Coronavirus (COVID-19): Reason, Prudence and Common Sense

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

By Mary O’Brien, M.D.

A pattern is emerging.  Clinical and laboratory experience in several countries reveals that there are two strains of coronavirus (COVID-19).  The virus is comprised of an unstable single strand of RNA that is mutating.  This is known as antigenic drift and it is expected.  Researchers have identified an “L” strain and an “S” strain.  At present, the “L” strain appears to be associated with more severe symptoms and a higher mortality rate.  More widespread and accessible testing (which is now underway) will help us discern which strain is prevalent in various regions.

The vast majority of deaths have occurred in elderly people with significant underlying illness.  The cluster of patients in a nursing home in Kirkland, Washington, underscores the fragility of sick, elderly patients in enclosed settings.  Outbreaks on cruise ships reflect a similar pattern of transmission.  A large percentage of cruise passengers are over 50.  People don’t like to think of 50 as older, but physiologically, it is.

Clinically, patients with more serious illness have a high fever (over 101°F), a deeper-sounding cough (not a tickle in the throat), and shortness of breath.  The mortality rate in countries with good health care is around one percent.  China and Iran are impossible to assess, but mortality rates there appear to be around 3.4 percent.  Older men in China have very high rates of smoking, which is a crucial factor in both morbidity and mortality.

For now, several additional practices make sense:

  • Minimize or restrict visitors to patients in hospitals and nursing homes. Sick, elderly people need to be protected.
  • Frequent, thorough hand-washing with soap and hot water for 20‒30 seconds is best; hand sanitizers are second best. Keep your hands moisturized to avoid cracked skin.
  • Don’t eat with your fingers; don’t lick your fingers.
  • Keep your hands away from your face, eyes, nose, and mouth.
  • Sanitize your phone everyday. It’s the filthiest thing you touch.
  • Facial hair on men is a veritable Petri dish for microorganisms — especially among the nose, mouth, and chin. Now would be a good time to shave.
  • Change your pillow cases everyday.
  • Don’t waste your face masks. Surgical masks protect other people from your coughs and sneezes.  They don’t protect you from others.  Besides, many viruses penetrate our immune defenses through our eyes.
  • Toss your toothbrush at least every month, and whenever you are feeling ill.
  • Increase oral care with antiseptic mouthwash several times a day.
  • Stay well-hydrated to optimize the integrity of mucous membranes.
  • Let yourself and your patients get more sleep. Sleep is immensely important for multiple aspects of immune function.

The virus will evolve, and we will adapt.  At some point, it will resolve.  Right now, many people, especially those in the media, are overreacting.  That is always a mistake.  There has never been a substitute for reason, prudence, and common sense.  Steady as she goes.  How often can you say it?

 

Novel Coronavirus (COVID-19): Now What?

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

By Mary O’Brien, M.D.

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

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

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

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

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

 

Coronavirus – An Update

Posted Posted in Elder Care, Homestudy, Nutrition, Seminars, Webinars

By Mary O’Brien, M.D.

It’s progressing. We knew it would.

The novel coronavirus, just renamed CoVID 19, has surpassed SARS in the number of deaths caused.

The number of confirmed cases worldwide is 60,081 with 1363 deaths. Nearly 99% of cases are still in China and the mortality rate remains around 2‒3%. There are undoubtedly far more unconfirmed cases in China since large numbers of people are at home with mild to moderate symptoms, or even asymptomatic infection. Inadequate testing to confirm the virus or rapidly triage and admit patients to intensive care in Chinese hospitals appears to be a serious problem.

The Chinese physician who first recognized an outbreak of SARS-like illness was targeted and arrested for “rumor-mongering.” He was even forced to recant his story. Dr. Li Wenliang contracted the coronavirus and died last week. Even his death was denied by authorities for a day. Dr. Li joins a brave, dedicated, compassionate group of heroic physicians throughout history who succumbed to the very illness they were treating. His memory will be honored.

The only way to solve a serious problem is to address it in an open, straightforward manner. Secrecy rarely solves serious problems. We’ve all heard the old dictum, “Sunlight is the best disinfectant.” Fortunately, the President’s task force on the coronavirus has done an excellent job of educating the public, securing and screening ports of entry, coordinating distribution of viral test kits to U.S. labs, evacuating Americans from China, and quarantining appropriate people with possible exposure.

The CDC, NIH, and Department of Health and Human Services personnel are working nonstop to contain the virus and develop a vaccine and potential treatment. In the meantime, supply chain disruption is affecting car companies, tech firms, and even medical supply businesses. Many of our OTC and prescription medications, including antibiotics, are made in China. The FDA has evacuated our personnel who inspect these production plants. There may well be consequences in the coming weeks and months here in the U.S.

Meanwhile, we’re in peak cold and flu season. Fastidious hygiene remains key:

  • Wash your hands – frequently and with soap and hot water for at least 20 seconds.
  • Do not touch your mouth, nose, and eyes. Viral particles suspended in respiratory droplets can penetrate mucous membranes and conjunctiva very easily.
  • Maintain at least 6 feet between yourself and others (social distancing)
  • Avoid crowds and unessential travel
  • Get more sleep than you think you need
  • Stay home if you have cold or flu symptoms (and don’t lay a guilt trip on colleagues who are sick)
  • Disinfect hard surfaces frequently. This coronavirus can apparently survive on hard surfaces as long as 9 days. Phones, keyboards, bathroom fixtures, door handles, and steering wheels are just a few examples.

Seasonal epidemics triggered by a mutated virus can be devastating, but eventually they are contained. Until then, our job is to stay calm, stay informed, and practice the time-tested principles of good patient care and common sense.

Coronavirus – Just the Facts

Posted Posted in Continuing Education, Homestudy, Seminars, Webinars

By Mary O’Brien, M.D.

Chances are good you have a lot going on this week. And there’s a lot to keep up with in the news. Bearing that in mind, here is a synopsis of the facts concerning Coronavirus.

  • Definition: Coronaviruses are enveloped RNA viruses which typically cause symptoms of the common cold. The name stems from the halo or corona-like appearance of the virus when viewed with an electron microscope.
  • Medical terminology: The current coronavirus causing illness will be referred to as 2019 nCoV (novel coronavirus 2019) in the medical literature.
  • Symptoms: Coronaviruses typically cause cold and flu-like symptoms such as runny nose, sore throat, headache, cough, fever, and malaise. Shortness of breath is often indicative of progression to a viral pneumonia.
  • Countries with documented cases of 2019 nCoV: China, South Korea, Vietnam, Thailand, Nepal, Hong Kong, Singapore, Malaysia, Australia, Japan, France, U.S., Canada.
  • Origins of current outbreak: Likely animal-to-human transmission with subsequent human-to-human transmission in Wuhan, China. Wuhan is the capital city of Hubei province and has a population of 11 million.
  • Current problems related to epidemic in China: Multiple hospitals in China are overwhelmed, with shortages of supplies including masks, gloves, goggles, disposable gowns; reports of patients being turned away. Food shortages are reported in various areas as a result of transportation bans and lock downs.
  • Containment measures in China: Travel bans now affect nearly 50 million people in China. Multiple tourist sites have been closed including some portions of the Great Wall, the Forbidden City, and Shanghai Disneyland. Movie theaters have been closed. Tour groups, cruises, and schools are closed. Many Chinese Lunar New Year Festivities have been cancelled. This week and next week comprise the busiest travel period in China and the resulting economic impact is expected to be significant.
  • Current medical measures in progress: The Chinese government is flying hundreds of physicians and volunteers into affected areas and two temporary emergency hospitals are under construction to provide an additional 2,000 beds.
  • Most vulnerable patients: Those at greatest risk include young children, the elderly, immuno-compromised patients, and those with diabetes, chronic heart or lung disease, and chronic renal disease.
  • Usual cause of death: Viral pneumonia with respiratory failure is the most common fatal complication of coronaviruses.
  • Appropriate workup in acutely-ill patients with possible exposure: Patients who have travelled in China, within the past 2‒3 weeks, or who have had contact with such an individual, who have fever, cough, headache, or shortness of breath may warrant a CXR, CBC, liver enzymes (especially LDH and AST). Coronavirus testing involves real-time reverse transcriptase PCR (RT-PCR) of lower respiratory secretions.
  • Historical perspective: Two other coronaviruses have caused serious respiratory illness in recent decades:
    • MERSCoV 2012 – Middle East Respiratory Syndrome
    • SARS-CoV 2002-3 – Severe Acute Respiratory Syndrome

MERS resulted in 2,066 confirmed cases worldwide with 720 deaths.

SARS resulted in 8,000 confirmed cases worldwide with nearly 800 deaths (a mortality rate of 10%). Deaths were reported in 37 countries.

SARS was eradicated in 2004 by rapidly identifying and isolating “super-spreaders” (patients who infect unusually large numbers of people in the general population.)

  • Prevention: Common sense and standard infectious disease principles are in order – frequent, thorough hand washing; avoid touching your face, nose, mouth, and eyes; do not travel, go to work, or socialize if you are ill; face masks can reduce transmission of virus-laden droplets from infected patients coughing or sneezing; avoid crowds; don’t share food, beverages, or utensils.
  • Current status: As of Monday 1/27 – 2,700 confirmed cases with 81 deaths. Mortality rate at present is about 3%. These statistics will evolve rapidly.
  • Recommendations:
    • Check for updates from the CDC.
    • Focus on facts, logic, and common sense.
    • Employ time-tested ID principles and protocols.
    • Realize similar outbreaks run their course (typically in winter) and eventually resolve with identification of the virus and isolation/containment of infection.
    • Get a careful history from patients. The vast majority of people with cold or flu symptoms have a cold or flu – not coronavirus from China.

Solomon and Churchill

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

By Mary O’Brien, M.D.

Here we are – midway through January 2020.  Have you crystallized your vision of vitality for 2020?  Has anyone noticed you have a new routine or attitude?  Have you already given up?  Don’t be too hard on yourself.  Between coping with severe weather and assorted viruses, many people are doing well to be functional right now.  Fortunately, it’s never too late to focus on the future and take corrective action.  After all, ships and planes rely on constant corrective adjustments of their navigational systems to reach their destinations.  How much more do fallible, fatigued, and sometimes fickle human beings need to take corrective action if we’re to achieve our destiny?

Now there’s a word that gets far too little attention in our culture.  Destiny.  No doubt there are those who would roll their eyes and dismiss the concept as delusional and arcane.  But I really believe each of us has a destiny or at least a potential destiny.  The key is recognizing it and taking steady action to achieve it.  Andrew Roberts, the acclaimed biographer, describes Winston Churchill’s profound sense of personal destiny in his book, Churchill: Walking with Destiny.  An intense spiritual experience at the age of 16 implanted in the young Churchill a deep conviction that he would be called upon to save London and indeed, Great Britain, at some point in his life.

Churchill had some major failures along the way, as all great people do.  And, despite stunning successes, he was the target of relentless, vicious criticism from political opponents, pretentious journalists, and even people in his own party.  Many of Churchill’s speeches were greeted with ridicule and contempt by his detractors.  This should not surprise us.  Nothing fosters criticism more predictably than jealousy.  Those speeches would later be hailed as some of the most inspiring rhetoric in history.  Winston Churchill endured massive criticism at nearly every turn, but his sense of destiny allowed him to persevere.

The concept of destiny infuses the wisdom of the ages. Several thousand years ago, Solomon wrote a sentence in Proverbs that should be noted by individuals and nations alike.  He wrote, “Where there is no vision, the people perish.” Solomon was onto one of the great secrets of the universe.  Can there be much doubt that communism has largely collapsed because it tried to suppress the vision of its people?  Would inner city darkness and despair exist if people pursued a vision of future success?  Would many of us wallow in depression for long if a vision of great destiny propelled us forward?

If you were less than thrilled with the accomplishments and personal progress you made last year, make a change.  Change whatever isn’t working in your life.  Of course, that means changing the way you think.  It means daring to dream and develop a vision for the future.  Don’t dwell on your circumstances, change them.

The vision to see, the faith to believe, and the will to work can bring your destiny within reach.  Solomon and Churchill were onto something.  The question is, are we?

A Whole New Decade

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

By Mary O’Brien, M.D.

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

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

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

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

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

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

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

A Modest Course Correction

Posted Posted in Continuing Education, Seminars, Webinars

By Mary O’Brien, M.D.

Are you exhausted yet?  Is the holiday frenzy taking its toll?  Do you feel moments of melancholy creeping into your consciousness?  Fear not.  Millions of people feel the same way.   The good news is that it’s not too late to salvage the final weeks of 2019. Stress and exhaustion need not characterize this time of the year.   A modest course correction could save the day and set the stage for a better 2020:

  • Don’t overextend yourself physically or financially.  We all have limits. Recognize and honor them.
  • Preserve and protect your sleep.  Optimal amounts of serotonin, dopamine, nor-epinephrine, and growth hormone are produced during the deeper stages of sleep.  Don’t skimp.
  • Bump up your exercise to boost endorphins (a $2,000 exercise bike is not necessary).
  • Perform frequent acts of kindness in the true spirit of the season. It will increase your serotonin and IgA levels.
  • Decrease time on social media sites and increase one on one time with real people you care about.
  • Avoid political conversations. Our country is profoundly divided now, and political arguments will not make the holidays any nicer.
  • Overlook the flaws of others and realize you have flaws too.  Don’t let yourself be overly sensitive about off-the-cuff remarks from relatives.
  • Don’t overindulge when it comes to rich foods, alcohol, and caffeine.  Moderation in the last two weeks of December can prevent a guilt trip in the first week of January.
  • Set aside at least 10-20 minutes each day for quiet, peaceful reflection, prayer, or meditation. Read or listen to something inspiring and uplifting.  The busier you are, the more desperately you need this.
  • Slow down and enjoy the moment. Before long we’ll all be working on taxes.  There’s a cheery thought.
  • Do what you can to mend a misunderstanding, forgive a wrong, or let go of a grudge.  Bitterness, anger, and resentment are exhausting.  Let it go. LET IT GO. Don’t make me sing that song from Frozen.

Holidays are supposed to be a time of joyful celebration with friends and family.  They can be the source of some of life’s most precious memories.  Holidays, like life, are what you make of them.  Everyone at INR (Institute for Natural Resources) joins me in wishing all of you a healthy, happy Hanukkah, Christmas, and New Year!

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.