So I enjoyed my first visit with the Los Angeles County psychiatrist who will be my rock as I navigate the shoals of time. She was at some pains to indicate that her function is to make a diagnosis and prescribe drugs, not to serve, even in the most casual fashion, as a therapist.
She asked me about symptoms, I responded, and she offered a truly dazzling variety of drugs, including several that I've tried in the past to either no effect or ones ranging from mildly negative to catastrophic, and several others I've never encountered in my fairly wide travels through the terrain.
She also informed me that she would under no circumstances prescribe alprazolam (generic Xanax) because it is addictive, which is true, but only if one uses it continually, at which point habituation renders it useless so what would be the point? Her preference for treating occasional anxiety is to prescribe one of several drugs that must be taken daily, forever, rather than prescribing something that can be taken only on those occasions when anxiety is present in force. She's French. C'est la vie.
Eventually she persuaded me—actually I allowed myself to be persuaded for reasons of my own—to try on one of the drugs with which I wasn't familiar. It's called 'Abilify', and it is an anti-psychotic drug originally developed to treat schizophrenia and now widely deployed in the battle against bipolar disorders.
'Abilify' sounds to me like one of those words which develop either on the street or in a Tony Robbins seminar. "What you got to do is abilify yourself, man. Abilification, you know what I'm saying? Unleash your skills upon the world." Abilify would be a verb. One shouldn't trust manufacturers who insist on naming products using inappropriate parts of speech.
Anyway, I accepted the samples and later that day, at what we euphemistically call bedtime, I ingested one. During the next eight hours, maybe two of which involved actual sleep, I experienced a panopoly of symptons that were either rare to my experience or totally beyond it, including wild dreams, linguistic mania, incoherence, uncontrollable restless movements, serious anxiety and several other symptoms that the drug was putatively designed to ease.
I awoke, to the extent that there was anything to awake from, feeling intensely irritable, irritated and, as the cherry on top, nauseous to the point that I thought I was going to throw up. Some of the symptoms persisted on and off throughout the day, but by nightfall I was more or less back to normal other than feeling the lack of sleep.
So I'm not going to abilificate any more, although I do plan to keep the drug around in the (sadly plausible) event an occasion arises when the various reactions to it might be of some use.
Saturday, May 24, 2008
Wednesday, May 14, 2008
Homeless global warming greedheads, plus "End-of-the-World Trade"
We'll refer you to Sadly, No! for the full skinny on how homeless Americans are producing greenhouse gasses at a rate twice the world average for individuals, but the short version is that one of the resident halfwits at the National Review's group blog is making the dual case that (implicitly) American derelicts are pretty well off and (explicitly) that if even the least among us are such prodigious producers of carbon dioxide, trying to trim emissions to the point that global warming can be mitigated is an exercise in futility and, perhaps more to the point, unnecessary discomfort.
In other news, a short essay in the London Review of Books delivers a quick rundown on an obscure variety of hedge insurance, otherwise known as gambling, that the author describes as the "End-of-the-World trade".
In other news, a short essay in the London Review of Books delivers a quick rundown on an obscure variety of hedge insurance, otherwise known as gambling, that the author describes as the "End-of-the-World trade".
Last November, I spent several days in the skyscrapers of Canary Wharf, in banks’ headquarters in the City and in the pale wood and glass of a hedge fund’s St James’s office trying to understand the credit crisis that had erupted over the previous four months. I became intrigued by an oddity that I came to think of as the end-of-the-world trade. The trade is the purchase of insurance against what would in effect be the failure of the modern capitalist system. It would take a cataclysm – around a third of the leading investment-grade corporations in Europe or half those in North America going bankrupt and defaulting on their debt – for the insurance to be paid out.
I asked one investment banker what might cause half of North America’s top corporations to default. No ordinary economic recession or natural disaster short of an asteroid strike could do it: no hurricane, for example, and not even ‘the big one’, a catastrophic earthquake devastating California. All he could think of was ‘a revolutionary Marxist government in Washington’. That’s not a likely scenario, yet the cost of insuring against it had shot up ten-fold. Normally one can buy $10 million of end-of-the-world insurance for between two and three thousand dollars a year. By early last November, the prices quoted were between twenty and thirty thousand, and even then it was difficult to buy in quantity – at least, said the banker, ‘not from anyone you trusted’.
Of course, the credit crisis has increased the risk of systemic economic failure. But the existence and rising price of the end-of-the-world trade indicate something beyond that. The crisis isn’t just about the bursting of the US housing bubble and dodgy sub-prime lending. Nor is it merely a reflection of the perennial cycle in which greed trumps fear to create a euphoric disregard of risk, only for fear to reassert itself as the risk becomes too great. What is revealed by the end-of-the-world trade is that the current crisis concerns the collapse of public fact.
"Public fact" is what everyone agrees to be true about the value of something. When everyone is wrong, a la Enron or Countrywide Finance, or mortgage loans in general, we get the sort of meltdown we're having now (which isn't even close to fully unfolding); public fact is in short supply, much like political integrity and other somewhat amorphous concepts. Lots of major financial players seem to be pretty sure that their counterparts are either lying about the worth of their products, or ignorant of it.
Of course the reality is that insurance against the apocalypse is one of those things without value, since no one who has to sell insurance for a living has the resources to act as a bulwark against the collapse of capitalism. Still, it's a fun read and a reminder that some people will buy any damn thing someone else can think to market.
Monday, May 12, 2008
The psychotic dwarf and other tales of displacement
I met the psychotic dwarf maybe two weeks after I landed in the Santa Monica area. This is not a simile; he was an actual dwarf and he was actually psychotic. That was at the mental health urgent care center, where I landed because never mind. The dwarf was there because his roommate had stolen his anti-psychotics, the first feedback from which was that the dwarf broke his hand on his roommate's head. When I met him he was drifting in and out of lucidity, talking about some sort of fiber optic catastrophe one minute and narrating the stolen pills saga the next.
Since then I have met many other crazy people. Not long ago at the homeless services center, a crazy person named Reuben asked me if I would be next to sit in the security guard's chair; when I told him no, I didn't want that sort of power, he poured his water bottle out at my feet and said "There's the power." And then he said "I'm a little mixed up today." Then the security guard said "Reuben, what the fuck is this?"
Reuben was also handing out cigarettes to people who hadn't even asked for one, and around here that's among the craziest things one could imagine. Reuben was having a bad day.
I have also met many fallen millionaires. The amount of money and property lost by these people has, I think, some relationship with those mysterious financial entities know as credit default swaps, which are a form of gambling that, I was told recently by someone who was not crazy or homeless, could theoretically lead to losses among banking and brokerage houses totalling some 10 times the size of the entire US economy.
"They're not regulated at all," this fellow told me. "Sometimes they're not even written down."
Reuben would have liked to put the water back in his bottle, but physics is ruthless.
At one of the free food places a few days ago, a guy—I have to mention that ages are tough to measure out here, because after a while most people begin to look a lot older than they really are—was pacing back and forth telling jokes and complaining about getting blown off by Leno and Conan O'Brien, the latter of whom he'd considered kidnapping but didn't "because it's New York." Before I began associating with California homeless people I would have said he was an old guy, maybe even of Henny Youngman's little brother vintage, but he's probably 35. For the most part homeless people in Hawaii, where I previously practiced the profession, age much better.
Anyway, he was nuts. And the jokes sucked to boot, although in fairness, I have to say his timing was pretty good.
Obama is pretty popular among my crowd. Clinton's image has been tarnished. Nate thinks she's sending out emails claiming Obama is a Muslim. In a similar vein, some other guy thinks that Ronald Reagan discovered the secret of Germany's late-WWII-era V-2s, but in his version the missiles were propeller-driven until Reagan came up with the idea of putting rocket engines on them some 40 years after the fact, a detail that remains unresolved mostly because I thought it pointless to raise the question.
James says that he's met many homeless people who adore Reagan even though they're otherwise reliably liberal and even leftist. This, in reaction to Reagan's support of the decision to abandon the long-standing policy of involuntary indefinite commitments of crazy people, although, like the V-2s, I had the impression that the emancipation of people who can't function in society predated Reagan by some years. But whatever. The loyalty is impressive.
My time here is done.
Since then I have met many other crazy people. Not long ago at the homeless services center, a crazy person named Reuben asked me if I would be next to sit in the security guard's chair; when I told him no, I didn't want that sort of power, he poured his water bottle out at my feet and said "There's the power." And then he said "I'm a little mixed up today." Then the security guard said "Reuben, what the fuck is this?"
Reuben was also handing out cigarettes to people who hadn't even asked for one, and around here that's among the craziest things one could imagine. Reuben was having a bad day.
I have also met many fallen millionaires. The amount of money and property lost by these people has, I think, some relationship with those mysterious financial entities know as credit default swaps, which are a form of gambling that, I was told recently by someone who was not crazy or homeless, could theoretically lead to losses among banking and brokerage houses totalling some 10 times the size of the entire US economy.
"They're not regulated at all," this fellow told me. "Sometimes they're not even written down."
Reuben would have liked to put the water back in his bottle, but physics is ruthless.
At one of the free food places a few days ago, a guy—I have to mention that ages are tough to measure out here, because after a while most people begin to look a lot older than they really are—was pacing back and forth telling jokes and complaining about getting blown off by Leno and Conan O'Brien, the latter of whom he'd considered kidnapping but didn't "because it's New York." Before I began associating with California homeless people I would have said he was an old guy, maybe even of Henny Youngman's little brother vintage, but he's probably 35. For the most part homeless people in Hawaii, where I previously practiced the profession, age much better.
Anyway, he was nuts. And the jokes sucked to boot, although in fairness, I have to say his timing was pretty good.
Obama is pretty popular among my crowd. Clinton's image has been tarnished. Nate thinks she's sending out emails claiming Obama is a Muslim. In a similar vein, some other guy thinks that Ronald Reagan discovered the secret of Germany's late-WWII-era V-2s, but in his version the missiles were propeller-driven until Reagan came up with the idea of putting rocket engines on them some 40 years after the fact, a detail that remains unresolved mostly because I thought it pointless to raise the question.
James says that he's met many homeless people who adore Reagan even though they're otherwise reliably liberal and even leftist. This, in reaction to Reagan's support of the decision to abandon the long-standing policy of involuntary indefinite commitments of crazy people, although, like the V-2s, I had the impression that the emancipation of people who can't function in society predated Reagan by some years. But whatever. The loyalty is impressive.
My time here is done.
In which Barack Obama cleans up among the homeless
Barack Obama is the clear choice of homeless people, at least those in the Venice and Santa Monica, CA, environs, for president. Despite polling that shows Hillary Clinton doing generally better among the backbone Democratic constituencies—blue collar workers and the poor, to the extent those are distinct groups these days—almost no one in the parks and alleys and food lines supports her other than a few who think an Obama presidency would be aimed exclusively at advancing the lot of black Americans.
Hardly anyone agrees with the official Urban Refugees position, which is that whichever Democrat wins the nomination and presumably the presidency will be so crippled by recession, interest on the national debt, the cost of Iraq and Afghanistan—where we will remain for the duration—and the inevitable burst of Democratic congressional corruption, when the party wins its near-bulletproof majority, that they'll do little to improve the lot of displaced persons even should they have the inclination, which isn't at all obvious.
Regardless the realities, though, Obama, assuming he gets the nomination, will collect virtually all the homeless votes here. That could amount to about three unless someone makes an effort to register the community and scrape them off the streets in time to get to the polls, but a demographic dominated is a demographic dominated.
In truth, the needs are so overwhelming that no traditional Democratic candidate would even dream of attempting to address them. The great majority of homeless people are in desperate need of psychiatric aid or substance abuse treatment or both, and those things are in desperately short supply.
Being homeless is mentally and physically exhausting; when you see homeless people laid out during the day, the chances are good that it's because they spent the night getting chased out of doorways, parking lots and parks, and they're attempting to catch up on their sleep. Since services for the crowd are only available during the day, many homeless people eventually give up on obtaining them because of the consuming need for sleep.
The most basic unmet need of the homeless is a home. Shelters are in short supply, and ones that can provide a bed continuously for the months or longer necessary to integrate people into rehabilitation programs of any stripe are even more rare, as is permanent, low-cost housing. Not to say that everyone is a good candidate for the services, but more often than not the ones who aren't have simply been ground down to human shells lacking the capacity to strive. Most people can handle only so much indignity, discomfort, physical strain and mental stress before sinking into semi-consciousness. Lots of homeless people smell bad because after a while the relatively simple act of locating an accessible shower requires an unsustainable effort of will.
We're talking tens of billions of dollars to eradicate homelessness. We need many more social workers and mental health professionals, along with traditional health care workers. We need many more short- and long-term shelters, and tens of thousands of permanent, low-cost housing units. In short, we need an all-out refugee assistance program like the one that should have been, but wasn't, in place after Hurricane Katrina, and we need to sustain it for decades despite the inevitable sense of intractability that will at some point take hold.
Obama shows no signs of initiating or even endorsing that sort of effort even in the absence of the political and fiscal obstacles standing in the way but his rousing rhetoric still carries the day on the streets, just as it does in high-income "liberal" enclaves and an increasing number of congressional office suites. It'd be interesting to arrange a meet and greet between the candidate and those diverse constituencies.
Hardly anyone agrees with the official Urban Refugees position, which is that whichever Democrat wins the nomination and presumably the presidency will be so crippled by recession, interest on the national debt, the cost of Iraq and Afghanistan—where we will remain for the duration—and the inevitable burst of Democratic congressional corruption, when the party wins its near-bulletproof majority, that they'll do little to improve the lot of displaced persons even should they have the inclination, which isn't at all obvious.
Regardless the realities, though, Obama, assuming he gets the nomination, will collect virtually all the homeless votes here. That could amount to about three unless someone makes an effort to register the community and scrape them off the streets in time to get to the polls, but a demographic dominated is a demographic dominated.
In truth, the needs are so overwhelming that no traditional Democratic candidate would even dream of attempting to address them. The great majority of homeless people are in desperate need of psychiatric aid or substance abuse treatment or both, and those things are in desperately short supply.
Being homeless is mentally and physically exhausting; when you see homeless people laid out during the day, the chances are good that it's because they spent the night getting chased out of doorways, parking lots and parks, and they're attempting to catch up on their sleep. Since services for the crowd are only available during the day, many homeless people eventually give up on obtaining them because of the consuming need for sleep.
The most basic unmet need of the homeless is a home. Shelters are in short supply, and ones that can provide a bed continuously for the months or longer necessary to integrate people into rehabilitation programs of any stripe are even more rare, as is permanent, low-cost housing. Not to say that everyone is a good candidate for the services, but more often than not the ones who aren't have simply been ground down to human shells lacking the capacity to strive. Most people can handle only so much indignity, discomfort, physical strain and mental stress before sinking into semi-consciousness. Lots of homeless people smell bad because after a while the relatively simple act of locating an accessible shower requires an unsustainable effort of will.
We're talking tens of billions of dollars to eradicate homelessness. We need many more social workers and mental health professionals, along with traditional health care workers. We need many more short- and long-term shelters, and tens of thousands of permanent, low-cost housing units. In short, we need an all-out refugee assistance program like the one that should have been, but wasn't, in place after Hurricane Katrina, and we need to sustain it for decades despite the inevitable sense of intractability that will at some point take hold.
Obama shows no signs of initiating or even endorsing that sort of effort even in the absence of the political and fiscal obstacles standing in the way but his rousing rhetoric still carries the day on the streets, just as it does in high-income "liberal" enclaves and an increasing number of congressional office suites. It'd be interesting to arrange a meet and greet between the candidate and those diverse constituencies.
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