Friday, July 24, 2009

A Little Ecological Story: Trying to Write Ourselves into the Scene

This morning my husband told me one of many charming tales he uses to illustrate his point when teaching the biological principle: you cannot do one thing. The Army Corp of Engineers built a couple bridges along the Mississippi River near where we live in Minnesota a human generation or two ago. The purpose was to manipulate the channel and river's current to assist the human endeavor of large container shipping up and down its course. A side effect of these changes was the accumulation of silt in one slew in particular (particular to this story). Muddy, marshy land developed where before there had been water.

A community of turtles, long-time inhabitants in this ecological community, found the new property quite appealing. As the rest of us would, the turtles settled into their new home and grew their families. Currently, this is one of the most robust turtle populations known to local scientists and turtle enthusiasts. My husband was working in the area yesterday, and noted with delight the time he spent watching the little faces of the turtles pop up through the thin membrane of the water's surface.

There is talk by the Army Corp of "rehabilitating" the slew to its "original" state by means of a dredge to remove the accumulated silt. An interested turtle enthusiast and local biologists involved in this stretch of river front are questioning the utility of "rehabilitation" in light of the clever group of turtles enjoying the sloppy interzone between dry land and water where they prosper.

Here's the trick in imagining our environment, imagining ourselves in it. My husband noted the irony of humans, while engaged in their own business of survival, unintentionally helping a few turtles out to the point where trying to undo what was done would harm our new friends. You cannot do one thing.

Humans have phenomenal imaginations and I would argue this alone truly distinguishes us from any other known species. But imagining ourselves in our environments is extremely difficult. Seeing ourselves in our mind's eye, then evaluating and anticipating how we interact with our physical and relational environment is something akin to cognitive yoga- stretching in all manner of directions we're not entirely sure we were meant to go.

Despite the brain discomfort, I argue we need to develop the cognitive skills (and make sure our children do as well!) to be able to stretch and manipulate our minds into significantly more sophisticated poses than generations previous have needed to manage. We must be farther seeing than our human ancestors and turtle cousins. Finding a nice little mud slew to hole up in and raise a family without worries beyond this season will not do. To survive and survive well, we need to be able to deeply imagine our species in ecological systems.

Those turtles were opportunistic in an altered ecological system. If that land had been drained and paved over, not even our crafty reptilian neighbors would have managed to survive. There are man-made changes to ecological systems that complex life forms (like us) cannot adapt.

Monday, July 20, 2009

Three Cheers

I have three cheers for media I have found useful and/or informative of late.

1. Cheers for Repower America, http://www.repoweramerica.org/, associated with Al Gore and pushing hard to create a national network of people interested in advocating for the renovation of our energy system into one that is both environmentally and politically sustainable. This is an organization that is promoting the kind of drastic change needed to actually address environmental degradation. And this is a pretty good time to invent new industry.

2. My friend Brent's new blog, http://www.garrulous.org/, where he has begun a series of essays on the last year in which he has survived oral cancer, the end of his relationship with a long-time partner, and further illness in his family. Brent and I have been friends for nearly twenty years and he happens to be a very gifted writer. I encourage anyone with a particular interest in cancer survival, or simply in the mood for a good read to check this one out.

3. The book "The Addict" by Dr. Michael Stein. He is a internist who has, as part of his practice, a buprenorphine clinic. The drug buprenorphine is used to assist opiate addicts in recovery. He writes with clear-eyed honesty about his experiences treating drug addicts with special attention on one young woman. The book really offers insight into addiction that is worth the read.

The joy-side of the information age!!

Sunday, July 5, 2009

Happy Fourth of July, Soldier

On the evening of the most recent Fourth of July holiday I was at work in a substance abuse treatment setting. A young man was brought in by his father and was attended by a security guard. The security guard is typical accompaniment for new patients and does not necessarily indicate any behavioral problems with the attendee. I did notice immediately that the young man was huge, like professional football player huge. He was a statistical anomaly of muscle laid over a monster frame. And he was loud.

Within moments it became clear there was a problem. The young man wanted help, but didn't want help in our program. Attempts to explain how the process worked for substance abuse treatment fell on deaf ears because he was too agitated to process auditory information. He explained quickly he was a veteran of the current war in Iraq and had PTSD. This information was either a warning or an excuse for the coming behavior, I do not know which.

He quickly decided he wanted to leave, and bolted when one of the two locked doors was opened for a staff person. Security followed him into the hall and a seasoned staff working the scene identified the man as hostile and perhaps dangerous to the staff and other patients. The staff called for help.

I worked to get the other patients to the safety of their rooms and returned to try to be of some help. I saw that the young man was in the hallway between the two locked doors letting fly the F-bomb and generally posturing in a very threatening manner to the security guard, who was sweating and seemed to be cowering a few feet from the soldier. And just for the record, anyone not fighting heavy weight in the UFC would have been scared shitless, too. Even with a tazer and mase, the first few men to try to control this soldier, if it had come to that, were likely going to the ER with injuries.

This huge, reportedly specially-trained soldier was a kind of physical threat to our safety like I had never seen before. If a human being can be considered a weapon, this young man would be one. And he was making verbal and nonverbal threats.

The staff on the floor were able to deescalate the situation and get the young man to sit down and consider his situation. His father, who had witnessed the scene, but did not seem particularly effective at controlling his son, seemed unhappy with the staff suggestions for the next step. However, the soldier considered his options, made up his own mind, and agreed to get the help he needed in a setting appropriate for him. The situation ended as well as it could.

In all, it took two hours to address the situation and everyone, including the other patients, had been stressed out by the goings on. The young man reported he had been in treatment for PTSD for several months. If his behavior was explainable by the PTSD, then the treatment needed to continue, perhaps for several more years. This guy had a ways to go.

After the fact, I spoke with people who had dealt with him before he came onto our floor as well as the staff on my floor. Most everyone suspected the man had been doping. The steroids would have helped explain his aggression and his unnaturally large size. Others offered that he was a bully who enjoyed frightening us. Whatever the deal with this soldier, we were not equipped in our community setting to deal with his level of threatened violence and probable skill in causing physical harm.

Reintegrating some of the veterans from the Iraq wars may end up being a profoundly difficult challenge. None of us want a repeat of what happened to many Vietnam vets who did not get the psychological treatments or the community support that they needed to successfully begin life again as a civilian. But the challenges we may be facing with these newer vets are quite different in some ways than from previous wars. Access to help has been spotty at best. Even in parts of the country where sophisticated treatments are available, they may not be sufficient for getting these people back on track.The brain trauma many soldiers have sustained has been highly associated with PTSD and treatments for those traumatic brain injuries may not yet be adequate.

Also, there are new dangers to people trying to heal their minds as well as their bodies after tours, particularly repeated tours, in Iraq including availability of drugs and other substances that have been manufactured by drug companies to be of help and make money, but have ended up being just another albatross on the shoulders of soldiers. And those are legal drugs available through docs, which doesn't begin to address illegal drugs and booze. Even the seemingly innocuous activity of playing video games has known negative neurological effects as it can activate the parts of the brain associated with aggression.

We need a strong VA system that can take these soldiers in and help them get better. There must also be the expectation that they do learn how to be in the world again in non-violent ways. We need them to contribute in positive ways to our nation and in our communities both for the betterment of us all, but very importantly, in order that their lives and what they have been through have meaning and purpose.

I would hate to think of the soldier who shut down my workplace for a couple hours becoming a drag on society. Instead, I hope he keeps up the work on healing his psychological and substance abuse issues and goes on to become an invaluable member of his community. It would not be fair to him and to the service he provided our country if he is lost to the war wounds that we cannot see. I hope very much that he gets better and gets on with it.

His apparent ability to make a tough call to accept help even when he knew someone he loved might not understand or agree may have been a sign of his internal fortitude. That could be the strength he learns to draw upon when life gets tough and scary instead of the threat of his brute, physical force.