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While the diagnostic categories of DSM-III and DSM-IV (and soon DSM-5) have provided the basis for much useful research, little has been written about how much of DSM-and how much “evidence-based medicine”-is built on a foundation of fantasy.

The day began on a high note. As I sat and talked with an elderly patient sitting in her wheelchair, quiet, not remembering much, she suddenly broke out in song.

After each violent tragedy, the politicians hypocritically mourn and harrumph, but wind up buckling under pressure from the NRA, fiscal constraints, and the prison and gun lobbies. Repeated dramatic events can shake the complacency and cowardice of a stalemated Congress and state legislatures.