Sunday, March 31, 2013

What Is Terrorism?

     The United States government declared the Earth Liberation Front (ELF) a terrorist organization.  Eco-terrorism is acts of violence committed in the name of the environment.   The violent acts committed by the ELF consist of sabotaging plans made by corporations to cut down forests or otherwise damage the environment in ways that are ecologically irreversible or are deemed to cause lasting damage to the environment.   One "terrorist" technique is spiking trees, which involves driving a metal wedge into a tree so that a chainsaw will be broken when an attempt is made to cut the trees down.  Eco-terrorism is a carried out by small, grassroots organizations without central leadership, and this is by design, to avoid infiltration by government agents.
     Saving forests is one eco-terrorist cause;  others include preventing animal cruelty (the Animal Liberation Front was founded in 1979), saving nature preserves, and intervening against illegal whaling and seal hunting.
     Not one person has been killed as a result of eco-terrorism, and there have been almost no injuries, not even when arson is used as a tactic.
     Nevertheless, the FBI has labeled acts aimed at defending the environment a federal terrorist crime, described as "the use or threatened use of violence of a criminal nature against people or property by an environmentally oriented, subnational group for environmental-political reasons or aimed at an audience beyond the target, often of a symbolic nature" (Wikipedia). 
    What is "terrorism"?
    In a program on National Public Radio (NPR) today, a speaker said that individuals belonging to groups that might be targeted by grassroots organizations say they feel terrorized.
     Terrorism, then, is any act which makes others feel frightened that they may be attacked.  It's the act of holding something over someone's head.   Eco-terrorists, as the FBI calls them, are attempting to halt corporate efforts (aided by lobbyists) aimed at decimating forests or overfishing.   Whether or not this is "terrorism" has been the subject of debate, and is a question for another day.   I don't see how acts of civil disobedience can be categorized as "terrorism," but it's the FBI's call, isn't it?  We have given the FBI the power to declare any group it wishes a "terrorist group," and we've given the FBI the leeway to wage a "war on terror."
     My question is this.  Hasn't the FBI been, by the definition above, a terrorist organization toward me?  Aren't I a victim of FBI terrorism?
     After three years of FBI investigation, and nearly two years of "having something being held over my head," without a clue as to what, or why, without evidence, information, an arrest, or a trial, I consider myself a victim of FBI terrorism.  Every day I live with the possibility that, for no reason I can fathom, FBI agents may show up at my house, or while I'm grocery shopping, or while I'm watching my autistic son swim, or when I'm in the garden counting grasshoppers... and handcuff me, and haul me off to jail. 
     If the FBI is going to call ecologically-minded people who can't afford the million-dollar lobbying agency fees required to promote their causes in Congress "terrorists," fine.  But what about the FBI itself?  Raiding businesses that have done nothing wrong, stealing money from those business owners' bank accounts, refusing to give a reason, forcing people like me, who have become targets of FBI attacks, to live in a state of constant trepidation, holding the threat of indictment and incarceration over my head, for years--maybe as long as ten years, my lawyers tell me--is terrorism.
     I would like to name the FBI a terrorist organization.  Let's put it on the list.  Let's target it.

Saturday, March 30, 2013

Bee Pollen for Arthritis

     There are more than a hundred different types of arthritis, but not a single truly effective treatment.  It's possible bee pollen might be of some value, according to a Ukranian study.  It's probably not a panacea but, alas, we'll never know--the funding for studies comes from Big Pharma, and none of them can make a profit testing bee pollen.
     Bees are interesting, though.  They had a small place, for a while, in the treatment of multiple sclerosis--which is, essentially, untreatable.   As it turns out, some people claimed that when they got stung by a swarm of bees, their multiple sclerosis went away.  Alternative practitioners administered "controlled stings" to effect a reversal of this otherwise terrible, debilitating condition.
     We know that the immune system is thrown out of whack when people are assaulted by allergic substances--and just about everyone is allergic, to some extent, to bee venom.   If the histamine response to hundreds of bee stings weren't enough to kill you, it might reboot your immune system.  And an overhaul of the immune system might be exactly what a person with multiple sclerosis, or recurrent hives, or severe allergies, or even arthritis, needs.
     Arthritis is described in western medicine as a "degenerative" condition.  The most common type is called "osteoarthritis," but this term doesn't say much.  The hallmark of all versions of arthritis is pain with movement, especially pain in the joints.  The medical profession divides arthritis into two general categories:  arthritis associated with aging, and arthritis "caused by" an autoimmune process.
     It seems to me that all forms of arthritis represent aberrations of the immune system.  The depiction of our bodies as machines that "wear down" might make sense intuitively, and it certainly has gained popularity in the west, but it doesn't represent the body accurately.  It's true that human anatomy takes advantage of laws of physics, hence our arms act as levers and our ligaments like pulleys.  But our bodies are not machines, and they don't work mechanically on the microscopic level, especially when it comes to illness and healing.
     Doctors speak about "inflammation" as though it has a real corollary within joint spaces.  When joints hurt, doctors say the cells in the vicinity are "inflammatory," but this is a misleading term  stemming from the hypothesis that arthritis is a form of inflammation.
     Rheumatoid arthritis, lupus, psoriasis and multiple sclerosis are conditions which often have their onset after severe stressors.  Such stressors include other illnesses, like infections (mononucleosis has been implicated), or emotional stress, like that following a death in the family, a shift in social status, or a betrayal, divorce, injustice, accident, or other rupture of the status quo.
     In the 1940's, many medical profiles attempted to describe the "rheumatic personality."  Alan Stroudemire (in Psychological Factors Affecting Medical Conditions) culls some of these personality features from articles by researchers who published between 1942 and 1980:  "self sacrificing, masochistic, inhibited, perfectionist, retiring," and "emotionally unavailable, depressive," withholding of anger, and "sexuality, neurotic." 
     It's fortunate that we no longer blame patients for having personalities that trigger medical illnesses.  But there may be a way to understand the role of psychological precursors, stress and the brain when it comes to treating conditions like arthritis, which has resisted most allopathic efforts to alleviate pain or effect a cure. 
     There is evidence (by researchers Melnechuk, 1988 and Renoux, 1987) which shows that stimulating specific regions of the brain (in the cerebral cortex, hypothalamus, and midbrain) can affect the immune system in body regions that correlate to the controlling areas of the brain (e.g., the right side of the brain governs the left side of the body).  We know that the sympathetic nervous system--which is poorly understood, but regulates heart rate, breathing, hair follicles, sweating, and body temperature--has an important role in inhibiting the immune system.  Conditions caused by an overactive immune system sometimes respond to surgery that splices sympathetic nerves.
     If arthritis is an aberration of the immune system, and specifically a self-destructive process within joints, treatments aimed at calming the immune response ought to be helpful.  Our model of rheumatoid arthritis describes proliferation of synovial tissue within joints, and heightened levels of  antibodies and immune complexes present, destroying tissue as though it were "other," infectious, or dangerous.  The attack by one's own immune system against healthy, functioning tissue is akin to suicide, at a cellular level.
     Bee pollen is collected by beekeepers from the sticky, hairy legs of bees as they squeeze through small openings to enter their hives.  A single bee colony can produce up to sixty pounds of pollen a year.  Because most people are allergic to bee stings, it's possible that the products of bees might have a beneficial, allergenic effect similar to that of bee sting therapy in multiple sclerosis. 
     People who have life-threatening reactions to bee stings should avoid all products connected with bees, because their immune systems might overreact to minimal triggers.  For those who are not in this small subgroup of highly allergic people, taking one or more teaspoons of bee pollen a day may recalibrate the immune system (by altering histamine production?) without having to suffer the serious, immune-modulating experience of multiple bee stings.  Bee pollen is a nutritive substance, high in  B-vitamins, protein, calcium, magnesium, sulfur (a component of joint fluid), and containing more than a hundred or more enzymes. 
     In 1998, a study by Voloshyn, of Ukraine, showed that ninety-three patients with rheumatoid arthritis had improvement in their painful joints after taking bee pollen.  Some of these subjects reported improvements in other symptoms (some of which could be modulated by the immune system), including gastritis, hepatitis, and gall bladder disease.
     The data isn't abundant, but bee pollen is as safe as any food product and has few, if any, side effects.  There are adequate studies showing that bee pollen may improve prostate and urinary symptoms, pelvic pain, and osteoporosis.  But claims that it increases energy, leads to weight loss, slows aging, or improves athletic performance are unfounded.
     At $20 to $40 for a 16-ounce bottle, bee pollen may be worth the experiment of a daily dose or two, if you suffer from joint pain.  Unlike the usual prescriptions for arthritis, it won't put you at risk for ulcers, kidney damage, or congestive heart failure.
     But remember:  the herb, vitamin and food supplement industries are rife with counterfeit products, often shipped from China (which has been known to lace supplements with cortisone-containing chemicals--they "work," but lead to much worse health problems).  Do your best to find bee pollen that has been collected locally, from bees that span a wide area and therefore make a better, more varied pollen, and from hives that aren't treated with chemical contaminants. 
     Bee pollen is an odd recommendation, but it beats most of the alternatives for safety, and you get to be the judge of its efficacy.

Friday, March 29, 2013

The Erroneous Assumption of Mother-Love

     We're in the third wave of feminism and I'll admit, there are some good things to be said about what's out there in the feminist popular press--for instance, Caitlin Moran's "new feminist" book, How To Be a Woman. 
     But in general, I'm sick of hearing commentaries on the status of women in the world, without some penetrating truth-telling about the messed-up state of our feminine psychology, bombarded as it has been, over the centuries, with imperatives and super-imperatives about beauty and niceness and sensitivity, and especially about loving one's children forever and ever, and giving them everything you, as a mother, are and have, including your life.
     Is being a mother only about unending generosity?  How can we mothers escape this unspoken rule of motherhood, that mothers never stop loving, or giving, or holding out hope for their children?  There is no way for a woman to escape the loving-mother stereotype without garnering public scorn, except by...let's face it, dying.
     The only thing better than a living, loving mother is a dead mother, when it comes to weaving fantasies about Hail-Mary-Mother-of-God-like perfection around women who give and give, and love overtly--and repress, or experience covertly, their own true beings, which sometimes are filled with hate.
     Yes, hate.  Mothers experience hate, including toward their own "flesh and blood," but they stop the process mid-feeling, because it is anathema to the culture.  They don't stop the feeling, which is impossible to do, but they stop feeling the feeling, and they change its direction.  Hatred can't possibly be aimed at their children, not in this world, so it makes a U-turn and sallies on back to the selfsame women, these endlessly affectionate mothers.  It stabs them with a vengeance that can only be explained by the culture's prohibition against speaking the truth, when it comes to motherhood.
     "I'm ugly."  "I'm too fat."  "I'm old."  "I have wrinkles, cellulite, a big butt, small boobs, fat legs."  "I'm not smart."  "I'm flabby."  "I'm a bad mother."  "I'm not sexy."  "I don't have a career."  "I've sacrificed my family for my career."  "I'm disgusting."  "I'm worthless." "I don't deserve to be loved by anyone."  "I don't deserve to live."
     These are the noises made by woman-hate and mother-hate when they twist back on themselves, to avoid the intolerable experience of hating others--especially (horror of horrors) hating one's own children some of the time, or even all the time.  These statements, which are our internal dialogue,  transpose animosity and fury into the keys of self-hate, which give way to a set of familiar, reassuring, discordant but socially acceptable tunes.  The self-hate sounds are interpreted by others as, "She's depressed," "She's tired," "She's going through the change," "It's that time of the month,"  "Who knows what she means?"  "Leave her alone," "She's a bitch," or "Women are crazy."
     I have four children, whom I, too, claim to have loved hugely, without reservation, without even a moment to catch my breath all these years, and without ever considering, I might claim, my own needs.  I have four children, and I've told them they are more important to me than anything in the world.  They are more important than life itself.  These are the right things to say.  I believe they're true, though cliched, but I'm also aware that in saying them, I'm following a social script. 
     I would like to hop that train of pure, unbroken, merciful mother-love.  I would like to add my name to the list of self-sacrificing women who, like lionesses with their cubs, care more for their children than themselves, and would give up their lives in the jaws of gruesome predators in abundant, maternal defense of their progeny.
     I want to say that I would gladly trade the possibility of my own self-actualization for the fulfillment of my children's dreams.  I want to aver that I love my children, and have always loved them, and will never stop loving them, because these are things mothers say, no matter what, even in a feminist age.  Such avowals are major building blocks in the edifice of our cultural mythology.  They are structural necessities for carrying on, as a race.  And they are a lullabies in everyone's ears:  soft, fluffy, harmonic, comforting...and just about as honest as church hymns.
     I'd like to tell you that I'm full of pure, selfless love.  But once, six and a half years ago (I remember the exact day), I heard myself blurt out, "I hate you!" to one of my children.  How this interjection made it past the many ingrained layers of censorship laid down in a mother's armor is a story of its own, which I am not equipped to tell, but suffice it to say that there were months of lying, cheating, peer-pressure, drugs, skipping school, theft, abuse of trust, and taking advantage of forever-mother-love that configured some of the backstory, at least from my point of view.
     I shocked myself, in the midst of my fear and fury, by saying such a thing to one of my sons.  How could I?  Did I mean it?  Could I hate him and love him, both?  Do other mothers say they hate their kids, or was I the only one?  If they do, how do they cope, afterward?  How could I live with myself, from now on?  How could my son  ever trust me?   I could no longer pose as a purely loving, haloed figure.
     The angry, hateful mother has a long history in legend.  The tales of Cinderella and Snow White sidestep the truth of the hateful mother by turning her into a stepmother.  In Hansel and Gretel, the witch is the shadow aspect of the mother.  Styx, the goddess of the Underworld, is the personified spirit of hatred, who sends her children (Nike, Zelos, Bia, and Kratos) to fight with the Titans.
     Also in Greek mythology, the goddess Agave (aunt of Dionysus) turns into a maenad and attacks her son, Pentheus, in the woods, tearing his limbs apart and eating morsels of his raw flesh.   Leto orders her two children, Apollo and Artemis, to murder the fourteen children of Niobe, so great is her hatred and envy.  Medea kills two of her own children as an act of revenge.  Phaedra, wife of King Theseus of Athens, falls in love with her stepson, Hippolytus--but when he doesn't love her back, she tells Theseus he raped her, and Theseus promptly murders him.  Echidna is a Greek goddess who is half woman, half snake.  (Her children include the monsters Cerberus, Hydra, and the Chimera).
     In Hindu mythology, Kali, the consort of Lord Shiva, is represented sometimes as a kindly mother-goddess, but more commonly as a force of evil.  Her name means "lord of death," and she is usually depicted as dark, angry, and violent.
     Mothers who kill their children make headlines everywhere--such is our fascination with the dark side of motherhood.  We may consider it a pathological aberration, and certainly there is no evolutionary advantage to child-murder, but these stories gnaw at the imagination.
     In 1994, Susan Smith killed her two children in South Carolina, and newspapers cried out, "How could a mother do such a thing?"  In Texas, Andrea Yates drowned her five children in the bathtub (including a 6-month old infant), and her "murderous rage" was attributed to postpartum depression.   In 1986, Marybeth Tining, driver of a school bus, was convicted of murdering her 4-month-old.  It was the ninth of her babies who died, without explanation, in her home, and the one, finally, that put her behind bars.
     Women who kill are a strange breed and find no resting-place in the public imagination.  We "understand," so to speak, when men murder--somehow it's considered part of the warring aspect of the male psyche.  But women are equated with motherhood, whether they have children or not, and are not accorded the prerogative to hate, or feel rage, or contemplate murder.  Why not?  (What exhausted mother has not, if she were honest, wished her screaming infant dead at 3 AM--if only for a moment!--until mother-love [which is real, too] steps in, and overrides the impulse with tenderness, and saves the human race?)  How is it that women, and especially mothers, have been assigned an image that is so one-sided?
      We must make room for Kali, and Echidna, and the witch, and the wicked stepmother, in our feminine psyches, and in society as a whole.  Without a cultural admission that women, including mothers, can be overwhelmed by hate, or act out of rage, or exact revenge, or even wish, at times, that their children were dead (the idea makes one shudder, doesn't it?) (Greek myths don't lie!)...without this admission, women will never be free.
      The myth that mothers love their children "unconditionally" and will sacrifice everything for them, is oppressive and, frankly, absurd.  Do you love your job unconditionally?  Do you love your parents, or your dog, or even your all-merciful god, unconditionally?  If you answer, "Yes," then I'll wager you're a person who's deep in the throes of denial.
     As long as mothers are yoked with the burden of expressing unconditional love, as long as we are painted with halos around our hairdos, as long as we are not permitted to give voice to anger and hatred, and are required, out of propriety, to keep that closetful of dark emotions locked away in the attic (like Rochester's "insane" wife, in Jane Eyre), we will shock ourselves with outbursts like the one I unleashed on my son, and we'll continue to suffer as victims of self-hate, with symptoms of depression and guilt, with eating disorders, and obsessive thinking, and failures in the workplace.
     Make way for Kali!  Kali offers treatment for depression.  Kali, the spirit of darkness, fury, and hatred, is the antidote to our saccharine idea of motherhood, and womanhood, and an important element in the next phase of feminist achievement.   

Thursday, March 28, 2013

Should You Drink Lots of Water?

     I once had a patient who almost died from drinking too much water.  In fact, there were multiple occasions when she was rushed to my office with life-threatening electrolyte disturbances, because she would not stop drinking water.  She said she couldn't.  Then she proceeded to tell me, in a didactic tone, that water is good for you, it flushes out your system.
     On one of those occasions I called the ambulance because she kept pulling out one of her gallon jugs and chugging down the water, even after I tried to impress upon her that her serum potassium was at a dangerous level, and her heart was likely to go into an arrhythmia, causing her to die.  She didn't flinch.
     The condition is called psychogenic polydipsia, and it's considered a mental disorder.  The patient's husband had, over the years, become distraught so often, that by the time he brought her to me (prior doctors had "fired" her, I was told) he appeared bored.  It's not that he didn't love her, but he couldn't be staring down the cliff of her death any longer in their marriage.  He read a book in the exam room while I spoke with and examined his wife.  He told me he accepted that one day she would die, no matter what he or I or anyone did.
     Many patients tell me they "drink lots of water," "about a gallon a day," as though I'll be pleased and impressed.  I'm not sure where it came from, this idea that drinking more water than you need to quench thirst is good.  Some people carry the belief, like an article of faith, that "flushing the kidneys" will keep these exquisite filters in top form--and they cite frequent urination as proof.
     But our kidneys are organs that adapt well to dehydration, and can't be "exercised" by being made to process large quantities of fluid.  Perhaps there is a genetic component, derived from environmental triggers, but the Bushmen of the Kalahari live on almost no water.  What they do get is obtained from eating ground squashes and other wild foods foraged from their desert habitat.  They don't "need" more water, and neither do you.  There is no evidence that drinking lots of water is good for your health.
     It takes seven days to die of dehydration if you're normal weight and are deprived of all fluids.  Without any water, the kidneys respond to a surge of antidiuretic hormone by producing highly concentrated urine, and by slowing their activity.  The series of messages that pass, via polypeptide hormones, across the pituitary, hypothalamus, right atrium, adrenals and kidneys are not well understood, but these structures "know" more about how much fluid our bodies need than we do.  Therefore, a feeling of thirst is the most reliable measure of whether you should get a drink of water (or any fluid) or not.
     As people age, their thirst sensors become less efficient (or the brain response to thirst isn't as vigorous), so very old folks over 85) are more likely to become dehydrated from inadequate fluids.  I tell people over 65 to drink what they need to quench their thirst, and then slightly more.
     Athletes who do a lot of anaerobic exercise may need extra water to carry away lactic acid and other byproducts of muscle metabolism.  But no one needs a gallon of water a day.  Getting too much water isn't a big problem, if it is drunk a little at a time throughout the day.  But drinking a large amount in a short time, for a person who isn't dehydrated, sends the kidneys into emergency overdrive as they scramble to excrete unnecessary fluids before the blood becomes so dilute it leads to toxicity in the heart or brain.
     Psychogenic polydipsia is a rare problem and usually requires hospitalization, fluid restriction, and frequent weight checks to determine whether the patient is obtaining water on the side.  You are unlikely ever to come across someone with this disorder.  But it's instructive, for those who don't think water can kill you.
    A normal total fluid intake, in a twenty-four hour period, is about 64 ounces.  When people drink more than this, and they say it's because they're thirsty, there are three main causes:
    First, they're on medications that cause thirst (e.g.,  many antidepressants, IBS and overactive bladder medicines, and sleeping pills).   Second, they eat too much of everything, especially foods containing salt.  Third, they drink too many caffeinated beverages.  Caffeine has a diuretic effect, stressing the kidneys, and can cause dehydration.  The natural response to this is to drink more--but satisfying thirst with more caffeinated beverages makes the situation worse. 
     In general, you should not drink more than you need to quench thirst, and you should avoid silly advice to drink lots of water as an aid in weight loss, or to rid your body of toxins.
     For people over 50,  drinking too much water can cause congestive heart failure.  All that water has to be pumped, by an increasingly tired heart, to the kidneys, and it's simply too much.   Congestive heart failure is the biggest reason for hospitalizations in this country--due, in many cases, to a basic misunderstanding about the body's response to too much fluid..
     Lots of people die of heart failure, a preventable condition.  Too much water--too much fluid of any kind--is the cause of death, in most cases.  These patients have hearts that get worn out pumping excess fluid to the kidneys.  The signs of heart failure are easy to read:  shortness of breath, coughing, swelling of the legs, and an increase in weight.  (One quart weighs about two pounds.)  The first line of treatment:  fluid restriction.
     No, it's not good to drink lots of water.   

Wednesday, March 27, 2013

The Cesspool

     The dust of unwatered soil is making me blink and sneeze as I till my garden by hand. It's early evening, and the chickens are underfoot, scrutinizing the upturned roots of weeds for tawny squash bugs.  I listen to the crunch of these beetles in their beaks, and have those brief moments of horror and grief that come when you witness the death of a creature.  I can't help putting myself in the place of these flailing beetles, and feeling their terror.  But I'm not a beetle, and can't possibly know how they feel--or if they even have feelings in their tiny neural tubes.  This is the way of the world, I remind myself, which is a small comfort.
     The sky turns dusky and my chickens waddle back to their coop.   Crystal, as chief hen, runs around me in circles, worried, trilling and squawking, "Get in!  Time to go inside!"  There are untold dangers out here, at night.  So, what's my problem, she wants to know?  I am a recalcitrant member of her flock, perhaps mentally deranged, so she's forced to leave me behind as one might leave a dog with a broken leg on the mountainside during a treacherous expedition.
     I  stay outside and till soil until it's dark.  Then it's past dark and the moon appears, a tiny sliver without much light, and the stars poke holes in the great black blanket of the hemisphere.  I look up, my neck stiff from staring downward, and rest my head on the small shelf of my upper thoracic vertebrae.  Who hasn't been made to feel tiny, under an enormous night sky?
     I keep hoeing, guided by the tough, grasping pull of weeds that resist my intention.  An hour passes:  it's getting cold.  I'm very tired, and there's something magnetic about the earth.  "Come to me," it says.  "Lie down and let me hold you."
     So, I lie down on my back, on the freshly tilled ground.  Do you know the heaviness of gravity, sometimes, drawing your spine, shoulders and legs downward, as though it could take you back into    It's one thing, to feel it on the soles of your feet.  It's another to be clasped, fully, by the strange force of dense matter keeping us attached, until spirit wafts away, attached to life.
     The air is chilly, but the soil emanates the heat it absorbed from fourteen hours of sunlight.  I wrap my old, woolly sweater around me, turning up the collar and buttoning it at the neck.  I let my thoughts go, one by one, and they float into night.  Then, I fall asleep.
     In the images that follow I am kneeling on the ground and reaching into what seem to be manholes.   Way far down, I see people coming up, and I am hoisting them out, one by one.  It's cavernous, and dark down there, and I hear the sound of underground rivers, carrying the dark, basic substance of life.  It's a cesspool, too, from which stinking grime and filth may be excavated.  But these are not rubbish, but jewels:  rubies, diamonds, gold, people.
     There is a saying, in alchemy, that gold, the philosopher's stone, the stuff of creativity, the new man, the hope of the world, arises from what is most wretched and despised, the prima materia.  In Alcoholics Anonymous, it is said that one must "hit bottom" before the process of transformation begins.  When we want to change, we find the means to do so in our worst habits and thoughts, and in the experiences of life from which we want to run fastest.
     When I woke from this dream it was under the same starry sky.  I could smell that underground river, mixed with the soddy fragrance of my new-turned garden, I felt the desperation and the gratitude of those men whose bodies I was pulling out of the mess of that cesspool, and I wondered what to do next.
     Should they come home with me, for a shower and a hot meal?  Should I ask them, "Now what?"  Might they have a clue about where I'm headed, next?  Are they going to accompany me, with their knowledge of the depths, into my future?

Tuesday, March 26, 2013

Obamacare: Another Booby-Trap

     The Galen Institute reports that, as of March 7th, Obamacare regulations encompassed 20,000 pages.  This is almost as many pages as Medicare's billing regulations for doctors, and the same for Medicaid.  Adding these to Tricare and Champus policies, Obamacare brings the pages of governmental rules and regulations that healthcare workers must know and follow to 75,000.
     With a predicted shortage of 67,000 doctors by 2014, the last thing the medical profession needs is more regulations for doctors to read and follow.  Even if the Obamacare documents are meant as reference material, like volumes of an encyclopedia, the fact that we're all responsible for knowing the contents will render the practice of medicine more impracticable, if not impossible, for solo doctors.
     When Senate Minority leader Mitch McConnell unveiled this so-called "Red Tape Tower" there were hoots and applause in Congress--riotous laughter--"because of the incredible burden this law is placing on the health sector and the economy."
     Why is it that everything the government does, has to be so complicated?  However much I support a national health plan, I can't help wondering if the complexity of Obamacare, like the insanity of our IRS tax codes, is a deliberate attempt to entrap anyone the government wants to catch in a net of criminal activity.
     Taking care of Medicare patients happens to be, I discovered while seeing patients in my solo medical clinic, a booby trap.  Since Medicare is a federal insurance program (funded by each tax-paying American but "managed" by the government) doctors who agree to see Medicare patients put themselves at risk for felony charges, if they misinterpret insurance guidelines, or--even worse--when federal agents misunderstand those 20,000 pages of Medicare rules, and then base an attack on a doctor (whom they can profit, by raiding and "taking back" money for government coffers) on convenient ambiguities which are everywhere in Medicare's compendium of rules.
     Medicare rules aren't static--the organization adds new guidelines, including many changes in coding rules, every two months.  These changes create more tremors in the shifting ground on which physicians ply their trade.  "Updates in coding guidelines" (as they're termed) used to be sent to all Medicare providers for free via snail-mail--but five or six years ago Medicare imposed a subscription charge for them, and most of us forgot about updates. 
     The last thing a doctor wants to do at the end of a busy day with patients is to read dozens of fine-print pages about changes in medical billing for a single insurance carrier.  Medicare's updates went electronic, but then I found myself forgetting about them, and so did my billing personnel.  So I paid for the written subscription, because I didn't want to miss new codes, and I knew that getting paid depended on accurate, meticulous billing. 
     It didn't help, did it, for me to keep abreast of Medicare?  I learned about new ways to code for the services I was providing, and I applied them--but it seems only to have gotten me into trouble.  I was billing more than my colleagues, and using codes hardly anyone knew about.  They were correct, but I became an outlier by taking Medicare at its word.  Too much knowledge is a dangerous thing.
     Coding and billing is a full-time job, rife with risk, even for a big team of specially trained clerks-- and the new Obamacare rules and regulations will add to this job, big-time.  Even if doctors hire more billing experts, to ensure compliance with all these new rules, they still bear ultimate responsibility for errors.  Think about how useful this could become for people in the doctor's milieu, not just government agents who want to stage a coup for publicity, but employees who are less than honorable.  A disgruntled billing clerk could transmit erroneous claims, then report the doctor for "a pattern of overbilling."  Such employees, if skillful at covering their role in this kind of plot, might even garner a whistleblower fee, when doctors decide to plea-bargain as a way to cut their losses in costly litigation.
     There has never been a better time to retire from medicine than now, for doctors.  The world of medicine, especially the business of medicine, is too rife with danger and complications for solo docs to survive.  We have become targets for so many money-mongering people--lawyers, patients, regulators, the media, and government agents--that practicing medicine is a scary proposition these days. 
     I am glad to be watching from the sidelines, sad to see solo doctors falling by the wayside, and extending my condolences to those who struggle, and seem to be drowning in the turbulent waters of regulatory change.

Monday, March 25, 2013

Where Does Illness Come From?

     To answer the question, Where does illness come from? we must take a few steps back and ask, first:   If illness is something that affects the human body, what is a "body"?  And:  If a body is made of matter, what is "matter"?  And, finally:   How does the matter which constitutes the human body different from other kinds of matter?
     We are fortunate, in this century, to have been lifted out of the two-thousand-year-old Aristotelian model of matter and the universe, and dispatched into the realm of quantum physics, because it provides a new milieu in which to penetrate the nature of illness. 
     Aristotle, Copernicus and Newton advanced a mechanistic theory of matter along the lines of causation.  For example, one thing makes another thing happen;  energy is transferred from object to object;  and effects can be traced back to causes, which have their roots in preconditions.  This theory proved to be useful for a long time, as it helped us predict future events and explain the patterns of nature.  But it cannot be said to have been the "truth" in any sense of the word, because it left so many questions unanswered.
     One of those questions is that tricky one about illness. 
     We might posit that strep causes sore throats and radiation exposure causes thyroid cancer, but why in some people, and not others?  Why should high cholesterol lead to heart attacks in one group of individuals but not another?  Why do some of us get heart failure but others, who also smoke and consume too much salt, slide right around the condition, escaping its devastation?
     I learned about atoms and their components, electrons, protons and neutrons, in eighth grade.  What impressed me most was the knowledge that atoms were mostly made of empty space.  The protons and neutrons are concentrated in the center, and the electrons orbit around them at such far distances that they might be considered little solar systems, there is so much vacant space between the "solid" particles that are said to "make up" atoms.
     But electrons aren't "solid," and neither, for that matter, are protons and neutrons.  Their sub-components are full of empty spaces, too.  They are more like energy fields, with fairly negligible "mass."  Therefore, the concept of "matter" has always seemed questionable to me, and even bogus. 
     What we perceive as the solid elements of our world are, in fact, illusions.  Descartes may have had a premonition about this when he suggested, in the early 1600's, that the entire world might be an illusion (his famous "methodic doubt" centered around the idea that there is nothing about which we can be absolutely certain).  
     If atoms are mostly space, how is it that matter feels "solid" to us?  It must be that our perceptions make it seem so, by imposing elements of our will upon it, just as our brains change reality by turning the upside-down images presented by our visual apparatus right-side-up, or erasing the errata of floaters--which are bits of vitreal debris that create visual defects, when they first appear.--from what, ultimately, we see.  Matter, being made of empty space and energy fields, is transformed by our senses into something solid because only in that way are we able, as sentient beings, to manage our way around it.  Insects, birds, and other living creatures are likely to experience the world less as solid matter than as multi-directional force fields, which may explain their ability to travel long distances without veering off-course, or to sense changes in weather or seasonal gravitational effects that we humans cannot perceive, and find extraordinary.
    Consider the possibility that our bodies are not, therefore, solid hunks of matter, but are gazillions of atoms--which are mostly empty space.  We are composed, then, mostly of empty space.  Our multitudinous atoms emanate forces that are electromagnetic in nature--and probably have other qualities we can't measure.  We are giant, porous beings, made of holes and spaces, like sponges, only with even less "substance," along which are aligned all our quarks (the sub-elements of atoms), according to energy fields which act the way the spaces between positive and negative poles of magnets act, only more complicated.  These energy fields interact with one another, and can be thrown out of whack, sometimes.  The chi of Chinese medicine is an attempt to conceptualize the way energy fields are organized to create an effect called "a human being."
     This chi, or alignment of energy fields created by the electromagnetic emanations of our atoms, can be thrown out of whack by nearby energy fields--sometimes known as other humans, or other kinds of beings, or planetary forces, gravity, weather fronts, ultraviolet and infrared rays, sonar, sunlight, dreams, goals, will power, and personal imaginings. 
     Magnets lose force with age, and so do we.  Magnets lose force when there is interference by other force fields, and so do we, perhaps making us more susceptible to forces that end up being perceived by us as "illness."  Illness may be an interference in our electromagnetic force fields that leads to our disintegration, and demise, or it may be a force that introduces elements that can set our chi right again.  We may not like it, but the ultimate effect may be to reconfigure the energic components of our being so that we survive in a manner unlike the identity we assumed in the past.  We might continue to survive as someone who is blind, or has cancer or has dementia, or died and was resuscitated into a new perspective on life.
     The point is, that with a new understanding of quantum mechanics, we are able stop thinking of illness in the Newtonian way, as one "object" (like a bacterium) bumping into and "infecting" another, and start thinking of ourselves as energy fields with a lot of force and a lot of sensitivity.  We are vulnerable to phenomena that aren't solid, but nevertheless interfere with some or all of the magnetic fields that operate across the vast spaces of our atoms, and within them, and make us "who we are."
     How else can phenomena like miraculous recoveries at the brink of death be explained?  Or the placebo effect, or the effect on one's health of new love, or friendship?  Or how loneliness and depression reduce a person's "resistance" to disease, and "immunity," or cold fronts and humidity affect joint pain and asthma?  How, too, can one explain the dramatic effect of certain dreams on the course of our lives, or psychotherapy on our well-being?  Why does taking a trip, or getting a few nights of good sleep, make a difference in our health and our outlook?   The efficacy of homeopathy, which is laughed at by doctors who remain wedded to cause-effect explanations for medical treatment, makes a lot of sense in the context of quantum physics and energy fields.  Medicines "carry" energy in their atoms, and the atoms can be made of water, or glycerine, or alcohol, so long as they "transfer" that energy to the atoms of our bodies.  In fact, water molecules have loose bonds with one another, and may be the best medium for transferring curative energies, explaining both homeopathy and the benefits of hydrotherapy.
     We are in the infancy of a new understanding of medicine and the human body, and the reasons for illness.  "Reasons" is, perhaps, is a poor choice of words, because it comes out of that old, linear, Aristotelian way of thinking, which doesn't really explain why we get sick. 
     If we reconsider ourselves not as solid bodies, but as centering agents for multiple force fields, then treatments like meditation, hypnotism, group therapy, and psychodrama make sense.   Then, spending time in nature, and avoiding people who make us feel bad, and utilizing the positive effects of certain experiences and avoiding the weakening effects of others, and making choices that don't "make sense" but "feel right" all end up being good things, and can help us sidestep illness. 
     Illness is an aberration in our personal energetics, not a collision of one causative agent against the solid body of another.   It is amenable to a wide range of "cures," or healing forces, if we are open to them, if we let them in.       

Sunday, March 24, 2013

Holy Week

     It was a crowd mentality that held sway when agents stormed my clinic to raid it nearly two years ago, and its crowds who govern public opinion.  So many people whom I considered my friends and allies have decided, it seems, that I am guilty.  It's a crowd phenomenon, and someone in my circumstances has to learn to defray its force.  The events of Holy Week help to depersonalize what happened to me, that week, and to put in its rightful place what continues to hurt.
     The crowd mentality was never more evident than during Holy Week, which starts today.   There may be something we can learn from this historical precedent.
     First, Jesus was celebrated as a new king, the Messiah, and rode into Jerusalem greeted by throngs of shouting disciples.   It was hoped he would replace Herod (who was Herod-the-Great's son), an abusive, tax-mongering ruler in a top-heavy, corrupt government.   Herod was complicit in the Roman occupation and oppression of Judah, the southern kingdom of Israel, and therefore was unpopular.  The Jews hated paying taxes to the Romans, and looked for a new King David who would rule with justice and freedom from Roman rule.
     "Hosanna!" his followers hailed him.  "Blessed be the kingdom of our father, David, that cometh in the name of the Lord, Hosanna in the highest!" (Mark 11:10)   "The whole multitude of the disciples began to rejoice and praise God with a loud voice for all the mighty works that they had seen--" (Luke 19:37).
     What greater adulation could any leader hope for?  People loved him, on Sunday.  He rode into Jerusalem in triumph, on a donkey, expressive of his humility and perhaps even more beloved because of his decision to forgo a horse.
     But maybe people wanted a less humble king, someone sterner and more intimidating, strong enough to defeat the Romans.   Jesus' ideas about how people should live, and how a kingdom should be understood by them, didn't meet the immediate needs of an impatient populace.
     Some people still loved him on Monday and Tuesday, but as the week wore on, his popularity waned.  The crowd that had leaned one way at the beginning of the week, leaned the other by the end. Were they the same individuals?  A crowd becomes an entity in itself, whomever its members.   The people who had celebrated him when he entered Jerusalem were shouting, "Crucify him!" by Friday.   Alas, the fickleness of crowds.  They change their feelings, or one crowd shouts one thing and the other shouts another.  Who can trust a crowd?   Who can trust a political party?  Who can trust a group of federal agents, acting as one? 
     The crowd was becoming unwieldy.  "And some of the Pharisees from the multitude said unto him, Master, rebuke thy disciples.  Then he answered and said unto them, I tell you that, if these should hold their peace, the stones would immediately cry out" (Luke 19:39-40).
     It's hopeless, then, to tell people in crowds to stop shouting what they shout.  Anyone who has an important message must go forward with that message whether the crowd supports it or decries it.   Jesus knew the crowd was with him one day, but would turn on him the next.   He knew that the Pharisees were against him, and the High Priests hated him, and so did the scribes and the elders.  He knew that the crowds would be on the side of the winner--and he was the winner on Palm Sunday, but the loser by Good Friday.
     "Then the Jews took up stones again to stone him.  Jesus answered them, Many good works have I showed you from my Father;  for which of those works do ye stone me?" (John 10:31-32).
     There are times when Jesus defeated mob violence, as when he was asked by the Pharisees what to do with a woman who had committed adultery.  "Let the one among you who has not sinned cast the first stone."  The crowd dispersed.   Jesus had asked people to think of themselves as individuals, not as part of a crowd, and to judge the actions of others by the actions of themselves.
     Government agents belong to a crowd.  They cannot think of themselves as individuals, nor can they think of the accused as individuals.  I, as one of the accused, belong to a crowd in the eyes of the FBI.
      It is intolerably difficult to separate oneself from a crowd of one's peers.   I don't criticize the crowd of agents who stormed my office--the crowd is magnetic and powerful, and sometimes insane.  But I wish that at least one person among that crowd might have stood up and asked, "Is this woman guilty?  Could she be innocent?  What, exactly, are we doing to her, if we proceed in this way? 
     "And what, exactly, are we doing to America, by doing this same thing, to other individuals, over and over again, without a second thought?"

Saturday, March 23, 2013

You Can't Make War on a Concept

     Twenty-six prisoners-of-war in Guantanamo have been on a hunger-strike for a month.  Most of them have been held as prisoners, without trial, without conviction, for twelve years.
     What exactly is the "war on terrorism" we started in the Bush era?  How can we declare war on anything other than another country?  When we declare war on a country, the war ends when one country surrenders.  Then, the prisoners-of-war are liberated and returned to their country.  Furthermore, we know that the prisoners of war are soldiers from the other country.
     In a "war on terrorism," the prisoners are anyone a country holding them decides they are.  Such are "war" never ends.  This is why, despite Obama's promise to do something about Guantanamo, the prisoners held there are unlikely ever to be afforded a fair trial, or released.  No state in America will agree to accept these prisoners or put them on trial:  they are too afraid.  What does the rest of the world think about our activities at the Cuban military base?  Who knows?
     Some of the alleged terrorists held at Guantanamo may, in fact, be innocent.  What exactly are they innocent of?   Terrorism?  What does such a concept mean, except that we are afraid of them?  There is no agreed-upon definition of terrorism.  It seems to me that "terrorism" means that we, Americans, are in fear of these people, for unknown reasons.  A terrorist is someone who terrifies us.  They are guilty of terrifying us.
     We might justifiably be terrified of anyone whom we have kept incarcerated, and tortured, without rendering charges, without a trial, and with no end in sight.  Wouldn't you be angry if someone did this to you?  Even if the "terrorists' weren't angry at Americans to begin with, they surely have a right to be angry now.
     Don't think this problem doesn't apply to you or me.
     I see many parallels in my situation, although I suppose I should be grateful not to be jailed by the DOJ.  The Obama administration wants to put more "terrorists" on criminal trial than Republicans--who want military tribunals.  (It's problematic getting convictions through military court systems.)  So far, no one wants to assume responsibility for Guantanamo prisoners-of-war.  No one can decide whether this is a military problem, or a DOJ problem.  President Bush:  Where are you now?
      I am not in jail, but I am being held without accusation, conviction or a trial.  My property has been seized and I have been forced, effectively, out of my business and profession.  Such treatment seems to be the modus operandi of the DOJ these days.  The way people in Guantanamo have been treated spans multiple administrations, and is not a party-specific problem.  It's a problem that is endemic to American policy.
     The tactic of attacking without cause, holding and punishing people without a trial or a conviction, and keeping them in limbo ad infinitum seems to have become an insitutionalized policy.  I am a victim, and so are prisoners in Guantanamo, and so are thousands of Americans whose lives have been damaged irrevocably, like Gibson, Mountain Pure Water, Midamor and Duncan Outdoor Sports (thousands of others decline to speak of their humiliation at the hands of the DOJ), without cause, and so are the hundreds of thousands of foreign civilians killed by United States in the "war on terrorism," or by drones every day, and so might you be, soon.   

Friday, March 22, 2013

Ted Yoho's Open House

     There were forty or fifty people milling around when I arrived.  They had a certain look I associate with Republicans:  the stick-straight posture of certainty, everyone white, with better-looking casual clothes than the casual clothes rural folks wear.
     There was talk about the term "tea party"--whether it's alienating too many people, and should be changed.  Two people mentioned the John Birch society meeting next week.  There must have been refreshments somewhere, because people were carrying plastic cups and styrofoam plates.
     I stood in line to talk with Ted Yoho.  The people in front of me shook his hand or hugged him, one by one, but there weren't questions about "issues" or pleas for help.   There were big smiles all around.  Ted is still in celebratory mode, and why shouldn't he be?  It was a big win, last year, and he worked hard to earn it.  Given how politics works these days, he needs to consider every public form an opportunity to win votes for the next election.
     "That guy was out campaigning at 6 AM every day, and he didn't stop until midnight," one person told me.  "I couldn't believe how much energy he had."
     "It's too bad it takes so much time and money to get votes," I said.
     "That's how you get in office."
     "Why can't we have a system where a few people are nominated from the crowd, without fanfare, because they seem like the smartest and best?"
     "What planet are you from?"
     "Then, they could give speeches to outline what they believe and how they'll vote in Congress."
     "Are we supposed to believe that?"
     "Don't be so cynical," I said.
     "Have you followed any elections lately?"
     "There are lots of good people who aren't running."
     "It's too tough."
     "It should be about integrity and issues, not expensive noise.  People could vote based on issues they care about, not smiles and celebrity."
     "Some people vote on issues," another guy said.  "But not many."
     "I've been checking into some of Ted's votes," someone chimed in.  "And I don't like what I see."
     "A lot of people say whatever will get them elected, not what they believe," I said.
     "You don't know who to trust."
     Then I was in front of Ted.
     "Hey!  How are you doing?"  he boomed, as if he knew me.
     "Ted, I'm Ona Colasante.  I saw you in Washington a week or two ago."
     "Oh, of course!"
     "Ted, I need your help."
     "What can I do for you?"
     "I want you to send a letter to the Chair of the Judiciary Committee, on my behalf."
     "I understand."
     "Do you remember that my medical clinic was raided, without cause?  And that this is happening to lots of businesses?"
     "Yes, of course."
     "We need to petition Congress for a hearing on this matter."
     "I'll help you."
     "How can I get in touch with you?  Representatives get 60,000 emails a week.  I can't send you an email."
     "Call my office."
     "Can I remind you to write that letter?"
     "Talk to Clay Martin.  He's around here, somewhere."
     I found Clay, his local assistant, and told him about the FBI raid on my clinic nearly two years ago.  I told him how the government must have tipped off Medicare, Tricare and Humana to stop paying me, without giving a reason.  Eighty percent of my services to those patients went unpaid these past two years.  It's wrong for the DOJ to ruin businesses and people like this--thousands of them, across the country.
     "Wait two weeks, and call me," Clay said.  Then Ted will be back in Washington, and it won't be so hectic." Clay said.  "I'll meet with you."
     A medical professional intercepted me, on my way to the refreshment table.  He asked me how retirement was going.
     "Fine, I guess." 
     "Why don't you run for office?" he asked.
     "What office?"
     "Where did that come from?"
     "You'd be good."
     "I'm in Corinne Brown's district.  She's been in office for twenty years."
     "People like her,"  I said.  "I voted for her."
     "That's because there hasn't been anyone else."
     "They need someone new," he said.  "I'm in that district.  I'd vote for you."
     "I'm a registered Democrat," I informed him.  "And you're a Republican."
     "I know."
     "You've probably never voted Democrat."
     "I might, if you were running," he said.
     "Have you forgotten?" I asked.  "I'm under investigation by the federal government."
     "But you didn't do anything."
     "That's true.  But I'm still under investigation."
     "You should be proud of that!" he said, raising his voice.
     "You should wear it as a badge of honor."
     "Because you're standing up to them, that's why.  You're doing something about it."
     "Get me a name tag," I told him.  "I'm going to wear it from now on.  It'll say, 'I'm under investigation by the government, and I'm proud of it.'"
     "Damn right," he said.  "And I mean it."
     Here's a multiple choice question:  Who should run for public office, or stay in office?  
          a) Someone who has committed a crime that everyone knows about (e.g., Nixon, or our Gainesville mayor, after this morning's DUI).
          b) Someone who has committed a crime, but no one knows about it (let's consider all those Wall Street executives for Congress).
         c) Someone who hasn't committed a crime, but everyone knows about it, as though the person had (e.g., all the people who have been falsely arrested, or falsely accused, or people held in jail without a trial--like at Guantanamo--or people who have been raided, without cause, and seem to be accused, like me).


Thursday, March 21, 2013

Should You Eat Weird Foods?

     Maybe it's a function of aging, but I tend to be skeptical of faddish foods.  In the 1970's these included all-in-one box-mixes for cheesecake and tunnel-of-chocolate, as well as odd inventions like Fruit Loops, Hamburger Helper, cotton candy, Neccos, gummy bears, Spam, and Dream Whip.  These prettily-packaged products resembled, on close inspection, spackle, or plastic, or toys--not comestibles.  Anyone with a vestige of instinct steered clear of them.
     In the 1980s, "health food" replaced convenience foods, and natural products like sunflower seeds, muesli, dried peaches, bulgar wheat, marrons glaces, and tofu appeared on supermarket shelves, followed in a few years by ethnic ingredients such as tahini, tamari, umeboshi plums, Marmite, kelp, marzipan, daikon, ginger root and phyllo.  People started eating weird meals of stir fried veggies and tempeh, spanakopita, tabbouleh, falafal, blintzes, borscht, chapati, tacos, moussaka, sushi, and West African peanut soup.  I remember my mother preparing such dishes--proudly gleaned from issues of Gourmet, proof of her cosmopolitanism--and serving them for Sunday dinner along with narratives on the geography and cultural anthropology of the regions from which they haled.
     The last two decades have brought a storm of new foods to this country, corresponding to the internationalism of our travel and politics.  We have so many choices about what to cook every day, that it's tempting to ignore them all, and revert to old-fashioned American food:  macaroni and cheese, oatmeal, baked beans, buttered toast, green-bean casserole, and egg-salad sandwiches. 
     But there isn't a health, fitness or women's magazine in sight that doesn't tout the benefits of a new set of weird foods, which makes readers wonder if they're sacrificing years of salubrious life by foregoing them. 
     Are we supposed to eat chia seeds every day, to get even more omega-threes than are packed into the fish-oil capsules we've been tricked into taking?  What about pomegranates?  At $3.99 apiece, they seem extravagant--and all those tiny seed-pods, what a red-speckled mess they make.  Then there are "studies" on food-components like nutritional yeast, probiotics, cold-pressed oils, and non-GMO soybeans--are they important?   I don't really know, and I'm not sure anyone is doing much more than advertising for these things.
     The human body is designed to handle a very wide array of foods from underground, up in trees, inside animals, or sowed in rows.  Just about everything we eat gets broken down, almost instantaneously, into glucose, which is exactly what our cells need to survive.  It's not a mystery, then, that our taste buds have evolved to seek out glucose in nature--it's the quickest way to supply organs, especially the brain, with fuel. 
     If, therefore, you choose to eat a vegan raw-food diet every day, those vegetables and grains just disappear into bundles of glucose--and the overabundance of micronutrients you ingest ends up in your excretory pathways.  You simply can't flood your system with way more nutrients than it needs, and expect them to turn you into a superhero. 
       Are doctors like me supposed to be telling patients to eat more kale, blueberries, and edamame, even out of season, even shipped from long distances, even if they don't like them?  Should everyone invest in a juicer, and then need to buy four times as many vegetables to make juice, with the goal of living longer?  If the fiber residue left from juicing has to be discarded, then aren't juicers just another strategy to get us to buy more, More, MORE?  America's economy doesn't flourish unless people purchase more this year than they did last year--but how can that make sense?  We can only consume so much.  That's why weird foods, with niche markets, high price tags and trumpeting claims keep finding their way onto supermarket shelves.
     It pays to be sensible.  The human body has adapted to a variety of foods over thousands of years, and now requires the same variety to function well.  Therefore, variety is important.  This may explain our innate attraction to new and exciting-looking foods.  Other primates experiment with new, colorful foods when they come across them in the wild--which isn't the case with wolves, big cats, gophers, or salamanders..  Humans succumb to packaging and taste, when it comes to weird foods, because we're programmed, biologically, to do so.
     Here's my advice.  Eat basic foods--what you grew up with, or grow and cook, or like.  Try new foods--but don't break your budget doing it.  It's important not to eat the same things, day after day, for months on end, because human physiology is primed to extract what it needs from many different sources, and it needs many different enzymes and nutrients.  You will suffer from deficiencies if you subsist on a mono-diet. 
     Beware of noisy promotions for new, weird foods, because they probably don't mean much.  You can buy and eat them without doing yourself harm, but you shouldn't eat what you don't like, just because you've been told it's good for you.  Many foods are good for you--surely, you can find some you like.   Remember the heyday of noni juice, spirulina, goji berries, and acai?  They've been replaced by chia seeds, and soy nuts, and flax, and acanthocyanins. 
     Weird foods aren't terrible--but they cost a lot more than they're worth.  And the claims you read about them are mostly a lot of hype.  As long as you realize it might be skillful marketing that impels you to buy weird foods--not facts, or prudence, or irrefutable health benefits--go ahead.  Buy whatever you can afford, and eat what you like.  

Wednesday, March 20, 2013

Why Do You Have Pain?

     Right from the start of my medical practice two decades ago I disagreed with the mechanistic theory of illness, which assumes that pain is "caused" by anatomical aberrations.
     According to this explanation, neck and back pain have their origin in spinal misalignment, headaches have something to do with erratic vascular flow or meningeal inflammation, infections are contagious, cancer is genetic, allergies are environmental, and accidents are--well, accidental.
     None of this has ever made sense to me, because the question, "Why this pain, instead of that?" doesn't get answered.  Isn't it curious, for example, that a person should have rheumatoid arthritis rather than ovarian cancer, or migraine headaches instead of chronic hip pain, or a rotator cuff tear but not carpal tunnel syndrome?
     The existence of the "subtle body," which has been established in psychological and spiritual texts, but ignored by allopathic medicine, is left out of mechanistic explanations of pain and suffering.  The subtle body is a template along which the physical body organizes its activities and symptoms.  The subtle body works behind the scenes.  Like the unconscious, it is unconcerned, for the most part, with a person's role in the world, or suffering and losses, or imminent death.  The unconscious has a panoptic view of life, and a prospective function, which is to say that it sees farther into the distance, and more broadly, deeply and purposefully than your or my absurdly small brains and culturally conditioned, subjective, "conscious" hopes and plans. 
     There is a parallel question, having to do with our dream lives.  Even if one has been seduced entirely by science, and therefore adheres to the reductive idea that dreams are merely the end-product of spontaneous neuronal firing--nothing more than chemo-electrical phenomena--one can't discount the fact that images in dreams are very specific.
     Why is it the case that you dream of an elephant, and not a bird?  Why was someone chasing you in last night's neuronal outpourings, and not the other way around?  How has it happened that your brain reached into the cauldron of memory and pulled out Jane McPhereson, from your seventh-grade homeroom, and not Jeremy Black or Susan Little?
     The choices made by your psyche, like the symptoms and diseases manifested by your body, are every bit as informative of underlying processes as an imminent cold front, a change in humidity, the germination of certain flower seeds along a walkway and not others, or the composition of foam and sludge deposited along a shoreline.  Cold fronts, humidity, flowers, and sludge are "symptoms" of  atmospheric conditions, soil make-up and pollution issuing from distant locales.
     One way of managing pain is to welcome it as the voice of the personal unconscious and perhaps even of the collective, the social group within which we operate.  You "listen" to it, just as you might pay attention to a weather report, or hear a train conductor telling you, "This is your stop," or attend to a companion who warns you not to step in the gopher tortoise hole up ahead.  Your unconscious is that weatherman, train conductor and companion, and your symptoms are messages--ignore them at your peril.   Staunching symptoms, so you won't feel pain, is like closing your ears to this information.
     How can you enter into the pain, to hear its deep message?  How, once you hear it, can you interpret it?  The doctors we need, to day, are the ones who can help understand our individual and collective symptomatology.  Your various pains, like nighttime dreams, speak a language unfamiliar to our rational, scientific mindset.  We need doctors who can take information from our symptoms and dreams and use it to develop our souls.  We don't need today's practitioners, whose aim it is to crush and eradicate pain, without hearing what it tells us.
     When someone calls out, "Fire!  Fire!" you would be crazy to drop a bomb on that person because you don't like the sound of his voice, or what he's saying.  Instead, you attend to his meaning:  Where is the fire?  How did it start?  What is fueling it?  Is it spreading?  How can it be put out?  What is it about the surroundings that permitted a fire to start in the first place?
     No one likes pain, so the urge to crush it by taking migraine medicine, or visiting a chiropractor for an adjustment, or a surgeon for surgery, is natural.  But think how often these treatments fail!  The recurrence rate of painful symptoms, even after definitive, corrective treatment, points to our failure to get at the real "cause" of pain, which is something like the message, "Fire!"
     One technique for "hearing" your pain is to meditate on it in a quiet place.  Imagine increasing the pain to an intolerable degree.  What would happen, do you imagine?  Would your back break in two?  Would your hand fall off?  Would your head explode?  Exaggerating symptoms in an imaginative way can give you clues about what the symptoms are saying.
     If your back pain were ten times worse, and you imagined your spine breaking in two, it's possible that something structural in your life may need to break, or the weight you're carrying has to be unloaded, or you don't have a backbone, or you have too much of one. 
     If you imagine that your hand would fall off if your pain got much worse, perhaps you need to "let go" of something, stop grasping, or cease "handling things."  It might help to immobilize your hand with a splint as a way of understanding what the pain wants you to do.  "I can't live without my hand," you say.  But living without your hand is exactly how you might accomplish what the subtle body is insisting upon.
     If your head explodes, in imaginative bodywork, it's possible that your thinking is getting you into trouble, that brainwork and logic are overriding important messages from your physical or emotional being.  A head under this much pressure has been pushed to its limits.  It needs a siphon, for drainage.  The ancients had it right, when they trepanned, but they took the message of "too much pressure" literally, when it should have been understood psychologically.
      Making generalizations about physical symptoms--as though there might exist a handbook for understanding the subtle body, by equating each symptom with an emotional cause (Lousie Hay did this, disastrously)--is not possible.  Individual people have symptoms which speak uniquely to them, and must be understood in the context of their toiling, and alongside their dreams.  The interpretation of symptoms cannot be applied to groups.
     The failure of western medicine is how doctors approach symptomatology, including pain, as purely physical phenomena--we use needles, surgery and bomb-like medicines, rather than the finely-tuned approach of psychology.  Despite many innovations in psychoanalysis over the past 150 years, we have failed in medicine to integrate a psychological understanding of illness into our treatment protocols.  We give lip service to "mind-body medicine," but no one really practices it, and insurance plans certainly don't cover the cost of dream interpretation and symptom augmentation.
     We need a new breed of doctors that isn't one-sided, and we need a braver population of patients, who are willing to look inside, not outside, for treatment.
     Unless we face our inner natures, painful and grotesque as they may be, as depicted in our dreams, our outer world, which we only imagine is outer--but in fact mirrors our deep, psychological selves--will decline, and fall into prehistory, requiring us to start the human race all over again.  

Tuesday, March 19, 2013

Burning My Lab Coats

     Is it sacrilege to do such a thing?
     In some cultures, physicians and priests are the same, made of one fabric.  They serve as intermediaries between human beings and the gods.  They are sought after, and projected onto, and made into agents of transformation.
     Throwing my lab coats into a blaze suggests destruction of the very things they stand for:  belief in a higher good, loyalty to mankind, faith in the healing arts, identity within our shared social structure,  spiritual connections among people.
     The lab coats are effigies;  the bonfire is a funeral pyre.
     What else am I supposed to do with these much-used, much-washed garments, stained with Pentel ink that bled into the pockets whenever I replaced a pen in a hurry, without its cap, and with tawny halos of Betadine near the hem, and blood on the lapels, from being right up next to an incision that spattered.  Some evidence can't be bleached out.  Some wounds smart, long after their surfaces have healed.
     I thought of snipping off the buttons for my button box, and using the fabric to cover, say, potted plants on the back porch, when frost is in the forecast.  The cloth is just the right thickness, not as coarse as canvas, nor as smothering as tarps, nor as thin as old bedsheets.  But then I'd have to see the coats, intermittently, rather than be allowed to forget what they stood for, and I'd be reminded of an experience that has begun to feel, against my better logic, like a failure.  My failure, or the failure of a era, or of an attitude, or a system.
     And there's the question of my name, embroidered in bold, black, readable Verdana font just above the breast pocket:  Ona Colasante MD.  Seeing that name, written in that way, would be like looking at an epitaph.
     Before the heat of summer, then, I tear up old papers--billing sheets, as it turns out, from my defunct office.  I crumple them and form a pyramid in the fire pit, which has been used many times for oysters, potatoes, marshmallows.  Then I drape over it heaps of Spanish moss, like hair, because it pops and crackles in the flames, and after that, last year's raspberry canes, which are brittle and needed to be pruned anyway.   I gather twigs for the next layer, cleaning up the yard after last week's windstorm, and then I arrange three rotted logs on top.  A few beetles run, as though lost, in circles around the logs before vanishing into the grass.
     As dusk settles into darkness, I set a match to the whole thing:  paper, moss, brush, wood.  It sizzles and flashes, high and bright.  The glow makes my skin look orange.
     Then, careful not to smother the flames, I place a crumpled-up lab coat at the edge of the pit and watch it catch fire, inch by inch, unfurling like a leaf, then turning in on itself the way a human body might, in a crematory, before disappearing into ash.  Then another coat, and another, and another.
     I can tell the fire doesn't like this fabric--which perhaps was treated with a flame-retardant--because it doesn't bite and swallow my lab coats easily.  There are times when, like a witch, I have to nudge a garment with a broomstick toward the center, where the flames are hottest.  I force each garment to accept its death.
     I think it takes a long time for eight lab coats to burn.  The smoke heads for the treetops, and then toward the moon.  In the stillness I empty my mind of thoughts, like a hermit or a novice, but the tune from that old song, paraphrasing Ecclesiastes, keeps finding a way in.
    To every season, turn, turn, turn.

Monday, March 18, 2013

Should You Buy a New Mattress?

     Do you have back pain?  
     Have you been tempted to spend thousands of dollars on a new mattress because you accept as truth the propaganda that says an expensive new bed will keep you from feeling stiff and achy in the morning? 
     Has someone told you to change your mattress as a way of fixing back and neck pain, hip arthritis, headaches, snoring, insomnia and fatigue?
     Have you read that "you spend one-third of your life in bed, so you should make this investment, for the sake of your health"?
     I checked the on-line mattress websites and was surprised to read that "most doctors advise patients with back pain to buy a new mattress."
     Is this true?  Why haven't I heard about it?
     And why are the "studies" showing certain mattresses help pain more than others all funded by mattress-making companies?
     I've been practicing medicine for twenty years, and not once have I advised a patient to buy a new mattress.  Mattresses are expensive:  like your kitchen table, they should last a decade or two.  Even the stained, second-hand, single, spring-type mattress I bought for my two aging dogs cost $75.  I love my dogs, but I'm not going to buy a high-tech mattress for them.
     I read medical journals on a daily basis, yet I don't recall seeing scientific articles that "prove" a special mattress will make a difference in a person's back or neck pain or, for that matter, any physical symptoms. Have I missed something in the New England Journal of Medicine, or Lancet, or the American Journal of Family Practice, or JAMA?
     I have found, when it comes to back pain, that what really makes a difference is taking a load off your back by losing abdominal weight.  If you had to carry a 25-pound bag of dog food in front of you all day, wouldn't you have back pain?  If you put it down, wouldn't it get better?
     It also helps to strengthen muscles that protect the back, especially the abdominal muscles:  rectus abdominus, internal oblique, extrernal oblique, and transverse abdominus.  And it's a good idea to exercise, as well, the opposing muscles:  paraspinal, latissimus dorsi, and gluetus maxiumus and medius, as well as the quadriceps. 
     When patients suffer from musculoskeletal pain or overuse injuries, it's because they've been attempting to use certain muscles beyond the capacity of those muscles to withstand the workload.   If you want to be able to lift 50-pound bags of horse feed, or yank the pull-cord on a lawn mower, or run two miles without having pain the next day, you have to strengthen the muscles required to do those tasks.  Otherwise, those muscles cry out.
     Therefore, back pain is almost always a consequence of having weak abdominal, thigh and back muscles--so weak that the activities of daily life are too much for your poor back to carry.  Back pain is not caused by a bad bed. 
     Why do people want easy, expensive fixes for constitutional problems that require exercise, diet, and general fitness?  Why spend $2,500 on a special mattress "used by astronauts" when doing fifty situps and a few exercises with dumbbells every day is what you really need?
      Save your money--don't buy a new mattress.  Instead, lose that extra abdominal weight you're carrying around, start do sit-ups and leg-lifts every say, spend $20 on two pairs of weights--and use them. 
     Admit it:   you're being American again, when you fall for something easy--like a pill, or a new car, or an expensive bed that you're going to have to rationalize for the next twenty years, by telling yourself "how much it helps," in that way we all have of selling ourselves on something we've already bought.
     Forget the bed, forget the hype, stop kidding yourself.  I know it's boring, but weight loss and exercise are the keys to sleeping all night, and waking refreshed and pain-free. 

Sunday, March 17, 2013

Blitz on Washington, Part 4, Finale

March 13, 2013
     9:00 AM
          We leave the Cannon Building and find our way back to Longworth, where Steve Southerland has his office.  He's a Florida representative from District 2, and one of a handful of this state's reps who will agree to see petitioners from outside his constituency.  But one week hadn't been enough notice, so he wasn't available.
          "Maybe next month," his executive assistant and scheduler said.  "I'm sure he'd like to talk with you."  We left the Rampant Injustice video (John had made twenty copies) and asked that one of his staffers watch it.  I wrote a letter to Representative Southerland right then and there, outlining my dilemma and requesting his help.
          If you send a letter by snail mail, it takes at least three weeks to reach a representative's office.
          "Why?" I asked one of the staffers.
          "First, the letter is sent to Ohio, to be irradiated.  Then, it's sent to New Jersey, to be decontaminated.  That's because of the anthrax scare.  After that, it's sent here, to be sorted and delivered.  Sometimes it never reaches its destination."
          "What about email?"
          "Each representative gets about 60,000 emails a week."
          "How do you handle all of them?"
          "We don't," the staffer said.
          "So, how are civilians supposed to communicate with their leaders in Congress?"
          "The best way is to do what you're doing.  Come here, in person."

     9:30 AM
          Back to the Hart Senate Building.  There's a line outside, and it's very cold.  The wind has picked up, and my hat blows off.
          We're supposed to meet with Thad Cochrane, a Republican from Mississippi.  We sit in the waiting room, where there's a bridal magazine full of Mississippi beauties.  It's a thick, glossy photo album, but every bride is white.
          "Why are all the brides white," I ask the receptionist, who is from Mississippi, and black.
          "I could have been in there, too, when I got married," she says.  "I chose not to, because you have to pay."
          "That says something about the economics of Mississippi," says Stacks.
          "You mean, the money is in the hands of the whites?"
          "It's probably not good to talk about this, now," Stacks says.
          "Doesn't it make you mad?" I ask the receptionist, ignoring the warning.
          "Well, no, I guess not," she answers, smiling professionally.
          We take some Laffy Taffy from the candy bowl.
          "Is Laffy Taffy made in Mississippi?"
          "No, it's made by Nestle, which is lots of places.  It's a Willy Wonka brand."
          "Why don't you have candy from Mississippi?"
          "I don't know.  It's the rules."
          "Doesn't Mississippi make candy?" I ask. " You could have peanut brittle, or pralines."
          "We have candy makers," the receptionist says.  "Like Robicheaux."
          "Everything else in here is from Mississippi."  I point to a picture of the river.
          Then, Taylor Lam comes out to greet us.  He's Homeland Security Fellow for Senator Cochrane.
          We are ushered into a private meeting room, and launch into our story.
          "Is this a Homeland Security issue?"  I ask.
          "It sounds like one to me," Lam says.  "Some of the same tactics have been used on you."
          "Can Senator Cochran help us?"
          "I'll communicate your concerns to him.  But you might want to contact Issa."
          "Who's that?" asks John Stacks.
          "Darrell Issa.  He's a representative from California, and he has a lot of influence.  He's Chairman of the House Oversight and Government Reform Clommittee."
          "Would that be better than the House Judiciary Committee?" I ask.
          "It wouldn't hurt to get both involved."
          "We have a lot of work to do," I say to Stacks.
          "We can do it," he answers, with his usual optimism.
          "The more people you can get on your side, the more likely you are to get a hearing on the matter," says Lam.
          "If we make a lot of representatives aware, then there won't be opposition to increased restrictions, or even new law, if we get a hearing."
          "It's very hard to change laws," Lam tells us.  "Very hard."
          "Well, some people do it.  Why shouldn't we?"
          "If that's what its' going to take," says Stacks, "that's what we'll have to do."
          "If we can get an Executive Order to limit the application of the laws that are currently in place, including RICO, that would be a step in the right direction."
          "It would go a long way," says Lam.  Representative Cochran could be a great help."
          "The problem is that an executive order is only good as long as congress doesn't change.  But as soon as a new tide of congresspeople get elected, we're back to the same laws, and the executive orders are dismissed with a wave of the DOJ's hand."
          "There's some truth in that," says Stacks.  "But we have to do what we can."
          "The wheels of justice move slowly," says Lam.
          We write down Issa's name, shake hands, and walk down the long corridor, our shoes clicking on the marble floors, to face the wind again.

     10:00 AM
          "Should we try Grasslee's office again?" Stacks asks.
          "He's from Iowa, right?"
          "Yes, and the Aossey family is good friends with Chuck Grasslee."
          "Did they set up a meeting?"
          "That's what I was told.  It's a shame they couldn't be here, but they've just come back from a tour in Dubai, where a lot of their halal products are exported."
          "Okay, let's try him again.  He's been a senator for more than thirty years, so he probably has some clout."
          "Plus, he's the Ranking Republican on the Senate Judiciary Committee.  If he sympathizes with our cause, we could have a powerful ally in the Senate."
          For the tenth time in two days, we pass around a tremendous sculpture that sits in the lobby, near the marble staircase that winds its way up the nine floors of this building.  "Mountains and Clouds" was created by Alexander Calder, and requires attention because there's no way to cross the lobby without walking through and around its giant legs.
          C-Span is playing on the big screen in Senator Grasslee's reception area.  There are dozens of young people in white lab coats waiting for a tour--their osteopaths-in-training.  Perhaps they're petitioning something from their senator.  It's probably their presence that makes it impossible for us to get a hearing with the senator or one of his staffers, despite the prearranged meeting.  Stacks and I aren't form Iowa, either, which works against us.
          We leave a video and some identification cards, and plan to visit next time we come to Washington.  Maybe the Aosseys will be with us, then.

     11:00 AM
          Our last scheduled meeting is with my congressional representative, Corrine Brown, from the 3rd District of Florida.  My home is in her district, my office in Yoho's.
          Congresswoman Brown has been in the House for twenty years, representing a district that outlined to carry the black vote.  It's a little like Affirmative Action for the House of Representatives.  I have voted for her, election after election, believing that she would help to balance the predominantly Republican ethics of the state.
     After the raid on my clinic two years ago, I contacted Corrine Brown, but I couldn't get a meeting with her.  My calls went unanswered, my letter seemed not to have been received.  That's when my party allegiance began to change.
          Lee Footer, her Senior Legislative Assistant, apologized for this mishap.
          "It's better to write to me, by email," he said.  "I'll make sure she gets your message."
          "You mean, my letter just disappeared?  I sent it to her Florida office."
          "I can't say what happened to it."
          "I have never asked a congressional representative for anything," I said.  "But I need Representative Brown's help now."
          "I'm sure she'll try to help you in any way she can."
          "Is she here now?"
          "Yes, but she's in session, and can't visit with you."
          "Can I get a meeting with her in Jacksonville?"
          "Why don't you send me an email describing your problem, and I'll make sure she gets it?"  Footer suggested.  "Send it directly to me, not to her."
          "Okay, but do you want to hear about my problem?"
          "Yes, sit down."  We had our meeting in the reception area.  "There aren't any open rooms," he explained.
          Once I described my situation, with a word or two about Stacks, who nodded in agreement, Footer reiterated his request that I send him the story in an email.  He handed me his card, and left.   I felt strangely abandoned, as though my problem didn't fit Brown's agenda.  Nevertheless, I need to let her know what I want, which is for her to hear me out and communicate my concerns to the House Judiciary Committee via a letter.

     12:00 noon
          My flight leaves in 78 minutes.  I hail a cab, after walking a few blocks.  But the driver doesn't speak English, and doesn't have a GPS.
          "Do you know how to get to the airport?" I ask.  "Ronald Reagan Airport?"
          "Airport?" he asks, looking confused.
          I exit quickly, and find another cab.
          Many cab drivers in Washington come from Ethiopia.
          "There are 400,000 Ethiopians living in the DC area," my driver told me.  "That's almost half of the Ethiopians in this country."
          "Why do Ethiopians come to Washington?" I ask.
          "Because it's a beautiful country."
          "Isn't Ethiopia beautiful?"  I ask.
          "Ethiopia is beautiful, but there is no opportunity.  The people at the top take everything."
          "Don't your leaders care, that all these Ethiopians are leaving the country?"
          "They like it," he said.  "Because we send lots of money back to our people."
          "But Ethiopia has oil, and gold, and tourism.  Why does the country need money from cab drivers in Washington?"
          "All that oil and gold money goes to the military leaders.  It's corrupt," he says, looking very sad.  "Very corrupt."
          "Our country has corruption, too," I reply.
          "Not like us," he says.  'Your country is beautiful.  Very, very good.  Everybody wants to be like your country."
          "Yes, our country is beautiful," I say.
          I have been feeling ennobled by my visit to Washington, and emboldened by my citizenship--especially by how seriously being an American, being a civilian, being a business owner has been taken by our congressional representatives.
          "Our country is very beautiful," I reiterate.  "And I'm proud."
          "Good," the cab driver says.  "It's good, here."