COVID-19: Scary Graphics

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

By Mary O’Brien, M.D.

Quick.  What’s the clinical definition of a “spike”?  You’re not sure, are you.  Don’t feel bad.  No one knows what the clinical definition of a “spike” is.  But the all-knowing bureaucrats and media types toss the word around with abandon.  It serves their purpose, which is to keep as many people as possible afraid and, therefore, controlled, especially in the age of COVID-19.

If you were fortunate enough to have had a good education and some training in critical thinking, you know you must define your terms. It’s the essential starting point for any serious discussion or debate.  You cannot make up terms or definitions on a whim.  This, of course, is distressing to those who worship their notions and emotions. Today, that means millions of people. Reality (or a “spike,”) is whatever people say it is.

Announcing that “the country is seeing a worrisome spike in COVID-19 cases” is misleading.  Defining the terms is not only critical for any measure of professional or intellectual integrity, it is essential for a prudent response.  Sadly, in far too many cases, a lack of intellectual integrity can be easily used to promote paranoia.  Today, nearly anyone can create scary graphics splashed with “worrywart red” ink.  This is done routinely to exaggerate the threat of anything from a virus to a thunderstorm.  Be afraid. Be very, very afraid.

No. Do not be afraid.  Understand what is happening:

  • There is exponentially more testing being done now compared with six weeks ago (as of late June 2020).
  • The criteria for COVID-19 testing have evolved tremendously over the past three months.In March, elderly people with obvious respiratory symptoms were told to stay at home and avoid the emergency room.  They were advised they did not need to be tested.  Today, in much of the country, many people can be tested on demand.
  • Greater numbers of young people are being tested.Naturally, more positive tests will be reported.  Most of these individuals are asymptomatic and will remain so.  Consider this — no one could walk into a clinic or makeshift roadside testing site and simply demand a test for flu, strep, hepatitis, or mono because he or she felt like it.  Medically speaking, what’s going on now is odd.
  • Deaths from COVID-19 have declined by 40% across the U.S. over the last two weeks.This is crucial for understanding what is really happening.  The mortality rate for COVID-19 here is around 0.05% (and probably lower).  Contrast this with what we were told initially.  Italy had a mortality rate around 10-11% and in the U.S. we expected a mortality rate between 3-4%.  That’s quite a difference.
  • Our focus should not be on the number of positive tests, but on hospitalization and mortality rates.There will be regional fluctuations in both.

COVID-19 is new.  Patterns of transmission, virulence, and regional penetrance will change gradually.  Our understanding of the best ways to treat seriously ill patients will change.  This has happened throughout history.  For now, don’t overreact to “worrywart red” on TV graphics.  Steady as she goes, America.  Steady as she goes.

 

Help for the Helpers on the Frontlines of COVID-19

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

By Dr. Jennifer L. Abel

Many healthcare workers on the COVID-19 frontlines are overwhelmed and traumatized. In addition to putting your lives on the line, many of you are quarantined from your family and some have insufficient PPE. Many are having to make multiple difficult decisions daily and have see an unprecedented number of people suffer and die; sometimes even colleagues.

You are amazing! You are also human! So, it is crucial that you express your emotions: cry in the restroom, cry on the way home, go outside for 10 minutes to shed tears or blow off steam. Angry at a co-worker, administrator, or politician? Pay attention to your driving, but imagine they are in the passenger seat and express your feelings.

Keeping your body relaxed is very important to help with immune function and to survive emotionally.  “How can I possibly relax? I have no time and am way too stressed to relax” are common thoughts on the front lines of COVID-19. Fortunately, relaxation strategies need not take any time at all and can be done without stopping your work activity. Test it out! Because most of you are standing or walking most of the day, stand or walk now while engaging in your favorite strategy simultaneously. Now pretend. Go through the motions of a common work activity while engaging in your strategy. The exception is you can’t do breathing strategies while talking.

It’s easy to get distracted and forget to use your coping strategies. Try to get into the habit of using strategies every time a machine starts beeping, each time you switch rooms, someone calls your name, or when you change tasks. Put up sticky note reminders when possible. Change the wallpaper on your phone or change the ringtone and text-tones. Each time you experience the reminder, engage in your strategy.

No doubt you’re exhausted. When you experience one of your reminders, ask yourself “do I need all this energy” or “what’s the least amount of energy I can use while doing this procedure? Writing notes? Walking down the hall?” Follow with your favorite word, like soft, loose, or relaxed.

People in helping professions are great at taking care of others, but aren’t nearly as good at taking care of themselves. Now is the time for you to finally ask for what you need, or even want, from others. And take time to self-nurture.

I heard today that people wearing scrubs are being discriminated against out of fear they’re carrying the virus. Some have been mugged or antagonized because they are known to have a job. Please know that the majority of us, not just patients and their families, are very appreciative of your sacrifices.  Know in your heart that having a purpose is a positive predictor of happiness, even though you probably aren’t feeling particularly happy right now. Similarly remember that even when you feel helpless, you are still helping!

Thank you very much for all the help you are providing, especially if you are putting your life at risk and/or isolating from your family to help!


Dr. Jennifer L. Abel is an expert in worry and the author of three books and two card decks including Resistant Anxiety, Worry, & Panic.

Errors in Judgement

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

By Mary O’Brien, MD

I’m confused.   It’s too dangerous to go to school.   It could spread COVID-19.   It’s too dangerous to go to work.  It could spread COVID-19.   It’s too dangerous to eat out, get a haircut, go to a concert, a clinic graduation, wedding, or funeral.  It could spread COVID-19.   But riots, vandalism, looting, and arson are somehow First Amendment rights, and they override concerns about spreading COVID-19.  Has everyone gone insane, or is it just I?

The reality is, going to school, work, or other everyday activities was never really problematic.   Riding on filthy, overcrowded subway cars or living in a nursing home has been really problematic.   So far, there is no statistical correlation between the economic shutdown and COVID-19 case rates, hospitalization rates, or mortality rates.   Sadly, there are devastating correlations between riots, anarchy, and the protracted decline of cities.

Some of us are old enough to remember the spring of 1968.   It was horrible.   Shortly after the assassinations of Martin Luther King, Jr. and Robert F. Kennedy, appalling levels of violence broke out at the Democratic National Convention in Chicago.   Cities across the country burned and many neighborhoods never recovered.   Areas of Los Angeles, Detroit, Chicago, Baltimore, Atlanta, and New York City are still scarred today.

Three months of lockdowns from COVID-19 have shown many educated people they can earn a living from the comfort of home.   The violence and destruction of the past two weeks will give many people pause about remaining in big cities.   The exodus has already begun.

Unfortunately, for those left behind, taxes of every type will increase, but the quality of life will decrease even more.   Economic decline leads to declines in education and public health.   And the people who suffer the most are those least able to cope.

The chief duty of any public official is to protect the citizens, not to lock them in their homes.   We have witnessed a series of dreadful errors in judgment on the part of many mayors and governors — over the past few months (in March 2020 and beyond).   It has devolved into gross incompetence and cowardice over the past two weeks of late May and early June 2020.   People in the media love it.   Suddenly, they have a topic to replace COVID-19.

Politics has a massive impact on education and health care.  We cannot pretend otherwise.   In light of that, I’d like to offer a few thoughts:

1.      Ignore 95 percent of the people in the media.  They live for conflict, anger, and fear.

2.      Realize that anyone promoting conflict, anger, or fear is a big part of the problem — in any situation.

3.      Understand that most people are not inherently racist, sexist, xenophobic, or homophobic, but identity politics lives on.  It’s cheap and it’s easy.

4.      Recognize that businesses, large and small, are a good thing for individuals, neighborhoods, and society at large.  Punishing business owners with violence, absurd taxes, or excessive regulations is spiteful and wrong.

5.      Know that people typically get the kind of behavior they tolerate.  If you tolerate violence and chaos, you’ll get more of both.   A famous passage from the Talmud sums it up, “When you’re nice to the cruel, you’re cruel to the nice.”

The year 1968 was awful.  Let’s not make the same mistakes again.

COVID-19: Clinical Observations

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

By Mary O’Brien, M.D.

Every new illness brings new knowledge. Global experience with COVID-19 is revealing patterns of clinical illness which will guide our approach to treatment. Here are some of those important observations:

  • The illness in 80% of people causes mild symptoms. Many people remain completely asymptomatic. Moderate and severe illness often has two phases. Days 1‒7 are characterized by fever (above 101° F), headache, significant cough, profound fatigue, myalgias, and malaise. Between days 4‒8 some patients have nausea, vomiting, abdominal pain, and/or diarrhea. Some patients lose their sense of taste and smell. Days 8‒21 are characterized (in 15‒20% of patients) by increasingly severe symptoms, including shortness of breath, dyspnea or difficulty breathing, chest pain or tightness, tachycardia and weakness.
  • The mean interval between onset of symptoms and hospitalization is 9.1‒12.5 days. This delay in the progression to serious illness may give us a window of opportunity for treatment.
  • Clinical findings typically include a low oxygen saturation level (O2 sat) on room air. This is a key finding and levels as low as 75‒90% are being seen (95‒100% is normal).
  • Laboratory results also show patterns similar to what was observed with SARS and MERS:

o   ↓ WBC or leukopenia

o   ↓ Platelet count or thrombocytopenia

o   ↑ Liver enzymes, especially LDH around hospital days 5‒8

o   CXR typically shows streaky opacities in both lungs consistent with an atypical pneumonia.

  • Serious complications of COVID-19 include severe viral pneumonia, ARDS (Adult Respiratory Distress Syndrome) respiratory failure, cardiac injury including arrhythmias and CHF. Poor perfusion can lead to hepato-renal syndrome. Neurologic symptoms, delirium, and coma may occur.
  • There is evidence that intubation and mechanical ventilation may be causing more harm than good in some patients. One component of ventilator function, the PEEP setting (positive end-expiratory pressure) may be delivering pressures that are too high for the alveoli or air sacs in the lungs. It appears that some COVID-19 patients in respiratory distress actually need lower levels of PEEP (15‒20) as opposed to levels around 25. Some patients seem to need higher O2 concentrations delivered by face mask, CPAP or BiPAP, and not intubation and mechanical ventilation.
  • According to the CDC, two thirds of the patients who have died from COVID-19 (as of mid-April) had documented serious underlying conditions (heart disease, diabetes, asthma, renal disease, malignancy, immuno-compromise). Obesity has been a significant factor contributing to mortality. 1.9% of patients who have died had no known underlying condition.

We have only scratched the surface here. The next few weeks will reveal new insights about the illness itself and the best treatment protocols. In the meantime, do what is prudent to protect yourself and others. It may not be obvious to everyone, but tremendous progress is being made.

Blessings to all through Passover and Easter.

 

Novel Coronavirus (COVID-19): Lessons Learned

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

We are living in historic times.  A century from now, medical personnel, civil authorities, small business owners, corporate leaders, average investors, and everyday citizens will study the lessons learned from this pandemic.  Here are just a few of the ones we’ve learned already:

  • We should all plan and prepare for crisis, disaster, or catastrophe — especially in good, stable times.  Every family and business needs to build an emergency fund of 3-6 months minimum.
  • It’s important to listen to knowledgeable, wise people (not conspiracy theorists and people on social media).  However, even the most brilliant experts can be wrong.  Predictive models are not crystal balls.  There are unrecognized variables in nearly every situation.
  • Panic never solves problems.  If it did, we wouldn’t have any problems left.  The antidote to fear and panic is perspective.  Every day in the U.S., approximately 8,000 people die from multiple causes.  Each year, we lose between 30-40 thousand people from complications of the flu.  We do not shut down the nation.
  • Bureaucracies often do more harm than good.  Their function is largely based on outdated, territorial group-think, and they cannot change or adapt quickly.  Control freaks almost always create more problems than they solve.
  • All decisions have unintended consequences.Some of them can be disastrous. “Either/or” thinking is often a false choice.  Health, both physical and mental, is heavily dependent on financial stability.  The notion that we must choose between public health or a stable economy is a false choice.  They are mutually dependent.
  • Tunnel vision is usually a mistake.  Rigid adherence to long-held principles of epidemiology can crash an economy and engender other, less obvious medical problems like cardiac events, severe depression, anxiety, sexual abuse, physical abuse, emotional abuse, child abuse, drug abuse, alcohol abuse, suicide, violent crime, and eventually societal breakdown.   It takes discipline and wisdom to see the big picture.
  • “Better safe than sorry” is not always the right choice.It’s understandable in a crisis, but it rarely addresses the root of a problem.   We can protect our most vulnerable people with selective isolation and quarantine and still move forward with life.   Sometimes we must take reasonable risks.
  • Saving a buck by reducing housekeeping staff and standards of cleanliness, especially in public places, can be horribly costly in the long run.  Many hospitals, nursing homes, and medical offices are nowhere near as clean as they were 40 years ago.  Better personal and public hygiene will turn out to be a very good thing in the years to come.
  • Living and working in overcrowded, congested areas has been a problem throughout history.   Smallpox, plague, cholera, yellow fever, malaria, and tuberculosis have taken the lives of millions over the centuries.  Flu pandemics, in many cases, have been even worse.   Perhaps this pandemic will teach us all to be more respectful of everyone’s personal space.
  • We have more everyday heroes than we realize.Celebrities are not heroes.   Nurses, doctors, respiratory therapists, pharmacists, social workers, cafeteria workers, cooks, cleaning people, truck drivers, police officers, firefighters, EMTs, grocery-store clerks, bank tellers, delivery people, postal carriers, farmers, utility crews, and millions of everyday people doing their jobs and looking after others are heroes.  They need to be honored.
  • Politicians should not control the number of hospitals, ICU beds, ventilators, or CT scanners.   Hospitals cannot be run as if they were merely ugly hotels, focused almost solely on occupancy rates.  Surge capacity in beds, staffing, and equipment is essential.   Since 1976, we have seen a 16% decline in the number of ICU beds in our country.  Prudence matters.   It always has.   It always will.

This crisis will end.  We will learn more than we can possibly imagine.  For now, be calm, be kind, be patient.  Your actions may be more heroic than you realize.

homestudy

Mindfulness and Social Connections Soothe Anxiety and Boost Immunity

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

By Andrea D’Asaro, MBSR

It is normal to be scared and even paralyzed in the midst of so much uncertainty around the Coronavirus (COVID-19). That’s where simple mindfulness practices can help us stay grounded and connected despite recommendations for social distancing and work at home for many Americans. Deep breathing can slow anxiety, depression and keep our nervous system stable. Reaching out to others can boost our sense of connection, increase oxytocin (the love hormone), and maintain our immunity, which can fall when stress rises.

1. Come back to the moment with five mindful breaths

It’s easy to immerse oneself in the constant stream of on-line and often conflicting information. This can also increase our anxiety. With stress, the rational part of our brain can spin out of control into survival mode or fight, flight and freeze.

Whenever you notice yourself ruminating, worrying or feeling overwhelmed, try 5 mindful breaths:

Sit in a comfortable seat with your feet on the ground (lying down or standing are also options) breathe slowly in through the nose and out through the mouth to slow the nervous system, count five breaths with in and out, counting as one. Pause at the end and check your body and mind to see if anything is different. Continue to 10 or 20 breaths, as you wish. You may want to count your five breaths on your fingers, tracing each digit while taking one breath as an additional grounding with the body.

2. Reach out to friends and boost oxytocin

Social distancing is not emotional distancing! We can increase our happiness when we make real-time connections with others and bring ourselves a spurt of oxytocin, “the bonding hormone.” Try calling distant relatives, friends and others who may feel isolated at this time, using an old-school technology–the phone! When we take the step to converse with relatives or friends, we are boosting our own mood with activation of serotonin, according to research from Stanford University School of Medicine. Such social support is associated with a decreased risk of infection and reduced stress hormones, according to research from Carnegie Mellon University.

Many senior living communities are limiting visitors and keeping elders apart from each other to avoid spread of the virus. Older people, who may not use email or social media, are already at greater risk for depression or anxiety. We know that loneliness is deadly too. Real- time phone calls allow us to hear emotion in another voice and exchange concerns and pleasantries; it’s much more engaging than texting, according to research from the University of Wisconsin.

In this time of the elbow bump, we are advised to avoid hugging. No worries, the self-hug can also enhance the oxytocin, also called the “bonding hormone”.

Try the self-hug: Open your arms wide as you take a breath in, then cross them over your chest and you breathe out. Gently grasp your upper arm with the opposite hands and give yourself some kind squeezes. If it’s comfortable for you, close your eyes and bring to mind your personal “circle of caring.” Imagine the faces of those people or pets who care deeply for you (living or decreased) around you, smiling tenderly. Or envision your favorite happy place like a fireplace or a cozy bedroom. Remember to hold your hug for 20 seconds or more for the best benefits.

3. Strengthen self-care with mindfulness

Mindfulness is all about paying attention on purpose. This means observing how you feel, what your body and mind is craving and how you may best care for yourself. Instead of reaching for social media, a new video, or a less nutritious treat, consider the best way to nurture yourself–what you might recommend to a good friend.

During these anxiety-provoking times, remember the tried-and-true stress reduction strategies. Do you best to get adequate sleep, exercise regularly, spend time in nature and employ relaxation techniques on a daily basis.

Meeting a friend for a brisk walk in nature while bringing your attention back to the moment can bring multiple benefits. You might also consider slow mindful walking where you bring attention to each foot as it touches the ground. It’s helpful to say, “heel, ball, toe” as you notice the movement of the foot against the ground. Enjoy your slow walking and remember, there’s wrong way to bring yourself mindfulness.

Prioritizing these behaviors during the coronavirus crisis can go a long way toward bolstering your immune system and increasing your psychological well-being. Caring yourself in these ways may be a new habit to build over time, so start with one practice at a time and add on as you go, with kindness. Giving yourself kindness allows you to extend it to others who are struggling at this time.

Novel Coronavirus (COVID-19): Now What?

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

By Mary O’Brien, M.D.

Everybody calm down.  Fear is spreading faster than the coronavirus at this point.  Financial markets are in turmoil over fear of a global economic slowdown caused by the virus.  Worries about lost productivity in China, reduced demand for oil and consumer goods, and disruption of travel, tech, and financial sectors have investors around the world hyperventilating.  The price of gold has reached its highest level in seven years, and the yield on the 10-year treasury is near record lows (1.37%) — both signals of a flight to safety.  Caffeine-toxic media types are nearly histrionic.  As is typically the case, the only two things missing from their breathless banter are knowledge and perspective.

Here are the facts, as of Monday evening, February 24, 2020:

  • The number of global cases of COVID-19 is around 79,000.
  • Virus-related deaths are at 2,600.  The overwhelming majority of deaths is still in China, but China is only reporting in-hospital deaths.
  • The current mortality rate is still around 2–3%.  The mortality rate of SARS was 10% and the mortality rate of seasonal flu is 0.1%.
  • COVID-19 is more readily transmissible than SARS (Severe Acute Respiratory Syndrome), but less deadly.
  • The incubation period is still considered to be 14 days.
  • Viral transmission of COVID-19 appears to occur through large droplets in respiratory secretions.  Both oral and anal swabs have detected virus (viral particles can be found in the GI tract).
  • Both SARS-CoV and MERS-CoV infect intrapulmonary epithelial cells more than cells of the upper airways. As a result, transmission occurs mostly from patients with recognized illness and usually not from patients with minimal symptoms.  COVID-19 seems to work the same way.
  • The most serious symptoms involve the lower respiratory tract and lungs, as opposed to upper airways. The resulting disease is now called “novel coronavirus-infected pneumonia” or NCIP (NEJM, Feb. 20, 2020).
  • So far the clinical breakdown of cases is fairly predictable:
    • 80% are mild illness (requiring little or no care).
    • 14% are of moderate severity.
    • 5% are critical (requiring mechanical ventilation).
    • 2–3% are fatal.
  • U.S. cases – 35 (nearly all travel-related).
  • Italy confirms 152 cases around Milan with more than 200 cases throughout the country. South Korea confirms 833 cases after testing over 20,000 people.
  • The most vulnerable patients are older individuals and those with chronic underlying illness. (CAD, CHF, COPD, DM, chronic kidney disease).

So now what?  We wait for more facts.  The headlines will reflect a frustrating level of paranoia for another 2–3 months — at least.  Universal precautions in medical settings, careful personal hygiene, and common sense are always prudent. `

Don’t panic.  Don’t dump your investments.  Don’t overdo the caffeine.  And one more thing:  Everybody, please calm down.

 

A Whole New Decade

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

By Mary O’Brien, M.D.

Are you making New Year’s resolutions?  Are you worried about your weight or waistline?  The vast majority of New Year’s resolutions involve weight loss.  Unfortunately, most of those resolutions will fall by the wayside within the next few weeks.  There is a better approach.

This year, as we begin a whole new decade, it might be better to create a vision of vitality.  Vitality is the state of being strong, active, and energetic.  It’s a crucial factor in living a truly good life and a major part of success.  The thought of merely cutting calories is not exactly inspiring.  And a number on the scale will not magically confer health or happiness — at least not for long.  Sooner or later assorted stresses can undermine the healthiest intentions.  That’s called life on Planet Earth.  Most of us realize that, and yet, nearly all of us need a little jump start now and then.

Sustained success requires clarity of purpose, a burning desire, and firm resolve. Some sort of change will be necessary.  If you always do what you’ve always done, you’ll get what you’ve always gotten.  A couple of questions are in order:

  1. How badly do you want it?
  2. What sacrifices are you willing to make?

Pursuing vitality in life may not come naturally, and we all have different challenges.  The slightest lack of discipline begins to affect your psyche.  However, a few simple disciplines practiced every day lead to success.  As motivational speaker and writer Jim Rohn has said, “The price is easy if the promise is clear.”

So what would you be willing to do in exchange for greater vitality?  Could you be more active, eat more healthfully, or get more sleep?  Perhaps you need more time outdoors, greater inspiration at work, or a captivating, creative endeavor.  Does your family, personal, or social life need more attention?  Is your spiritual life what it could be?  Success without fulfillment is tantamount to failure.

Perhaps over the next few days a little self-assessment would be helpful.  Then create a vision of your future vitality.  Write it down in detail — and begin. Vitality:  The state of being strong, active, and energetic.  It’s not a bad way to begin a whole new decade.

Not A Bad Idea

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

By Mary O’Brien, M.D.

It starts early.  It starts much too early. “Christmas in July” sales morph into “Black Friday Before Black Friday” sales.  Christmas decorations, promotions, and music assault us even before the Halloween candy appears.  What happened to all that preaching about mindfulness and living in the moment?  Ah, anything for a buck!

Some of us are old enough to remember Advent.  The centuries-old tradition of prayerful discipline during the four weeks leading up to Christmas has all but disappeared.  Advent calendars now are little more than an excuse to indulge in fancy chocolates or even beauty products for each day in December.  What stupendous marketing! We’ve learned how to turn self-indulgence into virtue.

The word “advent” comes from the Latin word “adventus,” or arrival.  It signifies the arrival of a notable person, thing, or event.  The original Advent calendars involved a simple numbered flap which opened to reveal a religious image related to the Christmas story.  But we live in a consumer-driven society.  The Advent practice only goes so far.  Why look at a religious image when you can stuff yourself with candy or try a new beauty product day by day?

Chocolates and beauty products are great, but they are not the reason for Advent or Christmas.  The more important something is, the more preparation and anticipation it deserves.  Spiritual events require spiritual preparation.  And since human beings are not mere blobs of protoplasm, we need to balance body, mind, and spirit.

Every sincere religion in the world promotes some form of physical discipline as a path to spiritual growth.  Periodic fasting can be beneficial for overall health (in medically stable people). There’s even evidence that refraining from eating between dinner and “breakfast” stimulates growth hormone levels and facilitates weight loss.

Fasting or abstaining as a spiritual discipline need not be limited to food. Consider how you feel (or behave) when deprived of your devices, TV, or electricity for an hour.  Advent disciplines can involve “giving up” anything from eating out, to sugar, to alcohol, to shopping.  In years gone by, people would save the money they didn’t spend on personal indulgences and give it to the needy.  Even in a strong economy there are plenty of people in need.

This year, Hanukkah and Christmas occur in the same week.  Family celebrations, festivities, and fun await millions.  Regardless of theology, several weeks of thoughtful spiritual and physical discipline beforehand will make the main event that much more marvelous.  Besides, there are only so many practices that can help you lose weight and save money at the same time.  Advent: It’s not a bad idea.

How To Get Back To Civility

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

By Mary O’Brien, M.D.

We all have blind spots about ourselves, but sometimes our self-image can border on delusional.  Seventy-eight percent of people polled believe that there has been a decline in civility during the past decade.  The other 22% were probably in a medically-induced coma.

The real shocker comes next.  Ninety-nine percent of people believe their own level of civility has remained constant.  So who are all those rude people out there?  Perhaps a brief self-assessment is in order.

Do you remember the last time you:

  • Sent a thank-you note (a real handwritten one)?
  • Let someone go ahead of you in a checkout line?
  • Waived another driver ahead of you in busy traffic?
  • Held a door open for someone else? (That’s called manners, not chauvinism.)
  • Offered to help someone struggling with boxes, bags, or packages?
  • Helped someone get his or her luggage in the overhead compartment of an airplane?
  • Helped an older patient in and out of a chair (as opposed to merely standing there and watching him or her struggle)?

There are countless other examples, especially in this age of narcissism.  Self-absorption is Cause No. 1 of the four major causes of rudeness.  This time of year, people talk about flu epidemics.  But “me, myself, and I syndrome” is a year-round epidemic.  Simply being unaware of other people or their needs is ubiquitous behavior these days.  It speaks to a failure of parenting and education.

That leads to Cause No. 2 of rudeness:  ignorance.  Manners and civility need to be taught, and no participation trophies are not awarded.  Civility is its own reward.

Cause No. 3 of rudeness is lack of character.  We don’t speak much about someone’s character these days.  It’s a serious flaw in our culture.  Character determines how any one of us behaves when no one is watching.  It’s our default mode of behavior.  Eric Hoffer said, “Rudeness is the weak man’s imitation of strength.”  It takes a strong person to be kind, gentle, patient, or polite.

Cause No. 4 of rudeness is simply being in a hurry.  It’s curious, but can you even imagine the spiritual giants of the ages being in a rush?  Granted, people like Moses, Jesus, and Buddha lived a long time ago, but no one could possibly picture their being frantic and frenetic.  As Emerson wrote, “Manners require time, as nothing is more vulgar than haste.”

Self-absorption, ignorance, lack of character, and haste.  These are the major causes of rudeness.  Maybe we could start to “reverse engineer” our way back to civility.  It would surely be worth the effort.