An article in the New York Times (NYT) describes the perverse incentives that make it more profitable for private drug companies to produce drugs that improve survival marginally in late-stage cancers than to produce drugs that prevent cancer in the first place.
It is a medical axiom that the best way to cure a disease is to prevent it from occurring in the first place (“an ounce of prevention is worth a pound of cure.”) However, when we survey the medical literature, we find very few studies of drugs that prevent disease, especially cancers. The reason for this is the perverse incentives of patent exclusivity.
The developers of a drug are given 20 years to exclusively produce (or license others to produce) that drug. On average, after clinical studies are complete, there are 12.5 years left of exclusivity for the company to profitably sell a drug. This incentive works against clinical studies that take many years to complete. By definition, a drug that prevents disease will take much longer to show significant results than a drug which treats the disease after it has already appeared. In many cases, prevention lasts a lifetime: 70 years or more, much longer than the patent exclusivity period.
The article refers to research done by Eric Budish, Benjamin N. Roin, and Heidi Williams that shows how this works for cancer drugs. The abstract of the study concludes:
… we document several sources of evidence that together show private research investments are distorted away from long-term projects. The value of life-years at stake appears large. We analyze three potential policy responses: surrogate (non-mortality) clinical-trial endpoints, targeted R&D subsidies, and patent design.
A good example (in a non-cancer context) is the case of Lipitor, formerly a widely advertised and popular drug that had patent exclusivity for Pfizer and made them a great deal of money. It took many years for a study to appear that had adequate statistical strength to prove that it lengthened lives. By the time this information was available and accepted by a preponderance of medical doctors, the patent had expired and there was no longer any financial incentive for Pfizer to advertise it or to sponsor studies of its use.
Despite the loss of patent protection, atorvastatin has come to be used for many other things than hyperlipidemia (high cholesterol and high fats in the blood): for example, atorvastatin has been used for progeria, polycystic ovary syndrome, transient ischemic attacks (mini-strokes), type 2 diabetes (the most common type), coronary artery disease (obstruction of the arteries that supply the heart muscle with blood, that leads to heart attacks), peripheral artery disease (obstruction of peripheral arteries), arteriosclerosis and atherosclerosis generally, after a heart attack to prevent further damage, and so on. Most of these diseases are directly related to hyperlipidemia, but polycystic ovaries and progeria are not.
Studies of high doses of atorvastatin given to patients with severe coronary artery disease, especially after heart attacks, have already shown that it lengthens the life span of people who take it. The main side effects, muscle pain and weakness, may require a patient to discontinue the drug, but most patients tolerate it extremely well with no side effects. It will take many more years to prove that atorvastatin lengthens the lives of people who merely have high cholesterol; some studies already suggest that administration of the drug to otherwise normal individuals has advantages.
One approach that reduces this problem is to look for “surrogate end points”, a method that has helped in the development of drugs for AIDS. In this approach, blood tests or other tests, even symptoms and signs, are used to determine if the drug shows any indications that it may improve survival in the long run. For AIDS, the surrogate end points are such things as the number of T cells in the blood. Very low numbers are associated with severe, end-stage AIDS, and drugs that can increase the number of T cells will usually improve survival, despite unpleasant side effects. Drugs that improve the patient’s weight, strength, and other outward signs of illness can also be used as surrogate markers.
The article discusses other approaches that may improve the incentives to produce drugs that prevent cancer, but it concludes:
Drug patents incentivize innovation, and F.D.A. approval is a check regarding drug safety and efficacy. The way they work together affects the incentives for research and could reduce something many would view as highly valuable: cancer prevention.
The approach that is not discussed in the article is the only one that is certain to improve incentives: government sponsorship of drug development for specific long term purposes. If the federal government were to set up a program that looked for and developed drugs that improve long term survival and well-being, the problem of perverse incentives would be overcome with a single stroke.
This idea is sure to be controversial because it sets up the government in competition with private drug companies; if it can be made clear that development will proceed in parallel and that the government will only develop drugs with long term benefit, drugs in which the private companies have no financial interest, it may be possible to further proceed in this direction.
The only alternative, the condition that exists today, is for naturopaths and other “quacks” to produce and sell drugs that have anecdotal evidence for benefits, hardly a productive state of affairs.
57-year-old Barbara Dawson died Monday at the Calhoun Liberty Hospital (25 beds) in Blountstown , Florida (population 2,500) (25 miles from the next hospital) at around 6:24 AM. She had been discharged from the hospital but refused to leave. She was using an oxygen tank, but the hospital staff refused to return it to her and called the police when she would not leave. A policeman put her in handcuffs and escorted her to his patrol car, but she collapsed while waiting for him to unlock the door. He removed her handcuffs and staff put her on a gurney to return her to the hospital. Supposedly her vital signs were OK when she was returned, but two hours later she was dead. A bystander, related to her, claims that she had no pulse after she collapsed in the parking lot, but CPR wasn’t started until she was back in the hospital.
According to the Talahassee Democrat (a Gannett company), Ms. Dawson had been admitted Sunday evening around 10:30 PM after arriving by ambulance, complaining of stomach pain. She was discharged early the next morning; in fact, she was thrown out for supposedly causing a disturbance. She refused to leave and demanded further medical care, complaining of shortness of breath and “not feeling well.”
Apparently Ms. Dawson was disturbing because she was complaining loudly and questioning her care.
Ms. Dawson was a “frequent flyer”; according to the article, she had been in Talahassee hospitals 22 times since 1987, and apparently other hospitals as well. No other details of her medical condition were given in that article. She had been ordered to leave the hospital in the past, and police had been called to remove her before.
The hospital’s chief administrator and CEO is Ruth Attaway. She gave the following statement to reporters later:
Attaway said blot clots in the lungs are hard to detect, often result in immediate death and are nearly impossible to treat.
The decision to remove her form the hospital was out of safety for the other patients in the 25-bed hospital.
As a matter of fact, the treatment required for a potentially fatal pulmonary embolism that is obstructing the flow of blood from the heart through the lungs is emergency cardiopulmonary surgery, an heroic procedure beyond the resources of any but the largest hospitals. The diagnosis of a pulmonary embolism that is not immediately fatal requires a high index of suspicion and ventilation-perfusion radioscintiscanning, another facility that is only available in large hospitals. Treatment of a nonfatal embolism is simple: large doses of heparin (requiring close observation and blood testing) for ten days, followed by coumadin for six months.
The most likely source of a pulmonary embolism is spontaneous clotting within the venous system, particularly the veins of the legs. These veins are frequently enlarged and obstructed, particularly in obese individuals.
The local chapter of the NAACP has become involved, and lawyers are preparing a case against the hospital and the police. It is unlikely that the policeman did anything untoward, but it is certain that the hospital staff failed to meet the standard of care, even for such a small hospital.
A side note about the hospital:
The Florida Department of Law Enforcement is investigating the hospital’s former CEO Phillip Hill in connection with a more than $1 million fraud scheme. Hospital officials have accused Hill of creating between 50 and 100 fake invoices for medical supplies the hospital never received.
There is nothing new about the observation that people who have repeated concussions eventually develop brain damage, altered personalities, mood changes, and mental deterioration. This is encapsulated in the word “punch-drunk.” What is new is that the National Football League (NFL) has seen its financial viability threatened by the repeated diagnoses of chronic traumatic encephalopathy in some of its most colorful and high-salaried players.
The NFL’s response to this potential threat has been inconsistent, beginning with denial and attempts to marginalize the first pathologist who published these diagnoses: Dr. Bennet Omalu. The diagnostic process and the league’s reaction has been dramatized in a movie, Concussion, with Will Smith in the lead role. Mr. Smith is well-practiced in this role, having done a realistic and appealing portrayal of a fictional doctor who diagnoses and treats a fictional epidemic of vampirism in New York City. That movie was a remake of the Charlton Heston classic, The Omega Man, and was titled after the original book: I am Legend. The Charlton Heston movie was actually the second adaptation of the book written by Richard Matheson, the first being The Last Man on Earth, with Vincent Price in the title role.
This post is not about Concussion, which I haven’t seen yet. It is about chronic (post)traumatic encephalopathy (CTE) and football. By the time Junior Seau killed himself with a shot to the chest, the problem was well known to football players, and Junior himself thought that he might have it. He didn’t specifically request that his brain be studied, but considering the method he used to kill himself, it is likely that he did want that to be done.
ESPN published an article about the struggle over Junior Seau’s brain in 2013, entitled Mind Control. By the time of Junior’s death on May 2, 2012, the NFL had designated Boston University (BU) as the site for CTE research that it would support. However, several researchers and medical examiners were involved in the work, and an unseemly competition developed between the separate researchers over possession and control of the brain tissue. Junior’s family members were approached more than once by different people requesting permission to take Junior’s brain tissue for study.
The National Institutes of Health was designated as the recipient organization. The NFL had a large part in that final decision, having disbanded its original concussion committee and forming a new committee. The NFL’s original stance has been radically changed, an improvement over a policy that the ESPN article described in this way:
The players charge that the league’s original concussion committee, which was disbanded in 2009, conducted fraudulent research to hide the connection between football and brain damage. That 15 years of research has been largely discarded, even by the league.
Dr. Rich Ellenbogen is the new committee’s co-chairman. The ESPN article states that although the NFL had designated BU as its “brain bank” there were complaints that BU had refused to share its tissue samples with other researchers. Because of these complaints, Ellenbogen and the committee had already tried to steer tissue from the brain of former Chicago Bears safety Dave Duerson to the NIH (unsuccessfully.) In the Seau case, the article describes Ellenbogen’s reasoning:
Asked in an interview why they suggested the NIH, Ellenbogen said, “We had been talking about it for a while. My point, for a long time I’ve been saying … if you’ve got a problem you want to solve, do you put one university on it or have multiple studies done? The federal government is very good, in some ways, really good about doing this. They don’t have an agenda.”
When they received Junior Seau’s brain, the NIH decided to direct samples to five different research institutions, including BU. This approach ensured immediate replication of the findings by independent groups, none of whom knew at the time the source or name of the deceased. The final diagnosis was no surprise given Junior’s symptoms, but it gave vastly more weight to the finding of CTE to have several independent groups all come to the same conclusion. By contrast, a single diagnosis from BU would have been “just one more brain” since they had already made so many diagnoses in former football players.
Four months after Junior Seau’s autopsy, the NFL donated $30 million to the NIH, an “unrestricted” grant that was the largest it had ever given at that time.
Tyler Seau, Junior’s son, got no “closure” from the diagnosis of CTE. In some ways, it made him feel even worse. He had been stressed beyond his limit by his father’s erratic behavior; he was then contacted at a particularly sensitive time after his father’s death for the necessary procedure of obtaining the family’s consent for examination of his brain; and now, with the diagnosis, he realized that, if he had known before his father’s death what was happening to him, he could at least have had an understanding of what was going on, even if the condition was untreatable.
The NFL attempted to direct Junior Seau’s brain away from researchers who had previously made CTE diagnoses and threatened its livelihood: first, away from Dr. Omalu (by having Dr. Chao, Junior’s team physician, bad-mouth Omalu to Tyler Seau), and second, away from BU, which had made so many CTE diagnoses. The end result was the best from a scientific point of view, although to the NFL, it was no help and may have been even worse because it was independently confirmed by disinterested parties.
The NFL settled the player’s lawsuit in April 2015, offering a projected $1 billion in compensation for head injuries after it agreed to remove the $765 million cap in August 2014. Some parties immediately filed an appeal of the settlement. Others have opted out of the settlement process in advance. Arguments about the fairness or unfairness of the settlement continue, and it won’t be finalized until at least early 2016.
New data from PBS’ Frontline and BU were released in September, showing that of 91 former football players who donated their brains for study after death, 87 had signs of CTE. This is not a random sample, as it is likely that players who suspected they had CTE would donate their brains for study. Nonetheless, it is disturbing to see that so many had the condition, because it suggests that many, or possibly even most, football players have a least some degree of CTE. No further enhancement is likely to occur until a method for diagnosing CTE prior to death is developed. See this International Business Times article for more about the Frontline study.
Junior Seau’s symptoms were the most important problem, and this problem should be emphasized to all; a definite diagnosis is not necessary to be on one’s guard. First, he lost what control he had had over his anger and violent tendencies. Second, he became erratic and prone to mood swings from depression to elation and irritability. Third, he became inattentive to details that he had formerly taken care to arrange to his satisfaction. Another symptom that is not universal but frequent was his uncontrolled gambling and sexual behavior. He also was involved in a car crash in 2010 that some believe was a suicide attempt.
The development of these symptoms, particularly personality changes, is a sign of early CTE. People who have symptoms like these should be examined and considered for the diagnosis. Once CTE is suspected, it is possible to control the damage to a person’s life and the lives of his family by placing him under observation and using legal means to prevent him from spending all his money or signing contracts that are damaging to him. His driver’s license can be taken away; while this does not prevent him from driving, it may reduce the possibility of car crashes.
Some of the behavioral symptoms of CTE may be controlled through the sparing use of what are called “neuroleptic” drugs. This is a controversial practice; the use of drugs to keep patients docile in the nursing home has been shown to reduce their life expectancy, and it is unlikely that the drugs relieve any of the symptoms internally. They only prevent a patient from thinking and planning complex, dangerous behaviors, in my opinion. They likely do not make the patient feel any better.
Thus, the diagnosis of CTE is somewhat like the diagnosis of Alzheimer’s disease. There is no cure, not even any partially effective treatment. There are only custodial measures to limit the damaging effects of the patient’s behavior. Despite this, the advantages of identifying patients who have CTE are significant: the family can know what to expect and be alert to prevent some of the traumatic behaviors.
There was a curious case that occurred a year ago that has some bearing on the age of development of symptoms of CTE. A 22 year old football player and wrestler with a history of unreported concussions killed himself just before Christmas of 2014. An autopsy showed that he “did not have CTE” but evidence of prior concussions was found. The young man texted his mother just before he died: “I am sorry if I am an embarrassment but these concussions have my head all fucked up,” the text said. It is possible that “chronic traumatic encephalopathy” as a tissue diagnosis takes a lot longer to develop than the symptoms of post-concussive encephalopathy.
Further research may identify treatment, but in the meantime, prevention is the only effective approach. This is where the NFL comes in. We can understand their complaint that no-one knows what the incidence of CTE is, that is, how frequently it occurs in people exposed to concussions. This does not excuse the organization from trying to reduce concussions and reduce the forces to which the brain is subjected during the game of football.
At the same time, the way football is played and who plays it have to be changed. Small children to college players should not be subjected to full-contact head-butting without making it clear to the parents and the players that there is a significant risk. Football is not alone in facing this problem. Soccer is also the scene of serious head injuries and less obvious concussions. There is little reason for having soccer players wear helmets, but precautions such as increasing time off after a concussion are warranted.
A woman who collapsed after being arrested for refusing to leave a hospital when doctors discharged her died from a blood clot in her lung, officials said Wednesday. The woman, Barbara Dawson, 57, collapsed on Monday while being taken in handcuffs from the Liberty Calhoun Hospital, where she had gone for treatment for breathing difficulties, the police said. She was arrested for disorderly conduct and trespassing when she refused to leave, according to the police. The Blountstown police chief, Mark Mallory, said the medical examiner’s office found that Ms. Dawson had died from a blood clot caused by her being overweight. State law enforcement officials were called in to investigate.
via Florida: Woman Forced From Hospital Dies – The New York Times.
Just a line to let you know our medical services are still functioning well.
Brain Size and Cognitive Ability
Studies have been done on large populations of men, women, Europeans, Africans, Asians, adjusted by body size, and correlated, and have found that Asians have the largest brains on average (say, 1350 cc), Europeans in the middle (say, 1300 cc), and Africans the smallest(say, 1250 cc); while men have larger (say, 1300 cc) brains than women (say, 1200 cc.) Intelligence tests, again of large populations, show Asians to have the highest IQs (115), Europeans the middle (100), Africans the lowest (85); whereas women have, possibly, slightly lower (96) IQs than men (100).
If brain size is so closely correlated with intelligence, why do women have higher IQs than Africans, who have just as large brains? Remember, that supposedly close correlation is not 1 to 1, it is 0.44; that is less than half the variance.
For comparison, the brain size of a gorilla is roughly 500 cc, and a chimpanzee, 350 to 400 cc. Another comparison: bottlenose dolphins have brains about 1500 cc in size, with body weights not much bigger than human, say 110 kg. Finally, the Neanderthal pre-human had an average brain size of 1500-1600 cc.
One answer is the degree of cerebral folding in each brain; a more tightly folded cerebrum can accommodate more surface area, and thus more neurons than a less tightly folded cerebrum. With a cortical thickness of 2 mm in the cerebral column but more than 2 cm including the subjacent white matter containing the necessary connections to and from the cerebral column, there is a limit to the amount of folding that can be obtained in a given volume of skull. The brain stem and midbrain are probably at least a minimum size, so tightly folding the cortex is an advantage.
The studies on brain size are quoted by racists as indicating that Africans are really less intelligent, on average, than whites; and Asians are the smartest of all. The intelligence quotient studies also back this up. However, there is the curious fact that despite having smaller brains, women test out as nearly as intelligent as men; in fact, women’s brains are, perhaps, slightly smaller than African’s brains, yet they are clearly more intelligent on the tests. This suggests that intelligence is not that closely related to brain size, or else the tests really are biased against Africans.
There are also other factors that contribute to brain size other than intelligence such as relative myelinization, density of neural packing, size of neurons, number of glia relative to neurons, and so on. In addition, the differences in average size are rather small and really don’t account for the fairly dramatic apparent differences in average intelligence. That is to say, there is about one standard deviation’s worth of difference in intelligence test results between each of the three “races”– but there is only a five to ten percent difference in total brain size.
Obama’s Subtle and Maligned Foreign Policy
Obama’s choice is the best of a bad selection: first the imperatives: America must not be seen to be unresponsive to the needs of people seeking freedom anywhere, particularly in Syria. America has global reach, having the largest military budget by far of any in the world. But we must not get overly involved, whatever that implies (1,000 or 10,000) with minimal casualties and minimal stress on a military budget relatively weak in manpower. Therefore: the least we can do, and the most we can do, is send a few Special Forces, characters who are itching to go anyway. And the objective: hold the territory already taken, not gain any new territory, and especially not a military victory. Finally, the time frame: no deadline, because deadlines cause the enemy to bide their time. All the more important that the operations be “sustainable”, that is renewable from year to year. So your “realpolitik”: no victory, but a dynamic stalemate or “Mexican standoff.”
Putin’s aggressive measures should be seen as based on a perceived need to hold the allegiance of his people in difficult times. Thus the impulse to fascism, which is acceptable to American foreign policy as long as it is not aggressive. Opposition must not be seen to be too effective .
The historic increases in productivity, only partially related to automation, has resulted in imposed poverty instead of distributed benefits partially related to automation. Productivity improvements have resulted in the production of a larger quantity and better quality of finished goods with less labor. Instead of distributing productivity improvements by shortening worker’s hours and keeping the same number of workers, owners have kept the hours the same and reduced the number of workers, creating unemployment instead of prosperity, and hijacking the worker’s gains.
The important issue is one of distribution of productivity improvements. If the improvements in productivity were distributed in the form of shorter hours spent producing the same or better product, then the workers would benefit by the time saved. Instead, the employer receives all the benefit when the workers’ hours are kept the same and the number of workers needed to produce the same amount of product is reduced.
The attraction of using each worker to the maximum extent of which they are capable is obvious to the employer. The workers are kept working as much as possible and paid the same, while more product is realized. Otherwise they might start thinking too much during their rest periods. The workers who are dismissed become poorer and resent their former employer but there is nothing they can do (except commit workplace violence, which occasionally happens.) This is inequitable and exploitative.
There are indications that productivity improvements have not been reflected in increased pay or other compensation since 1973.
“The fundamental understanding that ISIS/ISIL is a barbaric enterprise is enough to know, in many ways. I spent nearly a year and a half working in the Middle East. Over that time, I often experienced a level of deceit, cowardice, and illogical thinking from my hosts and their Middle Eastern advisors that was the most baffling thing I’ve ever seen, and which thwarted progress on many fronts. And this was all coming from people whose intentions were often, or at least started out as good. ”
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My best friend in Lamu, Kenya, a Swahili-speaking Yemeni, once told me that I should be killed because I had inadvertently left a Quran on the floor and that the only reason why he or someone from the local mosque would not do it was that he was trying to protect his best friend. Twisted logic?
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These are comments from people who have worked in areas that are majority Muslim and Arab. What does this mean for the struggle against the Islamic State?
Driving to Jacksonville: Second Draft
This is a Second draft. Anyone with comments or who has personal knowledge that can contribute to this story, please send your comments here.
Driving to Jacksonville
I was about eight years old in 1962 when my father (Theodore) drove me (Conrad) to Jacksonville, Illinois from Denver, Colorado. We were living in Denver with my sister (Cathy), me, and my mother (Greta) when my father came back from a trip. Unbeknownst to me, my father was dating a woman named Vicki, who would soon become my stepmother (he had met her when they were both taking a course in graduate psychology; she was several years his junior, perhaps 21 years old).
By this time, he had me living with him part of the time at his bachelor apartment with a closed-in porch that I slept in. One day, he threw out some old magazines, Playboys, and left a pile of them on the stoop. I came in, saw the magazines, and sat down to start reading them. He noticed that I was reading them, but he didn’t say anything, just let me keep on reading. I didn’t understand at that time what it was all about, or why there were so many pictures of naked women (with their pubic areas discreetly obscured.)
This was part of my desensitization to pornography and other shocking things. My father didn’t know it at the time, but he was making the pornography uninteresting to me by not reacting to my reading it. Maybe he did realize that not reacting was the best way to deal with it.
Another day, he stacked some milk cartons (at that time, they were made of waxed cardboard), crushing them and putting several crushed cartons inside another one. Then he set them on the sidewalk and lit them. They burned, slowly, for an hour, as the wax melted and contributed to the fire. I was impressed that so much energy could be obtained from old wax milk cartons.
He had an old Nash car, which was on its last legs, but it ran and got us where we wanted to go. Nash automobiles were last produced in 1957; I don’t know what year this car was, but it had to have been at least five years old or more in 1962. Here is a picture of a 1946 Nash four-door sedan from Wikipedia:
The three of us, mother, me, and my sister, were living in the student apartments, a group of three-story dormitory-like buildings of brick with basement common rooms. Our apartment had two bedrooms and my sister and I slept in one, on a bunk bed. My mother slept in the other bedroom.
The kitchen had a window that looked out over the yard between the buildings. During that time, I had many friends among the children who lived there while their parents were studying at the university. We played hide and seek, even at night, and met in the common rooms.
One day I was playing with matches in the window well of a basement common room. There were bushes around the window well so it was hard to see in. I wanted to strike a match and see what it looked like. The ground in the window well was wet and slippery, and I pitched over backwards onto the glass. I hit the glass with the back of my head, broke the glass, and cut myself in the occipital area of my head.
I stumbled out of the window well, ignoring the broken window behind me. My first concern was that my brains would fall out. Crying and screaming, I ran to the nearest first floor apartment and banged on the door. Blood was pouring out of the back of my head onto my shirt. The lady who answered must have been shocked, by her expression, and she helped me to my parents.
They took me to a hospital, and the doctor put thirteen stitches on the back of my head. My father took me home in his friend’s sports car after that; I think it was a Triumph TR-3. I stayed with my father more at his apartment. Here is a picture of a Triumph TR-3A, the most popular TR-3 model:
Later, we spent the summer in a resort town called Crystal Lake, up in the mountains above Denver. It had a lake that was eight hundred feet deep, with freezing water. I fished there for the first time that I can remember, and caught some little rainbow trout that they made me throw back. I had a little sailboat that I puttered around the marina with. We would go swimming, but that involved a ten- to fifteen-second dip with an immediate bound out of the water, which must have been about forty degrees Fahrenheit.
My father came to visit, driving his friend’s Triumph. I loved riding in that car; you could reach out from the passenger seat and touch the road while the car was in motion. There was a deep tunnel under the dashboard where I put my feet and legs, and I could scrunch down inside there and not be seen from outside with the top up. I didn’t understand that it was his friend’s car, but I enjoyed it anyway.
At first, my mother and I stayed with some well-to-do friends that had a boy my age; he had a tackle box full of pennies that we played with. We had read an advertisement in a comic book that said that pennies dated before 1932 could be worth “as much as $200” so we found all the old pennies and counted up our riches as if each was worth the full $200. We were terribly disappointed when his mother explained to us that “as much as $200” really meant that a rare one or two of those coins might be worth that much, but most were still only worth a penny.
I had some kind of quarrel with the other little boy, I don’t know what it involved. I just remember that he was terribly spoiled and his mother cut the crusts off the bread she served him in his sandwiches. So my mother, my sister, and I moved to a small summer cabin in the town of Crystal Lake. It was primitive, with a real “ice box” and a propane stove and a fireplace. It only had two rooms and an outhouse.
I was confused and upset by my parent’s separation; I didn’t know what was going on, and they didn’t explain it to me. I knew that they had been arguing a lot, but that seemed to have stopped after they were separated.
I began to act out in odd little ways; I would shoplift small items, like a plastic lemon (full of lemon juice, which I liked) and a miniature paper stapler. I tortured the kitten we had, but only in a minor way, by tying it up. I also tortured my sister’s Barbie doll; bondage and discipline were on my twisted little mind.
I tried to set fire to the field behind the house, but I didn’t get anywhere with that; the grass was too green. That fall we drove to Jacksonville.
We had been living in Hawaii; I was four when we moved there, and six when we went back to California. We flew to San Francisco, and my mother, my sister, and I moved in with her mother. I didn’t know where my father was at that time. My mother argued a lot with her mother.
We moved to Davis, where my mother enrolled in the University of California, Davis for graduate school. I learned how to ride a bicycle in Davis, but other than that nothing happened. I still didn’t know where my father was; I only saw him once in a while. One day, I was riding my bicycle when I accidentally steered through a group of older boys playing basketball on an outdoor court. I was paralyzed; I couldn’t stop, slow down, or turn, and I just went right through the group of kids on the basketball court without hitting any of them, although they were angry with me at the time. It was very quiet in Davis. I learned to eat malted milk tablets, which I don’t think are made any more.
We moved to Denver, and that was where I started seeing a lot more of my father. Apparently he had been working and going to school at the University of Denver the entire time. My mother, my sister, and I first lived in a nice brick house which had a basement; at Christmas I got an Erector set.
My mother stitched a large number of stuffed animals while we were living in that house; my sister arranged them all on her bed so that there was just room for her to lie down surrounded by stuffed animals.
One day my father told me that we were going to move to a new place, that it would be good for me. I had already had a number of tests of intelligence and creativity, part of his thesis for his doctorate in psychology. He was studying at the University of Denver to get his PhD in psychology, and his thesis was a research study of gifted children. He told me that because he was getting a doctorate, he would be able to take this really good job in Jacksonville.
It was only when we were in the car, the Nash, that I started asking questions about my sister and my mother. He told me that he and my mother had gotten a divorce, and that Cathy was going with her and I was going with him. I told him I didn’t like the fact that he had gotten a divorce. He said to me, “She was the one who asked for a divorce. It wasn’t my idea.”
I only found out years later that my father had told my mother that he had gone to a judge and had gotten custody of me and left my sister in my mother’s custody. He said the judge had ordered him to pay child support to my mother for my sister. He really wanted to avoid paying child support to my mother for me; that was part of his motivation for taking me with him when he moved to Jacksonville.
The part about going to a judge was all a lie; he had never gone to a judge, but he felt that telling her that would make it easier for her to comply with what he thought was right.
He also felt that my mother wouldn’t raise me right and that I would be intellectually stunted if he left me with her. For example, my mother told me that I didn’t have to memorize the multiplication tables, that I was too smart for that, and I should be studying other things. In fact, I finally did learn to memorize the multiplication tables and it took just a few minutes of study, well worth the time. Now, after memorizing the tables, I was able to do all those things, multiplication and division, in my head.
I also had terrible penmanship, and when I started doing math problems, the numbers would wander all over the page. My father had Vicki work with me to straighten up the numbers into columns so that the mathematics problems would be easier to understand; without the straight columns, it was difficult to do multiplication and division problems on paper (this was before calculators replaced doing these things with a pencil and paper.)
I said I wanted to see my mother and my sister again and my father said that they would come and visit us. I didn’t like it but there was nothing I could do. Later when I was really upset, after we had been in Jacksonville for a few months, I started thinking about how I could get back to Denver. I knew it was eight hundred miles, but I thought, “If I start walking now, maybe someone will pick me up and take me along.” I thought of all the cold and snow on the way, but I was so upset I just wanted to get up and start walking back to Denver.
I got sick and had a fever, and I wanted to see my mother, but she couldn’t come. I felt really small, like a bug on the bedspread, and everything was as big as mountains. I walked and walked along the spread, and I was still in the same place. Then everything reversed and I felt vertiginous as the scale seemed to slide back in place.
On the way to Jacksonville, it was dark as we drove down the highway; there was no moon, and the headlights of passing cars were the only things we could see, white in front of us and red behind us. Not driving, being a passenger, just looking out the side window, I could see nothing in the darkness.
We ran out of gas a mile before reaching a town. The dawn light was already full on us when he came trudging slowly back. After cranking the starter for a while, the engine fired again, and we set off into town to the gas station for a fill. I slept for a while. Then it got cold; my father fiddled with the heater controls but no warm air came through the vents. This was unusual because the Nash was famous for its advanced cabin heating system.
We finally reached Jacksonville after driving straight for eight hundred miles, stopping only for gas. As a faculty member, my father was allotted housing, a first floor apartment in a three story building; the second floor was occupied by a language laboratory, where students listened to taped lessons in their chosen language.
The first thing I noticed when I lay down in bed was that the sounds from the language laboratory could be heard through the ventilator shafts, which were commodious and made of sheet metal. Even at night, it seemed, I could hear people talking in French, Spanish, German, Russian, or unintelligibly in some unknown language.
I wanted to get a cat, but my father said no, you can’t have a cat. I suspected later that he didn’t want me to have a cat because he was afraid it would make me gay. So we went to a farm outside of town and he got me a puppy, a beagle. We tried to keep him in the house, but he couldn’t be paper-trained. Nothing would induce him to poop in the right place.
One day the dog pooped on the floor right in front of the front door. My father came in from class and stepped right into it, almost slipping on it. That was the last of the dog. My father gave the dog to our neighbors across the alley, who kept it tied up in the back yard.
My father got me two hamsters, a boy and a girl, and I played with them a little bit. Sometimes they got out of their cages and I had to go looking for them under the sofa.
Before we drove to Jacksonville, my father began dating a woman that he met in his psychology class (they were both in the graduate psychology program, he already having his master’s degree.) After he got the job in Jacksonville, he proposed marriage to her (although he had already made sure of her by taking her to bed.) She was very taken with him and accepted.
Her most important function, to him, was that she was an expert typist. She had been clocked at over a hundred words a minute on an IBM Selectric. She typed his entire PhD thesis on that IBM Selectric, and she actually wrote most of it as well. I learned to type on that same IBM Selectric, and I soon became a typing whiz. I loved the space age look of the rotating ball that held the letters the Selectric typed. Little did I know that the daisy wheel typing system was faster, simpler, and more reliable; that system caught on a few years later.
During the Christmas vacation, they got married while I stayed with my mother and sister. My mother was crying and I didn’t know what had gone wrong, but much later I realized that she was crying because she still loved him and didn’t want him to get married again. She couldn’t live with him because of the arguments so she had asked for a divorce; but she couldn’t avoid him completely, depending on him for money, for one thing. After the divorce, she only asked for child support for myself and my sister. Even so, it was hard on him.
We drove back to Jacksonville, the three of us, after Christmas. I had met Vicki, my new stepmother, before, and I had thought she was very nice; in fact, I preferred her over the other girl that my father had suggested to me for a new mother. I’m not sure, but I think he was pleased with my choice because he preferred Vicki too.
Many years later, Vicki told me that Ted had laid down some rules for her to follow. She told me that he had said that she should never touch me, not even a hug or a kiss. I was to be kept in the dark as much as possible with regards to her and she was to stay fully dressed whenever she was around me. I never saw that she was particularly good-looking, but some of my friends when I was in junior high school told me that, to them, she looked really beautiful.
Nonetheless, Vicki and I developed a close friendship and we played word games and other little amusements. I don’t remember exactly what we did but it was like playing with codes or something. Vicki served as a substitute for both my mother and my sister, and she managed to fill the job well after some practice.
When we got back to Jacksonville after Vicki and my father had gotten married, we opened the front door to find the rooms completely filled with steam and water all over the floor. The pipes in the bathroom had frozen and burst, and there was a natural ice sculpture in the bathroom with icicles hanging from the ceiling. Apparently the heat had been left off while we were gone and it got so cold that the water in the pipes froze. When it thawed, the pipes that had broken open started spurting water everywhere.
When I went to school, I found that classes had already started, and I was a few days behind. Everyone stared at me. I was not surprised to see a few black faces in the class, although I had never seen a Negro before. My father had told me that there would be black people here and explained that they were exactly the same as everyone else except that their skin color was darker. As a result of his talking to me, I developed a positive attitude towards black people, seeing them as being unfairly beaten down by whites with status.
He told me to treat everyone the same. I didn’t understand at first what he meant, but later I realized that not everyone thinks the same way. I got into trouble one day when I passed a note to Stuart Freiburg that had a naughty word in it, “shit” or something like that. The teacher sent me home with a note and I had to explain to my father.
He said that there are several words that people don’t want to have heard in public, and it was just a social convention. He said that I should not use those words with other people, but when I was grown up, it wouldn’t matter so much.
At first, I thought my father was a fount of wisdom, but after several years I began to question his judgement. The place where he succeeded the most was in making me get good grades. He paid me, for example, ten cents for every “outstanding”; if I got a “satisfactory” I got nothing. If I got a “needs improvement” then I lost ten cents. We got report cards every six weeks and there were some thirty or forty marks on each card. There was a chance I could get as much as three dollars on a single report card.
After he instituted this system, my grades picked up rapidly. Within six months, I was making two dollars or more on every report card.
My best friend when I was in fourth through eighth grade was Lynn Ruby. He was also ostracized by some of the other students. I was teased just for being different, but I stood up for myself and fought back whenever I was attacked. A few times I was ganged up upon by several other kids, but that happened rarely.
Lynn and I did a lot together. One of the last times I visited his house, he had a set of drums that he was playing on and we talked about starting a band. I even wrote a few lyrics, like “She’s as cold as a Frigid-Aire.” Later on, he started a band and played at night, being so tired during the day that he fell asleep in class. He told me later that he had been suspected of using drugs but he was really just tired from late-night jam sessions.
Lynn and I had a nemesis: Stuart Freiburg. He had some strange ideas. One day he chased both of us home from school. I escaped but he caught up with Lynn. Lynn told me that Stuart didn’t want to beat us up, he just wanted to be friends with us. Stuart was very confused. His father was a member of the college faculty, a physics professor. My father and his father didn’t get along, and would have arguments in faculty meetings. My father offered me money to punch Stuart in the face. Every time Stuart started fighting with me, I would try to punch him in the face. I broke his glasses, and my father gave me a dollar. He said he would give me five dollars if I broke his nose. That was a fortune for me at the time, but I couldn’t bring myself to hit him that hard.
Later on, Stuart did become involved with “drugs”– he used LSD a number of times and was hospitalized for two weeks because of it. He became a shoplifter and did a number of other things; I can imagine what he might have done but didn’t have any contact with him after I graduated from high school.
This is a Second draft. Anyone with comments or who has personal knowledge that can contribute to this story, please send your comments here.
Conrad Theodore Seitz 