our family; he was celebrated and held in honor.

On my mother’s side, three of her siblings didn’t marry, including her only two sisters. My two aunts lived together in a functional partnership.  They had defined roles, with my one aunt being more dominant and the decision-maker of the two. She attended DePaul University and was an accountant.  My other aunt was an telephone operator who retired early due to health problems. She was the more domestic of the two. My unmarried uncle was a bit of a lost soul.  He spent his work life testing radar equipment for Western Electric and led a solo life.  His health was failing, likely contributed to by alcohol use, so my aunts took him in, and he joined their untraditional family.

That uncle was a kind person, but a bit of an odd duck.  However, my aunts were esteemed in the family. There was no stigma around being single.  In fact, the only time that I heard my father say a sexist thing about them was when, in the late 1950s, my aunt decided that she and my other aunt should buy a house. “How in the world are two women going to manage a house?” my father said to my mother. They did, and in fact, my one aunt became quite handy.

I also had several aunts who continued to work outside the home after marriage, one for Sears catalog and the other in an office job.  I don’t recall hearing any negative comments about them working. 

I had an uncle who didn’t work.  He was an athletic guy who played minor league baseball in his youth.  The line was that he had a heart attack in the1950s, and hadn’t worked since. Something never quite made much sense with that story, as I remember him looking pretty healthy in the 1970s.  His wife owned a beauty shop, was the breadwinner, and the more dominant of the two. No one questioned their atypical marriage.

This was the reality that I witnessed.  Society imposed rules and regulations on both men and women in my family. However, there were many exceptions to these rules. Parents made an effort to improve the lives of all their offspring, but those paths were shaped by the resources available at the time.  For my parents’ generation, there was an emphasis on stable jobs and solid marriages with a strong religious center. For my generation, marriage was still important, but with role modifications.  Women were encouraged to become more educated and to contribute financially.  Men were encouraged to become more involved at home. These changes should have benefited all parties.  In reality, it meant more work and more burnout for both the husband and wife. Not all housework is drudgery, and not all work-for-pay is rewarding. When the expectation is to do both, it can be taxing.

Why did gender roles occur in the first place?  No one can say for sure, but it is improbable that they happened due to some plot of men to oppress women. Enduring behaviors continue for a reason and serve a purpose. Patriarchies have developed independently in many societies, but a few societies are matriarchal in their foundations.  This suggests that either system can work, but it has generally been more productive for a group to pick one side or the other. 

Most of us are familiar with the norm that the husband is the head of the family and the mother is the head of the household, but was it men or women who determined this concept of the typical monogamous nuclear family?

Some may say that men designed this to control their wives.  We do see this in some groups, for instance, the fundamentalist LDS cults, where women are raised at an early age to be submissive and to “be sweet.” But there is more to that story.  Fundamental LDS boys are often poorly educated to the point that many are illiterate. At an early age, they are sent to work on construction sites to raise money for the church.  A few elders control the population, notably the group’s Prophet, whose word is considered the word of God. Powerful men may have many wives, and they can forbid less powerful men from having relationships with their own wives; they can even banish these men from the congregation and claim their wives, if they so desire. This is not men oppressing women; this is a small group of individuals, who are men, abusing their power to oppress an entire congregation for their own needs. 

If we go back in time, it is clear that surviving was a tricky proposition.  Humans are relatively weak animals, and they found that their chances improved when they lived in groups.  In fact, there is evidence that Homo sapiens (us) have lived in groups since our species’s inception. 

For a species to survive, it must reproduce.  We are driven to exchange genetic material and produce offspring.  This biological drive supersedes any constructs about the benefits of having children. However, I’m sure early humans also realized the advantage of a continuing supply of younger members to their community.  Raising a child is a labor-intensive and energy-intensive undertaking, leaving the caregiver extremely vulnerable.

Males have a variety of options to spread their genetic material.  One male can impregnate a multitude of females and leave them to fend for themselves.  This “playing the numbers” method assumes that at least some offspring will survive. Another option is a male controlling many females.  Here, the most successful/powerful males would pass on their genetic material while having some responsibility toward the females in their harem, usually providing some resources and protection. There are also matriarchal systems, such as the Minangkabau of Indonesia, that have developed their own mores and folkways for rearing children. Evolutionarily, some of the above options could be more efficient than monogamy at passing on the best genes to the next generation (contrary, also true).  So what are the advantages of monogamy? 

Men had the advantage of size and strength and were well-suited to hunting and protecting.  Women were generally smaller and weaker.  They also had the additional burden of caring for infants and children, which required years of intensive work. Women had a greater need to enter into a union for these reasons. Offspring had a better chance of survival when females were protected and provided for.  What did they offer in return?  Beyond intimacy, women could take on additional tasks beyond child-rearing. This made the relationship valuable for both parties. In reality, it was to women’s advantage to establish traditional roles.  Is that why these unions happened?  Who knows, but that seems more logical than men’s need to oppress women.

Throughout history, most men worked under exhausting conditions, often performing backbreaking jobs.  Women’s roles were different because men and women are not the same. I’m NOT saying that men are more capable than women, I’m saying that men and women are different from each other. Women were also working very hard, but they were doing different tasks. This division of labor was logical and most efficient for thousands of years.  

My grandfather worked long hours in a hot and dangerous factory.  My grandmother had to manage a million different tasks from baking bread to plucking chickens. His work was likely tedious and mind-numbing.  Her work was varied and more creative, but never-ending. However, together they were stronger, and by assuming different roles, they achieved a significant goal: survival and a better chance for their children to survive. 

Life for the average person was very tough, with vast amounts of energy spent by both men and women on essential tasks. There was a small group of privileged men and women who, because of their position, followed a different set of rules. With enough money, one could bypass real life and hire maids, cooks, nannies, and any other necessary job-doer. 

Things began to change in the early 20th century, most notably in the 1930s, when homes were increasingly electrified. Then, many labor-saving devices were introduced, from washing machines to refrigerators. Jobs that once required an entire day of intensive labor could now be completed in hours. Radio was becoming commonplace, and this medium brought information, culture, and new ideas into the typical home. This medium could bring product advertising to consumers on a daily, unrelenting basis. New, less physically taxing jobs were also growing. New medical treatments emerged, and the need to have large families to ensure offspring’s survival diminished. Convenience food products, like Bisquick, hit the grocer’s shelves. Now there was time to ponder life.  Advertisers saw this time as an opportunity to build sales, which were sold along gender lines. Advertisements are designed to make you feel bad, then offer a solution, their product. Ads of beautiful, impossibly thin women made happy with a new vacuum cleaner, or handsome men in fashionable suits demonstrating their prowess by driving a new car, were commonplace. People had more time and were encouraged to buy more.  Is it any surprise that gender roles started to change?

Life was changing, but not everything was moving forward at the same pace.  This led to increased dissatisfaction and to movements ranging from women’s rights to worker unionization. This also pitted opposing forces who wanted the status quo. Why?  Because those in power want to retain it, they will use their power to influence others. Those in power tried to convince the populace that unions would ruin the country.  Those in power tried to convince the populace that granting women the right to vote (won in 1925) was unnecessary and would lead to chaos… and so forth. However, I hope Ihave shown that the average man wasn’t the enemy of women.  That he saw his wife and female offspring positively. Gender roles and expectations may have looked rigid in a textbook, but they were far more flexible in real life. 

So, where does the women’s movement fit into all of this? I was going to explore key figures such as Simone de Beauvoir, Sojourner Truth, and Gloria Steinem. But to be frank, my neck is starting to go stiff from sitting and typing, and I suspect I have already written so much that the vast majority of those who began to read this missive have since abandoned it.

Instead, I think I’ll write about a single pivotal figure, Betty Friedan, who wrote The Feminine Mystique and who co-founded the NOW movement. 

Betty Friedan was an intellectually gifted, strong-willed woman. When her high school newspaper rejected her application to write a column, she started her own literary magazine.  In 1938, she matriculated at Smith College, an elite institution and one of the “Seven Sisters,” women’s colleges. She excelled at Smith, graduating with high honors.  After Smith, she had a one-year fellowship at Berkley studying under the famous psychologist Erik Erikson. At every level, Betty Friedan was exceptional.

She married Carl Friedan in 1947. Carl was a theater producer, inventor, and advertising executive. Betty worked as a writer and freelanced for magazines. Based on the above, it sounds like Betty had a good and elite life. However, she felt that something was missing.

In 1957, she went to her college’s 15-year reunion and surveyed her former classmates about their education, experiences, and satisfaction with their lives.  This was a population of women who were likely financially privileged.  It should be noted that in 1940 (when these women were attending college), only 5.5% of men and 3.8% of women graduated, and Smith was not an ordinary college; it was an elite institution. I imagine that these women married successful men, who, by their very nature, worked a lot.  It is also likely that their economic and social status afforded them more free time than the average housewife. Here was a situation of intelligent, educated women living routine, isolated lives. Is there any wonder that they were unhappy?  In fact, Friedan talks about the “terror of being alone” in her groundbreaking 1963 book, The Feminine Mystique.”  The book that launched the second feminist wave.

Friedan believed that women should be able to pursue meaningful work commensurate with their intellectual capacity.  I don’t think anyone could argue with this. However, in an NBC interview, she made it clear that she disagreed with radical elements of the feminist movement that saw men as the enemy.  She felt that men and women should work together to liberate both from obsolete sex roles.  That is very different from the current stance of men vs women. The reality is that the typical man has been locked and bound in roles just as females have been.  It is just that these roles have traditionally been different, as I discussed above. So why has it become so easy to blanket men in general, when most men suffered the same fate as most women? We may have had different expectations placed on us, but that doesn’t mean that we were less free.  Did we have more choices? In the past, it was easier for a man to become a scientist or engineer, but those roles were reserved for a select few.  Most men were stuck doing grunt work, often under cruel bosses, in horrible conditions, and with little praise. It was expected that men would earn money and support their families. Men who chose specific careers that were deemed too feminine were mocked and ridiculed. The reality was that old rules trapped both men and women, and these rules were changing more slowly than other societal changes. The most effective path would have been for men and women to join together, but that didn’t happen.  Why?  Likely because most of us want to have our cake and eat it too.  Did women want to give up the good aspects of being a woman (yes, there were good aspects)?  No, they wanted to keep them but gain new opportunities. The same could be said of men who wanted more freedom in their roles but feared they would lose their primary function: to provide and protect.

Additionally, it is always easier to find an enemy to blame, and the easier it is to identify the enemy, the better.  “I’m not happy and satisfied because of men!”  “I’m not happy and satisfied because of women!”  In some ways, this mobilizes a cause, but it eventually becomes destructive, which I hope to illustrate in my next post. 

But who is to blame for these rigid roles?  In part, it is life.  For most of the last thousand years, our goal was just to survive.  People didn’t think about self-actualization; they thought about where they were going to find the next potato. Once roles are established, they become challenging to change.

Additionally, people in power want to stay in control, and they view any “other” as a threat to that power.  Was the typical man in power?  No, we were not. Most in power were indeed men, but most men were not part of this powerful minority.  We accepted our roles, our fate, and carried out our jobs, even when we didn’t want to, just like women did. Did this one-size-fits-all work any better for men? Nope, but it was what it was. Yes, there have always been abusive husbands, but there have also been abusive wives.  There have been religious groups that used their power to manipulate girls, but they also manipulated boys. At the same time, there have always been those who charted their own course, and I’m not talking about heroes like Emelia Eirhart or Madame Curie. Just in my very average family, some individuals bucked the norms because it suited their needs.

Our country has become progressively polarized into absolutes.  Good vs. evil, men vs. women, Christian vs. Muslim, and so it goes.  When it becomes easy to cast blame on someone else, it becomes challenging to make meaningful change.  Why change when you are right, and the other person (or group) is wrong?  They should change, not you! Such a stance not only strips the accuser of power but also alienates the accused, leading to stagnation rather than progress. That divisiveness may be what those in power want. 

When both husband and wife were working to their limits to survive, there wasn’t much time for either to assess whether they were living fulfilling lives. The traditional husband-and-wife system worked, but it worked better for some than for others.  

I stated at the beginning of this post that our society is better when we fully embrace all forms of diversity.  This means we must find common ground, not common enemies. Some of us want to be astronauts, and others are content to sweep floors. Some women are happy in traditional housewife roles, while others seek to discover the cure for cancer.  Some of us are happy despite our circumstances, and others who can bleed sadness from even the most joyful experience.  We are all different, and we all have the right to live to our desires and potential. The problem we should solve is how men and women can work together.  We need to let go of generalized statements designed to inflict harm on either sex. Societies chose paternalistic or maternalistic models for a reason; they served a purpose.  They are not inherently evil, and we would not have the lives that we do if those models were not in place. Yes, rules need to change, but to blame all the woes of women on men is not only inaccurate, but it is also cruel.

We need to move past blaming entire groups. Just think about how much recent damage we have done to our society by castigating Muslims, Hispanics, Somali,  Gays, and Trans people. What benefits were gained from these actions?  None.  What harm was done? Quite a bit, not only to those groups, but to our society as a whole.

However, it serves only the rich and powerful.  By assigning blame, the country can focus on those groups rather than on other policies that will affect everyone in the future. 

Betty Friedan identified a problem affecting her social group: wealthy, educated women.  However, it shed light on a broader issue: rigid roles for both men and women.  Somehow, that truth has been converted to men are bad, women are victims, while at the same time dictating a new rigidity for women, as witnessed by the backlash against Trad Wives, those women who embrace traditional values.

There will be individuals who use whatever they can to control and dominate others.  However, that is not the case for most.  A bigger problem is those in our society with ultimate power.  The individuals who set the tone for the rest of us to follow.  Instead of talking about toxic masculinity, it may make more sense to look at the power brokers who make it difficult for people to live lives.  If you don’t believe this, just go to any social media platform, which is now the most powerful source of influence.  With little effort, you will find countless influencers who will tell both men and women that the other side is wrong.  That will be the topic of my next post.  But for now, please stop using blanket statements that incriminate entire genders.  It is wrong and hurtful. If you call someone an enemy for long enough, they will become what you conjure. Is that what we want?

Peace

Mike

Just me

psychiatry, psychology, psychology/psychiatry

How Social Media And Confirmation Bias Are Destroying Society

When I watch one video on YouTube, I’m instantly presented with similar videos on my “For You” page.  Facebook shows 6-7 posts from random sources it thinks I would be interested in before presenting any content from my actual Facebook friends.  When I turn on the radio, it is easy to find stations that have one-sided political beliefs. If I were dating, I could load up apps to cherry-pick potential dating partners. Social media is full of unqualified, self-promoting influencers who gladly tell me what to eat, what to believe, and what to wear. My content is being curated, and information is presented to me on a silver platter. That’s good, right?  I would say no.  In fact, I believe this is one of the most destructive trends to have ever impacted individuals and society as a whole. 

I clicked on a “short” video on YouTube titled “All men should know this about women.”  This led me down a rabbit hole of more and more videos from the manosphere. A segment of content that typically shows videos of disrespectful women stating things like, “If a man won’t send me an Uber, pay for my babysitter, my hair and nails, and take me out to an expensive restaurant, he is not worth a first date!”  The male commentators typically highlight these ridiculous expectations, noting how women see men as a meal ticket and nothing more. 

There are an equal number of channels for women who examine how men treat them as sex objects or just want a mama to take care of them.  These channels present men in a similarly disgusting and predatory way.

I have always been a fan of radio.  In fact, radio changed my life when, as a kid. I fixed an old shortwave radio that I found in our basement.  This allowed me to listen to English-language broadcasts from countries with vastly different views from the United States.  It was incredibly educational for me to hear their logical opinions, which were sometimes the opposite of what I was hearing statewide; it started me on a path to become a critical thinker.  

Occasionally, I will do an AM radio band scan, starting at 520 kHz and working my way down to 1710 kHz, while listening to content.  AM radio has gone from a medium encompassing a wide range of interests to a narrow zone of mediocrity.  Sports, some news, religious, and foreign-language stations are available, but the predominant focus seems to be political. This has been especially true when I have traveled to more rural areas of the US, locations that may be served by only one or two radio stations. Here, the majority of stations are very politically right, and they often carry the same syndicated programming. These stations are hateful with a common theme: the right is always right, and the left is always evil, corrupt, communist, or whatever. 

What about cable news channels? If you want to hear that the left is always right, watch CNN or MSNBC.  If you want to hear that the right is always right, click on Fox News. It is possible to find similar biases across just about any social media platform, including YouTube and Facebook. Both of these venues have figured out that I lean left, and they are happy to serve up tons of that type of content, with zero right-leaning information. I never see an opposing viewpoint.

I’m not in the dating pool, but my kids have told me that most dating is now done on apps, where you can swipe left to reject someone or swipe right if you are interested. This creates so many problems for both sexes, as women are presented with hundreds of choices, and naturally, they are going to cherry-pick the most exciting ones. Why is that a problem?  Because many are choosing the same 10% of top-tier men, and rejecting the rest. Competing with such a large pool reduces an individual’s chances of success.  Additionally, this selection process is done based on a few characteristics, like looks, and ignores other qualities that are more likely to indicate a quality relationship. 

I remember treating a very nice patient who was suffering from rare panic attacks.  This person was genuinely a good guy.  He was a newly minted lawyer working in the legal field, but he was having trouble finding a decent firm that would take him on. He was good-looking, polite, stable, loyal, and had good values. He wanted a serious girlfriend and eventually wanted to be married with kids, but no one would click on him because he was on the shorter side, and (per him) women want 666 men: 6 feet tall, 6-figure income, 6-pack abs. Social media told women that 666 was the minimum requirement.

How many posts on social media have I seen where some pseudo-expert claims that we are killing ourselves because we are using peanut oil, or that we can avoid dementia by taking the special supplement that they are selling? You must believe!

Why is this curation happening?  Is it to help us?  No, it is to encourage continued engagement.  The more outrageous and one-sided the content is, the more likely it is to command the viewer’s attention. The old newspaper line, “If it bleeds, it leads,” was true then and truer now. The more engaged and enraged a person is, the more they can be manipulated. This is especially true when an idea is cleverly paired with another one, often by misrepresenting information and sometimes by outright lies.  

Combine universal healthcare with Communism.  How about pitting public health policies against individual rights? Another common ploy is to pit religion against science.  Although these examples may sound ridiculous, they have all been successfully used to shape opinion and to control others.

Social media can also suppress opposing information. Suppose I have the belief that pasteurizing milk was not implemented to prevent raw milk illnesses, like listeria, but was done by some evil science cabal that wants to control me. Social media allows me to find cult leaders and individuals with similar ideology easily. The more cult-like a group is, the more likely it is to demand social isolation and obedience. Such beliefs may be funny to others when the individual is convinced that the earth is flat, but less humorous when parents place their children and their community in harm’s way by rejecting proven vaccinations. 

Confirmation bias is a psychological tendency to accept information that supports one’s beliefs while rejecting information that contradicts those beliefs. We all tend to have some confirmational bias.  However, when severe, that bias prevents us from making good decisions and hampers our ability to think critically. In the past, we would hear opposing opinions from those around us. We then had to sort out the information by examining all of the variables.  Media sources were required to present information as objectively as possible.  This was especially true of radio and television, which used public airwaves. You could read the “National Enquirer” for gossip, but you knew that your local newspaper would give you the facts. Many news organizations had local news reporters and investigative units, groups that have now often been dismantled for various reasons. As reporting has become more centralized, it allows for more corruption and misinformation.

It is imperative that we, as citizens, regain our critical thinking skills and stop accepting biased information from self-serving individuals and groups.  But how can we do this? The first step is to recognize the problem.  If you are reading or watching content that consistently upsets or angers you, there is a chance you are being manipulated. If you belong to a group or organization, including a religious one, that demands that you think in a certain way and where questioning is considered disloyalty, you are being manipulated. If you can not have a rational conversation with someone with an opposing view, you have already been manipulated.

What can be done?

-Avoid curated content that biases you against any other group.  I’m not saying that you shouldn’t stay informed or have an opinion; I’m saying that you should avoid editorial content on YouTube, cable news, and other sources. The vast amount of information on cable news is editorial, and therefore often biased.  Much is designed to be rage bait, keeping you watching. Expose yourself to “the other side.” If all you watch is Fox News, dip into CNN now and then.  Better yet, avoid both and go for a more neutral news source, like over-the-air news, which has to conform to anti-bias rules. An additional option is to pick unbiased sources like the BBC, which is now easy to access online. I tend to listen to US-based news summaries and supplement them with other balanced sources. 

-Avoid all hateful channels on places like YouTube. The world is a better place when we work together, as we have for millennia. When it comes to dating apps, women are in control.  Here I may sound like an old codger… but I guess that is what I am.  Women, look past the superficial and focus on the qualities that really determine a good mate.  Here is another true story.  When I was in med school, I knew a woman who was trying to find a boyfriend (I was married at the time). I had a friend in med school who I thought would be a great catch.  He was very average-looking, but a great guy.  He was smart, kind, considerate, and thoughtful. He was motivated to succeed and (in fact) obtained a pharmacy degree prior to getting into med school.  He had great earning potential.  He wanted to settle down and was looking for a serious relationship. He had the potential to become a great dad.  I arranged a blind date, and he took my friend to a very nice restaurant for dinner. I was shocked when she summarily rejected him as he gave her the “ick.” Why?  Because he brought her flowers on their first date, and that was “too much.”  Holy cow. I’m happy to report that he is now happily married to someone who saw him as he actually was. His wife scored a good one. 

-Broaden your mind. Although I’m more liberal-leaning, I’m always willing to listen to opposing views in a civil conversation.  Sometimes I change my views, most times I don’t.  However, I leave knowing why a person thinks as they do, and by doing so, I know that they are not my enemy. It is OK to have a different point of view.

-Use your critical thinking skills.  If an individual or group demands that you think uncritically, allow yourself to question their motivations. There are so many examples of this, from claiming that everything is “fake news” to impostor influencers peddling their lotions and potions, to “experts” with statements like “This food will cure cancer!”  Our current best way of determining something is by studying real data and testing outcomes.  Listen to the majority expert opinion, not some quack.  Majority opinions are sometimes wrong, but quack views are often wrong and self-serving. 

We all benefit when we understand and accept each other and work together.  Those who want to split us based on hate rhetoric have their reasons, and those reasons do not benefit us; they only help them.

Peace

Mike

psychiatry, psychology

How Corporate and Governmental Greed Used The Distance Rule To Control You and Your Beliefs.

The following is my personal opinion.

Over the years, I have observed a phenomenon in various situations: I have dubbed it the Distance Rule. The rule is simple: the greater you can separate yourself from a person or group, the easier it is to justify or ignore harmful actions against that person or group. 

The converse rule, which I call the Closeness Rule, also applies.  The more one can relate to a person or group, the more difficult it is to justify harmful actions against that person or group.  

There is a qualifier.  These rules apply to individuals who have a moral center.  Those with sociopathic tendencies will do whatever is in their best interest, as their ability to empathize with another person is absent.  

Lastly, there is the phenomenon that I call Convenient Sociopathy, where it is so advantageous for an individual or organization to dehumanize an individual or group that they find a rationale to do so, often using the Distance Rule. Think of the corporation Enron, which regularly turned off electric power to parts of California, which caused harm to the most vulnerable while increasing the wealth of Enron’s shareholders. 

Entire nations can use these rules, often employing propaganda to reach a goal. This tactic is always seen in war situations.  During WWII, American propaganda portrayed both the Japanese and German citizens as bloodthirsty monsters, making it easier for US soldiers and the homefront to unite against them.  Naturally, similar campaigns were launched against Americans in those countries.  

Additionally, a systematic propaganda campaign was developed against non-Arians in Germany in the 1930s, and specific efforts by Germany, Italy, and Spain were developed to eliminate a particular minority population, the Jews.

Other groups were also targeted, from Eastern Europeans, to Romani, to gays, to those with physical, mental, and psychological issues. Creating an emotional distance between these groups and the general population allowed ordinary citizens to do the most horrific things to human beings.

It is easy to devise a method to separate one group from another. However, this process is more effective if the aggressor uses an easy-to-identify characteristic such as race, religion, economic status, education level, sexual orientation, or nationality. The aggressor’s goal is to gain power and control. That power can be expressed in privilege, wealth, or other forms of domination. 

A common characteristic of serial killers is that they dehumanize their victims, using the Distance Rule to turn them into objects for gratification. This can be seen in predators who kill for sexual thrills, such as John Wayne Gacy and the BTK killer Dennis Rader.  

The ability to distance from others to justify a behavior can be seen in less global ways. As a psychotherapist, I would see patients use the Distance Rule to create an emotional separation from a spouse when they enter into an affair relationship.  At the same time, I would witness them using the Closeness Rule to idealize the affair partner as further justification for their actions. I have never heard a person active in an affair say something like, “My spouse is great, but I decided to cheat on them anyway.”  Typically, an excuse is made focusing on their spouse’s flaws, lack of sexual response, inattentiveness, or whatever.  Likewise, the AP is usually characterized in an ideal way as the one “who understands me,” the one “I can talk to,” or the one “who appreciates my sexual prowess.” 

This Distance Rule is commonly seen in the corporate world and was promulgated by Jack Welch, the former CEO of General Electric. Before Mr. Welch, most large corporations’ strategies were for long-term, steady growth. Giving a workforce a sense of stability and rewarding them for their loyalty was part of that growth equation. Jack’s focus was very different. He saw a corporation as a profit-generating machine for stockholders and felt that the role of a corporation was to benefit those individuals. So be it if a job could be done less expensively in another country. A division that was not as profitable as another one should be closed and damn to the factory workers and communities that they lived in. Using that method, Jack made a lot of money for GE’s shareholders and himself.

GE survived as a corporation. However, this Distancing Rule sometimes destroys not only lives but also corporations. One example of that phenomenon is former Sunbeam CEO Albert Dunlap, known as Chainsaw Al for his business practices.  

Sunbeam Corporation was a 100-year-old company that made small appliances under the Sunbeam and Oster brands. These were well-regarded US-made appliances. My mother used a Sunbeam Mixer daily from the 1950s until the 1970s, when she was gifted a Kitchenade Mixer. That original Sunbeam Mixmaster was a quality product.  However, due to mismanagement, Sunbeam was less profitable than possible, so they brought in Chainsaw Al to improve the bottom line. Al fired around 50% of Sunbeam employees, closed down most of Sunbeam’s factories, and reduced their product line, destroying the lives of many.  Robert Reich, then secretary of labor, noted, “There is no excuse for treating employees as if they are disposable pieces of equipment,” Chainsaw Al promoted stock options, which meant that any profit for Sunbeam shareholders would also benefit him.  He was incentivized to do whatever it took to inflate Sunbeam’s stock, and that is precisely what he did, using fraudulent and illegal tactics that resulted in Sunbeam filing bankruptcy in 2001. Al left the corporate world with millions in his pockets despite paying off federal fines and penalties for his illegal practices. His fines were a small price to pay. Sunbeam was sold several times to larger entities, and Newell Brands now owns it. You can still find Sunbeam-branded products, including a crap version of the Mixmaster, which is now manufactured in China. No one aspires to have a new Mixmaster as the once legendary product has fallen far from grace.

The top 1% of income earners are those so isolated from the general population that the populace can become an object to achieve further gain rather than human beings with lives, families, and aspirations. 

I know of a university student who was given an internship at Amazon.  She was treated well in that temporary position, but she was appalled that workers were treated like machines.  For instance, lower-level workers were written up if they ever sat down.  Can you imagine?

Educated professionals can also be treated like commodities. For decades, we have been told that the secret to success was to become educated. Universities grew and prospered as US tuition reached stratospheric proportions.  Students studied complex STEM disciplines like engineering and computer science with the promise of a secure and financially stable life. Currently, many of these individuals can’t find jobs or have been laid off as they try to cope with massive student debt, excessive mortgages, and rising inflation.  

A particularly heinous practice in the US has been incentivizing shareholder profits in health care.  Let me first say this clearly: there is no justification to murder another person. However, I can understand the anger and rage placed on corporations that enrich themselves by acting as the unnecessary middleman in an industry that is supposed to help people and not cause harm.

We have been sold a bill of goods that says our health system is the best in the world; it is not.  Did you know that citizens in 48 other countries, including Costa Rica and Albania, have greater longevity than in the US?  Did you know that many citizens in countries with universal health care are happy with it and can’t imagine the healthcare shenanigans that happen in the US?  Did you know that medical debt is the number one reason for bankruptcy in the US?  Did you know all developed countries except the US have healthcare for all? It is accepted as a benefit of an enlightened society, just like free education, fire departments, and public libraries. No one says, “I don’t want my kids to learn how to read and write because it will turn our country into a socialist state!”

Many attempts have been made to establish universal health care in the US starting in the 1800s, including efforts from Presidents Theodore Roosevelt, Franklin Delano Roosevelt, and Harry Truman.  Are you aware that beyond profit interests, one reason for this not happening was racism?  Efforts for universal healthcare in the US started after the Civil War, but they were shot down by politicians, mainly from the South, as universal healthcare would have to include blacks.  White legislators noted, “Free assistance of any kind would breed dependence, and when that came to black infirmity (Ed note: sickness), hard labor is a better salve than white medicine.”  This should not be shocking as blacks have been excluded from many social reforms.  Large numbers of blacks were excluded from the 1935 Social Security Act, and structural discrimination limited black’s access to the GI Bill.

Private health insurance became a popular perk used by companies to entice workers during WWII when wages were frozen. This perk became a factor in amplifying the health insurance industry. 

Somehow, PR has made us believe that healthcare isn’t a right but a privilege.  To that end, 27 million US citizens are uninsured despite programs like Medicaid and the Affordable Health Care Act. This impacts all of us and our economy and is often the case due to governmental barriers at the state level.

Traditional Medicare is a government-run healthcare program that its users generally like.  Its administrative costs are 10 times less than private health insurance programs like Medicare Advantage. Traditional Medicare has a near-zero denial rate for accepted procedures. Lastly, its network of hospitals and doctors is vastly more expansive than any Medicare Advantage program.  Medicare Advantage subscribers often give up traditional Medicare and sign up with a private insurance company because they are promised trivial perks. Getting free stuff sounds terrific until you have a significant and expensive need and your Advantage program denies or delays approval.  

Regular private health insurance also practices these tactics.  A loved one of mine had a spinal fusion, and we were told that she would be in the hospital for 4-5 days due to the complexity of the procedure. After 24 hours, the insurance company was pushing for discharge, and despite my efforts, my loved one was discharged at 36 hours. My loved one wasn’t making sense, could barely stand, and was in terrific pain. We had to provide complete nursing care at home for many days.  Thankfully, I’m retired and have the knowledge and family support to take on that role.  How many others don’t have those resources?

Medicare Advantage programs are under government investigation for fraudulent billing practices and denial of claims. It has been proven that Medicare Advantage offers a lower quality of care while costing the government more than traditional Medicare.  So why are seniors always being pushed to go with an Advantage program?  Well, there is a reason that insurance companies spent over $117,000,00.00 in campaign contributions and lobbying efforts in 2024. We already have government health insurance in conventional Medicare, and it works quite well, but it doesn’t make a profit for shareholders and CEOs.

By using the Distance Rule, insurance clients become objects to be manipulated to increase profits for shareholders and employees of the company.  The recent tragedy of the murder of the CEO of United Health Care brought to the forefront the level of corruption in the industry.  Yes, that CEO was being investigated for insider trading.  Yes, he made 10 million dollars in his last year’s salary.  Yes, he illegally sold 15 million dollars of UHC stocks when he knew the stock was about to tank due to an FTC investigation.  That is horrible, but nothing compared to a 32% denial of claims by UHC.  That means almost one-third of requests from mammograms to life-saving surgeries were denied. Those denials were made by a computer program, not a medical expert, and that software is reported to be wrong 90% of the time! Consider the consequences and damage to our society by turning human beings into objects that can be manipulated to gain corporate profit. 

You may think insurance company denials are based on preventing evil doctors from performing unnecessary procedures, but that is not true. Some of the most significant legal investigations involving health care are due to insurance companies’ fraudulent billing of Medicare/Medicaid. Additionally, many doctors have stories of insurance companies denying payment even after getting pre-approved for a procedure. When insurance companies do pay, they can delay payment for months, causing hardship for practices with large overheads . Many rural and less endowed hospitals have been forced to close because of these and other practices, leaving entire communities without health care.

Insurance companies know that only about 0.2% of denials are ever appealed.  Clients may not know that they have that right to appeal or may not have the psychological energy to launch such a process during their health crisis.  Recently, our family had to face an insurance denial.  A loved one was diagnosed with a rare and life-threatening condition that was so complicated that it required traveling to a university hospital. A very long, complex, and potentially dangerous operation needed to be performed, and the university hospital got pre-approval for the procedure from the insurance company.  The operation took over 7.5 hours and involved a team of the hospital’s top doctors, including department chairs. Yet, 6 months after the operation, we received a bill for thousands of dollars as the insurance company denied a PART of the operation. I’m a physician; how do you deny PART of a pre-approved operation for a life-threatening condition?  That makes little sense. I did appeal the decision and was rejected twice by the insurance company.  I eventually filed a complaint with my state’s insurance commission before the charges were reversed. If only 0.2% appeal an insurance denial, how many of those 0.2% also know you can file a complaint to a regulatory commission?  Likely, not many.  Bonus for the insurance company. 

In our modern society, individuals are becoming more isolated from each other. People work from home, friends connect via text messages, and groups isolate themselves due to their ever-widening economic status. All of this makes it easier to apply the Distance Rule.

I live in an affluent community. I see entire families dining at expensive restaurants on weekdays. It is a place where people walk down pristine walking paths sporting designer clothes.  A place where many belong to a gym because they rarely do productive physical exercise.  It is a wonderful place to live, and I’m very grateful that I am fortunate to have called my town my home.  However, a short drive in almost any direction can take me to a different place.  A place where poverty is evident.  Where grocery stores don’t exist. Where schools are places of violence.  A place where poverty drives crime, addiction, and fear.  I generally avoid those places, as most of my neighbors do.  We don’t have to think about the plight of those human beings; they are far away, making it easy to objectify them.  Objects that we can blame and then ignore. “That’s not my problem.  Look at how successful I am,” we say—ignoring the opportunities that we have had. That is how things work in our society.  If it doesn’t directly impact the individual, it is ignored.  However, as we continue to distance ourselves from others on all levels, the result is that we will also eventually suffer. 

I was raised in a working-class neighborhood but managed to attend one of the country’s best medical schools.  Everyone who works hard enough can do the same, right?  Wrong.  I had many advantages in my favor.  I lived in a stable home and never worried that we would be evicted.  There was always food on the table.  Both sides of my family are academically oriented.  My parents strongly emphasized the importance of education.  I didn’t have the advantages of some, but I had many more benefits than many.  This enabled me to use my only gift, my ability to think, to my advantage.  Would that be the case if I was always hungry or afraid to go to school because I could be shot?  I don’t think so.  

Yet, it is still easy for me to objectify others using the Distance Rule.  I have to actively put myself in the shoes of others. I have conservative friends and family, and I make an effort to understand their positions.  I have working-class friends whose reality differs from mine, and I try to put myself in their shoes. When I drive through a poor neighborhood, I try to comprehend those people’s obstacles.  When dealing with a persecuted minority, I imagine what their life must be like on a day-to-day basis.

Recently, I have had someone I know come out as trans.  She possesses the courage and resolve that few, including myself, have.  However, as a minority, she will suffer from the Distance Rule. In my professional life, I have worked with trans people.  They represent an extremely tiny percentage of the population.  Their wish is simple; they want to have freedom to live their life and to be left alone.  There is NO evidence that they want to convert others to their position or that they get off from entering a bathroom. They just don’t want to be persecuted.  Yet, look at how easy it has been to use the Distance Rule to objectify them and make them into an object of hate. Why do this? If you want to control a group, find another vulnerable group they can fear and hate and then promise to protect the majority group from that imaginary threat. A method as old as time.

We live in a society where the distance between different groups grows daily.  That distance may be measured in terms of physical distance, monetary distance, educational distance, belief distance, racial distance, sexual orientation distance, liberal vs conservative distance, and just about any other separation you can think of. Consider this quote from our Pledge of Allegiance, “One nation, indivisible, with liberty and justice for all.”  Think of the power and wisdom of that statement.  When we apply the Distance Rule, we negate this promise.  In the short term, it makes our lives easier.  In the short term, it allows others to manipulate us and makes some richer.  But what about the long term?  What about our country and its promise to treat all fairly? In a country that should be the greatest on earth, such separations make the rich richer and the poor poorer. This can only lead to eventual collapse and disaster. That is common sense. Did you know that the three wealthiest individuals in the US have more money than the lowest 50 percent of the population? Three individuals have more wealth than the combined worth of 167 million humans. Their distance from that population is unfathomable. 

Government and industry leaders have employed the Distance Rule to split populations so they could manipulate them and extract power and wealth from them.  Why do we buy such a ridiculous concept that hurts everyone except for a few at the top? 

If you accept even ten percent of the premise of this post, it is incumbent on you to move from passive acceptance of the status quo to active pursuit of a better way.  You need to reject the Distance Rule and embrace the Closeness Rule. You need to look at how we are all more similar than different. At the same time, it is imperative to accept those slight differences that we do have and not buy into the manipulation of others who use minor differences as weapons to separate us.  

Find common similarities between you and someone different from you.  Listen to their dreams and their life struggles. You don’t have to adopt their ideas; they don’t have to convert to yours.  It is OK to be different. At the same time, open your mind, as you may find that some of your beliefs may change as you understand who they are as human beings. In turn, they may do likewise. Focus on the humanity of others. Immanuel Kant developed the Categorical Imperative in the late 1700s. The Golden Rule is as old as time. We know what we need to do, but we are manipulated to do otherwise.

A talking point from this last election was, “Are you better off than you were 4 years ago?”  It was a powerful point and likely won the presidency.  However, it was a manipulation because the statement should have been, “Are you better off than you were 40 years ago.”  For most, the answer would have been “No.”  But that reason is not because of the immigrants, or blacks, or trans people, or whatever.  It is because wealth has steadily moved from the poor to the rich.  That is the reality that the 1% doesn’t want you to know. They effectively used the Distance Rule to deflect blame onto vulnerable groups that can’t defend themselves. Remember, we are always stronger when we work together.  We are weaker when we allow others to separate us into groups, as that weakness can be exploited to all our detriment. 

Peace,

Mike

psychiatry, psychology

How I Became A Psychiatrist

When I told my father my plans he was clearly displeased.  It was a spring day, and I was talking to him in his south suburban backyard. “Dad, I’m going to specialize in psychiatry.”  His response was quick and sharp, “Why would you want to do that?  You should become a real doctor.  Psychiatrists aren’t doctors.”  

By that point in my life, I had long charted my own course.  I listened respectfully, but internally, I ignored his commands.  I no longer needed his approval, and my conversation was more perfunctory rather than advice-seeking. He had his agenda, and I had mine.  Since my decision would directly impact me, it was my decision to make.  I subtly changed the topic to something that I knew would interest him. It was a deliberate manipulation on my part to a neutral subject, and the conversation moved forward.

His question was valid for other reasons. Why had I decided on this career path? My answer was both surprising yet understandable.

There are certain key events in my life that I write about repeatedly. They serve as markers that indicate significant changes in my knowledge of myself and the world around me.  They are the road signs to my life.  Many other factors are equally important, but these events note a change in understanding or direction.  A fork in the road that led to a different journey.   

I often talk about my dyslexia, a diagnosis that is only partially accurate.  I use the term because it is relatable.  In reality, I have a variety of processing differences that can make simple tasks difficult for me.  For instance, I can visualize abstract concepts but can’t assemble a simple children’s jigsaw puzzle. This processing disparity was evident when I was in second grade and couldn’t read. In the early 1960s, the concept of learning disabilities was utterly foreign at the Catholic grade school that I attended.  My teacher, a nun, recognized that I was smart and erroneously concluded that my inability was caused by a vision problem, which prompted my parents to get me a pair of glasses.  This was a significant expense, and my father was not pleased, but he complied. 

I was hoping for a miracle and was crushed to discover that they did little to translate the incomprehensible set of symbols that moved around the page with a mind of their own.  I was at a phase in my life when I thought that any imperfection in me reflected poorly on my family and parents, and I was terrified of gaining even more displeasure from my father.

Yet, I had a certain confidence in myself, likely boosted by my teachers, who would comment on how smart I was.  I had to devise a solution, and I felt confident I could. But what resources did I have?  How could I take something I already had and use it as a tool?  The answer came to me via the Sunday comics. There was a strip called “Nancy” that was very simple in both its storyline and vocabulary. I could piece together the words by tying them to the pictures.  The traditional way I was being taught to read would never work for me because I could not see the separation between words and lines of text.  However, if I viewed a word as a shape instead of a series of letters, I could decipher its meaning.  My brain could do that, and print started to make sense.  I did many other things to teach my brain how to read. Soon, an entire world of information was revealed to me. By the time I took my 4th-grade achievement tests, I was testing at the 11th-grade level. 

I was a big kid, so I can’t say that I was the object of a lot of bullying.  I was part of the mass group of kids; neither a member of the popular crowd nor the reject group.  I had friends, and I did things.  Yet, I felt like an imposter.  Subjects that interested my friends didn’t particularly interest me, and things that I was interested in held no interest with them.  I learned that to be accepted, I would have to show interest in what interested them while hiding those things that I was interested in. 

My salvation was science, and my teachers were the pseudo-scientists of the B science fiction movies that I would watch on late-night TV. My ultimate hero and male role model was Don Herbert, AKA “Mr. Wizard” of TV fame.  Mr. Wizard seemed to have the answer to how everything and anything worked. He showed me that there was a method to understanding, a way to prove ideas, and a methodology to learning.  What he demonstrated formally was consistent with what I had been doing organically.  Mr. Wizard didn’t know me, but he understood me.  He had to, as what he was explaining on TV was exactly how I was already solving problems.  Mr. Wizard allowed me to feel “normal.”  I no longer believed I had to fake who I was; at least one person understood me. 

My success in learning how to read taught me that authorities didn’t always know what was best and that there were solutions to seemingly impossible problems if I allowed myself to think outside the box.  Mr. Wizard gave me a formal set of rules to test ideas. Science and math provided the tools to implement those solutions.  I was suddenly empowered. 

It was only natural that I would pursue science, and as I have said in a previous post, the most logical course of action would have been to obtain a Ph.D. and pursue a university career. I’m a rational person who examines potential outcomes, plots a course to achieve a particular goal, and then pursues that goal with force and dedication.  It works… well, sort of… well, sometimes…well, hmmm..ummm…keep reading.

I have already told you how I successfully reached my goal of graduate school and even had the school pay for my education. A perfect plan?  Then, despite all logic to the contrary, I had an irresistible urge to abandon my plan and apply to medical school, which was an insane idea that was bound to fail.  I knew that I would never be accepted into medical school.  All of my logic, all of my “scientific method,” and all of my dreams were tossed aside for a whim. Yet, that was precisely what I did; I allowed a force outside of myself to control my actions.  I was as shocked as anyone when multiple medical schools accepted me. Many of them referred to how meaningful my personal statement was to them. Here was a kid who couldn’t read in second grade who was now moving doctors with his writing.  Life is strange, isn’t it?

I have always had an immense interest in the interface between chemistry and biology.  My graduate work centered on changes to proteins as they are extruded through a bacteria’s cell membrane.  During my application to med school year, I left grad school and got a research job at the University of Chicago using tissue culture models to study Multiple Sclerosis.  We were using a cutting-edge technology (this was in the 1970s) called monoclonal antibodies to create specific markers.  Even then, I could see how such a targeted method could be utilized clinically, from cancer treatment to fighting infections.  However, those advancements would be decades in the future.

Logic would dictate that I pursue an area of medicine that incorporated my scientific knowledge with clinical practice.  The options were plenty: internal medicine sub-specialties like infectious diseases and endocrinology to specialties like Neurology.  I knew that one of those areas would be a perfect fit.  However, they weren’t.  

I was so excited to do my internal medicine rotations, but they disappointed me. I spent 90% of my time running down labs, examining scans, and writing notes.  The time that I spent with patients was minimal.  It felt like I was back in the lab, but my subjects were humans this time. As a family practice doctor, I may have been happy as that medicine was more integrative.  However, family practice options were discouraged at Northwestern.  When I asked the medical school dean why, he responded, “Our mission is to produce specialists.”  Despite this, my problem-solving and goal-direction abilities pointed me toward an internal medicine subspecialty. It was where my background and interests led me. 

Psychiatry was never a consideration.  I had some fears about the profession.  My mother was frequently hospitalized for ketoacidosis, a condition caused by her out-of-control diabetes.  Once, she was in a medical unit that shared a floor with Christ Hospital’s psych unit.  That unit had an imposing locked metal door with a thin slit window made more solid with embedded mesh wire.  It was scary looking, but young me was curious.  I crept up to the door and, with all the courage I could muster, looked into the window, not knowing what to expect. From out of nowhere, a face appeared directly opposite me.  A deranged and disheveled-looking man started to shout at me and threaten me. His face was one inch from mine, only separated by a thin piece of glass.

Along with his verbal threats, he started to beat on the door, and I could feel the vibrations inside my chest. I wanted to escape but felt frozen.  My heart was racing, and I was overcome by fear. Eventually, I broke away and ran down the hall.  In the background, I could hear laughing.  At the time, it sounded like an insane laugh reminiscent of those heard in horror movies. In retrospect, I believe it was the laugh of someone who felt he had just played the greatest joke on an unsuspecting, nosey kid.  However, it took me quite some time before I deciphered that realization.  I was freaked out for years, and at one point, I even had a fear that I could accidentally be locked up in a psych unit, never to escape.  

Our family has an intuitive psychological understanding, which stems from my mom. However, I never thought of pursuing psychology in any form. I was a science guy and never took a psychology course as an undergrad.  

Medical students rotate through all of the specialties as part of their training, and at Northwestern, all M3s are required to do a 6-week general psych rotation. This rotation was a low priority for me, and my main concern was completing it as simply as possible. I wanted a site close to Northwestern’s downtown campus for convenience and picked the least desirable one because it was only a block away.  I knew I would get it because no one else would want it.  It was a drop-in center for the sickest psych patients, the most chronically ill.  There, they could socially mingle, play a game, attend a group, get medically seen, and renew their prescriptions. Fellow students told horror stories about bizarre behavior and poor hygiene.  No one wanted that rotation, so I picked it.  I could survive anything for six weeks, and I wouldn’t have to travel to a distant site to complete my obligation.

My first day was as expected: bizarre, often disheveled individuals milling about, talking, and sometimes shouting to themselves. Mismatched clothes, sometimes garish makeup. “It is only six weeks out of my life,” I told myself. “I’ll do this one day at a time.” I had many obligations at that place, from doing initial psychiatric evaluations, to being a group therapy leader, to helping manage meds, to injecting patients with long-acting antipsychotics.  However, I also had more free time than was typical for a clinical rotation.  I started to hang around the day room.  Sometimes, I would sit in the day room and read; at other times, I would play a game with a client. Eventually, something strange happened.  Patients would come up to me and start a conversation. Those conversations were not about meds or the latest therapy; they were about their lives, hopes, and dreams.  They would ask me about me, not in an intrusive way but in an interested way. I was becoming part of their group.  They seemed to look forward to seeing me.

One day, a client could be rational, on the following day, completely psychotic. As they gained trust in me, they let me into their life, and I developed an admiration for them.  Despite having constant hallucinations and delusions, many could still navigate the world, form relationships, and problem-solve.  I would lack these abilities under such circumstances. Many lived a life of scorn and rejection, yet many of their desires were no different from mine.  They wanted to connect with others, have value, and have those basic needs that we all require. In this crazy setting, I was doing what I wanted: helping someone improve their life, even if it was just a tiny bit. Knowing the biochemistry of psych meds helped, but just relating to them as human beings was just as important. I looked forward to showing up, playing a game of checkers, or talking to them about their past and present lives.  I always felt different growing up, but kind individuals seemed to find me and convinced me that being different was OK. 

Here, I was dealing with people who had problems very different from mine, people who were very different from me, yet all I could see was how similar we were underneath.  These were human beings, not trash.  They deserved to have the best life that they could. I felt called to spend time with them.

Once again, my logic, planning, and goal-setting were about to be tested.  I had so much training in hard science, but much of Psychiatry was soft science. However, my course of action was right before me and couldn’t be ignored.  Hard science told me that I could use powerful drugs to block dopamine receptors and reduce psychotic symptoms.  However, soft science showed me that listening and relating to another human could be even more powerful.  My beliefs were being challenged, but I was willing to listen. But was this experience a fluke? The only way to find out was to test the hypothesis, and I did that by picking psych electives that were completely different from my drop-in center experience.  I did, and my mind did not change.

And so it started: residency, becoming chief resident, jobs, co-founding a clinic, working with the underserved, then… then…then.

Do you ever think there is some guiding force beyond yourself that directs you if you allow that direction?  A guardian angle? God’s direct interest in you? Some other force. Despite all of my planning, logic, and science, my best decisions in life seem to come from outside of me.  Interesting, no?

I spent many years sitting at this desk in my co-founded clinic.