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.

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

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.

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.”

____________________________________________________________________________
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.

 

We Can Do Better

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

By Mary O’Brien, M.D.

The pendulum has swung too far.  Fifty years ago there were psychiatric hospitals full of mentally ill patients who were poorly treated and even abused.  “One Flew Over the Cuckoo’s Nest” was required reading.  National outrage peaked and psychiatric hospitals closed leaving thousands of patients unequipped to face the outside world.  Alcoholism, drug addiction, and homelessness began to spiral out of control.

Today major cities like New York, Seattle, Portland, Los Angeles, San Francisco, and others have homeless populations overwhelming local resources.  Los Angeles County now has over 60,000 homeless people, and San Francisco publishes a map to help visitors avoid piles of human feces and used syringes.  Police officers are becoming ill as a result of contact with infected people.  Tuberculosis, Typhus, Typhoid fever, Hepatitis A, and scabies are only a few of the conditions smoldering on the streets.  Rape and violent assault are routine.  California now accounts for one-fifth of the homeless population of the entire country.

The two largest contributors to homelessness are mental illness and addiction.  Most cities have laws against sleeping on the streets, but often those laws are not enforced.  Decriminalizing bad or problematic behavior does not make it go away, and permitting squalor is not compassionate.  Homeless people do not represent a big voting block, but government officials have a responsibility to protect public health and safety.  Experience over the last 40 years has taught me something about caring for homeless patients and starting free clinics, so here are a few thoughts:

  • Commit to addressing the problem. If inaction, complacency, and blame solved problems, we wouldn’t have any problems left.
  • Enforce existing laws and give the police the support and back up they need. That is not being “mean.”
  • Triage people in tent cities. Most need help from social services, many need treatment for addiction and mental illness, some may respond to help from church organizations, and some probably need to be arrested.
  • Organize a volunteer force (the local equivalent of the Peace Corps or the Job Corps). Those not in need of acute treatment for mental illness or addiction might be salvaged with a program that teaches basic living skills.  Such programs already exist in some areas.  College and graduate students could volunteer and earn “credits” toward paying off some school loans.  Colleges and universities would need to cooperate, but at some point you have to put your money where your mouth is.  Tax credits could be given to non-student volunteers.
  • Organize mobile free clinics to vaccinate, screen for infectious diseases, and begin basic treatment. Invite nursing and medical students as well as retired professionals to help.  Sometimes people simply need to be asked.  They would need legal protection from malpractice.  Non-controlled drug samples and old medical equipment could be donated.  I know whereof I speak here.
  • Create transitional housing facilities (like senior life care in reverse). Old warehouses and military style barracks could be refitted. California has the largest percentage of billionaires in the country.  Ask them for help.  No one becomes massively successful because he or she has a dearth of ideas.

Fifty years ago some people were abused in mental hospitals.  Now we allow them to abuse themselves and one another on the streets.  This is a massive, complex, and expensive problem.  But failing to address it will have catastrophic consequences for everyone.  We can do better.

An Idea Whose Time Has Come

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

By Mary O’Brien, M.D.

Are you an adult?  Are you sure?  Young people today are taking longer and longer to grow up.  Throughout history people worked hard and started families in their teens.  Only a privileged few could afford the time or money for an education.  Even a mere century ago, finishing high school was a relative luxury.

A few weeks ago, during the 75th anniversary of D-Day, we heard remarkable stories of 18- and 19-year-old boys fighting for freedom and civilization.  These boys grew up very fast.  They had no choice.  Mommy and Daddy could not indulge every whim of their sons.

Growing numbers of people now realize we have a problem.  Young people are graduating from high school and even college with minimal practical skills.  Changing a tire, cooking a real meal, or opening a bank account can overwhelm them.  This is not good.  Many of us were required to take shop class or home economics in high school.  Then, the “geniuses” in education had their way.  The results speak for themselves.

Happily, there is hope.  A young teacher at Fern Creek High School in Kentucky has begun three-day workshops called “Adulting 101.”  Sarah Wilson Abell has been instructing students in real-life skills:  how to handle basic food preparation and cooking; how to change a tire; how acquire the fundamentals of money management; how to read a map (in case Siri is sick); how to behave on a job interview; how to have basic table manners and etiquette; and how to tie a tie.

Parents used to teach these skills, but the days of June and Ward Cleaver and Ben Cartwright are long gone.  This timely idea is spreading.  More and more people in their thirties and forties realize they need these skills.  I recently encountered a 31-year-old woman who didn’t know how to sign her full name because, “We didn’t learn cursive.”  You can’t make up things like this.

Someone reading this is probably not a high school teacher, but many of our readers teach students in the health-care professions.  Starting your own “Adulting 101” class could be tremendously helpful.  In addition to the topics listed above, a few more are worth considering:

  • Good, old-fashioned people skills. Professional etiquette when dealing with patients and colleagues must be taught.  Translation:  Put down your cell phone and look up from your computer.
  • Principles of personal hygiene and dress. Don’t act outraged.  Most of us realize standards couldn’t have sunk much lower.  Our failure to teach and maintain such professional standards has compromised patient care and the career advancement of many students and trainees.
  • Essentials of appropriate speech and behavior in the workplace. As is the case with appearance and manners, there are boundaries that separate work, play, and personal life.  This comes as a shock to many young people.  We do them a great disservice when we fail to correct the situation.

“Adulting 101:” It’s an idea whose time has come.  It should have never gone away in the first place.