Why now? Blacksburg and Montreal

Within the past 20 years, in my hometown of Montreal (Quebec), there have been three sets of shootings of college students. One took place at the Ecole Polytechnique in 1989 (affiliated with the University of Montreal), another (smaller) at Concordia University, and one recently at Dawson College. In the first attack 14 women died, in the last the toll was limited only by courage, good fortune and rapid medical care.

The Polytechnique massacre led to stricter gun control laws in Canada. I believe the weapon used in the Dawson shooting was illegal in Canada, but it is widely sold in the US.

In the US there is Columbine and now Blacksburg.

Has anything changed? If we look back at the last fifty years in North America, and we adjust for population growth, will we see intermittent episodes of these events?

I suspect modern hand held weaponry is lighter and smaller, easier to acquire (even where it is not legal), easier to operate, more affordable and more lethal than the weapons of twenty years ago. Is technology change alone responsible for any increased lethality of school shootings? Or perhaps there's no clear pattern at all.

I can't imagine any easy fixes. NPR had an excellent program on US gun control recently. The universal judgment was that the NRA has been utterly victorious. They have cleared the board and crushed the opposition. The NRA made Bush president in 2000, and America learned its lesson. No American politician will dare challenge the NRA for at least a generation. I would not encourage challengers, I know when a cause is lost. For now.

Update 4/18/07: I've been thinking about this, of course. Given Mr. Seung-hui's age, the prevalence of disease, and the history we're given, there's a reasonable chance he was schizophrenic. If so, then the most pragmatic preventive actions, given the impossibility of weapon's control in America, is to focus on the disorder of schizophrenia. Should every university professor and staff-person be required to complete a program of study in schizophrenia and major depression? Should universities focus on improved early recognition and treatment procedures, and techniques to manage the very difficult intersection of culture and psychiatric disease? Above all, we need far more knowledge of how to prevent and treat schizophrenia, and we need to know methods to divert the victims of the disease from violent paths.

Therapy for severe cognitive and behavioral disorders: A new era

Two stunning results may herald a new era in research, and even therapy, of disorders as diverse as Down's syndrome, schizophrenia, and autism:

• Be the Best You can Be: Reversing the cognitive dysfunction of Down's Syndrome
• Reversing a severe brain disorder in adult mice (murine autism)
  

A year ago I wrote about a deluge of research on autism genetics. Recent mouse models for autism and Down's syndrome are enabling radical new research directions. These models are the equivalents of the early telescopes -- radical new methods to investigate nature.

It's hard not to be carried away with this kind of discovery. We may run into the kind of dead-ends that stymied human gene therapy. If the results are confirmed, however, they will stand as Nobel-quality basic science discoveries.

More evidence of hacked wetware: the DARPP-32 gene and schizophrenia

I think humans have hacked and buggy wetware. I predict that studies underway on the frequency of autism in Ashkenazi populations will show that some of the genes underlying autism also have adaptive advantages.

In the meantime, we may be seeing this in schizophrenia: FuturePundit: Intelligence Boosting Gene Ups Schizophrenia Risk. The DARPP-32 gene provides a cognitive boost, but may also increase the risk of developing some forms of the mixed set of disorders we call "schizophrenia". This is what you see with "new" mutations that haven't been fully debugged yet.

The sooner we understand how buggy all our minds are, the sooner we'll learn wisdom, tolerance, and forgiveness.

Spindle neurons: 30 million years in Cetaceans, 15 in primates

It's not often that a research results gives me goosebumps. This one did, since I'd completely missed that spindle neurons had previously been identified in the toothed whales (how the heck did I miss that?!). Emphases mine.

Humpback whale found to have 'human' brain cell - World - Times Online

Researchers in the US have discovered that humpback whales have a type of brain cell seen only in humans, the great apes, and other cetaceans such as dolphins.

Studying the brains of humpbacks, Patrick Hof and Estel Van der Gucht of the Department of Neuroscience at Mount Sinai School of Medicine in New York discovered a type of cell known as a spindle neuron in the cortex, in areas comparable to where they are seen in humans and great apes.

Although the function of spindle neurons is not well understood, they may be involved in processes of cognition - learning, remembering and recognising the world around oneself. The cells are also thought by some to be affected by Alzheimer’s disease and other debilitating brain disorders such as autism and schizophrenia.

The findings may help to explain some of the distinctive traits exhibited by whales, such as sophisticated communication skills, the ability to form alliances and co-operate, the researchers report in The Anatomical Record.

They say their study may subsequently indicate that such whales are more intelligent than they have been given credit for, and suggests that spindle neurons – the likely basis for complex brains - either evolved more than once, or have gone unused by most species of animals, kept only in those with the largest brains.

.... the spindle neurons found in humpback whales were discovered in the same location as toothed whales, suggesting that the cells may be related to brain size, reported Reuters.

Toothed whales, such as orcas, are generally considered more intelligent than baleen whales such as humpbacks and blue whales, which filter water for their food.

The humpback whales also had structures resembling 'islands' in the cerebral cortex, also seen in some other mammals and which may have evolved in order to promote fast and efficient communication between neurons.

Spindle neurons are thought to have first appeared in the common ancestor of hominids, humans and great apes about 15 million years ago, the researchers added. In cetaceans they would have evolved earlier, possibly as early as 30 million years ago."

So many questions. What the heck could convergent evolution produce the same neuronal structure in both cetaceans and primates? Is there only one high-probability path to [whatever] from our ancient common ancestor? What does it mean to have 30 million years of evolution working on these structures rather than a mere 15 million? How the heck did I miss the discovery of spindle neurons in toothed whales in 2000?

One prediction. If we retain a liberal civilization (vs., say, Putin's Russia), creatures with these neural structures will have "human" rights within seventy years.

PS. My guess on why I missed this? The original discoveries of spindle neurons in dolphins may have predated theories of their unique role in human cognition -- so it didn't get much media coverage.

Update 11/27/06: More memories filtering in. I think dolphins pass the "mirror test". That is, they recognize that the image in a mirror is connected with them. I believe it was recently discovered that elephants also pass this test. I think cetaceans and hippos are related, more distant to elephants. I also dimly think there's some connection between the "mirror test" and "spindle neurons". So will we find elephants have spindle neurons?

DeLong, Mankiw and the Problem of the Weak

DeLong explores the dark side of Mankiw, the probability that this very bright man has confused the Market with the Good:

Brad DeLong's Semi-Daily Journal: Dysfunctional Behavior

.... In Michael Barone's view--and could it be in Greg Mankiw's too?--poverty in America is not something to be worried or concerned about because the poor deserve to be poor. The poverty of the poor is a just outcome. Poverty is, Michael Barone says, 'not... any structural failure of society.' Instead, poverty comes 'from dysfunctional behaviors.'...

but DeLong's blade then goes astray

...The point that it is a structural failure of society if (some) dysfunctional behaviors by parents trap their children in poverty seems to whiz by both Barone and Greg without penetrating.

Alas, my reply is swamped in a deluge of likewise misdirected comments (revised version below):

... Brad, you almost had it, but you slipped badly when you wrote "The point that it is a structural failure of society if (some) dysfunctional behaviors by parents trap their children in poverty seems to whiz by both Barone and Greg without penetrating."

Ahh. Would that all outcomes and all poverty could be cured by better parenting. Do you believe schizophrenia is due to bad parenting? Mental retardation? Austism? ODD? ADHD? Cerebral palsy?

Or, for that matter, a 10th percentile IQ? There is limited evidence that IQ can be influenced significantly after a child is born. (Test scores can be increased by practice and motivation/confidence however.)

Alas, "better parenting" is a false answer, and it has trapped you. The truth is that some children are dealt four aces, some a mixed hand, and some nothing at all. Look not for justice in this world.

So then what should a society do for The Weak, The Losers, those who finish last? Shall they fester beyond the gates?

It is the Problem of the Weak that divides the dwindling number of true Christians from evangelical Yahwhites, and that divides people like me from Republicans, Fundamentalists (Weakness and Suffering is a sign of God's displeasure) and Libertarians alike ...

Schizophrenia is "hot". Why now?

Schizophrenia is in the news. In the past week USA Today devoted much of their front section to this family of neurologic disorders, the Wall Street Journal featured an article on schizophrenia in the prison systems on their front page, and this morning NPR did a book interview with the parents of a schizophrenic adult.

Why now? This is not a new disorder. As measured by any reasonable combination of cumulative suffering, anguish, economic burden and prevalence schizophrenia is the worst affliction of the post-industrial world. And yet, it's been relatively ignored. Why should that change now?

The answer, my friend, is blowing in the wind. It's the boomers.

Schizophrenia is usually recognized around age 20. It's a disease that, unlike MS or breast cancer, silences its victims. Only parents can write about it and campaign against it.

The median boomer was born in 1955. She had her first child in 1983. That child was diagnosed with schizophrenia in 2003. By 2005 he was running into legal problems. Now she's writing about her son.

We can all wish that schizophrenia had been "public enemy number one" 10 years ago. No matter, now is the time. This is one issue on which a beleagured and widely despised president could win a few friends. Bush should declare war on schizophrenia. It's one of the few good things he can still do.

Neuregulin: Monster gene of madness

Neuregulin is a massive and complex gene that produces six proteins in the brain. Protein four is found to be over-expressed in some schizophrenic patients, possibly due to a point mutation in a regulatory gene.

Schizophrenia as Misstep by Giant Gene - New York Times

... Neuregulin is one of about 10 genes so far linked to schizophrenia ... It is one of the largest genes in the human genome, sprawling over some 1,125,000 units of DNA, and it generates at least six types of protein ...

... the variant stretch of DNA ... linked to schizophrenia does not lie in the neuregulin gene itself but just upstream of it, meaning that it presumably affects not the actual proteins produced by the gene but the way the gene is controlled.

... the first component of the transcript that makes the Type 4 proteins lies at the very beginning of the neuregulin gene and closest to the upstream genetic segment that is statistically linked to schizophrenia.

The researchers found that people who inherited two versions of the variant segment, one from each parent, were producing 50 percent more of neuregulin's Type 4 protein than those who inherited one or no copies.

... The role of neuregulin's Type 4 proteins is unknown, but they may be involved in making neurons migrate, a property of great importance when the brain is being constructed.

Dr. Law said that the variant segment linked to schizophrenia had a single DNA unit change at the center of one of the binding sites recognized by the transcription factors that control the gene. Loss of the binding site presumably upsets the regulation of the gene, causing too much of the Type 4 protein to be generated, she said.

Having slightly more than usual of a single protein may seem a very subtle derangement for so devastating a disease, but subtlety is to be expected, Dr. Weinberger said. "We know that all mental illnesses are about very subtle aspects of the wiring biases. They are about how you process complicated environmental stimuli, not about how you walk down the street.

It's extremely difficult to make a functioning brain. Autism, schizophrenia, mental retardation, all are felt to be related to possibly minor defects in brain development. Given how hard it is to make the brain work "out of the box", I'd bet there are a vast array of corrective processes that take place until the brain matures -- at age 25 or so in men, earlier in women. Some of the disorders we see may represent partial failures, and partial successes, of repair processes. (ie. sacrificing the mirror neuron network to support the primary neuron network ...)

Parasite and master

I'm addicted to these stories of parasites controlling their hosts. Were we less fussy when we carried worms? Is OCD (obsessive compulsive disorder) an adaptive response to the lassitude and carelessness worms create? (In other words, OCD is the disorder that emerges when the worms are gone, when the worms are present the same neurologic structures counteract the worm effect).

The big focus now is on Toxoplasma. How does this lovely litte brain infesting critter change our behavior? What's the curious relationship to some schizophrenia-like conditions? Carl Zimmer, one of our best science writers, summarizes the stor to date: The Return of the Puppet Masters.

Parasites are cool.

Schizophrenia and the increased attractiveness of the non-conformist

Why is schizophrenia so common? It's a terrible disease, yet it's quite prevalent. Why hasn't evolution selected against it? How can schizophrenia have any adaptive advantages?

A single small and probably unreliable study claims a correlation between schizophrenic traits, being "non-conformist", (they say "creative", but they aren't talking about inventors and scientists) and have more sexual partners. The implication is that a mild dose of schizophrenia is good for one's mating opportunities, and that's enough of an advantage to keep the genes around in the population -- even when a full dose is horrible.

Science & Technology at Scientific American.com: Creativity Linked to Sexual Success and Schizophrenia

Psychologist Daniel Nettle of the University of Newcastle upon Tyne in England and his colleagues recruited 425 British men and women through advertisements in a small town newsletter and specialty lists for creative types. The researchers surveyed this group with questions designed to measure various schizophrenic behaviors, artistic output and sexual success, among other aspects of their personal history.

Results of that survey showed that people who displayed strong evidence of "unusual experiences" and "impulsive non-conformity"--two broad types of schizophrenic behavior--had more sexual partners than their peers did and were more likely to be involved in artistic pursuits, either professionally or as a hobby. Those who professionally pursued the arts had the highest average number of partners--5.5--compared to just over four for the less creative study participants.

... the finding, published yesterday in the Proceedings of the Royal Society (B), offers some insights into why schizophrenia, which seems to be passed from generation to generation and affects roughly 1 percent of people, does not disappear from the general population. In the study, even non-creative types who revealed an urge to resist conformity had more sexual success. In short, some of the traits associated with the debilitating mental illness can actually increase a person’s desirability...

There's something about this story that reminds me of how parasites spread themselves by altering their host's behavior. Could one think of a schizophrenia gene as a parasite that spread itself for altering host behaviors? Probably not, but it's a funny similarity.

The study is pretty slender stuff, but one can imagine several ways in which "non-conformity" might be adaptive -- even beyond more sex partners. It would be interesting if schizophrenia were the price we pay for keeping some non-conformists around...

Visiting the first church of scientology and Hubbard's offices

When I was a youngling wandering southern california eons ago, one of my hobbies was visiting cults. From old photographs I can see I had a rather innocent and even vulnerable looking face, and cultists were always keen to recruit me. I found them quite fascinating, and over time I became familiar with the "marks" (troubled and lost youth typically), the true believers ("marks" who've joined up) and the handlers (those one level above the believers). I even met a few of the "operators" -- those who are in the cult for power or perks, not for belief. The latter were quite good at spotting my true nature, and would quickly turf me back to the street (my face was misleading).

Nowadays, 25 years later, I fear I no longer have a face that appeals to cultists. Fortunately a friend of mine, no younger than I, still does. So it came that he and I enjoyed a tour of the very first church of Scientology in Washington DC (1701 20th Street NW), and then took a unique guided tour of the unmarked building that was Scientology's first headquarters, around the block at 1812 19th Street Nw, Washington, DC 20009. This latter building is not marked in any way. I believe it is usually visited by Scientologists, but for some reason we were invited. Our hosts were gracious and personable, though I suspect that one of them (quite senior in the church) suspected my true nature. We did not deceive them and admitted to being physicians, but we were very quick to (honestly) state that we were not psychiatrists. In Scientology's doctrine psychiatrists are the closest thing to Satan, and while our guests might tolerate heretics Satan himself would be too much. It probably helped that both of us now work in health care software companies and no longer see patients.

My friend did tell an earlier younger host that we had, of course, often treated patietns with psychiatric medications, but fortunately she appeared not to hear.

So it is that I read of Hubbard's life, or at least the sanctified version thereof. It was a fascinating life. A brilliant, romantic, and precocious youth, a restless wanderer and adventurer, a college drop-out who churned out reams of pulp fiction (science fiction, adventure fiction, even romances -- all under varied pseudonyms). I could see many of the books in his offices and scan some of his 1950s writings (which were more direct and clear than his later writing). [Update 3/06: Alas, it's a life more fictional than I'd thought. Did Hubbard know what was fact and what was imagination? See more below.]

I think I could also tell when he developed what I'd guess was his schizophrenia-like disorder, his unusual thinking patterns [1] about about age 20 -- a very typical age of onset.

There were many fascinating aspects of the tour. Despite the name of the church, there were no science texts in Hubbard's collection -- nothing on biology, geology, medicine, physics, astronomy, chemistry, electricity, etc. He evidently read history, a bit of philosophy, science fiction and mystical stories -- but not science. Most curiously he had a copy of one of Freud's popular books on psychoanalysis; not marked with any bloody ink and mixed in with his other texts. Nowhere was there mention or reference to any women in his life other than his mother.

There's a remarkable series of 'e-machines', and a fascinating letter mentioning that the first e-machine was the descendant of 40 preceding years of research in psychogalvanometry (there are no Google links to that term, and only a handful of obscure links to the 'psychogalvanometer'. I am amazed there's not more on what was apparently a fad from 1910 to 1950).

Reading the books and literature a few themes emerge, which I think capture the flavor of Hubbard's mind. First and foremost there's his well known hatred of psychiatrists. He refers to the German (psychology), the Viennese (psychoanalysis) and the Russian (psychiatry - most foul). The intensity of his hatred may have some delusional qualities, but he lived in the era of Soviet dissidents imprisoned in psych facilities, frontal lobotomies, etc. The connection he made between the Soviets and psychiatry is particularly interesting.

Throughout his life he revisits themes that have, to someone who's cared for schizophrenic patients, a familiar feeling. He believed that Niacin was a good treatment for substance abuse and radiation poisoning, apparently because it induced facial flushing that he connected with sauna-induced vasodilation. His early books focus on radiation exposure, cellular memory (single-celled organisms 'learn' and pass their learning on to their descendants), and multiple lives. There's some suggestion of an antipathy to Christianity but a sympathy for Buddism; yet the newer Scientology churches display a modified Christian cross.

I was most interested in his use of language, and in his concerns about the meaning of words (shades of his science fiction colleague AE Van Vogt, who later signed up with scientology). His use of 'flub' for "error" is characteristic. He seemed very bothered by words having multiple meanings, and preferred that a word have only a single precise meaning. A children's book on learning makes a somewhat odd transition from a general discussion on learning styles to an perseverant discussion of the dangers of words that could be misunderstood. His concern with the meaning of words, and with the power of words to cause physical harm or effects, has a magical and tortured quality. It is ironic in a man who was a stupendously prolific writer and typist (90 words a minute!).

It is a fascinating tour of an increasingly powerful church (or cult -- a nascent religion). I can believe they easily have 300,000 members, and if each contributes $5,000/year (courses and contributions) that's a tax-exempt cash flow of $1.5 billion/year. Enough money to buy many US senators and politicians. Impressive!

It will be very interesting to see how Scientology evolves.

Update 10/27:

[1] The more I thought about Hubbard's mental status, the less ready I am to give him a label as "simple" as "schitzophreniform disorder". Given his extraordinary bursts of productivity, I could as easily and as amateurishly "label" him as "mania with delusional components". There is clearly something odd about his fixed beliefs and obsessions, and particularly his themes of struggles with the "unconscious" and his focus on words and their slippery meanings. I get the impression of someone fighting to master a mind coming apart, and ending in some odd truce that worked quite well the rest of his life.

I'm not confident, however, that even a professional psychiatrist would know quite how to categorize Hubbard in our current ill-defined taxonomies of psychiatric disorders. It would be very interesting to know more about Hubbard's family history, and whether any particular disorders were prevalent in his parents, cousins, etc.

As my friend noted, the relationship between the delusional disorders, religiosity, and the propensity to create religions is complex, interesting, and intensely controversial.

Update 3/2/06: Rolling Stone has a wonderful story on Scientology. It adds a bit of detail to his biography (note- I went to Caltech):

... After the war, Hubbard made his way to Pasadena, California, a scientific boomtown of the 1940s, where he met John Whiteside Parsons, a society figure and a founder of CalTech's Jet Propulsion Laboratory. A sci-fi buff, Parsons was also a follower of the English occultist Aleister Crowley. Parsons befriended Hubbard and invited him to move onto his estate. In one of the stranger chapters in Hubbard's life, recorded in detail by several biographers, the soon-to-be founder of Dianetics became Parsons' assistant -- helping him with a variety of black-magic and sex rituals, including one in which Parsons attempted to conjure a literal "whore of Babalon [sic]," with Hubbard serving as apprentice.

Charming and charismatic, Hubbard succeeded in wooing away Parsons' mistress, Sara Northrup, whom he would later marry. Soon afterward, he fell out with Parsons over a business venture...

Wow. I bet JPL doesn't put that bit in their official history.

Update 5/14/07: While tagging my scientology posts I came across this unpublished 2005 reference to a CT article on L Ron's creative biography. It reminded of Kim Jong-il's equally momentous list of achievements. I suspect the resemblance is not coincidental.

Very disappointing news on schizophrenia

Study Finds Little Advantage in New Schizophrenia Drugs - New York Times

The article might have been titled - no great meds for schizophrenia:

The study, which looked at four new-generation drugs, called atypical antipsychotics, and one older drug, found that all five blunted the symptoms of schizophrenia, a disabling disorder that affects three million Americans. But almost three-quarters of the patients who participated stopped taking the drugs they were on because of discomfort or specific side effects.

I suspect the 75% discontinuation rate is similar in older meds.

I'm disappointed. I was still seeing patients when the first of these meds came out, and I was very pleased with the benefits some of my schizophrenic patients seemed to receive.

We desperately need more basic science and clinical research in the treatment and management of schizophrenia -- one of the most terrible of all diseases.

Dianetics and Scientology: Lessons for the treatment of paranoid schizophrenia?

Salon.com Books | Stranger than fiction

I've not read many reviews of Dianetics. This one is interesting ...

In a way, it's impressive. Hubbard not only managed to get one of these books published, it actually became a bestseller and the founding text for Scientology. It's not your garden-variety crank who can take a crackpot rant, turn it into a creepy gazillion-dollar church with the scariest lawyers around, and set himself up as the 'Commodore' of a small fleet of ships, waited on hand and foot by teenage girls in white hot pants. But, I digress.

... Not only does "Dianetics" offer precious little sideshow appeal, it's impossible to read much of it without realizing that it's the work of a very disturbed man. (Here's where things get less entertaining.) Hubbard's grandiose preoccupation with "an answer to the goal of all thought," the reiteration of fantasies of perfect mastery foiled by invasive, alien forces (engrams are described as "parasites"), the determination to envision the mind as a machine that can be brought under absolute control if only these enemies can be ejected -- all these are classic forms of paranoid thinking. The alarm bells really start to ring when Hubbard describes colorblindness as caused by a "circuit" in a person's mind that "behaves as though it were someone or something separate from him and that either talks to him or goes into action of its own accord, and may even, if severe enough, take control of him while it operates...

The subsequent description of Hubbard as a high-functioning paranoid schizophrenic is persuasive; it includes a description of what seems to have been one of his core delusional complexes having to do with abortion and domestic abuse. If Hubbard were paranoid schizophrenic this would also account for his suspicion of physicians and hatred of psychiatrists.

I've long wondered about the natural history of paranoid schizophrenia and its relationship to religion. Hubbard's story adds an interesting angle. We are far from understanding what paranoid schizophrenia is, how it can be avoided or mitigated, and what the natural history of the condition is from age 20 to 40 and beyond.

I wonder if some of the methods Hubbard teaches in Dianetics (later incorporated into Scientology's "Thetan" retraining programs) reflect techniques Hubbard developed to manage his own psychiatric disorder. If so, could we translate them into evidence-based testable therapeutic techniques?

It would be a great irony if L Ron Hubbard, a passionate hatred of psychiatry, were to teach us valuable lessons in the management of one of the most terrible of human disorders -- schizophrenia.

The Lefkow murders, mental illness, and jumping to conclusions

ABC News: Man Claims to Have Slain Judge's Family

Judge Lefkow's husband and mother were murdered by a mentally ill man unrelated to the neo-Nazi groups that had threatened her in the past.

I give credit to the police and commentators for not jumping to conclusions about the neo-Nazi connection. The articles I read, in newspapers and blogs, were generally fairly cautious. Hale and his kin were obvious suspects, but both the police and the commentators were clear that there were many possible alternatives.

I haven't seen, however, much discussion of the mental illness aspects of this case. Bart Ross sued his care providers because of what sounds like some fixed beliefs (delusions) about his care. He lived alone and had few social contacts. His suicide note suggests a very troubled and guilt-racked person, not the typical sociopath.

I hope the mainstream newspapers will delve into the deeper story, the important story. Was Bart Ross paranoid schizophrenic, perhaps with some superimposed dementia? What kind of care did he receive for his illness? What is the best way to care for mentally ill adults, particularly paranoid schizophrenics?

Paranoid schizophrenia is a terrible disease that inflicts great suffering on both ill persons and their families. It's also associated with violent and irrational acts. We need to understand it much better, and we need to treat it far, far better than we do. The mainstream newspapers feel neglected and unwanted these days, but this is the kind of story they can and should do well. Perhaps Judge Lefkow, once she has time to grieve, will use her story to avert future tragedies.

The Kennedy Curse? Perhaps not all curses are mythical.

NEWS.com.au | Hidden Kennedy delivered from curse (January 10, 2005)

Rosemary Kennedy wasn't brilliant. I gather, from the limited description in this story, that she might have had an average to slightly below average IQ with some focal cognitive defects and learning disabilities.[1]

She was a disappointment to her ambitious father.

At the age of 23, in 1941, her father, Joseph Kennedy, had her lobotomized -- allegedly on the advice of one or more physicians. She spent the rest of her life in an institution. Over the next 40 years all of Joseph's children, save Rosemary, died a violent death.

I knew of Rosemary, I didn't know the story of her lobotomy.

This is a tale worthy of Shakespeare. At this point in my life I don't follow the theater, but a robot could write a play around this tale. Was Joseph Kennedy a complete monster, or only a very flawed human being? Did those physicians really recommend a lobotomy? What was their relationship to the American Eugenics movement, which flourished from 1905 to 1940? What happened to them afterwards? Did they ever face a sort of justice?

Josephy Kennedy suffered for his crimes. Was his suffering just? Even for his crimes, the punishments seem excessive.

[1] Caveat: It would not be surprising, given her age, if in fact Rosemary's true disability was the onset of schizophrenia. That would also better explain the recommendation for lobotomy, in the 1940s all manner of psychosurgery was being misapplied to schizophrenia. It would be typical of the media and many writers to confuse congnitive disabilities with schizophrenia.

The Brave New World of Psychic Reengineering and Robotic Monkeys: Be Afraid?

Brain's Reward Circuitry Revealed in Procrastinating Primates

Using a new molecular genetic technique, scientists have turned procrastinating primates into workaholics by temporarily suppressing a gene in a brain circuit involved in reward learning. Without the gene, the monkeys lost their sense of balance between reward and the work required to get it, say researchers at the NIH's National Institute of Mental Health (NIMH).

"The gene makes a receptor for a key brain messenger chemical, dopamine," explained Barry Richmond, M.D., NIMH Laboratory of Neuropsychology. "The gene knockdown triggered a remarkable transformation in the simian work ethic. Like many of us, monkeys normally slack off initially in working toward a distant goal. They work more efficiently—make fewer errors—as they get closer to being rewarded. But without the dopamine receptor, they consistently stayed on-task and made few errors, because they could no longer learn to use visual cues to predict how their work was going to get them a reward."

Richmond, Zheng Liu, Ph.D., Edward Ginns, M.D., and colleagues, report on their findings in the August 17, 2004 Proceedings of the National Academy of Sciences, published online the week of August 9th.

Richmond's team trained monkeys to release a lever when a spot on a computer screen turned from red to green. The animals knew they had performed the task correctly when the spot turned blue. A visual cue-a gray bar on the screen-got brighter as they progressed through a succession of trials required to get a juice treat. Though never punished, the monkeys couldn't graduate to the next level until they had successfully completed the current trial.

As in a previous study using the same task, the monkeys made progressively fewer errors with each trial as the reward approached, with the fewest occurring during the rewarded trial. Previous studies had also traced the monkeys' ability to associate the visual cues with the reward to the rhinal cortex, which is rich in dopamine. There was also reason to suspect that the dopamine D2 receptor in this area might be critical for reward learning. To find out, the researchers needed a way to temporarily knock it out of action.

Molecular geneticist Ginns, who recently moved from NIMH to the University of Massachusetts, adapted an approach originally used in mice. He fashioned an agent (DNA antisense expression construct) that, when injected directly into the rhinal cortex of four trained monkeys, spawned a kind of decoy molecule which tricked cells there into turning-off D2 expression for several weeks. This depleted the area of D2 receptors, impairing the monkeys' reward learning. For a few months, the monkeys were unable to associate the visual cues with the workload—to learn how many trials needed to be completed to get the reward.

"The monkeys became extreme workaholics, as evidenced by a sustained low rate of errors in performing the experimental task, irrespective of how distant the reward might be," said Richmond. "This was conspicuously out-of-character for these animals. Like people, they tend to procrastinate when they know they will have to do more work before getting a reward."

To make sure that it was, indeed, the lack of D2 receptors that was causing the observed effect, the researchers played a similar recombinant decoy trick targeted at the gene that codes for receptors for another neurotransmitter abundant in the rhinal cortex: NMDA (N-methlD-aspartate). Three monkeys lacking the NMDA receptor in the rhinal cortex showed no impairment in reward learning, confirming that the D2 [jf: rhinal cortex] receptor is critical for learning that cues are related to reward prediction. The researchers also confirmed that the DNA treatments actually affected the targeted receptors by measuring receptor binding following the intervention in two other monkeys' brains.

"This new technique permits researchers to, in effect, measure the effects of a long-term, yet reversible, lesion of a single molecular mechanism," said Richmond. "This could lead to important discoveries that impact public health. In this case, it's worth noting that the ability to associate work with reward is disturbed in mental disorders, including schizophrenia, mood disorders and obsessive-compulsive disorder, so our finding of the pivotal role played by this gene and circuit may be of clinical interest," suggested Richmond.

"For example, people who are depressed often feel nothing is worth the work. People with OCD work incessantly; even when they get rewarded they feel they must repeat the task. In mania, people will work feverishly for rewards that aren't worth the trouble to most of us."

---

Be afraid. Fundamentally, we are monkeys. This is psychic engineering on a new scale -- beyond current psychopharmacology and deep brain implants.

Also, if you have a family member suffering from severe psychiatric disorders -- be hopeful. This is a true breakthrough.

This NIH release shows that the effect is more subtle than the mass media are portraying. The intervention specifically blocked visual learning, it's not clear that it changed the Monkey's "character" so much as it changed their ability to interpret the visual input their cortex was receiving.

At a deeper level, if one sets aside the question of souls, the concept of "free will" is obviously a convenient and important fiction. This kind of research is making it harder to sustain that fiction. Somewhere in the next 10 years popular culture will recognize that, unless one posits a supernatural ingredient (eg. souls), "free will" and "responsibility" are clearly unsustainable concepts -- but they remain fundamental to our social structures.

Alvin Toffler is spinning in his grave and Huxley is looking down (up?) with a grimly satisfied expression.

Lurching towards wisdom: neurodiversity and the morality of abnormality

The New York Times > Week in Review > Neurodiversity Forever: The Disability Movement Turns to Brains

Although the text of this article is reasonably respectful, there's scornfulness in the titles, subtitles, and surrounding text. That's not surprising. This logic leads to some directions that will be challenging for most of humanity.

NEURODIVERSITY FOREVER
The Disability Movement Turns to Brains
By AMY HARMON

No sooner was Peter Alan Harper, 53, given the diagnosis of attention deficit disorder last year than some of his family members began rolling their eyes.

To him, the diagnosis explained the sense of disorganization that caused him to lose track of projects and kept him from completing even minor personal chores like reading his mail. But to others, said Mr. Harper, a retired journalist in Manhattan, it seems like one more excuse for his inability to "take care of business."...

But in a new kind of disabilities movement, many of those who deviate from the shrinking subset of neurologically "normal" want tolerance, not just of their diagnoses, but of their behavioral quirks. They say brain differences, like body differences, should be embraced, and argue for an acceptance of "neurodiversity."

And as psychiatrists and neurologists uncover an ever-wider variety of brain wiring, the norm, many agree, may increasingly be deviance.

... Science is beginning to clear up such questions, said Dr. Antonio Damasio, a neurologist at the University of Iowa Medical Center, by identifying distinct brain patterns and connecting them to behavior. But, he added, only society can decide whether to accommodate the differences.

"What all of our efforts in neuroscience are demonstrating is that you have many peculiar ways of arranging a human brain and there are all sorts of varieties of creative, successful human beings," Dr. Damasio said. "For a while it is going to be a rather relentless process as there are more and more discoveries of people that have something that could be called a defect and yet have immense talents in one way or another."

For example, when adults with A.D.D. look at the word "yellow" written in blue and are asked what the color is and then what the word is, they use an entirely different part of the brain than a normal adult. And when people with Asperger's look at faces, they use a part of the brain typically engaged when looking at objects.

... For patients, being given a name and a biological basis for their difficulties represents a shift from a "moral diagnosis" that centers on shame, to a medical one, said Dr. Ratey, who is the author of "Shadow Syndromes," which argues that virtually all people have brain differences they need to be aware of to help guide them through life...

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In the 1970s, if not earlier, psychiatrists, noting how common "neuroses" were, introduced the idea that perhaps "normal" was a statistical concept (which it is) rather than a categorization. Now we're studying neurophysiology and rediscovering the same idea.

It will take some time for this meme to propagate. Once upon a time Leprosy was a "moral diagnosis" -- the physical expression of depravity. In a just universe only the evil could be so accursed; the alternative was the acceptance of the universe as fundamentally "unjust" -- not a palatable prospect. In the 20th century we struggled to reframe schizophrenia as a disorder rather than a sin. In the 21st century will we one day see sociopaths and pedophiles as disabled?

Physicians, especially internists, who've grown up with the idea of critical diagnostic categories, will have a hard time getting their heads around a continuum of traits with variable degrees of adaptive advantage. This article falls into a similar trap by using the language of "disability". In truth disability is only meaningful in relation to environment. A blind person is disabled in the light, but may be more than able in darkness (relative to most sighted persons). A bit of autism may be a competitive advantage for an electrical engineer. Many writers are easily distracted, flitting from idea to idea. Schizophrenia is probably maladaptive in any conceivable environment, but I suspect the related genes are adaptive in some settings (Shamans and Saints?).

Some readers will intuitively recognize a slippery slope. The more we connect genetics and physiology to behavior, the more we struggle to redefine the closely related concepts of "free will" and "responsibility", and the more we would question our approaches to child rearing, "justice", and punishment. There are already some of us who think "responsibility", like "race", is a social rather than fundamental construction.

Alternatively, if one believes in souls, such research bounds or constrains that which is explained outside the soul; it narrows the range of unique "soulhood".

On the other hand, wisdom is perhaps the art of knowing oneself truly, and then applying one's strengths, friends, family and community to balancing internal weaknesses with internal and external strengths. Those of us who are prone to distraction learn to "work the plan" and "plan the day", we keep task lists and review tactics and strategies. Those who focus relentlessly keep few lists, but ought to set aside time to force exploration of new domains -- less they grow stale and dull.

Lastly, I have long felt that the human brain is a rather feeble construct; a patchwork of hacks and artifacts that barely sustains a shoddy sort of consciousness. If we begin to tweak the hacks, to refactor the cruftiest code, we may produce a qualitatively different entity.

Poverty in America

Number of People Living in Poverty in U.S. Increases Again

Poverty rose and income levels declined in 2002 for the second straight year as the nation's economy continued struggling after the first recession in a decade, the Census Bureau reported Friday.

The poverty rate was 12.1 percent last year, up from 11.7 percent in 2001. Nearly 34.6 million people lived in poverty, about 1.7 million more than the previous year....

... The poverty threshold differs by the size and makeup of a household. For instance, a person under 65 living alone in 2002 was considered in poverty if income was $9,359 or less; for a household of three including one child, it was $14,480.

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So 12% of Americans are very, very poor. Another very large chunk lives pretty close to the edge. That's a lot of very poor people. The article didn't provide many references, but I suspect the poverty rate is still lower than in the early to mid 1990s. The problem is next year, and the fundamental causes of poverty in the United States.

First -- next year. Other administrations have targeted recessional fiscal stimuli to help low income families directly. The Bush administration fiscal stimuli is considered by most economists to be extremely inefficient in terms of near term support for low income Americans. I think we should all be worried about what next year's numbers will look like. Will we give up all the progress of the 90s?

Then there are the fundamentals. The world in which we live is increasingly demanding in a classically Darwinian fashion. Rewards go to the elite -- those gifted by genetics, environment, experience, and inheritance. The non-elite lose out. They become poor, and their children become poor. At the bottom of the heap are the 8-10% of all humans who have serious psychiatric disorders (schizophrenia, bipolar disorder), low IQs (in theory half the population has an IQ < 100, but in practice I think it's about 30% are less than 100), or bad luck (such as parents with the above, or just plain bad luck).

In a real sense, a lot of humanity that was "able" in the 19th century would be, practically speaking, "disabled" today. Someone with a good temperament and an IQ of 90 could be a well regarded laborer or farm worker in 1942; in 2003 I think they'd be out of luck. That's a lot of people.

Of course the Bush administration, and many Republicans and religious conservatives, seem to consider prosperity as a sign of God's favor. So non-elite status is a mark of God's disfavor. Who's to argue with God? If that's what you believe, then you may believe that the poor are best left to fester in quiet. (Except eventually they join Al-Qaeda II, but that's another story.)

If, on the other hand, one has a wee bit more compassion and understanding (and a desire for self-preservation?), then it's time to rethink approaches to hard core poverty -- and all those folks who live on the edge of the precipice. Maybe the high disability rates in Nordic countries need to be examined with a slighly different perspective. If the market solution to 21st century disability is unpalatable, then maybe we need to consider other solutions.

Schizophrenia and Bipolar disorder both have shared pathophysiology?

BBC NEWS | Health | Mental illnesses share gene flaw

Sabine Bahn, who led the research, published in The Lancet, said: "We believe that our results provide strong evidence for oligodendrocyte and myelin dysfunction in schizophrenia and bipolar disorder.

"The high degree of correlation between the expression changes in schizophrenia and bipolar disorder provide compelling evidence for common pathophysiological pathways that may govern the disease phenotypes of schizophrenia and bipolar disorder."

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Fantastic results if they hold up. We've been so very much in the dark without a pathophysiologic mechanism. This is the kind of work that can lead towards a Nobel.