PSYCHIATRIC VIEWS ON THE NEWS
Dedicated to my longtime best friend, Barry Marcus, who sent me a Paul Simon album because he thought I would like it—and to my wife Rusti, who recommended that I continue to write about music.
Paul Simon’s recently released solo album Stranger to Stranger can probably be interpreted in various ways. Personally, I think he has taken the pulse of our psychosocial challenges of living in our society. These are the social determinants of health and mental health that we need to know about and ethically address for the sake of our patients.1
Any written review must fall far short of conveying the power of the music, of the multicultural instruments used in such inventive ways, and of the emotions Simon’s voice conveys. It won’t do justice to Mr Simon’s ability to pull off an artistic paradox: to couch the most serious problems with upbeat music. Like psychiatry, music must make the most unpleasant truths palatable. For that, you’ll have to listen to the album, if you have not already.
In the meantime, here is an analysis of how the different songs may connect with psychiatry, whether Mr Simon intended that or not. If not, I apologize to him if this approach is offensive. Simon runs through the cuts and teases out psychiatric symptoms that are portrayed much more poetically than in our cookbook descriptions in DSM-5.
The first track is titled Werewolf, and given that title, there may be no surprise of the violence that is chillingly portrayed right from the get-go:
Milwaukee man led a fairly decent life
Made a fairly decent living
Had a fairly decent wife
She killed him - sushi knife. . .
That a werewolf is behind such violence is one explanation, but a science fiction one. Another, of course, is that the wife killed her abusive husband despite his otherwise decent life. The song goes on to describe greed, ignorance, arrogance, and fear that can cause such violence.
The next song, Wristband, continues the discussion:
The riots started slowly
With the homeless and the lonely . . .
Those locked out of the American Dream are prophesied to riot. These include the homeless, many of whom have mental illness. This is not the first time Simon has sung about poverty, as witness the hit song Homeless from 1986. The songs also include the lonely, perhaps even the elderly, who so often are socially isolated in our country. Are we beginning to see the beginnings of such protests in our Presidential campaigns?
The third song is titled The Clock. There are no words, as it is an instrumental piece, but as it’s title goes, the tick-tock of the sounds suggest that we must address our societal problems before time runs out.
One outcome for homeless people other than violence is hospitalization, as conveyed by this excerpt from Street Angel:
Workin’ his way back home
He’s workin’ his way back home
They took him away in the ambulance
Made a way with the ambulance
He waved goodbye from the ambulance
My heart goes out to the street angel . . .
This homeless man is portrayed as a “street angel,” who is “taken away,” perhaps to be hospitalized unnecessarily. The story continues a couple of tracks later in a song titled In a Parade.
I write my verse for the universe
That’s who I am . . .
Occupation: Street Angel
This description of a psychiatric evaluation and diagnosis may be the first one ever represented in a song. But was this “street angel” delusional or was he more of a saint? Historically, religious prophets have conveyed a thought process that could be interpreted as either spiritually insightful or psychiatrically ill. How can we be sure when someone is dangerous or angelic?
1. Garg A, Boynton-Jarrett R, Dworkin P. Avoiding the unintended consequences of screening for social determinants of health. JAMA. June 28, 2016. http://jama.jamanetwork.com/article.aspx?articleid=2531579. Accessed June 29, 2016.
2. Dwyer J. Could This Be the End of Paul Simon’s Rhymin’? New York Times. June 28, 2016. http://www.nytimes.com/2016/06/29/nyregion/paul-simon-retirement-stranger-to-stranger.html. Accessed June 29, 2016.