The Morality and Psychosomatic Pain?

Why do bad things happen to good people?

This is the central question of religion. It further is a central question for understanding ‘pain’ in psychiatry.  

All pain is a ‘psychosomatic’ phenomena.  Psychosomatic means that body and mind are involved in the experience.  Psychosomatic does not mean speak to cause and effect but does speak to associated phenomena and potential contributing factors and possibly a different approach to solution.

For example a child is caned and strapped..  I pick this example because being caned and strapped was a recurrent experience of my own attending Viscount Alexander and Vincent Massey High School in Fort Gary Manitoba.  Fortunately this was not a routine occurrence though physical punishment by school administration was normal for a previous generation. Death by school caning was a social problem that preceded Japan’s embarking on WWII. It should be noted that while Nazi brutality has been extensively documented so that the word Nazi conjures up brutality, Japanese brutality is similarly understood in the east in all the countries which Japan invaded.

What is good. What is bad are questions of ‘interpretation’ and ‘morality’ not at all so obvious as some would argue.

The Japanese perceived their corporal ‘punishment’ of students as did the administration at my school in Winnipeg.  The Nazi’s felt the same.  The history of the world tells us that corporal punishment was indeed the norm for all nations with rare exception.  Consider simply the history of punishment in the Royal Navy, the leader of civilization and guiding light of the world, until the redistribution of power in the early 20th century. Records of hundreds of lashes slowly are reduced to tens of lashes and it was not uncommon for sailors to experience permanent mainming or death from their ‘correction’.  Further minor faults were very aggressively punished and only slowly was the ‘rod spared’ for worse crimes.  In Islam today according to Islamic laws , which some describe as barbaric, since the punishments went out of vogue sometimes hundreds of years past, the cruelty and offence of punishment remains as a historic note for all nations.

Hollywood would have us believe in the chivalric notion of the loving kind mother showing great sentimentality by heroines when faced with unpleasant punishments on the live screen.  Unfortunately this marketting to the ‘fairer sex’ for the pure purpose of selling dish soap is a travesty of abuse of public education as propaganda.  Attending my first boxing match I was shocked to see how lustful and violent the women audience were.  Historically matriarchy as opposed to patriarchy has been associated with torture and punishment.  

What did occur historically was that race horse trainers did note that a different approach to training from whipping gave better results.  Doystoyevski’s portrayal of the man beating his horse to death is an obvious example of the limits of corporal punishment. The Japanese government actually had to have committees to look into the death rate of children in institutions from corporal punishment.

Further modern psychology especially forensic psychology became interested in Sadomasochism, an ongoing issue of Hollywood and the upper classes in general. Just as today we know that pedophiles flocked to the church for access to the children so sadists flocked to positions such as prison guards and police for their access. Not much different than alcoholics seeking work as bar tenders or sex addicts seeking work as prostitutes.  Obviously the majority are motivated by money and more lofty aspirations or driven by need rather than greed. Still this significant minority are attracted to these positions of power simply for the means to act out their aberrant tendencies or desires.

Now move forward a half century and note the advances in what people historically called civilization. I remember being strapped by teachers in elementary school and while others in my class probably don’t remember the day I certainly remember when the strap was removed from the classroom, teachers denied the right to corporally punish students and this moved to the sole domain of the Principals Office. I graduated before Principals were denied their bit of physical activity and would only be billy clubbed by guards and surreptitiously physically punished in custody.  It was frowned upon by even my early 20’s when I was involved in demonstrations to leave evidence of injury.  It has been decades now since anyone in authority has physically abused me though I continue to be exposed to repeated verbal abuse and public humiliation and exhaustive shaming.

Raising white chickens I learned that the chicken with a black feather was visciously attacked by the other chickens. This is natures way of removing aberrant genes from the gene pool and one of the reasons that Utopian Darwinism is questioned as genetic difference is removed rather than celebrated in nature normally.

In my study of the Canadian school when I was interested in birth defect, IQ and school drop out I found that public schools punished the slow learner and the fast learner.  Not surprisingly the slow students dropped out. What was offensive to those who’d asked me to study the matter, where I first learned that politics funded research was my finding that the students smarter than teachers and administration, the high IQ kids were also dropping out of school.. The public school faced with ‘one shoe’ for all served the masses but not the “deviants.”, euphemistically termed “outliers” by those secure in their mediocrity. 

Apparently I had a high IQ.  Whatever that represents, blessing or curse.

But I was beaten repeatedly for correcting teachers and to this day am punished for pointing out that the Emperor has no clothes.

I’m kind of autistic in this regard and have taken delight in a new Canadian television show called the Good Doctor.  I self identify and story tellers have long known that even children love a story in which they can see themselves. I’m delighted with the excellent ratings of the show because I expect that it speaks to Canada as a ‘colonial’ nation more than it speaks to medicine.

In a Colonial nation there is a fixed upper class. Here in British Columbia, the game was rigged in the last generation for the English immigrant to win. In Quebec the French born person is a Royalty and Canadian life has it’s apartheid but it’s not so much by colour but by class, origin and family. When I lived in England I saw very quickly that upward mobility and wealth in society was relatively easy if your family was wealthy for generations and you’d been to the proper school to get the right education.

Dr. Jordan Peterson has pointed out some 10% of students due to lower IQ or even lower emotional IQ are ill fitted for modern society and unlikely to find even work easy.  The rise of the peasant class. Brutal maniacal killers like Lenin were able in an earlier generation to claim to represent these ‘masses’ and there by gain fortune and power for his own deeply evil designs as a mass murderer. Hitler similarly used this means to elevate himself. Today the closest we compare is late night shows with people begging for money for a variety of species of cuddly animals without any concern for reptiles and insects and certainly not the very underprivileged bacteria necessary for life.

How I perceive pain is best seen on a scale 1-10 with the contribution of mind and body being apportioned.  Chronic pain is separated from acute pain as acute pain, pain that lasts minutes or days isn’t the burden on society that chronic pain has. Chronic pain is more ‘mental’ as well.  

Men who have been caned in studies have been known to experience pain, the same objective physical injury 10 times another person who has not been caned in youth.  There is no ‘greater sensitivity ‘ for the upper classes as the white feminists argued when the black feminists challenged them about their relatively safety and security.  The universities at the time were doing ‘take back the night’ dances in which more lighting was put on the campuses to protect the privileged upper class feminists when the threat of rape on university campuses was the least in America. By contrast nearby black ghettos were the hotbed of rape and were not funded for ‘lighting’ or even much of a concern to the ‘take back the night’ crowd.  This idea of ‘sensitivity’ is itself a luxury of psychological value but not at the physical level.  The innocent is immediately more impugned by violence but their background of relative safety and comfort also gives them the means to be resilient and flexible.  There is a reason in history for the officer class and the tendency for race horses to be trained with the best of food, shelter, exercises, discipline and training. 

Women who have not been informed about menstrual cycles or have been sexually raped by painful intercourse early in life or had negative genital experiences are at great risk of having many times more genital complaints, cramping, abdominal pains etc.  

So the question is best considered if the sum total of the pain is 10 and 5 is assumed physical and.5 is assumed psychological is the physical component ‘5’ or 2 and the mental component 1 or 5.  

The example of a gunshot wound would appear straightforward ‘physical’ but if the gunshot was occasioned robbing a bank it’s a different ‘experience’ to a gunshot experienced saving the life of a child.  The body of a poor or rich man, the actual physiology will have similiar impact. However if a person has been beaten as a child they will fear the pain as greater than a person who has not. 

Add to this consideration my patients who are masochists. A group of people for whatever reason have found that inflicting pain while masturbation or during sexual orgasm heightens the perceived enjoyment. There are some neurological components as well as psychological components to be considered but it remains that this person may indeed feel ‘pain’ differently than a person who only experiences pain as a message of harm.

If a professional fighter experiences a blow as compared to an innocent the professional may well ‘know’ the blow was not ‘disabling’ and ‘will heal’ based on previous experience of fights as compared to the ‘shock’ of the innocent who experiences the blow and believes wrongly they are disabled , near death and rather than continue the attack reverts to a fetal position and prays.  I rather like the latter though have found when that didn’t work I’ve been forced to salvage what remains of my pride and body by actually fighting back which as original as it seemed the first time has significant historical precedent for stopping the pain.

In my work doing hypnosis and hypnotizing people for surgery I further found that distraction could well ameliorate the experience of pain. I was cutting a person with a knife but I had used hypnosis like I’ve used xylocaine injection to stop the pain.  Acupuncture distracts the body.  Mentalist apparoaches may work as well as physical approaches. Paradoxically with chronic pain exercise reduces the pain in the long run.

Now this addresses the existence of psychosomatic pain. So pain mostly is bad and good people and people designated as bad can have pain. It’s been said that pain is mandatory but suffering is optional.  

If a person considers themselves as bad they will indeed experience or perceive greater pain. Depression prolongs and worsens pain. indeed at one time chronic pain was called ‘somatic depression’.  All pain is psychosomatic.

Good people have pain.

Bad things happened to good people. However religious people who perceive negatives in life as ‘lessons’ from God rather than as ‘punishement’ or even as ‘random bad shit’ do better with recovery in general.  Chronic pain is addressed in the context of how does it affect what I do compared to what I did. IF I perceived myself as a good person because I was a surgeon and I loose my hand in a criminal minds episode to a cannibal I am more likely to have ‘phantom limb’ pain than perhaps a man who has his hand chopped off in Saudi Arabia for stealing a piece of bread to save the life of his dying child.  Understanding the ‘meaning’ of a person and their purpose and the meaning of the ‘pain’ and a person’s ideas of ‘good’ and ‘bad’ do alter the perception of pain.

Disability is a further issue because it appears quite surprisingly people who are high paid as beauty contestant judges appear to not experience the disabling pain that people who have similiar injuries do when the latter works 12 hours in a cold stinky outdoor fish plant.  

Just some thoughts about pain and perceptions with some ideas about past and present and the understanding that these factors can have and influence and change outcomes and indeed help us to understand better why bad things happen to good people.

This doesn’t even get into the issue of ‘secondary gain’ where a person injured or claiming to be injured when they weren’t even injured can be rewarded for the ‘drama’ of pain presentation.  Today some 40% of claims are ‘false claims’ and knowing that should explain to some extent why insurance companies are so slow to ‘assume’ a person is good , despite every special interest group insisting their group doesn’t lie.   

In Canada a convicted  terrorist who maimed an American soldier was rewarded  10 million dollars. 

Isaiah: Long necked women and their boys

Isaiah 1:1 1-49. “The vision concerning Judah and Jerusalem that Isaiah saw

“I reared children and brought them up but they have rebelled against me.....woe to the sinful nation, a people whose guilt is great, a brood of evildoers, children given to corruption! They have forsaken the Lord; ....your hands are full of blood!...Wash and make yourselves clean, Take your evil deeds out of my sight; stop doing wring, learn to do right; seek justice.  Defend the oppressed. Take up the cause of the fatherless; plead the case of the widow. .See how the faithful city has become a prostitute! She was once full of justice; righteousness used to dwell in her - but now murderers! .....Your rulers are rebels, partners with thieves; they all love bribes and chase after gifts. They do not defend the cause of the fatherless; the widow’s case does not come before them.

2. In the last days....the mountains of the Lord’s temple will be established as the highest of the mountains....Come let us go up to the mountain of the Lord, to the temple of the God of Jacob...He will teach us his ways so that we may walk in his paths.....stop trusting in mere humans who have but a breath in their nostrils. Why hold them in esteem?....

3. “I will make mere youths their officials ;children will rule over them..people will oppress each other -man against man, neighbour against neighbour. The young will rise up against the old, the nobody against the honoured....the look on their faces testifies against them; they parade their sin like Sodom, they do not hide it . Woe to them! They have brought disasters upon themselves.....Tell the rightestous it will be well with them for they will enjoy the fruit of their deeds, Woe to the wicked!....Youths oppress my people, women rule over them.....the Lord says the Women of Zion are haughty walking along with outstretched necks flirting with their eyes strutting along with swaying hips, with ornaments jingling on their ankles....therefore the Lord will bring sores on the heads of the women of Zion....instead of fragrance there will be stench...instead of beauty, branding...Your men will fall by the sword, your warriors in battle.’

Reading the Bible so often is as if the events described are today when indeed they are universal and forever.  That’s the  nature of the Holy.  It resonates.  It’s open to interpretations.  

In the Bible like in science there is cause and effect and there’s possibility of change.  In Materialistic Determinism all is fixed. There is no ‘free will’.  Naturally people take pride in success and blame others or fate in failure but they deny ‘right and wrong’. The Bible has morality and ethics.  I’ve left out a lot of this passage of Isaiah.  I like Isaiah.  Great images.  

Tolkien Play, Pacific Theatre

Incredible writing. Superb acting. Loved the sets and costume.  Kind of Darkest Hour with Hobbits. Opening night. Always a treat. Seeing friends. Over the years so many people returning for the highest minded theatre on the coast. Real challenges of ethics and morality.  The theatre as it’s own ‘my utmost for his highest’. Enlightenment meritocracy.  Ron Reed, director and playwright extraordinare. This script would please C.S. Lewis for sure and certainly have Tolkien’s interest.
I loved learning more about the Inklings. Never knew Owen Barfield was a part of this.  John Innes unfortunately absent opening night plays J.R.R. Tolkien but Ron Reed did a really good understudy job replacement though needed written prompts even though he’d written the play. That itself was ironic and amusing given all the irony already in the high minded play. Much British humor that would tickle John Cleese.  Certainly a respite from the low brow fake news of present day.  This really did challenge one to think and consider.  At the core was truth and friendship.
I truly loved Ian Fathing’s C.S. Lewis.  He really was Lewis as I imagined him.  Tim Dixon played a great role as Warnie Lewis, the Lewis military brother.  I didn’t really know Tolkien had been in the WWI trench warfare  Battle of Somme or even that C.L.Lewis was in the WWI front and took shrapnel in the fierce trench fighting. They both lost several close friends together there and this certainly affected their subsequent outlook and inner life.
The delightful contrast of Tolkien’s catholicism and Lewis’s conversion from atheism to Christianity is so well played.  We don’t talk of religions or life and death and meaning these unidimensional hedonist consumer days.  Everyone thrives on lust and  perversity while being offended by lust and perversity.  The real fighting in mud and blood seemed to have lifted these men together out of the genitals of self. Even Campbell, played by Simon Webb who also played writer Dyson, had been in the Spanish War.  The communists and fascist so clearly described as different sides of violent totalitarianism. The verbal descriptions Shakespearian in their vividness with no one needing severed heads on stage to make the point.
I loved Edith. Eria Faye Forsythe who  played Tolkien’s wife with all the wisdom and genius of the women who were partnered  the great men of that era. I’ve loved all of Forsythes acting, so sensitive and dynamic. Her timing is elegance itself.  Anthony F. Ingram played Charles Williams who I quite didn’t know.  That’s history. A great man of the day and in later years forgotten while Tolkien and Lewis remain as classics.  Ingram played him amost American and a harbinger of the Anglican church today with all the ‘magic’ left and the perhaps the ‘mystery’gone.
I loved Tolkien’s term ‘northerness’ a mystical reference which is all but lost in loudness of the racist obsessed southerners.  Beowolf, a study of myth and reality.
I’d read all these books in my teens 20’s and 30’s so knew Beowolf, read all of Tolkien and most of Lewis. I loved Catholic Tolkien’s line that said Lewis’s Mere Christianity was too mere.  It was clear that this was a time before political correctness when people were frank with each other.  No wonder these writers became like polished pearls with the obvious support and cutting criticism of each other. Today every meeting of Inkllings would have been followed by a dozen law suits.  I see students scurrying away from Tolkien and Lewis to their safe places and trauma counselling. I’ve loved Lewis, Tolkien and  Owen Barfield and and realize others of the Inklings served up the very ideas that served to set the sails of my own personal trajectory.  It was moving to be reminded of the idealism and reverence of my younger years.  I don’t think of these things much now  in the cacophony of postmodern  ‘fake news’ , "false witnesses" ,  "new totalitarianism" and ‘victimology’. There’s a gentleness in the world of men who have served their country and fellow man and see friends die and know the foolishness of leadership who want to be leaders.
The play speaks to a past both individual and societal. It also speaks  to the friendship of men and God but mostly of men.  It really was a play like all the great plays.  It had us all talking and checking encyclopedias long after we’d left Pacific Theatre. Laverne our Professor of Literature companion said she couldn’t wait to search out a reference to ‘cake and ale’.  There were so many layers, from a really good biographical history romp to subtle meanings within meanings.
I loved the Tree.   Set designer Drew Facey said much with just that tree. And today I learned from science that trees have heartbeats.   I loved  all the moving parts, and black clothed young people pushing things about in scene changes.  I loved Gauthier's and Hood's excellent costume design.   I loved Cabilete’s Stage Management and Akesen and Colhoun’s Sound Design. They were all so perfect that it was easy to just be in the play without consideration of the light and sound and background.
It really was all simply perfect.  Everything about the play rung true, universal and ancient.  A masterpiece.  It was  sheer gift to have been there tonight.

Museum of Sex, New York City

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John 8: 42 NIV Study Bible

"If God were your Father, you would love me, for I came from God and now I am here. I have not come on my own but he sent me.  Because you are unable to hear what I say, you belong to your father, the devil, and you want to carry out your father’s desire. He was a murderer from the beginning, not holding to the truth, for there is no truth in him. When he lies, he speaks his native language, for he is a liar and the father of lies.  Yet because I tell the truth, you do not believe me! Can any of you prove me guilty of sin? If I am telling the truth, why don’t you believe me? He who belongs to God hears what God says. The reason you do not hear is that you do not belong to God.”
The message of Jesus Christ is that God is not some old white hair guy or gal sitting on a cloud directing the universe. The Cosmic Christ is God Immanent.  God manifested himself in the world.  His son, his image, his word are here and now with us.  That word is the word of truth.
To me that is as true as ‘scientific truth’.  The Creationist knows God first manifest himself in Nature before the Fall and before the Cross.  Within nature there is the perfection and messages found in the matter of fractals, in the triangle, in the hologram.  There are immeasurably signs that man and nature did not just happen but were conceived.  A monkey given time simply could not compose as does Bach. The Big Bang theory, a foundation of science, states that there is a ‘finite’ time from creation. Within that time, a monkey simply could not compose as Bach.  Countless other matters of creation could not have ‘evolved’ simply because there is not the amount of time for evolution to occur. Further the idea of mutation doesn’t take into account that most mutation is devolutionary not evolutionary.  Understanding science and string theory and quantum physics scientists see the hand of God. Even Einstein, a theorist, said ‘God does not play with dice.’  This life is not ‘random’ but there is purpose.
I believe my purpose in life is truth.  The language of truth is fundamental.  The deep evil of political correctness language, the language of the demonic, is that it confuses truth.  “My truth”, says the devil.  Of course we all know that there are many perceptions and many angles of vision and experience. Yet in the end, we agree on truth in science. It’s called objectivity. My truth is subjectivity.  Together we know more than as one. Together we can.  The irony and hypocricy and utter deceit of the left and politically correct is their fixation on the ‘consensus opinion’ of ‘climate change’ yet they themselves insist on the language of ‘my truth’.  The very truth was the thing of ‘consensus’ not an individual claim. The devil lies. The devil is deceit. There is a yes and a no.  We know all is grey but the ‘aha’ moment gives us insight and discernment so that no everything isn’t true.  There is truth.  It is from God. It is the truth of science and gravity here on earth. It is the truth of right and wrong. There is morality.
Smoking marijuana and drinking excessively there is a blurring of the world. Everything is okay.  This is not enlightenment but devolution to a lower level of non discrimination. A child puts everything into his mouth and learns that poisons are not to be taken. The drug addict is so accepting so ‘chill’, so ‘cool’.  ‘Take it easy, Man, everything is cool.”  No it’s not. That’s the devil speaking. That’s a lie.  Everything is not ‘cool’.  Maybe in some metaphysical way it is but right here and now the killing of a child would not be cool. Ironically if I offer to taken the drug addict’s drug, suddenly this generous easy going guru of enlightenment becomes more truthful. The same with the politicians and rich men and women who are generous with the goods, labour and money of others.  It is not that they are evil but they do seem to heed the devil more than they heed the father. They are leaders who lead from behind not those who charge with the troops.
The historical Jesus said he was from God and that God sent him.  Fundamentally I don’t know how I got here.  I know from stories I was born to my mother but I don’t even remember it. I don’t remember my time in the womb. I have a birth certificate.  I presume that I exist as Descartes so simply stated, “I think therefore I am”  (Cogito ergo sum).  But I don’t know if I spontaneously occurred or was sent. It’s an act of humility to consider that I might not have the capacity to ‘self create’.  I know about sperm and eggs and that whole biological cycle but it’s all ancient and truly mysterious and difficult and unpredictable and even sketchy in parts that there is today no ‘consensus’ on the ‘start’ of human life.  The abortionists, great lovers of the devil, rich ruthless men and women who are the greatest of murderers and deceivers who have argued that it is not murder to kill even a full grown child in the mother’s womb about to be naturally born. These men and women for money would kill babies and toddler if they could convince the world that they were good.  The devil is the great deceiver.  But no we don’t quite know with utter certainly if God invests the fetus with life at the moment of egg meeting sperm or perhaps later in the womb. Indeed religionists say that each life is ‘predestined’. This means that God meant for the birth to occur. God mean for the egg to meet the sperm and life to follow. God did not mean for abortion to occur.
In this scenario there is a life purpose, that is God and there is the death purpose that is the Devil’s.  Freud called this ‘life wish’, eros and death wish, thanatos.  The devil is murderous. This dichotomy of good and evil is of this world , where truth and lie exist.  There is night and day. There is evidence of particle and wave.  Flow and stasis.  Right and wrong. Truth and lie.  The language is not ‘my truth’ and ‘your truth’ but rather ‘my perception of truth’ and ‘your perception of truth’ otherwise these politically correct nut bars would have us saying ‘my light’ and ‘your light’ and the pc police would have you arrested if you insisted at midnight in utter darkness that ‘its’ night’ not ‘day’.
Language is the first casualty of war.  And don’t get me wrong, I believe there is a war.  The devil is in the detail. The politically correct speakers are demonic. They are liars. They would try to convince us that ‘black is white’ so we will accept that ‘your money is my money’ and ‘your life is my life’.  Political correctness in all it’s forms is evil.  
Jesus Christ was without sin. To sin is to ‘miss the mark’. It means ‘to sin’ is to err.  My intention when I shoot my rifle at a target is to hit the bullseye.  When I miss I have ‘sinned’.  To those who argue that all is ‘determined’ and ‘all is fate’ and that they have no accountability and no responsibility then there can be no sin. Yet I have observed these sinners all my life and they are very specifically willing to accept praise and reward for what they do but unwilling to accept punishment and blame. They are above the law. Their truth is narcissism. Their father is the devil.   They ‘change history’ to agree with what they want because they do not want to admit that their ‘purpose’ was other and that good came regardless of their intent. They would argue that ‘good things’ happen and ‘bad things happen’ and they were ‘lucky’ and you were ‘un lucky’.  They deny they ‘fix’ the games because they are liars.  The devil is a murderer and a liar.  If all is ‘accidental’ then the devil doesn’t have to be accountable.  They never accept responsibility for their behaviour but would rather ‘deny, deny, deny, lie, lie, lie’.
Now  the old language of the Bible is nonetheless a valid language. I can use the word ‘karma’ instead of ‘retribution’. I can put the language of Jesus into the California message of the Secret. I can talk about the first law of physics as God and the second law of physics as the devil. I can show the opposing forces in the universe physically and ask why there would not be opposing forces in man. I feel there is a ‘good’ way to do something and a ‘bad’ way.  If I want to build something I can do it with ‘efficiency’ and ‘least waste and destruction’ or I can cause the most havoc and crisis to achieve my end.  The idea of good and bad, or good and evil is throughout our world and our society. We question the decisions that serve the fewest and celebrate those decisions that benefit the most.
Increasingly there are bankers and financial folk who trade in companies and acquire drugs that cure and yet they price them at maximum profit and show no interest in the outcomes of their decision and how they would affect a sick child.  There is a back lash.  It’s karma. It’s Jesus. It’s Christ. Life’s a bitch.  But there seems to be a connection between kicking and mule and being kicked back.  We know in war that more people are killed by ‘friendly fire’ and the ‘stupid decisions of leaders’ than by the enemy bullets.  This push back is everywhere. This is ‘truth’.
Now the politically correct would lie and lie extensively.  Truth is truth. It’s not a possession. The new consumer society would say this is ‘my planet’. This is ‘my galaxy’. This is ‘my creation’. They sound like little children because they have not morally or emotionally developed. They are not diaper trained either.  Jesus recognized that the world was full of children and he loved the children.  So he said, “forgive them for they know not what they do’.  They are the tool of the devil. They are deluded. They are the zombies who are taken over by political correctness and other godless lies.
Of course it’s not ‘cool’ to think of the Devil as a serpent. Just like it’s not cool to think of God as a white haired elder out on a cloud. Just as God is immanent so is the devil. The devil is that which is inside you that is destructive. God is that which is creative. God and the devil are two voices inside each of us.
Jesus is asking which you will call your Father. There is choice. And you will be accountable.

Sandy Hook, Guns, Asparagus and Social Terrorism

It's like Columbine all over again. The same occurred in Montreal. A tragedy occurs and those who have an ax to grind, or a gun to load or unload, derail the story with utter disrespect for the principal players, the victims and victimizer. These cabal of hyenas then put their brand all over the thing to sell their idea of a new world order or peace on earth stealing the Sandy Hook tragedy from those who forever live with the reality of the 'thing'.

What concerns me most about these random acts of violence, truly far rarer than the common random acts of human kindness that routinely go unreported, is that they overlook the most obvious facts of the critical drama played out by victims and victimizer.

 First and foremost the person who is accountable is the killer yet ever so very quickly we are distracted from the individual and individual responsibility to somehow feeling perhaps that his eating or not eating asparagus was as important as President Obama and the National Firearms Association.  The thing suddenly becomes about asparagus rather than about murder.

Frankly I'd think the Rifle Manufacturers wouldn't want to be drawn into this any more than a Toyota executive would wants to have his company's name mentioned when there's a car accident involving the deaths of dozens of 'victims'.   Rarely do I hear what 'brand of car' was involved in a drunken mass murder on the highways but  I actually learned what bullet types were used in this killing.  This is odd as  I can't recall anyone telling me the nature of the steel, domestic or foreign,  used in the recent slashing and stabbing that occurred down the street in my own city.

The critical factor to is that this man was part of a family and raised in a particular way in a particular community and went to a particular school. Somehow even our highly offensive media and this culture of irrelevance and  fatuousness have less influence on a person than the presence or lack of presence of a person's family. There is first and foremost accountability in the family and immediate community, followed by school and teachers and perhaps church, mosque synagogue and religion and lastly political party affiliation.   Did this kids' family vote democrat or republican in the last election?

For years we've been denying any relationship between children and their primary caregivers. This way when a child becomes a nobel prize winner we can't thank his parents for a job well done. Because simply, no praise, no blame. So some inanimate object, a tool, is held accountable for an intentional action rather than the people who gave birth and raised this child to manhood or increasingly in the case of violence these days womanhood. And I've known a mother who raised her son to jihad and spent every waking day of her time with him encouraging him to kill with revenge the infidels. But today I'd think Einstein wasn't responsible for relativity theory it must have been the pen or pencil he used that created that marvellous wonder of science.

It's amazing what can be given with mother's milk but we can't look there can we. We can't ask where was the father either.  Why wasn't  the father teaching his son the proper use and handling of guns. We can't ask either what gun safety programs were available in that community or what requirements specifically were in place around the purchase of guns if the guns were 'legitimate'. Somehow when teenagers are driving without a license and crash stolen cars we all register that there's something intrinsically wrong about the issues of possession, legitimacy and education in this case yet somehow those critical areas of concerns have been lost in competing agendas that have no respect for the victims or victimizers in this case and more concern with collecting funding for non profits and lobby group CEO's.

Not in a generalized consideration of a irrelevancies, but specifically what salesperson sold a gun to a man wearing a cap that said "I"m going to kill children first opportunity I have."? We ask bar tenders to assess the drunkeness of patrons before they are served so what occurred in this specific case? I don't know. I heard this whole important story immediatly hijacked by these dirty people with dirty agendas who simply love to pounce on these kinds of stories for their own promotion.  The causes and agencies with a dog in a wholly different fight were all over this story from the get go.  They lust for these kinds of the stories.

I never did hear the important parts of the very specific 'crime'. I don't know the name of the man who sold the gun to this man who was wearing a look "I want to kill my mother."  I want to know about that individual more than I want to know about asparagus.  I don't think what he ate was as important as what music he listened to or what magazines he read.

I want to know about this specific school and whether there were any courses on morality which I suspect were absent since God has been banned from the schools. I didn't hear any one saying 'perhaps we should return to having prayer in the school' since it seems these kinds of events have occurred in America since America dropped prayer from the curriculum. But I'm just a social scientist and I'd say that there have been guns around forever but this mass murder at the school seems to have taken an increase since we allowed the  courts rather than elected make decisions for society.

Now wouldn't that be interesting to hear from the media which frankly I would love to say caused these tragedies if only because there's often better news coverage these days from the late night comedians than the supposedly learned 'talking heads'. I do think that the whole exercise is about denying the individuals their personal tragedies and not letting the police do their work realistically, not politically and not as an 'entertainment' which this 'circus'  certainly became rapidly.

 It's not about guns as much as it's about accountability and responsibility and whether individuals, families, communities, business men or inanimate objects or whether he did or didn't eat asparagus is the problem. Next thing I'll be hearing is that this bad little monster kid ate at  Macdonalds and Big Macs cause mass killings so Macdonalds should go strictly vegetarian.

At least these events do wonders for reassuring us about the collective stupidity and herd mentality that will guarantee that more of these will occur. As we learned from teenage suicide epidemics, we can learn from Columbine and Sandy Hook , there's a whole lot of irrelevant inadequate needy individuals who will now know their way to fame is to shoot up their neighbourhood. That's why we put a muzzle order on the media reporting of terrorist acts back in the day of Carlos so that terrorists couldn't use violence as a means to get a stupid sideline view to the maximum number of people without going through American Idol like the rest of us.  As a result terrorism was then controlled better by the authorities. This kid was a social terrorist by any definition and these acts of apparently random violence are 'terrorism'.  As a result we should learn from the terrorist experts and take that learning into the schools.

When we advertise a teen suicide a dozen copy cats occur.   I'd like the media to be held accountable for it's celebration of death and to take some of the responsibility for this act of mass destruction. I'd point out to that the use of armed air marshals on planes and metal detectors are the best bet that multimillion dollar air industry has arrived at. When I enter a court room I have my bag scanned and empty my pockets.  I think kids would be safer in schools if the entrance had a metal detector and there was an armed security guard not unlike any government office. If anything perhaps we could learn from the death of the marines overseas and from these kids and ask what we can do to really make our schools safer because terrorism isn't going to go away just because we all collectively keened on face book.

While we're getting real we can also consider that this is the best evidence that removing God from the school has failed and perhaps suggest that a post constructionist study of morality and ethics in light of the learning spirituality should be as important to a school curriculum as art.  All the collective moaning and keening and angst isn't going to do much to stop the next attack. It's  being planned right now by some little nobody  needing serious psychiatric help in a society that would rather spend more money on public relations lawyers to do 'damage control' than on mental health resources to prevent the problem.

Let's get real. This isn't about inanamate objects, it's all about people. And personally I'm a little tired of those folk who get paid to hijack the news to their own ends. And yes we should also out law bombs, oops we did that, didn't we? And by golly gee, the president still has a security detail and the borders still have armed guards. Now why is that?  Don't you think we should care for our children, seriously.

Bad people are always crazy

"Bad people are always crazy," Dead Eye said. "That's why they do what they do. And sometimes it takes crazy guys like me and Uncle Boomer to go out there and stop them."

Quote from Apaches an excellent detective novel by Lorenzo
Carcaterra.

While this is probably right, and it does simplify things, what is implied if not stated outright is that 'crazy' people aren't always bad.

Prisoner's Dilemma

Prisoner's dilemna is a game that is used to study cooperative and non cooperative behaviour.  In the out come analysis there are 4 possibilities:
1) You win, I lose
2) You lose, I win
3) We lose
4) We win.

When I first studied this a quarter century ago I was struck by the finding that most people are unable to achieve the we win solution because they must forfeit the I win you loose option to achieve we win. Hence more commonly people end up in the 'we lose' scenario.

The game is described as follows:

Two men are arrested, but the police do not possess enough information for a conviction.
The men are separated.
Police offer both a similiar deal.
- if one testifies against the partner (defects/betrays) and the other remains silent (cooperates/assists), the betrayer goes free and the cooperator receives the full one year sentence.
If both remain silent, both are sentence to only one month in jail for a minor charge.
If each 'rats out' the other, each receives a thre month sentence.
Each prisoner must choose either to betray or remain silent; the decision of each is kept quiet.
What should they do?

Trolley Car Moral Dilemnas

One of the tools used to question morality and ethical behaviour is the trolley car thought experiment.

Imagine that a trolly car is headed down the tracks towards 5 people.
Imagine a bystander who can switch the trolly car from the path to another?
Imagine that the other tracks have only one person.

Is it morally required for the person to switch the trolley car to the second track?
Is it morally permitted for the person to switch the trolly car to the second track?
Is it morally prohibited for the person to switch the trolly car to the second track?

What if the bystander was himself standing on the second track alone?

Would it be permitted, required, or prohibitted to switch the trolly car to this second track now?

What if you could push a fat man in front of the trolly car and that would make the car safely switch from track one to track two, albeit killing the fat man?

The answers that you make to these questions defines to some degree the basis one uses for making decisions.

The Confession John Grisham

John Grisham is a captivating writer whose knowledge of law is impressive. His story of the condemned man on death row with all it's uncertainty and ambiguity is a trying story.  Falsely accused or not the drama unfolds with police and woods and race riots.  In the midst of this are governors and pr and media ratings. All the while a young man waits and a lawyer fights for his case.  Families huddle and sometimes cry. There's not much laughter in the serious business of life taking but that's just what Grisham in this novel is bringing forward to the reader's attention.  It's all about the death penalty.  Should the state be in this business and what about the mistakes in the justice system, or rather given all the mistakes in the justice system.  What is Christian and what is American and what is finally Texan? Who would have known that the cost of killing was greater than the cost of living? A good novel and very thought provoking read if only for the actions taken. There is little wonder why John Grisham is a New York Best Seller.

Morality for Appearances and the Ring of Gyges

In Plato, Republic Book II, the Ring of Gyges is a mythical artefact that allows the wearer to be invisible.  With invisibility granted by this ringer the wearer acted in an immoral way.  This was an example for the argument that people act morality not for an intrinsic morality but rather the appearance of morality as it instrumentally served them.
Psychologist Daniel Batson of University of Kansas did a series of empirical studies showing that students would 80% of the time be self serving and rate their morality in such cases as 4 on a scale of 1-10.  However if they were allowed to flip a coin and then do a self serving deed, this appearance of being 'reasonable' ie flipping a coin, resulted still in them acting selfishly 80% of the time but because they had taken the time to flip a coin, even though they ignored the results, this resulted in them seeing themselves as acting reasonably and justly, and rating themselves 6-9 out of 10 on the scale.
If a simple action such as putting a mirror facing them on in another experiment putting a pair of eyes was introduced people act less selfishly and more fairly.  The evidence is that most people act morally out of fear of shame.
I'm interested in the 20% who indeed appear to act morally from some more deeply seated sense.
However this speaks to the need for transparency in the courts and certainly supports the idea of television cameras in the court room at least for the masses.  We do this in parliament and despite back room deals this openess probably promotes greater morality.

Lawrence Kholberg and Stages of Moral Reasoning

Lawrence Kohlberg's Stages of Moral Development was derived from the work of Swiss Psychologist, Jean Piaget.  Piaget claimed that moral development coincided with the development of schema and stages of reasoning in other regards.
Moral reasoning (cognitively, socially and emotionally influenced, the basis of ethical behaivour was divided into six stages:
Preconventional level (morality is due to external controls)
Stage 1 - Punishment and Obedience; child`s limitted thinking bases moral decisions upon fear or self interest.
Stage 2 - Relativistic orientation; child moves from fear of punishment to concern for fairness, rewards obtained
               by bartering
Conventional level of morality (morality as rules for society`s order)
Stage 3 - Social approval
Stage 4 - Maintains laws of system; teen and adult move from preoccupation with what is ``fair`for individuals      
               to factor in conformity to society`s needs; social conscience
Postconventional principled level (morality as value defined)
Stage 5 - Society`s good paramount
Stage 6 - Universal ethics; focus on justice, fairness; recognition of other`s moral standards

Carol Gilligan asserted that male and female moral development diverged. She agreed with Kolhberg`s developmental until age 7-11 when she felt Ethic of caring in girls - Girl`s goals focuses upon compassion, relationships and responsibilities, not better but different from boys. She felt the Ethics of Justice in boys dominated with Boy`s goal bing rationally committing to moral ideals of justice.

An integrated approach to moral development saw five stages of conceptualization<
1) morality of restraint
2) morality of mastery
3) morality of virtuous striving
4) idealization
5) individual responsibility

The philosophical assumptions underlying were that his stages fit `moral reasoning`and not `moral conclusions`.  He insisted that the form and structure of moral arguments is independent of the content. In psychiatry this commonly described as `process``
Kohlberg`s theory centered on the notion that justice is the essential characteristic of moral reasoning.
He further considered that moral judgements could be evaluated logically.
According to Kohlberg one did not `skip`developmental stages but rather movd to higher level of moral reasoning by increasing competence.

In 1979, the Defining Issues Test, based on Kholberg,  was created by James Rest.  In 1999 it was revisd as the DIT-2.

I first studied these stages in the mid 80s during my psychiatry residency.   Later  in preparation for my Master of Divinity I would review this material.  I believe Gilligan`s work has not stood the test of time as well as Kohlberg`s.  Goldberg`s book Emotional Intelligence added to their understanding .I found them all to be useful and applicable to understanding clinical moral dilemnas my patients faced and helpful for my patients to see them as such.  

Theft, Culture and Copyright

When we were in Ottawa we were told by locals that it was a 'safe' city.  We left purchases locked in our trunk and were told that was okay.  We were told by people who lived in Ottawa that it was safe to go out at night.  A poll was just released on "most liveable cities'. Apparently, Ottawa was #1, Vancouver #56.  Alot of different criteria goes into the poll not just safety from theft but that's implicit in the 'liveability' of a city.
Obviously if there are rules, the people need them. There's no commandment 'Thou Shalt Breath".  In the 10 Commandments the Jewish people are told by God according to Moses , Thou shalt not steal.' One imagines Moses had a problem with theiving Jews.  Given that laws have been enacted all over the world against theft it's not just a Jewish problem but a human problem.  Christians certainly kept that commandment in their Bibles. Yet in terms of priorities it was the Jews that first put it on their top 10 chart.  Other cultures don't have  "Thou Shalt Not Steal" in their top 10.
Stealing was the problem that Westerners encountered when they first came to North America.  The First Nations people were great theives. It was a major problem that brought on much of the war.  It might well be said that the White Man was 'stealing' when he moved onto the Red Man's land but the Red Man at that time had no concept of 'land ownership' on an individual basis. Their 'land ownership' was still tribal.  In feudal times in Europe the same thing occurred, the chief or lord of any territory owning all the land all the people being related to him.  Yet the problem of stealing that's repeatedly written about is the theft of tools and clothing and personal items.  Within the tribal society there was prohibition against taking the chief's headdress for instance but it was alright to steal a foreigner's knife. Property considerations existed around medicine man's tools but this 'tribal' condition didn't extend across the boundaries to outsiders.
It's possible to see the beginning of stealing behaviour in young children. A 5 year old and a 3 year old playing. The 5 year old takes the 3 year olds toy.  The 3 year old cries.  The 5 year old is triumphant. I can't say for sure without more extensive research than I'm able to do at this moment but I would believe this reaction a 'normal' reaction which I've seen cross cultural and believe indicates that at the time the 5 year old took the 3 year old's toy the 3 year old considered it her property. I watch my dog playing this game of 'theft'. He knows he's taking the cats toy from her.
So theiving to my mind is inherrently associated with a knowledge of a) somehow that the other person is hurt b) some element of feeling good and powerful c) a sense that a taboo has been broken in someway.  I believe that developmentally children and societies have a concept of property and possession.  Even if I'm 'renting' a motorcycle I'm not going to be happy if you take it from me. I'l be even less happy and show it if you even touch my Harley Davidson that I worked hard and long to be able to buy and own outright.
Bullies, dogs and children steal.
So why do Kings, Queens, Leaders of State, Religious Leaders,  Adults and others steal?
What stops them?
Well, the bully always says, "I steal because I can".  The powerful lead unrestricted lives.  Indeed the admonition among the powerful against stealing is principally "don't get caught".  Caught by who?  First the person who you are stealing from? Secondly any authority that might disapprove of stealing.
It's very easy for those who don't believe in God or an afterlife because they have less likelihood of getting caught eventually. Unfortunately for them they live lives of paranoia as a consequence because in their world view, quite likely, everyone is a potential thief.  Even in Christianity, the thief on the cross beside Jesus gets to go to heaven by simply believing in him. That's why the Italian Catholic Mafia families liked to have a priest handy in hope that a last moment confession would wipe out their lifelong history of theft and rape, murder and mayhem.  What silly superstitious men these were?
When as a kid I tried to steal my brothers stuff he was older and bigger and punched me.  Therefore if I wanted to take something of his I had to do it 'sneekily'.
In the pagan anaimalism religions the rules against theft aren't as clear as Judeo Christian  "Thou shalt not steal".  Instead they're fairly nebulous.  A person whose animal sign is a chipmunk or crow wouldn't be faulted for stealing bright shiny things. That's what chipmunks and crows do. It's in their nature.  Indeed the notion of change in many cultures and religions denies the capacity to learn or alter behaviour of members.  A person is born good or bad, a theif or not a theif. Fate versus free will dictates how much a person can change or learn.  Multi culturalism sounds nice on the surface but in the nitty gritty there's serious potential for problems.
In that case chipmunks and crows shouldn't be given jobs in banks.  Yet in our society in which there is a requirement for assimiliation to some degree we have rules against discrimination.  Yet we are quite happy to discriminate against a crow or chipmunk after they have stolen been caught, done time, and now have a criminal record that denies them work in any place where theiving would be a concern.
So theiving even if it is in one's nature is restrained by oneself in face of greater power. My dog is likely to steal from the cat but being a cockapoo won't steal from his great dane friend if the great dane holds a toy and growls.
But in Vancouver I can't leave anything in my car.  Thieves will and have broken in repeatedly and stolen things. The insurance folk are very loathe to replace the lost items, blame me for my stupidity, everyone knows Vancouver is a city of thieves, and hikes up my insurance premiums.
When I was in Costa Rica I was told the same about leaving things in my car.  Lonely Planet the travel guide often tells tourists in a variety of places that they should beware of leaving any wealth where it can be taken and even says that one should be ware of wearing jewelry.  In some places in the world people have had their fingers cut off by theieves in public places in snatch and grab moments all for the sake of the ring.
Many rich Americans I've heard are increasingly afraid to travel to lots of places in the world for fear of being kidnapped, kidnapping and selling the person back, being a profittable form of theft.
There are also people who think it's perfectly acceptable and culturally right to steal peoples hearts and kidneys. Naturally the person who was using their heart and kidneys at the time consider this a cultural affront.
In contrast there are poor places in the world where despite terrible poverty I've not felt I should fear for my life bcause I was carrying an expensive camera. I felt this way in parts of Bombay (now Mombai) I visitted. Yet in Mexico City I felt the theives were always watching me and my camera.
It's not surprising that 'cutting off hands' was once the treatment for theives.  Kleptomania is a disease category that's very difficult to treat. It's thought that the parents of kleptomaniacs denied their children love and now those adult children  are taking things to fill the gap.  Others argue  that their brain development isn't normal. The research around kleptomania could well be used as a template to understanding common theives, not loved as children, brain missing some part necessary for mature social behaviour as a start.
In one city in the United States everyone is required by law to own a gun. As a result of that this city has the least break and entry and theft in the country.  Theives are as opportunistic as my dog.  They're naughty animals rather than big lions.
There's a lot to do with the 'belief' systems which support 'entitlement'.  The idea that the rich are idle rich and came by their wealth as bullies and theives makes it right somehow for me to be a little theif. Philosopher Dr. Johnson, paraphased by Bob Dylan, said 'steal a little and they put you in jail, steal alot and they make you king'.  Being rich doesn't stop one from stealing either.  Rich men and women have often been caught stealing shiny items in shopping malls. Others walk away with things with an attitude of "I dare you to stop me."  A local former Member of Parliament is forever stealing locally by bullying special treatment and extra 'perks' claiming it their right.
All those who are filled with 'self pity' are potentially at risk for stealing from others because they believe others 'owe' them.
As Canadians who respect "multi-culturalism' I think we should make a concerted effort to investigate immigrant attitudes around thieving.  I know the rules are very clear with Christians who made the laws and constitutions of this society but I'm not sure if a person associated with some odd sect from another part of the world agrees with me that "Thou Shalt Not Steal" means "Thou Shalt Not Steal" from anyone not just members of your sect. This is the law that the Hell's Angels goes by.   As a tribe they feel it's okay to steal from me but not to steal from one another.  Robin Hood of old was all in favour of stealing from the sheriff but he wouldn't steal from Friar Tuck.  Communists like the present Chinese feel perfectly good about stealing from Capitalists like the present Americans.
Now the matter gets even more complicated because we're looking at the notion of 'intellectual property'.  If I write a book and spend 20 years doing it, or make a movie or compose a symphony, do you have the right to take that and distribute it on mass.  If your ideas about stealing weren't too clear about whether to steal your neighbours power tools to build your own house then it's not likely you are going to respect 'copywrite'.
So questions which need to be asked are 'under what conditions do you think its right to steal?
From whom is it okay to steal?
Should there be a death penalty for thieves?
Should all theives be offered the same treatments which have been beneficial for kleptomaniacs.  New medications following on the original success with SSRI's have been shown to reduce kleptomania.
Should the families and tribes of those who steal be punished , because some cultures haven't developed a sense of 'individualism' and the individual as such caught stealing is really nothing but an agent for the family or tribes
Should bankers like those at Goldman Sacks be allowed to keep their bonuses?  Or should all executives of the recent white collar crimes have their pictures posted everywhere so that we recognise them and avoid them. This was found to be an effective strategy dealing with pedophiles and might well work with theiving bankers.
In the end, Thou Shalt Not Steal was seen in studies of 'cultural evolution' as evidence of a higher cultural development because theft caused war and unhappiness. Cultures which were considered 'toilet trained' as such agreed with the golden rule, "Do unto others as you would have them do unto you".  "Treat others as you want to be treated".   That's why there are laws against theft.   My dog knows he shouldn't do it. It's in his nature and I've been able to stop him from taking the cat's things with training. It's not easy.  But it's certainly going to be necessary if we're going to have a society which encourages genius. Right now we have a society which encourages bullies.
We can't all live in Ottawa either.

Bioethics and Psychiatry, British Columbia

A young physician joined a research facility.  A number of physicians worked there. The head physician had been 'star' in his day. His research was mostly on new medications. He was well financed by  one drug company in particular.  The trouble was getting patients enough for his drug studies.
He and some of his colleagues addressed this problem by 'broadening  the "diagnosis".  Though the disease category wasn't 'cancer' it could well have been. To recruit more people for his research he included people who would not traditionally have been said to have 'cancer'  These "healthy' recruits would further 'dilute' the side effects of the medication and allow for better outcomes.  It did subject a whole lot of people to unnecessary toxicity though and in addition could cause some people without other disorders to be given simply the wrong treatment thereby missing the right treatment for their 'correct' diagnosis.
The young researcher was suspicious of this and raised his concerns early. The head researcher explained this away and used a lot of 'attitude' and 'dominance' behaviour to make his point. This of course concerned the young physician even more because people who depend on the gun don't usually have any better argument.
Using the 'local' research criteria the young researcher diagnosed a man with the condition.  The man was indeed sick with this particular condition that could affect his judgement. He was offered a position in the research trial.  When he balked the head physician came and essentially sold the man on the research.
In selection for research people can be recruited for pay, or be offered a position, or have the pros and cons explained and an advocate or family member included to help in the decision. The young physician having had some research experience before joining this community had been exposed to a much different and  more 'patient centered' approach to selection.
In this community however  there seemed to be a real 'drive' to get patients enrolled in programs.  At the time the young physician never thought that there might be incentives associated with this. He'd worked in sales to pay his way through undergraduate studies and he actually saw patients being 'sold' on being part of research that really wasn't likely to benefit them and might well not provide any benefit for the world as a whole. The interactions were distinctive to those trained in process.
Of course this is also all hypothetical and fictitious. In medicine it's said that hindsight is a proctoscope that's 100% perfect only because it's in the hands of assholes.
That the man would be treated with the research drug and die as a result of the wrong diagnosis and wrong treatment could well have happened to anyone. Medicine isn't an exact science.  Mistakes occur and only after death does one recognise the errors.
Usually after death, though,  especially suspicious deaths, there isr a post mortem. This can be a physicai post mortem done by a pathologist and it can also be a psychological post mortem done by the staff. The head physician ensured that neither was done confirming the young man's concerns.
The young man followed the old man's directions because he was  senior and more experienced. The young man  never even speculated that there was conflict of interest.
The experimental drug didn't work.  The research failed.  The man died.  Usually, having an experimental drug is sufficient cause for more intensive investigation of the factors leading up to death.
The young physician had  pleaded with the older more experienced physician but had been  silenced repeatedly. The young physician questioned the diagnosis and questioned keeping the man in the double blind research trial because he was clearly deteriorating and death was imminent.  In those days the young physician was known for being very diplomatic and respectful of authority as the young and highest trained from the finest institutes are.
He'd never encountered such a problem before and didn't know what further he could do.  There was no one, he believed, more senior he could take his concerns to. Further the young man had already been told that that he wasn't considered a good  '  team player".  Being a 'team player' was indeed the highest praise one received in this hospital research institute and perhaps this community at large. .
He sadly learned later from other researchers  that there were many discrepancies and other deaths had occurred . No one spoke up because that was considered unprofessional. The doctors in this community appeared to put the greatest emphasis on professionalism and a lesser emphasis on such matters as patient life and death, , truthfulness, transparency, patient advocacy, patient's rights or any number of considerations that might well have contributed to saving  the man's life.
Further, there was no place in the university for anyone who bucked the system. The hierarchy in research was sacrosanct and the grand man was politically well connected. This hierarchal problem is central to 'systems research' and the study of why corruption is so wide spread in some communities.  For example, the success of the Japanese car industry at one point was the result of a letter box which was solely read by the CEO of the company and open to be used by all employees. Prior to that innovation in the 'system' was blocked by middle management and yukuza who simply removed any one who suggested change in the existing system.
The reformer is the enemy of anyone who benefits from the status quo.  Only the CEO and Board were specifically interested in the quality of Japanese cars because of world wide competitiveness whereas the lower level managers were only interested in their jobs remaining unchanged with all the privileges and perks in tact.
The young man wanted to do something but exhausted all avenues except whistleblowing. Whistleblowing is not taken lightly by professionals.  It's essentially committing suicide to bring attention to someone being murdered.  It's like Tibetan monks who pour gasoline on themselves and ignite it.  Whistleblowying in Canada is routeinely punished.  In British Columbia whistleblowing is crucified. So it was not something to be done lightly.
The young man in the end had  refused to  make the unsavoury decisions alone and insisted that the old man attend the patient and give the orders publicly rather than the young man doing what he no longer believed in alone and in silence.  The old man was furious with the young man for this refusal to cooperate but saw the patient and publicly gave the order which caused the patients death.
The patient died.
The young man not trusting the older , came into the hospital and copied  the file.  The next day he learned that the old man was saying that the patient had died through an error of the young man's.  Further, the chart was suddenly missing and the orders of the old man were expunged from existence. The research assistant later said that the research data was all re written too.  It had been done before when people had died she told him.  Crying she said I can't say anything because he'd ruin my career if I objected.  He learned that several of his colleagues had been directly involved in this sort of thing unbeknowst to him.
Everyone has heard the adage, you can't make an omelette without breaking a few eggs.  No one higher in the food chain was ever concerned about such matters because they had their own skeletons in their closets to worry about.
The young man simply left the hospital. He didn't want to have anything more to do with the old man or with the colleagues whose behaviour, specifically sins of omission, contributed to the deaths of patients. As he put it, "I just wanted to play hockey. I didn't know that I'd joined a bush league run by the mafia. " He never lost his love of hockey though.
He later learned that the research funding had further caused the senior man to have a conflict of interest because there was serious support for a particular outcome measure in the research.  Alot of money apparently was involved not in finding  if the drug was good or not but solely in proving this drug was good and extending it's distribution potential.  The particular drug company involved did not itself have a good reputation.
The young man did not know any of the history of the trend of the very government  appointed beaurocrats to choosing sketchy low cost  suppliers rather than reputable institutions.  Deaths of patients could therefore be likened to the crashes of airplanes that occured increasingly because maintenance was being done by low cost knock offs rather than the specified parts the manufacturer required for wings and engines.  A patient's death could always go by quietly but airplane crashes attracted attention.
The difficulty for young doctors  in primitive barbaric systems is that they are so dependent on the context of their situation and lizards have long been known to eat their young whereas mammalian species usually care for theirs.
The young researcher left the hospital  and returned to general practice.
He was subsequently approached by a  former senior colleague to come forward and speak out against the head and tell the truth about the death of the patient,he was was less than keen.  He felt he was out of that system and had nothing further to contribute.  .  The colleagues who approached him and begged him for his assistance  said that they could not do it as their careers and positions with the university would be jeopardized if they did.  They said that the old man was crazy and killing people and it was his duty to stop the carnage because he had the evidence and could make the complaint.
He discussed this request with a colleague.  The colleague said simply, "I've known that man who wants you to do this  for many years. He's a psychopath.  He is playing on your goodness and doesn't care for anyone but himself. He lacks empathy. He hasn't the capacity for love. He's a chameleon but he's still a lizard. "
Women doctors who he'd formerly worked with also approached him and begged him to help them, his female colleagues.
So he wrote the letter.
The letter caused the head doctor to lose his position. He was deposed by a jury of his peers who felt his behaviour was wholly 'unprofessional'. .
The young physician was never forgiven.  The other senior colleagues who'd 'used' him went on to high position. The woman colleagues never looked him in the eye again. ..
At the time the young physician thought there was still nobility in his colleagues  and that he was duty bound to stop the unnecessary death which was continuing. At the time he never suspected that the persons who were asking him to make the supreme sacrifice  were indeed only hoping to get the old man's position.  He personally knew of no conflict of interest that he had.  Thanks to his teachers and his family and their values he was quite simply most interested in doing what he thought was right, helping out and helping ensure better health care for patients specifically and in general.   Otherwise  he happy to be hunting and fishing and working in his private practice. He figured he'd do research elsewhere if the opportunity arose but he wasn't going to do research locally given the lack of regulation and the tendency of governing bodies to either be themsevles corrupted or simply wholly negligent.
The longer he was in the community the more of a political Sodom and Gomorrah it appeared.
It was at this time that national and international regulatory bodies were refusing to certify the provincial institutions in general. The greatest calamity of the decade was that the Vancouver Stock Exchange lost it's license to practice due to gross corruption. The business community en mass was considered so criminal it lost the right to self government. For years thereafter it only ran with supervision of the Toronto Stock Exchange.  The government in general was notorious for questionable practices which explained why everyone called this the 'wild west'.  A day didn't go by in his office where some patient wasn't being harmed by some group of shysters and their government affliliates like those in the infamous 'leaky condo fiasco'.
Even when MLA  Moe Sihota caught the Attorney General and Premier doing dirty deals over their cell phones, the Premier and Attorney General tried to have Moe Sihota arrested for 'eavesdropping'.  They subsequently brought in a law that would severely punish anyone who exposed graft in government. I was shocked that those caught red handed seemed quite content to accuse the accuser. It was with great admiration I watched Moe Sihota avoid imprisonment.  What seemed significant was that no particular 'party' was alone in dirty tricks.
Everyone was complicit at the time in no end of lawlessness that was occuring partly because of the great growth in the city and province and because of the wealth that was flowing through the great port. The principal agricultarl trade of the community was marijuana and all manner of individuals in all levels of government were somehow involved in the multi billion dollar industry.  The city was further one of the principal avenues of heroin into the US with millions of dollars of profits dispersed through the community.
The logging companies were clear cutting and lying about replanting but at least paying taxes whereas non tax paying  fat cat marijuana criminals were planting acre large plantation in the clear cuts left by the logging companies .
The business of the administration and promotions were made for those who would 'turn a blind eye'.
Conflict of interest was the norm. Further, greed was the community pathos.  With rising costs of living and declining pension potential everyone seemed to be scrambling and no one was interfering in how their neighbour went about survival. Mad men and mad women dominated the landscape.
What was interesting was that they didn't tend to go to church as much after their deeds of dubious treachery and barbarianism, they as often as not showed their hypocricy by seeking social support for their age old villainy in psychological and philosophical theories that would justify their venomous behaviour.  Social darwinism was all the rage along with pursuit of happiness at all costs.  In this age of narcissism there were all manner of drugs illicit and medicinal which could be guaranteed to remove any insomnia or depression that might have once made guilt and shame more unbearable. Sympton management was all the rage.
The young man thought that his colleagues  decisions  to remain mum, and protect their careers, appeared to him to suggest they were like  thieves in a den, not willing to question a thief among them, All manner of shady things had been going on at the time which he'd found offensive but none had caused the unnecessary death of a patient.  So he wrote the  letter which was used by the hospital and university authorities to depose of the  great man.
What the young man didn't know about office politics was that he was just a tool in a greater conflictt, carelessly and stupidly used to remove an opponent.  The puppet master, another drunk and thug, didn't win the gambit but someone else became head.  That person was not necessarily any better or any more caring of patients.
The old man was in retrospect just declining and scared, anxious about money and aging, clinically out dated and irresponsible. In the grand scheme of things using the retrospectoscope of highsight, he was really the best of a very bad lot.  The young man regretted seeing him brought down even if it was the right thing because this old stag was really just surrounded by wolves.  The wolves took over then and things went even worse. It wasn't for another several years before a head was chosen who actually took their Hippocratic Oath seriously and research and the hospital began to function once again somewhat as a 'patient centred' facility.
In a way the old man was like  a King Lear. In other ways he was a MacBeth. Seeing him go was like watching a Zorba the Greek episode with all the clawing old ladies and lesser rat like people grabbing the remains of what he had left. Years later the young man was sorry he'd hurt the older man simply  because he was so much better than what immediately had followed.  Further as he grew to know those who'd pressured him to come forward he realized he had indeed fallen in with worse than theives.
He' d learned however that he could depose a metaphorical Hitler.  He was like David in the Bible who could relatively easily depose a Goliath but it was much more complicated when he had to deal with Saul.   The problem wasn't just single men in his mind but rather all the alliances.  He described his predicament  as not being able to deal with the   NEST.  To explain this he'd say,  if the allies or even the Germans themselves had assassinated Hitler, it was just possible that Goebbells or Eichman would have taken  his place.  Quite possibly they'd have been worse.
The idea that removal of a leader meant better things was only a communist idea from the failed machinations of Marxism.  Revolution didn't improve things but rather as likely made things worse. Like the Beatles he'd all along sung, "We don't want a revolution" but somehow through his inability to see the Saul in a person he'd thought a friend he'd betrayed his own personal principles alligning with a project which was intrinsically ungodly from the start.
Years later one of the gang would suggest he needed to study ethics and professionalism.  By then he knew that God had a great sense of irony.
Professionalism was loyality to the group and the group's good cause. The difficulty with professionalism was specifically that it was so similiar to  tribalism. The German Army was the most professional soldiers of history yet the cause they served changed from what was called higher " kultura" or culture to low culture.  The lower unit of any society after family is  tribe.  It's a gang.  It's a self serving entity that defines all outsiders as the enemy.  Historically a profession was a subsection of society that served its membership and the greater needes of the society as a whole.  Tribes care not for society as a whole and like gangs serve only themselves.
The young man only stayed with the team because he thought it better than the alternative gang.  Professional soldiers were said to be superior to the mob because of the discipline and allegiance. But it was a Prime Minister of England who said " I don't need you to agree with me when I'm right, I need you to agree with me when I 'm wrong." That's the nature of the party system of the government.  It's especially dangerous when it devolves from professionalism into tribalism.
A National Post editorial put forward the question "What is the difference today between a Canadian Political Party and the Hell's Angels?"  This was a question that didn't need to be asked 20 years ago but was clearly one being asked today.
In medicine the doctor owed allegiance first to his Oath and his profession.  His oath was first 'Do no harm' and that the "patient should come FIRST:'.  The Beurocrats were very good at platitudes and 'saying the right thing'.  Georgia Strait newspaper  annually made a joke of banning the words over used by beaurocracy as 'buzz words' and 'politically correct' hypocrisy. There was a serious disconnect between the words and behaviours of some individuals and especially the institutions which promoted them.
By use of the corporate and beurocratic term,  'terms of reference' all investigation into any malfeance limited  their 'apparent' culpability, accountability and responsibility. Hence even  a massacre commission might insist that it was only called to judge the death of one person in a massacre when that sole person alone  had in fact, as the subsequent report showed, died of natural causes.  By limitting 'terms of reference' the commission didn't have to account for the countless machine gunned bodies.
The young physician had seen too much unnecessary death and in the end was labelled a whistle blower. He'd stopped many individual deaths. by speaking up.  His 'sacrifice' individually had been in countless lost nights of sleep, personal threats to himself,  endless hours of research and consultation with others, and immense loss of income all to conclude that the 'NEST' seemed the same as when Kafka described it as the "Castle". He had played the Glass Bead Game and become Magister Ludi but to no avail.  The best he could do was indeed simply the 'next right thing'.
Talking with the deacon of the Queen's church in Buckingham he was told by this old white haired poet, "I finally learned that there's all the money in the world to help the sheep that survive the fall from the top of the cliff as long as you don't do anything about the hole in the fence up there.  And God forbid you don't say anything about the people pushing the sheep off the cliff."
Today he was looking for a bioethicist who had sacrificed his career to save the life of one man.  From what he'd read so far philosophers learned far more from the death of Socrates than Christians learned from the death of Jesus.  He wasn't sure though they had anything to offer in tying action to word because everyone was so very good at paying lip service and no one seemed willing to pay the blood price.