Memorial Day, D-Day and Cicero

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

By Mary O’Brien, M.D.

Traffic Delays.  Slow Wi-Fi.  Dead phone batteries.  Forgetting a password.  Insufficient “likes.”  These are among the top stressors listed by millennials in a recent survey.  Contrast this with the real stresses endured by similarly aged men storming the beaches of Normandy in World War II and the absurdity of current culture becomes painful.

I’ve always been baffled by the number of people who confuse Memorial Day and Labor Day.  They’re not even embarrassed.  Ask nearly anyone much under the age of 50 what he knows about June 6, 1944, and prepare for a blank stare.  Twenty- and thirty-somethings may well scrunch up their faces in annoyed perplexity as only they can do.  People today lead frenetic, cluttered lives that leave little room for history.  But as Cicero wrote in 46 B.C., “To be ignorant of what occurred before you were born is to remain always a child.”

Memorial Day commemorates those who died in active military service.  Originally, it was called Decoration Day and was observed on May 30th.  Eventually, it was changed to the last Monday in May mostly as an excuse for another three-day holiday weekend.  This year Memorial Day falls on May 27th.  People will have barbecues, picnics, and parades. They will open neighborhood swimming pools and proclaim the unofficial start of summer.  A few thoughtful people will attend memorial services and place flowers on the graves of those who sacrificed all.  But millions will remain clueless as they consume hot dogs and beer.

This year, on June 6th, those of us fortunate enough to live in the free world will observe the 75th anniversary of D-Day (June 6, 1944).  The planning, hope, courage, determination, perseverance, and sacrifice of the Allied Forces on that momentous day cannot be overstated.  The unwavering commitment of thousands of men to stopping the onslaught of the Nazis despite the terror, horror, and agony of it all is beyond our grasp.  What those men endured makes our worries laughable.

The next time you find yourself upset by traffic delays, slow Wi-Fi, or a dead phone battery, remember Memorial Day, D-Day, and Cicero.  Some of us need to stop thinking like children.

A Heroine of the Highest Order

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

By Mary O’Brien, M.D.

Media reports described her as merely “an older woman.”  The implications are obvious.  “Older woman” translates into commonplace, generic, ordinary, and unimportant.  Nothing could have been further from the truth.  Lori Gilbert-Kaye was the 60-year-old lady who threw herself between the vicious 19-year-old gunman and the rabbi at the synagogue shooting in Poway, California.

Members of the congregation were observing the final day of Passover when they were attacked by unbridled evil.  Lori Gilbert-Kaye gave her life to save her rabbi. There is nothing commonplace, generic, ordinary, or unimportant about that.  Rabbi Goldstein described her valiant action at a deeply moving ceremony in the Rose Garden on the National Day of Prayer.  He lost several fingers in the horrific attack, but his wisdom, insight, courage, and compassion were only highlighted in the process.  He honored Lori Gilbert-Kaye in his brief but eloquent remarks.  A march in her honor is scheduled for early June.  No doubt many people will learn more about this kind, generous, devoted, and heroic “older woman.”

Is there something those of us in health care and education can learn from all of this?  Indeed, there is.  People have names.  They are not merely generic patients, students, or account numbers.  They are not simply old ladies or cases or room numbers.  Every human being has an identity, a personal story with challenges, heartaches, triumphs, and loved ones.  A woman who instinctively gave her own life to save another deserves to be known and remembered by her name.  Lori Gilbert-Kaye was heroic in life and in death.  She set a beautiful example for our nation.

Most of us will never have to make the split-second decision to sacrifice our own life to save that of another.  We do, however, have an opportunity everyday to honor others by using their proper names.  Lori Gilbert-Kaye was far more than an “older woman.”  She was a heroine of the highest order.

Guidance and A Good Example

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

By Mary O’Brien, M.D.

Do you teach students? Do you manage employees? Are you setting a good example for those who will come after you? Last week, I heard Jamie Dimon, the chief executive of J.P. Morgan, discuss the importance of cultivating a bench of good people from which the board of directors could select a worthy successor. A truly wise leader in any organization thinks like that. Of course, in order to think and plan on that level, one needs tremendous maturity, discipline, humility, and prudence.

Many people today are too insecure and self-obsessed to train their own replacements. They’re more worried about who might threaten their power and position. But history is a good teacher. Socrates trained Plato, and Plato trained Aristotle. Jesus picked 12 apostles and numerous disciples. Sir William Osler trained an elite cadre of young physicians to follow in his footsteps at Johns Hopkins.

Superior leaders surround themselves with first-rate people, and these leaders cultivate several key attributes and skills. Whether you are a senior partner, a professor, or a parent, here are some of the qualities that are essential to your ultimate success as you pass the baton:

  • A deeply ingrained sense of right and wrong. Many people focus on what they can get away with. Moral relativism is not the secret to greatness or even long-lasting success.
  • A willingness to accept personal responsibility for success or failure. Expressions like “It’s not my fault,” “It’s not my job,” do not make for an acceptable mindset.
  • The ability to speak and act with courage. This one is tough in the age of social media nonsense and nastiness. The vast majority of people in board rooms and conference halls are afraid of what someone might say, so they hide behind the commonplace and comfortable. There is no honor in cowardice.
  • The wisdom to encourage and inspire others. Mediocre-management types make excuses. Top notch people bring out the best in others. When you have a great parent, teacher, coach, or boss, you can’t bear the thought of disappointing your hero.
  • The capacity to engage in independent thought and creative problem solving. The world is full of lemmings, parrots, copycats, and complainers. It takes a secure, confident leader to inspire real leadership in others.

Whether you work in a huge medical center, a small office, a corner pharmacy, or at home, someone is looking to you for guidance and a good example. Don’t be afraid to set the bar high.

The Keto Craze

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

By Dr. Laura Pawlak

Unlike any time in history, Americans are faced with an obesity epidemic.  The sensible weight-loss guidelines of a mere decade ago appear to be failing.

“The best foods to eat on a diet?  The best foods to eat to keep weight off?  The same foods you should eat when you are not on a diet, but just less of them.”  Dr. Frank Sacks, Harvard School of Public Health, 2009.

The above statement was based on the study of 48 popular diets. All diets failed to produce significant differences in sustained weight loss.

Fast-tracking to 2019, the American diet has drifted far from the standard of what should be consumed. The foods we eat are primarily processed, containing almost 90 percent of the diet’s added sugar.  Also, these foods contain too much salt, very little fiber, and lots of saturated fats.  Eating less of these foods may result in weight loss, but the body and brain remain unhealthy.

When it comes to dieting, today’s fast-changing lifestyle demands novel, quick fixes.  The hype in the latest keto diet craze is infectious:  Fast weight loss without exercise;  novel tools to measure rising ketone levels;  easy-to-find processed keto foods; and keto pills when the diet is too tough to follow.

You eat lots of fat (at 80 percent of calories), moderate amounts of protein (at 20 percent), and very few plant foods, sugar, or starch (at 5 percent).  The excess intake of calories from fat triggers metabolic, nutritional, and hormonal changes not meant to be sustained for long periods of time.  Guidance by a registered dietitian is definitely recommended.

The Atkins program proposes a moderate approach to the keto craze:  A choice of 20 percent or 40 percent of the diet as carbohydrates for a limit of one month — and progression toward more plant foods.

If weight loss is achieved on a keto diet, a major challenge still remains:  The need to maintain your lower, healthy weight with a diet that offers protection against disease — not a keto plan.

A 25-year study evaluating healthful longevity and diet, published in 2018, identified the foods you should eat for a long, disease-free life:  Consume approximately 50 percent of your calories as carbohydrates, primarily as whole plant food; eat proteins, mainly from fish and plants; and add healthy oils from olives, avocados, nuts, and seeds.


Dr. Laura Pawlak (Ph.D., R.D. emerita) is a world-renowned 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.

Nuts About Nuts

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

By Dr. Laura Pawlak

Americans love nuts. Their passion has led to an increased consumption by almost 40 percent in the last 15 years.

Contrary to the belief that nuts are fattening, nuts are nutritious foods categorized as superfoods.  Nuts offer a wide variety of nutrients especially protective for the brain and cardiovascular system.

A trio of nutrients in nuts — healthy fat, fiber, and protein — make them a satisfying snack that won’t affect your waistline, assuming the portion size is a handful each day.  In fact, researchers at the Harvard School of Public Health found that regular nut consumption was associated with a slightly lower risk of weight gain and Type 2 Diabetes than a diet devoid of nuts.

A caveat is noteworthy:  If the nut is adulterated, i.e. honey glazed or chocolate coated, the word fattening would be an appropriate description of the nut.

Although nuts vary slightly in nutrient content, all varieties are beneficial. Almonds are especially high in fiber.  The macadamia nut has the most fat, mostly as monounsaturated oil.  Brazil nuts are famous for their selenium content. Pecans and hazelnuts are loaded with a variety of antioxidants.  Pistachios contain more potassium than a banana.  Cashews excel in the nutrient, lutein, a protectant for your eyes.  Walnuts provide anti-inflammatory fats similar to fish oil.

The peanut, really a legume, is a valuable addition to the nut family, offering more protein than any nut.  Ground into a nut butter, this spread is a tasty alternative to butter or margarine.

Before purchasing a peanut butter, read the label.  Unnecessary emulsifiers may be added to prevent the separation of oil.  There’s no need to purchase peanut butter with added sugar even if you have a sweet tooth.  Spread plain or crunchy peanut butter on slices of a crisp apple.  Your sweet tooth will be as satisfied as your gut.

Has your doctor asked you to lower your intake of sodium?  A few brands of peanut butter are just ground, unsalted peanuts.  Here’s a suggestion for adapting your taste buds to salt-free peanut butter:  Mix a small amount of unsalted peanut butter with the regular salted version.  Over time, increase the amount of the salt-free spread until you reach 100 percent.

In my opinion, the best-tasting peanut butter is freshly ground.  Grocery stores often place a grinder and containers next to the bulk peanut supply.  Enjoy!


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.

Pop Quiz!

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

By Mary O’Brien, M.D.

Quick!  What illness can cause fatal pneumonia, bacterial superinfection, meningitis, myelitis, encephalitis, acute thrombocytopenic purpura, transient hepatitis, or subacute sclerosing panencephalitis?  The answer is measles.  Each year nearly 20 million people are infected worldwide.  There are 200,000 deaths, most of which occur in children.  The anti-vaxxers are utterly unaware of these facts, but there has never been a shortage of ignorance in the world.

Measles is a highly contagious viral illness that typically strikes children. Unfortunately, more than 90 percent of susceptible people who are exposed will contract it.  Measles spreads mostly by aerosolized droplets from the nose, throat, and mouth during coughing.  The virus can survive airborne for two hours in closed areas like a classroom.  The vast majority of measles cases in the U.S. are transmitted by travelers and immigrants, with subsequent transmission to unvaccinated children and teens.

Measles has a 7 to 14-day incubation period.  The prodrome begins with fever, sneezing, watery eyes, conjunctivitis, and a hacking cough.  Koplik spots develop on the oral mucosa, opposite the first and second upper molars — before the rash develops.  Dental professionals take note.

A sore throat typically develops shortly before the rash, which is maculo-papular.  Macules erupt just in front of and below the ears, then migrate down the sides of the neck.  Papules begin to emerge as the rash spreads down to the trunk and extremities, including the palms and soles.

Peak severity is often marked by a fever above 40⁰C.  Many children have periorbital edema, photophobia, irritability, pruritis, and a hacking cough. These kids look and feel very sick for 3 to 5 days, at which point the fever subsides and the rash fades and desquamates.  Immunocompromised patients may be profoundly ill with severe, progressive pneumonia but no rash.

Mortality in measles is about 2 in 1000 cases in the U.S. and much higher in developing nations.  In the year 2000, measles was officially declared eradicated in the U.S. by virtue of the tremendously effective MMR (measles, mumps, rubella) vaccine.  Unfortunately, multiple outbreaks have recently occurred in California, Washington, Oregon, Utah, and New York.  Many outbreaks have been linked to unvaccinated children in Amish and Orthodox Jewish communities.  Currently, an outbreak of measles in Brooklyn, New York, has been declared.  There were 285 cases, a public health emergency.  Nationally, the figure stands at 465 cases documented in 15 states.

Scientific ignorance and paranoia on the part of some parents and stunning misinformation on the internet has led to clusters of unvaccinated children and rapid spread.  The original “study” claiming that vaccines cause autism was entirely fraudulent.  It involved 12 patients and was thoroughly debunked.  The author lost his medical license.  Legitimate studies of over two million children have demonstrated absolutely no relationship between vaccines and autism.  Autism has been linked to over 100 genetic mutations.  Many people today do not like to hear the word “genetic.”

A landmark study published several years ago in the New England Journal of Medicine revealed disrupted stratification of multiple cellular layers in the cerebral cortex early on in fetal development.  The stage for autism seems to be established before birth.

Making decisions based on misguided notions and emotions can be catastrophic.  Those of us in health care and education need to set the record straight.

Whoever Shouts The Loudest

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

By Mary O’Brien, M.D.

Can you tolerate watching “the news” these days?  If you’re much over the age of 40, you probably realize we scarcely have any real news programs left.  Nearly every option revolves around opinion, bias, personal and corporate agendas, and ridiculous panel discussions with people shouting over one another.

I’m willing to listen to almost anyone who can discuss the facts of a given topic in a cogent, logical manner.  Sadly, there isn’t much of that on TV or most other venues.  Somehow people have gotten the idea that whoever shouts the loudest or spews the most obnoxious sarcasm wins.

This is frustrating on TV, but it can be even more problematic at work or in social settings.  More and more people dread family gatherings for this very reason. Most of us are fond of work, family, and friends.  So with that in mind, here are a few tips on preserving such gatherings:

  • Be civil and never talk over another person. Remind yourself to disagree agreeably.
  • Always look for common ground. Most people want a safe, happy, healthy life for themselves and their loved ones.  Start with that assumption.
  • Pick your battles. If it won’t matter five years from now, it probably doesn’t matter much now.
  • Listen carefully and actively. Many people today don’t listen much at all, especially on TV.  They’re too busy planning their next snide, sarcastic retort.  Repeat what the other person has said and try to understand his or her perspective.
  • Remain calm. In a debate, the angry person almost always loses.  Very few people in our culture have ever taken a course in logic, ethics, or debate, and it shows.  Be the adult in the room.
  • Don’t aim to prove you’re right and the other person is wrong. Concentrate on the facts and explain them clearly.  Most arguments have nothing to do with facts.
  • Avoid making accusations. Insecure people become defensive very quickly.  Truly knowledgeable, accomplished, mature people have no need to be defensive or even bother with accusations.
  • Never use vulgar language or derogatory terms. Calling someone an idiot will not persuade him that your point is correct.
  • In a tense situation, let the other person blow off steam. A patient or family member receiving bad news can become emotionally volatile and angry.  Let him vent.
  • Watch your physiology. Aggressive body language and irritated facial expressions are usually the mark of an undisciplined individual.  Practice your best Mr. Spock imitation, especially when others are upset.

If you’re young enough and charming enough, and you master these principles, you just might get your own talk show on TV.  I’ll be rooting for you.

Lest Ye Be Judged

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

By Mary O’Brien, M.D.

It occurred to me the other day that I have a peculiar reason to appreciate “retirement.”  It has nothing to do with sleeping in a bit or taking an occasional nap.  It’s completely unrelated to dressing more casually or having a nice cup of tea whenever the mood strikes.  What I was truly enjoying was the notion I had been freed from the onerous task of evaluating other people.  But no!  Last week I had a Salvation Army pick up and the driver handed me an evaluation form.  I was supposed to rate the Salvation Army on promptness, friendliness, and efficiency — among other traits.  The Salvation Army!  I think we’re going overboard here.  I just wanted to donate some clothes.

No doubt anyone in healthcare, law, education, or business knows whereof I speak.  In fact, in recent decades this practice has reached ridiculous proportions.  Faculty evaluate residents who evaluate students who evaluate faculty.  Administrators evaluate managers who evaluate trainees who evaluate the whole system.  Every individual who speaks at a conference, seminar, or lecture is evaluated on everything from the tone of his (or her) voice to the title of his talk.  Filing cabinets and computer databases across America are bursting at their metal and electronic seams with evaluations.

The real question is:  Why do we need to judge one another?  I realize that some form of grading system is necessary through college and various training programs.  But over the past two decades we’ve gone far beyond grades.  We might have developed a national preoccupation with criticizing one another.  I genuinely enjoy giving people good evaluations.  But there are times when a negative evaluation is in order and, frankly, I’d just as soon undergo a root canal.  Every one of us has bad days, bad weeks, and sometimes even bad years.  Wouldn’t it be nice if we could be a bit more understanding?

The process of evaluation can be helpful when it’s geared toward encouragement, guidance, and improvement.  But when it reflects a harsh, critical spirit, nothing helpful happens.  Fighting the tide is not easy.  But I’d like to think that there’s hope.  A very wise man once said, “Judge not, lest ye be judged.”

I gave the Salvation Army people an “A.”

Some Timeless Investment Tips

Posted Posted in Continuing Education, Psychology, Seminars, Webinars

By Mary O’Brien, M.D.

It’s tax time again.  Those little pieces of paper that seem so important to the Internal Revenue Service are arriving in our mailboxes.  It’s a good time to review a few basic tips on money management and investing.  You know, the principles no one actually taught us during our many years of training to save lives.

What does money management or investing have to do with health care?  A lot. Financial worries, either personal or institutional, often compromise patient care.  People can act with “impure motives” if dollar signs cloud their thinking.  Everything we recommend to a patient, client, or student should be in his or her best interest.  Those of us in health care should keep our finances in order so that our motives are honorable.  Working with a fiduciary financial planner is similar.  Such a professional is obligated to do what’s best for his client, not himself or his company.

Keeping all of this in mind, there are some timeless investment tips that apply to almost all of us:

  • Saving and investing are different. Step 1 is to get out of debt. Step 2 is building up an emergency fund of at least three to six months of living expenses.  Then investing can begin.
  • Educate yourself and don’t invest in things that you don’t understand. In our culture you can earn an advanced degree and have no idea how to handle money. The first thing you have to invest is time.
  • Sign up for a 401(k) or 503B plan at work and fund it to the max. Investing each month (with money taken out of your paycheck before you see it) is the best path to security.
  • Watch out for management fees and fund expenses. There is a cost to investing, and awareness is key.
  • Take advantage of time and youth. Shocking numbers of people in their 20s, 30s, and 40s have no investments at all.  Modest, steady, monthly investments in your 20s and 30s can lead you to millionaire status in your 60s.
  • Whether you’ve been investing for six months or six decades, do not make decisions based on fear or greed. What separates most people from their money is emotional overreaction when markets tank.  Anyone who has worked in an ER (emergency room), OR (operating room), or ICU (intensive care unit) knows you cannot save a patient if you panic.  “Steady as she goes” sounds simple, but it’s tough when markets correct as they always do.  Stick it out.  The rebound always occurs.
  • Diversify investments and institutions. Depending on your stage in life, some mix of stocks, mutual funds, bonds, REITS (real estate investment trusts), and CDs (certificates of deposit) is prudent. Never put all of your eggs in one basket — or in one hen house.
  • Don’t fall for hot stock tips, free-dinner seminars, or charming financial sales people.
  • Don’t fuss or meddle too much. Some people cannot leave their investments alone. Occasional adjustments are warranted based on your personal situation and market conditions.  A giant oak will never reach its full potential if it’s transplanted every few months.
  • Be cautious and discipline yourself. People with significant financial assets often develop significant egos. Don’t let brokers take advantage of you by flattering your ego.  Remember the Bernie Madoff scandal.  Unscrupulous people can be master manipulators.

Some combination of hard work, discipline, prudence, and common sense helped you develop your career.  Those same principles can help you secure your financial future.

Don’t Do Anything Rash

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

By Mary  O’Brien, M.D.

Are you feeling upbeat and happy?  Have you looked at your end-of-the-year financial statements and credit card bills?  Most of us are feeling a bit tense and dismayed these days.  But take heart.  The markets have improved since Dec. 31, 2018 and your statements aren’t as bad as they look.

This is actually an excellent time to re-group financially and protect yourself from further chaos.  High frequency trading and complex algorithms contribute to frightening volatility on Wall Street.  A single comment from a government official can trigger 800-point swings on the Don Jones Industrial Average.

However, there are a few prudent principles that still work and may well save your sanity.

  • Get out of debt! This requires a daily commitment, but it’s worked in countless cultures for thousands of years.  Since financial security has a massive impact on health and emotional well-being, learning how to save money and reduce debt are crucial.
  • Don’t spend more than 25% of your monthly income on housing. No one “needs” or “deserves” top-of-the-line everything.  For 40 years, I’ve watched my fellow physicians fall into this trap.  And it is a trap.
  • Don’t even think of buying a house or condo if you can’t put at last 20 percent down. Aim for a 15-year mortgage.  It will not double your payments.  It makes no sense to end up house-poor because you’ve made a bank rich.
  • Stop buying or leasing new cars. Buy a used car or dealer-program car, take care of it, and drive it for 10 to 12 years.  I kept my last car for 22 years.  It was just fine.
  • Don’t be an impulse buyer. We can all live without much of what we have.  Consider the people who lived in Paradise, California, or the panhandle of Florida.
  • Don’t waste money on eating out or ordering restaurant food in until you’re completely debt free.
  • Stop wasting money on fancy coffee drinks and alcohol. Both your wallet and your waistline will benefit from these two steps alone.
  • Never buy anything to impress other people. If your friends are impressed by your Smartphone or your handbag, you need better friends.
  • Stop indulging yourself with excessive spending on hair, nails, facials, massages, etc. Many young women fall into this trap, especially if they pay attention to “beauty influencers” on social media.  You are capable of taking care of your own grooming.
  • Resist the temptation to go on vacations or indulge in entertainment until you have eliminated all debt. Millennials like spending money on “experiences.”  I recommend the experience of being debt-free.

Finally, use the money you save to build up an emergency fund of three to six months of living expenses.  Twelve months are better.  For most people, this should be at least $10,000.  Shocking numbers of people can’t afford to miss a single paycheck — just ask the folks affected by the partial government shutdown.

Next time, we’ll tackle some tips on investing wisely.  Until then, don’t do anything rash.