MEMORIAL DAY — Tragic Ambivalence

I am tremendously conflicted on Memorial Day.

Of course I honor the ultimate sacrifice made by our brave men and women in the service of our armed services. They and their families have paid the ultimate price–their lives. Of the many who return from combat maimed and wounded, I offer my deepest admiration for their bravery and the difficult path that lies ahead of them.

My own deceased father was a purple heart recipient of WWII. And here is where my ambivalence kicks in.

I feel dreadfully sorry to voice the opinion that many families may have lost their loved ones in vain. Likewise the maimed and injured have suffered tremendously because they followed their commanders into wars that made no sense.

World War II may have been the last "good" war. It was different. There was a maniacal tyrannt clearly bent on world domination and genocide. We were attacked by his Japanese allies at Pearl Harbor.

What about Korea, Vietnam, Iraq and Afghanistan? Is it unpatriotic to question our military leaders decisions? I believe that history has shown just the opposite.

Perhaps the answer to war is to have a universal mandatory military draft. Israel and other countries depend on it. If we re-instituded the draft I would doubt very much that either the conflicts in Iraq or Afghanistan would have lasted as long as they did. Where are those weapons of mass destruction anyway? And wouldn't targeted drone strikes have made more sense for retaliation after 9/11 ?

And perhaps we need to have open and public debate before we committ ground troops to harm's way. And perhaps we need to understand the culture and history of those countries in which we place our troops.

A patient of mine, a retired Army colonel, was present in Iraq when Saddam Hussein was brought to justice. He met with tribal leaders who thanked him for ridding the country of such an abominable human being then requested the Americans to leave. Such a simple act would have been better understood and appreciated than the attempt at nation building we began.

Place American feet on foreign soil and you set us up for ultimate failure. We had better be sure of the outcome before we do it again and again. What is the benefit? Does it outweigh the risk and suffering that results?

Once again I regret implying what I have already done by this posting. I can only hope that America does not do it again.

ISRAELI & TURKISH “BROTHERS” — The Human Connection

So have you heard the one about how the Israeli mountain climber saved a Turkish mountain climber?

No this is not a joke. It happened and it should be headline news everywhere and for one important reason. It is about one human being helping another irrespective of religion, national origin and politics. Of course it isn't as dramatic as showing conflict and rage. But it is beautiful and uplifting and offers hope in a world darkened by hate.

In short the 24 year old Israeli Nadav Ben-Yehuda was climbing Mount Everest on route to be the youngest Israeli to do so when he spotted the still body of Aydin Irmak, 46 his Turkish-American "friend" from base camp. "When we friend Aydin there was no question," Nadav said.

They had recently met there and felt an instant connection. Ben-Yehuda abandoned his run on the summit and immediately lifted his "friend" on his shoulders and carried him for eight hours down the mountain to base camp IV without gloves and oxygen in minus 40 degree temperatures.

To quote Irmak "I don't care what the hell is going on between the two countries. I don't care about that. I talked to his family today and I told them you have another family in Turkey and America."


Does anyone consider the role of a physician to be easy?

Presumably not. But in addition to the long hours, physical stress, concern over running a business, diminishing reimbursements, increasing governmental intervention, threat of malpractice law suits etc. etc. comes another "gift".

How does a physician handle the emotional turmoil that accompanies the role of being the source of life-altering information for our patients. And what about their own personal emotional challenges? Are they in any way better equipped to deal with them than anyone else?

In the NYTimes article the author attempts to address the issue. There is no doubt that we struggle with having to give bad news to our patients. We struggle with the knowledge they will be facing a frightening, uncomfortable and often futile course of medical or surgical treatment. Some of us choose to drop the bad news all at once. Others attempt to reveal distressing diagnoses and information in small, digestible increments. We,too, struggle with the great metaphysical issues that challenge all human beings–how to deal with suffering and death.

Our own insecurities and personal histories will impact how handle each unique situation. And what do we do with our own emotions? We clearly can't show them. We often retreat behind our white coats and grim faces. We know that we can be influenced by our own personal confusion and angst over our own deaths and of those we love.

And yet we are human beings. We are imperfect and vulnerable just like everyone else. We suffer, we grieve and we do feel the pain that our messages deliver to our patients. But that awareness might even disturb our patients.

It is an interesting phenomenon. Patients often seek to peel away the professional veneer we wear and to find out a little about our personal lives. Yet do they really want us to reveal our frailties as well? I wonder.

I have always believed that medical education woefully prepares individuals for the task of practicing medicine. We kind of "wing it". We try to use common sense and good judgment. But it is all improvisation. I do believe it is necessary for physicians to look within themselves. We need to experiment with self-reflection.

What are our personal beliefs regarding death and dying? How can we deal with delivering terrible news to another human being? Do we have the tools to do so? Not really. Some of us are inherently better at the task than others. Some of us find a way to mix compassion with professionalism. It is far from easy. I'm not sure anyone can teach us how to do it. But we should finally address the issue fully and openly.

Facing deep, troubling metaphysical issues are not easy for any of us. Physicians are not better equiped to deal with them than anyone else.

We need to be better at it. It is part of what we do. It sets us apart from how most individuals live their lives. And how we do it truly matters.


Just back from an interesting and stimulating two week travel through Spain and Portugal. Both fascinating countries on many levels. Both suffering through the possibility of becoming the next economic Greece.

Some of this tour involved Christian religious sites and pilgrimage routes such as Camino de Santiago, Santiago de Campest, Fatima and a plethora of churches, basilicas and even cathedrals. One of the fellow travelers from Australia used the term ABC (another bloody church). But I did find the experience worthwhile.

The religious drive is nowhere more evident than in the Iberian peninsula. At present it is a powerful historical center of Christian belief which retook the peninsula after a seven hundred year period of Muslim/Moorish Islamic control and dominance from 700 to late fifteenth century.

A brutal and barbaric religious Spanish Inquisition led to the confiscation of property, expulsion, forced conversion and death of those whose religious fidelity was questioned.

As usual, the Jewish population of Spain and Portugal suffered from the whims of its leaders. At times appreciated and even tolerated, at others expelled, killed, burnt at the stake for being infidels or insincere converts (marranos or conversos).

There were discussions by our extremely knowledgeable tour guide about the re-discovery in post-Franco Spain of their original "Golden Age", namely during the Muslim/Moorish occupation. This period had been purposely ignored because it was not based on Church domination.

Of note was the considerable achievements in art, science, architecture, medicine, chemistry, sanitation, scholarship, philosophy by a collaborative and collaborative efforts of the three Abrahamic religions (Judaism, Christianity & Islam).

In fact much of the important Greek and Roman writings, philsophy and poetry, nearly forgotten and lost, was preserved and re-introduced into Europe by the Muslims. While much of Europe was struggling through its Dark Ages, civilization in Spain and Portugal was flourishing.

I found it interesting that one Spanish tour guide seemed to justify the Inquisition by stating that Queen Isabella and King Ferdinand found it "easier" to deal with only one religion. How sad that such a brutal and ultimately self-destructive period of European history could be rationalized and dismissed so casually.

If there was a clear historical lesson for all of us to be learned from Spanish and Portuguese history it seems to be this–embrace the benefits of diversity and the sharing and collaboration with those whose backgrounds and belief systems differ from your own. Lose the fear of learning from others. Seek cooperation rather than annihilation of those who differ from us. Reject xenophobia and fundamentalist beliefs.

There is much for the contemporary Islamic world to learn from their own history. Five hundred years ago they led the known world in intellectual pursuits. Today adopting a more moderate and collaborative relationship with nonbelievers might reap rewards for all concerned.

All groups can learn from their shared past. What worked then was collaboration, cooperation, sharing and mutual respect. With an enlightened awareness of history, it can happen once again.


Whether we refer to them as ADCs (after-death communications) or "visits from heaven" they are communicationsfrom souls who have crossed-over. So what do I mean by an "assisted ADC?" ( call it an AADC ?). It is essentially any communication which requires a medium to accomplish the connection.

 By creating this new concept I am de-emphasizing the mode of communication (direct personal vs medium) and focusing in on the existential essence of it. What is demonstrated is the continuation of consciousness after physical death. To me, that is what is ultimately important anyway.

More specifically I am relating the personal story from a long-standing patient I'll call Sally. Sally lost her husband Jim suddenly and unexpectedly. While desperately hoping for a personal connection with him after death, she found none.

She describes placing his favorite fishing boots outside her door in with the fantasy that he would return for them.

Meanwhile a psychic friend from England who had never met Jim began to email her messages from him. She described them as being remarkably accurate and extremely personal, reflecting conversations that only she and Jim could have known about.

Finally Sally decided to give Jim's fishing boots away to one of his friends. That night an email from her British friend stated that Jim said she should give away his fishing boots that were at her door!

The field of paranormal investigations have always differentiated the spontaneous communications versus the medium-assisted ones. I don't believe that the distinction is all that important. It is the message and the reality of the communication from our deceased loved-ones should be most profoundly significantly understood and cherished.

So whether the connection occurs via an ADC or an AADC is less relevant than the healing power of either one.