Meditation for HIV Patients

Image via WikipediaMindfulness meditation in medicine: I have written previously (here) about early evidence indicating that meditation can decrease the inflammatory response in the body, which in turn can have a major impact on prevention of disease, and also on reduction of symptoms in chronic diseases. A recent application of the use of meditation in medicine involves patients who are HIV positive. Findings from a study conducted by researchers at UCLA are summarized as follows:

Researchers at UCLA report that the practice of mindfulness meditation stopped the decline of CD4 T cells in HIV-positive patients suffering from stress, slowing the progression of the disease. The study was just released in the online edition of the journal Brain, Behavior, and Immunity.

Mindfulness meditation is the practice of bringing an open and receptive awareness of the present moment to experiences, avoiding thinking of the past or worrying about the future. It is thought to reduce stress and improve health outcomes in a variety of patient populations.

"This study provides the first indication that mindfulness meditation stress-management training can have a direct impact on slowing HIV disease progression," said lead study author David Creswell, a research scientist at the Cousins Center for Psychoneuroimmunology at UCLA.

I actually got to hear about this study, from one of the researchers involved in the work, back in April at the Research Conference sponsored by the Center For Mindfulness (CFM) at U. Mass. It was one of a very impressive array of recent research projects, using highly sophisticated designs, that are beginning to provide very solid scientific evidence that mindfulness meditation benefits the human mind/brain/body in ways that we might never have anticipated. I think we can expect to see more and more mainstream health providers who use, teach, and promote meditation with their patients, and with very good results. Maybe we can cut down on our over-reliance on the pharmaceutical industry for our health care needs???

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Alzheimer's

So, it is Alzheimer's. At least, the neurologist is "90% sure," which at this time is all anybody can say, without better diagnostic tools. Finally, after 3 weeks of trying to get a proper evaluation of my mother's cognitive functioning, yesterday she saw an excellent neurologist (one who specializes in geriatric problems). This never could have happened without the help of the professional geriatric care manager that I retained to help with my mother's situation... and it took me quite a while to learn that such a thing even existed.

So I'll give another major boost and thank-you, here, to the National Association of Professional Geriatric Care Managers (NAPGCM), and to the local company that I found through that organization: Creative Care Consultants, in Kansas City, MO. Gini Toyne, RN, at Creative Care, has totally turned this awful situation around. If I had just left my mother in the "care" that she was getting from the physician at the (supposedly excellent) nursing home, she would have been there (theoretically) until she died, without a proper evaluation, without being accurately diagnosed, on the wrong medications, and trapped in a place that she hated.

During our meeting yesterday, the neurologist, Ginny, a pharmacist, my mother, and I sat down together and agreed on a plan. My mother will go home, with in-home care provided through Ginny Toyne's company; and she will be on the appropriate dementia meds (which are likely to stop the progress of the disease for a year or so), and OFF the meds that she does not need. Mother seemed agreeable (for a change!)... but bewildered. As we were walking out of the medical office building, she asked me to explain what was happening, once again. I said: "Next week, you are going home." She leaned over and whispered to me: "Where is 'home'?"

I know that it won't be easy; my mother is likely to cause all kinds of havoc, because she does not like to have people in her house. She will accuse them of stealing... she will be verbally abusive. But we'll cross those bridges when we get to them.

If you are dealing with an elderly parent, not knowing how to get the proper assessment, treatment, and ongoing care that your parent needs, I strongly recommend that you look for a good professional geriatric care manager. It is way too easy to get lost in the shuffle; to end up with a parent in a rotten facility; to have a parent who is receiving lousy medical care; and to find your whole life consumed, trying to put out fires, trying to monitor and stay on top of what's going on with your parent.

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Idjit Nursing Home Physician

Image by 7-how-7 via FlickrOn Friday my mother's nursing-home physician finally, after more than 3 weeks in the facility, decided to spend some time with her to evaluate her mental status (and this is my mother's primary medical problem). Despite my subsequent voice mail and email to the physician, I have (as of today, the following Wednesday) heard nothing from her. But I did just hear, from the nurse care manager that I hired (because I was getting NO help from the nursing home physician or social worker about the best course of action and level of care for Mother) that this physician had told HER that, in the physician's opinion, my mother was competent to make decisions for herself unless/until a court appoints me guardian (and that process takes 6 months, and is extremely expensive). This is just after my mother complained to the staff because they took her "telephone" out of her room. She never has had a telephone in her room. They removed her nebulizer (for breathing treatments), because she has consistently refused to permit any breathing treatments...

Reportedly, the physician is now telling other staff members at the nursing home that I should not be permitted to make any decisions for my mother. And this is despite my durable power of attorney, and despite my mother's psychotic state, her violent outbursts, and her frequent refusal to take her medication(s).

I am so very disgusted.

If my mother is competent to make her own decisions, then why does this physician not just discharge her from the facility, which is my mother's oft-expressed desire?

I suppose I should be grateful that she has not done exactly that.

The nurse care manager urges me to be patient. We are still taking Mother to an outside neurologist today (this was our own plan, not initiated by the (idiot) nursing home physician, who--get this--is a board certified internist, with a fellowship in geriatrics).

This nursing home physician is known (I have learned over time) to her colleagues and co-workers as an "odd duck," with an "unusual communication style," a doctor who should only be given the most uncomplicated cases.

I am told, of course, that this physician is "very busy," and I am very tired of hearing about how "busy" physicians are. This is just a euphemism for "important," a reminder to all of us patients, family members of patients, and non-physicians in general, that the physician expects to be treated with great deference, like a little god... that his/her time is much more valuable than ours... and that we should be grateful for any interaction whatsoever with such a "busy" person...

Yeah. I am disgusted.

Today's Must-Read Recommendation

Image via WikipediaHere is the top of my list, today, for a must-read article about the U.S. conduct in the "war on terror": Bob Herbert's column today is called "Madness and Shame." He's writing about Jane Mayer's new book called The Dark Side. Here are a few excerpts from Herbert's column:

When the constraints of the law are unlocked by the men and women in suits at the pinnacle of power, terrible things happen in the real world. You end up with detainees being physically and psychologically tormented day after day, month after month, until they beg to be allowed to commit suicide. You have prisoners beaten until they are on the verge of death, or hooked to overhead manacles like something out of the Inquisition, or forced to defecate on themselves, or sexually humiliated, or driven crazy by days on end of sleep deprivation and blinding lights and blaring noises, or water-boarded.

To get a sense of the heights of madness scaled in this anything-goes atmosphere, consider a brainstorming meeting held by military officials at Guantánamo. Ms. Mayer said the meeting was called to come up with ways to crack through the resistance of detainees. “One source of ideas,” she wrote, “was the popular television show ‘24.’ On that show as Ms. Mayer noted, “torture always worked. It saved America on a weekly basis.” ...

Donald Rumsfeld described the detainees at Guantánamo as “the worst of the worst.” A more sober assessment has since been reached by many respected observers. Ms. Mayer mentioned a study conducted by attorneys and law students at the Seton Hall University Law School.

“After reviewing 517 of the Guantánamo detainees’ cases in depth,” she said, “they concluded that only 8 percent were alleged to have associated with Al Qaeda. Fifty-five percent were not alleged to have engaged in any hostile act against the United States at all, and the remainder were charged with dubious wrongdoing, including having tried to flee U.S. bombs. The overwhelming majority — all but 5 percent — had been captured by non-U.S. players, many of whom were bounty hunters.”

Is it possible that anyone could believe that the rest of the world is unaware of what we (in the United States) have been doing?

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Kitteh Face Transformed!

More fun with the face transformer (see earlier post)!

I decided it might be really fun to feed the face of one of my cats into the machine, and see what happens. If you want, you can vote in the comments about what you think is the best result. Here's what we got:

First, the original photo of my beautiful (and narcissistic) cat, Jezebel:

Next, Jez as half-chimp (ick!):

Jez, Cartoon style (pretty cute):

Jez, Botticelli version (I like this one):

Jez, "drunk" (not very drunk, just a little... ):

Jez, Modigliani style (scary):

And, finally, Jez "Mucha" style (whatever that means... also a little scary, I think)

Crazy-Making

Crazy-Making: Yesterday I wrote just a bit about the emotional cost of being around a "difficult" mother. I referred to psychological phenomena called "projection," and "projective identification" (*see the bottom of this post for definitions*). Although these processes are not well understood, it is widely known that certain individuals with mental/emotional problems sometimes express these problems by way of non-conscious interpersonal processes that can influence the emotions, and even the behavior, of others. Expressed in non-technical terms, the problem is that there are some people whose presence, behavior, and emotional states simply make others highly uncomfortable.

If your mother is such a person, you might wish to say to her: I love you, but I can't tolerate being around you. You are making me crazy.

A couple of examples from my own life with my "difficult" elderly mother (and these are not recently emerging phenomena): If I tell my mother I am leaving on a business trip (or any kind of trip), she immediately displays great anxiety and unhappiness, and asks me where I am going. And then, regardless of my reply (it might be that I am just going somewhere close by, or it might be somewhere very far away) she responds as if I have said something shocking and unacceptable. I might say: "I am going to St. Louis." She will inevitably reply: "St. LOUIS???" with a rising tone on the final word. This induces all kinds of negative emotions in me... I feel the need to apologize, explain, reassure her... and I also feel irritation, because her response is so unreasonable, and because it induces all these unpleasant emotions in me.

Another example: when I spend time with my mother, she typically tells me stories about how she has been mistreated by others. Many of these stories are obvious distortions, if not outright paranoid delusions, about people who in fact have been very patient and kind to her. She usually asks me what I think about the situation she has described, and/or what she should do in response to the imagined outrage. This places me in an impossible, and uncomfortable, dilemma. If I urge her not to retaliate against the neighbor (or doctor, or banker, or whoever it might be), then she becomes very angry with me. If I respond as if I believe the truth of her accusations, I feel as if I have entered some kind of twilight zone of insanity.

And one of the worst aspects of this type of mental functioning is that a person can live her whole (unhappy) life with these patterns, without being sufficiently impaired that anyone can effectively intervene. She certainly will not believe that she needs any sort of psychological or psychiatric "help"! Others will avoid her, and she will never understand why...

In a law review article about the Americans with Disability Act (ADA), Elizabeth Emens writes about the barriers to integrating people with mental illness into workplace settings. Here's an excerpt:

"People often discriminate against those with mental illness... because of how those with mental illness make them feel, in ways that are intimately bound up with how people with mental illness themselves feel. Mental illness tends to produce what I call "hedonic costs"-an increase in negative emotions or a loss of positive emotions-in people with mental illness. And the hedonic costs of an individual's mental illness may create hedonic costs for nearby others...

Hedonic costs based on "emotional contagion" form a peculiarly sympathetic and potent basis for discrimination. Emotional contagion is the process by which we absorb the emotions of nearby others through largely unconscious mechanisms. Research on emotional contagion suggests that people with mental illness are likely to cause others to share their negative emotions. For example, spending time around a person with depression-even having a short conversation-typically causes others to feel greater sadness and hostility. And studies indicate that liking someone makes the liker more susceptible to absorbing the other person's emotions. Thus, someone who bears no animus towards people with mental illness, and perhaps cares about or likes certain individuals with mental illness, may for this reason feel an impulse to avoid coworkers and others with mental illness." [emphasis added]

So there are good reasons why it can be difficult to work with people who have mental illness... And it is even more difficult if you like, or love, a person with psychiatric problems.

*Here are a couple of pretty good explanations of "projection" and "projective identification," from the Cross Creek Counseling website:

"Projection:

"Attributing one's thoughts or impulses to another person. In common use, this is limited to unacceptable or undesirable impulses. Examples: (1) a man, unable to accept that he has competitive or hostile feelings about an acquaintance, says, “He doesn’t like me.” (2) a woman, denying to herself that she has sexual feelings about a co-worker, accuses him, without basis, of flirt and described him as a “wolf.”

"This defense mechanism is commonly over utilized by the paranoid.

"A broader definition of projection includes certain operations that allow for empathy and understanding of others. Recognition that another person is lonely or sad may be based not upon having seen other examples of loneliness or sadness and learning the outward manifestations but upon having experienced the feelings and recognizing automatically that another person’s situation would evoke them.

"Projective Identification:

"As in projection, the individual deals with emotional conflict or internal or external stressors by falsely attributing to another his or her own unacceptable feelings, impulses, or thoughts. Unlike simple projection, the individual does not fully disavow what is projected. Instead, the individual remains aware of his or her own affects or impulses but mis-attributes them as justifiable reactions to the other person. Not infrequently, the individual induces the very feelings in others that were first mistakenly believed to be there, making it difficult to clarify who did what to whom first."

And here's an excerpt from a website ("What Makes Narcissists Tick") that explains, in very down-to-earth terms, how this process of projective identification typically operates when one partner in a relationship is pathologically narcissistic:

"Now and then, you're bound to object to the degrading way the narcissist treats you. He or she will throw a fit at you for objecting, and there will be an argument.

Or... just relate to the narcissist as his or her equal; just behave as though you deserve consideration in some matter. Then look out. Uproar...

A narcissist just has to take a crap on someone every so often to feel better to about him- or her-self.

He knows just how to pick a fight. And when he wants to pick a fight, there's no avoiding it, because... he will keep at it until he gets what he wants. He will work you into some kind of corner, demand something impossible of you there, and then throw a fit when you can't do it.

The narcissist won't even let you walk away. She will follow you telling you how intolerable you are just for being the way you are, saying that she doesn't have to put up with that. If even that doesn't get a rise out of you, when she has you in a corner, she'll assault you, forcing you down on your back and climbing on top of you, saying, "I'm stronger than you." ...

During this fit, the raging narcissist projects his or her anger off onto you and accuses you of being the one who is "flying into one of your rages." ... That's what narcissists do.

When narcissists pull this stunt, they aren't using you only as a dumping ground for their toxic emotions: they are also doing their best to make you act out their fantasy that you are the raging maniac here. In other words, they are trying to enrage you. Get it?

That trick is called "projective identification." ... Indeed, when you're trying to pacify a raging maniac, and she heaps insult on injury by mocking you with the accusation that you are the one "who got mad," the one who's "flying into one of your rages," normal people do get angry.

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Something Fun, For a Change

Just a little break from the drama... [my mother and her various situation(s) have always been whirlwinds of drama and urgency, most of which she has created and fed, herself, so that, in a magical (or malevolent) interpersonal process of infection (or projection, or projective identification), all of those in her vicinity also get whipped into deeply experiencing the sense that there is something URGENT that must be done RIGHT NOW about whatever it is that Mother says that she wants or needs done... ]

So, absolutely essential to take breaks from it all. And while I was browsing on Slate this morning, I ran across this interesting online gizmo that you can use to transform facial photos... And at nearly the same time, I realized that my own notebook computer has a tiny little camera in it, always looking at me. Never have used it, before. So I figured out how it worked, and took a picture of myself, and then fed it into the face-transformer machine. I found that most of the variations that you are permitted (you can make the face look (sort of) like the face of a baby, for example, or the face of someone of another race, or into a hybrid chimp face--ick! ick!) are truly horrific, especially if you are working with a picture of yourself. There are also cartoon variations and artsy variations. I posted the result of the artsy version of my today-at-the-computer picture, up at the top of this post... I kind of like it. I'm going to use it as my online blog photo, till I get bored with it.

And now I am off to the nursing home with my mother's clean laundry. Yesterday I finally gave in to her unrelenting insistence that I give her some money to put in her purse. She now has $50 cash, and insists that she has stuff she wants to spend it on, there at the nursing home (she won't tell me what that might be, but she once alluded to the idea that she will be able to get someone to take her somewhere). And then as I was leaving, she ordered me to bring her "at least $600" on Monday. And when I told her I loved her, she laughed scornfully, and said: "Oh, no, you do not."

The Past:: Never Past

The Past Is Never Past: Part of this task of taking care of my mother involves cleaning up her house, and getting it ready for whatever is next. That business of what might be "next" is still unclear; it might be that Mother comes back to her house, with in-home care. Or it might mean that the house needs to get sold. Any of the possible scenarios requires that the house be cleaned up, and cleared out, quite a bit. So, every day or so, I go over there and check the mail, make sure everything is OK, and I do some clearing and cleaning. I keep on finding photographs that I have never seen before, and it's pretty emotional, sometimes. Here's one: My mother's parents' family names were McColgan and Delany. All of them came here, to the USA, from Ireland, long ago. The McColgans somehow ended up in Southeast Missouri; they were a prominent farming family back around the turn of the (19th to 20th) century. My great-grandparents had four daughters (plus a son who died in infancy): Reba, Ruth, Lee, and Erie (my grandmother). All the girls went to college. Reba never married, and she ran the farm after her parents died. The McColgans lived in Dexter, MO, and they had the first automobile in town, or so I am told. Here they are, probably around 1940.

I can hardly stop gazing at this old photo... These are my people. And they are nearly all gone. My mother, second from the right, is still living. She is holding hands with her grandfather, Papa (J.W. McColgan). He died before I was born; my mother absolutely adored him. It's amazing for me to see the two of them, together. The only other person in this photo who is still living is my mother's cousin, the guy on the far left. He is Gordon Porter Hill, of Sikeston MO. My great-aunts, Reba and Lee, are in the middle, along with Margaret, who was not actually a blood relative, but a part of our family, nevertheless.

And here's another one I don't remember ever seeing before; this is Rip, the dog who was around before I was born, and when I was a baby. He loved a ride in the car. Picture taken probably around 1951.





















Much later (maybe around 1966), my mother and I were on the beach in Florida, with the dog I mostly grew up with, an Airedale named Ruff.

Tough Decisions

Here's another wrenching (and guilt-inducing) comment (written by Cheri Miller) that I ran across in the NYT blog about aging:

"My husband and I have been caregiving for the past three years... for [my husband's grandmother]... She’s now 102... We’re still caring at home for Granny’s daily needs. She has no diseases, is frail, cannot hear, see or walk any longer, after her stroke, but she continues to live on and on and on... It’s changed our lives. We can never be away from home more than 2 hours. And, we have seven children to manage on top of this... But, at least she’s not in a home." [emphasis added]

My 88-year old mother is intermittently irrational, but certainly in better shape (both physically and mentally) than the vast majority of patients in the nursing home where she's been for the last three weeks. And the doctor (a geriatrician!) she has been assigned to at this nursing home has made no apparent effort (despite my urging, despite my complaints) to get to the bottom of Mother's cognitive problems. Eventually, I took matters into my own hands, and hired a geriatric care manager. We'll be taking Mother to a neurologist in a few days.

Meantime, I am faced with the daily task of trying to explain to my mother why she is in a nursing home, why she can't go home... Her "doctor" has only seen her twice in the three weeks since she's been there, and certainly has not explained to her that we are concerned about her poor decision-making... Over and over again, that little talk is left up to me. And my mother is not well-disposed to hear this from me. The problem is that she cannot seem to understand or remember new information that people tell her about her medical status, she does not follow through with medical (and dental) advice and prescriptions, and she often "fires" her doctors soon after she has met them. When she went into the hospital, a month ago, she had no primary care provider. She had fired them all. I am quite sure that this same pattern will start up, all over again, if she leaves the nursing home and goes back to her house. This is how it is beginning to look, to me: unless I just give up my life, and take over my mother's life, there will be no way to make sure that she is getting good medical/dental care (her teeth have been falling out, and she has refused to pay the dentists and oral surgeons... ).

Nobody wants to be "in a home," and I don't think anybody really wants an elderly relative to be "in a home." Even though my mother is, and has always been, an exceedingly difficult person to be around, I do not want her in a nursing home. Maybe my only real option will be to get my mother back into her house, with daily in-home care, and one of the bedrooms set up for the in-home care provider, if/when she needs someone there all the time... and the third bedroom set up so that I can stay there at night, too, if I need to. And maybe that would be a total disaster. Once my mother is discharged from the nursing home she's now in, they will have no obligation to take her back... and, given her dreadful behavior while she's been there, I doubt that they would take her back. No good choices, here.

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The "Difficult" Elderly Parent

The "difficult" elderly parent: Here is a basic fact-to-be-faced in caring for elderly parents. An elderly parent who has a decent capacity for positive relationships with others (including her/his own children) is most likely to be cared for in the home of one of his/her children, if that ever becomes necessary; and, at the same time, an elderly person such as this would also have the best chance of faring well in assisted-living facilities. But, of course, the reverse is also true: if your elderly parent is (and probably always has been) what we euphemistically call "difficult," then you most likely do not want to let this person destroy your life, under your own roof; and the assisted-living people (and the nursing home people, and the home-care people) don't want to deal with her/him, either.

I saw a review, in the NYT, of a TV documentary, "Caring for Your Parents." One physician, John Murphy, was quoted as saying that "the single most important variable to never spending time in a nursing home is having a daughter." And of course that tore at my heart... I am a daughter! Why can't (or won't) I just take care of my own mother, in my own home, like I ought to? Certainly, that is what my mother expects of me, and has always expected of me. She has always demanded that I be at her beck and call, at the drop of a hat. She has been perfectly capable of hiring caregivers, drivers, housekeepers, but unwilling to do so (perhaps knowing that they would not put up with the abuse she routinely dishes out)... But the review also notes some unpleasant facts that are often disregarded in these chirpy, upbeat TV shows:

“Caring for Your Parents” examines a handful of families... who have turned their lives over to the physical and emotional needs of elderly parents. The sense of devotion that [these caregivers display] display, the idea that whatever compromises they are making are intrinsically worth it, permeates the film and hampers it, creating a world in which all men and women behave honorably and admirably.

In each case study the camera lingers on the images of the elderly when they were young and happy, the presumption being that all the parents we’re seeing gave their children lives rich and full. No one resembles the ornery and selfish patriarch of “The Savages,” the recent fictional film that regarded the same subject with more complexity and skepticism, examining how grown children respond when they are obliged to care for parents who failed (spectacularly) to care for them. “Caring For Your Parents” leaves the impression that we all love our mothers and fathers without ambivalence or reservation... "

It turns out that in this TV documentary, Dr. Murphy (who made the comment about daughters) "is in the employ of an affluent 65-year-old woman... who cares for her 91-year-old mother... with a staff of seven rotating aides at a cost of $250,000 annually. Dr. Murphy oversees [the mother's] medical care and meets regularly with the aides as if he were a corporate leader running a project... "

In the NYT "New Old Age" blog, I found this heart-rending comment from "Eliza":

"My aunt is belligerent, loud, uncooperative, demanding, and mean in her dementia. When she was in the hospital for a broken hip, the nurses continually called my uncle, very frail himself, in to control her so often that he nearly died from exhaustion. They didn’t hesitate for a minute to demand that he come in 24/7, even though he was visibly weak from cancer treatment.

Nursing homes reject her because they can’t handle her.

Now what? Rejected by the experts, this difficult, dangerous woman is supposed to be successfully cared for at home?

Our medical community is geared to take care of the frail and cooperative dementia patient. The families who really need the help are being rejected."

My mother has been rejected by two assisted-living facilities, so far. In the nursing home that she's now in (hating every minute of it), she has been "difficult." She has used foul language, she regularly refuses her meds, she won't eat dinner in the dining room, and she has hauled off and hit some of the staff members. When I go to visit her, the "visit" usually consists entirely of her demands that I take her home, and her bitter accusations against me and the nursing home staff (and I am convinced that they are very good with her). And the history section in her chart reveals (to anyone who is making decisions about her) that she has a long history of firing her doctors, and getting into arguments with her neighbors. All of this is quite heartbreaking, and also totally beyond my influence or control. She has always been "difficult," but now she is demented and difficult.

So here is another thing I have recently learned about this whole business of taking care of the elderly parent: getting them placed into a good facility is sort of like selling a house. You really have to clean them up nicely and market them effectively. But, in the case of elderly people, the "sale" is never final; if a care facility takes in an old person, but then finds that s/he is too much trouble (they will say: "we cannot meet her needs"), then they will either call you and tell you to come and get her, or they will over-medicate and neglect her. I found that I was not able to do this "marketing" of my mother effectively, by myself. So, I have retained a professional care management person, and I have temporarily taken my mother "off the market." The care manager person I found is a nurse, and she is very experienced in this field. She knows which doctors are best at which areas of elder care; and she knows the directors of all the elder care facilities. She has gotten my mother an appointment, next week, with a neurologist who specializes in dementia and other disorders of old people. She hopes that she will be able to get an accurate picture of what is really going on with my mother, and (we hope) some changes in her medications that might help with some of these "behavioral issues." We'll see. I am cautiously hopeful.





Here's a picture of me when I was a little girl, 3 years old. My mother and I were visiting her parents (her mother was a lot like she is, now; her father was very stern and distant). We were all out on my grandfather's boat, on the St. John's River. The adults are enjoying their evening cocktails. I think I look a bit like "Fluffy/Zuul" in the LOL Cats photo just below (yesterday's post).

Back Home in KC

I'm back in Kansas City, after spending the night in Columbia MO, and testifying in a criminal case... it was great to be out of town for a little while, after all this incredible stress and difficulty with my mother's situation here at home. But then of course... driving home this afternoon after I got out of court, as soon as I got close to Kansas City, I began to feel really exhausted, again. Here we go, again... One of today's LOL Cats struck me as somehow fitting:

Testifying in Ferguson Hearing

Image via WikipediaTestifying (again): I'm in Columbia, MO to testify in a hearing on the Ferguson case. I've written about this case, before (here), and also here; it's a very unusual case, involving memory, forgetting, a possible false memory, and murder. Here's a recent article in the local paper about where the case was, as of yesterday. As the article states, there were two defendants accused of the murder of a newspaper sports writer. One of the guys, Erickson, said that he began (2 or 3 years after the crime) to remember that he and the other guy, Ferguson, committed the murder. Erickson pled guilty; Ferguson went to trial. Erickson testified against Ferguson at the trial, and Ferguson was convicted. Ferguson has always denied his involvement. A quote from the newspaper:

"Ferguson, 23, was convicted in October 2005 of second-degree murder and first-degree robbery in Heitholt’s slaying. He was sentenced to 40 years in prison, which he is serving at the Jefferson City Correctional Center, according to the Missouri Department of Corrections.

Ferguson and his family have proclaimed his innocence since his March 2004 arrest, contending co-defendant Chuck Erickson dreamed of his and Ferguson’s involvement in the crime. Heitholt was found early Nov. 1, 2001, beaten and strangled in the Tribune parking lot."

I will be testifying today. Apparently they want me to tell the Court about Erickson's mental condition when I examined him before the trial, and also about my interactions with Ferguson's attorney. One of the claims that Ferguson's lawyer is making is that his lawyers did not effectively represent him at trial (this is the claim that is nearly always made after a person is convicted and imprisoned, and after his appeals have been denied; it is considered a sort of last-ditch effort, and is very rarely successful).