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readingforsanity · 2 years

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One Flew Over the Cuckoo’s Nest | Ken Kesey | Published 1962 | *SPOILERS*

An international bestseller and the basis for a hugely successful film, Ken Kesey’s One Flew over the Cuckoo’s Nest was one of the defining works of the 1960s.

A mordant, wickedly submersive parable set in a mental ward, the novel chronicles the head-on collusion between its hell-raising, life affirming hero Randle Patrick McMurphy and the totalitatian rule of Big Nurse. McMurphy swaggers into the mental ward like a blast of fresh air and turns the place upside down, starting a gambling operation, smuggling in wine and women, and egging on the other patients to join him in open rebellion. But McMurphy’s revolution against Big Murse and everything she stands for quickly turns from sport to a fierce power struggle with shattering results.

Boisterious, ribald and ultimately shattering, Ken Kesey’s novel is the seminal novel of the 1960s that has left an indelible mark on the literature of our time. Here is the unforgettable story of a mental ward and its inhabitants, especially the tyrannical Big Nurse Ratched and Randle Patrick McMurphy, the brawling, fun-loving new inmate who resolves to oppose her. We see the struggle through the eyes of Chief Bromden, the seemingly mute half-Indian patient who witnesses and understands McMurphy’s heroic attempt to do battle with the awesome powers that keep them all imprisoned.

We’re first introduced to the hospital patients by Chief Bromden, a large half-Indian man who has been committed to the hospital for many years. At the start of the book, we find that he has been there the longest out of everyone. He portrays himself to be stupid, deaf and dumb just so he can squeak by without issue. While he was introduced to various things within the hospital, like electric-shock and the like, he tries to avoid all of that by doing what he’s told the first time he’s told to do it.

Enter R.P. McMurphy. He’s like a storm coming through the ward, and is meant to challenge the authority placed over them. He befriends everyone on the ward, and gives them the confidence needed for them to speak out against Nurse Ratched, the nurse in charge of the ward during their daytime hours. She’s a horrid woman, who takes joy in watching them all slowly suffer through her reign.

When McMurphy comes, he begins questioning her authority, trying to get her to break. It isn’t until he’s told that she is the one keeping him held to the ward that he begins to back off a little. When he arranges for a fishing expedition for at least 10 men to attend, including himself, it really changes things. Chief begins speaking again, and having a wonderful time, and the group has such a great time that even one of the committed boys, Billy, decides that he’s ready to enter into a relationship with a woman who joined them on the trip.

When it’s arranged for the woman to return on a Saturday evening, they all agree that this is the perfect time for them try to get McMurphy out of the hospital. However, their plan fails and it ultimately leads to the death of one of the patients. Soon after, a lot of the patients begin signing themselves out and leaving the hospital.

Discussion Questions

1. In what way is Kesey’s novel representative of the 1960s. The book, issue in 1962, is nearly 50 years old. Are the thematic concerns of Cuckoo’s Nest still relevant today, do they speak to the 21st century...or are they outdated? I find some of the things discussed outdated. In the 1960s, not much was known regarding mental illness and their differences. A lot of them are treated the same as other mental illnesses when in fact they’re quite different. For example, they no longer perform lobotomies or electric-shock treatment.

2. Cuckoo’s Nest centers around a classic plot device - the introduction of disorder into an ordered environment. How does Randle McMurphy destabilize the psychiatric ward? First, discuss how “order” is maintained...who enforces it...and what form order takes. Then talk about what happens when McMurphy enters the story. Order is maintained by Nurse Ratched. She is the person in charge of the ward, and ultimately, wants things to run a certain way. When McMurphy enters, he doesn’t conform to the norm, therefore it throws off the balance of the entire ward.

3. Was Chief Bromden mentally insane when he was committed to the hospital 10 years ago? How does he appear when we first meet him? What is the cause of his halluicinatory fog - his medications or his paranoia or...? I believe that he was mentally ill, but not insane. He may have also been under the assumption he was insane because someone put that into his head. He was in the army, and fought in a war, so that could very much have had something to do with it. He appears to be a large, dumb and deaf man, when he is first introduced. But, we quickly find out that he can both speak and hear the others around him, and is just playing the role that people assumed him to be.

4. Trace the change in Bromden that occurs over the course of the novel. What does he come to understand about himself? Why he has presented himself as deaf and dumb? Why does he believe he has lost his once prodigious strength? What effect does McMurphy have on him? He presents himself in such a light because someone told him that he was deaf and dumb. It was first brought to his attention that people overlooked him despite his size when he was a young boy living on a river with his parents. But, like the affect that McMurphy has on them all, he teaches Chief that he is much more than what the ward is telling him that he is.

5. At one point, Bromden pleas with the reader to believe him. He says, but it’s the truth even if it didn’t happen. What does he mean - how can something be true if it’s not based in reality? It’s because he believes it to be what had happened, therefore it is true to him, but not necessarily true to everyone else.

6. Is McMurphy crazy? Under what circumstances does he enter the hospital ward? if this is a parable...or allegory, what does McMurphy represent symbolically? Can he be seen as a Christ figure, one who sacrifices himself for the good of others? Yes or no? No, he does not sacrifice himself for the good of others. He was good for the others to be around as it restored a lot of their confidences that they seemed to be lacking while on the ward. However, he even said it himself that he looks out for number one, and number one only, and that is himself.

7. What is Dr. Spivey’s theory of the therapeutic community - and how does McMurphy challenge it? What does he mean when he compares the process to a flock of chickens? When one person is called out, and degraded in front of the entire meeting, McMurphy calls it the chicken pecking. Which is absolutely is. The nurse in charge is so hard up on making others miserable, that she calls out individuals during the meeting, and the others flock to tear them down without even realizing they’re doing it. Ultimately, though, therapeutic community is helpful to them, as it really opens everyone up in the long run.

8. As a follow-up to question 4, what does Nurse Ratched represent? What’s funny, by the way, about her name? Talk about her ability to disguise her true hideous self, which shows readily to Bromden and the aides, from the patients. Bromden sees her as a combine...and nickna,es her Big Nurse. What are the implications of those words? Chief believes that she is larger than even he is. She is an authority figure, and like many of us, the authority is meant to be questioned (McMurphy). Her name is hilarious, because she truly is a ratched person behind everything else she is trying to portray herself to be.

9. How does Ratched maintain power over her patients? She believes that she is the knower of all things, and that if even one person questions her authority, that the entire order will be compromised.

10. How does Ratched eventually gain control over McMurphy? Why does he gradually submit to her - and why does the newly subdued McMurphy confuse the other patients? What has he become to them? It’s found that she has control over who leaves and who doesn’t when they’re committed. Unlike Harding, who voluntarily admitted himself to the hospital, you have McMurphy, who was committed to the hospital by an authority figure or government entity. Harding has the ability to leave at any time whereas McMurphy must wait to be released. When this is mentioned, he stops acting out so he could possibly get out, but he had already hurt his chances by questioning her authority in the beginning.

11. Talk about the fishing trip that McMurphy arranges for the inmates. what does McMurphy teach the other patients about being on the outside? What’s the symbolic significance of the fishing expedition? It gives them a sense of renewal. Many of them likely haven’t been outside in quite some time, at least not in the way they had been. They’re able to see what it would be like to have freewill again.

12. Why doesn’t McMurphy escape from the ward the night Billy has a date with Candy? He did it to show that the nurse doesn’t have control over everything when she isn’t there.

13. Ultimately, Ratched looses her old over the ward. Why? With Billy’s death. I think this afffected her in a way she wasn’t able to completely understand herself, and she was trying to blame everyone but herself when truthfully, she could have turned a blind eye and said nothing. She was basically reprimanding him for doing something that is super natural to everyone.

14. What is this novel about? What dichtomy is being suggested by Ratched and the hospital vs. the patients? Good vs. evil? Power and authority vs. freedom? Repression vs. expression? Women vs men? The machine vs. nature? War vs. humanity? The novel shows what it was like to be in a mental ward in the 1960s. Unfortunately, a lot of the time, regular men go in and when they get out, they’re not the same.

15. Why does Bromden narrate rather than McMurphy? McMurphy isn’t a central character because he was only committed because of a battery charge. Chief was in the longest out of everyone on the ward present at the time of the book beginning.

16. Ultimately, how does Ken Kensey challenge societal notions of sanity and insanity? Who is sick, according to Kesey? Nobody is truly sick, according to Kesey, but those who are in charge.

17. Who is the book’s hero? To me, the book’s hero is Chief. He changed everything he knew about himself because of one person’s confidence in him as opposed to the many people rooting against him.

18. What is the title’s significance? It’s a allegory for what the Chief’s grandma used to say to him when he was a boy.

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confusedbyinterface · 5 years

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PLAYBOY: Because of your success in persuading the Supreme Court to outlaw school prayer in public schools, many outraged Christians seem to feel that's just where you belong. What made you decide to pursue your suit in the face of this predictable indignation?

MURRAY: I was shamed into it by my son, Bill, who came to me in 1960 -- he was 14 then -- and said: "Mother, you've been professing that you're an atheist for a long time now. Well, I don't believe in God either, but every day in school I'm forced to say prayers, and I feel like a hypocrite. Why should I be compelled to betray my beliefs?" I couldn't answer him. He quoted the old parable to me: "It is not by their words, but by their deeds that ye shall know them" -- pointing out that if I was a true atheist, I would not permit the public schools of America to force him to read the Bible and say prayers against his will. He was right. Words divorced from action supporting them are meaningless and hypocritical. So we began the suit. And finally we won it. I knew it wasn't going to make me the most popular woman in Baltimore, but I sure as hell didn't anticipate the tidal wave of virulent, vindictive, murderous hatred that thundered down on top of me and my family in its wake.

PLAYBOY: Tell us about it.

MURRAY: God, where should I begin? Well, it started fairly predictably with economic reprisals. Now, I'd been a psychiatric social worker for 17 years, but within 24 hours after I started the case, I was fired from my job as a supervisor in the city public welfare department. And I was unable to find another one, because the moment I would go in anywhere in town and say that my name was Madalyn Murray no matter what the job opening, I found the job filled; no matter how good my qualifications, they were never quite good enough. So my income was completely cut off. The second kind of reprisal was psychological. The first episode was with our mail, which began to arrive, if at all, slit open and empty -- just empty envelopes. Except for the obscene and abusive letters from good Christians all over the country, calling me a bitch and a Lesbian and a Communist for instituting the school-prayer suit -- they somehow arrived intact, and by the bushel-basketful. Hundreds of them actually threatened our lives; we had to turn a lot of them over to the FBI, because they were obviously written by psychopaths. and you couldn't be sure whether or not they were going to act on their very explicit threats. None did, but it didn't help us sleep any better at night.

Neither did the incredible anonymous phone calls we'd get at every hour of the day and night, which were more or less along the same lines as the letters. One of them was a particular gem. I was in the VA hospital in Baltimore and I had just had a very critical operation; they didn't think I was going to make it. They had just wheeled me back to my bed after two days in the recovery room when this call came in for me, and somebody who wouldn't give his name told me very seriously and sympathetically that my father had just died and that I should be prepared to come home and take care of my mother. Well, I called home in a state of shock, and my mother answered, and I asked her about Father, and she said, "What are you talking about? He's sitting here at this moment eating bacon and eggs." Obviously, that call had been calculated to kill me, because whoever it was knew that I was at a low ebb there in the hospital.

Then they began to take more direct action. My Freethought Society office was broken into; our cars were vandalized repeatedly; every window in the house was broken more times than I can count, every flower in my garden trampled into the ground all my maple trees uprooted; my property looked like a cyclone had hit it. This is the kind of thing that went on constantly, constantly, over a three-year period. But it was just child's play compared to the reprisals visited upon my son Bill. He'd go to school every day and hand in his homework, and a couple of days later many of his teachers would say to him, "You didn't hand in your homework." Or he'd take a test and about a week later many of his teachers would tell him, "You didn't hand in your test paper. You'll have to take the test again this afternoon." This was a dreadful reprisal to take against a 14-year-old boy. It got to the point where he had to make carbon copies of all his homework and all his tests to prove that he had submitted them. But that's nothing to what happened after school, both to him and to his little brother, Garth. I lost count of the times they came home bloodied and beaten up by gangs of teenage punks; five and six of them at a time would gang up on them and beat the living hell out of them. Many's the time I've stood them off myself to protect my sons, and these fine young Christians have spat in my face till spittle dripped down on my dress. Time and again we'd take them into magistrate's court armed with damning evidence and eyewitness testimony, but the little bastards were exonerated every time.

But I haven't told you the worst. The neighborhood children, of course, were forbidden by their parents to play with my little boy, Garth, so I finally got him a little kitten to play with. A couple of weeks later we found it on the porch with its neck wrung. And then late one night our house was attacked with stones and bricks by five or six young Christians, and my father got very upset and frightened. Well, the next day he dropped dead of a heart attack. The community knew very well that he had a heart condition, so I lay a murder to the city of Baltimore.

I decided that we'd have to take our chances with the law and get the hell out of Baltimore. I thought of seeking asylum in Canada or Australia or England, but I didn't want to leave the United States, because for better or worse I'm an American, and this is my land; so I decided to fight it out on home ground, and finally we hit upon Hawaii, because of the liberal atmosphere created by its racial admixture, and because of its relatively large population of Buddhists, who are largely nontheistic, and might therefore be more tolerant of our views. So we packed up all the worldly possessions we could carry with us and took the next flight to Hawaii from Washington.

PLAYBOY: How many were in your party?

MURRAY: Six of us -- my mother, my brother, my two sons, Bill's wife and me. And I can tell you, it took just about every cent we had to our name just to pay the plane fare. When we arrived, we had about $15 left among us. We were really in pitiful shape. But we were together, and we were alive, and this was all that mattered.

#atheism #Madalyn Murray O'Hair #religious violence #animal abuse #bullying

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stevensegravesmd-blog · 5 years

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The Mental Health Specialist In Health Reform

Physician specialists are frequently viewed as the culprits within the financial aspects of healthcare. Numerous articles have made an appearance in media about the advantages of acquiring non-physician health care geriatric psychiatrist kansas city. Many ponder whether decades of specialised training could be compacted right into a twelve months training program. What exactly could be the benefits my patients receive by visiting a mental health specialist? Insurance payers have produced the parable that psychiatrists are trained only in using medications. It might surprise many who during 3 years of residency psychiatrists receive training and supervision in a number of kinds of psychiatric therapy. My lengthy term supervisor within my residency was the previous president from the American Psychoanalytic Society. Like a trained mental health specialist, can one easily be replicated with a non specialist with limited training? How must i advise my patients concerning new provider selection necessitated by alterations in their insurance reimbursement?

Like a initial step, it's important for any patient to know their diagnosis and just how it may limit their daily existence. The press and herbal industry advertise interventions that supposedly might help depression including herbs, massage, and integrative alternatives. Regrettably, advertisements don't separate mild and severe depression. Alternative healthcare might be useful for mild depression that is generally attentive to distraction.

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The content "Pregnant Pause" featured fashionable Magazine (May, 2009) would be a poignant description from the daily challenges faced by individuals within the subspecialty of reproductive psychiatry. The content described an expectant female with eating phobias and bizarre obsessive ideas which impeded her daily functioning. Yet she was reported as getting mild depression and it was treated by her doctor. The content highlighted the adverse connection between antidepressant treatment while pregnant. It emphasized a person's mild illness which she received erroneous information. However, patients with certain illness frequently receive their mental healthcare from individuals with limited psychological training because the stigma of psychiatry is rampant.

Trustworthy magazines frequently don't address harshness of illness and introduce potential interventions which are without scientific merit. Like a mental health specialist by having an knowledge of reproductive health, I discuss risks versus benefits when counseling patients about treatments. My top rated book, Her Pregnancy Decision Guide for ladies with Depression, was written being an informational resource for use in the introduction of individualized treatment plans. Ladies have various treatments which are based on the seriousness of their illness.

My patients' queries about other potential mental health providers are clarified by my suggestion with an honest thought on their illness. For those who have a serious illness that impedes your functioning, challenging prior medication trials, a present medication that isn't the typical low dose of the SSRI, you need to support the guidance of the mental health specialist. Prozac and the development of the serotonin selective inhibitors (SSRIs) would be a great advance in mental health treatment. Nevertheless, for those who have had two decades of struggling with depression, stabilization of signs and symptoms will need experience coping with treatments that aren't usually comfortable for health providers with less training.

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sonnywortzik · 6 years

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What is " forces that impede an understanding of the beast " from?

it’s a subsection title from “on killing: the psychological cost of learning to kill in war and society” by dave grossman, from the larger section “killing and combat trauma: the role of killing in psychiatric casualties”

grossman references the parable of the blind men and the elephant as an analogy for different theories/interpretations/contributions et al re: psychiatric casualty causation:

“we have consistently found authorities who would claim that their perspective of the problem represents the major or primary cause of stress in battle. Many have held that fear of death and injury was the primary cause of psychiatric casualties. Bartlett feels that ‘there is perhaps no general condition which is more likely to produce a large crop of nervous and mental disorders than a state of prolonged and great fatigue.’ General Fergusson states that ‘lack of food constitutes the single biggest assault upon morale.’ And Murry holds that ‘coldness is enemy number one,’ while Gabriel makes a powerful argument for emotional exhaustion caused by extended periods of autonomic fight-or-flight activation. Holmes, on the other hand, spends a chapter of his book convincing us of the horror of battle, and he claims that ‘seeing friends killed, or, almost worse, being unable to help them when wounded, leaves enduring scars.’

…Like the blind men of the proverb, each individual feels a piece of the elephant, and the enormity of what he has found is overwhelming enough to convince each blindly groping observer that he has found the essence of the beast. But the whole beast is far more enormous and vastly more terrifying than society as a whole is prepared to believe.

…Even the field of psychology seems to be ill prepared to address the guilt caused by war and the attendant moral issues. Peter Marin condemns the ‘inadequacy’ of our psychological terminology in describing the magnitude and reality of the ‘pain of human conscience.’ As a society, he says, we seem unable to deal with moral pain or guilt. Instead it is treated as a neurosis or a pathology, “something to escape rather than something to learn from, a disease rather than—as it may well be for the vets— an appropriate if painful response to the past.’”

i chose it as my punisher series tag because — aside from “Forces That Impede an Understanding of the Beast” sounding raw as fuck — everything grossman speaks to here rings true in the context of the punisher insofar as frank is a representation of combat trauma, but further that frank is a representation of war itself.

the bolded bit is particularly appropriate, as the punisher could not exist if not for the will and failure of society and it’s perhaps because of this that society generally either outright ignores him or writes him off as “crazy”.

there’s also a passage in punisher: born that refers to a “beast” in the midst of a defining battle of frank’s military career:

#Anonymous #there is so much to unpack here i gotta shut up

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tranbackrantla1970-blog · 6 years

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Your sisters are trying to shun you to make you feel so bad and make you think that you need them. They are emotionally trying to hit you where it hurts by thinking you feel abandoned if you don do this. I would have a moment and talk with your mom and just your mom. Not helped by the reality that NZ still has the expectation that everyone wants their own 1/4 acre section and 3 bedroom house, despite it no longer being achievable to the majority of the rising generation, and isn really necessary for most. As family sizes tend to average downward, most can now get by on a 1 or 2 bedroom apartment, except that NZ has ever really had an apartment attitude. I have no doubt that is going to change significantly in the next couple of decades, driven partially by necessity, and also as the boomers die off and take the old expectations of land, garden and 3 bed house with them.. Then they will take you outside to the bike and they have 평택출장샵 to read the engine number which is pretty quick unless they have trouble finding it. After you go back in and they fill out more information into the computer which takes a bit longer. You pay, they give you the plates and its compete. Experts recommend being skeptical of drive by contractors who knock on your door peddling their services. If you do have interest in hiring someone without a personal recommendation, you can protect yourself. First, ask for references of former clients you can call. The health insurance companies are vultures and we need to find a way to transition away from them and phase them out. People know they bad, the numbers and studies show they bad, and other countries prove that not relying on them anywhere near to the extent that the US does is good. Let cut the bullshit and pass M4A. And I totally agree that the shimmery ones are easier to work with the matte ones set so quickly and blend out kinda patchy. I gonna try them again with an angled brush as liner and see if they work better that way (I like using Evening Spell in this way). Otherwise I prefer my Nudestix Magnetic Matte eye crayons for cream matte shadows as they blend out much nicer.. My developing understanding of TULIP should mean that because of I and P, OSAS is a "safe" doctrine onto which a Reformed Believer may hold, as long as we do not presume who is and is not elect. In this way, we ought not to be tempted into antinomianism by dint alone of understanding election in its proper Christian manner, let alone the litany of Scripture that should put antinomianism to rest permanently before it even has a chance to get out of bed, such as the parable of the fig tree, St. James, et al. It hurts today. I got little sleep from the toothache, and woke up to one of my baby chickens being sick. I 평택출장샵 spent the entire morning, most of my afternoon, and half the evening dealing with her. Let them complain, you don care. Cutting of a parent emotionally is hard, but it works. Don talk to them. In California, we have to have identify ideation of committing suicide, a means to commit suicide, and an immediate plan to commit suicide before we can hold you involuntarily (and even then, you are only held for 72 hours). After the 72 hour hold concludes, the majority of people are not held any longer. If the patient does display a wanting of suicide, a means of suicide, and still holds their plan of committing suicide, they can be committed for another 2 weeks (a The 5250 must be heard by another psychiatric health specialist and a judge before being finalized.

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nightfallsupon · 2 years

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Remembering when the doctor injected me/drugged me with a different drug to quote "make me more animated." Wow okay, so you want me to be a different personality now, one that's lively and happy and bouncy while I'm imprisoned in a fucking psychiatric hospital where every step I take is being analysed. I'm an introvert ffs, of course I'm going to hide in my room and listen to music where it's safer, are you fucking insane ?? I felt like a pinball machine. Then they asked me if I knew what a parable was, and then diagnosed me with another illness due to this, and how I spent a lot of time on my own ?? Vile people. How the fuck does knowing what a parable is have anything to do with my state of mind ? They were CRAZY. It's just so weird to me even now to write this down, knowing that they used this to diagnose me with another mental illness.

When you're misunderstood by other people it is so much lonelier to be around them. I felt/still feel alone in a room full of people whose sole job is to judge me. When so many people have hurt me deeply of course I would choose my own company. That doesn't make for a psychiatric diagnosis. And then at the end of my "stay" the doctor reached out to shake my hand, and I felt coerced to shake it for fear of what he would do it I didn't. I regret that so much. Shaking the hand of someone who made my life hell during my time there. Same doctor also questioned why I was crying when it was my birthday in that place. Would you not be upset if you were locked up in a psychiatric hospital for your birthday ?!! He treated me as if that was another reason to be labelled as mentally ill. There was nothing wrong with me. I carry so much pain and hate from this experience in Levin. I wish I remembered his name, so I could lay it out here for the world to see.

I need to write this all down, to show people how badly we get treated. The cruelty and inhumanity we experience at the hands of incompetent, prejudicial, malignant doctors and nurses adds to the immense pain we already have to carry from our traumatic pasts.

I won't rest in my fucking grave until these people have discovered what it's like to be locked within their own walls and drugged with needles and pills for who they are. I want, I need them to LITERALLY get a taste of their own medicine. Prison is too kind for them. They each exist intentionally within an evil fucking profession that harms not helps survivors. They know how much damage they do, and even wilful ignorance is NEVER AN EXCUSE. We all have to pretend like we're okay just so they don't punish us through drugs or imprisonment again. They know this. I don't believe these people deserve mercy, they certainly never showed us it.

PS: I can thank my mother for dropping me in all of this, and for not standing up for me when these people who had control over me and my freedoms hurt me, but going along with what they said. She told me a doctor had been telling people bad stuff about me and it got back to her through someone else she knew, but when I wanted something done about it she said "I wish I'd never told you." As if it wasn't important at all that a "professional" had been unethical and cruel in regards to their opinion of me, and had breached my privacy. That was Doctor John Little, and nothing ever came of it, because my mother refused to tell me what was said. Same doctor told me he didn't believe me when I said I thought I was raped. Sociopathic.

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96thdayofrage · 3 years

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Excited Delirium: How Cops Invented a Disease

It might not be “real” in the conventional sense, but it’s still a deadly diagnosis in the hands of police.

Arjun Byju filed 13 April 2021 in Criminal Punishment

In March of 2020, Daniel Prude died in police custody in Rochester, New York. When body camera footage was released that fall—showing Prude as he lay unarmed and handcuffed, hooded and pinned to the asphalt, snowflakes melting on his naked skin—protests erupted across the country, and found common cause with an already roiling Black Lives Matter movement.

Prude’s death was, in many ways, depressingly similar to the litany of police killings that had inspired a year of dramatic demonstrations and calls for systematic reform. Documents later revealed how officials took over four months to release arrest footage to the victim’s family and refrained from disciplining police leadership in the face of mounting public pressure. That Prude’s death had so much in common with George Floyd’s, both men subdued and asphyxiated in the street, offered a symbolic reminder of the ubiquity of injustice.

Yet, Daniel Prude’s demise was also distinct because among the causes of death listed at his autopsy was “excited delirium.”

As a medical student who had recently begun clinical clerkships, I was curious about this diagnosis, which I had never read about in my textbooks or heard on the wards. A quick internet search revealed a host of explanations. From the Seattle Police Department, excited delirium was: “A state of extreme mental and physiological excitement, characterized by extreme agitation, hyperthermia, hostility, exceptional strength and endurance without apparent fatigue.” Variously referred to as “agitated delirium,” “Bell’s mania,” “lethal catatonia,” and “acute exhaustive mania,” proponents of the syndrome defined it as a constellation of fear, panic, exaggerated strength, hyperthermia, respiratory arrest and death—chiefly in the context of drug use, physical restraint, and police custody.

Although excited delirium has been invoked to write-off dozens of deaths at the hands of police in the last decade—including, in another morbid parallel to the case of George Floyd, as a possible defense in the trial of Derek Chauvin—it is not recognized as a veritable clinical entity by the American Medical Association, the American Psychiatric Association, the World Health Organization’s International Classification of Diseases (ICD), or the Diagnostic and Statistical Manual of Mental Disorders (DSM-5).

Despite this lack of recognition, “excited delirium” helps police absolve themselves of deaths that occur during arrest. Outlets ranging from Mother Jones to Slate to NPR have reported on how this “questionable diagnosis” provides a medicolegal explanation for what otherwise might be considered murder. In the last few months alone, the controversy has gained broader coverage and has been featured on the television news program (and bulwark of mainstream, bourgeois journalism) 60 Minutes. Nearly simultaneously, the paragon New England Journal of Medicine published a critical (albeit guardedly so) editorial about Prude’s death and excited delirium—written by a Black neurosurgeon who works in Rochester and, remarkably, also happens to be a cousin of Daniel Prude.

While these recent critiques are laudable, I couldn’t help but think they still fell short. Focused on proving why excited delirium is not “real,” they missed a broader point: why are diseases like excited delirium manufactured in the first place, and how are cultural beliefs and stereotypes reflected in the process of categorizing, diagnosing, and treating illness? Put another way, surely something suspicious is going on when a bunch of young Black men die suddenly upon encountering the police—whether it’s a “legitimate” clinical syndrome or not. In fact, if excited delirium is, as advocates maintain, a sterile, biochemical process—which remains doubtful—then the phenomenon is still a tragedy. For here are sick people, receiving not a hospital bed and medication but a hogtie and electroshock. Even if we accept the (very) debatable idea that excited delirium is real, it requires compassion and a dedication to better outcomes. For every sickness—manmade or not—has its own narrative, a parable of suffering and diagnosis, and hopefully, triumph.

How Excited Delirium Became ‘Real’

Most histories of excited delirium begin with Luther Bell, a psychiatrist working at the McLean Hospital in Belmont, Massachusetts. During the mid-1800s Bell described what he believed to be a novel presentation of mania and delirium typified by “exceedingly great overactivity; marked sleeplessness…transient hallucinations that border on illusions” which frequently culminated in death of the patient. (The paper’s title, “On a form of disease resembling some advanced stages of mania and fever, but so contradistinguished from any ordinary observed or described combination of symptoms as to render it probable that it may be overlooked and hitherto unrecorded malady,” gives you a good sense of what 19th century science was like.)

It was not until roughly 130 years later, in the 1980s, that a medical examiner in Miami named Charles Wetli revived interest in excited delirium, and launched its modern association with drug use and police interactions. Wetli described a phenomenon of psychosis and hyperactivity, culminating in sudden death, among seven habitual cocaine users, five of whom died while in police custody. His syndromic description took hold and led a handful of researchers, including Deborah Mash, to seek to identify excited delirium’s pathophysiology—the biological and chemical explanation of how it arises. Mash and others posited “chaotic dopamine signalling” and aberrant quantities of proteins in the brain, like heat shock protein 70, as the cause of excited delirium. Although a singular theory has never been promulgated, Mash also proposed that excited delirium’s etiology was tied to changes in kappa opioid receptors as well as an over-expression of alpha-Synuclein, a protein linked to Parkinson’s, in the brain.

On the surface, these findings grant a veneer of scientific rigor and legitimacy to excited delirium. See, these people aren’t just killed by the police, there are distinct differences in their brains! But upon closer inspection, these justifications falter on multiple fronts. First, as Meabh O’Hare, Joseph Budhu, and Altaf Saadi of MGH and Harvard Medical School explain, delirium—which is a legitimate and commonplace diagnosis (just delirium, not the supposed “excited” type)—does not by itself cause rapid death. Delirious patients have a “fluctuating disturbance in attention and cognition, typically provoked by an underlying medical condition such as infection, drug intoxication, a medication’s adverse effects or organ failure” but their condition, crucially, “is not associated with sudden unexpected death.”

Moreover, the two neuropsychiatric conditions which proponents of excited delirium most commonly compare it to—Neuroleptic Malignant Syndrome (NMS) and Malignant Hyperthermia—both have identifiable triggers: antipsychotic medications and anesthetic drugs, respectively. By way of analogy, the only possible “trigger” for excited delirium would be confrontation by the police. And, as O’Hare, Budhu, and Saadi note, the proposed biomarkers of excited delirium are not specific to that condition, repudiating claims to a unique category of illness.

Dubious biochemistry aside, since its forensic debut, excited delirium has also proved diagnostically inaccurate. During the 1980s, over 30 women—all of them Black—were found dead in Miami. Most were sex workers and habitual cocaine users and even though evidence pointed to assault, Wetli, who was then working in Miami as a medical examiner, concluded that they all were killed by a variant of excited delirium relating to sex and cocaine use. As reported in the Miami New Times, Wetli told journalists that the women had died in relation to “a terminal event that follows chronic use of crack cocaine affecting the nerve receptors in the brain” and even more puzzlingly, that “the male of the species becomes psychotic [after chronic cocaine use] and the female of the species dies in relation to sex.”

Despite Wetli’s ludicrous implication that all 32 women had died in the heat of intercourse (!?), by 1992 police had identified a serial killer behind the gruesome murders, revealing the more obvious fact—that marginalized people like sex workers, drug users, and women of color are not only consistently disregarded by contemporary society, but are also routinely blamed for their own victimhood.

Remarkably, Wetli clung to his diagnosis and excited delirium continued to gain traction as industry influences bolstered the shaky diagnosis. As Reuters investigative journalists report in a fascinating series, research into excited delirium got a major boost from a dubious source: TASER International (now known innocuously as Axon Enterprise). In the last several decades, the company has spent millions of dollars on research to defend its eponymous electroshock gun in court, deliberately promoting a nexus of research, law enforcement, and medicine that establishes excited delirium—and not the company’s weapon—as a legitimate cause of death.

Reuters found that excited delirium was:

listed as a factor in autopsy reports, court records or other sources in at least 276 deaths that followed Taser use since 2000…in at least 30 of 128 lawsuits against the company, the condition was cited as a factor, either by Taser, its expert witnesses or municipalities whose police used the weapon. In all but one of those cases, Taser’s defense prevailed…with excited delirium often one plank in the winning legal argument.

It may come as no surprise to some, then, that Taser has paid both Wetli and Mash to appear as expert witnesses in various defense cases.

At this point, proponents of excited delirium like to proffer the condition’s recognition by the American College of Emergency Physicians (ACEP) and the National Association of Medical Examiners (NAME); both organizations, on this point, are in opposition to the other major professional groups in their insistence on excited delirium’s existence.

Yet, it’s now known that at least three of the authors of the ACEP white paper on excited delirium were paid Taser consultants, including Mash and an E.R. doctor named Jeffrey Ho—and that according to Reuters, the trio’s links to Taser were not revealed until two years after the paper’s publication. Ho, who is a physician and police officer in Minnesota, served for many years as Taser’s medical director. In this capacity he was paid hundreds of thousands of dollars to research and travel and teach about excited delirium and the relative safety of Taser guns. In June of 2019, facing sharp public backlash, Ho’s hospital finally terminated the contract that allowed him to serve as Taser’s medical director. As one local official bemoaned, “What hospital has a relationship with, you know, a gun manufacturer?”

As it turns out, the same hospital where George Floyd died.

But what about the medical examiners? Don’t they recognize excited delirium as a real clinical entity? In this specialty, too, Taser exerts its influence. According to Reuters, Taser has on its payroll at least one former president of NAME, and actively sues officials who link deaths to their guns, including an examiner in Indiana and another in Ohio. Accordingly, Amnesty International, in its review of over 300 cases of deaths following Taser use and subsequent industry challenges to autopsy findings, concludes that “medical examiners may be subject to pressure by companies or other entities with an interest in protecting a product or reducing their liability in potential lawsuits.”

Nevertheless, several high-profile physicians have spoken out against excited delirium, including Werner Spitz, a forensic pathologist who investigated the deaths of JFK and MLK, as well as Paul Applebaum, former president of the American Psychiatric Association. As Applebaum states, excited delirium is a “a wastebasket phrase…a way of explaining what happened without necessarily bearing responsibility for it.” Homer Venters, former CMO of NYC Jails, gets even closer to the inherent frailty of excited delirium as a diagnosis when he notes that, “The most consistent feature of excited delirium deaths seems to be contact with law enforcement.”

Indeed, other than a Taser shock, physical restraint appears to be the only thread linking all excited delirium fatalities—the sine qua non, to borrow from medical parlance (where Latin likes to elevate all discourse.) As a student, I’m encouraged to remember the essential and indispensable condition for a disease, the sine qua non, without which it would not be. You can’t have the seizures of eclampsia without high blood pressure, nor are you likely to have the fevers of malaria without a mosquito bite. So, what about excited delirium? A meta-analysis from 2020 concludes that “there is no evidence to support ExDS (excited delirium syndrome) as a cause of death in the absence of restraint” (italics mine). Rather than an occult pathophysiologic process, the authors suggest “restraint-related asphyxia must be considered a likely cause of death.”

Why the Police Love Excited Delirium

While understanding excited delirium’s murky genesis is important, it is equally revealing to consider how the syndrome is conceived of by those who lean on it the most: law enforcement. Take for instance this description of a typical case of excited delirium, which comes from a police department in Indiana:

…the subjects will generally exhibit extreme strength and most likely will not respond to law enforcement efforts in the area of pain compliance techniques. Law enforcement will commonly identify these behaviors as an attempt to defeat their efforts for a safe apprehension of the subject. Eventually, a greater number of law enforcement personnel or a successful application of a CEW (Taser) will most likely allow for an apprehension. Routinely, the subject might remain in the prone position or be secured in a transport vehicle for a few minutes while law enforcement continues gathering information for report purposes. In most ExDS incidents, during transport or during the restraint process the individual will suddenly become calm, unconscious, or go into respiratory distress/cardiac arrest.

In medical school, we are taught to recognize a multitude of “illness scripts:” an array of clinical signs and symptoms which, in concert with a patient’s history and risk factors, can lead us to a diagnosis. Some illness scripts are straightforward. A woman who went hiking in Connecticut and now has a bullseye rash? That’s Lyme disease. Others are a bit more opaque, and have a broad differential. A child with dull, aching bone pain? It depends. It could be an infection, avascular necrosis, perhaps cancer—or something completely benign, like “growing pains.” Such cases warrant further history-taking (When did the pain start? Does anything make it better?) as well as blood tests and imaging.

Unfortunately, such measured analysis doesn’t happen with excited delirium, a syndrome without clear diagnostic criteria or biomarkers, and whose sufferers often die in custody. And apart from the question of how accurate diagnostic constellations are—that is, what percentage of people with X symptoms actually have Y disease, and what percentage of people with Y disease don’t have X symptoms—is the question of what cultural messages our scripts impart.

Lexipol, a private company that provides training manuals and consulting services to thousands of police agencies across the country, offers a primer on excited delirium in which it explains that sufferers are likely to assault officers due to a lack of “remorse, normal fear or understanding of surroundings and rational thoughts of safety.” Lexipol adds that “pain compliance techniques are not likely to be effective as ExDS subjects are often impervious to pain.”

Authors of other descriptions of excited delirium seem to lack even more self-awareness in their role as peddlers of the script of intractable violence and danger. The Indiana police department mentioned above includes among the cardinal symptoms of excited delirium: “unfounded fear and panic…hyperactivity and thrashing (especially after being restrained)…unexplained strength/endurance.” Of course, exhibiting fear and panic in the face of violent arrest and struggling while being forcibly restrained seem to be natural responses, rather than evidence of pathology. And in the context of a literal life and death struggle—the adrenergic system ramped up in “flight or fight”—it is not unreasonable to expect individuals to demonstrate more than normal strength or endurance (e.g., people surviving in the wilderness despite amputation injuries or cases of parents lifting cars off their children—although evidence for such “hysterical strength” is admittedly scant).

The belief on the part of law enforcement that individuals afflicted by excited delirium have exaggerated strength and a diminished response to pain is one of the most striking features of the diagnosis, and perhaps predictably, can be traced to Wetli, who once proclaimed, “It’s as if they’re impervious to pain — to pepper spray, to batons, to numchucks [sic]. You spray them with pepper spray and they just sort of look at you.” It remains unclear why Wetli believed individuals with excited delirium would be impervious to nunchuks, an obscure oriental weapon that despite the increasing militarization of the police would appear to be reserved mainly for YouTube compilations and strip-mall martial artists. Oh wait, nevermind. The cops use them now, too.

Outlandish weaponry notwithstanding, it’s easy to appreciate how an illness script that highlights a supposed lack of response to traditional policing tactics paves the way for dangerous, and potentially fatal, escalations in force. Every disease narrative comes with a concomitant therapeutic repertoire. For the guy with the crushing left-sided chest pain radiating to the jaw—chew an aspirin and head to the E.R. For the kid with intermittent wheezing and shortness of breath—try an albuterol inhaler. Such directives have the ability to affirm the severity of illness (rush him to the cath lab, stat!) or dismiss it entirely (a 24-year old who normally drinks eight cups of coffee shows up on New Year’s Day with a splitting headache and a resolution to kick caffeine cold turkey. Rx: go to Starbucks).

The trouble with excited delirium—whether it’s “real” or not—is that its “therapeutic” directive is one of complete force that simultaneously lays culpability at the foot of the afflicted person. The Journal of Emergency Medical Services emphasizes this point in its description of excited delirium, creating a caricature of a violent, raving menace:

…excited delirium patients will, for no known reason, strike out at objects made of glass. They display what some describe as animalistic behavior by grunting, groaning and exhibiting strength that seems superhuman. They aren’t actually stronger; rather, they don’t recognize the implication of any painful stimulus. This includes CEDs, pepper spray and physical compliance holds.

Again, official descriptions of excited delirium prove unabashedly dehumanizing. And while Lexipol contends that those with excited delirium are “remorseless,” it is actually the officers, fed an overwhelming narrative of pain imperceptibility, who are empowered to feel no guilt. Don’t feel bad about shocking and body slamming that guy—he couldn’t even feel it.

Those who defend excited delirium’s clinical veracity—particularly within the medical profession—would be wise to consider the narrative they are peddling. If it is a real clinical syndrome, then why not treat it as such? With treatment comes compassion and a willingness to heal, to see people as patients rather than perpetrators, and the ability to refrain from vindictiveness and proactive strikes.

Here then I may break rank with some who criticize police brutality by contending that it is not the sadism of individual officers that enables episodes of extreme violence—at least, perhaps, not in the case of excited delirium—but the prevailing pseudo-medical rhetoric relating to pain. The sheer universality of the claim that those with excited delirium have a heightened if not infinite tolerance for pain, and the doggedness with which it is preached, from manuals to all manner of online police training videos, exposes, I believe, a subconscious discomfort with the tactics being used, and a need for a buffer on conscience.

Excited Delirium and the Question of Pain

In an episode of the popular Netflix series Black Mirror, a soldier discovers that the zombie-like humanoids that he has been hunting and killing (nicknamed “Roaches”) are actually human beings, their faces and voices transmogrified into grotesque monstrosities and awful howls by a neural implant placed surreptitiously in each soldier. If an analogy to pop culture is allowed, excited delirium—or rather, the medical mythology that surrounds it—serves in our society as the neural implant: a gimmick without which we would be unable to tolerate our own atrocity. As Mark Greif writes in his essay Seeing Through Police, “The restraints in civilization on attacking anyone, especially a citizen who portends no harm or threat, are fairly high. For most forms of violence that breach civilized norms, even if it is one’s art or profession, steps of habituation are needed.” Imbibing the legend of excited delirium, a narrative of irrevocable insanity and subhuman sensation, is for many, a first step in habituation to violence.

History offers examples, too numerous to count, of how (pseudo)science, with its connotations of impartiality and inevitability, permits extreme cruelty, namely by telling us, “That is how they are.” And in the case of excited delirium, “This is how they must be handled.”

At the same time, it doesn’t take a Ph.D. in critical race theory to appreciate the tropes at play in institutional descriptions of excited delirium. Emphasizing “superhuman strength” and the ability to “overcome multiple officers,” the literature around excited delirium hearkens back to the myth of the superpredator. Perpetually conflating drug use and violence feeds into the same moral panic that fueled the War on Drugs. In almost every way, the ritualized description, diagnosis, and management of excited delirium—the unpredictable, wild threat that needs to be forcefully subdued—evinces characteristic anxieties about Black bodies that have shaped American culture, politics, and criminal justice since our country’s inception.

In particular, the question of pain—who can and can not feel it—has a troubled history in medicine, which undoubtedly imbues the modern conception of excited delirium. As Linda Villarosa details in New York Times magazine, white physicians have long believed that Black people are not as capable of feeling pain, a conclusion which for many years supported not only slavery, but the practice of outright medical experimentation on people of color. Villarosa cites, among others, the work of Dr. Benjamin Moseley, a British physician who proudly described his experiments on racial discrepancies in perception of pain in 1787: “What would be the cause of insupportable pain to a white man, a Negro would almost disregard.” He continued, “I have amputated the legs of many Negroes who have held the upper part of the limb themselves.”

Moseley’s writing has disquieting parallels with Wetli’s, as both men describe with frank, almost cheerful prose, how individuals can tolerate what seems surely impossible—post-amputation stoicism or unflinching eyes in the wake of pepper spray. And though doctors might have (mostly) evolved beyond such insensitive pronouncements, the question of how to judge and treat pain remains particularly difficult for those in medicine, leaving plenty of room for implicit (and explicit) bias to run free [1]. As Villarosa and others have pointed out, Black patients’ descriptions of pain, in many medical contexts, are still rated less seriously and treated less meaningfully by providers. Most embarrassingly to me as a student, outdated beliefs in physical differences relating to pain perception—the same myths that were first proposed in the era of Moseley—continue to abound. A recent survey revealed that nearly 40 percent of first and second year medical students endorsed a false statement like “black people’s skin is thicker than white people’s” or “black people’s nerve endings are less sensitive than white people’s.”

Perhaps the most appropriate historical parallel for excited delirium, then, is Drapetomania—a once-proposed “mental illness” that sought to explain why Black slaves ran away from their masters. Initially described by Samuel Cartwright, a physician who practiced in the antebellum South, Drapetomania was suggested to be the mental derangement that led wayward slaves to seek liberation; for prophylaxis, Cartwright unironically suggested whipping [2].

Although Cartwright’s proposed clinical syndrome seems laughable today (someone runs for freedom and they called that Drapetomania?), I wonder whether future generations will look at contemporary defenses of excited delirium in the same light (someone was killed by the cops and they called that “excited delirium”?).

I’m cautious about disregarding a purported clinical entity like excited delirium just because it appears at first glance improbable and its pathophysiology may not be fully elucidated. We don’t know why exactly some people are stricken with inflammatory bowel diseases (IBD), although as anyone suffering from daily bouts of abdominal pain, cramping, or bloody diarrhea can attest—it is very much real.

However, when a disease category is unbelievable, has a murky explanation, and seems to exist to exculpate police officers and a shock gun company, we are warranted to raise our eyebrows. Some who take a critical stance toward the medical diagnostic schema contend that an increasing “medicalization” of life has been pushed to service the bottom line of pharmaceutical corporations (e.g., an explosion in the diagnosis of depression, or sleep problems, or even obesity—which now can all be treated with a pill, rather than say, talk therapy, better sleep hygiene, or more exercise). While there is undoubtedly some truth to this argument, in all of these cases there existed at least an a priori substrate for the pathology—some suffering on the part of people that brings them to their doctor. And even when they are sold pills, these potions have at least the intention of cure. No one comes to their doctor saying, “I’m agitated and unruly and violent, can you please choke me or taser me to death?”

Nosology—the field of medicine dedicated to categorizing disease—is like all other human enterprises in that it is informed by our virtues and vices, prejudices and stereotypes. And while Drapetomania and excited delirium represent the use of diagnosis as a means of oppression, it’s worth mentioning that withholding disease recognition can also adversely affect disenfranchised groups. For example, consider fibromyalgia and chronic fatigue syndrome, both of which are poorly understood conditions that predominantly affect women. It took significant effort and much too long for the medical establishment to recognize these disorders, although this is slowly starting to change. Similarly, posttraumatic stress disorder (PTSD) was only formally recognized by the medical community in 1980, despite having been described since at least the time of Gilgamesh.

While it’s doubtful that excited delirium is a “real” disease in the conventional sense, it would perhaps prove helpful to conceive of the social milieu from which it arises as one. Last year, many in my profession began to call systemic racism a “deep-rooted disease” and a “public health crisis.” The skeptic eyerolls at virtue signaling. Yet the optimist thinks that maybe this is the way to move forward, to make progress the only way we know how. If calling the structural forces that give rise to excited delirium a disease is what it takes to finally address them, then perhaps that’s a medicalization of everyday life we should be willing to accept.

When approached with benevolence, and not as a tool of oppression, formal recognition of illness can be incredibly salubrious for those suffering: it gives a name to their struggle, it provides a sense of relief in discovering others who share their burden, it opens doors to government and private research, and it begins the quest for an underlying etiology, treatment, and hopefully cure. Those who stand by the “diagnosis” of excited delirium, invoking a facade of science and biology—Tasers (and sometimes nunchuks) at the ready—would be wise to remember another bit of Latin that lies at the core of modern medicine: primum non nocere. First, do no harm.

[1] Leaving aside racial disparities, pain continues to be an inscrutable malady for the medical profession. Some of the most basic questions still remain, like, what exactly is pain anyway? For several decades, at least, it has been known that pain is not just based in anatomic derangements, but can be influenced and

exaggerated by stress, mental anguish, and sociocultural factors.

Importantly, given a general sentiment that pain had been “undertreated” for much of the 20th century, a

crusade

was begun in the beginning of the 21st to recognize and medicate pain—it became “the fifth vital sign.” Some people attribute an ensuing overzealousness in managing pain, particularly with potent narcotics, as a driving force behind what would become the opioid epidemic. Pendulums swing, back and forth.[2] Cartwright also mused on

Dysaesthesia aethiopica

, a supposed state of mental laziness or “rascality” that afflicted Black Americans and opposed the adoption of the germ theory of disease. Needless to say, none of his theories have aged well.

#DefundThePolice #ProsecuteCriminalCops #EndQualifiedImmunity

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suicidalidea · 7 years

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Home Heart

More than metaphor, here is an actual story:

The semester was an implosion. By far the worst graded/evaluated performance of my adult life. Horrendous, on par with my behavior immediately preceding my psychiatric ward visit.

*Side Note: I don’t think it matters that I did poorly this semester. School is a soft “no-fail” kind of atmosphere. And although my grades tanked, I read/wrote/painted/”gee-tar’ed”/napped/danced/listened/socialized more in 3 months than I had done in a long time. The “opportunity cost”, may as well use the verbiage they teach us in fancy business school, for failing was a huge investment into my person-hood. Economic decision are made at the margin and the differential between cost-benefit was exponential. An order of magnitude different. You can only value a decision by the cost of what is lost by making that decision (the cost of losing the 2nd best, or next best, choice). In this case there was no loss. Just significant gain. But I digress. *Return to text*

By this point in the story my behavior has become what can only be described as “volatile.” My soul was burning with that particular brand of manic-depressive discontent, of which anyone with the condition is accustomed. After failing my last final, and after very little preparation, I jumped in my car and headed to Florida. Left at noon and drove for seventeen hours straight. Burning the midnight oil, driving straight for the one place my heart dearly missed.

Being home. Baptized and absolved. The return of the prodigal son. There is a cleansing feeling that only accompanies being away from home for too long. The absence of some absence is the greatest gift. My suffering relieved. The first sip of some cool water after 40 days in the desert. The truest, most pure moments, are not the addition of some positive in life. But only come from the negation of a negative. This has been codified in myth and proverb, psalms and fables, didactic parables and contemporary novels, but has been so lost in these post-modern times. (See, “absence of irony” for further explanation)

“I keep shouting but no one seems to hear.” -Pink Floyd (& also every artist ever)

-Prophet$

#home #afterfinals #postfinals #college #nassim #shalom #profit

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queernuck · 8 years

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Why Theory?

That the outgrowth of critical theory has lead to theory-unmodified, the name “theory”, coming to totalize a wide range of discourses, of ideas and ideologies, of some of the most basic claims and some of the most particular, that any given claim will rest upon is in part due to the particular manner in which American speech has developed, and in particular when discussing online communities the way in which the turn-to-theory is structured by the manner in which such turns took place in a similar temporal sphere as the growth of the internet as a tool of communication, there is a great deal which needs to be critiqued as part of posing “theory” as something other than a hopelessly neutralized word or an implicit denigration, a specific neutrality that carries its own dismissal with it.

That such wide ranges of questioning are brought under a singular label can be at least vaguely useful in order to highlight the similarities in process and often in authorial goal (if not the actual realized goal of the text) of “theoretical” texts. Badiou’s The Communist Hypothesis is a work that touches on issues of collective memory, of critiquing and offering a new historical basis for Maoist claims of subjectivity, and of situating various “moments” within their larger context as well as delineating what makes the locating of the moment possible. Foucault, in works such as Discipline and Punish uses rough historiographies (vivid but rarely terribly good by historiographical standards) in order to describe a movement through the body as well as how that movement is represented upon the body, what the supposed individual “means” to the penal system and how that reflects upon their place within a larger socius. Deleuze and Guattari, in offering a critique of the psychoanalytic apparatus and its violent structure, critique moreover the process of naming and Oedipalizing performed not only by Freud but by later psychoanalysts like Lacan as well as the manner in which they have named a process of the operation of Capitalism and its violence through structuring, naming, renaming, so on. They introduce a paradigm of schizoanalysis in Anti-Oedipus and A Thousand Plateaus, and this is part of what Foucault names as a work of anti-fascism, which resonates rather deeply given the manner in which they have described the enabling of fascist violence by liberal-democratic structures. Freire, in Pedagogy of the Oppressed, is not merely making specific claims about pedagogical practice: there is relative little about discourses that dominate the field such as proper lighting and the influx of the Standing Desk into the field: instead, working upon a notion of what a meaningful pedagogical process entails, drawing upon a great deal of theoretical knowledge in order to structure his claims, he not only puts forth a model of education counter to that of typical schools (even radical ones) he does so in a manner that is itself a claim about discursive education, about the encounter between teacher and student, the necessity and moreover potential of a revolutionary subjectivity and the communality of such a subject.

Freire is perhaps the best example to move forward with at this moment, in that he so clearly presents a moment where the categorical structure of “theory” is obliterated but “theory” is still being done. Freire draws heavily on a consciousness of revolution that is almost unmistakably Maoist in its consideration of the “peasantry” as a class, how Mao repudiated Stalinist ideas for the necessity of urbanization-for-itself in order to create an apprehendable proletariat out of peasantry. Meanwhile, Maoist writing, and Freire’s following claims, consider the location of peasantry and work from it in a manner that is radically different and a radical development upon the concept of proletarian subjectivity. Freire poses a model of pedagogy that specifically rejects that which he calls the “banking model” of education because it restructures the way in which the bourgeoisie relate to the peasantry, the “well-to-do” peasants of Mao relate to other peasants, so on. It is through an encounter within the group that education occurs, and Freire does not merely see this as a potential accessory to learning, to raising proletarian consciousness, he sees it as entirely vital, as vital in the most basic of fashions.

Freire spends a great deal of time discussing how, through education, those entering a classroom will be specifically imbued with a subjectivity that has precluded them from understanding their situation. They are either unaware, or moreover aware but have become aware in refutation, in an articulation of proletarian consciousness that redoubles upon structures of violence, that owes to the neoliberal myth of development. Freire talks of how the most vital aspect of a pedagogy of the oppressed is in realizing the oppressive structure at hand, in being able to describe it and moreover to organize from that moment of realization. The greatest break that Freire requires in his theory is one from the previous consciousness of situationality that makes peasantry into a life of the static, of unchanging relations no matter whether a tractor has a gearshift or a touchscreen, a vital status that cannot be meaningfully elaborated upon. Freire recognizes the specific quality of this previous realization, of the manner in which the “theoretical” and the “radical” are excluded before any encounter may occur specifically through the concept of self passed down from bourgeoisie concepts of self. Only they, only the definable other, may pass through a becoming-subject, not those collected in Freire’s classroom.

The questions of discourses labeled theoretical are so often posed by experience, and in fact are often critiqued and elaborated upon by those experiencing them, to a point where one must absolutely accept the turn by which involvement in theory is so frequently increased by experience of oppression. Freire’s pedagogy lies in not only working against the notions of what may constitute meaningful engagement, but in fact in opening up the flows of engagement, flows of desire, that enable and structure an outpouring onto texts, a critique thereof, the radical readings that become so important for liberatory practice.

To entirely reject a theoretical discourse is, in many ways, to endorse a certain claim regarding it. Claiming that a question of gender is irrelevant is not a refusal of the question, but rather an articulation of one’s relation to the question at hand. When the expanse of capitalism, its gaping maw, stretches so wide that even externality is included in the expanse, simply claiming that there is a sort of Real onto which the theoretical cannot be applied is itself a claim that supports other concepts of the theoretical, other manners of applying epistemic and ontological claims onto bodies, the socius, structures of political and psychiatric and medical and gendered and all sorts of other differentiated violences. Not reading Butler is simply not reading Butler, but to reject any reading of Butler is to imply that notions of performativity are useless even if one endorses them in one’s critique of another’s claims. Spivak’s reading of Derrida is especially pertinent here, in that her Translator’s Preface to Of Grammatology is in many ways a work-in-itself, discussing a process of translation in particularity, but moreover the conceptual framework by which translation becomes possible-or-impossible and the implication that has upon language regarding coloniality and its violence. Spivak’s specific reading of Derrida not only shifted the larger American perception of his work, but in fact lead to Derrida writing in response to that shift, effectively engaging in a sort of metatextual turn whereby Spivak realizes a potential flow within Derridean theory and writes upon it to great effect. This is an unusual example due both to the way in which Spivak was able to access Derrida himself and maintain a friendship during the translation, as well as Spivak’s own theoretical claims and their interaction with Derrida’s. However, conversely, even a more conventionally faithful translator such as Massumi (rarely mentioned regarding A Thousand Plateaus itself) can develop theoretical frameworks following the works they approach: Parables for the Virtual is a thoroughly Deleuzean book that resonates with great strength over a decade and a half after its publication despite its hypercontemporary subject matter: Massumi’s “virtual” is particularly tied to the internet technology of the early 2000s but the questions of the Virtual posed in the text are still incredibly fruitful today.

There is more than a bit of irony in writing with the style I use about issues of ignoring the theoretical for its density, obscurity, so on. However, critiquing the particularity of an author’s style in order to critique their claims rather quickly devolves into putting forward a concept of the text that assumes its death, that not only revives the author as a revenant but kills them in turn, that does not and moreover cannot lead to a meaningful engagement with the question of the usefulness of “theory” instead leading to incoherent posturings of what one or another “belief” constitutes, what can be truly meant by any claim, and a maintaining that totality over a text can be easily come to.

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everydayobosan-blog · 7 years

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Suicide Intervention

During my lifetime, I have come into contact with two people who later took their own life. The first was a colleague with whom I worked with at the Cape and the second was the husband of a member of the temple to which I was assigned. To this day I grieve for them wishing there was something I could have done to prevent them from taking their own life. Unfortunately, contrary to popular belief, not all suicides are preventable.

Suicide affects people from all age groups. In 2015, suicide was the leading cause of death in people 15 to 34 years of age, and the third leading cause of death for children ages 10 to 14. Just today I read an article by the Associated Press (AP) that 50% of college students have contemplated suicide during their undergraduate program. If you have a child in college, it is particularly important to listen for signs of despair, anxiety, or depression.

I have read different interpretations by as many ministers of the Buddhist teachings on the topic of suicide with wide interpretations including one who said that to take one's life is to take revenge on one's negative karma. Buddhism teaches that life is invaluable, our life being one of limited time and occurrence. Buddhism uses the parable of the tortoise swimming in the ocean whom every thousand years comes up for air. During that time, there is a wreath floating in the water, traveling with the ebb and flow of the tides and currents. The chance of the turtle which comes up for air only once every thousand years happens to come up for air in the middle of the wreath is the same as the likelihood of being born into human life. I have taken certain liberties with this story without changing its original meaning. Though the probability of being born into human life is immeasurable and living this truth has profound life changing implications, I am not certain that relating this story to one who is contemplating suicide would have much effect.

Many people have differing opinions on suicide to include labeling people who take their own life “cowards” or worse. Even some Emergency Room nurses who receive people who have injured themselves through attempted suicide become irate saying “we spend our entire career trying to keep people alive and you want to die.” The fact of the matter is that to commit suicide takes a lot of courage and the majority of people who attempt suicide suffer from some form of mental illness, particularly major depressive disorder. The brain is like any other organ – if someone has a heart attack or stroke, we do not blame or shame them. So why should those who have mental illness leading one to contemplate suicide be stigmatized or rejected?

Let's take the example of one who has a major depressive disorder. If we have a computer and the Central Processing Unit (CPU) to mean the chip that does all the calculations is not working correctly, regardless of the data you try to push through the computer, it is incapable of registering or being processed correctly. And so, even if we use parables or talk about the immeasurable value of human life, I don't believe it can be understood by those who are close to taking their own life.

However, if we look at this from a Jodo Shinshu Buddhist perspective, the fact that we are embraced by the active workings of infinite compassion and infinite wisdom is to mean that because of the actions we have taken, all of the thoughts we have thought, and everything we have said, it is precisely for this reason that we are unconditionally embraced by the Buddha of Infinite Compassion, Infinite Wisdom, and Eternal Life without exception. If in the moments of deep despair, or when we experience the effect of our negative karma, and it seems like we are in hell, where is Amida Buddha? Amida Buddha is within us sitting in hell and out of compassion shedding many tears seeing us in suffering.

What brought this to mind is that I recently had an opportunity to attend a seminar on suicide here in Hilo where they taught how to recognize and approach those who are contemplating taking their own life. This doesn't mean that we were trained to stop suicide, but to help those who are suicidal to get qualified help.

Some of the warning signs of someone who is contemplating suicide are:

Feelings of hopelessness or desperation

Insomnia

Panic attacks

Social isolation

Feeling overwhelmed

Irritability

Rage

Feelings of being a burden

Also included in the list is changes in dress or cleanliness, i.e. someone who is normally clean and wears fresh clothing wearing rumpled unclean clothing or they appear to not have been taking care of themselves, i.e. personal hygiene.

If your child or anyone you know exhibits such symptoms, take them seriously. Do not make light of their suffering. They are calling out for help.

The vast majority of those contemplating suicide do not want to die. What they do want is a relief to their problems and for them they believe that suicide is a viable option. If it is possible to intervene, then you may have saved someone's life.

Imagine if we were all able to recognize those in distress and be catalysts for connecting those contemplating suicide to qualified help. Together we can make a difference.

I am not a Mental Health Professional, What Can I Do?

Again, unless we are trained mental health professionals, we are limited in our ability to help another. However, we are not powerless. We can intervene and in so doing possibly save a person's life by following steps outlines below:

The key to remembering these steps is the acronym “TALK.”

T – Tell – Approach the person and tell them that you have noticed certain changes in their behavior, dress, attitude, or mood and that people who exhibit such symptoms are often contemplating suicide. Do not be afraid to be blunt, do not use the words “seeking to harm themselves” as this takes on a different connotation from the word Suicide.

A – Ask – Ask if they themselves are contemplating suicide. Just asking can help bring them back from the edge.

L – Listen – Just listen. The majority of people who are contemplating suicide want someone who will listen to them. Do not be judgmental or critical and don't offer your own advice. Just listen attentively and don't look at your watch or greet passer-byes. It could be 30 minutes, an hour or two hours, just sit and listen.

K – Keep Safe – Tell them that you know of someone who can help “us” and make sure that they are safe from danger. Ask them if it is okay to contact your resource and wait with them until that resource arrives. Then bring the resource person up to date in the presence of the one who was contemplating suicide and ask them if there is anything you might have missed. Tell them that they are in good hands and you will check in on them later. It is also important for you to keep safe. If they say they have a weapon within reach then while speaking to them back away from the weapon. You do not want to endanger your own life.

Don't limit your help to just people in the temple community or your circle of friends. If you see someone crying or looking despondent on a park bench for example, come up to that person and use the TALK methodology described above. They may not have been contemplating suicide, and if this is the case then great! If on the other hand they were, you might just have saved a life.

To help them Keep Safe, Call 911 and wait with them for help to arrive or drive them to the Hilo Medical Center emergency room for psychiatric evaluation.

Though we may possess limited compassion and limited capabilities, this does not mean that we not try to express compassion and concern no matter how limited they may be. Together we can make a difference in our community.

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classicfilmfreak · 7 years

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New Post has been published on http://www.classicfilmfreak.com/2017/10/19/wolf-man-1941-starring-lon-chaney-claude-rains/

The Wolf Man (1941) starring Lon Chaney and Claude Rains

��Even a man who is pure in heart and says his prayers by night may become a wolf when the wolf bane blooms and the autumn moon is bright.”

Much of the folklore—“wolflore,” wives tales?—known about werewolves and the process of their transformation, lycanthropy, originated in The Wolf Man. If any one watching this 1941 film is unfamiliar with the werewolf legend, a number of the characters quote the above line, ad nauseam, as a reminder.

The first of these signposts mentioned in the film is the pentagram as a sign of the werewolf, engraved on the handle of a most important cane. Another myth perpetuates the idea that this wild canine metamorphosis occurs during a full moon. The old gypsy woman of the movie initiates the idea that a werewolf can be killed with a silver bullet, a silver knife or, as demonstrated at least twice in the film, that cane with its silver handle. Introduced last, and to quote the old gypsy herself, “Whoever is bitten by a werewolf and lives becomes a werewolf himself.”

Unusual for this early in his career, Claude Rains has a non-villainous role here, remaining aloof from this werewolf business and denying that his son, played by Lon Chaney, Jr., has had the “wolf experience.” He began his career, however, playing disagreeable fellows. His first film, The Invisible Man in 1933, is one of the best in the horror genre. While it wisely mixes some diverting humor with the horror, The Wolf Man takes it all seriously.

The following year, Rains goes insane in The Man Who Reclaimed His Head, and, in 1935, he becomes an opium addict in The Mystery of Edwin Drood, a choirmaster who murders all suitors of his inamorata and buries them in the cathedral crypt. Next, as aristocrat Don Luis, a gout-crippled husband in Anthony Adverse (1936), he kills his wife’s lover in a duel. From eighteenth-century Italy to medieval England Rains lusts for power, first as the Earl of Hertford in The Prince and the Pauper (1937) and then as Prince John in The Adventures of Robin Hood (1938), both opposite Errol Flynn.

When The Wolf Man opens, Larry Talbot (Chaney) is returning to his father’s ancestral home (a detailed matte painting) after eighteen years away. The death of his brother in a hunting accident has reunited him with his father, Sir John (Rains), after years of estrangement.

After Larry has met his father’s friend, Colonel Montford (Ralph Bellamy), chief constable of the district, he visits an antique store. He flatters a young woman, Gwen Conliffe (Evelyn Ankers), but she appears impassive. She, however, sells him a silver-handled walking stick, with an engraved pentagram and wolf’s head. She acquaints him with the werewolf legend and the “Even a man . . . ” quote. Despite her indifference, he says he will meet her at the shop that night and take her to the gypsy carnival that has just arrived in town.

After a brief scene at home where his father quotes the “Even a man . . . ” line, Larry returns that evening to the antique store. Strangely enough, Gwen is waiting and introduces her friend Jenny (Fay Helm), who also quotes the line.

A fortuneteller, Bela (Bela Lugosi), reads Jenny’s palm and sees a pentagram, a portent of evil. “Go quickly! Go!” he says. As she runs through the foggy woods, she is attacked by a wolf, which Larry kills with his cane but not before he is bitten on the chest. Maleva (Maria Ouspenskaya), another gypsy fortuneteller, happens by in her cart, greatly distressed over Larry’s wolf encounter. Unfortunately he leaves his cane.

Psychiatrist Dr. Lloyd (Warren William) and the police find beside the dead Jenny the body of Bela, but where is the wolf that Larry killed? (As Maleva will later explain, Bela was a werewolf and, upon death, returned to human form.)

During another visit to the carnival, Gwen is accompanied by her fiancé, Frank (Patric Knowles). In reading Larry’s fortune, Maleva sees the worst and gives him a protective pentagram pendant, which he later will give to Gwen “just in case.” For a reason unexplained, the pentagram, a sign of the werewolf, now becomes protection against one.

Larry goes home, notices the pentagram sign on his chest and sees his feet growing hair (no facial shots are used). Now transformed into a wolf, he tiptoes through the fog-drenched woods—what has tiptoeing to do with a wolf?

Next morning, Larry has no memory of killing a gravedigger (Tom Stevenson), but awakens to see muddy paw tracks on the carpet and windowsill. He at least has enough sense of guilt to rub them out.

Though still denying any wolf connection with his son, Sir John interprets the werewolf legend as a parable of “the good and evil in every man’s soul,” that “anything can happen to any man in his own mind.” Despite Larry’s cane being found beside Bela’s body, Dr. Lloyd lays on the psychiatric jargon, attributing any of Larry’s werewolf links to his own “psychic maladjustment.”

On another nightly prowl as a wolf, Larry gets his foot caught in one of the traps which Frank and the colonel have set. By the time Larry has returned to human form, he has freed himself from the trap and returned home.

Sir John of course still refuses to believe what Larry tells him, that he has killed Bela and the gravedigger, that he has seen the pentagram in Gwen’s palm. He must leave town, he says. When Colonel Montford comes for Sir John to join the wolf hunt, he straps his son to a chair and takes the silver-handled cane upon Larry’s insistence.

In the woods, Frank and Colonel Montford, armed with shotguns for any wolf contingency, end up chasing a wolf that is after Gwen. Gwen falls unconscious and the wolf turns on Sir John, who uses the cane to kill the animal.

The hunters return just after the wolf has turned back into Larry, who obviously had escaped his bonds. (The two previous human-to-wolf dissolves had been only of feet; now, for the third and last time, seventeen continuous dissolves show the face, the work of special effects expert John P. Fulton and make-up artist Jack Pierce.)

“The wolf must have attacked Gwen,” Montford surmises, “and Larry came to the rescue.” The father, the one most in denial of his son being a werewolf, is now the only one who knows the truth.

By the true nature of the film—The Wolf Man is, after all, a horror film—it’s difficult for elements such as the subtleties of acting or serious character development to be exploited. Claude Rains, however, comes through best of all, as expected, solid and determined, but, for a man with his character’s intelligence, he is a little slow to comprehend the goings-on.

Lon Chaney, in the first of five appearances as the wolf man, is sincere in his portrayal of an innocent man experiencing a series of changes through no fault of his own. At first he is merely suspicions of what he might have done, then haunted by terrible visions and hallucinations beyond his comprehension and finally tormented—practically driven mad—by the realization that he has committed murder and, in his state, could endanger the life of the woman he loves. Bela Lugosi had actively campaigned for the role, but ended up with his brief, killed-off-early part.

Evelyn Ankers and Maria Ouspenskaya, two quite different actresses in age and persona, serve well two extremes—the attractive love interest for Chaney and, talk about sincerity, the more than credible gypsy who delivers her hocus-pocus nonsense so convincingly she could have been recruited from an authentic band of gypsies, much as Jan Rubes as the Amish patriarch Eli Lapp in Witness (1985) seems borrowed from that religious sect.

As for the remaining three stars—Ralph Bellamy, Warren William and Patric Knowles, they are pretty much wasted, making a lot of entrances and exits, encumbered by some often trite dialogue. Knowles, for one, is studio-supplied with the props of an English country gentleman, with pipe and tweed coat. The film also features a number of well known supporting players of the ’30s and ’40s: J. M. Kerrigan, Forrester Harvey, Harry Cording, Olaf Hytten and Leyland Hodgson, among others.

https://www.youtube.com/watch?v=AsrFMBWRC1M

#Claude Rains #Lon Chaney #Patric Knowles

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themadbomber187 · 8 years

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DYLAN ROOF IS SENTENCED TO DEATH. TODAY IS A GOOD DAY!!!!

CHARLESTON, S.C. — Dylann S. Roof, the impenitent and inscrutable white supremacist who killed nine African-American churchgoers in a brazenly racial assault almost 19 months ago, shocking the world over the persistence of extremist hatred in dark corners of the American South, was condemned to death by a federal jury on Tuesday.

The jury of nine whites and three blacks, who last month found Mr. Roof guilty of 33 counts for the attack at Emanuel African Methodist Episcopal Church in downtown Charleston, S.C., returned their unanimous verdict after about three hours of deliberations in the penalty phase of a heart-rending and often legally confounding trial.

The guilt of Mr. Roof, who coolly confessed to the killings and then justified them without remorse in a jailhouse manifesto, was never in serious doubt during the first phase of the proceedings in Federal District Court in December. By the time the jurors began their deliberations on his sentence, it seemed inevitable that they would lean toward death, not only because of the heinous nature of the crimes but because Mr. Roof, 22, insisted on denying any psychological incapacity, called no witnesses, presented no evidence in his defense and mostly sidelined his court-appointed lawyers.

Mr. Roof, who showed no emotion as the verdict was read, will be formally sentenced on Wednesday. The decision effectively capped Mr. Roof’s first trial for the killings on June 17, 2015, the Wednesday when, after six scouting visits to Charleston, he showed up in Emanuel’s fellowship hall and was offered a seat for Bible study by the Rev. Clementa C. Pinckney. Mr. Roof sat quietly, his head hung low, for about 45 minutes while the group considered the meaning of the Gospel of Mark’s account of the Parable of the Sower.

Continue reading the main story

What You Need to Know as the Dylann Roof Trial Concludes JAN. 10, 2017

Dylann Roof, Charleston Church Killer, Is Deemed Competent for Sentencing JAN. 2, 2017

No Regrets From Dylann Roof in Jailhouse Manifesto JAN. 5, 2017

Dylann Roof, Addressing Court, Offers No Apology or Explanation for Massacre JAN. 4, 2017

Dylann Roof Himself Rejects Best Defense Against Execution JAN. 1, 2017

Then, with the parishioners’ eyes clenched for a benediction, Mr. Roof brandished the .45 caliber semiautomatic handgun he had smuggled into the church in a waist pouch. First taking aim at Mr. Pinckney, who was a state senator and the youngest African-American ever elected to South Carolina’s Legislature, he began to fire seven magazines of hollow-point rounds.

The reverberation of gunfire and clinking of skittering shell casings subsided only after more than 70 shots. Each victim was hit repeatedly, with the eldest, Susie Jackson, an 87-year-old grandmother and church matriarch, struck at least 10 times.

During the brief siege, the youngest victim, Tywanza Sanders, 26, pleaded with Mr. Roof not to kill. “You blacks are killing white people on the streets everyday and raping white women everyday,” Mr. Roof said during the rampage, according to a jailhouse manifesto he wrote after his arrest.

Before leaving shortly after 9 p.m., Mr. Roof told one of three survivors, Polly Sheppard, that he was sparing her so she could “tell the story.” He stepped over one minister’s bleeding body on his way out the side door, Glock pistol at his side. The killer expected to find officers waiting for him, and had saved ammunition to take his own life, Mr. Roof said in his confession to two F.B.I. agents.

But the police, alerted by 911 calls from Ms. Sheppard and Mr. Pinckney’s wife, Jennifer, who was hiding with their 6-year-old daughter under a desk in the pastor’s study, had not yet arrived. Mr. Roof got into his black Hyundai Elantra and drove north through the night on country roads.

Officers in Shelby, N.C., detained Mr. Roof the next morning after a florist on her way to work spotted his car, which had been depicted in nationally broadcast alerts based on images from the church’s security cameras. Mr. Roof offered no resistance, admitted that he had been involved in the shootings and directed the officers to the murder weapon under a pillow on the back seat.

In addition to Ms. Jackson, Mr. Pinckney and Mr. Sanders, six other people were killed: Cynthia Hurd, Ethel Lee Lance, the Rev. DePayne Middleton Doctor, the Rev. Daniel L. Simmons Sr., the Rev. Sharonda Coleman-Singleton and Myra Thompson.

They were familiar, frequent presences at the church known as Mother Emanuel, the oldest A.M.E. congregation in the Deep South and one with a storied history of resistance to slavery and civil rights advocacy over nearly 200 years. In 10 days of testimony, their names and photographs appeared again and again. Family members filled the reserved seats on the right side of the courtroom each day, and 23 relatives and friends delivered emotional testimonials to their character and the impact of their loss.

Ms. Hurd, a librarian, had adopted a simple motto for her life: “Be kinder than necessary.” Ms. Lance was a perfume aficionado with a gentle smile that unified her family. Ms. Middleton Doctor’s first sermon had been titled “The Virtuous Woman.” Mr. Simmons, a veteran of the Vietnam War, had been among the first blacks in South Carolina hired to drive a Greyhound bus. Ms. Coleman-Singleton was a beaming mother whose ebullient preaching made her a popular figure in Charleston’s churches. Ms. Thompson was a workhorse of Emanuel who had chaired its trustee board. Mr. Sanders, whose parents found hundreds of poems in his bedroom, aspired to become an entertainment lawyer.

“That night, they were getting basic instructions before leaving earth,” Felicia Sanders, Mr. Sanders’s mother and a survivor of the attack, testified.

The jury found Mr. Roof guilty in December of hate crimes resulting in death, obstruction of religion and use of a firearm to commit murder during a crime of violence. Eighteen of the 33 counts carried a potential death sentence.

Although Mr. Roof declined to testify or present any evidence, his trial was unusual for the jury’s ability to hear from an accused mass murderer in his own unapologetic words. They watched video of his two-hour confession to the F.B.I., and heard readings of his online manifesto, a journal found in his car, suicide letters to his parents, and a jailhouse essay written within seven weeks after his arrest.

The trial became a duel of competing narratives on the slightly-built, ninth-grade dropout from the Columbia area. In the prosecution’s depiction, Mr. Roof was the personification of evil, a racist ideologue, radicalized on the internet, who plotted an intensely premeditated assault over more than six months, waiting only until he was 21 and old enough to buy a weapon.

He downloaded a history of the Ku Klux Klan 10 months before the attack, used the online handle LilAryan to communicate with like-minded white nationalists, created the website www.lastrhodesian.com to post a deliberative screed against blacks, Hispanics and Jews, and audaciously adorned his canvas prison shoes with supremacist symbols, even wearing them to court. He proudly embraced his mission to incite a race war, and admired himself in his writings for having the courage to carry out actions that less-committed racists only prophesied.

“Sometimes sitting in my cell,” Mr. Roof wrote while in jail, “I think about how nice it would be to watch a movie or eat some good food or drive my car somewhere, but then I remember how I felt when I did these things, and how I knew I had to do something. And then I realize it was worth it.”

But in the portrayal suggested by defense lawyers, Mr. Roof was a deeply disturbed delusionist who most demonstrated his incapacity by denying it. Indeed, Mr. Roof insisted on representing himself during the sentencing phase for the purpose of preventing his experienced capital defender, David I. Bruck, from introducing potentially mitigating evidence about his family, educational background or mental health. Mr. Roof sat impassively at the defense table, almost every minute of every day, showing no interest or expression even when his own words were read aloud.

The results of at least two psychiatric evaluations have been kept under seal by Judge Richard M. Gergel, who ruled Mr. Roof competent to stand trial and to represent himself. Jurors heard little of Mr. Roof’s family, which arrived in Lexington County from Germany in the first half of the 18th century and included Lutheran ministers, Confederate soldiers, slaveholders and two county sheriffs, according to a family genealogy.

His paternal grandfather is a well-regarded lawyer and his father a construction contractor. Mr. Roof was born in 1994 to parents who had already divorced but had briefly reconciled. Mr. Roof began his online treatise by absolving them of any responsibility for his beliefs: “I was not raised in a racist home or environment.” Experts on white supremacists said Mr. Roof was younger than most who resort to violence, and stands apart for his lack of contact with organized groups.

Carol S. Steiker, a Harvard law professor who has written extensively about the death penalty, said that the two narratives about Mr. Roof were not necessarily inconsistent, and that a concealed psychological defect could have left Mr. Roof susceptible to a disconnected worldview. “It’s pretty hard to tell the difference between bad and mad, between evil and crazy,” she said, “and that’s why we need the investigation needed to present a mitigating case.”

Mr. Roof’s rampage staggered this area, which was already reeling from the April 2015 shooting death of an unarmed black man, Walter L. Scott, by Michael T. Slager, a white police officer in North Charleston.

But two days after the church shootings, with Mr. Roof standing expressionless in the Charleston County jail, five relatives of the victims publicly offered him forgiveness during an extraordinary bond hearing. The following week, President Obama argued in a soaring eulogy for Mr. Pinckney, which culminated in an a cappella rendition of “Amazing Grace,” that the attack’s lessons offered a way forward for race relations.

Later, South Carolina lawmakers voted to remove the Confederate battle flag from the grounds of the Statehouse in Columbia, where it had flown for more than a half-century and enjoyed decades of political protection.

The Justice Department announced last May that its prosecutors would seek the death penalty for Mr. Roof, in part because of what officials described as his “substantial planning and premeditation” and his “hatred and contempt” toward black people. Although federal capital prosecutions are complex and expensive, the government rejected Mr. Roof’s offer to plead guilty in exchange for a life sentence.

Federal law classifies the jury’s decision as a binding “recommendation,” and Mr. Roof will be sentenced formally at a later hearing, when survivors of the attack and relatives of the victims may testify without constraints in the trial intended to preserve his due process rights.

Yet the verdict confers no certainty about whether Mr. Roof will ever be put to death at a federal prison in Terre Haute, Ind. His case could spur years of appeals — the courts could well consider his mental competency and even the tearful tenor of the sentencing phase — and the scarcity of lethal injection drugs could hinder his execution.

The federal government has not killed one of its prisoners since 2003. Mr. Roof also faces a separate capital prosecution for murder in South Carolina, where no inmate has been put to death in more than five years. The state trial, initially set for Jan. 17, has been indefinitely postponed.

That it at times seemed more important to Mr. Roof to not be depicted as mentally ill than to avoid execution prompted some in the courtroom to question whether he simply preferred to die than to serve a long life in prison. His writings and confession offered evidence on both sides of that question, wavering between glimmers of hope — even that he might someday be pardoned — and an attraction to the prospects of martyrdom. But his commitment to his cause — the restoration of white power through violent subjugation — never publicly flagged.

“I have shed a tear of self pity for myself,” he wrote in 2015. “I feel pity that I had to do what I did in the first place. I feel pity that I had to give up my life because of a situation that should never have existed.”

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#dylann roof #true crime #hate crime

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