5.16.2009

The Incredible Rightness of Being Delusional

The power of delusional thinking was first made apparent to me in the summer of my junior year of medical school.

I was assigned to the acute care lock down ward of the county hospital for my psych rotation. The best way to describe the place is that it was where they emptied the nets. I had no idea the circumstances in which some of my fellow human beings would find themselves. Every time I see homeless people talking to themselves or a report on cutting mental health services, I remember that place and the people it admitted. But that's not the point of this little memory exercise.

One day I was walking around the common room when an attendant, who was playing checkers with one of the patients, said, "Why don't you ask the doc about it?" The first part of this patient's delusion was that I was a doc instead of a white coat garbed figure randomly moving about like one of those old electric football players that ends up stuck against the side, vibrating in place. But I sat down anyway and he decided he could tell me his theory.

The patient was a huge lad afflicted with schizophrenia and in that medical transition period between violent paranoia and drug induced sluggishness that was his most functional state. He was in that happy delusional land in the middle. You know, the place where many of us spend the lion's share of our lives.

He rolled up his considerable pants leg and asked me to feel a bone, the tibia, of his right leg. The attendant looked nonplussed so after a bit I cautiously palpated his anterior tibia. It took only a moment and my professional assessment and response was, "ok?"

He said, "So do you see?" (Fortunately this took place outside of a Thomas Harris novel.)

"Seeeee what exactly?"

"The bone. It's flat. Bones are round. My bones are flat. So my bones are made of metal."

Not much more logically challenged than the Discovery Institute was he.

Being a newbie I found it necessary to challenge his clearly delusional assertion. After all, it shouldn't be that hard to convince him of such an obvious error in reasoning. (The power of logic compels thee! The power of logic compels thee!) I explained the relevant anatomy to him - that the tibia is actually almost triangular in shape at that level and that he was merely feeling one surface of it. But none of it could wash that knowing smile from his face. So I decided that only one thing could convince him.

I rolled up my own pants leg and asked him to feel my tibia so that he would see the error in his thinking. (Many no doubt can see where this is heading...)

He did so. Then with an incredulous look on his face, he bellowed. "You've got metal bones too!"

That was the last time I ever tried to talk someone out of their delusion. Drugs as it turns out are far more effective than logic. I bring this up because neurochemical studies of brain function suggest that the difference between the kind of paranoid delusional state that my young friend experienced vs the dogmatic acceptance of mystical truths may be rather more a matter of degree than we might wish.

That's why Pliny avoids most of the intellectual arguments that go on around this great land of ours. Instead I have been quietly amassing a vast underground storehouse of Thorazine and Navane. When I have enough, a network of strategically placed crop dusters will spray key segments of the population with it in aerosolized form ushering in a new era of logical discourse...

(PS; for the NSA algorithms - that last bit is just a bit of satire...)

6 comments:

pboyfloyd said...

Still, it might have worked!

Stacy S. said...

Please do the crop dusting in FL first please! :-)

Michael Lockridge said...

So, uh, who gets to decide just where we all should be in the range of delusional states?

Will there be tests? Something hidden in tabloid papers, perhaps, ala Men In Black? Or just monitoring averaged levels through detectors in the sewer?

Perhaps you might consider my plans for inmate management for your larger scale program. Heavy sedatives and mild hallucinogenics for everyone. That, and Cartoon Network.

Hey, wait a minute! How do I know you haven't already implemented your plan? These may not even be MY delusions at all! If that's the case, your plan sucks!

Mike

Asylum Seeker said...

"Heavy sedatives and mild hallucinogenics for everyone. That, and Cartoon Network."

Wow. I am way ahead of the curve in pursuing that treatment plan. Except for the "mild" part.

morsdei said...

Stacy, I think we should both make a sacrifice and allow Texas to be first...

Pliny-the-in-Between said...

Mike, You'll know when my plan is in motion - the Pope will take a vow of poverty... Til then, your delusions are your own business :)