FROM THE ANNALS OF PSYCHIATRIC ABSURDITY

Rhazes the Arabian Doctor

From A.D. 865 to 925, Rhazes was an Arabian doctor who was considered to be and outstanding scholar of the times. He wrote over 200 different volumes on medicine, religion, philosophy, and astronomy. As he rose to prominence, he became physician-in-chief to the Baghdad Hospital, which was a remarkble institution of its time, because it had a ward exclusively for the mentally ill. Rhazes saw the body/mind connection with mental illness and even used a primitive form of psychotherapy. However, the Arabian doctor ran afoul of the other influential doctors who believed that all illness was the result of demon activity. Since Rhazes disagreed with the medical establishment he was sentenced “to be hit over the head with his own book, until the book or the head broke.” This early psychiatrist was rendered blind after this punishment. ( Taken from The History of Psychiatry by Franz. G. Alexander and Sheldon T. Sel;esnick)

Suicides Punished in Medieval Times

The act of suicide was extremely repugnant to the medieval mind. Those who killed themselves had extreme punishments carried on on their corpses to enact symbolic shame. The book, Legal Lore, by William andrews explains that, “The body was, by the customary law … to be drawn to the gibbet (instrument of hanging) as cruelly as possible … . The very door-step of the house in which he lay was to be torn up, for the dead man was not worthy to pass over it. Impalement, transfixture by a stake, though well enough known on the continent as a punishment for the living, became there (in France) and in England alike, the special doom of the suicide.

Psychotic Mass Movement in Medieval Times

During the 13th and 14th centuries mass movements arose, driving many psychotic. In Hungary, in the year 1231 a cult arose that believed that the plague was caused by personal sins. The History of Psychiatry says that, “They marched through Europe singing hymns, bearing red crosses on their breasts, and carrying whips with knots from which hung iron tongs.” They were known as “flagellants” and their converts whipped themselves in public. Although their group was condemned by Pope Clement, another group of flagellants sprang up in Strasbourg in 1418.

“The radiologist wants a follow-up mammogram in six months,” your doctor tells you.

You’ve heard and seen all the TV and Radio ads about 1 in 8 women getting breast cancer. So, you’ve been good–you got screened. Now you have to do it all over again?

As it turns out, the mammogram is difficult to interpret due to “dense glandular tissue,” a very common finding in younger women or those on HRT.

And that’s when you realize that not knowing whether you have a tumor or not is one of the most trying experiences of your life.

You don’t have a tumor, but you know lots of women get breast cancer. You’re scared but as far as anyone can tell there really is nothing wrong with you, so why talk to anyone about it? It’s enough to make you a nervous wreck.

Your doctor reassures you, quoting statistics about screening and telling you that “this is just a standard practice–there is no indication of tumor.” But somehow the prospect of bad news lingers in the back of your mind.

Doctors know that repeated mammography may pose a risk of cumulative radiation exposure, yet the risks of missing a tumor far outweigh this. But now there is a way to reduce the number of mammograms some women receive due to dense glandular tissue.

And a more definitive answer to “that question” may make quite a few patients feel much better.

Why is “dense glandular tissue” a problem? Conventional x-rays (a mammogram is a low-radation x-ray) are not the best way to view soft tissue changes. It is ironic that x-rays are used to diagnose breast cancer because a small tumor inside dense glandular tissue cannot be seen.

This is why you may see radiologists constantly and tediously poring over mammograms with magnifying glasses. They do their best not to miss anything.

If there is a finding of “dense glandular tissue” and the radiologist cannot rule out a tumor (she can’t rule out what she can’t see) the best course in the past has been to follow the patient with a repeat mammogram in 6 months, usually, or sometimes 12 months so the radiologist can compare the series of mammograms to see if there any changes.

A recent study of 196 women shows that MRI (Magnetic Resonance Imaging) can be used to rule out suspicious-looking mammograms. The benefit to the patient is that she doesn’t have to worry for 6 months, waiting for her “follow-up.”

One of the big pay-offs of using MRI is that there is no radiation used in the procedure. MRI uses radio-frequency magnetic pulses that have not yet been demonstrated to have any ill effects. In addition, MRI is considered much better than other radiographic procedures in imaging soft tissue such as fat, glands, muscle and ligaments.

During the initial stages of a romance, e-mail becomes both a blessing and a curse. E-mail flirtations increase in frequency, and the infatuated recipient can mull incessantly over every abbreviation and bit of punctuation. Phraseology can prompt tortured late-night conversations with empathetic friends, analyzing the minutiae of flirtatious e-mail etiquette. When he opened his note with the line “Hey there cutie” did it mean anything special—or is he just a player? When he ended his note with a nonchalant “see you later” was it a profession of his true love, or a casual blow-off? Why didn’t he sign his name at the end of the message? What is the deeper meaning behind his punctuation, capitalization, and abbreviation? What about “e-motions,” those little smiley faces of all sorts?

My friend Katherine engaged in such tortured over-analysis when she and her current boyfriend, Ryan, began the dance of e-mail flirtation. Ryan jotted and mailed to Katherine an inspired poem containing references to both microeconomic theory and brazen behaviors. She attempted to decode his hidden messages. For the rest of the semester, nightly e-mail conversations ensued between the microeconomics homework partners. A year later, written flirtations and hilarious semi-tawdry exchanges led the way to an actual romance. Partially, thanks to e-mail, Katherine and Ryan have been dating happily for a year.

More than written flirtations, e-mail also encourages the exchange of little gifts. In the age of mp3s and picture sharing, e-mail provides a medium for testing the waters of new relationships with cost-free presents. Before we considered ourselves a couple, my boyfriend Brian and I engaged in little exchanges. Upon the receipt of the Eagles’ “Witchy Woman” my roommates declared that the romance was dead based upon the secret message Brian must have intended when sending me that song! Yet a month later, Brian sent me a photograph of a dozen roses for Valentine’s Day … followed by the biggest teddy bear I had ever seen. E-mail and real life melded perfectly, and the relationship is going strong to this day.

But real life and “e-life” don’t always work together so nicely. While e-mail can provide a safe medium for flirtation, a crucial element of communication is lost when human emotions are translated into computer code. A warm smile and enthusiastic intonation can’t really be captured in characters on a screen, and panic can creep into a relationship if messages change in style or decrease in frequency.

As a friend Rajiv shared, “let’s just say that technology not only brings people together … but it has also reduced the time required to break people apart.” Other friends concur: “E-mail seems to be a way for some guys to get OUT of actually talking to you about how they feel—kind of hiding behind the computer screen.” Face-to-face confrontation becomes unnecessary when the computer provides an easy escape.

But let’s assume you’ve made it past the tricky initial stages of a relationship and have entered the land of couplehood. What role does e-mail play in long-term relationships?

The Long Term Relationship

What might a long-term couple say about the wonders and drawbacks of e-mail in their relationship?

Katherine insists that in the age of e-mail the seriousness of commitment is gauged by one thing: passwords. “Couplehood” often entails shared e-mail passwords. “In its own silly way, sharing passwords can prompt feelings of intimacy and trust,” believes Katherine.

However, a deteriorating relationship can be harmed with something as small as a password change. Rob asked his new fling Liz not to e-mail him, because his girlfriend Leslie had his password; meanwhile, Liz felt hurt because a no-email policy seemed to be Rob’s attempt to squelch their relationship. On campuses all across America, scenes like this are reenacted every day as e-mail gains even greater stature.

Still, for some couples e-mail benefits can be great. Kirsten insists that e-mail allows her to share feelings with her boyfriend of almost two years, Abe. “Sometimes I can write about my feelings better than I talk about them. E-mail has let me share some important things with Abe that I might not have been able to say to his face.”

@mixedmessages.com

So where does this leave us? Does e-mail lead to over-analysis of the details of budding romances? Or does it prompt us to be more introspective and really understand what a person wants from a relationship?

In reality, e-mail’s biggest problem is that it is so neutral. Humans are complicated creatures who add emotional baggage and secret messages to a technical stream of computer code. What we need to remember is e-mail’s neutrality. Instead of becoming caught up in decoding the hidden intent behind a message, let’s step back from the keyboard and remember the depth and complexity of real human relationships.

The art of the letter may be dead, but any college student will assure you that the art of the e-mail is alive and well. For college students, the importance of e-mail extends beyond its ability to request eleventh-hour paper extensions from professors or send quick notes to friends. E-mail has changed the way we look at romantic relationships. For better or for worse, “will he call” has turned into “will he e-mail?” and the old-fashioned request for someone’s phone number has likely transformed into a request for an e-mail address. “Is that @aol.com?” has become a familiar refrain at pickup scenes.

College romantic relationships and e-mailing are inextricable intertwined. E-mail offers convenience, informality, and a medium to test gingerly the potential interest of that special someone. The cute guy in finance class is accessible … via e-mail. Dash off a few carefully crafted lines with just the right proportions of warm wit and casual coolness, run to class, and wait to gauge the response. Will he respond? He does. Now the message must be interpreted. A reply must be fashioned. The pattern continues. Perhaps a relationship blossoms, or maybe a fling ensues, or a brush-off two-line reply will end the affair. But no matter what the outcome, at every turn—from initial dainty steps into flirtation, to joined-at-the-hip relationships—e-mail adds a new dimension to the dance of romance.

Let’s examine “e-mail as enabler” as it relates to flings, budding romances, long-term relationships. Sit down, cozy up with a cup of tea, and prepare to recognize and analyze the quirky ways that technology has influenced each of our love lives!

The Fling

Looking for a safe flirtation? Oh the joys of e-mail! From behind the flicker of the computer screen and with the confidence of a 3 a.m. caffeine or alcohol infusion, a degree of boldness can develop when addressing the object of romantic interest. Take my friend Alice* whose bold two-line message to a future boyfriend has become the stuff of Dartmouth legend. “I’m bored. Wanna hook up?” Would Alice have said such a brazen thing while in the physical presence of her future beau? Most likely not. However, e-mail emboldens. Alice’s gumption reaped success: thanks to the face-saving technique called e-mail, she could “joke” about her true intention. If he had responded negatively she could have played the message as a joke—but given his enthusiastic agreement, she was able to proceed with her plans.

However, e-mail has its darker side. The morning after meeting someone at a party, a newly infatuated college student can crouch in front of the computer, agonized by an empty in-box. Similarly, many a student has found fingers paralyzed over the keyboard while trying to remember an e-mail address mumbled in haste and haze from that previous night’s fling.

E-mail can enable bold flirtation, but it can also prompt heart palpitations from anxiety. What about the next stage, a budding romance? More excitement and more anxiety await.

As stated on Wikipedia, Finasteride is a synthetic antiandrogen (it blocks the biological reactions of sex hormones of the male). Finasteride, sold under the name of Proscar, Fincar, and Finara, was originally meant as a treatment for men with benign prostate hyperplasia, as a 5 mg dose alleviates urinary symptoms. Finasteride has also been proven to help with hair loss in men. By taking a 1 milligram dose, finasteride (or Propecia) might reverse male pattern baldness.

When taken orally, a 1 mg dose of finasteride blocks production of the enzyme that converts testosterone to dihydrotestosterone, a hormone that causes shrinkage of hair follicles (Wellness Letter, University CA Berkeley). In clinical trials, it has been demonstrated that finasteride encourages hair to enter its active growth phase, reverses shrinkage of hair follicles, and slows hair loss. Propecia works best in men who are just starting to lose their hair and are not entirely bald. It also works better on hair loss that occurs around the crown rather than with receding hairlines. A visible difference will appear in about six months, so patience is needed, and by two years most of the hair growth has taken place. If you want to continue to keep your new hair, you will have to take this drug indefinitely. As well, this drug is effective only if your baldness is caused by androgenic alopecia (male pattern hair depletion).

Some unusual side effects that you should know about are erectile dysfunction and loss of libido. Effects of long term usage are currently unknown, and since Propecia affects bodily systems the entire time that it is being taken, this is a factor that should be considered by younger men.

WARNING: Propecia is not acceptable as an aid for women to turn around their hair loss. Severe birth defects in male fetuses can occur if this medication is taken by women. Because it is dangerous during gestation, women who are pregnant, or considering pregnancy, must avoid  contact with pills that are not coated entirely, or with any residue from the pills.

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