Football Protest

The professor who the California students stopped an intercollegiate game in a protest about yesterday and are threatening a hunger strike over...  I read the background in a couple of places and have an impression. When I say this I do truly mean impression. Without interviewing her it is quite provisional.  With an actual person, some new bit(s) of information can emerge that suddenly upends a diagnostic theory. Drug use. Head injury. Catastrophic trauma. But I thought it would be entertaining if I took a stab at it just from the news accounts.

Late onset paranoid schizophrenia, which likely developed in very small increments, beginning 15 or 20 years ago, gradually accelerating. Though it is no longer a recognised category in the DSM-V, old guys like me still believe in it, having seen it with our own eyes, though admittedly rarely. It strikes women far more often than men. She is probably at least 45 years old, as the illness does not even get started until after age 30. If I were to take a roll of the dice, I would guess she was in her mid-50s. It is likely accompanied by hallucinations of smell or taste, believing that she detects gas leaks, or poisoning her food. Another possibility is a medical condition that they are convinced they have, though there is no physical evidence.  I knew one who wore a neck brace even though X-Rays revealed nothing. Lovely and brilliant woman who had been a software engineer. Her other cognitive abilities are probably intact, but she will be increasingly distracted and eventually obsessed by her sense that someone is persecuting her.  It will be threadbare evidence, but her impression will be so strong as to be unassailable. The circle of who is persecuting her may grow, but doesn’t have to. 

That she is a leftist is probably of no importance in the origins of her illness, but it very likely influences her supporters, who seem to be convinced that this is a politically-tinged persecution. 

These women don’t respond very well to antipsychotics alone, but interestingly, improve somewhat if antimanic medications are an adjunct. The delusions do not go away with those, but they are able to get on with their lives and not be obsessed with them. Their social skills remain pretty much intact, so they can be charming, and therefore retain some friends and people who will believe that her delusions must be at least partly real, because they is so convincing. Because of this, they are just heartbreaking to deal with. They seem absolutely impervious to any logic or therapy attempts to get them to look at how weak the evidence is. 

The first one I met was before I even worked at the psych hospital, when I was a hotel clerk fresh out of college. It was a woman in her 50s, who was staying at our motel, and kept detecting smells of gas, leaks, and wanting to be switched from room to room. we eventually found out she had a son in Long Island, who would take her in, and my friend Archie Archambault* and I drove my car and hers down to drop her off and then came back late at night. I met the son only briefly, and he just looked harried and discouraged, saying that he had been putting up with this for the last 10 years. When I went to work at the hospital about 3 years later I mentioned the incident and other staff remembered her, including that she had convinced two of the doctors that her ability to subtly detect gas leaks that others could not was quite real.

I can think of five in almost fifty years and 3000 patients, which likely means there are an equal number I have forgotten. They don't usually get admitted to hospitals as dangerous.

*Local artist who died a few years ago, known for pen-and-ink drawings of local scenes.