The Liberal Arts: Stealing from Peter to Pay Paul (Hum Magazine, April 2013)

“You know, we don’t need a lot more anthropologists in the state. It’s a great degree if people want to get it, but we don’t need them here. I want to spend our dollars giving people science, technology, engineering, math degrees. That’s what our kids need to focus all their time and attention on. Those type of degrees. So when they get out of school, they can get a job.”
 -Florida Governor. Rick Scott  (The Marc Bernier Show, 10/11/2011) 

Since late 2012 to present, Mr. Scott, pursuant to his statement above, has been pushing the Florida legislature to consider freezing state university tuitions for three years in “strategic areas” based upon supply and demand in Florida’s job market. Effectively, this means that the tuition burden for those obtaining degrees in science, technology, engineering and mathematics (STEM) would remain stable while the tuition for those choosing liberal arts degrees (such as anthropology) would climb to fill the financial gap. In other words, under his proposal, a liberal arts degree would be more expensive than a STEM degree.

Despite having pursued a STEM degree myself, I am perplexed by this logic. I knew that by going into medicine I would be well compensated; shouldn’t I have paid more than my liberal arts colleagues and not the other way around? As a psychiatrist-in-training I am confused in other ways: how am I to understand the underpinnings of behavior without the work of anthropologists? How am I to appreciate the depths of human misery without the work of those who have devoted their lives to literature, the stage, and the screen?

I can imagine Mr. Scott’s reply, “I’m not saying the arts aren’t important. But we only need a dozen musicians to fill our iPods, a few artists to deck our walls and a handful of actors to grace our stages. So why are we investing in so many?” The reason is this: art, like science, is not based on a one-to-one ratio. Investing in one artist or scientist does not translate into a piece of work that “legitimizes” the funding. Artists and scientists alike all stand on the shoulders of those who came before. The Beatles did not create Sgt. Pepper’s Lonely Hearts Club Band by themselves. John Lennon and Paul McCartney were informal students of American blues and rock luminaries upon whose work they built their own masterpieces. Similarly, Albert Einstein’s photoelectric law was not a singular creation but rather a work deeply influenced by Max Planck’s quantum theory developed years earlier.

According to Dale Brill, who chairs this task force on academic funding, when it comes to liberal arts majors, “There will always be a need for [liberal arts graduates]. But you better really want to do it, because you may have to pay more” (Sun Sentinel, 10/12/2012). Given the similar nature of artistic and scientific progression, such a proposed funding structure reeks of hypocrisy. If there will “always” be a need for liberal arts graduates, then why are we disincentivizing their education? The answer lies between the lines of Mr. Brill’s policy: while we need the liberal arts they are inherently less valuable than the sciences.

Bizarrely, despite his overt support of producing STEM students, Mr. Scott fails to address what actually happens to STEM majors while in college. According to a study released in October 2011 by the Center on Education and the Workforce at Georgetown University, 60% of STEM students end up leaving the major prior to graduation. This figure begs the question: if these careers are so lucrative and necessary, why are students switching? Elaine Seymour’s and Nancy Hewitt’s Talking About Leaving: Why Undergraduates Leave the Sciences (Westview Press, 1997) established that poor teaching was found to be the most significant factor. The Wisconsin Center for Education Research is currently working on a study entitled Collaborative Research: Talking about Leaving Revisited: Exploring the Contribution of Teaching in Undergraduate Persistence in the Sciences in order to further address the issue. The Wisconsin group posits that a mere 10% reduction in the transfer rate of STEM students would produce three-fourths of the one million STEM graduates that President Obama announced last year as a goal over the course of this decade.

I do not believe that Mr. Scott has a grudge against the liberal arts. I think he, in good faith, is searching for a solution to the problem of our lack of STEM graduates to fill the increase in STEM jobs. He is looking to bolster Florida’s economy and incentivize the pursuit of a college education in an era when tuition has spiraled out of control. However, his approach is at best merely shortsighted and at worst completely unnecessary. While using financial resource allocation to incentivize STEM majors may create more STEM students in the short-run, research suggests that these students may not even graduate with these majors and therefore fail to fill STEM jobs in the long-run. The solution to this problem lies in a reallocation of funding which reaps rewards on a much longer timescale but with a far less headline-capturing strategy: revamping the ways that we educate those students already motivated to pursue STEM majors so that we can bring them to graduation and subsequently into STEM careers. Unfortunately, investments in improvements in teaching style frequently requires a large investment up front with long-term rewards only reaped long after the lawmakers who championed them are out of office.

The Rape of "India's Daughter" by India's Sons (Hum Magazine, March 2013)

“Mother, I want to live.” Unable to speak, 23-year-old Jyoti Singh Pandey wrote these words on a piece of paper in an intensive care unit at Safdarjung Hospital in New Delhi while being treated for injuries resulting from being gang-raped and beaten on a bus. Only 5% of her colon remained in her body when she was brought into the trauma center on December 16th, 2012. She died on December 29th from her multiple blunt injuries and massive gastrointestinal infections.

As a physician I pride myself on being able to tolerate ghastly images. I did not vomit or faint when I saw my first cadaver or bloodied trauma victim. However, just reading the details of Ms. Pandey’s experience nauseates me. In trying to wrap my mind around what happened to her I find myself at a loss. I am reminded of when astronomers explain how much farther Saturn is from Earth than Mars. Both distances are on the order of millions of miles. Though Mars is much closer to Earth, on such a scale my mind is unable to realistically differentiate the distances. Similarly, Ms. Pandey’s experience is many orders of magnitude greater than the darkest experiences of my life and thereby nearly impossible to fully appreciate.

She has been dubbed “India’s Daughter.” As such I like to think that she is collectively Our Daughter. In order to honor the memory of Our Daughter, we need to effect change. Although I am heartened by the demonstrations and hope her story will help lead to a reduction in the incidence of sexual assault in India, I do not want the details of her lived experience to be lost in the sociopolitical shuffle. The words “gang-rape” and “beating” do not capture the hell this woman experienced. To ensure that our enthusiasm for change does not waver with governmental distractions and changes in the news cycle, we need to put ourselves into her shoes on that horrible night and tattoo her experience into our memories. Let’s not allow safe journalistic language to obfuscate the depths of devastation this woman endured.

In service of harnessing our collective vitriol, I would like to engage you, dear reader, in a thought experiment. Since her suffering was on a nearly inconceivable level, we need to psychologically layer the multiple transgressions she experienced upon ourselves to fully appreciate it. For example, I begin by imagining my clothes being removed forcibly on a city bus. If the transgression stopped there I would go home sobbing and eternally humiliated. I would likely never ride a bus again. Then I add another layer: in addition to being forcibly stripped, someone touches my genitals. This is beyond humiliation; I have been physically violated. Then I add a multiplier: violation by not one person but by five. Already I am approaching a level of terror of which I struggle to conceive. Up to this point, legally speaking, I have been “molested.”

Then I move into a plane of terror that thoroughly exceeds my ability to fully appreciate. I imagine that those men take turns penetrating me. Without condoms. For nearly an hour. Thoughts about deadly infectious diseases like hepatitis or AIDS fly through my mind. Next someone is beating my head with a luggage rod. In my semi-conscious state I realize that someone has pushed that same rod into my anus, past my rectum, stopping at my transverse colon (roughly 2 feet into my body). Then an incomprehensible sensation occurs wherein the rod is removed, pulling my colon out with it, pulsing and bleeding onto the bus floor whereupon millions of bacteria leap onto my entrails. I haven’t been merely exposed. I haven’t been merely violated. I have literally been turned inside out. On a city bus.

This is exactly what happened to Our Daughter.

Lets not distance ourselves from the perpetrators no matter how comforting such separation might feel in this moment. As Ms. Pandey has been called “India’s Daughter,” let’s remember that her assailants are also “India’s Sons.” This moniker is neither a point of pride nor an insult. If we are to truly appreciate the magnitude of this issue we have to recognize that our sons have a problem. Sadly, instead of addressing the problem with our sons, some Indian state governments have foisted greater limitations on our daughters. In some states, women are further limited in how they dress or how late they may stay out at night as a result of Ms. Pandey’s rape and subsequent death. Such statutes only serve to reinforce a patriarchal system in which the sexuality of women is considered a liability and thereby covered over in order to curtail male sexual violence.

Instead of more rules that simply sweep sex under the rug, we need to pull the rug off completely to show our sons what sex is and what sex is not. Sex is about love. Sex is about passion. While sex is powerful, it is not to be used as power over another person. Least of all, sex is not a weapon. When our daughters show their skin, they are not inviting harassment or assault. They are allowing themselves to feel pride in their own bodies. Our sons must recognize that the mothers, sisters, and grandmothers they love so dearly were once the young women currently being catcalled, molested and raped.

If our goal is to raise men as opposed to overgrown boys, we must show our sons that manhood does not occur when the clock strikes midnight on their eighteenth birthday. A boy becomes a man slowly over time, through demonstrations of respect and restraint. A man is secure in his masculinity such that he does not need to molest or rape a woman to feel sexually vital. Furthermore, a man does not need to participate in gangs or think with a mob-mentality; he thinks and acts for himself. So secure is he in his sense of right and wrong that he is willing to intervene in a mob, even if it causes him to lose face. If there was a single man in that group of boys that took Our Daughter’s life, the event would have been over before it began. If these expectations of our sons seem daunting lets remember the details of the evening Our Daughter spent on that bus. Let’s put ourselves into her horrifying position. Let’s remember that in the aftermath of her experience she voiced one basic wish: she wanted to live. We owe Our Daughters so much more.

Why (Most) Diet and Exercise Regimens Fail (Hum Magazine, January 2013)

Every January, Americans nationwide start the year off with a new diet and exercise regimen. I am confident that almost all of these will fail. I am loath to bet against the underdog, as I have found myself in that very position multiple times in my life,  but with this one I can’t help myself. This approach to change is simply fundamentally flawed because it does not acknowledge that being overweight is an addiction. Like so many other addictions, being overweight is merely the tip of the iceberg below which myriad other addictions reside. Not only are we addicted to the transient hyperglycemia/caffeine high from our high-sugar cereals and coffees, we are addicted to the speed with which our cars take us to our parking spots as this allows us to sleep in just a bit longer. We are addicted to the convenience of the elevator that whisks us to our comfortable desk where we will work our sedentary jobs that keep us at a comfortable heart rate. We are addicted to the productivity we feel as we motionlessly work while eating our lunches at these desks and eventually reverse the entire trip home all the while jonesing for the largest meal of the day, the calories from which will transform directly into fat as we slip into sleep. Then the cycle begins again.

With all of these micro-addictions, it makes sense that wholesale change is Herculean at best and Sisyphean at worst. I don’t blame people for failing; the entire enterprise is destined for failure. I don’t mean to say that change is impossible but I think the only way to approach the kind of change most people seem to want (lower BMI, definition of skeletal musculature, higher exercise tolerance, lower daytime fatigue, improved mood, etc.) is to assess every change you are considering instituting as something you will do for the rest of your life. For example, ask yourself, “Will I wake up every day for the rest of my life and run thirty minutes before work?” or “Is it realistic for me to never eat sugar again?” The answer is most likely no.

Nothing frustrates me more than to see new diet programs advertised on television. These programs propose a precisely opposite approach to what has been proven to help people overcome addiction. We don’t need more options. We need better ways to utilize the ones we already have. I think we should approach our addiction to food and our sedentary lifestyles via the Alcoholics Anonymous model for change. Alcoholics Anonymous has been demonstrated to work in the long term. In the market of ways to curb alcoholism this program has the largest body of evidence for success.

In AA, successful members of the program acknowledge first that they are powerless to alcohol. I love the seriousness of that word: powerless. I have never heard a dieter say that they are powerless to food. But its true. The truly amazing part of AA is despite the rigor with which they have achieved their long-lasting effects, even the most stalwart participants have relapsed twenty and thirty years after sobriety. This is how devastating addiction really is. I also love that alcoholics consider themselves alcoholics for life as a way to internalize the disease and remain constantly vigilant. To approach such a difficult change with any less intensity is like trying to fight a lion with an overcooked noodle. You might as well put an apple in your maw and lie down on a plate.

So what the hell are we supposed to do? I have an idea. If being overweight is a multifaceted addiction, why not approach each part individually as opposed to some kind of all encompassing diet/exercise regimen. I would employ a multistep method akin to AA. The first step could simply be taking the stairs to your office every single day for a few months. That’s it. Eat anything you want day-in and day-out but you no longer use elevators. You don’t even remember what that box with sliding doors and buttons does. I know that sounds incredibly slow on the scale of weight loss progress but I guarantee you many would fail. I don’t say that to be harsh; the odds are stacked against people as its not easy to even find the stairs in many buildings. Also, you’re busy. You are expected to be somewhere quickly all the time. I think if you can do that for a couple months you’re ready for the park-your-car-far-away-from-the-office-and-walking routine. That’s not easy either. You’re going to need a good parka because you will be the only one who parks in the last space and walks through a torrential storm while coworkers silently consider the state of your mental health. Now, here comes the real challenge. Now you have to take the stairs every day AND walk from the furthest parking lot spot. And remember: this is for the rest of your life. Let’s do just that for another few months. Notice that we have not even touched the issue of diet. No gym memberships purchased. No spandex worn. Indeed no money has changed hands and yet you have done an incredible amount of change: you now leap up stairs to meetings, powerwalk in the parking lot daily, and have replaced that once savory morning sleep time by going to sleep earlier. Forever.

Of course, it stands to reason that at some point in the future when a large number of obesity promoting habits have been stably changed that you could start using the elevator or the closer parking spot. However, at that point you’ll likely be making up for those easy yet inconvenient tasks with replacements that are far more rigorous and in a much more compressed time frame such that you might miss the days of a simple walk up the stairs.

Eventually, if one is successful at stacking these tasks I imagine one could tack on a diet change here or there. But just like the stairs and parking lot scenario, this would have to be relatively small and repeated for a rather long time before larger changes are instituted. If all of this seems exhausting, then you’re accurately appreciating how incredibly difficult it is to treat an addiction. You need to physically change your brain on a neuron-to-neuron basis. Considering there are billions of neurons in the cerebral cortex alone, this is no simple task.

I think the problem with most people’s wish to diet is our underlying desire is not to actually change the way we look but rather to be someone else entirely. We see a picture on a magazine cover or in a film and secretly covet not only the way that person looks but the glamour of their very existence. Being ourselves with an improved physique is nice but far from glamorous. Consider that rarest-of-rare person who is hard-headed enough to start January 1st running thirty minutes daily, consistently eating low-fat, low-carbohydrate, high-protein foods, sleeping eight hours nightly, and drinking copious amounts of water and actually keep it up for, say, six months. The pounds will no doubt come off but that person is the same person with the same hang-ups that made him overweight in the first place. Relapse is almost inevitable. The problem is that no real neuronal change has been effected as this blitzkrieg of reform was enacted out of the excitement of turning over a new leaf rather than a reasoned decision to completely change one’s life forever. The discipline that comes out of slow and steady piecemeal segmental modification represents actual character change for which I can’t think of any substitution. That level of discipline likely feels superior to any level of glamour and probably leads to a greater likelihood of overcoming the addiction in the long-term. If this seems overwhelming and impossible, consider what they say in AA: you have to take it one day at a time.

Let's put gender on a continuum (Hum Magazine, December 2012)

I don’t understand the fervor of gender identification and the subsequent lifelong segregation we impose upon children. Gender is a mantle placed on fetuses in utero by way of the pink coloring of a genetically female infant’s room to the blue balloons hanging from a mailbox in anticipation of a genetically male infant. So what if it’s a boy? So what if it’s a girl? Why are these facts so important?

As a scrawny boy in elementary school I envied girls mainly because their games usually didn’t require physical prowess. Mostly, their games appeared to revolve around fantasy, e.g., MASH MASH is an acronym for Mansion Apartment Shack House. This paper-and-pencil game is based somewhat on a combination of chance and arbitrary questions (the specifics of which I now forget). Regardless, by the end of the game one’s future abode was determined. Perhaps my jealousy was misplaced as I later learned that such games had a dark subtext of catty abuse. At the time, however, I would loved to have taken part, avoided being terrible at kickball, and had the chance to actually speak to people. Boys, in my opinion, didn’t do enough talking. They were all action, sweat and violence with the occasional merciless taunting.

I think my frustration with hard-and-fast “boy” and “girl” activities stems from growing up in a home in which strict gender identification was not pushed. I don’t mean to suggest that I was not raised as a male but rather that my parents allowed me to play as I liked. I gravitated towards “boy” games, no doubt secondary to the influence of television and school, but I don’t recall my father or mother saying, “that’s a girl’s game” and steering me away. Just as importantly, sexual preference was never pushed. I have always dated girls but I wonder what would have happened if I brought a boy home. We never ran into that situation but I think my parents would be accepting of my choices as they always have.

So what am I like now? I think that I embody a lot of what people consider feminine attributes. I speak with a feminine lilt unless I’m around a bunch of men who don’t know me well and then I feel compelled to give off a more “masculine” air. I’m averse to violence. I don’t like watching or playing sports. I like things that are delicate and small. I am a good listener and I love stories. My perception of romance, from what I learned in school and on TV, was restricted to the tall-dark-and-handsome-take-charge attitude expected of boys and the damsel-in-distress-waiting-to-be-swept-away attitude expected of girls. The type of romance that actually appeals to me is the intertwining of two people who share elements of both of these types; some days I want to be the one who sweeps away and sometimes I want to be the one who is swept.

I chose to address this topic because I think that if we all took a moment to examine the proportions of masculinity and femininity within us then perhaps certain groups, particularly people who are transgendered, might seem more like points on the same continuum of strictly “boys” and strictly “girls” rather than aberrations that don’t have a place in society. Transgender is a term under intense dispute and as I don’t purport to be an expert on sexuality I hope people more knowledgeable than I will make some comments on the subject. My basic understanding of the term transgender is that it is an umbrella word for those who fundamentally disagree with the gender dictated to them by virtue of being born genotypically male or female (XY or XX) or phenotypically male or female (possessing a penis or a vagina).

I feel we are making a mistake to so fervently place our children into one category or another. Perhaps we do this to side-step the life stressors currently experienced by those who consider themselves transgendered. While I think we can teach our kids to be more tolerant than that, I can’t condemn anyone who wants to protect their children from the pain related to crises of identity.

Perhaps the best way we can instill comfort with regards to gender identification for our children is to start them early with the idea that perhaps gender is an issue of proportion rather than two slots. Maybe in every man there is a proportion of femininity and vice versa. We could describe it like eye color. Some people have blue eyes, some have blue-green eyes, some have green eyes, etc. Of note, I purposely do not address sexuality (homosexuality, heterosexuality, pansexuality, etc.) because as I understand it, sexual preference operates independently of the gender with which someone identifies.

In college I took a class on gender and sexuality in which we read about the Incans placing transsexual people in positions of reverence. Anthropologists hypothesize that the reason behind this placement was that if one person could cross boundaries of sexual identity with ease then perhaps he/she had an uncommon insight into the human condition from which others could learn. I am fascinated by this situation for two reasons, 1) gender identification is hardly a new issue and 2) perhaps American society has it all wrong; maybe we are marginalizing the very people who carry unusual insight into personhood.

I realize I am hardly the first person to propose a proportional view of gender or gender as being on a continuum. My point is that if we elect to accept these hypotheses, we have a lot to gain with respect to the treatment of people who are transgendered. They may seem less different than those who fit into the strictly “boy” and “girl” categories thereby receiving the treatment and respect they deserve. As a result, I think American society would collectively take a large step forward in terms of tolerance and understanding.

Bullying: What are we doing right? What are we doing wrong? (Hum Magazine, October 2012)

Once all of us sixth-graders piled into the gym the rules were simple: find the nametag of your eighth-grade “big brother/big sister” for the year. As one would imagine, it was sheer pandemonium. “Who would I get?” “Who did you get?” We scurried across the squeaky floor searching for our nametags with the name of our corresponding eighth-grader who would steward us through the choppy waters of early junior high. Simultaneously, our “big siblings” were on the lookout for the nametags of their mentees to whom they would impart their fourteen years of wisdom. Within minutes I saw hugs and pats on the back. I saw broad smiles and bright faces.

And then it happened.

After he pulled me by the shoulder, whipped me around and literally punched my nametag onto my chest, I thought I would vomit. The next few months were hell. Unbeknownst to the school administration, this was not a mentorship; this was a pairing of the nastiest bully with the feeblest kid. I started to take the far stairs to get to science class. Even then I couldn’t hide. I was constantly paranoid. Empty hallways felt like long, dark alleys. My routes to class became so circuitous that I started arriving chronically late. Even then he would find me. My “big brother” cannily chose to punch me in the arm so my bruises would not reveal the abuse. I would take my tardy slip without a word and then settle into my desk still shaking. He told me he had come by my house and knew which window faced into my bedroom. I’d never been so terrified in my whole life. I was too scared to tell my parents. I was too embarrassed to tell my friends. I felt paralyzed.

That was 1992. Exactly twenty-years ago. However, back then, when I went home from school I felt safe. I didn’t have a cell phone to receive harassing text messages. As these were the days before Facebook, I didn’t have any nasty posts waiting for me. In this era of incredible connectivity among young people there is seemingly no respite from such harassment. This all-encompassing psychic pounding of vulnerable young people has accompanied a frightening uptick in suicides in the context of bullying. During the last school year, “John,” a 7-year-old student in Miami, Fla. was bullied and sexually assaulted by an older classmate to the point that he attempted suicide once by deliberately standing in traffic with his eyes closed and another time by sticking a metal hanger into an electrical socket. Rachel Ehmke, a 13-year-old seventh grader in Mantorville, Minn., died April 29, 2012 after hanging herself at her home after receiving merciless texts and reading school graffiti calling her a “slut.” Perhaps most famously, on the evening of September 22, 2011, Rutgers University student Tyler Clementi posted from his cell phone on Facebook, “Jumping off the gw bridge sorry” after which he jumped to his death from the George Washington Bridge. Clementi’s death followed soon after his roommate secretly recorded and streamed online video of Clementi being intimate with a male partner in his dorm room. Seemingly no age group is spared. These are our elementary school students. These are our high school students. These are our college students. As a parent of a toddler, I find myself asking, “What would I do for my daughter in this situation?” Even worse, since I cannot predict how bullying will evolve, I feel woefully unprepared to protect her. I feel paralyzed in a similar way to when I was bullied myself.

Perhaps the most surprising element of this worsening and evolving trend is that the advice we as adults give our children does not seem to be working. Stan Davis, LCSW and Charlisse Nixon, PhD conducted the Youth Voice Project, a research project surveying 13,000 students’ perceptions in grades 5-12, from 31 schools in 12 states of strategy effectiveness to reduce bullying in schools (http://www.youthvoiceproject.com/). Sadly, some of the most commonly recommended strategies by adults (i.e., telling the person to stop, telling the person how I feel, walking away, and pretending it doesn’t bother me) produced markedly worsening of bullying. Furthermore, worsening of bullying was reported when school staff gave reprimands rather than strategies, i.e. saying if they had acted differently they would not have been mistreated, telling them to solve the problem themselves, or silencing youth by telling them not to tattle.

So if our traditional ways of advising our children are ineffective, what seems to work? Davis and Nixon’s research suggests that telling an adult at home, telling a friend, and telling an adult at school seem to make things better more often than make them worse. Overall it seems that the age-old recommendation to  “take matters into your own hands” is not only ineffective but frequently contributes to worsening the issue rather than improving it. Instead, approaching the issue by making others aware (peers and adults) seems to have an appreciable effect in reducing abuse.

Even though there weren’t such well-developed studies when I was in the sixth-grade, I coincidentally ended up doing one of the recommendations from the Youth Voice Project. After a few months, I simply could not tolerate the physical and psychological toll. I gingerly walked into my Principal’s office and tried to explain the situation calmly and rationally but couldn’t help but to burst into tears mid-sentence. I didn’t know how devastated I really was until I saw her reaction to my runny face. I frequently think about her consolation and how she completely understood the fear and misery of daily bullying. I’m not sure exactly what happened but I was never harassed again by this particular boy. To that particular Principal (you know who you are) thank you so much. As we start this new school year, I am reminded that in a world where bullying has become more vicious, pervasive, and lethal, we as mental health providers need to further examine this difficult subject and our students need more educators like my Principal.

Oak Creek Massacre: Trying to Understand Hate Crime (Hum Magazine, September 2012)

The Federal Bureau of Investigation defines hate crime (also known as bias crime) as “a criminal offense committed against a person, property, or society that is motivated, in whole or in part, by the offender’s bias against a race, religion, disability, sexual orientation, or ethnicity/national origin.” While we will never know the motivation behind Wade Michael Page’s rampage at a gurdwara in Oak Creek, Wisc. last month, through his affiliation with white supremacist organizations and claims by his friends that he talked about an impending “racial holy war” it stands to reason that his offense was motivated by hate.

As a mental health provider I am curious about what motivates people to commit such atrocities. I find the word “hate” to be too generalizing to precisely identify the motivations for these crimes. Fortunately, some social justice literature has been generated on this topic to help parse this word out. In a 2002 study, McDevitt et al. suggested that hate crime offenders can be grouped by four motivations: thrill seekers (66%), offenders who view themselves as defending their turf (25%), those responding to a real or perceived hate crime (8%) and a small group of offenders whose life’s mission is to rid the world of groups they consider evil or inferior (1%). Their investigation using data from the Boston Police Department suggests that the most common type of hate crime was one where an attack was committed for the thrill or excitement experienced by the offender. According to McDevitt et al., “In 91 percent of these thrill-motivated cases, the perpetrators reported having left their own neighborhood to search for a victim in a gay bar, a temple in another part of town, or a minority neighborhood. The target was chosen because the offender perceived that the victim was in some way significantly different from the offender.”

The issue of “difference” plays prominently in the Wisconsin murders. If Page had attacked worshipers at a mosque, a link to the events of September 11th, 2001 might have been more comprehensible, although no less tolerable. Instead, he elected to attack non-Muslim Indian-Americans on a seemingly random day. This appears to be less likely an act of retribution against a certain group but rather against people who simply fit an perceived image of terrorism. While it may be appealing to explain the motivation for these crimes as a case of mistaken identity, in a recent piece for The Washington Post, Valarie Kaur and Simran Jeet Singh lucidly explain the pitfalls of such a hypothesis: “The notion of ‘mistaken identity’ is not just wrong, it’s dangerous. In the initial aftermath of 9/11, Sikhs told the media, ‘Sikhs are not Muslims.’ Our community quickly realized its mistake, and made a commitment to express solidarity with Muslims. Although we are distinct religious communities, we have shared in the experience of hate violence, religious bigotry, and racial profiling.”

While the issue of difference motivating Page frightens me very much, I find myself even more afraid of the “thrill-seeking” element of hate crimes as noted in the research by McDevitt et al. While psychiatric interventions would have likely been employed with Mr. Page had he survived, I see this as a second-best solution by virtue of it being after the event. Fundamentally, we as Americans must confront the fact that so many find a “thrill” in violence against a nameless, shapeless “other.” As a clinician I feel at a loss as to what effective measures can be taken. Certainly issues of bias begin early in life suggesting the value of an education that emphasizes tolerance. Also, a heavier emphasis on psychiatric evaluation in routine medical care could help to identify and help those at risk for such thrill-seeking violent behavior. Further research in this area, particularly in light of recent events, is merited. Until a clearer management strategy is developed, the best we can do is to support those who have been psychologically traumatized by these incidents and mourn those who we have lost.

Sources:

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Kaur, V. and Singh, S.J. (2012, August 10). Two Sikh Americans: Let’s retire ‘mistaken identity.’ The Washington Post. Retrieved from http://www.washingtonpost.com/blogs/guest-voices/post/two-sikh-american-activists-lets-retire-mistaken-identity/2012/08/10/776ab9d8-e329-11e1-a25e-15067bb31849_blog.html

McDevitt, J., Levin, J., and Bennett, S. (2002). "Hate Crime Offenders: An Expanded Typology (abstract)." Journal of Social Issues 58(2): 303–317, NCJ 204396. Retrieved from http://www.nij.gov/topics/crime/hate-crime/motivation.htm

The unconscious way SLC citizens keep the peace (The Salt Lake Tribune, 6/30/2012)

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The unconscious way SLC citizens keep the peace

By arjune rama

After working for two years in Salt Lake City following years of living in New York and Boston, I left Utah last month for work back on the East Coast. A few months ago I wrote about my transition from New York City to Salt Lake City in “Why in the world would you move to SLC?” (Opinion, Feb. 12).

In that article I wrote about how my overall experience in Salt Lake was positive, particularly with respect to the friendliness of the people. Now that I have returned to familiar territory, I am struck by the differences between geographic areas but also the effect my time in Salt Lake has had on what I value in a city.

One unfortunate incident in my new city sent my mind reeling back to my life in Salt Lake. Three days after moving to New Haven, Conn., my wallet was stolen. After signing up for my library card I accidentally left my wallet in plain site while browsing the stacks.

While this error could have led to theft in just about any community, a very disappointing difference played prominently in this case. 

According to the officer with whom I filed my police report, a library patron reported seeing a wallet to the circulation desk employees. To my surprise, they proceeded to do nothing, and the wallet was subsequently stolen. While I do not hold anyone responsible for my carelessness, I couldn’t help but think, “You know, in Salt Lake, the librarian would have just picked it up and held it behind the desk.” 

Maybe I’m giving the citizenry of Salt Lake too much credit, but my gut says otherwise.

I use this example not to highlight urban crime but rather to contrast the sense of community or lack thereof certain cities evoke. While living in New York City I learned to love the independent every-man-for-himself vibe. However, the communal feel of Salt Lake charmed me and shifted my perspective on what I value in city life.

In my theft case, certainly all of the requisite municipal services were well-executed, including the swift arrival and professionalism of the New Haven police, even considering the relatively low-level nature of the crime. Despite the appropriate police response, I will never forget how I felt as I left the library. 

Once all the paperwork was done, I walked out into the street with only my new library card and two books, past hurried sidewalkers who avoided eye contact, didn’t smile or say hello. At that moment, the financial loss and bureaucratic headache of replacing my identification and credit cards felt immaterial. Instead, I couldn’t shake the great city paradox of feeling completely alone in a crowd.

When I think about my situation I recall the writing of urban theorist Jane Jacobs: “The public peace — the sidewalk and street peace — of cities is not kept primarily by the police, necessary as the police are. It is kept primarily by an intricate, almost unconscious, network of voluntary controls and standards among the people themselves, and enforced by the people themselves.” 

I believe Salt Lake is a city wherein such an unconscious standard prevails. A police presence would not be the impetus for a Salt Lake librarian to use common sense and pick up an accidentally misplaced wallet. Rather, picking up a wallet is a choice to preserve the public peace that does not require a sidearm, badge or uniform. 

For all the advantages and resources of my new home, I will miss those simple acts of kindness that serve to bind the Salt Lake community. 

Arjune Rama completed his psychiatry internship at University of Utah School of Medicine. He will continue his psychiatry training at Yale in July.

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© 2012 The Salt Lake Tribune