Opium for Separation Distress in Victorian-era Infants

Infant's Delight Mother's Joy

“I haven’t heard that morphine or buprenorphine is recommended for human babies who cry persistently and excessively,” I declared in a post about Opioid Drugs for Mental Anguish on my main blog.

Silly me! In a comment on the post, Ray Davis said…

An earlier generation of field-researchers found it quite (and sometimes permanently) effective: http://www.victorianweb.org/science/health/health4.html

The article on Opium and Infant Mortality states:

Medical officers were convinced that one of the major causes of infant mortality was the widespread practice of giving children narcotics, especially opium, to quieten them. At 1d an ounce laudanum was cheap enough — about the price of a pint of beer — and its sale was totally unregulated unitl late in the century.

Indeed, the New York Times of 1879 reported a terrible opium poisoning that caused the death of a one year old child.

Opium - The Cause of a Child's Death

 

There were other dangerous “soothing” products of the day with quaint and reassuring ads. One can imagine that administration of these potions was not limited to teething and bowel complaints. The U.S. National Library of Medicine has a lovely collection of these.

Baby Ease

 

The Quack Doctor has a great post on Atkinson & Barker’s Royal Infants’ Preservative, which “has been acknowledged the best medicine in the world.” Ingredients included 1 dr. Laudanum, an old-timey tincture of opium.

Atkinson's and Barker's Royal Infants Preservative

Six drops of this fine medicine was enough to kill a six week old baby in 1886.

Lest you think that in the modern era, we know better than to poison our children with such foolish remedies, there was a recall of a dangerous product in 2009. The recall was “in response to a reported case of potassium bromide poisoning in an infant, associated with the use of a locally purchased teething product.”

The name of this product? Monell’s Teething Cordial (Cordial de Monell para la Dentición).

Monell's teething cordial 2009

I’m a Lumberjack

Image

The eighth and final season of the hit series Dexter took a scientific look at serial killers. Dr. Evelyn Vogel, a neuropsychiatrist who wrote the definitive book on the brains of psychopaths, consulted with Miami Metro Homicide on a series of unusual cases. The killer would saw open the skull and scoop out the “empathetic” part of the brain (the anterior insula) with a melon baller. The most brutal of these murders occurred while the victim was alive and awake.

Dr. Vogel was ultimately killed by the “Brain Surgeon” who turned out to be her own psychopathic son (presumed dead for over 25 years; he faked his death by starting a fire in the asylum where he was housed).

But now the show has ended in a most unsatisfying way. The reasons for this are succinctly captured in the tweet below. Our favorite serial killer lives on, but in an unexpectedly isolated and self-punishing way after (you guessed it) faking his own death and moving far away from his son and girlfriend.

In an interview, Jennifer Carpenter, the actress who played Dexter’s sister Deb, had this to say about the end of the series (where her character dies due to a horrible mistake in her brother’s judgment):

“I’m picturing an older model television where you have to get up to turn the TV off and then it slips into that tiny little dot until it’s all gone — that’s what I feel like is happening to me.”

It’s a great interview from an actress who got better and better as the series progressed. I always thought of Deb as the most traumatized woman on television.

Finally, here’s an alternate ending from an executive producer who left the show after four seasons:

“In the very last scene of the series,” Philips explained, “Dexter wakes up. And everybody is going to think, ‘Oh, it was a dream.’ And then the camera pulls back and back and back and then we realize, ‘No, it’s not a dream.’ Dexter’s opening his eyes and he’s on the execution table at the Florida Penitentiary. They’re just starting to administer the drugs and he looks out through the window to the observation gallery.

“And in the gallery are all the people that Dexter killed—including the Trinity Killer and the Ice Truck Killer (his brother Rudy), LaGuerta who he was responsible killing, Doakes who he’s arguably responsible for, Rita, who he’s arguably responsible for, Lila. All the big deaths, and also whoever the weekly episodic kills were. They are all there.

“That’s what I envisioned for the ending of Dexter. That everything we’ve seen over the past eight seasons has happened in the several seconds from the time they start Dexter’s execution to the time they finish the execution and he dies.  Literally, his life flashed before his eyes as he was about to die. I think it would have been a great, epic, very satisfying conclusion.”

The Melancholia of Kirsten Dunst and Lars von Trier

Melancholia_gray_wool_dunst

“Gray wool, clinging to my legs, it’s heavy to carry along”

The disastrous wedding reception of the severely depressed Justine precedes the end of the world, depicted as a highly stylized and artistic event feared by some but welcomed by others. Kirsten Dunst plays the role of von Trier‘s own melancholia, which was the inspiration for his film.

The image above occurred out of context, at the very beginning, during the bombastic Wagnerian apocalyptic prelude to Part One, “Justine” and Part 2, “Claire.” We don’t hear Justine say those words until later, when she had lost the ability to care for herself. “She should be hospitalized,” I thought at the time, and wondered why no one was getting her psychiatric help. But then we wouldn’t have a movie that deals with internal struggle and suffering.

Melancholia is also the name of the giant blue planet that destroys the Earth.

Melancholia_the_planet

A beautiful movie about the end of the world

DIRECTORS STATEMENT

It was like waking from a dream: my producer showed me a suggestion for a poster. “What is that?” I ask. ”It’s a film you’ve made!” she replies. ”I hope not,” I stammer. Trailers are shown … stills … it looks like shit. I’m shaken.

Don’t get me wrong … I’ve worked on the film for two years. With great pleasure. But perhaps I’ve deceived myself. Let myself be tempted. Not that anyone has done anything wrong … on the contrary, everybody has worked loyally and with talent toward the goal defined by me alone. But when my producer presents me with the cold facts, a shiver runs down my spine.

This is cream on cream. A woman’s film! I feel ready to reject the film like a wrongly transplanted organ.

But what was it I wanted? With a state of mind as my starting point, I desired to dive headlong into the abyss of German romanticism. Wagner in spades. That much I know. But is that not just another way of expressing defeat? Defeat to the lowest of cinematic common denominators? Romance is abused in all sorts of endlessly dull ways in mainstream products.

Lars von Trier, Copenhagen, April 13, 2011.

 

Melancholia_movie_poster

Celebration of Trauma

Series2_jts

“here’s the plan: don’t go out of your backyard”

 

Why do people memorialize individual grief and collective tragedy? A father’s death, the national trauma of 9/11, your anniversary with an ex, an unfortunate medical diagnosis, the date of a breakup or a betrayal. 

tempting to finish this disaster under midnight sun
hope, gin

so you’re not lucky
you look a little thin
burdened

your courage wasted time
your courage and mine

lay down your arms
you were plenty strong

i’ve heard enough of your howling
say you succumb
are you completely numb?

your gentle aftershock shock
your fragile aftershock shock

-Kristin Hersh, Ginhttp://kristinhersh.cashmusic.org/series2/

 

The Journal of Traumatic Stress has a special 10 year issue on “9/11 trauma studies”:

Special Section: The September 11, 2001 Terrorist Attacks: Ten Years After

Alterations in affective processing of attack images following September 11, 2001

Editorial by Daniel S. Weiss

The September 11, 2001 terrorist attacks: Ten years after 

This issue of the Journal of Traumatic Stress contains a special section on the consequences of the terrorist attacks on the World Trade Center (WTC) in New York City and the Pentagon in Washington, DC that occurred on Tuesday, September 11, 2001 (9/11). It is a truism to note that this man-made terrorist disaster fundamentally, and permanently, altered the world view of the citizens of the United States, at least those who were old enough to appreciate its meaning. For the latter, however, their world view has always included the reality of the collapsing WTC towers and its horrible aftermath. It is also fair to say that the world view of citizens of many other countries around the world was also fundamentally and permanently altered. Victims of 9/11 came from over 70 countries. As well , 9/11 propelled emergency services workers (e.g., police, firefighters, and search and rescue personnel) and the role they play in disasters into the forefront of associations with 9/11. The 9/11 attacks also increased public awareness of the psychological processes that are required to adapt to and recover from exposure to traumatic stress (e.g., Weiss, 1993) and that such processes can be, blocked, derailed, or overwhelmed.

The first article published in the Journal of Traumatic Stress that mentions the WTC appeared in the February issue of Volume 15, which was published in 2002 (Koplewicz, Vogel, & Gallagher); ironically it was a study of the impact on children and parents of the 1993 bombing of the WTC, gathering data 3 and 9 months following exposure. The findings of this study were prescient for what was to follow involving the WTC only 8 years later. Exposed children reported symptoms of posttraumatic stress disorder (PTSD) and disaster-related fears; their parents reported their own symptoms of PTSD. The children did not report a decrease in symptoms at 9 months, although their parents did. The initial distress of the children was predictive of the parents’ status at 9 months.

The first paper about 9/11 published in JTS appeared 21 months after the attacks themselves (Boscarino, Galea, Ahern, Resnick, & Vlahov, 2003). Since then, there have 27 other papers in JTS describing the etiology, prevention, risk or protective factors, epidemiology, course, treatment, and recovery from exposure to 9/11, not including those in the special section. The scientific literature on 9/11 is large. As of June 2011, the PILOTS (Published International Literature on Traumatic Stress) database of the National Center for PTSD lists 518 peer-reviewed entries, and 788 of all types. The earliest are reviews, case studies, editorials, and public service and health presentations (e.g., Stephenson, 2001). It is not until the beginning of 2002 that empirical papers appeared (e.g., Galea et al., 2002).

The articles in the special section build on that legacy, and will be part of a major expansion of the 9/11 literature as many other journals will be publishing special sections or issues commemorating the 10th anniversary of 9/11. It will be of interest to observe how large that contribution will be. The content in the special section is diverse, comprising among others, the impact of potential genetic vulnerability (Holman, Lucas-Thompson, & Lu, this issue), longitudinal findings for disaster workers (Cukor et al., this issue), suicidal ideation in children (Chemtob, Madan, Berger, & Abramovitz, this issue), and ex
ploration of trauma response using evoked potentials (Tso, Chiu, King-Casas, & Deldin, this issue).

It would be a failure of compassion and empathy not to take note of the impact that the 10th anniversary of 9/11 will almost certainly have on the families, friends, coworkers, and acquaintances of those whose lives were lost or altered by injury or illness as a consequence of exposure to the attacks. Though it is well established that acute responses ebb over time, it is also well established that anniversaries are times when the pain of loss is more sensitive. One of the most well-established findings in the PTSD literature is the positive role of social support (e.g., Ozer, Best, Lipsey, & Weiss, 2003). As we consider what we have learned from the study of the consequences of 9/11, we might well consider providing support to those who could benefit from it.

Demonic Attributions in Nondelusional Disorders

The more a delusion is investigated, the more understandable and less bizarre it becomes, often interwoven with the very individual patterns of experiencing relationships, adversities and suffering, and finally, for every delusional content, as bizarre and remote as it may appear, there may be a cultural niche, in which the same content may be considered legitimate and reasonable.

 

Reference

Pfeifer S. (1999). Demonic attributions in nondelusional disorders. Psychopathology 32:252-9.

OBJECTIVE: Belief in demonic influence has repeatedly been described as a delusion in schizophrenic patients. The goal of this explorative study was to examine the frequency, as well as the psychodynamic and social functions of such beliefs in a sample of nondelusional patients.

METHOD: The sample consisted of 343 psychiatric outpatients who described themselves as religious. In semistructured interviews they were asked to give their view of demonic causality of their illness.

RESULTS: A high prevalence of such beliefs was not only found in schizophrenic patients (56%) but also in the following groups of nondelusional patients: affective disorders (29%), anxiety disorders (48%), personality disorders (37%) and adjustment disorders (23%). Belief in demonic oppression tended to be associated with lower educational level and rural origin, and was significantly influenced by church affiliation.

CONCLUSIONS: Beliefs in possession or demonic influence are not confined to delusional disorders and should not be qualified as a mere delusion. Rather they have to be interpreted against the cultural and religious background which is shaping causal models of mental distress in the individual.

 

The Day of the Dead

The Bioethics of BODY WORLDS

Gunther von Hagens’ BODY WORLDS: selling beautiful education

Gunther von Hagens’ BODY WORLDS 1, 2 and 3 (hereafter referred to collectively as BODY WORLDS) are traveling exhibitions of “real human bodies” that have attracted very large crowds and a great deal of controversy.  The bodies in question are human corpses that have been plastinated through a process that infuses body tissue with polymers and resins to prevent decay and that allows whole bodies to be posed. The strong yet ambivalent public response is partly due to the multiple levels on which the exhibit operates. In large part, BODY WORLDS expresses a “museum ethos” oriented to public education.  Its didactic aim is to communicate the importance of preserving one’s health and the complexity of the human body. However, BODY WORLDS is also an art show. Some of the “whole-body plastinates” are outfitted with sports gear such as skis and skateboards to “bring them to life” as dynamic sculptures. Other bodies are transformed into surreal body-sculptures, for example, a man holding his own skin or a body opened up like a chest of drawers. Small cards that bear a title, the stylized signature of Gunther von Hagens, and the date of creation are placed alongside many of the plastinates, marking them as artwork and von Hagens as the artist. Finally, BODY WORLDS also entertains the public in the manner of a circus or freak show that presents a shocking and fascinating spectacle of death in exchange for a fee.

This target article in the American Journal of Bioethics is followed by 12 Peer Commentaries ranging from No Dignity in BODY WORLDS: A Silent Minority Speaks and Metamorphosis: Beautiful Education to Smarmy Edutainment to The Virtues of Blurring Boundaries in BODY WORLDS.

BODY WORLDS exhibitions have seen their share of controversy:

In January 2004, the German news magazine Der Spiegel reported that von Hagens had acquired corpses of executed prisoners in China; he countered that he did not know the origin of the bodies, and returned seven disputed cadavers to China.[38]

and

In 2003, while promoting a display in the Hamburg Museum of Erotica Von Hagens announced his intention to create a sex plastinate.[31] In May 2009 he unveiled a plastinate of a couple having sex, intended for a Berlin exhibition.[32]

Body Worlds is going XXX

Gunther_von_hagens_and_necrophilia

Corpse artist/anatomist Gunther von Hagens poses near his latest creation (designed for the necrophiliac, presumably).

 

Finally, Lady Gaga might incorporate the theatrically flayed bodies into her act (in case her plastinated feminist meat dress wasn’t enough for you):

 Lady GaGa’s Aupopsy

LADY GAGA has come up with a way to make her live shows even more shocking – having dead bodies on stage.

The singer is teaming up with corpse-preserving scientist GUNTHER VON HAGENS to spice up her already blood-soaked Monster Ball Tour.

. . .

Now GaGa wants the gruesome body pickler to design the set for her tour when it reaches Las Vegas next March.

For more info, see Cadaver Shows: Voyeuristic or Educational?

Reference

Burns L. (2007). Gunther von Hagens’ BODY WORLDS: selling beautiful education. Am J Bioeth. 7:12-23.

via @channelNvideo