Grand Rounds #27 is up...

and who will respond to the first post, about a med student's thoughts on psychiatry? Few fields attract - and deserve - as much scrutiny and criticism as my own. Given that, I must add that there are many reasoned arguments against our current theories and practices, and that the Grand Rounds post does not include them. He does link uncritically to an article filled with distortions. He also links to a transcript of a debate between Szasz and the opposing camp: "Is depression a disease?" No, says the student: it's a mental and spiritual process.

This argument always reminds me of the tale of the blind men and the elephant (with some "chicken-or-egg" thrown in). Clinical depression is clearly a mental (and often spiritual) process, but why dismiss the mounting evidence (hormonal, neurochemical, and genetic) that's converging on a physiologic disease mechanism? I suppose it's because that evidence is only converging. We blind folk are still palpating the elephant. Until a lab test or x-ray can establish the diagnosis, some will not be satisfied. The debate most certainly does not end here...