Get Thee Behind Me, 2022

Sing hallelujah

Dec 31, 2022

Links are at the end, including to examples of today’s writing music.

That’s Arnel Pineda, lead singer for Journey, at a solo concert. He is not singing “Get Out!”

Not Bad As Years Go

At least in the U.S., although not for the 200,000 or so people who died from Covid, or the millions who were otherwise impacted. Thank the music that’s over. Now if we can get Biden to declare the end of poverty and the Fed, we’ll be swinging.

Ray Suarez

Long long time ago, we listened to Ray Suarez on NPR whenever we got the opportunity. Suarez and Click & Clack were the best of the network, and Suarez remains the best-informed guy I ever heard there. His departure from NPR for PBS was a sad day, although probably not for him.

He seemed much more constrained on the teevee; on NPR he had been something of a radical, never hesitant to politely bomb away on corporations and the government, but on PBS he was conventionally liberal when he adopted a point of view at all. Then he vanished from our field of view.

Today we were delighted to run across him again, in a somewhat languid video, part 3 of a series for The Intercept in partnership with the Economic Hardship Reporting Project,1 called “Insecurity,” looking at the travails of people on the edge—in this instance someone trying to get mental health care from Medicaid.2 (Parts 1 & 2 are here.34)

Fortunate though we’ve generally been in this respect, we can attest to the paucity of mental health care available through Medicaid. (It’s not that great with Medicare either.) At one point the psychiatric choices here were limited to a right-libertarian osteopath — our eventual choice — or two despicable twin brothers, one of whom had previously mistreated us during a medication study. All of them came with a waiting list on which openings occurred only when someone dropped off the radar or got arrested or institutionalized. That’s in a town of more than 100,000 souls.

Anyway. Good to see Ray working.

Ketamine in the convenience of your own home

We don’t have the cash money for this — and anyway, our ketamine guy stayed open the whole time after he started administering the FDA-approved, Medicaid-covered version — but evidently lots of people can scrape it together. During the pandemic, what with the risk of office visits and the spike in depression and other mental health distresses, some doctors began prescribing ketamine tablets on the basis of patient evaluations conducted via video.5

Smith estimates that about 5 percent of patients who come to him aren’t good candidates for ketamine therapy, and he declines to treat them. Occasionally, younger patients will ask for a prescription simply because they want to try the drug.
“They think it’s like an internet service,” he said, “like there’s a drive-through window at McDonald’s for ketamine.” Smith only treats patients for a legitimate medical purpose, he said, usually for depression, anxiety or post-traumatic stress disorder.
. . .
Smith knows his practice is controversial but isn’t concerned. “What is the risk versus benefit, is the question society needs to ask,” he said. Rather than returning to pre-pandemic regulations where he would have to consult patients in person, Smith says the key to making ketamine therapy safer is for the DEA to create a registry and closely monitor the drug’s prescribers.

Our own experience with Spravato, the nasal spray containing a ketamine mirror molecule, suggests that administering the drug where practitioners of some level are physically present regardless the version is a good idea. Not that we’ve had issues, but we’ve seen the occasional meltdown in others. If we had no alternative, though, we’d certainly consider Dr. Smith or one of the other practitioners mentioned in the Post story.

In any event the pandemic-driven federal waiver allowing online consulting and prescribing of the drug continues at the pleasure of the DEA. We suspect a pirate equity interest in practices such as Dr. Smith’s — given their already substantial presence in the mental health arena, we’d be surprised if it didn’t exist — and the pirates often enough get what they want from the regulatory regime.

The Briar Patch Beckons

FORMER PRESIDENT DONALD Trump, who threw his nightmarish red cap back into the ring and launched a fourth bid for the White House last month, shared an article on Wednesday that suggested he run as a third-party candidate.
Posting on Truth Social, the social media platform he started after being booted from Twitter, Trump promoted an article from conservative publication American Greatness by writer Dan Gelernter. Staying true to the site’s unofficial role as a Trumpist mouthpiece, Gelernter claimed the “RNC can pretend Trump isn’t loved by the base anymore” and that Trump is still “admired and even loved by those who consider themselves ‘ordinary’ Americans,” particularly those who reside “anywhere outside the Beltway.”

The overall quality of writing in Rolling Stone has taken a nosedive. Maybe it’s just interns this week.6

Battening Down the Hatches

New Year’s Eve in Honolulu is less smoky than in the bad old days when one had to get a high floor in a nice hotel to escape the haze, but people have been setting off massive bomb-like fireworks intermittently since July 4th, and we expect a jarring evening. Keeping the inhaler close to hand just in case.

We wish a very happy New Year to all of our friends and readers. Cheers, and stay safe.

Music to Write By

Ghost Woman, “Ghost Woman;”7 Exploded View, “Obey;”8 New Candys, “Vyvyd;”9 Grace Cummings, “Storm Queen;”10 Los Bitchos, "Let the Festivities Begin!"11 The Rolling Stones, "Let It Bleed."12