Tuesday, July 28, 2009

Good mental status

The address to this blog contains the words "mental status." I was hoping for "good mental health" but this name has already been taken.

You might recall "good mental health" was part of the sign off phrase Dr. Frasier Crane used in the TV show "Frasier" as he signed off his wacky radio program. (I always liked trying to figure out which celebrity the voice of his callers belonged to)

But what exactly is mental status anyway?

It comes from a psychiatric tool known as the mental status exam. When I google that term, the first site I get is:
http://www.psychpage.com/learning/library/assess/mse.htm

The "mse" is usually a one page form with variations among hospitals and clinicians. It is used to as a quick checklist to see "where you are at" and is usually filled out without you knowing it. It covers various categories: attitude, motor activity, affect, mood, speech, thought content, suicidality, homicidality.

Within each category is a range from normal to something other than normal. For example, under "mood" there might be choices of normal, elevated, irritable, depressed, hostile, hyper and so on. Naturally, if your mse contains a lot of check marks next to items that would be considered "not normal" chances are something is not going very well for you at that particular moment.

I am sure my mse, if done when talking to an incompetent customer service rep on the phone (bless you all anyway), would probably go off the chart.

But that's beside the point.

The point is this: as I happened to watch Sarah Palin's "I quit" speech, the one that was hastily conducted at her home in the late afternoon on July 3, I noticed something odd. It was not so much what she said as it was how she said it. In the mse category of speech I have at my disposal such labels as normal, loud, excessive, delayed, slurred, pressured and so forth. Her speech struck me as pressured. Which leads me to ask, why?

There could be various reasons. Maybe she had a stone stuck in her shoe and couldn't wait to finish to kick that pump off. Or maybe she really had to go to the bathroom. Or maybe the sun was in her eyes. It doesn't matter what it is, the point is that there was something going on underneath. But what? You never know unless you ask and hope the response you get is an honest one. But alas, what a politician says and its relation to truth is like putting two cats in the same cage. It's not that politicians lie blatantly, though some have been caught in that many times, what they say is more a variation of the truth or some piece of it. It's called "spin."

Let's take it a step further. In the mse there is also a category for "thought process." In its given range we find: intact, obsessions, tangential, loose associations, flight of ideas, racing and so on.

Now if you've watched her speech and mull that last category you might think "Hold on here. Didn't she say something about dead fish and point guards on a basketball team? And wasn't that all coming in a bizarre, haphazard way? I mean, is that what you mean by 'loose associations, flight of ideas or racing?'"

You betcha darlin'. That's exactly what was going on.

It became obvious that the reason her mental status at the time of her speech was a bit "off" was because she knew she was dropping a bomb on the public, that there would be controversy surrounding it and that she wanted to get out of that situation as quickly as possible. After all, imagine if you were speaking to a crowd and you knew you were saying things that would elicit a firestorm of questions and that there's a good chance you'd be perceived as a quitter. Wouldn't you want to get out as quickly as possible? Heck, my speech would be pressured too. In fact, it might be more than pressured, it might be more like "I quit. Bye."

Add to that her odd rationales that came across as "loose, racing, or a flight of ideas" (of course if you are a SP fan the whole spectacle made perfect sense) and it leads one to believe this was someone who had something to hide. Someone half honest. The end result is someone who wanted to get through this as quickly as possible, who showed you some of her cards but kept her trump cards behind her back. In other words a player. A pro. A politician.

There is no ulterior to point to this. I'm just sharing something that caught my attention on that late afternoon, on the eve of Independence Day.