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SWEAT, BETRAYAL, AND DEGRADATION: A SHRINK EXAMINES OUR NAVAL FIASCO

by Steven Goldsmith MD

This regards our latest national disgrace—or rather, one of them; the others will have to pick a number and wait in line to be addressed in turn.

Words fail me; I cannot summon any that capture with precision the shitshow unfolding aboard our naval vessels in and around the Persian Gulf. Suicidal sailors, grave weight loss, onboard sabotage and fights, rations unfit for consumption, moldy showers, clogged plumbing; deprivations of showers, deodorants, dental supplies, clean clothes, and, perhaps worst, deprivation of belief in the worthiness of their sacrifice and in a coherent, morally justifiable purpose for their venture. Instead, the awareness that they were conscripted to incinerate schoolgirls. What is worse than moral injury is moral injury without support from the public and from those who sent you into an idiotic, unprovoked war. Throughout, a stench of sweat, betrayal, and degradation.

It would be cathartic to vent about the two men most responsible: the Great Leaky Buttock aka POTUS and his Secretary of Preening and Flexing, both of them caricatures of stupidity, immaturity, and delusional self-worship; poseurs as avatars of testosterone. But I won’t go there as these days I have to watch my cortisol level. And I won’t address the military, political, and moral implications as media pundits have covered these angles in spades. (Except to say that if the Nuremberg tribunals meant anything, these bozos would be wetting themselves right now in a docket at The Hague.)

What I will do is examine the debacle from a functional psychiatric standpoint, this being a perspective that addresses not mere symptoms of mental illness but their root biological causes. Because the U.S. vessels are floating Petri dishes of root causes: filth, boredom, lack of sunlight for many, prolonged involuntary confinement, exposure to pathogens like mold and fecal bacteria, and levels of nutrition not much worse than we’d find in the poorest villages of Somalia. (I nearly gagged when I viewed photos of their meal trays.)

Many underestimate the impact of this last issue, as illustrated by armchair snipers who infest media threads. They impugn the integrity and hardiness of sailors who crack under the strain, labeling them snowflakes, sissies, and worse. Such critics of those enlisted grunts—I say this as a Board-certified psychiatrist and former USAF medical officer—crawl within strata beneath our contempt. Millipedes who wriggle under the covers of septic tanks.

For any of us will decompensate if deprived of adequate nutrition (not to mention the other stressors enumerated above). Your personal virtue, your inherent manliness will not spare you from this fate. Nature does what nature must.

Exhibit A is the Minnesota Starvation Experiment, an example of medical research redolent of sadism while enwrapped with a cloak of scientific justification, humanistic concern, or political expediency. Such were the cases of Nazi doctors, the Tuskegee syphilis study, Anthony Fauci’s predations, and experimentation performed at the University of Minnesota in 1944-45 upon 36 mentally and physically healthy young men. The investigators subjected the men to 6 months of a semi-starvation diet (about half their normal ration of calories) consisting largely of root vegetables and sundry carbs. During the course of this study, subjects averaged a loss of 25 percent of their original body weight and developed a panoply of psychiatric symptoms—depression, anxiety, psychosis, self-mutilation, apathy, social withdrawal, impaired cognition.

These results should surprise no one familiar with the biological underpinnings of mental health. Insufficient caloric intake alone deprives brain cells of energy necessary to optimize their function. Moreover, you rely upon an adequate supply of micronutrients—vitamins, trace minerals, amino acids, fatty acids—from your diet to manufacture the neurotransmitters—serotonin, dopamine, norepinephrine and epinephrine, GABA—that modulate mood, sleep, and energy. For example, you cannot manufacture serotonin without sufficient supplies of Vitamins D, B9, and B6 as well as zinc and magnesium. Without these essential micronutrients and adequate calories, your mental health deteriorates, even if you are the manliest man on the planet.

Accordingly, our military’s and government’s current treatment of its sailors qualifies for inclusion in the lengthening roster of medical infamy and moral turpitude.

Be well.

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EPITAPH FOR JIFFY LUBE PSYCHIATRY? PART II

by Steven Goldsmith MD

Part I of this post examined a major reason why psychiatry fails to heal us. But another question taunts us: why has modern psychiatry, unlike its medical contemporaries, addressed only superficial symptoms even though its inadequate results seem to demand change in its practices?

During the past two centuries, in order to detect root causes medicine refined its diagnostic tools—the blood pressure gauge, ophthalmoscope, EKG, EEG, blood count and blood chemistry analyses, bacterial culture, MRI, etc. Meanwhile psychiatry, with sporadic exceptions, has addressed symptoms like depression, anxiety, and psychosis at face value, as the proper and sole targets of its ministrations.

Think of a cardiologist prescribing for a new patient’s chest pain without evaluating its cause. Could it be from muscle strain, gas, cartilage inflammation, pneumonia, pulmonary infarction, a dissecting aneurysm, or a coronary? Who knows?No detailed history, no physical exam, no lab and radiologic tests, no EKG. Only a fifteen minute chat and then a prescription. Wham bam. Like your appointment with a mainstream psychiatrist. Tell him your symptom, get a drug.

Consider the history of my profession’s interventions. Hypnosis for “hysteria,” a malady the infant field of neuropsychiatry in the late 1870s ascribed to uterine problems (never mind that it could afflict men). This diagnosis boasted as much scientific justification as General Ripper’s precious-bodily-fluids theory of life in Doctor Strangelove. Then a cavalcade of barbarisms paraded through hospital wards and clinics: insulin coma therapy, frontal lobotomies and other psychosurgeries, and ECT for intractable cases, all accompanied by drugs, each more expensive and profitable than the last but still toxic. The profession based none of these treatments upon an analysis of root causes but only what worked in some cases. It consigned notions of causation to the realm of unfalsifiable, therefore unprovable theories such as Freudian psychoanalysis, which prevailed through the 1970s and dominated my residency training.

It is paradoxical but fitting that we often capitalize psychiatric diagnoses such as Major Depression, Recurrent, unlike lower-case labels of physical illness such as ulcerative colitis and asthma (unless they are named for someone, like Grave’s disease). Why the difference? Because medical labels usually reflect empirical evidence of abnormal structure and/or function within tissues and cells. In other words, material reality. Whereas psychiatric diagnoses are abstractions, as in that catalogue of disorders, the DSM. Unprovable, they float like waterless clouds through philosophers’ minds (think Plato’s Forms). Moreover, they aspire through capitalization to mimic works of theological authority like the Talmud and the Bible, inflating through capital letters their pose as incontestable designations of Truth, even though every few years they are voted in or out of the DSM nomenclature as fashions and politics change.

Take the DSM diagnostic labels for homosexuality. The DSM-I edition listed it in 1952 as “sociopathic personality disturbance”; DSM-II in 1968: “sexual deviation”; DSM-II-Revised in 1973/1974: “sexual orientation disturbance.” (In 1973 I attended the American Psychiatric Association conference in Honolulu, where a stormy debate, accompanied by audience applause and boos, erupted on the motion to revise the previous label.) In 1980 the DSM-III changed it to “ego-dystonic homosexuality,” meaning you had this disorder only if it disturbed you; in 1987 DSM-III-R, with the justification that homosexuality constitutes a normal variation of human sexuality, eliminated even that diagnostic vestige. What changed between 1952 and 1987? No dispositive scientific findings swayed psychiatry in their judgment about this topic any more than did empirical research persuade society to give women or black people the vote. Rather, a change in cultural and social norms, in humanistic sensibilities, won the day, not hard science. So much for the Truth inherent in psychiatric diagnosis.

But psychiatry, as currently constituted, can never apprehend fundamental truths of human functioning. Take the year my lawn turned spongy. To step across it felt like walking across a waterbed. The culprits: moles, who had invited all their relatives, neighbors, and fellow lodge members to join in tunneling through the loam. I could have hired an exterminator to poison the bastards. But that would have been a fool’s errand. Because the moles had decamped upon my lawn in order to feast upon grubs, which while invisible to me, infested the soil. If I were a mole, I would have done the same.

Why then didn’t I hire an exterminator to poison the grubs? Because they too abounded for a good reason, having proliferated when the soil’s composition deteriorated to one more hospitable to them. If I wanted to evict the grubs and moles, I needed to nourish the soil—or terrain, as functional and integrative physicians refer to the totality of physiological function within each organism. It is dysfunctional terrain that generates vulnerability to the more superficial and apparent manifestations of illness—to our own versions of moles and grubs such as microbes, parasites, inflammatory cells, cancers, and micronutrient deficiencies, any of which can constitute or generate symptoms, including symptoms of mental illness.

The above is common sense. Yet why does psychiatry persist in exterminating moles instead of investigating the underlying defects of our soil and treating those?Why does psychiatry seem to operate under different rules of evidence than, say, internal medicine?

To understand why, travel back to the 17th century, to the problem posed by Rene Descartes of mind-body dualism. He proposed that our mind and body are different entities, composed of different stuff and/or operating according to different laws. This notion gained currency in the Scientific Revolution of his era and the 18th-century Enlightenment because it melded with the ethos of the period: knowledge of nature can best be understood by analyzing it through objective, empirical study into its component parts. Instead of considering the mind and body as interdependent and overlapping aspects of a whole organism, sages and scientists viewed them as separable, capable of being independently studied and treated, much as kidneys differ from livers. This view atomized people into parts, dissociated us from ourselves, and damaged the ability of physicians to heal.

To this day we honor this legacy with the nonsensical concept of “psychosomatic,” as if mind and body are different entities. As if there is any experience that is not psychosomatic. When I worked as a psychiatric consultant on medical wards, attending physicians often asked my opinion about whether a particular patient’s symptoms were physically or mentally caused. The correct answer was always “yes.” The existence of independent disciplines of psychiatry and neurology is further evidence of our illusion of separation, even within the single realm of the brain.

Or consider the perceived distinction between psychiatry and any other specialty, such as gastroenterology. Given what we now know about the centrality of the gut in the regulation of our moods and cognition, we should consider psychiatry and gastroenterology as subspecialties of each other.

Functional psychiatry attempts to bridge the chasm that mind-body dualism created, and that the Enlightenment’s balkanization of the human organism enforced. Everything that affects the mind affects the body, and vice versa. That is why conventional psychiatry, which brackets off and targets mere symptoms of emotional and cognitive dysfunction, fails and will always fail until we replace it.

Be well.

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THE NEW AMAZING DRINKING GAME

by Steven Goldsmith MD

Do you know about the new drinking game? Downing a shot of booze whenever you hear anyone utter the word “AMAZING”? Turn on YouTube to a podcast dedicated to popular entertainment, sports, dating and relationships, music and art, travel and dining reviews, or human interest stories. Settle into your favorite armchair with a bottle and shot glass by your side. Wait. It won’t be long before your first slug. “I met an AMAZING woman online”; “just saw an AMAZING sci fi flick”; “he’s such an AMAZING friend”; “their chicken vindaloo was AMAZING . . . AMAZING prices” . . . . Arguably the most common adjective with which we describe people, places, and things, it outcompetes past contenders like “awesome” and “cool.” According to Merriam-Webster, it means “causing astonishment, great wonder, or surprise.”

Why does this word pepper our utterances with the profligacy of a linguistic tic? Three possible reasons. The first: more has emerged in the past decade worthy of this adjective. The second: it is not the elements of our lives that have changed, but our increased receptivity or capacity for amazement by them. The third: no more people, places, or things in our lives truly amaze us than before, but we label them as AMAZING anyway.

If you chose the third option, you win. Your discernment is AMAZING. Have a shot on the house. The main factor in our orgy of amazement is the progressive degradation of our cognitive and language skills. We don’t read books anymore, just scroll through screens and gape at influencers. Our “education” system admits and then graduates functional retards who cannot write even one coherent sentence (LOL), know nothing of history or the world. If you consider this hyperbole, ask any teacher or college professor.

This state of affairs shouldn’t surprise us. After all, where are the role models? Where are the public figures with the eloquence of yesteryear? When literary figures like Gore Vidal, Truman Capote, Norman Mailer, James Baldwin frequented the TV talk show circuit. When political leaders orated, expressing nuance and irony, displaying knowledge of history the envy of professors, men who made us think, who inspired us to consult dictionaries—JFK, Eugene McCarthy, MLK, William Buckley, Everett Dirksen. Can you imagine an intellectual contest like Buckley’s Firing Line being held now?

Given our inability today to articulate with precision and specificity, we rely upon low-resolution words like AMAZING that can suggest dozens of disparate meanings or serve as a filler with no meaning at all. In fact, it covers for the absence of meaning. It’s LIKE, dude, AMAZING.

A second factor in AMAZING’s rise is the diminution of actual wonder in our lives, of astonishment. What is wonder anyway? A sensing of some quality or entity that supercedes quotidian existence, that violates and transcends our usual apprehension of the natural world we inhabit. A sense that there is more to all this than we understand. A sense of the divine. A sense many of us have lost with the fading of church attendance and political attacks upon religion; and our obsession instead with the tinker toys of material existence. AMAZING is the ersatz divine, the tawdry filler of the hole within us where God used to reside.

In short, AMAZING is our attempt to compensate—for the emptiness of our thoughts and lives. Its compensatory function mirrors the increased need in recent years of Western men to bulk up and get ripped during an era of diminishing testosterone levels. Compensation has its compensations. But we also need to address what we lack and to find it again.

Be well.

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EPITAPH FOR JIFFY LUBE PSYCHIATRY: PART I

by Steven Goldsmith MD

You shuffle into your primary care doctor’s office, bent over, clutching your belly, moaning from pain. He whips out a prescription pad—“I know just the thing for abdominal pain”—scribbles the name of a drug and schedules a followup appointment.

What is wrong with this picture? For starters, he prescribes a drug while clueless about what your pain signifies, i.e. its root cause. Does it stem from gas? From a muscle strain? An infection? Inflammation? Cancer? Acute intermittent porphyria? Reflux? Syphilis? Did you fall under the wheels of a bus? You get the idea. You would consider him a moron or charlatan, a prime candidate for a multimillion dollar lawsuit and delicensure.

Yet this is what mainstream psychiatrists do daily. They approach your symptoms as the problem to be treated, with no serious attempt to address their root cause(s). Their object: suppress symptoms with drugs. Depressed? Then Zoloft or Cymbalta it shall be, with no recognition that the root causes of your depression may differ from those of the hundreds of other patients for whom they have prescribed these drugs. Anxious? Expect an antidepressant and maybe an anxiolytic like Xanax or Klonopin. If you are hearing voices, an antipsychotic. Like pulling into Jiffy Lube for a quick oil change and lube from an attendant who doesn’t know your car. These days psychiatric appointments can last 15 minutes or less because there is little the prescriber needs to understand.

Contrast these practices with a competent PCP’s approach to your belly pain. She or he would obtain a detailed history, examine you, order tests—blood count and metabolic profile, among others—and if not satisfied, may order X rays, an ultrasound, MRI, etc.

Is it any wonder that the prevalence of every psychiatric disorder has surged in our society? And that fully successful treatments of such disorders—meaning complete remission, i.e. the total disappearance of symptoms with no need for further medication—are sufficiently rare to qualify for publication in professional journals? A cured psychiatric patient is a unicorn in the wasteland of the chronically ill.

Take my profession’s track record in treating depression, the world’s top cause of disability. The Star*D Trial, conducted years ago by our National Institute of Mental Health, reported the outcomes of pharmaceutical treatment of more than 4000 depressed participants. After investigators discovered statistical errors in the initially published results, they recalculated them. What percentage of the subjects underwent a complete and sustained remission of depression after they received up to four different antidepressants and adjunctive meds? Ready? . . . (You may wish to pop a Xanax or Ativan or wait weeks until your Prozac kicks in before proceeding further.) Spoiler Alert: 2.7 percent! (That’s not a typo.)

That figure should not shock us. After all, psychiatric “diagnosis” bereft of root cause analysis is a synonym for guesswork. Shrinks might as well consult Ouija boards. They select meds the way a blindfolded partygoer swings a bat in the hope of striking a piñata.

But conventional, drug-besotted psychiatry is no longer the only game in town. A form of psychiatric treatment does exist that effectively addresses not mere symptoms but their root causes. As a result it is gaining popularity although most lay people and even many physicians know little about it.

Having spent decades providing a variety of treatments for mental health problems—drugs, multiple models of psychotherapy, hypnosis, homeopathy—I remained dissatisfied with the limitations of my efficacy. So I began a year-long fellowship in functional psychiatry (FP).

FP investigates and treats root causes, be they nutritional, metabolic,

environmental, stress-related, biochemical, immunological, or infectious. Treatment may include supplements that replenish levels of vitamins, trace minerals, neurotransmitters, and amino acids; remediation of gut microbiome disturbances, mitochondrial dysfunction, or covert infestations of Lyme, mold, and other pathogens; attenuation of auto-immune disorders; alteration of environmental stressors like blue light and EMF; optimization of physical activity, sleep, and nutrition; coaching in stress reduction techniques like breath work, nature walks, and meditation.

Unlike its conventional cousin, FP is a holistic enterprise. After all, psychiatric symptoms are often the first indication that something is amiss within you. Because the brain uses about 20 percent of your body’s energy supply, it is especially sensitive to covert or nascent dysfunction anywhere in your body. Accordingly, affections of your brain serve as canaries in the coal mine of your physiology. If your mind is ill, you are ill; and often vice-versa. Conversely, by targeting your psychiatric symptoms FP indirectly addresses all of you.

Three cases illustrate this discipline.

Walter, an extremely anxious 40-year-old salesman, had failed to benefit from psychotherapy and multiple psychiatric drugs. But his anxiety vanished and he felt “like a new man” after daily supplements of Vitamin D3 and Vitamin B12 that I prescribed because of low levels of both that previous doctors had told him previously were fine.

Most MDs do not even know that your body requires adequate levels of these micronutrients in order to manufacture serotonin, a key neurotransmitter that regulates mood. Lab tests for B12 and D levels should be a part of every psychiatric evaluation of depression or anxiety. However, unwary doctors often misinterpret lab reports that a patient’s values of B12 and D are within normal range when in fact they are suboptimal. In the case of B12, up to 10 percent of reportedly normal levels lead to B12-deficiency symptoms. In the functional psychiatric world, serum B12 is considered optimal only above 400, and preferably 500 pg/mL. Vitamin D levels are considered adequate only above 40 ng/mL, with 40-60 ng/mL considered the sweet spot.

Dan, 47, a married financial advisor, suffered from severe depression with suicidal ideation after the death of his father. Having declined antidepressants, he seemed on the verge of needing hospitalization when laboratory hair analysis revealed an absence of the trace mineral lithium from his body. After I recommended to him a very low dose, 5 mg daily, of over-the-counter lithium orotate, he became significantly less depressed and non-suicidal within a week, and his improvement persisted thereafter.

Distinct from the better known, prescribed lithium carbonate used mainly for bipolar disorders, the orotate is used in functional psychiatric circles because its much smaller doses generate only a negligible blood level and much less likelihood of side effects than the carbonate. Optimizing multiple neurotransmitters, stimulating the activity of brain-derived neurotrophic factor, among many other salutary functions, it has been found effective in multiple research studies for ADHD (I vouch for its efficacy also for that problem), depression, suicidality, and cognitive impairment, even early Alzheimer’s.

You don’t hear about it because lithium pills can’t be patented, which means Big Pharma cannot profit from it, as the mineral occurs naturally in our ground water. Speaking of which, numerous worldwide studies have demonstrated a consistent inverse relationship between levels of lithium in drinking water and the incidence in those localities of depression, suicide, and dementia. That is, the higher the lithium, the lower the likelihood of those ills. (By the way, do not try any of this at home, folks; I am not recommending any specific treatments for readers. Undertake functional treatment for any serious mental health problem only in collaboration with a qualified clinician.)

Our gut microbiome (the population of microbes residing in our intestines) is anti-Las Vegas. What happens in our gut does not stay in our gut, but inevitably affects our brain and overall functioning. Jenny, a 37-year-old homemaker, despite years of conventional psychiatric treatment and therapy, complained of chronic anxiety and intermittent stress-related diarrhea. Among the tests I ordered was an organic acids test of her urine. It revealed the presence of high amounts of HPHPA, an acid metabolite of Clostridia bacteria residing in the gut. This single finding explained her symptoms, for HPHPA blocks the ability of the enzyme dopamine beta-hydroxylase to transform the neurotransmitter dopamine into norepinephrine. The resulting excess of dopamine and paucity of norepinephrine is a recipe for mood dysregulation. Her symptoms subsided after a month-long course of the probiotic Bacillus coagulans terminated the Clostridia with extreme prejudice.

I could go on but suffice to say, during only my first seven months of my FP fellowship I have helped a number of ongoing patients I could not help previously and new patients I could never have helped as much had I maintained a conventional psychiatric hat. I have heard countless functional practitioners say the same.

But why, with the rationale for root-cause treatment so compelling, the benefits of FP so evident, and normi psychiatry’s results so uninspiring, have my conventional colleagues not questioned their core assumptions and practices? Why have they remained trapped within their self-imposed tar pit of mere symptom management? We will seek the answer in Part II of this series.

Be well.

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CRUISING TOWARD ENSLAVEMENT

by Steven Goldsmith MD

Recently I rented a 2026 Toyota RAV4 hybrid. A more spacious car than I needed but perfect for those who fantasize helming a yacht from a captain’s chair along intercoastal waterways; and for those who require their dashboards to be only slightly more complex than consoles in 747 cockpits.

As for me, I prefer my 2004 Toyota Corolla, termed by its regular mechanic as “the tank” because of its durability and seeming indestructibility. Besides a burned-out clutch, it has never needed major repairs. (In their design of that model, Toyota forgot the memo about planned obsolescence.) I require from my Corolla only that it goes where I point it and stops on command. The rest I can figure out.

So imagine my alarm after I slid into the rental and started the engine. The large dashboard screen above the radio lit up and announced Toyota Audio Multimedia Services with functions for Roadside Assistance, Destination Assist, Cloud Navigation, Intelligent Assist, Driver Support, Proactive Driving Assist, Lane Change Assist, Traffic Jam Assist, and Dynamic Radar Cruise Control.

As I shifted into Reverse to back out of my spot, a pinging startled me. The screen flashed to an aerial view of my car’s position in a space bounded by colored lines (a “Driver Assist” feature that I appreciated as otherwise I wouldn’t have known where my car was or that I was actually in it). “CHECK SURROUNDINGS FOR SAFETY” the screen commanded. Pondering that novel idea I exited the lot onto a country road. I drove maybe two hundred feet before a fresh set of images on the screen drew my glance. With my touch of ADHD I couldn’t resist. Instantly a message flashed on the dashboard directly in front of me: “DRIVER INATTENTION DETECTED. LOOK FORWARD.” I spewed a few bad words at my omniscient nanny. (Fortunately, my cell phone was off so Siri couldn’t hear me. Or maybe she could and was too embarrassed to comment. Who knows these days?)

To compound the insult, when I approached an intersection the electronic nursemaid finger-wagged, “CAUTION: CROSSING TRAFFIC DETECTED.” And I don’t know how I could have arrived at my destination in one piece if it hadn’t continued to flash for the duration of my journey the official speed limit for my route even though road signs were perfectly visible. Not to mention, thank God, that it alerted me throughout with a luminescent “D” that the gearshift was in Drive as opposed to Reverse, Neutral, or Park, the only four gears available. Once, when I parked briefly to study a street map, “VEHICLE WILL TURN OFF IF PARKED FOR 1 HOUR. PERFORM AUTO OFF?” followed with a YES and a NO button in case I couldn’t recognize a question when I saw one or was unaware of the binary choices for my reply.

You may laugh at this idiocy. I did at first. Then I reflected upon its implications. Starting in 2027, by federal law all new cars in the U.S. must contain such functions plus a kill switch that stops the car if the driver show signs of impairment like sudden swerving or the appearance of fatigue, intoxication, or inattention. Accordingly, my RAV4 rental represented a vanguard of the new smart cars designed to do one thing, and one thing only. It is not to make us safer. How does a chip that stops your car in the middle of a highway do that? A dashboard screen that distracts the driver with enough bling to make a neon-lit Times Square billboard blush—how does that make us safer? Safety is not the agenda; it rarely is anymore. No, the purpose is to seduce us into surrendering our agency, our autonomy.

This anecdote coalesces with other contemporary phenomena that prompt us to jettison self-governance because of convenience, time savings, submission to authority, laziness, and/or fear: reliance on electronics to tell us where to go (GPS), what to think (AI, Siri, Alexa), how to count (calculators), how we function (wearables). We need only to lift a finger—literally—to have our smart phones tell us anything we wish to know. Why read books when electronic narrators can read us audiobooks or we can read synopses on Wikipedia? Why struggle with illness or depression when government euthanasia programs can take care of us . . . permanently? We have bought the lie that anything that makes our lives easier is good, and that includes letting others do our thinking for us. We have admitted this Trojan horse through the gates of our defenses, not recognizing the evil and degeneracy enwrapped within its beribboned and glittering package.

Our culture does not exempt children from this enforced dependence. Instead of allowing them to improvise their own leisure time with friends and activities of their choosing, we enslave them with scheduled playdates and rules under the panopticon surveillance of helicopter parents. Not to mention that fraudulent enterprise known as public education—indoctrination camps led by group-thinking mediocrities who discourage creative, autonomous thought while teaching to the test; graduates leave their years of such educational struggle sessions knowing only what they are supposed to think—perfect candidates to “drive,” or rather be driven by 2026 Rav4 hybrid cars.

Given these trends is it any wonder that we have submitted to an incremental government takeover of our daily lives, have acquiesced to the increasingly open contempt and abuse that degenerate political grifters heap upon us? And why shouldn’t they? Who is going to stop them? Surely not the masked zombies who lined up for death shots like good little boys and girls during the Covid hysteria.

Much ink has been spilled, much podcast time expended on the machinations of the elite globalist class who war against our autonomy, who strive to enslave us through control of our health and financial assets and to depopulate us. All true. But we commoners cannot control what they try to do, cannot temper their sociopathy. What we can do is look at ourselves in the mirror and recognize how we have been disempowering ourselves, allowing our autonomy to be up for grabs; how we have been surrendering that which differentiates us from other animals—free will. Without that we are merely beasts of burden, or useless eaters as Marxists would have it. We are inadvertently greasing our slide into a future of social credit scores, transhumanoids, and hive minds.

In this war against us, given the stakes we have only two choices. Surrender or revolt. And surrender is not an option.

Be well.

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PUPPIES R US

by Steven Goldsmith MD

Can we talk about Waggy Dog? The YouTube promo for it, the concept of it scared the snot out of me. An online ad proclaims: ”A Fluffy Robotic Puppy that Loves Your Child Back. . . . With over a million users worldwide, Waggy Dog brings the joy of a real puppy into your home — without mess, allergies, or stress. . . . an AI-powered robotic puppy crafted to replicate the warmth, charm, and playfulness of a real pet — without the mess or maintenance. . . . encourages imagination, empathy, and screen-free fun. Perfect for . . . anyone wanting a lifelike companion that’s always ready to play.” (The video ad touted it as, inter alia, a boon for the elderly, a cure for loneliness.) The dog responds in a reinforcing fashion to “pets, cuddles, and hand gestures” by tail-wagging, approaching, tilting its head.

This reminds me of one of my scariest dreams as a boy. In it I watched the keys of a piano rising and falling as if someone was playing it. But no one, no human being, was there! Only a poltergeist, a phantom. It may not sound like much, but I awakened in a cold sweat. The tagline of the 1979 film Alien was “In space, no one can hear you scream.” No one was there.

More disheartening, an online reviewer of consumer goods rated Waggy against 20 competing makes of robotic dogs. So Waggy is not merely a one-off but the leader of a cultural trend. What disturbs me most about the proliferating packs of AI dogs? Not their robotic simulations of living beings. We humans have always played with dolls, collected them, comforted ourselves with their proximity in the dark of our childhood bedrooms. Though we knew after the age of three they were pretend, we interacted with them as if they were real. What distinguishes our interactions with AI dogs, not to mention Siri, Alexa, ChatGBT, sex robots, video porn, virtual reality goggles, our cell phones, texts and social media communications with invisible strangers is that we are losing the as if quality. We are losing the sense of what qualifies as a living being versus a mere simulacrum; what qualifies as life itself.

In defining ourselves, our self-images, in relation to the living beings with whom we interact, we cannot retain core features of our humanity by engaging primarily with nonliving things. We must wake up and combat the anti-human influences permeating our lives—dismissal of biological sex; devaluation of children, the family and community, heterosexuality, and God; estrangement between the sexes; vanishing allegiance to our respective cultures and their histories and standards.

OK, I’ll put my cards on the table. The AI dogs are sick, Satanic shit. They and their makers are shepherding us into a transhuman world in which we are all instruments that transmit and receive electronic signals from robots and other ex-humans; in which humanity has obsolesced. Remember, in space no one can hear you scream. Questions that confronted the protagonist Deckard in the film Blade Runner will challenge us more profoundly than we realize: Are we humans or machines? Are the machines we created more human than we are? What’s the difference?

Where does this lead? To an isolation and loneliness so profound as to beggar the imagination. If that prognosis seems extreme, get a load of this. Last year Canada’s ever-expanding MAID (Medical Assistance in Dying) program executed a man because officials judged him to be suffering from a “grievous and irremediable” (i.e. incurable) condition, their qualification for euthanasia. What was that condition? Loneliness. An emotional state fostered by the sense of isolation and reality of societal disintegration. An age-old problem, now medicalized and dehumanized by MAID into a diagnostic label, a bureaucratic criterion. All the easier then to extinguish the carriers of this malady with euthanasia or profitable drugs or both. No wonder we feel tempted to purchase fluffy pseudodogs, for they can assuage our pangs of realization that no one out there can hear us scream. But we need real dogs, with their poops, barks, and the rest of the mess and inconvenience inherent in life.

Be well.

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TRUMP IS US

by Steven Goldsmith MD

When a New York Times reporter recently asked if there were limits on his global power, Donald Trump said, “Yeah, there is one thing. My own morality. My own mind. It’s the only thing that can stop me.”

So much for the U.S. Constitution he swore to uphold and defend. Forget international law. Forget Congress and the Supreme Court. Forget the Bible. Forget even God, now superfluous, banished in His retirement to a high-rise casino on the new Gaza Riviera. For Trump reigns as his own arbiter of everything. His own God.

Why should it surprise us that our President expresses such moral solipsism in the Year of Our Lord 2026; such contempt for the values that have guided our nation—officially if not always in practice? And by“President” I mean not just Trump, for this is not really about him. It is about the nature of a President, the sort of leader our society has earned. For in a parallel universe any alternative candidate the U.S. citizens might have elected in 2024 would be evincing the same amorality. (Perhaps not with such vulgarity, for Trump raises that bar to Olympian heights, but with the smarmy virtue that has greased all the degenerates and con artists who have slithered into our Oval Office for decades.) Why is this the best our nation can achieve?

Here is a clue. In recent months, YouTube bombarded me with ads of young women saying, “Yesterday my husband fucked me for three hours straight, and I went to sleep with my legs still shaking. . . .” In a similar ad ladies promised viewers that “your AM wood will be back with a vengeance.” In yet another a woman rapidly stroked the neck of a beverage bottle until its contents foamed over into her mouth. Can you imagine such ads ejaculating onto our TV screens back in the day? Leave It To Beaver (no pun intended) or Gunsmoke being interrupted for “a word from our sponsor” about butt plugs?

In brief, Trump is the elected (selected?) avatar of the intellectual, cultural, and, above all, moral degeneracy and vulgarization of our society. He belongs exactly where he is. Mind you, I am not a reflexive anti-Trumper. A Taft-Buchanan conservative, I voted for His Cosmic Majesty in 2024 over his predecessors—President Wormfood and Cackles, the DEI airhead—the way I’d choose severe colitis over colon cancer. But I have become a bipartisan hater of U.S. politicians. If I were not such a paragon of emotional stability and Christian virtue I would fantasize day and night about hanging 97 percent of these traitors by meathooks in town squares up and down the land.

Although I don’t regret that vote, I never believed that DJT is a maestro of 4-D chess. Any critical thinker, let alone a shrink like myself, can see that his chess set is short three pawns and a rook before he even opens the board. But set aside for now his ignorance, fifth-rate intellect, vulgarity, cognitive impairment, emotional incontinence, impulsivity, cruelty, and intolerance of dissent. Instead examine further the implications of the most salient attribute of his personality: the worship of self.

I believe that self-worship is the deadliest sin, for all other sins and crimes follow from that. Being the God of your life, with no moral guardrails. ME uber alles.

Let’s face it. My generation, to which Trump belongs, has blazed a dirt path of narcissism deep into the barren wilderness in which we now stand, without a compass, bereft of our bearings and roots, hollowed out by an anomie that festers. Other than self-absorption what is the meaning, the purpose of our lives?

In the sixties, teens and twenty-somethings, we worshipped our own tribe. We were special—hip, turned on, contemptuous of elders who had achieved nothing of value with the minor exceptions of surviving the Great Depression and winning WWII. “Never trust anyone over thirty,” we crowed. With no Depression or World War to occupy us, what did many of us who were not jungle-fighting do instead? We dropped acid; peacocked about in our beads, granny glasses, and tie-dyed shirts; and balled (the hip verb back then) anyone with a pulse. Free love, guarantor of a meaningful life. In short, except for our fabulous rock music, we were full of it, insufferable. I do not exempt myself.

In the 1970s Tom Wolfe labelled us the “Me Generation” because of our self-absorption, our emphasis on personal fulfillment. And in the1980s many of us morphed into yuppies, urban fashionistas (remember those red suspenders?) devoted to material acquisition. Investment banking was in, highlighted by Wolfe’s novelBonfire of the Vanities and the film Wall Street (“greed is good”); with church attendance increasingly declasse, an afterthought or irrelevance, we gradually stopped Merry Christmasing others, fearing their scarlet letter of opprobrium for such hate speech.

But you think we were bad? Younger generations have upped the ante of collective narcissism in their obsession with selfies and likes. To paraphrase Descartes, I receive a dozen likes, therefore I am. Our cell phones have become our cathedrals. The entering classes of my medical school, Columbia, at their White Coat Ceremony (on YouTube if you have a strong stomach) no longer swear allegiance to the venerable Hippocratic oath and its moral commands, but compose their own oaths (before they have seen a single patient!), which teem with the shibboleths of social justice and wokery. They never mention God—or even “gods,” the way Hippocrates did. After all, if no transcendent values, no standards guide us and if God is absent, having taken the last train to the Coast, and we are our own Gods, anything goes; might as well award these bright young things a participation trophy, toss them their MD diplomas frisbee-style and call it a day.

In a 1798 address to the Massachusetts Militia, John Adams said, “Our constitution was made only for a moral and religious people. It is wholly inadequate to the government of any other.” We have fulfilled his warning. Politicians, regardless of party, soak in purulent puddles of self-aggrandizement, violating the Constitution 24/7, none more so than DJT. And we the people do little about it but scroll on our phones. In our post-moral, vulgarized, narcissistic society Trump serves as fitting flag-bearer.

As Fyodor Dostoevsky wrote in The Brothers Karamazov, “If there is no God, then everything is permitted.”

Be well.

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by Steven Goldsmith MD

There comes a time when one must face the facts. My time is now. Donald Trump is an avatar of that old Gestalt psychology brain-teaser, in which the viewer will initially perceive disguised within the illustration either an old hag or a beautiful woman. He will not see both simultaneously. No matter whether he sees the hag first or the beauty, he will stare in vain seeking the other figure that his friend swears is right there in front of him. He stares and stares, wondering which of them is crazy, until he perceives in an instant the new form. He wonders how he could have missed it. After several tries he can switch his perception back and forth easily from hag to beauty so he can visualize both.

But what if he continues to deny the existence of the other figure, say the beauty, even after his friend traces the lines that form it? Moreover, what if he refuses to look further, asserting that no such figure can possibly exist, and that his friend must be trying to deceive him? He cannot see it, he says, because it doesn’t and cannot exist and that his eyesight is 20-20, thank you very much.

As a psychiatrist, I have seen countless patients with delusions—of their imminent death, of plots to kill them, of their identity as Jesus or Cleopatra, of mice devouring their insides. A delusion is a fixed false belief; being fixed, it is not swayed by contrary evidence. Delusion is one sign of psychosis, in which people can no longer test reality. We develop delusions because of a deep emotional need for them. They are protective symptoms, aka psychological defenses, however maladaptive. As distressing and disabling as delusions can be, to abruptly deprive psychotics of delusions is to plunge them into even deeper distress and mental chaos.

What does this have to do with Trump? You do not have to be clinically psychotic or even mentally ill in any way to maintain beliefs that are unfalsifiable. Religions are unfalsifiable, based as they are upon faith and not logic. The devoutly religious hold their beliefs despite all contradictory evidence. They can always invoke a workaround, perhaps citing a passage in the Bible or Koran to support their points. Freudian psychoanalytic theory also is unfalsifiable and therefore unscientific, for genuine science must allow for correction if the evidence is sound. In that respect it is akin to religion. If you criticize the beliefs of Freudian analysts, they may explain how you defend against the truth because of your emotional conflicts; may hurl terms like reaction formation, undoing, projection. Denial or negation becomes confirmation.

For much of the American populace, Donald Trump is either the Gestalt hag or the beauty, with no plasticity of perception allowed.

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WHY THE CRACKER BARREL FIASCO MATTERS

by Steven Goldsmith MD

We have been here before. Woke white girl boss of a major company spits in the faces of her loyal customers, a demographic she evidently holds in contempt. Just like the Marketing VP for Bud Light who sneered at those “fratty” toxic males and installed as their spokes-creature Dylan Mulvaney only to crash the brand and her career there. In the recent Cracker Barrel (CB) clownshow, the CEO replaced their iconic logo that depicted an overalled old-timer, Uncle Herschel, setting a spell against the eponymous barrel. She unveiled in its place a logo devoid of any graphics save the company name.

Why did this decision ignite a Category 5 backlash from the public, whose fury compelled the company to revert to its original logo? Uncle Herschel was a familiar image to CB’s devoted clientele, a comfort food to the eyes no less than their buttermilk pancakes are to the palate. And familiarity is CB’s identity—a place and menu redolent of Mom’s cooking, of grandad perched on the front porch watching the sun set as we kids played in the yard, of biking with buddies down to the creek to catch frogs, of family dinners around tables when intact families were a thing. Even if we never did any of that, these experiences are entrenched in our collective consciousness, shared memories of mythical communities, now mere inscriptions on gravestones, a sense in our bones that we once cared for and looked out for each other, that we were once a family in spirit.

And the nitwit of a CEO cancelled all that when she replaced the logo. She replaced the past. Our history; our identity. In so doing she betrayed disdain for the regular folks, especially those of flyover and rural America and the South, those bereft of Ivy diplomas who don’t consume soy or avocado toast, the “deplorables” as a psychopathic former girlboss once snarled.

But why did this woke CEO choose that particular logo to replace Herschel? Odd. You would think, given her ideology, that instead she would have devised a new graphic of, oh I don’t know, a pants-suited woman at a laptop, preferably black, or maybe a black or Latino man. Or what about a pair of hairy legs in a dress? However, she did none of that. Instead she created . . . nothing. Only letters. And that is the point. She erased the humanity.

This trend towards dehumanization is nowhere more apparent than in my profession of medicine. Patients in sterile examining rooms glimpse corporate physicians for 7 minutes at a pop—physicians they scarcely know; they receive prescriptions for sick parts of themselves, while computers regurgitate data reporting the status of scores of molecules in their bodies.

Dehumanization is the woke project, actually the globalist goal for which wokesters are “useful idiots.” Eliminate men; women; romance; non-electronic conversation; eye contact; heterosexual sex, which is the only kind that ensures a continuation of our species; religion; families; traditions; our nation. All gone, if they get their way, just like Uncle Herschel. Replaced by a dehumanized logo.

I don’t know about you, but next chance I get I will dig into Cracker Barrel’s grilled catfish with their “warm, hand-rolled buttermilk biscuits” and, if I ask nicely, a touch of gravy to remind me of the home I never had.

Be well.

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