Richard G. Petty, MD

Fatalism and Ethics

We are constantly inundated by reports of the consequences of bad decision-making, and that leads us to consider two issues: genetic determinism - the notion that our behavior is totally the result of our genes - and whether or not we have free will. This is a hugely important issue, not only for each of us personally, but also for our views about morality and the justice system. And what happens when everyone becomes convinced that they have no free will and that “they’re genes made them do it?”

We know from our own experience as well as empirical studies that changing a person’s sense of responsibility can change his or her behavior.

Interestingly, the link between fatalistic beliefs and unethical behavior seems never to been examined scientifically.

In two recent experiments published in the journal Psychological Science psychologists Kathleen Vohs of the University of Minnesota and Jonathan Schooler of the University of British Columbia decided to see if otherwise honest people would cheat and lie if their beliefs in free will were manipulated.

They gave college students a mathematics exam. The math problems appeared on a computer screen, and the subjects were told that a computer glitch would cause the answers to appear on the screen as well. They were told that to prevent the answers from appearing, the students had to hit the space bar as soon as the problems appeared.

This was a ruse: the researchers were observing to see if the participants surreptitiously used the answers instead of solving the problems honestly on their own. Before the test they used a well-established method to prime the subjects' beliefs regarding free will. Some of the students were told that science has disproven the notion of free will and that the illusion of free will was an artifact of brain activity. The other group where told nothing about free will.

The results were clear: those with weaker convictions about their power to control their own destiny were more likely to cheat when given the opportunity compared with those whose beliefs about controlling their own lives were left untouched.

The researchers then went a step further to see if they could get people to cheat with unmistakable intention and effort. The experimenters set up a different deception. This time they had the subjects take a very difficult cognitive test. Then they were asked to solve a series of problems without supervision and to score themselves. They also "rewarded" themselves $1 for each correct answer. To collect the cash they had to walk across the room and help themselves to money in a manila envelope.

The psychologists had previously primed the participants to have their beliefs in free will bolstered or reduced by having them read statements supporting a deterministic view of human behavior.

This study shows that those with a stronger belief in their own free will were less likely to steal money than were those with a weakened belief.

The results of this study indicate a significant value in believing that free will exists. The work also raises some significant questions about personal beliefs and personal behavior.

“The flame of Christian ethics is still our highest guide.”
--Sir Winston Churchill (English Statesman, British Prime Minister, 1940-1945 and 1951-1955, and, in 1953, Winner of the Nobel Prize in Literature, 1874-1965)

"You’re born with intelligence, but not with ethics.”
--Masad Ayoob (American Firearms and Self-defense Instructor and the Director of the Lethal Force Institute in Concord, New Hampshire, 1948-)

“Fatalism, whose solving word in all crises of behavior is "All striving is vain," will never reign supreme, for the impulse to take life strivingly is indestructible in the race. Moral creeds which speak to that impulse will be widely successful in spite of inconsistency, vagueness, and shadowy determination of expectancy. Man needs a rule for his will, and will invent one if one be not given him.”
--William James (American Psychologist and Philosopher, 1842-1910)

“To live lightheartedly but not recklessly; to be gay without being boisterous; to be courageous without being bold; to show trust and cheerful resignation without fatalism -this is the art of living.”
Jean de La Fontaine

“Custom has furnished the only basis which ethics have ever had.”
--Joseph Wood Krutch (American Naturalist, Writer and Critic, 1893-1970)

Violence and Diet

We have talked before about the link between nutrition and violence.

The evidence has continued to mount and I was pleased to see that the Wellcome Trust is funding trials in three British prisons to investigate the link between nutrition and behavior. This is a placebo study that will examine which nutrients are most important and at what dosage.

Volunteers from three young offenders institutions housing male prisoners aged 16 to 21 will take nutritional supplements in addition to their normal choice of food to ensure they receive the necessary vitamins, minerals and essential fatty acids to meet daily guidelines. The investigators will monitor how levels of nutrients affect a range of behaviors including violence, drug-related offences and incidents of self-harm.

The new trials build on previous research published in the British Journal of Psychiatry that was conducted at the then maximum security Young Offenders Institution in Aylesbury, Buckinghamshire. That study was funded by Natural Justice, a research charity that investigates the social and physical causes of offending behavior. Nutritional supplements  - 2 grams per day of the omega-3 fatty acids EPA and DHA for three months - were given to ensure that inmates' diets reached recommended UK dietary standards. The researchers found that the prisoners who consumed the active nutrient capsule committed on average 26% fewer disciplinary offenses overall than those taking the placebo and 37% fewer violent offenses.

The most likely reason why supplements can have such a large effect is because the proper functioning of nerve cell membranes and signaling molecules depends upon adequate amounts of minerals, vitamins and essential fatty acids in the diet.

This is extremely important work. Clearly nutrition is not the only driver of violence but it has been wondered for a long time whether the industrialization of our diets has contributed to the enormous rise in violent crime between the 1950s and 1970s.

“Violence is the last resort of the incompetent.”
Isaac Asimov (Russian-born American Biochemist and Writer, 1920-1992)

“Blessings crown the head of the righteous, but violence overwhelms the mouth of the wicked.”
--The Bible (Proverbs 10:6)

“Peace cannot be achieved through violence, it can only be attained through understanding.”
--Ralph Waldo Emerson (American Poet and Essayist, 1803-1882)

Antioxidants May Raise Cancer Risk?

Regular readers will know that I have for some years now been raising a red flag the wholesale promotion of antioxidants.

The trouble is this: antioxidants are supposed to help rid us of some of the free radicals that have been implicated in a small number of diseases, and may also play a role in some of the physical aspects of aging. However, free radicals are also some of the major cancer killers in the body, so eradicating them – even if it were possible – hardly seems like a good idea.

According to an analysis of a dozen studies including more than 100,000 patients in the Mayo Clinic Proceedings taking antioxidant supplements do not reduce cancer risk.

In fact smokers who take beta carotene supplements could be increasing their risk of smoking-related cancer and death.

Different antioxidants have different effects, and their effects may also vary depending on the part of the body involved.

The researchers looked at 12 trials that compared antioxidant supplements with placebo on cancer incidence and mortality. Antioxidant supplements did not reduce the risk of cancer. When they looked separately at beta carotene, they found the nutrient actually increased cancer risk by 10 percent among smokers. There was also a trend toward a greater risk of dying from cancer with beta carotene supplementation.

Selenium supplements reduced cancer risk by 23 percent among men, the researchers found, but had no effect on women. While vitamin E had no anti-cancer effect overall, supplementation with the nutrient was tied to a 13 percent lower prostate cancer risk.

A large study looking at vitamin E supplementation for prostate cancer is currently underway. While future studies of beta carotene and vitamin E for cancer prevention are very unlikely to show effectiveness, it would be worth doing further studies on selenium.

The moral of the story: we should be going for a balanced diet and a balanced life in general rather than putting our hopes in an over-simplified nutritional message.

A Shrine to Bobby

For people interested in the late Bobby Fischer, an enthusiast has put together every public video featuring or about Fischer.

A real labor of love, and there are many fascinating items there.

Bonnie D. Graham on WGBB Tonite

I have the privilege of being on Bonnie D. Graham on WGBB Tonite:

LISTEN LIVE TODAY 6PM-EST: www.am1240wgbb,com
Up Close & Personal with Bonnie D. Graham on WGBB Tonite – Featured guests:
6 PM: Richard Petty, MD, "Healing, Meaning and Purpose–The Magical Power of the Emerging Laws of Life" on journaling, integrated medicine, healthy aging & more. www.RichardGPettyMD.com

The second guest is:
6:30 PM: Masha Malka, "The One Minute Coach– Change Your Life One Minute At A Time" believes we are all potential geniuses capable of achieving success in all areas of life. www.MashaMalka.com

I have just reviewed Masha's most recent book on the Amazon website.

LISTEN to PODCASTS Anytime: www.BonnieRadioPodcasts.com
Digital media services: www.QBProductions.com
See you on the radio!.../bonnie

I shall let everyone know once we have the Podcasts prepared.

Bobby Fischer R.I.P.

News services round the world have been reporting the untimely death of Bobby Fischer, a.k.a. Robert James Fischer, the American-born chess genius.

Fischer’s match with Boris Spassky in 1972 had a huge influence on me, tempting me back to competitive chess, and over the years I studied most of his games in great detail. So I was definitely a fan.

But sadly much of the coverage has focused on some of the foul things that he said in his later years. It is particularly unfortunate because most of the reports failed to mention a number of other things about him.

I never met or examined Fischer and it is dangerous to diagnose people at long range. But there were multiple reports that made it very clear that he long ago crossed the line into mental illness.

He was always single-minded and cantankerous, and some of his allegations about cheating turned out to be correct. But when he began to believe that people could pick up or manipulate his thoughts through the fillings in his teeth, it was clear that something else was going wrong with him.

Some people have tried to link genius in chess and mental illness, but the link is at best tenuous, even though more than one very strong player has succumbed to mental illness. As we have discussed, there may be a link between creativity and schizotypal personality disorder, but the thing about chess is that high-level play requires enormous sustained concentration and motivation, to say nothing of the ability to withstand intensive mental stress. Thos are all things that become difficult as mental illness progresses.

One of the best ways of evaluating a culture is the way in which it treats its weakest members. So let us remember and celebrate Fischer’s genius and recognize that his later and ever darker life was driven by a terrible mental deterioration.

“The chessboard is the world, the pieces are the phenomena of the Universe, the rules of the game are what we call the laws of Nature. The player on the other side is hidden from us.”
--Thomas Henry Huxley (English Biologist and Educator, 1825-1895)

“Chess is the touchstone of intellect.”
--Johann Wolfgang von Goethe (German Poet, Playwright and Philosopher, 1749-1832)

Judah Folkman R.I.P.

I just heard that Judah Folkman just passed away at the age of 74. That is a name that is not widely known outside the scientific world, although a couple of years ago an excellent book –Dr. Folkman’s War - was written about him and his work.

His major work and his enduring legacy was in the field of angiogenesis: the production of new blood vessels. In the 1960s he came up with the idea that a way to kill tumors was to starve them of the blood supply that they need to survive. He was initially ridiculed, but history is now proving him correct. I got to know him twenty years ago after publishing a paper in which I described the discovery of a growth factor that is involved in the production of new blood vessels at the back of the eye in people with diabetes. Judah was very supportive and we had many good discussions about the potential role of angiogenesis not only in tumors and diabetic retinopathy, but also in diseases like rheumatoid arthritis and psoriasis.

Last November, at the 12th Annual Society for Neuro-Oncology Meeting in Dallas, researchers from the University of Virginia and several other leading brain tumor centers in the United States presented data on the successful use of an inhibitor of angiogenesis in the treatment of glioblastoma multiforme (GBM), the most common form of primary brain cancer. It is hard to treat, and if it recurred after surgery, radiation and/or chemotherapy there was often not much to be done.

Building on Judah’s work, they wanted to see if they could inhibit vascular endothelial growth factor (VEGF) that has an important role in the disease. VEGF fosters the growth of a tumor by stimulating the growth of new blood vessels to feed it. According to earlier studies, bevacizumab (BV) (Avastatin), a humanized monoclonal antibody that specifically targets VEGF, in combination with irinotecan (also called CPT-11) could have a role in recurrent glioblastoma multiforme. The researcher was an attempt to establish the clinical benefit of BV, both alone and in combination with CPT-11, in a multicenter, randomized phase II trial.

The results were very promising, substantially exceeded the pre-specified thresholds set for this work.

They looked at 6-month progression-free survival (PFS) defined as no clinical or MRI tumor growth and the objective response rate (ORR), which measures tumor shrinkage. Secondary endpoints included safety and survival. Response assessments were conducted by an independent radiographic facility that did not know which patients had been treated. All patients were followed for 24 weeks to determine efficacy and safety.

When taking BV, 35.6 percent of patients on average had a 6-month survival with no progression of their cancer, and an objective response rate of 21.2 percent on average.

The combination of BV and CPT was even more effective, with results of 51 percent and 34.1 percent, respectively.

The investigator group found similar results when they evaluated the patients. Those results showed that 44.7 percent of patients on average had a 6-month survival with no progression of their cancer, and an objective response rate of 38.8 percent on average. The combination therapy yielded results of 60.9 percent and 46.3 percent, respectively.

The surviving patients have remained in the study and are still being treated and followed, so we shall be seeing some longer-term results in the future.

In the United States bevacizumab has already been approved for the treatment of metastatic colon cancer and most forms of metastatic non-small cell lung cancer.

This is very encouraging research and a fitting tribute to a genuine medical pioneer.

Grapefruits, Medicines and Medical Correspondents

Mark Twain once said:
“Be careful of reading health books, you might die of a misprint.”

I was thinking about that as I was watching a TV show earlier.

I have spoken before about the frustration of many of us about the quality and accuracy of some media medical correspondents. Though every show has a disclaimer about the importance of discussing any issue with a health care provider, it is really unfortunate to present inaccurate data that could needlessly alarm people.

I will immediately put my hand up and say that I have done more than my share of media work, not just in the United States and Great Britain, but also in countries from Finland to Australia and twenty or thirty more in between. And I may well have misspoken at some time or other. Even the most well intentioned people sometimes make slips, and it is especially easy when you are in a studio and you know that the clock is counting down.

But that stress makes it all the more important to have accurate material prepared in advance so that slip-ups don’t happen.

Today’s piece was about a story that pink grapefruit may not interact with some medications. The correspondent rightly said that any type of grapefruit may interact with some medications, but then said that there was an interaction in the stomach. This is not correct and could be very confusing.

The issue is that grapefruit juice may induce the enzyme complex cytochrome P450 3A4 in the liver and intestine. So if you or a medication that is metabolized by the enzyme, grapefruit juice may lower the plasma level of the drug, making it less effective. This is another example of the importance of telling your health care provider about ANYTHING that you eat or drink, in addition to listing any herbs and supplements that you take.

Here is a list of some of the more common medicines metabolized by cytochrome P450 CYP3A4:

Alprazolam
Amiodarone
Amlodipine
Aripiprazole
Astemizole
Atorvastatin
Buspirone
Cafergot
Chlorpheniramine
Cimetidine
Cisapride
Clarithromycin
Cocaine
Codeine
Cyclosporine
Dapsone
Dexamethasone
Dextromethorphan
Diazepam
Diltiazem
Domperidone
Erythromycin
Estradiol
Felodipine
Fentanyl
Finasteride
Fluconazole
Fluvoxamine
Grapefruit juice
Faloperidol
Hydrocortisone
Iindinavir
Itraconazole
Ketoconazole
Lidocaine
Lovastatin
Methadone
Midazolam
Mifepristone
Nefazodone
Nifedipine
Nitrendipine
Norfluoxetine
Ondansetron
Pimozide
Progesterone
Propranolol
Quetiapine
Quinidine
Quinine
Risperidone
Ritonavir
Sildenafil
Simvastatin
Tacrolimus
Tamoxifen
Taxol
Telithromycin
Terfenadine
Testosterone
Trazodone
Triazolam
Verapamil
Vincristine
Ziprasidone
Zolpidem

Sir Richard Branson’s Integrated Health

Sir Richard Branson is a hugely popular British entrepreneur and adventurer who has been able to keep the common touch and does not seem to be as ruthless as some other self-made billionaires.

For more than three decades Richard has also shown that he has a remarkably good nose for identifying important and/or lucrative new trends. Like all people, he has made the occasional bad call, but his overall success rate is astonishing.

So I was extremely interested to see that Richard Branson’s Virgin Group has launched a foray into the British National Health Service (NHS) primary healthcare market and they are trying to persuade family doctors to join them in establishing a network of branded clinics.

It is particularly interesting that British government ministers are welcoming Virgin Healthcare’s decision to open the first of six “one-stop-shop” health centers later this year. The plan is to offer services from homeopathy to psychotherapy alongside typical primary care services.

This project has been two years in the planning and the group has just started its first advertising campaign to generate interest among family doctors who could join its health centers.

The business model allows family physicians to retain their existing contracts but Virgin would manage funds the doctors receive for staff costs and rental. Virgin would then offer a range of additional NHS and private services to visiting patients, including dentistry, screening, a pharmacy “and a range of conventional and complementary therapies.”

The British government has identified the importance of providing more and better primary care services and has £250m a year earmarked for the new services and Virgin wants to be a provider.

What is different is that Virgin Healthcare is proposing to work with primary care physicians to help develop more integrated, accessible and personalized services for patients and that they are quite prepared to consider providing less conventional therapies for which there is patient demand and/or empirical evidence.

That last piece – including less orthodox therapies – will inevitably put the cat amongst the pigeons, but Richard Branson and his advisers have correctly identified that there are some good reasons for including some of these therapies, even if the research base is not yet as good as we would like.

Writing and Rewriting Your Own Life Story

I had the privilege of being on the Donna Seebo show yesterday. And when I say that it was a privilege, it really was. It is not often that I find someone who so fully understands the power of an Integrated approach to health and medicine. Toward the end of the call an interesting question came up about the value of journal writing in healing. I am a firm believer in it, I recently reviewed a terrific book by Sheppard Kominars on the topic and I have published a reading list on Amazon.

There is some empirical research to show that journal writing can improve our physical and mental health (1, 2, 3, 4). Why should this be?

One of our most fundamental and enduring needs is to tell people our stories. And even more than that: to leave our stories as the records of our lives. Our stories define us. They are the vehicles of meaning and they serve as the narrative of our views about our world and ourselves. And our stories create our legacy. We all constantly tell stories that shape virtually every human activity from our emotions to our personal relationships and our politics.

It has clear evolutionary advantages to be able to tell good stories, not only for social cohesion, but also as a device to pass on wisdom. But perhaps most of all, storytelling is a device to help us make sense of the world about us.

Jerome Bruner has indicated that children acquire language in order to tell the stories that are already in them. We learn through story telling. The brain breaks down when we no longer manage to make sense of the world around us. Patients with schizophrenia seem to lose the ability to tell a coherent story about themselves or about the world around them.

I am reminded of the tragic letter written by Dimitri Koesnikov, the young Russian submariner on the Kursk who continued to write a letter to his wife, even when he knew that death was inevitable, or the passengers on the Japanese jet liner that crashed in 1985. As the plane went down, people were writing letters. Or people in the Warsaw ghetto who wrote letters and poems even when they knew that they only had minutes to live.

Writing our stories introduces another dynamic: most of us find that putting out thoughts and feelings down on paper helps to give us mental and emotional clarity. Writing helps us to express our individuality and to make connections with others.

Our memories are not just videos of our life events; they are dynamic and malleable and are constantly being edited. So we can change our stories, and with that, remove some of the restrictions that they have imposed upon us. This is not an invitation to enter into a fantasy world or to start lying to yourself or to other people, but is instead an incredibly valuable tool to clear some of the blocks I our lives.

It is a good practice to think through your stories every day. If you care to write about them, that is even better. We need to answer the question: “What are the stories that have defined who you are and how you act?”

When we think about our relationships, isn’t it true that the ones that matter the most and have the most emotional charge attached to them are those in which our stories are intertwined? How often have you met an old friend, after a gap of many years, and found that you no longer have much to talk about, because your stories have diverged so far? How many people maintain family relationships even when their respective stories have nothing in common? Maintaining a relationship out of duty is unfair and disingenuous. Either the stories need to be repaired, or the relationship is doomed.

As an exercise, I would like you to examine some of the dominant stories that have determined some of your personality and your character. And I would then like you to write a brief story about how you would like your life to be.

To help you get started, let me make some suggestions:

•    What is your favorite type of story?
•    What is the first story about your family that you remember hearing?
•    What are your favorite stories about yourself as a child?
•    What are your favorite stories about yourself as an adult?
•    Who are the key characters in your life story?
•    How many of the key characters know each other?
•    Does your life story have a plot line?
•    Could you create a better one?
•    What stories would you like others to tell about you?
•    How would you like your story to end?

I would love to have some feedback if you find this helpful.



“A man's mind is hidden in his writings; criticism brings it to light.”
--Solomon ben Yehuda ibn Gabirol (Spanish-Hebrew Poet, Neoplatonist Philosopher and Mystic, c.1021-c.1058)

“Writing is a form of therapy; how do all those who do not write, compose, or paint manage to escape the melancholia, the panic and fear which is inherent in the human condition?”
--Graham Greene (English Writer, 1904-1991)

Forgiveness and Health

The January issue of Mayo Clinic Women's HealthSource summarizes a substantial body of research indicating that forgiveness may be good for your health.

Holding a grudge appears to affect the cardiovascular and nervous systems (1, 2). In one study, people who focused on a personal grudge had elevated blood pressure and heart rates, as well as increased muscle tension and feelings of being less in control. When asked to imagine forgiving the person who had hurt them, the participants said they felt more positive and relaxed and thus, the changes dissipated. Other studies have shown that forgiveness has positive effects on psychological health, too.

Forgiveness does not mean forgetting, condoning or excusing whatever happened. It is instead a matter of acknowledging hurt and then letting it go, along with the burden of anger and resentment.

There is no single approach to learning how to forgive. Talking with a friend, therapist or adviser (spiritual or otherwise) may be helpful during the process, to sort through feelings and stay on track. The January issue of Mayo Clinic Women's HealthSource recommends four steps that are included in most approaches to learning forgiveness.

-- Acknowledge the pain and anger felt as a result of someone else's actions. For forgiveness to occur, the situation needs to be looked at honestly.

-- Recognize that healing requires change.

-- Find a new way to think about the person who caused the pain. What was happening in that person's life when the hurt occurred? Sometimes, the motivation or causes for the incident have little to do with those most affected. For some people, this step includes saying, "I forgive you."

-- Begin to experience the emotional relief that comes with forgiveness. It may include increased compassion for others who have experienced similar hurt.

“When we forgive, we free ourselves from the bitter ties that bind us to the one who hurt us.”
Claire Frazier-Yzaguirre (American Therapist and Christian Minister)

“Fear binds the world. Forgiveness sets it free.”
--A Course in Miracles (Book of Spiritual Principles Scribed by Dr. Helen Schucman between 1965 and 1975, and First Published in 1976)

“Forgiveness breaks the chain of causality because when someone forgives you - out of love - he takes on the consequences of what you have done. Forgiveness, therefore, always entails a sacrifice.”
--Dag Hammarskjöld (Swedish Statesman, Secretary-General of the United Nations from 1953-1961, and, in 1961, Winner of the Nobel Peace Prize, 1905-1961)

“Here is a mental treatment guaranteed to cure every ill to which flesh is heir: sit for half an hour every night and mentally forgive everyone against whom you have any ill will or antipathy.”
--Charles Fillmore (American Co-founder of Unity School of Christianity, 1854-1948)

“Forgiveness is the key to action and freedom.”
--Hannah Arendt (German-born American Political Philosopher, 1906-1975)

“Without forgiveness life is governed... by an endless cycle of resentment and retaliation.”
--Roberto Assagioli (Italian Psychiatrist, Theosophist and Founder of Psychosynthesis, 1888-1974)

“The weak can never forgive. Forgiveness is the attribute of the strong.”
--Mahatma Gandhi (Indian Nationalist and World Teacher, 1869-1948)

“Today I forgive all those who have ever offended me. I give my love to all thirsty hearts, both to those who love me and to those who do not love me.”
--Paramahansa Yogananda (Indian Spiritual Teacher and, in 1920, Founder of the Self-Realization Fellowship, 1893-1952)

“Judge not, and ye shall not be judged: condemn not, and ye shall not be condemned: forgive, and ye shall be forgiven.”
--The Bible (Luke 6:37)