ADDICTION & AMBIVALENCE
The key to dealing with addiction is understanding ambivalence. The addict is ambivalent, because he loves the euphoria but hates the sickness of addiction. Similarly, we are ambivalent, because we love the addict but hate the addiction. These two different kinds of ambivalence create a disconnect between the addict and us, so that we are never on the same page, and keep having the same fruitless, frustrating conversations. So in order to help addicts, we must focus on ambivalence, both theirs and ours.
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ADDICTION IN PHYSICIANS AND NURSES
Physicians and nurses are prone to addiction, because they both have knowledge of and access to addictive drugs, and therefore a false sense of security with these drugs. Unfortunately, they forget that addictive drugs are a deadly paradox: the more you know them, the more they fool you; the more you use them, the more they control you; and the more you enjoy them, the more they hurt you. It is wise for physicians and nurses to be proactively on guard against becoming addicted to addictive drugs.
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ALARM-GATE
The climatologists and epidemiologists at the Henny Penny institute of pseudo-science have inadvertently performed a public service. Climate-gate and flu-gate have immunized the public against media-spread alarmism.
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ALL FINE ARCHITECTURAL VALUES ARE HUMAN VALUES, ELSE NOT VALUABLE (FRANK LLOYD WRIGHT)
Architects are the unsung heroes of buildings. Working quietly behind the scenes, they design the beauty and functionality of homes, hospitals, houses of worship, schools, stores, theaters, museums, and skyscrapers. With imagination, creativity, and precision, architects convert empty space into rooms, ergonomic furniture, artwork, atria, cathedral ceilings, clerestory windows, stained glass, skylights, and landscaping. So let's celebrate the magic of architecture and incorporate all of its beauty and functionality into our lives.
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BEAUTY IS MORE THAN SKIN DEEP
The pursuit of beauty is a terrible burden. A beautiful face requires bright eyes, gleaming teeth, luxuriant hair, perfect features, and flawless skin. A beautiful body requires strong muscles, flat abdomen, trim buttocks, and no fat or flab. And a beautiful appearance requires monogrammed, designer clothes with matching accoutrements. So it's no wonder that so many people are obsessed with fashion, jewelry, cosmetics, cosmetic surgery, and image. Let's rebel against these obsessions, and free ourselves from the inanity and insanity of vanity. Then we can dedicate ourselves to life, love, health, and work, and let our appearance take care of itself.
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BEDLAM
Bedlam is more than a medieval psychiatric hospital. It is a metaphor for institutionalized chaos, confusion, and insanity. Today, when we think of Bedlam, we shake our heads and cluck our tongues at the primitive barbarism of early psychiatry. But we must remember that someday doctors of the future will likewise shake their heads and cluck their tongues at the primitive barbarism of today's psychiatric hospitals. So let's try to contain our hubris, accept our place in history, be objective about our institutions, and remember that today's modern medical center is tomorrow's Bedlam.
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BEWARE OF ADVERTISING
No matter what we are doing, we are constantly barraged with advertising; it permeates television, radio, movies, theater, print, and the internet. This relentless, ubiquitous advertising is much more sophisticated than we realize, because it employs subtle, subliminal messages that influence our unconscious. So no matter how inviting and friendly advertising appears to be, we must learn to recognize and resist the false and misleading aspects of its cleverly crafted messages.
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BEWARE OF BIG PHARMA
Big Pharma is the preeminent force in healthcare. It controls medical schools, medical research, medical journals, medical certification, continuing medical education, health insurance, and health policy. Big Pharma indoctrinates physicians, patients, and governments with a pharmaceutical orthodoxy that excommunicates all non-believers as sinners, heretics, and lunatics. In order to liberate healthcare and promote scientific progress, Big Pharma should fund independent, ongoing research into its excessive influence over healthcare. But let's not hold our breath waiting for this to happen.
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BEWARE OF BREAKING POINTS
Nothing in nature is perfect, including us. We all have sensitive nervous systems with many imperfections, and breaking points that manifest themselves at the worst possible times. So let’s take prophylactic measures to ward off these breaking points and avoid unnecessary catastrophes. Physicians and nurses should ask their patients about stressors in their lives and possible breaking points. This is not a call for more psychiatric diagnoses, drugs, or hospitalizations. Rather, this is a call for more sympathetic and supportive social services that recognize the imperfections and breaking points in human nature.
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BEWARE OF SCARE-CARE
Knowledge about healthcare is a mixed blessing. It can enlighten and help us, but it can also frighten and depress us. How do we strike the right balance? We should try to maintain a healthy level of skepticism and optimism, so that we don't become so overwhelmed with theory, dogma, and jargon that we lose our independent judgment and common sense. No one has all the answers, and those who claim to have all the answers are, at best, mistaken or, at worst, charlatans and scare-mongerers.
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BEYOND BIOLOGY
We are social mammals, and all of our activities are emotionally charged with thoughts and memories of our relationships. These thoughts and memories control much of our lives, including such physiological activities as sleeping and eating. In order to correct sleeping and eating disorders, such as insomnia, anorexia, bulimia, or obesity, we must understand their emotional associations and social context. Sleeping and eating are more than rapid eye movements and peristalsis; they are also dreams and reassurance. Both sleeping and eating revolve around our need for love and security. We are more than biological beings, and it's impossible to overestimate the significance of our emotional and social life.
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BIG PHARMA AND LITTLE DOCTORS
The relationship between the drug industry and doctors is upside down and backwards. Although the drug industry is motivated primarily by profit, lacks clinical experience and judgment, and has a history of egregious dishonesty, the drug industry nonetheless dominates doctors. The drug industry's economic might, political connections, deceptive marketing, biased research, and self-serving educational functions render even experienced doctors little more than medical students who seek a passing grade and prize the prescription pad as a badge of honor and raison d'être.
It's no wonder that doctors and medical journals are now half-heartedly and belatedly trying to emancipate themselves from the drug industry's hegemony and patronage, while the drug industry is hypocritically trying to maintain the status quo. And it's no wonder that healthcare is so frustrating, expensive, confusing, ineffective, and dangerous. How sad for doctors, patients, and patients' families, who suffer along with patients and struggle to pay inflated medical bills.
Those who seek to defend the drug industry's right to monopolize healthcare, gouge the public, and make rapacious, extravagant profits should read Mark 8:36, "For what shall it profit a man, if he shall gain the whole world, and lose his own soul?"
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BLUEPRINT FOR WRITERS
Writing is like building a skyscraper. The writer must be the architect, contractor, janitor, interior decorator, real estate agent, and doorman. As architect, the writer envisions the concept and blueprint for the writing. As contractor, the writer turns the blueprint into sentences and paragraphs. As janitor, the writer edits the sentences and paragraphs. As interior decorator, the writer embellishes the edited sentences and paragraphs. As real estate agent, the writer presents the embellished, edited sentences and paragraphs to the public. And as doorman, the writer greets all readers. In short, the writer is reaching for the sky and taking you along.
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BREAD & CIRCUS
Imperial Rome pacified the common people with free food and gladiator contests at the Colosseum, which the satirist, Juvenal, called bread and circus. Sadly, little has changed since those days; governments continue to pacify the common people with bread and circus. But today, the bread is welfare, provided by the liberals; the circus is warfare, provided by the conservatives; and the Colosseum is television, provided by the media.
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BREAKING UP IS HARD TO DO (NEIL SEDAKA)
Relationships are paradoxical. Although many relationships end badly, no one ever expects this to happen. And the bad endings always catch us by surprise. This happens in marriage, family, friendship, and business. So why do these bad endings surprise us? Perhaps it’s because many relationships are based on fantasy, denial, distortion, and transference, and can’t survive the light of day. Like dreams, relationships abruptly end when we wake up, and then the nightmare of breaking up begins.
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BUT THY ETERNAL SUMMER SHALL NOT FADE (SHAKESPEARE SONNET 18)
Grieving is bittersweet. At first, we are overwhelmed with the shock and bitterness of losing a loved one. But after a while, after the shock starts to wear off, we begin to reminisce about the sweetness that we shared with our loved one. Still later, after the bitterness and sweetness begin to recede, we start analyzing our relationship with our loved one, and come to new understandings. So the grieving process is lengthy, complicated, and ultimately productive. Let's give ourselves ample time to go through the whole process and come out a better person.
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CAVEAT CELEBRITY
Celebrity is a mixed blessing, because it offers the opportunity for comfort, candor, and philanthropy; but it also offers the opportunity for self-indulgence, self-destruction, and extravagance. Ironically, many celebrities lead short, unhappy, meteoric lives that are paradoxically both fascinating and revolting. So let's be grateful for our modest, mundane, mediocre lives which enforce a measure of normality, rationality, and reality.
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CLIMB EVERY MOUNTAIN (THE SOUND OF MUSIC)
Mount Everest is more than the tallest mountain on earth; it is a metaphor for the ultimate challenge. Life presents each of us with a unique series of opportunities and challenges. The task in life is to seize opportunities, face challenges, and turn challenges into opportunities. Each of us is a lone mountain climber scaling a unique mountain. And each of us needs creativity, courage, companionship, determination, and luck.
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CONNUBIAL CONUNDRUMS
There's no middle ground with marriage. It's either good or bad; it's either the boon or the bane of our existence. If it's good, it offers a bounty of love, companionship, security, and reassurance. But if it's bad, it offers nothing but an expensive, oppressive, omnipresent prison without walls. So let's spend more time selecting and caring for our marriage partners and avoid the dilemma of choosing between a bad marriage and a devastating divorce.
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CONSENT MAKES THE LAW (CONSENSUS FACIT LEGEM)
Informed consent is a redundancy, because being properly informed is a precondition of consent. Without being properly informed, a patient or client cannot give any legitimate, binding consent. Therefore, it is imperative that all professionals withhold any request for agreement or signatures, until after all information and questions have been fully addressed.
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CONSERVATIVES AND LIBERALS
The eternal conflict between conservatives (fundamentalists) and liberals (humanists) is, in part, linguistic. The former adhere to literal and denotative language, while the latter adhere to figurative and connotative language. Perhaps this conflict reflects a fallacy of false choices, because both kinds of language are equally valid and not mutually exclusive. So let's syncretically reconcile our political and religious differences, by increasing our semantic tolerance of language.
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CYBERPHOBIA
The internet is a modern miracle but a mixed blessing. It enables us to search and communicate with the rest of the world; but it also enables the rest of the world to search and communicate about us. Like most progress, the internet enhances our lives, but compromises our privacy. Since the internet is a sine qua non of modernity, let's not worry about things we can't change and can’t do without. And let's not succumb to Ludditism or paranoia and reduce our lives to cloak-and-dagger pulp fiction.
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DEATH BE NOT PROUD (JOHN DONNE)
Life and death are inseparable. From the moment of birth we begin to die, because our cells are programmed to grow, mature, and die by a process called apoptosis. But nevertheless, death often comes as a surprise, even to doctors and nurses, who try to forget that every symptom, injury, or sickness is yet another memento mori. The burden of life and death is too heavy for the medical profession to cope with by itself. In order to alleviate this burden and improve patient care, doctors and nurses should have interdisciplinary conferences with clergy, philosophers, psychologists, sociologists, and other non-medical experts, who can help to illuminate and mitigate the universal paradox of life and death - the danse macabre.
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DOCTORS AND NURSES
Life is competition for survival. This competition breeds conflict and jealousy, which affect all relationships, including those between spouses, siblings, neighbors, and co-workers. So we shouldn't be surprised that there is some conflict and jealousy between doctors and nurses. However, we must ensure that no internecine competition ever affects the quality of patient care.
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DOCTORS ARE NOT DEMIGODS
"By the authority vested in me, I hereby confer upon you the degree of Doctor of Medicine." With these magic words, spoken 37 years ago, the president of the university sanctified my four years of hell in medical school. But little did I realize that the hell of sickness and searching for answers had just begun. It took me decades to realize that traditional healthcare does not have all the answers, and that alternative healthcare does have some answers. So I find it disturbing that some medical doctors condemn alternative healthcare, and even suggest that alternative doctors do not deserve the title of doctor. I believe that healthcare should be complementary, and that medical doctors should be complimentary to their alternative colleagues. Despite their exalted status, medical doctors should strive to be humble, open-minded, and respectful, and give their patients every opportunity to receive help.
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DON'T FORGET THE DISAFFECTED
Professional leadership is an oxymoron. Professionals, such as doctors and lawyers, are trained to be passive, compliant followers, who reflexively accept and promote the party line. Moreover, professions tend to dismiss, ostracize, and marginalize disaffected members, who challenge the prevailing ideology and policies. This is counter-productive because art and science advance by dissension, as well as consensus. So let's stop cloning the status quo, and instead let's promote real progress by including the disaffected.
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EDUCATION: PRO & CON
Education is a mixed blessing. It teaches us to believe and remember facts, but it also teaches us to surrender our independent judgment and common sense. The net effect is that we are enlightened with facts, but benighted with dependence and gullibility. Our head is in the sky, and our feet are barely touching the ground. Let's counterbalance the enervating, stultifying effects of education with the energizing effects of practical experience, common sense, skepticism, spontaneity, humor, and exercise. Otherwise, we will all become clones of robots programmed by other robots.
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EXTROVERTS & INTROVERTS
As social mammals, our sociability spans a continuum from extroversion to introversion. Extroverts are outgoing and talkative, while introverts are reserved and reticent. These social characteristics are inborn and largely unchangeable. So we should all conduct an honest assessment of our personalities and structure our lives accordingly.
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FABLES AND FAIRY TALES
Fables and fairy tales are timeless wisdom, and no one is too old, or too educated, to learn from them. The potential beneficiaries of such wisdom include doctors, scientists, journalists, teachers, lawyers, and politicians. I propose that the curricula for all higher education incorporate the study of fables and fairy tales. Let's learn to view society from the perspective of such fabulists and social critics as Aesop, Hans Christian Andersen, and the Brothers Grimm. Let's learn to identify and criticize the pretentious, unjust, and absurd nature of society's arrogant power structure.
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FACILIS DESCENSUS AVERNO (THE DESCENT TO HELL IS EASY)
It's easy to become addicted, and it's easy to find fellow addicts. But it's hard to escape addiction, and it's hard to find effective help. Why is this? The sad truth is that society is based on addiction and would collapse without it. The entertainment industry is based on promoting and glorifying addiction; the tobacco industry is based on nicotine addiction; the food and beverage industry is based on sugar, chocolate, vanilla, alcohol, cola, and caffeine addiction; and the healthcare industry is based on treating all of this addiction with the addictive products of the pharmaceutical industry. So let's be honest about the role of addiction in society, and not simply blame the addict, who is really a victim of society's hypocrisy and greed.
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FACING DEATH
Facing death is life's final and most frightening challenge. What will happen to us? Will we disappear, or will we enter a new dimension and be greeted by loved ones who predeceased us? And what will happen to our loved ones who we leave behind? Will they be able to cope with losing us? Will they miss us, or will they forget us? Alas, we are mortal and can't answer any of these questions for sure. So we must have faith in our Creator who brought us here and then decided to reclaim us. Amen.
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FATE VERSUS FREE WILL
Notwithstanding all of its creative brilliance and originality, Freudian theory nonetheless harkens back to, and borrows from, the Classics. For example, Sophocles plays Oedipus Rex and Electra form the basis for Freuds theories of the oedipus and electra complexes. These plays and theories all serve as metaphors for the power of the unconscious and fate over the conscious and free will. In general, Eastern philosophy believes in the former, while Western philosophy believes in the latter. But regardless of culture or philosophy, we must all come to terms with these eternal dichotomies, and reconcile our lives according to them. A satisfying and productive way to do this is through the medium of art, which magically transcends all dichotomies by means of imagination, creativity, symbolism, and the juxtaposition of opposites.
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FIDES ET RATIO (FAITH AND REASON)
Truth is elusive, and we all feel the pull between faith and reason. While extremists adhere exclusively to one, and ignore the other, most of us recognize that life requires a realistic and practical combination of both. Faith teaches us to be dependent and obedient, while reason teaches us to be independent and objective. Since life requires all these qualities, we should avoid extremism and instead practice eclecticism by tempering faith with reason.
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FLOWERS ARE FOREVER
As symbols of beauty and vitality, flowers are a natural gift for loved ones. Flowers remind us that the purpose of life is to live and enjoy life. Unlike us, with all of our ambivalence, flowers have no problems with anger, guilt, depression, or suicide. They simply want to live, thrive, and reproduce. So we should celebrate flowers, and incorporate them into our lives. We need to be reminded that life is a gift that should be enjoyed.
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GLOBAL DEATH ROUNDS
The global financial crisis is end-stage pseudo-hypo-faux-commercialism caused by a metastatic cancer of cronyism, corruption, and tax-free, off-shore, alias bank accounts, which have rendered the marrow of our body politic necrotic, despotic, and idiotic. The various economic stimulus packages are emergency, involuntary transfusions, walletectomies, and bypass operations performed with great, ravenous, venal graft. The prognosis is guarded and depends on plausible deniability, persuasive posturing, pathological passivity, and perpetual deep sedation provided by the media under the supervision of spin doctors and hypnotherapists.
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GREAT EXPECTATIONS (CHARLES DICKENS)
Life is full of great expectations and equally great disappointments. Time and again our hopes are dashed, but each time they resurrect themselves like the mythical phoenix. This eternal hopefulness is the essence of life, because without it we succumb to disappointment and give up on life. So let's be grateful for our great, albeit unrealistic expectations, but let's try to temper them with the wisdom gained by past disappointments.
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GUNS: PRO & CON
When it comes to guns, there are two kinds of people: those who love them, and those who hate them. Gun-lovers use their guns for hunting, target practice, and self-defense. Gun-haters associate guns with gratuitous violence, injury, and death, to both people and animals. How can we reconcile the divide between gun-lovers and gun-haters? Frankly, this may not be possible, because the divide is simply too fundamental and deeply rooted. So perhaps the best we can do is to try to keep an open and respectful mind about both points of view.
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HEALTH AND SICKNESS
Like the two ends of a seesaw, health and sickness have an inverse relationship. As health goes up, sickness goes down. As health goes down, sickness goes up. By balancing the seesaw in favor of health, we can avoid sickness and the merry-go-round of endless doctors. Sadly, most doctors focus on sickness, but ignore health. Doctors define health as the absence of sickness. But health is more than the absence of sickness, just as life is more than the absence of death. Health is our most important goal, just as life is our most important possession.
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HEAVENLY FATHER
It sounds trite, but my father was a great guy. Lacking sophistication, but not dedication, he supported us in a comfortable home, while he worked in a filthy factory. After ten hours of standing at a noisy machine and inhaling clouds of toxic dust, he came home cheerful and loving, without self-pity or resentment.
One day, my father surprised me with a bicycle he built from spare parts that he found in the basement of our tenement. I loved that multi-colored bike, because my father built it for me with his hands and his heart. God, thank you for my father. Now I know what to expect from You.
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HUDNA (ARABIC FOR TRUCE)
An Open Letter to Palestinians
I suspect that behind your relentless and rigid rhetoric, you are sad, lonely, and unwell. Let's put politics and polemics aside for the time being. Instead, please allow me to be a source of friendship and comfort to you. If you wish, I'd be happy to give you free health advice. Also, since we are poets, perhaps we can read each other's poems. Let's become poets for peace and health. Let's write peace poetry. Shukran.
Salaam alaikum
Hugh Mann, The Patient Doctor
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HUMAN NATURE & AMBIVALENCE
Human nature is contradictory. We are all burdened with conflicting emotions about life and death. At any given moment, we can feel positive and negative emotions, which tear us in different directions. How can we cope with this? We should accept the limitations of human nature, both in ourselves and others, but at the same time, we should also strive to retain control of our behavior. Ultimately, our lives are determined by our behavior, not by our emotions.
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IN PRAISE OF DISABLED PEOPLE
The world is full of disabled people who are routinely stigmatized, marginalized, and ostracized. We shun the disabled, because they frighten and depress us by reminding us of life's dangers. Let's reverse this systematic exclusion of the disabled by recognizing that the disabled are not unfortunate, irrelevant burdens, but rather heroic figures who can teach us how to face and overcome life's inevitable challenges.
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IN PRAISE OF FATHERS
When it comes to parenting, we tend to overestimate mothers and underestimate fathers. We assume that mothers are more devoted and caring than fathers. This is unfortunate, because parenting does not depend on gender, and in many families, it is the father who provides the love and nurturing for the children. So let's not disregard or diminish the role of fathers; they love their children just as much as mothers do, and sometimes more.
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IN PRAISE OF PIONEERS
Nothing is free, and everything has a price, whether it be financial, physical, or emotional. But there is an especially heavy price for going up against the system, because the system doesn't tolerate disagreement or opposition. So I salute all brave souls who challenge the system and bear the consequences. These brave souls are the greatest pioneers in civilization, and they deserve to be honored.
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IN PRAISE OF THE ELDERLY
Life is a paradox: we want to live, but we don't want to age or look old. Since living and aging are inseparable, and since old age is inevitable, we must reconcile ourselves to the consequences of living. So let's learn to appreciate the magic of a wrinkled face, thinning hair, mottled skin, trembling hands, a toothless smile, and a wise gaze that has seen life. And let's pay homage to the elderly by emphasizing their unique beauty and wisdom.
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IN PRAISE OF THE LAITY
Society's institutions are controlled by oxbridge-ivy-league professionals, who ostensibly represent "the best and the brightest." Government is controlled by top lawyers; medicine is controlled by top doctors; banking is controlled by top economists; and education is controlled by top professors. The net effect is that society is controlled by homogeneous coalitions of elite professional insiders who cloak their arcane activities with esoteric jargon. I propose that all societal institutions be controlled by redbrick laypersons who can apply common sense and function as conduits between the professionals and the public. This will provide some long-overdue transparency and accountability over wealthy, powerful, inscrutable institutions whose members tend to be arrogant and condescending. Sometimes the brightest are not the best.
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IS HEALTHCARE A RELIGION?
Doctors proudly declare themselves scientists. But is this really true? Although science is based on the scientific method of predictability and reliability, healthcare is often unpredictable and unreliable. Perhaps healthcare is, in part, a religion, in which the doctor (priest) inquires about symptoms (sins), prescribes a medicine (sacrament), and performs a procedure (baptism), in order to cure (save) the patient (parishoner) of sickness (eternal damnation) and restore health (grace). Both healthcare and religion depend on faith.
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ISRAEL VERSUS ARABS
Like two roosters trapped in a cock fight, Israel and the Arabs are co-equal victims in a world that is motivated by conflict, gore, and profit, rather than cooperation, health, and peace. Let's stop blaming the victims, and let's put the blame where it belongs: the failure of the world's academics and physicians to solve man's problems and change man's mindset.
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IT'S NOT SO ELEMENTARY, MY DEAR DOCTOR
Sir Arthur Conan Doyle's unforgettable characters, Sherlock Holmes and Dr. Watson, are a study in contrasts. Holmes, the addict, autodidact, and astute bohemian, is a perfect foil for Watson, the abstemious, formally educated, dull doctor. Together, Holmes and Watson represent Doyle's intrapsychic conflict: Holmes is the free-spirited (albeit Victorian) id, while Watson is the stodgy stumbling superego. Doyle resolves this intrapsychic conflict by aligning Holmes (good id) and Watson (superego) against the evil Professor Moriarty (bad id) in a battle of wits (ego). Doyle’s masterpiece memorializes Freud's tripartite structural theory of id (instinct), superego (conscience), and ego (intellect) so skillfully that it seems "elementary."
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KINDNESS
Every spring, a bluebird flies down our chimney, gets trapped in the flue, and makes a tremendous racket trying to free itself. But birds cannot fly vertically, so eventually the little fellow falls into the woodstove, exhausted and defeated. Then we gently rescue him, take him outside, and watch him fly away. Like the bluebird, man is trapped, unable to escape or ascend. And man is waiting for the gentle hand of kindness to lift him up.
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KUDOS TO PATHOLOGISTS
As an intern, I rotated through anatomic pathology and performed autopsies under the supervision of senior pathologists. Although my graduating medical school class was 90% male, with no non-whites, these pathologists were a surprisingly and delightfully diverse and avant-garde group of physicians who enriched my understanding of life. They were kind, helpful, knowledgeable, philosophical, and unquestionably the best teachers I encountered in my medical education. They correlated the basic sciences with clinical medicine and taught me to actively question, think, and analyze, rather than passively accept, believe, and memorize. Although my internship ended many years ago, and I did not become a pathologist, I still have fond and appreciative memories of these pathologists. Each one was a gem, and it was a privilege to know them.
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KUDOS TO SURGEONS
Healthcare is a profound process that alters both physician and patient. Medical education is a demanding, exacting, life-altering process that trains physicians to alter the patient's anatomy (surgery) and physiology (medicine). Anatomical alterations are the exclusive domain of surgeons, whose training is the longest and most demanding of all specialties. Surgeons require not just knowledge, but also strength, stamina, speed, acuity, and dexterity. Surgery is so central to healthcare that the history of surgery is the history of healthcare.
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L'ALLEGRO AND IL PENSEROSO (JOHN MILTON)
Life is a series of dilemmas. We are constantly faced with imperfect choices which conflict with each other. How can we resolve such dilemmas? First, we must recognize that both choices might be wrong, and that we have yet to consider the correct choice. So we must not rush headlong into prematurely resolving a dilemma by making a choice. Instead, we must delineate and analyze the underlying factors and search for all possible solutions. Let's strive to be more penseroso (thoughtful) and less allegro (action-oriented).
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LAND OF OPPORTUNITY
Although it is called the "land of opportunity." America is far from a paradise for many people. But then again, no country is perfect, and all have their faults. So how should we evaluate and compare different countries? What standard should we use? I prefer the standard cited by the English lexicographer, Samuel Johnson, who said "A decent provision for the poor is the true test of civilisation." Opportunity is nice, but compassion and mercy are nicer.
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LET EVERY MAN BE MASTER OF HIS TIME (MACBETH)
If you don't have enough time to take care of your health, you will spend a lot of time suffering and going to doctors. And after you have taken the doctor's medicine, you will still spend a lot of time suffering. The time that you spend suffering and going to doctors is often a waste of time. If you spend your time promoting and protecting your health, you will have lots of free time to enjoy yourself.
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LET'S PROMOTE FEMINISM
Society has always been patriarchal, even in its mythology and religion. The Book of Genesis says that God, the Father, created Eve to be a companion and helpmate for Adam. Sadly, women have always been second-class citizens subordinate to men. I propose that this universal sexist bias against women is the root of all other bias, including paternalism, elitism, racism, ethnocentrism, and ageism. The best and most efficient way to correct such bias is to extirpate sexism and promote feminism. Patriarchies are passé.
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LIFE AND DEATH
Both medicine and law grapple with issues of life and death such as abortion, euthanasia, and suicide. Notwithstanding facile positions promoted by political extremes, these issues remain vexing dilemmas, which require Solomonic wisdom. Sadly, most professions seem long on facts, but short on wisdom. Perhaps we have yet to properly define or articulate these dilemmas. And perhaps there is no more eloquent articulation of these dilemmas than Hamlet's words, "To be or not to be, that is the question..."
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LIFE IS A LOCKED-IN SYNDROME
The locked-in syndrome is more than just a brainstem stroke with quadriplegia. The suffering and courage of locked-in patients has captured the public's imagination, because we can all identify with such patients. We realize intuitively that the locked-in syndrome is a metaphor for the loneliness, helplessness, and hopelessness of life. With few exceptions, we are all "locked-in" bad jobs, bad relationships, bad marriages, and bad financial, legal, or health problems. Let's dedicate ourselves to finding the key that opens all locked-in states.
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LOVE-HATE RELATIONSHIPS
Since all of our feelings are ambivalent, it's no surprise that love-hate relationships are so common. No matter how hard we try to have pure feelings, it's impossible. Let's accept ambivalence as a fact of life, and reconcile ourselves to the painful, embarrassing inevitability of love-hate relationships. And let's learn to appreciate love, even if it's sometimes tinged with hate.
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MIND-BODY DUALISM
Mind-body dualism is as old as history, and as current as today. This eternal dualism has been explored by many great philosophers, and it remains a central issue in today's materialistic world. For example, it informs conflicts between faith and reason, religion and science. It also informs conflicts between psychologists, who treat the mind, and physicians, who treat the body. In order to resolve these conflicts, we must revisit the conundrum of mind-body dualism in a multi-disciplinary fashion, so as to minimize polarizing polemics and facile solutions.
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MOTHER EARTH
Our relationship with Earth is paradoxical. We struggle with the forces of nature and seek to dominate Earth, but we need Earth’s air, water, food, and shelter to stay alive. We travel and explore Earth, but we need Earth’s energy to overcome gravity and inertia. We claim to own land on Earth, but when we die, the land reclaims our bodies. In the midst of our struggles with the forces of nature, we tend to forget that life is a magical, mysterious gift that Earth creates, controls, cancels, and recycles. Life and death have no meaning apart from Earth.
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MOTHER NATURE
Mother Nature designed us to drink milk. We are mammals, which means that mothers feed their babies with breast milk. So milk is not only nutritious, but also comforting. If you feel anxious or depressed, have a glass of organic whole milk and you'll feel better. I've noticed that people who dislike milk, also dislike eggs. Since milk and eggs both represent female sexuality, perhaps these people find it hard to accept female sexuality. We must all remember that Mother Nature is a woman.
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NECESSITY IS THE MOTHER OF INVENTION (PLATO)
Most inventions are created just in the nick of time, thus proving that necessity is the mother of invention. Without the pressure of necessity, we don't feel motivated to be creative in the first place. So we should try to accept, and even welcome, the pressure of necessity as a prerequisite to creativity and progress.
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ONCE UPON A TIME...
Storytelling is a timeless, universal form of entertainment, education, and inspiration. Scripture, myth, legend, fable, and fairytale are fantastic, unforgettable stories that magically blend fact and fiction with logic and illogic. So let's rediscover our love of bedtime stories and apply the magic of childhood to our drab, dull, adult lives.
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PACIFISM, NOT PASSIVISM
"In the end, we will remember not the words of our enemies, but the silence of our friends." With these incisive words, Dr. Martin Luther King, Jr. diplomatically expressed his frustration with the prevailing silent acquiescence and tacit consent to America's egregious discrimination against people of color. Like his mentor, Mahatma Gandhi, Dr. King was assassinated, but both men will live forever in the pantheon of human dignity, civil rights, and social justice. Let's hope that their exemplary acts of selfless, courageous pacifism will inspire all of us to appropriate levels of moral outrage and activism.
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PAGING DR. FREUD
Psychiatric intervention is reflexively synonymous with pharmacotherapy. Modern psychiatry is dominated by reductionist, mechanistic psychopharmacology, which focuses almost exclusively on synapses, neurotransmitters, and SSRIs. Unfortunately, modern psychiatry has largely dismissed the seminal work of Sigmund and Anna Freud. The former described structural theory (id, ego, and superego); topographic theory (conscious, preconscious, and unconscious); oedipus and electra complexes; and transference and countertransference. The latter described ego defense mechanisms: repression, denial, rationalization, sublimation, identification, displacement, projection, and reaction formation. In my opinion, it is difficult, if not impossible, to truly understand someone’s motivation and behavior without an appreciation of these two great pioneers.
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PARASITOLOGY 101
The world is full of parasites. They are in our air, water, food, home, bedding, and clothing. They even live in and on us. Some of these parasites are harmful; some are harmless; and some are even helpful. How can we deal with all these parasites, and how should we feel about them? First, we should maintain proper hygiene and take all necessary precautions. Second, we should seek medical care when necessary. Third, we should be philosophical and recognize that life is a complex and never-ending food chain, in which we are both diner and dinner, predator and prey. In short, parasites are part of the price that we pay for living.
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PEACE AND HEALTH
Individual health and public health are inseparable. Both are essential elements of a successful society. In order to promote individual health, physicians must also promote public health and function as medical sociologists, with an eye on quality of life, social justice, international relations, and world peace. The path to world peace begins with the physician's commitment to individual health and public health. Peace and health are inseparable.
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PEACE POETRY I
Peace poetry is poetry that emphasizes our common humanity and promotes religious tolerance and interfaith dialogue. Since religious conflicts often lead to violence, and since religions are based on scripture, which is essentially poetry, it makes sense to solve religious conflicts and violence with peace poetry. One example of peace poetry is my poem called “Brother,” which has received positive responses from all over the world. (Click here for my poem of peace called Brother. Click here for reviews of Brother.)
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PEACE POETRY II
At the root of most religious debate is the identity of the promised Messiah, who will solve all the world's problems. Most of the world is waiting expectantly for the momentous arrival of the Messiah. What can we do while we’re waiting? Let's stop fighting and arguing with each other about whose vision of the Messiah is most correct. Instead, let's celebrate the Messiah with poetry, the universal language of truth, unity, and peace.
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PEACE POETRY III
Religions are based on scripture, which is mostly poetry. So it only makes sense that religious conflict must be resolved through poetry, and not through politics, negotiation, or war. I propose that all religious conflicts be redefined poetically, so that they can be resolved without bloodshed, winners, or losers. So let's sharpen our pencils, not our swords; send missives, not missiles; and apply our minds to metaphor, simile, rhyme, meter, and prosody, but not pomposity, animosity, ferocity, atrocity, or monstrosity.
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PHYSICIAN IMPOSSIBLE
A physician with a sick family member is faced with the difficult, if not impossible, task of relinquishing the role of physician and accepting the role of co-patient. This role reversal is an awkward dilemma for all parties and should be discussed openly with flexibility and compromise. One possibility is an ad hoc clinical alliance between the treating and non-treating physicians which bridges the divide between physician and patient, so that irrespective of the outcome, all concerned will feel they did their best, and will not be haunted with doubts, regrets, or guilt.
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PLACEBOS: TRICK OR TREAT
Psychoanalysis teaches us that there are two kinds of thinking: primary process and secondary process. Primary process is magical thinking characteristic of children. Secondary process is rational thinking characteristic of adults. Since we never really outgrow our childhood, we never fully give up our primary process thinking. Ironically, education sometimes promotes primary process thinking, rather than secondary process thinking. This happens in medical education, in which medical students are taught that the use of placebos promotes a sense of "healing" in the patient, and moreover, promotes a sense of "success" in the physician. Sadly, a sugar pill is being used to "treat" both patient and physician. Since health care is ostensibly based on science and secondary process thinking, it's time to dispense with placebos and to stop dispensing them to patients.
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"PLEASE, SIR, I WANT SOME MORE." (OLIVER TWIST)
Regarding most institutions, it has been said that the wrong people have the keys. This cynical remark has much truth and raises questions about the legitimacy of our institutions. Oftentimes, luck and circumstances determine who runs the institution and who resides in the institution. I propose that we re-think the whole issue of institutions, including prisons, mental hospitals, and orphanages. These institutions are a blot on society, and their residents deserve much better treatment than they receive. Surely, society can develop more humane ways of dealing with unfortunate people, who are often unable to change their dysfunctional lifestyles.
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POLITICAL SCIENCE: FACT OR FICTION
Political science is an oxymoron. Since politics involves secret alliances, hidden agendas, broken promises, and media misrepresentation, it's hard to imagine that politics is scientific. And it's not hard to imagine that politics is, in fact, inimical to science. So I propose that science free itself from politics, and that politics stop masquerading as science.
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POLITICS & RELIGION
Politics and religion are philosophies that function as software for the hardware of our nervous system. Liberalism is read-and-write software that promotes progress; while conservatism and fundamentalism are read-only software that protects the status quo.
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POWER TENDS TO CORRUPT (LORD ACTON)
Despite abundant examples of how money and power often lead to corruption, we continue to be surprised each time another example is uncovered. Why are we so surprised? Perhaps we unrealistically elevate powerful people as exemplars of morality who can function as perfect leaders. Let's resist this temptation and recognize that powerful people are often driven by ambition, greed, and hubris, and must be viewed with a measure of skepticism and cynicism. And let's demand that powerful people provide the public with real evidence of transparency and accountability.
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PRESCRIPTION FOR HAPPINESS
There are two kinds of happiness: real, inner happiness; and false, superficial happiness. Real, inner happiness is the spontaneous contentment that comes from good health, creative work, and loving relationships. False, superficial happiness is the contrived fun that comes from addictions, possessions, and power. It's important to distinguish between the two kinds of happiness, and to not settle for false happiness.
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PRESCRIPTION FOR PEACE
Aesop's fable "Androcles and the Lion" tells the story of Androcles, who removed a thorn from a lion’s paw, and was subsequently rescued by the very same lion. The moral of this story is that kindness can sometimes turn a dangerous enemy into a great friend. So let's not be too quick to hate our enemies. Instead, let's treat our enemies as potential friends, by demonstrating kindness and compassion. It's more humane to cure your enemies than to kill them.
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PRESCRIPTION FOR PESSIMISM
Life is unfair. Some people seem blessed with opportunity, while others seem cursed with obstacles. So it is natural for some people to feel optimistic, while others feel pessimistic. How can we cope with the deadening, disabling feelings of pessimism? The trick in life is to turn obstacles into opportunity by using courage, creativity, and perseverance. It's amazing how often this formula works, and I encourage all pessimists to give it a try.
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PRESCRIPTION FOR WORRY
Life is precarious, and there are many things to worry about. Our most common worries are money, relationships, and health, in that order. Unfortunately, this order is backwards. That's why we're so unhappy. If we reverse this order, each worry solves the next worry. Good health leads to good relationships. Good health and good relationships lead to financial security. And all three lead to happiness. In order to reduce our worries, we must establish the proper priorities. This is my prescription for worry.
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PRETTY MUCH ALL THE HONEST TRUTH-TELLING THERE IS IN THE WORLD IS DONE BY CHILDREN (OLIVER WENDELL HOLMES)
Children are a paradox. Their innocence and ignorance make them good lie detectors and truth reporters. Lacking sophistication, children tend to blurt out unpleasant truths that adults repress or suppress. This curious paradox has been memorialized in Hans Christian Andersen's tale The Emperor's New Clothes. So let's learn to appreciate the simple but painful truth of children. We need their honesty, just as they need our protection.
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PRIDE GOETH BEFORE A FALL (PROVERBS 16)
Success is intoxicating. It can mislead us into reveries of pride, privilege, perks, petulance, and grandiosity. Sadly, this sometimes happens with physicians, attorneys, and public officials, who serve the public and should know better. How can this be prevented or corrected? Continuing medical and legal education should promote humility and gratitude by requiring some pro bono work for the disadvantaged in prisons, orphanages, soup kitchens, and homeless shelters. It is wise to remember that titles are not entitlements.
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PSYCHIATRIC DISORDERS: FACT OR FICTION
The Diagnostic and Statistical Manual of Mental Disorders (DSM) published by The American Psychiatric Association (APA) contains a growing number of psychiatric disorders that parallel the growing number of psychiatric drugs produced by Big Pharma, so that there is at least one psychiatric disorder for every psychiatric drug. This curious coincidence is fortunate for the financial interests of Big Pharma and makes some people wonder, with justifiable cynicism, if DSM and APA are subservient to Big Pharma.
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PSYCHIATRIC DRUGS: FACT OR FICTION
Psychiatric drugs ostensibly help patients by correcting imbalances in neurotransmitters, like dopamine, serotonin, epinephrine (adrenaline), and norepinephrine (noradrenaline). Unfortunately, this simple and straightforward theory doesn’t translate into practical results. Instead, psychiatric drugs tend to hurt patients by creating new neuropsychiatric problems, which complicate and aggravate pre-existing psychiatric problems. I suggest that the mechanism of action for psychiatric drugs is a folie à deux between doctor and patient, which has been cultivated by Big Pharma, whose economic might exerts enormous control over medical schools, medical societies, medical journals, and the media.
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RATIONALITY AND REALITY
As the most intelligent species, we are prone to hubris and self-deception. We tend to equate our intelligence with honesty, rationality, and infallibility, although our history is replete with quite the opposite. We seem to forget that life is often overwhelming, and that we are constantly tempted by escapism. So as we advance our science, technology, and belief systems, we must be humbly mindful of our many shortcomings and question our assumptions about reality. Let's remember the insightful words of T.S. Eliot, who said, "Humanity cannot bear very much reality."
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RELIGIOUS VOWS
Although noble in intent, religious vows of poverty, chastity, and obedience are nonetheless draconian and difficult, if not impossible, to keep. So it should come as no surprise that many votaries unwillingly succumb to destructive behavior. Prospective votaries should carefully consider the superhuman effort it will take to honor their vows. And religious institutions should alleviate the extreme burdens placed on votaries, who wish to serve humanity and deserve to be treated humanely.
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RESPECT EGO BOUNDARIES
"Ego boundary" is a psychoanalytic term that refers to the ego function of distinguishing between self and non-self. One example of an ego boundary problem is the person who invades your privacy and violates your dignity by making gratuitous, unkind remarks to or about you. How should we respond to such remarks? In general, it is best not to respond, for if we do, we only dignify the unkind remark and invite more of the same. So let's not reward boorish, uncouth behavior, and instead demonstrate that it is unworthy of comment. Let's promote a healthy respect for ego boundaries.
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ROMEO AND JULIET (SHAKESPEARE)
To varying degrees, every mixed marriage is a potential Romeo and Juliet with feuding families. How can we avoid such a tragic outcome? How can different races, ethnicities, nationalities, and languages live in peace and harmony? First, we must advance beyond the tired, passive shibboleths of diversity and tolerance, by actively befriending those who are different from us. Second, we must free ourselves of negative stereotypes and recognize that feuds are "much ado about nothing." Otherwise, our world will not survive.
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Rx FOR COMPETITION
Competition is a mixed blessing. It can motivate us to improve our performance, but it can also dominate us with fears of inadequacy. The best way to deal with competition is to compete with ourselves, but not with other people. Try to focus on achieving your goals and improving your abilities, but don't worry about how you compare with other people. Learn to accept yourself and appreciate your unique humanity, regardless of whether you achieve your goals.
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Rx FOR COURAGE
It takes courage to live. Problems loom large; resources are scanty; pessimism is pervasive; and the air is heavy with hopelessness and helplessness. So how can we persevere, let alone prevail? We should remember that we are not alone and turn to the emotional support of family and friends, who can provide us with sympathy and encouragement. We should also turn to the divine guidance and mercy of our Creator, who is rooting for us, but will always love and accept us even if we fail.
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Rx FOR CREATION
The superabundance of natural and man-made disasters in the world, none of which can be corrected, suggests that the world is imperfect and incomplete, and that God should have spent more time on Creation, and less time on recreation, by working a half day on the Sabbath.
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Rx FOR FDA
Like most regulatory agencies, the US Food and Drug Administration (FDA) is compromised by financial conflicts of interest with the very industries it ostensibly regulates. These conflicts of interest raise questions about the integrity and/or agenda of the FDA, and thereby frighten and confuse the public. The first priority of a new FDA commissioner is to restore the public's confidence in this vital agency by eliminating all of its cozy relationships with industry. Let's make sure that FDA doesn't stand for Force Drugs and Devices on Americans.
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Rx FOR FEUDS
The Israeli-Palestinian conflict is an intractable feud impervious to negotiation and in need of a new perspective. I propose that we eschew the polarizing, stigmatizing rhetoric, and instead redefine this conflict as a humanitarian health crisis based on dehydration, hunger, and addiction, all of which aggravate conflict by making people frustrated, angry, and violent. To stop a feud, change the food.
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Rx FOR JERUSALEM
Notwithstanding the terrible realities of Gaza and the West Bank, the central issue between the Israelis and Palestinians is philosophical, and based in Jerusalem. Like most cities, Jerusalem is divided by competing political and religious philosophies. Unfortunately, the competition associated with these well-meaning philosophies often creates unintended conflict. I propose that Jerusalem, and other cities, counteract such conflict by developing a new, non-political, non-religious, non-competitive philosophy based on our common humanity. Such a philosophy would emphasize that all people, regardless of politics or religion, or any other divisive factor, share common origins, needs, and rights.
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Rx FOR LOGICAL REASONING
Philosophers and logicians teach us that there are two kinds of reasoning: deductive (a priori) and inductive (a posteriori). The former involves reasoning from cause to effect, and from general to particular; while the latter involves reasoning from effect to cause, and from particular to general. Like most sciences, healthcare tends to emphasize the value of deductive reasoning at the expense of inductive reasoning. I propose that this imbalance is hindering medical progress and requires the corrective input of philosophers and logicians, both of whom understand the dual and contradictory nature of reason and reality.
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Rx FOR MARRIAGE
Marriage is an unconscious attempt to recreate and repair childhood traumas. So it's no surprise that marriage frequently ends in a traumatic divorce. Considering the prevalence and pain of divorce, people should be married by a lawyer and divorced by a clergyman. Let's practice prevention and merciful intervention.
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Rx FOR MDs
The role of a doctor is impossible. First, the doctor must recognize that he or she is sick and scared, just like the patient. Second, the doctor must weave a tapestry of hope and hopelessness, by functioning as clinician and magician, scientist and alchemist, parent and priest, athletic director and funeral director. All of this haunts doctors and alienates them from their families and communities. Doctors should not be expected to function as apologists or salesmen for a healthcare system that obviously does not have all the answers.
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Rx FOR SELF-ESTEEM
Although each of us feels unique and uniquely important, society regards and treats us as ordinary and unimportant. This discrepancy threatens our self-esteem and alienates us from society. How should we deal with this troubling discrepancy? We should recognize that our uniqueness is a hidden treasure that can only be discovered by our loved ones, and most of all, by our Creator, who endowed each of us with an aspect of His own divinity.
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Rx FOR SUCCESS
Apart from the few gifted people for whom everything comes easy, most of us have to work hard to achieve anything. Often our efforts are unsuccessful, and we must deal with failure, disappointment, and discouragement. However, we must remain hopeful and persevere with dedicated, continued efforts. Like the basketball player who makes a second effort by charging the basket after shooting the ball, we must make secondary and tertiary efforts to achieve our goal. To paraphrase Sir Winston Churchill: Never give up. Never give up. Never, never, never, never.
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Rx FOR TECHNOLOGY
Today's world is a virtual reality that has been morphed, warped, and dwarfed by technology. We live in a world dominated by TV, radio, movies, internet, and cell phones. All of this technology is a mixed blessing: it connects us with others, but it disconnects us from ourselves. In order to reconnect with ourselves, we must "disumbilicate" ourselves from technology, by spending at least one hour a day in solitude, silence, and inner reflection. Let's rediscover the soothing nature of aloneness, which allows us to commune with ourselves.
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Rx FOR THE GATES FOUNDATION
The most neglected diseases are poverty, hunger, homelessness, and addiction, all of which are intractable and ubiquitous. These pandemic diseases are especially devastating, because they leave victims stigmatized, ostracized, and isolated - without opportunity, hope, or the will to live. The Gates Foundation should approach these diseases as interrelated elements of a single syndrome and fund non-pharmaceutical interdisciplinary research which seeks new understanding and practical treatment modalities. Let's shine a light of attention and compassion on those who are neglected and helpless.
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Rx FOR TRUTH
The information age is upon us, and we are drowning in facts, but starving for truth. Despite all the scientific and technological advances, our problems remain the same, and our institutions are failing. Even worse, our institutions are shirking their responsibility by covering up their failures with hype, hoopla, razzle-dazzle, and misdirection. However, one bright spot is the free and open internet, which has exposed and challenged the hegemony of the stagey, elitist mainstream media. Now we need a plenipotentiary truth and reconciliation commission that will provide us with full transparency and accountability over our previously trusted institutions.
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Rx FOR VIOLENCE
Violence is a worldwide mysterious plague that infests every level of society. It baffles and intimidates teachers, doctors, lawyers, police, and politicians. What is violence, and why is it so powerful and pervasive? Violence is a predictable and inevitable consequence of addiction. The addict suffers with insatiable cravings, frustration, and anger, all of which frequently lead to violence. The best way to deal with violence is to identify and treat the underlying addictions.
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SALT: PRO & CON
Our free and easy access to table salt is a mixed blessing. Salt enhances the taste of food and helps to maintain electrolyte balance and fluid volume; but it also causes hypertension and cardiovascular disease. Therefore, we must monitor our total daily salt intake, so that we have enough but not too much. In my experience, the average healthy adult needs about 1/4 teaspoon of salt and 8 glasses of water per day. I prefer plain (non-iodized) sea salt, because sea salt has more trace elements (like iodine) than land salt, and because we only need iodine in very small amounts.
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SCIENCE VS. TECHNOLOGY
Many people equate science with technology. This is unfortunate, because the two are not the same. Science is a pure pursuit of knowledge with no agenda, while technology is applied science with a political and/or commercial agenda. Therefore, science should lead technology, and not the reverse. Sadly, we live in a world in which technology leads science. This is why politics and commerce are so prominent, but scientific discoveries are so rare. We need a new scientific revolution, in which pure science exists for its own sake, and not for the sake of politics and commerce.
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SCIENTISTS ARE NOT DEMIGODS
We are ambivalent about scientists, because we are in awe of their almost magical ability to understand and control the forces of nature. Like modern-day Merlins, they thrill and mystify us with their jargon, potions, equipment, procedures, and results. But we tend to forget that science is incomplete, imperfect, experimental, and a work-in-progress. This is why scientists can't fully heal us or solve all of our problems, and this is why they occasionally hurt us. So let's respect and appreciate scientists, but let's not worship them or give them our unqualified trust.
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SELF-ACCEPTANCE
Self-acceptance is the ultimate act of courage and compassion. After all, none of us really likes himself, and we all pretend to be someone we're not. The road to self-acceptance is bumpy, and there is much denial and pretense along the way. How can we expedite or ensure self-acceptance? We should regard self-acceptance as a lifelong goal that needs constant self-examination plus nurturing from family, friends, and professionals. The world would be a better place, if we could all learn to accept ourselves and others.
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SEVEN DEADLY SINS
Christianity supplements the Ten Commandments with the Seven Deadly Sins, which are lust, envy, gluttony, sloth, greed, anger, and pride. These sins pertain to individuals, but not to groups, and thereby, exonerate societal sins. The Seven Deadly Sins should be supplemented with Society's Seven Deadly Sins, which are hunger, thirst, homelessness, sickness, illiteracy, bigotry, and poverty. These sins violate basic human rights and reflect institutionalized societal neglect. Let's evaluate and grade societies accordingly.
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SKIING AS METAPHOR
Skiing is more than an Olympic winter sport that has captured the interest of average people. It has become a metaphor for life, because it epitomizes the strength, courage, and endurance that life requires. But life also requires flexibility, which we seem to lack. Life asks us to zigzag right and left around obstacles, as if we are on a slalom course. But we like to proceed fast and straight, as if we are schussboomers. Since life is a slalom, but we are schussboomers, it's no wonder that we so often plow headlong into problems.
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SOCIAL ENTREPRENEURS
Social entrepreneurs are altruistic visionaries whose innovative ideas help to launch beneficent new businesses. Sadly, many of these businesses fail financially, because the entrepreneurs are more motivated by idealism than pragmatism. In order to succeed, the entrepreneurs must team up with accountants and managers whose pragmatism can shelter and nurture the entrepreneurs’ altruistic vision, which is sometimes worth its weight in gold.
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SOCIAL JUSTICE
Society's legal system is a mixed blessing. It provides us with the stability of law and order, but it also provides courts and attorneys with the ability to defraud us with impunity, none of which goes unnoticed. Many of us have the impression that courts tend to promote pre-determined biased agendas, which consistently benefit the powerful and wealthy. Sadly, there is often a world of difference between legal justice and social justice, even in so-called developed countries.
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SOCIETY AND SUPERIORITY
Society is based on institutionalized stratification. The monarchy has the royalty and the commoner. The military has the officer and the enlisted. The workplace has the employer and the employee. The bank has the creditor and the debtor. The hospital has the doctor and the nurse. Stratification is an elitist system, in which a few fortunate people, with special titles, blindly and arrogantly luxuriate in the delusion that they are actually superior to others.
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SUPPORT GROUPS: PRO & CON
Support groups are a mixed blessing. They can provide us with information, sympathy, structure, and hope; but they can also subject us to misinformation, criticism, oppression, and misery. How can we maximize the good, but minimize the bad? We should accept help from carefully screened support groups, but we should also recognize that no individual or group has all the answers, and we should not completely surrender our independent judgment to others. In the final analysis, our life is our possession and responsibility.
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SUNSHINE IS THE BEST DISINFECTANT (LOUIS BRANDEIS)
The world is full of cruel, audacious dictatorships that routinely violate human rights. These violations are outrageous, infuriating, and heartbreaking. But private citizens, non-governmental organizations, and even governments, seem helpless to effect change. Perhaps our best option is a media campaign to expose all these violations and the guilty parties. So I commend all publications that provide an open forum for international dialogue and debate. Hopefully, this will not only shame dictators and their henchmen into better behavior, but also sensitize all of us to the danger of government's abuse of power.
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SYMBOLS VERSUS SUBSTANCE
Society is long on symbols, but short on substance. We are awash in religious, political, professional, and commercial symbols that promise but don't deliver. Why is there such a disparity between symbol and substance? Perhaps it's because our language is largely symbolic and subject to misunderstanding, misrepresentation, and manipulation. So let's try to clearly distinguish between the symbols and substance of society by minimizing the former and maximizing the latter.
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THANK GOD FOR CHAPLAINS
Society's institutions are a mixed blessing. They provide us with hospitals, nursing homes, orphanages, and the military. But they also subject us to regimentation, which can be overwhelming, depersonalizing, and depressing. One refuge from such regimentation is the chaplain, who ecumenically provides much-needed emotional and spiritual care. So let's reach out to chaplains and receive their unique and vital help. Literally and figuratively, chaplains are a godsend.
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THE ABCs OF LANGUAGE
Words are magical. They are like musical notes, which when strung together, create a symphony of meaning and feeling. As the speaker, we are the composer, arranger, conductor, and musician. So it's up to us to choose our words carefully and to present them clearly and concisely. Sadly, some people don't pay enough attention to their words, and as a result, they and their words are often ignored. So let's pay more attention to our words, because they are the building blocks of language, communication, and relationships.
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THE ART OF MEDICINE
Notwithstanding great scientific advances, the art of medicine is nonetheless imperfect and full of treatment failures. These failures are disappointing and dispiriting for both patient and physician. Fortunately, the art of medicine can be enhanced by turning to the fine arts. Art therapy is a magical modality, which offers patients a respite from the rigors of healthcare, and a sanctuary for self-expression, satisfaction, solace, symbolism, and supplication. Let's elevate the art of medicine to a fine art that can heal the body, mind, and spirit.
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THE CROOKED TIMBER OF HUMANITY
The crooked timber of humanity is Immanuel Kant's sour, cynical metaphor for man's imperfection. As a student of humanity, Kant succumbed to the occupational hazard of misanthropy, and failed to appreciate the positive aspects of humanity, such as compassion, creativity, and the conquest of the unknown. Despite crooked timbers, loose screws, leaky plumbing, faulty wiring, and dim bulbs, humanity remains the Creator's crowning achievement, and we should always be proud of that.
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THE DOCTOR PATIENT
The most important role of the doctor is as a patient, because then, and only then, can the doctor truly understand how frustrating and frightening it is to be sick and seek help. This understanding enables the doctor to identify with patients and relate to them in a more effective, compassionate, and humble manner. And this, in turn, improves the doctor-patient relationship, patient compliance, and treatment outcome. In short, having been on both sides of the stethoscope, scalpel, and gurney, the doctor-patient is uniquely motivated to practice and advance the art and science of healthcare.
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THE IMMUNOLOGY OF PREJUDICE
Despite our best efforts, we continue to be plagued with prejudice in all its ugly manifestations. Why is prejudice so resistant to all intervention? Perhaps there is a biological component that we are overlooking. Perhaps prejudice is similar to an immune response, in which we automatically recognize and reject foreign protein as potentially dangerous.
Our immune response is a mixed blessing, because sometimes the foreign protein is dangerous, but other times the foreign protein is harmless. Sometimes our immune response protects us, but other times our immune response turns on us and creates self-destructive autoimmune diseases such as rheumatoid arthritis, rheumatic heart disease, multiple sclerosis, scleroderma, lupus, and colitis.
I propose that prejudice is a self-destructive autoimmune disease, in which we automatically and incorrectly reject harmless people who appear to be foreign and dangerous. Let's treat the pernicious disease of prejudice with familiarity, tolerance, reason, good will, and hope.
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THE MEDIUM IS THE MESSAGE (MARSHALL MCLUHAN)
The media are a mixed blessing. They don't just report the news; they also spin the news and make the news. So we must filter the media through a lens of skepticism and cynicism. Most of the media are full of either liberal or conservative bias, and few, if any, provide balanced investigative reportage. This creates a conundrum best captured by the American humorist, Mark Twain, who said, "If you don't read the newspaper, you're uninformed. If you do read the newspaper, you're misinformed."
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THE RETROSPECTOSCOPE
History can be a harsh judge. It can reduce our lives to facts, without regard for circumstances or mitigating factors. This seems to happen especially with great people, who have foibles and flaws just like the rest of us. Before we judge such people, we should try to understand the times and circumstances of their lives. This will enable us to better appreciate their contributions, and at the same time, to forgive their errors. Sooner or later, we will all be part of history, and we would like the same merciful judgment.
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THE RIGHTEOUS GENTILES
The Holocaust was a time of contrasts. There was evil and good, cowardice and courage, and silence and protest. Although the net effect was death and devastation, the courageous protests will live on forever. Some of the greatest acts were those of the Righteous Gentiles, who risked and even sacrificed their lives to fight Nazism and thwart its genocidal motives. The world will never forget the great work of Oskar Schindler, Corrie Ten Boom, Raoul Wallenberg, Miep Gies, and Sophie and Hans Scholl of the White Rose, all of whom, along with many others, have been memorialized in history and the Holocaust Museum.
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THE TORTOISE AND THE HARE
Aesop's fable about the race between the tortoise and the hare contrasts the slow, steady, sure progress of the tortoise with the rapid, erratic, ruinous non-progress of the hare. The tortoise symbolizes the modesty and humility that lead to success; while the hare symbolizes the arrogance and grandiosity that lead to failure. The timeless wisdom of this fable teaches us to slow down, calm down, and think about what we are doing.
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THE TREE OF LIFE
People are like trees. With their roots planted firmly in the soil, trees stand tall and straight, and survive inclement weather. Likewise, people whose roots are firmly planted in family grow up strong and healthy, and survive adverse events. But without strong roots, both people and trees become weak and frail. Ideally, society is like an orchard, in which the strong and healthy shelter the weak and frail, so that all life has a chance to be fruitful.
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THEORIES OF PERSONALITY
Notwithstanding the many well-reasoned theories of personality, we remain a mystery to ourselves and others. Nevertheless, these theories, which represent the work of physicians and psychologists, provide us with a language and structure that elucidates personality. Sometimes one theory is more applicable to a particular situation. So it is wise to familiarize oneself with as many theories of personality as possible, including those of Freud, Meyer, Rank, Sullivan, Adler, Horney, Reik, Deutsch, Jung, Erikson, Frankl, Hartmann, Kris, and Lowenstein. In order to understand a patient's disease, we must understand the patient.
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THEY SHOOT HORSES, DON'T THEY?
Concerns about the current economic crisis and suicide are evocative of a haunting film called “They Shoot Horses, Don’t They?" in which a dispirited contestant in a Depression-era dance marathon commits suicide, after learning that the marathon is a cruel hoax, and that the winner receives no prize money. As the specter of a looming worldwide depression, the current economic crisis is an important reminder that poverty is ubiquitous and ruins many lives. For too many people, life is a compulsory lottery with great advertising but no prizes.
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TIME & HAIR
Time is like hair. Either you have too much or too little. Time and hair epitomize the perverse realities of Mother Nature. She seems to delight in testing and torturing us with excess and deficiency. How can we improve our relationship with Mother Nature? Perhaps we don't really understand her, and we are trying to bend her to our will. What is Mother Nature's will, and where do we fit in? Are we part of her plan, or are we an exception to her plan, and therefore her adversary? These questions must be answered before we continue our struggles with Mother Nature.
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TO ERR IS HUMAN, TO FORGIVE DIVINE (ALEXANDER POPE)
Despite our best efforts, we are all fallible and make mistakes. Some of these mistakes are trivial, while others are serious, and even fatal. How can we best cope with our fallibility? First, we must recognize and accept our fallibility as inevitable. Second, we must provide safeguards for our fallibility, such as checklists and oversight by colleagues. Third, we must treat our mistakes with acknowledgment and apology, not denial and cover-ups. And finally, we must analyze our mistakes, in order to avoid repeating them. Fallibility is an inherent part of the human condition, and we must not be ashamed of our humanity.
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TO EVERYTHING THERE IS A SEASON...
...and a time to every purpose under the heaven: A time to be born, and a time to die (Ecclesiastes 3.1-2)
Unless the deceased is a centenarian, death never seems timely. And death is never less timely than when it affects the young. But we must remember that life and death are inseparable, and that medicine involves death as well as life. So let's fight for life, but learn to accept the inevitability of death. And let's focus on the quality of life, and not just the quantity.
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TO THINE OWN SELF BE TRUE (HAMLET)
The tyranny of being graded and trying to measure up to other people's expectations is a lifelong burden on all of us; it begins in kindergarten and never ends. If we allow it to, grading can dominate and ruin our lives by turning us into sycophants and slaves who curry favor. How can we emancipate ourselves from this tyranny? We should accept less than perfect grades, and focus on developing our own unique individuality. It's better to be rejected for who you are, than accepted for you're not.
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TOMORROW! TOMORROW! I LOVE YA TOMORROW! (ANNIE)
Hope is the essence of life. It encourages and enables us to go on living. Without hope, we give up and succumb to "the slings and arrows of outrageous fortune." How can we keep hope alive? We must dedicate ourselves to work that gives our lives meaning, purpose, and a kind of perpetuity. So that even after we're gone, there will always be a tomorrow.
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UNIVERSAL HEALTHCARE
Universal healthcare is more than a noble ideal; it is a sine qua non of modern civilization. While the financial costs must be borne fairly by everyone, the key ingredient is the personal responsibility of the patient, who must maintain a healthy lifestyle, free of all self-destructive habits, such as alcohol, tobacco, and junk food. Universal healthcare needs universal self-care.
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WANTS VERSUS NEEDS
We have four basic needs that must be satisfied: hunger, hygiene, home, and hope. Hunger requires a nutritious diet that eliminates all addictive substances. Hygiene requires that our food, water, air, and home are free of toxins. Home requires safety, comfort, and companionship. Hope requires the freedom to be ourselves and pursue our unique talents. If we satisfy these basic needs, we will not be tortured with endless wants and wars.
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WAR AND PEACE
War plagues us, and peace eludes us, because we overlook the connection between war and sickness. War and sickness are inseparable, just as peace and health are inseparable. In order to promote peace and health, we must first cure the universal sickness of dehydration, malnutrition, and addiction, all of which create frustration, anger, and violence, and ultimately lead to war.
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WAR AS METAPHOR
War has become a popular but unfortunate metaphor and euphemism for society's failures. The "wars" on drugs, illiteracy, and poverty have all been lost, and the war on terrorism seems endless. Since war connotes conflict, violence, and death, we should dispense with this malevolent metaphor, and instead find beneficent metaphors that are more conducive to peace and health. Words have power and meaning, and they should be chosen carefully.
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WEANING
The purpose of weaning is not to remove milk from the infant's diet. The purpose of weaning is to weaken the maternal-infant bond, so that the infant can be introduced to other people and other food. The maternal bond is the most powerful and enduring relationship in our lives. In fact, we never fully separate from our mothers. We just find maternal substitutes, like food, friends, teachers, spouses, and doctors.
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WHAT ARE SPIN DOCTORS?
Spin doctors are political and corporate media-meisters, who bend, mince, twist, torture, and trash the truth with nuanced innuendos, linguistic legerdemain, word wizardry, imaginary imagery, fantastic fantasy, fluffy puffery, and plausible deniability. In short, spin doctors are lovable liars and rogues in vogue who specialize in hyper-uber-hoopla.
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WHAT IS CHARITY?
Charity is sharing some of our good fortune with those who are suffering and in need. Sadly, some cynical people regard charity as a financial option, tax deduction, or burden, rather than a moral obligation and opportunity to be humane. These people conveniently forget that their good fortune is mostly luck, and that their lives could have been much worse. So let's count our blessings, and share some of our blessings with those in need. Charity is a measure of our humanity.
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WHAT IS CULTURE?
Culture is a mixed blessing. It can be a cocoon that protects and nurtures us, but it can also be a cage that traps and suffocates us. The "cocoon" is a positive force which enables us to grow and mature so that we can face the world, but the "cage" is a negative force which disables us and stunts our growth so that we learn to fear and hate the world. The contrasting cocoon-cage quality of culture stamps personality, so that each of us is a combination of positive and negative training. And each of us must try to maximize the cocoon but minimize the cage, both in ourselves and others, so that we can live in peace and harmony. This is the goal and challenge of multiculturalism, a progressive sociopolitical philosophy of tolerance, diversity, and equality.
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WHAT IS FUN?
The Shakespearean character of Falstaff is a tragic-comic embodiment of self-indulgence in vices. Unfortunately, many people equate such self-indulgence with fun. This is unfortunate, because most fun is imaginary, harmful, and expensive. The fun of being tipsy from alcohol, high from marijuana, or sated from sweets, is flimsy and ephemeral, compared to the lingering and painful after-effects of addiction. The sad truth is that most fun is hell you enjoy.
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WHAT IS HUMOR?
Humor is more than levity with physical and emotional relief; it is a window into the inner mechanisms of the mind. In The Psychopathology of Everyday Life, Sigmund Freud theorizes that humor satisfies the libidinal instincts of verboten sexual and aggressive material, by catching the ego and superego off-guard. This theory is consistent with most humor and establishes the validity of psychoanalysis as a research tool and treatment modality. Although it has been eclipsed by psychopharmacology and relegated to the dustbin of history, psychoanalysis still has much to offer us. It reminds us that we are more than synapses and neurotransmitters; we are human and have the capacity for understanding, compassion, and choice.
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WHAT IS INTELLIGENCE?
Society has a one-sided view of intelligence. In school and at work, our intelligence is measured by how fast and completely we can learn. But learning is only half of intelligence. The other half of intelligence is unlearning the many falsehoods that we have been taught. Ironically, most highly intelligent people cling to their education, resist unlearning falsehoods, and perpetuate the harmful effects of these falsehoods, such as sickness, conflict, and war. Let's redefine intelligence to include unlearning, so that our leaders, many of whom are highly intelligent, can have open minds and truly promote peace and health.
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WHAT IS MONEY?
As the universal medium of exchange, money has both objective and subjective meanings. Objectively, money represents fair value; subjectively, money represents interpersonal trust. So money is more than just numbers, symbols, charts, graphs, and equations; it can also be compassion, communication, friendship, happiness, and hope. If we invest in each other, we will maximize our return.
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WHAT IS PAIN?
Pain is the penalty for living: a toothache is the penalty for eating; a backache is the penalty for moving; and a heartache is the penalty for loving. Alas, life and pain are inseparable.
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WHAT IS POETRY?
A poem is an answer to a question or problem. Poets are philosophers who ponder questions and problems, and occasionally come up with an answer, which they call a poem. If you want to write a poem, think about a question or problem, but don't try to answer it. Let the question or problem sink from your conscious into your unconscious. Then wait until your unconscious contacts you, in a dream, a random thought, or a sudden insight, with an answer. This answer will be your poem.
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WHAT IS REGRET?
Regret is wisdom gained with age. Throughout life, we make many mistakes, some of which we later recognize. With this recognition, comes regret and painful nostalgia. So regret is an inevitable consequence of living and learning. Let's learn to expect and accept regret, even though it is so poignant and haunting. As the Danish philosopher Soren Kierkegaard said, "Life can only be understood backwards; but it must be lived forwards."
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WHAT IS RELIGION?
Notwithstanding all of its respectful liturgy and doxology, religion is, in part, frustration and anger with the Creator, who gave us enough intelligence to understand life's dilemmas, but not enough intelligence to do anything about it.
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WHAT IS TIME?
Time is a paradox. As children, we long for the future; as adults, we worry about the future; and as elders, we relinquish the future and relish the past. But somehow, we never seem to live in the present. Like a tightrope walker without a net, we are suspended between the past and the future, fearing that we will fall into a timeless abyss. How can we reclaim the present? Let's free ourselves from fear by recognizing that time is not limited or linear, but an eternal and endless loop, with the past and the future spliced in the present. Time is the very essence of life.
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WRITING & QUILTING
Writing is like quilting. Quilters save random remnants and swatches of fabric, then sew them together into beautiful patchwork quilts that last for many years. Likewise, writers save random thoughts and memories, then weave them together into poetry or prose that lasts forever. Both writers and quilters preserve the past, by weaving it together with the present and future.
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YOU'LL NEVER WALK ALONE (CAROUSEL)
Life is a solitary and lonely quest for friendship and support. Sometimes we receive the unexpected support of good samaritans who inexplicably seem to care about us. These good samaritans often play a crucial role in our lives and rescue us from certain disaster. So let's be grateful for these good samaritans, and return the favor by befriending other lost souls and hopeless cases like ourselves. Charity and kindness are the best medicine.
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YOUR THINKING CAP
Thought is a necessary but mysterious and frustrating function. Life requires us to make many informed decisions, but it doesn't tell us how to acquire or process the necessary information. How can we stimulate and generate thought? First, research the topic and acquire background information. Second, organize this information into a clear, concise format. Third, clear your mind of everything, and allow it all to sink into your unconscious, where it can germinate. Then your unconscious will contact you in a dream or random thought, and provide you with new answers. Simply put, your thinking cap is a metaphor for the creativity of your conscious and unconscious.
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ADDICTION & AMBIVALENCE