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.

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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 (?) (Deadspin.com)
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.

But.

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: http://bit.ly/iZ2QKK
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!


[ If you like what I write please donate so I can keep on fighting for the 99ers! Thank You!]



Wednesday, May 11, 2011

SF Public Defender Jeff Adachi Has Video, Alledges SF Police Misconduct

In a press conference today, San Francisco Public Defender Jeff Adachi showed a series of videos that, his office holds, shows the San Francisco Police Department conducting illegal searches and committing police brutality.

This is the second time in three months the San Francisco Public Defender has stepped forward with video showing SFPD misconduct. The first time resulted in a still-ongoing Federal investigation.

Mr. Adachi's department has provided this blogger with the videos, which were segmented. They are, as this is written, being put into sequential order to run as one video. That video will be ready this afternoon.

Adachi, along with his Chief Attorney, Matt Gonzalez, called for a zero-tolerance policy for police officers who commit perjury in San Francisco.

As to what happened, on December 30th, four San Francisco police officers - Ricardo Guerrero, Peter Richardson, Robert Sanchez, and Sergeant Kevin Healy - entered the residential hotel called The Jefferson Hotel. They were in plain clothes, without badges, and looked like, "thugs" to quote a person at the scene.

There, they illegally (without a warrant) searched the room of 48-year-old Fernando Santana, and in the process, they say, stole his property.

The officers claimed that crack cocaine was in his hands, outstretched, but the video shows Santana's hands in his pockets.

A bystander named "Joe," walked up to see what was going on. As the video shows, officers Ricardo Guerrero and Peter Richardson race to catch the man, after he realized he was going to be beaten up, as he believed. Remember, and he told this blogger, he did not know they were cops.

They caught him,and as the video shows, roughed him up and at one point choked him. They searches him and found nothing. The police report does not go into detail, calling it a brief "detention."

The main problem for the SFPD is explaining why Guerrero walked out of Santana's room with a black duffel bag. The bag was never booked as evidence.

Also, Guerrero found Santana not after "seeing him conducting a narcotics transaction" but after "casing the joint" that is the hotel, going from floor to floor, looking for trouble, armed with a residential master key that allows him to just walk into any room of the building.

This is the latest in a string of incidents where videos show a reality different that what is in the SF police reports.

Stay tuned.

Matt Gonsalez calls for zero tolerance of SFPD police misconduct
Matt Gonsalez calls for zero tolerance of SFPD police misconduct
Jeff Adachi talks new SF Police misconduct video now
Jeff Adachi talks new SF Police misconduct video now
@YouTube must block use of the N-Word in the comments of videos. It is out of hand.

GOP Sits on $31 Billion While Letting 99ers Starve

According to Keep America at Work and World Report today, the GOP is sitting on $31 billion dollars of paid in UI money, while they continue to let the 99ers starve daily.


From the article:

“The stated reason that HR 589 or a Tier 5 unemployment extension could not be introduced on the House floor was that neither could be financed, just another lie in a long stream of lies. Dave Camp, who chairs the House Ways and Means Committee that is refusing to hear any legislation for unemployment extensions, has introduced his own bill, HR 1745 – Jobs, Opportunity, Benefits and Services (JOBS) Act of 2011.


Apparently there is $31 billion sitting in a bank account which is unemployment money we have paid in. Camp wants to take that money and turn it over to the states to use to give more tax cuts to the corporations that downsized our jobs. This is a diversion and misappropriation of public funds.


Camp is being supported by Human Resources Subcommittee Chairman Geoff Davis and Human Resources Subcommittee member Rick Berg. This group wants to steal more public monies to give to the filthy rich in a time when the filthy rich are making gluttonous profits while everyone else is going hungry in the cold.”

So the real question is how much more of this is hurting America willing to take, just sitting back idle or will the struggling millions finally get up and take a stand?


The article goes on to say:

“This country is ripe for revolution. Let’s do it. Let’s run these carpet baggers out of our country and our lives and restore our great Republic under our Constitution which will allow our free enterprise system to work again, and thus allow we the people to prosper again.”


How will things ever change for the better until good decent Americans stand up and say: ENOUGH! and do so out in public in huge massive demonstrations? But it must begin with the courageous few and spread like wildfire.


U-Cubed in a facebook posting today said of the GOP sponsored HR 1745: “The so-called "2011 Jobs Act" gives states permission to divert federal unemployment dollars to pay for things other than unemployment benefits. A better name for this bill would be the NO JOBS ACT..... Did we mention the so-called '2011 Jobs Act' would also deny unemployment benefits to workers who lack a high school diploma or GED?"


The Hill today also had a story on this ridiculous sham of a bill. From that article:

“The legislation, called the JOBS Act, would provide states the leeway to spend unemployment insurance funds on other things, including tax cuts.


Rep. John Larson (Conn.), the chairman of the House Democratic Caucus, said that with unemployment still soaring at 9 percent, the bill represents "an assault" on the millions of Americans who rely on that safety net.


"It doesn't make an awful lot of sense to throw them out in the cold and not have them be able to pay their taxes, buy their food, pay their rent," Larson told reporters in the Capitol. "When we peel away the veneer of what the proposal is — aka 'We're going to reduce the deficit' — really what we find here is an ending of the social compact between the people and their government."


House Minority Whip Steny Hoyer (D-Md.) also took a shot at the proposal:

"They are referring to one of their bills on unemployment — to end benefits for long-term unemployment, taking away the assistance to 4 million people who are going to run out of unemployment benefits — they are calling that the JOBS Act," Hoyer said Tuesday. "I am very interested to see how eliminating unemployment insurance is going to be a jobs bill."

Well I sure am NOT interested in seeing anymore UI exhaustees suffering in the streets. All this bill is doing is wasting precious time that the 99ers and other hungry, homeless Americans do not have. This bill is nothing more than a diversion for the GOP to once again fool the people (who do not actually read what is in the legislation) into believing they are actually doing something - when all they ever really do in Congress is take vacations and not work at all for “We The People” even when in session.


Isn’t that the truth? But what we have all come to expect from the GOP, right? Face it folks, this Congressional session is a wash already and nothing will get done in Congress this year to make conditions better for anyone except America’s wealthy elite. Why is the American public at large so afraid to do something to stop the systematic extermination of the “Have nots”?


If you want to die a slow miserable death due to hunger and homelessness, then just keep doing the same thing: NOTHING! But, if you want to survive - you had better get up from your lethargy and do something, ANYTHING and fast!


[If you like what I write please donate so I can keep on fighting for the 99ers! Thank You!]



Tuesday, May 10, 2011

Recalling an excellent salmon salad at the Capital Grill across Broadway and 1/2 down 50th from Radio City in NYC
Recalling an excellent salmon salad at the Capital Grill across Broadway and 1/2 down 50th from Radio City in NYC

What the NFL and the Homeless Have in Common

doc gurley, health journalism, health reporting, traumatic brain injuryWith a traumatic brain injury, as can happen in the NFL, you feel yourself slipping away. You can't remember things that used to come easily, things like how to find the grocery store - acts and details that live, mocking, at the edges of your thoughts, just outside your grasp.

You know there's something wrong, but you have a sense that it's all your fault. Rage bubbles and pops to the surface, the only emotion that seems to escape the thick stew of depression that dulls your days.

You make lists and lists, trying to get your life under control. But two days later, you stare at pieces of paper, trying to remember what the scribble meant, which thing it is that you were supposed to do next.

Chronic pain is there all the time, and you try to plan and wait and be patient and stick with a process, but then you find yourself sitting, head in hands, unable to remember what's next. All you know is that something's wrong. And the rage squirms and writhes, trying to bubble up again.

The behavioral changes and impaired functioning caused by post-traumatic brain injury aren't poignant science fiction. They're real.

Traumatic brain injury, especially from repeated concussions, has become a pivotal topic in sport, particularly in the National Football League. Watching a game on TV, it used to be easy to scoff at the concept, as you watched players collide a million times and heard the dull thud of plastic against muscle, bone against bone. You've seen players get up and walk it off. How could it be life-damaging? And even if it is, didn't they kind of ask for it?




Background red color represents the proportion of homeless people by supervisory district in San Francisco. Individual dots represent reported assaults to SFPD during three weeks, April to May, 2011.




Read more...


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.

Photo credit: dbking via Flickr

Google I/O More Than Just Updates: Special Samsung Tablet Given

Google I/O is in its second day, of three days of events at San Francisco's Moscone Center, and surrounding Google's interest in bringing together developers to create the "next web."

The agenda consists of some interesting "breakout sessions," like "Best Practices for Accessing Google APIs on Android," "HTML5 Showcase for Web Developers: The Wow and the How," "ClientLogin #FAIL," and one going on now, and on live online "Don’t just build a mobile app. Build a business," by Wayne Pan, a former AdMob engineer, now Front-End Lead for Mobile Display Advertising at Google.

In it, Mr. Pan talks about how to "business on mobile apps so you can quit your day job." In the live stream, he talks about cross-promoting apps, and even how to calculate expected ad revenue from an app. Here's Mr. Pan, live:



The event is one that was not expensive to attend, considering the wealth of information, with prices as low as $150. Plus, attendees got something of expense as swag they couldn't buy: a Limited Edition Samsung Galaxy Tab 10.1. Here's Morodroidlife to show what you and I missed getting:



Google also has these widely-reported news items about the growth of Android in just two and a half years:

100 million activated Android devices
400,000 new Android devices activated every day
200,000 free and paid applications available in Android Market
4.5 billion applications installed from Android Market

Stay tuned for more from Google I/O and a focus on Google Music.

Bay To Breakers - 100th Zazzle Bay To Breakers This Sunday In SF

The 100th running of what is now called The Zazzle Bay To Breakers is this Sunday. And if you're wondering what all the fuss is about, the Bay To Breakers started as something called the Cross-City Race, and to lift San Francisco's spirits in the wake of the 1906 Earthquake.

Now, 100 years later, it's become San Francisco's largest party not connected to a holiday. This year, the event set an online registration record with 50,000 registrants, and the last 20 of them signed up while this blogger was making this video of the office and an interview with Bay to Breakers Director Angela Fang:



On top of the 50,000 officially registered runners, expect another 50,000 people at various spots along the course, and some running or walking it too. And look for the costumed participants, from the Elvis look-alikes to President Obama, and of course folks in just their birthday suits. The Bay To Breakers is never a dull moment.

Bay To Breakers Week Specials

As this is the week of the Bay To Breakers, a number of events are planned for this special series of days leading up to the Zazzle-sponsored run. According to the Bay To Breakers website, the happenings are as follows:


The 2nd Anniversary Bay to Breakers throwdown called "Damn Gina! It's at The Ambassador and features $2 Drink Specials and $125 Bottle Service, with Guest DJ Niros, DJ Fox and Kool Karlo. The Ambassador is at 673 Geary St in San Francisco.


The Beauty Bar has new wave, no wave, and "other oddities." The establishment also has Bay To Breakers drink specials. The Beauty Bar is at 2299 Mission Street in San Francisco.


Club Trigger at 2344 Market Street has Ladies Night.


Mission Mini, at 3168 22nd Street, has a special Bay to Breakers cupcake all week.


El Burrito Express has the ZOMG Cinco Burrito, that comes with chips and salsa, for $5 all week at 1601 Taraval Street.


Transportation To The Bay To Breakers

BART and MUNI announced expanded Sunday service for the Bay to Breakers. BART is opening at 5 AM because Bay to Breakers has an earlier start time of 7 AM, not 8 AM as in years past.

CalTrain will have four express trains, departing at 5 AM. NBC Bay Area explains that "The Special A train will depart the Mountain View Caltrain station at 5:10 a.m. The Special B train will depart San Jose's Diridon station at 5:20 a.m. The Special C train will depart San Jose's Diridon station at 5:25 a.m. The Special D will depart at 5:30 a.m."

Stay tuned for more details.