A recent NY Times article by Nicholas Bakalar "Bigger Breakfast, Bigger Daily Calorie Count" reminded me of a posting I blogged on 7/29/08. 

 In it I observed that when I ate breakast I seemed to nibble / nosh throughout the rest of the day.  I lamented that my "will power" seemed to be rather lame when I ate breakfast. 

  Bakalar's article was less philosophical but equally condeming of the "sacred cow"   of eating a "good" breakfast.  He notes that those who indulge do NOT eat any less throughout the day than those who do not eat breakfast.  So in essence breakfast merely adds calories to the daily total. 


The lesson here?  Perhaps none other than its OK if not absolutely important to question so-called "sacred cows".  The Buddha himself was famous for advocating the questioning of every belief.

“That’s Him! The Man Who Pinned Me to My Bunk”–Re: An ADC from Iraq

I saw her today.  Judy S.  was undergoing an upper endoscopy but I asked her to re-tell the story of how her soldier son-in-law  in Iraq was saved by her deceased father.

She began and slowly teared up. 

She described how Johnny told reported that he was resting in his barrack bunk when he tried to get up and go to the PX to buy some candy.  He felt as if he was being held down buy a force exerted against his chest.  He closed his eyes, then opened them.  Pushing on his chest was elderly but powerful built gray-haired man wearing a black T-shirt with a yellow image of the Police Benevolant Association, gray shorts and sneakers.  He said to him, "you can't go, she needs you".

He then disappeared and shortly afterwards there was a tremendous explosion.  The PX had been bombed.  Many GIs were hurt, a few killed.

Months later Johnny returned to the States and told the story to Judy,  his then future mother-in-law and other family members.  Crying Judy grabbed a family album and opened to a picture of her deceased father who was wearing exactly what Johnny had described.  Johnny had never seen that album before. "That's him! That's the man who pinned me down to my bunk that day in Iraq.  I probably would have been killed that day." 


Therapy is often hailed as the necessary prerequisite for emotional healing.  A recent article by Dr. Richard Friedman in the NY Timeshttp://www.nytimes.com/2011/01/18/health/views/18mind.html?_r=1&ref=science addresses its role in the overall process.

The old Woody Allen joke was that he had been undergoing therapy for decades.  Clearly the value of knowing why you are suffering doesn't hurt but certainly doesn't guarantee healing.

The bottom line regarding our emotional state of being is more related to our attitudes about our lives, our interpretation of life's events than the actual events.

It may ultimately be our choice regarding how we look at our lives.This is known as refraiming. Pessimists seem to only see the negative events in their lives while dismissing  or ignoring any positive elements.  Optimists do the opposite.

Who is better off?  Optimists do tend to be healthier physically as well as mentally.  Their immune systems function better. They live longer.

So knowing why we are in distress may be valuable.  Its what we do with that knowledge that will or will not heal us.

I B S — Is Evidence Based Medicine (EBM) The Answer ?

I am presently working on a book about IBS.  It is the quintessential mind/body disease and I have been treating patients who suffer from it for over thirty years.

It is fascinating and challenging because of its paradoxical nature.  While it is never fatal, nor does it lead to cancer or colitis, it can be quite debilitating.  In a word its patients suffer.

Of course the concept of suffering is very Buddhist and the Buddha spoke of his mission teach suffering and the end of suffering.  Our approach and methods are different but our goal the same–to end suffering.

Many physicians rely of what is known as EBM–evidence based medicine.  It is essentially the consensus opinion of 'experts' based on summaries of scientific evaluations.  EBM is considered by many to be the "standard of care". In other words it may actually dictate to some physician what they can and cannot offer to their patients.

On the opposite end of the spectrum of medical knowledge is what is known as "anecdotal medicine" or AM as I'll call it.

This is essentially a physician's experience with one particular patient under specific circumstances.  Professorial, academic, research-based physicians are fond of demeaning the value of AM.

"You can't generalize from that one patient to all patients.  You need the highest level of RCT (randomized controlled trials) perhaps with meta-analysis of scores of studies in order to discover how to treat patients."

I do understand their argument.  The problem is this: as a private practitioner I have a different perspective.  I have a suffering patient who sits in exam room A.  They have come to me with a trusting heart and a deep desire to get better.  My obligation is to do my best to relief THEIR suffering.  EBM does not always offer the solution to that ONE patient.

The reality of treating human beings is simply that they are all different.  Despite carrying the same diagnosis they are unique.  A treatment which makes one patient happy leaves the next feeling worse.

It has led me to seek alternative and complementary approaches.  It has led me to explore the mind/body relationship in greater depth.  It has led me to weigh the risks and benefits of any recommendation.  It has led me to consider acupuncture, Reiki healing, herbal therapies when it seems the best approach.  It has led me to consult with my patients as to how they would like to proceed  when choices arise rather than dictate to them as if they were children. It has made me a pragmatist in the service of their suffering.

It has forced me to do anecdotal medicine.  That one patient IS an anecdote and they want to feel better.

The Buddhist approach requires me to find the way to end THEIR suffering, in that moment of awareness I have no other patients.


THE HATE HORMONE — Oxytocin And We All Possess It

A recent New York Times article by Nicholas Wade http://www.nytimes.com/2011/01/11/science/11hormone.html?_r=1&ref=science  offers more scientific evidence for man's inherent selectivity when as regards the Golden Rule.  Love our neighbor who looks like us, hate the rest.

Oxytocin has been lauded as the hormone of love, the peptide that binds us to each other.  Now we know the rest of the story.

I wrote about this in my November 29th 2009 blog posting Beware of The Tribal Gene.  At that time I pondered where in the human genome existed the genetic propensity to love our clan and detest all others.

Oxytocin appears to be the hormone which mediates this ethnocentricism.  But it clearly has some gene based pattern yet to be determined.

The article offers elegant scientific studies which merely confirm what history continually does. It is replete with genocies, holocausts, mass exterminations, holy wars, jihadism, etc etc.

The tendency to focus on which groups have performed the worst examples of this is to miss the big picture.  Clearly people and groups must accept historical responsibility for the atrocities they have committed.  The danger is for others to hold themselves out as incapable of doing the same.

Germans, radical Muslims, African tribalists, Serbs etc are all human beings!  We are just like them–in potential.

This is the message we should be shouting.  This is the lesson for our youth and for us all.  Human beings possess this inherited and inherent potential for hatred and the evil that ensues.

Only those who are aware can act to remain vigilant, strive to ensure that it remains unmanifest.

Oxytocin can be the hormone of both love and hate.  It remains in our hands to choose how we act on it.


I don't want the reader to come to the conclusion that I regard all religious practices as necessarily negative or inconsequential.  Religion, once understood as man's creation to explain divinity, can offer healing consolation during times of suffering.  Death is certainly one of those times.

Many may be unaware that flowers are traditionally absent from a Jewish funeral.  When I researched this a bit it seems that in times past, flowers and spices became of the mourning ritual in cultures which "waked" the dead.  Delayed burial, open caskets when embalming was incomplete resulted in disturbing odors.  Flowers and spices helped reduce them

Jewish practices call for burial within 24hours under most circumstances.  Flowers were not deemed necessary or fitting.

In the Fall I attended my cousin's funeral.  She was 92 and a fine artist.  She had met many friends though her work and one couple who attended and spoke were not Jewish.  They brought a small pail of flower petals with the intention of placing them on top of the casket.

I watched the Rabbi who was officiating.  I do not recall his name but understood that he was "retired" from his congregational work and did funerals.  I wasn't quite sure how he was going to react to the presence of the flowers.

He could have made explained how flowers are inappropriate for a Jewish funeral.   But he didn't.  Without missing a beat he, instead, suggested that we all take a few petals and sprinkle them over the coffin.

I'm not sure how many people standing at the graveside understood what the Rabbi did.  He understood the deep love and sadness which brought this non Jewish couple to the funeral that day.  He understood the spiritual intention, kavanah in Hebrew,  behind their act.

He did the right thing.  He was a good Rabbi.

“And Man Made God In His Own Image….” — Religion At Its Core

My interest in religion is far from new.  It was my undergraduate major at Franklin and Marshall College before I went to medical school.  It is an undying are of fascination for me because of the powerful impact it has always had and continues to have on history, culture, politics, war etc.

This impact has run the gamut from beautiful art, poetry, ethics and helping people lead more spiritual and productive lives.  The dark side of religion has been and continues to be all too apparent.

What bothers me most is the assumption of exclusivity–my religion is metaphysically correct, yours is wrong.  And furthermore I can regard you as ultimate evil, the enemy, not fully human and worthy of annihilation.

Perhaps a simple realization that ALL religion is man's creation might just give all of us pause to reflect.  Our religion may "work" for us.  Another's may "work" for them.  We can respect their choices.  They should ours as well.

As a recovering atheist I now do believe that "God" or some higher spiritual energy does exist.  My belief is based on evidence not faith.  But to continue….

This all came to mind, strangely enough last evening at the Metropolitan Museum of New York. It was an exhibition of the paintings of Dutch master Jan Gossart from the 16th century.

What struck me were his portrayals of Mary and baby Jesus.  They were clearly blond, haired-blue eyed Northern Europeans. Of course this was standard operating procedure for Dutch, German, English, French artists.

I would love to be able to interview Gossart or any of his contemporaries.  Did they truly belief that Mary and Jesus resembled their fellow Northern Europeans?

Would they have been shocked to see a black Jesus and Madonna painted by an African?

Since Mary and Jesus were historically Middle Eastern Jews it should be obvious that they didn't truly resemble each of these examples.

Does it matter? Did it matter to the artists themselves?

Probably not.  After all we do make God in our own image.

The Jewish God from the Five Books of Moses is ostensibly a warrior God, quick to anger, to lead his people into battle and to demand destruction of other human beings.

This is not the esoteric spiritually enlightened Ein Sof of mystical Kabbalah centuries later.

Which is the "real" God? Does it matter? 

Guess it depends on who is looking.



Want to instigate and near riot in the hall of science? Suggest that the paranormal / psychic may actually exist.

Recently a prestigious psychology journal actually published data to suggest that psychic phenomena is real. The N Y Times reported this in http://www.nytimes.com/2011/01/06/science/06esp.html?ref=science January 5th article by Benedict Carey.

Its fascinating to read the robust responses from scientists who feel compelled to question the results of these experiments in powerfully emotional terms.

The basic foundation of their scientific belief system has been shaken to its core and they are fuming.  Strange.  Where is the scientific dispassionate approach to research now?

I have always believed that an open minded investigation of psychic/paranormal/medium experiences is necessary.  Some of Gary Schwartz's work on the validity of medium readings under controlled conditions adds a scientific credibility to the subject.

My own personal exploration of the topic has offered me evidence that can only lead to one conclusion–there is survival of consciousness after death.  If this does not rise to the level of "scientific" proof then so be it.  It is the best explanation for the phenomena.

I have always found it interesting that scientists can seriously study autistic savants with extraordinary mental abilities to do math, art or music.  Though they cannot explain how they do what they do, they believe the phenomenon to be real.

Yet the same approach is NOT applied to psychics and mediums.  Who is to say their mental abilities, though unexplainable in present scientific terms,  may not be one day understood as well.

So let's watch this scenario play itself out.  It will be interesting to say the least.


Once again the Health and Science sections from the New York Times offer scientific support for a spiritual practice–mindfulness.

As I have described in previous postings (sorry cut & paste doesn't work on this computer) eating while paying attention to the actual process and not attempting to multitask leads to fewer calories consumed, recognition of satiety and more enjoyment of the experience.

The article by Nicholas Bakalar from January 4th adds an interesting twist. It has to do with memory and even influences snacking at a later time.

It seems that memory of eating contributes to satiety even later in the day.

It is worth taking notice in our own behavior.  If we nibble/nosh "mindlessly" we often forget that we did so.

So pay attention when we eat (I hope I do).

IBS– It IS in your head !! But….

Those readers of this blog might be shocked by the title of this posting.  "In your head?"  Isn't that the traditional put-down of IBS sufferers?  Doesn't that imply that everyone with IBS is neurotic and exaggerating their complaints? Don't you write about how integrated the mind and body are?  What's up with that?

Well now that I have your attention its important to note that IBS IS in your head.  But it is also in your body, your entire gastrointestinal tract, your guts. 

 Various types of brain scans, PET scans, functional MRIs of the brain do reveal abnormal patterns in patients suffering from IBS.

But they also exhibit abnormal motility patterns in the intestines as well as documented hypersensitivity known as visceral hyperalgesia.

So is IBS in your head? Yes, but that's not the whole story.