Perhaps there is a psychiatric resident's progress or the fields progress implied in the mood disorder codes. As a first year resident you confront the awe inspiring threatening pellucid black cloud of Major Depression, 296.2. Getting something of a grip, you find that the patient did too but lost it and progressed to 296.3, Major Depression, recurrent. But there is more to mood disorder. Sometimes the patient might have prominent irritability or high moods and be in Bipolar I disorder, manic, 296.4. And sometimes they have been there but are in a state perhaps now indistinguishable from Major Depression but, having been to 296.4, they are now at 296.5, Bipolar I disorder, depressed. And, finally, or not, they may be having alternating or mixed states together and, no longer a child in psychiatry, you see Bipolar I Disorder, mixed, 296.6.
Tuesday, June 24, 2014
All official diagnoses have a numeric code attached to them. It struck me a while back that there is a bit of history implied in those codes. Attention Deficit Hyperactivity Disorder, combined type is 314.01, inattentive type alone is 314.00, but hyperactive type alone is 314.01 which I suppose suggests that the original perception of the diagnosis was of something associated with hyperactivity and only later was it seen as useful to consider the criteria and make a diagnosis in the absence of hyperactivity.
Thursday, June 19, 2014
Megan McCardle asks. Of course, notpresidents aren't all that popular either. It's like playing poker. You've got to put together a hand that wins you the office. Recently this has been harder for a Republican candidate though Bush drew into a straight almost busted by his past alcoholism in light of Clinton's misbehavior and our desire for propriety. What might be considered an anti-Republican constraint affected Bush later in the game though in that he effectively was told he had to sell a casus belli on Iraq to the U.N.; so he emphasized the likelihood of present WMD in Iraq. Ever after, 'he lied;' actually he presented his best evidence at the time about which there was rough consensus, kind of like global warming now; and he was probably more concerned about future dangers. Hubris plays a role. It may be that of the American people who can demand that other people not idealize communists as Eisenhower and Dulles and Kennedy, following through the presidential door, did in VN. Or it can be that of a man such as Nixon, who, perhaps following the example of predecessors, breaks'little laws,' but, in his case, wants meticulous evidence of what he did. Obama plays his cards by not leaving 'one scintilla of evidence' which satisfies his partisans completely. Others not so much.
Saturday, June 07, 2014
Marc Ramirez recently reported on salvaged elements of Dallas history, appealing decorative sculpture. When I moved here many years ago, I realized in the summer heat I wasn't in Chicago, mostly a loss, but the gigantic tableaux picture of the Mexican woman in the land at the El Chico on a large open wall was intriguing and reassuring. This I believe still is at the Lovers lane location now near the Tollway. One author has called the regional culture El Norte, and for me this picture better represents the ongoing issues of adaptation that the imposing Amercan culture faces than did the hitching stake did at the DMA.