Life is Short and Precious

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

By Mary O’Brien, M.D.
It happened in an instant. Unimaginable horror and tragedy stunned a community and, indeed, the world.  The collapse of a condominium building in Surfside, Florida, at 1:38 A.M. instantly changed the lives and focus of thousands of people in the U.S., Israel, and South America.

Hundreds of people have been working around the clock, under brutal and treacherous conditions, to save a single life.  Rescuers of every race and background are feverishly trying to find even one survivor of any race or background.  Brave, skilled, and dedicated heroes are doing what brave, skilled, and dedicated heroes always do:  They sacrifice their own safety and well-being to help others.  Rescue personnel, regardless of their color or politics, must be pulled off their shift against their will.  Trying to save another human being is their sole focus. They work together selflessly as a unified team to save life.

This is not shocking to anyone who has ever worked in an ER, an OR, or an ICU.  It’s not a mystery to veterans who have served in combat or police officers who have saved countless lived in emergency situations.  However, too many individuals in the realm of politics, the media, academia, and the corporate world remain baffled by genuine courage and devotion in others.  Since the beginning of our species, ill-intended people have tried to sow division and strife.  Pitting people against one another is malicious, but it has always created an opportunity for power-hungry individuals to seize control.  Teaching children and young adults to be suspicious and resentful of others based on race, gender, or any other physical — therefore superficial — characteristic is a form of cultural rot.  It is a poisoning of the mind.

The tragic collapse of a condominium complex in Surfside, Florida, shows how misguided our priorities can be.  Life is short and precious.  There is never a good reason to promote hatred.  There is more than enough heartache in life without deliberate nastiness. We should never permit ourselves to be focused on race.  We have every reason to keep our focus on grace.

Correct Answers

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

By Mary O’Brien, M.D.

Quick.  Looking back on your life, who was your favorite teacher or coach?  Was it the one who let you get away with anything?  Was it the one who set standards so low you tripped over them?  Was it the person who gave you a gold star for repetitive breathing?  The answer to all of those questions is a resounding “no.”  Most of us would agree that our favorite teacher or coach was the one who inspired us to give our best and achieve more than we thought we could.

Recently, many of us were stunned when state education officials in Virginia proposed eliminating any advanced or accelerated math classes prior to the 11th grade.  They opined that such classes were “unfair” or “intimidating” to less gifted students.  Somehow they reasoned that slowing down the smarter students would make sense.  We already went through this in the 1970s.  Educational giants back then introduced the “New Math” and declared that spelling and grammar didn’t “count.”  Creativity was king.  More recently, the “woke” crowd has informed us that correct answers don’t even matter when it comes to math.  “Process” matters.  In order for our future generation to compete at the highest level, both precision and creativity matter; we need both to succeed. 

We need advanced math to send astronauts to the moon and to the international space station.  We need math to calculate a safe antibiotic dose for critically-ill patients with deteriorating renal function.  Correct answers matter.

Perspective, Humanity and Common Sense

Posted Posted in Brain Science, Elder Care, Psychology, Seminars, Webinars

By Mary O’Brien, M.D.

It’s been a year now.  Several hundred thousand frail, elderly people have died in hospitals and nursing homes alone, confused — and no doubt — feeling abandoned.  Tens of thousands of people have lost their businesses and livelihoods.  Children and teens deprived of normal schooling, sports, and other activities are suffering from anxiety, depression, insecurity, and loneliness.  Poor and disadvantaged children and those with learning disabilities are falling behind rapidly.  Online absenteeism is staggering, and grades are sinking.  The frustration and loneliness are excruciating for millions of innocents.

Politicians and bureaucrats are not lonely, however.  Their lives have not been destroyed.  If they want to dine out, work, socialize, or travel they do.  After all, they’re special.  They are enlightened elites.  We have heard the elites preach “science” to us for over a year.  The question is which science?

Medicine involves many sciences — chemistry, biology, mathematics, physics, statistics, genetics, physiology, pathology, epidemiology, and microbiology.  And that’s only a partial list.  Medicine, however, is also an art.  Sadly, over the past year, too many people have forgotten that.  Individual nurses, doctors, and other professionals have worked heroically to save lives and to be kind — under impossible circumstances — to patients.  But bureaucrats and politicians, with rare exceptions, cannot fathom the art of caring for seriously ill or dying patients — deprived of even a loved one — to hold their hand.  Once they taste control over others, they will not relinquish it willingly.

Human beings are social creatures.  We need contact, communication, and — perish the thought — touch.  Throughout human history exile, isolation, or solitary confinement has been considered painfully harsh punishment.  Yet this is precisely what has been inflicted on young children, the frail elderly, and millions of people in-between — all in the name of “science.”

The point of medicine is to relieve pain and suffering, it is not to control behavior.  Elderly people giving up hope and dying alone, and young people committing suicide were entirely predictable.  Some of us warned about an epidemic of anxiety, depression, addiction, abuse, and suicide a year ago.  These concerns were largely dismissed.  Histrionic media types and “officials” had millions of people convinced that COVID was a veritable death sentence for everyone. 

In reality, 99.7 percent of people who test positive for COVID survive.  Children are not vectors for this illness.  This virus attaches to human cells via angiotensin, converting enzyme receptors in the nasal mucosa and respiratory passages.  Children have very low levels of these receptors.  This is not difficult “science.”

Across the country we are seeing dramatic declines in case numbers, hospitalizations, and deaths.  In all likelihood, millions more people have antibodies to COVID than we realize.  They were simply never sick enough to be tested.  Millions more have been and are being vaccinated.  When 80 percent or so of the population has antibodies (either from infection or vaccination), we will have herd immunity.  There is no need to compromise the physical, social, psychological, and academic well-being of children and teens for one more day.  There is no need to refuse grandparents a hug.  We are rapidly losing any sense of perspective, humanity, or common sense.  We have developed a penchant for panic.  But panic is not policy.  Paranoia is not policy.  We must never again permit the self-serving notions of so few to dictate the misery and destruction of so many.

On Leadership, Science, and Happiness

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

By Mary O’Brien, M.D.

It’s safe to say we’ll all be happy to see this year come to an end.  Fifty years from now people will still be studying the pandemic of 2020, catastrophic hurricanes, tornadoes, wildfires, riots, a controversial election, and the Nashville bombing.  We have reasons to be exhausted.

Despite all these dreadful events, or perhaps because of them, there is much to be learned.  It could easily fill a book, but for now, a few thoughts will suffice:

On Leadership

  • The people who are trying to frighten you are trying to control you.  Ignore them. Good leaders inspire confidence and optimism, not despair.
  • There is never a place for panic in leadership. There is never a place for panic in public policy.
  • Good leaders actually do what they ask others to do. They do not exempt themselves from difficult, inconvenient, or unpleasant tasks.
  • True leaders respect others.  They do not harbor disdain for others.
  • Tyrants (false leaders) often succeed because cowardice is so common.  Show some spine when bullies arise, and remember, no politician or bureaucrat has missed a paycheck in 2020.
  • When in the course of human events, it becomes clear that what you’re doing isn’t working, it’s time to change what you’re doing — especially in a crisis.

On Science

  • Genuine science requires brutal honesty, discipline, openness, acceptance of uncertainty, and humility.  Real science always has been and always will be a work in progress.  When people scream, “Follow the science,” all too often they mean, “Do as I say.”
  • The main point of science is to help us overcome problems and adapt to difficult circumstances. Creative people in every domain have learned to adapt to massive challenges over the years. The Year 2020 was no exception.  In a crisis people need practical advice and suggestions, not domination and suppression.

On Happiness

  • Most of us still have much for which to be grateful, and there is no happiness without gratitude. Take nothing for granted. Many of us now miss things as simple as family, friends, hugs, and handshakes.
  • There are plenty of unkind people in the world. Don’t be one of them.  Kindness and happiness go hand in hand.
  • Don’t believe anyone who insists our darkest days lie ahead.  Such people do not understand the wonders of the human spirit.  It is never time to give up, despair, or cower in a corner.

Fear not.  We’ve learned a great deal in 2020, and we will build on that knowledge.  Be focused.  Be engaged.  Stay informed (not indoctrinated).  No matter what happens in 2021, do not relinquish your right to engage in independent thought and speech.  The future depends on it.

Happy New Year to All.

The Greatest Enemies of Freedom

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

By Mary O’Brien, M.D.

Election Day.  Veteran’s Day.  Pearl Harbor Day.  Do these days have anything in common?  They do — more than most of us might think.  The catastrophic attack on Pearl Harbor on December 7, 1941, shocked the nation into unprecedented action.  Millions of people who had ignored the war in Europe and Asia could no longer remain unaware or uninvolved.  Massive numbers of people rushed to enlist or pitch in on the home front to defend freedom itself.  People willingly sacrificed everything from gasoline, to meat and sugar, to fabrics and metals for the sake of the war effort.  Discipline and sacrifice were a given.

Veteran’s Day (originally called Armistice Day) honors the end of World War I. Few of us can even begin to fathom the anguish, misery, and suffering endured by the troops in Europe.  The horrors of trench warfare, malnutrition, hideous infectious disease, nerve gas, and deprivation of every sort took a terrible toll.  Nearly half of U.S. troops who died succumbed to complications of the Spanish Flu.  A hundred years ago, there were no antiviral drugs and no antibiotics to treat secondary bacterial pneumonia or meningitis.  Curiously, President Wilson never even gave a speech about the flu pandemic.

In World War I and World War II, the hardships of sacrifices endured by so many millions of people were intense.  But how does that relate to Election Day 2020?  It’s not that strange or complex.  The two greatest enemies of freedom are apathy and cowardice.  It’s been that way for thousands of years.  We are in a time of great conflict and uncertainty.  Angry, jealous, controlling people are everywhere.  Remember, if someone is trying to frighten you, he or she is trying to control you.  Don’t be intimidated.  Don’t be demoralized.  Observe, think, and vote.  Apathy and cowardice have dreadful consequences.

This Too Shall Pass

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

By Mary O’Brien, M.D.

Raging wildfires, hurricanes, flooding, tornadoes, riots, arson, violence, lockdowns, pandemic fears, economic upheaval, and political turmoil.  If you’re not stressed out at this point you may be in a medically-induced coma.

Nearly everyone is dealing with some degree of anxiety, sleeplessness, weight gain, tension, irritability, frustration, and/or depression.  There are some constructive strategies we all know and have even advised patients to follow.  But we’re in “Physician, heal thyself” mode these days, so here are a few reminders:

  • Avoid people who are chronically angry and, if possible, don’t be one of them.
  •  Don’t obsess about things you cannot control, including the behavior of other people.
  • Re-invent some aspect of yourself — invest in a new hobby or resurrect an old one that used to give you joy.
  • Freshen up your work space or home. A pleasant, cheerful, clean, de-cluttered environment can really boost morale.
  • Move more.  Sitting at a computer or in front of a TV for hours on end is not healthy physically or emotionally
  • Take a good look at yourself and your appearance.  It may be time to kick it up a notch, if only for your own mental health.
  • Limit your exposure to negative, nasty, snide, snarky people on TV — that means 95% of the “news.”
  • Let yourself have 30 minutes of total silence every day.  It might feel like withdrawal if you’re addicted to noise and devices.
  • Make an effort to compliment someone — about anything.  It may turn around your entire day and theirs.
  • Go out of your way to be kind to a patient, colleague, neighbor, stranger, or — this is shocking — relative.  Acts of kindness boost levels of endorphins, serotonin, and Immunoglobulin A in everyone involved.
  • Get your minimum daily dose of uplifting inspirational reading, prayer, and meditation.  Human beings are more than bodies.
  • Don’t be difficult.  Being pleasant and cooperative is a gift to the people around you.  As we read in the Book of Proverbs, “A merry heart doeth good like a medicine.”

Cheer up.  Do some good for others.  This too shall pass.

COVID-19: The Whole Goal

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

By Mary O’Brien, M.D.

What is guiding your life right now?  Is it notions and emotions fueled by the media?  Is it political correctness and group-think?  Is it fear of ridicule, criticism, or worse?  What we do, what we avoid, and what we fear speak volumes.  Malevolent forces are at work in our culture, and the whole goal is control.

Sadly, far too many people in health care have become passive, dutiful sheep.  “I’m just doing what they tell me to do” has become a veritable mantra.  Nurses, doctors, dentists, and pharmacists who should be capable of independent thought and logic now lower their gaze and comply with idiocy.  It’s embarrassing.

This week (in August 2020), the CDC (Center for Disease Control), in usual fashion, issued a statement contradicting previous communications:  Patients without symptoms do not need to be tested.  Anyone with modest medical knowledge and a three-digit IQ should realize that.  Asymptomatic people, with rare exceptions, are not the problem.

Once again, we don’t have people line up in cars to be tested for flu, strep throat, tuberculosis, mono, or hepatitis because they feel like it.  We have wasted an obscene amount of money, time, and effort on unnecessary and often unreliable testing.  Ah, but it makes us feel as if we’re doing something, and it fuels the fear and paranoia.  Clearly, fear and paranoia make control so much easier.  What could be better?  Put on your mask and spray some Lysol — if you can find any.

There is no clear evidence anywhere in the world that lockdowns mitigate anything.  Viral epidemics run their course regardless of the interventions.  Many people in politics, education, and even health care have trouble with that reality.

We didn’t shut down the country during World War I and the Spanish Flu epidemic. We didn’t shut down business, travel, and education because of tuberculosis, yellow fever, whooping cough, polio, or the Hong Kong flu of 1969.  But back then, we didn’t have ignorant, malicious people pushing an agenda on cable TV and the internet.  We weren’t suffocated by pretentious bureaucrats issuing irrational edicts.  Sensible people would have laughed at such nonsense.

When a brand new illness develops, there are no “experts.” Guidelines will never take the place of facts, logic, and common sense.  Notions and emotions will never solve problems or save lives.  Group think and political correctness will never spark creativity or innovation.

We need to stop the passive, dutiful sheep routine.  The choices we make out of fear are almost always wrong.  Remember, the whole goal is control.  Just say no to the nonsense.

COVID-19: It’s Time

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

By Mary O’Brien, M.D.

Are you caught up in the back-to-school debate?  It’s stunning that anyone is arguing about this.  There was never a medically valid reason for closing schools and colleges in the first place.  As far back as February, we know who the vulnerable people have been.  They were older individuals with multiple, significant underlying illnesses.  This pattern was observed everywhere from China to the European countries.

The panic-stricken rush to close schools and colleges was precisely that — a panic.  Experience over the centuries should have taught us that quarantining a healthy population is ineffective.  The sound, medically sensible approach is to isolate and protect the vulnerable people as quickly as possible.

Consider a few facts:

  • In the U.S. since February 2020, approximately 40,000 deaths attributed to COVID-19 have occurred in people age 85 and older.  Approximately 32,000 COVID-related deaths occurred in people aged 75 to 84.
  • Between the ages of 5 to 14, there have been 14 COVID-19 deaths.  Over 120 children have died from the flu.
  • Children are not vectors for COVID-19.  This illness does not mimic transmission patterns seen with cold and flu viruses in kids.  Young children do not bring COVID-19 home to grandma and grandpa.  There are several medically documented cases of adults transmitting the virus to children (out of millions of cases), but not the other way around.
  • The main reason for this curious fact appears to involve receptor sites in the nasal passages. ACE2 receptors (angiotensin-converting enzyme) in the nose seem to function like docking stations for COVID-19. (Most people are familiar with a class of blood-pressure medications called ACE inhibitors.) Children under the age of 10 have very low levels of ACE2 receptors.  Children between the ages of 10 and 17 have slightly higher levels of these receptors.  Adults gradually develop greater concentrations of these receptor sites as they age.

What does this mean?  It means that there is no medically valid reason for normal, healthy children to wear masks.  Masks can trap bacteria, spores, allergens, pollen, particulate matter, and even increase carbon dioxide retention in certain patients.  Socially and psychologically, there may be a price to pay one day.

Children should go back to school.  Colleges should reopen.  Teachers will be exposed to colds and flu as they are each year.  But COVID-19 is not a massive threat to faculty unless they are already old and sick.

According to the CDC website on “COVID-19 and Children” updated, July 23, 2020:

The best available evidence indicates that COVID-19 poses relatively low risks to school-aged children.  Children appear to be at lower risk for contracting COVID-19 compared to adults.  To put this in perspective, according to the Centers for Disease Control and Prevention (CDC), as of July 17, 2020, the United States reported that children and adolescents under 18 years old account for under 7 percent of COVID-19 cases and less than 0.1 percent of COVID-19-related deaths.[5]  Although relatively rare, flu-related deaths in children occur every year. From 2004-2005 to 2018-2019, flu-related deaths in children reported to CDC during regular flu seasons ranged from 37 to 187 deaths.  During the H1N1pandemic (April 15, 2009 to October 2, 2010), 358 pediatric deaths were reported to CDC. So far in this pandemic, deaths of children are less than in each of the last five flu seasons, with only 64. Additionally, some children with certain underlying medical conditions, however, are at increased risk of severe illness from COVID-19.*

Scientific studies suggest that COVID-19 transmission among children in schools may be low.  International studies that have assessed how readily COVID-19 spreads in schools also reveal low rates of transmission when community transmission is low.  Based on current data, the rate of infection among younger school children, and from students to teachers, has been low, especially if proper precautions are followed.  There have also been few reports of children being the primary source of COVID-19 transmission among family members.[6],[7],[8]  This is consistent with data from both virus and antibody testing, suggesting that children are not the primary drivers of COVID-19 spread in schools or in the community.[9],[10],[11]  No studies are conclusive, but the available evidence provides reason to believe that in-person schooling is in the best interest of students, particularly in the context of appropriate mitigation measures similar to those implemented at essential workplaces.

Wash your hands.  Don’t touch your face.  Stay home if you feel poorly.  Keep surfaces clean.  Avoid crowds.

It’s time for kids to go back to school and for adults to go back to work.

COVID-19: Reasons for Optimism

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

By Mary O’Brien, M.D.

Are you demoralized by “spikes” and “surges” in COVID-19 “cases”?  Are you afraid to go to the grocery store without a gallon of hand sanitizer and a hazmat suit?  That’s how you’re supposed to feel.  Don’t fall for it.  There are reasons to be encouraged, and they won’t be reported by most people in the media.

Consider the following:

  • Mortality rates continue to fall across the country. The highest number of deaths or maximum mortality in the U.S. occurred on April 10th, 2020.
  • Clinical experience with COVID-19 in hospital and ICU settings over the past five months has improved diagnosis, care, and outcomes dramatically.
  • Hospital length of stay (LOS) for COVID-19 patients is half of what it was in March and April of 2020.
  • Media reports of ICUs being near capacity are misleading. For example, in Texas, on July 6th, COVID-19 patients filled 15% of ICU beds; 85% of ICU beds were filled by non-COVID patients.  Remember, for months, many people who should have been hospitalized with other conditions simply stayed home. Furthermore, most clinicians with significant experience have seen multiple episodes of packed ERs and ICUs at nearly any time of year.  It happens.
  • Protocols using Remdesivir, Dexamethasone, convalescent plasma, and other therapies are improving survival here and in other countries.
  • The current mortality rate for people under the age of 50 is 0.05% or half that of the flu. The mortality rate for people in their 20s is 0.007%.  So far, despite initial concerns, there are no well-documented cases of children transmitting COVID-19 to adults.  Schools in Germany, Norway, Denmark, the Netherlands, and Australia have opened without problems.  The schools in the U.S. can reopen without panic and paranoia.  There is a sensible way to do this.
  • Confirmed cases of COVID-19 are substantially lower than reported cases. An actual case of COVID-19 must be confirmed with additional testing.  False positives seem to outnumber false negatives at present.  A positive “case” or test result does not automatically translate into a sick patient.
  • There is a difference between dying with COVID-19 and dying from COVID-19. Heart disease, COPD, bacterial pneumonias, diabetes, renal failure, strokes, dementia, and cancer have not disappeared.
  • Rapid progress is being made by numerous companies working on vaccines and therapeutics. This would not have been possible without unprecedented public-private partnerships and the easing of burdensome red tape.

It’s easier to scare people than it is to “un-scare” them.  The simplest way to control people is to silence independent thinkers and keep everyone else afraid and uncertain.  Uncertainty promotes fear, and fear is contagious.

The vast majority of people in the med0ia and far too many “officials” and politicians are trying to make this situation sound as bad as possible for as long as possible.  They are teaching people to be afraid of everything including one another.  This is insane.  It borders on sinister.

We are making for more progress than most people realize.  Fear not.  There are plenty of reasons for optimism.

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.