A Dark Night

On July 20th, shortly after midnight, a 44 year old neuroscientist suffered a massive heart attack while driving down the freeway.  His car spun out of control, killing 12 innocent bystanders and wounding scores of others.

This didn’t actually happen (that I know of).  But I hope for the reader to take a moment and reflect on how they reacted to the above paragraph, and compare it to the paragraph below:

On July 20th, shortly after midnight, a 24 year old neuroscientist opened fire in a crowded theater.  Twelve people were killed, and scores of others were injured.

A very different reaction to that news, I would think.  Unfortunately, however, the second event did occur, and many innocent lives were lost as a result.

The reaction to the first paragraph is usually a feeling of remorse, and a reflection on the fragility and randomness of life and death; accompanied by a feeling of sympathy for all the victims (including the driver).  However, feelings about the second paragraph are more often going to be dominated by anger, blame, and sympathies for the victims (exclusive of the shooter).  Therein lies a major key to understanding this human tragedy.

In our society, mental and psychiatric illness is not treated in the same vein (no pun intended),or with the same degree of respect, as physical illness.  Despite countless years of research indicating the physiologic basis for psychiatric disease, the basic feeling remains that somehow the person suffering from the illness, whether it be depression, psychosis, neurosis, or any other manifestation, is to blame to some degree.

Gun control advocates have been quick to blame lax gun laws for the shooting, and they have been anxious to use this shooting to restart a national discussion about gun control.  I don’t disagree with them, or with the premise that our gun control laws are too lax in this country.  Unfortunately, while they are addressing an important issue, they are missing the true root of the problem.  The fact is that this man suffered from a severe psychiatric illness which hijacked his actions.  And the sad fact is that even if guns were illegal, his illness would have demanded of him that he either find a way to obtain them, or use whatever weapons were at his disposal (such as tear gas and explosives–which he did use) to wreak the havoc that he did.

Assuming news reports are correct, the man, James Holmes, considered himself to be the “Joker” from the second Batman film–a character who sees himself charged with a mission to expose society’s ills through the institution of anarchy.  The shooter’s methods, like the Joker’s, were deliberate, highly organized, and intelligent.  I am not a psychiatrist, but these characteristics are highly consistent with psychosis, likely schizophrenia.  It is unclear whether this was ever even diagnosed, much less treated.  In fact, when the suspect’s mother was called, her first words were “you have the right person.”  This intimates that the family was potentially aware of these tendencies, even if they were in denial.

I would contend that Mr. Holmes’ psychiatric disease was allowed to progress to this homicidal conclusion precisely due to our inability as a society to deal with it as a true medical illness.  The taboos associated with psychiatric disease of all variants are so strong and pervasive that patients are often unwilling to seek treatment, families remain in denial, and proper precautions and treatment are not undertaken.  Imagine the reaction among his peer circle or his employers if he told them he was taking medications to control schizophrenia, and compare that to the reaction they would have if he told them he was taking high blood pressure medication.  These social mores are a strong disincentive to seek treatment; and a lack of treatment is what leads so many psychiatric patients to end up at the end stage of their disease–gravely disabled, a danger to themselves, or a danger to others.  The end stage manifestations then reinforce the social taboo, and the vicious cycle continues.

What happened in Colorado is inexcusable, and I am not suggesting a lack of culpability on the part of the shooter by any means.  However, if we are to use this tragedy as a springboard to a social discussion, let’s make sure that we at least have the correct discussion.   I believe that as a society, we should grieve for all the victims of this heinous, preventable strategy, including for the young man whose brain was hijacked by a relentless disease.

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Ramadan Mubarak!

It has been a long time since I posted in this space, life seems once again to have gotten in the way of artistic expression (such as it is).  Now that Ramadan is on the horizon (quite literally), life promises to get only busier, and inspiration less frequent.  Last year, I was asked by my good friend and prominent blogger Aziz Poonawala (of City of Brass fame) to write a little about fasting during Ramadan.  The result was a humble essay which nonetheless summarizes many of my thoughts regarding the fast.  I have reproduced it here for my own readers.

Why do I Fast?

Every year around this time, as I begin preparations for Ramadaan in my personal and professional lives, I am asked that perennial question: “Why do you fast?” I am asked this by colleagus, friends, peers, and even myself. Of course, fasting is only one of the many manifestations of the rituals of Ramadaan, but as the most dramatic, it often attracts the most attention. Having observed the Ramadaan fast for twenty five consecutive years, I have answered this question every year multiple times. Each year, however, I find my answer to be slightly different than the year before, perhaps a testament to my changing attitudes, maturity, and station in life.

Having asked and answered this question many times myself, I have also heard a myriad of different answers. On the one hand, there have been complicated discussions on how the fast serves as a nexus between body and soul, an intensely physical act of the body which is meant to affect the health of the soul. On the other hand, there is the simple “because it says so in the Quran”. There was even once an interesting analysis on the importance of periodic depletion of hepatic glycogen stores. However, none of these answers can encompass all aspects of the fast. Just like every facet of a diamond reflects a different color leading to its brilliance and beauty, so too does every facet of the fast play an important role in understanding its importance.

Over the years of asking and answering the question, certain themes have emerged which serve to illustrate the importance of the fast in terms and ideas which are universal and easily understood regardless of culture, education, or religious affiliation.

A real, true, feeling of accomplishment.

The month of Shaaban (the month before Ramadaan), usually passes in a fog. Ramadaan looms in the near future and is coming forever closer. Thirty days of fasting and prayer, during the Los Angeles summer at that– it seems impossible. When I describe it to my friends, it seems impossible even to me. When I lie in bed at night, it seems impossible. As I make my preparations, it seems impossible. And it may prove to be this year, but I doubt it. After all, I have been doing this for 25 years consecutively and it has not been impossible yet. Somehow, one day at a time, I make it through. When Eid comes, I reflect upon the last month and inevitably wonder how I could have done it–it immediately seems impossible again. A challenge of this magnitude, requiring this degree of discipline and sacrifice, and met consistently by most of the community makes other wordly challenges pale in comparison. What can really seem more difficult than the fasts of Ramadaan? With that feeling on Eid, there is a real confidence that I can accomplish whatever I set my mind to. That my success at a task is only limited by the priority I give it.

The priority I give it.

Those people who can fast easily try to tell me that fasting does not affect their daily lives. That they can go on and do anything they would do if they were not fasting. Some even try to convince me that they can accomplish more, because they feel lighter, or have more time. I hope that’s true for them… But it is surely not true for me. During my Ramadaan fast, I have to constantly make choices. I have a limited amount of energy and strength, and I have to continually evaluate my every action to make sure it is something worth my energy expenditure. Or, is it so important that it is worth missing a fast to accomplish? The fast of Ramadaan forces me to prioritize each and every one of my actions with respect to each other, and with respect to the fast itself.

One of my passions is training in the Martial Arts, a week without a training session and I feel a true sense that I am missing something. And yet, is it more important to me than my faith? On any regular day, riding the endorphin high of a great workout, I might wonder. But Ramadaan crystallizes the answer that was within me all along, as I realize that missing a day of fasting just so I can train is incomprehensible. Most of us in the Western world are faced with a very real decision during Ramadaan about how much time to take off from work/school. And the answer is different for each individual. But within that answer lies each individual’s personal priorities, laid bare for them to reflect upon… and isn’t that one of the major advantages of Ramadaan–reflection?

Reflection.

What is it about the hungry state that makes me more pensive? Perhaps, denied of the energy I normally possess, and forced to budget my strength continuously, I turn inwards. The power of reflection is a potent side effect of the Ramadaan fast, if not one of its main intended effects. With every hunger pang or dry swallow, I am reminded that I am Muslim. Not only that I am Muslim, but that I afford this part of my identity a very high priority in my life, whether I normally realize it or not. It seems that the fast serves to throw one’s internal spiritual landscape into sharp relief, to be examined with painful veracity.

Fasting makes me realize that I believe in a hereafter, in a world view greater than Earthly pleasures. Mankind rules this earth. Uses resources freely, hunts to extinction, and dominates his environment and all living things. That is a simple fact. But who will control such a creature? And how? By reminding him continually that we don’t need all of the resources that we use. We don’t need to eat quite as much as we do, or hunt until there is no more. That the hunger pangs we feel for 1/12th of our lives are felt by others for their whole lives. That the world is not our pleasure palace, to spend our days doing whatever feels good at the time and moving on. This constraint on our basic bodily function, self imposed, reminds us continually that it is not all about the “here” and the “now”. Just as the confidence imbued by Ramadaan carries throughout the year, so too does this basic humility.

What’s the purpose of the fast? Perhaps it is meant to be different for everyone, like a Rorschach ink test for the soul. And perhaps it is meant to change over time, as one’s outlook on their faith and their place in it changes. But what is definitely true is that the Ramadan fast holds the potential for spiritual growth for everyone, regardless of age, culture, or level of education. And it also helps deplete hepatic glycogen stores.