Richard G. Petty, MD

Medical Correspondents

When I am at home, I have a regular Sunday morning ritual: I watch the Fox News medical correspondent while working out. It’s a fair bet that every week he will make at least one major howler that is guaranteed to increase the amount that I can bench press by 50%!

I don’t personally know the Sunday Fox medical correspondent, and he seems a nice fellow. But why oh why doesn’t he do his research before going on the air?

A few weeks ago he was endorsing “Wilson’s syndrome” that was created by E. Denis Wilson, M.D., who practiced in Florida in the early 1990s. The syndrome's supposed manifestations include a rag bag of fatigue, headaches, PMS, hair loss, irritability, fluid retention, depression, decreased memory, low sex drive, unhealthy nails, easy and excessive weight gain, and about 60 other symptoms. Wilson claimed to have discovered a type of abnormally low thyroid function in which routine blood tests of thyroid are often normal. He claimed that the main diagnostic sign is a low body temperature that is on average below 98.6° F and that the diagnosis could be confirmed if the patient responds to treatment with a "special thyroid hormone treatment." The American Thyroid Association published a position paper about this syndrome, saying that it probably does not exist. People have paid good money to be tested and treated, and though some may have benefited, most probably have not.

It is very easy to check these facts. So why didn’t the Fox medical correspondent do so?

Then a couple of weeks ago he talked about an herbal preparation without once mentioning that the FDA had just issued a warning about potential liver toxicity.

Then today he starts discussing a preparation called Airborne, that is purported to help prevent colds. It may or may not do so. The FDA has not evaluated the claims. The problem was that the correspondent then said that it could do no harm. Yet that is quite wrong. Though I could find no published cases of harm, the possibility most certainly exist, and the public needs to be made aware of the reasons to be a bit cautious:

1. It contains 5,000 IUs of vitamin A. If you take it every three hours as recommended, some people could overdose on it.
2. The same with vitamin C. If you take a lot, most is quickly passed out in the urine. But some people can get bladder irritation and could conceivably get kidney stones from taking that amount over a period of time.
3. The remedy also contains seven herbs: Lonicera, Forsythia, Schizonepeta, Ginger, Chinese Vitex, Isatis Root, Echinacea. In a couple of hours I did a literature review looking at potential toxicity of these compounds. They all look fairly benign, but there are scattered reports of side effects with a couple of them.
   
4. The difficulty is that side effects can be cumulative if several herbs and supplements are taken at the same time.

I have nothing at all against the Sunday Fox Medical Correspondent: he seems an affable and quite knowledgeable fellow. Neither do I have anything against Airborne. If it helps people, all well and good.

The trouble is that we have had at least three occasions in the last couple of months where advice has been given that had clearly not been checked. I think that unfortunate. Before I post any article I spend hours checking and re-checking. Even with all that checking, I’m quite sure that something could slip through, and if an error occurs, I shall be delighted if someone picks it up, so that I can correct it.

I only wish that everyone who writes or speaks about things medical would do the same kind of obsessive checking.

I really do believe that readers, listeners and watchers deserve nothing less.

The Parachute Approach to Evidence

Almost three years ago, one of the British Medical Journal – one of the top rated medical journals in the world - published an amusing article with an extremely serious sting in the tail. The article, entitled "Parachute use to prevent death and major trauma due to gravitational challenge," highlighted some of the absurdity surrounding the constant demand for scientific validation using only one set of criteria.

The authors pointed out that - as with many interventions intended to prevent ill health - there had been no randomized controlled trials of parachutes in preventing the major trauma that may be caused by gravity!! Yet we would hope that nobody would consider exiting a plane in flight without first equipping himself or herself with a parachute.

Advocates of evidence-based medicine have criticized the adoption of interventions that have only been evaluated by using observational data.

The authors therefore said that, “We think that everyone might benefit if the most radical protagonists of evidence based medicine organized and participated in a double blind, randomized, placebo controlled, crossover trial of the parachute.”

They used the lack of randomized controlled trials in testing parachutes to show that situations still exist where such trials are not only unnecessary, but also dangerous.

Anyone who has spent 30 seconds on this blog knows that I’m firmly committed to the rational analysis of data. But I am just as certain that there are many valid types of evidence.

There is an important article in this week’s issue of the British Medical Journal that lies at the heart of Integrated Medicine, and the research that we’ve been facilitating. The article suggests that waiting for the results of randomized trials of public health interventions can cost hundreds of lives, especially in poor countries with great need and potential to benefit. If the science is good, we should act before the trials are done.

The article argues that the “parachute approach,” where practice and policies are based on good science but without randomized trials, is often more suitable in resource poor settings. They go on to consider three areas of critical importance, in which there are real ethical, moral and logistical problems if we wait for the results of randomized controlled trials.

They use the three examples of:

1. Oral rehydration therapy
2. Male circumcision to prevent HIV infection
3. Misoprostol for postpartum hemorrhage

We have constantly run into the same kinds of problems with alternative, complementary and now Integrated Medicine. In most of theses fields there is precious little in the way of randomized controlled trials, but a wealth of clinical reports and case series. The problem with unorthodox medicine is that much of it does not fulfill one of the criteria for the parachute approach: to be “based on good science.” This is one of the reasons for expending so much energy on finding common ground between conventional and Integrated Medicine, and for investigating several advances in the basic sciences that may help us square the circle.

It is also why we have adopted a second criterion: the potential for a therapy to do harm. Clearly the level of evidence for risk and benefit is quite different for a potentially risky surgical procedure, compared with, say, crystal therapy. The biggest risk with crystal therapy is that it might get used inappropriately in place of a treatment that has been shown to work.

But above all else, when we are dealing with sick and suffering people, we have to take action. Safe action, action that has a good chance of helping, and action that is fully explained to the individual. Honestly and straightforwardly, and without false optimism.

“A man's best friends are his ten fingers.”--Robert Collier (American Writer and Publisher, 1885-1950)

The Author Revealed!

I’ve had a great many very kind comments about this blog. So to all the people who’ve said nice things, “Thank you!” And for all the people who’ve wanted to discuss, debate, criticize and clarify, I thank you too: that’s the way that we’re going to move forward and create a more comprehensive science-based approach to personal growth, health and wellness.

I’m also constantly asked who writes all these blog items, the podcasts, the articles and the book reviews at Amazon? It can’t be one person can it? Well, it actually is all one person: C'est moi, a.k.a. RP.

So I take full responsibility for everything that I write. And, of course, any errors of omission or commission are my own.

Though I try exceptionally hard to ensure that all the entries are as accurate as I can make them. That being said, I also give you follow up resources and things like the Healia.com search box so that you can check on what I say. I want to guide, educate, help and support you, so that you can make you own decisions. And if you are working with someone else, then I would like your next meeting with your health care provider to be even better informed.

This weekend I was horrified to hear a fairly well known doctor give a very glib and somewhat inaccurate summary of a new medicine that's just just been given "approvable" status by the US Food and Drug Administration.

Several people challenged his evaluation: “Where did you get that from?” they asked. “The Wall Street Journal,” was the response. Now I like and respect the WSJ, and the doctor was, in fact, misquoting the article. But that’s not the point: nobody who has responsibility for providing medical care or advice should be doing it without carefully reviewing the evidence. What we call examining the “Primary sources.”

An important study was published a year ago, and we saw an extraordinary spectacle: some doctors and psychologists began making statements about how patients should be treated, and about how healthcare policies should be changed. Based not upon the evidence, but on newspaper reports of the evidence. In the end, the National Institute of Mental Health issued a press release to clarify what the study did and did not say.

On the topic of evidence and primary sources, let me turn to one of the other pieces to our work, and that is self-help.

There are many people in the self-help movement who have revolutionized the lives of millions. But there are some others who have not.

The days of people being able to get away with telling others how to live their lives or how to achieve health or success, based only on their personal opinions, rather than on something tangible, are finally coming to an end.

When a self-help guru says, “If I can do it anyone can,” they are just plain wrong. They are dismissing so many factors in a person’s life and then claiming that one size fits all. It’s so sad that many people who have failed to fulfill all these gurus' proclamations and promises blame themselves rather than the bad advice. And as a result some end up being much worse off, for they feel that they have failed.

I have seen countless people racked by guilt because they had bought into the idea that all illness is self-created. I recently read something outrageous: that all depression is caused by unexpressed anger. So according to this nonsense, if you stop being angry, you'll stop being depressed.

I have no idea where the writer got this from, and of course, sometimes a person's depression can be traced back to anger about trauma, abuse or a failed relationship. But as a generalization it's utter bovine excreta. I've seen people attempt to kill themselves because of profound depression, and it most assuredly had nothing to do with unexpressed anger!

Attitudes and emotions can have a huge impact on health, but people certainly don't need to be made to feel guilty because they are ill!

This website and blog and the many others that I highlight are quickly transforming the world of self-help, health and wellness from hyperbole and opinion to an empirical science. Naturally enough, there are people with vested interests who want to keep things as they are, but they are like King Canute whose courtiers believed that he could turn back the tide!

With your help, I’m going to continue to do this work, and I would like to thank all the people around the world who are already helping us to introduce, what a great Sage has called:

"The Prophecy of a New Dawn in Health and Healing."

Nobel Prizes 2006

This is always an exciting week for anyone interested in science, the arts or the future of humanity.

Every year, the first week of October is the time when the Nobel Prizes are announced. Many of us have our short lists of people we think SHOULD get the Prizes, and it's always interesting to see who does. I also have to admit to a personal interest: I have several friends and colleagues who are in the running, so I've got some fingers and toes crossed for them.

Last year the Prize in Physiology or Medicine went to the discoverers of Helicobacter. Their discovery has lead medicine to reconsider just how many illnesses might be caused by infections in combination with genes, stress and environmental factors. In one moment we moved from blaming a whole group of illnesses on bad behavior to bad bugs.

I just got a little flash on my screen to tell me that this year's Nobel Prize in Physiology or Medicine has been awarded.

At the risk of sound like an announcer at the Oscars, the 2006 Prize has gone to Andrew Fire from Stanford and Craig Mello from the University of Massachusetts Medical School.

Their work on RNA interference has been receiving massive plaudits amongst biochemists for the eight years since it was discovered. It is doubly remarkable that the Prize has come so soon after the first publication: that is very rare. It is a fundamental mechanism by which genes are regulated in the body, and we believe that the discovery has the potential to allow us to switch off harmful genes. The discovery also allowed us to systematically test the functions of all human genes.

When I have talked about mechanisms by which environmental factors and even thoughts and emotions can change gene expression, it was driven in part by an understanding of some of this work.

Let me add my warmest congratulations to their magificent achievement!

Reversing the Irreversible

When I am analyzing current medical research for you, I focus on findings that are relevant to our underlying theme of Integrated Medicine.

One of the most important of all is the evidence for “spontaneous” remissions of otherwise fatal illnesses, and the reversal of diseases that are usually thought of as irreversible. It is exciting when we can show that arteriosclerosis and some neurological disease may be reversible, though most physicians still do not know that good news.

Two years ago I was asked to comment on a remarkable clinical problem. A 28-year old woman had seen a neurologist about some odd symptoms, which included quite severe visual disturbances. On MRI and electrical she had clear evidence of demyelination, the hallmark of multiple sclerosis. All of which has resolved after just one month of complete withdrawal from her diet of the sweetener aspartame. Multiple sclerosis is a disease that comes and goes, but the point of this case is that there was clear evidence that it went away completely. The neurological lesions in the brain that should have stayed forever, just melted away. I’ve looked at thousands of brain scans and this is extraordinary. And clinically the young woman is just fine.

Cases like this must be very rare: the FDA has determined that aspartame is safe, though on a future occasion I’ll say a bit more about the pros and cons of sweeteners. Discussions about artificial sweeteners usually generate more heat than light, but there is a lot of very helpful data to guide us.

Now let’s look at another condition that is supposed to be irreversible: cirrhosis of the liver. The liver is a remarkable organ. It has almost unique regenerative abilities. I’ve often wondered if the Ancient Greeks somehow knew about that remarkable attribute of our largest solid organ. When Prometheus was chained to a rock, an eagle came every day to eat his liver, which had re-grown by the next day.

The trouble is that if the liver keeps getting damaged and trying to re-grow, it produces a lot of fibrous scarring, the hallmark of cirrhosis. For more than a century, every expert has said that this fibrosis is irreversible. Now some first class research has shown that it isn’t true. An inexpensive medicine can reverse the fibrous changes in the liver.

The medicine is called sulfasalazine (sulphasalazine in the UK) that is normally used for treating inflammatory bowel diseases and some kinds of inflammatory arthritis. A team of scientists lead by Professor Derek Mann has recently moved from Southampton to Newcastle University has made a series of ground breaking discoveries. One of the most exciting is that sulfasalazine can reverse fibrosis in the liver.

The results were published in the journal Gastroenterology. A second and third papers published in Apoptosis, that describe the - then - Southampton group's collaboration with chemists and oncologists to produce novel and more effective derivatives of sulphasalazine.

The researchers believe that, subject to further research and clinical trials, sulfasalazine could potentially be used to treat types of chronic liver disease – like cirrhosis – that are currently considered untreatable. Sadly because of greater alcohol consumption, especially binge-drinking, and obesity, liver disease is rising dramatically.

And if a simple medicine can reverse something previously believed to be irreversible, the final question that we have to ask is whether other the non-invasive methods may also help? Since most of the non-invasive methods work at deeper and more subtle levels of the organism, the answer to that one is, “Highly likely.” But it is going to have to be tested scientifically, just as every other hypothesis has to be tested.

Remembering Mahatma Gandhi

On this day in 1869, in the town of Porbandar, Gujurat State, India, a child named Mohandas Karamchand Gandhi was born. His life has been written about in hundreds of books and articles, and nobody can deny that he, and his non-violent resistance, changed the world in the most extraordinary way.

Yet we all still have much more to learn about what he tried to teach.

Starting life as an English-trained lawyer, he read widely, drawing inspiration from such sources as the Bhagavad-Gita, John Ruskin, Leo Tolstoy, Ralph Waldo Emerson, and Henry David Thoreau, and his personal philosophy underwent significant changes.

It was not until later in life that he became known as "Mahatma," or Great Soul.

Not only did he leave a profound political and philosophical legacy, but he left us an extraordinary number of sayings and quotations. Here are a few of of my favorites.

 

_________________________

“A "No" uttered from deepest conviction is better and greater than a "Yes" merely uttered to please, or what is worse, to avoid trouble.”

“A coward is incapable of exhibiting love, it is the prerogative of the brave”

“A faith gained in strength only when people were willing to lay down their lives for it.”

“A genuine fast cleanses the body, mind, and soul. It crucifies the flesh and to that extent sets the soul free.”

“A life of sacrifice is the pinnacle of art, and is full of true joy.”

“A living faith cannot be manufactured by the rule of majority.”

“A vow is fixed and unalterable determination to do a thing, when such a determination is related to something noble which can only uplift the man who makes the resolve.”

“Action alone is just that does not harm either party to a dispute.”

“Adaptability is not imitation. It means power of resistance and assimilation."

“An eye for an eye will only serve to make the whole world blind”

“Anger and intolerance are the enemies of correct understanding”

“Be the change you want to see in the world.”

“Both heaven and hell are within us.”

“Earth provides enough to satisfy every man's need, but not every man's greed.”

“Forgiveness is the attribute of the strong”

“Freedom is not worth having if it does not connote freedom to err.”

“God alone is the judge of true greatness because he knows men’s hearts.”

“God answers prayer in His own way, not ours.”

“God forbid that India should ever take to industrialism after the manner of the west... keeping the world in chains.  If [our nation] took to similar economic exploitation, it would strip the world bare like locusts.” 

“God is not a person...God is the force. He is the essence of life. He is pure and undefiled consciousness. He is eternal. And yet, strangely enough, all are not able to derive either benefit from or shelter in the all-pervading living presence.”

“God turns his back on those who quarrel amongst themselves.”

“Happiness is when what you think, what you say, and what you do are in harmony.”

“How can I, who knows the body to be perishable and the soul to be imperishable, mourn over the separation of body from soul?”

“Human life is a series of compromises, and it is not always easy to achieve in practice what one has found to be true in theory.”

“I am painfully conscious of my imperfections, and therein lies all the strength I possess, because it is a rare thing for a man to know his own limitations.”

“I am part and parcel of the whole and cannot find God apart from the rest of humanity.”

“I am prepared to die, but there is no cause for which I am prepared to kill.” 

“I believe in what Max Muller said years ago, namely, that truth needed to be repeated as long as there were men who disbelieved it.”

“I believe that the sum total of the energy of mankind is not to bring us down but to lift us up, and that is the result of the definite, if unconscious, working of the law of love. The fact that mankind persists shows that the cohesive force is greater than the disruptive force, centripetal force greater than centrifugal.”

“I claim to be no more than an average person with less than average ability. I have not the shadow of doubt that any man or woman can achieve what I have, if he or she would make the same effort and cultivate the same hope and faith.”

“I do feel that spiritual progress does demand, at some stage, that we should cease to kill our fellow creatures for the satisfaction of our bodily wants.”

“I first learned the concepts of non-violence in my marriage.”

“I have also seen children successfully surmounting the effects of an evil inheritance. That is due to purity being an inherent attribute of the soul.”

“I have found that life persists in the midst of destruction, and therefore there must be a higher law than that of destruction.”

“I have learned through bitter experience the one supreme lesson to conserve my anger, and as heat conserved is transmitted into energy, even so our anger controlled can be transmitted into a power that can move the world.”

“I hope there is no pride in me. I feel I recognize fully my weakness. But my faith in God and His strength and love is unshakable. I am like clay in the Potter's hands. I shall continue to confess blunders each time the people commit them. The only tyrant I accept in this world is the 'still small voice' within me. And even though I have to face the prospect of a minority of one, I humbly believe I have the courage to be in such a hopeless minority. I believe in the supreme power of God. I believe in Truth and, therefore, I have no doubt in the future of this country or the future of humanity.”

“I implicitly believe in the truth of the saying that not a blade of grass moves but by His will. He will save it (my life) if He needs it for further service in this body. None can save it against His will.”

“I know of your capacity to do great things, but I have yet to discover your capacity to do little things.”

“I own no enemy on earth. That is my creed.”

“I suppose leadership at one time meant muscles; but today it means getting along with people.”

“If I had no sense of humor, I would long ago have committed suicide.”

“If we reach the heart of our own religion, we also reach the heart of other religions.”

“If your heart acquires strength, you will be able to remove blemishes from others without thinking evil of them.”

“In doing something, do it with love or never do it at all”

“In matters of conscience, the law of majority has no place.”

“In the attitude of silence the soul finds the path in an clearer light, and what is elusive and deceptive resolves itself into crystal clearness. Our life is a long and arduous quest after Truth.”

“. . . in the midst of death life persists . . .”

“In this age of the rule of brute force, it is almost impossible for anyone to believe that any one else could possibly reject the law of the final supremacy of brute force.”

“Indolence is a delightful but distressing state; we must be doing something to be happy. Action is no less necessary than thought to the instinctive tendencies of the human frame.”

“It is health that is real wealth and not pieces of gold and silver.”

“It is knowledge that ultimately gives salvation.”

“It is the quality of our work which will please God and not the quantity.”

“It is unwise to be too sure of one's own wisdom. It is healthy to be reminded that the strongest might weaken and the wisest might err.”

“Just think out for yourselves, if a man who was good yesterday has become bad after having come in contact with me, is he responsible that he has deteriorated or am I? ... It is well to take the blame sometimes.”

“Keep your thoughts positive, because your thoughts become your words.
Keep your words positive, because your words become your behavior.
Keep your behavior positive, because your behavior becomes your habits.
Keep your habits positive, because your habits become your value system.
Keep your values positive, because your values become your destiny.”

“Life becomes livable only to the extent that death is treated as a friend, never as an enemy.”

“Life is an aspiration. Its mission is to strive after perfection, which is self-realization.”

“Life is greater than all art.”

“Live as if you were to die tomorrow. Learn as if you were to live forever.”

“Love and exclusive possession can never go together.”

“Love can never express itself by imposing sufferings on others. It can only express itself-suffering, by self-purification.”

“Love is no love which asks for a return.”

“Man’s destined purpose is to conquer old habits, to overcome the evil in him and to restore good to its rightful place.”

“Men often become what they believe themselves to be. If I believe I cannot do something, it makes me incapable of doing it. But when I believe that I can, then I acquire the ability to do it even if I didn’t have it in the beginning.”

“My life is my message”

“No culture can live, if it attempts to be exclusive.”

“Non-violence, which is the quality of the heart, cannot come by an appeal to the brain.”

“Nonviolence is not a garment to be put on and off at will. Its seat
is in the heart, and it must be an inseparable part of our being.”

"Nonviolence which is a quality of the heart, cannot come by an appeal to the brain."

“Not to have control over the senses is like sailing in a rudderless ship, bound to break to pieces on coming in contact with the very first rock.”

“Peace will not come out of clash of arms but out of justice lived and done by unarmed nations in the face of odds.”

“Personally, I hold that a man, who deliberately and intelligently takes a pledge and then breaks it, forfeits his manhood.”

“Prayer is a confession of one's own unworthiness and weakness.

“Prayer is not asking. It is a longing of the soul. It is daily admission of one's weakness. It is better in prayer to have a heart without words than words without a heart.”

“Prayer is the key of the morning and the bolt of the evening.

“Prayer is the only means of bringing about orderliness, peace and repose in our daily acts.”

“Real sacrifice lightens the mind of the doer and gives him a sense of peace and joy”

“Service has no meaning unless one takes pleasure in it”

“Silence is a great help to a seeker after truth. In the attitude of silence the soul finds the path in a clearer light and what is elusive and deceptive resolves itself into crystal clearness. Our life is a long and arduous quest after Truth, and the soul requires inward restfulness to attain its full height.”

“Strength does not come from physical capacity. It comes from an indomitable will.

“The control of the palate is a valuable aid for the control of the mind.”

“The Difference between what we do and what we are capable of doing would suffice to solve most of the world’s problems.”

“The dignity of man requires obedience to a higher law, to the strength of the spirit.”

“The future depends on what we do in the present.”

“The golden rule of conduct.. is mutual toleration, seeing that we will never all think alike and we shall always wee Truth in fragment and from different angles of vision.”

“The history of the world is full of men who rose to leadership, by sheer force of self-confidence, bravery and tenacity.”

“The law of love knows no bounds of space or time.”

“The man of prayer will be at peace with himself and with the whole world.”

“The mice which helplessly find themselves between the cats' teeth acquire no merit from their enforced sacrifice.”

“The music of life is in danger of being lost in the music of the voice.”

“The only devils in this world are those running around in our own hearts, and that is where all our battles should be fought.”

“The only tyrant I accept in this world is the still voice within.”

“The pure unadulterated love of one can nullify the hatred of millions.”
“The seven social sins:

1. Knowledge without character,
2. Science without humanity,
3. Wealth without work,
4. Commerce without morality,
5. Politics without principles,
6. Pleasure without conscience,
7. Worship without self-sacrifice.”

“The still small voice within you must always be the final arbiter when there is a conflict of duty.”

“The weak can never forgive. Forgiveness is the attribute of the strong”

“The wise are unaffected either by death or life. These are but faces of the same coin.”

“. . . there are chords in every human heart. If we only knew how to strike the right chord, we would bring out the music.”

“There are innumerable definitions of God because his manifestations are innumerable.”

“There are people in the world so hungry that God cannot appear to them except in the form of bread”

“There are subjects where reason cannot take us far and we have to accept things on faith. Faith then does not contradict reason but transcends it. Faith is a kind of sixth sense which works in cases which are without the purview of reason.”

“There comes a time when an individual becomes irresistible and his action becomes all-pervasive in its effects. This comes when he reduces himself to zero.”

“There is a soul force which if we permit it, will flow through us, producing miraculous results”

“There is a sufficiency in the world for man's need but not for man's greed.” 

“There is more to life than increasing its speed.” 

“There is no god higher than truth.”

“There is nothing that wastes the body like worry, and anyone who has any faith in God should be ashamed to worry about anything whatsoever”

“Though I cannot claim to be a Christian in the sectarian sense, the example of Jesus suffering is a factor in the composition of my undying faith in non-violence which rules all my actions, worldly and temporal.”

“To forget how to dig the earth and to tend the soil is to forget ourselves.”

“To give pleasure to a single heart by a single act is better than a thousand heads bowed in prayer.”

“To my mind, I hold that the more helpless a creature, the more
entitled it is to protection by man from the cruelty of man.”

“To see the universal and all-pervading Spirit of Truth face to face one must be able to love the meanest of creation as oneself.”

“True beauty consists of purity of heart.”

“Truth never damages a cause that is just.”

“Unity to be real must stand the severest strain without breaking.”

“We have no evidence whatsoever that the soul perishes with the body.”

“. . . we have to learn to use that force (love) among all that lives, and in the use of it consists our knowledge of God. Where there is love there is life; hatred leads to destruction.”

“We may never be strong enough to be entirely nonviolent in thought, word and deed. But we must keep nonviolence as our goal and make strong progress towards it. The Attainment of freedom, whether for a person, a nation or a world, must be in exact proportion to the attainment of nonviolence for each.”

“We must be the change we wish to see.”

“What is faith worth, if it is not translated in to action?”

“Whatever you do will be insignificant, but it is very important that you do it.”

“When his duty is to face danger and he flees, it is cowardice.”

“When I despair, I remember that all through history the way of truth and love has always won. There have been tyrants and murderers and for a time they seem invincible but in the end, they always fall -- think of it, ALWAYS!”


“Whenever you are in doubt or when the self becomes too much with you, try the following experiment: Recall the face of the poorest and most helpless person you have ever seen and ask yourself if the step you contemplate is going to be for any use to him or to her . . . Then you will find your doubts and your self melting away.”

“Where there is love there is life.”

“Wherever you are confronted with an opponent, conquer him with love.”

“Without prayer there is no inward peace.”

“You must be the change you wish to see in the world”

“Your capacity to keep your vow will depend on the purity of your life.”

A Valuable History Lesson

“Those who cannot remember the past are condemned to repeat it.”
--George Santayana (Spanish-born American Philosopher, Humanist and Poet, 1863-1952

I’m a bit of a history buff, and like most armchair historians who know something about medicine, it’s always interesting to try and work out why some civilizations underwent rapid collapse. Was the decline of Rome really due to malaria, lead pipes or societal malaise? Why did the huge Khmer Empire in Southeast Asia vanish in just a few years? Was it ecological failure, disease or pollution? The list goes on.

The map shows some of the major empires in Eurasia around A.D.1200. See how few still exist. (Click on it for a larger view)

One of these historical puzzles seems to be close to solution, and provides important lessons for us today. In the second year of the Peloponnesian war, the city state of Athens was devastated by an epidemic known as the Plague of Athens. Historians and scientists have been debating the cause of the Plague for years. When I was a young schoolboy, the debate was already a century old.

According to historical records, the plague began in Ethiopia and passed through Egypt and Libya to Greece in 430-426 B.C.E. It forever changed the balance of power between Athens and Sparta, effectively ending the Golden Age of Athenian dominance in the ancient world. It is thought that up to one third of the Athenians, including their leader, Pericles, dies in the epidemic. Most of our knowledge about the Plague came from the fifth century B.C.E. Greek historian Thucydides, who himself was taken ill with the plague but recovered. Though Thucydides gave a detailed description, researchers have not managed to agree on the identity of the plague. Several diseases have been suggested, including bubonic plague, smallpox, anthrax and measles.

Now a study in the International Journal of Infectious Diseases helps answer this question that has puzzled historians for decades: What destroyed ancient Athens, the cradle of democracy? Analysis carried out by Manolis Papagrigorakis and colleagues from the University of Athens, using DNA collected from teeth obtained from an ancient Greek burial pit points to typhoid fever as the disease responsible for this devastating epidemic. Typhoid fever (or enteric fever) is an illness caused by the bacterium Salmonella Typhi. It is common throughout the world, more so in tropical and semitropical climates. It is transmitted by ingestion of food or water contaminated with feces from an infected person.

There are some classic physical symptoms of typhoid: In the first phase there is coughing, a fever, sweating and a rash of “rose spots,” particularly on the abdomen. Typhoid has a unique feature: normally when you get a fever your pulse rate increases. In typhoid the pulse slows. In the second phase of the illness people get severe headaches muscle pain and diarrhea. And it is the diarrhea that usually dehydrates and kills people. You may have heard about typhoid in the last few days after publication that a well-known terrorist was supposed to have died from it.

It is humbling to realize that entire civilizations have been put to the sword, not by force of arms, but by microbes. Climate change or a breakdown in sanitation of food inspection can all lead to a reappearance of typhoid: within the last hundred year there have been outbreaks all over the Western world, and it is endemic in many less developed countries.

I mention in Healing, Meaning and Purpose that one of the reasons for the persistence of the gene for cystic fibrosis is thought to be that carriers of the gene are resistant to typhoid.

We must never forget the power of micro-organisms and how rapidly they can re-appear if we let down our guard or if we neglect the impact of climate change on their growth and viability.

It is no coincidence that H.G. Wells vanquished the Martians not with guns, but with microbes.

Vaccinating Against the Snivels?

I’m using a deliberately provocative title for a story that is quite serious, both medically and ethically.

We have today heard about two new developments. Researchers from the University of Rochester Medical Center announced that they are starting trials of a new vaccine aimed at eliminating childhood ear and sinus infections as well as many cases of bronchitis in adults. Second, and on the same day, the University of Rochester announced that it had won a $3.5 million grant from the National Institute of Deafness and Communication Disorders, one of the divisions of the National Institutes of Health, to develop the new vaccine. The team at Rochester helped to develop the vaccine marketed by Wyeth as Prevnar. It is used to protect infants and toddlers against some strains of bacteria that can cause pneumonia, meningitis and ear infections.

The vaccine will target Nontypeable Haemophilus influenzae or NTHi, which is the main remaining cause of ear and sinus infections and bronchitis, now that vaccines exist for various forms of streptococcal bacteria and Haemophilus influenzae B, the previous leading causes. NTHi is now the leading cause of ear and sinus infections, and of bronchitis in adults.

But why this news is so important for all of us, is that unlike virtually all other vaccines on the market, this one will not be aimed at saving lives, but at preventing what are usually nuisance illnesses. But please note my use of the word “usually.”

Dr. Michael Pichichero, a professor of microbiology, immunology, pediatrics, and medicine at the University of Rochester Medical Center who is leading the trial, was quoted as saying, “While ear infections are never fatal, they can cause serious damage in some children.” He went on to say that “83 percent of U.S. children experience one or more ear infections by age 3 and in some cases hearing loss becomes permanent.”

This is the point, and also why the National Institute of Deafness and Communication Disorders has chipped in. Most of these infections get better on their own, so an initial reaction might be to say, “why bother with this at all?” The trouble is that not only can they lead to long-term problems with hearing, I have seen more than one person develop a cerebral abscess as a result of a severe infection: the illness is not always innocuous.

Another problem is that infections of the sinuses and ears bring children to clinics and emergency rooms, and are the leading reason for antibiotic prescriptions. Even though many of the infections are viral, and viruses do not, of course, respond to antibiotics. Every expert agrees that antibiotics are overused in the United States, which wastes money and also helps the evolution of bacteria that ultimately resist all antibiotics.

What’s the downside of these announcements?

1. We have already run into a great many problems with previous vaccinations. Some long-term and some subtle; so we desperately need long-term safety data.I know many natural healers who blame many of our health woes on vaccinations.
2. I hope that the researchers have built into the contract a clause to allow them to report efficacy and safety data without having to clear everything with the study’s sponsor.
3. We are facing major resource problems, not just in the provision of health care, but also in the funding for research. So should we be diverting resources into these kinds of problems while every 30 seconds another child dies of malaria?
4. There has been a great deal of discussion about what is often called the “hygiene hypothesis:” the idea that the increasing rates of some allergic illnesses and asthma are a result of children having avoided minor infections early in life, that would have stimulated their immune systems. The hypothesis is not proven, but there is a great deal of circumstantial evidence.
5. If successful, would the vaccine create a host of secondary problems ten or twenty years from now?

Banquo’s Ghost

“Chess is the game which reflects most honor on human wit.” -- Voltaire (a.k.a. François-Marie Arouet, French Writer and Philosopher,  1694-1778)

For anyone with even a passing interest in chess, a re-unification match for the World Championship is currently taking place in Elista, the capital city of Kalmykia, a small region of the Russian Federation that is Europe’s only Buddhist country. Though I’m sure that some would quibble about whether it should be in Europe or Asia.

The beginning of the match between two of the world’s top Grandmasters - the aggressive Bulgarian gambler Veselin Topalov and the conservative Russian, Vladimir Kramnik - has led to and 2-0 score in favor of the Russian.

So why am I mentioning this is a blog dedicated to Personal Growth, Healing and Wellness? Because the current one-sided score line has a lot to do with each of these topics. This match is not just about chess playing ability: it is also about psychological and emotional strength, character and resilience.

There was a time when chess masters were unfit, often over-weight and the majority smoked. When I first started playing in tournaments in England, it was quite normal to have ashtrays beside most of the boards.

Oh how things have changed!

Now the players prepare physically, psychologically and some even spiritually with prayer and meditation:

1. Very few players smoke, not just because of long-term health risk, but because the deleterious effects of lowered oxygen levels on cognition outweigh the short-term improvement in attention caused by nicotine.
2. Aerobic exercise is essential to ensure that the brain is perfused with oxygen, and if you are physically unfit you cannot expect to survive a number of games that may each last for five or six hours.
3. Strength training is also essential to overall fitness and physical and the maintenance of psychological resilience. Topalov is going to need that now.
4. Posture is extremely important. According to Chinese and Ayurvedic physicians and chiropractors, bad posture results in a restriction in the flow of Qi, Prana, or blood. Whether or not you believe in the flow of Qi in the body, it is easy to demonstrate that bad posture has bad effects on cognition.
5. Flexibility is also an essential part of physical wellness that affects you psychologically as well as physically. Daily stretching should be part of everyone’s life.
6. Relaxation and meditation: one or other or both are essential tools for maintaining your balance while under stress, and for building resilience.
   
7. Diet: a carefully balanced nutritious diet rich in omega-3 fatty acids (without any added mercury!) and fiber is essential for optimum mental functioning.
8. Fluid intake: the current recommendations are for a healthy person to drink between 80 and 120 fluid ounces of pure water each day.
9. Avoid alcohol: A former World Champion – Alexander Alekhine – lost his title after turning up drunk on a number of occasions during a match to defend his title.

Looking at the pictures from the match, in both games Topalov looked intense and Kramnik far more relaxed. It could have been an illusion: I would need to be in proximity to be sure. In the first game Topalov took a needless risk in a dead level position. In the second, he had an absolutely won game. I’m no grandmaster, but even I spotted a win in three moves. How could he have failed to find it and then lost?

What is the explanation? Chess players have to play a certain number of moves in a specified time, so not only are they playing their opponent, they are also playing against the clock. The biggest prize in the game is on the line, for which both players have been preparing since childhood. And there are hundreds of thousands of people who are watching and analyzing their every move.

I know from personal experience that it can be hard enough to be interviewed on a television show being watched by millions of people, where any false statement would haunt me forever. Imagine having a battle of wits with one of the finest chess players in the world in the knowledge that every move will be analyzed for the next century, and computers are already analyzing every permutation of every move that the two players have made.

The stress on the players is unbelievable. Both have prepared for it, but it is also a matter of who has prepared best: that is a mixture of temperament and training. Just today I read an article talking about ways of avoiding stress. This is silly: stress is part of life and it can provide the motor in motivation. The trick is how we learn to respond to stress.

There is also another stressor that has only been felt by world championship contenders on two or three previous occasions. This match is being played in the shadow of the retirement of Garry Kasparov, who, in the opinion of most people, is the strongest player who ever lived, with the possible exception of Bobby Fischer. The difference is that Bobby became World Champion all by himself, with little help and by inventing a new approach to chess. It is a great tragedy that his life has apparently been blighted by mental illness, and that he has played only a few recorded games in the last 34 years.

By contrast, Garry was the strongest player in the world for twenty years, and in the opinion of most experts would probably still beat both of the current contenders. So whoever wins wants to prove himself a worthy champion. Garry’s specter remains like the ghost of Banquo in the Scottish play.

The final essential is that both players have to detach from the results of the first two games. Kramnik will obviously have his tail up now, but he is too smart and too experienced to give in to complacency. Topalov has to completely forget about the first two games and focus on what lies ahead: I’m sure that he has someone on his team working on simple techniques to stop the past from populating his psychological present.

Whatever lies ahead for these two men in the next few weeks, we shall see that chess is a microcosm of life in general.

“What is needed, rather than running away or controlling or suppressing or any other resistance, is understanding fear; that means, watch it, learn about it, come directly into contact with it. We are to learn about fear, not how to escape from it.” --Jiddu Krishnamurti (Indian Spiritual Teacher, 1895-1986)

Stopping Malaria with a Sugared Mousetrap

When I was an active clinician I saw several people die of malaria and it’s one of those things that you don’t forget. Nobody likes losing a patient, particularly to a potentially preventable disease. I would often think of the millions of people infected by this parasite. There are 300 million clinical cases of malaria each year, and around the world over one million people die of the illness each year. It has been calculated that a child dies of malaria every 30 seconds, with the largest number of deaths occur among young children in Africa.

We know that cleaning up water supplies and appropriate insecticides would make a huge dent in that terrible clinical toll, and hats off to the Bill and Melinda Gates Foundation for its massive attempts to do things that make sense for helping eradicate malaria and a score of other problems.

There are academics and some pharmaceutical companies that are working on malaria vaccines, and I wish them well. But I wonder about the practicality of paying for vaccines for hundreds of millions of people, when for a fraction of the cost, clean water would do a much better job, and without all the potential problems that might be associated with vaccination.

Global climate change will likely make the range of malaria-carrying mosquitoes much greater in the years to come: it was recently suggested that malaria might in our lifetimes spread as far North as England.

I was very interested to read of an entirely new approach to targeting malaria that could be cheap and easy. It’s also so obvious that I’m sure that there are scientists the world over who are slapping their foreheads this weekend.

I a study reported in the International Journal for Parasitology a team from Hebrew University was able to devastate a local mosquito population by spraying acacia trees with a sugar solution spiked with an insecticide.

The Plasmodium parasites that cause malaria are spread by female Anopheles mosquitoes. The female mosquitoes need blood to develop their eggs, but they also need large amounts of sugar to support their metabolism, so they need large amounts of sweet plant nectar.

What the Israeli team did was to spray acacia trees in an oasis in Southern Israel with a sugar solution containing the insecticide Spinosad. This area was chosen because there were few other plants from which the mosquitoes could obtain sugar. After spraying, the mosquito population was decimated.

Clearly this technique is going to be most valuable in areas with limited plant growth, so the mosquitoes aren’t just going to be able to go next door for food. Though that being said, Anopheles mosquitoes are fussy eaters and only visit a limited number of plant species. So now one suggestion is to plant mosquito attracting plants and spraying them with insecticide. Naturally enough, one worry is that the mosquitoes will learn to go to plant sources that they normally wouldn’t touch, or that they will develop resistance to the pesticides. And though Spinosad is supposed to be an environmentally friendly insecticide that doesn’t effect other insects, birds or animals, we have to keep an eye on the possibility that it may not be all that benign.

This work is going to need to be replicated, but it is an encouraging new approach to a horrible illness that is second only to tuberculosis in the number of people that it kills each year.

When Is It An Illness?

There’s been a very worrying trend in recent years, and that is constantly to medicalize every kind of behavior: we are no longer allowed to be shy, we have to be “socially phobic;” many things once regarded as vices, like excessive gambling, drinking or eating are now being re-cast as impulse control disorders and adolescent temper tantrums could be “Intermittent explosive disorder.” And I now read a report about giving selective serotonin reuptake inhibitors (SSRI) antidepressants to people with emotional lability.

In April of this year the Public Library of Science published a series of articles on the important topic of “disease mongering,” which two authors define as “the selling of sickness that widens the boundaries of illness and grows the markets for those who sell and deliver treatments.” The authors made the point that some of the medicalization of human behavior is being driven by some pharmaceutical companies. They picked on several conditions or illnesses in which claims of prevalence and severity have been inflated in order, they claimed, to generate a need for medicines. One of their targets was female sexual dysfunction, where there has been a serious attempt to convince the public in the United States that 43% of women live with this condition. Many experts have heavily contested those figures.

One of the big worries about expanding the boundaries of an illness is that it is easy to throw out the baby with the bathwater. To use this last example: saying that the figures for female sexual "dysfunction" are inflated can lead some clinicians to dismiss everyone who has a problem, and then not to treat people with genuine organic difficulties. It is tragic to see people referred to a psychiatrist for a physical problem like low testosterone or undiagnosed diabetes or thyroid disease.

There can also be marked differences of opinion about the nature of illness. “Premenstrual dysphoric disorder,” (PMDD), is a particularly severe premenstrual syndrome, with some additional mood features. The American Psychiatric Association has precise diagnostic criteria for PMDD. The regulatory authorities in the European Union decided that this was not a real illness and declined to let a pharmaceutical company market a medicine for it.

I’m all for doing anything that I can to help people and to alleviate suffering. Part of the problem is that it is acceptable to have a “disorder.” The prevailing attitude is that no one can be blamed for being sick. The reality is that by most estimates, 70% of human illness is caused by lifestyle choices. By turning everything into disorders we take away our responsibility for our actions.

Most people are not looking for the causes of their troubles, they want a quick fix. Changing is hard, it is inconvenient and it is much easier to believe a pill will make everything better.

The second issue is that “better living through chemistry” may not be. There’s been a question rumbling round for some time now: has the over-exposure of young people to antibiotics, analgesics and sleeping tablets, been partly responsible for the rise in asthma and in substance abuse in later life? We don’t know the answer but it is important for us to think about.

The third point is that we need to think about what we are doing to ourselves if we want to medicate our way to happiness. Do we really want to deny ourselves the opportunity for becoming happy by our own actions rather than relying on a pill and being told what is normal?

P.S. Four years ago the Nuffield Council on Bioethics produced an important report entitled Genetics and Human Behaviour: the Ethical Context. It looked at some of the ethical challenges that are coming with the constant new discoveries in biology, and warned against the dangers of widening diagnostic categories, to encourage the use of medication by people who would not necessarily be thought of as exhibiting outside the normal range. It is well worth reading.

It’s Not Just Spinach!

The news yesterday of E. coli contaminated spinach must have been enough to make Popeye weep.

According the Centers for Disease Control and Prevention in Atlanta, as of today, 102 people have been infected with the outbreak strain of E. coli O157:H7 have been reported to CDC from 19 states, and one person in Wisconsin has perished.

Just to re-iterate what you’ve probably heard on the news already: E. coli is often a nasty resistant little bug that is not always killed by cooking. So the best advice is to throw away any spinach that may be suspect. The bacterium can make you very sick. You may have heard that one person has already died and at least a dozen more are in the hospital.

Several years ago there was an egg-borne Salmonella outbreak in the United Kingdom, and we’ve heard of several outbreaks of hepatitis A related to food contamination. There are outbreaks of food poisoning every now and then. And then there is the constant worry about “Mad cow disease,” that led to the wholesale slaughter of animals in the United Kingdom a couple of years ago.

Overall, Secretary Johanns and his team at the United States Department of Agriculture are doing a good job of protecting us.

Be aware, though, that apart from food, there are many other places that bacteria and occasionally viruses can lurk:

1. Makeup: the ingredients in makeup can make good breeding grounds for some bacteria. Don’t keep makeup for too long, particularly if it’s been in a hot damp place
2. People carry a lot of bugs. That doesn’t mean that you have to become worried about being around them, but it’s best not to get in an elevator is someone’s coughing or sneezing. I’d like to say the same thing about planes, but that’s usually not practical. I’ve many times had to use homeopathic remedies after a flight to prevent a cold – or worse – from emerging. Others have even taken antibiotics after a long flight next to someone nursing a cold. A bit illogical in my view: most upper respiratory tract infections are viral.
3. Many bacteria and a few viruses get transferred to hands and doorknobs. You cannot spend your life being terrified of such things: it ruined the life of Howard Hughes, and in real life Adrian Monk would really be suffering. But you can wash you hands – with soap – in warm water for one minute whenever you get the chance. Studies have shown that most people don’t wash their hands properly. And I like those little sterilizing towels that you can carry with you.
4. Change your toothbrush every 2-3 weeks.
5. If you can afford them, those Ionic Breeze devices do seem to help keep the air cleaner.
6. And I’m sure that I do not need to remind you, gentle reader, of the importance of carefully washing your hands after visiting a rest room.

September 11th

We all have our own memories of what we were doing on that awful day.

I was lecturing at a University in New Jersey, when people started walking in and out and my cell phone began to ring. I stopped speaking and my friend - the chairman of the department - and I spoke for a moment before he announced what had happened. And he had the prescience to say, “Today America has changed forever.”

I stayed in New Jersey and Pennsylvania for the rest of the week and it was a good thing that I did: I visited a number of hospitals where the staff was in shock, and it was helpful to have someone from outside give advice on how to handle such a traumatic situation.

A year later I returned to the same department to do a special lecture. My topic: the psychology and biology of human violence.

Darwin Awards

I just received a question, about whether I knew anything about what Darwin Awards were?

Well, as it happens I do.

In the midst of tales of gloom and doom, but also stories of amazing hope, courage and possibility, I thought that I should share with you their origin, despite, of course, wanting nothing to do with them.

The Darwin Award carries no monetary reward, just some recognition. Often posthumously. It is an honor given to people whose questionable judgment leads them inadvertently to improve the human gene pool by removing themselves from it.

The Darwin Awards have an amusing website, though the outcomes of some of the events were not amusing in the slightest.

They include Russian soldiers who found a canister containing a white powder on a garbage dump. Presumably Russian mothers do not tell their sons to avoid unknown white powders on military garbage dumps. The soldiers decided to use said powder as a substitute for talcum powder and as something to smoke. Sad to say, the white powder in question was thallium, and putting it on your skin or worse yet in your lungs is suboptimal.

Other "winners" tried things like juggling a hand grenade; jumping out of a plane to film sky divers but forgetting to wear a parachute; and using a cigarette lighter to illuminate a fuel tank to make sure that it contained nothing flammable. The list is a long one.

But I have a question: if such foolish behavior will likely remove the perpetrator from the gene pool, how come that there are still so many silly things going on around the world??

Discuss.

Labor Day Trivia With a Twist

The English language must be one of the oddest. Well actually I know that it is. Except perhaps for those few languages that have managed to get by with hardly any words for emotion. Or the ones that have hundreds of ways of describing snow.

In English there are more than one thousand words describing groups of things, usually animals. Many of these words go back to the Middle Ages: fun to look up on a wet English afternoon. And many have been taking up some of my precious neural storage space for a very long time.

In today’s trivia corner, the question came up as to what name is given to a group of cats? I knew that one, it’s a clowder, and if they’re kittens, it’s a kyndyll, also spelt kindle.

Then I started putting together a few others that I remembered, and looked up a couple more. If you type “Collective nouns” into Google you’ll get hundreds, but I’m not sure about some of them!

Here are a few fun ones:
Army of frogs or ants

Bale of turtles 

Band of gorillas 

Baren of mules
Bed of clams or oysters 

Bevy of quail or swans 

Brace of ducks 

Brood of chicks
Business of ferrets
Cast of hawks 

Cete of badgers 

Charm of goldfinches or hummingbirds
Chine of polecats
Cloud of gnats
Clutch of chicks
Colony of rabbits, ants, gulls and bats
Company of wigeons (they’re dabbling ducks found all over North America)

Congregation of plovers
Convocation of eagles 

Covert of coots 

Covey of quail or partridge
Cry of hounds
Down of hares 

Draft of fish (That one’s rarely used these days)
Dryft (drift) of tame swine 

Drove of cattle, sheep, pigs 
(In the Middle Ages, cows were also called kine or kyne)
Exaltation of larks 

Fall of woodcocks
Flange of baboons
Flight of birds 

Flock of sheep, geese, ducks 

Gaggle of geese 

Gam of whales 

Gang of elk 

Grist of bees
Harras of horses 

Herd of cattle, deer, elephants, horses, and sheep
Hive of bees
Horde of gnats 

Hover of trout 

Husk of hares 

Kettle of hawks
Labor of moles
Lepe or leap of leopards 

Leash of foxes 

Litter of pigs, cats, dogs 

Murder of crows 

Murmuration of starlings 

Muster of peacocks 

Mute of hounds 

Nest of rabbits, vipers, turtles and hornets
Nide, or nye of pheasants 

Pack of dogs, hounds, wolves, and mules
Parliament of rooks or owls 

Pod of dolphins, whales or seals
Pride of lions
Raft of ducks (paddling around on water) 

Rafter of turkeys 

Rag of colts
Route of wolves
School of fish (At one time they were called shoals of fish)
Scold of jays
Sculk of foxes
Sedge of cranes, bitterns, herons 
shoal of bass
Singular of boars
Shrewdness of apes 

Skein of geese (In flight)
Skulk (sculk) of foxes 

Sloth or sleuth of bears 

Sounder of wild swine or boars  

Span of mules 

Spring of teal 

Stud of mares 

Swarm of bees
Team of ducks, horses, pigs, oxen 

Tribe of goats 

Troop of kangaroos or monkeys
Unkindness of ravens

Volary of birds 

Walk of snipe 

Watch of nightingales 

Wedge of swans 

Wing of plovers 

Yoke of oxen
Zeal of zebras

There are some very funny ones that can’t be genuine. Try these:
An addition of mathematicians
A brace of orthodontists
A bunch of florists
A clutch of car mechanics
A concert of yes-men
An expense of consultants
A flash of paparazzi
An intrigue of politicians
A prickle of hedgehogs
A rash of dermatologists
A tedium of golfers

This is all harmless fun. But there’s also a slightly more serious side to it. Developing your vocabulary, even for odd words like these, appears to reduce your risk of developing age-related cognitive decline and should help keep you mentally sharp.

And I’ve got the brain scans to prove it!

When Being First Is Not the Only Thing

Regular readers and anyone who's looked at my blogroll, knows that I like Zach Lynch's consistently insightful blog.

He has been working on a project for four years, and now it appears that someone is coming out with some of the same ideas in a book that is due to arrive in late September.

This does not look to me like plagiarism. Once a new idea is out there, it quickly spreads, and people will run with it.

You might be interested to see some of the comments that I made on Zach's site.

The other book may be superb. But the important point is that although being first is the only thing in competitive games, in the world of ideas that will help us, being first is not the only thing.

Being correct is the only thing.

Disclosure

There’s a sad situation rumbling around the psychiatric and neurological worlds this week.

The Chairman of the Department of Psychiatry at Emory University in Atlanta is reported to be stepping down as Editor of the prestigious journal Neuropsychopharmacology, after failing to disclose that he had a financial interest in a treatment about which he had written approvingly.

The editor says that this was simply a clerical error, as on the previous occasion in 2003 when he published an article in which there was a conflict of interest.

This is all a great shame: the treatment that he talked about in this paper - vagal nerve stimulation - really does appear to be a genuine advance in the management of treatment resistant depression.

It is also eminently avoidable. Anybody who is an expert in their field will likely be asked to consult to a wide range of bodies. I have advised many pharmaceutical companies, governments and non-governmental agencies around the globe. Whenever I lecture, wherever it is in the world and whatever the subject, I always show a slide with a list of all the people with whom I have worked, and my office constantly updates the list, so that it can be appended to every document that we send out. And because I consult so widely, I don’t hold stock in any pharmaceutical or medical devices companies.

But here is another piece of failed disclosure. There is a comment to the report at the Scientist. The writer says that “Psychiatry has the greatest conflict of interest possible--they are prescribing drugs and, in this case, mechanical "treatments" for conditions that have no verifiable physical cause.”

This is absolutely and totally untrue. There are mountains of data confirming the physical component of most major psychiatric illnesses. And every day, all over the world, people in their tens of thousands are saved and their lives restored by pharmacological treatments used together with psychological and social help.

This is the same nonsense promulgated earlier this year by Tom Cruise. It reminds me of the critics of Galileo who refused to look through his telescope.

The writer herself fails to disclose that she is also involved in Scientology.

Cultural Competence

One of the problems about so many self-help articles is not only that their authors have often not done their homework, neglecting research and sometimes ignoring the dictates of common sense, but they also tend to be culturally myopic.

I’ve spent a great deal of time in different cultures and some of the advice proffered by a few American business experts would quickly get you shown the door in Japan or Germany!

I’ve just learned that Wal-Mart is pulling out of Germany, writing off a loss of around $1 billion. Part of the problem was that this super successful American company failed to understand German culture. It attempted to introduce the “greeters,” that are a familiar sight in the United States. Germans found it offensive to be confronted by someone ordered to smile at every customer. To a German, a broad toothy grin may be seen as intrusive and an invasion of privacy.

My personal background, extensive travels and work with people from every corner of the world, have made me very sensitive to these differences, and I’m often asked for advice before people head off to do teach, speak or to do business overseas. I was very pleased to find out about a company that specializes in training executives to be culturally competent, and one of the tools that they use is cultural profiling.

I just read an excellent article in the Telegraph by Michael Gates, in which he describes a moment in Finland, when he asked someone how they were, to get the response, “You asked me that last week.” Ask a German how they are, and they will probably spend the next ten minutes telling you.

Different cultures have very different ideas and attitudes toward time, space, truth, privacy, authority, individuality, and, of course, gender. The glass ceiling is still alive and well in many cultures. Children are raised quite differently in different cultures: I knew a British doctor working in the pharmaceutical industry. Her company sent her to the United States for three years, but in less than two she and her family were back in England: she did not like the effects of American education on her children.

The Expat Telegraph website has also launched a series of “National Cultural Profiles.” This is a terrific resource to help us understand the thinking patterns of the world’s major cultures. The resource has been taken from the CultureActive cultural web program that is used throughout the world by governments, non-governmental organizations and corporations. It is also the core of a project (InterCulturalEdge) based at Duke University's Fuqua Business School in North Carolina.

CultureActive is based on the work of Richard D. Lewis, the author of When Cultures Collide, a book that I recommend highly. He is the chairman of Richard Lewis Communications. Lewis has developed a theory, known as the Lewis Model of Culture. He classifies cultures into three main types:

1. Linear-active
2. Multi-active
3. Reactive

These National Cultural Profiles are different from typical country profiles that you find in the Encyclopedia Britannica or the CIA website that detail economic or political data. These profiles concentrate on key cultural questions such as values, beliefs and communication.

There are free mini-introductions available at the Expat Telegraph website, and there are much more detailed profiles available for subscribers.

CultureActive also allows you to complete your own Personal Cultural Profile by filling in an online questionnaire.

Learning how to communicate with people from different cultures is essential if you hope to expand your own personal horizons, as well as developing your business.

“Civilization is the order and freedom promoting cultural activity.”
--Will Durant (American Historian, 1885-1981)

Scientific American Podcasts

One of the very many useful resources on the Internet is the Scientific American website.

Attached to it is a weekly podcast that summarizes a few of the most important recent new items.

For those of us engaged in developing, evolving and refining a new model of reality that will have practical applications to health, wellness and personal evolution, it's really important to know about the most up to date discoveries of conventional science. And how they fit in with - or challenge - our attempts to grow our field.

So many people have claimed to create new models that have collapsed at the first challenge. They usually contain the words "quantum" or "Einstein" somewhere near the beginning, or some half-remembered piece of High School or "Pop" psychology. It is usually easy to see that most have not done their homework!

We have instead been embracing new data from many sciences, from clinical experience, from intuitives and spiritual teachers and constantly testing the concepts and methods to see if they can be refined or improved. I'm pleased to report that we have been making rapid progress.

Enjoy the podcasts!

Plague: A Follow Up

I've had a lot of very positive feedback about my article about global warming and the risk of Plague.

One person said that he didn't want to think about something scary like that. Which reminded me a bit of our new kitten, who has still not worked out that if she can't see you, then maybe you can still see her. She hides her head in a large stand of Pampas grass and assumes that she's now invisible....

As the conversation with Mr. Head-In-the-Sand continued, I had a sudden flashback to the Hitchhiker's Guide to the Galaxy, in which the "Ravenous Bugblatter Beast of Traal" was described as "so mind-bogglingly stupid that it assumes that if you can't see it, then it can't see you."

I just received this report from the Centers for Disease Control (CDC) in Atlanta.

As you will see, there have been very few cases of Plague in the United States and the CDC keeps a close watch for us. The article also lists some of the key clinical featres of the illness.

Health Marketing at the Centers For Disease Control

I was very interested to see that The Centers For Disease Control have launched a website for the National Center for Health Marketing. I learned about it from Carol Kirshner.

This could be an important step for creating and disseminating accurate information about health, and health care options.

I just have one small worry about all this: if insightful and knowledgeable people do not become involved in providing direct input into the enterprise, it is inevitable that the main focus will be on physical interventions: diet, exercise, nutrition, workplace stress and so on. In other words, the medical model. Only because that’s the dominant way of thinking about illness and health.

But as I have been showing in these pages, there are tens of thousands of leading thinkers around the world who have long since recognized the limitations of that medical model, to say nothing of the demonstrable fact that some new Laws of Health and Healing have been emerging over the last century.

I laud this new initiative, but I’m also hoping that it will also include communication about not just the physical, but also the psychological, social, subtle and spiritual aspects of health, wellness and healing.

If these fine people would like some documented research to do so, I know that we can oblige!

Apple Computers

I make no bones about it; I’m a Mac guy. Always have been, and probably always will be.

I don't have any stock in the company, but I think that I’m on about my ninth or tenth Apple computer. Every time that I have to scuttle off to use a Window’s based machine I start getting antsy.

Apple has just had their Worldwide Developers Conference in San Francisco.

As a scientist and clinician very concerned about the epidemic of attentional and mood disorders in the population, something caught my eye. During Steve Jobs’ keynote preview, in which he highlighted some of the key features of the new Mac OS X “Leopard” operating system, there was more and more emphasis on developments designed to reduce the frustrations of working with a computer and ways to deal with the ever-increasing number of demands on our attention. There were a dozen new gizmos all designed to simplify and streamline our interactions with our computers, email and our Internet experience.

I don’t know whether this is the fruit of market research, or just a natural reaction by computer developers who are feeling themselves overwhelmed by a constant barrage on information. But whichever it is, I’m delighted to see this very welcome development.

Note to self, maybe I should send this note to Steve Jobs and say a big "thank you" on behalf of millons of users.

Airport Security and That Liquid Explosive

Well, your humble reporter was in New York on Thursday and became a statistic: one of the people held up for hours after the arrests in the United Kingdom and Pakistan. I mused that it was not aiport security that foiled the plot, but some very good detective work.

I’m not usually the most patient of people, but I grew up in Europe during the years that multiple groups of terrorists considered us to be fair game, so I’m used to this kind of thing.  On 9/11/01, I happened to be lecturing in New Jersey, got trapped after the airline system was closed down, and ultimately took one of the very first commercial flights in the country once the airports were re-opened.

It was not machismo, but an understanding that if we give in to terror, we have lost.  Turned out to be a good thing that I was on the flight: three people had panic attacks outside the departure gate, and some of the tapping therapies did them the world of good.

As I spent hours waiting, my thoughts turned to one of my first loves: chemistry. I had some terrific teachers who taught me to really understand science.

Since several had been in the military, we used to have all kinds of discussions about how to make things go bang. An unusual way to learn chemistry. But now I had several hours to see what I could remember: I began to wonder what explosives these could have been?

From the little described in the media, I came up with a short list. A few minutes ago I saw an article on the Scientific American website that seems to have come up with many of the same thoughts that I did. The one that I had not thought of was Astrolite.

This whole thing is such a sad development, but it just shows the importance of understanding some of the roots of our current global crisis and what we may each be able to do help.

Black Cohosh and Liver Damage

After discovering that some of the Black Cohosh sold in the United States contains precious little of the active ingredient, we now learn that that may not have been such a bad thing.

In 2004, a Conference sponsored by National Center for Complementary and Alternative Medicine and Office of Dietary Supplements, National Institutes of Health indicated that Black Cohosh appeared to be safe. However, earlier this year, the regulatory authorities in Australia issued a policy statement about adding warnings about liver toxicity to all herbal products containing Black Cohosh. The European and British regulatory authorities followed suit.

This highlights a problem with which we’ve struggled before: are the reports of hepatotoxicity due to a “bad batch?” Adulterated perhaps, or collected incorrectly? Yet that highlights both the strength of natural remedies and also their Achilles’ heel. We have so little information about the purity of individual products.

The standardization of herbal medicines is difficult, particularly since herbals usually contain complex mixtures of constituents, some of which are active, and some not. We often do not know exactly which component of an herbal medicine is responsible for clinical effects. There are often also differences in the composition of herbal preparations among manufacturers and lots. There are also enormous variations in the identification of plants by the manufacturers, how they are handled and the presence of other chemicals. Just think of the variations in the taste of different types of coffee, and you will see the point.

This variation has important consequences in clinical trials, many of which have failed to address the question of whether the herbs that they were using were of high quality.

The information on the label does not always reflect the actual content of the preparation and it is difficult to give one standard dose for an herbal medicine.

I thought that I should give you the wording from The European Medicines Agency (EMEA) and the Committee on Herbal Medicinal Products (HMPC)”

“Following review of all available data, the HMPC considered that there is a potential connection between herbal medicinal products containing Cimicifugae racemosae rhizoma (Black Cohosh, root) and hepatotoxicity.

The EMEA therefore wishes to give the following advice to patients and healthcare professionals:

Advice to patients:

-- Patients should stop taking Cimicifugae racemosae rhizoma (Black Cohosh, root) and consult their doctor immediately if they develop signs and symptoms suggestive of liver injury (tiredness, loss of appetite, yellowing of the skin and eyes or severe upper stomach pain with nausea and vomiting or dark urine).

-- Patients using herbal medicinal products should tell their doctor about it

-- Advice to healthcare professionals:

-- Health care professionals are encouraged to ask patients about use of products containing Cimicifugae racemosae rhizoma (Black Cohosh, root).

-- Suspected hepatic reactions should be reported to the national adverse reaction reporting schemes."

Training Doctors to Use New Medicines

I was saddened to see a press briefing by four senior members of the British Pharmacological Society  at the Society’s 75th Anniversary meeting in London. They called for an immediate improvement in the training of medical students and doctors in pharmacology and clinical pharmacology. They lamented the reduction in the teaching of the basic and clinical principles underpinning the use of medicines, that was leading doctors to be less confident in prescribing. This at a time when medicines are becoming increasingly powerful and complex to use, and when patients are more likely to be taking a number of different drugs.

I have known all four of the people who made these statements, and none is given to hyperbole. Professor David Webb from the University of Edinburgh had this to say: “Patients are becoming ill and some are dying as a result of poor prescribing. There is no doubt about that. A substantial proportion of that is undoubtedly avoidable.”

I was in San Francisco earlier today, and I was shocked by one of the questions, “What is the P450 system?” This is one of the most important metabolic pathways for medicines in the liver and the intestines, and it was worrying that a prescriber did not know that. In my view if a student doesn't know something, it's the teacher's fault, so it means that we trainers are not doing as good a job as we should, and that the problems are not confined to the United Kingdom.

The discussion soon turned to the increasing evidence that some medicines may be associated with metabolic disturbances in some people who take them. We soon started talking about the broader issues of drug side effects. My view is that we don’t need to blame doctors or pharmaceutical companies, that have no interest in bringing unsafe medicines to market: the financial and legal consequences can be devastating. And in any case, I’ve met hundreds of people working in senior position in over thirty pharmaceutical companies and the vast majority of them are deeply committed to trying to improve the lot of humanity.

I think that the problem is not with medicine itself or with doctors or companies. The problem is inadequately trained and/or bad doctors and bad companies.

And fortunately all of those are uncommon. But if these pharmacological luminaries are flagging up a problem, we all need to re-double our efforts to ensure that everyone working in medicine is trained in the basics.

Technorati tags: Pharmacology Medical training Cytochrome P450

A New Warning from the FDA about Some “Sexual Enhancers”

On Wednesday of this week the Food and Drug Administration issued a warning to consumers not to purchase or consume Zimaxx, Libidus, Neophase, Nasutra, Vigor-25, Actra-Rx, or 4EVERON. These products are promoted and sold on web sites as "dietary supplements" for treating erectile dysfunction (ED) and enhancing sexual performance, but they are in fact illegal drugs that contain potentially harmful undeclared ingredients. Chemical analysis by FDA revealed that Zimaxx contains sildenafil, which is the active pharmaceutical ingredient in Viagra. The other products contain chemical ingredients that are analogues of either sildenafil or a pharmaceutical ingredient called vardenafil, which is the active ingredient of Levitra.

These undeclared ingredients can interact with some prescription drugs, in particular nitrates. In combination with nitrates, they can cause a catastrophic fall in blood pressure. You may have seen Keanu Reeves warn Jack Nicholson about that in the 2003 movie Something's Gotta Give.

We have seen so many examples of adulteration of herbal remedies and supplements, and I’ve written a previous item about this huge problem. Huge, not in terms of numbers of cases, but in terms of the potential for harm.

I always recommending reading the label whenever you buy anything. The problem with the products mentioned in this latest FDA warning, is that there was no indication that the products contained drugs. Also be careful about whose advice you trust. Several years ago, a study done in health food stores in the United Kingdom showed that most of the staff knew very little about the products that they were promoting. Things have improved in recent years: we have a couple of health food stores in Atlanta with very knowledgeable staff. But it’s always a good idea to check before accepting the advice of someone in a store. Be doubly careful if you are buying things online: it’s you body.

So Caveat Emptor!

Technorati tags: Food and Drug Administration Sexual enhancers Herbal remedies Viagra Sildenafil Vardenafil Levitra Keanu Reeves Jack Nicholson 

The Passing of the Crazy Diamond

You may have heard of the passing of Syd Barrett, one of the founding members and creative drivers of Pink Floyd. He was only 60 years old.

His extraordinary creativity is well known: his fingerprints were all over the early performances and albums, and he was a muse to a generation of performers. I remember everyone’s consternation as his behavior became progressively more erratic between 1967 and 1968. I was very young then, but we all loved the music.

Some blamed his psychological meltdown on his consumption of prodigious amounts of LSD and all manner of other trendy chemical amusement aids. But in hindsight, he was probably suffering from a psychotic illness, and he was either self-medicating, or the drugs pushed him over the edge. Without doing a full evaluation, I could not say for sure. Although it’s now a moot point, several things make me think that he had a psychotic illness:
1.    His startling type of creativity before and in the early stages of his illness.
2.    There are clues suggesting that he already had problems before become obviously unwell.
3.    The chronicity of his problems are not at all like drug-induced psychosis. I saw a man in Australia who told me that all his years of psychosis were the result of a single “bad trip” in the 1960s. Unlikely.
4.    He suffered for years from diabetes mellitus. Diabetes may be as much as twice as common in people suffering from schizophrenia and bipolar disorder, and also in their first-degree relatives. (England’s first chess grandmaster, Tony Miles, who sadly had a psychotic episode in the late 1980s, also struggled with diabetes for many years, and died at the age of only 46.)

Why does any of this matter now?

If you ever see a young person abusing drugs, be aware that it is not necessarily that he or she is being impulsive or has just fallen in with a bad crowd. It may be that they are self-medicating.

People with major mental illnesses are at increased risk of many other physical illnesses, not all of which are a result of poor lifestyle choices. If you in contact with someone struggling with mental illness, anything that you can do to help them look after their physical health is all to the good.

And finally, a favorite song of mine that was written about Syd. According to legend, by a strange coincidence he arrived at the Abbey Road studio un-announced, at very time that the song was being recorded. It was nice that he was well enough to come and listen.

Remember when you were young, you shone like the sun.
Shine on you crazy diamond.
Now there's a look in your eyes, like black holes in the sky.
Shine on you crazy diamond.
You were caught on the cross fire of childhood and stardom,
blown on the steel breeze.
Come on you target for faraway laughter, come on you stranger,
you legend, you martyr, and shine!

You reached for the secret too soon, you cried for the moon.
Shine on you crazy diamond.
Threatened by shadows at night, and exposed in the light.
Shine on you crazy diamond.
Well you wore out your welcome with random precision,
rode on the steel breeze.
Come on you raver, you seer of visions, come on you painter,
you piper, you prisoner, and shine!

Technorati tags: Syd Barrett Pink Floyd Psychotic illness Diabetes mellitus Substance abuseSelf-medication 

The End of Life As We Know It?

Your humble reporter was discombobulated to read a recent report from E3: the Electronic Entertainment Expo in Los Angeles.

It appears that hordes of young men – yes they were virtually all young and male – were far more interested in the electronic games on display than they were in a number of quite attractive young dancers and models who graced the event. Though we have not one iota of interest in the orientation of the assembled company, on statistical grounds alone we would expect that at least some of these young men should be wired to take an interest in presumably intelligent members of the opposite sex. Yet they seemed to prefer playing with their silicon monsters and joysticks.

Perhaps the gamers are all too cerebral to be interested in young models who may be unable to tell a bit from a byte. But in the midst of all the sage commentary about the expanding gaming market and the ready accessibility of computer games to people who have access to not much else in the way of entertainment, our thoughts meandered off in a different direction: we have been wondering if we are here witnessing some form of natural selection at work….

Technorati tags: Evolution Relationships Sexual attraction

The Prince of Wales and Integrated Medicine

It is not widely known in the United States that His Royal Highness Prince Charles, the Prince of Wales, has been instrumental in the development and adoption of integrated medicine in the United Kingdom and in some parts of Europe and the Middle East. I had the privilege of working extremely closely with his Foundation for many years, and have acknowledged his personal influence in my most recent book, Healing Meaning and Purpose.

The British media is today reporting that his position on trying to integrated the best of conventional medicine with the best of traditional approaches if once again under attack, from a well-known group of critics. This time they are saying that the adoption of inadequately tested therapies is a needless drain on resources, and that regardless of what patients want, the money should be spent on treatments that are “evidence based.” This has become the new clarion cry of medicine: that everything that we do should have a defined research base. A terrific idea in theory, but sometimes disastrous in practice. As an example, there is not much in the way of an evidence base for appendectomy.

This morning, one day after the critics published their letter in the Times of London, the Prince of Wales spoke about his position and his work at a meeting of the World Health Assembly in Geneva and he had this to say:

"I believe that the proper mix of proven complementary, traditional and modern remedies, which emphasize the active participation of the patient, can help to create a powerful healing force for our world. This is where orthodox practice can learn from complementary medicine, the West can learn from the East and new from old traditions."

It will not surprise you to hear that I strongly agree with the Prince’s views. If you glance through a few of my blog entries, you will see that I am a huge advocate of good research: I analyze dozens of studies every week and present you with the best. I have also had to spend a great deal of time making decisions based upon cost. But it would be a big mistake for us to declare that any therapy that does not have a biological basis, or conform to the medical model should be excluded from health care. After all, patients also have a say, and they are clearly deriving benefit from complementary medical therapies. And as I have reported before, we are slowly collecting more and more data indicating that at least some of the 500 different schools of complementary and alternative medicine do have research to support their use.

“In scientific work, those who refuse to go beyond fact rarely get as far as fact.”
--Thomas Henry Huxley (English Biologist and Educator, 1825-1895)

Technorati tags: alternative medicine complementary medicine evidence based medicine prince of wales

Crackpot

I thought that title might attract your attention!

But before you think that I am being rude or self-referential, I’m referring to a report from the BBC, about a tiny hamlet in the Yorkshire Dales that does indeed rejoice in the name of Crackpot.

I have previously reported that I am directionally challenged. I am speculating about whether I need a GPS system in my own house. But now I discover that some of the electronic marvels aren’t all that they are, ahem, cracked up to be.

It turns out that a satellite navigation system is directing strangers on to a steep unclassified road that is normally impassable, and boasts a 100 foot drop on one side. Because everyone has assumed that the electronics are infallible, delivery men, sales people and minibus drivers have ignored a sign saying that there is no through road, and have, lemming-like, even opened a five bar gate so that they can continue in the direction indicated by the silicon spy in the sky. Local farmers have not been amused by having to rescue vehicles that have got stuck on the road to Crackpot.

I’m no Luddite, but I think that it may just be safer to use a map and do without these newfangled electronic things. And it’s an interesting example of people trusting technology more than themselves….

Technorati tags:satellite navigation, England

Climate Change and Your Health

When I hear the continuing arguments about climate change, I often fancy that I can in the far distance hear Nero playing his lyre while Rome burns. In March the BBC reported faster than expected warming of the Antarctic over the last 30 years. This report was based on a paper in the journal Science by a team from the British Antarctic Survey.

Gradual climate change is drawing particular attention in Europe, where the climate is exquisitely dependent on the Gulf Stream. In some places records have been kept for centuries, and there seem to have been genuine changes in a short space of time. A few years ago I was in Stockholm in the week before Christmas, and it was so warm that I was able to walk around in my shirtsleeves. That made it the warmest December in almost 800 years. People notice things like that, and governments and populations are eager to do something before the Arctic is reduced to a puddle.

Even if we are just seeing a natural climatic cycle, the consequences could be disastrous. Leaving aside the obvious matter of a rise in sea level, there is also the impact of global climate change on health. Earlier this year the BBC reported a speech by Professor Paul Hunter from the University of East Anglia in Norwich, to the Society of Applied Microbiology at the Royal Society in London. He pointed out that global warming, with hotter summers and more frequent and heavy rainfall and storms, would create the right conditions for an increase in food poisoning and other gastrointestinal upsets caused by microorganisms.

Global warming could also create conditions favorable for a return of malaria to the United Kingdom. Professor Hunter has published papers on this important topic before. He is no alarmist, and his work underscores the way in which our environment and we are closely interlinked, and even small climatic changes may have major effects on illness.

We could discuss this topic in a great deal of detail. Suffice to say that it is more important than ever for all of us to get into the habit of washing our hands, ensuring the cleanliness of food, and even more so of the water that we use, and that we do all that we can to build our resilience.

There is also another matter of equal importance, and that is the dwindling supply of fresh water around the world. The number of us is growing fast and our water use is growing even faster. A third of the world's population now lives in water-stressed countries, and it is expected that this will rise to two-thirds by the year 2025. The cruelty of the situation is that there is altogether more than enough water available for everyone's basic needs. The water is in the wrong places and much of it is unusable.

The United Nations recommends that people need a minimum of 50 liters of water a day for drinking, washing, cooking and sanitation. Global water consumption rose six-fold between 1900 and 1995 - more than double the rate of population growth - and goes on growing as farming, industry and domestic demand all increase.

As important as quantity is quality - with pollution increasing in some areas, the amount of useable water declines. Each year, more than five million people die from waterborne diseases, which is 10 times the number killed in wars around the globe. Most of the victims are children.

Seventy percent of the water used worldwide is used for agriculture. Much more will be needed if we are to feed the world's growing population, which is predicted to rise from about six billion today to 8.9 billion by 2050. And consumption will further increase as more people expect Western-style lifestyles and diets. Here is a useful statistic: one kilogram of grain-fed beef needs at least 15 cubic meter of water, while a kilo of cereals needs only up to three cubic meters. Many futurists are already predicting that water will become as much of a strategic issue as oil is today, with wars being fought over the water supply.

As of today, we should all start thinking about ways in which we can reduce our own water consumption and make provision to collect and purify water ourselves.

“Everybody talks about the weather but nobody does anything about it.” -- Charles Dudley Warner (American Author, 1829-1900)

Technorati tags: global warming, water, Environment, Climate Change, pollution

Win A Copy of Healing, Meaning & Purpose

Between now and May 31, 2006, if you sign up at www.richardpettymd.com to receive the newsletter you will be entered into a drawing to receive a free, autographed copy of Healing, Meaning & Purpose: The Magical Power of the Emerging Laws of Life.  We will hold the drawing on June 1, 2006 and there will be 5 winners.

Please Click Here to sign up.

And Now For Something Completely Different

I wouldn’t like it to be thought that this blog only deals with the serious side of life. I’m also eager to alert you to products and services that may enhance and enrich you. I was perusing a favorite blog: when I came upon mention of an important resource: Strange New Products Blog

Seeing such weirdness and creativity should give us all hope for the future….

Though it may be a somewhat "different" future....

Taking the Measure of a Society

“You don’t have to be big to be great.” -- Sholom Aleichem (a.k.a. Solomon Rabinowitz, a.k.a. “The Jewish Mark Twain,” Russian-born American Yiddish Writer, 1859-1916)

How do we really take the measure of a society? How do we decide whether it is compassionate and great? Is it just a subjective, culture-bound opinion? I have faced this question on many occasions when doing interviews and having meetings in which I am advocating for the mentally ill. I have seen are many different criteria for trying to evaluate a society and a country:

1. The way in which a society treats its youngest and oldest citizens;

2. How a society honors its dead;

3. What opportunities it offers to its citizens and for people who come to the country and join the society;

4. How it behaves toward other countries;

5. The leaders it chooses to follow.

All of those are correct. But I would like to suggest that we should expand on those.

For me:  “The true measure of a society is how it treats its weakest members.”

For this is a measure of how far a society has progressed from a dog-eat-dog dominator model toward a more egalitarian partnership model. I have previously described my admiration for the work of Riane Eisler, and in my book and CD program Healing, Meaning and Purpose, I dedicate a whole chapter to ways of applying and expanding on some of her work.

I was once speaking to a Minister of Health in another country, and he expressed the view that providing care for the mentally ill was not the responsibility of government, and that they were simply a drag on the country’s economy. I politely but firmly disagreed, and was able to show him that providing good quality compassionate care for the mentally ill was not just the right thing to do, but it could also have a positive impact on his country’s bottom line. It happened that we were in a Buddhist country and he had a small image of the Buddha in his office, with some incense in front of the statue. At the end of my presentation I used a quotation attributed to the Buddha:

“In separateness lies the world's great misery; in compassion lies the world's true strength.”

When I talk about the advantages of an expanded, five dimensional model of thinking about people and their interactions, it is exceedingly practical. Many of the same things that are good for individuals are also good for society as a whole. That seems such an obvious statement, but when you think it through and apply my same principles of personal integration to integrate relationships and to produce an integrated society, the results can be remarkable.

“Compassion is the chief law of human existence.” -- Fyodor Dostoevsky (Russian Writer, 1821-1881)

Technorati tags: Riane Eisler, compassion, Buddha, society

Glucosamine and Chondroitin

A study has been published in last week’s New England Journal of Medicine that seems to show that there’s no advantage in taking the popular dietary supplements glucosamine and chondroitin. Indeed that’s what has been reported in the media . But notice that I said, “Seems to show,” for on closer examination there is more to this paper than it appears.

The investigators are to be congratulated for doing the study in the first place. What they did was to take a large group of 1583 patients who all had osteoarthritis of the knees, and divide them into five groups:

• A placebo group
• A group that took celecoxib (Celebrex) 200mg/day
• 1500mg of glucosamine/day
• 1200mg of chondroitin/day
• A combination of 1500mg of glucosamine/day and 1200mg of chondroitin/day

The study lasted 24 weeks, and the main outcome measure was pain in the knees. The study showed that although patients on Celebrex did very well compared with the placebo group, those on glucosamine and chondroitin did not do better than placebo, although the combination was better than using either supplement alone. But one of the odd things was that people with moderate to severe pain WERE helped by the combination, and in fact the combination out-performed Celebrex!

Not only does the combination seem to help people with the biggest problems with pain, but also there are some other important points:

1. The worse someone is, the bigger the room for improvement. If someone only has mild pain, you need a lot more patients to find a statistically significant improvement.

2. As in most studies, multiple measurements were done, and Celebrex was no better than placebo in 12 out of 14 of them. So if the “active comparison” failed on multiple measures, we need to be very cautious about how we interpret the study.

3. The placebo response rate in the study was 60%, while the average is 30-35%. This is a huge difference. This may be because the patients knew that they had a four in five chance of getting a treatment that might help them, so they went into the study with high expectations.

4. This is only one study, concerning one type of joint problem. There are more than 30 others that have in general been even more positive then the findings in the moderate to sever group, including a very long-term study that showed that over an eight-year period, the combination dropped the rate of knee replacement by almost 75%. It is crucially important to examine the results of any study in the context of everything else that has been known and discovered. Every type of study has to be checked, and verified.

5. The study was funded by the National Institutes of Health and is the first of two parts, with a second study of the impact of the treatments on X-rays of the knees still pending.

6. None of the groups had many side effects, but it is worth remembering that medicines of the Celebrex type are under intense scrutiny because of the possible association with cardiovascular disease.

7. Many specialists use anti-inflammatory medicines together with glucosamine/chondroitin, at least at the beginning of a course of treatment. And that makes good sense.

8. What about the dosing of the supplements? Although those are the doses used by most people, they may not always be enough. In patients who weigh more than 200 pounds, many experts recommend 2000mg of glucosamine and 1600mg of chondroitin. It is also wise to take the supplement in divided doses with food. (I have sometimes also found it very useful to add Methylsulfonylmethane (MSM), 1000mg/day to the glucosamine and chondroitin, though there is little research to support it.)

None of these treatments can be given to pregnant women or nursing mothers.

One other small caveat, if you are having surgery make sure that you tell you surgeon if you are taking these supplements. Chondroitin has minor anticoagulant activity , and so may glucosamine.

And remember that the maintenance of joint health is not just a matter of taking some supplements. It is a judicious mixture of taking the right medication when needed, together with supplements, a healthy diet containing some omega-3 fatty acids and antioxidants, exercise, management of posture, particularly of the spine, and weight management. To say nothing of ensuring that joint problems are not being compounded by psychological and relationship problems, and disturbances in the subtle systems of the body.

Technorati tags: glucosamine, chondroitin, knee pain, arthritis

Online Therapy

There is a very interesting article in Newsweek that talks about the growing trend to offer psychotherapy online. The article highlights the main reasons for this new development: convenience, anonymity and low prices. Without the overhead of running an office, internet therapy is roughly half the price of a regular office visit.

I was initially rather skeptical about the potential effectiveness of internet therapy: any experienced therapist will tell you of the amount of non-verbal material which is used during a session. Body language is a potent indicator of internal psychological states, and there is often a meta-text in communication, that can be difficult to pick up if you are not in the room with someone. And good therapy requires a lot of intuition. But on the other hand, there are times when people will open up when they do not see another person. It is one of the reasons that psychoanalysts used to use a couch, with the therapist out of sight of the patient.

So I have reviewed the research literature on the use of the internet for psychotherapy for an array of conditions, including addictions, and found over 190 studies, at least a third of which were reports of well conducted studies. Although it is still early days, and most of the research studies are small, the results are almost all positive. Clearly we cannot use the internet for trying to treat people with severe or life threatening problems, but for many of the problems which create such difficulties in many peoples’ lives, I think that this is a very positive development. So much so, that I am currently considering setting up an online service myself. I would be interested to hear of other people’s experiences of online services, and whether they would like me to offer one myself.

Technorati: More blogs about Online therapy.