The Right to Die: Kevorkian Revised

California is on the brink of something big. A monumental decision in human rights, tail-gating the epic Supreme Court ruling on gay marriage, but unlike the law of marriage, where one’s life is just beginning, this law meets us at the end of it. The Right to Die Bill, better known as the Death with Dignity Act, Physician Assisted Suicide, or even “Kevorkian Revised,” is nestled on the desk of California governor Jerry Brown, awaiting his inscribed approval. But will he give it or will he condemn thousands of suffering Californians to a painful, embarrassing death?

For years, a handful of states in the US have been proposing and passing bills and laws allowing one to make their own decision on when they prefer to die. Some people have likened this process to Dr. Jack Kevorkian’s practices of the 1990s, where he assisted in ending the lives of 130 patients, all of whom he claimed were terminally ill, though this has been disputed. It is alleged that often times he didn't even verify that the patients were ill, and ended up assisting a few who simply suffered from severe depression. But in spite of his misguided practices, Kevorkian may have been on the right track. In the midst of his own failings, ones that would eventually land him in prison for second-degree murder in Michigan, Oregon passed a state law that would allow individuals who were terminally ill to choose to end their own lives. This would help them avoid a long and drawn out death that would end in nothing but extreme pain and humiliation. In 1994, the Death with Dignity Act was signed into law.

But the law was not without its opposition. Like many bills, misinformation had been spread thick, coating more gullible minds and manipulating them into a stealth support system around the nation. Many warned of the inevitable slippery slope: if we start killing terminally ill patients, why not the mentally ill? Why not the mentally and physically disabled? Why not kill people who don’t want to die but whose children are trying to get the inheritance, or who don’t want to bother with the costly care of a sick parent? Why not kill the Kardashians? (But seriously, why not the Kardashians?). A few claimed prescribing a deadly medication was against the Hippocratic Oath. Others claim suicide is the easy way out, that these people are weak, that they’ve simply given up. One Archbishop claimed the law would provide insurance companies an easy way out, denying patients appropriate care in favor of an easier and much cheaper solution. Some cite religious factors, that if you end your own life, you’re going to hell.

First off, multiple safeguards have been put in place to ensure that we cannot go on a genocidal killing spree of the various “plagues” of society, as Hitler may have done. Oregon state law and the California bill specifically state that only individuals who have been diagnosed by two separate physicians as terminally ill and expected to die within 6 months may receive this medication. These individuals are also expected to undergo intensive mental health examinations to ensure they are of sound mind and body to make such a decision. Once provided the medication, no one can administer it except the patient themselves. The medication is mixed into a drink; the patient is required to drink it themselves without the assistance of any physician, family member, or friend. If they cannot administer the medication themselves, they cannot utilize it. In short, if you can’t hold your own glass and swallow your own medicine, you will have to wait out the rest of your life until you pass away naturally. There is virtually no chance of someone else rubbing you out. Sadly one man had ordered his medicine but was waiting until the right time, and he ended up having a severe stroke, leaving him incapable of giving himself the medication. He suffered until his last day.

Some individuals have been concerned about providing doctors the power to “do harm” in contrast with the Hippocratic Oath they swear upon licensing. Doctors themselves have grappled with the decision in prescribing deadly medications. This was briefly mentioned in the documentary, How to Die in Oregon. One doctor finally came to realize when her patient Cody asked for the script, she would be doing more harm in forcing her to suffer through the pain of terminal cancer in her last months than to ease her into a quick and gentle eternal slumber.

The easy way out. I can only imagine the reaction some of the benefactors of this law would give when they hear that. All of these individuals have fought. All of them have suffered. They have faced numerous chemotherapy  and radiation treatments, they have stumbled through the side effects, the nausea, the weakness, the hair loss and weight loss, and the surgeries and tests in hopes of battling their diseases into remission. And sadly, they failed. Their efforts were not enough. Their bodies could not muster the strength and the antibodies to silence the invading cells once and for all. They rode into a war some of us will someday fight ourselves, a war all of us will have witnessed with our loved ones. And after all they have been through, they deserve that peaceful death, in their own time, with their own choice, adorned with the dignity they have earned. Cody tried her best to get through it on her own, to arrive at the moment where she would naturally “float away” without the medicine. She had ordered the medication and it sat in her cabinet for nearly a year as she outlived her life expectancy. Initially she had planned the date to die, but decided against it, because she was not suffering at that time. Suddenly, after months of extended comfort, fluid began to build up around her lower abdomen, creating so much pressure that her organs were displaced and her ribcage was shifting upwards, compressing her chest cavity. Draining the fluids offered only temporary relief and she was often hurting, struggling to keep foods down, incapable of keeping most of her pain management pills down. Doctors informed her that in spite of the cancer, her body was strong, and she could continue to live on in severe pain for several more months. There would be no floating away. It was time to go.

As for healthcare companies and the easy way out, in the same documentary mentioned above, one man had been diagnosed as terminally ill and was denied treatment for chemotherapy by his insurance. He was, however, provided in his denial letter a solution. In being notified that he cannot receive what he believed may be lifesaving treatment, he was also informed of his option to request life-ending medications, which would be fully covered by his insurance. This understandably angered him, but let’s get a few things straight: he had no possible chance of survival and the treatments would have been largely ineffective anyways (once he went public with his complaint, the insurance company granted his treatment, and he died a few short weeks later). But I will not deny that this could be a very real possibility given the dastardly methods insurance companies have employed to save a buck over a life day in and day out. However, why prevent some people from having the option to avoid suffering because of a corrupt healthcare system? Address the system head on! Where is healthcare reform? Where are the checks and balances? These people shouldn’t have to suffer because billionaire insurance companies have lost their sense of humanity.

Religion? Bottom line: your religion is not their religion and you cannot use it to make laws for everyone.

Last year, Britney Maynard made headlines when she relocated from California to Oregon to take advantage of their Death with Dignity Act. Diagnosed with a terminal form of brain cancer, Britney had undergone multiple operations and treatments to battle the disease before recognizing that she would not win. Given that she had no right over her own life, she was left with little option than to move, but became a significant advocate and a public figurehead for getting similar laws passed in states that have not acquired such legislation. Britney passed away at the age of 29 at home surrounded by her loved ones.

As I watched How to Die in Oregon, I bawled after each patient took their medication and slipped into a calm and gentle darkness. I was torn in half in the moment. I have never seen someone pass away, and I couldn’t imagine standing there in a room watching someone I love take a mixture that would rip them out of my life in a matter of minutes. I would never be able to hug them enough, I would never be able to say enough to them before I finally had to say goodbye. I would never get enough of the sound of their voice or their smile before they slipped away from me. But, like many of you, I have watched my family members and friends suffer and wither away from cancer, from terminal diseases that render them helpless. I have seen my family, always strong, always proud, try to mask their embarrassment as someone had to feed them and clean the excess that dribbled down their chins, as someone had to wash them in spite of their deep-seated modesty, or wipe them after using the bathroom. They were lucky, I suppose, in that they never lived long enough to be confined to diapers, sitting in their own urine and feces like helpless infants until the nurse came ‘round again to change them. And they suffered. They hurt. They couldn’t bear the pain, the nausea, the weakness, the humiliation and embarrassment. As one family friend had put it, “I’m sick and tired of being sick and tired.” But we had no solution for them. Just make them comfortable. Pump them full of pain meds and wait for the inevitable, whenever that may come. But like Cody, sometimes they can’t keep the pain meds in. Sometimes, as they get closer to the end, the pain meds are rendered totally ineffective, and they suffer in their final days.

Cody died in the comfort of her own home. She was not weakened to the point of being bed-ridden; she was not strewn limply across her bed with tubes and needles feeding in and out of her. And because her fluids had been recently drained, she was not suffering at the moment. Cody was singing. She had gathered her family in her bedroom and her children and parents sang songs to her, light-hearted children’s songs she no doubt sang to her kids when they were young. They hugged and kissed, they said their goodbyes, and she took her medicine and lay down. In a matter of minutes, she breathed a sigh of relief, and slipped into a coma that would soon allow her to finally float away as she had always wanted.

This law must pass. We cannot condemn people to suffer in their final days because we fear the loss, because we fear the choices they’re making for themselves. I struggle to comprehend how we can be so humane as to inject our beloved pets and animals with a painless medicine to end their own suffering, but we refuse to allow it for human begins. We can’t treat each other as well as we treat our dogs. We deserve so much more than that, and our loved ones deserve more too. 

Out of Orange Juice

Possibly the most unnerving moment in a homosexual’s life, the coming out party, has the potential to uplift you, to raise a harrowing burden off your shoulders, to unmask the lies you’ve lived and send them fluttering away like torn pieces of paper on the wind. Or it has the power to level you, dissemble you bit by bit and leave you broken and dying in the gutter. My party took form in the latter.

At 15, I had done little to hide my sexuality as for the most part I hardly understood it myself. But my mother saw it, and had seen it for years: the moment she caught me kissing my female next door neighbor as a young child, my lack of boyfriends, the promiscuous photos of women I had printed off the internet, and the not so subtle confrontation from my high school teacher during conference night when she informed my mother the photos of women in bikinis were unsuitable decor for the inside of my binder. Driving to the store one afternoon, my mother finally asked that definitive question, and for a moment the world froze. Unsure how to respond, all the while knowing she had asked a question she already knew the answer to, my hesitation came from the fear of what this confirmation would bring. I took a breath and nodded in the affirmative, but added the qualifier that I was not gay, but bisexual, as if the 50% of Normal that lingered somewhere in my gut might’ve softened the blow and made me seem more human somehow. This did not sway my mother, and a lecture ensued, littered with religious proclamations and damnations as I was beaten down by God’s hatred for gays and my ultimate destination of a fiery afterlife.

I wanted to die. I grappled with my own self-hatred. Raised a Christian and incredibly devout through my childhood and preteens, I had turned away from the church for several reasons, but my sexuality played a larger role. My peers at school were beginning to catch on as well, and the bullying that ensued pushed me to the edge. I watched movies and read books about other homosexuals, hoping to identify with their stories. Instead I felt anger and jealousy whenever I read of a situation where someone else’s family supported them and loved them through their coming out (above). Why couldn’t I have that? Why don’t I deserve that? A failed suicide attempt left me with one dark realization: without the love and support of my mother, I wouldn’t make it through this world alive.

I always sensed that my mother clung to the hope that the 50% of Normal in me would prevail and I would end up with a nice man, get married, have a family. Even I hoped it, knowing the perilous road that I would walk if the evil lesbian in me won. But as I progressed through my adolescence, the dream of normalcy faded along with my deluded attraction to the opposite sex. A date with a male companion finally made me realize that I was fully gay and the hopes of a peaceful heterosexual life died. I would have to do what many homosexuals have never faced: coming out a second time.

When I was 21, following the date with the male friend, my epiphany, and an eager inquiry about a second date from my mom, I sat down to tell her that the Normal was gone. Shaken and traumatized from the first coming out response, I immediately began sobbing and blubbering out that I didn’t like men and never would. Noting my devastation and the utter fear in my eyes, my mother took a softer stance than before, insisting that she still loved me and she always would, I was her daughter, after all, but adding the point that no matter what, she could never support my lifestyle or what I was doing. It was against her religion and she couldn’t be made to see differently. Begging for her acceptance, I was denied. It was unconditional love with an asterisk and a footnote: “I love the You, I love my daughter. I can never love the Lesbian, I will never accept the abnormal.” Leveled again, I retreated to my room in solemn resignation. Accepting the loss, I began to tentatively live my new life alone.

Dates came slowly and were enveloped in my mother’s disapproval. Knowing I was going out, she would ask where. Once I revealed that I was going on a date, her lips pursed shut and she spun on her heels, hastily vacating the room. I often returned from my date to icy silence and tried to keep future dates under wraps, lying that I was going out with friends or going shopping. But gradually, very gradually, things began to change. A few years later, dates began with my mother asking directly if I was going out with a girl. Then they were capped in the end by the simple question: “Did you have a good time?” One quick “yes” and the conversation was over as my mother retreated to the kitchen, having done her duty by asking at all. It was understood that details were not requested or required, but my mother was trying.

But it was not a steady ascent to acceptance and harmony. Our progress was pock-marked with regressions and fallbacks. Like me explaining to my mother why she couldn’t use the word “faggot,” or my mother absent-mindedly lamenting her disgust for two women walking down the street hand in hand, forgetting I was seated in the car beside her. I think, however, that the biggest step back came in 2008, when my mother informed me she had voted yes on Prop 8. Furious and confused, a ticker tape of memories ran through my mind of all the progress we had made, all the changes we had gone through, only to stop at such a critical crossroads. My mother explained that she didn’t mind gays dating and living together, but felt it frivolous and inappropriate to grant them marriages. Arguing still that marriage was a religious institution and homosexuality had no place in marriage, she couldn’t grasp the significance of her vote or the obstacle it created in helping me feel that sense of Normal again.

Older now, a bit wiser, slightly more patient, I was angry, but understanding. My mother had been fighting her deeply rooted religious beliefs for 10 years, trying to balance her faith with her biological attachment and affection of her own child. She tried to make heads or tails of which path to take: follow the 3,000 year old theology her life had been based on, or erase the asterisk from her unconditional love and support her daughter, embracing her completely. The decision could not have been easy, and separating the two was a challenge my mother had tasked herself with for the past decade. But bringing that lifestyle into the church? Merging the two by granting marriages before the eyes of God in his very house? My mother could not handle those worlds colliding and she voted the only way a God-fearing woman of tradition could.

The following years, as I went on sporadic dates, my mother’s interest increased and the events were sandwiched with questions and comments like “where are you guys going? You look nice, have a good time!” and “What was she like? What’s her name? Will you see her again?” And the Normal began to grow. We survived my brother’s wedding, an event which at the time I looked upon with somewhat blighted eyes. I struggled through the pain of thinking I would never be afforded the same opportunity as a legal marriage, and I watched as my mother buzzed around preparing what she must have thought would be the only wedding of her children, even commenting it would be “the only bridal shower [she] would give” and “the only daughter-in-law [she] would have.” I did not take this to be a malicious comment, just more so a statement of fact as the fate of Proposition 8 sat on a desk somewhere outside the US Supreme Court, awaiting someone’s consideration.

Lately I have been flittering through internet dating sites and personal ads, struggling with my own perpetual social anxiety and my dislike for the club and bar scenes to find love. On top of that, I have the worst case of baby fever as my hormones have kicked into full gear. Though I am not even 30, my own unfulfilled expectations of where I should be in my personal life leave me melancholy. While family members and friends are getting engaged, marrying, having babies, I have yet to secure even a long term relationship in my hapless decade on the gay dating scene. Overjoyed by the announcement that my brother and sister-in-law are expecting a child, a twinge of pain struck my heart knowing that a baby for me is so far away. I always knew I wanted children. I of course dreamt of sharing the precious milestones of raising a child with a partner, but even if I never found a partner to have one with, I had made up my mind I would be a mother through my own pregnancy or adoption. But being gay makes the task that much harder in that you must pay for either artificial insemination or adoption, in addition to all the other costs that come with having a baby. Knowing I cannot afford this on my own, I am left feeling alone.

I burst into tears one night. My mom held me as I cried for my loneliness, I cried for my uncertain future in love and motherhood. And with one comment from my mother in one moment, I realized how far we had come in the last 15 years: “I will pray for you. I know someone is out there for you, and I know you will find her. I will go home and pray for you, I just want you to be happy. That’s all I ever wanted for you.”

I love you, Mama.

From Ribbons and Dolls to Fish Nets and Johns

Hookers. Whores. Harlots. Wenches. Women of ill-repute. Prostitutes. There are many names and titles for women who sell their bodies for sex. Did you ever think "child" would be one of them? Most people don't. Even when we think of children being used for sex, we think sexual abuse and pedophiles, not solicitation and pimps. What about the phrase "human trafficking"? For most, the term brings to mind thoughts and images of foreigners, refuges, unfortunates being shipped in from around the world, gliding through the US borders under the cloak of the black market for sexual favors. It doesn't foster mental pictures of American teenage girls on the street corners of LA, New York, Nevada, and many more states working their territory as a villainous pimp lurks in the shadows nearby. But that is exactly what is going on in the US today, and has been for quite some time.

Many girls and boys in the US are being scooped up in the despicable world of solicitation by pimps and gang bangers just looking to make some quick money. And when I say girls and boys, I mean exactly that. At this time, the average age for entry into solicitation is 12, though children as young as 7 have been documented to have been sold for sex in the states. Girls are more prominent in the population than boys, but there are young boys being utilized on the streets as well. This blog, however, will address the females since most studies have focused on them and more information is readily available. How do these girls get picked up? Pimps practically soar above the dankest neighbors and cities like hawks, searching for prey, and have an eye for the "type".

Most girls who are easily manipulated and drawn into "the life" (as they call solicitation) are girls coming from broken or disturbed homes. Many struggle with self-esteem; they lack the attention and involvement they should be getting from their parents, lack a sense of safety and belonging. Many are runaways, and most have been sexually abused in the past, which automatically raises the risk for re-victimization. Being well-educated on their needs and short-comings, pimps ride in on their soiled horses, a knight in aluminum armor, ready to sweep these tragic children off their feet and persuade them with a fairy tale ending, which is of course nothing more than a fairy tale. Typically, a pimp finesses the child, sweet talks her, and makes her feel important, wanted. He might compliment her on her beauty, tell her she's special, make superficial promises. An introductory dialog might go like this: "Hey baby, you are looking so beautiful tonight, I can't believe you don't have a man looking out for you! You are gorgeous, you got it going on! Why don't you let me take care of you, baby? Let me take you out, I'll take you to nice places to eat, I'll buy you this dress, I'll get you some diamonds,you'll live in this great house, come on girl, get in the car!" While most of us know a pathetic game when we hear it, a 12 or 13 year old girl who has been emotionally neglected for the majority of her life and still suffers from the poor judgment all tweens have is overwhelmed by the positive attention, gushes and blushes and jumps in the car to start her new life. A life, a fantasy, which lasts a few weeks at best.

There is, at times, wining and dining and some flirting and "love". After a week or two, though, once the trust has been earned, the fairy tale shatters, and the dark nightmare begins. The pimp, who is done with the flowers and the threads, suddenly turns on the girl, tells her in short "girl, I'm a pimp, you're now my bitch, and you're gonna make me some money." Threats of harm follow to cement the reality of the situation. Of course, in that brief period of ecstasy that preceded this revelation, information has also been gathered on the girl's family and their addresses. So to secure the business deal, viable threats toward her family are made. The girl is coerced into sexual exploitation and she begins her fairy tale life of rape, violence, johns, pimps, and degradation.

A pimp usually has multiple girls in his pocket and one "head girl" ironically named the "bottom bitch." This girl is typically favored by the pimp, receives the most benefits, and is in charge of managing the other girls, as well as recruiting potential workers. They teach the new girls the ropes, show them how to draw in the customers, coach them on discerning between undercover police and legitimate johns, and most importantly, teach them about the life under their new "daddy." There are quotas to meet, rules to follow, expectations for behaviors, and severe consequences for any breach in guidelines or protocol. Missing a quota usually results in a beat down, refusal of food, shaving one's head, and walking home barefoot as the pimp drives behind them. Many girls have reported being run down and hit by the pimp's car, not hard enough to kill them, just enough to make a point. Sometimes it means compensating for the loss of money (a gang rape), or in one girl's case, being tied down naked to the bed and, like a revolving door, having one john after another come in and rape her, leaving the money with the pimp before each encounter. The girl was 13. If, on the other hand, the girl meets her quota, her rewards depend on the pimp. Some will give them a small percentage of the money earned. Some girls have reported earning a $1 cheeseburger at McDonald's if they meet their quota (most quotas are set to $700 and above every night). Some just avoid physical abuse and live to work another day.

The most effective weapon these pimps have to reign these girls in is psychological warfare. As previously mentioned, these street princes bait the girls with charming hollow promises and whispers of sweet nothings, then like a pumpkin carriage on the stroke of midnight, they transform into the menacing antagonist they are at heart. Threats of harm towards the girls and their families keep them in his pocket, too terrified to run and pursue freedom. It was once reported that a girl had attempted to run away from her pimp, but was caught. To set an example, the pimp gathered his other girls, took them all out to a field, and lined them up. He told the others "this is what happens when you try to leave me!" and shot the runaway in the head, leaving the others far too frightened to try a similar escape. But, at times, even when the looking glass has shattered and they see the reality before them, some girls cannot accept the truth. Suffering from trauma bonding, formally known as Stockholm Syndrome, these girls develop a sense of love and affection for their exploiters, who, in their eyes, can do no wrong. Many have deluded themselves into their own fabricated fairy tale, lamenting "he really does love me! He buys me clothes, and we sleep in the same apartment, he gives me some of the money I earn, he takes me out to nice dinners and he's a good daddy to our son!" They ignore the beatings, the fact that he has four other girlfriends, and that at the end of the day, if money is low, he will send them out to have sex with other men for more money.

The justice department is of course, not much help. Though many girls picked up by the police are underage, they are charged for solicitation and detained or placed on probation. Ironically, in the state of California, an individual under the age of 18 cannot consent to sex with someone over the age of 18. Under normal circumstances, if a 17 year old child is found having intercourse with an adult, the adult can be charged which sexual assault or statutory rape. If a 13 year old child prostitute is found having intercourse with an adult, the child is arrested, and the adult is giving a warning or a ticket. The child can spend up to a year in juvenile hall. The adult? An 8 hour course on illegal solicitation (this is the same consequence for receiving a traffic ticket). Other times, the police actually become johns, being educated on where these children work, they have no difficulty taking advantage of what they find to be favorable circumstances. A recent proposition was passed in California in the 2012 elections which would criminalize pimps and johns for seeking intercourse from minors, which passed overwhelmingly, however the prop was placed on hold after a judge deemed the language of the bill "too ambiguous to protect the rights of the accused." And these girls are once again victimized by people who were expected to protect them.

It is has become a dark world when a child cannot walk home from school alone because pimps are recruiting on the street corners. I have begun working with many of these clients; it is tragic when 20% of my clients have been approached by pimps, and another 20% have worked for one at some point and time, if they aren't still. Child Sex Trafficking is made up of a population with many titles which are constantly changing to provide the most accurate perception, from Sexually Exploited Minors (SEM), to Commercially Sexually Exploited Children (CSEC), and now Domestic Minor Sex Trafficking (DMST) to reiterate that we are not talking about foreign refuges and unfortunates. Many cases are hard to swallow, many break my heart, and some have traumatized me. But this is a problem that has flown under the radar for so long it can never begin to be resolved if it continues. If awareness cannot be bred, these children cannot be saved.

For more information on domestic child trafficking, visit these sites:
http://www.misssey.org/
http://www.gems-girls.org/

And you can watch the informative documentation, Very Young Girls on YouTube Here:
Part One:
http://www.youtube.com/watch?v=ycgaPw38fkc

Part Two:
http://www.youtube.com/watch?v=u7I54dPNQqk

Part Three:
http://www.youtube.com/watch?v=6gEbqPRnBEI

Apologies

Sorry to my few readers for the extreme delay in blogging, life has been cray-cray with a new job, new apartment, and all kinds of crazy new experiences, which will undoubtedly be blogged within the next few weeks. Hope you enjoy the latest!

The Cold, Callous Child: Sociopath in Training

To act without emotion, without a sense of empathy, with little concern for the pain one causes another and even an almost obscene enjoyment of harmful acts. These are symptoms usually reserved to describe most individuals with sociopathy today, also known as Antisocial Personality Disorder. As with most personality disorders, there are age requirements and limits to meet the criteria for diagnosis, and with APD, one must be at least 18. So what happens before 18? It has been shown through most studies that those who qualify for APD as adults presented with symptoms of Conduct Disorder as children. Both are categorized with symptoms of criminal behavior: harm to others, theft and property damage, serious rule violations, deception and defiance. But one key symptom seemed to have been left out of Conduct Disorder that presents in APD: lack of remorse. While most children with Conduct engage in maladaptive behaviors, there is usually resulting remorse or regret, even if it’s simply the fear or disdain of the punishment that inevitably follows. Additionally, studies have demonstrated that most children eventually grow out of such behaviors by the age of 21 rather than progress to the more chilling diagnosis of APD. However, aside from Conduct Disorder, there is no other diagnosis that can accurately diagnose children presenting with possible Antisocial tendencies. But is that to say it doesn’t exist? Can children be sociopaths and should we diagnose them at such young ages?

In my line of work as a therapist working with severely disturbed children, I have handed out many diagnoses of Conduct Disorder and all kids have had similar symptoms as well as similar origins. Most are given this disorder due to serious rule violations (truancy from school or running away from home), deceitfulness (lying about where they are going), theft (stealing from family or local stores), and other negative activities such as drug use, gang activity, etc. One last category included in the diagnosis is of course harm to other people or harm to animals. In nearly all my cases, harm to others has included fighting with peers at school; in rare cases, it was fighting with staff at their school or group homes. All were impulsive acts, poorly thought out, all fueled by anger or pain, and while some did not openly express remorse toward their victims, there was an element of emotional response: anger for being caught and punished or blame toward the victim for upsetting them (typical to avoid self-blame and thus remorse).

In Antisocial Personality Disorder, aggression and acts of violence towards others are rarely impulsive. These behaviors are usually planned and carefully calculated. A premeditated act, there is no crime of passion or rage, just cold, undeserved punishment against some defenseless victim. A good example of such would be Timothy McVeigh, who for months plotted a terrorist attack against the Alfred P. Murrah Federal Building in Oklahoma City. He had no particular victims in mind, no one who upset him other than the US Government. McVeigh detonated a car bomb which caused over $500 million in damage and killed 168 people. When he learned there was a daycare in the building, he wrote the lives of 19 children off as “collateral damage”. He remained calm and collected throughout his arrest, questioning, trial and death. In the remaining years of his life before being executed, he never expressed remorse for his actions.

While it is difficult to imagine a child as cold-hearted as McVeigh, to assume that such characteristics arise purely in adulthood is absurd. Signs and symptoms present themselves early in life. Ted Bundy had such an incident when he was 5, where he stood by his aunt’s bed while she slept. When she awoke, she found him with a devilish grin, watching intently. As she became more alert and aware of her surroundings, she found that she was surrounded by a collection of knives laid on the bed, points directed inward toward her. The book “Children Who Kill" also gives several accounts of disturbed children engaging in acts of cold murder and torture far beyond typical problem children. And I have had the unfortunate business in my 21 months of work as a therapist to come across two such kids.

Both were six years old. My first was much harder to diagnosis: he presented with a mosaic of symptoms, bits and pieces of disorders never quite coming together to conclusively provide one concrete diagnosis. His symptoms ranged from possible autism, Aspergers, or developmental delay, Conduct Disorder or Oppositional Defiance, anxiety, depression, or bipolar disorder. He was moody, most times without antecedent, which would throw him into fits of rage that would last for several hours, or an abundance of depression, triggering crying fits for days. He also presented with a remarkable ability to control his emotions and behaviors, having fits and tantrums at home but not any issues at school. Even in a brief exchange during therapy, while I was explaining that therapy was a safe place to talk about our thoughts and feelings, he angrily retorted “I KNOW!" Taken slightly aback by this abrupt outburst, I calmly addressed it, asking why he felt so frustrated. His physique changed in the flash of a moment: his hunched shoulders sloped, his furrowed brow relaxed, his expression almost angelic, and he sat back and cooly responded “Nothing, I’m fine”, as if he had been caught with his hand in the cookie jar and tried to cover the evidence. He acted aggressively towards his younger brother, 3, whom he would drag around the house from room to room on their tile floors by a small limb, or whom he would calmly walk up to him and without warning scream inches from his face and frighten him to tears. Previous therapists could not pinpoint a disorder, and my task was no easier. While my supervisor pushed for Conduct, at the time to me a conduct disorder diagnosis was a life sentence on a dark road to sociopathy. He was given a provisional diagnosis of conduct, but it wasn’t until 8 months later that I was no longer given an option. A call from his frightened mother informed me that he had killed a duck at the local park, and she believed it was intentional. While somewhat fantastic, she relayed the tale of woe, that he, a pitcher for his local little league with a strong arm, had collected a pinecone, approached a duck by the riverbank, and threw the pinecone full force at the duck’s head. The duck began seizing, no doubt from a hemmorhage, and flopped over in the water, dead. Mom reported he did not seem phased by the incident and did not show remorse. When I later asked him what his intent was, he stated he “wanted to see what would happen”. He later confided that he had the option between the duck and a turtle that was also in the water, but noting the turtle’s protective shell, he stated “I knew if I hit the turtle, nothing would happen, he would just swim away, so I threw it at the duck”. Chilled by this calculated thought process, I reluctantly listed Conduct Disorder on his file.

My most recent case, I cannot go into detail with given that the case is still open, however he presents with a less complex case, nearly no mood lability or developmental delay but similar symptoms of disturbances which resulted in the death of an animal. Both children we exceptionally bright, both came from families with histories of significant mental health issues.

What has become apparent is that in comparison to my typical conduct cases, these children are in a class all their own. While Conduct Disorder has been generally considered the childhood APD, the connection between Conduct and Antisocial Personality Disorder is built on nothing more than a mere resemblance of one another. As previously stated, APD lacks the crucial component of humanity: empathy and care for one another, regret and remorse for our own behaviors, which is not necessarily reflected in CD. But even if the DSM could create a more appropriate diagnosis for children presenting with sociopathy, would the field allow it? Much like my reluctance to diagnose a 6 year old with such a dismal label, many others would most likely be just as apprehensive to diagnose a child with a damning sociopathy label. But as with my dilemma, my concern for labeling a patient and my hesitation to do so did not bring that duck back to life, and it did not make my patient’s difficulties disappear. If anything, it only delayed receiving more appropriate treatment. While labels can be hurtful, refusing to diagnose for fear of social stigma can be far more detrimental and as a therapist it is ethically unsound.

Dan Waschbusch, a researcher at Florida International University, has continued his study in children presenting with similar symptomology as my cases, and even one child named Michael was an almost exact replicate of my first kid with moody lability, hysterical outbursts, calculated aggression and violence toward his siblings and amazing mood control. Waschbusch described the condition as “Callously Unemotional Children”, and began a research camp where many children with the same affliction were sent to be observed and treated. The level of manipulation was immeasurable and bringing these children together could have been a recipe for disaster. Many children ended up worse, some remained the same, few improved, though Washbusch maintains that early intervention and intensive treatment could drastically improve the chances of these children growing into productive members of society. I am not so sure that I agree at this point and time, as an effective treatment cannot have been developed yet; typical behavioral interventions are probably ineffective as a simple system of rewards and consequences mean little to children who struggle with apathy. Certain medicinal interventions have been ruled out such as Ritalin, which would decrease any impulsivity the child suffered from and allow them more time and mental clarity to plan and coordinate more intricate attacks. In residential or treatment facilities they would be grouped with other children either with the same symptoms which they could pair with and learn from, or in facilities with children of different diagnoses they could dominate or harm. But no one wants to write any case off as being hopeless or untreatable and we have to try, at the very least to intervene when it might still make a difference.

It is impossible to claim that Antisocial tendencies don’t exist in children, and it has been demonstrated that it is inappropriate to lump preliminary APD into the Conduct Disorder category. On the other side of the scales lies the concern of wrongly diagnosing a child. What needs to be developed is not only an appropriate diagnosis and supporting criteria, but diagnostic tools to assist in accurately recognizing this disorder in children. Only when that path is paved can we begin to explore and create more effective treatments and help these kids before it’s too late.

Bullying: Bruised and Battered

Hey guys, Happy New Year! We're starting off 2012 celebrating four years of Another Drop in the Ocean (which was really three if you consider the year-long hiatus I took)! Thanks to my readers, however few and far in between, for staying with me and reading my rants and raves about various issues. Admittedly this post is a few days late of my anniversary, but I struggled with topics and you just can't force this stuff out. So here's my latest, inspired by the movie "Cyberbully".

Bullying has been an age-old pastime for children, teens, and even adults. But times have changed, the ante has been upped. The bullying of past decades starkly pales in comparison to the bullying of today. Older generations can recall schoolyard scuffles with a laugh and a shake of the head. Younger generations recall them with pain, trauma, and at times, lifelong impacts on their self-worth. Perhaps this is why so many people don’t take it seriously. Far removed from the reality and severity of the case, many parents, school administrations, and even law-makers tsk tsk the wounded and sweep the problem under the rug. And that is when it becomes deadly.

Back in the day, playground banter was better described as superficial childish name-calling. The classics are ones we’ve all heard: if you wore glasses, you were named four-eyes, if you were fat, they called you various derivatives of tubby, fatty, piggy, etc. If you wore braces you were metal mouth, acne: pizza face, and so on. These were names that would sometimes send kids home crying, only to face their antagonists again the next day. Now I won’t pretend that such names weren’t hurtful or somehow damaging to a child’s confidence, but most usually overcame the experiences and moved on to successful lives.

Nowadays, bullying has reached new levels of brutality that blaze through the barriers of harassment and teeter on the edges of assault. What was once simple teasing, usually on the basis of appearance has escalated to deeply damaging slurs, character defamation and public humiliation. In the golden days, bullying was usually an unfortunate chance encounter by the monkey bars or crossing the wrong street when walking home from school. Now they’ve turned into hunts, with bullies banking on growing intimidation; they scout the school grounds like packs of wolves for weaker prey, and the slaughter is horrific to watch.

My own experiences with bullying were extensive, to say the least. Resigned to wear glasses, in elementary school, I endured the superficial name calling, nothing that left a very deep impact. It wasn’t until I reached Jr. High that the bullying started. I was always heavy but gained much weight as I got older, and my peers took notice. Names like lardo, Free Willy, and fat ass were not in short supply from my classmates, but I was usually able to brush it off.

High school was where it became unbearable. I was heavier than ever, wore glasses, and hardly put any effort or thought into my appearance; I never wore make-up or styled my hair and my clothes were a fashion disaster. Bullying me was like shooting fish in a barrel, and it attracted new patrons all the time. Accustomed to my typical bullies who were in my classes, I was suddenly being attacked by people I’d never met, which caught me off guard. People I didn’t know would trip me in the hallways, one spit gum in my hair as I was walking by, and one day, for no reason at all, while walking down the hallway, a boy passed me and slammed me into the concrete wall before walking on, laughing with his friends. The people I knew were much worse. I endured name-calling and trash talking in class, usually as other students sat by and laughed as my tormentor rattled off painful insults. One episode sent me running out of the class crying. Another pushed me to the brink, and I rose from my desk, approached the student and slapped him across the face. He took a pen and attempted to stab me in the throat, but couldn’t break the skin.

But this was just one level of bullying. Many students began to go out of their way to make my life hell. Students who took issue with me, though for what reason I never knew, started a regimen of harassment. Figuring out my schedule, some would get hall passes, walk by my class, stand in the hallway out of the teacher’s view, and mouth insults and threats to me. At times, during passing periods they followed me to my next class, tormenting me for the three minute trip. Once I reached my room, they would stand outside the door, talk trash, and peek into the class to watch my reactions and laugh at me. I wasn’t safe after school either. There were times when I had to walk home, which left me wide open for attack. One day, two girls made it a point to follow me home to bully me. Never mind the fact that they lived in the opposite direction, they stayed five steps behind me for the twenty minute walk, calling me names like whore, fat ass, slut, bitch, dyke, and fag. When I reached my street, two cars pulled up and multiple students filed out. At first confused by their presence, I realized somehow word had spread that I was being harassed and some anticipated that a fight would ensue. They wanted front row seats. I entered my house and stole glances outside my bedroom window. The girls stood at the foot of my driveway, yelling obscenities and slurs at my house, threatening me before finally disappearing. Even the faculty had their moments. During one class, I tripped and fell back on the floor. The teacher, standing on the far side of the room, blurted out “wow, I felt that all the way over here!” and the class erupted in laughter. Another teacher who also had her assumptions about my sexuality overheard a piece of a conversation about me chasing down a girl and she remarked in front of my classmates “so you’re chasing girls?” with a smirk.

I asked my mother to allow me to be home-schooled in order to get away from the daily torture, but given that I was in the midst of my depression and was becoming increasingly isolated from society, my mother was concerned that if I were home-schooled, I would never leave the house. She refused, and the hell continued, though it ultimately contributed to lasting damage to my self-esteem, and to my suicide attempt my sophomore year.

Today, risks of suicide have increased, creating a new trend called Bullycide, breeding electronically. The internet brings with it not only a new tool for bullies, but the anonymity of false names, faceless interaction, and little to no personal responsibility for your words. Text messages, stalking, degradation, insulting web pages, embarrassing photos, and impersonation are all new ways that bullies have begun to attack their victims. The harassment has reached a new level, where bullies and their minions go above and beyond name-calling and taunting and have actually told their victims that they should kill themselves; the victims obliged. Ryan Halligan told a “friend” he was going to kill himself, and the friend responded “it’s about time”. Another bully told Phoebe Prince she should hang herself. So she did. Ashlynn Conner was only ten years old when she hanged herself in her closet due to excessive bullying.

Sadly, bullying doesn’t stop after high school, as it seems more and more people are failing to grow up. The perpetrators continue on into adulthood intimidating, insulting, lying, back-stabbing, creating drama, and laughing at the pain of their victims, as if someone were filming a sequel to Mean Girls starring the Plastics: All Grown Up. Sitting in my Master’s Program class, I couldn’t believe the insulting and degrading comments I would hear from my cohort about other peers, bullies who were twenty years older than me, but acting like they were sixteen.

Now I’m not going to sit here with my pipe-cleaner halo and pretend I’ve been the innocent by-stander all these years. I have fought fire with fire; I’ve bullied those who bullied me. I remember in high school I was in the girls’ room with my friends and a rival came in. She called me fat ass. Noting her up-turned nose that from the proper angle resembled that of a pig’s snout, I retorted “who are you calling fat, Miss Piggy?” My friends and I laughed and began pressing our noses up with our fingers, snorting at her. A look of pain flashed across her face and she quickly exited the bathroom. My heart sank when I realized I’d lowered myself to her level and hurt her. But even today, I’ve made my comments about people and joined in on the laughter when comments were made by others, even when I knew I shouldn’t have been laughing. It’s a work in progress and I’m always trying to improve myself by taking the high road. Sometimes I fail, but try again the next day.

I hate to sound cliché and regurgitate the heavily spewed dicta regarding the breeding of bullies, but it all rings true. Most bullies suffer from an inferiority complex, they are insecure with low self-esteem, so they put others down not to raise themselves up, but simply to bring their victims down to their level; “if I feel lousy, why should you be so happy?” Misery loves company, yes? Other times they don’t even know they make people feel bad. Again, though I wouldn’t consider myself a bully, there have been times when I’ve unintentionally made people feel dumb while trying to showcase my own intelligence. Now I’m no Einstein, but I’m certainly no Gomer Pyle either. Thanks to all the bullying I endured, I draw most of my self-esteem from the one thing that I succeeded in: academics. But in trying to prove my worth, at times I’ve embarrassed others, moments I still look back on and cringe: “why must I always be right?” And yes, many bullies become such because they’ve been bullied themselves. My usual tormentors came from seemingly perfect families, but I later found their mothers were alcoholics, or their fathers were abusive. People like that just need empathy, love, and forgiveness. Chances are they don’t have many friends anyways; chances are they’ve been hurt by many more bullies. So don’t add insult to injury by becoming another one in their lives. Take the high road, you’ll feel better in the end.

If you're being bullied or see that someone else is, speak up! Visit:
http://www.stopbullying.gov/

Frankenfood and Famine

The fight over genetically modified foods is a battle that has carried on for years on many different fronts. What opponents have called playing God, those in favor of the scientific advances being made in agriculture see a solution to a worldwide problem. Once again, the mediator in this debate is good old fashioned propaganda, and, like so many other situations the media sticks its nose in, the results can be and have been deadly for decades.

The genetic modification of foods started as nothing more than the interbreeding of different species in a laboratory. Experimenting with such began as purely that, experimentation: out of simple curiosity, researchers wanted to know what would happen if the genetics of one species were manipulated with the genetics of another. Becoming an expedited process of unnatural selection, the results of these trials produce strings of both unremarkable and fascinating organisms which grow and develop in ways never before thought possible. With the exchange of some proteins, individual chromosomes, and full DNA strands, plant species were created that could grow larger and in different climates.

Of course, once you mention that a lab experiment encompassing what is abstractly the slicing and dicing two beings and pasting them into one, a Frankenfood of sorts, the crazed pitchfork wielding mob screaming “monster!” is not far behind. This mob, littered with various personalities like environmentalists and theological zealots, is mostly headed by Greenpeace. And once they nabbed the media’s ear, common sense gave way to ignorant fear.

The media was thrown into its usual disarray as when any group has an aversive agenda, shoving misinformation down the general public’s throat and frightening them into submission. Erroneous claims were splashed across newspapers and websites such as animal and plant genes being mixed and sold, upsetting the natural course of life by playing God with a Petri dish, untested, unregulated sales of produce that would ultimately replace all produce in American stores, and worst of all, fighting the technology that could end world hunger. I recall in my undergraduate program in an ecology class, we were given various environmental issues and had to give a presentation on the pros and cons of each. While most projects had differing arguments and points to make, the group presenting on GM foods presented and debated facts that mirrored each other, as if one side stood in Bizarro world and the other in our own. “Foods are unregulated” “Foods are regulated by the government.” “They mix animal genes with plant genes”. “No they don’t”. “They’ll sell nothing but GM!” “No they won’t.” If soon to be college graduates couldn’t extract from their in depth research more compelling arguments than this, how can the average American by simply watching TV?

As mentioned before, science is driven by curiosity, and all the advances that come with it are the result of experimentation, simple trial and error. We would not be where we are medically, environmentally, or socially if someone somewhere hadn’t asked themselves “what if?” These lab explorations began with switching the genes of plant species with one another, and gradually migrated towards playing with animal genes. However, in spite of the outrageous claims, these animal-plant experiments are simply that-experiments. The Greenpeacers insist that labs are taking fish genes and putting them in lettuce and taking rat genes and putting them in tomatoes and stocking the shelves with them, therefore vegetarian and vegan practices are undoubtedly in danger! Once GM foods infiltrate and overrun the produce market of America, vegans and vegetarians will be unable to find animal friendly vegetation and they will starve and vie. I mean die. Unfortunately for the anarchists, universities and agricultural researchers alike assure us that though they are observing what such changes in an organism these manipulations create for the purpose of science, these specimens were never meant to be used as a food crop, and will never be sold in any store to the general public. Even if they wanted to, the government would never allow it.

One statement that has been a widely used favorite of the GM opponents is that these crops are completely and totally untested and unregulated by the U.S. government. This produce is created in labs, grown in crops, cut and sold in stores, without the government even bothering to glance over their shoulders at, let alone examine the process. Right. The Federalians are good, but they are not that good; they would never get away with that. As a matter of fact, GM foods are more carefully tested than any other produce sold in stores and it took millions of dollars and years of testing to be approved for human consumption. They are also heavily regulated by the U.S.D.A to determine the effects on the surrounding environment where they’re grown, the F.D.A for food safety, and the E.P.A if a pesticide is involved in the crop growing. To be perfectly clear, it’s probably safer to eat GM produce than organic or even plain old pesticide riddled regular vegetables. But, thanks to the American way of business, never fear! You will always have a choice on what types of produce you want to buy. If you don’t want the Frankenfood, you can pay extra for that crazy organic crap, which, mind you, you spend more time washing off bugs, slugs, and caterpillars (yup, found ‘em all in my lettuce). If you don’t like the added protein from the insecta class, and don’t trust the GM stuff, you will always be able to buy the regular veggies. To monopolize the market with one type of food is not just frustrating, it’s communism. But hey, even if we had one choice, and one choice only, who are we to bitch if we are lucky enough to have food?

Many have also argued that by manipulating the natural order of these species DNA strands and creating hybrids is like playing God, and therefore is an abomination. I believe that letting people all around the world starve to death is an abomination. Now I’m not a Bible Thumper myself, but I believe that God is as much like a parental figure as anyone else. No parent who wants their child to grow and become successful believes that doing every little task for them will help them achieve this. No decent parent comes running the minute their child cries out, ready to pull them out of the mess instead of letting them learn to find their own way. Like any good parent, they provide the tools and sit back to see what their child can accomplish with them. God has provided us the tools. He has provided us the brains that developed the technology to resolve our own problems. And not only do we keep crying for help, straddled by religion-induced self-helplessness, but we actually fight the people who might just have the answer.

The various hybrids created by these experiments have been engineered to not only grow larger and feed more people, but they can actually sustain life in harsher climates with fewer necessities. Many people in third world countries starve, not because they’re lazy, not because they don’t want to help themselves, but because in most countries, the summers are too hot, the winters, too cold; the region too dry or far too wet, the soil, useless. They cannot grow their own crops because no crops survive. Many of these GM foods can last in dry heats with minimal water or in flooding rains. They can survive permafrost; they can survive with few nutrients most other crops require in rich soil. They would thrive in nations in Africa or Southern Europe. And people would live. Norman Borlaug knows this story well. Using similar technology, he helped engineer various strains of grains (wheat and rice) and introduced these specimens to Mexico, India, and Pakistan, doubling their food production in less than 5 years. He was awarded the Nobel Prize in 1970 and has been credited for saving over one billion (yes, BILLION) people from starvation. Way to kick ass, Mr. Borlaug.

So taking this into consideration, some Americans are still not happy with GM foods being sold in America. Fine, but this technology is not just for you. We are fat. We are gluttons. We really don’t need it. But others do. So let’s send the food and technology over to the other countries and let them enjoy it, right? Wrong, said Greenpeace. Damn it, those little tree-hugging hippies are at it again! And this time, it wasn’t just propaganda through interpretive dance that we could all ignore. At the 2002 Environmental Summit in Africa, Greenpeace and Friends of the Earth crammed their misinformation down the throats of several African presidents, convincing them GM foods were poisonous and harmful. Therefore, many countries turned down tons of GM foods that had been donated by the U.S., leaving their people to continue starving. One fact Greenpeace forgot to mention? In the last 50 years, not one person has ever become ill or died as a result of consuming a GM food product.

It never ceases to amaze me that the people who are fighting the biotechnology that could feed the world are always the ones who have enough food in their refrigerators. Even if there were risks, could you look at your starving child and deny them food that may make them sick in 30 years, even though without it, they will die in 30 days? As one Greenpeace hippie dude said about GMs, “yeah we could save the world but, like, uh your kid might grow four eyeballs!” Watch out world, we’re in the presence of a mental giant here. Norman, we miss you.

Minhaj Gedi Farah, starving baby weighed just over 7 pounds at 7 months old. Weeks later, after receiving nutrients through an IV, he's almost at a normal weight for his age. Come on Greenpeace, you're doing this to everyone.