I’d be remiss not to point out that Medscape, in this context, is merely reporting medical news. Their article centers around a new analysis, drawn from the Columbia Mass Murder Database (CMMD), which suggests that mental illness is incidental in mass shootings.

“People with serious mental illness constitute only a small portion of the perpetrators of gun violence in this country,” Paul Appelbaum, MD, professor of psychiatry, medicine, and law at Columbia University in New York City. told Medscape.

The analysis covered 82 incidents of mass murder in academic settings including schools, colleges, and universities. The average number of victims of these incidents was eight. All 82 incidents were initiated by men (mean age 28), and 67% were Caucasian. About two thirds (63%) involved guns.

More than three-quarters (77%) of all perpetrators of mass murders in academic settings had no recorded history of psychotic symptoms. (emphasis added by author)

Swiss Cheese

To extrapolate data and draw conclusions from an existing data set, the cohort needs to be at least mildly historically similar. All this analysis suggests is that 77% of the shooters were not yet diagnosed as suffering from a mental illness or had insufficient coping mechanisms to deal with the stresses they faced. The authors conclusions, that only 23% of the shooters suffered from mental illness is an overreach of monumental proportions.

Most modern research suffers from these biased slants, which either lose sight of their controls or interpret data in wildly irresponsible fashion. All the more sad, as the true value of the data is lost behind an overriding narrative the authors wish to justify. What is clear from this analysis data, is that our systems for managing and identifying mental illness and related conditions are flawed. As is the care we offer to those diagnosed.

A significant majority of these shootings may have been prevented had individuals with a myriad of life challenges or psychological struggles been flagged. This begs the argument, why did the 23% slip through the cracks if they had been diagnosed and were, one would assume, under treatment?

These incidents, targeting young children by individuals who are themselves still just teenagers or newly minted adults, are a new phenomenon. Discovering the “why” matters almost as much as restricting access to weapons.

What can the 82 teach us?

Numerical data in this instance, used as it was, for the analysis above, is of little import and can be manipulated to suit any agenda. What researchers should instead be pursuing are the 82 lives that led to these horrific events.

Who were these young people, social backgrounds, family, schooling, infractions with law and authority, medical histories, friendships, potential triggers, medication, anything and everything that can be found that relates to their lives. Examine this and patterns will emerge. Patterns that may very well point the finger of blame to society, broken families, flawed mental health policies and the social stigma of reaching out for help – even in-patient care.

Identifying these patterns and potential triggers matters. Our human capabilities no longer limit us and AI can be incorporated to search social media for matches, allowing for early intervention. Teenagers or young adults do not just pick up a weapon and commit mass murder. They progress, in increments, to this course of action.

There are always signs.

Often we simply fail to see the signs and sadly, when we do pick up on them, we tend to ignore them – we cannot image that they will lead to something so horrible.

But, there is another challenge – access to mental health help. Ask anyone who needs to find a therapist how daunting the task is. It can take months, sometimes more than a year, to secure an appointment with someone with experience to address serious mental health challenges.

Again, this is unsustainable in a society where stable parenting is becoming an archaic concept, whether by design or necessity. Stable homes are in rapid decline.

The real indictment of this analysis are the diagnosed 23%. They represent the ever-increasing cost of our inability to help children who are crying out for guidance, care and a sense of belonging and purpose. How many lives could have been spared? How many lives will still be forfeit? We can, and must, do better.

Reaching for the closest solution

Mental health issues may be the motivating factor to committing mass murder. The preferred tool of choice for these murders is the assault weapon or other firearm. While we can debate the motivation for each individual heinous act, this choice of tool is far simpler to comprehend. Ease of access.

In countries where access to firearms is limited or non-existent, school shootings DO NOT HAPPEN. In America, gun ownership, legal or otherwise has reached pandemic proportions. It is even questionable at this point if tightening ownership laws and policy changes will have any impact whatsoever on teens being able to find and use weapons designed to maim and kill, so prolific is their distribution in American society.

While we struggle to find ways to prevent these tragedies from a mental health perspective, an arduous and difficult task, surely removing the preferred tool from the equation makes far more sense. No access to guns equates to no school shootings. A globally proven fact.

The post Why It is Imperative We Redefine Mental Illness and How We Treat It appeared first on Medika Life.

Full disclosure: back when Covid was rampant, and our hospital was busting at the seams with Covid patients, I was in full support of everyone having to wear a mask. I believe it definitely helped reduce transmission of the virus, and this saved lives, especially when we did not have a vaccine, and most of our population was still susceptible to the virus.

We are in a different situation now. Vaccines are widely available, and many people have already been vaccinated and boosted (myself included). Most of the adult population has either been vaccinated or have had Covid or both. While cases are rising – and hence my donning a mask every time I go inside – hospitalizations are not rising to the same degree. Things are different now.

What I like most about our current situation is the “live and let live” approach. I recently went shopping, and I was probably one of a small minority who wore a mask. Yet, no one gave me a hard time. No one yelled at me for wearing a mask. No one gave me a dirty look. Those who had masks went on their merry ways, and those without masks did the same.

The same went with me: I did not take anyone who did not wear a mask to task. I didn’t look at them with disdain or think they were “ignorant.” Every person can gauge their own personal risk tolerance, and every person was tolerant of another’s choice with respect to masking in public.

For me, with cases rising in the community, I wear a mask because I don’t want to get sick – with Covid or anything else. If I get sick and can’t work, it puts strain on my colleagues who have to cover my shifts while I’m out. It causes a huge disruption to many people’s lives, and so to protect myself and others, I endure the inconvenience – especially in the hot weather – of wearing a mask.

Others do not have the same worries and constraints as I do, and that’s fine. We are all living and let living, and this is very refreshing. Perhaps the lack of contention over masks is a result of the fact that indoor mask mandates are now a thing of the past. Perhaps the mask mandate – of which I was indeed very supportive – did more harm than good from an overall societal perspective.

I am willing to concede that I may have been wrong about the importance of mask mandates, not from a viral transmission perspective, but from a social cohesion perspective. As we study the aftermath of this pandemic, hopefully we will learn important lessons on how we can do better the next time a global pandemic reaches our shores.

It is sad that our country has been so divided over the issue of whether to wear a mask in public. Indeed, back in 2018 when I was in Paris on vacation, I would look at people wearing a mask in large crowds with derision. Fast forward to today, if I ever go back to Paris on vacation, I will be one of those people wearing a mask, too. My how times have changed.

The most important thing is that we tolerate each other’s decisions. Whether it is on a plane (where I also still wear a mask), in the mall, in the park, or anywhere else, we should respect each other’s choice to mask or not wear a mask. The “peace of the mask” has been most refreshing.

The post ‘The Peace Of The Mask’ Has Been Most Refreshing appeared first on Medika Life.

Fear-mongering news stories hype the question of vaccine hesitancy. Will enough people accept the vaccine to help us reach herd immunity and allow us to get our lives back?

The answer, I think, is yes. People will get vaccinated. Here is why.

Back in April, Emily Mullin wrote an outstanding yet disturbing story covering immunity passports. The basic concept is those who have immunity through previous infection or vaccine-induced antibody conversion will have a dystopian economic advantage. Her article haunted me from the first time I saw it. If you have not read it, check it out.

Emily Mullin’s story was ahead of its time, but now the reality of immunity passports may be coming to fruition. Humans are ready to return to normalcy, and, like it or not, many private companies are going to require proof of immunity to participate in certain aspects of society.

People express fears and concerns over the vaccine approval process. The safety and efficacy of the currently approved Covid-19 vaccines are highly encouraging. The Food and Drug Administration (FDA) has a strict protocol for vaccine approval. Enough data to qualify for emergency use authorization of the Covid-19 vaccines was made possible because of the substantial $10 billion financial investment combined with the virus’s high prevalence worldwide. The FDA did not rush the vaccine approval. It was well-funded, and there were a massive number of trial candidates.

An effective vaccine is only useful if people get it

Public support for vaccination is already changing. Many workers prefer an employee vaccination mandate. This CNBC poll shows the rapidly changing public perceptions.

Technology adoption curves

Vaccine acceptance will most likely follow a typical technology adoption curve. New technology adoption often follows a bell curve pattern.

With the Covid-19 vaccine, the innovators are the health care workers. Doctors and nurses celebrated vaccination day and shared the moment on social media. Here, is the video of when I received mine. Do You Want to See What COVID Vaccination Looks Like? Finally, a turning point in the pandemiccoronavirus.medium.com

Senior citizens and those with medical conditions represent the early adopters. This group is classified as 1B. Qualifications vary state by state but generally include those greater than 65 years old or with chronic medical conditions.

In a typical technology adoption curve, the innovators and the early adopters are the driving force. Think of the innovators as those who camp out overnight to buy the latest iPhone. The early adopters are those preordering online.

Once enough of the innovators and early adopters provide feedback and excitement over new technology, we reach “the chasm.” At this point, the bell curve starts to take shape. The new technology “catches on” and begins to reach the early majority.

Private industry is likely going to be the driving force to move us past the chasm and into the widening breadth of the bell curve leading to widespread vaccine adoption.

Recent Equal Employment Opportunity Commission guidance indicates employers may mandate vaccination, but government mandates will not be needed. The marketplace will solve the problem of vaccine adoption.

Qantas Airways CEO Alan Joyce reported in an article in Forbes his plans to restrict airline travel to those who have been vaccinated or have documented immunity. During a CNBC interview, Live Nation CEO hinted at the potential for immunity documentation before issuing tickets to concerts and sporting events. Ticketmaster released a vague but clarifying statement on their website, stating “We are exploring a number of safety features for event organizers to utilize as they look to welcome fans back to events.”

Employers will be motivated to encourage vaccine compliance to avoid lost workdays, reduce remote working, and prevent increases in health insurance premiums.

During a recent Yale Chief Executive Leadership Institute poll at a virtual summit, 72% of current and recent CEOs of major companies signaled an openness to vaccine mandates. Companies participating in the Yale summit include important players such as Walmart, Goldman Sachs, and eBay.

The world may not be ready to accept the reality that immunity passports are in our near future. Nadhim Zahawi, the British minister responsible for the vaccine rollout, suggested immunity requirements for British pub admission. He received negative social medial feedback requiring a walk-back statement.

Emily Mullin’s prediction for a future of immunity passports is likely coming. The Commons Project, the World Economic Forum, and a broad coalition of public and private partners developed the CommonPass app. Soon, this app will allow iOS and Android users to share their lab results and vaccination records. Several airlines have expressed interested in evaluating the option.

As the vaccine rollout improves, permitting widespread access, we will cross the technology adoption curve. The majority of the public will choose vaccination. In the end, it may not be science or government mandates that push us to herd immunity.

We will reach herd immunity because people want their lives back.

The post Vaccine Refusal Will End When Businesses Start Telling People No appeared first on Medika Life.

Literature and film aren’t entertainment; they are predictions of what may come to be our future unknown life experience. Whether it is computer intelligence, suspended animation, or self-driving cars, the writers have used research to advance their medium.

Today, much of this change is driven by the force of a killer virus, COVID19, that like plagues before it, has transformed life as we have known it. We’ve seen some aspects of the “future,” but no one has an inside track on that one.

Consider the 1990 film “Total Recall,” where what is real is created in one’s mind to be “real.” Mental manipulation is critical. In such a world, the notion of a vacation is a fabrication of one’s wishes and finance. Want to experience life different from your current one?

Provide your fingerprint, an implanted chip in your hand, or a scan of your retina, and it’s yours. There will be no need to leave your current location. No packing, no scurrying to catch transportation, or worrying about your itinerary. It’s all planned out perfectly by an AI program or implant or drug. You will sit back and enjoy it whenever you want.

They could plan vacations for your lunch hour and compress them into that time slot with no loss of entertainment. You will never miss out on something or someplace you wish to visit or activity of a lifetime.

A World Reimagined

The physical world of major cities must change. Of this, there is no doubt because technology has opened vast fresh opportunities to work collaboratively from afar.

Zoom opened a window of possibilities. Now that platform provides access with less travel, less need to rent or buy space for any business, even the healthcare business, and at lower costs all around.

The competition is already breathing down Zoom’s neck and forging alternative ways to change the business model of corporations. Google, no slouch in the arena of computer platforms, has upgraded its Google Meet program sitting right inside its mail program. Why would anyone want to leave their home or family when they can do most business from their home office, backyard, or kitchen?

Even the fashion industry has seen how this will affect them. The media ran with it and other forms of “Facetime-like” video connections during periods of travel restrictions. Reporters in jacket and ties can wear jeans or shorts with aplomb.

Plus, no need for a computer. Video conferencing requires only a cell phone connection. If the Sony Handycam changed the news business during wartime, the cell phone has, similarly, upped technology in the entire spectrum of daily life.

Facebook was late out of the gate, but they now offer video meetings for up to 50 people with their Facebook Messenger. Verizon has acquired BlueJeans for business “chats.” Cisco, emphasizing the security of conferencing, has Webex.

Unafraid to beat its chest, Zoom showed that they now host up to 300 million daily participants. Not all of it is business we might assume since other non-business groups will avail themselves of this technology.

The Real Estate Market

With teleconferencing as a staple of worldwide business, the real estate market is prime for innovation. The pandemic emphasized new special requirements to restrict virus dispersion, and Zoom and its competitors have pierced commercial real estate’s former plans.

Office towers packed tightly together in cramped city quarters appear passe in reformulation by architects, social psychologists, and city zoning commissions. Now, greenspace need not be the purview of an office penthouse or rooftop. Trees and grass may once again be seen on city streets devoid of asphalt. Virtual landscapes could also be created according to a person’s whim.

Transportation hubs, too, and inner-city buses and transit can no longer be the packed-like-a-sardine experience of yesteryear. Will bicycles with Waze gadgets become the vehicle of city life?

Forget skyscrapers, what about entertainment venues? Social distancing now requires new design concepts for Disney parks around the world as it does for restaurants and theatres.

Will the drive-in movie with new technologic gadgets come back to combat lagging movie ticket sales? Retail spaces like malls were dying already in 2017 before the pandemic. How will they be re-imagined?

Enter the World of MR

Within this unimaginable unknown world we face, AI may prove a saving grace. The newfound sense of freedom, however, may also prove to be an invisible anchor.

A famous social psychologist, Erich Fromm, in the 1940s, wrote “Escape From Freedom” in which he detailed the pressures and unpleasantness of “freedom.” Choice, according to Fromm, brings stress as we attempt to work our way through to decisions. Are fewer options easier for us to handle than innumerable ones? Could be.

As Fromm wrote in his classic book, “Our aim … (is to) show that the structure of modern society affects man in two ways simultaneously: he becomes more independent, self-reliant, and critical, and he becomes more isolated, alone, and afraid.”

What do we give up for this new freedom? Can our mental health handle this isolation, or do we need the physical presence of others? Studies with school children have shown that physicality is essential for learning and the development of personality.

Interestingly, and somewhat in a forward-thinking mode, Fromm stated that “Most psychiatrists take the structure of their own society so much for granted that to them the person who is not well adapted assumes the stigma of being less valuable.”

To which “society” was he referring, and who will decide this “less valuable” in our new normal? Will these “less valuable” people be given the same freedoms as the more valuable ones? Does that mean they will be limited in their access to jobs, healthcare, and human rights? Will AI and MR play a role?

Freedom appears to be a fluid notion and based on creating norms. The new rules may not be so fluid and may, in a search for stability, be rigid and stratified as never before. MR could be used in nefarious ways to calm the displeasure of the less valuable. In this, will it be a type of mental prison?

And we can redesign our inner world with algorithms. Planning has begun on a novel concept of contact lens where programs will be displayed at will, your’s or someone else’s.

How far are we away from the control of behavior, if not bodily but mentally, as shown in “Demolition Man?” Extreme in its depiction of how advanced technology can “imprison” violators, the programs could also be used to enhance someone’s vision of their lives. Algorithms become life without the person’s permission. I can almost see a relationship to “The Stepford Wives” but without the “fembots.”

Graduation speeches always stress how the class leaving will determine the future, but we have to wonder how in this new pond, they will sink or swim.

The post A Pandemic-inspired Lifestyle: How a virus and MR may change our lives appeared first on Medika Life.

I realize I may be in the minority here, but I wanted to share some thoughts on those “healthcare heroes” signs outside our hospitals.

First, thank you to everyone for what you are doing during this global pandemic. The work you are doing is truly amazing, even heroic. That goes without question.

However, I ultimately believe that labeling ourselves “heroes” does more damage than good. I’ve read pieces from healthcare colleagues across the nation who argue that the “hero label” can be used as a subtle form of (often unintentional) gaslighting.

No one calling us heroes is trying to gaslight us, or put us in an uncomfortable situation, but here are some examples of some of the unintended consequences:

1 — Don’t have enough PPE or safe working conditions? Well, you’re a “hero” to work under those circumstances and heroes don’t complain or demand safe working conditions, they just get the job done. While my current hospital system is fortunate not to be in this situation as they have prioritized securing adequate PPE for all of us, this is a serious issue faced by colleagues in other areas of the country. Some of these “heroes” were fired for speaking out against dangerous working conditions. “You signed up for this” they were told as if the Hippocratic Oath had a section about always agreeing to work in dangerous work environments with suboptimal protective gear.

Nurses and Doctors Speaking Out on Safety Now Risk Their Job. Hospitals have warned, disciplined and even fired staff members who went public with workplace concerns about…www.nytimes.com

2 — As the first wave of COVID-19 was reaching its peak in Italy and New York City I saw several stories of clinicians becoming infected (and some dying) from infections they contracted because they ran into a code blue without proper PPE. There were several clinicians pleading for their colleagues to make sure to don adequate PPE and not just run in unprotected to a code blue. Protecting yourself first is the right thing to do, even in a code situation, as you will be little help to other patients if you are dead, but stopping to don PPE while someone is pulseless certainly doesn’t fit the traditional “hero” ethos.

California nurse treating ‘code blue’ coronavirus patient dies after lack of proper PPE: A nurse in California died weeks after she treated a “code blue” coronavirus patient without wearing proper personal…www.foxnews.com

3 —Clinicians’ burn-out levels were definitely high prior to COVID-19 but have continued to increase. And the New York City medical community was recently rocked when an EMT and an emergency medicine physician, both of whom had been on the front lines combating COVID-19, committed suicide recently. Do “heroes” seek counseling or talk to colleagues when they’re depressed (they should, but I’m talking about the stereotypical portrayal of a hero, here — there are no Marvel movies about Avengers going in for some cognitive behavior therapy)?

Calling health care workers ‘heroes’ harms all of us – STAT. Here’s an unjust fact: Some of the frontline health care workers we’ve been celebrating with social media likes…www.statnews.com

4 — Many of our colleagues, whether it be due to age or medical comorbidities, are at higher risk for developing COVID-19 and worse outcomes, and have been appropriately reassigned to lower risk roles. “Heroes” don’t turn down a rescue mission because their personal risk is too high. The “hero” label does little but cause guilt in many of our colleagues who can’t serve on the front lines due to these conditions.

Anna Wexler, Assistant Professor of Medical Ethics at the University of Pennsylvania Perelman School of Medicine put it this way:

“More perniciously, the hero narrative perpetuates the false notion of health care workers as inherently altruistic, as individuals who will accept the unbridled personal risk, no matter the cost. But in the face of hazardous conditions, there may come a point at which they may not be willing to endanger their own health, nor that of their partners, children, and parents. In the absence of adequate PPE, how much risk can we reasonably ask health care workers to take on?”

“Within the health-care-worker-as-hero narrative, the decision not to work — or to work less, to work in a different hospital, or even in an alternate capacity, such as telemedicine — is nothing short of taboo. It is antithetical to the selfless health care worker stereotype.”

But some people argue that they interpret signs lauding healthcare “heroes” using the nuanced, real-world definition of “heroes”, not the cartoonish superhero version. And I respect that if that’s your interpretation. But that nuance is lost in what has essentially become a public congratulatory campaign. Also “Heroes (but in the real-life sense of the word that allows for all the faults and traits of normal human beings) work here” doesn’t fit nicely on a bumper sticker or a banner.

Reiterating what I said before, I am proud of all of my healthcare colleagues and the tremendous work that we are doing during this international pandemic. If you have no issue with the label of “hero” then I respect that. For me, personally, and I don’t think I’m alone, it feels too self-congratulatory and risks putting superhuman expectations on normal human beings.

It’s one thing for others to call us heroes, it’s another thing to call ourselves heroes. After all, I don’t see firemen (whose actions I often view as heroic) marching into Firehouse Subs wearing shirts that say “community hero.”

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