Daddy, Can I Eat at the Grownup Table?
January 9th, 2015

You’ll want to read this first, if you can stand it.

 

God knows I’ve tried, Daddy. Every day I wake up and I say to myself, “Today is the day I will stop putting my thumb in the eye of authority. Today is the day I will state my objections with good manners and consideration.” I put sticky notes on my mirror that say “Civility” “Respect” and “Politeness.” And I mean it.  I want to eat at the adults’ table, to partake of their wine and conversation, their wealth and taste,  and their establishment organs instead of the tripe and Coca-Cola they serve to us cackling kids.

But gosh darn it, Daddy. Sometimes it’s just so flipping hard. I mean, some days the excrement just hits the fan so hard. (And please note the restraint, resisting blasphemy, an f-bomb and bathroom allusion in three consecutive sentences, a regular hat trick of civility.) Like today. I went to bed last night, I’ll admit it, with immature and unkind thoughts in my head about religion, thoughts that failed to distinguish adequately between fundamentalists and the truly religious, you know, the ones capable of multiple viewpoints, who can, for instance, have a son in the Israeli military and yet remain dispassionate about the Palestinian situation. I was thinking about all the stupidity that religious belief gives birth to–and not just religion but godless faith as well. I was thinking about Charlie Hebdo of course, but I was also thinking about the Christian kid I met with yesterday who discovered that his pastor had been sleeping with a parishioner for many years, even fathered a kid or two with her, about how crestfallen the poor kid was, and how unaccountable the pastor. I was dwelling on piety, in other words, on the way that people armed with the right combination of certainty and weaponry can wreak holy havoc, and even as I drifted to sleep I was filled with the wish to grind my thumb into the eyeball of the nearest zealot–or, more accurately, to make some hostile jokes about the pious, because everyone knows that what satirists and provocateurs and other outlandish figures share, in addition to their puerility, is their cowardice. They don’t have the courage of good manners, which is why society, in its unerring judgment, rightly denies them complete respectability or an invitation to the grownup table. .

So I woke up today resolved to be brave. I kissed my wife good morning–a peck on the cheek, no tongue. I did not grope or leer at her or sneak up on her in the closet when I knew she would be naked like some kind of adolescent. I made coffee in my tasteful stainless steel coffeepot and drank it black, none of that kiddie cream-and-sugar stuff.  I listened to NPR and not The Daily Show while I washed my breakfast dishes. I did not mock its droning; I did not allow myself to be offended by its inoffensiveness. I switched on the New York Times, and did not engage in the usual hermeneutics of being fit to print. I let the paper horrify me with details about Paris, and then, on the op-ed page, reassure me that Islam was not to blame. I was heartened by Ezekiel Emanuel’s recommendation that I skip my yearly physical, relieved not to have to endure the prostate exam one more time, and I did not indulge the thought that maybe I shouldn’t take medical advice from a guy who wants to check out when he’s seventy-five.  I nodded along as Paul Krugman once again tilted at the right wing windmills, did not entertain my fantasy in which some Eurocrat says, “You know what, Paul? You’re absolutely right. We’re a bunch of paranoid, ignorant, power-hungry sycophants. No wonder you won the Nobel. We’re changing our ways now–not because you are right, but because we realize this is the only way to make you stop.” I did not groan or gnash my teeth or bore my wife with my outrage. I just sat at the table and read and nodded.  I even pretended I was reading the Times on actual newsprint, that I was licking my thumb and adjusting my reading glasses and, between sips of my perfectly brewed coffee, quietly turning the pages.

I was, in short, the picture of the man with a complicated view of reality and a forgiving view of others. But then I clicked to David Brooks. Oh, how I tried, Daddy! How I tried! I got past the “I am Not Charlie Hebdo” headline without thinking too much about Lloyd Bentsen. When he compared the slaughter in Paris to “campus micro-aggressions,” I did not bellow in outrage but rather recalled my days on a college faculty and how professors could be like beavers who had run out of trees and had to gnaw on each other. I accepted his offer to turn this into a teachable moment, reminded myself that Brooks teaches at Yale, so why not be taught by the best? You can’t get more complicated and forgiving than that, can you?

Honest, I think I would have made it. I think I would have gone all the way with Brooks. I would have cruised past his condescension and his arrogance and his self-puffery. I would have read his “Satirists and ridiculers expose our weakness and vanity when we are feeling proud,” his “most of us” and his “rest of us” and his “we” who “maintain standards of civility” without saying back, “Who’s this ‘we,’ white man?” maybe even without wanting to say it. I’d have bypassed his making an equivalence between Ann Coulter, who, let’s face it, is mean and creepy and idiotic, and Bill Maher, who is actually funny and very smart even if sometimes abrasive, chalked it up to Brooks’s compulsion to show how both sides are always wrong, which of course leaves him as the one-man Isle of Right, but which nonetheless seems involuntary, the pundit version of Tourette’s syndrome. I’d have let go the whole thing about manners and standards and respect, and nodded in vigorous, well-mannered agreement with his conclusion that we shouldn’t outlaw offensive voices, even as we ostracize those to whom they belong, as if this sin-not-the-sinner argument weren’t bathetic beyond belief, as if college campuses were legislative bodies, and as if “social discrimination,” at least when practiced by the mighty, wasn’t more powerful than any legislation could be. And then I’d have licked my thumb, turned the page, and waited for my evite to the adults’ table.

But Daddy, how could I? How could I look past that crack about “their unguided missile manners?” Could a man so smart, a man who makes his living with words, be so unaware of language, of the fact that he’s saying that in the end those poor bastards at Charlie Hebdo deserved what they got? Who’s firing the missiles here? I wanted to say. (And did, out loud, even though my wife had already left.) Who’s got their hands on the trigger? It’s the people who have the guns. The fanatics, of course–who were not, for fuck’s sake (sorry, Daddy!), firing back at unguided non-metaphoric missiles, but firing first, and shooting real bullets into unarmed people–but also the calm and civilized and sedate grownups, the ones who do their level best, day in and day out,  to quiet and pacify and reassure and, when that doesn’t work, to suppress and discredit the dissenters, to damn the “holy fools” with faint praise, to level their AirSoft Uzis at them, to paint them with the tar of extremism, to do whatever it takes–equate Coulter to Maher, dismiss them and their kind as puerile and irresponsible, even grudgingly accept them (while claiming this as a virtuous act)–to keep the guns in their own hands.

So I guess I can’t join you with the crystal and the china and the sterling and the foie gras and the fine burgundy and your glittering conversation and your good manners. I’m sorry, Daddy. I really am. But maybe when you stop acting so outrageously, I’ll finally be able to grow up.

 




Scotland: The Paperback, Second Edition
January 9th, 2015

Available now: the updated version, complete with amazon kindle bestseller status emblazoned on the cover, and the epilogue. Thirteen more pages, same low price.




Top Doc: I Just Flip a Coin
January 9th, 2015

I swore off writing about psychiatry, but today’s Times features–in addition to what we all have to hope will be the Most Inane David Brooks Column Ever–Weill-Cornell psychiatrist  Richard Friedman once again letting the cat out of the bag, so I can’t resist.

Writing about the latest neurodoggle, in which Helen Mayberg claims to have found a biomarker that can predict whether a depressed person will respond to drugs or CBT (really, this stuff sounds more like phrenology or palmistry every day), Friedman says this:

In fact, I used to delight in tormenting the drug company representatives when they asked me how I picked an antidepressant. I would take a quarter out of my pocket, flip the coin and say I’d let chance decide because their drug was no better or worse than their competitors’.

Now I gotta tell you–this one puts a hair across my ass. If I had a dime for every psychiatrist from Stamford to Seattle to Sydney who has accused me of inducing patients to stop taking their drugs and throw themselves under the nearest bus simply by telling them that prescribing antidepressants is a guessing game, I’d be able to make a lot of phone calls, if there were still payphones and they still cost a dime. And yet here it is, confirmed by a prominent psychiatrist on the pages of the newspaper of record in a way that I would never dream of saying: “Yeah, we just flip a coin.”

Not that I mind being yelled at, at least not too much. I mean, if you poke a polecat, you’re gonna get sprayed. But really, who’s the one who seems uncaring about the patients? The guy who raises doubts about the science behind the treatment and suggests that people do their homework before they embark on a course of drugs that work by changing their brains (maybe forever),  or the guy who compares it to figuring out who kicks off in the Super Bowl?

You also have to wonder how Jeffrey Lieberman, head of psychiatry at Weill-Cornell’s uptown rival Columbia, is going to take this news. In his forthcoming book, Lieberman, in the course of assuring us that psychiatry has “matured from a psychoanalytic cult of shrinks to a scientific medicine of the brain,” claims that psychiatrists are now “empathic prescribers of medication targeted to specific diseases,” and that the drugs fit the illnesses “in a lock-and-key relationship.” Seems to me you shouldn’t have to flip a coin if that’s so.

Oh, and one more thing. Friedman uses his column to take a swipe at the National INstitute of Mental Health, which has recently (and famously) decided to double down on the bet that we can decode the brain and figure out its role in mental illness. I personally think this is a doomed undertaking–or, more precisely, that it can only succeed at the cost of redefining the human, which is more than even the most ambitious and self-assured psychiatrist would consciously take on–but it at least has intellectual integrity. If mental illnesses are medical illnesses, they are saying, then by gum we should look for them directly in biology, which is better than just punting the issue as psychiatry has done for 150 years.  Sadly for many psychiatrists, however, the NIMH initiative (known as RDoC) points to something sort of embarrassing, which is that we still don’t know what mental illness is, or which ones exist. RDoC is focused on symptoms rather than diseases, and the preliminary findings are challenging the boundaries of long accepted diagnostic categories like schizophrenia and bipolar disorder, mental illnesses that are many psychiatrists’ bread and butter.

So many psychiatrists are sore at NIMH, especially because it decided to go fully public with RDoC right on the eve of the release of the DSM-5, and to use that unveiling to announce that it is moving away from the DSM style of diagnosis. Lieberman spanks NIMH director Tom Insel for his timing (and for his ideas) in his book, and Friedman joins the chorus in his column. Following up on the conclusion that some patients are more suited to talk therapy than drugs and vice versa, he wonders if we can specify which therapy is right for which patient. But, Friedman laments,

right now we don’t have a clue, in part because of the current research funding priorities from the National Institutes of Mental Health, which strongly favor brain science over psychosocial treatments. But these are important questions, and we owe it to our patients to try to answer them.

Friedman overlooks not only that RDoC, at least on paper, is committed to psychosocial research, but also that researchers have tried for nearly eighty years to answer that question, and keep coming up with the same one: that all therapies are equally effective (or ineffective). This finding even has a name: the Dodo Bird Verdict (check your Alice in Wonderland for the reference.) The only consistent effect that can be found is that success in therapy is not a function of technique but of relationship, but mostly it seem it is nearly impossible to answer the outcome question without assuming your conclusions as your premises. In other words, the research almost always shows that the researchers’ methods are the best. this may indicate that therapy is not penetrable by the scientific gaze, but Friedman decides to overlook the knotty epistemological issues here and take the easy way out. He just blames the government. And blaming NIMH for the Dodo Bird Verdict is like blaming hte National Weather Service for the weather.

And not only that, but guess who paid for Mayberg’s research? That’s right: the National Institutes of Health.




Scotland: The Paperback
December 21st, 2014

My buddy Glenn Cheney has a little publishing company called New London Librarium. There he publishes a lot of his work, which is very good. Glenn is testimony to the way that talent itself is not what gets rewarded when it comes to the writing biz. (Or the music biz, or anything else that happens where art meets commerce.) He put together the pages and designed a cover and presto! a book. Which you can order right there on the website, or, I believe from amazon. Although, really, does amazon need your business?

Speaking of the devil, many have asked about my experience with amazon. Everyone I worked with there was smart, courteous, prompt, and competent. Everything happened exactly the way they said it would. Scotland topped the Kindle singles charts for the better part of a week. They voted it into the top ten of the year. That has all translated to selling about 2500 units, total royalties $3000. Which, depending on how you look at it, is either pitiful or better than a sharp stick in the eye.

I don’t know whether amazon’s point is to turn writers into sweatshop workers, but our relationship to amazon is chillingly like the relationship of iphone assemblers in China to Apple. In the interests of bringing consumers what they want for low price, amazon will turn us all into content serfs. Too bad.

That’s the only reason I regret my involvement with them. But it’s a pretty big reason.

To be fair, one thing I think amazon is trying to do by having this tier of not-quite-self-published work is to restore the curatorial function of the publisher–which, of course, they have done everything they can to destroy. I mean, they must recognize that most of what gets self-published is pretty bad, writing-wise, and that as profitable as it is for them to kill the gatekeepers (for what is the necessity of gatekeeping when the gate is only a portal to bits and bytes? You just open the gates, collect a dime from everyone who passes through, and after that who cares?) there is still some reason, some responsibility even, to exercise judgment and to help the public figure out what to read. They don’t recognize it enough to pay an advance or a guarantee, but still at least they’re trying. I don’t exactly hope they will succeed, but if this is what is going to happen, if the tastemaking function of the traditional publishers is going to be obliterated, then I suppose I don’t want them to fail either. It’s just too bad that the emerging model will make it so that the only people who can afford to write (aside from the Gladwells and the Cornwells out there) will be the independently wealthy, the impoverished, and the otherwise engaged.

Of course, Sony Pictures, a traditional gatekeeper, sure did a poor job of tending its gates recently. And plenty of crap has gotten in, and plenty of really excellent material (like Glenn Cheney’s)  has been largely excluded by the old regime, so I’m not sure the good old days were really so good. Things are never as good as they used to be, and they never were.




Scotland: The Update
December 21st, 2014

It took a little while, but some folks in town have now read Scotland–mostly in paperback form. (I made a paperback–more on that in a minute.) The reviews are mixed. Russell Perry seemed to like it fine. My farmer friend thought it made a nice read, although he wished I hadn’t repeated the rumor about the pastor. He was probably right about that. My truck driver friend also liked it, expressed admiration for my finding so many words. The former first selectman and the current town clerk are evidently irate (I have that second hand, although the FFS was decidedly cold to me on the phone the other day), and Bud, so I hear, went ballistic about the pastor rumor thing.

Oddly, I don’t seem to mind any of this. Maybe I’m just getting old. It’s not that I don’t care–I feel a little trepidatious whenever I venture out these days, and I really do regret the remark about the pastor. It was unnecessary, just one of those things you write because it is a nice detail, but overlook that there are real people involved. But really I can see why people would be upset, even if I think I tried hard not to be mean and to see things from their point of view. It’s hard to find yourself  written about even when you know it is coming, and these people did not. You lose control over your identity; it’s a violation of privacy, or so it feels. Of course, it really isn’t, especially when the events being depicted happened in public, and on the public record, but still.

Only one citizen has had the moxie to confront me directly. That would be Pete the Farrier, who started his comments in the public discussion section of our last zoning commission meeting by objecting to my calling him that. It seems that my leaving out last names (or sometimes names entirely) was disrespectful. I didn’t fully understand that, but it seemed to have something to do with credentials. Wendy is a captain and her husband is a veterinarian, he told the commission. It didn’t quite make sense, but I think the overall point is that I’d given people short shrift. He also said that it was not right for me to have profited off my involvement in this matter, or to be simultaneously running the zoning commission and writing about it. Here again, I wasn’t quite sure what he meant, but I think what he was saying was that it isn’t fair to people who come before the commission to think that in addition to my power to determine the fate of their application or request, I might write about them.

That’s probably a fair objection, although I don’t think it rises to the level of a conflict of interest over which I ought to resign or be deposed as chair. The commission agreed with me–as it happened, Pete’s comment came just before we elected our board of officers for the upcoming year, and I was re-elected without opposition. But I can’t say I entirely disagree with him. I suspect that people will always associate me now not only with the sex offenders (and I hear they are calling the Reliance House home “Greenie’s Sex House,” which I think is hilarious) but also with another betrayal: the one that inevitably follows the journalist’s seduction.

I did have a chance to talk to Pete after the meeting. He clarified one thing: the big objection seems to be that “you made us sound like ignorant country bumpkins, like hicks from the sticks.” To which the obvious response is something about what you do when the shoe fits.  I didn’t say that, however, because it doesn’t seem quite adequate. I mean, I know I didn’t come out and call anyone a hick, and my tone was far from ridiculing. I tried to uphold everyone’s dignity, which in my world means seeing it from their point of view. But sometimes that doesn’t matter. Even if you’ve made racism comprehensible, or attributed narrow-mindedness to legitimate fears, or chalked up scapegoating to ancient and perhaps immutable human tendencies, and even if you’ve resisted self-righteousness or even moral certainty, still you’ve shown people at less than their best and frozen that version of them in amber. I wouldn’t mind if some of them examined themselves and decided to try to be different, but that wasn’t my intention either. My intention was to tell  a story.

There is something heartless about writing, and it’s really beyond apology. I’m not crazy about Janet Malcolm, but she sure had this right. And it may be that living in a small town and writing about it is one of those have-it-both-ways dilemmas. You know, the kind that test character.

Our conversation lasted for about a half hour. We talked about the problem with sex offenders, and somehow got on the topic of the closing of the mental hospitals. He told me about what one of the men at the house had done to get arrested, and it sounded really gruesome. We talked about small town life. We complained about our high taxes. I told him that the only thing he’d done or said that really bothered me was calling me a liar in front of so many of my fellow citizens. I told him that people respect him, they listen to him, and that he needed to be careful about what he said in public. (Fine advice from the guy who repeated the rumor about the pastor.) We shook hands and went home.

Anyway, the story continues. It will always continue. Whether or not the paperback ends up in the library is an interesting question. It probably should, but I don’t want to put the librarian in that position.