We seem to live in a culture which seems determined to find out what happiness is and why we don’t have it.  It is clearly because we have our basic necessities taken care of and live without fear of imminent death on a daily basis.  For most of human history our ancestors had no need to ponder the meaning of happiness– just staying alive from one day to the next was enough of a challenge. Who had time to worry about being happy?

There has been much written in pop culture and pop psychology about the desirability of being happy. True so-called happy people seem to live longer, healthier lives. But it seems that to a considerable extent we all have a genetic predisposition for a certain degree of it.  And certainly there are those life experiences which impact our perception of our own state of happiness.  Yet  happiness is more than an emotion such as joy.  It is more likely a state of contentment and, as such, is a state of mind.

 And yet we all know that life is filled with trials and tribulations. Adversity and negativity should not be regarded as failure in anyway.  Accepting that anger, sadness, disappointment and frustration are normal reactions to living is key.  Learning to tolerate them, learning from them and moving on is a valuable skill.  Sadness when appropriate is just that– appropriate. 

 When sadness, frustration and anger outlive their usefulness ( motivating us to fix what is broken) but become a chronic state of mind it is time to seek a change. That is when we need to realize that we have the ability to change the way we think about our lives and the situations in which we find ourself.  We can be active participants in creating our mind set and not merely passive recipients. It is our ultimate statement of free will. 

 The Serenity Prayer speaks volumes when it reminds us to accept what we cannot change after we have tried our best to change what we can.  This acceptance is akin to the Buddhist notion of nonattachment.  It is not the same as not caring or not feeling.  But it is a position of wisdom. 

Yet happiness can not be found sitting on a beach, by isolating ourself from negativity and by avoiding life’s challenges.   We need to continuously challenge ourselves in many ways.  Curiosity, learning, meeting new people, having new experiences and overcoming adversity all give us a sense of growth and achievement. 

We don’t find happiness by seeking it directly– it is a pleasant byproduct of living life to its fullest and accepting the bad with the good.

“DEATH PANELS” ?– NO– End of Life Panels– YES

Medical ethics will never be divorced from personal beliefs and politics. 

A prime example is the concept of end of life planning.  Representative Earl Blumenauer, Democrate from Oregon had introduced a provision into Medicare to cover voluntary discussions between a physician and patient regarding advance directives and treatment preferences at end of life. http://newoldage.blogs.nytimes.com/2013/08/28/death-panels-this-time-maybe-not-so-scary/?ref=health

Unfortunately the right wing of the Republican party seized on this valuable undertaking and slapped it with the perjorative, “Death Panels”.  The term stuck and the plan was shelved.

 Now I am no fan of Obamacare for a slew of reasons– but this is one of its original tenents I could have supported.   It appears that cooler heads are now reintroducing this important concept to Congress and the public domain.

As Blumenauer points out, advance directives offer the individual an opportunity to have input into their personal philosophy of life and end of life.  It should help with an increasingly opaque and confusing process that occurs when loved-ones are dying. 

I believe that these end of life discussions will not completely resolve the controversy and anguish that occurs when decision-making falls into the hands of health care proxies at the end of life.  But they are imperative nonetheless.


NOTE– I will beginning a year long course in BioMedicalEthics sponsored by my medical school alma mater– Albert Einstein College of Medicine commencing September 11. Of interest to me is its co-sponsorship by Montefiore Medical Center where I spend three years do an Internal Medicine residency.  It is being held at Cardoza Law School in Greenwich Village.  I intend to use this blogsite to share some new insights with my readers


My friend and personal medium Lynn Milano from Metuchen NJ wowed one eof my longstandng patients who I will refer to as Pat ( not real name).  She presented Lynn with a photo of several family members. 

Lynn noted her adult son (Bob)’s picture and immediately asked if he were a Civil War re-enactor.  She noted that he was.  Lynn  then went on to state that she doesn’t always “see” someone’s past life but absolutely knew that her son had died at age 16 fighting in the Civil War.  Now I have alwals wondered about Civil War re-enactors.  What draws them so powerfully to engage in such activities?  Could they all be remembering the past lives (and deaths) and been drawn to connect with them?

Furthermore, Lynn noted two young children’s photos.  She perceived that the young girl was outgoing, sefl-assured, and comfortable with people.  The young boy, however, was completely the opposite–shy, withdrawn and a loner.  She then pointed to the adult male ( Pat’s son-in-law)  standing nearby and noted that he was a ‘son-of-a bitch’.  He emotionally abused the young boy, either ignoring him or demeaning him in a horrific manner.  Lynn also felt that Pat’s daughter would eventually leave him—but not yet. 

Pat was blown away by Lynn’s reading.  It not only demonstrated her ability but strengthened my belief in reincarnation.


The Near Death Experience (NDE) so named byRaymond Moody in his 1975 book Life After Life has become ingrained in popular culture via a multitude of books, movies and articles. 

Although this phenomenon is well accepted, its underlying metaphysical implications remain controversial.  Is this merely the neuroelectric firings of a ‘dying brain’ or does it offer insights into another dimension that exists after physical death?  

A recent NYTimes article by Douglas Quenqua reporting on work done with lab rats seems to show hightened brain arousal within 30 seconds of clinical death.  Is this, therefore, evidence to dismiss the NDE as a quasi-spiritual experience?  I don’t think so. 

The prime examples are the “verdical” (truthful) bits of information that occur when an individual is in such as state.  When the NDEr reports perceptions that are physically impossible, or meeting “beings of light” who they later find out are deceased relatives, then I feel we are not ready to dismiss them as mere dying brain activity.  I reported several in my book, Metaphysician On Call For Better Health.  Neither of these case studies from reliable sources could be explained by the phenomena in dying rats.

But keep an open mind. If science can completely explan all aspects of the NDE to my satisfaction, I will be the first to accept their conclusion that they are epiphenomeon.  Until then….. I don’t.


This blog offers me an opportunity to opine on a variety of subject matters.  Politics and geopolitical issues affect all of us and I would like to express my thoughts on the issue of democracy. 

Of course it is the finest form of government.  Yet should it always be embraced in its immediacy, its totality, under every geopolitical situation?

 Our country’s history is a unique testimony to how it can work and work well (despite the obvious difficulties).  Yet we often fail to understand the historical and cultural background from which our “Founding Fathers” arose.  Without such an understanding, we are doomed to be shocked and surprised when democracy doesn’t seem to “work” so well in other countries and other cultures. 

The debacle presently going on in Egypt speaks to that point.  a recent article in the NYTimes by Charles A. Kupchan (Democracy in Egypt Can Wait) addresses these issues quite well. 

You see our Founding Fathers were products of an English history and education which was steeped in European Enlightenment philosophy and understanding.  A 25OO year history of justice, moral and ethical principles and severe problems with religion, monarchy, injustice and war helped mold the philosophical underpinnings of the Declaration of Independence and the Constitution.  There is no lack of literature on this topic.  Suffice it to say, the the creation and formation of the USA was a perfect storm of brillance, understanding, enlightenment and a celebration of the rights and liberties of individual human beings and their freedom to live life unencombered by state or religion. 

The same can not be said for the Middle East.  It’s history is rife with religious fundamentalism, xenophobia regarding outsiders, intolerance of differences, brutal dictatorships and monarchies and no tradition of justice, a legal system which protects the rights of the individual or minorities.  In other words–it should not come as a surprise to anyone with half-a brain that democracy cannot succeed in the Muslim world as it presently exists. 

Adolph Hitler was brought to office by democratic principles in a European nation with strong intellectual and philosophical credentials.  Yet he quickly dismanteled the forces for protecting individual liberties.  Democracy became the gateway to its own destruction, the slaughter of millions and the ultimate annihilation of Germany itself. 

So this issue is not just about particular religious or cultural differences.  When demoagogues, dictators and a failed justice system clash, democratic elections can bring horrific outcomes as well. 

So, as Kupchan points out, democracy needs to be embraced under a gradual process which emphasizes the protection and rights of the individual.  It will be difficult to be sure.  But wholesale welcoming of democracy at any price will lead to further chaos and destruction.  Just check in with your daily source of news information to find unfortunate evidence of this truth.

“DID YOU KNOW HOW SMART HE WAS?…” A Loving Wife & A Doctor’s Despair

“Can you see Mom today?”  

“Of course”.

I told Beth to bring her mother Rose right in.  “She only trusts you and she was sent home from the ER again.  She had such chest pain.  They said her heart is OK so it must be gastrointestinal. Right?  And besides, she is losing weight, doesn’t eat enough.  What do you think?”

Rose and her husband Sam had been patients of mine for many years.  She was now 88, he was 89.  Sam was suffering from dementia/Alzheimer’s.  Rose was heartbroken.  It was clear that her role as caregiver was literally killing her. 

He doesn’t seem to recognize me all the time” Rose said, her eyes welling with tears.  “And you know how smart he was? He was valedictorian of his City College class and founded a very successful accounting firm.  It is so sad to see him now.”

I could say little to her.  “Does he seem to be suffering?” I asked. 

“No….but I am.” 

“Of course, it must be so hard to see him like that.  But you have to take care of yourself now.  You need to find time for yourself, away from Sam.  Distract yourself.  See your friends, grandchildren, go to the movies.  And don’t feel guilty.  See how you wound up in the ER.  Rose, I you don’t find some peace, you will get sick.  You won’t have the strength to be there for Sam”. 

“I know this for a fact.” I told her. ” It happened in my own family.” 

I thought back to my own life situation.  Both my parents have passed on.  But my father took responsibility for my mother as she was dying from dementia.  He never acknowledged his own suffering.  He probably didn’t realize how the daily stress was affecting him.  As we were waiting for her to die  under Hospice care, he “crashed” and almost died from overwhelming pneumonia.  It was clear that his immune system had been horribly compromised.  How?  From unremitting stress over my mother’s condition.  Soon my family was dealing with two dying parents.  My father’s only desire was to be there when his wife died.  Although she was “supposed” to die the day he was hospitalized, she miraculously lasted the five weeks that he was an inpatient.

She died a week after he was discharged and I was there when they reunited.  She didn’t realize that he had been gone for more than a minute.  I left the two of them alone.  After the funeral, he fell and fractured his hip. 

He survived several more years with relatively good quality of life.  But his immune system never fully recovered.

So I see the scenario being play out again and again.  Rose and Sam, Frank and Millie (my parents)–race and ethnicity become irrelevant.  It is about love and loss.  It is about being a witness to the most horrific of events– the loss of someone before their body dies.  When the mind goes, there is little left but a shell.  It is the hardest blow to take.

As a doctor I can’t  help but bring my own life’s lessons to the exam room.  It is a sacred place– where space and time give way to  the challenge  to heal what needs healing– be it mind or body.

And frequently it is both.



If we ever doubted that monogamy was an imposed cultural value (vs instinct) we need not look beyond the latest news of our political leaders. Or, perhaps, just look within. Yet monogamy seems to have offered our species survival advantages which favor its presence in many of our cultural traditions. 

A recent NYTimes article by Carl Zimmer http://www.nytimes.com/2013/08/02/science/monogamys-boost-to-human-evolution.html?ref=science addresses this topic.  Perhaps the greatest benefit to monogamy was to keep the paternal unit in the picture for an extended period of time.  No longer merely a sperm donor, a monogamous family arrangement allowed emotional bonds to develop between a father and his offspring.  The result was a committment to provide food, shelter, protection and care.  Such is the recipe for survival for the individual child and the society in which they reside. 

But because monogamy is not biology, we see far too many examples of fatherless families.  The results are almost always extremely negative if not devastating.  

And yet polygamous social arrangements could still conceivably offer some of these benefits.  It just seems that the more dilute the father’s influence (emotional and financial) the less potent it would be.

So to a large extent monogamy is not about morality or ethics (although it certainly can be) it is more practical than that.  It offers our kind the best hope for creating an individual who can survive and contribute to the betterment of one and all.

Will monogamy ever become an instinctual drive?  Unlikely.  The temptation and ability to break that pattern remain a strong force in our culture and clearly in our genes (and jeans).  But the benefits of monogramy may continue to offer us a choice we choose to make.