Optimism about the mental health of the Iraqi people

The news service of the United Nations Office of Coordination of Humanitarian Affairs has a report out on psychological trauma among Iraqis. What Iraqis have gone through over the past 40 years rivals the suffering of any other people in the world, but overall, things actually look less bleak in terms of Iraq’s mental health than they did a few years ago.

The mental health survey numbers in the UN account are shocking if you compare them to rates in peaceful countries, but among nations that have experienced war and terrorism (e.g., Lebanon, Rwanda) they are actually relatively low. When I predicted an epidemic of PTSD a few years ago I may have underestimated some important stress buffering factors in the country: Families are close knit, religious faith is widespread, and while addiction is becoming much more prevalent, a significant portion of the population uses no alcohol or drugs at all.

The UN news report mentions the expansion of psychological therapy services in Iraq, which is a major achievement for the Iraqis and was facilitated by the support of the U.S. Substance Abuse and Mental Health Services Administration, the U.K. National Health Service and Royal College of Psychiatry and the International Medical Corps. Another critical factor has been the leadership of Dr. Salih Mahdi Motlab al-Hasnawi, who is a rare creature in the world of health policy: A national Health Minister with a specialization in psychiatry. Continue reading “Optimism about the mental health of the Iraqi people”

An Accident

Witnessing a harrowing accident, I realized that I haven’t trained in emergency first aid since Boy Scouts and my car has only a primitive medical kit. I’m going to correct these oversights. Maybe you should, too.

I witnessed a harrowing motorcycle accident yesterday on I-57 North, just south of Chicago. Two guys weaved through traffic past me, going maybe 80mph. They passed me so close that I flinched as one nearly ripped out my driver-side mirror.

One of the riders went down maybe 30 seconds later, perhaps ½ mile ahead of me. He had whipped onto the shoulder trying to pass someone on the right. Maybe he hit some leaves or some junk that ended up on the side of the road. The motorcycle was totaled and had scored quite a path along the ground and along the roadside barrier.

The rider himself was maybe 100 feet ahead, supine near the shoulder grooves. He was raising his right hand a few inches and then lowering it again. He was wearing a helmet. He didn’t look cut up, but I don’t know whether he will survive. I called 9-1-1. Right at that moment, the police arrived. Some guys pulled up too. They looked like his buddies. Distraught, they raced over to him.

I don’t know what cosmic significance can be drawn from this scene. If he survives, his helmet will deserve credit. So would decent highway safety engineering, which protected him from hitting light poles and other deadly obstacles. Many public health studies indicate that such investments are often neglected; they are much more cost-effective than typical medical interventions. I’m not sure what could have protected this young man from the testosteronic urge to drive like a maniac one fine Sunday afternoon.

A crowd of people and the police officers tended to him, waiting for the ambulance. Knowing that I had nothing to contribute, I felt funny, but I drove on.

What should one learn from witnessing tragedy befall a reckless stranger? One immediate thought came to mind. I haven’t trained in emergency first aid since Boy Scouts. My trunk contains a tiny first aid kit suitable for minor cuts and bug bites, but that would be of little value for something worse. Before this summer is out, I’m going to correct these oversights. Maybe you should, too.

Intimate dinner of crow chez O’Hare

We have an extra refrigerator in the basement, useful for its freezer and holding extra stuff for parties, leftovers after parties, and the like.  It was more useful when we had a family of four, and my wife has wondered if we wouldn’t save some electricity if we got rid of it.

I pooh-poohed this for a few months, because it is rarely opened, the basement is always fairly cool, refrigerators got much more efficient after the seventies, yada yada, but my wife has good instincts about this stuff, so I finally went into engineer mode instead of know-it-all-tech-hip-male mode and did a little actual research.  I was pretty sure any savings would not be worth the inconvenience, but we pay a lot at the margin for power in California, and Debbie at least deserved a serious response.

Oops. This page lists a LOT of old refrigerators’ energy consumption, an indicator also available for new units and in any case easily convertible to money.  When the spreadsheet cleared, after a little searching for energy star fridges, we found a unit at Sears only 10% smaller in size (plenty big) whose average annual energy use was fully 800 kwh less than the one we had.  With rebates from the power company for replacing appliances, it will cost about $300 including moving it in and taking the old one away, which means it will pay for itself in a little more than a year.  It will what??!!  Yes, in 13 months: a 90% CD, warm fuzzy green feelings, and one more lesson in humility and respect for data (I don’t need any more lessons in respect for my wife’s judgment, just practice in implementation) for yr. obdt. svt.

YMMV, ours too: maybe all that not opening the door and stuff means we will only save half what I calculated. But I don’t know of any 45% CDs, do you?  If you have a refrigerator from the 90s, you might want to check out your options.

From the cutting edge

Reiirees as a killer ap?

I don’t want to boast, but Matthew Yglesias fingers me:

In a lot of ways, I think retirees are going to prove to be the killer ap of digital content creation.

I look forward to our unstoppable rise to cultural hegemony. For one thing, the blogosphere has far too many clips of music groups we have never heard of. This will change for, e.g.:

Missing a friend, and learning from his example

Life being what it is, we overlook or take for granted so much that is special in our friends and colleagues. When a friend dies, one small consolation is the opportunity to celebrate what made him special to us. We try, in our own halting ways, to make some of the best of him live on through us. That’s the best way to honor a friend, and to be enriched by his example.

(Cross-posted with Huffington Post)

Given my profession and some unlucky life turns, I’ve had more occasion than many to mourn beautiful people close to me, or—more often—to mourn beautiful people one or two steps more distant. Aside from the routine roster of elderly relatives who died at the natural sunset of human life, I’ve known people who overdosed on drugs, died of AIDS, were victimized by violence or depression, lost an infant to SIDS.

I don’t want to overstate things. Death hasn’t touched me with the frequency it touches friends and colleagues who are street outreach workers, police officers, health care providers, or who are simply gay men of a certain generation who came of age before HAART medication. Death has touched me quite enough. When it has, I’ve often been surprised by deeply and in what ways I mourn the people I miss.

Some weeks ago, I went to dinner with my old college friend, David Kramer and a young journalist friend. After dropping her off, David and I had a serious conversation about my work, in particular two Chicago youth who had been shot. I knew of both through a violence prevention intervention I help to research. One was left paralyzed after being shot in the face by another 15-year-old in a particularly stupid crime. The other was killed accidentally by another teen in an equally stupid handgun accident.

It was not our first conversation about mortality or other serious themes. I sometimes called David to decompress as I dealt with some difficult family challenges. We would talk about some of the daily frustrations, joys, and comedy of caring for my intellectually disabled brother-in-law Vincent. I noted how shattering it was to see Vincent’ simple desire to be a man—to have a girlfriend and his own apartment, to play football, to have a cellphone–go mostly unfulfilled, David would listen to these stories and find grounds for hope and optimism, adding: “I struggle with the existential questions. Why shouldn’t he?”

David wrestled more deeply with such questions than most people. A literary scholar who raced through Princeton in three years, David headed off to Yale to study English. Yet the life of academic literary criticism was too sedate. He moved to Washington, DC, became a junior high school and community college teacher.

He was an inveterate jokester and prankster. One night during my senior year, my roommate answered the buzzer at midnight, only to see the partially-obscured figure of a Burger King delivery man with bundles in a fully-authentic uniform noting: “I’ve got an order for four whoppers, a chicken sandwich and three fries.” My roommate responded “It’s Kramer.” David asked “How could you tell it was me?” He was irate at the obvious answer: “David, anything that weird is always you.”

He brought that same sensibility to the 8th grade classroom. He once arrived at school one Halloween dressed from head to foot in a white rabbit costume, walking from the Metro trailed by a growing entourage of captivated students.

His attitude as a teacher was “By any means necessary,” as he conveyed his love of serious literature to DC kids. Few teachers have this gift. I have before me my own daughter’s term paper assignment: The rhetoric of Shakespeare’s Julius Caesar. It begins: “The rise of rhetoric in Ancient Greece was of particular concern to philosophers like Plato and Aristotle….” David would have considered that malpractice. If you were a friend who wanted to talk about Christian iconography in Moby Dick, the Death of Ivan Illich, or the linguistic vitality and drawbacks of Ebonics, he’d keep you for hours. If you were an easily bored 8th grader who had never read Shakespeare, he was equally happy to jump on his desk with a plastic sword and relate this account of love, treason, and betrayal to kids’ daily lives. Talking to David, you never forgot that literature is about living and breathing human beings.

He met and married a beautiful Caribbean woman with whom he had a daughter, Veronica, now eight years old. He pursued some wacky investment strategies that appalled me, but that somehow made a ton of money. He became a semi-retired investor, giving away much of his money to Doctors without Borders and other good causes. He had recently purchased a new house so he could spend time with his daughter.

Within a week of that last dinner, David was dead. His car was struck from behind under circumstances that are still being investigated. Veronica was remarkably poised and composed at his memorial. In the simple and direct way that children bring grace to a tragic occasion, she read a poem thanking him for countless tennis matches and Monopoly games, the surprising number of times he had taken her to street festivals and (she might have added) Tibetan human rights demonstrations.

David poured so much of his unconventional, well-lived life into the life of that little girl. My own life has been a bit different, more conventional, more driven and distracted. More time with my kids is hindered by emails marked “urgent” pinging the Blackberry. I can’t help noticing that her list of thank-you’s was longer and more specific than my own daughters could likely provide. When I’m tempted to mail it in and present the same old Powerpoint lecture slides to my students, I’ll think of David, too.

Life being what it is, we overlook or take for granted so much that is special in our friends and colleagues. When a friend dies, one small consolation is the opportunity to celebrate what made him special to us. We try, in our own halting ways, to make some of the best of him live on through us. That’s the best way to honor a friend, and to be enriched by his example.

Under the Volcano

…no, that’s not the right play; it’s Huis Clos, maybe.  I’m in London in a hotel with about ten Americans originally gathered for a conference that ended Friday.  We don’t know when we can leave, it’s a nice enough group but the only link is that we all have some connection with biofuels policy, and have been trapped by this most bizarre natural disaster that hasn’t killed anyone or even damaged any property. We have rebooked tickets for various upcoming days, but of course there’s no assurance flights won’t be cancelled again Our hosts at Imperial College have been extremely hospitable, negotiating reasonable room rates at the hotel, setting us up with a place to work, arranging a field trip to Rothamsted tomorrow.  It’s been beautiful sunny British spring weather, and there’s no risk of running out of museums and the like in London in the next, um, year, I guess. We have internet access, phone, underground and buses to get around on; except that everyone is asleep when we email them during the day, it’s a lot like being home but with no dishes to wash.

It’s a bizarre crisis, because there’s no evidence of it day to day  (apparently the supermarkets are liable to run out of vegetables and fruit that come in by air freight, but no sign of that at the Waitrose down the block yet) except that we can’t quite leave.  And being stuck in London in 2010 is very different from three or four decades ago; that Waitrose has a fabulous collection of food from all over Europe, there are good restaurants of every type, indeed the only reminder of traditional British food is the hotel breakfast.  We’re staying in South Kensington, two blocks from three world-class museums, and it seems the entire V&A has been reinstalled since I was last here, very nicely.  The worst part of it in some ways is that there’s no one to blame, though the aviation authorities are beginning to get beat up for being too cautious and constantly changing their forecasts.  It’s certainly a nightmare decision scenario for the airlines and the regulators both, as the real risk of flying is not completely clear.

Thousands and thousands of Brits were caught all over the world on school holiday week, including students and teachers, and the news stories of them trying to get home, sleeping in airports, and running out of money and clean clothes, are pretty heartrending.  The government is not covering itself with glory figuring out how to get them home; there are 50,000 of them in Madrid (for a few days, the only European airport operating) waiting for buses that were promised but apparently only available to people who fly in in coming days; everyone else is advised to “make your way to the channel ports” (that’s more than a day on a packed train).

For me and my colleagues, this has to be the cushiest, safest, lowest-risk adventure imaginable, but it is beginning to grate.

We were in a pub on Thursday night when the debate came on the TV.  No-one there paid any attention to it, but someone must have been watching, because it apparently blew the Lib-Dems up to Labor/Conservative poll levels,  like, let me see, like a volcano (do you get your completely original imagery and similes at the RBC? for sure!)  underneath them.  Exciting, but the way they run their national elections here is a scandal in a capitalist country; it’s all over in a couple of months, and the amount of commerce in advertising, polling, political consulting, punditry, dealmaking and corruption, and related thrashing about that’s left on the table by this haste  is absolutely shocking.

Ted Kennedy’s funeral: the one discordant note

It takes a touch of divine grace to upstage the President of the United States from the podium at your father’s funeral. Ted Kennedy, Jr. accomplished that rare feat with his beautiful eulogy this morning. Our hearts go out to Ted Kennedy’s family today, and to the mother of his children, too.

It takes a touch of divine grace to upstage President Obama from the pulpit at your father’s funeral. Ted Kennedy, Jr. accomplished that rare feat with his beautiful eulogy this morning.

Listening to Yo-Yo Ma, Susan Graham, and Placido Domingo perform so beautifully in that beautiful setting, enjoying the unfeigned testimonials to this warm father and great leader in the fight for social justice, my mind drifted to one discordant note: the lonely figure of Joan Kennedy.

Continue reading “Ted Kennedy’s funeral: the one discordant note”

Edward Kennedy, RIP

Edward Kennedy, self-actualizer.

Everyone will have their own memories and views, of course: here is a great one by Charles Pierce from 2003. I suppose for me, one thing that stands out about Ted Kennedy was that he could find his true calling once he had finally put away what everyone else told him he “should” do, i.e. become President of the United States. Maybe he realized by the early 80’s that he could not win, but my limited experience with politicians is that they never realize this, and need a crushing defeat to have it drilled into them. At the Presidential level, Kennedy never had that: he came close to unseating a sitting President, who then went on to a crushing defeat himself. Kennedy was the logical nominee afterwards.

But maybe once he had (finally) run, he didn’t really want to run anymore. He just wanted to be a Senator — hardly a modest ambition for most people, but practically self-effacing for a Kennedy. He didn’t want to be the hero and symbol and hope of the country — he just wanted to help working people and the less fortunate.

And he did. Others will state the record better than I can, but in the 1990’s, he was responsible for among other things, the ADA, the Civil Rights Act of 1991, health care portability, several minimum wage increases, etc. etc. This during a time, during the Gingrich Dark Ages, when it was difficult to get anything progressive done. By finally giving up what everyone else wanted for him, Kennedy could do what he wanted for himself and for others.

There is a great story from Evan Thomas’ fine biography of Robert Kennedy that is telling. It is some time in 1965, and Ted and Bobby are sitting on the floor of the Senate, listening to someone drone on and on. Though younger, Ted had seniority over his older brother, who was a freshman. Bobby, who was never patient and never really liked legislatures, finally leaned over to Ted and said, “Do we really have to sit here and listen to this?”

“Yes,” said Ted. “We do.”

Rest in peace.

Probity bites

Where’s a corrupt public official when you need one?

Georgia’s anticorruption campaign has gone too far. Only a few years ago, you couldn’t drive a hundred yards without a “traffic policeman” shaking you down. They were fired en masse shortly after the Saakashvili administration came to power. The government then took on the universities, where admissions, grades, and degrees all had price tags. By all accounts, petty corruption has been almost entirely routed out.

I’ve been caught in a vortex of bureaucratic misdirection and red tape, all because the most-recent arrival stamp in my passport is wrong (I arrived in January 2008, and my passport shows December 2008—the month wheel on the date stamper obviously was off by one click). For another document I need to show that I arrived in the last few months—and that I’m not a visitor from the future (yes, several officials have made Terminator cracks). I’ve been shuttled from one ministry to another, as they try to sort out who’s responsible and how to verify my claim. It’s not a model of efficiency, but everyone is trying to help.

In the recent, bad old days, this would’ve been easy. Slip twenty dollars to a border guard, and get a stamp that says whatever I want it to. Today, that would be unthinkable. This is an astounding cultural shift. Georgia has had a reputation for corruption that goes back centuries and, since independence, had scuttled around the bottom of the cross-country corruption ratings. Most Georgians accepted that it was part of their “mentality” (a favorite word in the post-Soviet lexicon). Not so, much to my inconvenience.

I tried waving a copy of “Economic Development Through Bureaucratic Corruption” at the border guards:

Following the procedure suggested here, however, governments would accept corruption as an aspect of their societies, and try to optimize policy-making within this framework.

But they weren’t to be swayed, saying “don’t you read Becker-Posner?”

Goodbyes

This week I returned from a memorial service for my first collaborator in arts policy research, and my second PhD advisee, to find that my most recent coauthor, on biofuels and global warming, had taken his life. It’s been a tough week, as both were friends, optimal colleagues, much too young, and respectively central to the two main areas of my research.

J. Mark Schuster had been straightarming cancer for years, so we weren’t blindsided. MIT put on a wonderful event, hundreds of people sharing recollections and appreciations of a really remarkable person who had made all our lives better, more productive, more fun, and more interesting.

Alex Farrell was a much more private person; yesterday everyone associated with the Energy and Resources Group gathered to try to make sense of it and we failed completely. The afternoon before he died he was emailing people about plug-in hybrid batteries. No-one saw it coming, no-one remembered a conversation or a hint that he was in despair or depressed about anything. It was a complete black swan: incomprehensible, unanticipated, and devastating.

Alex was only in his mid-40s and high on a steep upward professional path with no inflection point in sight: a key player in California, nationally, and internationally on the most important issue of the current era, and a model of scholarship and commitment for public officials, students, and peers. His death is not only a frightening and painful experience for everyone he worked with but also bad news for ERG, Cal, California, the nation, and the planet.

I spend almost all my time among really smart people and I take it for granted that I can learn something from any of them. We’re all pretty good at defending our positions. Arguing with Alex, however, was a higher-level experience, because while he would roll over for nothing without evidence and some good science, it was obvious that he would rather be forced to change his mind than to change yours. Working with Alex we could all feel ourselves getting better at what we did.

He was an Annapolis man whose career began as an officer in nuclear submarines, and his management style evidenced the best in the military tradition, by which I do not mean command-and-control hierarchical authority, I mean leadership and understanding that the duty of officers is to be sure their troops have what they need to figure out what would advance the mission, and to do it. I wish I could ask him for some guidance on what to do when the captain is shot off the bridge while action is underway; now we have to improvise.