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The intersection of law and medicine can be a real sticky wicket.

Most people have heard of someone being “not guilty by reason of insanity” and most people know that some defendants might be found incompetent to stand trial.

But the processes are sometimes vague and often confusing – especially to the lay audience. Read more on Mentally Retarded But Comptetent To Stand Trial…

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A beloved football coach – I might even say a living legend – finds his life destroyed after a luminous career.  All because of alleged inaction – perhaps to shield a friend, perhaps to preserve the “old school” or for other reasons.

Penn State coach Joe Paterno

More than a coach -- Joe Paterno has been a diety at Penn State

And the sad story of Joe Paterno is only one more chapter in how the victims who suffer are once again vilified, and how we wonder if it is even possible for justice to prevail when such tragedy is involved.

When I was in the year of training for psychotherapy, I felt fortunate to study under a knowledgeable PhD who ran the gamut from psychoanalysis to cognitive styles in his competencies.

The thing he told us was the most important thing to do during our psychotherapy training was for each of us to isolate the population with which we could not work. Read more on Penn State Sports Scandal Destroys Lives…

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Down the hall she came making sounds of distress and physical effort.  When she got to my door, it didn’t get any easier.  She had to push her way through the narrow doorway, one of those doors designed for thinner people of years past.

I saw a wildly obese 23 year old, with suicidal ideation, who told me her life was worthless.  Doctors had found a rare uterine cancer and done a total hysterectomy.  She was told that she could have no hormone replacement.  So she was dealing with some symptomatic treatments of hot flashes that weren’t doing very much.

I was pretty much impressed by the doctors who had made a rare save.  She seemed to be cancer-free now, although she was not “crazy” about the abdominal wall hernia repair that had been necessary to hold her stomach together.  Also, she was not enthusiastic about the bimonthly pap smears.  But she was alive, and granted, she could not have hormone replacement.  She sat in front of me telling me all about how the doctors had taken care of her.

She was crying and depressed.  It was not hard to figure out why.

“I will never have children.  I will never be a mommy.” Read more on What Can You Do With Your Life?…

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Poverty, illness and desperation are a tragic trio and destroy unknown numbers of lives.

One story that broke my heart was that of a sweet young thing, age 23, who had inherited nothing from her father but a disease.

She needed a “specialty medicine” for it — one of those medicines that is so expensive that nobody seems to want to pay for it.  But she lost her job due to “downsizing” so she had no insurance and no money. Read more on US Healthcare Is A Tragedy, Not A Success…

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Probably, a lot of people would claim that they were my mentor if I was famous enough to be worth claiming.  I had some great teachers, especially early on, and I had a bunch of wackos, too.

MentorMy-Father-Of-Blessed-Memory had to take up the slack when my first Hebrew teacher in a Yeshiva — now defunct — was a highly insecure (and probably gay) man who even got chalk all over himself.  As a teacher, he was neither condemning nor very helpful, knowing no way to teach except repetition, both oral and written.

One of the reasons that I had no real mentoring when quite young was that I really did not know exactly what I wanted to do with my curious life, aside from “something in the arts and sciences” which covered pretty much anything I liked, or didn’t. Read more on The Fortunate Few Have Mentors…

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Lovers spatThis seems to be a new era of people trying to change other people’s behavior. And no one asks me how to do it more often than women who are concerned about behaviors in their husbands.

Even though absolutely anybody from AA and Co-dependents Anonymous to most PhD psychologists would tell them that it can’t be done, it CAN be done by those who have great self-control and great patience.

Curiously enough, like so many of the things that I’ve seen work in humans as well as animals — like offering conditioning — they have their forerunners in the ancient wisdom coming from My-Grandmother-Of-Blessed-Memory. If she heard someone say something stupid or do something stupid and talk about it, she would mutter in Yiddish something that sounded like, “Af alle narishkeit eaft’min nisht anferin!”

What this means is, “You don’t answer every single foolishness!” Read more on How To Change Your Husband…

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As I write this, a song is running through my head.

Ah, look at all the lonely people
Ah, look at all the lonely people*

Not surprisingly, of the people, of all ages, the overwhelming number of those who complain to me about loneliness are female. If and when the adolescents get past any and all of the awkwardness without contracting any life-threatening depressions, I really think most of them will be all right. I am a little more worried about those in their late thirties, maybe around forty, who tell me they are lonely.

Plaque Dedicated to Eleanor RigbyThey have generally had at least a couple of relationships, maybe even a marriage.  Their associations with males, sometimes disastrous and maybe even violent, are over.  Happily over, I should think, but they are not so sure.

The lonely women of this age are generally truly beautiful — maybe more beautiful, physically than I have ever been or might ever be.  Sometimes, they have devoted all of their lives to beauty, and are now on maintenance.  I have never met anyone in the same boat I am, who have been brains all of their lives and suddenly find that being physically attractive is something like the ice in your drink that rushes up and hits you in the teeth when you are expecting a rush of cool liquid.  It hits you and you got to deal with it.

“I am sorry to hear that you feel so lonely,” I say. “What would you have to do to stop feeling lonely?  Just do it.” They look at me confused, as if the answer is magically obvious and I have magically missed it.

In a way they are right. Few are those whose loneliness can be relieved by church friends or bingeing on rich ice creams in the middle of the night. Most of them have enjoyed a sexual relationship at some time during their lives and now they miss it. Sometimes, I think they just need masturbation lessons.  But there are several live links to that on the internet, and heaven knows they are NOT hard to find. Read more on The World Is Full Of Lonely Women…

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I get blazing mad whenever one of those knee-jerk “patriots” cry, “You don’t support our troops!” if anyone should criticize the military, our government’s foreign policy or any specific wars, invasions or other actions we’ve taken in this brave new millennium.

I was in the peacetime United States Army. Since my honorable discharge, I’ve served several Veteran’s Administration medical facilities in several states, and in private practice, I’ve made a special study of the treatment of Post Traumatic Stress Disorder – which the military routinely denies even exists and doesn’t even try to treat in many VA facilities.

Yes, I was in the Army, and No – I wasn’t in combat. Nevertheless, with the idea of war always hanging over my shoulder, my life was different. I never really understood the “grunts” — the infantry without appreciable rank — who wanted nothing more than to see “action.” Read more on Can’t We All Just Get Along?…

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I never paid a great deal of attention to politics, until I realized that health care had become politics.

I may be the last of a generation that learned, in medical school in France, that the responsibility of a doctor was to keep a record of cash transactions, something best done in a bound notebook with no pages ripped out, and only a single line to cross out errors, so that integrity would not be questioned.

The same year I entered medical school, President Richard Nixon signed the Health Maintenance Organization Act of 1973.

Wealthy industrialist Henry J. Kaiser, billionaire shipbuilder, and steel and aluminum magnate (as well as staunch Republican and major contributor to the Nixon campaign) was the first person to establish a “for-profit” hospital. Read more on Don’t Tell Me You Think Insurance Will Actually HELP…

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I was a 2nd year resident in neurological surgery when there was news that a single neuron could link with a single computer wire and messages could travel from the one to the other. Nobody in my doctors’ lounge seemed to care.

Brain In A JarI remember seeking out a psychologist who had a fairly high tech research background, to see if he was anywhere nearly as excited as I was. To say “no” is a gross understatement.

He told me about an idea which long before that had been both funded and forgotten.  The idea had been one of a prosthetic frontal lobe.  Frontal lobe of the brain, among other things, tells people what is “appropriate” socially. The one example I will never forget is the physician who (inappropriately) peed in his pants on rounds, and ended up having a frontal lobe tumor. So the idea was that somebody who had a hunk of frontal lobe excised to get rid of the tumor, or presumably some other kind of illness, could have a teency-tiny computer to hold in their hand that would do some frontal lobe kinds of things that they no longer could.

The attempt to develop this happened on the east coast, presumably sometime after Noah’s flood, and the funding dried up just like that great flood did.

Of course, another possibility is that men do not much care where and when they pee.  I doubt this, since I had a patient in Oklahoma who had purchased a fair amount of real estate in his life and thought it necessary and appropriate to “mark” it in the same way a dog marks his territory.  Yes, it involved peeing in public, but the fellow had no known frontal lobe pathology at the time.

Ah, those Oklahoma men. Read more on Maybe Those People Who Annoy Can Get A Prosthetic Brain…

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