Friggin' Nuts

What is the DSM-IV diagnosis for this?

WASHINGTON — President Bush, saying that "normalcy is returning back to Iraq," argued Thursday that last year's U.S. troop "surge" has improved Iraq's security to the point where political and economic progress are blossoming as well.

Bush coupled his description of the situation in Iraq, meant to lay the groundwork for next month's report to Congress by U.S. military and diplomatic chiefs, with a forceful slap at war critics.

"Some ... seem unwilling to acknowledge that progress is taking place," Bush said in a speech at the U.S. Air Force Museum in Dayton, Ohio. He accused war opponents of constantly shifting their critique, adding: "No matter what shortcomings these critics diagnose, their prescription is always the same — retreat."

In touting progress in Iraq, however, the president appeared to gloss over developments that most would characterize as a far cry from "normalcy," even by Iraqi standards.

Gee, d'ya think? For example, there's this: Hospitals in the unrest-stricken city of Basra received more than 60 bodies and 300 others wounded until Thursday evening in clashes flaring up in southern Iraq, a medic said. "There are many casualties that are not received by the hospitals for inability to reach them," he said. Sure, that's perfectly normal, happens in Boston every Thursday. Or this: Thirty-nine people were killed and 389 others wounded in the clashes that erupted on Tuesday in Sadr City, eastern Baghdad, a medic said on Friday.

I mean, if you can kill 39 people in just one neighborhood of the capital city in two days, that's got to be progress! And believe me, there was a lot more progress than that -- people all over the capital city were killed by mortars and bombs, not to mention the as yet unnamed U.S. diplomat -- or possibly CIA agent -- who was killed by a mortar attack on the "embassy," and the guy who died in the mortar attack on the Iraqi Vice President's office. And you absolutely know your security plan is working when gunmen kidnap its chief spokesman and burn down his house. As soon as that happens to Dana Perino, I'll know that Bush is all the way back! And when the artillery starts falling on Dick Cheney's office, then hey, the New American Century is here!

I'll tell you what, it's not quite a perfect fit, but there's Schizophrenia, paranoid type: "A type of Schizophrenia in which the following criteria are met: A. Preoccupation with one or more delusions or frequent auditory hallucinations. B. None of the following is prominent: disorganized speech, disorganized or catatonic behavior, or flat or inappropriate affect." Is the disorganized speech too prominent to allow this diagnosis? And the affect, while not flat, seems inappropriately joyful, especially when discussing the people he has killed or tortured. He does claim to hear the voices, so that part fits.

There's also Delusional Disorder, grandiose type, which sounds good but may have some criteria that rule it out: "This psychotic mental disorder is diagnosed when prominent nonbizarre delusions are present for at least one month and the symptom criteria for Schizophrenia have never been met. Hallucinations may be present, but auditory or visual hallucinations cannot be prominent. Olfactory or tactile hallucinations may be prominent, but only if they are related to the content of the delusion. Psychosocial functioning may not be impaired and any co-occurring mood episodes must be of relatively brief duration." The grandiose part is "delusions of inflated worth, power, knowledge, identity, or special relationship to a deity or famous person."

That certainly fits in some ways, but the issue for me is whether the delusions are "non-bizarre." And is "psycho-social functioning" impaired? I would say that being responsible for the deaths of a million people is suggestive of impaired psychosocial functioning but I'm not a trained diagnostician.