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.
It's fascinating how crowded Everest is becoming these days, with queues of mountain tourists for the rope lines. The highways are all mapped out, ladders installed, ropes installed, sherpas hired, etc., so it's almost like a rich man's chilly Disney World.
The medical part - and the risk of bad weather - seem to be the greatest challenges. First World Problems, if you will, because nobody needs to do this. However, if it is made too safe, where's the credit?
As with the Olympics, I think it's wonderful that some people want to try these sorts of adventures in life, but I do not admire the amateur tourists. Good film:
In a contemporary, and often unacknowledged, rebooting of Freud, many psychologists have concluded from such findings that unconscious associations and attitudes hold powerful sway over our lives—and that conscious choice is largely superfluous. “It is not clear,” the Baylor College neuroscientist David Eagleman writes, “how much the conscious you—as opposed to the genetic and neural you—gets to do any deciding at all.” The New York University psychologist Jonathan Haidt suggests we should reject the notion that we are in control of our decisions and instead think of the conscious self as a lawyer who, when called upon to defend the actions of a client, mainly provides after-the-fact justifications for decisions that have already been made...
Of course, recommendations like this change all the time, just as do all dietary recommendations. I take it all with a grain of salt or, I should say, with plenty of salt. I love salt.
There apparently was too much swelling in his leg to do the needed surgery, so the current stabilization technique (photo yesterday) is temporary for a week or so, then I assume a tibial rod or other internal fixation.
Guys gotta do what guys gotta do, and sometimes they have to get banged up in the process. I applaud these male efforts - and female efforts - to remain in the game and not to quit despite the risks to bones, pride, etc.
A medical colleague emailed me a photo of his own left tibia this weekend, acquired when skiing at Jay Peak. Ouch. An MD degree is not required for this diagnosis. For a layperson, this is a version of a "broken leg." This will need pins or a plate or something. Some metal and some screws, and I think he'll miss a day or two of work.
An annual re-post, but re-posted again because we seemed to help a number of people with this:
Forget the "Obesity Crisis." That's a crock. Abundant, good food is a blessing and a rarity in human history so it is a great privilege and luxury to be overweight. It certainly is true that, when tasty food is cheap, people will eat a lot of it and their bodies will kindly store what they don't need to survive today, to the detriment of our knees, hips, appearance, comfort, and general vigor. Trouble is, we won't need that storage tomorrow - or ever. It's like hoarding.
We can all be as fat or fit as we wish to be. It's a free country, and being fat (but not obese) isn't terrible for your health unless you are diabetic or want to be able to get around energetically. But don't listen to the Dieticians and Nutritionists. They will want you to get in shape slowly and in a "sustainable" way. In your heart, you know that will never happen. If you are bothering to read this, you just want to get in shape as quickly as you can without liposuction or use of the vomitorium.
Eliminating carbs reduces or eliminates carb craving in most overweight people over several weeks.
This can be a one- to three-month program as desired. Maintenance is another topic.
I never expect honest answers from questions about sex, substance use, or money, so I won't expect perfect honesty here.
However, in an effort to warm up this frigid winter season, here's my scientific Maggie's Farm poll question for today:
How often during a normal day out and about in the world do you think "Hmmm, that's appealing; I think I wouldn't mind having some sex with that guy or gal"?
"Most important job in the world"? You betcha. It can be joyful, boring as heck, frustrating, and mindless drudgery. In my opinion, Moms need plentiful adult-oriented breaks from child-rearing tasks, and the husband must always be the priority. The best way to kill a marriage is to make the kids more important than the spouse.
The US government recommends 9-11 servings of fruits and/or vegetables daily.
What are they smoking? Unless a stalk of raw celery or a leaf of spinach counts as one vegetable.
If you ate all that, you would be obese, especially with the fruit which, as I always say, is God's dessert. Unless you are at a starvation weight, you don't need fruit. Fruit is just sugar, and you might just as well have some ice cream.
Is there any justification for that in a free country?
We debated the topic at dinner last night. At the end, I had to admit that sentiment and tradition were not adequate reasons for laws and, especially, criminalization. When I (rarely) refuse my hubbie nighttime pleasures, he has been known to mumble "I shoulda been a Mormon." I know he'd enjoy a threesome, in fantasy anyway, but that's not how I roll. I am a traditionalist.
Most of the studies he discusses avoid defining happiness, and just let people report. At issue, of course, is that as long as one is not in dire straits, happiness and contentment in life depend on non-economic factors: temperament and personality, relationships, family, hobbies and interests, etc.
There is no one "happiness." Some are most happy when taking risks, others more comfortable when they feel more secure. Material gain is not a universal goal.
I am a fan of online dating, especially for those who are out of school. There is just no other way to interview so many available candidates efficiently, with the advantage of screening them in advance.
When people get divorced, I usually recommend that a person have a coffee with at least 25-30 candidates, at minimum, before deciding to get involved with anyone. That's because the recently-divorced are usually lonely, unhappy, sex-starved; often hurt or angry or worried about the future, and generally prone to poor judgement and poor choices. However, those things may apply to many single people.
Antidepressants fail to help around 70% of depressed patients on the first try.
Antidepressants are now the treatment of choice for anyone with acute or chronic symptoms of "major depression," ie anxiety, disturbed sleep, hopelessness and helplessness, self-hatred, appetite loss, irrational guilty feelings, loss of sex drive, inability to concentrate, sometimes suicidal feelings, and inability to find pleasure or interest in things. In my experience, the vast majority of patients with a fair number of those symptoms feel better with antidepressants, but, in my view, medicine should never be given without psychotherapy of some sort.
Where it gets complicated is that 1. there are many kinds of depression besides major depression; 2., the personality type, and personal strengths and weaknesses can effect the way depression occurs, and whether it occurs at all, and, 3. life circumstances have a real impact on the ability to improve depression with medicine (if your business is going bust, or your child dying with cancer, no antidepressant will make you merry).
I'll try to keep it brief. The generic term "depression" runs the gamut from the heavily-inherited form that occurs in Bipolar Disorder (which is probably a brain-wiring abnormality), to the grief-like depressive reactions to life-events, especially loss, which occur in vulnerable people. In between are sad-sack people with chronic mildy depressed mood, and many people with chronic mood problems due to personality disordersor neurotic problems. My point is that there is not one "depression". The word refers to a group of symptoms, not a diagnosis.
Because depression is not a unitary phenomenon, different forms require different treatment approaches, whether psychotherapeutic or chemical, but the research says preferably both for severe depression.
It is not widely understood that the new SSRI antidepressants are not "mood elevators." They have no effect whatsoever on people without depression, which is why they are never abused.
I will have to follow-up with a Part 2 later, because this is getting too long, according to our blog rules. "Short and sweet." But some subjects are complex and nuanced, as our esteemed French Senator likes to say.
She points out the (rather obvious) practical and economic advantages of committed relationships. I can't imagine handling all of the complexities of life without a partner.
"Science has become an international bully." I doubt that I will change my mind about this being the best essay of 2014, by Yale's computer scientist David Gelernter: The Closing of the Scientific Mind.
It's about subjectivity, mainly - being human, and a defense of Nagel in part. The essay is so rich and deadly-serious that it cannot really be taken in in one reading, and it is difficult to select a representative quote so I'll post a random one:
The dominant, mainstream view of mind nowadays among philosophers and many scientists is computationalism, also known as cognitivism. This view is inspired by the idea that minds are to brains as software is to computers. “Think of the brain,” writes Daniel Dennett of Tufts University in his influential 1991 Consciousness Explained, “as a computer.” In some ways this is an apt analogy. In others, it is crazy. At any rate, it is one of the intellectual milestones of modern times.
How did this “master analogy” become so influential?
Well, because we derive our metaphors from the world around us. Freud's first metapsychology was modeled on the steam engine. The essay deserves study. Take a Ritalin and dig into it.
Another:
Many scientists are proud of having booted man off his throne at the center of the universe and reduced him to just one more creature—an especially annoying one—in the great intergalactic zoo. That is their right. But when scientists use this locker-room braggadocio to belittle the human viewpoint, to belittle human life and values and virtues and civilization and moral, spiritual, and religious discoveries, which is all we human beings possess or ever will, they have outrun their own empiricism. They are abusing their cultural standing. Science has become an international bully.
Nowhere is its bullying more outrageous than in its assault on the phenomenon known as subjectivity...
Samizdata found this gem by Rauch in The Atlantic. A couple of quotes:
"Introverts may be common, but they are also among the most misunderstood and aggrieved groups in America, possibly the world."
and
"Do you know someone who needs hours alone every day? Who loves quiet conversations about feelings or ideas, and can give a dynamite presentation to a big audience, but seems awkward in groups and maladroit at small talk? Who has to be dragged to parties and then needs the rest of the day to recuperate? Who growls or scowls or grunts or winces when accosted with pleasantries by people who are just trying to be nice? "
The message is that magical thinking about health and food, etc., doesn't accomplish very much. Neither does magical thinking accomplish very much in any other area of life - except in fiction.
The best way to go, many feel, is to get pneumonia in old age and to die quietly, peacefully. Most are not so lucky and some darn doc will try to treat your pneumonia at age 92 to extend your life for a few weeks in the ICU on a respirator. However, for many, if you outlive heart disease cancer will get you: Why Everyone Seems to Have Cancer.
We don't call it "dying of old age" anymore because we have much better diagnostic tools. Everybody has to die from something or other.
From the Editor of The Atlantic, Surviving Anxiety - I've tried therapy, drugs, and booze. Here’s how I came to terms with the nation's most common mental illness:
I wish I could say that my anxiety is a recent development, or that it is limited to public speaking. It’s not. My wedding was accompanied by sweating so torrential that it soaked through my clothes and by shakes so severe that I had to lean on my bride at the altar, so as not to collapse. At the birth of our first child, the nurses had to briefly stop ministering to my wife, who was in the throes of labor, to attend to me as I turned pale and keeled over. I’ve abandoned dates; walked out of exams; and had breakdowns during job interviews, plane flights, train trips, and car rides, and simply walking down the street. On ordinary days, doing ordinary things—reading a book, lying in bed, talking on the phone, sitting in a meeting, playing tennis—I have thousands of times been stricken by a pervasive sense of existential dread and been beset by nausea, vertigo, shaking, and a panoply of other physical symptoms. In these instances, I have sometimes been convinced that death, or something somehow worse, was imminent.
Even when not actively afflicted by such acute episodes, I am buffeted by worry: about my health and my family members’ health; about finances; about work; about the rattle in my car and the dripping in my basement; about the encroachment of old age and the inevitability of death; about everything and nothing. Sometimes this worry gets transmuted into low-grade physical discomfort—stomachaches, headaches, dizziness, pains in my arms and legs—or a general malaise, as though I have mononucleosis or the flu. At various times, I have developed anxiety-induced difficulties breathing, swallowing, even walking; these difficulties then become obsessions, consuming all of my thinking.
It's a vivid description of what we used to call Anxiety Neurosis but now term Generalized Anxiety Disorder. Stossel says that nothing has helped him except for moderate use of Xanax and/or alcohol. He has concluded that he just needs to live with it, if not to embrace it.
81% of kids have a mental disorder? "Everybody has Psychiatric symptoms."
The point is, you need a diagnosis for your insurance. Even if you're a troubled normal neurotic, we'll stick a label on you as a favor to you. Dr. Alan Francis, et al (h/t, Boring Old Man)
It is true. Docs who use electronic records spend more time on the computer than with their patients. Even worse, the treatments are increasingly done by prescribed protocols instead of designed for the individual situation. Case in point: When treating a patient with dementia, electronic health records fall short.
Furthermore, those records are not private. This is what you get when government gets more involved with medical care - and anything else.
My patients know that they are not on an assembly line, and I'll keep it that way until they make it illegal. Doing things my way, however, requires that I take no government insurances. Just pay me for my time at around the same fee as a master electrician and below the rate of a fancy lawyer.
I never expect honest answers from questions about sex, substance use, or money, so I won't expect perfect honesty here.
Antidepressants fail to help around 70% of depressed patients on the first try.