ow!

Trazodone again. Less effective and again I have a wicked, all-day headache. You know, the kind of headache that makes thinking difficult. 

I'm as hydrated as I can get, and taking ibuprofin dulls the ache only a little. So now I have to weigh whether to keep taking it and hope that the side effect goes away soon. 

Reading the PI sheet and other information on trazodone, I thought it would be a good fit for me. In addition to its sedative effect, it works as a mild anxiolytic. For whatever reason, I usually don't experience side effects extreme enough to not take any given med, so I decided not to worry about the "trazodone hangover." 

We have plans to float the Harpeth tomorrow. I think I might rather be a little tired than how I feel now. So it's back to the Ambien/clonopin combo for tonight at least. 

Dreaming with trazodone

So Ambien has crapped out on me. It's pretty common for a person's body to get used to some sleep aids (and certain other agents) after a while, which is probably part of why their makers recommend them for short term (6 months or less) use only. Last night, I started a round of trazodone to replace the Ambien. 

----

It worked. And I had one of those movie dreams I sometimes have when I'm sleeping deeply. In last night's dream, I was a teenage daughter in a family of five. We had a colonial-style house in the country, with really big rooms. When a series of catastrophes killed most of the adults in the world, the family opened their (our) house to refugees, but it was safer for us to not let on that the house had belonged to us before the apocalypse. (I don't remember why, something to do with immunity to something.) Most rooms filled with cots, benches, and terribly sad children.

In one of the most vivid scenes, one of these children asked why I was so sad. After all, I still had my family. "This used to be my home!" I sobbed. The child replied, "It still is." Very dramatic.

Cut to a montage spanning a long time.  More and more people found their way to what was becoming a children's colony. Many of the children hit puberty, and many of the teenagers became adults. Slowly, we erected more buildings. As a community, we set up a complex system to protect people from what was still killing most adults, by taking kids out the general population when they showed signs of puberty and putting them in small, isolated groups. The idea was that if an illness emerged in one set of adults, the rest might still be protected. It was an unpopular stopgap, and a serious problem remained: discovering the onset of puberty in each child. No one wanted to be quarantined. Pubescent children began hiding their development. Adults clamored for solutions that would free them from isolation. But no doctors were available to determine what exactly was causing adult deaths, how to determine who would be affected, or how to inoculate adults from whatever was killing them.

----

A lot happens after that, and I think I've set up the major conflicts. To describe it all would take up too much space and time. (Maybe I could write a serial.) At any rate, my main point is that the trazodone worked. Now I just need to get through the temporary side effects I'm experiencing. The liver metabolizes trazodone, so initial side effects feel like hangovers. And it doesn't help that I had five glasses of wine last night. 

Political Math

As I mentioned in the previous post, Obama should be the Democratic nominee.

But this afternoon I figured out why Clinton still thinks she could have the numbers to win. I believe that when the DNC Rules and Bylaws Committee meets on 5/31, she will argue that all pledged delegates in Florida and Michigan should be seated. As a compromise, she'll offer that half of the superdelegates of those states should be seated. This argument fulfills both the idea that every vote should be counted and the idea that the state DCs must still be punished in some way.

I won't try to reproduce the chart I made on the back of our electric bill, but let me give you the highlights of this math. As the DNC rules stand, Obama has a 190 delegate lead over Clinton. He needs 56 delegates to reach the magic nomination number (2025). 294 delegates are left. You can see how the current situation (i.e., what Florida's DC, Michigan's DC, and both candidates agreed on before the process began) makes Obama the clear nominee.

If the Rules and Bylaws committee choose to seat all pledged and half super delegates of FL and MI, the new number for the nomination would be 2143. Clinton's net pledged delegate increase would be 145, which would decrease Obama's delegate lead to 42. Of the 311 delegates still available, Clinton would need 57%, or 176, a number that she could still reach. 

(I think my math is right. These numbers were current on 5/21, just so you know.)

The Rules and Bylaws Committee probably won't select this option. It smells of corruption. But I wouldn't be surprised if they chose to seat half the FL and MI delegates, pledged and super, raising the nomination number to 2117. This would cut Obama's lead to 133, and he would need to win 11 more pledged delegates (out of 86) to clinch the majority. It would still be unlikely for Clinton to win the nomination, but such a solution gives her quite a bit of bargaining power.

Now I just need to figure out why her campaign isn't floating the new political math.

Delegates of Florida and Michigan

The blog 2008 Democratic Convention Watch has great graphs for 5 of the most likely scenarios for seating the Florida and Michigan delegates. 

In the fifth scenario, Clinton and Obama get pledged delegates based directly on the popular votes of those primaries, which means that Obama would get none from Michigan. In this scenario, according to DCW, the total delegate count needed to win would be 2209, and Obama would need to get 57 of 86 delegates in order to have a majority of pledged delegates. Obama's lead would shrink to 70 (from 184), and Clinton would have a much better shot at getting the nomination.

It's highly unlikely that the DNC Rules and Bylaws Committee will choose something like the fifth scenario. 

If the rules change at this point, causing Clinton to win the nomination, it's almost certain that the party will fracture. In fact, it's possible that a large portion of the Democratic Party would split off to coalesce around Obama. 

For a historical perspective, consider T. Roosevelt's Bull Moose Party. During the 1912 primary season, then President Taft won 48 delegates, and TR won 278 delegates. 258 seats remained contested until the convention.  

President Taft and his supporters controlled the RNC, which awarded Taft 235 of the contested delegates at the convention. TR took his delegates and left. The 1912 Bull Moose platform: "To destroy this invisible Government, to dissolve the unholy alliance between corrupt business and corrupt politics is the first task of the statesmanship of the day." Sound familiar?

Of course, TR lost to Wilson, but he came in second, the last third-party candidate to do so. 

For bonus points: Who seconded TR's nomination at the Bull Moose Party Convention? Jane Addams.

Continued madness

As J-P mentioned in comments to the "Mad" post, mad pride doesn't help those who have been deinstitutionalized. According to the Treatment Advocacy Center, of the 744,000 people who are homeless (according to 2005 statistics), one-third have untreated psychiatric illnesses.

TAO reports that the DOJ's 2005 data reveal that of the 2.2 million prisoners in local, state, and federal jails and prisons, approximately 10% have severe psychiatric illnesses. TAO says, "There are now more severely mentally ill individuals in the Los Angeles County Jail, Chicago's Cook County Jail, or New York's Riker's Island Jail than there are in any single psychiatric hospital in the nation." Many of these inmates committed crimes at least in part because of their mental impairments (e.g., disordered thinking, hallucination, delusions). 

We don't adequately support people with severe mental illness, many of whom refuse to admit or don't know they are sick. The process of deinstitutionalization began in the 1950s and continues, even though the number of people who need treatment is increasing.

I'm not saying that inpatient treatment is the way to go. Having been a patient in a private facility, I can only imagine what the state-run facilities are like. Even at Bridgeway, staff focused on keeping patients "calm" (or more accurately, sedated) and the facility's making money, not treating patients. That's another story for another time, though. 

What may work is assisted outpatient treatment, in which people with mental illness receive mandatory treatment but continue to live in the community. AOT laws typically provide support for finding housing and coping with tasks of daily living. Although I'm uncomfortable with the paternalistic air of AOT, it may be that we as a nation bear the responsibility for helping people with serious mental illnesses who cannot help themselves, just as we must help those who cannot afford to feed their families.

The civil rights questions surrounding AOT go right to the heart of how the government should view individuals who cannot for whatever reason abide by its laws. To what extent can individuals be required to take psychotropic medication? Should the focus be on protecting the public or rehabilitating/treating the individual? Who gets to make decisions about an adult's wellbeing, and how are those decisions made? I'm still thinking about the answers to these questions and more. Stay tuned.

Year 7

Yesterday was the culmination of a week-long celebration of our wedding anniversary. We've been married 7 years now, and marrying Sam was the best move I have ever made so far.

Mad

Yesterday, the New York Times published a somewhat fluffy article on the mad pride movement. (The link directs you to the MindFreedom website so that you can avoid having to log in to the nyt website.)

I'm not sure what to think about the idea of mad pride. Fighting the stigma associated with mental diseases is great, but convincing people that psychotropic drugs are unnecessary? Not so much. Next month's Bonkersfest (London) sounds like a lot of fun in theory, but then again, it's just not accurate to portray people with serious mental illness as zany, madcap, or eccentric but brilliant. And serious mental illness is not some kind of "mad gift," as the Icarus Project claims. (Serious mental illness as a category comprises schizophrenia and bipolar disorder.)

Mad Pride rides the line between civil rights movements (e.g., feminisms, GLBT rights) and patients rights movements. On the one hand, serious mental illness cannot be cured, only managed, and so I can see why some people would turn it into an identity. On the other hand, I have serious misgivings about putting schizophrenia and bipolar disorder in the same identity categories as race, gender, and sexual identity. And to talk about Cancer Pride is nonsensical. 

Also, my memories of being deeply depressed are still vivid, and I still don't feel quite like myself. (I might never, now that my mood is controlled.) I would catch myself smiling and feel guilty about that little bit of brightness. Now, that's fucked up. 

I don't think I could ever celebrate a disease that includes such utter despair. 

To J-P's appendix

As a former part of my friend, you could argue for more sympathy. I suppose being useless and cooped up can make an organ angry. "I wanted to be somebody!" I can hear you exclaim.

But you meddled in the anniversary plans and made J-P hurt and Melissa worried. You attacked the man who nurtured you, and that is unacceptable. 

No longer will you lurk, making dark viscera plans. You're gone. You're off the team.

Mr. Anderson's appendix, you went too far, and you got what you deserved: exile. 

To J-P and Melissa: Happy anniversary. You didn't get to NOLA, but you got through this emergency together. I wish you many more years of happiness, mutual support through times of trouble and illness, and the unremarkable but amazing connection that we all see, all the time.

Virgil's Aeneid

This is the first of two planned Aeneid posts. (The second will be devoted to Dido, the tragic queen abandoned by Aeneas.)  I've always been fascinated by Tartarus, the deepest pit of hell in Greco-Roman mythology. Virgil, Plato, and Dante, among others, wrote chilling descriptions of the terrors, and many people remember figures like Tantalus and Sysyphus.

Here's Dante's description of sinners submerged in Phlegethon, the fiery river of blood that circles Tartarus (verse translated by Mark Musa; line breaks removed for the sake of more space): 

So with this trusted escort [Nessus] we moved on along the boiling crimson river's bank, where piercing shrieks rose from boiling souls. . . . Then I saw other souls stuck in the river who had their heads and chests above the blood, and I knew the names of many who were there.

Older sources describe Tisiphone, the guardian of Tartarus. From Virgil (prose translation from W.F. Jackson Knight): "An iron tower also rose high into the air; and there sat Tisiphone, with bloody robe girt up, the never-sleeping guardian of the entrance-court by night and day." There's more, but it scares me.

I think I've found a great costume for Halloween.

Mea culpa

I was thinking this morning about the Indiana results, then about odd ideas people have about tattoos--kanji? on your back? I just don't understand--and then, because I was reading the internet, about the stupid writing mistakes people make.

Note that this entire progression of thought has to do with other people's errors. Fault-finding is not an attractive quality, and having firm ideas about style and mechanics tends to be unrewarding. I wish for a massive bullhorn to help me exclaim, "The acceptable plural forms of 'octopus' are 'octopuses' and 'octopodes.' And stop saying 'is faced by.' You can usually just say 'faces.'" The shouting would never end. Instead, I have some mental editing stamps: "purple prose," "bad comma use," "passive voice," "arrgh!" 

My critical eye turns inward, as well. I'm constantly trying to refine my style. So far, I've discovered, and struggle to change, tendencies toward overusing modifiers and relying on weak verbs. The previous paragraph contains examples of both.

So, what can I do? I can see Phlegethon from here.