Because the web 2.0 “crowd” is so “smart” the intelligence agencies are thinking of tapping into this so-called collective wisdom and you can read about new efforts designed to create open source spying in the NYTimes. And make sure to check out Chris Kelty (who was on my dissertation committee) excellent commentary

At the University of Chicago, the Department of Economics was right across from my home-stomping ground, the Anthropology Department. Less than 30 seconds away, the world views and methodologies packaged for students were actually much much further apart not do to physical space but mind space.

Though “there” (not physically the whole time) for 8 years and now gone for two, it only today, this morning before the sun has arisen, when I have had more concerte exposure to what econ undergraduate students get taught during an introductory course thanks to a very well-written article, What We Learn When We Learn Economics.

The article’s author is clearly biased in certain respects but what is nice is that he demonstrates well that the articulation of a largely free-trade, market-heavy theory of economics made famous by a group of Chicagoans, which is given in the name of neutrality, is also, like any sort of model, not free entirely from bias and blinders. And whatever your take on free trade economics is, the article is quite well-written so take a dip!

I just finished a pretty good article The Myth of Thomas Szasz, about the man who most famously attacked the psychiatric profession in part by claiming mental illness was manufactured, a myth. In a nutshell here is the point of the article:

“It is hard to doubt the reality of mental illness, especially when the suffering of affected individuals is so complete and the impairment so extreme, when psyche and identity are crippled almost beyond repair. But it is also remarkable how much of modern psychiatry is still theoretical rather than empirical, and how many of the supposed mental illnesses that appear (and multiply) in the Diagnostic and Statistical Manual of Mental Disorders have no known biological underpinnings or explanations. Although Szasz’s critique often became a caricature, his intuition about the limits and deformations of modern psychiatry cannot be ignored. Many sick people have surely benefited from psychiatric treatment, both “talk therapy” and pharmacotherapy. But psychiatry’s long history of error—from snake pits to ice baths to spinning chairs to electroshock to lobotomy—should give us pause. Skepticism is not backwardness, even if Szasz often took his skepticism to rhetorical extreme”

The part I found most interesting (and now I must read it):

A piece in The New York Times Magazine[by Szasz] titled “Mental Illness Is a Myth” reportedly induced more reader response than any article in the magazine’s history. If he had preached from the pulpit with The Myth of Mental Illness, he had now nailed his thesis to the church’s front door.

I must must check out the reader response!

For those who know little about what came to be known as anti-psychiatry, this article is worth reading. It is written well and presents the virtue of skepticism, even if extreme, which is what Thomas Szasz, was all about. My only complaint is that if you know nothing of anti-psychiatry or the visible and patient-led challenge to psychiatry that followed in the 1970s, you would think that Thomas Szasz was entirely in a class of his own. While he may be the most famous figure, and may have certainly led the charge in many resepcts, there were others (that is critical psychiatrists like him (and not just in the US) not to mention wide spread critique from various social quarters. But a great great article otherwise.

It is good to see the New York Times critically report on the (ab)use of cocktail psychiatric drugs used for treating children (and see this older New Yorker article The Pediatric Gap on the general lack of saftey testing for drugs given to kids).

What is a shame, however, is that the total lack of critical interrogation that there may be actual environmental causes for some of these problems and this, despite the publication of new studies from leading medical journals (such as Lancet) that finally are addressing the possibility that over 200 chemicals are causing havoc on brains, behavior, and thus life… (kinda a no brainer at some level even if we do need more specific studies…)

As the article on the chemicals reports, critics of they study say they Lancent authors are verging on scare-mongering, because there is no proof of a pandemic.. Well, we do need more proof but does that mean we should not study what is so understudied (and hard to study because how does one measure the effects of the synergistic combination of x number of chemicals over x many years??)

But as the NYTimes piece shows there does seem to be a pandemic in prescribing people and kids psychiatric medications. So possibly there is some connection to be made here??

And what I can’t understand is why it is that those within the medical establishment who are confronting kids with so called behavioral and those that are critics of overprescription are not asking what may be behind some of these problems…

While I agree that a percentage of the kids being put on drugs are totally fine and just being kids, I am sure there are many others who are suffering. And while some of these psych drugs may be an acceptable and necessary short term solution, this NY Times article should make us pause, and seriously pause, about the viability of these drugs as a realistic solution, given the horrible side effects they cause (just read the article). Even if some so think these are necessary, these are crude therapies.

I think we need another “Silent Spring” with an eye toward possible behavioral effects to shake people not out of an apathy, but from a myopia that seems satisifed with engaging only with symptoms and surfaces.

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This morning I came across Michael Berube’s response to Jodi Dean’s critique of Berube’s book What’s Liberal about the Liberal Arts?: Classroom Politics and Bias in Higher Education… It is a fascinating interchange worthy of a close read or two but without first-hand knowledge of the book, I hesitate to pledge my allegiance on either side. But I will hopefully to do so. The only thing that surprised me was that there was no mention of the grand master of the critique of liberalism, Stanely Fish… Not sure why but he seems like an obvious place to start.

These ppst happened to really captured my attention this morening given I found them after reading the Chronicle of Higher Education piece Input or Intrusion? which examines the recent attacks against scholars deemed as “anti-Israel/pro-Palestine,” including against Nadia Abu El-Haj who happened to be on my dissertation committee… It will be very interesting to see how this all pans out and I am sure many of us are watching closely.

And as an added bonus, here is a student’s thoughtful perspective on the Berube book.

My friend Jonah has written a provocative post that asks how the example of free software can be applied to the environmental politics as to create a free energy movement. His suggestion is a good one and it centers on the clear and accessible provision of information of labeling so as to create the conditions for meaningful choice and action.

There is a line of critique launched against free software and the free culture movement accusing it of being myopic, privileged and limited. It is composed of a lot of well educated, white (many boys), honing in on liberating a set of artifacts—software, music, movies—etc, that are seen not to have all that much consequence in the world, compared to other more pressing matters, like famine, genocide, global warming, disease etc. I think this is somewhat of a negative critique that actually misses the point about why so many folks are attracted to the free culture movement in the first place and why it should be considered in a more positive light as a model for other forms of politics not because of its content but because of its form (and this is what Jonah basically says).

In a world in which the mere thought about how to change the world is utterly paralyzing, seemingly futile, and just completely depressing, open source and free culture, by providing a set of tools along with a political message, has broken through the armour of apathy many of us are strangled by. It provided an opening to practically engage in politics, and thus allow many to taste the fruit of political action. And it is the taste, which keep people coming back to try to change the conditions of life.

So the lesson to draw from free software is less whether its politics are radical or important enought, but that it provided an avenue and framework for alternative action. And it is this abililty to build the capacity for empowerment, which is one of its greatest virtues.

I now need to start looking for a flickr replacement. Yes, I am offended by the patent.

Recently I read an amazing review of patient advocacy and health (counter)movements by Steven Epstein from the STS program at UCSD. It is still a draft but bound to be published in the New Handbook of Science and Technology Studies and when it is, anyone who works in this area will gain so much from reading the review. It was stunningly broad yet highly specific. He is able to synthesize an enormous literature on patient advocacy, a field that has seen a blizzard of activity, especially in the last twenty years. Along with providing points of entry and departure into the field, he also examines who the burgeoning interest in the field of STS.

What I found interesting is that there is very little work being done on a topic I happen to know a lot about, lyme disease and whose politics I have been following since at least 1999. I am not sure why the lacuna but it is an odd disease dripping and screaming with controversy and seems to stand apart from many illnesses, in part because of its odd dual existence. On the one hand, it is an illness that the medical establishment totally recognize as “real” (and thus in some respects is unlike the class of syndromes from MCS to chronic fatigue, which another STS researcher, Joe Dumit provocatively describes as “illnesses you have to fight to get”).

But that is only half the picture because mainstream medicine tends think that lyme is not only easy to diagnose but also to treat, so much so that if a person thinks they have lyme (even after a round of antibiotics or lacking diagnostic markers), the are either seen as suffering from something else (and usually then told they have one of those highly contested syndromes), or more often just crazy. So it exists dually: at once recognized but only narrowly, so that in another form, that of chronicty, lyme cannot exist.

It is this dual quality of lyme that defines and shapes its politics and just recently, new developments have fueled the controversy. Namely it follows from the Infectious Diseases Society of America new guidelines for the diagnosis and treatment of lyme, published last month. In a nutshell, they basically re-reduce lyme to a very easily diagnosable and treatable illness, calling for even more strict guidelines for its diagnosis than now exist. They sanction a small range of blood tests and thus totally nullify the role for clinical diagnosis, which even the CDC had acknowledged as vital in times past.

Unsurprisingly this has thrown the chronic lyme community in a total tizzy and they have not taken this sitting down. A petition has been launched and protests have been planned. And amid the controversy, politicians have already heard the call to arms. In the state where lyme is a famous entity for it was first discovered there, Connecticut, its Attorney General is calling for an “anti-trust” investigation into the Infectious Diseases Society of America, in essence for using their clout and prestige to legitimate a gold standard in diagnosis and treatment, when it seems far from obvious that this should be the standard. According to the LDA press release:

“The national non-profit Lyme Disease Association (LDA), representing more Lyme disease patients than any organization in the United States, applauds Connecticut State Attorney General Richard Blumenthal for beginning an investigation into the Infectious Diseases Society of America (IDSA) Lyme disease guidelines development process. In an unprecedented move, the Attorney General’s office filed a Civil Investigative Demand (CID) to look into possible anti-trust violations by the IDSA in connection with exclusionary conduct and monopolization in the development of the Lyme guidelines”

What I find so interesting is that this latest chapter in the grungy and torrid politics of lyme encapsulates the very nature of the politics of lyme, which really is about the “agency of bacteria” and in the Latourian sense. If Pasteur had to put a lot of effort into making credible the bacteriological model of disease as Brunto Latour covers in The Pasteurization of France and if there was plenty of future prostelyzing needed to bring credibility to the bacteria to more general publics, as Nancy Tomes illustrates in The Gospel of Germs, well now, I think we are in an era where we think we have such intimacy with the biological ins and outs of bacteria, it is almost impossible for the scientific community to imagine bacteria as such complex organisms that they can be in fact very difficult to diagnose, eradicate and treat. It is just no longer part of the basic conceptual universe of most doctors and medical researchers to think of bacteria in this way.

The LDA press release acknowledges this very fact in the following way:

“The October 2006 guidelines do not acknowledge that a complex bacterium such as the Lyme disease spirochete could possibly survive in the body and the brain, evading the immune system and short-term courses of antibiotics.”

For many lyme researchers and doctors, since lyme is a bacteria and we know how to treat those pesky critters, it is frivolous to even imagine or contemplate otherwise. I would call this a hubris that arises not from the arrogance of doctors and the medical establishment but following the heels of success that medicine has indeed had with conquering the bacteria with antibiotics. Even new forms of poweful and highly resistanant TB are still treatable with a potent cocktail.

That is, at a cultural level, I understand the blinders. At a political level, however, because people are suffering and because it is plausible that lyme can exist chronically, it is imperative to unseat this cultural comfort borne from past success to get the ball of research rolling anew.

I think bacteria (and parasites for that matter as a recent smattering of articles demonstrate) are a lot more savvy creatures that should be treated as novel, wondorous creatures, once again. I would dare say the medical establishment, by refocusing energies on that which they think they have solved, would find themselves quite surprised.

updateHere is an article discussing the issues.

So I am in Alberta, Canada but I decided not to get a local phone number mostly because I have a VOIP phone that works fine and it lets me call Puerto Rico for free, and allows my sister call me for free too.

But not having an Alberta 780 area code can be quite problematic at times and the latest chapter in the confusion has come from trying to get the IBM warranty folks to accept that you can call from Alberta with a non Alberta area code and realze that even if they accept that, the computer is the one wearing the pants and thus making the decision…So even if you convince them that new technologies make this possible, the transaction is still sabotaged because in the end, they rely on computer to get the actual service repair person to call you and the computer relies, and can only rely on the area code., who can only see that an area code 773= USA, so then it gets a US rep to contact you back after the initial phone call.

Here is an IRC transcript discussing the confusion, which I think is pretty amusing:

m: they are so confused
m: the guys says “what province are you in?” I say “Alberta”
m: and then he gets my number and he says “You aren’t in Alberta, sir”
m: and I say “Yes I am, my phone number is a US phone number, but I assure you, I am in Edmonton, Alberta right now”
m: and he says “Are you a canadian citizen?”
m: and I say ‘no, do I need to be, in order to be in Alberta?” and he says “The problem is, you are actually in the US right now”
m: I AM NOT IN THE USA
biella: heh
m: so I had to say “You realize that cell phones and voip technology allow you to roam outside of the USA and still use the same phone number?!”
b: and then what?
m: well he said I needed a canada number or their system would send it to the states
m: regardless if thats where my address is
m: their computer is too smart
micah anyways
biella: or not smart enough

Well, we are now using my office number so hopefully all will be OK.

While anyone who has had a

1) medical condition and 2) access to Internet in the last five years

probably knows that patients are increasingly using the net (and now google) to diagnose medical conditions, it is only now that the “medial establishment” is starting to recognize or really admit to the reality of this widespread phenomenon and even doing studies on them, such as the one released a few days ago by the BJP Googling for a diagnosis—use of Google as a diagnostic aid: internet
based study. The study sought to ascertain how effective google was as an aid in medical diagnosis. As various new outfits are reporting it is moderately high.

What I love about this study and the corollary reporting is the naive tone they have to assume, transmitting the news as if the public knew very little about this, and would in fact, be induced into surprise!!!!!!!!!! when first facing the new. But in fact, I think it works in the opposite way. The surprise is that they took so long to admit to what was in front of us for many years now.

While the news articles reporting on the study stay within the province of doctors, the report acknowledges, in fact opens with, the fact that patients may be forging the path in Internet-diagnosis. The authors write in their second paragraph:

“It seems that patients use Google to diagnose their own medical disorders too. After evaluating a 16 year old water polo player who presented with acute subclavain vein thrombosis, one of us (HT) started to explain that the cuase of the thrombosis was uncertain when the patients father blurted out “But of course, he has paget-von Schrotter symdnome. Having previously googled the symptoms, he gave us a mini-tutorial.. and the correct treatment for the syndrome. This experience led us to ask “How googe is google in helping doctors to reach the right diagnosis”

Again, what I love about the tone of this opening is that it is as if these doctors stumbled on a great but deeply hidden fact to make a breath-taking discovery, one that, however, since is it is SO very emergent and thus still not *really* verified by Science, they must proceed with great caution, qualifying with phrasees like “It seems that patients use Google to diagnose their own medical disorders too”. I am sure they and most doctors are personally are not so naïve but since this has been something virtually without no official acknowledgment among professionals and in the journals, the genre of writing just requires it to be framed cautiously.

As fun to read are the comments, for they stretch from moral panic:

“The implication that ‘googling’ be an adjunct to proper medical school training, continuing medical education through courses and reading peer reviewed journals is laughable and bordering on dangerous. I am shocked that this has been published by the BMJ.”

to celebration:

“For the modern dermatologist, the internet is indispensible and google is only the start, and for this reason a desktop computer with high speed internet access is an essential tool for all clinicians. Long live the information superhighway!”

While others muse on the broader emacipatory possibilities

“One can imagine the benefit to young doctor in developing country who now have access to a grand medical library in their hands.”

I am especially interested in this very dynamic because it is one pillar propping my next project on psychiatric survivors, which exceeds the particular topic of challenges to psychiatry in its general focus on medical/patient reconfigurations following from Intent-based activism, self-help, diagnosis, and critique. And for those who think I have made a radical departure from my last project, here is where I see one (of two or three) threads of continuity: for patients are generating an enormous amount of “amateur” knowledge, that I think is not unlike the peer-to-peer production of software hacking, and it is a form labor usually accompanied by a strong critique of expertise and other medical practices.

I am now reading some literature on patient activism, like the issue from the February 2006 in Social Science and Medicine that collects 11 articles on patient organization movements. For those who work on this topic, the collection is worth your while and the editorial introduction by Kyra Landzelius is stellar. It is not only written beautifully (which I think is rare for these openings because it is often a rote, unimaginative regurgitation but this was a pleasure to read) but provides an engrossing overview of some new trends and some of the diverging forms of politics that arise from what is really a motley bunch of organizations and contests in patient and anti-patient activsm.

She opens by defining four spheres that shape and inform the forms of contents that are part and parcel of these patient movements, the four being:

1. Revolutionary feats in technoscientific engineering
2. Restructuring of healthcare systems across industrialized nations
3. A Revised contract between science and the public stemming from a criss of confidence in science
4. An upsurge in the articulation and diversification of health activisms (p. 530)

These four are key but I was shocked that there was no specific inclusion—though it comes out plenty in the introduction in other ways—of the Internet. For while I am no techno-determinist, the Internet I think, can’t be ignored for it has fundamentally changed the map and tenor of patient activism, allowing for more rapid connections between various stakeholders, providing a medium by which those officially unrecognized illnesses are given shape and form, and where an ethical cultivation of self-help, self-diagnosis, self-medication, along with copious critique and forging of alternatives is happening, right before our eyes, virtually in real time.

It is the medium by which a new chapter of patient activism is being written and I think it is a real mistake not to give it serious attention and credit. And perhaps one of the most interesting things about it is that it without it, it would leave many otherwise home-bound, sick folks, without a medium by which to engage in political activity or even community self-help, for let’s face it, these take a lot time and energy.

When you are sick and home-bound, for example, there may be a limited number of types of engagements you literally have the energy to partiicpate in and the Internet lowers the barrier of political entry because of its ease and because you can still type away, even when feeling otherwise totally awful… This may be a brute material point but nonetheless, key to understanding the political power of the Internet.

Now of course the question left is will Google capitalize on this and create “Google Diagnosis”?