Social medial I believe has transformed the issue of free speech. This is certainly a controversial area to write about with strong feelings supporting unlimited free speech and the other side questioning such an approach. I am certainly not a Constitutional scholar nor even an attorney but I am aware that ‘hate speech’ is protected by the First Amendment as long as it isn’t “ direct, personal, truly threatening or violently provocative.”

Which seems reasonable on its face until we ponder the power of social media. My real concern is that our Constitutional experts may not have foreseen the multiplier effect of social media in its ability to magnify and provoke the emotions of its viewers.

Hate and strong emotions have always been evil twins and provocative, exaggerated, stereotypes of groups can become ingrained into gullible readers as confirmed and documented truth. The more these slanderous and damaging tropes are repeated and more credible they seem to be. They become ‘truth’ by virtue of repetition and exaggeration.

We cannot deny the power of words and their ability to lead to action. Jihadists, right wing fascists, left wing progressives have mastered the use of social media to spread hatred and sow the seeds for real attacks and physical damage to individuals.

We need to revisit the relationship between social media and hate speech in the reality of 21st century existence. The consequences can be life threatening.

Who and how the censoring of hate speech occurs will clearly be challenging but the subject should not be dismissed as an issue of Free Speech alone.

S.E. Hodes

Serenity is the steady state—emotions and experiences are ephemeral.

Perhaps one way to encourage meditation is to consider varieties of approaches to it.

The following may be rather unique because it is based on one of the best known passages from the Book of Genesis 2:7.  The King James Version states “And the Lord God formed man of the dust of the ground, and breathed into his nostrils the breath of life; and man became a living soul.”  

The original Hebrew relates through various words the concept of breath and soul. But without delving too deeply into the varieties of soul according to Kabbalistic concepts, try to visualize God breathing the gift of the soul and therefore life into us through every breath.

Breathing in through our nostrils can be visualized as a passive act on our part, an active one by God who by doing so signifies ‘his’ desire to grant us continued life, literally from breath to breath. Allow our breath to slowly exit our mouths. Allow the process to continue as slowly or quickly as it flows. Allow the breath to pause at times as if God is considering the option of continuing to grant us life or not.  It is ultimate submission to God, the Universe, Divinity, Ein Sof, Source etc.

Relax in the mystery of existence and stop trying to control what may not be in our power to do so.

My apologies

To you Jane S.

Because my eyes

Peer downward

At my laptop

Not forward at you

I am not scanning

The face

I have known for years

I am not gleaning meaning

In that millisecond

Before you speak

And you feel my frustration

Because you

Know my face

As well as I

Know yours

 

I have an issue with eating which needs attention.  Although considered ‘overweight’ based on a BMI graph (I prefer to believe muscle mass corrects for some of this )

I do find myself, at times, eating mindlessly. I find that I eat when I’m bored, or stressed, or multitasking and completely not paying attention to what I am eating.  At times I can perceive a sense of fullness but continue to eat food that is tasty anyway.

 Although I do believe the mindfulness approach will help greatly in directing me on a sensible and safe approach to eating, I believe my approach needs ‘tweaking’.  What might help is a friend’s suggestion that I should feel as if I will report what I am eating to another individual.  By doing so I will consider what I am eating and whether or not to make a quick grab of something or continue to ingest food after I am actually full.

What i now believe is that other individual can actually be me!  This corresponds with what mindfulness meditation refers to as the ‘witness’ or the ‘observer’.  By playing the role of the ‘observer’ I can offer myself a moment to choose whether or not to eat the way I usually do.  That moment of awareness may seem subtle but I believe it to be powerful.

 I truly believe I will consume less calories and make better choices. I am putting myself to the test right now. Good luck to me and the other me, the observer.

I rarely agree with the statements and positions of Ezekiel Emanuel, MD. Politically he is to the left of what I consider rational and reasonable, but when I comes to his opinion on medical education we are in complete agreement.

In his article Does Medicine Overemphasize IQ? In the February 20, volume 319 of JAMA he offers concepts I have shared in my own personal and published writings over the past few decades (including my book Meta-Physician on Call for Better Health). Emotional IQ, EQ is clearly an under-appreciated quality.

The system which produces physicians has traditionally valued the student who can assimilate vast volumes of scientific material and to score well on standardized tests. However, it is more than clear to me that the best physicians need an additional skill set. The process of treating and helping to heal patients is not a mathematical or scientific formula. Rather it is more like the working through of a serious philosophical, psychological or written narrative.

What becomes the best option, the most reasonable approach to the patient who sits before me in my exam room? How do I handle a patient who is NOT responding to my treatment plan? How do I tell a patient that they are not going to get better or that their condition is terminal? How I dance to this music determines ultimately what kind of physician I truly am.

My own personal journey began with my interest in science and the humanities. My fascination with the metaphysical origins and backdrop to nature and the human condition led me down multiple paths which ultimately brought me to medicine as a career. My undergraduate degree in Religious Studies seemed initially incongruous with becoming a physician. Fortunately I was able to persevere through the arduous and often irrelevant pre-medical obstacle course of calculus, physical and much of chemistry. I matriculated in an excellent medical school named after a brilliant physicist was well as a metaphysician, Albert Einstein.

But even there throughout my educational process, what was never emphasized were the deductive reasoning skills which would aid me in my chosen profession. What I found intuitively was what mattered most was not only WHAT I communicated to my patients but HOW I did so.

I learned to communicate both verbally and nonverbally that my concern was for that ONE patient who inhabited by exam room at the time I was with them. No other patient of mine mattered at all. My attention, my concern, my deepest thoughts centered on that one patient alone. And it was true. I did see my practice in those terms. Hopefully that sincerity was felt and understood by the patient.

Emphasizing the power of the mind to affect the physical, asking the patient to participate in their own healing process. All these are strategies I employ on a daily basis which are not in their nature ‘scientific’ per se. If that represented my Emotional Intelligence then where did it come from? I believe it was natural for me. But clearly it isn’t for all physicians. Can these skills be taught? Because I believe they are innately present within all of us I do believe that they can be awakened, brought to the level of awareness that might even make some physicians uncomfortable at first.

It requires lowering our personal guard, revealing some of our own humanity to our patients. Of course we are the professional healer ‘in the room’ but we are also merely human beings. We can share a bit of ourselves, our common humanity with our patients without threatening that ‘professionalism’ we so dearly seek.

The term EQ contains, after all the word emotion. We are emotional beings and although we are trained to withhold our emotional selves from our patients, it is not inappropriate to allow our own humanity to seep through when it is necessary and appropriate. It is not inappropriate to smile when we are dealing with patients. Not all medical conditions and situations involve life and death issues. Relatively benign conditions can produce considerable suffering. Allowing the patient to perceive our lack of concern for their ultimate improvement has healing value.

Admitting that we don’t always know all the answers, the solutions to their problems is necessary. But equally so we can commit ourselves to seeking those answers and remain committed to the process of healing itself. Allowing that the process may be long and difficult but that we will not abandon the patient or their condition is a powerful EQ tool.

We suffer through an age when medicine seems LESS personal, more regulated by insurance companies and bureaucratic nonsense, when physicians find themselves tethered to their computers and burdened by electronic medical records which force our gaze from those we are attempting to heal. We find ourselves labeled ‘health care providers’ and no longer physicians.

But why should honoring our EQ be the goal of physicians alone? Wouldn’t all of society benefit from all of us seeking to become more caring human beings who recognize our common humanity? Therefore, there is more need than ever to seek that inner core of caring and honor the challenge we as physicians have embraced. But it is a worthy goal all of us both physician and patient can share.

The grandparent experience defies verbal/written description. Until becoming one myself I would flee from an oncoming grandparent wielding scores of pictures of their own newly minted grand-offspring. I would appear to be superficially interested and verbalize such worn out comments as anyone would. I would often silently swear to myself that I would never become that kind of grandparent. So now that I have had the experience I try to be very selective in who I reveal pics of the truly brilliant, beautiful and ultimately talented grandson (s) I have. All kidding aside words, either spoken or written do not adequately describe the feeling, or any powerful feeling, for that matter, of the experience itself.

But there is a paradox to the entire phenomenon. My dark side speaks from a place of existential truth. Becoming a grandparent only brings our ultimate demise into stark reality. Fortunate individuals (like myself) retain great memories of particular grandparents and their love. They died decades ago. Now that I have become one the realization comes fully– I’m next in line to fulfill by mortal directive. As my wife’s wise grandmother shared with her when she was small, the older generation must make room for the next. My ancestors did so for me so it is only fair.

I’m OK with that, I guess. There is no option as birth comes with an expiration date stamped somewhere, invisibly on our soul. But just remember you ecstatic grandparents as you lift your bundle of joy into the air–you’re holding your genetic replacement up to the heavens. Enjoy the experience fully as you take a deep, soulful sigh.

The only Zen you find on mountaintops is the Zen you bring up there…. Robert Pirsig

Because we live either in the future or the past we inevitably suffer in the present moment over that which may or may not occur. The human mind has evolved to ponder how to survive in an often hostile and threatening universe. This by necessity requires creating and imagining future narratives and strategizing how to deal with them.

This clearly beneficial survival mechanism can unfortunately produce suffering when it is allowed to range free and without constraints. We seem to live in that imagined future and in the process accelerate the perception of time. The challenge we all face is how to balance the necessity to plan and protect ourselves and our loved ones while not abandoning the need to recognize the beauty and majesty of the present moment.

Our lives seem to race by us. Minutes become hours become days, weeks, months and years. We shock ourselves at the passage of time and it seems to accelerate as we age. This time treadmill is on fast forward with no evidence that it will slow down until we ultimately stop running. Will we inevitably reach the end of our lives and look back in shock at how quickly it has passed?

It may just require a recognition of our nature and to make a concerted effort to slow down the process. I return to the topic of meditation. It requires the ‘time-out’ or in other words taking a forced vacation from the incessant thoughts that bring stress and anxiety to our daily existence. It requires a recognition that we can be in a safe place–even for that time we take to do it. It allows us to calm the mind and observe its thoughts.

This is the practice of mindfulness in which the contents of our minds—our thoughts and feelings can be allowed expression but without attachment. It also changes how we perceive time. The present moment may seem like an eternity when we attempt to change our perception of it. That is what is so fascinating about meditation. Try it for only ten minutes and shock yourself by the difficulty in staying with it.

It is difficult to accomplish because it challenges the way our minds have developed over a lifetime and how it works by default. But it is worth the effort if we can just take the time to practice it.

I keep returning to this topic because I need to reinforce to myself the need to do it. The intellect understands what should be done even though we constantly find excuses to avoid it. We just need to act on it. Nameste

Anyone out in cyberspace presently immersed in a meditation practice? Raise your hand. What about those who have tried numerous times and always seem to have it slip away. My hand is raised now. Why is it so difficult and more importantly why is it so valuable? Clearly this short piece will not answer these questions completely but here’s some thoughts on the subject.

We should meditate because of its health benefits. Really. It leads to a reduction is stress, in measurable stress hormone levels, it increases self-awareness, it reduces blood pressure and the fight or flight response on our cardiovascular system. It increases sense of serenity and reduces reactivity (how we respond when we get cut off while driving). It seems to promote an optimistic approach to life rivaling the benefits of antidepressants, it decreases the brain volume in the amygdala, the center of stress, anxiety and fear, increases the grey matter volume throughout the brain in older meditators versus older non-meditators. It may also open individuals up to spiritual experiences. Need more reasons?

So why is it so difficult to do? Probably for the reasons we need to do it. Our minds through culture and evolution are determined to think about a multitude of thoughts in as short a period of time as possible. Anyone who has tried meditation can attest to that. Try meditating for only ten minutes. Set an alarm and realize how inpatient we all are. We will often check the timer just to make sure it hasn’t stopped working. Only ten minutes seems like an eternity.

Known by a variety of terms including ‘monkey mind’ our thoughts leap from one to another like monkeys in a cage. We can understand why this occurs. Darwinian survival mechanisms promoted the ‘worriers’ over those who chilled out and just let it all happen. Which one of our ancestors could anticipate threats could escape or avoid them. This cognitive legacy can now hurt us as much as help us. Meditation endeavors to dampen that innate response of the mind.

Some of the confusions regarding meditation may relate to the variety of approaches. From mantra to mindfulness and a seemingly infinite variations of each, we can can caught in the middle ground of not know what to do. I have been there and clearly each approach has benefits and admirers. Mantra may be somewhat easier to begin with but I will return to the mindfulness approach. It relates simply to the present awareness of the breath. When thoughts intrude, as they inevitably will simply observe them and go back to the breath. Sounds easy but it isn’t. I like this approach because it leads to the Buddhist notion of the witness consciousness. We are NOT our thoughts or emotions but can become the witness of them. We can recognize that our higher self, the soul, observes the creation of our mind. This awareness can be profound in and of itself. Difficult to achieve. That’s why it is called a practice.

In an era where many are diligent in working out the body, let’s be equally committed to training our minds to function at their highest level.

Good luck and namaste. I know I’ll need it.