Coping with post-election stress disorder


We’ve often blamed the pharmaceutical industry for medicalising the normal ups and downs of life. But journalists are not above disease-mongering. I’ve just noticed a promising new ailment to which members of the Fourth Estte themselves are particularly susceptible: post-election stress disorder.  

According to columnist in Psychology Today, “Countless Americans are reporting feeling triggered, traumatized, on edge, anxious, sleepless, angry, hopeless, avoidant of connection, alone, and suddenly haunted by past traumas they believed they had buried” because of the Trump election.

As of now, no pharmaceutical company is marketing a drug to cure these anxieties. Instead, therapists are recommending a range of behavioural strategies for dealing with the stress. “I advise my clients and friends affected by the election and its aftermath to reach out, connect, affiliate and show compassion for those similarly affected,” wrote Steven Stosny in the Washington Post.

Some people are indignant that Post-Traumatic Stress Disorder after battle is being compared to discouragement after an election loss. Republican Congressman Brian Mast lost both legs in Iraq because of a roadside bomb. Let him have the last word:

There was a big missed opportunity in naming it ‘Post-Election Stress Disorder,'” he says. “I would have preferred they name it ‘Post-Inauguration Stress Disorder,’ that way they could have called it ‘PISD.’ There’s a big difference between being pissed off about things and what happens on the battlefield.”

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Churchill on science


Winston Churchill was once voted the “greatest Briton of all time” in a BBC poll, edging out Isambard Kingdom Brunel (who?), Lady Diana, Shakespeare and John Lennon. Now, in addition to his gifts as a statesman and politician, orator and historian (and artist), we have been reminded that he helped to popularise science as well.

As reported in Nature, an historian has discovered an 11-page manuscript which Churchill penned in 1939 but never published, speculating about life on other planets. It turns out that the great man was deeply interested in modern science and followed developments keenly. Gazing at the gathering storm, he wrote pessimistically:

“I, for one, am not so immensely impressed by the success we are making of our civilization here that I am prepared to think we are the only spot in this immense universe which contains living, thinking creatures, or that we are the highest type of mental and physical development which has ever appeared in the vast compass of space and time.”

But despite the reminder that Churchill was a fan of science, it’s also good to remember that he believed that there were moral limits to science. In one of his most famous speeches, he foresaw dark days for the world if Germany were to win the War:

If we can stand up to [Hitler], all Europe may be free and the life of the world may move forward into broad, sunlit uplands. But if we fail, then the whole world ... will sink into the abyss of a new Dark Age made more sinister, and perhaps more protracted, by the lights of perverted science. Let us therefore brace ourselves to our duties, and so bear ourselves that, if the British Empire and its Commonwealth last for a thousand years, men will still say, "This was their finest hour."

Science, so Churchill believed, was fascinating, but not good in itself. It had to be governed by morality, lest it become “perverted”. It’s not a bad reminder for us, three generations on, as we enter an era of genetic engineering. 

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Controversial solution to self-harm


A child who self-harms must be one of the most agonising experiences a parent can have. But it is relatively common. A study in The Lancet a few years ago found that about 1 in 12 teenagers, mostly girls, engaged in self-harming behaviour, with the most common methods cutting or burning. Most of them stop as adults, but some continue. It is a phenomenon which still seems to baffle the medical profession, despite the abundance of statistics.

In this issue of BioEdge, we report on an interesting response to self-harm, at least for some patients – educate them to minimise the harm, but supply them with razors. Given that harm minimisation is a popular public policy approach in other areas, like drugs, this makes some sense. But I think that most people will regard it as quite confronting. What do you think?  

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Introducing “In Depth”, our comment section


We have introduced a new feature in BioEdge this week. It’s a new section called “In Depth”, where we plan to feature commentary, analysis, background and interviews.

This week Clark Hobson, of the University of Leicester, in the UK, argues that assisted suicide has a chance of becoming law in Britain through the courts, not through Parliament. In previous cases the courts have stated that Parliament must address the ban on assisted suicide appropriately. If it does not act, the Supreme Court might find that the ban infringes Article 8(1) of the European Convention of Human Rights (ECHR).

It’s an intriguing argument, one that will cheer supporters and dismay opponents of assisted suicide. Of course, Theresa May, the Prime Minister, has vowed to make withdrawal from the ECHR a central plank in the 2020 election, so there might not be much time... 

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POTUS and torture


It beggars belief that the leader of the free world and the world’s policeman, the President of the United States, thinks that torture is not a bad thing. On the campaign trail he insisted several times that torture works and that even if it didn’t “they deserve it anyway, for what they’re doing.”

Now that he is in office, however, Mr Trump seems to be having a two-way bet. While personally in favour of waterboarding, he is deferring to the opinion of his Secretary of Defense, James Mattis, a tough and experienced soldier, who says that it does not work. In this way, he keeps faith both with voters who want him to be tough on terrorism and voters who want him to rebuild the military.

So the upshot of this week’s confusing news about a draft executive order from the President permitting “enhanced interrogation” techniques is that no one really knows what he believes. But it is an ominous sign that Mr Trump’s moral compass is so weak that he resiles from repudiating torture, keeping it in reserve as a potential vote-winner. In a civilised society which respects human dignity, torture should be absolutely unthinkable.

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President Donald Trump


Donald Trump was a different sort of candidate and he gave a different sort of inaugural speech. It was short, sharp, divisive and isolationist, the kind of remarks that often precede a massive swamp-draining project. But in one respect it was similar to speeches by other presidents: bioethics was not a major theme.

He did say that "We stand at the birth of a new millennium, ready to unlock the mysteries of space, to free the earth from the miseries of disease" -- which sounds vaguely promising for scientific and medical research.

His twice-repeated invocation of the Almightly suggests that he might follow a Christian line on controversial issues like contraception, abortion and assisted suicide. 

But who knows? Mr Trump is a bit like that quintessentially American poet Walt Whitman -- "Do I contradict myself? Very well then I contradict myself, (I am large, I contain multitudes.)" No one really knows what he has in mind about a range of topics. Buckle up. It's going to be a bumpy ride.

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Waste not, want not


Transplant surgeons in Belgium and the Netherlands are already harvesting organs from patients who have requested euthanasia. Could this happen in Canada, the new kid on the euthanasia block? Perhaps. In a recent article in the Journal of Medical Ethics, two bioethicists from Quebec argue that organ donor euthanasia is a homage to autonomy and needs to be legalised. Apparently the Quebec government and the society of transplant surgeons in Quebec are on board.

Of all the bad ideas associated with euthanasia, this must be one of the worst. The potential for exploiting vulnerable people is immense. Imagine that you are a quadriplegic. Your organs are healthy; you are lonely, frustrated, discouraged. You see a TV program in which a doctor praises the unforgettable generosity of So-and-so whose life was not worth living but found a way to give life to others, etc, etc. Wouldn't you think of ringing up the doctor and asking him how to go about it? 

Will Canada be able to stop this from happening?

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Happy Christmas!


All the best to our readers for a Merry Christmas and a Happy New Year! BioEdge will be taking a break for a while. Our next email will arrive, depending on your time zone, around January 11. We plan to move to a mid-week, rather than a weekend, mail-out. 

Quite a few people have responded to our fund-raising campaign. We are very grateful for your support and generosity. The funds will help us to redesign the website in the new year. 

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The dignity of Mr 66 Garage


When there’s talk of border crossings and illegal Mexican migrants, my thoughts used to turn to the ugliness of Donald Trump’s dream: "I will build a great wall -- and nobody builds walls better than me, believe me --and I'll build them very inexpensively. I will build a great, great wall on our southern border.”

But after reading a remarkable feature in California Sunday Magazine, I’m trying to think about 66 Garage instead. The name of Mr 66 Garage may not ring a bell with you, but to be fair, it doesn't ring one with him either. He is an undocumented migrant whose truck overturned on a border crossing in June 1999. He hit his head and never woke up.

Ever since, 66 Garage has lived in a persistent vegetative state in a San Diego nursing home where he is given round-the-clock care. What a country America is! It produces a politician who treats illegal migrants as if they were cockroaches and nurses who treat them as if they were their own family.

Anyhow, this 18-20-year-old man had taken the “undocumented” part of his journey seriously. He could not be identified and the nursing home christened him 66 Garage, although some of the staff protested that it was undignified. A wonderful woman named Paula visited him every week for 15 years and wondered who he was.

There are thousands upon thousands of missing migrants and their relatives are desperate to find them. A photo of 66 Garage has been shared more than 300,000 times on Facebook. Earlier this year a friend of Paula’s took an interest in the case and 66 Garage was finally fingerprinted. A match led to his sister in the southern state of Oaxaca. Now she can wave at him over Skype on his birthday.

It’s a remarkable story about vulnerability, dignity, blood ties, and American generosity. Read it.

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Reflections on California’s assisted suicide legislation


California’s assisted suicide law came into effect on June 9. Betsy Davis, an artist with ALS, also known as Lou Gehrig’s disease, was one of the first to take advantage of the legislation. She drank a lethal cocktail on July 23, after a long party with close friends. I’m afraid that we missed the story at the time.

Reading her sister’s account of Betsy’s death, which is full of loving sorrow at her passing, I was struck by how quickly Californians started to ignore all the careful safeguards. It is clearly specified in the law that the person must “self-administer” the drug. But she was too weak to hold the cup and drink it quickly, so her friends held it for her. They may have broken the law.

People tend to think that a lethal barbiturate brings about death quickly. This wasn’t true in Betsy’s case – she lingered on for four hours. Given that the drug was a homemade cocktail of morphine, pentobarbital and chloral hydrate which smelled like paint, her friends were “lucky” that it worked. Some assisted suicide patients in Oregon have woken up to discover that their suicide has failed.

It wasn’t a good beginning for the law. 

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