An Old-Fashioned, Counter-Cultural Approach

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

By Mary O’Brien, M.D.

Are you already worn out from holiday activities?  There is Thanksgiving travel, Black Friday, Cyber Monday, and reports of morning, noon, and night sales hitting record levels.  The cold and flu season is well underway, and millions of Americans are totally tuckered out.  They will, nonetheless, try to sustain this frenetic activity for another month.  There is an alternative, old-fashioned, counter-cultural approach.  It’s called Advent.

Long, long ago, before people had electronic devices surgically implanted into the palms of their hands, they observed a quiet, disciplined period of waiting for Christmas.  The word, “Advent,” is from the Latin word “adventus,” referring to the arrival of a significant person, time, or event.  Over the centuries, Christians developed the practice of spending the four weeks before Christmas in prayer, fasting, and giving alms to the poor.  It was a way to discipline themselves, physically and spiritually.

Many of our grandparents were very serious about this tradition.  They waited to put up a tree and decorate it until Christmas Eve.  The 12 days of Christmas were actually celebrated from Christmas Day to January 6th, the Epiphany, or arrival of the three Wisemen.  Today, Christmas-in-July sales have us in major shopping mode for half the year.  Many people are tired of Christmas long before it arrives.  By the time credit card bills arrive in late December, very few people are ready for any sort of Epiphany, spiritual, or otherwise.

There are some healthy, helpful things any of us can do in the spirit of Advent.  Most folks want to find meaning in their lives that extends beyond acquiring money, stuff, and titles.  Nonstop, frantic striving can only distract us for so long.

  • Before the holiday craziness consumes any more of your mental, physical, emotional, or spiritual energy, consider a slightly different approach to December: “Fast” from all electronics for one hour a day (while you’re actually awake).  This will reveal volumes about where you are in life.
  • Practice the old-fashioned discipline of giving up candy, sweets, desserts, etc. The first bite of your favorite holiday treat will taste heavenly.  Chances are good that you’ll drop a few pounds in the process.
  • Avoid spending money on fancy coffee, eating out, alcohol, and other little indulgences; give the money you save to help a family devastated by the recent natural disasters.
  • Do something nice for someone else — anonymously.
  • Do something nice for someone you really can’t stand.
  • Invest 15–25 minutes each day in prayer, meditation, contemplation, or spiritual reading to focus on what matters most to you.
  • Make a serious effort to replace cynicism and sarcasm with gratitude and gentleness.

If all of us did even half of these things for a few weeks, the ripple effect would be immense.  Advent.  It’s an old-fashioned, counter-cultural approach.

A Little Extra Thoughtfulness

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

By Mary O’Brien, M.D.

It’s coming.  The busiest travel time of the year is nearly here.  Thanksgiving is next week, and we’ll be bracing for impact.  Tens of millions of people will go somewhere they don’t really want to go and will do things they don’t really want to do — in some cases with people they may not even like.

Painful delays at airports, agonizing congestion on highways, bad weather, stress, and exhaustion will give a green light to viruses everywhere. Welcome to the cold and flu season.  It might be prudent to rethink a few things.

Despite a strong economy, this has been a very tough year for many people.  Historic flooding, catastrophic hurricanes, terrifying tornadoes, and hellish wildfires have inflicted untold suffering and loss.  Mass shootings, violent threats, angry mobs, and generally vicious behavior have overshadowed civility and decorum.  Many decent people across the country feel overwhelmed and demoralized.  I don’t think anyone needs more stress, certainly not at the Thanksgiving table.

But all is not lost.  Difficult situations bring out the worst in some people but the very best in many others.  Heroic acts of courage and compassion abound whenever disaster strikes.  Few of us will ever have to save someone from a raging flood or fire, but we can all be a bit more thoughtful and understanding.  This year, consider a few ideas that might make Thanksgiving less stressful and more pleasant for everyone:

  • Don’t put pressure on loved ones to travel. People only have so much time, energy, and money to spare.  Controlling relatives is not helpful here.
  • Include someone who might otherwise be alone.  Chances are good such folks are all around you.
  • Don’t be a perfectionist in the kitchen. Thanksgiving is not a competitive event.
  • Offer to help or bring a dish, but don’t force your brussels sprouts casserole on the host. Some people don’t know when to cease and desist.
  • Resist the temptation to talk politics. Now is not the time to upset people.
  • Put a ban on phones, television, and assorted other devices. Through your church, synagogue, or club, sponsor a Thanksgiving dinner for a family in need.
  • Show interest in other people at dinner. Good conversation starts with sincere questions about the other person and really listening to that person.
  • Don’t inflict yourself on others if you’re sick. Someone will almost certainly be happy to bring you some wonderful leftovers.
  • Be genuinely grateful for all the blessings you do have. Let people know that you appreciate them.

Thanksgiving is a lovely holiday with charming traditions.  With a little extra thoughtfulness, we can make it better than ever for everyone.

The Holidays: A Time for Comfort Food

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

By Dr. Laura Pawlak

The term comfort food can be traced back to 1966, when the Palm Beach Post used the term in a story:  “Adults, when under severe emotional stress, turn to what could be called ‘comfort foods.’  These foods are associated with the security of childhood, the relief of stress, and euphoric feelings.”

Although the identification of particular items as comfort foods may be unique to an individual, patterns are detectable.  In a study of American food choices, males preferred warm, hearty, meal-related comfort foods, such as steak, casseroles, and soup.   Females consumed snacks as comfort foods, such as chocolate chip cookies and ice cream. Young or middle-age people, under 55 years of age, overwhelmingly chose snack-related, comfort foods.

As the holidays approach, families and friends gather to share an array of comfort foods that provide nostalgic or cultural value.  These foods are often characterized by their high caloric nature, rich in (1) carbohydrate and fat or (2) fat and salt.

Consuming energy-dense food awakens a group of brain structures wired together into a reward system.  This brain circuitry elicits emotions based on the sensory experience of the food.  Comfort foods trigger pleasurable feelings — moments of joy.

The chemicals responsible for feeling good are two-fold:  endorphins, nature’s opioids; and endocannabinoids, the feel-good chemicals found in marijuana.  Sugary foods activate the release of endorphins.  Pizza, cheese casseroles, and other fatty foods spur the production of endocannabinoids.

When fat and sugar are combined, as in desserts, an explosion of both endorphins and endocannabinoids floods the brain, causing elation beyond nature’s offerings.  The temptation to overeat may be overwhelming, especially when a fond memory is linked to the food.

Enjoying holiday celebrations, without consuming excessive amounts of comfort foods, requires forethought.  A plan is helpful!  For example, set aside the day before the event as a time to eat fewer calories.  Drink water, coffee, and/or tea. Have two light meals — perhaps a fruit salad and a green salad.

On the day of the celebration, eat a healthy breakfast and add a salad if you feel hungry before attending the festivity.  At the party, take a deep breath between bites of your favorite foods.  Notice the positive memories that surface as you eat slowly.

Lastly, don’t take goodies home.  Holiday gatherings are meaningful times with friends, not just food.  Savor the season!


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.

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A Circle of Prayer

Posted on Posted in Brain Science, Continuing Education, Elder Care, Homestudy, Psychology, Seminars, Webinars
Credit: National Review

They knelt in prayer and grief.  A dozen brave, dedicated, selfless firefighters and rescue personnel in Wilmington, NC were heartbroken on sight.  A mother and her 8-month old baby girl were killed when a tree crashed through their house during Hurricane Florence.  The father was severely injured and rushed to the hospital.  Upon completion of their agonizing task, the first responders were captured in a photo kneeling in a circle of prayer.  Within hours, the image went viral and millions felt their anguish.

Suffering and heartache are rampant here in the Carolinas now.  It will take many months and even years for people to recover from the devastation.  This part of the country has been my home for many years and my heartfelt thoughts and prayers go out to everyone in need.  I know that everyone at INR joins me in that circle of prayer.  To all our customers and colleagues who have worked with us for so long, we wish you Godspeed in your recovery.

A Wonderful Ritual

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

It has started.  Across the country, kids from kindergarten to college are heading back to school.

I miss that back-to-school ritual.  Shopping for new clothes (even uniforms), textbooks, pens, folders, notebooks, and lunch boxes made me happy.  Spending a day with my mom and sister focused on a bright, new beginning.  It was a wonderful ritual.  We would always be excited to show our dad all the new treasures.  He would heartily approve of our purchases and remind us to use them to get good grades.

I could be wrong, but I get the feeling that much of that ritual and tradition is fading away.  Online shopping, frantic last-minute errands, and people doing “their own thing” seems to be replacing planned family outings.  Maintaining some structure, routine, and ritual is more and more challenging.

But the “whatever” approach to life is not very fulfilling.  Human beings, whether they are in a newborn nursery or a nursing home, do best when they have a healthy routine.  If you have school-age kids, it may help to consider a few time-tested principles.  Establishing these “rules” is a lot easier at the start of the school year than it is after a month or two of foundering and fiascos.

  • Preserve and protect bedtime — few factors influence performance at school (or work) more than sleep. And most kids need a lot more of it.  Unfortunately, when kids stay up until 10, 11, or 12 at night during the summer and then try to go sleep at 8:30 or 9, things don’t go well.  Begin to ease everyone into school-day bedtimes and wake-up schedules a week before school starts.  Only the strongest and wisest of parents will even attempt this.
  • Get everyone up early enough to have a decent breakfast and avoid morning rush and chaos. Some people never learn this principle, but most successful people get up long before they “have to.”
  • Teach kids to prepare as much as possible the night before — homework, projects, clothes, permission slips, etc. This is another principle of success in life and does wonders for easing stress and anxiety.
  • Limit TV and screen time, especially on school nights. Bullying and generalized nastiness abound on social media.  Kids will always complain about rules and boundaries, but deep down every child wants to feel safe, secure, and loved.  It helps if mom and dad set a good example here.
  • Create a home environment that’s conducive to calming down. Overstimulation and overextending are epidemic in our culture and disastrous for concentration or restorative sleep.
  • Establish and maintain a family dinner hour without devices. Kids must be taught how to have a conversation and actually be attentive to others.  There are 50-somethings out there who haven’t learned this.

People will always insist they don’t have time for lots of things.  But we all get 24 hours of time each day.  The question is, which activities will really make a difference down the road?  Establishing a healthy back-to-school routine can be the foundation for a happy, successful life.

Pearls of Wisdom

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

By Mary O’Brien, M.D.

He was a disciplined thinker, a real-life Mr. Spock, in a world where so many worship emotion.  Dr. Charles Krauthammer died on June 21, 2018, after a battle with cancer and 46 years of paralysis from a diving accident.  He finished medical school at Harvard and trained as a psychiatrist before turning to political journalism.  Early in his career he won a Pulitzer Prize.  The rest is history.

Dr. Krauthammer was an intellectual force of nature.  Facts, reality, logic, and truth served as his compass.  He had an unusually inquisitive mind and was open-minded enough to allow his thinking to evolve.  This stood in stark contrast to so many in the media who idolize notions and emotions.

Always patient and respectful in debate, Dr. Krauthammer was kind, thoughtful, gracious, and dignified.  But those qualities never suppressed a laser-like wit and genuine sense of fun.  He knew what there was to know about baseball and chess. People loved being around him because they always learned something and had a good laugh.  Being confined to a wheelchair did not prevent him from enjoying life.

Most people will remember Dr. Krauthammer for his political analysis and writing.  But as a physician who struggles with multiple illnesses, I have a slightly different focus.  Here are just a few pearls of wisdom I learned from his remarkable example:

  • Resist the temptation to feel sorry for yourself. Bitterness and victimhood will not solve anything.
  • Think about death every day. This is not morbid.  Charles Krauthammer was a wonderfully cheerful, funny man.  Confronting death allows one to appreciate life fully.
  • Keep your focus on others. We live in an age of malignant narcissism.  Krauthammer rarely talked about himself and kept his focus on the needs, problems, hopes, and dreams of other people.
  • Be courageous enough to say what you think but always be measured and civil. Hatred and nastiness abound today. There’s nothing constructive or healthy about it.  Civility, patience, gentleness, and humility will always be the mark of true wisdom.

Dr. Charles Krauthammer could have given up on everything at the bottom of that swimming pool when he was 22 years old.  He chose to fight back, and I’m one of millions who is grateful that he did.

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More Healthy Bread, Maybe Not!

Posted on Posted in Continuing Education, Homestudy, Nutrition, Seminars, Webinars

By Dr. Laura Pawlak (PhD)

The vast variety of breads available in supermarkets and bakeries reflects the unquenchable appetite of Americans for this grain-based food.  Breads labeled as “whole grain” appear to be a smart way to add fiber to your diet.

Whole grains improve regularity, slow digestion, reduce appetite, improve cholesterol, and prevent spikes in blood sugar — a major driver of obesity, high blood pressure, and Type 2 diabetes.

A whole grain bread uses the entire grain seed:  the bran (an outer layer with fiber, antioxidants, and B-vitamins); the endosperm (the middle layer of starchy carbohydrates); and the germ (the inner core, which has vitamins, minerals, some protein, and a drop of oil).

Commercial whole grain breads differ in the relative amount of whole grain content in the product.  A simple calculation, called the “10 to 1 Rule,” can guide you in choosing healthy whole grain breads:  Using the nutrition facts on the label, identify the grams of total carbohydrate and fiber.  Divide the total grams of carbs by 10.  Is there at least that much fiber stated on the label?  If so, it is considered a healthy bread.

But wait, there’s something more to consider before purchasing a whole grain bread.  Andrew Weil, M.D., an expert in Integrative Medicine, states:  “A true whole grain food retains all three parts of the seed intact.  A recent government study linked the fiber found specifically in intact whole grains to a longer, healthy life, that is, a lower risk of death at any age from conditions such as cardiovascular, respiratory and infectious diseases and possibly some cancers.”

To make bread, the intact whole grain is ground into flour.  Some of the physical properties that promote good health are less effective when whole grain seeds are processed into flour.

There are many tasty, intact whole grains available, including: amaranth; barley; brown rice; buckwheat; bulgur; cracked wheat; farro; kamut; kasha; millet; oats; quinoa; rye; wheat berries; and wild rice.  Use intact whole grains as side dishes or stuffing, in soups, stews, and salads — and as a hot, breakfast porridge.

Despite research reporting some differences in the positive effects of intact whole grains as compared to processed (ground) whole grain flour, here’s the most important message:  Aim for at least three servings of whole grains every day, including cooked, intact whole grains, whole grain cereals, and whole grain breads.  Enjoy!

Morals, Manners and Mindsets

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

By Mary O’Brien, M.D.

Our culture appears to be in free fall.  Movie moguls assault young women.  Campus doctors exploit and molest patients.  Gymnastics coaches and doctors engage in appalling sexual crimes.  The abuse of women and children has occurred for millennia. However, as individuals and as a civilization, we’re supposed to be advancing.

The human person, the human body, must be treated with dignity and respect at all times, at every stage of life.  The notion that we can do whatever we want, whenever we want is wrong.  It always has been, it always will be.

Professional stature is non-existent without self-restraint and honor.  And those in leadership positions who merely look the other way bear just as much guilt as the perpetrators.  It’s shocking to realize how much disgraceful behavior is tolerated out of ineptitude, laziness, greed, or complacency.  Virtually every sector of our society is at fault here.  Until we reach a critical mass of people willing to challenge this horrid behavior, nothing will change.

In our professional realm, there are a few things we can do to restore respectfulness:

  • Call patients or clients by their proper names: , Mrs., Mr., Dr., Reverend, Judge, etc. are all appropriate until someone invites familiarity.  Using first names with a new patient is not “friendly” as we have been led to believe.  It merely signals a sloppy level of unearned familiarity and unprofessional demeanor.  A medical or dental office is not a nail salon.
  • Male professionals should not be alone in an examination room with a female patient. The “expense,” “inefficiency,” or “inconvenience” of having a nurse or assistant present is an unacceptable excuse for this breach of protocol.
  • Manners matter. “Old school” nurses and doctors were taught to ask the patient’s permission before we touched him or her.  “May I listen to your heart?”, “May I examine your abdomen?”  No doubt some youngsters in health care would roll their eyes at this.  But we should never make assumptions about touching anyone (apart from emergencies), and yet it happens routinely today.
  • It’s good to remind ourselves, our colleagues, and our students that decorum and propriety are not old-fashioned and unnecessary. On the contrary, they are critically important, and their absence is palpable.

Morals, manners, and mindsets do not exist in a vacuum.  When someone is disrespectful or unethical in one domain, that vice will eventually metastasize.  Regardless of our age, culture, or profession, we should always try to treat others the way we’d like to be treated.  It’s not corny.  It’s not outdated.  It’s our only path forward.

A Little Reminder

Posted on Posted in Continuing Education, Homestudy, Pain, Seminars, Webinars

By Mary O’Brien. M.D.

Are you a terrorist?  Are you a drug dealer?  Perhaps a criminal of some other variety?  The fact that you are reading this makes any of those possibilities quite unlikely.  And yet, our culture now assumes the worst of nearly everyone.  In an airport, we’re all treated like potential terrorists.  Hand the clerk in a grocery store a hundred dollar bill and she checks it to see if it’s counterfeit.  Anyone needing pseudoephedrine to breathe normally is treated like as if she may be running a crystal meth lab in her garage.  That’s ridiculous.  I don’t have a crystal meth lab in my garage.  It’s in the attic.  These days, too many people can’t recognize humor, much less reality.

Needing to fly somewhere does not make someone a terrorist.  Wanting to pay cash for groceries does not make someone a counterfeiter.  Trying to breathe more easily does not make someone a meth dealer.  Hoping for some pain relief does not make someone an addict.  As a society, we are making some very misguided judgments.  I recall that seven years ago I sought help from another internist when a long list of autoimmune diseases began spiraling out of control.  The “medical assistant” asked me what my main complaint was.  When I explained I had increasingly severe pain in my hands and feet, she quipped, “We don’t do pain management.”  I had to restrain myself.  I was there for a diagnosis, not a prescription.

Pain is the single most common symptom of most malignancies, autoimmune diseases, vascular diseases, and serious infections.  Renal disease, neurological disorders, metabolic diseases, and any inflammatory process can cause agonizing pain.  And we haven’t even touched on trauma.  Most patients who complain of pain are totally genuine and honest.  Some people exaggerate, some are manipulative.  Some, but not most.

Today, we have many veterans suffering constant pain from multiple amputations and other terrible conditions.  In many cases, they cannot obtain a month’s supply of pain meds.  They are forced to endure preposterous “policies” and “protocols” created by sanctimonious idiots.

If we really understood as much as we think we do about pain, pathophysiology, or pharmacology, we would ensure that patients have the pain medications they need to function.  Opioid addiction and overdoses are devastating problems.  But forcing patients with documented causes of severe pain to suffer needlessly is simply wrong.  Everyone who has had a cocktail, a beer, or a glass of wine does not become an alcoholic.  Everyone who needs chronic opioid treatment does not become an “addict.”

The whole point of health care is to relieve pain and suffering.  Perhaps we all need a little reminder.

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The Shock Value of Anything

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

By Mary O’Brien, M.D.

Our culture is in big trouble.  Civility is under assault.  Over the past 20 years, most of us have heard increasing use of vulgar language in public and even professional settings.  Some of us have even heard vulgar language used at funerals, especially when celebrities are involved.  It’s typically done in an effort to lighten the mood.  It doesn’t work.  It’s not appropriate, it’s not funny, it’s not hip, it’s not “cool.”  More of us need to speak up and call people on it.

Rude, crude, vulgar language merely announces to the world a limited vocabulary, emotional immaturity, and a lack of class.  The timid giggles elicited by comedians using crude language is nothing more than the nervous response of an insecure audience.  When a joke is truly funny, people laugh in a genuine, spontaneous manner because they recognize a universal truth.  Really talented people don’t need to rely on incessant efforts to shock an audience.  They actually have a gift for seeing everyday realities in novel, insightful ways. The shock value of anything wears off quickly.  Before long, the whole gig becomes tiresome.

The use of vulgar language often signals a nasty, vicious, vituperative mindset. Unfortunately, most offenders don’t even realize how badly they embarrass themselves.  The disgraceful monologue inflicted on people at the recent White House Correspondents’ Dinner was a case in point.

Cruel attacks on anyone’s appearance, wishing someone would be crushed by a falling tree, and “jokes” about abortion are not funny.  The nonstop use of the “F” word only underscored the pathetic mentality of the “comedienne.”  Some folks had the spine to walk out.  Too many sat there like overdressed lemmings.

Regardless of our age, gender, profession, economic status, political perspective, race, or creed, no one will ever think more highly of us for spewing vulgar language and nastiness.  Two thousand years ago, a very wise person said, “Out of the fullness of the heart, the mouth speaks.”

Truth is timeless.