We’ve never paid particular attention to Scott Alexander (pseudonym) and his blog, Slate Star Codex (now Astral Codex Ten). Long ago, we ran into a few SSC posts and our very vague memory is that we liked them. Then, while reading more on the New York Times‘s crucifying of Donald McNeil, we came across the Times‘s smelly article on SSC, including the gratuitous and sleazy outing of Alexander.* We explored a little, including reading this thoughtful critique of SSC. Still, we didn’t, and don’t, look to have an opinion on SSC, or on the “rationalism” in which it is supposedly immersed. (We did however, come to the opinion, that the New York Times has lost its collective fucking mind.)
A couple days ago, however, and completely by chance, we ran into an old, 2014 post on SSC. Alexander is a psychiatrist, and this post was on his long and futile attempt to conduct a study of a screening test for bipolar disorder, a test that Alexander suspected was of limited worth and knew was being widely misused. From the introduction to Alexander’s saga:
You ask patients a bunch of things like “Do you ever feel really happy, then really sad?”. If they say ‘yes’ to enough of these questions, you start to worry.
Some psychiatrists love this test. I hate it. Patients will say “Yes, that absolutely describes me!” and someone will diagnose them with bipolar disorder. Then if you ask what they meant, they’d say something like “Once my local football team made it to the Super Bowl and I was really happy, but then they lost and I was really sad.” I don’t even want to tell you how many people get diagnosed bipolar because of stuff like this.
Alexander’s post struck a particularly strong chord. Our father was a clinical psychologist, and he saw the worst. The whole Cuckoo’s Nest thing. More importantly, he didn’t think the not-worst was generally all that much better. In general, he regarded his psychologist and, especially, psychiatrist colleagues as arrogant, narrow-minded, drug-pushing quacks. Alexander’s story is from a different angle, but it fits right in.
Alexander’s post is alternately hilarious and horrifying. Read it. And then scream.