EVERY now and then an event occurs in my profession, psychiatry, that is so unlikely as to seem either miraculous or at least totally weird.

United States senator Rand Paul, a Kentucky Republican and a former ophthalmologist, has entered the ranks of psychiatrists.

What makes that unlikely is the fact that eye doctors earn about five times the take home pay of "I" doctors. Dr Paul has invented a new psychiatric diagnosis.

In response to the critics of Donald Trump's obsequious behaviour with Vladimir Putin at Helsinki along with his throwing American intelligence agencies under the bus by denying their finding of Russian meddling in the 2016 election, Dr Paul believes critics have developed "Trump Derangement Syndrome".


Without further description from Paul, I'm left to parse the meaning.

It is the claim that Trump's critics are so addled by the animus towards him as to be "deranged"— that is, they are "nutters".

If the latter evokes a familiar sound, it's because a former mayor here in Whanganui used the same language to describe his critics, and for the same purpose — to shoot the messenger and thereby destroy the effectiveness of the message.

In former times I might take umbrage at the waka jumping of an ophthalmologist making psychiatric diagnoses.

These days, when my fellow psychiatrists embarrass themselves by diagnosing Trump from afar and the American Psychiatric Association publishes a diagnostic manual that pathologises ordinary human experience — such as grief — while providing scientifically weak categories useful mainly to enrich pharmaceutical companies, then making new psychiatric diagnoses becomes fair game for anyone.

Except, of course that "Trump Derangement Syndrome", like "nutter", is not a diagnosis but simply name calling with psychobabble.

Any diagnosis in medicine and psychiatry is a shorthand way of describing a cluster of symptoms for a number of people with the goal of determining a path to treatment and assessing likely outcomes. Not a high-fallutin term to avoid grappling with serious issues. That's just quackery.

In 2004, a year into the Iraq war, just after the Abu Ghraib revelations, I was invited to an amateur performance of William Shakespeare's Julius Caesar.


It was produced by the conservative Federalist Legal Society with a cast of US federal judges and members of the Harvard Fellows, an elite club within an elite club.
The subsequent discussion was to be about executive over-reach.

My previous positive bias, favouring the superior intelligence of these august worthies was dispelled when, after I wondered aloud whether the Bush administration's use of torture didn't cast a shadow on the verdicts at Nuremberg, my point was promptly dismissed as that of a "Bush hater".

That sort of ad hominem attack is evidence of the desperation of the holder of a weak argument.

Besides, hatred is a form of continued attachment that doesn't align well with the cold disdain I feel for the Bushes, Trumps and — yes — the Michael Laws of this world.
But since it is now open season on making psychiatric diagnoses, I'm going to offer one for the likes of Senator Paul.

It's called "Trump Malabsorption Syndrome".

Jay Kuten
Jay Kuten

This seems to affect a number of so-called Republicans and particularly describes Senator Paul's present condition.

As a Republican libertarian, Senator Paul was formerly against deficit spending, staunch in support of free trade, opposed government surveillance and drone warfare, opposed the war on drugs, and was against foreign adventurism.

Perhaps it was electoral fear that made him vulnerable to the Trump virus. Once imbibed, the virus erodes the spine, alters the brain and erases principle.

Paul now defends the $1.5 trillion deficit after tax cuts for the rich, the US involvement in Yemen alongside the Saudis, endorses Trump's protectionist trade war, and defends Trump's disparaging of allies and the US intelligence agencies, while kowtowing to Putin.
Respected senior conservative pundit George Will says there is no Republican party with traditional conservative values today, only a Trump party.

Astonishingly, he advises all to vote Democratic in 2018 and 2020. He may be on to something — the cure for "Trump Malabsorption Syndrome".

Jay Kuten is an American-trained forensic psychiatrist who emigrated to New Zealand for the fly fishing. He spent 40 years comforting the afflicted and intends to spend the rest afflicting the comfortable.