We are a commune of inquiring, skeptical, politically centrist, capitalist, anglophile, traditionalist New England Yankee humans, humanoids, and animals with many interests beyond and above politics. Each of us has had a high-school education (or GED), but all had ADD so didn't pay attention very well, especially the dogs. Each one of us does "try my best to be just like I am," and none of us enjoys working for others, including for Maggie, from whom we receive neither a nickel nor a dime. Freedom from nags, cranks, government, do-gooders, control-freaks and idiots is all that we ask for.
Executive orders allowed the past administration to keep the program alive. They allow this administration to destroy it. Like his predecessor, President Donald Trump has been frustrated by lack of action in Congress on Obamacare. Like his predecessor, he has resorted to executive fiat to get around that obstruction. Only instead of frantically trying to save the troubled program, he is yanking out the life-support cords installed by President Barack Obama.
This week saw two executive actions. With the first, Trump is trying to expand health insurance options outside of the Obamacare exchange for individual insurance plans (which will have the side effect of making on-exchange policies less attractive to healthy customers).
The second is even more serious: After threatening it for months, the president has finally ended the cost-sharing reduction payments to insurers, which subsidize the provision of special policies with lower out-of-pocket expenses for people who make less than 250 percent of the federal poverty line. At the very least, this will probably mean a further increase in premiums, and growing instability in at least the parts of the individual market that aren’t eligible for subsidies to offset the increase. At worst, especially if it gets bogged down in lawsuits, it may cause insurers to say “enough is enough,” leaving broad areas of the country without any firm willing to sell individual policies through the Obamacare exchanges.
While the Congressional Budget Office has issued a delightfully counterintuitive forecast that ending the subsidies could actually increase insurance coverage, there’s little question in my mind that these policies are bad for the exchanges. 1 At the very least, I think we can all agree that they put the exchanges at greater risk. There is also little question that this is at least part of the reason that the administration is pursuing them. And yet, believe it or not, there are still arguments for both.
It has become evident that millions of uninsured Americans are uninterested in buying insurance on the exchanges, because it’s too expensive, or the “narrow networks” don’t cover enough doctors and hospitals. The new options the administration aims to create could be a genuine boon to those people. If you have spent years bemoaning the dire fate of the uninsured, you have to take that benefit seriously.
As for ending the subsidies … what am I, some sort of monster? Do I just hate the poor so much that I can’t stand to see them getting help paying for health care? Well, no. I have no particular objection to the payments as policy. Except for one small thing, which is that they seem to be sort of illegal...
It is the rare male who is entirely lacking in barbarian fantasies and impulses of various sorts. Rape, murder, mayhem, etc are all part of the dark side (aka uncivilized side) of the human soul. The rich and powerful, like medieval lords, quickly discover that they can get away with lots of id-driven behavior. Thus the world of female pulchritude can become not a feast for the eyes but a literal feast. Lesser people who try it tend to get into trouble fast but in Hollywood it's just tabloid fodder.
I sometimes wonder how people would behave if they were guaranteed that they could get away with anything. Would I rob a Brinks truck, or lift a Cartier watch from the store? Have an affair with Brad Pitt? I would like to think not.
So when I read that Weinstein is headed for "rehab," it knew it was a pure PR stunt. Rehab for living the role of a dirty old predatory man? There is no "rehab" or treatment for rotten behavior outside the judicial system. And that rarely works either. Rules are for the little people, the bourgeoisie, where there are more consequences.
I'll say that being powerful in some way, like alcohol or cocaine or wartime, can be disinhibiting for some or even many people. Most likely, for people with a little sociopathic tendencies because of the evident absence of remorse. After all, the men in question here have daughters...
The Weinstein Co., reeling from the accusations against the co-chairman of the company, released a statement on Tuesday denying any knowledge of the accusations. "These alleged actions are antithetical to human decency. These allegations come as an utter surprise to the Board. Any suggestion that the Board had knowledge of this conduct is false," the TWC board said.
Everybody knows that having a belly is the major risk factor for heart and cardiovascular disease, diabetes, arthritis, and dozens of other nasty ailments, but the association of overweight with at least 13 cancers is not so well known.
Being heavy may be one of the greatest risk factors for a large variety of cancers. There are many theories about why this might be. Breast and prostate cancers are high on the list.
It is worth thinking about, even though we all must accept that the odds are, now that we can handle most infectious diseases, that we will die either of cancer or cardiovascular disease sooner or later. But why rush it?
At least 50% of American medical students are women. That has been a dramatic cultural change in the profession, at least in the US. When I was in medical school we were around 20%.
At the obvious risk of being assaulted for stereotyping and demeaning females in my profession, I will share some of my observations (with countless exceptions, of course):
- Women in medicine are very smart and detail-oriented. Excellent students without much rebellion or cantankerousness. However, they are often too much "by the book" and rule-oriented to adjust to specific situations. I have fought this in myself. The men tend to be willing to take more risks, less rule-bound, more blunt, and willing or eager to work ungodly hours. Definitely more defiant and skeptical of authority.
- Women in medicine tend to view it more as a career than as an identity. Men in medicine have traditionally seen it as their raison d'etre, members of an ancient priestly caste. Men in medicine feel heroic and manly about responding to that 3 AM phone call, women generally not so much.
- As a career rather than as a 24 hr/day identity, women in medicine tend to be more comfortable with a regular paycheck, defined hours of responsibility or even part-time hours of duty, and good job benefits. That often means working for somebody else.
For better or worse, the coming dominance of American medicine by women will be changing the culture of the profession. Other influences, like the emergence of large group practices, and of hospital-owned practices, are changing the character of American medicine too.
It is a general term for all of these things: being pleased with the way you look naked, feeling energetic, and having well-developed strength/musculature, cardiovascular endurance, and athleticism (agility+speed+power).
I pretty much follow something like the Maggie's program of a combination of weight-lifting, calisthenics, and endurance cardio. About 5 hours weekly but I also play sports one night/week and on weekends. I watch my nutrition carefully because many middle-aged women have a tendency to get sloppy regardless of their exercise program. (No rational amount of exertion can produce fat loss, unfortunately, but physical exertion does reduce subjective hunger and "false hunger" - the hunger that overweight people experience.)
Regarding muscle maintenance and strength-building in middle age (40+), I want to highlight a paragraph from yesterday's post:
Research has demonstrated that low load high intensity lifting at 30% of the one repetition max (1RM) to failure can elicit similar rates of muscle protein synthesis as traditional, high load low intensity lifting at 90% of 1RM. Data suggests that low and high load lifting performed to failure yield equivalent hypertrophy over time. So exercise volume (repetitions x sets x load) can achieve maximal muscle fiber activation, including the important larger type II fibers. This is also much less likely to cause injury, an important consideration at any age.
Note that it says "to failure." That is the key, and that is the tricky part because the mental "I give up" almost always precedes the muscles giving up. Fighting that mental part is the discipline of exertion, and why trainers know they can almost always say "C'mon, give me one or two more." Women have no need to fear developing the hard or bulging muscles of their fit and athletic menfolk. That can't happen naturally with females.
To hedge your bets on the current consensus, I suggest going heavy with the weights on power lifts occasionally. You might even see your 1RM increase if you dare to check it (with a spotter) every few months.
Physical (and mental) fitness begin slowly going downhill after age 30-35 and accelerate thereafter. Deconditioning by avoiding strenuous exertion makes it worse. I am a skeptic about mental exercise, but not about the role of exercise in slowing natural physical decline.
A variety of social forces extradited muscle from respectable mainstream health. Muscularity once suggested physical labor and therefore a lower class station. More recently body builders hijacked the mesomorphic, minting steroid-fueled Rodin caricatures that were anything but a model of health.
Muscle also has been perceived as anti-intellectual. In the organ kingdom, it is the antithesis of the exalted brain, as in brain or brawn. It is our brain that distinguishes us from the great apes. Even within the muscle category one finds a hierarchy. Cardiac muscle appeared to carry none of skeletal muscle’s stigma. Academics might have jogged, meatheads pumped iron...
Skeletal muscles, and the bones to which they attach (muscle stress is what keeps bones strong), undergo continual alteration and renovation. They are both adaptive: they respond to lack of stress by weakening or atrophying, and to stress by becoming more robust. This occurs regardless of age. Those 80 year-old women I see lifting weights in the gym are doing a smart thing. Weights are good for females.
There is also growing evidence that regular intense physical exertion is good for maintaining mental functioning. It's definitely good for mental health.
Should "Orthorexia Nervosa" be a diagnosis? No. We are already trying to label every human quirk, foolishness, and obsession as a medical diagnosis. Quirks are one thing that makes people interesting if not amusing. Many people ascribe magical properties to food. Some people think more about food, and some people just view it as fuel.
"Symbolic representation" sounds like a dull topic. Prof Peterson here is stunning as he takes on the organizing myths of human existence. Maps of meaning orient us to the world, and without them we encounter the dragons of chaos, confusion, and existential horror.
He connects psychology, myth, art, philosophy, politics, religion, good and evil, heroism, parenthood, and almost everything except the kitchen sink. The man is a Canadian national treasure.
"Any coherent organizing principle is better than none." Interpretive structures. I gave it a few listenings to fully appreciate this 2-hour talk.
However, Lifton's career has been about expanding his professional role from his office to the larger world. Big mistake. The truth is that we in the shrinkology fields have a terrible time just trying to understand one person in our office. When it comes to strangers, or the larger world, we are as much amateur opinion-vendors as anybody else.
Maybe it's Lifton's grandiosity (but I am doing the same thing to him now) but, more likely, it's pure political animosity from disappointed Hillary fans. About half the country voted for The Donald so maybe we (I include myself, voted for him with a mix of disgust and delight, choosing Buffoon over Wicked Witch, but few of my colleagues have admitted to doing so) are all nuts. After all, Trump is just a messenger.
Using diagnoses as projectiles is simply rotten behavior. If you hate somebody, just say so in plain English. Recent history shows that ploys like Lifton's have been most obviously directed towards Goldwater, Nixon, Reagan. Any pattern?
It seems to me that the social value of different personality traits, behaviors, and accomplishments varies widely across cultures and subcultures, and certainly across history.
I'm not sure what "worthy" means, though. Christian praise songs say "Only You are worthy." All I can think of about "worthy" is worthy to marry one of my splendid kids. That is a high bar in many areas, I'm afraid.
It's a strange approach to the subject, written by a therapist of some sort. Why does anybody break any sorts of covenants, agreements, vows, commitments, laws, etc., even when they know how destructive to conscience and good cheer it can be?
Of course it's because we are implanted with strong, relentless desires of all sorts. Food, lust, love, violence, competition, revenge, excitement. Raw life forces. You can call them emotions or instincts or whatever you want to call them. Most human desires lack any moral, much less bourgeois-moral, components and often lack any practical components. We need only refer to our fantasies to see that.
A more interesting topic is to consider is why and when people do notbreak any sorts of covenants, agreements, vows, commitments, laws, social conventions, etc. despite pressing desires. It's more interesting because it's the special human part. The monkey parts are no mystery at all.
Last week, I posted on one reason for the paradox of why overweight people tend to feel more hunger, and to eat more avidly, than others even though they have no nutritional needs.
How can that be adaptive? Not all of physiology is adaptive to everything.
It's an interesting effect which may have some adaptive value, or maybe not. It does explain why many normal-weight fitness-seekers need to force themselves to eat some protein when they have no appetite and no interest in food. It could be part of why hard cardio exercisers lose weight. Exercise doesn't provide fat loss, but the cardio reduces appetite. I am not talking about anorectics, just regular people who want to be in fighting shape and kind to their joints.
Aging is characterized by changes in body composition. CT studies demonstrate that as we age, subcutaneous fat (below the skin, SF) decreases and visceral fat (in abdominal cavity, VF) increases. VF is the enemy. Because it causes systemic inflammation, it is an independent risk factor for coronary artery disease, stroke and death. If that’s not enough, VF also provides the Buddha-belly mid-life midriff.
The other most common age-related change in body composition is muscle loss. Because muscle has a high metabolic rate, its loss is associated with a reduction in energy expenditure. This decrease in caloric burn lends itself to weight (fat) gain.
We term this phenomenon "False Hunger" because overweight people have no need for outside energy sources. In fact, though, overweight people tend to experience more subjective hunger than normal-weight or ectomorphic people. Is that cause, or effect?
A bit of both but mostly effect, as it turns out. It mostly has to do with how pudgy people ramp up their insulin response and the resulting, or related, insulin insensitivity. Illogical as it seems, having extra body fat makes people feel hungrier. Feed me, Seymour. It's a vicious cycle: Always Hungry? Here’s Why.
Overweight people can survive weeks or months without carbohydrates/sugars using their body fat as an energy source as long as they consume protein, fats, and oils to prevent muscle deterioration.
Can you lose weight via exercise? No, not practically
Does high-intensity exercise reduce appetite? Yes, usually. Dedicated fitness people force-feed themselves to keep their strength and endurance improving.
Stomach-stretching? People who eat bulky meals on any regular basis do stretch their stomachs, which can result in increased subjective appetite and hunger. We recommend small meals for everybody, regardless of weight. Except on feast days or special occasions. People feel less tired, more energetic, and more productive with small meals.
Fast eaters, voracious eaters? Fast eaters trick their satiety signals by overeating (ie, greater volume of nutrients than needed to thrive) before satiety can kick in. Very few fast eaters are in good shape. A bad habit, and bad manners too.
Can an analogy be made between the pursuit of mental fitness and of physical fitness during aging? I certainly do not know, so I will remain skeptical.
The idea that pursuing mental fitness could prevent Alzheimer's is ridiculous. However, it appears to me that many retired people take on difficult mental challenges for an hour or two daily to try to keep their brains geared up. I am not talking about passive learning (ie reading), but active studying. A few examples from people I know:
- A retired guy who decided to refresh his college calculus, and has since taken his math studies three levels beyond where he had gone before, and is still going
- A retired gal who has become fluent in Italian, and can now read Dante and hang out in Italy, considering buying a summer place in Ferrara.
- A retired lawyer who has become fluent in Mandarin
- A friend who decided to become fluent and literate in a new language every two years, and has thus far done that three times using Rosetta Stone.
- A friend who at age 50 has taken up piano in a serious way
- A retired executive neighbor who thought he was too smart to take up mechanics in high school who took up small engine mechanics and is moving on to (pre-computerized) auto mechanics. Now a grease monkey and very happy.
- A retired physician who decided to become an expert in immunology and the genetics of immunology, and has been doing so, while having to learn biomedical statistics on the side.
- A friend who has just gone back to college. Graduated decades ago, but feels she missed a lot.
Mental exertions/disciplines like these are analogous to physical training. I'm sure it's not wasted effort because difficult achievement is its own reward. One thing we know is that strenuous physical exertion (ie not walking or relaxed swimming) is good for brain maintenance but not the opposite.
That may or may not be true, but we will all grow old, get sick, and die unless we encounter a fatal accident or get sick and die before we get old.
It's worth reading Cicero's essay On Growing Old before growing old. Appropriately enough, that edition is in large print. Meanwhile, I endorse efforts to remain physically and mentally as vigorous as possible for as long as possible. It makes life more productive and fulfilling but, with luck and if we want to, we might end up old.
I know people who use meditation to settle their minds. I also know people who use prayer in a similar way. Smart guy Robert Wright (The Moral Animal) seems to have become enchanted with a secular Buddhist form of meditation.
There must be an adaptive aspect to that. It explains why body-builders and getting-in-shape exercisers (those who are not in the fat or overweight category, but just a little 5-6-lb pudgy with undeveloped muscles) need to force-feed themselves their five small meals (large snacks instead of "meals") daily to support their fitness-building. Over months, some of those fat pounds can be replaced by solid muscle pounds in other places.
Overweight people, on the other hand, have many weeks or even months of survival energy stores already on board and really only need several 30-gm doses of protein daily if they are embarking on a strenuous daily fitness program because body fat is a fine energy source. Certainly not three regular American meals/day if they want to get in fighting shape. We have discussed the various forms of eating (ritualistic, social/recreational, impulsive/emotional, false hunger, etc.) here.
In the first case and in the second, we see that subjective "appetite" can be a trickster for adults. I could build an analogy to sexual instincts, but I won't. Goals, logic, and discipline are powerful human tools. Perhaps our most powerful.
Side note: If you enjoy difficult fitness training, you have a problem. Like grammar school, you are supposed to hate almost everything about it. If you don't hate it, and if it isn't mentally and physically painful and aversive, try a new program. If you hate it, but feel glad you did it afterwards, great, because that is life's deal in most ways. If your daily life is strenuous physical work, you can ignore all of this.
As summer begins to reach an end here in the northern hemisphere, I found myself recently alone on a remote beach in Maine soaking up beneficial solar rays with no clothing and no sunscreen. I pulled a small kayak up on the little island's rocky beach, and exulted in Mr. Sun's reaching sweetly into every crack and pore of my imperfect and slightly-aging multi-gravida but decently-athletic body. Mr. Sun doesn't discriminate.
I reflected on the pure animal pleasures as only the human kind of animal can reflect. The delight of touch, like the delight of a warm breeze. A gently rocking boat. The heat of the sun on skin, a breeze through your naked pubes. A hug from a friend or kid. A dog licking your hand. Sexual delights, of course. Powerful. The taboo relief pleasures of peeing and pooing. A hot shower that you hate to leave. The thrill of a violent thunderstorm. The tingle of a spoonful of delicious champagne sorbet or fresh raspberry sorbet. The joy of smacking a tennis overhead onto the sneakers of an opponent on a sunny morning. A hot tomato off the vine. The smell of hot trees and flowers. The pleasure of giving in to gravity onto a cozy bed at the end of a day. The fun of walking into cool air conditioning from a sizzling street, and the fun of walking from a car onto a sizzling beach. A chilly glass or two of chardonnay on the lawn at 5 pm.
Mindless, happy-animal, universal pleasures. Controlled hedonisms with no vomitoria or alcohol- and cocaine-fueled orgies. Each season offers its own set of innocent delights, but summertime offers the most.
Carpe diem, because you and I might not be alive next year. Anything can happen. I believe in working hard and long, but not always being a drudge. What's for supper? Grab a beer and make yourselves a turkey sandwich, family. I ain't cooking.
As summer begins to reach an end here in the northern hemisphere, I found myself recently alone on a remote beach in Maine soaking up beneficial solar rays with no clothing and no sunscreen. I pulled a small kayak up on the little island's rocky beach, and exulted in Mr. Sun's reaching sweetly into every crack and pore of my imperfect and slightly-aging multi-gravida but decently-athletic body. Mr. Sun doesn't discriminate.