Category: Health

The Fountain of Youth: We are all Ponce de Leon

medical-symbol1As a 12-year old Florida school boy, I was introduced early to the 16th century Spanish explorer Ponce de Leon, whom legend says came to Florida in quest of the Fountain of Youth.  Drink or bathe in its waters and you could be young again.  A story-line like this isn’t unique, finding its replay in myth and legend throughout the world. 

Its insistence  doesn’t surprise us at all, since it mirrors our consummate dream to stay young, not for its own sake, but because we associate youth with beauty, vigor, and libido, or from another angle, the absence of chronic ills like coronary disease, cancer, arthritis, and God only knows what, that often define our later years.  All the parts are new and they work well and at 25 we may sometimes think ourselves immortal.  We dream not just ordinary dreams, but visionary ones that say I can and I will.

Sooner or later, we are all Ponce de Leon, clutching to “the splendors in the grass” (Wordsworth).  Our ads promulgate our folly with promised effulgences of youth’s attributes, abolishing gray, dissolving winkles, restoring passion.

But even medicine itself increasingly wanders into the Ponce de Leon camp these days, some doctors proffering we may soon banish the ills of our human sojourn, advancing our life span dramatically into the 100 year range what with the promise of genetics making individualized therapies possible, perhaps a pill as it were targeting your specific ill, say cancer.

This is pretty much the message of Dr. David Agus’ fascinating The End of Illness, sort of what we do now at the car shop or electronics outlet, plugging into a computer that in seconds spits out solution.  He tells the story of 44-year old Bill Weir, host of ABC’s Nightline, who volunteered to go live, or cameras rolling in prime time, as the newest medical technology imputed his medical data at USC University Hospital.

It was the whole works, including not only blood tests and CT scans, but DNA analysis to assess his hereditary risk for illnesses such as heart disease, Alzheimer’s disease, colon cancer and about 32 other disease scenarios.  A CT uncovered substantial calcium build-up in Weir’s coronary arteries, narrowing his arteries and portending a possible heart attack in the next several years.  He had seemed a very healthy man until testing found him out.

The point is that we can increasingly predict and find impending diseases, and employing  intervention therapy, reduce if not eliminate, their threat.  Because of the high expense, sounds to me like you want to make sure you and your loved ones have the best possible medical coverage.  In the end, prevention may well be less costly than treating a patient with cancer, heart disease or diabetes.

Here I agree with those in Agus’ camp.  Take those prescribed pills, undergo the recommended testings, etc.  Consider pancreatic cancer, for example, a disease that takes no prisoners and recently killed actor Patrick Swayze, astronaut Sally Ride, and Apple’s Steve Jobs.  It’s an insidious illness that manifests its symptoms when it’s usually too late.  Still, you can undergo an annual complete abdominal ultrasound, MRI, or CT and gain a chance to nip the culprit in the bud.

But do I think medicine in the next 25 years will largely eliminate illness?  I will only say I think the jury’s still out on this one, though I’m doubtful. There is the expense; human inertia; new diseases in an increasingly global village appearing, impervious to our best antibiotics and the lengthy interval in developing new ones.  Even Agus contradicts his own optimism in predicting the inevitability of a pandemic:

The swine flu scare that occurred in 2009 will someday be dwarfed by a real epidemic that will spread rapidly through virgin immune systems and kill millions in its path (as happened, for example, in the flu epidemic of 1918, when an estimated 50 million to 100 million people died) (p. 277).

And I think the title of his book extravagant.  It may spawn sales, but little else, for fragile beings that we are, fraught with mortality, we share the fate of all living creatures, governed in the end by entropy.  We will never arrest illness completely, though we may at times lessen its impacting, and even its timing, by employing health enhancing strategies that will also lend quality to our lives.

At present, the American medical establishment is in breakdown mode.  While heart disease has shown a decrease, cancer continues to plague us.  Apart from disease, our doctors kill up to 200,000 patients yearly by way of medical mistakes; 50 million of us have no insurance; 25 million of us are underinsured.  Meanwhile, our unhealthy lifestyle continues to menace both our health and our wallets.  We have more diabetics than ever, for example.  Many of us are just plain fat.

I’d like to continue this subject in a later post and tell you things you can do specifically to help safeguard the health of yourself and loved ones, though I can’t promise you centenarian status.  Only 1 in 20,000 achieves that!

–rj

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Finding serenity

I mentioned in a recent post how I’ve been reading Natame Soseki’s The Gate. I’m nearing the end now and just came upon the protagonist, Sosuke, ruminating that “he must find a way to attain serenity in life, given his many troubles and high anxiety.”

Serenity, I had almost forgotten this word I used to bounce around in my thoughts like a rubber ball.  I think it a beautiful word, right up there with love, compassion, empathy, and the like.

But what is it really?

I’m not a religious person, but one of the best definitions comes from the Bible which speaks of “the peace that passes understanding.”

Similarly, theologian Richard Niebuhr said it exceptionally well in a prayer he devised that later became popular and is sometimes erroneously attributed to St. Francis of Assisi.

Its beginning goes like this:

God grant me the serenity
to accept the things I cannot change,
courage to change the things I can;
and wisdom to know the difference.

Alcoholics Anonymous has liked it so much that they recite it at the opening of their Twelve Step sessions.

Danger lurks, however, when we conflate serenity with passivity.  As the news media confirm daily, we live in a world of virtually palpable wrongdoing and robust evil, sometimes beyond words.   All good people must wage the fight, since indifference or passivity surely contributes to their dominion.

Serenity comes from accepting we may not realize our most ardent desires, even those bathed in love and compassion for those who suffer.  Paradoxically,  accepting our often ineffectuality makes room for serenity’s defining characteristic, transcendence.  I like how Bishop Desmond Tutu put it at a time of failing health:

I don’t think I’ve ever felt that same kind of peace, the kind of serenity that I felt after acknowledging that maybe I was going to die of this TB.

The way of serenity isn’t any sudden showering of the gods, for it necessitates self-emptying, or the surrendering of Ego that fosters our suffering with its myriad desires and its denial of our mortality.  Paradoxically, when we do so, it promotes our healing, or as Victor Frankyl expessed it, “The more one forgets himself–by giving himself to a cause to serve or another person to love–the more he actualizes himself.”

The good news is that we can cultivate serenity by pursuing several avenues that unlock bad habits, replacing them with alternatives promoting our well-being.  Here are some that help me:

Cognitive:  Change the way you respond to things that happen to you.  Do you act or react?  Why let someone’s curt remark destroy your day?  Are there positive alternatives to the negative way you’re interpreting things?  Negative thoughts produce emotional distress.  Pluck them by the root.

Music:  Shakespeare once famously said, “Music  hath charms to soothe a savage  breast.”  Avoid the frenetic.  Indulge the soothing.  Music reduces stress levels by 61%.

Exercise:   Physical activity relieves stress, besides being good for your health, giving you less to worry about.  You may want to add restorative yoga or Tai Chi, which have proven their worth over several millennia and are endorsesd by today’s medical community.

Interests:  Find something you like to do such as gardening, hiking, volunteering.

Friends:  Cultivate relationships with positive people.  Establish a support network.

Humor:   Laughter is its own medicine.  Research indicates it can promote blood flow, boost the immune system, and promote sound sleep.

Reading:  There are many fine reads out there written by experts on reducing stress.  Reading reduces stress by 68% according to cognitive neuropsychologist, Dr. David Lewis.  Reading works because it takes us out of ourselves which, of course, fosters serenity.

Eating:  Certain foods like blueberries, almonds, whole grains, and veggies can improve your mood and reduce stress.  You might like to peruse Elizabeth Somer’s thorough study, Food and Mood.

Organizing:  For some of us, including myself, neatness affords me a sense of being on top of things, and is thus its own tranquilizer.

Sleep:  Establish a regular schedule and keep to it.  Avoid stressful activities or exercise three hours before bedtime; same for intense mental activity.

Nature:  It isn’t accidental that nature inspires a lot of poetry or that many people opt for remote vacations away from our noisy world.  Nature enhances sensory awareness, and with it, provides relief from daily stress.  It’s as close as keeping a garden, taking a walk, and cutting the grass.  You can enhance your experience by learning the names of common trees, flowers and birds.  For me, it’s become synonymous with sanctuary.

Meditation:  I like this one best for its quick returns, especially mindfulness meditation.  (See my essay in Recent Posts, “Mindfuness and the recovery….”).  Breathing and focusing can produce immediate relief and the ability to let go of negative thoughts.  Combined with yoga or Tai Chi, you’ve a double whammy against anxiety.

In all honesty, I’ve not gotten there yet, but I’m trying, remembering that the longest journey begins with the first step.  Serenity comes down to doing what I can, subtracting the difference.

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Mindfulness and the recovery of compassion, empathy and joy

Nearly always I come upon new reads, not through lists but, unexpectedly, in the marketplace of life.  I like it this way–the surprise of it, the joy of discovery, the smack of fate rather than coincidence, like the chance finding of a new friend or bumping into wise counsel, unanticipated, in a corner; its aftermath of empowering, the mystery and the beauty of it.

It happened for me this way yesterday when I came upon Mark Williams and Danny Penman’s Mindfulness:  An Eight Week Plan for Finding Peace in a Frantic World.  Intuiting a must read, I immediately downloaded the kindle version, which also features several sound tracks for the exercises.

I’ve been suffering lately from a good deal of anxiety, largely because of health issues.  I’m not used to things being this way and my need to control makes matters worse.  The trick in life is learning how to cope with issues you can’t always resolve.  While I know the script in my head, it’s quite another thing to carry out.

I like this new way of finding yourself and the freedom it brings, not in resolving, but in coping.  Mindfulness actually isn’t new, but a bedrock of Buddhism.  What changes the scorecard for me, however, is the empirical yield of sophisticated brain-scanning methodologies affirming its effectiveness.  What’s more, it can alter brain patterns long term for the better.  Studies show it substantially reduces depression and its frequent return,  improves blood pressure, lessens chronic pain, and boosts the immune system.  In daily life, it promotes empathy, compassion and joy.

I’ve always had great respect for the potential of meditation to promote both physical and emotional wellness.  My mind, however, works like a metropolitan airport, the runways always full.  Mindfulness meditation may thus work better for me, as instead of eliminating your thoughts, you passively observe them in conjunction with focusing on breathing.  You learn that you are not your thoughts and that thoughts can come and go like black clouds in the sky.  This gives you power to catch wrong thinking or patterns before they impact, and it lends space to help you heal.

Mindfulness is all about bringing us to our senses, and by this, I mean the sensory repertoire of touch, taste, sight, smell and sound.  We take ourselves too seriously and in doing so lose direct contact with the cornucopia of life’s potential blessedness all around us when we subjugate the sensory to the taunt reins of the cerebral.

As Williams and Penman point out, we spend our lives “on automatic pilot,” creatures of habit, oblivious to the priorities that really matter.  Mindfulness takes us out of ourselves, giving us power to discern and thus choose.

I began the eight week course yesterday with the “raisin” exercise, a simple endeavor lasting several minutes that helps rekindle the sensory, noting things like weight, texture, taste, smell and tongue movement.  Once again, I rediscovered Flaubert’s maxim that  “anything looked at long enough becomes interesting.”

I hope this exercise is a harbinger of future benefits as it delivered me from my self-concern, channeling my focus on the here and now.  I thought of other raisins to be savored:  a hooting owl in dawn’s pink-fingered rays, a mountain brook bubbling its way, a child’s innocent giggle, the sweet smell of morning cinnamon toast, the spring rose’s first blush.

I thought of Helen Keller’s eloquent wisdom:

“I who am blind can give one hint to those who see: Use your eyes as if tomorrow you would be stricken blind.  Hear the music of voices, the song of a bird, the mighty strains of an orchestra, as if you would be stricken deaf tomorrow. Touch each object as if tomorrow your tactile sense would fail. Smell the perfume of flowers, taste with relish each morsel, as if tomorrow you could never smell and taste again. make the most of every sense.”

Selah!  I am at peace.

–rj

Further Reflections on the Mediterranean Diet Findings

Michael Milken
Michael Milken

There’s been a lot of euphoria, I think mistaken, over the recent research  findings evaluating the Mediterranean diet.  (See my earlier post, “On the New Mediterranean study:  Proceed with Caution” [March 1, 2013.])  Not only was the alternative low fat diet administered in pedestrian fashion,  e. g., inadequate counseling, but a substantial number of those on the Mediterranean diet suffered heart attacks or strokes.  We need to remember that none of the participants had a history of either at the outset of  the experiment.

But let me be fair.  We’re all different and there’s no plug-in diagnostic that’s going to yield a universal physical metric.  This applies to diet, surely, and explains the plethora of approaches which work for some, but not others.  What we do know is that following a diet that emphasizes complex carbohydrates, low sugar, minimal saturated fats, and plenty of nutrient dense fruits and vegetables along with reduced sodium intake is beneficial.

The Mediterranean diet thus moves in the right direction, but would be even more effective were it to reduce meat and dairy product content.  We might then see not only reduction in coronary disease, but its reversal, which truly low fat diets (10% consumption of total calories) have consistently demonstrated in extended government studies.

But let me bring up the Michael Milken story.  Do you remember him?  One of Wall Street’s top investors, he was indicted by the government in 1989 for racketeering and securities fraud and served 22 months in prison.  What followed is a story that moves us with its redemption.

Worse than prison, Mike was diagnosed in 1993 with Stage IV prostate cancer at just age 46.  Biopsy indicated it had metastasized and spread to his lymph nodes; consequently, his doctor advised that his scheduled prostatectomy wouldn’t save him.

Mike responded where others might have given-up, launching vigorous research, founding the CaP Cure foundation, and making major changes in his diet by adopting a nonfat, vegetarian regimen.  For Mike, a typical diet will feature mushroom barley soup, a tofu mock egg salad sandwich replete with tofu, carrots and lettuce, and a black bean and corn salad, accompanied by a soy drink.

Mike also founded and heads the Prostate foundation, working closely with Major League Baseball and matching every donated dollar.

It’s now 20-years since that fatal diagnosis.  Mike?  He’s still out there going strong and giving hope to thousands.

You’ll find many of Mike’s favorite low fat, soy-based foods, compiled with the aid of Beth Ginsberg, a grad of the Culinary Institute of America, gathered in The Taste for Living World Cookbook.  With its subtly delicious recipes, it’s a best buy.

Prescription malpractice: widespread and deadly

Good doctors are hard to find and when you’ve found one, you’re still not out of the woods, as even the better ones can often impose undesirable outcomes, especially when it comes to medications.  With IV drugs and the sensitivities involved, the mistakes can prove irreversible and even kill.  According to the Institute of Medicine, up to 5% of medications are faulty.  Each year, some 2000 die.

Frankly, you need to have your wits about you to intuit when to say no to your doctor’s prescription.  Despite the ritual of your supplying their office with your prescription and medical history, doctors rarely review your medications for potential interactions with the new prescription. They may also prescribe an excessive dosage or promote an antibiotic too often or for too long, or lack sensitivity to the special needs of the elderly patient.

You may rightly want to ask your doctor to review your present medications to filter out  potential interactions and side effects of your new prescription, only to be disappointed.  I asked my urologist about the side effects of her recent prescription, only to get a “You’ll have to check with your pharmacist,” this from a physician rated as a “best doctor” at her university online site who has presumably been prescribing this medication throughout her long career.

Just the other day, my GI prescribed librax to help relieve my occasional stomach cramps.  Lo and behold, it’s a benzo with a strong addictive history and you take it three times daily.  It’s also contraindicated, meaning don’t take it if you have BPH, which seems the ultimate fate of most of us men.  He’s a good doctor, but he didn’t get it right on this, simply because he prescribed, like most physicians, off the top of his head.

It makes me wonder, by the way, as to how many doctors stay tuned to the latest research.  I like Dr. David Agus’s own observation in his informative The End of Illness:  “I implore you to ask your doctor, How do you stay current?  Ideally, you want someone who stays up-to-date with the latest literature and technology.  Asking this question isn’t a threat . . . .Playing nice won’t result in you being treated better or your disease being diagnosed sooner.  Much to the contrary, playing too nice and not challenging your doctors when they need to be challenged can leave you in the dust—literally.”

While it’s true your pharmacy always gives you an FDA spec sheet with each of your prescriptions,  too few of us read the fine print.  This begs, the question anyway, since each of us is different and one person’s cup of tea is another’s poison.  Because pharmacies dispense only what a doctor prescribes, this means doctors need to scrutinize medications carefully to maximize healing and/or maintenance while minimizing side effects, some of which can prove profoundly dangerous.

Often there’s no right answer and there may even be several for what ails us.  This means you and I play a key role in researching creditable sources, many of them now available online.  I recommend the prestigious and objective Cochrane database as a best source (http://www.cochrane.org/about-us/evidence-based-health-care/webliography/databases).  Ask your self,  given my medical history and age, what new relevant studies have appeared?  I also recommend drugs.com for tracking drug interactions and, for just $15 a year, Best Pills, Worst Pills (http://www.worstpills.org/) for its no nonsense approach.

The bottom line is that drugs are latent with side effects and tradeoffs.  Should I take androgel for low testosterone to minimize osteoporosis and a hip fracture, knowing it may increase my risk for prostate cancer?

Aspirin has shown itself a potent cancer and heart disease preventative, but is it wise to take it if I have chronic gastritis?

All the more why you and your doctor, in tandem, need to exercise a thorough cautiousness in finding the best fit.  Just a short while ago, our health establishment gave a rich endorsement of the analgesic rofecoxib (Vioxx), which has now been found to double the risk of a heart attack.

If I were reduced to giving one maxim for medical safety, it would come down to this:  Be your own doctor first.

–rj

Additional:  See state seeks to suspend medical licenses following 12 deaths linked to doctors’ prescriptions

http://www.jconline.com/article/20130319/NEWS03/303190027/State-seeks-suspend-medical-licenses-following-12-deaths-linked-doctors-prescriptions

What if: Reducing chronic worry

We worry about a great many things:  How will my interview go? What will people think of me?  Will I pass the test?  How will I pay this bill?  Will I get the loan?  Do I have cancer?  When worry becomes chronic, it can be debilitating, souring our relationships, triggering illness, and fostering pessimism.

Worrying is always an exercise in control.  It prospers because it temporally gives us a fix, falsely giving us a sense we’re in charge, only to reach an inevitably higher threshold to keep our anxieties in check.

One lasting memory I have of my father was his spending long hours in his favorite chair looking out the window, deep in thought, most of it worry.  In doing so he lost a great deal of life’s joy.  It’s what worry does in overdrive. If he had been paid for every worry he’d have been very rich.

Worry is a bully you need to standup to, not indulge, to make it go away.

It’s also a habit and in this case, needs undoing, and like all bad habits, can be unlearned.

The good news is that its remedy may be less difficult than you may have expected, or a matter of getting a handle on it by changing the way you think about life’s inevitable stresses.

The vast majority of our worries fall into three categories, each with its own remedy:

1.    The unimportant:  So much of what we worry about turns out to be trivial if you apply the test of time.  You’re having trouble with a neighbor. That can be unpleasant. Or what about the deadline for getting that assignment done at work?  Or that you may not get that job or promotion you had your heart set on?  Or that Nancy or Bill may not return your affection?  For perspective, ask yourself what would something like this matter a hundred years from now?  

 2.   The unsolvable:   Common sense should tell us the futility of worrying about fixed verities like death and taxes that can’t be changed no matter how we try.  I know such things can be scary, but we lessen our anxiety when we accept life’s randomness and adopt coping strategies to keep ourselves reasonably safe, and pile-up while we can, the nows of life around us as in fostering good relationships, doing what we enjoy, and thinking positively.

3.   The uncertain:  This category may include what we worry about most.  Will I still have a job?  How can I pay my bills?  Is it cancer?  If we could predict the future, we’d invest wisely and profit immensely in the best stocks, bonds and real estate. But even here, the experts at this sort of thing often predict wrongly and fail miserably. The consolation is that most of the uncertainties we worry about never happen or that we”ve simply squeezed out alternative possibilities with one scenario conclusions, making ourselves miserable.  As Montaigne in his inveterate wisdom once put it, “My life has been full of miserable misfortunes, most of which never happened.”  The trick is to accept uncertainty by not reaching conclusions you’ve no way of knowing are inevitable. It’s always a good thing to question your assumptions and consider alternative outcomes.

Summary:  Worry has a positive role when it alerts us to take action as a preventative. It’s why we save for retirement, buy life and health insurance, limit our indebtedness, change our diet, etc.  It becomes a weight when we wake to it, carry it throughout the day, and take it to bed with us at night.  It can harm relationships and affect our physical and mental health.  Remembering the three primary worry types and putting their coping strategies into daily practice can help you retrieve the happiness you mislaid.

Be well,

rj

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On the new Mediterranean Diet Study: Proceed with Caution

I’ve been reading about the excitement in the medical community over the results of the first sustained clinical study of the effects of switching to the much touted Mediterranean diet for those at high risk for cardiac disease.  You can read the results in detail at the the New England Journal of Medicine website (NEJM.org).  You’ll recall that this diet abounds in olive oil, nuts, beans, vegetables and fish.  Whether participants took statins, were diabetic, or hypertensive, or overweight, the results across the board showed a 30% reduction in heart attacks, stroke, and death.

The study, encompassing 7,447 people in Spain, employed two diet regimens:  the Mediterranean and a low fat diet.  Up to now, evidence for the efficacy of the Mediterranean diet has been inconclusive, while the low fat approach hasn’t been shown to be effective in previous studies, primarily because many people find it hard to stay with.

Unfortunately, appearance, as in so many things, may not be the reality, given the human tendency, even in the sciences, to make unwarranted associations; for example, while the medical establishment has pummeled cholesterol as the primary villain in cardiac disease and urged us to cut down on organic meats, the truth is that only about 20% of our total cholesterol derives from our food.  That helps explain why nearly half of those suffering heart attacks have low LDL levels.  Inflammation, not cholesterol, is more likely a primary instigator.

While olive oil, a staple of the Mediterranean diet, is widely believed to reduce inflammation, thus promoting a healthy heart, it actually impairs endothelial function like most oils and should be avoided.  I have to scratch my head sometimes at the absurdity of health authorities telling us to reduce saturated fat foods, then waxing enthusiastic about olive oil, which is 14% saturated fat!  Ironically, canola and flax seed oil are better for you because of their greater omega-3 content, though still to be avoided.  (See Vogel RA. Corretti MC. Plotnick GD. The postprandial effect of components of the Mediterranean diet on endothelial function. Journal of the American  College of Cardiology. 36(5):1455-60, 2000 Nov 1).

Behind the diet’s success lies its plethora of vegetable, fish, whole grains and, yes, red wine.  In any event, the new research doesn’t halt or reverse heart disease because it doesn’t limit oils. On the other hand, low fat diets (10 % max) do succeed when consistently followed. The problem is getting people to stick with a sharply reduced fat diet ( i. e., vegan), an admitted weakness in the just concluded study. Not incidentally, those on the low fat diet were, for a time, not given the ample support those on the Mediterranean diet enjoyed, which in my view suggests bias or pedestrian methodology from the very outset.

What’s more, the study’s low fat group consumption was a mere 37%, and not the 10% of truly low fat diets shown to prevent and reverse heart disease. It should be noted, as well, that many of the study’s proponents have ties to food interests, including the Spanish government.

But let’s look at the facts about the original Lyon Heart Study (1995), which utilized the Mediterranean diet, specifically Cretan version, for its research findings, launching near universal medical endorsement along with a tsunami of new cookbooks. Mortality rates from heart disease declined by 70% among those on the Cretan diet vs those on a normally prescribed diet for reducing coronary risk.

In retrospect, the facts are that the Lyon diet actually reduced total fat consumption from the 40% in the Cretan diet to 30% and limited dairy intake and meats, while emphasizing salads, vegetables and grains.

But then why did the Cretans enjoy a lower mortality rate, considering their higher fat in-take?  For one thing, they still ate a largely plant diet and worked very hard.  For another, the study found that canola oil with its high omega-3 fatty acids was a significant  factor, not olive oil, which has a low omega-3 content.  Omega-3 fatty acids reduce inflammation whereas omega-6 fatty acids can increase it.

However, what the media ignores is that by the end of the Lyon Diet Heart Study, nearly four years after its start, fully 25% of the subjects on the Mediterranean Diet had either died or undergone a cardiovascular event.

If you’re like me, you’ve grown tired of medical flip-flops.  In some circles, physicians like Dr. Walter Willett at Harvard’s school of Public Health have been promoting unlimited quantities of so called “good fats.” The truth is that fats play a leading role in fostering heart disease through weight gain. Saturated fat can mount up and is especially dangerous.  Olive oil is rich in the latter.  The clincher for me, at least, is the Vogel study I alluded to earlier.

The bottom line, as in so many areas of life, is to be wary of new enthusiasms in medicine that have their vogue, only to fade quickly–in part, because they’ve often proven dangerous. The Mediterranean diet goes right in its emphasis on whole grains, vegetables, and omega-3 fatty acids.  It goes wrong when we misuse it to overeat or
overload with fats of any kind.

A low fat diet at 10% of total calories combined with unrefined foods and low glycemic load remains the pathway to optimal digestive and coronary health. When adhered to, its potential to reverse heart disease has been demonstrated consistently, something the Mediterranean diet per se cannot claim.

rj

Love as a many splendored thing

Recently one of America’s favorite singers, Rihanna, reconciled with her on and off again boyfriend, Chris Brown.  You’ll remember he had beaten her up several months earlier.

In a similar vein, about a year ago I got to know a girl in her early twenties who complained of her uneasy, abusive relationship with her boyfriend. While she didn’t tell us of any violence, she made it clear she was undergoing daily verbal abuse.  All of us, puzzled by the dynamics, wondered why she didn’t bang the door shut on the guy.

When it comes to this kind of thing,  I can be pretty sensitive.  My mother, after all,  endured an abusive relationship with my father across the years that sometimes included violence.

The poet Sylvia Plath, shortly before her suicide,  wrote famously of the masochism underlying such manacled couples as “a love of the rack and the screw.”  As a professor who taught this poem for many years, I take it she had in mind the role of culture in nurturing feminine subservience in a patriarchal world, the “for better or worse” syndrome of  the traditional marriage vow.   Women, however, were the only ones taking it seriously, as may still be the case.

But I think Plath’s conclusion errs in its reductionism.  In those days, few women had access to employment and thus independence.  And then there is evolution’s maternal instinct that still kicks-in, the children to be protected at all costs.

Today’s scene, however, is vastly different and still changing as women have secured options earlier women perhaps never thought about, since they were precluded possibilities.  And yet a good many women, and some men, still cling to demeaning liaisons.

The truth is that many relationships should never have had their genesis.   We live in a culture that dilutes love by conceiving it falsely, with our movies, harlequin novels, and music playing out the theme of lovers “as the luckiest people in the world.”

Romantic love, or ”being in love,” has a fixity about it, a must have it now and abundantly; a possessiveness centered in emotional absolutes.  Root bound, it cannot grow and lacks a future.   At best, it turns habit.

“Loving,”  on the other hand, is like a fine vintage that gets better with the years.  Here lies the advantage of postponing life choices until the grapes are ready.  I was raised in a world that told me that first love was true love.  This may be so for some, but I think not for many.

Unfortunately, a good many relationships pose a latent psychological component, or dread, that the late psychiatrist Reuven Bar-Levan nailed down persuasively when he wrote that “what holds people in destructive  and humiliating ’love’ relationships, and what makes them plead and even beg to be ’loved,’ is extreme fear of abandonment.  The force of this fear is so great that people degrade and humiliate themselves to avoid it”  (Thinking in the Shadow of Feelings, p. 145).

This dread, overwhelming and prevalent, primarily traces back to our parents and whether they succeeded in making ourselves feel lovable.  When missing, it pursues us, like a shadow, all of our life and through mistrust we prove quite capable of driving genuine love away in wanting rather than giving, demanding and not allowing.

Again, authentic love lacks stasis or rigidity.  As such, it maturates and transcends love’s vicissitudes because, with time, it grows in wisdom, acknowledging flux in all relationships, and allows even for exits, since loving abounds in the context of freedom, or ability to sometimes let go.  Genuine love has its ending ultimately in our mortality if from nothing else; but whatever its source, its loss results in sadness, not fear or anger.  Free from fear,  love thrives.

Removed from anxiety, love is, indeed, “a many splendored thing.”

Something worse than global warming?

We hear much about global warming these days, understandable given its smothering consequences for all life on earth.  Unfortunately, humans have at large remained callous to making lifestyle changes that may delay its full onset or lessen its consequences.  Recent research clearly indicts us as primary contributors to climate change in our dependency on fossil fuels.  Last year was the hottest on record.

Bad as the global warming scenario may be, I would argue we face a greater crisis elsewhere, simply because it’s happening right now and we’ve less than 20-years to find a solution.   I’m writing about the exponential increase in resistant microbes.  I don’t mean to push the panic button, but this isn’t a false alarm.

I wish things were otherwise, but an ostrich stance just won’t do.  Like many of you, I’ve read articles, even books, promising  not only the extinction of many of our primary diseases, but the near abolishment of death itself, or at least pervasive longevity.  This optimism, swelled by genetic research, hints at our finding targeted therapies that can prevent, modify, or eliminate diseases like cancer, diabetes, and dementia.  With dietary alterations, we may even speed the healing.

I’ve read recently that it’s essentially only 25-years and we’ll find medicine revolutionized.  Labs will diagnose your genomes and, like today’s culture specimens, suggest a solution.  No more fussing with finding the right medication and risking their frequent side effects.  We sometimes call it “metric” medicine, treatment individually tailored to get at or prevent what may ail you.

Unfortunately, this heaven-on-earth scenario isn’t likely to happen any time soon, given the inveterate increase of microbes resistant to antibiotics.  Again, its threat dwarfs the crisis of global warming.  As Professor Sally Davies, England’s chief medical officer, recently shared with parliament members, “It is clear that we might not ever see global warming; the apocalyptic scenario is that when I need a new hip in 20-years, I’ll die from a routine infection because we’ve run out of antibiotics” (“Antibiotic ‘Apocalypse’ Warning”).  www.bbc.co.uk).

By the way, think twice when it comes to a hospital stay.  Currently between 5 to 10 percent of patients develop an infection.  90,000 of them die, up from 13,300 just back in 1992 (www.medicine.net).  The cost impact of infections is enormous at $20 billion annually and eight million additional hospital days (Centers for Disease Control and Prevention [April 2011]).

Now the World Health Organization warns that we’ve reached a crucial point in the matter of resistant microbes.  Consider the present situation:

Presently we’re down to just two antibiotics for treating MRSA and one of these isn’t very good.  (MRSA now exceeds AIDS in annual U. S. mortality.)

With highly prevalent gonorrhea, we’re just about out of remedy.

And then there are candida, malaria, tuberculosis, staph and even UTI’s, all of them exhibiting increasing insensitivity to antibiotics.

Like global warming, we’ve done a lot of this to ourselves.

1.  Antibiotics are overly prescribed or treatment isn’t fully carried out.

2.  Hospital staff don’t consistently practice good hygiene.

3.  Cattle are fed antibiotics to inhibit disease and encourage growth.

4.  We’re destroying our rainforests, with their potential for new antibiotic substances.

5.  Ubiquitous use of antibacterial soaps and napkins, etc, increasing germ tolerance.

6.  Increased travel to underdeveloped countries, raising the possibility of Superbug contagion.

Matters aren’t helped by the scourge of HIV and TB raging across Africa, largely due to patient mismanagement of medications.  In India, currently, there’s a new Superbug that’s made its appearance, infecting even the water supply in Delhi. Compounding its threat is widespread travel these days, and the bug’s recent appearance in North America.  The sad fact is that exotic diseases are potentially only an air flight away.

This is always the ultimate threat–that somewhere, somehow, a new infection source will emerge for which we haven’t any remedy.  As Dr. Davis Agus reminds  us, even in the context of his best selling The End of Illness (2011) with its vibrant optimism, “The swine flu scare that occurred in 2009 will some day be dwarfed by a real epidemic that will spread rapidly through virgin immune systems and kill millions in its path (as happened, for example, in the flu pandemic of 1918, when an estimated 50 million to 100 million people died” (p. 277).

As I write, a new TB strain has made its appearance in Papua and like AIDS in Africa,  is badly managed.  Experts fear it may soon defy any cure.

Of course there are optimists who argue we’ll come up with treatment solutions.  We always have.

The reality is we’ve very little time and the research isn’t promising.  As Professor Hugh Pennington of the University of Aberdeen bluntly puts it, “We have to be aware that we aren’t going to have new wonder drugs coming along because there just aren’t any.”

The quest for individuation: a Jungian looks at Matthew Arnold’s “The Buried Life”

Intelligent Life, the free cultural news magazine of The Economist, recently featured a fascinating several day exploration of the labyrinthian stream flowing beneath Paris’ infrastructure with its scenarios ranging from party venues to ossuaries and catacombs.

In those outliers of thought that often follow a stimulus, I found myself musing a poem I had presumed I’d long ago relegated to absentia, seeing I retired from college teaching seven years ago.  But there it was, Matthew Arnold’s “The Buried Life,” in bold dress on my mental screen, refulgent in its own musings, pre-Freud, pre-Jung, cogently exploring in all its ebb and flow the subterranean river of the Unconscious that lies deep within all of us, frequently surfacing to veto or check our best intent with intuitive urgency.

Then I thought of  Jung’s concept of the Shadow, that primordial aspect of ourselves that can express itself suddenly, individually and collectively, when repressed or unintegrated into consciousness, disrupting relationships and even contributing to social disorder.  It isn’t evil in itself, or some kind of resident demon we try our best to confine.  The Shadow, no intrinsically Hyde element spotting the cultured Dr. Jekyll of the day world, has potentiality for making ourselves whole as we acknowledge undeveloped aspects of ourselves.

Arnold’s prescient poem acknowledges the Shadow’s salient wisdom in shaping our psyches, especially in regard to our inhibitions, though of course he comes too early (1822-1886) to use that term. On the surface, the poem muses on how even lovers sometimes paradoxically conceal themselves from each other, given the intransigent ego in all of us. Here, the poem begins its prison imagery, prominent throughout the poem.

      Alas! Is even love too weak to unlock the heart, and let it speak?
      even lovers powerless to reveal
      To one another what indeed they feel?

But the poem probes far deeper in exploring a resident conflict within ourselves arising from the tension between the Ego and the Unconscious, or Shadow element familiar to Jungians.

    Ah! well for us, if even we,
   Even for a moment, can get free
   Our heart, and have our lips unchained;
   For that which seals them hath been deep-ordained!

Arnold gives tribute to this dimension working its will in us, instinctually, covertly, as our true source of identity.  It works in stealth to keep us from tampering with its design to foster wholeness, for the human proclivity is to falsify true feelings in servility to convention:

    Fate, which foresaw
    How frivolous a baby man would be–
    By what distractions he would be possessed,
    How he would pour himself in every strife,
    And well-nigh change his own identity–
    That it might keep from his capricious play
    His genuine self, and force him to obey
    Even in his own despite his being’s law,
    Bade through the deep recesses of our breast
    The unregarded river of our life
    Pursue with indiscernible flow its way;
    And that we should not see
    The buried stream, and seem to be
    Eddying at large in blind uncertainty,
    Though driving on with it eternally.

This is hardly Freud’s dynamic of repression at work, but rather the Jungian perspective that each of us is actually two entities in antithesis.  The “unregarded river” can be thought of as our instinctual self, defiant of culture, and a legacy of our evolutionary past, the Shadow entity resident in us analogous to the dark side of the moon. 

Amid the often banality of our commercial world, we sometimes long for communion with this alter ego.  Adroitly, Arnold coalesces mining and river imagery here.  We yearn to track the line of ourselves, plumb to its depths, and extract its ore.  At this level, the poem anticipates Jung’s concept of “individuation,” or the quest for wholeness; a pilgrimage for conjunction of the Conscious and the Unconscious:

    But often, in the world’s most crowded streets,
    But often, in the din of strife,
    There rises an unspeakable desire
    After the knowledge of our buried life;
    A thirst to spend our fire and restless force
    In tracking out our True, original course;
    A longing to inquireInto the mystery of the heart which beats
    So wild, so deep in us–to know
    Whence our lives come and where they go. 

Alas, we never do succeed wholly, so deep is that hidden Self, and so we withdraw from the fray, giving ourselves up to distractions:

    But deep enough, alas! none ever mines
.……………….
    Hardly had skill to utter one of all
    The nameless feelings that course through our breast,
    But they course on forever unexpressed.
    And long we try in vain to speak and act
    Our hidden self, and what we say and do
    Is eloquent, is well–but ’tis not true!

But neither can we escape this longing within for something more:

    From the soul’s subterranean depth upborne
    As from an infinitely distant land,
    Come airs, and floating echoes, and convey
    A melancholy into all our day.

Sometimes, however, there occur those transient moments lovers experience, near mystical, when we intuit and achieve unity with our instinctual self, fathom all things about ourselves, and live genuinely with those we love:

    When our world-deafened ear
    Is by the tones of a loved voice caressed–
    A bolt is shot back somewhere in our breast,
    And a lost pulse of feeling stirs again.
    The eye sinks inward, and the heart lies plain,
    And what we mean, we say, and what we would, we know,
    A man becomes aware of his life’s flow,
    And hears its winding murmur; and he sees
    The meadows where it glides, the sun, the breeze.
    And there arrives a lull in the hot race
    Wherein he doth forever chase
    That flying and elusive shadow, rest.
    An air of coolness plays upon his face, and an unwonted calm pervades his breast.
    And then he thinks he knows
    The hills where his life rose, and the sea where it goes.

Some years ago, psychiatrist Reuven Bar-Levav cogently observed that “most people today are at least superficially aware of unconscious motives, but few realize how powerful and how prevalent they are.  Man is not what he claims to be” (Thinking in the Shadows, p. 19).  Arnold uncannily fathomed this in “The Buried Life” more than 150 years ago, anticipating depth psychology and Jung in particular.  Across the years,  I have always found this poem riveting for its profundity, beauty and sincerity.

I hope you will like this poem, too.

Do well.  Be well. 

–rj

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