On Constitution Day…

Monday Musings for Monday September 16, 2019
Volume IX, No. 37/448

constitution_quill_pen

Constitution Day, Supremacy of the Rule of Law,

What Makes America Great?

By Assad Meymandi, MD, PhD, ScD (Hon), DLFAPA*

Jill LePore, The brilliant Professor of History at Harvard, opens her most recent colossal 936 page book, “These Truths, The History of United States”, as follows: One day, Tuesday October 30, 1787, the readers of a newspaper called NEW YORK PACKET found on the front page an article, The Constitution of the United States, 4400 words long…” According to Professor LePore, the 4400 words essay attempted to chart the motions of the branches of government and separation of their powers…That meant the start of a new era. ‘the origin of that idea, and its fate, are the story of American history. The review of this book will appear in this space.

232 years ago, on September 17, 1787, the founding fathers of our beloved Republic singed the sacred document we know and cherish as the US Constitution. Thereby they gave birth to America. They gave birth to our great nation. No, America is not great because of its prosperity. It is not great because of the proverbial “American dream” of a brick home with a two car garage. It is not great because it gives us security, opportunity, and order. And it is not great because of its advanced technology, and the number of Nobel Laureates it produces in science, medicine, literature and humanities. America is great because it is a nation of laws and its absolute commitment to uphold and maintain the supremacy of the rule of law. On this Constitution Day, it is fitting to take a psychological scalpel and dissect what goes into the grandeur of America’s reverential devotion to upholding the rule of law. I am selecting two cases, one national and one local. They dramatically and eloquently tell us the story of America.

On the national scene, we saw the trial of psychiatrist Major Nidal Hasan who by his own admission in a rampage on November 5, 2009 killed 13 and wounded 32 of his fellow soldiers at his Texas military base. During his trail, speaking on his own behalf, in the court he said “The evidence will clearly show that I am the shooter.” Major Hasan is paralyzed below chest. He requires special medical attention at Brooke Army Medical Center. He is incontinent and in need of round the clock nursing care and rehabilitation. Also, there is a special security team assigned to protect his life- day and night. He was tried in a specially fortified court room. Sources familiar with his care report that Major Hasan’s security detail rivals that of those of the US President. For example, when he was transported back and forth to court, a helicopter and bullet proof cars are used to ensure his safety. The cost is in the millions. Besides, since November 5, 2009, he has been paid a salary of $278.000 in addition to $78,000 for housing allowance. Yes, the majesty of the supremacy of the rule of law in the beloved land of America is dramatically demonstrated by how we are treating an admitted killer. As stated above, the American dream is not the proverbial brick house with two car garage, vacation homes, technology, and prosperity. It is the US laws, its sacred Constitution, the sacrifice of the founding fathers who gave us our Republic are the muscles, bones, and spirit of American Dream. The supremacy of the rule of law and not the whims of a dictator, a king, a Shah, or an Ayatollah is the basic foundation of the majesty of American democracy.

On the local scene, a few years ago, with astonishment and awe, I sat and watched the court proceedings of the former NC Governor Michael Easley on television- astonished, because a former Chief Executive Officer of a sovereign state was being sentenced, and in awe, because of the unshakable and uncompromising supremacy of the rule of law in America. America from time to time may go down financially, retrenched economically, and our state may have a three billion dollar budget deficit, but nowhere on earth the sanctity and supremacy of the rule of law are so cherished and enshrined in the nation’s psyche as they are in America.

God has blessed our beloved nation, the United States of America, and we are blessed to be Americans.

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*The writer is Adjunct Professor of Psychiatry, University of North Carolina School of Medicine at Chapel Hill, Distinguished Life fellow American Psychiatric Association, and Founding Editor and Editor-in-Chief, Wake County Physician Magazine (1995-2012). He received Raleigh Medal of Art in 2001, inducted to Raleigh Hall of Fame 2013, elected Lifetime Trustee, North Carolina Symphony in 2015, and 2016 recipient of NC Award, Fine Arts.

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On Forgiveness…

Monday Musings for Monday September 9, 2019
Volume IX. No. 36/447

saadi

Abū-Muhammad Muslih al-Dīn bin Abdallāh Shīrāzī,
better known by his pen-name Saadi (1184-1291)

 

ON FORGIVENESS

By Assad Meymandi, MD, PhD, ScD (Hon), DLFAPA*

Wednesday, September 11, 2019, is the 18th anniversary of the brutal attacks on America. The attacks were a series of four coordinated areal insurgence by the Islamic terrorist group al-Qaeda on the United States on the morning of Tuesday September 11, 2001. The attacks killed 2,997 people, injured over 6,000 others, and caused at least $10 billion in infrastructure and property damage. It was a brutal attack on our beloved nation, The attacks destroyed people and properties but they did not destroy the soul of America. The National September 11 Museum and Monument are there as eloquent testimony of America’s resolve. A few reflections on forgiveness:

About a year ago, a 77 year old man came to see me about gradual onset of a devastating depression. Harry (not his real name), always a positive, energetic and productive person, had lost his will to live. He told me that he was experiencing a gnawing sensation at the pit of his stomach. He could not sleep, had lost his appetite causing him to lose a considerable amount of weight. His wife confided in me that she was afraid that “Harry would end it all.” She had carefully removed all firearms from home. This, in itself, caused further escalation of Harry’s anger and irritation. We evaluated Harry and ran appropriate laboratory tests to rule out myriad of physical causes for his depression, including endocrinopathies such as hyperparathyroidism often caused by a parathyroid adenoma, a benign cancer of the parathyroid gland, and others. By the way, this was the cause of the late US Senator from North Carolina, John East’s depression and suicide, a perfectly curable form of depression by surgery).

In the course psychotherapy, exploring his past and family history, we came across a demon. He casually mentioned that he has not seen eye to eye with one of his sons. As a matter of fact, he became angry that we were spending so much time on that unimportant lost relationship. In the course of therapy, the issue of forgiveness was bought up and explored. Harry took the matter seriously. He had 40 years’ worth of anger for his estranged son. Finally, as our work progressed, he chose to approach his son. The miraculous process of forgiveness rapidly assisted his total recovery. He became well and was terminated, and his medications were gradually discontinued. In the Christmas card I received from him and his wife, they were thankful to discover the powerful effect of forgiveness. Harry is back enjoying life, being positive, energetic and productive. This process prompted me to write the following essay on “Forgiveness.”

Some Thoughts and Reflections on Forgiveness:

In the ten thousand year annals of Neolithic man, the issue of forgiveness vs. revenge occupies considerable space. Since Sumerians’ earliest recorded history, the contributions of three stars in the intellectual constellation guide us with their luminosity and brilliance. They are St. Augustin of Hippo, born in 354, the author of City of God and Confessions; Moses Maimonides of Cordoba, born in 1137, author of Talmudic Laws; and Ibn Khaldoun, who penned the definitive Islamic Cannons in 1363 (born 1332, died 1405). Throughout their work, all three have spoken of grace, stoicism, altruism and forgiveness in the most compelling and persuasive manner. Some believe that the Lord’s Prayer, especially the passage: “Forgive us for our trespasses as we forgive those who trespass against us”, a staple of Christianity, and the only actual piece of literature ever authored by Jesus of Nazareth, is a hand me down from Zoroaster, the 500 BC Persian prophet and author of Avesta, and Abraham. It has been vastly copied by other major religions of the world, namely Judaism, Christianity and Islam. The celestial books of Torah, the Bible and the Holy Quran, each have hundreds of references to the issue of forgiveness and peace. A celebrated Persian poet and Sufi, Sheikh Mosleh-e-Din Saadi Shirazi, born 1210-1290, in his book, Gulestan-e-Saadi, refers to this subject with the most tender words: “Forgiveness heals, comforts, transforms, preserves, remembers, promises, buries the dead and raises them once again. Forgiveness refuses to be quiescent until all possibilities have been exhausted.”

Psychologically, forgiveness is altruistic and selfless. Forgiveness does not mix with self-centeredness and narcissism. It takes discipline and selfness to be able to forgive. God created us with the gift of forgiveness, compromise and peace. With recent stunning advances in biochemistry and neuroendocrinology, we have come to know that forgiveness plays a major role in preserving the function and the architecture of our brain, our hearts and our souls. Brain research, in the last half of the twentieth century, clearly demonstrates that feelings of enmity, adversity and anxiety produce undesirable and harmful hormones, specifically Beta Carbolines and the bad kind of catecholamine that increase blood pressure and heart rate; decreases immune response, and lowers the number of precious T-cells that fight infections. On the other hand, data driven seminal articles in peer reviewed medical magazines such as Archives of Internal Medicine, Lancet and New England Journal of Medicine demonstrate that forgiveness, peace and a sense of spirituality decrease blood pressure, sharpens body’s immune response and lengthens life span.

One of the most overworked words in English lexicon is the word “communication”. It has almost lost its meaning and effectiveness. The tools necessary for achieving the nirvana of forgiveness are understanding and empathy, both of which are achieved through communication, talking, sharing feelings and ideas. Forgiveness is not achieved through virtual reality. Two people must see each other, talk to each other, and possibly touch each other before forgiveness takes place. One must have not only a sense of sympathy for the other person’s pain and discomfort, but empathy, to feel the pain that the other person is experiencing. There are many alienated children, parents, and in laws who fall prey to this circuitous labyrinth of hatred, intolerance and “I will not say a word to that person as long as I live” diatribe. To hate, to resent, and to avoid wastes enormous emotional energy aimlessly directed at draining, depleting and destroying.

The evil acts of September 11, 2001 have posed an unprecedented ethical challenge. How do we, as a decent and civilized nation, respond? These events have clearly demonstrated that the answer to world ills does not come solely through advanced technology and inflated stock market values. America is the most decent and generous nation on earth. The supremacy of the rule of law, and not of kings, Shahs and Ayatollahs, guaranteeing every American the dignity of individual human right, is unprecedented.

However, In the 1950s, with lingering cold war and the age of Sputnik, America accelerated programs of science, math, and technology. While these advances are essential, we are just beginning to learn that the ultimate answer to the world’s problems lies with better understanding of ourselves and those who hate us. In this terror driven world, we must resolve to learn more about ourselves through introspection, reflection and self- examination. As an act of thanksgiving, it might be a good idea to dedicate ourselves and a portion of our time to be more prayerful, more reflective, more knowledgeable, and more altruistic. Also, it is a good time to go see and call on those family members and friends whom we have long resented. Let’s replace the beta carbolines of our brain with endorphins and dopamines.

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*The writer is Adjunct Professor of Psychiatry, University of North Carolina School of Medicine at Chapel Hill, Distinguished Life fellow American Psychiatric Association, and Founding Editor and Editor-in-Chief, Wake County Physician Magazine (1995-2012). He received Raleigh Medal of Art in 2001, inducted to Raleigh Hall of Fame 2013, elected Lifetime Trustee, North Carolina Symphony in 2015, and 2016 recipient of NC Award, Fine Arts.

 

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On Reflection…

Monday Musings for Monday September 2, 2019
Volume IX. No, 35/446

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Some Reflections

By: Assad Meymandi, MD, PhD, Sc D (Hon), DLFAPA*

Homosexuality in Iran

I fully agree with the President of Iran that there are no homosexuals in Iran. They hang them.

Psychiatric illnesses Caused by Fowl Biochemistry

Here is a bit of medical sleuthing in regards to many psychotic and depressive states that are clearly caused by medical conditions: A patient told me that his father became “insane” after he was diagnosed to have lymphoma. The word “insane” and “psychotic” should trigger in a physician’s mind the necessity to exclude all organic and chemical causes.

From history, we know King George III became dangerously ill. His malady was porphyria. By 1811, George III had become permanently insane and was locked away at Windsor Castle until his death. Sometimes speaking for many hours without pause, he claimed he talked to angels. One day on a drive through Windsor Great Park, the king threw his arms up into the air and shouted, “Stop!” He alighted, walked over to an oak tree and shook hands with of its branches. He spoke for several moments before a footman asked him if he was feeling well. The king replied, “Of course I am. Now, do not interrupt me, Sir. I am talking to the King of Prussia.” (That was of course King Wilhelm II of Prussia.) To treat his illness, his doctors gave him James’s Powder which is calomel and tartar emetic, and bled him.

Porphyria is a disease of the enzymatic system where porphyrine synthesis is inadequate or interfered with. It is hereditary. From what you told me about your father, he may have had this illness.

Throughout my 50 plus years of medical practice, I have seen 15 cases of psychosis caused by porphyria. We did not use James’s powder and we did not bleed them. We took care of them and many of them are living and leading productive lives.

Treating Depression With A Scalpel

The tragic death of the late Senator John East, the Republican Senator from NC, is another example of how biochemical imbalance may lead to depression and suicide. Sen East had a parathyroid adenoma causing hyperparathyroism with sky high serum calcium and parathyroid hormone (parathormone.) It is well known that this condition causes depression and very often leads to suicide. Symptoms of hyperparathyroidism are manifold and malignant, among them gastric and peptic ulcer disease, hypertension, stone formation in pancreas, kidneys and gall bladder. Many of these patients, because of multiple symptoms are labeled “crocks” in emergency rooms and cmedical clinics. Their complaints are often not taken seriously. Wiith surgical intervention and removing the most likely parathyroid adenoma, the patients come out of their depression almost instantly and miraculously. Over the years, we have compiled over 30 of these cases.

Opportunity for Health Care reform in America

It is well known that the cost of health care is breaking the back of most auto manufacturing companies. Recently, United Automobile Workers Union reached an agreement with General Motors to essentially deal with the health issues in a radically different manner. The management and UAW’s leadership agreed to exchange company-provided retiree health care an a long standing insistence on equal pay for all workers in return for commitments to invest in plants and fund 29.9 billion dollars for a new health care trust. This is a tremendous opportunity for the UAW to educate their 70,000 employees that this their trust fund. The money is theirs and they spend it frugally. For those who under use medical facilities and devote their efforts in prevention, there is a cash reward at the end of the year. It ill give the workers a sense of “ownership” of their health care knowing that the money is theirs and it comes out their pocket when they use it. This is exactly what Hospital Savings Accounts do in Singapore. To put the patients in charge of their health care by promoting prevention, weight loss, cessation use of tobacco and alcohol and staying fit. In return take the left over cash and use it for their children’s education and other necessities.

Thanks Goodness, the Waste is Over!

The schools are open again. My daily walk takes me by our neighbourhood elementary school. I hear the air conditioners humming and the electric lights burning. The fields are beautifully mowed, and the sidewalks properly scrubbed. I also see chairs stacked, doors locked and not a soul in sight. There are no children. What a waste! I don’t mind to pay taxes, and really, I don’t even mind to give my life for our Republic. The liberty we enjoy and the freedom given to us are American values worth dying for. But I do mind waste. These huge spaces that go unoccupied during the summer months represent a set of misguided, narcissistic and short-sighted values. They do not represent American values. We have boldly substituted profligacy for progress and indulgence and self pampering as individual rights. It is an abomination.

I have been following the school system in Philadelphia, one of the worst historically. a decade ago more than one half of its students were “below basic” on state assessment tests. The former Governors Tom Ridge and Mark Schwieker have turned things around. They privatized education, hired Paul Vallas, the successful educator from Chicago and appointed him as superintendent of the district’s 264 schools. The private providers have turned the bleak Philadelphia school system around. In the short period of ten years, proficiency in reading, math and science has risen by 41%.

I believe we need reasonable people in position of leadership to cut waste, stop inefficiency and prevent broker fees of three quarter milllion dollars in land transaction involving Wake County school system. Surely, we must have several Paul Vallas type people in our midst

To my Amazonian/Brazilian Brethren and Colleagues:

Your ancestral home, the holy and ancient land of gods is on fire. I have been thinking of you. The scenes on TV screen somehow remind me of Dante’s inferno. Dante to the Italians is like Shakespeare is to British, the Declaration of Independence is to America and Iliad and Odyssey are to Greeks. Dante’s work, a sort of psychological self help book carries the promise of eternal peace and how to achieve it. I do hope that the Greece on fire and the frightened Greeks with their scorched faces shown on TV will, like Dante, find final peace and relief from the present day inferno. I wish you well.

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*The writer is Adjunct Professor of Psychiatry, University of North Carolina School of Medicine at Chapel Hill, Distinguished Life fellow American Psychiatric Association, and Founding Editor and Editor-in-Chief, Wake County Physician Magazine (1995-2012). He is a dramaturge. Received Raleigh Medal of Art in 2001, inducted to Raleigh Hall of Fame 2013, elected Lifetime Trustee, North Carolina Symphony in 2015, and 2016 recipient of NC Award, Fine Arts.

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On the Future…

Monday Musings” for Monday August 26, 2019
Volume IX, No. 34/446

dr-michio-kaku

Book Review: Michio Kaku’s “The Future of the Mind”

By: Assad Meymandi, MD, PhD, Sc D (Hon), DLFAPA*

 

The Future of The Mind

342 pages of text
10 pages of meticulously indexed notes relevant to each discussion
61 pages of index
Doubleday Publishing Company, Inc.
New York, London, Toronto, Sydney, Auckland

Review of Science Books Series

When a publisher sends a book for review, I routinely cast an editorial “screening” glance to separate substance from fluff by noting the book’s proportion of text to notes, bibliography, and index. A scholarly and substantial book usually carries an extensive set of notes and references for documentation of almost every line of the book. A high volume of notes and an extensive bibliography assure the reader that the book is not fluff. Such is the book “”The Future of The Mind” by Dr. Michio Kaku, Professor of Theoretical Physics at the City University of New York (CUNY). The book’s subtitle is “The Scientific Quest to Understand, Enhance, and Empower the Mind”. The book does all that and more. Faithful readers of this space recall our review of books by psychiatrist Eric Kandel, 2000 Nobel Laureate in Physiology or Medicine, “The Emergence of the New Science of Mind”, Stephen Hawking’s book “Standing on the Shoulders of Giants”, 1989 Nobel Laureate in Medicine or Physiology “Retroviral Oncogenes”, by Harold Eliot Vamus, and many others. This book is a continuation of the series on science.

First, a word about the author:

As you see in the picture, Michio Kaku is of Tibetan descent. His grandfather immigrated to the United States to work in the cleanup efforts following the devastating 1906 earthquake in San Francisco. Dr. Kaku was born on January 24, 1947, in San Jose, California. He first became attracted to science as a young child, and while a student at Cubberly High School in Palo Alto, he famously built an atom smasher in his parents’ garage. He eventually landed at Harvard University, where he graduated first in his physics class in 1968. From there it was on to the University of California at Berkeley, where he worked at the Berkeley Radiation Lab and earned his Ph.D. in 1972. The following year Kaku lectured at Princeton, but not long after, the Army drafted him. He was trained as an infantryman but was spared combat when the Vietnam War ended shortly before he was scheduled for deployment.

“The Future of the Mind” is Kaku’s ninth book. In my view he is a symphonist like Beethoven, Shubert, Mahler, and others, with nine symphonies. I think this, his latest book, is very much like Beethoven’s Ninth. It is not just plain physics, raw science and equations, but an intellectual celebration of possibilities. The book carries with it spiritual and artistic messages. For example, in the chapter about Einstein’s brain, the author speaks of plasticity of the brain, refuting the past notion that brain does not grow. He brings in subliminally Pauline theology of redemption, possibilities and hope. Brain grows…brain matures…brain gets bigger…brain gets “smarter”

The volume consists of an acknowledgment listing the names of 11 Nobel Laureates, followed by six and a half pages that contain the names of luminaries in science, technology, nano-technology and journalism. They include Ann Druyan, widow of Carl Sagan of Cosmos Studio and John Donoghue, creator of Braingate (see below). Physicians acknowledged include Francis Collins, Director of the National Institutes of Health (University of North Carolina Medical School alumnus) and many bioethicists and environmentalists. The acknowledgment clearly reflects the author’s vast contacts. It also presents his humility and humaneness. The acknowledgment is followed by an introduction and three books.

Book I:

The Mind and Consciousness, and his viewpoint of consciousness;

Book II:

Mind over Matter deals with mental telepathy, and telekinesis, and moving objects by will through thoughts and memories. It offers explanation about Einstein’s brain with the promise that we can be smarter, and our brain can grow. He gives the example of a 2011 study that analyzed the brains of “London’s famous taxicab drivers who have to laboriously memorize 25 thousand streets in the dizzying maze that makes up modern London. It takes three to four years to prepare for this arduous test, and only half of the trainees pass. The brains of the cab drivers who successfully passed the test were studied several years after the test, and it was found that the brains of the taxi drivers who passed the test successfully “were bigger and grown in volume.” He proposes while geniuses are born, brain’s capacity to grow and become “smarter” is undeniable. The evidence of plasticity of the brain and its capacity to grow, presented in Book II, are most exciting. This is where I make the connection between Kaku’s science and Pauline theology of hope, redemption, and possibilities. This is where I hear Beethoven Ninth’s message of joy belonging to human race…

Book III:

Altered Consciousness elaborates on a most attractive and comprehensive tour de force of artificial intelligence, mind as pure energy, and finally, the future of the mind. The protean nature of the topics discussed in Book III reflects the author’s vast interests and penetrating curiosity. It has meritorious discussion on the diagnosis and treatment of depression. He cites the work of Dr Helen Mayberg and colleagues at Washington Medical School. Using brain scans, they identified an area of the brain, called Brodmann area 25 (also called the subcallosal cingulate region) in the cerebral cortex that is continuously hypoactive in depressed individuals. Deep brain stimulation (DBS) has astonishing results in relieving depression. Of course, clinically, we reserve this approach for those patients who are treatment resistant and do not respond to pharmacotherapy and psychotherapy.

The chapter on telekinesis illustrates cosmologist Stephen Hawking, a victim of Amyotrophic Lateral Sclerosis (ALS or Lou Gehrig disease) whose many books we have reviewed in this space (the latest was “Standing on the Shoulders of Giants”) wore a neuroprosthetic device attached to his glasses with a special feature. Like an Electroencephalogram (EEG or brain wave test machine), it could connect his thoughts to a computer to maintain some contact with the outside world.

These neuroporostheses have profound effect on improving the quality of life of ALS patients, and of those who are quadriplegics, such as stroke victims. He cites the heart rendering story of Cathy Hutchinson who was “trapped” in her body, quadriplegic, for 14 years as the result of a massive stroke. Brown University scientist John Donoghue and colleagues placed a tiny chip on the top of her brain called Braingate (see above reference to John Donoghue) which is connected by wires to a computer. By simply thinking, she gradually learned to control the motion of her arm so to grasp objects. Her thoughts or intentions are translated into action. This is the nearest thing to a modern day miracle.

The book looks into the future of artificial intelligence (AI) and its possibilities. The work of futurist Ray Kurzweil who received his PhD at MIT under Marvin Minsky, one of the founders of artificial intelligence, is cited. Dr. Kurzweil has predicted that by 2019, a $1000 PC will have the computing power of the human brain—twenty million billion calculations per second. He proposes that this number was not grabbed out of thin air. It is obtained by taking the one hundred billion neurons of the brain, multiplying one thousand connections per neuron, and two hundred calculations per second per connection.

As an aside, it might be useful to say a few words about the new age of connectomics. We have had genomics, proteomics, and now we have entered connectomics which is the field of study of connectomes, and production of comprehensive maps of connections within an organism‘s nervous system, typically of the brain. These maps are being developed and studied with enormous speed. Harvard biologist Jeff Lichtman has devised a contraption, connecting a giant electron microscope to Magnetic Resonant Imaging (MRI) and functional MRI (fMRI) taking pictures of the connections of the neurons in the brain. The number of connections is astounding. It is in the trillions. Now back to the prediction of futurist Ray Kurzweil:

By 2029, a $1000 PC will be a thousand times more powerful than the human brain and the work of futurist Kurzweil;

By 2055, $1000 of computing power will equal the processing power of all human brains on the planet.

What is most impressive, this book, Kaku’s ninth which I call his Ninth Symphony, just like Beethoven’s Ninth, gives the reader a sense of transcendence and elevation. Like Beethoven’s Ninth, listening to the celestial voices of the Chorales singing “Freude, Tochter of Elyzium, deine Zauber binden weider was die Mode stren geteilt; alle mencchen werden Bruder who dein sanfter weilt.” “Joy, daughter of Elysium, your magic again units all that custom harshly torn apart, all men become brothers beneath your gentle hovering wing”, in Kaku’s latest book, I felt like I was floating among myriads of angels of hope, comfort, promise and beauty. Who knows, Kaku might be related to Beethoven or maybe Dali Lama. Reading Kaku elevates Augustinian awareness of the gift of our brain, this 2.5 pounds of mystery given to us for free, a sheer act of grace. We must enjoy discovering our brains by learning more and more, the highest form of joy. The latest work of Michio Kaku The Future of The Mind is all music and no noise. I highly recommend it to readers of all ages.

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*The writer is Adjunct Professor of Psychiatry, University of North Carolina School of Medicine at Chapel Hill, Distinguished Life fellow American Psychiatric Association, and Founding Editor and Editor-in-Chief, Wake County Physician Magazine (1995-2012). He is a dramaturge. Received Raleigh Medal of Art in 2001, inducted to Raleigh Hall of Fame 2013, elected Lifetime Trustee, North Carolina Symphony in 2015, and 2016 recipient of NC Award, Fine Arts.

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On Humanities and Science

Monday Musings for Monday August 19, 2019
Volume IX. No, 33/445

John Templetontownes_charles_small

Sir John Templeton                                 Dr. Charles Townes

 

Religion, Spirituality, The Arts, Healing and Medicine

By Assad Meymandi, MD, PhD, DLFAPA

The relationship between religion, spirituality, healing, medicine, the arts, music and love is most intriguing. While polemicists pontificate, philosophers argue, clergy and Mullahs parse, and poets and artists beneficently float us in the cosmic rays of their warmth, it is the scientists who have doggedly pursued the subject producing data driven papers to lead us on the road to certainty and knowledge. One of my favorite poets Irish William Butler Yeats (1865-1939) measures human achievement by these simple lines. “In life, we should have high laughter, elevated love and magisterial conversation.” Scientists are beginning to discover that transcendence brings about all of that and more…It brings on healing, reduction of pain and suffering, increase concentration levels of brain endorphin and dopamine. It facilitates up-regulation of a cascade of positive and life giving psychoendocrinological events in the bowls of our brain that bring good feelings and joy.

As early as 1950’s, scientists ran an experience dividing two groups of patients at Columbia University Eye Center. Patients with retinal detachment post-operatively were divided in two groups. One group received religious help and the control group did not. The rate of healing and hospital discharge in the first group was statistically higher than the control group. Over the last 50 years, many studies sponsored by the National Institute of Health have gradually produced evidence that transcendence should be a part of the medical black bag.

In recent years we have seen more and more scientists who are interested in the arts, humanities and religion. These scientists follow trail blazers such as Aristotle (384- 322 BC) the Greek supreme rhetorician/philosopher/biologist/taxonomist all wrapped in the cloak of theology; the Persian Physician and scientist Abu Ali Sina or Avicenna (908- 1037), the renowned Jewish physician theologian and humanist, Moses Maimonides of Cordoba (1135-1204). Stories about Moses Maimonides are abound that he seldom saw a patient without having a prayer in heart and a verse of Talmud on his lips. More needs to be done to bridge the gap between basic sciences an the arts and humanities. NC boasts the presence of the National Humanities Center in RTP. The Center attracts learned men from all walks of lives in humanities, and offers them the opportunity to come in residence for one year and pursue their literary ambition at the Center. Recently a special Fellowship was established to bring eminent scholars and basic research scientist of Nobel Prize caliber who are interested in humanities and religion to the Center. Dr. Edward O. Wilson, Harvard Professor of Entomology (the antsman), father of sociobiology and author of over 20 books, most on New York Times best seller list was the first Assad Meymandi Fellow, spring 2003. We all had the privilege of his lecture when he visited RTP, North Carolina.

Sir John Templeton (died in 2008, age 96) established an annual prize awarded to the one scientist who is most involved and interested in making progress toward research or discoveries about spiritual realities. 2005 winner was Charles Townes (died in 2015, age 100), co-inventor of the laser and a Nobel Prize-winner in physics. His writings about relating science and religion take up where Aristotle and Avicenna left off. They are truly the blueprint of an exciting future in scientific discovery and application of an integrated approach to the use of religion in science. The John Templeton prize is the richest in the world. The 2005 prize was worth 795,000 British pounds or 1.75 million dollars. Dr. Townes who has already won the Nobel Prize for the discovery of laser (light amplification by stimulated emission of radiation) and maser (microwave amplification by stimulated emission of radiation) in 1964 teaches Sunday School at NY City’s Riverside Church. When at MIT, his fellow students made fun of him because of his religious beliefs. In his acceptance speech he said that his doctoral adviser at California Institute of Technology “jumped on me for being religiously oriented.”

Dr. Townes was born and raised in Greenville, SC. He graduated from Furman University before earning graduate degrees at Duke University and Caltech. He has compared his flash 1951 discovery of maser principles while sitting on a park bench in Washington with the revelations depicted in the Bible. He contended that it “seems extremely unlikely that the existence of life and humanity are just accidental.” Dr. Townes had an exciting mind. He wrote extensively on optical searches for intelligent life elsewhere in the universe. He received the prize in a private ceremony at Buckingham Palace in London. He donated a major part of the money to Furman University, the Pacific School of Religion, the Center for Theology and the Natural Sciences, the Berkley Ecumenical Chaplaincy to the Homeless and Berkley’s First Congregational Church.

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*The writer is Adjunct Professor of Psychiatry, University of North Carolina School of Medicine at Chapel Hill, Distinguished Life fellow American Psychiatric Association, and Founding Editor and Editor-in-Chief, Wake County Physician Magazine (1995-2012). He is a dramaturge. Received Raleigh Medal of Art in 2001, inducted to Raleigh Hall of Fame 2013, elected Lifetime Trustee, North Carolina Symphony in 2015, and 2016 recipient of NC Award, Fine Arts.

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On Gun Violence…

Monday Musings for Monday August 12, 2019
Volume IX., No. 32/449
gun rack

Gun Violence Control, Where is the Wisdom?

By Assad Meymandi, MD PhD, ScD (Hon), DLFAPA*

The horrific mass shootings of last weekend left at least 31 dead and many more injured,

The former President Obama called the massacre of 20 innocent children and six adults on Dec 27, 2013, in Sandy Hook Elementary school in Newton, Connecticut, the worse day of his presidency. History tells us that every president since GW has had a/the worse day. For George W Bush it was September 11, 2011, for FDR it was Pearl Harbor, December 7, 1941. All our 45 presidents have had the worse day in their presidencies. It would be a meritorious project for some PhD candidate in history to compile a volume on every US Presidents’ worst day in the office.

We thought and hoped that the December 27 occurrence was a turning point in the debate over guns in America. But it was not. Last month’s deadly shooting at Marjory Stoneman Douglas High School in Parkland, Florida, was just the latest example of gun-related violence targeted at students, often by individuals not much older than themselves. The statistics are staggering: The first four Months of 2018 (real-time data, May 1st): -4,685 gun deaths -8,301 gun injuries -196 children shot/killed -819 teenagers shot/killed. The numbers are logarithmically increasing and the dynamics of these violent acts are becoming more complex.

A brief review of the history of gun violence, especially since the 1960s, might be helpful. We remember the University of Texas clock tower in Austin Texas, then in the 70s Kent State University Massacre, in the 80s. Cleveland School mass killing and the 90s several schools, including Columbine High School, mass shooting at Virginia Tech, not counting mass murders in other facilities including Sikh Temple, army bases and others, the numbers are staggering. But none was as gruesome as the Sandy Hook massacre. Everyone seems to agree that these tragedies must end.

After the December 27, 2013 shooting, the then Vice President Joe Biden chaired a task force to examine the issue by holding extensive public hearings in which expert testimony was given by representative of American Psychiatric Association (APA), American Medical Association (AMA), American Bar Association (ABA), and forensic authorities were collected. A report was compiled but no action took place. The matter became politicized, National Rifle Association (NRA), Democrats, Republicans, Second Amendment to the Constitution all began spinning in the media. Gun control advocates brought in an extensive agenda, namely tougher penalties for ill gun sales, increased school safety programs, expanded background check for gun buyers and mandate to keep guns out of the hands of criminals and folks with history of mental illness. Republicans and NRA saw this as unnecessary interference by government. So a compromise was generated by Senators Joe Manchin, a Democrat from West Virginia and Patrick Toomey a Republican from Pennsylvania, focusing attention on background check. It failed.

Issues like gun violence control, abortion, and cloning carry within their constitutional DNA a huge dose of controversy. My focus in this essay is a dispassionate and analytic examination by separating the hype and hysteria from reality and data. It is hoped that cool heads and wisdom will prevail.

In the debate of gun violence mental illness has gotten a bad rap. The alleged connection between mental illness and mass violence is not supported by objective data and science: “substantial research shows that the vast majority of people with serious mental illness never act violently, and the vast majority of violent crimes -96 % by the best available data-is not perpetrated by persons with mental disorder” said Paul Appelbaum, Past President of APA, Professor of Psychiatry, Medicine and Law at Columbia College of Physicians and Surgeons. What we need to do is to face and design program of mental health care instead of warehousing the mentally ill in jails and prisons.

The APA position which I am advocating is to appoint a presidential commission to develop a vision for a system of mental health care, creating a mechanism for facilitating responses to key mental health issues such as designating a White House point person, improving early identification of youth with mental health problems and developing sensible, nondiscriminatory approaches to ensuring that dangerous individual cannot gain access to guns. In his report and testimony Dr Appelbaum stated that people with mental illness who are engaged in regular treatment are considerably less likely to commit violent acts than those who need but do not receive appropriate mental health treatment.

Another expert testimony at the Vice President Task Force was Dr. Thomas Insel, the then Director of National Institute of Mental Health stated that “Suicide, not homicide, is the most urgent public health problem associated with gun violence. About 90% of suicides involved individuals with mental illness. Dr. Insel reported that “the popular association of homicidal violence and mental illness is tenuous at best..” Despite common public perceptions, there is little connection between gun violence and mental illness. Only 6 percent of violent crimes are committed by someone with a diagnosed mental illness, as opposed to 96 percent suicides that are associated with mental illness.

What to Do?

First and foremost, for gun ownership, a universal background check should be implemented. We should ban assault weapons.

For more than 55 years, I have been involved in various capacities with the North Carolina mental health system. At no time the services to and for our patients have been as chaotic, sparse, and erratic as they are today. Fifty years ago, in North Carolina, we had a system in place that was truly superb. At Dorothea Dix Hospital, where I received my psychiatric training, in the late 50’s and early 60’s, patients had predictable, excellent, and academically cutting edge treatment available to them with ready access. No patients had to wait for days and in some instances for weeks in emergency departments of general hospital waiting for a bed. And no patients were put in jail and prisons because of lack of mental health treatment and shortage of psychiatric beds. We have certainly devolved and regressed. Taking care of patient with mental illness–and really it is brain disease—is a moral responsibility about which Thomas Jefferson and our country’s other founding fathers expounded.

dad_sig_pic*The writer is Adjunct Professor of Psychiatry, University of North Carolina School of Medicine at Chapel Hill, Distinguished Life fellow American Psychiatric Association, and Founding Editor and Editor-in-Chief, Wake County Physician Magazine (1995-2012). He is a dramaturge. Received Raleigh Medal of Art in 2001, inducted to Raleigh Hall of Fame 2013, elected Lifetime Trustee, North Carolina Symphony in 2015, and 2016 recipient of NC Award, Fine Arts.

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On Epigenetics…

Monday Musings for Monday August 5,2019
Volume IX. No. 31/448

DNA

Epigenetics and the Bible—Brain and Behavior

By Assad Meymandi, MD, PhD, ScD (Hon), DLFAPA*

It seems a bit odd to start a discussion of cutting edge, up to the minute, science of epigenetic with an ancient Biblical story: Genesis chapters 41 through 47 talks about the Egyptian Pharaoh’s dream of “seven years of plenty and seven years of famine…” Well, here is the relevance of the Old Testament to this cutting edge 21st century science.

There is a place in northern Sweden called Norrbotten sparsely populated, six people per square mile that has offered astonishing epidemiologic and scientific data which have given birth to the science of epigenetics. In 19th century Norrbotten there were literally seven years of famine followed by good harvest and abundance of food. For instance, 1800, 1812, 1821, 1836, and 1856 (the year of potato famine in Ireland) were years of total crop failure and famine for the people of Norrbotten. But in 1801, 1822, 1828, 1844, and 1863, there was excellent harvest and abundance of food. Scientists of renowned Karolinska Institute have taken the painstaking work of tracing the effect of this famine and feast to see how it affected the lives of the children. With these studies, they have established “life conditions could affect your health not only when you were a fetus but well into adulthood”, concluding that “Parents’ experiences early in their own lives change the traits they passed to their offspring.” The result of the study is that the years parents were well fed; their children grew up to be healthier and physically bigger offspring.

In 1967, when the writer was director of Cumberland County Mental Health Center, applying for a grant for the Head Start program, I used a study by Karolinska Institute which was published in the Acta Physiologica Scandinavica, and Lancet, demonstrating that fetus and fetal central nervous system (CNS) exposed to excess secretion of maternal catecholamines and its metabolites, especially metanephrines, vinyl mandellic acid, and 3-methoxy 5-hydroxy methyl glycol (MHPG) produces babies that are more irritable, scrawny, cranky, susceptible to Attention Deficit Hyperactive Disorder (ADHD), and prone to anxiety, phobia and social maladjustment. The project titled “Intrauterine Head Start” was funded and our findings were published. So, the knowledge of environmental influence on fetus is not new. What is new is the epidemiologic studies from Norrbotten in defiance of Darwin’s assertion in his seminal work “On the Origin of Species”, 154 years old coming November 2013 (I will have another ‘MM’ in November marking the anniversary of this seminal work), that evolution takes place over millions of years. The Norrbotten studies suggest that evolution and environmental influence affect genes in one or two generations. It does not take millions of years. This is heretical. Suddenly, we have evidence that Darwin was wrong! It takes only 25 to 75 years, one to three generations, and not millennia for evolution of genes to take place.

What is epigenetics?

The exciting science of epigenetics as the name implies is “the study of changes in gene activity that does not involve alteration to the genetic code but gets passed down to successive generations…” It is very much like a switch on the outside of the genetic circuits and genome that influences the behaviors of a gene. The very word epi means above explains that this activity while not an integral part of an organism’s genetic code, from outside or above influences the gene’s activities. In essence it is like a switch that may turn on or off the activity of a gene.

In Utero Cell Differentiation

A cell in the kidney and the cell in the brain, a neuron, have the exact same DNA. The nascent cell can differentiate only when crucial epigenetic processes turn on or turn off the right gene in utero. This is why studies of identical twins show why one sibling develops asthma or bipolar disorder, even schizophrenia while the other is perfectly normal. The studies from Norrbotten clearly show that because of epigenetic switch you can pass down epigenetic changes in a single generation.

There are several epigenetic drugs on the market. 5-Aza-cytidine (produced by Celgene Corporation is an example of an epigenetic drug that prolongs the life of patients afflicted by severe myelodysplastic syndromes, MDs). By turning a switch that is outside of the genome sitting on DNA, one enhances (turns the gene on) or inhibits (turns the gene off) of DNA’s activities. Cutting edge science is after discovering how to enhance the activities of the good genes and how to silence and discourage the activities of the bad genes. The task is not very difficult. To chemically turn on the good switch is to introduce a methyl group (CH3) to the side chain of DNA, a very simple procedure. Or vice- versa, remove demethylate (take the methyl, CH3 group off) the compound and suppress the activities of the bad genes. In recent years FDA has approved three other epigenetic drugs that are thought to stimulate tumor suppressing genes. It is hoped that we will find drugs that turn off expression of genes of many diseases including cancer, Alzheimer’s, autism, and schizophrenia, even alcoholism.

In the case of Alzheimer’s disease, where blobs of starch like gunk or amyloids are deposited in the brain interfering with transmission of messages in nerve cells (neurons) causing dementia, by using the instrument and knowledge of epigenomics, it is conceivable to find the switch (the epigenome) that turns off the dumping of amyloid in the neural synaptic clefts. Currently, the National Institute of Health is investing heavily in better understanding and codifying epigenomics. The Human Genome project completed in March 2000 found that the human genome contains approximately 25,000 genes. Private enterprise, and Craig Venter, who won the Nobel Prize in Medicine or Physiology in 2005 bested government bureaucracy and completed the project ahead of the government by two years. We had Venter’s book reviewed in this space a few years ago. Now we need a massive project to identify the epigenome and compile the human epigenomic book. The number of epigenomes far exceeds 25,000 and the cost of completing the project will cost hundreds of billions of dollars. Besides, it will cause a bad case of Darwinitis. We will keep you posted as the science of epigenomics further develops.

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*The writer is Adjunct Professor of Psychiatry, University of North Carolina School of Medicine at Chapel Hill, Distinguished Life fellow American Psychiatric Association, and Founding Editor and Editor-in-Chief, Wake County Physician Magazine (1995-2012). He is a dramaturge. Received Raleigh Medal of Art in 2001, inducted to Raleigh Hall of Fame 2013, elected Lifetime Trustee, North Carolina Symphony in 2015, and 2016 recipient of NC Award, Fine Arts.

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On Brain Disease

Monday Musings for Monday July 29, 2019
Volume IX. No. 30/447

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Schizophrenia (Part II)

Spirituality in Treatment of

Schizophrenia

By Assad Meymandi, MD, PhD, ScD (Hon), DLFAPA*

It was a hot day in Fayetteville, North Carolina. The August sun was beating down. You could fry an egg on the sidewalk by Cape Fear Valley Hospital. The thermometer at the Savings and Loan Bank registered 101. The climate on the street felt like something between a Turkish bath and a green house.

I had just gotten back from lunch and was seeing my first patient at of the afternoon at 1:00 o’clock. My personal secretary buzzed me. We had a strict rule that my sessions with patients would not be interrupted unless it was an emergency, like life or death. So her interrupting me must have been very important. It was. I answered the phone. My secretary was very upset. All she said was that I ought to step out and see a patient who urgently needed help.

The patient was a young man in his early twenties. He was gaunt, emaciated, a shell of a man, a mere shadow of a person. He was tall, unshaved, with matted hair and sunken eyes. His clothes were torn and his bare feet were caked with dirt. There was a stench of body odor, old dried sweat and neglect surrounding his handsome frame. His parents said that he had not eaten any food in four days. They reported that he had refused all forms of liquids, even Mountain Dew, his favorite drink. He had not slept for four days. Earlier that morning they had found him in the barn behind the house with a large butcher knife trying to cut his throat. The family was a kind and gentle sort. They were farmers in a rural community near Fayetteville who grew tobacco, peanuts and soy beans. The family was well established and their farm dated back several generations to the Civil War.

I approached the young man and extended my hand to shake his. He ignored me. He was looking away, mumbling something to himself, something that his parents called “gibberish.” They said that he had been saying the same thing, like some kind of mantra, day and night for four days. We quickly ruled out the possibility of alcohol and substance-induced psychosis because his parents had been with him day and night during his illness, and he had no intake of food or water, much less drugs or alcohol. He was locked up in his own closed world.

I noticed that he was agitated with a fine tremor in his hands, yet there was a sense of peace and calm about him. There was no question that he was psychotic, hallucinating and delusional. He was completely disconnected from his environment and those who were in the room with him, including his sweet and distraught mother. I took the patient to one of the examining rooms in my office. I listened carefully to what he was mumbling, what his parents and the family were calling “gibberish”. After careful listening and paying attention to the faint movements of his lips, I heard scattered words in a staccato and dysrhythmic manner. I heard “lamb of God…sacrifice…lamb of God…Jesus the Lord…” I asked Bryan (not his real name) to tell me more about the Lord, Lamb of God. He ignored me. We just sat there patiently with my request repeated. Without pushing him, I made it known that I would listen if he wanted to tell me more about the Lord, Lamb of God.

He began to throw skulking glances in my direction. His hand furtively approached my hand resting on the arm chair and extended in his direction. He finally said that he was Jesus, Lamb of God and wanted to be sacrificed for the Lord. A thought occurred to me like a stroke of lightening. I said, “The Lord does not want such a skinny and nervous lamb to be sacrificed for Him. Why don’t you eat, fatten up, and take some medication to calm you down, so that you will be worthy of the sacrifice?” Somehow he connected with the promise of turning him into a more sacrifice-worthy lamb. He took a sip of water, and gradually ate some food. Then he accepted some intramuscular medication consisting of Thioridazine (Mellaril) and Benzodiazopine (Valium), state of the art medications in the 1960s. He took more food and drank some Mountain Dew before he was admitted to the hospital.

When I made rounds that evening, he greeted me with some degree of warmth, his fulminating acute psychosis subsided. He gradually calmed down, rested and ate. In the following days, through psychotherapy we explored the genesis of his psychotic breakdown. He continued to recover with full restoration to health. We never brought up the subject of his wanting to be a sacrificial lamb, because through therapy, he learned how to become an “I” and stop being a “me”, a lamb-like subject who could be manipulated by people around him.

Several months ago, a fat packet came to me in the mail from Bryan. It was an invitation to the bicentennial anniversary of his farming village. Interestingly, my former patient, now in his early sixties, was listed in the program as the leading citizen of that community and the convener (master of ceremonies) of that day’s festivities.

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*The writer is Adjunct Professor of Psychiatry, University of North Carolina School of Medicine at Chapel Hill, Distinguished Life fellow American Psychiatric Association, and Founding Editor and Editor-in-Chief, Wake County Physician Magazine (1995-2012). He is a dramaturge. Received Raleigh Medal of Art in 2001, inducted to Raleigh Hall of Fame 2013, elected Lifetime Trustee, North Carolina Symphony in 2015, and 2016 recipient of NC Award, Fine Arts.

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On Brain Disease

Monday Musings for Monday July 22, 2019
Volume IX. No. 29/446

schizophrenia1

GOOD NEWS: CELEBRATING THE GOSPEL OF SCIENCE

By Assad Meymandi, MD, PhD, ScD (Hon), DLFAPA*

In the limited life span of Neolithic man, roughly ten thousand years, we have experienced stunning advances in knowledge, humanities, civil and individual rights; and with the birth of our beloved America, a perfection and maturation of the rule of law. These are all good news, indeed Gospels. But what stands out, if one would do a meta-analysis of all factors advancing the cause of life and advocating the dignity of humankind, is the field of science and its contribution to improving the quality of life.

Let’s take the case of understanding and treatment of schizophrenia, a dreaded brain disease. Yes, I said brain disease. We have come far from the days of demonic etiology of schizophrenia, the days of snake pits, and inhumane treatment of patients with schizophrenia (note: I did not call these patients schizophrenics. They are individual suffering from schizophrenia) The life giving transformation of care by pioneer institutions, such as England’s Bethlehem Hospital and our own Dorothea Dix Hospital, followed by the emergence of community psychiatry are eloquent testimonies of the evolution of care of severely ill psychiatric patients.

What is currently filling our psychiatric literature and journals is most promising. We are in the throes of making new scientific discoveries based on neurochemistry and high resolution MRI. We are learning that schizophrenia is a diseased or disarrayed neuronal web in the central nervous system, especially the brain.

Research scientists in neurobiology are in hot pursuit of finding an effective pharmacological agent to help treat schizophrenia. We have learned about the cholinergic neurotransmitters, the muscarinic and nicotinic neuro-receptors and dopamine1 and dopamine 2 agonists and antagonists.

A new group of drugs now under investigation, cholinergic agonists, mediated by two families of receptors, nicotinic and muscarinic receptors are in the final phase of clinical investigation. The nicotinic receptors are ligand-gated ion channels formed by pentameric (5) combinations of different a and b subunits, as well as homomeric (consisting one repeated unit) receptors. Activation of the nicotinic receptors leads to a rapid increase in sodium and/or calcium conductance that increase neuron activity and neurotransmitter release. This explains why persons afflicted with schizophrenia have such a hunger for cigarettes.

Saint Paul, a fascinating brain, and an elegant stylistic writer summed up the future of mankind in offering hope, charity and love. What science does for us is a combination of all three. It takes a tremendous amount of motivation and discipline (charity), tenacity and optimism (hope) and dedication and altruism (love) to pursue science.

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*The writer is Adjunct Professor of Psychiatry, University of North Carolina School of Medicine at Chapel Hill, Distinguished Life fellow American Psychiatric Association, and Founding Editor and Editor-in-Chief, Wake County Physician Magazine (1995-2012). He is a dramaturge. Received Raleigh Medal of Art in 2001, inducted to Raleigh Hall of Fame 2013, elected Lifetime Trustee, North Carolina Symphony in 2015, and 2016 recipient of NC Award, Fine Arts.

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On a Few More Things…

Monday Musings for Monday July 15, 2019
Volume IX, No 28/445

potpourri

Potpourri of Literary Concerns (Part II)

By Assad Meymandi, MD, PhD, ScD(Hon), DLFAPA*

US Women Soccer Team

Delighted to see our country ‘s women soccer team to claim another win. We rejoice the victory. However, the cacophony generated by the super-enthusiastic rah, rah, rahs, the unwelcome meretricious behavior of the champs and their arrogant, narcissistic aura call for some moderation. We suggest infusion of a modicum of humility and temperance. America is a noble and altruistic country. Let us demonstrate it to the world by word and by action.

Etymology of the Word “Religion”

Saint Thomas Aquinas (1225-1274) and John Calvin (1509-1564), two disparate theologians of the 13th and 16th centuries, along with Persian physician Abu Ali Sina, Avicenna (980-1037), the famed medical diagnostician and clinician of the eleventh century have written independent treatises on the “religion.” Here is a summary of their work on the topic

The etymology of the word “religion”, re-ligion”; re: again, ligating: binding, connecting (surgeons ligate veins and tie up arteries); thus, re-connecting, re-binding, re-attaching…what to what is the question. Perhaps to the beatific vision of eternity and transcendence of love…

A Euro for Asia

The wire services just unloaded a very heart warming and personal story: Robert Mundell, Raegan’s Chairman of Economic advisors, father of trickle down Reaganomics (Ibn Khaldoun ‘1332-1406’ was the real father, Robert Mundell was a promulgator!), but he was the true father of the “Euro”, the 1999 Nobel Laureate in Economics, is now back in the news. He wants to foster or father the equivalent currency of Euro for Asia. The name has not been conceived. The Sultan of Abu Dhabi, owner of the multi-trillion dollar “Sovereign Fund” which has been rescuing American Banks and Financial institutions (including Bank of America, UBS, Citibank, and Washington Mutual) is behind the effort.

A personal note: We had the privilege of having lunch with Dr. Mundell in his Palladian villa in Italy on Friday June 25, 1992. It was a memorable occasion.

Joy of Death: Is it an Oxymoron?

Many years ago, Randy Pausch’s name was being considered by some members of the National Humanities Center Nominating Committee for membership to the Board before we learned that he was dying. I was fortunate to be in the audience when he gave his “Last lecture” at Carnegie Mellon. It was a fascinating experience. He was a picture of health. He did summersaults and push ups during his lecture, and at the conclusion of his speech, carried his wife off the stage. It is very sad that he died. Yet, it is glorious the way he lived and the legacy he left for us. I am reviewing his book which will appear in a future issue of WCP.

The Dope on Cannabis

In response to a reader’s question about cannabis and alcohol:

The scholarship on cannabis and data driven research on this controversial drug show that cannabis may and does affect not only the higher cortical structures but also the subcortical parts of the brain, what is known as the Limbic system, causing bipolar disorder (radical mood swings and irrational and impulsive behavior) but actual psychosis. Alcohol has the same adverse effects on the brain through different pathways. So, I really condemn both. I am absolutely against legalizing cannabis. I would be happy to give you reference to these studies. A drunken parent should not hypocritically admonish a pothead child. It does not work. This is one of the astonishing teachings of Saint Augustine of Hippo, the ultimate role model to humankind. Although he was addicted to sex, after his conversion to Christianity and soon after becoming a Bishop, he had enough discipline to stop sex altogether. The same, I condemn tobacco and its ill effects on the body in general. However, I guess the reason tobacco is not banned is that it does NOT cause bipolar disorder and psychosis. Some states are legalizing the use of cannabis because it is a cash cow and produces huge tax revenues.

The ultimate answer to these problems is education which starts in utero. Mamas must adopt Augustinian discipline to love themselves and their fetus(es), stop tobacco, alcohol and over-eating while they are pregnant, and continue to be role models to their children.

Hypocrisy and Greed of University Leaders

I am opposed to lowering drinking age in college as many, including 100 college and university leaders, promote. While prohibition is often counterproductive, I believe the answer to binging, abuse and unreasonable use of alcohol is education. The answer also lies in curtailing greed and hunger for money. The University leaders ought to cut out advertising of beer from all TV sports. It is sheer greed to have alcohol products sponsoring sports events, and it is sheer hypocrisy for the university leaders to tolerate this practice because it produces revenue for their institutions. Ban alcohol ads from all television sports.

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*The writer is Adjunct Professor of Psychiatry, University of North Carolina School of Medicine at Chapel Hill, Distinguished Life fellow American Psychiatric Association; Life Member, American Medical Association; Life Member, Southern Medical Association; and Founding Editor and Editor-in-Chief, Wake County Physician Magazine (1995-2012). He is a Raleigh, North Carolina writer and dramaturge and the 2016 winner of the NC Award in Fine Arts.

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