Ghost wars and grimaces

As a graduate student, I began studying a medical problem that was just about to become a disease of the past. Is all this arm waving about predicting and preventing generalized war history repeating itself?

Tardive dyskinesia (TD) is a rare abnormal movement disorder that results from exposure to the classic anti-psychotic medications we also refer to as the major tranquilizers or neuroleptics. They include the phenothiazines and butyrophenones and some others. Names of these meds include Haldol (haloperidol), Thorazine (chlorpromazine), Navane (thiothixene), Prolixin (fluphenazine), and Mellaril (thioridazine). These are potent drugs that were considered miracles in the 1950’s because they provided a treatment for psychosis that was not surgical lobotomy. They were, and are, very effective in quieting the positive symptoms of schizophrenia and other psychotic disorders. However, the side effects can be serious.

The classic one is tardive dyskinesia, which appears later rather than earlier in the course of treatment (hence the “tardive”) and manifests as abnormal movements, especially of the face, including tongue thrusts, grimaces, blepharospasm (blinking), and many others. Interestingly, patients are usually unaware of the movements.

My doctoral dissertation involved modelling the relationship between the severity of these
movements, perceived social support, and psychological stress. I argued at that time that a
biopsychosocial model of tardive dyskinesia in institutionalized patients such as those in my sample would explain why a subset of these people displayed the worst stress, the least social support, and the worst tardive dyskinesia. My thinking was that as people got worse TD they look really quite bizarre, they alienate their potential sources of social support,and thereby remove the main mitigating factor for stress, i.e. social support. Anyway, the Ph.D. dissertation is in the Library of Congress (helping to block a draft there) if you are interested.

But, back to my point: Around the same time I was conducting my research at a large state psychiatric hospital in the Midwest, clozapine (Clozaril) was approved and began to be used. It had the same beneficial effects in psychosis, without anything like the same risk of movement disorders. Since then, other atypical antipsychotics have come on line that offer the same benefits of clozapine without the agranulocytosis (low white blood cell count). So, TD is becoming a disorder of interest only to historians.

Is generalized war going the same way as tardive dyskinesia? By the time we model it and predict it, will it all be beside the point anyway?

I recently finished the excellent book Ghost Force: Secret History of the SAS by Ken Connor. The author, a long serving member of this elite British military brigade, makes a bold recommendation: disband the SAS. He argues that the new global environment we live in has changed the nature of war. He argues that in the future we will not see wars characterized by huge armies, vast troop movements, and infantry combat of the sort that gave us the Somme, Verdun, and Gettysburg. He points out that in the information age, a soldier in plain clothes with a spanner (read “wrench”) or a computer program can do the equivalent damage formerly done by B52s and Flying Fortresses dropping bombs. He even hints that perhaps the SAS will evolve into such a covert force, if it has not already.

William Gibson suggested this future war in Neuromancer, all those years ago, did he not? Conflict between private security forces replaces classic war. Global multinationals replace nation states.

My interest in applying the new techniques of non-linear dynamic modelling and simulation to the problem of war may echo my interest in modelling the biopsychosocial aspects of tardive dyskinesia. Will the problem be solved by prevention by the time we develop a cure? What do you think? Comments please.

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