Catch-22 in mental health: An open letter to Andrew Williams, CEO of Stratford General Hospital and Randy Pettapiece, MPP

Dear Andrew Williams and Randy Pettapiece,

Recently, my father was hospitalised for schizophrenia in the psychiatric ward at the Stratford General Hospital. This was good news. It was a welcome change after months of increasingly abusive and dangerous behaviour on his part that affected the entire family. Not only was he suffering from disordered thoughts and paranoid delusions, he lost his impulse control with regard to money (and some other things as well). Due to his condition he lacks the ability to deal with his own finances. He was admitted to the Stratford General Hospital and shortly thereafter, a medical tribunal determined that he was not competent to make his own medical decisions. My mother was assigned to be his medical decision-maker and power of attorney.

Yesterday, we found out that some unscrupulous lawyer visited the Stratford General Hospital to arrange the papers so that my dad could transfer his medical decision-making and power of attorney away from my mother, and give it to another patient on the psychiatric ward. As far as we know, this other patient is just some guy that my dad met less than two weeks ago when he was admitted. The name sounds made-up, though, so for all we know, it’s not his real name. This “other patient” could even be a delusion of my dad’s.

Needless to say, we were upset.

We contacted the lawyer to ask him what he thought he was doing. He said he didn’t do anything—that it was my dad who made it happen, and that he had training to determine when someone was competent to make such decisions. We will be inquiring about what legal options we have against this individual.

When we told our own lawyer about the problem, his administrative assistant broke out laughing, because it was such a ridiculous turn of affairs. He advised us to get a letter from dad’s psychiatrist, and on the basis of such a letter, it would be possible to have this transfer of power of attorney reversed. This seemed reasonable. On contacting the doctor, we were told that he could not release such a letter, since my dad has requested that his medical information not be shared with us (one of his paranoid delusions is that we’re out to get him), and my mother no longer had her status as his medical decision-maker and power of attorney.

In the face of this Catch-22, we’re not sure what to do next. As of today, the doctors at the Stratford General are still refusing to provide a letter indicating my dad’s condition, because they are afraid of being sued.

I’d like to emphasise at this point that the unscrupulous lawyer got paid for what he did. Paid with money. He came in to the locked ward of the Stratford General and walked out substantially richer, thanks to money he took from a person who was determined by a medical tribunal to be incapable of making his own medical decisions.

If someone walked into a hospital and found an old woman with dementia and exploited her condition for his own financial gain and gave her nothing in return, that conduct would be reprehensible, but it still wouldn’t be as bad as what this lawyer did to my dad yesterday. Not only did he take money from someone whose mental condition renders him incompetent to handle his own financial affairs, but he made it a thousand times harder for us to get my dad back on his meds to stop the paranoia and abuse.

So, Andrew Williams: When do your doctors plan on doing the right thing for their patient and his family?

Yours angrily,

Benjamin Carlisle

(Edit 21h00—the original version had more cursing, but as my friend advised, “Try not to swear so that your interlocutor doesn’t have an excuse to dismiss you.”)

Things that any Tom, Dick or Harry would know how to do

“John Smith,” “Bob,” and “George,” are very “common” names. That is, they were probably common once, but now, even though they have largely fallen out of use, we all still have a cultural memory of them being “common” and “normal-sounding.” We even use them when we’re trying to think up non-specific names for use in examples or clever aliases. Who among us wasn’t given a set of dummy data to enter into a spreadsheet in grade nine business class that included names like “Bob,” “George” and “Harry” in the “names” column? (Side note: the next time I need a clever alias, I’m going with “John Q. Taxpayer.”)

This summer, I started composing a short list of things I don’t know how to do. Of course, there are lots of things I don’t know how to do that could have gone on this list. It’s easy to come up with specific professional skills that I don’t know how to do: I don’t know how to commit brain surgery, milk a cow, draft legislation, pilot a Tardis … the list could go on indefinitely. But those sorts of things are not what I had in mind with this list.

This list was specifically for “common” skills—skills that are common in the way that the names “Harry,” “Bob” or “George” are common. That is, we think of these skills as being ones that most people know how to do (more-or-less), but in reality, they have fallen out of common use, or maybe never were very common.

For example, in books or movies, when someone is thrown a rope and told to tie a person or a boat or something up, every character instantly knows exactly what knot to tie and how to do it, without thinking, even if it was totally implausible for that character to know how to do that at all. In other movies, cars are hot-wired in seconds. Locks are picked with the use of only bobby pins, and by people who you would not expect to be able to do that. If you drop any character from any movie in the woods, after a brief montage, she will have caught a fish, and be frying it over a fire that she started without matches.

As for me, if I ever even lost the keys to my own apartment, I’d have no flying clue how to get back in.

For the record, I do realise that I shouldn’t aspire to master a set of skills simply because it would make me more useful in an action-adventure movie. That said, there’s a saying, that if you only have a hammer, all your problems start to look like nails. I wonder how many inefficiencies I have endured and problems I have left unsolved simply because the set of skills or tools I possess is limited. I remember my Grandpa Searles always used to carry a knife around with him, and it was useful to him all the time.

With the exception of juggling, I have no concrete plans right now to learn how to do any of these things, but they are all things that I would eventually like to know how to do. After finding this list again, I’m strongly tempted to start carrying around a pocket-knife, a length of rope and a bump key set. Maybe I can look up some YouTube videos for interesting ways to use them.

Here’s the list for your consideration.

Things I don’t know how to do

  • Clean a fish
  • Sharpen a knife
  • Juggle
  • Do handsprings/backflips/etc.
  • Drive a car with standard transmission
  • Change a car’s oil
  • Change a flat tire
  • Anything related to automobile maintenance, really
  • Diving (I can swim a number of strokes decently well, tread water and even do flip-turns, but I could never make myself dive)
  • Do my taxes (I just go to an accountant. Let him deal with it.)
  • Start a fire with only rocks
  • Tie knots
  • Tie different kinds of ties (I only know one)
  • Tie a bow tie
  • Hot-wire a car
  • Pick a lock
  • Dance

If you have some other suggestions for things that most of us probably don’t know how to do, but might be a useful thing to know in certain contexts, please leave it in the comments.

A scary email to receive less than a week before the thesis submission deadline

I bet you thought I was done posting about my thesis. Last Friday (6 days ago), I received this email after I had the pleasure of submitting my thesis electronically.

[Your supervisor] approved your e-thesis on September 23, 2011 at 11:51.

If your thesis has been accepted by all your supervisor(s), it has been sent to GPSO for processing.

If your thesis has been rejected, please make the changes requested by your supervisor(s) to your original document*, and create a new pdf, delete the file on the server, and upload the new file.

You can track the progress of your thesis on Minerva.

Hooray! It was good news to receive this email, and I tweeted about it immediately, of course.

Then, this morning, I received the following email.

Dear Benjamin, … We [at the philosophy department] have been told that you haven’t submitted your thesis electronically, and this is one of the graduation conditions. Can you do this immediately? The conditions have to be met by Tuesday, 4 October. Best wishes.

October 4th is on Tuesday (5 days from now). I’m pretty sure that my thesis has been submitted electronically. Here is my evidence:

  • Minerva lists my thesis as being uploaded and approved
  • I received the aforementioned email from the e-thesis computer

So I really don’t know what this fuss from the philosophy department is all about, but now I’m nervous that something’s messed up.

E-thesis final submission

This week, my goal was to make final submission of my thesis. All the actual work on the document was finished. I just needed to figure out how to hand it in. As per instructions on the GPS website, my thesis has to be submitted in PDF/A format.

For those of you who are unaware, a PDF/A is not the same thing as a PDF. What’s the difference? It’s more expensive of course.

The thesis has to be converted to PDF/A using special software to ensure that it can still be opened in the future. So, in order to submit my thesis, Graduate and Postdoctoral Studies recommends that I buy Adobe Acrobat Pro, at a cost of $101.38 with tax—and that’s the reduced student price.

And the most frustrating thing about this? According to the instructions, “Standard PDF files will be rejected unless the thesis was written in LaTeX.” For those of you who are regular readers of my blog, you will recall that up until February, I was using LaTeX to typeset my thesis, and it was a painful and scary transition for me to move to Microsoft Word part-way through.

So ultimately, it came down to a choice between trying to convert my thesis back to LaTeX, or spending $100 to avoid all that hassle.

Laziness won, of course.

On Thursday, I went in to the bookstore and bought the software. When I first installed it and tried to convert my thesis, I got an error. Acrobat couldn’t convert my thesis. This seemed strange, since there wasn’t any strange formatting in it. I fiddled with the settings, tried restarting, but the very expensive software wouldn’t do it. Fortunately after a half hour, it auto-installed an update and after that, the conversion went as planned.

So as of yesterday, I have submitted my thesis to McGill. It’s over! Those are all the requirements for my master’s in bioethics! The only thing that’s left is my supervisor clicking “accept.”

By the way, one of the most satisfying things about making final submission of my thesis is the fact that I can take the ugly EndNote app out of my computer’s dock. It was such an eyesore! :P

Completion inefficiencies—going for the last one percent

Humans are very good at making most processes 99% efficient. It’s the last 1% that’s hard to figure out. The last 1% of the job takes the most effort, causes the most stress, costs the most money and produces the most waste.

Here are a few examples of what I mean.

Internet inefficiency

For example, humans invented the internet. Cities, countries, even different continents can connect and share incredible amounts of information constantly. This is an example of what I mean by a process that is 99% efficient. Maybe even more than 99% efficient.

And yet, connecting that vast network to the computer in my apartment can be painfully difficult. That is an example of what I mean by “the last 1%.” The telephone pole just outside my building has wires that, if properly connected, will get me on the internet. It’s only metres away from me. And yet, it took months for Bell to finally figure out how to connect my internet properly because the wires in my apartment building are messed up. (It’s still somewhat messed up, although not as messed up as before.)

Social media and the Vancouver riot

Another interesting example is the case of the Vancouver riot: Police are pretty efficient at catching and taking people away to be processed by the justice system. When the police are looking for you, generally speaking, they catch you. (Bounty hunters in the States are even better.) The inefficient part of this process is finding and identifying people who break the law. When my van was broken into, two summers ago, the police took my information, but really, there was nothing they could do. They just don’t have eyes and ears everywhere. They can’t always be watching, and so some criminals get away with breaking into my van and stealing the GPS.

The recent Vancouver riot is a clear example of what happens when this inefficiency is taken away. More than 100 people were arrested by Vancouver police as a result of the use of mobile phones during the riot. Some have even suggested that the increase in use of mobile phones with cameras have caused a decrease in the rate of crime generally.

It turns out that in some cases it might not be such a bad thing that Big Brother is watching.

“Tea, Earl Grey, hot”

Consider the case of food distribution. Farms are very good at efficiently producing food. We’re pretty good at putting that food on trucks and getting them to grocery stores without losing very much in the process. It’s the last step, at the grocery stores themselves, where the efficiency drops dramatically. If you go behind any supermarket, there are always dumpsters full of expired produce, eggs that break, meat that goes bad.

Imagine if your house had a Star-Trek style replicator, where you pushed a button and whoosh, a machine produced the food you like best, one “food pixel” at a time, heated by a laser beam and drawn from a food printer cartridge. These could be frozen and kept indefinitely. No more spilling—no more waste. No more trying to choose the best tomato or the ripest avocado. Just buy a cartridge of the right stuff, and away you go.

This isn’t even sci-fi anymore. 3D food printers exist, although they’re really expensive. We could have incredible control over the efficiency of food production and the consistency in quality in food with such a system. We could give consumers exacting control over portion size and nutritional completeness. In situations where food aid is required, such a system would have great benefits as well.

I imagine logging on to the iTunes Food Store, syncing my recipes with my replicator and then receiving a notification on my iPhone when dinner is done printing.

Trying to park my car

Having moved to the island of Montréal two years ago, one of the most frustrating things for me was trying to park my vehicle. Here in Montréal, people will just bring their car to a stop on a major thoroughfare and turn their reverse lights on. If they do this in front of you, it’s because they want to park on the side of the road and need to back into their spot. They expect you to just go around them.

Parking is not just a problem in Montréal. Cars are wonderfully efficient at getting you from point A to somewhere within about 500 metres of point B. To actually get to point B, you usually have to backtrack a bit, circle the area for 15 minutes, find a spot, then discover that the spot is only available for 20 minutes at a time anyway, and even when you do find a spot to park (usually for a price) you have to walk a good while to get where you’re actually going. Then you have to remember where you parked, and hope that no one breaks into your vehicle to steal your stuff while you’re gone.

Airports are a prime example of this. They have officers at the entrances to airports whose only job is to make sure that people don’t just park their car in front of the door leading to “domestic departures.” You’re allowed to stop your car, pull your stuff out, kiss your loved one and then drive off. That’s all. If you’re going to park the car, there’s a huge inefficiency of the other person having to wait for you while you park it, and if you don’t want to have to bother with that, you have to either get a friend to go out of her way to help you, or you have to hire a taxi at great cost to yourself.

In response to this problem, I’m somewhat intrigued by Google’s driverless car project. I don’t think that this will solve the problem I have outlined in its entirety (even if this project succeeds), but I would be very happy to see the day where I can get in my car, tell it my destination, jump out when I’m in front of the building I’m going to and watch it drive off to find a parking spot on its own.

Process Efficient part Inefficient part Solution
Internet connexion Communication between large centres The last few metres from the telephone pole to the back of your computer Wireless internet
Crime investigation Arrest and processing of already-identified suspects Identification of criminals Camera phones + Facebook
Food distribution Mass production, distribution to retail venues Sales and consumption 3D food printers
Automotive transport Travelling, especially long distances Parking Driverless parking
Table 1. Examples of completion inefficiencies

I submitted my thesis today

ACCO-Press bound thesis
ACCO-Press bound thesis

When I woke up this morning, I was three steps away from submitting my thesis:

  1. Get French translation of my abstract
  2. Print thesis
  3. Get my supervisor’s signature

Well, it turns out my translator’s computer crashed, and so I didn’t get the French version of my abstract until exactly 12h today.

I printed my thesis—all 87 pages—bound it in ACCO-press binders, applied the necessary stickers, packed everything up and then wondered why I hadn’t heard back from my supervisor. He’s generally very fast at responding to emails, and last night he offered by email to sign my thesis submission form this afternoon, so it was surprising that he hadn’t got back to me.

I called his office. I called his home. I sent another email. I decided to do a stakeout at the Biomedical Ethics Unit and see if I run into him. When I was putting on my shoes, I considered for a moment whether I should put on my running shoes or my regular shoes. I had this nagging feeling like somehow I would end up sprinting to the James Administration Building at the last second, and that I would be happy to be wearing running shoes. Then I dismissed that thought. All I had to do, after all, is get my supervisor’s signature and then walk across the street and submit it. Putting running shoes on would be silly.

I put my regular shoes on and went to the Bioethics Unit to look for my supervisor. I ran into the administrative assistant who informed me that he was having a terrible day. A few seconds later I got a phone call from him.

Apparently my supervisor had a minor car accident and spent the morning in the emergency room. He invited me to his house to have the forms signed. This would not normally have been a problem, but Villa-Maria station (where he lives) is closed until September 6, and so I went to Vendôme station and hired a cab to get me to his place.

I saw the back of his car when I arrived. There were indentations that I’m sure were never intended by the manufacturer to be there. My supervisor and his family are all right, I think, but understandably this has been a bad day for them.

The forms all signed, I sprinted to the nearest Bixi station and decided that it would be fastest to just ride the Bixi all the way to campus. This may or may not have been the case, but I made it back to campus in 25 minutes, which is probably better than what it would have taken to get to a métro, wait, transfer at Lionel-Groulx and then walk from station McGill to the James Administration Building.

On arrival, I was hot, sweaty and breathing heavily, but I still had the presence of mind to turn on the Voice Memo app on my phone, so that I could secretly record it when the person in the Graduate and Postdoctoral Studies office said, “Yes, everything appears to be in order.” (Thank goodness for iPhone headphones that have a built-in mic for clandestine voice recording.)

I guess I’m paranoid because I’ve recently had two separate experiences where I handed in everything on a document checklist only to receive a mystifying message later on, indicating that I failed to submit all the required documents. I don’t plan to use this recording for anything but soothing my own nerves, for the record. It just feels good to hear someone say that I submitted everything.

So after all that, I have now made initial submission of my thesis. Hooray!

Catch-22: the final test of my master’s degree

In order to graduate, I must submit my thesis.

To submit my thesis, I have to hand in my Nomination of Examiners Form, available from Graduate and Postdoctoral Studies as a fillable PDF. In the top-left corner, it reads, “this form must be typed.”

If you look at the fillable PDF, you’ll notice that I can’t fill in the form completely until I know who my internal reader is.

I spoke to the Philosophy Department, and they told me that they would inquire as to which professors would be able to serve as my internal reader after I hand in the Thesis Submission form and the Nomination of Examiners Form. I’m not allowed to contact professors myself to ask them to be my internal readers.

This is my final test.

Quirks and Quarks Roadshow in Montréal

Quirks and Quarks Roadshow in Montréal
Quirks and Quarks Roadshow in Montréal

This Wednesday night, I went to the Quirks and Quarks roadshow at Concordia University here in Montréal. It was their question-and-answer programme, so they had scientists answer listeners’ questions. Questions prepared in advance, that is. One wasn’t allowed to stand up an ask a random question. It was a very pleasant evening. I actually got to see what Bob McDonald looks like (that was weird—he’s supposed to be a bodiless radio personality), the questions were interesting and the scientists were entertaining.

I brought my towel, because it was May 25. You would have thought that an event like that (a radio recording of something aimed at über-geeks) would have brought out more people with towels, but nope. You’d be wrong.

I left to get some food because I was hungry after the recording, but I was strongly tempted to stay and heckle Bob McDonald for one of the questions.

One of the listeners asked how it is that we know that what he sees as red is the same thing as what anyone else sees as red. This is a classic problem in philosophy. It is a problem of philosophy of mind, and one that touches on issues of qualia, naturalism, the hard problem of experience, and our phenomenal experience of the world as distinct from our brains’ and our eyes’ mechanism for discerning colour.

I was excited when I heard the question.

Then they had an ophthalmologist answer the question. She totally missed the point! She did not answer the question. She talked about rods and cones. She talked about optic nerves. Those things are interesting in their own right, but you can’t use them to prove anything about whether my phenomenal experience of the colour red is the same as yours.

Bob McDonald: Don’t bring in a scientist to do a philosopher’s job! I think I’ll email Paul Kennedy (host of CBC’s Ideas) and tell him that you’re encroaching on his territory!

I’m glad I went though. They also had free cookies. Well, they were unguarded cookies. I assumed they were free.

If you want to hear this broadcast, it will be on CBC Radio 1 at 12h on Saturday afternoon.

The Bonhomme Theme Song

Bonhomme Bonhomme, qu'est-ce que tu fais?
Bonhomme Bonhomme, qu'est-ce que tu fais?

Do you remember learning about the Carnaval de Québec in French class?

There’s a particular song that they used to teach us during the unit on the Carnaval. It’s Bonhomme’s theme song, I guess. When I went to Québec this winter, there was a marching band that followed Bonhomme around playing it.

I used to think that the lyrics were, “Bonhomme Bonhomme qu’est-ce que tu fais? Bonhomme Bonhomme qu’est-ce que tu fais? Je vais jouer au violon! Je vais jouer au violon! …”

Translated to English, this means, “Bonhomme Bonhomme, what are you doing? Bonhomme Bonhomme, what are you doing? I’m gonna play the violin. I’m gonna play the violin.”

Turns out, according to a native French-speaker, that is not only incorrect, but also very creepy.

That it was creepy was not at all surprising. I mean, look at him. And I suppose, given the state of French instruction in Ontario, it shouldn’t be too surprising that I got it wrong.

Makes sense to me though. “Bonhomme Bonhomme, what are you doing? Bonhomme Bonhomme, what are you doing?”

In related news, my cellphone ringtone is now the theme song to Téléfrançais.

Plurals for hippopotamus and octopus

It is a popular and well-known fact that the correct plural for “octopus” is not “octopi,” but “octopuses” or “octopodes.” This is because the word “octopus” is Greek in origin, not Latin, and the Greek word for the word “pos” (foot) is “podes.”

Here’s my question: If it is incorrect to pluralise “octopus” as “octopi,” then why is it okay to pluralise “hippopotamus” as “hippopotami?” The OED says that this is an acceptable plural.

The word “hippopotamus” is also Greek in origin. It comes from “hippos ho potamios.” In Greek, “hippos” means “horse,” and “potamos” means “river.” The plural of “hippos” is “hippoi,” as I recall.

So shouldn’t the plural be “hippoipotamus” or maybe “hippopotamoi?”