diagnosis via video - why I'm taking it seriously in this particular case. [View all]

[cab67]

We've all seen commentaries, written or video, by psychologists, psychiatrists, and other medical professionals explaining that Old Colostomy's obvious decline is caused either by Alzheimer's disease or frontotemporal dementia. All sort of evidence is lined up - his frequent confabulation, his declining sense of decorum (which was never substantial to begin with), bruising on his hands, his posture, and so on.

It's often said that psychiatric diagnoses based on anything other than direct evaluation of the subject in person are guesswork and shouldn't carry much weight. And for the most part, I agree entirely with that.

In fact, there's an ongoing real-life example of how uninformed diagnoses can cause harm - the Vaccine Adverse Event Reporting System (VAERS). This is a system run by HHS to monitor adverse reactions from vaccines. Or at least, that's the intent. In reality, it's worthless. Reactions can be reported by anyone. This means a lot of them are from parents convinced that a vaccine gave their child autism. But beyond the reports by people without medical training, and the reports that are obviously fake (e.g. there are several reports of penises growing out of people's foreheads following vaccination), the person reporting the reaction need not be someone working with or related to the person with the alleged reaction. It could be a "concerned" neighbor who thinks the kid down the block was harmed by a vaccine. Did this person ever really interact with the child? No, but they saw a change in the child's behavior, and that must have been because of a vaccine.

Some have compared the practice to what happened during the Terri Schiavo case, in which videos of a young woman in a vegetative state were used by politicians and commentators (nearly all on the political right) to argue that she might not be in a deep vegetative state after all, that she might improve, and that her feeding tube shouldn't be removed. The videos had been edited to make it look as though the young woman was interacting with people and objects in ways someone in a permanent vegetative state would not be able to do. It was a disgusting display of partisan misuse of media to promote an agenda.

So I don't have much use for psychiatric diagnoses based on video evidence.

But in the case of the current president, I'm more inclined to take them seriously. Why?

Two reasons - first, it's not just a handful of medical experts speaking up. A lot of them are. And we're not necessarily talking about internists and OB-GYN's - these are people specifically trained in psychiatry or clinical psychology with extensive experience on the subject of dementia.

But the second, which I regard as more important, is the sheer volume of the evidence. With Terri Schiavo, we had a modest amount of video, and it had been cleverly edited. With the Orange One, we have years' worth of video, much of it shot live and not edited, going back to when he first became a public figure in the 1980's. It's not just that we're seeing a plainly obvious decline; we're seeing very specific changes in his behavior, and these symptoms show up repeatedly.

I'm not a psychologist myself. My wife is, and I might have absorbed some knowledge of the subject osmotically from her, and I saw what my mom and uncle went through with my grandfather, but neither of these renders me qualified to make any kind of diagnosis. But when so many experts are converging on one or a few diagnoses based on impartial evidence anyone can see, my willingness to accept the claims grows.

None of the claims made in the media are conclusive. They can't be - these people have never examined the president in person, nor have they given any of the tests used to generate a diagnosis. (They might have been done and not released to the public; if so, that would be a Watergate- or Iran-Contra-level scandal.) But they're not on par with someone down the street thinking I must have been compromised by a vaccine because was once seen tripping on my front lawn.

My thoughts, anyway.