Name My New Cat - Update

Thank you, all, very much for all your great suggestions. As you know from a recent blog piece, a stray cat adopted me. Okay, here's where I stand. This little furball very much has a queenly aspect, at least till she hears the crackle of the cat food bag crinkling in my hand. The catch is the queen names have been done to death: Cleopatra, Nefertiti, and so on.

Little meowgirl also has the way of the enchantress, so I'm also thinking along the lines of Sappho (ancient Greek erotic poetess) and Circe (who beguiled Odysseus and crew).

Yesterday, a friend took a good long hard look at the photo on my iPhone and came up with Sheba. Another done to death queen name, I'm thinking. Then, suddenly, Bathsheba popped into my head. Bathsheba, as you may recall, is the Bible babe (pictured here) who made the mighty King David all weak in the knees (but strong in the loins), which kicked off a sequence of events that involved the usual lust and bliss followed by an unwanted pregnancy, which resulted in David dispatching husband Uriah the Hittite to certain death in battle, thereby incurring the wrath of God, who visited ultimate calamity upon the House of David.

(Something we can all identify with, obviously.)

The next thought that popped into my head was that a good shortened name for Bathsheba would be Batty.

As things stand right now: I'm leaning toward Bathsheba and Batty, but nothing is final yet. I've narrowed my choices to queen names (the more obscure the better) and enchantress names. So - feedback on Bathsheba and Batty, please, and ideas on queen and enchantress names. Please use the comments below ...

Guest Blog - The God Negotiations: Acts II and III

Yesterday, Act I to Elizabeth's masterpiece. Today, the concluding acts.

Act II

God was right! He always is, you know. If you cover your body in garbage bags, very easily obtainable in these amazing free shopping places called dumpsters, you stay nice and warm throughout a Cleveland winter and the weird people don’t bother you. It’s as if they aren’t even there!

Down on the streets of Cleveland, I was getting very chummy with this nice guy named Joe, and we were sharing this delicious elixir called Wild Irish Rose. Spring was springing, the rats dancing most gracefully, and all I had to do was look up at the sky and see the most serene beauty, a different picture every day, indeed every minute sometimes. Joe had just made me the most glorious crown out of aluminum foil that really worked in keeping the extra-terrestial bureau of investigation from extracting my most precious thoughts, and which Joe said was most becoming on me, when God turned me into water vapor. The last thing I heard was Joe moaning, why does this always happen whenever I meet a nice chick?

Then I was going up, up, up into the clouds, and the next thing I knew I was in God’s office. Some weird music was blaring, the lyrics going something like War, huh, good God y’all. What is it good for? . . . The office was an absolute disaster. God was sitting at his desk playing solitaire on his computer, still in his bathrobe. Well, he always wears a bathrobe, even to work. Who’s going to stop him? He’s God!

I had to shout The Serenity Prayer in His ear three times before He recognized my presence. Just hold on, He said. I might win this one. But He didn’t, sighed, and turned to me. Sorry, forgot all about your appointment, He said, looking more than a bit dour. Like the last thing he wanted was the presence of another soul.

You called me, I said, quite annoyed by being pulled away by all the fun I’d been having in Cleveland but trying to keep my cool. Didn’t want to be smooted. Or smited. Whatever.

Right, forgot, He muttered. Where’s that file?

He finally found it under a pile of Weekly World Newspapers. Have you considered that life I was telling you about?

I was thinking maybe You have something better in there. Maybe a Guess model. Any of those in your file?

Oh, no, you don’t want to be a Guess model, he said. That’s a terrible fate.

Well, I didn’t know what to say. They seem so happy in their photos, but I didn’t pursue it. Instead, I just asked, What else do you have in there?

He shuffled some papers around and pulled out a form. I have a very promising life as a worm, He said. There. That sounds good.

A worm? Are you kidding me? Who wants to be a worm?

Well, they are quite evolved. If you happen to get cut in two, you live on as two worms, which could help you to unkink some philosophical quandaries. Plus, it would be a chance for you to actually do some good for the planet earth. Darwin was very interested. . .

No, no, no. They’re too icky. Make me something a little less icky, please. I’d like to be human.

He muttered under his breath for a while, saying things like, oh, sure, they all want to be human, and so few of them who think they are really are. Really, I should have let Satan take over. This job is just too much pressure sometimes.

Why, oh why, is God always saying things like that? He’s omnipotent, omnipresent, omniscient and all the rest, yet His office is a disaster and you can’t get Him on the phone for months on end.

O.K., He says. If you insist on a human form, I’ve got three choices for you: a Catholic bishop with a taste for choirboys, a diamond miner in Africa, and that one I was telling you about.

A diamond miner in Africa! That sounds absolutely idyllic! Zebras and giraffes and amazing flowers, and all I have to do is find a few diamonds?

You think? You think worms are icky? The ants in Africa are huge! Plus it says you get your hands chopped off at the age of 15 and spend the rest of your life looking around for someone to feed you. I don’t think you’re ready for it, though, he says. Too spiritual. He crumples that form in his hand and throws it at the wastebasket, missing.

Oh. I sit there for awhile, mulling it over my remaining two choices. I twist a lock of my hair around my finger and try to look cute. He just scowls at me. Don’t even try it, he growls.

I was thinking, I do like hats. Bishops get to wear these fabulous hats and beautifully embroidered vestments and tell people what to think in glorious cathedrals with amazing stained-glass windows. And I do like choirboys myself, just not that way. That’s the only trouble. Hmmm. Meanwhile God played more solitaire on his computer. Finally he turned to me and said, I’ve been playing this game all afternoon, and I just can’t seem to win. Look, take the first option. Just take it and get out of here. You’re wasting my time.

Is that a command? What about free will?

You have three minutes, He said, turning the sands of time from His Yatzee game.

I pondered and pondered and swiveled myself around and around in the desk chair God had so benificiently provided for me. Fun! Finally I said O.K. So what’s so great about this life You’re trying to sell me on? Anything else on that form You can tell me? Any perks?

He looked at the form. You get to be a woman and have a child. That’s really cool. And you meet some wonderful people who will help you along. Oh, and every once in a while you laugh so hard that water spurts out your nose, and there’s a 7-11 down the street from you that sells excellent Indian convenience food for cheap. But back to the main problem you’ll have. Let me tell you, the cures for your disorders are there—you just have to persist. You find them and then that’s the end of it. Sort of like an Easter egg hunt. What the heck else could you want?

I know, I really do know, that God loves me infinitely, so I figured I’d take His advice.

O.K. I said. I’ll take it.

Act III

There is no Act III. Or rather, I’m living it.

Guest Blog - The God Negotiations: Act I

This masterpiece from Elizabeth:

John McManamy wrote in his book that he has a feeling that he chose his fate before he was knit in the womb, so to speak. That he has a feeling that he was offered options and actually chose to be bipolar in a pre-womb, metaphysical state. This is an idea I’ve had about myself for many years. I told John that we with mental illness should create our own religion. I guess, though, he’s too busy providing people knowledge that could save their lives. Go figure.

So I’ve been thinking about this choosing-your-life idea for some time, and came up with my latest version of me picking my own bipolar life. Let it rip. Here’s the opening scenario:

Act I

Situation: It seems necessary that I have to be born into another planet-earth life once again, and God and I are discussing options. He takes out a file from his rather disorganized cabinet.

He pulls out a form from the file. He says, here’s one you might want to consider. It requires you to have many disorders that are pronounced incurable. Let’s see. Sexual abuse in your teens. Something termed chronic fatigue in your twenties. Then it says fibromyalgia in your thirties. Then a diagnosis of bipolar as you reach 40. Hmmm. Says it should have been diagnosed earlier on that one. Darn, I need a better editor. Need to get rid of that word “should.”

Doesn’t sound so bad, I say. That looks like a breeze. Remember that past life when I lived in a small agrarian New England town that ran a lottery that required us to stone to death one innocent person a year to make the crops grow better? Didn’t work. And those people I had to live with were so boring! Plus all those kids I gave birth to and loved who died in their infancy. Seven dead out of nine!

Look, He says, don’t get snarky. Just be quiet and let me continue. You people who think they can remember past lives are getting on my nerves. You all say you were Cleopatra or Atilla the Hun or some such. Wrong! As for you, you were not in a short story. Believe me, I’ve wiped your memory clean in an ECT contraption. You are getting too imaginative again, so watch it. Here, do this crossword puzzle till you calm down.

Then He leaves me in a cubicle for eight hours with nothing but this crossword puzzle, a pen that doesn’t work, a computer with many, many viruses, a razor blade, a raven feather, and a woman in the next cubicle who keeps blathering about the bras she’s about to order from Victoria’s Secret. I tell you, it seemed like an eternity.

When He comes back, He looks at the blank puzzle and says, what have you been doing all this time?

The pen you gave me was out of ink, I simper. And what’s a six letter word for stupid? Plus, You’re the Expert, so I must ask you. Should I show more or less cleavage?

He ignores this most urgent question, and dismisses my excuses for not completing His assignment. Don’t you know by now that blood is an excellent ink?, He asks. Are you totally out of it?

So let’s get on with it, He says, pulling at his snowy white beard and trying to be kinder. Try to focus. Keep on-point. He says to me. O.K. More on this potential life. Here’s the objective of the life I’m proposing for you. You spend most of your life trying to heal yourself. On this form it says that lots of people termed “assholes” get in your way. Gosh, I really need better editors. Told them many times not to use that word. They just don’t listen.

I say, O.K. God, or gosh if you’d rather be called that, what do you have in mind? All I have to do is cure myself of a few ailments and then I get a mansion in heaven? I hear there are many mansions, some with pool tables in the basement. Any still available? Do they include mineral baths and servants way wiser than I am but whom I can keep in near-poverty and at my service, attendant to my every emotional tizzy, like in the classic Hollywood movies?

He answers, the real estate market here in Heaven is a bit farked up at the present moment. However, I do have an opening for a basement efficiency in a district of Indian computer service providers.

O.K., I say, getting excited. That sounds fine, as long as I get fed decently.

Well, He says, pulling at his long snowy beard and showing deep wrinkles around his eyes—He should really see a plastic surgeon about that—let me review the form. Says here that you can get a junior bacon cheesburger, plus a small fry and a small drink consisting of caffeine, refined sugar, and many artificial ingredients for under $5. Is there anything else that can complete your order?

O.K., I say. Do you mind if I sleep on this decision? I’m feeling a bit woozy.

No problem, He replies. Being that it’s January in Cleveland and a bit chilly, just go downtown. There are some really nice grates on the sidewalks that blow hot air up from hell that you can sleep on. Pretty cozy. Lots of people who talk to me sleep there.

More to come ...

Flying Home

October and November tend to be weird months for me. Early October, 2006 saw the publication of my book: "Living Well with Depression and Bipolar Disorder: What Your Doctor Doesn't Tell You That You Need to Know."

The book represented a major personal triumph for me, but life is seldom simple. It's amazing, in hindsight, how I didn't see it coming, but we never do. One day I was winding down from a round of book-related speaking engagements and radio interviews, making a mental note to pick up a Thanksgiving turkey, the next my marriage broke up.

I had been married (for the second time) for nearly three years, living in central New Jersey. On December 1, ten days after my break-up, I boarded a one-way flight to San Diego, wanting to sleep and never wake up.

I collected my bags and stepped outside the terminal. In the dark, I made out cruise boats in the brightly lit harbor and the silhouettes of palms. Under the circumstances, I could be forgiven for thinking I had set down in the middle of a holiday resort rather than waiting for my ride in an ugly airport. The balmy temperature lent to the illusion.

Paul drove up and I got in. San Diego Airport is located in the heart of the city. If this were New York, you would literally have planes taking off and landing in Central Park. I recall thinking how convenient this would be for me, that is until Paul got driving.

We got onto Interstate 8 going east and kept going. And going. Then civilization literally ceased. No lights no buildings, nothing. Surely, this had to be some kind of anomaly, I thought. Surely, some kind of satellite city would materialize, a St Paul, a Fort Worth, a Newark, even.

Meanwhile, I had the strange sensation of being airborne. Our wheels were on the ground, but we had gone from sea level to above 2,000 feet in the space of 30 minutes. Oh crap, I could only think, what have I gotten myself into?

At 3,500 feet we got off at an exit that could have featured in a slasher movie. Then we were in total darkness. My worst fears were realized. We were in the country. The country! Probably completely off the grid in a void where zip codes don't exist.

We got out of the car and I gazed up at the unfamiliar sight of stars in the sky, unbelievably bright stars, pristine in the mountain air, with nothing standing in the way of me and something billions of light years away, maybe only millions.

I woke up the next morning to a searing Van Gogh sun against a brilliant cobalt blue sky. Where there should have been a Walmart was a valley surrounded by 4,000-foot peaks. Time to check out my new neighborhood.

All the houses appeared to have be built out of box kite material, only not nearly so sturdy, seemingly wind-tossed at crazy angles. Oddly, though, the overall effect was harmonious, blending in with the rocky and hilly terrain. A straight line or level surface would have stuck out like a sore thumb.

A short walk and the houses gave way to horse farms. In contrast to the sky, the hues of the landscape were muted. The trees and vegetation here are testimonies to perseverance rather than abundance. Water is scarce, exceedingly so. Only the rocks flourish – boulders, outcrops, summits. The wind was blowing in from the desert and had a decidedly flinty tang.

Back in the old days, a wrong turn on a mule wagon spelled certain death. The Mexican border is about 10 or 15 miles away. These days, those seeking the American Dream are prepared to risk everything negotiating this treacherous northern passage.

I rounded a curve and suddenly I was the only person on this planet. Just me and splendid desolation. Any second, I expected to come across Buddhist prayer flags fluttering in the stiff breeze. Perhaps a wise Indian shaman who could tell me why the hell I was here.

Talk to me, land, I found myself saying. I felt a spiritual tug, but I was confused and out of sorts. I was badly missing the life I had just left behind, but I knew in my heart this was the place I needed to be. If any healing were to occur, it would happen here, in these mountains, where I could clear my head, establish a sense of perspective, and slowly come to terms.

But I had a major shock in store when I came back from my walk and inspected the pantry.

Hmm. Cans of refried beans (is there an air raid shelter out back?). Soup in packets (desiccated chemical nodules that no amount of super-heated water could ever satisfactorily dissolve). I mopped some beaded sweat from my brow. Rice-a-Roni, I read on one box. Something salty that claimed to be food on another. The type of cans you only see in food drives.

I already knew what was coming next. I’ve seen grown men cry over the sight, but my reaction is always one of anger and disbelief. How is such a thing possible in a world that gave us Shakespeare and Sophia Loren? I could only think. Why? But there is no logical answer to explain man’s inhumanity to man. Just the inscrutable wording on the box:

Ramen noodles!

“What a piece of work is a man! How noble in reason, how infinite in faculties, in form and moving how express and admirable, in action how like an angel, in apprehension how like a god! The beauty of the world, the paragon of animals! And yet, to me, what is this quintessence of dust?”

But I’m a highly-trained professional and it was time to take charge. In a calm and authoritative voice I told Paul and my other housemate: “Put your hands to your sides and slowly step back from the pantry.”

Don’t worry, I assured them, demonstrating to them that the skillet I had in my hand would be used for cooking real food, assuming I could locate some. But hey, I love a challenge. It's the one thing I have in common with Jesus - I've got the loaves and fishes thing down pat.

Life is about the little things. Several days later, seven FedEx cartons containing my life arrived at my door. By now, I had the food situation under control and was preparing a chili. Priorities are priorities. I ripped open the carton containing my kitchen gear and dived in for my zester. A minute later, I was in business. Zest-zest-zest – one peel to a lime into the pot, plus the juice. Now my chili had the missing zing and zap. Now I had a real chili going. A simple kitchen implement and suddenly I felt at home. My non-zester possessions could wait for later.

To be continued ...

Name My New Cat

A month ago, I arrived back home from a day of water volleyball and recuperative chilling out only to discover that my cat Bullwinkle was not there to greet me. Immediately, I knew something was wrong. The little furball literally attaches herself to me like velcro. Every morning at 3, she would demonstrate the strength of our karmic bond by climbing into my bed and affectionally jamming her paws into my eyeballs.

I acquired her as a kitten some 10 months earlier. She is not the type to run off. I live 3,500 feet up in the mountains and not all the animals are friendly.

A friend asked me if I wanted another cat. No, I said, still grieving Bullwinkle. I'm not ready. Same answer to another friend.

Two weeks went by.

Me-owww!

A very sad meow. Bullwinkle? Couldn't be.

I looked out. Nothing. Then another meow.

Hey, Little Guy, I called out. A huge pair of pointy ears connected to a tail walked into view.

Me-owww!

The poor little thing looked like she (definitely a she) hadn't had a bite to eat in weeks. I grabbed a handful of dry food intended for Bullwinkle and emptied it into a dish and set it outside the door, along with a dish of water and a dish of milk. The food was gone in a micro-second, along with a second helping.

Then the little waif walked in the door and made herself at home. In nothing flat, she was sleeping on my lap. That night, she curled up in bed with me.

That was two weeks ago. This little furball isn't going anywhere. Ready or not, I have a new cat in my life. Time to set up an appointment with the vet. Time to give her a name. That's her in the picture. Names, please? Comments below ...

More Cool Stuff

Yesterday, I described a conference session I attended this year in which Daniel Weinberger of the NIMH was the presenter and 2000 Nobel Laureate Arvid Carlsson was in the audience. The focus of the piece was that neither brain science nor psychiatry was ever the same following Dr Carlsson's discovery of dopamine. This blog post zooms in on the similarly seismic effects of a study that Dr Weinberger participated in:

I first ran across Dr Weinberger (pictured here) at the 2003 APA in San Francisco, in relation to a gene that influences a different neurotransmitter, serotonin. I was an innocent, about to have my eyes opened:

Dr Weinberger told his audience about a study that came out of his lab, published in Science the year before (Ahmad Hariri, lead author). In the study, the researchers rounded up healthy subjects and put them into a brain scan machine (not all at the same time, I presume. I think they lined them up one at a time). The individuals were divided into two groups, those who had a certain variation to a particular gene, what they call the short allele to the serotonin transporter gene, and those who had the long allele.

The serotonin transporter - or serotonin reuptake pump - is the target of SSRI antidepressants. Based on this knowledge, researchers knew there had to be a genetic smoking gun somewhere, but they were stumped. The problem was they were looking for a "depression gene" or a "bipolar gene." Genes, unfortunately, don't conform to the way we classify psychiatric disorders.

In 1998, for instance, a German team came to the conclusion that "no association between alleles conveying functional differences in serotonin transport gene expression and major depressive disorder or bipolar disorder could be found."

Basically, genes act as "on-off" switches. But they don't switch on "depression" or "bipolar" or anything else. Instead, they activate proteins that regulate how cells function and and organize themselves into interacting with other cells. This in turn may influence whether a certain individual is predisposed to depression or bipolar, but you're not going to find that out by looking for a direct link.

It's simple mechanics really. First link the gene to the cellular function it influences. Dr Weinberger and his team already knew that a certain region of the genome, SLC6A4 with the chromosomal address of 17q21, is responsible for the cellular activity that involves vacuuming excess serotonin from the synapse between the neurons.

But then what? What was the connection to behavior? On one hand, Dr Weinberger and his colleagues needed to build on the work of Dr Carlsson's generation; on the other, they needed to throw away all their preconceptions.

As the study subjects' brains were being scanned, they were made to perform a simple cognitive task involving looking at images of "scary" faces. If you have any doubts about what a two-dimensional image can do to the brain, simply turn on Fox News without the sound. Seriously, just the sight of those idiots - don't get me started.

It turned out that the "short allele" people - that is, those with a certain variation to the gene in question - in reaction to the scary faces, a certain portion of their brains lit up like a Christmas tree. You guessed it, we're talking about the amygdala, which features mightily in my adventures with raccoons and skunks.

As we know, the amygdala mediates fear and arousal, and is directly and indirectly wired into all areas of the brain. Think of the amygdala as a simple smoke alarm. It can detect smoke, but it's too dumb to know whether the smoke is related to grilled meat or a five-alarm fire. The thinking areas of the brain will eventually provide you with the info you need to make a rational decision, but all that takes too way long to boot up.

In the meantime, it's prudent to sound the alarm, even if it is a false alarm. But what if the alarm is over-sensitive or won't shut off? It's one thing for your fight or flight response to kick in at the sight of a predator (or Dick Cheney with a face lift) at the door, but what if you keep having the same reaction to, say, the UPS guy?

When the amygdala goes off, we are reacting rather than thinking. We are operating out of fear. As Dr Weinberger explained to his audience, "this could be the first study to link genes to emotions."

What does this mean? Let's turn to a closely related study:

About 35 years ago, researchers from the University of Otago recruited a "birth cohort" of more than 1,000 infants born in Dunedin, New Zealand, and subsequently assessed them every two or so years. Had my daughter (who was born in Dunedin) arrived five years earlier, she might have been part of that cohort. Then again, had she been born five years earlier, I wouldn't have been the father.

"Longitudinal" studies of this sort represent the gold standard of population research, as opposed to "retrospective" findings based on recalled events. Over the years, this cohort has been to medical and psychiatric and behavioral research what wild Tanzanian chimps have been to Jane Goodall.

On July 18, 2003, the journal Science published the latest installment coming out of Dunedin. The year before, the same research team had identified certain childhood risk factors in antisocial behavior, together with a strong link to a suspect gene (acting on the enzyme MAO-A). This time, the researchers (Avshalom Caspi, lead author) analyzed the cohort for stressful events over the past five years, such as death in the family, losing a job, or breakup with a partner and this time their attention was directed at the very same gene that featured in Dr Weinberger's study.

Lo and behold, of those meeting the criteria for at least four recent stressful events, 43 percent of the short allele people experienced depression vs just 17 percent with the long allele.

In a field where researchers are accustomed to teasing out frustratingly small statistical blips, these numbers represent something truly seismic.

It is important to note that the researchers did not identify this variation as a "depression gene." Rather, drawing the short genetic straw makes one susceptible to stress and its downstream effects (which may include depression). One also needs to have regard for the fact that not all depressions are caused by stress.

Think of the short allele as a "vulnerability gene." Those with the long allele, by contrast, may be regarded as the proud owners of a "resilience gene."

To further clarify the resilience factor, the depression rates for those with the long allele did not vary, regardless of whether they had experienced zero recent stressful events or four or more. Those with the short allele, by contrast, only experienced this same low depression rate as the long allele people when not exposed to any major stress, period.

As Dr Weinberger described it at a subsequent APA, this particular gene "impacts on how threatening the environment feels." Or, as his colleague Andreas Meyer-Lindenberg put it at yet another conference I attended, the short allele "impairs your ability to respond to what life throws at you."

Noted the Dec 19, 2003 Science: "Together, these studies suggest that the gene variant biases people to perceive the world as highly menacing, which amplifies life stresses to the point of inducing depression."

Science was reporting on what it considered the top ten scientific breakthroughs of the year. This pair of findings (plus several others) ranked number two. The origin of the universe came in first, and we’re not about to argue with that.

So it's not nature vs nurture. It's more like nature via nurture. But it's even more dynamic than that. The brain isn't simply influencing how we perceive and respond to our environment; our environment, in turn, is literally building our brain. We're not stuck with the same brain cells we were born with. Your brain is literally changing right now, as you are reading this. You might not be able to trade in your hair-trigger amygdala for one a bit less sensitive, but you can literally set to work building your own neuronal work-arounds.

The upshot of all this is that literally every idea about how we think and feel and behave is now in play. Dogma may be dead, but wisdom and insight are thriving. If you're big on biological psychiatry, the brain studies are coming in thick and fast. Likewise, based on precisely these same studies, you can make a case for bringing back Freud. Similarly, if you're bullish on the precepts of the ancients, you can brandish the exact same evidence.

The same applies to centuries-old philosophical foodfights involving the distinction (if any) between the mind and the brain.

Eventually, new findings will resolve a lot of these debates, but in turn the facts are bound to raise a lot more questions than they answer. In the meantime, that strange interlude we call life is demanding we make choices right now.

Cool Stuff I Love Talking (and Writing) About

If you're a serious researcher wanting to know more about your field, you don't waste your time attending the Annual Meeting of the American Psychiatric Association. The week-long meeting is largely regarded as a junket where clinicians can pick up the CME credits they need to remain in good professional standing.

But if you know what you're looking for, you can learn a hell of a lot. In eight years of APAs, I've had the honor of listening to three Nobel Laureates, plus numerous others who deserve a free trip to Stockholm. I particularly enjoy hearing the brain scientists, who are kind enough to dumb down their presentations for the psychiatrists, which means people like me can kind of follow along.

Here's how it works: When Daniel Weinberger of the NIMH is at the APA and happens to mention the COMT Val 108/158 Met variation, he pauses to explain what that means. Not only that, he has cool PowerPoint slides that even psychiatrists and Geico cavemen can follow. When the same Dr Weinberger is at, say a schizophrenia research conference, addressing an audience that includes 2000 Nobel Laureate Arvid Carlsson (pictured here), he doesn't even bother to let on what the COMT Val-Met variation is all about. He just assumes everyone knows. And forget about a cool PowerPoint.

Research conferences don't intimidate me. Remember, raccoons respect my piss. In San Diego in 2009, at the International Conference on Schizophrenia Research, I approached a table where very smart people were drinking their morning coffee, and introduced myself as the only C student at the table. The line worked so well I used it the rest of the day. It didn't take me long to get into the spirit of this particular conference, and soon I was referring to my coffee as my "neuro-cognitive starter."

Naturally, I knew exactly what to say to the likes of Dr Carlsson. Being a journalist, I assumed a totally professional demeanor and introduced myself as someone about to become a grandfather who would like to thank his son-in-law for his participation in the effort - who happens to be a neurosurgeon in training - if he (Dr Carlsson, that is) would be so kind as to provide an autograph.

Dr Carlsson, to his credit, smiled indulgently, and graciously signed the back of my program. His co-Laureate, Eric Kandel, did the same for me a few years earlier at the APA in Atlanta when I told him about my nephew who is as smart as Einstein. "I really admire your work," I burbled to Dr Carlsson, as my parting remark. I'm sure that was the high point of his life, coming from a C student.

A little background: Dr Carlsson literally discovered that dopamine is a neurotransmitter. Finding a new neurotransmitter was to brain science what the discovery of Uranus was to astronomy, only far more significant. At least, back in William Herschel's day, we knew what a planet was and what it did. By contrast, as late as the early 1960s, we had only the vaguest idea how brain cells - neurons - communicated.

Back in those days, scientists were divided into two hostile camps that literally didn't talk to each other - those who believed cells instant-messaged each other electrically and those who thought that chemicals were the prime agents. So for Dr Carlsson to even arrive at the concept of neurotransmitter and dopamine, first he and his contemporaries had to figure out the Newtonian physics of that mysterious inner universe we call the brain.

We now take it for granted that a neurotransmitter is a packet of chemicals that is delivered from one nerve cell across a gap (or synapse) to another nerve cell. The neurotransmitter glutamate, for instance, literally instructs neurons to get excited. It's all about chemicals outside the brain cell setting off chemical reactions inside the brain cell (after first being assembled inside a different brain cell). Technically electricity is also involved, but we don't need to go there.

Had Dr Carlsson stopped right there, he certainly would have earned his plane ticket to Stockholm. (Wait, Dr Carlsson is Swedish - he probably only had to drive across town to collect his prize, assuming he could find a place to park.) But no, Dr Carlsson connected dopamine deficiency in the brain to Parkinson's, which led to L-dopa and other agents for its treatment, thereby significantly improving the lives of countless millions.

That isn't the end of the story. Dr Carlsson's discovery literally opened up the field of biological psychiatry, which posits that - hello! - the brain is not undifferentiated tofu. You can argue till the cows come about whether the mind and brain are the same or two entirely different entities, but when all is said and done, how we react to the environment around us and how we anticipate our future is mediated through the elegantly intricate processes of the meat housed inside our skulls.

We think with our meat. Newtonian meat, quantum meat, highly specialized units of meat, 100 billion cells - as many as the stars in the Milky Way - arranged in infinite connections switched on by some 16,500 genes out of a total of about 25,000 in the human genome.

So when I told Dr Carlsson I admired his work, I really meant it. Not only that, I was in awe of it. I would have felt the same way had I a chance to shake Einstein's hand. So - seriously - I didn't mind at all that I looked like a fool. Every day, when my very smart son-in-law is conferring with neurologists and prepping for surgery with a precious life hanging in the balance, he is literally performing his work in the very considerable shadow of Dr Carlsson. And now he has Dr Carlsson's autograph hanging from his wall.

To be continued ...

Guest Blog - Cellphones and Unintended Circumstances

Another gem from Elizabeth:

The word keeps coming out that cellphones are dangerous to use while driving, even if you are wearing that Bluetooth thing on your ear that make you look like a cyborg. People ask, why should that be any different than talking to someone in your car?

I suggest that electronic communication system devices make you not really there even though you’re there.

Ever been on an elevator with someone having an intense conversation on the cellphone? I have, many times, and the frequency is increasing. Shoulder to shoulder with people on an evelator and there’s someone with us hissing loudly on her cellphone that “you did too sleep with that bitch.” Or some guy yelling “don’t even tell me you care about me.” These people seem totally clueless to the fact that they are in a very small space among many strangers who are hearing their most personal business. This is really changing elevator etiquette.

I can’t help noticing how much technology is altering how we communicate, and how much—or rather little—we notice or care about the people in our immediate environment as a consequence.

I teach at a couple of college campuses. Campuses were once places where you met new people, and your education extended far beyond the classroom to talking about the material you’ve been exposed to with students you’ve met in those classrooms. Cellphones are really changing all that.

Why extend yourself to new people in your immediate environment when you can just call up the people you’re already comfortable with on your always-available cellphone?

I always smile and nod a hello to anybody who passes by me. But more and more, people just don’t seem to be present: they’re on their cellphones.

When the cellphone phenomenon first started to bloom, I’d think the person talking next me was talking to me. When that person failed to respond, I’d think, maybe this person needs a new med. But no. This person is on her cellphone. I really don’t exist for her.

A whole new layer of alienation, brought to us by a device that greatly extends our ability to connect.

Talk about your unintended consequences!

Tooting From Greater LA - IIl

This is my housemate, Paul Cumming, with his Advocate of the Year Award, presented at a luncheon at the NAMI CA conference held yesterday in Torrance.

Paul has been a tireless advocate for years, working quietly behind the scenes, a champion of people with fresh ideas, a defender of those with no voice, and an unrelenting thorn in the side of those who wish we would all go away.

Significantly, three of the featured speakers at the conference - Tom Wootton (author of The Bipolar Advantage), Kathi Stringer (quality improvement innovator), and Gene Johnson (founder of Recovery Innovations) - owe a lot to Paul.

Paul is the frequent flyer point man for Network of Care, an innovative mental health web resource that is helping millions improve their lives.

Tooting From Greater LA - II

I'm at the NAMI CA conference in Torrance. Above is a seven-second video I shot last night on my iPhone.

That's Nathaniel Ayers you're looking at and listening to. Nathaniel Ayers is "The Soloist," whose life is recounted in Steve Lopez's book of the same name and in a movie of starring Jamie Foxx and Robert Downey Jr.

Mr Ayers was a cellist attending Julliard when he experienced a major psychotic break. He wound up in LA's notorious Skid Row where he lived homeless for more than two decades. Mr Lopez, a columnist for the LA Times, discovered him on the streets playing a violin with two strings. What began as a reporter-subject relationship developed into a bond far greater. Steve was able to convince Nathaniel to move into public housing, but had some lessons of his own on how delusional thinking doesn't just apply to those with mental illness. In the end, Steve had to learn to accept Nathaniel for who he was rather than what he would like to turn him into.

Anyway, here we were, sitting down to dinner, when Nathaniel, with no introduction, got up on stage and started playing. Adlibbing. Very much Bach-inspired, but very free form with no breaks for a good 30 minutes.


After dinner, we were told we were going to view an incompleted and shortened documentary, "The Chorus," about life on LA's Skid Row. I braced myself to be bored out of my mind for the next hour, only to encounter the most incredible experience ever from nine years of attending mental health conferences.

The documentary followed six or seven Skid Row residents for several months. Gradually, we got to know these individuals and identify with them. We laughed, we cried, we got outraged, filled with hope, were swept off our feet and hit in the gut.

Then the lights came on and the people responsible for the video and some of the cast, along with Nathaniel Ayers, got up on stage. The image here is from my iPhone. I hope I get the name right here. This is Linda, who was also an extra in "The Soloist" and one of the star attractions in "The Chorus." She is belting out - and I mean really belting out - a Gospel tune.

The documentary is simply too good not to find a distributor. When it comes out, trust me, "The Chorus" is a must-see. As I said, the documentary and the live cast and crew experience, together with Nathaniel Ayers, constituted my most incredible experience in nine years of attending mental health conferences.