Old Geezers Out to Lunch

Old Geezers Out to Lunch
The Geezers Emeritus through history: The Mathematician™, Dr. Golf™, The Professor™, and Mercurious™

Thursday, March 21, 2013

Diagnosis du Jour

A news article today had this as a headline:

"1 in 50 Americans Has Autism."

...to which I say: 

No, they don't. 

Autism is a popular disorder today, like some others that are still in full vogue at the moment, and others that have had their prime and are now on the wane. A few years ago, we were convinced that pretty much every kid in American had some form of ADHD. There was a time when "Personality Disorder" was the buzz term, and "Bipolar" now seems to be nominating itself as the next big thing. Depression has developed such staying power that it's developed an entirely different linguistic usage. You know longer say "I'm depressed;" now it's "I have depression", and we're told that virtually all of us has some level of depression, all the time. Routinely waking a little grumpy before the morning coffee now means you have "rapid cycle depression."  A moodiness that sets in during long periods of dreary weather is "Season Affective Disorder (SAD)." 

Don't get me wrong. I'm fully aware that autism is a very real thing. And I surely don't doubt that it comes in different levels of intensity, and that Asperger's disorder is a convenient and helpful way to distinguish a more mild but still debilitating form along the autism "spectrum." I have known a couple of unfortunate families who have had kids fitting the classic, sobering definition of autism: utterly non-verbal, non-social kids who really have no normal future in store for them.  And I have also known some families with kids with clear social development disorders that are distinctly disabling and which deserve to be studied and treated. 

And of course ADHD, personality disorder, Bipolar condition, clinical depression are also real and problematic conditions worth attention. Giving labels to certain easy-to-recognize syndromes and behavior patterns is convenient and useful as a tool for recognizing and dealing with them. The same is true of many, many such labels. My argument is simply with the overuse of these and other diagnostic terms. As descriptors these phrases are fine, but the trouble is that they’ve become pseudo-medicalized, and symptomatic diagnosis has led to an explosion of chemical treatment, many of which have been studied only briefly.

As a firmly established Geezer with close to 60 decades on the planet, much of that time involved with teachers and others in education, I have known hundreds of kids, and the number that genuinely fall into what is now called the autism spectrum really can be no more than a large handful, maybe a dozen at most. It simply is not 1 in 50. The same can be said for most of the other diagnoses du jour. They are quite justified in some instance, but just too popular for their own good. 

Yup. We actually had candy cigarettes in 1960.
And we're still alive. I preferred non-filtered camels. 
It's all indicative, I think, of the insistence we have on making sure we, and everybody we know, is part of some diagnostic class.  For every person who is has some real, genuine digestive disease caused by a wheat gluten allergy, for example, there are millions of people who claim it because it makes them feel special or lets them justify the attention of a medical specialist.  When Geezers were kids, we ate nearly 110 pounds per year real, natural sugar and didn't seem to come apart at the seams.  Today, though, “enlightened” parents are convinced that their fragile kids will explode if a teaspoon of good old fashioned cane sugar enters their system. They are "fructose sensitive." 

The list of over-diagnosed conditions is almost endless. What is "inflammation" and why is it the modern plague? Why is pretty much everybody today susceptible to a life-threatening allergy?  The other day, I heard somebody who sprouted a small rash after hiking in poison ivy down in North Carolina, confide with a prideful whisper that he had been diagnosed by an allergist specialist as suffering from "contact dermatitis."  Look it up. This means you itch after touching something. 

A fellow publishing professional involved in popular health books told me that the next big epidemic will be the discovery that more than half of us suffer from some sort of blood fungus. And shingles is a virtual time-bomb waiting to explode in society: if you don't already have a full-blown case, you almost certainly are in the early festering stages of it; you simply don't know it. 

This could have been me at age 6. I was called "feisty," not "sociopathic." 
This trend is especially fierce among parents of younger children these days, who seem quite desperate to place a diagnostic label on their kids. I've sat at tables during social events and heard every parent of a school age kid proudly give the diagnosis of their child. Among the favorites: a plain old fashioned rebellious teenager has “Oppositional Defiant Disorder.” Not a good old-fashioned normal kid among them.

(One of my Geezer friends notes that this type of parental obsession and sensitivity has increased in direct proportion to parents’ desire to appear engaged, when in fact they are really NOT as engaged as generations before. It makes us feel like we’re doing our jobs if we have some professional ascribe a medical label to our kids.)

This has, of course been brewing since back in the day when Mrs. Mercurious and I were raising the Brats. What following is a paraphrase we had with one of my daughter's teachers when She-Brat was about seven years old.  My memory for the precise words is inaccurate, but the gist of the conversation is something like this. 

Teacher:  "Mr. and Mrs. Mercurious, thanks for coming in today for She-Brat's conference. She is.....an unusual child…A handful. "

Mrs. M (sighing):  "Don't we know it."

My kinda kid. 
Teacher:  "I must tell you, her teaching team has discussed her at length, and we see all the classic signs...."

Mr.s M: (slightly worried): "Signs...."?

Teacher (carefully):  "Yes.  Constant curiosity about just about everything....Questioning authority....catching you in every contradiction.....Unending questions…...the insistence to know where your facts come from.....always asking 'what if'…....choosing to read rather than listen to her teachers...."

Me (skeptical) :  "Yes, what are you suggesting?"

Teacher (with authority):  "Well, Mr. and Mrs. Mercurious, we've concluded that all the classic symptoms are there. She-Brat is quite clearly a Spirited Child."

The fact that this was a formal noun, designated with capital letters, was clear from the teacher's tone.

Me (incredulous):  "Say what?"

The teacher proceeded, with a completely straight face, to describe "Spirited Child" as a well studied syndrome, with clear symptoms, a course of recommended behavioral modification and, if we chose, the possibility of chemical treatment aimed at making She-Brat more like "normal" kids. There was a whole body of published work on the subject matter. "Spirited Child" appeared to be an actual diagnosis, and, unbelievably, a condition thought to require correction. 

Me (venomously) :  "Fuck off. We're outa here."

Mrs M (with equal poison):  "Me too. What he said."

My conclusion here is from the Geezer playbook:  While there are certainly kids who have special needs that need to be recognized and addressed, there's also good merit to recognizing that diversity is normal, expected, and desireable; and that we don't need to find a label for each and every human condition. And treat yourself with the same respect owed the kids. It's okay to have an itchy nose and watery eyes in the spring without defining yourself as "elm-pollen-sensitive." And rather than claiming lactose intolerance, you might just say that “milk makes me fart so I don’t drink it.”

Diagnose your kids, and yourself, only when your happiness and quality and live genuinely depend on it.

(By the way, She-Brat grew into a fine young woman who now works in education herself. When she comes across a spirited child, she gives them an extra cookie.)