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.

All the Little Warning Signs

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

By Mary O’Brien, M.D.

A friend of mine died last week from cancer. She was 52 years old.  Few people knew how seriously ill she was.  She didn’t want pity.  She didn’t even want sympathy.  The only thing she wanted was exuberance in life and dignity in death.  She successfully achieved both.

Sitting in the back of the church and listening to her eulogy, I wondered how many people struggle silently with serious illness and stress.  I suspect every one of us knows people who, despite their poise and polish, suffer tremendous personal anguish that remains hidden from the world.  They function day to day scarcely skipping a beat.  They’re the first ones to lend a hand when someone else is in a jam and they hardly ever grumble or gripe.  Other folks tend to dump extra work in their laps because they’re so good-natured and conscientious.

Then one day, overwhelmed by stress, illness, depression, or exhaustion, these selfless stoics collapse.  Nearly everyone in their sphere of influence is shocked because they failed to notice all the little warning signs.  Somehow it was so easy to overlook the growing fatigue, the waning enthusiasm, or the uncharacteristic irritability.  I’d like to say that doctors are usually expert at recognizing the subtle signs of serious illness and stress.  But the truth is, most of us are not.  Doctors, by and large, are so accustomed to chronic exhaustion in their own lives, they often overlook it completely in others.  There is no laboratory test for stress and no scan will screen for exhaustion.  It takes time and concern and insight to detect the subtle signs of serious stress.  And while many of us may be interested in the well-being of others, few of us take the time to develop true insight into other people’s problems.

Maybe if we all slowed down long enough to notice a friend’s fatigue or a colleague’s quiet mood, we could do something helpful before it is too late.  Maybe if we stopped placing so many unreasonable demands on one another, we wouldn’t be plagued by chronic fatigue and burnout.  Maybe if we made an effort to be more friendly and flexible in our daily encounters, folks would feel free to ask for help when they need it.

It would be wonderful if teachers and preachers and bosses and bureaucrats would promote empathy and compassion as much as they promote rules and regulations.  But until patience and kindness work their way into the culture’s curricula, we’ll have to rely on the insight of individuals.

Do you know someone who’s overwhelmed, worn out, dejected, or depressed?  Be gentle with him or her.  Cut such people some slack.  They may be up against serious stress or illness.  Be kind to them and to everyone you encounter today.  You may not have the chance to be kind to them tomorrow.

Some Timeless Advice

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

By Mary O’Brien, M.D.

How’s your bank balance doing these days?  More importantly, how’s your emotional balance doing?  Incessant political nastiness, market swoons, natural disasters, urban decline, violent crime, geo-political tensions, ever-expanding congestion, traffic, and professional pressures are weighing on all of us.  And we haven’t even mentioned the personal stresses of illness, family strife, teenage traumas, aging parents, and relationship struggles.  At least there doesn’t seem to be a massive asteroid threatening our existence.  That was a joke.

Most of us have learned that taking only withdrawals from a bank account does not work well.  Sooner or later we need to make some deposits.  The same principle applies to our emotional balance.  The stresses we face in everyday life represent withdrawals from our emotional reserve.  We need to balance those withdrawals with some regular deposits.  And that, unfortunately, is not always so easy or obvious.

Emotional depletion has consequences.  Eventually it can compromise our immune, neuroendocrine, and cardiovascular systems.  Since millions of us are experiencing emotional depletion, we need to be intentional about restoring our emotional account balance.  Here are a few ideas:

  • Take a deep breath and slow down long enough to realize you’re running on empty.
  • Disconnect from your devices, social media, and TV for several hours. If this causes undue stress, you know you’re emotionally depleted.
  • Spend at least 15-20 minutes each day in a natural setting. Remember nature?
  • Let go of anger, resentment, and criticism. No one can experience love, joy, or peace when he or she is consumed with negative thoughts and emotions.
  • Do something physical and useful. Clean out a closet, spruce up the yard, bake cookies, wash the car.  As long as it gets you up and moving and has tangible results (not staring at a screen), it will help.
  • Call or visit with a sympathetic person who will truly listen and encourage you. Texting doesn’t count.
  • Do something thoughtful and unexpected for another person.
  • Forgive everyone.

If all else fails, remember some timeless advice from Abraham Lincoln, “This too shall pass.”  It always does.

Passport to Health? Maybe not…

Posted Posted in Brain Science, Continuing Education, Elder Care, Homestudy, Pain, Psychology

By Mary O’Brien, M.D.

“It relieves headaches, insomnia, anxiety, depression, arthritis, fibromyalgia, and pain of all kinds.” Sounds great. Unfortunately, this is merely an excerpt from an ad for CBD oil. CBD stands for cannabidiol, a non-psychoactive molecule that has some documented anti-oxidant, anti-inflammatory, and anxiolytic properties. CBD products and stores are popping up all over the country. Even the business networks are covering possible investment opportunities. CBD products now include teas, tinctures, topical creams, pills, oral solutions, sprays, candies, cookies, gummies, chocolates, and Italian ice. No kidding.

The vast majority of studies on CBD are preclinical, animal studies (mostly rats). Trying to extrapolate research findings from rats to humans is not medically sound. It can also be downright dangerous. But many people have a stunning ability to believe what they want to believe.

We live in an age of narrative. The narrative about far too many topics is carefully crafted by self-proclaimed elites in the media, the entertainment industry, the political realm, and the academic world. Money is a critical factor in forming a narrative, but equally vital is the perception of being “cool.” Being perceived as “cool” is of the utmost importance to a staggering number of people. The really “cool” people don’t even realize they’re cool because they’re too busy pursuing truth and genuine accomplishment.

When it comes to a fad like CBD, the prudent people are open-minded but cautious. Centuries of experience in numerous cultures should have taught us something about con-artists and snake oil. Some of our grandmothers were certain that a dose of castor oil every week would cure anything. Millions of people in Asia still believe the rhinoceros horn can heal everything from impotence to cancer. And despite all our science, people still spend ridiculous sums of money on ground apricot pits and crystals in place of chemotherapy.

The actual pharmacologic effects of CBD products are still being evaluated. Standardization, purity of product, dosing, absorption, bioavailability, half-life, potential contraindications, adverse effects, and drug-drug interactions need to be elucidated -– in people, not rats.

Until then, be careful. Snake oil salesmen abound, and they’ll probably seem really “cool.” Buyer beware. CBD Italian ice is likely not your passport to health.

homestudy

Patriot Day

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

By Mary O’Brien, M.D.

It’s hard to believe, but it happened 18 years ago.  The horrific events of Sept. 11, 2001 (9/11), shocked the nation and the rest of the civilized world.  We now have an entire generation of young people who know of 9/11 only through video images.  They have no actual memories of that day.  Those of us who do will never be the same.

This coming Wednesday, 9/11, is Patriot Day. Many people across the nation are honoring those who sacrificed themselves for others by performing an act of kindness.  Wouldn’t it be great if kindness became our second nature, our default mode?  We would wake up thinking, “Whom could I help today?”  Sadly, we do not think this way.

Instead, we are focused on getting “likes” on Facebook and/or other forms of social media.  As a result, far too many people are literally addicted to attention.  Getting “likes” on Facebook actually stimulate dopamine release in the reward pathways of the brain.   However, did you know performing or witnessing an act of kindness also stimulates release of serotonin and boosts “Immunoglobulin A” (IgA) production?  IgA is our first line of defense against infection.  It is most concentrated in tears, nasal secretions, and saliva.  This could be helpful as we head into cold and flu season.  And, heaven knows, millions of us are worried sick about horrible headlines and hurricanes.

Given this reality, performing acts of kindness truly becomes therapeutic.  Maybe this year on 9/11 we could:

  • Take the time and interest to compliment someone — especially someone who probably hasn’t received a compliment lately.
  • Pay for the driver in the car behind us at a toll booth or drive-thru.
  • Donate clothes or household items in good condition to Goodwill, the Salvation Army, or a shelter.
  • Take a box of donuts, muffins, or chocolates to the people at the bank, pharmacy, fire station, or police station.
  • Leave a basket of treats on the doorstep of a single mother or elderly neighbor.
  • Send a greeting card (a real one) to someone who has had a rough year.
  • Donate blood.
  • Send flowers anonymously to someone in a nursing home.
  • Give a donation to the American Red Cross for disaster relief.

There has been a battle between good and evil since the beginning of time.  Two thousand years ago someone told us to overcome evil with good.  So far, no one has come up with a better plan.

A Precious, Healing Balm

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

By Mary O’Brien, M.D.

It’s not on Amazon.com.  None of the brick and mortar stores have it.  You won’t find it in a catalogue.  It’s not available at a bank or hospital.  This elixir is so rare and valuable you couldn’t even talk your doctor into giving you a prescription for it.  That’s just as well because no pharmacist would know how to fill it.  This vanishing and precious healing balm is silence.

We are addicted to noise.  It’s nearly impossible to escape.  Incessant noise bombards us in the workplace, the grocery store, the drug store, airports, waiting rooms, and neighborhoods.  People bring their own noise with them everywhere they go — just in case there might not be enough ambient noise.  People can’t even go for a walk without portable noise.  Years ago, Max Picard wrote, “Nothing has changed the nature of man so much as the loss of silence.”

He was right.  Silence gives rise to the very rhythm and harmony of life.  Without silence, there is no calm, comforting stability.  Chaos is, by its very nature, noisy.  Consider the floor of any stock exchange.  Everything is noisy and chaotic, and yet markets crave stability.  Most people crave stability whether they recognize it or not.  Perhaps we use noise to avoid facing the deepest truths about ourselves.

Many of us are familiar with Henry David Thoreau’s quote, “Most men lead lives of quiet desperation.”  The American writer James Thurber tweaked that sentiment in 1956, writing, “Most men lead lives of noisy desperation.”  Given our current culture, that’s probably more accurate.  Anyone who has lost electrical power for even 20 minutes knows that feeling of desperate frustration.  We want our gadgets to function.  We want our noise.

Oddly enough, when we’re sick or in pain, we usually want peace and quiet.  Could it be that silence is therapeutic?  That concept seems foreign to many people today, but it’s worth considering.  Silence is indeed a precious, healing balm.  It lies at both the center of the universe and the human heart.  Maybe, one day we’ll catch on.

The Root of the Problem

Posted Posted in Brain Science, Continuing Education, Homestudy, Psychology, Seminars, Webinars
(Photo credit MARK RALSTON/AFP/Getty Images)

By Mary O’Brien, M.D.

Dozens of people are dead.  Dozens more are wounded.  Grief and shock have gripped the citizens of El Paso, Dayton, and the rest of the nation.  Politicians, as usual, will blame their opponents and insist more legislation is the answer.  They are misguided.  The answer begins with understanding the real root of the problem.  And the real root of the problem is complex.

We must ask a forbidden question:  What is normal?  Is normal defined by centuries of acceptable behavior?  Is normal that which enables individuals to form a stable, productive society?  Over the past 50 years, we have tossed aside our ideas of normal:  traditional marriage; nuclear families; the sanctity of life; respect for elders, authority, and other people.  We have ridiculed religion and tradition as old-fashioned, useless burdens.  We now worship fame and outrageous antics.  Young people lead virtual lives online, often devoid of any actual friends.  Hyped-up, exaggerated, and downright fictitious lifestyles are posted nonstop in a frantic effort to achieve celebrity status.  Many young people are desperate for attention.  Their behavior, however, often leads to rejection and isolation.  Everyone experiences rejection and isolation, but normal people gradually mature and learn how to cope.  They adjust their behavior in an acceptable, productive manner.

Unfortunately, when time-tested values and institutions are stripped away and replaced by whatever is bizarre, nasty, violent, vulgar, or self-indulgent, the results are disastrous.  Unstable, angry, young men with fragile psyches cannot spend endless hours playing “first person shooter games” without consequences.  Many of us over the age of 40 are completely unaware of how realistic and gruesome many video games have become.  We’re not talking about cartoon characters.  Virtual people and real people blend into one another.  Combine this with mental illness, anger, hatred, drugs, and a complete lack of any moral compass, and the results can be horrific.

Angry, unstable, amoral people should not have access to guns.  But sooner or later, we need to address the real root of the problem.  There is such a thing as “normal.”  Most of us are still sane enough to recognize its absence.

The Wonders All Around Us

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

By Mary O’Brien, M.D.

I was startled recenty at 5 A.M.  A strange, golden light was shining on my bedroom wall.  It was not a familiar pattern.  Grabbing my robe, I went to the window and pulled back the curtains.  A massive, misty, yellow sphere was glowing just above the tree line on the horizon.  I went outside.

Was it a search light?  Was some group starting construction at 5 A.M.?  The air was heavy and still with a level of humidity that was oppressive.  The birds were beginning to chirp, but there were no typical sounds of annoying human activity.

The sphere of light was larger than any natural phenomenon that I had ever seen.  It was bright yellow and appeared to be expanding as I watched in perplexed amazement.  Trying not to trip in the dark of my backyard, I stood at the edge of the tree line. Clouds on the horizon started to part.  I gasped out loud as I realized a full moon was setting in the most spectacular fashion I had ever witnessed.

I wanted to call my neighbors to come see this miraculous spectacle.  But then, not everyone appreciates exquisite beauty at 5 A.M.

It occurred to me that 50 years earlier, Neil Armstrong, Buzz Aldrin, and Michael Collins were blasting off on Apollo 11 for man’s first trip to that magnificent yellow sphere.

Now I understand.  “Tranquility Base:  The Eagle has landed.”  On July 20, 1969, anyone on earth who had access to a TV was glued to it.  The entire world paused for a time, united in hopeful, anxious awe at what we were watching on grainy black and white images.  Most people under the age of 57 or so don’t understand.  We were spellbound in our pride and joy at being Americans and citizens of the good earth.  No one watching that glorious event had a dry eye.  It was literally hard to breathe.

July 20, 1969, was one of the most important days in human history.  It happened because President Kennedy set the goal, and 400,000 people worked around the clock for nearly a decade to achieve it.

Most of us will never be part of something as tremendous as the space program.  But we can choose to notice the wonders all around us.  Sometimes, I wonder how many extraordinary sights we all miss because we’re sleeping or busy or distracted.  Getting up at 5 A.M. has its rewards.

You Never Know Who Might Be Listening

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

By Mary O’Brien, M.D.

Are you well-spoken?  Would other people agree?  There are many aspects of professional behavior, and speaking is one of the most important. Unfortunately, as a culture, our speech patterns, vocabulary, and grammar are deteriorating badly.

Incessant use of e-mail and texting has had a negative impact on speaking skills and vocal quality.  Parents, teachers, and bosses seem reluctant to correct anyone.  Someone might get upset.  People often confuse correction with criticism.  That’s misguided and it can undermine success.  Part of being an effective health-care professional involves conveying knowledge and inspiring confidence among patients and colleagues.  Bearing that in mind, here’s a little checklist to help polish your speaking skills:

  • Watch out for verbal crutches (um, uh, well, like, you know). Better yet, eliminate them.
  • Don’t start or end a sentence with the word “so.” So, we’ve had a lot of turnover lately, so.
  • Learn the correct use of the words “fewer” and “less.” Skim milk has fewer calories than whole milk.
  • Try not to begin or end a sentence with a preposition (to, of, with, for, on).
    • Incorrect: He doesn’t have any place to go to.
    • Correct: He doesn’t have any place to go.
    • Incorrect: We have many medications to choose from.
    • Correct: We have many medications from which to choose.
  • Learn when to use the subjunctive case.
    • Incorrect: I wish it was true.
    • Correct: I wish it were true.
  • Review the proper use of pronouns: Attention, Southerners.
    • Incorrect: Her and her husband went to the seminar.
    • Correct: She and her husband went to the seminar.
  • Recall the use of past perfect tense: Attention, Midwesterners.
    • Incorrect: Ordinarily I would have went home.
    • Correct: Ordinarily I would have gone home.
  • Eliminate redundant adjectives: Attention entire country.
    • Incorrect: The patient had a small, little bruise.
    • Correct: The patient had a small bruise.
  • Pay attention to singular or plural agreement between nouns and verbs.
    • Incorrect: There’s lots of options.
    • Correct: There is a lot of options.
  • Avoid constant self-reference.
    • “For me, this is not helpful.”  It’s not about you, but this phrase is ubiquitous.
  • Check your vocal quality. Is your voice loud, shrill, strident, or frenetic?
  • Watch out for bad habits in the cadence of your speech. Refrain from “sing-song” phrasing and “up-talking” at the end of a sentence.  It makes anyone sound like a silly school girl.
  • Slow down. Smart people often speak quickly, but you don’t want to sound like a toy machine gun or a cartoon character on amphetamines.
  • Diction is a crucial part of effective speaking.  It requires effort.
  • Guard against “whiny girl” or “lazy girl” voice. Irritating sound emanates from the posterior pharynx with inadequate volume.  The speaker comes across as bored and boring.  Modulate your voice to sound like a competent, knowledgeable adult.
  • Be careful with gestures. Many people overuse hand gestures.  It’s distracting and undermines the real message.  Excessive gestures can make someone look desperate.  Politicians take note.

We work hard to develop our careers.  Don’t allow poor speaking habits to sabotage your future.  You never know who might be listening.

Spotlight on Eggs

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

By Dr. Laura Pawlak

The hard-boiled egg, a breakfast omelet, and fancy deviled eggs — these are favorites among Americans. Eggs are also a good source of protein, along with meat, fish, and poultry.  But, is the egg considered a healthy choice?

In 1980, the U.S. Department of Agriculture began releasing dietary recommendations for Americans with a focus on cardiovascular health.  Dietary cholesterol was stated as a major contributor to heart disease.  Eggs, the number one source of cholesterol in the diet, took the spotlight.

While dietary cholesterol can be found in all foods derived from animals, one egg has about 200 mg. of cholesterol while a serving of beef, pork, or chicken has less than 100 mg. per serving.  The dietary limit for cholesterol (300 mg. per day) significantly limiting the choice of egg-based meals and snacks.

Decades of research have led to a very different interpretation of the role cholesterol plays in heart health.  There was no direct evidence to support the link between egg consumption and blood levels of cholesterol — the risk factor for heart disease. The liver produces most of the cholesterol measured in the blood.

By 2015, dietary cholesterol was no longer considered “the nutrient of concern” for healthy people. New dietary guidelines reflected an emphasis on whole foods, rather than individual nutrients.  For example, fish provides essential omega-3 fatty acids and protein, not just cholesterol.  Red meat contains multiple substances beyond cholesterol that negatively affect heart health.

Eggs made a comeback, but included a warning to eat eggs in moderation — only one or 2 eggs per day. Further restriction was recommended for persons with Type 2 diabetes:  Limit eggs to four per week.

This year, new research by Victor Zhong and colleagues (Journal of the American Medical Association, 2019) rekindles the debate about the role of dietary cholesterol from eggs and red meat in cardiovascular disease and all cause mortality, but official guidelines remain unchanged.

According to Dr. Frank Hu, of the Harvard School of Public Health (2019), “For persons who are generally healthy, eat fruits, vegetables, whole grains, nuts, and legumes and lower [the] consumption of red and processed meats and sugar.  A low to moderate intake of eggs can be included as part of a healthy eating pattern, but they are not essential.  There is a range of other foods one can choose for a variety of healthful breakfasts, such as whole grain toast with nut butter, fresh fruits, and plain yogurt.”

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Dr. Laura Pawlak (Ph.D., R.D. emerita) is a world-renown biochemist and dietitian emerita.  She is the author of many scientific publications and has written such best-selling books as “The Hungry Brain,” “Life Without Diets,” and “Stop Gaining Weight.”  On the subjects of nutrition and brain science, she gives talks internationally.