Steady As She Goes

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By Mary O’Brien, M.D.

Are you afraid to open your financial statements for March? Have the recent market gyrations triggered a sudden interest in Xanax? Nonstop news cycles and social media postings have spawned massive overreactions to every comment made by political or business leaders. Down drafts of 1,000 points can cause even the most seasoned investors to panic. Over the past two months I’ve had to curtail my exposure to the business networks. Watching the Dow Jones Industrial Average plunge 700 points at 2 P.M. can make me feel as if I’m about to go into ventricle fibrillation. I’d rather stay in normal sinus rhythm.

Sadly, that is not a joke. I have a vivid memory of sitting at a stoplight in Little Rock, Arkansas, on October 19, 1987. It was about 5:30 P.M., and I was headed home from my office. Over the car radio I heard, “The Dow Jones Industrials are down 517 points.” I distinctly remember thinking, “Oh, he’s reading that wrong! The DOW couldn’t possibly be down that much.” It was.

Shortly after I arrived home, my beeper went off. One of my favorite patients was in the emergency room (ER) with a massive myocardial infarction. George A. was a 76-year-old gentleman from Hope, Arkansas. He had grown up in poverty but had educated himself and built up several successful businesses. He was bright, witty, charming, dapper, and gracious. But on that day, George A. had lost over a million dollars, at least on paper. He was devastated.

I grabbed my bag and raced back to the hospital. We got George admitted to the cardiac care unit (CCU). His electrocardiogram (EKG) looked awful, and he looked worse. He was utterly convinced that one dreadful day on Wall Street had destroyed his future. Around 8 P.M., George become very ill (coded). We worked on him frantically for over an hour, but we couldn’t bring him back. There was no doubt in my mind that the thought of financial ruin had literally scared George to death. I felt numb.

Later that week, two of my colleagues committed suicide. They had also lost a fortune, at least on paper. Everyone was stunned and afraid that week. One year later, however, the market had recovered nearly all of its losses. Thirty years later I still mourn the loss of three good people. For all intents and purposes, they died from acute financial panic.

I am no financial genius. But forty years of investing have taught me a few lessons that may help someone else:

  • Don’t watch market moves minute to minute. Before long, you’ll need heavy sedation.
  • Don’t dump stocks when everyone is panicking. You’ll almost always miss out on the best part of the recovery phase.
  • Remember the wisdom of the ancient Greeks: Moderation in all things. Balance stocks, mutual funds, bonds, certificates of deposit (CD’s), cash, real estate, and precious metals based on your age, health, family needs, and risk tolerance.
  • Don’t give in to ignorance, laziness, fear, or greed. Sixty-six percent of millennials have nothing stashed away for retirement. Failure to invest is one of the greatest mistakes of all.
  • No matter what happens, avoid the temptation to overreact. You are infinitely more important than your financial statements.

Now take a deep breath and open the statements from March. Steady as she goes. You’ll be fine.

One Devastating Flaw

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

By Mary O’Brien, M.D.

It happened again.  Seventeen precious lives were snuffed out by a vicious young man.  Before their bodies were laid to rest, “experts” began screaming at one another on TV.  However, finger-pointing, shouting matches, and emotional rants do not solve problems.  Thoughtful, well-informed, practical strategies solve problems.

Clearly what we have been doing to prevent school shootings has been inadequate.  The reasons are myriad.

  • Gun control laws are flawed.  I’ve long been baffled by the fact that there are more restrictions on me as a physician prescribing four ounces of cough syrup containing codeine than there are on a violent teen buying an assault rifle. Most reasonable people would probably agree:  This makes no sense.
  • Counseling is a fine endeavor.  We need more of it. But caring, prudent advice will not stop slaughter.  It’s impossible to reason with someone who is irrational.
  • School security needs attention.  In Israel, schools are locked at the final morning bell and teachers with military training carry hidden weapons. We now have hundreds of thousands of well-trained veterans who could help secure schools and do data mining of social-media sites to enhance intelligence analysis.  Why are we not enlisting their help?
  • Over the past 30 years, children have been exposed to tremendous levels of violence on TV, in movies, and perhaps most intensely, in video games.  Here there are no consequences to killing, apart from racking up points. Many kids who have been left to fend for themselves never have been taught to respect another person.

Additional resources providing better security, practical law enforcement, and sensible mental health care are needed almost everywhere.  But one devastating flaw remains.  Many people realized the shooter in Florida was dangerous.  The police had been called multiple times over the years.  He had beaten his mother and reportedly tormented and killed small animals.  His social media postings threatened murder.  Other students feared him and school authorities expelled him.  The FBI failed to follow-up on two credible reports.

Why do any of us fear getting involved in difficult situations?  It’s simple. We’re scared to death we might be sued.  We’re afraid of revenge or even the possibility of being called “mean.”

Many years ago, I had to confront a serious situation in a training program. Patient safety and professional standards were on the line.  I took action I deemed necessary and was clobbered with a lawsuit along with several other faculty.  It made our lives a living hell for nearly five years.  Other physicians and administrators simply looked the other way.  They suffered no retribution.  Some of us did what we believed was right.  Some chose to remain silent.

On February 14, 2018, many people did the right thing.  Some of them died trying to save others.  None of us is off the hook here.  Fear can have fatal consequences.  Courage is the antidote.

Memory Loss

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

By Michael Howard, Ph.D.

While some memory loss — such as misplacing the car keys or wondering where that library book is — happens to people as they age, the memory loss associated with Alzheimer’s disease (AD) and other dementing illnesses is far more dramatic, severe, and progressive.

Memory loss is one of the distinguishing symptoms of AD, and it influences other aspects of the disease as well. Memory loss affects communication because the individual begins to forget words and, over time, loses the ability to read and write. Memory loss also affects mood and behavior because patients inevitably become frustrated, angry, and depressed as continual and worsening lapses impair their ability to think and function effectively. Several medications have been shown to slow memory loss and other cognitive decline. Many professionals also believe that exercises designed to stimulate memory, including memory enhancement and reality orientation exercises, may help slow deterioration somewhat. However, these exercises are demanding because they need to be repeated several times a day, and it would be helpful if caregivers could enlist the help of friends and relatives to work with the patient at specific times of the day or week.

Short-term memory loss, that is, loss of memories of events that occurred from several seconds to several days or weeks ago, is the first type of memory to become impaired with dementia. Patients may forget that they just finished a meal, or that a favorite cousin just paid a visit. Loss of long-term memory, memory for events that occurred months or years ago and that also involves remembering how to perform basic tasks such as cooking and dressing, is affected during the middle and later stages of the illness. The effects of memory loss cut across every aspect of the lives of people with AD and other dementias, affecting their ability to communicate, work, enjoy free time and relaxation, and care for themselves. In the later stages of illness, individuals lose their ability to recognize their spouses, family members, and friends. They forget how to bathe, dress, feed themselves, and use the toilet.

A Bit Of A Twist

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

By Mary O’Brien, M.D.

Have you given a thought to Valentine’s Day yet?  I suspect for most people it’s a last minute scramble for dinner reservations or roses.  The Valentine cards and candy in stores have been staring us in the face since Christmas Eve.  But most of us have had a few other things on our minds, things like floods, flu, holiday bills, and taxes.  Hearts and flowers aren’t top priorities for most folks unless they work for Hallmark or Russell Stover.

This year there’s a bit of a twist.  February 14th is Valentine’s Day and Ash Wednesday.  It’s most unusual.  As soon as I noticed this anomaly on the calendar, I realized several things would happen.  Some people would turn it into a theological controversy over which observance should take precedence.  I’ve always been perplexed by the propensity of some people to promote “either-or” thinking.  Sure enough, several prominent clerics have issued stern statements about the obligation of their members to fast and forego any Valentine treats.  That’s their call.

Some people will slog through the day unaware of either observance.  They don’t worry about philosophical or theological dilemmas, and, for the most part, they’re not terribly romantic or thoughtful to begin with.  No big deal.

I have a different take on this.  As a 63-year-old woman, I’ve had my share of lovely Valentine surprises and a few bitter disappointments.  That’s life.  As a geriatrician, I know how many sick, lonely, elderly people are ignored on Valentine’s Day.  That’s sad.  As a lifelong Catholic, I understand that Ash Wednesday is all about spiritual priorities and discipline.  We’re not supposed to be self-indulgent morning, noon, and night.  That’s prudent.

Here’s the good part:  Valentine’s Day and Ash Wednesday don’t have to be at odds with each another.  There is no need for “either-or” thinking.  St. Valentine was a real man, a priest who brought great kindness and love to persecuted people in third century Rome.  He was martyred for his devotion in 270 A.D.  Ash Wednesday is a major reminder that life is short.  The only thing we’ll take with us at the end is the love and compassion we have shown to others.

We all have patients, colleagues, neighbors, and even passing strangers in our lives who will be neglected on February 14th unless we remember them.  Valentine’s Day and Ash Wednesday.  Curious.  There’s never a need to “fast” from being thoughtful.

A Different Tradition

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

By Mary O’Brien, M.D.

Has your home returned to a relative state of post-holiday normality?  I’m almost there.  The boxes and bags and bows and ribbons have been put away until next year.  The “thank you” notes are in the mail.  And my kitchen table has been restored to an acceptable state of neatness.

Many people will start to focus on new year’s resolutions now, knowing full well the resolutions are unlikely to last.  I have a different tradition at the end of December.  It goes back quite a few years.  In a reflective state of blissful solitude, I write down my own little “year in review.”  It takes some time, thought, and effort, but it’s an exercise that can generate some profound insights.

  • What were the best or most positive events of 2017 — personally, nationally, and globally?
  • What were the worst or most tragic events of 2017 — personally, nationally, and globally? How did I cope or respond?
  • What event or situation made me feel most grateful?
  • What was the most beautiful, unusual, or remarkable sight I saw in 2017? (Personally, it would be difficult to top the perfect, unobstructed view of the total solar eclipse I had from my own backyard in August 2017.)
  • What was the biggest mistake I made in 2017? This one can be tough and sobering.
  • What was the most important lesson I learned in 2017? It’s often related to the biggest mistake I made.
  • What experience or moment touched me the most deeply?
  • What was the most noble, courageous, or generous thing I did in the past year? Coming up short on this one is not a good sign.
  • And finally, what could I do in 2018 to become a better person — physically, mentally, emotionally, and spiritually?

The little, personal “year in review” may not be as fascinating as a list of the year’s top news stories, viral videos, or celebrities who have passed.  It will, however, become profoundly revealing to you 10 or 20 years from now.

Have a happy new year.

 

Let It Go!

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

By Mary O’Brien, M.D.

Did you survive Thanksgiving without major family stress or tension? If the answer is “no,” you’re not alone. Holiday gatherings don’t always bring out the best in everyone. Some folks are already frazzled by travel nightmares. Those hosting the feast are tense and worn down by days of planning, preparation, and cooking. No one ever has quite enough room in her kitchen for all the food, much less the guests who congregate in the middle of the mess. There’s nearly always one culinary mishap and someone is sure to announce she has a life-threatening allergy to gravy.

But wait! We haven’t even begun to address deeply ingrained differences in political perspectives, religious beliefs, and good, old-fashioned feuds and grudges. Was all of this supposed to be fun? Fortunately or not, many of us will have another crack at family festivity soon as we try to celebrate Christmas or Hanukkah. I have a few time-tested thoughts that might help—at least a bit.

  • Psychologists tell us that it takes 21 days to replace a bad habit with a good one. That means we have just enough time to make a difference. Starting now, try not to criticize, condemn, or complain. It’s not easy, especially in this culture. However, it will make the next family gathering much easier to endure, if not actually enjoy.
  • Remember some basic neurophysiology. The human brain cannot hold onto diametrically opposed emotions simultaneously. We can’t feel love and hatred at the same time. We can’t feel empathy and anger in the same moment. And we can’t experience gratitude and resentment all at once. It may sound simplistic, but gratitude is often the best remedy for resentment, anger, anxiety, and sadness. Those of us who have food, water, shelter, clothes, electricity, a little money, and a few loved ones have more than hundreds of millions of people around the world. Smile and say “thank you” — a lot.
  • Forgive yourself and everyone else. I’ve watched relatives feud for decades. They make themselves and everyone else miserable. None of us is perfect. We’ve all said and done things that were misguided or thoughtless. However, refusing to forgive is like drinking poison. It makes no sense. Forgiveness represents the ultimate act of overcoming ego. Let it go. LET IT GO!

Please don’t make me sing that song from “Frozen.” I have relatives who would never forgive me.

 

Vitamins & Minerals: What Does The Body Need?

Posted on Posted in Brain Science, Continuing Education, Elder Care, Homestudy, Nutrition, Seminars

By Annell St. Charles, Ph.D., R.D., L.D.N.

In 1912, Casimir Funk, a Polish biochemist, isolated a concentrate from rice polishings that cured polyneuritis in pigeons.  He called the substance a “vital amine” or “vitamine” because it appeared to be vital for life.  There was widespread interest in eradicating several prevalent diseases at the time, and, in an article published in 1912, Funk postulated the existence of four substances:  one that prevented beriberi (“antiberiberi”), one that prevented scurvy (“antiscorbutic”), one that prevented pellagra (“antipellagric”), and one that prevented rickets (“antirachitic”).  Funk was one of several researchers in the early 20th century investigating these and other substances and their connection to health.

Epidemiologists, physicians, physiologists, and chemists all worked on this puzzle through the mid-20th century; the work was slow and onerous and plagued by many setbacks and contradictions.  Chemists were the ones ultimately able to identify and isolate the substances we call vitamins, leading to the development of synthetic forms that are available for wide consumption.  The proposed benefits and risks of vitamins and vitamin supplementation continue to be hot topics today.

The vitamins needed by the body for growth and normal development are:

  • Vitamin A
  • B Vitamins (vitamin B6, vitamin B12, folate, and others)
  • Vitamin C
  • Vitamin D
  • Vitamin E
  • Vitamin K

Vitamins are divided into two groups:

  • Water-soluble are easily absorbed by the gut and stored only minimally. These include Vitamin C, thiamin, riboflavin,niacin, biotin, pantothenic acid, B6, folic acid, B12, and others.
  • Fat-soluble are stored in body tissues and excess accumulation can be toxic.  Vitamins A, D, E, and K are fat-soluble vitamins.

Macrominerals & Trace Elements

These essential inorganic elements are categorized by abundance:

  • Macro-minerals are present in the body over 100 mg:  calcium, phosphorus, magnesium, potassium, sodium, chloride, and sulfur.
  • Trace elements are present in microgram or low-milligram amounts:  iron, zinc, iodine, selenium, copper, manganese, fluoride, chromium, molybdenum, silicon, nickel, boron, arsenic, tin, and vanadium.

When Something’s Not Right

Posted on Posted in Brain Science, Psychology, Seminars, Webinars
(AP Photo/Laura Skelding)

By Mary O’Brien, M.D.

“Anyone who believes in God is stupid.”  This statement was among many posted by the monster who murdered 26 innocent people in November 2017 in a Texas church.  The victims ranged in age from 18 months to 77 years old.  Eight members of one family were killed, 20 people were wounded. No one had a chance to hide or escape.

The man who committed this atrocity had been seething with anger and brutality for years.  There were many red flags.  He had received a dishonorable discharge from the Air Force and served time for assaulting his wife and child.  His attack was so brutal, the baby suffered a skull fracture.  He was known to have beaten and starved his dog. Any man capable of beating a woman, a baby, and a dog does not turn into a decent human being after 12 months in prison.  The many pieces of this puzzle are already coming together.

In the realm of religious thought and theology, anger is considered one of the seven deadly sins.  Unjust anger, if allowed to smolder, can lead anyone down a vicious path of destruction.

In the realm of clinical medicine, anger and hostility are considered the two most deadly and dangerous emotions.  Those of us in health care encounter angry, hostile people almost every day.  In fact, all of us encounter angry, hostile people with increasing frequency.  Anger triggers a flood of potent hormones and neurotransmitters that can literally change brain function and even brain structure if the process lasts long enough.

However, pathologic anger, violence, and evil do not exist in a vacuum.  There are always warning signs.  All too often they go unnoticed or unreported.  Most of us have been well-schooled to “mind our own business.” After all, we don’t want to be called judgmental, and we certainly don’t want to be sued.  But considering the horrific happenings in Columbine, Aurora, Sandy Hook, Fort Hood, San Bernardino, Orlando, Las Vegas, and New York, it’s time to rethink a few things.

Folks in law enforcement have been begging us for years: “If you see something, say something.” That advice sounds painfully simple, but simple things often save lives. Most of us know when something’s not right. We need to trust our instincts.

The good people of Sutherland, Texas, trusted their instincts hours after the massacre.  In response to unfathomable evil and anger, they held a candlelight prayer vigil.  That doesn’t sound “stupid” to me.

A Real Hero to Honor

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

By Mary O’Brien, M.D.

Gary Michael Rose is a devoted 69-year-old husband, father, and grandfather.  Many people in Huntsville, Alabama, know him from his commitment to multiple volunteer projects.  For decades he has served as a Knight of Columbus, helped at a soup kitchen, and repaired broken appliances for the sick and elderly.  That’s only a partial list.

Only a handful of people knew that Gary Michael Rose was a war hero of the highest caliber because for 40 years he never said one word about it.  Not one word.  On October 23, 2017, Captain Rose received the Congressional Medal of Honor.  Now the whole world has a real hero to emulate and honor.

“Mike,” as people call him, trained as a Special Forces medic during the Vietnam War.  His second assignment involved a top secret mission into Laos to stem the flow of weapons to enemy fighters.  It wasn’t long before all hell broke loose.

The men in Mike’s unit sustained heavy casualties.  Desperate to save them, Mike raced into small-weapons and machine-gun fire, tending to the wounded as he shielded them with his own body.  One by one, Mike used one hand to hoist a wounded soldier over his back and held a gun in his other hand to return enemy fire.

Eventually, Mike sustained multiple wounds himself, but that didn’t deter him. When a chopper finally arrived to evacuate the wounded, it was unable to land and was forced to hover above the ground.  Mike lifted and pushed his wounded buddies into the helicopter in the midst of gunfire.  As the chopper began to lift up, the gunner was struck in the neck by a bullet.  Mike fashioned a pressure dressing with several bandanas to contain the bleeding.  But the helicopter was badly damaged and crash- landed.  In an unbelievable display of courage and fortitude, Mike raced in and out of the smoldering chopper to save the wounded before everything exploded.

After four days and nights of constant combat, no food or sleep, and nonstop efforts to save others despite his own injuries, Mike and his men were evacuated.  The Army believed that Captain Gary Michael Rose saved between 60 to 70 men, including the man who was shot in the neck.

All of this happened in 1970.  Mike never discussed it with anyone because the mission was classified.  His men talked about it though — through channels at the Pentagon.  For 47 years his men campaigned to get Mike the medal he deserved.  Mike finally received his medal, and many of men witnessed the ceremony at the White House.

If someone had written a screenplay detailing the heroism of Gary Michael Rose in combat, it would have been rejected as “unrealistic.”  Fortunately for the world, Captain Rose is very realistic.  After a ceremony at the Pentagon, he’s going home to Alabama with his family.  He still has people to help.

 

Why Mindfulness Matters?

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

By Mary O’Brien, M.D.

Will you exit the same way you entered?

Making that assumption is human nature.  Tragically, as people in London, Manchester, Brussels, and Berlin have witnessed, ordinary assumptions can be deadly.

Survival requires alertness.  It always has.  It always will.  There has never been a shortage of danger in the world.  The nature and complexity of threats have evolved over the millennia, but certain principles of survival endure.  Being mindful of your surroundings is one important principle.

Mindfulness is not new.  Nor is it merely a pleasant pastime. “Being in the moment” is a good way to slow down, enjoy a meal, or notice a full moon.  It may, with practice, help reduce blood pressure and stress.  That’s nice.  However, in an age when deranged fanatics and terrorists can wreak massive devastation in minutes, mindfulness can save lives.

An off-duty police officer is still a police officer.  The same is true for health-care professionals.  The next time you’re out in public, be it in a classroom, a café, or a concert hall, practice some mindfulness that really matters:

  • Be alert, be vigilant — pay attention to people and things around you — not your devices.  Do not “zone out.”
  • Scan the area for possible exits.  It is human nature to leave a place the same way you entered.  This can be a fatal mistake in a fire, a terrorist attack, or any catastrophe.
  • Resist the temptation to follow the crowd.  Panic-stricken people can be exceedingly dangerous.  Be mindful of alternate options for escape.  Being trampled to death is not a good option.
  • Cultivate enough silence in your daily life to foster good instincts and intuition.  When seconds matter, this can save lives.

The principles of mindfulness have been practiced and promoted by some very wise people over the centuries.  It is curious that a step on the path to enlightenment may be the most crucial survival skill of all.