I hear a lot of people say these days that they don't even need a watch anymore, because they've got their cell phones on them and their cell phones have a clock -- younger people, especially, but more and more older people, too.
That would be fine, if the only reason watches existed was to tell time, but that's not all mens watches or women's watches are for.
A good watch is a fashion accessory, every bit as important as your tie or cufflinks or shoes or socks. A watch can say something about you. I've got a really nice-looking, professional watch that has a discreet Buffalo Bills logo on it; from more than a few feet away, the watch simply looks like an expensive, fancy piece of jewelry. Up close, it serves as a conversation piece and a little bit of insight into me.
That's how watches work -- they emphasize an outfit or highlight a bit of your personality. And they can serve as excellent gifts -- who ever heard of giving a CELL PHONE as a reward for service? Nobody. But you get a gold watch for retiring, and watches make great gifts for anniversaries, birthdays, and more. (I frequently buy watches for gifts for people over at Blue Dial.com; they have seriously low prices and they ship in just two days.)
Johnny Depp recently did a big photo shoot where he wore a watch on a chain. Nobody would do that with a cell phone.
Sure, watches are timekeepers, and they're great for that. I can wear my watch and not have to dig in my pocket to find out what time it is, and I can wear a sport watch while I'm jogging or biking and have my hands free and not worry about dropping my phone just to keep track of my time. But they're more than that.
I hope I've gotten you to rethink watches.
Thursday, October 13, 2011
Wednesday, October 12, 2011
One day about a month ago, I was talking to someone on the phone, and this person was trying to explain the difference between him, as he saw it, and trial lawyers like me, as he saw it. He thought trial lawyers like me weren't nice people, and so to show the difference between him, and me, he said this:
"I'm a nice person. I rescued a kitten that was dying on our lawn."
To which I wanted to say "I would rescue a kitten, too, what am I, a soulless machine?"
But I didn't because this was, as strange as that seems, a business conversation.
But later, I thought: How is that the test of niceness, rescuing a kitten? Who wouldn't rescue a kitten? Wouldn't everyone?
So I asked people in my office -- lawyers and law students, all -- this question:
If a kitten were dying on your lawn, would you rescue it?
That was all the facts I gave them: That was the sole extent of the question. And what I figured I'd get is what I answered the question with: "Yes," without hesitation.
I mean, Jesus didn't expressly tell people they have to rescue kittens, but it's pretty implied, isn't it?
Here are the answers I got, before I gave up hope:
"I'm from the south. I own a shotgun. I don't like cats."
"Depends. How grossly maimed is it? If it's not too gross, I might take it to a shelter, if I don't have to drive too far."
"Why would I?"
"No way. I hate cats. Maybe a baby penguin."
That last one led to a debate about which is actually a cuter animal, a kitten or a baby penguin, and no more work was done that day.
What's ironic is one of our office mottoes is "We Help Quickly."*
*Provided you are not a kitten.
Tuesday, October 11, 2011
My Generically-Titled Autism Post: Today, sleep disturbances, and why maybe melatonin isn't right for your kids.
I used to call this "Autism Works," but then I found out there's a group called that already. (Find them here; I'll talk more about them in the future.) So while I think up a new title, I'll just go with the generic title. Click here for more posts like this with information about businesses, apps, people, and other aspects of raising a child with autism.)
It's 5:53 a.m., and I'm awake and working on my blogs instead of sleeping until... well, I'd usually only sleep until 6 a.m., so it's not that bad that I'm up, but still, I don't like losing that last 15 minutes of sleep on days like today, which began with Mr F and Mr Bunches both waking up at about 5:45 a.m.
Or, at least, that's when they woke me up. Mr Bunches woke me up by yelling "Dad!" and getting me in there to restart the movie he's currently watching ad infinitum ("Lilo & Stitch"), while Mr F had likely been awake for a lot longer, given that he was wide awake and tapping a stick against a wall to kill the time.
Mr F doesn't sleep. Or at least, not like we sleep. Sweetie and I joke that Mr F only sleeps every fourth day, and that's about right: Most nights, we can hear him in his room (which we keep locked to avoid him wandering around or getting out of the house at night) until well after we fall asleep, and many nights we can hear him around 2 or 3 a.m. wake up and begin his day. Then, about every fourth day, that catches up with him and he can't be woken up, as happened this past Sunday when he fell asleep on the couch from 4 to 5, then, after I gave him a bath to wake him up, he fell asleep again and then fell asleep in the car while we were driving around until finally we let him go to bed at 7 p.m.
So sleep is on my mind this week: Sleep and autism.
This study, "Sleep Problems In Autism: Prevalence, Cause, and Intervention", looked at just that problem. It noted that as many as 89% of autistic children exhibit some form of sleep disorder at one point, and summarized the types of problems:
Studies of sleep in children with autism have generally reported severe problems associated with sleep onset and maintenance. Irregular sleep–wake patterns, problems with sleep onset, poor sleep, early waking, and poor sleep routines have been found at all developmental levels, with increasing severity at lower developmental levels.
Additionally, shortened night sleep, alterations in sleep onset and wake times, night waking and irregular sleep patterns (with the presence of a free-running rhythm in one case) have been reported.
That's Mr F right there: all of them. The study concluded that autistic kids are more likely than any other group of children to have sleep problems and also concluded that it's likely due to something specific in the kids.
And it doesn't just cause dads to be awake before 6 a.m.; it also leads to problematic behavior during the daytime, including communications delays. Or, perhaps, the study notes, communications delays lead to sleep disturbances:
A relation between social and communication difﬁculties and sleep problems is possible. The sleep–wake cycle is a circadian rhythm and there is evidence to suggest that, as well as the light–dark cycle, humans use social cues toentrain circadian rhythms.
Routine and social cues are thought to help young infants develop stable sleep–wake patterns with the longest sleep occurring during the night hours. Children with a primary social-communication deﬁcit may therefore ﬁnd it difﬁcult to use such cues to entrain their rhythms, resulting in problems with their sleep–wake schedule.
See? You didn't know that you know when to go to sleep because society tells you, did you? And autistic kids may not pick up on that.
The study also noted that melatonin deficits may be a problem, about which more in a minute. Another possible cause of sleep disturbance was increased anxiety, which makes me sad -- I don't like to think of Mr F and Mr Bunches being too nervous to sleep, but it seems to fit at least Mr F's personality. And, finally, there was some stuff about EEG's in sleep and REM sleep patterns.
Bottom line: We don't know why autistic people don't sleep well, which makes it kind of silly to recommend cures or interventions, but, then, we do lots of silly things, and the paper goes on to recommend some cures and interventions for something that we don't know the cause of.
To editorialize for a moment: Suggesting a solution for a problem without knowing the root cause of the problem is stabbing in the dark, or treating only a symptom, and either one may or may not be better than doing nothing. Consider an old joke:
Man: Doctor, my arm hurts when I go like this.Doctor: Don't go like that.
That solves the problem, right? But it's not medical care. Or suppose a person shows up at the ER with a gunshot wound, and the doctor removes the bullet fragments and sews up the wound and sends the person on his way. Would you consider that an effective treatment? Or should the doctor have inquired how the bullet got there?
Just some thought experiments. Now, on to the solutions for the unknowable problem!
The study begins by noting that medications were the most common form of help for autistic kids with sleep problems -- but that about half of the parents questioned thought behavioral interventions worked just as well as medications. In our house, we've talked about medications at times for Mr F, and I downloaded the Autism Speaks Medication Decision Kit, a helpful packet that helps provide information and questions to guide you in a decision on whether or not to medicate your child-- for whatever problem. (Get it here.)
Using it, I decided (with Sweetie's help) that we wouldn't medicate Mr F, at least not yet -- because most of the medications listed don't have any clearcut effects on Mr F's conditions and some of them can have severe side effects. It seemed wrong to me to put a 5-year-old on strong antipsychotic medicines when he's not that much trouble.
If your child is on medication, or you've considered it, you should definitely get the kit and read it through. It raises a bunch of issues that I hadn't considered at all, and has helpful questions to ask your doctor, and yourself, about the medications.
Another attempted treatment was faded bedtimes, or moving bedtimes gradually to get the kids to sleep at the appropriate times. This was found to have little effect on the autistic children in the study, something I could've told them. (Currently, our routine is to begin bedtime at about 7:15, with the boys getting medicine, then a story read to them, then a bath, then bedtime with a movie on their TV. The movie on their TV is imperative: they will not sleep without a movie on, and we've learned to put movies in that have a continuous play feature, because the movie ending will frequently wake Mr Bunches up, and you haven't lived until you've been woken up every 87 minutes to restart a movie.)
Then there was parent training: Teach parents how to properly encourage good behavior (sleep) and discourage bad (not sleep.) Although only one family completed the 6-week program, that family reported reduced stress and slightly better sleep routines; I suspect the reduced stress came from parents being more able to cope with the stress through the training, but that's the cynic in me.
Then there's the one I might try: Light intervention:
Two additional treatments for sleep disorders which involve adjustment of the circadian sleep–wake cycle, are light therapy and chronotherapy. Light therapy may be used to treat a variety of rhythm problems, including sleep problems. Bright light suppresses the secretion of melatonin.
Additionally, it has been shown that periods of bright light treatment in the morning will advance the melatonin and sleep–wake rhythms, while bright light treatment in the evening has a delaying effect.
That is, show kids a light box in the morning to get them to sleep better at night, which might work for kids (like ours) who routinely wake up at 3 or 4 a.m., when it's dark out and then have trouble getting to sleep at night.
Finally, melatonin, which almost everyone we talk to treats as a panacea for this problem. At the boys' 5-year-checkup, Sweetie asked the doctor whether it was okay to take melatonin for their sleep, and he approved it: 1 mg each night, he said.
The first melatonin we were able to find was tablets, which is a problem, because the boys won't take pills -- they won't even take medicine from a spoon or those little plastic cups; we have to put it in a syringe and squirt it into their mouths.
We addressed that by pounding the pills into a powder -- literally, I hammer them into a powder, because I'm not a 15th century chemist and don't have a mortar-and-pestle -- and then mix them in with some other liquid, ordinarily some ibuprofen or water; it works better with ibuprofen because they (oddly?) like the flavor of that. (Lately, they've had a cold, so they get the melatonin mixed in with their nighttime cold medicine.)
That worked okay until Mr Bunches saw me scraping the pills into the medicine and then didn't want to take the medicine, at all -- because he now knew it had pills in it and it grossed him out. So for a week we had to wrestle him into the medicine and risk him spitting it back out, until he cut his foot one day and I began telling him the medicine was to make his foot feel better, after which he took it.
(So at night, Mr Bunches will say "Medicine!" and when I say "Yes," he still sometimes says "My foot!" even though his foot is long since healed.)
We also got some of the Natrol liquid melatonin, which we thought would be easier to use than the crushed-powder pills, but the boys hated the flavor of it -- spitting it back out each time, so we've foregone that and every night I get out my hammer, medicine, tablets, and syringe and go to it.
But here's the thing:
I don't think it's working.
Mr F has been on melatonin for a month now, and so has Mr Bunches, and I've seen no real changes in their sleep patterns, at all. I'm not ready to call it quits yet, but I suspect that the melatonin is like the gluten-free diet and other fad remedies: Not exactly the catalyst for change, but it gets the credit for change when it happens, like an ineffective quarterback who wins the Super Bowl in spite of himself.
And here's the other thing: I'm not sure melatonin is a good thing, because I took it for a week or two; I've also suffered from insomnia most of my life and have had sleep problems off and on for the last few months, and so I took the same dose that the boys took for a few weeks, and I didn't like it: My sleep felt less restful, and I had more realistic dreams that left me feeling tired -- it was like I never slept, at all, even though Sweetie would swear I did.
So after two weeks, I stopped taking it entirely, and I won't go back.
Which makes me wonder about why I'm giving it to the boys, if it doesn't seem to work and I didn't like it. But I'm not ready to declare it a failure yet, because a month seems too short to really test it out... for the boys? I don't know what effect it's having on them; Mr F can't tell me "It gives me vivid waking dreams that make it feel like I never sleep," so I have to guess whether it's doing good, or bad, or nothing. 2 out of 3 of those say don't give it to them...
...These are the kinds of decisions you never even suspect you'll have to make. I'll let you know what I decide.
Monday, October 10, 2011
I see faces, and so do you, and because I see faces, I'm probably wrong about the bees. But if I am wrong about the bees, then maybe Carl Jung was wrong about beetles.
Not long ago, I was sitting in the emergency room waiting for a chest X-ray results to come back -- the trip to the ER having been made against my will because I knew I didn't need the emergency room.
That's another story, I suppose; briefly put, I had been having a bad day, heart-wise, and had chest pains and trouble breathing, but not the heart-attack-y-kind of chest pains, which I know all too well. So I went to the Urgent Care, where I took care to describe my symptoms and then took care to specifically tell the doctors it was not a heart attack, pointing out that I knew what a heart attack felt like because, you know, I'd had one. Only when you have had a heart attack, every time you have a medical condition that's anything but "Stepped on a rusty nail" you're going to get an EKG and shipped off to the ER.
Which is what happened to me: I got shipped off to the ER, where I lay on a stretcher trying to breathe and not be dizzy and also to keep patiently explaining to the various doctors, nurses, and anyone else who walked by that I was not having a heart attack, and also that my vision was going kind of tunnel-y, which I found concerning.
They gave me a vision test, then, which, I'm pleased to note, I passed.
Five months later, I'm left with no answers about what I now call my liver condition, other than to assume, on my own, that it's because of the bees, and to then find out that I might just blame the bees because that's what people do, and also because it's all related to seeing faces in things where there are no faces.
Here's how I get from "I'm not having a heart attack" to "Blaming the bees is kind of related to the Man In The Moon."
That night, while I was waiting to have the ER doctors confirm what I'd been telling them all along -- that I wasn't having a heart attack, remember -- which they eventually confirmed -- I had nothing to occupy me except my cell phone, and the curtain that cut me off from the rest of the ER.
The curtain hanging in front of me was one of those abstract-y curtains that had a bunch of little boxes each with sort of shadow-y figures in it, and I occupied myself for a while by trying to figure out the pattern of the boxes... because (a) I'm that kind of person and (b) what else are you going to do in the ER, play Angry Birds? You can't do that. If you play Angry Birds in the ER, they're going to treat you less seriously than they already treat you, and am I alone in having an inferiority complex at the ER? They never take me seriously, it feels like. When I went there after the bee stings, they gave me some Benadryl and were going to send me home right up until I collapsed. When I went there a week later with a heart attack, they gave me some antacids and were going to send me home, again. Then, when I went there against my will and told them it definitely wasn't a heart attack but it was something else kind of serious seeming, they treated me for a heart attack.
Plus, they checked my vision. I can't forget that.
Anyway, laying there looking at the curtain pattern, I came to realize that every fourth block or so had a pattern in it that looked exactly like a stylized, 80s-woman-wearing-sunglasses. I was convinced that was what it was; I could see the 80s-lady so clearly that after a while I couldn't not see it.
I didn't get a picture of it, but if you ever saw one of those Nagel paintings like the one that's on this post, you get the idea; the woman on this post in fact is almost exactly what this blob-on-the-curtains looked like.
Eventually, I got out of the ER, with no answers (but okay vision), and I almost forgot about the woman, but not completely, because here's the thing: I knew that there was no woman on those curtains.
It was an entirely abstract pattern. I was sure of that. But yet, I'd seen a woman.
That's what led me to realize, this morning, that my feeling about the bees was probably wrong entirely.
See, I knew that the reason I'd seen a woman on the curtains is because humans are, in fact, hard-wired to see faces. I read an article a long time ago that noted that -- that human beings tend to pick out details in any random assortment of objects and mentally assemble them into faces, which is why this commercial exists:
What I didn't know, until today, was that there's a word for that: Pareidolia, or the phenomenon of seeing stimulus in a random sound or image.
I know that word because I went looking for it today, to find out why it is that humans assemble things into faces, only once I found out the word for it, I found out that people don't just assemble random objects into faces -- we take almost every random thing we see, things that are jumbles or mix-ups or mishmashes or simply white nose -- and assign meaning to it.
Pareidolia is how the Rorschach inkblots work, it's been used to explain how people keep seeing Jesus in their snack foods, and, in one case, led a Japanese researcher to conclude that humans had not evolved at all, but had simply always looked like humans... only we were once only 3.5 millimeters tall.
That guy, Chonosuke Okamura, actually took photographs of what he thought were fossilized remains of tiny people, and more than tiny people, tiny dogs, and even tiny gorillas. He published pictures of the fossilized faces of tiny humans:
Pareidolia also helps explain why there's a man in the moon,
And a face on Mars:
And a whole bunch of other things that look like things, like a sasquatch on the sun.
I'd gone looking for the word for seeing faces in things, and found it -- but what I found before I found that word was a different word: apophenia, which is a related phenomenon, and means the experience of seeing patterns in random collections of data.
Apophenia is what Carl Jung blamed for people believing in synchronicity, and what's possibly responsible for my thinking that all this not-having-heart-attacks is related to the original bee stings that I got about a year ago that led to all the trouble. Apophenia, as I see it, is a feeling that things can't be coincidental.
I had a case once where a woman was in a low-impact car accident and developed a very serious injury as a result of that accident, at least according to us and her doctor. The insurance company defending the case claimed the accident hadn't caused the injury -- but the symptoms of the plaintiff's condition began shortly after the accident, and repeatedly, throughout the years that I worked on this case, someone from our side would raise the question: Do they want us to think that's just coincidence?
That's how I came to blame the bees for my ongoing not-a-heart-attack: I'd never had any problems before, then I got stung by bees, then I had problems, including heart attacks and not-heart attacks. Do they want me to think that's just coincidence?
But maybe it is; what Jung meant was that events can be grouped by cause-and-effect -- the bees caused me to have a heart attack -- or by meaning: The bees caused me to suffer, and other things cause me to suffer, and I therefore relate them to the same thing.
What's interesting is that Jung, who coined the term synchronicity, didn't seem to ultimately believe that things were just coincidence: Jung talked with Einstein and Wolfgang Pauli about his theories of synchronicity and how they might relate to then-evolving theories of quantum mechanics, and later on seemed to believe himself in synchronicity as more than just our brains imposing order on random events, but as something larger. He wrote of treating a patient:
A young woman I was treating had, at a critical moment, a dream in which she was given a golden scarab. While she was telling me this dream, I sat with my back to the closed window. Suddenly I heard a noise behind me, like a gentle tapping. I turned round and saw a flying insect knocking against the window-pane from the outside. I opened the window and caught the creature in the air as it flew in. It was the nearest analogy to a golden scarab one finds in our latitudes, a scarabaeid beetle, the common rose-chafer (Cetonia aurata), which, contrary to its usual habits had evidently felt the urge to get into a dark room at this particular moment. I must admit that nothing like it ever happened to me before or since.
That leaves open the question, still, of whether we impose order on random events, or random events aren't random. Suppose Jung's patient had been talking not about beetles, but about clouds. Jung likely wouldn't have thought anything about the beetle knocking at his window, other than that it was an annoyance.
Jung's thinking on the topic led me to looking at Littlewood's Law, which is a law that says you can expect a miracle to happen about once a month. Littlewood based that on a theory that a miracle is a "one in a million" event -- something of special significance that occurs about one time out of every million events. Littlewood then said we experience one event per second, most of them unexceptional (you reading this line is an event.) In 35 days or so, you've gone through 1,000,000 waking moments, and so the odds are that something exceptional happened to you in one of those moments.
Exceptional being the key word; when I looked at the pattern of my songs randomly played on my iPod during one jogging session, each one had something to do with health, or life, or death -- an exceptional occurrence, that such synchronicity would occur while I was jogging. Except that we're back to my imposing the significance on the songs, especially depending on how loosely you define the relationship of the songs to the theme.
Which leads up to confirmation bias, or the tendency people have to favor information that backs the conclusion they want to make. If you, like me, oppose gun ownership*
*guns and cigarettes are the only two things people make which, when used exactly the way they're intended to be used, are fatal
then you probably remember stories about three-year-olds grabbing guns and killing people, and don't pay much attention to the fact that thousands of hunters roam the woods every year shooting deer and very few fatalities occur**
**assuming, of course, that you don't count the deer.
Confirmation bias can be as dangerous as synchronicity, depending on who you're talking to; I assume that any chest pains I suffer are related to my heart and were caused by the bee-stings initially, and that there's some fundamental change that occurred when those bees went all bee-y on me and I heroically saved Mr F and Mr Bunches' lives***
***It was heroic, and neither of them got stung.
But if that's a false belief -- if that's me imposing order and meaning on my life by grouping random events by meaning -- then what of the doctors, who look at my medical history and decide that chest pains=heart attack? They want to be sure that I'm not having another heart attack, thereby exposing them to ridicule on my blog and worse*4
*4 I am a lawyer, after all. I'll sue you at the drop of a hat and not think twice about it.
And I got started on all this simply by seeing a face in the curtains, which is where the headline for this post comes from: Having been told once that people see faces in almost everything, I can't stop seeing faces, and in fact, I've made a game of it, almost, because (a) I'm that kind of person and (b) what else are you supposed to do when you're working/driving/supposed to be in a meeting? Play Angry Birds? I don't think so. I'm tired of that game.
And you probably won't be able to stop. Look around where you're sitting right now. I bet you can find 10 different faces without even trying.
The point of this post is to mention cool things I never learned in school, and pareidola and the rest of these things are all very cool things that I never learned in school and probably nobody ever learned in school, which seems kind of wrong to me; schools are supposed to be teaching students how to think after all, aren't they? They should be; schools teaching people when the Civil War started isn't really productive anymore. We can all look that up. But schools teaching people how to think is productive, and teaching people now just how to think but how we actually think also seems important to me...
...if only to let us know why there's an 80's Nagel painting in that curtain on the ER, and why the doctors are going to keep telling us that we're not having a heart attack as we wonder about the Nagel painting.