Life is Short and Precious

Posted Posted in Continuing Education, Elder Care, Homestudy, Psychology, Seminars, Webinars

By Mary O’Brien, M.D.
It happened in an instant. Unimaginable horror and tragedy stunned a community and, indeed, the world.  The collapse of a condominium building in Surfside, Florida, at 1:38 A.M. instantly changed the lives and focus of thousands of people in the U.S., Israel, and South America.

Hundreds of people have been working around the clock, under brutal and treacherous conditions, to save a single life.  Rescuers of every race and background are feverishly trying to find even one survivor of any race or background.  Brave, skilled, and dedicated heroes are doing what brave, skilled, and dedicated heroes always do:  They sacrifice their own safety and well-being to help others.  Rescue personnel, regardless of their color or politics, must be pulled off their shift against their will.  Trying to save another human being is their sole focus. They work together selflessly as a unified team to save life.

This is not shocking to anyone who has ever worked in an ER, an OR, or an ICU.  It’s not a mystery to veterans who have served in combat or police officers who have saved countless lived in emergency situations.  However, too many individuals in the realm of politics, the media, academia, and the corporate world remain baffled by genuine courage and devotion in others.  Since the beginning of our species, ill-intended people have tried to sow division and strife.  Pitting people against one another is malicious, but it has always created an opportunity for power-hungry individuals to seize control.  Teaching children and young adults to be suspicious and resentful of others based on race, gender, or any other physical — therefore superficial — characteristic is a form of cultural rot.  It is a poisoning of the mind.

The tragic collapse of a condominium complex in Surfside, Florida, shows how misguided our priorities can be.  Life is short and precious.  There is never a good reason to promote hatred.  There is more than enough heartache in life without deliberate nastiness. We should never permit ourselves to be focused on race.  We have every reason to keep our focus on grace.

Einstein Was Right!

Posted Posted in Brain Science, Continuing Education, Homestudy, Psychology, Uncategorized

By Mary O’Brien, M.D.

“Everything should be made as simple as possible, but not simpler.”  Albert Einstein said that many years ago.  He was referring to physics, but his wisdom could easily apply to any situation, including COVID-19 vaccines.

Increasing numbers of people in business, politics, education and, of course, the media, are trying to force COVID-19 vaccines on everyone.  “Vaccination or termination” has become the new threat to employees and students.  Most people, regardless of their lofty achievements in other areas, are not well-versed in the fine points of immunology.  Sadly, however, some of them are convinced that they know what’s best for everyone.

Nearly everything in medicine carries potential risk and reward.  Both possibilities must always be considered.  Every prescription we write and every procedure we do has some potential to cause harm.  Every patient is unique.  Every individual has a combination of genetic factors, past illnesses, medications, and allergies.  Also each patient has metabolic, endocrine, hematologic, rheumatologic, neurologic, and cardio-pulmonary conditions that may need to be considered.  For example, patients with rheumatoid arthritis, psoriatic arthritis, Crohn’s disease, and other autoimmune disorders produce antibodies that attack their own tissues, hence the need to suppress — with potent drugs such as TNF (tumor necrosis factor) inhibitors — certain parameters of immune function.  Giving such a patient a vaccine, which stimulates the immune system to produce antibodies, can be unwise.  This is usually most problematic with live virus vaccines such as those for varicella, measles, and mumps, and rubella.  The COVID-19 vaccines are messenger RNA-based.  They do not contain live virus.

Pregnant women with COVID-19 illness are at increased risk for serious disease and mortality.  According to the Food and Drug Administration, data on the COVID-19 vaccines are “insufficient to inform vaccine-associated risk in pregnancy”.  Translation:  we don’t know enough yet to be dogmatic about these decisions.

All of COVID-19 vaccines available in the United States (Pfizer, BioNTech, Moderna, and Johnson & Johnson) are safe, effective, and appropriate for the vast majority of people.  But good medical practice is not about the vast majority of people.  Medical decisions are based on the conditions, needs, and details of the individual patient.  Politicians, corporate chief executives, school board members, and media types have no business making (or forcing) medical decisions on other people.

Einstein was right.  Oversimplifying anything is a bad idea.  So is judging others without knowing all the details.

Correct Answers

Posted Posted in Brain Science, Continuing Education, Psychology, Seminars, Webinars

By Mary O’Brien, M.D.

Quick.  Looking back on your life, who was your favorite teacher or coach?  Was it the one who let you get away with anything?  Was it the one who set standards so low you tripped over them?  Was it the person who gave you a gold star for repetitive breathing?  The answer to all of those questions is a resounding “no.”  Most of us would agree that our favorite teacher or coach was the one who inspired us to give our best and achieve more than we thought we could.

Recently, many of us were stunned when state education officials in Virginia proposed eliminating any advanced or accelerated math classes prior to the 11th grade.  They opined that such classes were “unfair” or “intimidating” to less gifted students.  Somehow they reasoned that slowing down the smarter students would make sense.  We already went through this in the 1970s.  Educational giants back then introduced the “New Math” and declared that spelling and grammar didn’t “count.”  Creativity was king.  More recently, the “woke” crowd has informed us that correct answers don’t even matter when it comes to math.  “Process” matters.  In order for our future generation to compete at the highest level, both precision and creativity matter; we need both to succeed. 

We need advanced math to send astronauts to the moon and to the international space station.  We need math to calculate a safe antibiotic dose for critically-ill patients with deteriorating renal function.  Correct answers matter.

Perspective, Humanity and Common Sense

Posted Posted in Brain Science, Elder Care, Psychology, Seminars, Webinars

By Mary O’Brien, M.D.

It’s been a year now.  Several hundred thousand frail, elderly people have died in hospitals and nursing homes alone, confused — and no doubt — feeling abandoned.  Tens of thousands of people have lost their businesses and livelihoods.  Children and teens deprived of normal schooling, sports, and other activities are suffering from anxiety, depression, insecurity, and loneliness.  Poor and disadvantaged children and those with learning disabilities are falling behind rapidly.  Online absenteeism is staggering, and grades are sinking.  The frustration and loneliness are excruciating for millions of innocents.

Politicians and bureaucrats are not lonely, however.  Their lives have not been destroyed.  If they want to dine out, work, socialize, or travel they do.  After all, they’re special.  They are enlightened elites.  We have heard the elites preach “science” to us for over a year.  The question is which science?

Medicine involves many sciences — chemistry, biology, mathematics, physics, statistics, genetics, physiology, pathology, epidemiology, and microbiology.  And that’s only a partial list.  Medicine, however, is also an art.  Sadly, over the past year, too many people have forgotten that.  Individual nurses, doctors, and other professionals have worked heroically to save lives and to be kind — under impossible circumstances — to patients.  But bureaucrats and politicians, with rare exceptions, cannot fathom the art of caring for seriously ill or dying patients — deprived of even a loved one — to hold their hand.  Once they taste control over others, they will not relinquish it willingly.

Human beings are social creatures.  We need contact, communication, and — perish the thought — touch.  Throughout human history exile, isolation, or solitary confinement has been considered painfully harsh punishment.  Yet this is precisely what has been inflicted on young children, the frail elderly, and millions of people in-between — all in the name of “science.”

The point of medicine is to relieve pain and suffering, it is not to control behavior.  Elderly people giving up hope and dying alone, and young people committing suicide were entirely predictable.  Some of us warned about an epidemic of anxiety, depression, addiction, abuse, and suicide a year ago.  These concerns were largely dismissed.  Histrionic media types and “officials” had millions of people convinced that COVID was a veritable death sentence for everyone. 

In reality, 99.7 percent of people who test positive for COVID survive.  Children are not vectors for this illness.  This virus attaches to human cells via angiotensin, converting enzyme receptors in the nasal mucosa and respiratory passages.  Children have very low levels of these receptors.  This is not difficult “science.”

Across the country we are seeing dramatic declines in case numbers, hospitalizations, and deaths.  In all likelihood, millions more people have antibodies to COVID than we realize.  They were simply never sick enough to be tested.  Millions more have been and are being vaccinated.  When 80 percent or so of the population has antibodies (either from infection or vaccination), we will have herd immunity.  There is no need to compromise the physical, social, psychological, and academic well-being of children and teens for one more day.  There is no need to refuse grandparents a hug.  We are rapidly losing any sense of perspective, humanity, or common sense.  We have developed a penchant for panic.  But panic is not policy.  Paranoia is not policy.  We must never again permit the self-serving notions of so few to dictate the misery and destruction of so many.

On Leadership, Science, and Happiness

Posted Posted in Brain Science, Continuing Education, Elder Care, Homestudy, Seminars, Webinars

By Mary O’Brien, M.D.

It’s safe to say we’ll all be happy to see this year come to an end.  Fifty years from now people will still be studying the pandemic of 2020, catastrophic hurricanes, tornadoes, wildfires, riots, a controversial election, and the Nashville bombing.  We have reasons to be exhausted.

Despite all these dreadful events, or perhaps because of them, there is much to be learned.  It could easily fill a book, but for now, a few thoughts will suffice:

On Leadership

  • The people who are trying to frighten you are trying to control you.  Ignore them. Good leaders inspire confidence and optimism, not despair.
  • There is never a place for panic in leadership. There is never a place for panic in public policy.
  • Good leaders actually do what they ask others to do. They do not exempt themselves from difficult, inconvenient, or unpleasant tasks.
  • True leaders respect others.  They do not harbor disdain for others.
  • Tyrants (false leaders) often succeed because cowardice is so common.  Show some spine when bullies arise, and remember, no politician or bureaucrat has missed a paycheck in 2020.
  • When in the course of human events, it becomes clear that what you’re doing isn’t working, it’s time to change what you’re doing — especially in a crisis.

On Science

  • Genuine science requires brutal honesty, discipline, openness, acceptance of uncertainty, and humility.  Real science always has been and always will be a work in progress.  When people scream, “Follow the science,” all too often they mean, “Do as I say.”
  • The main point of science is to help us overcome problems and adapt to difficult circumstances. Creative people in every domain have learned to adapt to massive challenges over the years. The Year 2020 was no exception.  In a crisis people need practical advice and suggestions, not domination and suppression.

On Happiness

  • Most of us still have much for which to be grateful, and there is no happiness without gratitude. Take nothing for granted. Many of us now miss things as simple as family, friends, hugs, and handshakes.
  • There are plenty of unkind people in the world. Don’t be one of them.  Kindness and happiness go hand in hand.
  • Don’t believe anyone who insists our darkest days lie ahead.  Such people do not understand the wonders of the human spirit.  It is never time to give up, despair, or cower in a corner.

Fear not.  We’ve learned a great deal in 2020, and we will build on that knowledge.  Be focused.  Be engaged.  Stay informed (not indoctrinated).  No matter what happens in 2021, do not relinquish your right to engage in independent thought and speech.  The future depends on it.

Happy New Year to All.

Exactly What We Need

Posted Posted in Brain Science, Continuing Education, Homestudy, Nutrition, Psychology

By Mary O’Brien, M.D.

The holidays have gotten off to an odd start.  Thanksgiving was different, to say the least.  Most family gatherings were small and lots of people were alone.  Now the focus has shifted to shopping and decorating. At least it’s a pleasant distraction.

Hanukkah begins on December 10th and Advent started this week.  Who knows what will happen by Christmas.  Given the depressing and stressful nature of this entire year, it might be uplifting to embrace some time-tested traditions of a spiritual nature. For centuries the Christmas tradition of Advent was a time of fasting, prayer, and alms giving.  Many of us were taught to “give up” something like candy or soda as a spiritual discipline in preparation for Christmas.  Nothing wrong with that, especially since many of us have gained a few pounds during the pandemic.  But giving up candy doesn’t help someone feel better.  And right now, nearly everyone needs a little something to feel better.  So here’s an old idea that might help us all feel uplifted.

Cut 25 strips of paper and write an activity for the day on each one.  Fold the strips of paper and place them in a jar or bowl.  Each morning, pick one, and commit to performing the activity.  By Christmas, you will be a better person (and a happier one) for the ripple effect you will have set in motion.

Here are some examples:

  • Send a Christmas card with a personal note of gratitude and encouragement to an active service member or veteran.
  • Leave a little treat (not homemade this year) on the doorstep of a neighbor you haven’t met.
  • Stop by your church or synagogue for a few minutes of quiet prayer or reflection.
  • Give up fancy coffee drinks or alcohol for a month and donate the money you save to a shelter.
  • Offer to do a grocery store run for an elderly neighbor.
  • Say something pleasant or kind to someone you don’t like, perhaps a grumpy patient.
  • Send a small floral arrangement anonymously to someone in a nursing home.
  • Order take out or delivery and give an unexpectedly generous tip.
  • Apologize to someone you may have hurt or offended. It may be more difficult than giving up candy.
  • Place a treat in the mailbox for your mail carrier just because.
  • Try to get through the entire day without criticizing anyone.  There’s some spiritual discipline!

You can make up your own list. It’s well worth the effort.  The next four weeks will pass regardless of our actions.  This year the true spirit of Advent could be exactly what we need.

homestudy

The Greatest Enemies of Freedom

Posted Posted in Brain Science, Continuing Education, Elder Care, Pain, Psychology, Seminars, Webinars

By Mary O’Brien, M.D.

Election Day.  Veteran’s Day.  Pearl Harbor Day.  Do these days have anything in common?  They do — more than most of us might think.  The catastrophic attack on Pearl Harbor on December 7, 1941, shocked the nation into unprecedented action.  Millions of people who had ignored the war in Europe and Asia could no longer remain unaware or uninvolved.  Massive numbers of people rushed to enlist or pitch in on the home front to defend freedom itself.  People willingly sacrificed everything from gasoline, to meat and sugar, to fabrics and metals for the sake of the war effort.  Discipline and sacrifice were a given.

Veteran’s Day (originally called Armistice Day) honors the end of World War I. Few of us can even begin to fathom the anguish, misery, and suffering endured by the troops in Europe.  The horrors of trench warfare, malnutrition, hideous infectious disease, nerve gas, and deprivation of every sort took a terrible toll.  Nearly half of U.S. troops who died succumbed to complications of the Spanish Flu.  A hundred years ago, there were no antiviral drugs and no antibiotics to treat secondary bacterial pneumonia or meningitis.  Curiously, President Wilson never even gave a speech about the flu pandemic.

In World War I and World War II, the hardships of sacrifices endured by so many millions of people were intense.  But how does that relate to Election Day 2020?  It’s not that strange or complex.  The two greatest enemies of freedom are apathy and cowardice.  It’s been that way for thousands of years.  We are in a time of great conflict and uncertainty.  Angry, jealous, controlling people are everywhere.  Remember, if someone is trying to frighten you, he or she is trying to control you.  Don’t be intimidated.  Don’t be demoralized.  Observe, think, and vote.  Apathy and cowardice have dreadful consequences.

This Too Shall Pass

Posted Posted in Brain Science, Continuing Education, Elder Care, Psychology, Seminars, Webinars

By Mary O’Brien, M.D.

Raging wildfires, hurricanes, flooding, tornadoes, riots, arson, violence, lockdowns, pandemic fears, economic upheaval, and political turmoil.  If you’re not stressed out at this point you may be in a medically-induced coma.

Nearly everyone is dealing with some degree of anxiety, sleeplessness, weight gain, tension, irritability, frustration, and/or depression.  There are some constructive strategies we all know and have even advised patients to follow.  But we’re in “Physician, heal thyself” mode these days, so here are a few reminders:

  • Avoid people who are chronically angry and, if possible, don’t be one of them.
  •  Don’t obsess about things you cannot control, including the behavior of other people.
  • Re-invent some aspect of yourself — invest in a new hobby or resurrect an old one that used to give you joy.
  • Freshen up your work space or home. A pleasant, cheerful, clean, de-cluttered environment can really boost morale.
  • Move more.  Sitting at a computer or in front of a TV for hours on end is not healthy physically or emotionally
  • Take a good look at yourself and your appearance.  It may be time to kick it up a notch, if only for your own mental health.
  • Limit your exposure to negative, nasty, snide, snarky people on TV — that means 95% of the “news.”
  • Let yourself have 30 minutes of total silence every day.  It might feel like withdrawal if you’re addicted to noise and devices.
  • Make an effort to compliment someone — about anything.  It may turn around your entire day and theirs.
  • Go out of your way to be kind to a patient, colleague, neighbor, stranger, or — this is shocking — relative.  Acts of kindness boost levels of endorphins, serotonin, and Immunoglobulin A in everyone involved.
  • Get your minimum daily dose of uplifting inspirational reading, prayer, and meditation.  Human beings are more than bodies.
  • Don’t be difficult.  Being pleasant and cooperative is a gift to the people around you.  As we read in the Book of Proverbs, “A merry heart doeth good like a medicine.”

Cheer up.  Do some good for others.  This too shall pass.

COVID-19: Independent Thought

Posted Posted in Brain Science, Continuing Education, Homestudy, Psychology, Seminars

By Mary O’Brien, M.D.

Are you running on fumes these days?  You’re not alone.  For seven months, we have been bombarded by endless, awful news about the pandemic.  Riots, vandalism, looting, arson, and horrifying murder rates continue to plague cities across the nation.  Economic and financial stresses have taken their toll on nearly everyone outside the political class.  Somehow the elites of the ruling class never suffer the consequences of their own policies.

News alert:  Our rights are not granted by governors.  Our rights are not granted by health care officials or supercilious people on some city council.  Our unalienable rights of life, liberty, and the pursuit of happiness come from our Creator. Many people seem to have forgotten this. Cowardice, perhaps born of fatigue and fear, has overtaken too much of our society.  “Stay home or put on your mask and be a good little lemming.”  Tens of millions mindlessly comply.  Power corrupts and absolute power corrupts absolutely.  This has been true since the beginning of time.  At some point, however, a critical mass of people needs to say, “Enough!”

“Freedom is never more than one generation away from extinction.”  Ronald Reagan said that over 50 years ago.  He was right.  There will always be people who lust for power and control over others.  They will invent reasons to keep people fearful, uncertain, and angry.  The one thing they cannot abide is independent thought.

They say, “We know what’s best for you.”

No.  You know what’s best for you.  You know what’s best for your family, your business, your patients.  Over the past seven months, the “experts” have been spectacularly wrong.  They have fostered a level of panic that is out of proportion to reality.  Unless you live in a nursing home, you are at greater risk from getting into a car than you are from COVID-19.

Fear and sadness deplete energy.  Courage and good humor replenish it.  People adapt.  We can proceed with life, work, school, and business by combining prudence with creativity.  We can focus on facts, not on someone’s fearful narrative intended to control others.

If we actually value freedom, we need to stop cowering in a corner.  Fear is the enemy of freedom.  It’s time to show some spine.

COVID-19: It’s Time

Posted Posted in Brain Science, Continuing Education, Homestudy, Psychology, Seminars, Webinars

By Mary O’Brien, M.D.

Are you caught up in the back-to-school debate?  It’s stunning that anyone is arguing about this.  There was never a medically valid reason for closing schools and colleges in the first place.  As far back as February, we know who the vulnerable people have been.  They were older individuals with multiple, significant underlying illnesses.  This pattern was observed everywhere from China to the European countries.

The panic-stricken rush to close schools and colleges was precisely that — a panic.  Experience over the centuries should have taught us that quarantining a healthy population is ineffective.  The sound, medically sensible approach is to isolate and protect the vulnerable people as quickly as possible.

Consider a few facts:

  • In the U.S. since February 2020, approximately 40,000 deaths attributed to COVID-19 have occurred in people age 85 and older.  Approximately 32,000 COVID-related deaths occurred in people aged 75 to 84.
  • Between the ages of 5 to 14, there have been 14 COVID-19 deaths.  Over 120 children have died from the flu.
  • Children are not vectors for COVID-19.  This illness does not mimic transmission patterns seen with cold and flu viruses in kids.  Young children do not bring COVID-19 home to grandma and grandpa.  There are several medically documented cases of adults transmitting the virus to children (out of millions of cases), but not the other way around.
  • The main reason for this curious fact appears to involve receptor sites in the nasal passages. ACE2 receptors (angiotensin-converting enzyme) in the nose seem to function like docking stations for COVID-19. (Most people are familiar with a class of blood-pressure medications called ACE inhibitors.) Children under the age of 10 have very low levels of ACE2 receptors.  Children between the ages of 10 and 17 have slightly higher levels of these receptors.  Adults gradually develop greater concentrations of these receptor sites as they age.

What does this mean?  It means that there is no medically valid reason for normal, healthy children to wear masks.  Masks can trap bacteria, spores, allergens, pollen, particulate matter, and even increase carbon dioxide retention in certain patients.  Socially and psychologically, there may be a price to pay one day.

Children should go back to school.  Colleges should reopen.  Teachers will be exposed to colds and flu as they are each year.  But COVID-19 is not a massive threat to faculty unless they are already old and sick.

According to the CDC website on “COVID-19 and Children” updated, July 23, 2020:

The best available evidence indicates that COVID-19 poses relatively low risks to school-aged children.  Children appear to be at lower risk for contracting COVID-19 compared to adults.  To put this in perspective, according to the Centers for Disease Control and Prevention (CDC), as of July 17, 2020, the United States reported that children and adolescents under 18 years old account for under 7 percent of COVID-19 cases and less than 0.1 percent of COVID-19-related deaths.[5]  Although relatively rare, flu-related deaths in children occur every year. From 2004-2005 to 2018-2019, flu-related deaths in children reported to CDC during regular flu seasons ranged from 37 to 187 deaths.  During the H1N1pandemic (April 15, 2009 to October 2, 2010), 358 pediatric deaths were reported to CDC. So far in this pandemic, deaths of children are less than in each of the last five flu seasons, with only 64. Additionally, some children with certain underlying medical conditions, however, are at increased risk of severe illness from COVID-19.*

Scientific studies suggest that COVID-19 transmission among children in schools may be low.  International studies that have assessed how readily COVID-19 spreads in schools also reveal low rates of transmission when community transmission is low.  Based on current data, the rate of infection among younger school children, and from students to teachers, has been low, especially if proper precautions are followed.  There have also been few reports of children being the primary source of COVID-19 transmission among family members.[6],[7],[8]  This is consistent with data from both virus and antibody testing, suggesting that children are not the primary drivers of COVID-19 spread in schools or in the community.[9],[10],[11]  No studies are conclusive, but the available evidence provides reason to believe that in-person schooling is in the best interest of students, particularly in the context of appropriate mitigation measures similar to those implemented at essential workplaces.

Wash your hands.  Don’t touch your face.  Stay home if you feel poorly.  Keep surfaces clean.  Avoid crowds.

It’s time for kids to go back to school and for adults to go back to work.