Thursday, May 12, 2011

PTSD and the Homeless: Shell-Shocked on Your Streets

You're working your way through your many patients one day, and this is what you encounter:

  • A woman who won't meet your gaze when you ask her questions.
  • A man who rocks on the end of the exam table, arms crossed over his chest, eyes unfocused, even as he denies hearing voices.
  • Another woman who says she's not using heroin, but whose drifting gaze makes you want to snap your fingers in front of her face to get her to focus.

Nearby, you hear another provider leaving an exam room in disgust, saying, "What can you do if they just won't listen? I can't care more about their problem than the patient does, now can I?"

It's just another typical day on an urgent care shift at a homeless clinic. All of the patients described here are showing tangible symptoms of complex PTSD.

homeless, doc gurley, reporting on health, health journalism, PTSDMany of us know a bit about post-traumatic stress disorder, or PTSD, a constellation of symptoms that can arise after a severe trauma, like a car crash, a fire, or a rape. But few of us - not even medical providers who see it day in and day out - know very much about complex PTSD, or disorders of extreme stress, not otherwise specified (DESNOS).In older, quainter-seeming times, it was sometimes called shellshock.

I saw it in Haiti, where friends brought a woman to the aid tent and told me, in horror, that she wouldn't drink water. When I gently pointed out that refusing to drink water would inevitably kill her, the woman would only nod, eyes averted, arms crossed. She could not have been more distant, more dulled, more, well, bored seeming.


Disclaimer: Identifiable patients mentioned in this post were not served by R. Jan Gurley in her capacity as a physician at the San Francisco Department of Public Health, nor were they encountered through her position there. The views and opinions expressed by R. Jan Gurley are her own and do not necessarily reflect the official policies of the City and County of San Francisco; nor does mention of the San Francisco Department of Public Health imply its endorsement.

Jay Mariotti - Former ESPN Personality Charged With 3 Felony Counts

Jay Mariotti and Girlfriend (?) (
Jay Mariotti, the once-on-the-rise and now former ESPN Personality, who first gained fame as a biting sports columnist for the Chicago Sun-Times and then on AOL Fanhouse, is in hot water again, and just less than a year after his headline-making arrest on suspicion of domestic abuse.

It was after an altercation with a woman described then as his girlfriend that started with an argument at a club in Santa Monica, California and then ended with Jay's reportedly violent confrontation at her Venice Beach apartment.

Eventually, Jay Mariotti was charged with seven misdemeanor counts, but the four domestic-violence-related counts and charges of grand theft and false imprisonment were dismissed.

This time, Jay reportedly had some kind of confrontation or encounter with the same woman, and on the same day he was told by the LA court to stay away from her. He was charged with three felony counts on Wednesday.

According to the LA Times, His lawyer Shawn Holley said "These allegations are complete fabrications, made by an accuser who, since October of last year, has doggedly tried to have Mr. Marriotti arrested and charged on numerous past occasions without success."

If you recognize the name, Shawn Holley, she's the same attorney who regularly represents Lindsay Lohan. One thing's for sure, he's got a good chance of getting past this episode with Ms. Holley's help.


What the hell's wrong with Jay Mariotti that he can't take his focus off this ex-girlfriend and on to restarting his career and getting back on ESPN? If the court told him to stay away from her, there are billions of other women on the planet, why not just find them?

If she's "tried to have Mr. Marriotti arrested and charged on numerous past occasions" that should be enough for him to first, stay away from her, and second, carry a camcorder to record those times when she approaches him first, and third, file a restraining order of his own.

That's what he should have done.

And how's former Chicago Sun-Times colleague Roger Ebert responding to this on Twitter?

ebertchicago Roger Ebert
Sportswriter Jay Mariotti, our least favorite former Chicago Sun-Times writer, faces felony charges:
2 hours ago Favorite Retweet Reply

There you go...

GOP Approves Jobs Bill to Deny UI to Jobless Lacking Diploma or GED

GOP Approves Jobs Bill to Deny UI to Jobless Lacking Diploma or GED.

Wednesday, a congressional panel approved a Republican bill that would allow states to divert $31 billion worth of federal money for the long-term unemployed and use it to pay down state debt instead. The bill also would disqualify jobless Americans from receiving unemployment benefits if they lack a high school diploma or a GED. The bill would also set a national minimum standard for work-search requirements for laid off workers who apply for benefits.

The Jobs, Opportunity, Benefits and Services Act (JOBS Act for short), approved by the House Ways and Means Committee, would let states trim or even eliminate extra weeks of benefits, which currently support more 4.1 million laid-off workers. The bill now heads to the full House of Representatives.

What is next? No UI benefits unless you have a college degree? This is just the latest assault on the poor, especially since the GOP seems determined to cut education programs and has already devastated the college grants once available to assist low income Americans seeking a college education.

Isn’t it bad enough that Congress and Obama refuse to lift a finger to help millions of 99ers and other UI exhaustees, struggling daily to survive? Now they fast track a worthless bill to the House floor that adds insult to the injury of virtually killing HR 589 - a bill specifically designed to help the 99ers survive.

If there is $31 billion dollars available for HR 1745 then there is certainly $14 billion of that which has been available to pay for HR 589 all along. Congressional GOPers just prefer to let the 99ers die off and by the apparent lack of resistance on the part of millions of UI exhaustees - the 99ers are letting Washington do exactly that and without much of a fight.

WAKE UP AMERICA! An uneducated, under compensated work force of cheap labor and a fearful, sheepish population of “Have Nots” is just what the Republican agenda seeks to attain. They do not want smart, courageous people among the poor, as that might just mean massive unrest in rebellion and the end to the greedy, self-serving “cash machine” that is now the status quo in Congress. Sitting by and allowing the rich elite to ravage, pillage and plunder the poor even further is the equivalent to condoning such and NOT the American way. You reap what you sow - so be it!

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