Medical Correspondents
When I am at home, I have a regular Sunday morning ritual: I watch the Fox News medical correspondent while working out. It’s a fair bet that every week he will make at least one major howler that is guaranteed to increase the amount that I can bench press by 50%!
I don’t personally know the Sunday Fox medical correspondent, and he seems a nice fellow. But why oh why doesn’t he do his research before going on the air?
A few weeks ago he was endorsing “Wilson’s syndrome” that was created by E. Denis Wilson, M.D., who practiced in Florida in the early 1990s. The syndrome’s supposed manifestations include a rag bag of fatigue, headaches, PMS, hair loss, irritability, fluid retention, depression, decreased memory, low sex drive, unhealthy nails, easy and excessive weight gain, and about 60 other symptoms. Wilson claimed to have discovered a type of abnormally low thyroid function in which routine blood tests of thyroid are often normal. He claimed that the main diagnostic sign is a low body temperature that is on average below 98.6° F and that the diagnosis could be confirmed if the patient responds to treatment with a "special thyroid hormone treatment." The American Thyroid Association published a position paper about this syndrome, saying that it probably does not exist. People have paid good money to be tested and treated, and though some may have benefited, most probably have not.
It is very easy to check these facts. So why didn’t the Fox medical correspondent do so?
Then a couple of weeks ago he talked about an herbal preparation without once mentioning that the FDA had just issued a warning about potential liver toxicity.
Then today he starts discussing a preparation called Airborne, that is purported to help prevent colds. It may or may not do so. The FDA has not evaluated the claims. The problem was that the correspondent then said that it could do no harm. Yet that is quite wrong. Though I could find no published cases of harm, the possibility most certainly exist, and the public needs to be made aware of the reasons to be a bit cautious:
- It contains 5,000 IUs of vitamin A. If you take it every three hours as recommended, some people could overdose on it.
- The same with vitamin C. If you take a lot, most is quickly passed out in the urine. But some people can get bladder irritation and could conceivably get kidney stones from taking that amount over a period of time.
- The remedy also contains seven herbs: Lonicera, Forsythia, Schizonepeta, Ginger, Chinese Vitex, Isatis Root, Echinacea. In a couple of hours I did a literature review looking at potential toxicity of these compounds. They all look fairly benign, but there are scattered reports of side effects with a couple of them.
- The difficulty is that side effects can be cumulative if several herbs and supplements are taken at the same time.
I have nothing at all against the Sunday Fox Medical Correspondent: he seems an affable and quite knowledgeable fellow. Neither do I have anything against Airborne. If it helps people, all well and good.
The trouble is that we have had at least three occasions in the last couple of months where advice has been given that had clearly not been checked. I think that unfortunate. Before I post any article I spend hours checking and re-checking. Even with all that checking, I’m quite sure that something could slip through, and if an error occurs, I shall be delighted if someone picks it up, so that I can correct it.
I only wish that everyone who writes or speaks about things medical would do the same kind of obsessive checking.
I really do believe that readers, listeners and watchers deserve nothing less.
The Parachute Approach to Evidence
Almost three years ago, one of the British Medical Journal – one of the top rated medical journals in the world – published an amusing article with an extremely serious sting in the tail. The article, entitled “Parachute use to prevent death and major trauma due to gravitational challenge,” highlighted some of the absurdity surrounding the constant demand for scientific validation using only one set of criteria.
The authors pointed out that – as with many interventions intended to prevent ill health – there had been no randomized controlled trials of parachutes in preventing the major trauma that may be caused by gravity!! Yet we would hope that nobody would consider exiting a plane in flight without first equipping himself or herself with a parachute.
Advocates of evidence-based medicine have criticized the adoption of interventions that have only been evaluated by using observational data.
The authors therefore said that, “We think that everyone might benefit if the most radical protagonists of evidence based medicine organized and participated in a double blind, randomized, placebo controlled, crossover trial of the parachute.”
They used the lack of randomized controlled trials in testing parachutes to show that situations still exist where such trials are not only unnecessary, but also dangerous.
Anyone who has spent 30 seconds on this blog knows that I’m firmly committed to the rational analysis of data. But I am just as certain that there are many valid types of evidence.
There is an important article in this week’s issue of the British Medical Journal that lies at the heart of Integrated Medicine, and the research that we’ve been facilitating. The article suggests that waiting for the results of randomized trials of public health interventions can cost hundreds of lives, especially in poor countries with great need and potential to benefit. If the science is good, we should act before the trials are done.
The article argues that the “parachute approach,” where practice and policies are based on good science but without randomized trials, is often more suitable in resource poor settings. They go on to consider three areas of critical importance, in which there are real ethical, moral and logistical problems if we wait for the results of randomized controlled trials.
They use the three examples of:
- Oral rehydration therapy
- Male circumcision to prevent HIV infection
- Misoprostol for postpartum hemorrhage
We have constantly run into the same kinds of problems with alternative, complementary and now Integrated Medicine. In most of theses fields there is precious little in the way of randomized controlled trials, but a wealth of clinical reports and case series. The problem with unorthodox medicine is that much of it does not fulfill one of the criteria for the parachute approach: to be “based on good science.” This is one of the reasons for expending so much energy on finding common ground between conventional and Integrated Medicine, and for investigating several advances in the basic sciences that may help us square the circle.
It is also why we have adopted a second criterion: the potential for a therapy to do harm. Clearly the level of evidence for risk and benefit is quite different for a potentially risky surgical procedure, compared with, say, crystal therapy. The biggest risk with crystal therapy is that it might get used inappropriately in place of a treatment that has been shown to work.
But above all else, when we are dealing with sick and suffering people, we have to take action. Safe action, action that has a good chance of helping, and action that is fully explained to the individual. Honestly and straightforwardly, and without false optimism.
“A man’s best friends are his ten fingers.”–Robert Collier (American Writer and Publisher, 1885-1950)
The Author Revealed!
I’ve had a great many very kind comments about this blog. So to all the people who’ve said nice things, “Thank you!” And for all the people who’ve wanted to discuss, debate, criticize and clarify, I thank you too: that’s the way that we’re going to move forward and create a more comprehensive science-based approach to personal growth, health and wellness.
I’m also constantly asked who writes all these blog items, the podcasts, the articles and the book reviews at Amazon? It can’t be one person can it? Well, it actually is all one person: C’est moi, a.k.a. RP.
So I take full responsibility for everything that I write. And, of course, any errors of omission or commission are my own.
Though I try exceptionally hard to ensure that all the entries are as accurate as I can make them. That being said, I also give you follow up resources and things like the Healia.com search box so that you can check on what I say. I want to guide, educate, help and support you, so that you can make you own decisions. And if you are working with someone else, then I would like your next meeting with your health care provider to be even better informed.
This weekend I was horrified to hear a fairly well known doctor give a very glib and somewhat inaccurate summary of a new medicine that’s just just been given "approvable" status by the US Food and Drug Administration.
Several people challenged his evaluation: “Where did you get that from?” they asked. “The Wall Street Journal,” was the response. Now I like and respect the WSJ, and the doctor was, in fact, misquoting the article. But that’s not the point: nobody who has responsibility for providing medical care or advice should be doing it without carefully reviewing the evidence. What we call examining the “Primary sources.”
An important study was published a year ago, and we saw an extraordinary spectacle: some doctors and psychologists began making statements about how patients should be treated, and about how healthcare policies should be changed. Based not upon the evidence, but on newspaper reports of the evidence. In the end, the National Institute of Mental Health issued a press release to clarify what the study did and did not say.
On the topic of evidence and primary sources, let me turn to one of the other pieces to our work, and that is self-help.
There are many people in the self-help movement who have revolutionized the lives of millions. But there are some others who have not.
The days of people being able to get away with telling others how to live their lives or how to achieve health or success, based only on their personal opinions, rather than on something tangible, are finally coming to an end.
When a self-help guru says, “If I can do it anyone can,” they are just plain wrong. They are dismissing so many factors in a person’s life and then claiming that one size fits all. It’s so sad that many people who have failed to fulfill all these gurus’ proclamations and promises blame themselves rather than the bad advice. And as a result some end up being much worse off, for they feel that they have failed.
I have seen countless people racked by guilt because they had bought into the idea that all illness is self-created. I recently read something outrageous: that all depression is caused by unexpressed anger. So according to this nonsense, if you stop being angry, you’ll stop being depressed.
I have no idea where the writer got this from, and of course, sometimes a person’s depression can be traced back to anger about trauma, abuse or a failed relationship. But as a generalization it’s utter bovine excreta. I’ve seen people attempt to kill themselves because of profound depression, and it most assuredly had nothing to do with unexpressed anger!
Attitudes and emotions can have a huge impact on health, but people certainly don’t need to be made to feel guilty because they are ill!
This website and blog and the many others that I highlight are quickly transforming the world of self-help, health and wellness from hyperbole and opinion to an empirical science. Naturally enough, there are people with vested interests who want to keep things as they are, but they are like King Canute whose courtiers believed that he could turn back the tide!
With your help, I’m going to continue to do this work, and I would like to thank all the people around the world who are already helping us to introduce, what a great Sage has called:
"The Prophecy of a New Dawn in Health and Healing."
Nobel Prizes 2006
This is always an exciting week for anyone interested in science, the arts or the future of humanity.
Every year, the first week of October is the time when the Nobel Prizes are announced. Many of us have our short lists of people we think SHOULD get the Prizes, and it’s always interesting to see who does. I also have to admit to a personal interest: I have several friends and colleagues who are in the running, so I’ve got some fingers and toes crossed for them.
Last year the Prize in Physiology or Medicine went to the discoverers of Helicobacter. Their discovery has lead medicine to reconsider just how many illnesses might be caused by infections in combination with genes, stress and environmental factors. In one moment we moved from blaming a whole group of illnesses on bad behavior to bad bugs.
I just got a little flash on my screen to tell me that this year’s Nobel Prize in Physiology or Medicine has been awarded.
At the risk of sound like an announcer at the Oscars, the 2006 Prize has gone to Andrew Fire from Stanford and Craig Mello from the University of Massachusetts Medical School.
Their work on RNA interference has been receiving massive plaudits amongst biochemists for the eight years since it was discovered. It is doubly remarkable that the Prize has come so soon after the first publication: that is very rare. It is a fundamental mechanism by which genes are regulated in the body, and we believe that the discovery has the potential to allow us to switch off harmful genes. The discovery also allowed us to systematically test the functions of all human genes.
When I have talked about mechanisms by which environmental factors and even thoughts and emotions can change gene expression, it was driven in part by an understanding of some of this work.
Let me add my warmest congratulations to their magificent achievement!
Reversing the Irreversible
When I am analyzing current medical research for you, I focus on findings that are relevant to our underlying theme of Integrated Medicine.
One of the most important of all is the evidence for “spontaneous” remissions of otherwise fatal illnesses, and the reversal of diseases that are usually thought of as irreversible. It is exciting when we can show that arteriosclerosis and some neurological disease may be reversible, though most physicians still do not know that good news.
Two years ago I was asked to comment on a remarkable clinical problem. A 28-year old woman had seen a neurologist about some odd symptoms, which included quite severe visual disturbances. On MRI and electrical she had clear evidence of demyelination, the hallmark of multiple sclerosis. All of which has resolved after just one month of complete withdrawal from her diet of the sweetener aspartame. Multiple sclerosis is a disease that comes and goes, but the point of this case is that there was clear evidence that it went away completely. The neurological lesions in the brain that should have stayed forever, just melted away. I’ve looked at thousands of brain scans and this is extraordinary. And clinically the young woman is just fine.
Cases like this must be very rare: the FDA has determined that aspartame is safe, though on a future occasion I’ll say a bit more about the pros and cons of sweeteners. Discussions about artificial sweeteners usually generate more heat than light, but there is a lot of very helpful data to guide us.
Now let’s look at another condition that is supposed to be irreversible: cirrhosis of the liver. The liver is a remarkable organ. It has almost unique regenerative abilities. I’ve often wondered if the Ancient Greeks somehow knew about that remarkable attribute of our largest solid organ. When Prometheus was chained to a rock, an eagle came every day to eat his liver, which had re-grown by the next day.
The trouble is that if the liver keeps getting damaged and trying to re-grow, it produces a lot of fibrous scarring, the hallmark of cirrhosis. For more than a century, every expert has said that this fibrosis is irreversible. Now some first class research has shown that it isn’t true. An inexpensive medicine can reverse the fibrous changes in the liver.
The medicine is called sulfasalazine (sulphasalazine in the UK) that is normally used for treating inflammatory bowel diseases and some kinds of inflammatory arthritis. A team of scientists lead by Professor Derek Mann has recently moved from Southampton to Newcastle University has made a series of ground breaking discoveries. One of the most exciting is that sulfasalazine can reverse fibrosis in the liver.
The results were published in the journal Gastroenterology. A second and third papers published in Apoptosis, that describe the – then – Southampton group’s collaboration with chemists and oncologists to produce novel and more effective derivatives of sulphasalazine.
The researchers believe that, subject to further research and clinical trials, sulfasalazine could potentially be used to treat types of chronic liver disease – like cirrhosis – that are currently considered untreatable. Sadly because of greater alcohol consumption, especially binge-drinking, and obesity, liver disease is rising dramatically.
And if a simple medicine can reverse something previously believed to be irreversible, the final question that we have to ask is whether other the non-invasive methods may also help? Since most of the non-invasive methods work at deeper and more subtle levels of the organism, the answer to that one is, “Highly likely.” But it is going to have to be tested scientifically, just as every other hypothesis has to be tested.
Remembering Mahatma Gandhi
On this day in 1869, in the town of Porbandar, Gujurat State, India, a child named Mohandas Karamchand Gandhi was born. His life has been written about in hundreds of books and articles, and nobody can deny that he, and his non-violent resistance, changed the world in the most extraordinary way.
Yet we all still have much more to learn about what he tried to teach.
Starting life as an English-trained lawyer, he read widely, drawing inspiration from such sources as the Bhagavad-Gita, John Ruskin, Leo Tolstoy, Ralph Waldo Emerson, and Henry David Thoreau, and his personal philosophy underwent significant changes.
It was not until later in life that he became known as "Mahatma," or Great Soul.
Not only did he leave a profound political and philosophical legacy, but he left us an extraordinary number of sayings and quotations. Here are a few of of my favorites.
_________________________
“A "No" uttered from deepest conviction is better and greater than a "Yes" merely uttered to please, or what is worse, to avoid trouble.”
“A coward is incapable of exhibiting love, it is the prerogative of the brave”
“A faith gained in strength only when people were willing to lay down their lives for it.”
“A genuine fast cleanses the body, mind, and soul. It crucifies the flesh and to that extent sets the soul free.”
“A life of sacrifice is the pinnacle of art, and is full of true joy.”
“A living faith cannot be manufactured by the rule of majority.”
“A vow is fixed and unalterable determination to do a thing, when such a determination is related to something noble which can only uplift the man who makes the resolve.”
“Action alone is just that does not harm either party to a dispute.”
“Adaptability is not imitation. It means power of resistance and assimilation."
“An eye for an eye will only serve to make the whole world blind”
“Anger and intolerance are the enemies of correct understanding”
“Be the change you want to see in the world.”
“Both heaven and hell are within us.”
“Earth provides enough to satisfy every man’s need, but not every man’s greed.”
“Forgiveness is the attribute of the strong”
“Freedom is not worth having if it does not connote freedom to err.”
“God alone is the judge of true greatness because he knows men’s hearts.”
“God answers prayer in His own way, not ours.”
“God forbid that India should ever take to industrialism after the manner of the west… keeping the world in chains. If [our nation] took to similar economic exploitation, it would strip the world bare like locusts.”
“God is not a person…God is the force. He is the essence of life. He is pure and undefiled consciousness. He is eternal. And yet, strangely enough, all are not able to derive either benefit from or shelter in the all-pervading living presence.”
“God turns his back on those who quarrel amongst themselves.”
“Happiness is when what you think, what you say, and what you do are in harmony.”
“How can I, who knows the body to be perishable and the soul to be imperishable, mourn over the separation of body from soul?”
“Human life is a series of compromises, and it is not always easy to achieve in practice what one has found to be true in theory.”
“I am painfully conscious of my imperfections, and therein lies all the strength I possess, because it is a rare thing for a man to know his own limitations.”
“I am part and parcel of the whole and cannot find God apart from the rest of humanity.”
“I am prepared to die, but there is no cause for which I am prepared to kill.”
“I believe in what Max Muller said years ago, namely, that truth needed to be repeated as long as there were men who disbelieved it.”
“I believe that the sum total of the energy of mankind is not to bring us down but to lift us up, and that is the result of the definite, if unconscious, working of the law of love. The fact that mankind persists shows that the cohesive force is greater than the disruptive force, centripetal force greater than centrifugal.”
“I claim to be no more than an average person with less than average ability. I have not the shadow of doubt that any man or woman can achieve what I have, if he or she would make the same effort and cultivate the same hope and faith.”
“I do feel that spiritual progress does demand, at some stage, that we should cease to kill our fellow creatures for the satisfaction of our bodily wants.”
“I first learned the concepts of non-violence in my marriage.”
“I have also seen children successfully surmounting the effects of an evil inheritance. That is due to purity being an inherent attribute of the soul.”
“I have found that life persists in the midst of destruction, and therefore there must be a higher law than that of destruction.”
“I have learned through bitter experience the one supreme lesson to conserve my anger, and as heat conserved is transmitted into energy, even so our anger controlled can be transmitted into a power that can move the world.”
“I hope there is no pride in me. I feel I recognize fully my weakness. But my faith in God and His strength and love is unshakable. I am like clay in the Potter’s hands. I shall continue to confess blunders each time the people commit them. The only tyrant I accept in this world is the ‘still small voice’ within me. And even though I have to face the prospect of a minority of one, I humbly believe I have the courage to be in such a hopeless minority. I believe in the supreme power of God. I believe in Truth and, therefore, I have no doubt in the future of this country or the future of humanity.”
“I implicitly believe in the truth of the saying that not a blade of grass moves but by His will. He will save it (my life) if He needs it for further service in this body. None can save it against His will.”
“I know of your capacity to do great things, but I have yet to discover your capacity to do little things.”
“I own no enemy on earth. That is my creed.”
“I suppose leadership at one time meant muscles; but today it means getting along with people.”
“If I had no sense of humor, I would long ago have committed suicide.”
“If we reach the heart of our own religion, we also reach the heart of other religions.”
“If your heart acquires strength, you will be able to remove blemishes from others without thinking evil of them.”
“In doing something, do it with love or never do it at all”
“In matters of conscience, the law of majority has no place.”
“In the attitude of silence the soul finds the path in an clearer light, and what is elusive and deceptive resolves itself into crystal clearness. Our life is a long and arduous quest after Truth.”
“. . . in the midst of death life persists . . .”
“In this age of the rule of brute force, it is almost impossible for anyone to believe that any one else could possibly reject the law of the final supremacy of brute force.”
“Indolence is a delightful but distressing state; we must be doing something to be happy. Action is no less necessary than thought to the instinctive tendencies of the human frame.”
“It is health that is real wealth and not pieces of gold and silver.”
“It is knowledge that ultimately gives salvation.”
“It is the quality of our work which will please God and not the quantity.”
“It is unwise to be too sure of one’s own wisdom. It is healthy to be reminded that the strongest might weaken and the wisest might err.”
“Just think out for yourselves, if a man who was good yesterday has become bad after having come in contact with me, is he responsible that he has deteriorated or am I? … It is well to take the blame sometimes.”
“Keep your thoughts positive, because your thoughts become your words.
Keep your words positive, because your words become your behavior.
Keep your behavior positive, because your behavior becomes your habits.
Keep your habits positive, because your habits become your value system.
Keep your values positive, because your values become your destiny.”
“Life becomes livable only to the extent that death is treated as a friend, never as an enemy.”
“Life is an aspiration. Its mission is to strive after perfection, which is self-realization.”
“Life is greater than all art.”
“Live as if you were to die tomorrow. Learn as if you were to live forever.”
“Love and exclusive possession can never go together.”
“Love can never express itself by imposing sufferings on others. It can only express itself-suffering, by self-purification.”
“Love is no love which asks for a return.”
“Man’s destined purpose is to conquer old habits, to overcome the evil in him and to restore good to its rightful place.”
“Men often become what they believe themselves to be. If I believe I cannot do something, it makes me incapable of doing it. But when I believe that I can, then I acquire the ability to do it even if I didn’t have it in the beginning.”
“My life is my message”
“No culture can live, if it attempts to be exclusive.”
“Non-violence, which is the quality of the heart, cannot come by an appeal to the brain.”
“Nonviolence is not a garment to be put on and off at will. Its seat
is in the heart, and it must be an inseparable part of our being.”
"Nonviolence which is a quality of the heart, cannot come by an appeal to the brain."
“Not to have control over the senses is like sailing in a rudderless ship, bound to break to pieces on coming in contact with the very first rock.”
“Peace will not come out of clash of arms but out of justice lived and done by unarmed nations in the face of odds.”
“Personally, I hold that a man, who deliberately and intelligently takes a pledge and then breaks it, forfeits his manhood.”
“Prayer is a confession of one’s own unworthiness and weakness.
“Prayer is not asking. It is a longing of the soul. It is daily admission of one’s weakness. It is better in prayer to have a heart without words than words without a heart.”
“Prayer is the key of the morning and the bolt of the evening.
“Prayer is the only means of bringing about orderliness, peace and repose in our daily acts.”
“Real sacrifice lightens the mind of the doer and gives him a sense of peace and joy”
“Service has no meaning unless one takes pleasure in it”
“Silence is a great help to a seeker after truth. In the attitude of silence the soul finds the path in a clearer light and what is elusive and deceptive resolves itself into crystal clearness. Our life is a long and arduous quest after Truth, and the soul requires inward restfulness to attain its full height.”
“Strength does not come from physical capacity. It comes from an indomitable will.
“The control of the palate is a valuable aid for the control of the mind.”
“The Difference between what we do and what we are capable of doing would suffice to solve most of the world’s problems.”
“The dignity of man requires obedience to a higher law, to the strength of the spirit.”
“The future depends on what we do in the present.”
“The golden rule of conduct.. is mutual toleration, seeing that we will never all think alike and we shall always wee Truth in fragment and from different angles of vision.”
“The history of the world is full of men who rose to leadership, by sheer force of self-confidence, bravery and tenacity.”
“The law of love knows no bounds of space or time.”
“The man of prayer will be at peace with himself and with the whole world.”
“The mice which helplessly find themselves between the cats’ teeth acquire no merit from their enforced sacrifice.”
“The music of life is in danger of being lost in the music of the voice.”
“The only devils in this world are those running around in our own hearts, and that is where all our battles should be fought.”
“The only tyrant I accept in this world is the still voice within.”
“The pure unadulterated love of one can nullify the hatred of millions.”
“The seven social sins:
- Knowledge without character,
- Science without humanity,
- Wealth without work,
- Commerce without morality,
- Politics without principles,
- Pleasure without conscience,
- Worship without self-sacrifice.”
“The still small voice within you must always be the final arbiter when there is a conflict of duty.”
“The weak can never forgive. Forgiveness is the attribute of the strong”
“The wise are unaffected either by death or life. These are but faces of the same coin.”
“. . . there are chords in every human heart. If we only knew how to strike the right chord, we would bring out the music.”
“There are innumerable definitions of God because his manifestations are innumerable.”
“There are people in the world so hungry that God cannot appear to them except in the form of bread”
“There are subjects where reason cannot take us far and we have to accept things on faith. Faith then does not contradict reason but transcends it. Faith is a kind of sixth sense which works in cases which are without the purview of reason.”
“There comes a time when an individual becomes irresistible and his action becomes all-pervasive in its effects. This comes when he reduces himself to zero.”
“There is a soul force which if we permit it, will flow through us, producing miraculous results”
“There is a sufficiency in the world for man’s need but not for man’s greed.”
“There is more to life than increasing its speed.”
“There is no god higher than truth.”
“There is nothing that wastes the body like worry, and anyone who has any faith in God should be ashamed to worry about anything whatsoever”
“Though I cannot claim to be a Christian in the sectarian sense, the example of Jesus suffering is a factor in the composition of my undying faith in non-violence which rules all my actions, worldly and temporal.”
“To forget how to dig the earth and to tend the soil is to forget ourselves.”
“To give pleasure to a single heart by a single act is better than a thousand heads bowed in prayer.”
“To my mind, I hold that the more helpless a creature, the more
entitled it is to protection by man from the cruelty of man.”
“To see the universal and all-pervading Spirit of Truth face to face one must be able to love the meanest of creation as oneself.”
“True beauty consists of purity of heart.”
“Truth never damages a cause that is just.”
“Unity to be real must stand the severest strain without breaking.”
“We have no evidence whatsoever that the soul perishes with the body.”
“. . . we have to learn to use that force (love) among all that lives, and in the use of it consists our knowledge of God. Where there is love there is life; hatred leads to destruction.”
“We may never be strong enough to be entirely nonviolent in thought, word and deed. But we must keep nonviolence as our goal and make strong progress towards it. The Attainment of freedom, whether for a person, a nation or a world, must be in exact proportion to the attainment of nonviolence for each.”
“We must be the change we wish to see.”
“What is faith worth, if it is not translated in to action?”
“Whatever you do will be insignificant, but it is very important that you do it.”
“When his duty is to face danger and he flees, it is cowardice.”
“When I despair, I remember that all through history the way of truth and love has always won. There have been tyrants and murderers and for a time they seem invincible but in the end, they always fall — think of it, ALWAYS!”
“Whenever you are in doubt or when the self becomes too much with you, try the following experiment: Recall the face of the poorest and most helpless person you have ever seen and ask yourself if the step you contemplate is going to be for any use to him or to her . . . Then you will find your doubts and your self melting away.”
“Where there is love there is life.”
“Wherever you are confronted with an opponent, conquer him with love.”
“Without prayer there is no inward peace.”
“You must be the change you wish to see in the world”
“Your capacity to keep your vow will depend on the purity of your life.”
A Valuable History Lesson
“Those who cannot remember the past are condemned to repeat it.”
–George Santayana (Spanish-born American Philosopher, Humanist and Poet, 1863-1952
I’m a bit of a history buff, and like most armchair historians who know something about medicine, it’s always interesting to try and work out why some civilizations underwent rapid collapse. Was the decline of Rome really due to malaria, lead pipes or societal malaise? Why did the huge Khmer Empire in Southeast Asia vanish in just a few years? Was it ecological failure, disease or pollution? The list goes on.
The map shows some of the major empires in Eurasia around A.D.1200. See how few still exist.
One of these historical puzzles seems to be close to solution, and provides important lessons for us today. In the second year of the Peloponnesian war, the city state of Athens was devastated by an epidemic known as the Plague of Athens. Historians and scientists have been debating the cause of the Plague for years. When I was a young schoolboy, the debate was already a century old.
According to historical records, the plague began in Ethiopia and passed through Egypt and Libya to Greece in 430-426 B.C.E. It forever changed the balance of power between Athens and Sparta, effectively ending the Golden Age of Athenian dominance in the ancient world. It is thought that up to one third of the Athenians, including their leader, Pericles, dies in the epidemic. Most of our knowledge about the Plague came from the fifth century B.C.E. Greek historian Thucydides, who himself was taken ill with the plague but recovered. Though Thucydides gave a detailed description, researchers have not managed to agree on the identity of the plague. Several diseases have been suggested, including bubonic plague, smallpox, anthrax and measles.
Now a study in the International Journal of Infectious Diseases helps answer this question that has puzzled historians for decades: What destroyed ancient Athens, the cradle of democracy? Analysis carried out by Manolis Papagrigorakis and colleagues from the University of Athens, using DNA collected from teeth obtained from an ancient Greek burial pit points to typhoid fever as the disease responsible for this devastating epidemic. Typhoid fever (or enteric fever) is an illness caused by the bacterium Salmonella Typhi. It is common throughout the world, more so in tropical and semitropical climates. It is transmitted by ingestion of food or water contaminated with feces from an infected person.
There are some classic physical symptoms of typhoid: In the first phase there is coughing, a fever, sweating and a rash of “rose spots,” particularly on the abdomen. Typhoid has a unique feature: normally when you get a fever your pulse rate increases. In typhoid the pulse slows. In the second phase of the illness people get severe headaches muscle pain and diarrhea. And it is the diarrhea that usually dehydrates and kills people. You may have heard about typhoid in the last few days after publication that a well-known terrorist was supposed to have died from it.
It is humbling to realize that entire civilizations have been put to the sword, not by force of arms, but by microbes. Climate change or a breakdown in sanitation of food inspection can all lead to a reappearance of typhoid: within the last hundred year there have been outbreaks all over the Western world, and it is endemic in many less developed countries.
I mention in Healing, Meaning and Purpose that one of the reasons for the persistence of the gene for cystic fibrosis is thought to be that carriers of the gene are resistant to typhoid.
We must never forget the power of micro-organisms and how rapidly they can re-appear if we let down our guard or if we neglect the impact of climate change on their growth and viability.
It is no coincidence that H.G. Wells vanquished the Martians not with guns, but with microbes.
Vaccinating Against the Snivels?
I’m using a deliberately provocative title for a story that is quite serious, both medically and ethically.
We have today heard about two new developments. Researchers from the University of Rochester Medical Center announced that they are starting trials of a new vaccine aimed at eliminating childhood ear and sinus infections as well as many cases of bronchitis in adults. Second, and on the same day, the University of Rochester announced that it had won a $3.5 million grant from the National Institute of Deafness and Communication Disorders, one of the divisions of the National Institutes of Health, to develop the new vaccine. The team at Rochester helped to develop the vaccine marketed by Wyeth as Prevnar. It is used to protect infants and toddlers against some strains of bacteria that can cause pneumonia, meningitis and ear infections.
The vaccine will target Nontypeable Haemophilus influenzae or NTHi, which is the main remaining cause of ear and sinus infections and bronchitis, now that vaccines exist for various forms of streptococcal bacteria and Haemophilus influenzae B, the previous leading causes. NTHi is now the leading cause of ear and sinus infections, and of bronchitis in adults.
But why this news is so important for all of us, is that unlike virtually all other vaccines on the market, this one will not be aimed at saving lives, but at preventing what are usually nuisance illnesses. But please note my use of the word “usually.”
Dr. Michael Pichichero, a professor of microbiology, immunology, pediatrics, and medicine at the University of Rochester Medical Center who is leading the trial, was quoted as saying, “While ear infections are never fatal, they can cause serious damage in some children.” He went on to say that “83 percent of U.S. children experience one or more ear infections by age 3 and in some cases hearing loss becomes permanent.”
This is the point, and also why the National Institute of Deafness and Communication Disorders has chipped in. Most of these infections get better on their own, so an initial reaction might be to say, “why bother with this at all?” The trouble is that not only can they lead to long-term problems with hearing, I have seen more than one person develop a cerebral abscess as a result of a severe infection: the illness is not always innocuous.
Another problem is that infections of the sinuses and ears bring children to clinics and emergency rooms, and are the leading reason for antibiotic prescriptions. Even though many of the infections are viral, and viruses do not, of course, respond to antibiotics. Every expert agrees that antibiotics are overused in the United States, which wastes money and also helps the evolution of bacteria that ultimately resist all antibiotics.
What’s the downside of these announcements?
- We have already run into a great many problems with previous vaccinations. Some long-term and some subtle; so we desperately need long-term safety data.I know many natural healers who blame many of our health woes on vaccinations.
- I hope that the researchers have built into the contract a clause to allow them to report efficacy and safety data without having to clear everything with the study’s sponsor.
- We are facing major resource problems, not just in the provision of health care, but also in the funding for research. So should we be diverting resources into these kinds of problems while every 30 seconds another child dies of malaria?
- There has been a great deal of discussion about what is often called the “hygiene hypothesis:” the idea that the increasing rates of some allergic illnesses and asthma are a result of children having avoided minor infections early in life, that would have stimulated their immune systems. The hypothesis is not proven, but there is a great deal of circumstantial evidence.
- If successful, would the vaccine create a host of secondary problems ten or twenty years from now?
Banquo’s Ghost
“Chess is the game which reflects most honor on human wit.” — Voltaire (a.k.a. François-Marie Arouet, French Writer and Philosopher, 1694-1778)
For anyone with even a passing interest in chess, a re-unification match for the World Championship is currently taking place in Elista, the capital city of Kalmykia, a small region of the Russian Federation that is Europe’s only Buddhist country. Though I’m sure that some would quibble about whether it should be in Europe or Asia.
The beginning of the match between two of the world’s top Grandmasters – the aggressive Bulgarian gambler Veselin Topalov and the conservative Russian, Vladimir Kramnik – has led to and 2-0 score in favor of the Russian.
So why am I mentioning this is a blog dedicated to Personal Growth, Healing and Wellness? Because the current one-sided score line has a lot to do with each of these topics. This match is not just about chess playing ability: it is also about psychological and emotional strength, character and resilience.
There was a time when chess masters were unfit, often over-weight and the majority smoked. When I first started playing in tournaments in England, it was quite normal to have ashtrays beside most of the boards.
Oh how things have changed!
Now the players prepare physically, psychologically and some even spiritually with prayer and meditation:
- Very few players smoke, not just because of long-term health risk, but because the deleterious effects of lowered oxygen levels on cognition outweigh the short-term improvement in attention caused by nicotine.
- Aerobic exercise is essential to ensure that the brain is perfused with oxygen, and if you are physically unfit you cannot expect to survive a number of games that may each last for five or six hours.
- Strength training is also essential to overall fitness and physical and the maintenance of psychological resilience. Topalov is going to need that now.
- Posture is extremely important. According to Chinese and Ayurvedic physicians and chiropractors, bad posture results in a restriction in the flow of Qi, Prana, or blood. Whether or not you believe in the flow of Qi in the body, it is easy to demonstrate that bad posture has bad effects on cognition.
- Flexibility is also an essential part of physical wellness that affects you psychologically as well as physically. Daily stretching should be part of everyone’s life.
- Relaxation and meditation: one or other or both are essential tools for maintaining your balance while under stress, and for building resilience.
- Diet: a carefully balanced nutritious diet rich in omega-3 fatty acids (without any added mercury!) and fiber is essential for optimum mental functioning.
- Fluid intake: the current recommendations are for a healthy person to drink between 80 and 120 fluid ounces of pure water each day.
- Avoid alcohol: A former World Champion – Alexander Alekhine – lost his title after turning up drunk on a number of occasions during a match to defend his title.
Looking at the pictures from the match, in both games Topalov looked intense and Kramnik far more relaxed. It could have been an illusion: I would need to be in proximity to be sure. In the first game Topalov took a needless risk in a dead level position. In the second, he had an absolutely won game. I’m no grandmaster, but even I spotted a win in three moves. How could he have failed to find it and then lost?
What is the explanation? Chess players have to play a certain number of moves in a specified time, so not only are they playing their opponent, they are also playing against the clock. The biggest prize in the game is on the line, for which both players have been preparing since childhood. And there are hundreds of thousands of people who are watching and analyzing their every move.
I know from personal experience that it can be hard enough to be interviewed on a television show being watched by millions of people, where any false statement would haunt me forever. Imagine having a battle of wits with one of the finest chess players in the world in the knowledge that every move will be analyzed for the next century, and computers are already analyzing every permutation of every move that the two players have made.
The stress on the players is unbelievable. Both have prepared for it, but it is also a matter of who has prepared best: that is a mixture of temperament and training. Just today I read an article talking about ways of avoiding stress. This is silly: stress is part of life and it can provide the motor in motivation. The trick is how we learn to respond to stress.
There is also another stressor that has only been felt by world championship contenders on two or three previous occasions. This match is being played in the shadow of the retirement of Garry Kasparov, who, in the opinion of most people, is the strongest player who ever lived, with the possible exception of Bobby Fischer. The difference is that Bobby became World Champion all by himself, with little help and by inventing a new approach to chess. It is a great tragedy that his life has apparently been blighted by mental illness, and that he has played only a few recorded games in the last 34 years.
By contrast, Garry was the strongest player in the world for twenty years, and in the opinion of most experts would probably still beat both of the current contenders. So whoever wins wants to prove himself a worthy champion. Garry’s specter remains like the ghost of Banquo in the Scottish play.
The final essential is that both players have to detach from the results of the first two games. Kramnik will obviously have his tail up now, but he is too smart and too experienced to give in to complacency. Topalov has to completely forget about the first two games and focus on what lies ahead: I’m sure that he has someone on his team working on simple techniques to stop the past from populating his psychological present.
Whatever lies ahead for these two men in the next few weeks, we shall see that chess is a microcosm of life in general.
“What is needed, rather than running away or controlling or suppressing or any other resistance, is understanding fear; that means, watch it, learn about it, come directly into contact with it. We are to learn about fear, not how to escape from it.”
–Jiddu Krishnamurti (Indian Spiritual Teacher, 1895-1986)
Stopping Malaria with a Sugared Mousetrap
When I was an active clinician I saw several people die of malaria and it’s one of those things that you don’t forget. Nobody likes losing a patient, particularly to a potentially preventable disease. I would often think of the millions of people infected by this parasite. There are 300 million clinical cases of malaria each year, and around the world over one million people die of the illness each year. It has been calculated that a child dies of malaria every 30 seconds, with the largest number of deaths occur among young children in Africa.
We know that cleaning up water supplies and appropriate insecticides would make a huge dent in that terrible clinical toll, and hats off to the Bill and Melinda Gates Foundation for its massive attempts to do things that make sense for helping eradicate malaria and a score of other problems.
There are academics and some pharmaceutical companies that are working on malaria vaccines, and I wish them well. But I wonder about the practicality of paying for vaccines for hundreds of millions of people, when for a fraction of the cost, clean water would do a much better job, and without all the potential problems that might be associated with vaccination.
Global climate change will likely make the range of malaria-carrying mosquitoes much greater in the years to come: it was recently suggested that malaria might in our lifetimes spread as far North as England.
I was very interested to read of an entirely new approach to targeting malaria that could be cheap and easy. It’s also so obvious that I’m sure that there are scientists the world over who are slapping their foreheads this weekend.
I a study reported in the International Journal for Parasitology a team from Hebrew University was able to devastate a local mosquito population by spraying acacia trees with a sugar solution spiked with an insecticide.
The Plasmodium parasites that cause malaria are spread by female Anopheles mosquitoes. The female mosquitoes need blood to develop their eggs, but they also need large amounts of sugar to support their metabolism, so they need large amounts of sweet plant nectar.
What the Israeli team did was to spray acacia trees in an oasis in Southern Israel with a sugar solution containing the insecticide Spinosad. This area was chosen because there were few other plants from which the mosquitoes could obtain sugar. After spraying, the mosquito population was decimated.
Clearly this technique is going to be most valuable in areas with limited plant growth, so the mosquitoes aren’t just going to be able to go next door for food. Though that being said, Anopheles mosquitoes are fussy eaters and only visit a limited number of plant species. So now one suggestion is to plant mosquito attracting plants and spraying them with insecticide. Naturally enough, one worry is that the mosquitoes will learn to go to plant sources that they normally wouldn’t touch, or that they will develop resistance to the pesticides. And though Spinosad is supposed to be an environmentally friendly insecticide that doesn’t effect other insects, birds or animals, we have to keep an eye on the possibility that it may not be all that benign.
This work is going to need to be replicated, but it is an encouraging new approach to a horrible illness that is second only to tuberculosis in the number of people that it kills each year.
