Monday, October 31, 2011

Secrets of the Universal Sisterhood Revealed: Part One - What Goes on in Women’s Rooms

I feel like Indiana Jones who has just discovered the Lost Ark, only this secret is far more significant and way more dangerous. The last person who attempted to reveal it “disappeared.” I won’t disclose how I came across this information. Let’s just say that I’ve finally discovered what really goes on in women’s rooms across the world.

Guys - you all know what I’m talking about. You are at a table in a public place. It could be in a food court in a mall. It could be in a rotating restaurant atop a skyscraper. You are having a conversation with a woman you would like to know better. She swirls the ice in her lemonade. Or maybe she licks the salt off her margarita. Then she excuses herself to powder her nose. Typically, one or more friends accompany her.

When she returns to the table, the tenor of the conversation radically changes. She may casually drop the fact that she has a boyfriend. She may allude to a recent outbreak of leprosy at her workplace. The verdict is in. You have been weighed and measured and found wanting. The waitress in on it. “Abandon all hope,” reads the check she hands you.

Or it could go the other way. The potential love of your life (or considerably shorter) lets you know her favorite spot to watch the paint dry, which is your cue to respond with something like, “Why don’t we check it out?” You’ve passed the road test. The waitress who hands you the check is doing an end zone dance.

What just happened?  

Here is what I only just found out about women’s rooms: An inner door opens into a spacious oak-paneled chamber. A panel of twelve women in judicial robes are seated around a mahogany board table. The woman you may or may not get a chance to know better (perhaps with one or more of her friends) takes a seat at a smaller table.

It doesn’t matter whether the venue is a trendy eatery on New York’s upper east side, a dive in Bakersfield, or a tea house in the Himalayan foothills. All inner chambers to women’s rooms are built to the exact same specifications. At all times, twelve women with the power to decide your fate are on duty. There are no exceptions.

The women jurists have observed everything via discreet monitors. The deliberations begin. Conversation is brief, judgment is summary. If there is any doubt, a wall panel slides open, revealing a ten-foot flat-screen monitor. The monitor is in a particular shade in the blue-violet spectrum for which they have yet to assign a lip-gloss name.

The monitor shimmers, slowly revealing three Jungian archetypal woman in some type of ancient Egyptian or Aztec or Inca gear. Or maybe they are Cher’s hand-me-downs. No one says anything, not the archetypal women, not the twelve jurists, not the woman (or her friends) seeking a ruling.

Finally, the chief archetypal woman - the one looking the most like Cher - signals the tribunal’s decision with “the look.” There is no room for misinterpretation. Everyone in the room gets it instantly.

In the case of a thumbs-down, three woman dressed as social workers emerge from a side door. Their job is to advise the woman petitioner on how to best carry out the verdict. The old “I just remembered I need to return a library book” trick?

If it’s a thumbs-up, a pit crew of makeover artists descends on the woman petitioner. A subtle shift in fabric this way or that way, a faint splash of scent, a slight application of color. Nothing a man would actually notice, but on some unconscious level would register in his brain as an actual “yes.”

It could be a conditional yes, a modified unconditional yes, or a mixed modified conditional/unconditional yes. The man, of course, has no way of figuring this out.

And there you are - poor guy - alone at the table, pretending to check messages on your phone, totally clueless, totally unaware.

Now you know. A lot of good it will do you.

Wednesday, October 26, 2011

Three Pop Tunes Cultural Masterpieces

Great pop tunes truly speak to our innermost feelings and experiences, but we are hardly expecting a three-minute ditty to compete with Finnegan’s Wake. Then again - once in a blue moon - a song comes out of nowhere, totally unique, inviting comparisons with the best that literature has to offer. This is hardly the way to sell records, particularly when the subject matter is incredibly dark and depressing, but - of all things - the songs I mention below became hits, then classics. How else would I have heard them?

From my personal “Where Did THAT Come From?” Department, three cultural masterpieces from my youth:

The Beatles’ Eleanor Rigby

I was 16. I flipped over my younger brother’s “Yellow Submarine” 45.

“Ah, look at all the lovely people,” Paul laments to the accompaniment of two string quartets. George Martin’s string arrangement is spare and minimalist and totally atypical. No guitars or drums or keyboard. A bit of background vocal from John and George.

The song is Paul’s work, but according to Wikipedia, Ringo came up with the line, “Father MacKenzie, writing the words to a sermon that no one will hear ...”

At the end of the song, the two lonely people meet. Alas, Father MacKenzie is attending to Eleanor Rigby’s burial.

Is there an eighth century Old English ballad that predated this?

Bobbie Gentry's Ode to Billie Joe

During 1966, it was possible to have three radios tuned to different stations, all playing this song at the same time. Call it a narration set to music.

The family gathers for dinner at the end of a sleepy dusty Delta day. As the daughter relates, Mama tells everyone: "I got some news this mornin' from Choctaw Ridge. Today Billie Joe MacAllister jumped off the Tallahatchie Bridge."

We learn from Papa that Billie Joe never had a lick of sense. Mama and daughter and brother take in the event in their own ways. We find out that Billie Joe and “a girl that looked like you was throwing something off the Tallahatchie Bridge.”

A year goes by. The brother has married. Papa is dead, and Mama is in a deep depression. Daughter is picking flowers and dropping them “into the muddy water off the Tallahatchie Bridge.”

Is there an unpublished Faulkner novel that Bobbie Gentry adapted this from?

Neil Young’s After the Gold Rush

This 1970 apocalyptic vision is associated with drugs, typical of the hippie era, but in truth this piece is no more about drugs than St John’s Revelation is about sitting in a cave.

The song opens with a Medieval festival, with arresting imagery involving a “fanfare blowin’ to the sun.”

But now mother nature is on the run. The man with the vision is in a burned out basement looking up at the moon, when the sun unexpectedly makes a reappearance.

A nuclear explosion?

The shit is definitely hitting the fan, just like in Revelation. In a dream, the narrator sees the chosen being loaded into silver spaceships flying “to a new home in the sun.”

Ah, the sun again.

What does it all mean? We are left, with the band playing inside our heads, to figure that out for ourselves.

Tuesday, October 25, 2011

A Mental Health Patients' Bill of Rights

Smitty wrote:

“What does it take to be a great or even good psychiatrist? What are our criteria as patients? What are the criteria that psychiatrists value to be good, even great?"

Kathy added: “I would really value an exploration of Smitty’s questions ...”

You got it.

Smitty and Kathy were responding to my Sunday rerun post, Smart Meds Strategies - No This is Not an Oxymoron. The post was based on three reader polls that found eight in ten of you reported that your meds were not working “very well.” As I concluded:

The meds are the one constant in this equation. The two variables are you and your psychiatrist. First imagine a smart patient working with a smart psychiatrist. Now picture a naive patient placing his or her trust in a lazy and indifferent psychiatrist. Are we likely to see dramatically different outcomes? I rest my case.

I’ve made numerous comments on psychiatrists in past posts. Perhaps now is a good time to organize them into a sort of Patients’ Bill of Rights. Let’s get started:

The Right to a Psychiatrist Who Listens

Literally every complaint I get from readers boils down to the fact that their psychiatrists refuse to listen. The most common cases involve doctors who downplay their patients concerns about the side effects of their meds. I remember pointing this out to a group of clinicians in my first and last-ever grand rounds that I delivered in 2008. “Trust me,” I said. “When your patients complain to you about feeling like fat stupid zombie eunuchs on the meds you prescribe we are not doing this to ruin your day.”

My audience reacted as if I had just ruined their day.

A year later I was in the audience at a psychiatric conference as a prominent doctor told us how psychiatrists are trained to listen. I stifled my derisive outburst of shocked disbelief just in time. The comment was too much even for the psychiatrist sitting next to me. He whispered something to me, and we just shook our heads in amazement.   

There is no question that a clear disconnect exists between patient and psychiatrist. According to a 2003 study by Scott and Pope, clinicians felt their patients quit lithium owing to "missing highs." Patients who quit, on the other hand, cited other reasons.

More egregious - and still fairly common - are cases where a psychiatrist will insist on prescribing a med over the patient’s strenuous objections. Typically the patient will inform the doc that the med has caused an extremely bad reaction in the past. Typically, the doc will prescribe the med anyway.

Even a psychiatrist who wants to listen is disempowered, thanks to the demands of managed care. The standard ten-minute meds check militates against a concerned physician probing beneath the diagnostic label to find out what is really going on. We get lumped and categorized and prescribed to. But are we being treated?

The Right to a Psychiatrist Who Values Us as Human Beings

Three years ago, I heard a prominent psychiatrist tell a class of psychology undergrads that the worst stigma to be found anywhere comes from psychiatrists. Blow me down - a candid and honest psychiatrist. I have no reason to dispute him.

Too often, we hear from psychiatrists and other clinicians that we lack insight into our illness, that we refuse to take their advice, and that we go off our meds for no reason. Okay, there is some merit to these claims, but when you hear them mindlessly repeated with no regard to the actual facts, then the result is to devalue us as human beings.

Xavier Amador PhD, author of “I am Not Sick, I Don’t Need Help,” is the foremost proponent of the lack of insight hypothesis, which he insists is a brain disease in its own right (“anosognosia,” is the label he applies). I happened to run into him at a poster session of a psychiatry conference a few years back.

“Patients lie,” was his parting shot, as he walked away from me. He obviously didn’t realize I was a patient.

Dr Amador, I think you just proved my point.

The Right to a Psychiatrist Who Values Our Uniqueness as Human Beings

Back to my first and last-ever grand rounds. Regular readers here have heard this a million times, but it bears retelling:

"Keep in mind," I told my audience, "a lot of us view the world through the eyes of artists and poets and visionaries and mystics. Not to mention through the eyes of highly successful professionals and entrepreneurs. We don't want to be like you."

It was as if I had let rip a roof-rattler and everyone was too polite to laugh. Then I blurted out: "To me, you all have flat affect."

Kelvin grade frozen stony cold silence.

Really, why would I want to be like my psychiatrist?

The Right to a Psychiatrist Who Is Committed to Getting Us Well, Not Just Stable

Here is how I phrase the issue in an article on bipolar treatment on mcmanweb:

You are stable, no longer in a state of crisis. You are looking ahead - to the whole rest of your life - to returning to your normal life. Your doctor, on the other hand, is looking back - from the days or weeks that you emerged from crisis - at preventing another hospitalization. Already, there is a major disconnect between you and your doctor. ...

Your doctor tends to call it a success stabilizing you into a state of being clinically “undead.” But is that where you want to be? And if you bring this to your doctor’s attention - is that just you, another patient who lacks insight?

Wrapping It Up

Obviously, these four rights are interconnected and related. A psychiatrist who refuses to listen, for instance, is obviously someone who devalues us as human beings, fails to recognize our uniqueness, and is not committed to getting us well.

Unfortunately, there is little incentive for bad doctors to change their behavior. Legally, their asses are covered, professional discipline is non-existent, and they are removed from the pressures of the free market. Basically, even if their patients fail to get better - or even if they get a lot worse under their care - they still get paid.

Six months ago, I had lunch with two out-of-town visitors. The topic turned to psychiatrists. I twirled my pasta with my fork and looked up at the person facing me. If you had to take a guess, I asked, how many psychiatrists would you say are bad ones? From the look on his face, I could tell he was formulating the same answer as mine.

Two-thirds? I suggested.

He nodded his head. Two thirds, he replied. My other visitor was also nodding her head in agreement. Two-thirds sounded right to her, too.

Two-thirds. Does that sound right to you? Just asking ...

Further reading from mcmanweb:

The Problem Clinician
Problem Patients, Problem Meds
Opportunity Lost

Sunday, October 23, 2011

Rerun: Smart Meds Strategies - No, This Is Not An Oxymoron

From Feb this year ...

Following is a chopped version of a new article on mcmanweb. The article, in turn, is based on three or four posts published here over 2009 ...

During the first months of 2009, I ran three successive reader polls  on my blog, Knowledge is Necessity. Let's pick up on the action in my  second poll:

"How do you rate your meds in managing your illness?" I asked my readers. The results, quite frankly, astonished me.

One half responded that meds were their single most important  tool and one third that their meds were "important, but no more so than  their other tools." In other words, four in five patients put meds at  the top of their list, either as a solo act or with a dance partner.

Obviously, if meds are so important to patients, then they must be working like gang-busters, right?

Not exactly. No, in fact. Make that unequivocally no. The month  before, I polled my readers on how well they were doing. One in four  replied they were "in crisis or close to crisis." Four in ten reported  they were "stable but not well." Just one in five said they were on the  way to recovery, and only 14 percent responded that they were back to  where they wanted to be or better than they ever could have imagined.

Thus, a full six in ten of those who responded to my poll  indicated that they were in pretty bad shape while more than eight in 10  reported feeling short of well.

Put the two poll findings together and you can appreciate my  astonishment: 82 percent who rate their meds as their number one  management tool vs 14 percent who are actually well. What is wrong with  this picture?

Time For Another Question

"How well have your meds worked for you?" I asked in my third poll.

Only 14 percent answered, "very well." The overwhelming rest (86 percent) had reservations.

Thirty-six percent  - about one-third - responded, "conditionally  well." In other words, your meds may not be perfect but they were  meeting your expectations. When you add in the "very well" group, fully  half you reported satisfactory results with your meds.

So, can we put a positive spin on the results? No.

One in five (19 percent) told me their meds were "rather  problematic." In other words, these people weren't happy with their  meds, but were experiencing some benefit.

Nearly one in five (17 percent) responded that their meds were  "very problematic" and 11 percent told me their meds were "a complete  disaster." Added together, nearly one-third have given an unambiguous  thumbs down to your meds.

Interpreting the Results

Let's go negative first:

The fact that more than eight in ten of you - yes, you - reported  that your meds are not working "very well" - for whatever reasons -  speaks volumes. Consider that most of those in the "conditional" and  "problematic" groups are more likely headed down than up (based on very  clear trial evidence that less than a partial response to meds is a very  strong predictor of relapse).

Add to that the fact that the "complete disaster" group is  running in a virtual dead heat with the "very well" group and we are  talking very low levels of customer satisfaction.

The only way we can put a positive spin on the results involves  seeing possibilities in the "conditional" and "problematic" and even  "disaster" groups. Suppose, for instance, half of those in the  conditional group were to graduate to "very well." Likewise, suppose we  could get similar conversion rates from the "problematic" and "complete  disaster" groups. Then three-quarters of you would be happy customers.

How is that possible?

The meds are the one constant in this equation. The two variables  are you and your psychiatrist. First imagine a smart patient working  with a smart psychiatrist. Now picture a naive patient placing his or  her trust in a lazy and indifferent psychiatrist. Are we likely to see  dramatically different outcomes?

I rest my case.

Tuesday, October 18, 2011

Occupy the World - I WIll Bring My Drum

“Several people pounded on drums.” - From a Sunday LA Times article, “LA marchers chant ‘We are the 99%’”, buried on page A37.

I attended my first protest in the spring of 1969. I was just starting to grow my hair long. On a chill fall night several months later, I was part of 500,000 demonstrators that marched past the White House as Richard Nixon watched a college football game.

The Vietnam War dragged on another five years.

No one listens, which may explain We the People’s embarrassing lack of participation in the political process. In any given Presidential election, only 6 in 10 of those eligible to vote even bother to turn out. During mid-term elections, a mere 4 in 10 make the effort.

“In democracy we get the government we deserve,” de Tocqueville famously declared. “Government is the problem,” Reagan infamously riposted 150 years later.

My view of life is that we all come equipped with control buttons that are not connected to anything. We press, we press. Eventually, the smart ones figure out that nothing happens and find better things to do.

“I was a victim of a series of accidents, as are we all,” Vonnegut’s Malachi Constant told us in “The Sirens of Titan.” Forget about our foolish conceits that we are masters of our own destinies. The wise man and fool suffer the same fate, says Ecclesiastes. Nothing changes.

We know that, but occasionally we do suffer relapses. We delude ourselves into thinking that our control buttons are actually connected to something. This happened to me three years ago when I voted for Barrack Obama. “Oh crap. Obama is still President?” I found myself saying over breakfast two days ago at my good friend’s place.

There is something to be said about depressive realism. I was up in LA, spending a long-overdue weekend, catching up. My friend pointed to an article in the Sunday LA Times. Some trend-setters in the gay community were making the scene in high-heels. Clearly, this was far worse than global warming. “When men wear better shoes than the ones I have on ... “ she exploded.

It will only get worse, I reminded her, ever the depressive realist. Should this trend take off in the gay community, then eventually straight men will copy it. In ten years, I let her know, all men will be walking about in stilettos that will put this year’s Prada's to shame.

Ah, there is nothing like spending the weekend ranting and raving with a dear friend. The day before, she and I and her boyfriend and a friend took the Metro down to Pershing Square where a crowd was gathering for an Occupy LA march that had spun out of Occupy Wall Street and was now part of a worldwide Occupy movement.

I was under no delusions. I was fully aware my personal control button remained unconnected to anything, but I was satisfying an insatiable urge to tap it. For the purpose, I brought along my recently acquired Nigerian talking drum. Okay, the drum was probably made in China.

You sling the hourglass-shaped drum over your shoulder and bang on the top hide with a curved stick. With your opposite elbow, you apply pressure to a superstructure of connecting strings to top and bottom hides, thereby regulating the pitch of the drum in mid-beat. The effect mimics human vocal intonations. West African tribes used to employ this type of drum as a sophisticated method of long-distance communication. This days, the drum is valued as a musical instrument.

A virtuoso drummer can literally make this thing talk, but even beginners are capable of coaxing cool sounds of the thing. Besides, I knew how to count to four.

The crowd was small by protest standards, maybe three thousand. Nearly everyone was carrying home-made signs. My friend's sign was filled with a list of all the countries that had universal healthcare.

“New Zealand,” I banged out on my drum. Soon, I was vocalizing other signs in the crowd.

“We ARE the 99 percent,” I beat out, in sync with some of the chanting. We started moving. I noticed two drummers ahead of me. One, an older Latino man, had a set of bongos strapped to his body. He was using drumsticks to project very staccato retorts that carried above the crowd. The other, a college-age lad, was toting an African djembe, which is the classic West African hand drum.

I moved up to join the two drummers. In nothing flat we were banging out simple stuff together, paying close attention, adjusting our beats to the movement of the crowd and the chanting. I was mostly using my drum as a kind of bass drum, in support of the other two drummers. Occasionally, I would break out into some of my own thunking flourishes. The narrow canyons created by the tall buildings on either side acted as a natural amplifier. We were feeding off of each other's energy and that of the crowd. The sum was greater than the parts. The mystics have many names for this - connectedness works just fine.

A mile or so into the march, my Latino companion broke out his water bottle. He offered the kid a drink, then me. The older guy was named Vinnie. The kid was Danny. We fell back into step and resumed our drumming.

“We ARE the 99 percent.”

Yes, we are.

Near the end of the march, we pulled up in front of the large building housing the Bank of America. Our young djembe-player now had both hands free to bang out a cool beat. Another kid with a snare drum found his way to us. A middle-aged African American woman with a djembe joined us. Now we had a real drum circle going. I kept my beat simple but urgent.

THUNK!-THUNK! I pounded. The other drummers filled in with their much faster beats. A crowd gathered around us. A woman started playing a recorder.

All too soon, it was time to move on. Over on the next block was a small park where a small band of protesters had been camping out in a tent city, literally occupying LA. This is where the march ended. I rejoined my friends. Someone came over and handed me a booklet of his poems. I shook hands with my fellow drummers. Time to catch the Metro back.

I am under no illusions about the fact that my control button is not connected to anything. No one listens. But, on this day at least, someone heard our drumming.

Wednesday, October 12, 2011

Columbus Day Reflections

Happy “There Goes the Neighborhood Day.” Before Christopher Columbus crashed the party on this day 519 years ago, the people who really discovered America were doing just fine. This comes out loud and clear in two books: Jack Weatherford’s 1989 “Indian Givers: How the Indians of the Americas Transformed the World,” and Charles Mann’s 2005 “1491: New Revelations of the Americas Before Columbus.”

Essentially, say both authors, Indian society was far more populous and sophisticated than the white man’s histories would have us believe. For starters, most of the food we consume derives from Indian plant husbandry and processing (potatoes, corn, beans, peppers, tomatoes, squash, and chocolate, just for starters), as does countless ways of preparing it (such as barbeque). As for the shirts on our backs, you have Indian cotton technology to thank for that.

Food and clothing - pretty major accomplishments. Throw in advanced astronomy, mathematics, road-building, monument-building, terra-forming, urban planning, metallurgy, pharmacology, and - oh, yes - democracy, and suddenly we are left with the stunning proposition that Indian society was not only a lot more advanced than we thought, but may have attained a higher level of civilization than European society of the day.

Okay, the wheel was unknown to the Indians (though there are exceptions), but likewise personal hygiene was unknown to the Europeans. The bottom line, says Charles Mann, is your typical Indian living in 1491 was better off than your typical European living that same year. Better fed, better clothed, better housed, better looked after. Taller, healthier, with a degree of personal freedom unknown in the Old World, with a voice in his (and in a lot of instances her) society’s affairs.

Get ready for the eye-opener: Both authors contend that the democratic values we take for granted today derive from the Indians. No one in Europe was even talking about such things prior to first contact. Then, Thomas More came across Amerigo Vespucci’s reports of his life amongst Indians, and - surprise, surprise - the 1516 publication of Utopia.

Soon after came the Enlightenment, with thinkers such as Rousseau idealizing the “noble savage.” But while Europe was merely talking about representative government and the rights of man, Indian society was actually doing it. Your average white settler took note. So did our Founding Fathers. Both Benjamin Franklin and Thomas Jefferson were profoundly influenced by the Iroquois Confederation.

The stupidest idea in all history - an Old World concept - is that nearly all men and women are born decidedly unequal. That it is the natural order that just about the entire human race be exploited and condemned to lives of overwork, hardship, and squalor, all in the service of a select few. There was no way either Europe or those who settled in the New World would have turned that thought around - much less put something less stupid into practice - without first bearing witness to a society that actually practiced more civilized values.
New World ideas and technology, not to mention loot, would transform the Old World and kick-start the Industrial Revolution, contends Jack Weatherford. The Indians were not so lucky. According to the accounts of the first European adventurers, the Mississippi Valley, the eastern seaboard, the Amazon basin, Mexico, and the Andes were densely populated. These were flourishing and highly developed agricultural societies that could have easily swatted away any white man incursions.

The next waves of Europeans encountered something radically different. The white man’s diseases had preceded them and fanned out. The Mississippi Valley was virtually devoid of human life. The eastern seaboard lay largely empty. Nature reclaimed the Amazon basin. The great empires of the Aztec and Inca collapsed in the onslaught of European microbes, easy prey for the Spanish.

The Indians that these Europeans encountered were survivors of the greatest catastrophe in human history. The few, the traumatized. We have no way of knowing how far Indian society would have advanced on its own. A strange new race of people was setting up camp on abandoned Indian settlements and plantations. White man would be writing the history books.  

Friday, October 7, 2011

Are We Meant to be Happy? No. Are We Meant to Have a Life of Meaning? Funny You Should Ask ...

Very quick piece. Last night, I gave a talk at NAMI San Diego. I had no problem picking a topic, as we would be holding our annual Inspirational Awards Dinner the next evening (tonight). We are honoring six local heroes, so I focused on connecting the dots - from values to a life of meaning to happiness.

I really don’t know too much about happiness, I confessed to my audience. I haven’t experienced it that much, and neither, I suspect, have you.

I spotted the heads nodding in agreement, and knew I was in for a good evening. Call me a killjoy, but there is something about demonstrably “happy” people that doesn’t ring true with me. They come across as fake. There’s a whole lot of personal unpleasantness that I know they are covering up. They are not being honest, with themselves or others.

Okay, that’s just my opinion, but my audience seemed to be validating it.

We’re really not built to be happy, I went on to say. Happiness is not well-suited to survival. Think about it. Imagine one of our distant ancestors - a happy caveman - merrily waltzing his way to the local watering hole, delighted to strike up an acquaintance with a saber-tooth tiger.

That caveman is not going to live long enough to pass on his happy genes.

Depression, of all things, is much better suited to survival. The rose-colored glasses come off. We see things as they really are. We make wise decisions. There is even a name for it - depressive realism. Too much depression, of course, like too much of anything, is not good. Nevertheless, I trust you get the point - we are wired to be depressed for a reason. 

But, yes, we would all like a bit more happiness in our lives. A number of enlightened thinkers have written on happiness in a psychological context, including George Vaillant, Martin Seligman, and the Dalai Lama. One common theme is that those who serve others are far more satisfied with their lives than those who are out for themselves.

One thing for sure, these people are not alone. Are they happy? Who knows? But they certainly have meaning in their lives.

Service to others is one characteristic all our six Awardees tonight share in common. To a person, they are on a mission, they have a calling.

How about you? I asked my audience. How many of you have a calling? A number of hands shot up. This was, after all, an audience of people involved in mental health, whether as advocates or caring for family members. One man mentioned facilitating a support group. I pressed him on this. Can you describe a satisfying moment for you? I asked.

Yes, he said. When a new member of the group hears other people’s stories and she realizes she is not alone. The look on that person’s face.

I used to facilitate a support group. I could well relate. It kind of makes showing up early to turn on the lights and arrange the chairs in the room and lay out the brochures on the table worth it, I suggested.

There were a lot of nodding heads in the room.

Did Steve Jobs have a calling? His passing the day before was fresh on everyone's minds. I pulled out the script of a 1997 Apple ad. “Here’s to the crazy ones,” I began. “The misfits. The rebels. The trouble-makers. The round pegs in the square holes. The ones who see things differently. ... They push the human race forward.”

By rights, NAMI San Diego should be the most miserable place on earth. We have been through hell and hell again. But everyone there has a calling. To a person, their lives have meaning. No surprise, when I walk into NAMI these are people I want to be around.

One member of the audience raised the point that happiness is not a goal. That we should be striving for something else. This is a person who has collected quite a few awards of her own over her very meaningful career.

Ah, a life of meaning.

A few seconds later, my iPhone went off. I had forgotten to mute it. In full view of the audience, I pulled it out of my jeans pocket. I know somewhere up there Steve Jobs is smiling.

Thursday, October 6, 2011

Steve Jobs - Making Connections and Creativity

“Creativity is just connecting things. When you ask creative people how they did something, they feel a little guilty because they didn’t really do it, they just saw something. It seemed obvious to them after a while. That’s because they were able to connect experiences they’ve had and synthesize new things. And the reason they were able to do that was that they’ve had more experiences or they have thought more about their experiences than other people.

“Unfortunately, that’s too rare a commodity. A lot of people in our industry haven’t had very diverse experiences. So they don’t have enough dots to connect, and they end up with very linear solutions without a broad perspective on the problem. The broader one’s understanding of the human experience, the better design we will have."

Steve Jobs: 1955-2011

Wired, February 1996

Wednesday, October 5, 2011

In Honor of Steve Jobs

Here's to the crazy ones ...

Steve Jobs: 1955-2011