walkitout (walkitout) wrote,
walkitout
walkitout

Good Journalism

http://www.newyorker.com/reporting/2009/04/27/090427fa_fact_talbot

Margaret Talbot writes about people, including college students, a professional poker player and the expectable transhumanists, who take drugs in an effort to improve the function of their "brain". The bulk of the article is about stuff like Adderall and Provigil, but wanders off into stuff like piracetam. She mentions, in passing, the obvious parallel to athletes and steroids, mostly to quote people who dismiss the comparison as invalid. Which is pretty entertaining, because that's _exactly_ what happens in sports, every time some new method of using drugs to cheat is devised. Oh _this_ thing I take doesn't count as doping. Not like that other list of things that didn't count. Until they did.

The comparison to the 60s appears towards the end, with the expectable zeitgeist analysis. That's a little weak, but probably has to be said. I mean, how could anyone stop themselves? There is a nice quote from a psychiatrist at Johns Hopkins:

Paul McHugh: “Maybe it’s wrong-footed trying to fit people into the world, rather than trying to make the world a better place for people. And if the idea is that the only college your child can go to is Harvard, well, maybe that’s the idea that needs righting.”

[ETA: I feel compelled to note that just because I agree with and quote this particular bit from Paul McHugh, I should not be interpreted as agreeing with McHugh on his other, more controversial opinions. He's more than a little non-interventionist in general, and in specific, he's opposed to surgery for T's. Like, _really_ opposed.]

All in all, an enlightening piece. I'll comment a bit more, but consider what follows to be outside the scope of the article, and thus in no way a complain that it was not covered.

I want to know, and account for all of what something does when I get involved in it, whether that's a drug, or an exercise program or whatever. You can call them side effects, and hope the customer dismisses them as irrelevant, or not likely to happen to her, or whatever, but I'm going to pay attention. I really think other people should, too. Especially before they sign up for something just to be a better wage slave. Which is what this shit is.

Nowhere in the article was the problem of defining the limits of disease discussed. "Mission creep", and new drugs creating markets was mentioned, however, there was no exploration of the idea that everyone has some amount of "attention deficit" (which is what this shit is addressing) and it's diagnosed when it interferes with "normal" functioning. Several of the profiled non-medical users of these drugs look like they probably _would_ have been diagnosable if they hadn't had such strong academic skills/high IQ/whatever coping mechanisms. That's not to say they should be taking this shit. I would argue that _no one_ should take something that makes them forget to eat. That's the major reason we worry about giving this shit to kids who there is wide agreement (not by me!) that they "need" it -- it disrupts their physical growth because they can't eat enough.

Finally, there's a whole lot of the not thinking about basic needs going on. One of my LJ friends had a great quote recently about where will power comes from, and it applies directly here, along with my usual invocation of basic needs. We can focus on something when we have a habit of focusing on things. We can focus on something when more important needs have been addressed. Using a drug to avoid addressing more important needs (like sleep), is a bad idea.

Which leaves the question of whether one can learn a habit of focus from taking a drug for a while and then weaning off it. These drugs habituate, which is worrisome. I don't know what it's like to stop taking them (do you become less able to focus than before you started?). But some of the rationale for anti-depressants revolves around feeling enough better to get through some talk therapy and other stuff so that feeling better happens for other reasons, and then weaning off the anti-depressants. A similar strategy here might make sense, particularly if someone had so little ability to focus that they could get none of the intrinsic benefits of focusing and thus had no motivation. Once they learned, hey, buckle down and good stuff happens, there is some built-in motivation to help build the small habits that add up to will-power.

I also had a lot of concerns about the idea that this helps rote work at the cost of longer term retention, particularly in older people. I don't think the creativity metrics were worth much. I do know that anything that interferes with longer-term processing (whether that is the longer term retention that can add up to wisdom, or the longer-term thinking that can add up to creative insight) is very, very, very difficult to anticipate problems with. And when those problems occur, they are intractable.

Oh, yeah, and taking drugs (or having cosmetic surgery or whatever) to extend youth because you fear old age and death? Waaaaayyyy stupid. Huge risk for nothing good. I have more sympathy for people who starve themselves or get cut to look good for the camera for a couple more years. At least they usually have a decent idea what the paycheck looks like.
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