Letters to the Editor
ashley
Published Letters: 13 Editor's Choice: 9
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bipolar disorder and poor judgement
[Read the article: The war on terror: Miami]
[Read more letters about this article: Here]Speaking as a diagnosed bipolar patient (rapid cycling with severe psychotic features when untreated), this guy was in dire straits before he boarded the plane. It was obvious not only to his wife but to surrounding witnesses that he was highly agitated, appeared delusional, and was singing spirituals. He was psychotic while he was boarding.
While I agree that deadly force may not have been necessary, the truth is that Alpizar and his wife are partially responsible for the situation. Let me explain.
Bipolar disorder is not about "moodswings". It is a deadly serious brain disorder. Everyone who has been correctly diagnosed as bipolar has had at least one severe manic episode - you cannot receive a diagnosis without a manic episode, and more often than not, a manic episode has psychotic features. It seems to me that Alpizar has three strikes against him: he had a definitive diagnosis of bipolar disorder; he was off his medicine; and his wife didn't get him straight to a hospital.
If he was diabetic, you can be sure he'd have had his insulin on hand. If he was prone to cardiac events or even high blood pressure, it's likely he'd either be on continuous medication or else in the hospital. It is finally the patient's own responsibility to take charge of his or her own treatment, and the second line of defense lies with family members who understand the illness.
This case speaks to me less about the state of airline security and much more about the state of mental health care and awareness in this country. Far too many bipolars have the mistaken belief that their illness is minor. A subset of those believe that their illness is "cured" once they are stabilized on the correct medications. The truth is that bipolar disorder is incurable; only the symptoms can be ameliorated. Fully fifty percent of diagnosed bipolars are non-compliant with their medication regimen, and that is an unacceptable number.
It's a terribly vicious cycle. Bipolar patient gets put on good medicine - bipolar patient feels cured - bipolar patient goes off meds - bipolar patient slowly succumbs to an inevitable relapse, which causes a profound erosion of insight and judgement. A psychotic person generally isn't capable of reasoned, rational response. A rational response for someone with a heart problem would be, "Oops, I just had a major palpitation; I should get that looked at or get back on my medicine as soon as I can." But someone who has slipped into severe mania or psychosis doesn't have that ability. They lose their mental capacity to understand the severity of their own mental state.
It was obvious that his wife knew how sick he was. Even if there had been some unlikely extenuating circumstance that had prevented her husband from taking his meds, the responsibility was on her to either get him to a hospital for immediate treatment or at least to tell flight personnel about her husband's mental state. Ideally, he never should have flown at all in his delusional state.
It makes me very angry that so few people take this illness seriously. I can't tell you the number of times people have downplayed my own struggle with bipolar disorder with the refrain of "just snap out of it" or something equally dismissive. The truth is that most untreated bipolars only wind up hurting themselves; the suicide rate for those that refuse medication is outrageously high. (Just try to find an insurance company that will admit a pre-exisiting bipolar diagnosis.) For that reason, bipolar disorder has a mortality rate higher than most forms of cancer. But psychosis is tricky, and psychotic people do sometimes hurt other people, most often their own children or beloved family members. And yet it is still treated as a simple annoyance or minor impediment by most health care providers and most patients.
The real story here is yet another tragic instance of severe, debilitating mental illness being treated as a head cold.
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top 10 lists, and some personal favorites
[Read the article: Top 10 books of the year]
[Read more letters about this article: Here]I'm a devout listophile, and I look forward every year to the flurry of lists that come around the holidays.
Considering Salon's new letter format, I'd love to see some reader recommendations posted here. I'd read several of the books mentioned in the article - "Never Let Me Go" and "White Teeth" are two I particularly loved - but I'd really appreciate some top 10 lists from Salon readers as well. Even more fun would be some "worst" lists.
Not to dwell on the negative, but I read two books that I considered to be highly overrated. One was "Prep", by Curtis Sittenfeld. It's all over "best of" lists - including the NYT list - and I just hated it. I thought it was maudlin, and I can't remember reading a novel that had a falser ring to it. Just horrible.
Another book that arrived with much fanfare was Elizabeth Kostova's "The Historian". At first I thought it had to be a gothic parody - it trotted out every dusty old stereotype from that genre - but the only horror that it elicited was the dawning realization that it was meant to be a straight-faced Dracula novel. I can't remember the last time I actually quit reading a novel, but this one made me fling it to the floor in disgust after about 600 pages. It makes a lovely doorstop, by the way.
On a sunnier note, I thought that Doris Kearns Goodman acquitted herself from that nasty plagiarism scandal quite admirably with the nonfiction "Team of Rivals: the Political Genius of Abraham Lincoln". It was factually dense but as readable as a good novel, and it helped me to finally make sense of the 1850's, the fateful decade that led up to the American Civil War. It also spotlighted Lincoln's gracious and magnanimous nature, attributes that made him the perfect man for the office of President. Lincoln stands in such stark contrast to the dwarves we presently have in high political office.
So - any takers among Salon readers? What were the highs and lows from your year in literature?