On Continuation of Brain Series

Monday Musings” for Monday June 26, 2017
Volume VII, No. 26/338

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Brain and Behavior, Part IV

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

(Editor’s Note: This is part IV of a four part series on Brain and Behaviour. In Part I, the general topography and physiology of the brain was discussed. In parts II and III, Memory and Post Traumatic Stress Disorder were explored. Today, Part IV, we are exploring the emergence of ‘Age of Mind’ by presenting the review of a book by Nobel Laureate American psychiatrist and Nobel Laureate Dr. Eric Kandel. Next week, in Part V, we will examine the issue of the holy marriage between psychoanalysis and neurosciences.)

IN SEARCH OF MEMORY

THE EMERGENCE OF A NEW SCIENCE OF MIND

By Eric R. Kandel, Psychiatrist
2000 Nobel Laureate for Physiology or Medicine
429 pages of text. 23 pages of glossary. 31 pages of notes and sources. 26 pages of index. Total: 510 pages.
W. Norton & Company, NY. London

Since Benjamin Rush, a framer of the US Constitution, and father of American psychiatry, there have been two psychiatrists who have won the Nobel Prize. The first winner was Julius Wagner-Jauregg, Psychiatrist (b. Wels 1857, d. Vienna 1940). He invented “Malaria-therapy” for the treatment of progressive paralysis, especially tertiary syphilis. He was awarded the Nobel Prize for Medicine in 1927. It took seventy three years before psychiatry had a second Nobel Prize winner. He is Eric R. Kandel, a University Professor at Columbia.

Dr. Kandel received his psychiatric training and training in psychoanalysis at Massachusetts General Hospital and McLean Hospital. Before entering medical school, he was interested in literature, the arts and humanities. He also found himself intrigued by the work of Freud and the relationship between neurology, biology, id, ego and superego, all components of Freudian theory of psychoanalysis. However, realizing that he needed to be a medical doctor to pursue his psychiatric ambitions he entered NY University Medical School where he received his MD. As a medical student and clinician, he became more interested in biology, physiology and cell, especially nerve cell (neuron), communication. Pun excused, he became more interested in “neuronics” rather than “neurotics.” His fifty years of work produced many books and seminal articles published in Journal of Nature and Science, reflecting his groundbreaking work on the cellular and molecular process of memory. This work ultimately earned him the Nobel Prize in Medicine or Physiology in 2000.

Reading this book is a sheer joy. Parts of it are heady and heavy neuroscience and neurobiology. But it is a page turner. Also, it is a kind of a book one wishes to re-read. The volume is autobiographical, weaving personal life experiences from childhood through student and professional life into a rich tapestry of words, syntax, and composition in an exquisitely readable and entertaining style. Dr. Kandel’s writing style is reminiscent of the writings of Freud. As I read and re-read parts of this enormously appealing book, through synesthesia, I kept hearing the complex and rich bouquets of baroque music of Bach and Telemann alternating with melodic symphonies of Haydn, Sibelius and the triumphant Mozart’s Jupiter Symphony in C major. While reading his words, I also saw a rich display of paintings of the masters, Michelangelo, Leonardo de Vinci and the smooth amorphous impressionist masters, like the work of Monet and Pissarro. It also reminded me of a recent symphony I heard conducted by Lorin Maazel. It has that characteristic Maazelian blend of incandescent colorings, unerring execution and cool brilliance.

The book starts when the author was nine, and a student at a neighborhood school in Vienna. Being Jewish, his parents, his brother, Ludwig (later Lewis), and he were expelled from his country by the Nazis. They came to America where Eric received a superb education in New York. In Vienna, his father had owned a small toy store. His mother was a stay at home Mom. At age 9, he recalls getting a shiny new battery operated toy car with a remote control from his father, which he brought to the United States. It is like “rosebud” and Hurst in the movie Citizen Kane. This illustrates the author’s understanding of object relation which is so important in psychiatry.

The science part of the book starts with Dr. Kandel’s introduction to the leading US biologist, University of Columbia’s Dr. Grundfest (Kandel later became Director of that laboratory). At that time Dr. Kandel developed techniques to micro puncture almost every cell of hippocampus, the seat of memory, as he put it “one neuron at a time.” He recorded the action potential of the cells and studied how the cells communicate with one another–how the messages (conversations) are transmitted from hippocampus to amygdala and other parts of the limbic system (thalamus, hypothalamus, mammary bodies, para-median gray and fornix). He identified the role of chemicals, the proteins and the cyclic AMP (cyclic adenosine-3’,5’- monophosphate) discovered earlier by another Nobel Prize winner, pediatrician Dr. Earl Sutherland of Vanderbilt, in cell transport.

The book is an elegant exposition of ethology, the study of animal behavior in its natural environment. It is also an in depth probe in molecular biology, the chemicals, proteins, neurotransmitters of memory, and the process of storage and recall of knowledge. It explains how the ionotropic receptors, the proteins that span the cell surface membrane and contain transmitter-binding sites and channels through which ions can pass and send messages to the next neuron.

This highly readable and delightful book also carries a compendium of people of note who have contributed to neurobiology and understanding of the central nervous system and how commands are generated by the cranial nerves and carried out by the peripheral network of neurons. The impressive pantheon starts with the work of Santiago Ramon Y Cajal, and Camillo Golgi to whom all of us were quickly exposed to in our first year of medical school. It continues to develop a rich anthology of all the names and a brief description of their contributions. Of course, the list starts with Aristotle. Here is an example of the author’s skillful writing bringing the ancient and the new together:

“Aristotle, and subsequently the British empiricist philosophers and many other thinkers, had proposed that learning and memory are somehow the result of mind’s ability to associate and form some lasting mental connection between two ideas and stimuli. With the discovery of NMDA (N-Methyl-D-Aspartate) receptor and long-term potentiation, neuroscientists had unearthed a molecular and cellular process that could well carry out this associative process.”

With clarity and eloquence, Dr. Kandel explains various forms of memory, such as habituation, sensitization, classical conditioning, short and long term, somatic, procedural, and verbal memory and the biological basis of individuality. He makes the reader feel a participant in the conversation between nerve cells.

We expect our educators from Kindergartens to Universities to teach their students the essentials in critical thinking. This is the ultimate goal of education. It is exciting to learn the molecular biology of critical thinking and memory. As one who has been doing book reviews for over 50 years, I have become accustomed to examine the down side of books reviewed. It is astounding that I can say nothing negative about this most impressive and seminal work. I recommend the book to all ages, even grammar school children. I plan to read parts of it to my grandchildren.

Finally, I believe people like Eric Kandel are saints. Eric is my kind of a saint. The kind of a saint who KNOWS, yet lets his knowledge get marinated in the elixir of spirit, faith and transcendence, giving it the lofty status of being in the presence of God and better yet, dining with God on an infinitely rich intellectual diet. And yes, Eric is a Jew, who escaped from the Nazi’s grip and emigrated to America, where he received the opportunity to learn, to study, to create knowledge and to earn a Nobel Prize. Like many of us who are Americans by choice and not by birth, Eric appreciates America’s rule of law, freedom of speech, worship and pursuit of one’s passions. Yes immigrants are blessed by America, and America is blessed for having so many living saints, like Nobel Laureate Eric R. Kandel, a psychiatrist for 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 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 Memory

Monday Musings” for Monday June 19, 2017
Volume VII. No. 25/337

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Post-traumatic Stress Disorder (PTSD)

by Assad Meymandi, MD, PhD, DSc (Hon), DLFAPA*

(Editor’s Note: Last week we interrupted the “MM” science series on Memory and Post Traumatic stress Disorder to observe Father’s day.  We resume the series toady, Part II concentrating on the topic of PTSD.

Science Series. Part  II:  Memory and PTSD

In her memoirs, Jacqueline Kennedy Onassis wrote of her flashbacks of the November 22, 1963 assassination of her late husband. She was suffering from PTSD. The official description of PTSD, or Post-traumatic Stress Disorder, published by Veterans Affair is “a psychiatric disorder that can occur following the experience or witnessing of a life-threatening events such as military combat, natural disasters, terrorist incidents, serious accidents, or physical or sexual assault in adult or childhood.”  Most survivors of trauma return to normal given a little time. However, some people will have stress reactions that do not go away on their own, or may even get worse over time. These individuals may develop PTSD. People who suffer from PTSD often relive the experience through nightmares and flashbacks, have difficulty sleeping, and feel detached or estranged, and these symptoms can be severe enough and last long enough to significantly impair the person’s daily life.

People with PTSD experience three different kinds of symptoms. The first set of symptoms involves reliving the trauma in some way such as becoming upset when confronted with a traumatic reminder or thinking about the trauma when you are trying to do something else. The second set of symptoms involves either staying away from places or people that remind you of the trauma, isolating from other people, or feeling numb. The third set of symptoms includes things such as feeling on guard, irritable, or startling “easily.”

It is estimated that 8 percent of Americans will experience PTSD at some point in their lives, with women twice as likely as men to develop PTSD. About 3.6 percent of U.S. adults aged 18 to 54 (5.2 million people) have PTSD during the course of a given year. This represents a small portion of those who have experienced at least one traumatic event. The traumatic events most often associated with PTSD for men are rape, combat exposure, childhood neglect, and childhood physical abuse. The most traumatic events for women are rape, sexual molestation, physical attack, being threatened with a weapon, and childhood physical abuse.

What does science have to offer?

In my daily reading diet I value several publications which include ScienceNatureNew England Journal of Medicine (NEJM) and Lancet.  Lately, I have been impressed by another journal PLOS ONE, a peer-reviewed open access scientific journal published by the Public Library of Science (PLOS). It is a publication that translates experimental laboratory data into clinical practice. It is one thing to accomplish or make discoveries in the laboratory with animals. But it may take years and years before the results are applied in clinical practice to humans. In that sense PLOS is unique. It is a truly translational journal. Its purpose is to speed up the process of applying laboratory discoveries into bedside patient care and clinical practice.

Published studies by Marc J. Kaufman, PhD, Director of the McLean Hospital Translational Imaging Laboratory and colleague Edward G. Meloni, PhD, are of seminal value and promise to have lasting benefit. In these studies, the scientists discovered that rat exposure to Xenon, a noble (inert) gas blocks traumatic memories. It becomes very useful to block bad memories in individuals suffering from PTSD. The chemistry is fancy but simple. Memories are stored and transmitted in specific parts of the brain called amygdala, hippocampus and frontal cortex. They are transported by many neurotransmitters in the brain from the memory centers to other parts of the brain. The most prevalent neurotransmitter charged with transporting memory is N-Methyl-D-Aspartate (NMDA). Just a word about what is a neurotransmitter– a neurotransmitter is like a bus or a car that carries instead of passengers, messages from one nerve cell (neuron) to other parts of the brain. The key to interfering with transmission of memory is to interrupt the neuronic flow mediated by NMDA. In essence, take a chemical scalpel and cut off or tie off the flow of NMDA. Well, the Boston scientists have hit the pay dirt. They discovered Xenon is the chemical that accomplishes the task and chemically interrupt or cut off NMDA transmission in rats. Here is an abstract of the publication.

Xenon (Xe) is a noble (inert) gas. These gases belong in group O of the periodic chart.  The group includes radon, helium, neon, argon, and krypton. Xenon gas has been developed for use in people as an inhalational anesthetic and in diagnostic imaging procedures. Xenon inhibits receptors involved in learning and memory and affect those parts of the brain, namely amygdala and hippocampus, responsible for memory formation and information storage. When Xenon is administered after memory of a trauma is formed (they call it fear memory), the memory disappears after the Xenon is administered. Male rats were used to develop this elegant animal model of PTSD they call fear-conditioning. The rats were trained to be afraid of environmental clues that were paired with brief foot shock. The researcher found that a single exposure to the Xenon gas blocked memory formation in the brain, dramatically and persistently reducing fear responses up to two weeks. The researchers are planning to apply the work to humans. The research holds much promise for those millions suffering from PTSD.

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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 Father’s Day

“Monday Musings” for Monday June 12, 2017
Volume VII. No. 24/336

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Hagar and Ishmael Banished by Abraham, Pieter Jozef Verhagen,(1781)

 

 Father’s Day

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

We interrupt our series on Neuroscience, Memory and Post Traumatic Stress Disorder (PTSD) to observe Father’s Day which is coming on Sunday, June 18, 2017. We will resume the neuroscience series next week.  Now a few reflections on Father’sDay:

Brief History

Arkansas has not only given us the Clintons and the perennial presidential contender, the Reverend/Governor/evangelist/guitar picking/author Mike Huckabee, but it has given us also Sonora Smart Dodd who literally created Father’s Day back in 1910. She celebrated the first Father’s Day in Spokane, Washington to honor her father, the Civil War veteran William Jackson Smart, a single parent who raised his six children single-handedly in Arkansas. Sonora was moved to recognize her father’s contribution by proposing a day to honor all fathers. However, it was not until 1972, 58 years after President Woodrow Wilson made Mother’s Day official, that the Father’s Day became a nationwide holiday in the United States.

Father vs. Dad

It is so easy to be a father. All it takes is a willing partner and nine months later a child is produced. But it takes a whole lot of preparation and commitment to be a dad. One of the main reasons we have more per capita prison/jail inmates than anywhere else in the industrial nations is this very simple notion: plenty of fathers who bring children to the world have no preparation or commitment to be or become a dad. Recent statistics point to the fact that the rate of imprisonment in the United States more than quadrupled during the last four decades. The U.S. penal population of 2.2 million adults is by far the largest in the world. Just under one-quarter of the world’s prisoners are held in American prisons. The U.S. rate of incarceration, with nearly 1 out of every 100 adults in prison or jail, is five to 10 times higher than the rates in countries of Western Europe and other democracies. The reason is simply too many men, like sex machines, reproduce and abandon. Most prisoners grew up without love, care and devotion of a dad. And our government seems to reward this delinquent behavior by giving incentive in expanding the welfare state. It is an abomination that so many single mothers of four or five, and so many children who have never met or known their fathers…

Dads love, care, provide, and offer moral leadership to, and role models for their children. Dads are selfless, giving and loving. Dads offer security, permanence, and they are there for their children forever. To be a dad is the most responsible job on earth. No, I am not suggesting to cut resources of, and services to, the children. On the contrary, we need to pump in love and all resources necessary to make sure the children who are already here have what it takes to become responsible citizens. I am saying that family planning should be emphasized and through education and information, sex machines dismantled. If we could spend the corrections budget on education, eventually we will decrease the prison population drastically.

Historically, the roots of the Arab Israeli conflict go back to the days of Abram (before he became Abraham–Genesis 17) of Ur. The two biographers of Abraham, Zakaria-ye- Massuyeh, and Honein Ibn Ishagh ably trace the origin of the Arab-Israeli conflict to Abraham and his two sons, Ishmael and Isaac. The two brothers were fighting as most children do. Ishmael gathered his friends in one camp which became the origin of Arabs, and Isaac doing the same, naming his camp and entourage/followers the Israelis. Two brothers and their progenies, blood related cousins, have been killing one another for more than three thousand years…I guess one might say that Abraham was a faithful and superb prophet, fathering Judaism, Christianity and Islam, but did not know how to be a daddy to his own sons.

Personal Memories

 Speaking of children fighting, I remember as a small boy being the youngest in the family. I used to argue and fight all the time with my sister next in age to me. We used to go to my father with our stories as to how we were victimized, expecting father to intervene on our individual behalf. My father would sit patiently and dispassionately listen to us carefully one at a time. My sister and I would anxiously await a judgment and a disposition. My father would hold both of us in his arms and say something like “I see you two have a disagreement, and I have faith in both your abilities to resolve the disagreement by understanding and talking and not fighting…” He would kiss us and let us go. My father was an esthete. He was a poet and a calligrapher. He flooded our home with books, and books and books… We had music, poetry, and flowers…Next to God, love and family, education was most revered by our father.

What to Do?

What do we need to do to correct what Abraham failed to do? How do we bring peace and reconciliation to Jews and Muslims? All major religions and their Holy Books including Bhagavad Gita of Hindus, Avesta of Zoroastrians, Torah of Moses, Quran of Islam and Bible of Christians recommend forgiveness and conciliation. As one exposed to all these Holy writings, I am most impressed by Christian love and the Pauline theology of hope, possibilities, forgiveness, and redemption. It is the unique attribute of Christian teaching to transform one’s enemy through the act of love and turning the other cheek. What a magnanimous feat of humanity and Godliness. I am for establishing dialogue, learning the enemy’s language, pressing flesh and showing acts of love and mercy.

Happy Father’s Day to all.

The Meymandi touring Exhibition Gallery, North Carolina Museum of Art, is named for my late father, Farajollah Meymandi.

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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 Memory

Monday Musings for Monday June 5, 2017
Volume VII.  No. 23/335

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The Science Series: Memory

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

Part I The nature of Memory

The print and broadcast media have made the diagnosis of post traumatic disorder (PTSD) ubiquitous. 15 years of war in Afghanistan, wars in Iraq and Syria have produced veterans who indeed suffer form PTSD and brain trauma. We will devote the next three “MM”s to the understanding of memory and recent advances in understanding and treatment of PTSD.

The Faithful readers of this space recall our review of the book “Searching for memory” by Daniel Schacter, a University of North Carolina at Chapel Hill (UNC) alumnus and professor of psychology at Harvard.  In that book with an outline of different types of memory Schacter devoted a broad section to persistent memory which is the hallmark of post-traumatic stress disorder. Recurring unpleasant memories. In this piece, after describing and discussing the phenomenology and architectonics of memory and its types, I will focus on post-traumatic stress disorder,

Schacter’s research explores the relation between conscious and unconscious forms of memory, the nature of memory distortions, how individuals use memory to imagine possible future events, enhancement of online learning, as well as the effects of aging on memory. In general, there are four large categories of memory which are always included in psychiatric evaluation and standard mental status examination. They are:

1)    Episodic memory: dealing with the patient’s ability to recount biographic data such as dates, places of significant events of life, marriage, birth of children, service in the Armed Forces, travels and jobs

2)    Somatic memory: which has to do with the functions of various parts of the brain, and the reaction of those brain structures to the cascade of neuronal hormones sweeping over them. Somatic memory is often affected by anxiety and depression

3)    Procedural memory: how well the patient can repeat a series of numbers or objects forward and backward immediately or after a given time lapse. Also, how well the patient may recall a seven part story.

4)    Verbal fluency memory: such as testing the a patient’s ability to generate words starting with a given letter such as “O”. The number of words generated in a given time, let’s say one minute and the quality of the words generated reveal much about the patient’s memory and general fund of knowledge and vocabulary. For example, if a patient is asked to generate in one minute words starting with the letter ”o”  and he goes like a machine giving words in alphabetic order, “octave, octennial, octet, octillion, octillionth, October, octodecimo, octogenarian, octomerous, octoary, octoploid, octopod, octopus, octoroon, etc…” you know that he excels in verbal fluency memory and is of superior intellect.

Schacter characterizes memory in a different way.  He calls these the seven sins of memory The Seven Sins of Memory: How the Mind Forgets .

  • 1)  Transience–the decreasing accessibility of memory. Schacter cited as a somewhat facetious example former President Bill Clinton’s “convenient lapses of memory” during the Monica Lewinsky investigation. Clinton claimed in the hearings that he sometimes couldn’t remember what had happened the previous week.
  • 2)  Absent-mindedness–lapses of attention and forgetting to do things. Examples, said Schacter, are forgetting where you put your keys or glasses. He noted a particularly famous instance in which cellist Yo-Yo Ma forgot to retrieve his $2.5 million cello from the trunk of a New York City cab.
  • 3)  Blocking–temporary inaccessibility of stored information, such as tip-of-the-tongue syndrome. Schacter recounted the embarrassment of John Prescott, British deputy prime minister, when a reporter asked him how the government was paying for the expensive Millennium Dome. Prescott struggled to find the word “lottery,” trying “raffles” instead.
  • 4)  Suggestibility–incorporation of misinformation into memory due to leading questions, deception and other causes.
  • 5)  Bias— For example, research indicates that people currently displeased with a romantic relationship tend to have a disproportionately negative take on past states of the relationship.
  • 6)  Persistence–unwanted recollections that people can’t forget, such as the unrelenting, intrusive memories of post-traumatic stress disorder. They become a tragic prisoner of memory,” and eventually committed suicide.
  • 7)  Misattribution–attribution of memories to incorrect sources or believing that you have seen or heard something you haven’t.

Next week, Part II, we will discuss post-traumatic stress disorder which has to do with sustained unwanted, obsessive intrusive memory.

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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 Memorial Day

“Monday Musings” for Monday May 29, 2017
Volume V. No. 22/334

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Memorial Day, Pericles, Abraham Lincoln, Gettysburg Address

 

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

Today is Memorial Day. Some reflections:

In so many great books and in so many great bodies of literature, we are told that “to die for one’s own country is the noblest deed.” The conceptual architectonics of this notion goes back to 5th century BC Athens and to mid-nineteen century AD America. The architects are two superb statesmen, Pericles of Athens and Abraham Lincoln of America separated by almost 2500 years. The occasion was the funeral oration by Pericles for the war dead in Athens 404 BC, and the funeral oration by Abraham Lincoln at Gettysburg in 1865 AD for the America’s civil war dead.B oth speeches proclaim that democracy is worth sacrificing lives and spending the nation’s financial and material resources. In their speeches, Pericles and Lincoln forcefully and eloquently submit that “to die for the cause of democracy and national unity is the noblest act.”

Pericles and Lincoln, these two incomparable souls had qualities that set them apart as statesmen. They were not merely politicians. They both had bedrock principles and solid foundation of beliefs that did not change with public polls and political expedience. They both had a moral compass and had a sense of absolute right and wrong. They each had a vision for their nation as a model for the world and humankind, and they had the ability to build consensus. Pericles and Lincoln both led their respective nations, Greece and America, into civil wars. Pericles led his nation to war between Sparta and Athens (431 to 404 BC), and Lincoln led America to our Civil War (1861 to 1865). The Athenians and Spartans spoke the same language and worshipped the same gods. So did the Confederate soldiers and their brethren to the north. They spoke English (or according to H. L. Menken they all spoke ‘American’) and worshipped the same God. As an aside: you will enjoy reading H.L. Menken’s “American Language” which gives a deep analysis contrasting British English with American English.

The Origin of Memorial Day

The journey starts with Pericles and his funeral oration of 404 BC. Later Publius Vergilius Maro (70 BC to 19 BC to ), usually called Virgil or Vergil in English, the celebrated Roman poet in his famous epic poem in Latin, Aeneid, translated the words of Pericles from Greek to Latin. Lincoln, an intellectual and scholar, had read Aeneid as much as he had read the Bible. Aeneid is a poem about war. It spells out the conduct and the protocol of man at war. Virgil came to the conclusion that men who gave their lives to their country should be memorialized. Virgil popularized Pericles’ of views some 400 years earlier, laying down the roots of what we today know as Memorial Day.

Lincoln used Virgil’s concept of memorializing the dead soldiers. He also emulated Pericles who with unparalleled eloquence and clarity concluded that “to die for one’s nation is the noblest deed”. Almost 2500 years after Pericles, Abraham Lincoln, on November 19, 1863 in his funeral oration in 272 words Gettysburg Address told the nation why the war, where he was going with the war, and what the outcome of the war would be. He clearly articulated why 620,000 soldiers have given their lives. He told the nation that the ultimate goal was to ensure the unity of the nation and guarantee freedom for all Americans.

The Gettysburg Address, Lincoln’s marvelous use of words loaded with religious and Biblical symbolisms such as “fourscore, dedicate, consecrate, hallow, and sacred ground” invoked the spiritual dimensions of his persuasive message. And Lincoln did not have a team of speech writers and spin artist pollsters on his staff… In contrast, it is unclear to us why the ill-defined Iraq and Afghanistan wars now going on 14 years, at a cost of thousands of lives, and the expenditure of hundreds of billions dollars, continue. America is still waiting for an explanation of why we are there. Would not it be nice if we had a living Lincoln who could use 272 words to give us this reason?

Memorial Day as we know it today, originally called Decoration Day, is a day of remembrance for those who have died in service of the United States of America. Memorial Day was born out of the Civil War and a desire to honor our dead. It was officially proclaimed on May 5, 1868 by General John Logan, national commander of the Grand Army of the Republic, in his General Order No. 11. “The 30th of May, 1868, is designated for the purpose of strewing with flowers, or otherwise decorating the graves of comrades who died in defense of their country during the late rebellion, and whose bodies now lie in almost every city, village and hamlet churchyard in the land,” he proclaimed. Memorial Day is now observed in almost every state on the last Monday in May with Congressional passage of the National Holiday Act of 1971. This helped ensure a three day weekend for this Federal holiday, though several southern states have an additional separate day for honoring the Confederate war dead.

Salute to the veterans for the noble act of sacrificing for America and condolences to their families of the deceased.

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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 Wagner, and Opera

“Monday Musings” for Monday May 22, 2017
Volume V, No. 21/332

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Bayreuth Margravial Opera Stage

Happy Birthday to Richard Wagner: A Few Thoughts about Opera

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

Today is Richard Wagner’s 204th birthday (May 22, 1813- February 13, 1883). We celebrate his natal anniversary with joy and some added reflections: Wagner was a German musician, opera composer, and a disciple of the German philosopher Arthur Schopenhauer, (Feb 22, 1788- September 12, 1860) with whom he split over the issue of “toleration”. Wagner was truly a genius. But he hated the Jews and the Italians, all of whom he called barbarians. He also hated the word opera because it is an Italian word and he thought Italians are of a lower race. Instead, he called his work “Music Drama“. Wagner was a contemporary of Verdi (October 10, 1813-Jan 27, 1901), the world famous and renowned Italian Opera Composer. Toward the end of his life, Wagner had a change of heart about Italians and had some good things to say about Verdi. But he remained a staunch anti-Semite.

Richard Wagner, the ruthless, racist and megalomaniacal genius not only composed his own opera but wrote the libretto (pleural, libretti), designed the stage, and conducted the work. His compositions are not just opera but an all encompassing Gesamtkunstwerk, like the Super Bowl halftime show! In addition to writing the libretto, composing the music, and designing his sets, he was a brilliant prose writer. I recommend getting a hold of some 12 volumes of his original work and read them for the sheer power of their syntax and thematic composition.

He also architecturally created the Bayreuth Opera House where his work was produced and staged.  After 204 years, almost all of his operas including the Flying Dutchman, Ride of Valkyries, Tannhauser, and Die Meistersinger Von Numberg are a steady diet of most opera houses and symphonies throughout the world. From time to time, North Carolina Symphony plays Wagner.  The colossal  program of Wagner and Russian music which featured in the first half, Prelude to Act I, Lohengrinn and the second half the memorable performance of virtuoso violinist, Itzhach Perlman playing Violin Concerto in D Major, Opus 35, by Peter Ilyich Tchaikovsky remain vivid in memories.  As an aside, the world renown violinist, Joshua Bell, played Jean Sibelius’ Concerto in D minor for Violin and Orchestra, Opus 27, with North Carolina Symphony to a standing room only crowd in Raleigh’s Meymandi Concert Hall. And there will be other special programs of Wagner’s music in the future.  Raleigh has an extraordinarily rich cultural life.

Wagner’s writings and Teutonic operas tell us that he had a deep knowledge of history. His operas, especially Tristan and Isolde, and the “Ring Cycle” consisting of four operas, 18 hours, are full of Zoroastrian parables, Buddhist reference to “nothingness” before becoming “something” and the writings of Rumi, Shams Tabrizi, and Baba Taher Oryan. He loved Aryan Persians as much as he hated the Jews. He spoke of the Jews as inferior creatures preoccupied with usury, money changing, and nothing else. He made fun of Jewish cantorial music and ridiculed the religious tradition of the Jewish synagogue.

Delving into his personal life, one discovers that he was an illegitimate child of a Jew, Ludwig Geyer. He was born in the Jewish quarter of Leipzig, the ninth child of Carl Friedrich Wagner who died six months after Richard’s birth, following which Wagner’s mother began living with the actor and playwright Ludwig Geyer with whom she had a longstanding relationship. Ludwig was a friend of Richard’s late father. Richard almost certainly suspected that Geyer was his natural father. He and Ludwig whom he publicly called “Dad” shared a love of theater, opera and language. Around age 14, however, Richard changed his name from Richard Geyer back to Richard Wagner.

In his early life, Wagner was heavily influenced by Shakespeare and Goethe. He was determined to set the writings of these two illustrious authors into music. In 1826, at age 13, he started to take music lessons. By 1827, the family had moved back to Leipzig. Wagner’s first lessons in harmony were taken in 1828-1831. In January 1828 he first heard Beethoven’s 7th Symphony and then, in March, Beethoven’s 9th Symphony performed in the Gewandhaus. Beethoven became his inspiration, and Wagner wrote a piano transcription of the 9th Symphony. Regarding his obscure genealogy, He often kiddingly said “May be Beethoven is my dad!”… Wagner was also greatly impressed by a performance of Mozart’s Requiem. From this period we have Wagner’s early piano sonatas and his first attempts at orchestral overtures. In 1829 he saw the dramatic soprano Wilhelmine Schröder-Devrient on stage, and she became his ideal of the fusion of drama and music in opera. In his autobiography, Wagner wrote, “If I look back on my life as a whole, I can find no event that produced and left so profound an impression upon me.” He had an unsuccessful marriage to his second wife, Cosima, and had disastrous relationships with other women including Minna Wagner.

In Wagner lies an enigma. He was a truly brilliant artist with gifts in music composition, writing, poetry, and deep knowledge of history who was pathologically intolerant of others, especially Jews. Yet he was the son of a Jew and had Jewish DNA. His profound anti-Semitic rant has given to millions of words of psychobabble attempting to explain that his hatred of Jews was deeply rooted in self-hatred. As a person, he had no shred of decency and no touch of sublime humanity. He broke up with his idol and mentor, philosopher Schopenhauer, because of Wagner’s extreme hatred of Jews. Schopenhauer could not take Wagner’s extreme intolerance of the Jews. Personally, I take and enjoy Wagner’s rich and lasting contributions to the arts and literature, and merely ignore the rest of him.

On the local scene in Raleigh, the transfer of Dix property to the city of Raleigh was accomplished on May 5, 2015,   I am looking forward to the day we will have an opera house built in Dix Park, NC’s answer to the NY’s Central Park. With such a venue, we can not only do the more lavish and demanding Wagner operas, but stage some modern operas the list of which is approaching 90. I have noticed and admired the Met’s willingness to add some of the modern operas such as Cyrano de Bergerac with Placido Domingo as Cyrano, Sondra Radvanovsky (Roxanne), and librettist Henry Cain. I have yet to see any opera in America by Michael Tippett, Hans Verner Henze and Olivier Messiaen (I saw his Saint Francois D’Assie in Paris several years ago), and other composers.

Meantime, Happy 204th Birthday to Richard Wagner!

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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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“Monday Musings” for Monday May 15, 2017
Volume VII, No. 20/332

 ahippo

INTELLECTUAL HISTORY

CRITIQUE, REVIEW AND COMMENTARIES ON JAMES O’DONNELL’S BIOGRPAHY OF SAINT AUGUSTINE, THE GREAT THEOLOGIAN OF THE 4TH AND 5THCENTURY.

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

Augustine, A New Biography
By James J. O’Donnell
USA $26.95
336 pages of text
Four pages of explanation of abbreviations, 36 pages of notes and 20 pages of index
HapersCollins, Publishers Inc., NY

If there were a Mount Rushmore for scholars of Saint Augustine, the four heads would be the likeness of Dante Alighieri (1265-1321) Benedictine Monk, Guibert de Nogent  (1115-1195) Thomas Merton (1915-1968) and James J. O’Donnell (1950-) the author of this deeply scholarly, yet delightful book.

But there is something different about O’Donnell.  He is an Augustinian scholar with an attitude.  His day job is the difficult and demanding post, Provost of Georgetown University in DC, dealing with faculty hiring, appointments, administration and all the things provosts of vast and complex universities do.  Besides, he serves on many boards dealing with the classics and the humanities, among them the National Humanities Center Board where as a fellow Board member, I came to put a face on the vast body of his writings on various subjects, including Augustine, philology and classics. O’Donnell is a product of Jesuit education.  He seems to be on a mega dose of intellectual steroids.  I have attempted, yes, attempted, to read his extensive commentary about Augustine, in Latin, which he edited in three volumes (Oxford: Clarendon Press, 1992) with only a moderate amount of success.  The first volume of this monumental work contains the Latin text of the thirteen books that comprise Augustine’s Confessions.  The second and third volumes are a systematic, line by line commentary, with particular emphasis on the relationship between Confessions and other works of Augustine.  Some of the Augustinian scholars, including the very learned Maria Boulding, O. S. B., refer to O’Donnell’s three volume work as “magisterial writings.“ “Professor James J. O’Donnell’s three volumes…Will transform the task of translation for generations to come…” she said.  I am still reading them, and will let you know when I finish.  You are in for a treat when my review of those three volumes comes out.

The book starts with a prologue, followed by 12 chapters, and an epilogue.  We are accustomed to think of Augustine’s Confessions as his autobiography with the first nine books as narratives and the last four books, meditative and reflective.  The last four books discuss philosophical and theological issues of timeand memory.  They expose the reader to Augustine’s deeply moving and intellectually rich Biblical interpretations.  In this book, O’Donnell brings the essence of Augustine’s Confessions on stage, just like the unfolding of a theatre masterpiece, with intact dialogue and superb scenery.  It demonstrates Augustine’s painstaking attention and almost obsession with confession of sins, confession of faith and confession of praise.  O’Donnell, a master rhetorician, himself, skillfully demonstrates his subject’s reverential devotion to the notion that it is the redemptive power of God which ultimately brings mankind grace and salvation.

During my student days at College Saint Louis, a French Jesuit school in Tehran, I bought a copy of Augustine’s Confessions not for scholarship and a burning desire to acquire wisdom, but for the purported sexual and salacious material.  I was disappointed that I did not find any, and to this day I have not found any.  I am happy to report that reading the Confessions invariably makes the reader a better and a wiser person!

Aurelius Augustinus Hipponensis, born November 4, 354, in Tagaste, modern Souk Ahra, or Annaba, was an extremely intelligent young man, an “A” student through and through.  His father, Patricius, not a Christian, was a minor landowner and middle class citizen.  In Confessions, he is only a bit player, although often praised for providing money to buy his son a superior education.  However, Augustine’s mother, Monnica, a Christian by birth and upbringing, was an influential woman in her son’s life.

Having been exposed to many religions including the mysticism of Sufi, Transcendence of Buddhist; persuasive, disciplined and focused approach of the Jesuits, consequential and pragmatic teachings of Moses and his followers, stoicism of monastic monks, in my mind, the road to matters Godly may be through mysticism, spiritual, intellectual, emotional, faith, and even physical fusion with God.  What I have learned from Augustine and his writings is that it is possible to embrace all these modalities at once.  Augustine teaches me, while thinking about the destination, how to enjoy the trip and the process of getting there.  Augustine is a consummate planner, traveler and traveling companion.  It is perfectly fine to get addicted to Augustine, as it is permissible to get addicted to opera, classical music, poetry and dance.  The tapestry of erudition, eloquence and faith, woven by Augustine is all of that to me.

Augustine died in 430, after a most interesting and fruitful life.  His influence, not only in the life of the church, but in literature, philosophy, linguistics and shaping of the intellectual lives of many generations after him, is remarkable.  While enamored by the teachings of Mani, he explored the ancient Greek philosophers and Platonists to find wisdom and truth, the truth, the ultimate truth.  He eventually found them in Christianity and was converted at the age of 31 in 386 A. D.

Many politicians and leaders who are war mongers, to justify their hostile policies and actions, often use the phrase “just war” which Augustine coined.  He coined another phrase, “original sin,” the bread and butter of generations of theologians to this date, and possibly for eternity, and “concupiscence” tendency for humans to be attracted to evil.   These commonly used concepts remain Augustine’s leitmotifs, just as Kleenex is to “tissue,” Freud to “psychoanalysis,” and Ford to “automobile.”  Augustine’s name is also eponymous with grace and salvation.  Regardless of what religion one practices, or in what part of the world one travels, when it comes to discussing grace and salvation, even in India and Southeast Asia, the name of Augustine surfaces automatically.  One can not resist admiring Augustine’s courage to lay his life on line, air all his dirty laundry, and tell all, including fathering a “bastard son,” discussing his “sexual addiction,” having a hard time resisting temptation.  The first nine books of Confessions are narrative and reportorial delving at length into his dalliance, and sexual misconduct.  By telling his life story, he wanted to altruistically benefit his fourth century Christian flock, immediately, and future generations of believers subsequently, if not eternally.  Stealing from his parents, having two mistresses and fathering a son out of wedlock, as will follow, occupy a great deal of space inConfessions.

Yet, O’Donnell brilliantly argues that Confessions is not about Augustine, his life, or his biography.  It is about his god (interestingly, god with little ’g’, and not ‘God’.)  The author claims that everything Augustine wrote, the corpus of his work exceeding 5.3 million words, compiled in more than 48 volumes of written work goes back to his god.  O’Donnell calls it Augustine’s “obsession.”  The author calls Augustine’s Confessions,written between 397 and 401, completed when he was 46 years old, “the first modern biography, and a classic of modern literature.”   The way O’Donnell presents Augustine’s writings is very interesting in that ultimately Augustine makes “god the center stage character of the discourse…”

Confessions” does not start with some lofty mystical premise, pontificating, preaching, or sounding like a commencement address, given by some wise and renowned theologian.  The entire 13 books is really a prayer that starts with the humble declarative sentence “inquietum est cor nostrum, donec requiescat in te,“ “our heart is restless, until it rests in you,” and 80,000 words or so later, it ends with “Amen.”

In the course of searching  the ultimate truth and wisdom, Augustine struggled with Manicheans, Donotists, Pagans, Arians and studies of Caecilianism, pelagianism and Platonists.  These studies and encounters led him on the path of maturing intellectually, quieting down his temper and impulsive nature, and ultimately to the satisfying experience of conversion.  Augustine’s work in philosophical reflection of time, memory, and his book on “Trinity,” suggesting Father as memory; Son, as time; and Faith as the Holy Spirit and eternity (time frozen in the present) as well as his pamphlet ,“Teacher,” a dialogue with his son Adeodatus, are penetrating and stimulating reading.  Dante used Augustine’s perception of time in “Inferno,” Circle VI, canto IX and X to describe the nature of purgatory and hell through Augustinian prism.  As indicated above Dante would not be, if there were no Augustine.  As a footnote, another great, Martin Luther who was trained as a lawyer but turned into a theologian and musicologist/composer, and a Augustinian Friar, heavily incorporated Augustine’s style and theology in his prolific output

A Summary of the 13 Books of Confessions:

We must know that in 4th century Carthage was the center of the Roman Empire, which then spanned from the Irish Sea to the Persian Gulf.  Hippo, modern Algiers, was very much a part of Pax Romana.

Book I of the Confessions deals with Augustine’s birth, infancy and childhood.  There are many revealing stories in the pages of this book.  Also, there are many stories that arouse the readers’ antennae that are skillfully unwritten.  To do justice, the uninitiated should take a course on “how to Read Augustine’s Confessions!” The unwritten innuendoes are as important as the written stories.

As a child, Augustine went to a very good private school.   He was an excellent student.  He feared his teachers’ regular beatings. He recalls his first prayers as a child were to besiege god, “Don’t let the teacher hit me!”  He later refers to his childhood prayers as “selfish and self-serving,” concluding that it may be that many of our prayers throughout life are in that childish, self-centered and self-serving mold.  Similarly when in Book 4, he loses a very close friend to an untimely death, he becomes very sad and grief stricken.  Later, he realizes that his sadness was his anger for losing a loved one who was “good to me.”  He considered the whole process of grieving selfish and self-consuming.  The grieving process was not to benefit the lost friend, but to meet his own narcissistic needs.

He reports stealing pears from a neighbour’s yard, not because he was hungry, not because he needed the pears, but because it was “fun” for him and his buddies to steal.  He reports that he felt a sense of independence and freedom when he did what he wanted to do and he knew that he was not supposed to do.  He stole from his parents because it was “cool” and he could brag to his friends about his misdeeds.  Later on in Book VIII, after his conversion, he stated that he truly felt independent and free, what he longed for in childhood by stealing….  The notion of narcissism versus altruism, without using the words, dominates the theme of all 13 books.  In Augustine’s words, he had to struggle between good and evil all of his life.  He repeatedly talks about his prayers in his early youth as “god, what can you do for me?”  This goes on until book IX in which the death of his mother, Monnica, occurs.  He describes the scene with tenderness, shedding tears and experiencing a deep sense of loss.  It was only then that he realized that he was grieving the loss of his mother unselfishly.  This spiritual and personal growth continues through book XIII where his prayers change to “god, what can I do for you?” instead of his previous mode of “god, what can you do for me?”  If spreading the fruits of a penetrating intellect, unwavering faith and influential writings are any measure of unselfish giving, Augustine has given much not only to God, but to hundreds, if not thousands, of generations of mankind.   O’Donnell quotes Augustine, “I sinned in that I sought pleasure, exaltation, and truth not in god but in his creatures, and so I fell into pain,depression, and errors…”

Books II through V deal with Augustine’s adolescence and sexual awakening.  He elaborates on his sexual addiction, taking two mistresses, and engaging in affairs with married women.  He also speaks of his close friend Alypius’ addiction to violence frequenting gladiatorial games, and enjoying the sight of blood.  He also refers to his mother Monnica’s “wine swelling” habit, driving home the issue of addiction comparing it to links that formed a chain of evil suffocating him.

In Book III, Augustine goes to Cartage, a city of 400,000, much more sophisticated than Tagaste, population 44,000.  Possibilities of sexual intrigue were such that Monnica kept telling him not to have affairs, and to marry if he could not handle his sexual impulses.   “To Carthage I came and there crackled around me all sides the sizzling frying pan of sinful loves.  I was not in love, but I was in love with love…”  He took a mistress, lived with her, had a son Adeoditus (God sent) and continued his studies in rhetoric, which is the art of persuasion, something akin to our law schools.

By the age of 28, Augustine had become a famous and able rhetorician.  In Carthage, he had a job as a high paying teacher to the children of the rich.  However, he was restlessly intrigued with philosophical issues, such as the nature of evil.  In the Book of Genesis, at the end of the sixth day, God proclaimed that all which He created was “good”.  This was puzzling to Augustine because he could not understand how evil can be good, simply because God created it. And all things created by God are supposed to be good.

This daunting puzzle made Augustine to intellectually fall in love with Manicheans, a branch of the ancient religion of Zoroastrianism, who espouse the dualistic theory of good and evil.  At the age of 18, he also ran across a book, Hortensius, by Cicero, the famed orator and rhetorician (106-43 BC),which is a brief biography of Quintus Hortensius Hortalus (114-43 BC), and fell in love with Cicero’s writings.  Augustine notes this event “a turning point of my life.”  He had other encounters with significant persons including a highly thought of and famous Manichean Bishop, Faustus.  He found him to be “empty.”   He described Faustus as a “false prophet,” with impeccable style of delivery and command of language, but his sermons and speeches had “no content.”

His road to intellectual inquiry led him to read Platonist philosophy recently translated from Greek to Latin.  Augustine was most impressed by the writings of the Platonists.   He is credited for establishing the historical connection between Athens and Jerusalem.  “I learned the truth of Christianity by reading pagan philosophers,” he professed.  However, while very impressed by the writings of Platonist philosophers, thinking of Socrates and Plato as “saints” of their days, Augustine remained restless and dissatisfied.   He had heard of a fellow rhetorician and colleague, Bishop Ambrose of Milan.  He decided with his friends, Victorinus and Alypius, went from Rome to Milan.  Augustine wanted to check out Bishop Ambrose (b. 337-340; d. 397) and see for himself if he is another phony Faustus, or is he really good as his reputation suggested.  If this were the case, he then wanted to learn to improve his own style.  He wanted to gain more skill in the art of persuasion.  He attended several sermons delivered by Ambrose, and became fascinated not only by Ambrose’s eloquence and style, but also by the content of his speeches.  This was the second most significant “turning point of my life,” he wrote (the first was reading Cicero’sHortensius.)

Books VII and VIII are the culmination of Augustine’s finding Paul, a Fellow convert (From Saul to Paul). In a mysterious possibly hallucinatory moment, he hears the voice of a child or children in a garden telling him “pick it up and read!”  And he did pick up the Bible.  It so happened that he opened the Bible to Paul’s passage in Romans 13, the famous command against “debauchery and lewdness.”  From this point the road for his conversion was wide open.  He, his close friend, Alypius, once addicted to gladiatorial violence, and several other friends, in the presence of his mother Monnica, converted to Christianity. Bishop Ambrose whom Augustine admired and saw as “the beacon of truth” officiated.  After a period of semi-monastic life style reminiscent of his hero, Saint Anthony of Desert, on his way back to Tagaste, Augustine was stopped in the strange city of Hippo.  It was a complete strange place to him.  However, his fame had preceded him.  The townspeople and the ailing Bishop Valerious asked him to stay in Hippo and succeed him as the next Bishop.  Thus was the beginning of Augustine’s service as the Bishop of Hippo (395-96).

Finally, the four meditative and reflective books IX-XIII dealing with time, memory, and theological and biblical issues cap this most fascinating compendium.  O’Donnell’s gift in taking a psychological scalpel and minutely dissecting the individual passages and lines written by Augustine takes the reader into the heart, brain and mind of the famous Bishop.  Augustine often reminds one of another genius, intellectual par excellence, who, too, was a convert.   Lorenzo Conegliano converted from Judaism to Catholicism at age 14.  You might know him as Lorenzo Da Ponte, Mozart’s librettist for the three operas, Marriage of Figaro, Don Giovanni, and Cosi Fan Tutti.  Lorenzo, too, became a Catholic priest.  He, too, was addicted to sex and had many wives; concubines, paramours and mistresses while a priest.  His behaviour caused him to be excommunicated from the Church and defrocked from priesthood.  However, the parallel stops at the conversion.  De Ponte used his conversion narcissistically to advance himself.  Whereas Augustine’s conversion was a cleansing ritual after which he became a Bishop and served his flock.  Augustine chose celibacy and priesthood.  He wrote clearly that an addict can not and may not go back to moderation, and saw priesthood and celibacy as antidotes to his sexual addiction. After his conversion, he lived a semi-monastic life for a few years, and then began writing 48 volumes, more than five million words, now translated into more than 200 languages, in addition to his daily demands of being a Bishop.  There is no book, perhaps except the Bible, that has attracted more world wide attention than Augustine’s work, especially his Confessions and his other work of colossal proportion, over one thousand pages, “The City of God which he completed in 426, four years before his death.

In my daily clinical practice, treating any form of addiction, alcoholism, drugs, sex and our modern obsessive compulsive disorder, I frequently use Augustine’s writings to illustrate ways of correcting an errant and defective will.  After all, Augustine rid himself of his sexual addiction. He saw to it that his mother, Monica, give up her addiction to alcohol and his friend Alypius liberated himself from addiction to violence and gladiatorial fights.

The final colloquy which occurred before Monica’s death is a touching tribute to the uniting of the souls of Monicca and her son Augustine:

”If the tumult of the flesh fell silent for someone,
and silent too were the phantasms of earth, sea and air,
Silent the heavens,
And the very soul silent to itself,
that it might pass beyond itself by not thinking of its own being…”

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For further reading:

If you wish to read the original text of Confessionsin Latin by Augustine himself, that would be the finest feat.  There is another version by Paulinus of Milan, who was the original biographer of Augustine.  It, too reads well.  The volume, of course, is available only in Latin.  In English: of all the translations I have seen (and there are literally hundreds of them) the one by Sister Maria Boulding (Vantage Book, 1997) has the highest fidelity to the original text.  Maria’s is a translation and not interpretation.  It is available in paper back.  Another author, Gary Wills, a scholar, has written 13 books each commenting on the individual 13 books of the Confessions. Gary is erudite, wise and “cool!”  I am sure you will enjoy visiting his volumes.  The Confessions are immortal, just like the Iliad and the Odyssey (see the allusion to both in the ‘Sacred Space’ column in the October 2007 issue, of WCP) and Aeneid and Dido…Other sources which I recommend are Pierre-Marie Hombert’s Nouvelles researches de chronology Augustiennes, and Francois Dolbeau.

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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 Mother’s Day

“Monday Musings” for Monday May 8, 2017
Volume VII, No. 19/331

mother

Happy Mother’s Day

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

(Editor’s Note: This year, Both Mother’s Day, May 14, and Richard Wagner’s birthday, May 22, deserve observance. We will devote today’s Musings to Mothers and the next week’s Musings to Richard Wagner, the anti-Semite genius whose character as a person was as loathsome as his music was admirable, if not transcendental.)

Mothers have a special place in the construction and fiber of every society– Western, Eastern, Northern, Southern. Way before the prophets of the Old Testament, Avesta, the Zoroastrian Bible, recorded the “lofty status of mothers before the shrine of Ahoura-Mazda . . .” In the writings of Cyrus the Great, the liberator of Jews from Babylon, who reigned nearly 2600 years ago, he repeatedly insisted that “The wisdom and love of mothers should be employed in all ranks and posts of the government…”

Mothers indeed were more than slaves who cooked and kept the children clean. In the court of Cyrus the Great, there were many mothers as high functionaries and Viziers (ministers). In the personal notes of Benjamin Franklin, credited for founding US Postal Services, he refers to Cyrus the Great the inventor of the postal service, and his first Postmaster General who was a woman by the name of Mithra.

In biological terms, the relationship between a mother and her fetus is unique and unparalleled. This is the ultimate in intimacy: fusion of two human beings, loving, protecting and nurturing of one person, the fetus, who is in the process of becoming, by another person, the mother. A pregnant woman–prospective mother– offers such an in depth and stirring example of “giving-of-one’s-self-totally-to-another” (altruism) that no psychiatrist or behavioral scientist has ever been able to fathom and explain. Freud has written much about women’s penis envy. I am afraid we men cannot have that ultimate form of intimacy in a relationship that women have. Only in recent years have we been looking at, and talking about, this form of ubiquitous pervasive envy that men unconsciously have, being blind to the fact that many men have womb (uterus) envy, that they hold for women.

Frankly, a pregnant woman is angelic in sight. The rich hormones estrogen, progesterone, oxytocin, and oodles of other corticosteroids make her soft, loving, lovable and pure. The mere appearance of a pregnant woman stirs all kinds of noble and altruistic feelings in others. We want to reach out and help, carry their baggage, compulsively ask about how far along they are, and many other brotherly and platonic gestures of love and compassion. I don’t know of any other sight that evokes more noble and altruistic feelings in mankind than the sight of a mother-to-be.

Mothers are saints. Have you noticed that at times of extreme stress, even the most powerful people immediately think of their mothers? This is almost a reflex reaction as commonplace as the knee jerk. When Napoleon Bonaparte was captured in Russia, he cried vociferously, “ou es tu, maman? . . .” “Mother, where are you?” In our own era, when the late former President Nixon was forced out of office, while almost crying, he spoke of “my mother was a saint …”, while 100 million people watched on TV. Much attention has been paid to this fairly inappropriate remark. However, it was most appropriate; because at the time of stress we tend to call on our most intimate and powerful friends. One’s mother, at the time of total impotence and distress is indeed the most intimate powerful and rescuing force.

Being a mother is the most important job on earth. It is also the least rewarded and the least recognized job by the western societies. It takes the nurturing, the selflessness, the staying up all night, the love and care of a mother to raise a child. No creature, under any circumstance, gives so much, so unselfishly, so constantly as does a mother.

My own mother, with whom I share the same birthday died in 1994 at the age 101. Kobra, who was always called Janbibi– means BiBi or Lady of the world-was never, ever, by any one in our family called by her given name Kobra, which would have been blasphemous–loved life. She loved music, dance, poetry, singing, chansons, and parties. And yes, she loved to travel. Like her parents, she, too, fed the poor and there were regular intervals when they made rice and lamb and served them in huge copper trays to the masses that would come to their vast court yard. Our mother was equally serious about knowledge, learning, education, and studying. She had us all memorize Hafez, Saadi, Rumi and of course, the Holy Quor’an. Right up to the last days of her life, when I would talk to her on the phone, after the preliminary exchange of greetings she wanted to know “What did you learn today?” or “What are you reading today?”…

A Personal Note

One of the myriad of things my mother has done for me is to sharpen my sense of observation and awareness. Often when climbing stairs together, when we reached the top of the stairs, she would say “Ageh gufti tchand ta pelleh? Can you tell me how many steps? We travelled together much and she counted the steps in all places- we climbed the 898 steps to the top of the Washington Monument; we climbed the 710 steps of Eiffel Tower in Paris, not only once, but several times; we climbed the 354 steps to the crown of the Statue of Liberty in NY, not to mention the 463 steps going up to the top of Duomo in Florence, Italy and the 285 steps separating the upper hilly Buda and the lower Pest, in Budapest, Hungary, just to name a few adventures…

Well, my mother’s gift, in addition to the gift of medical education which puts extremely high value on observation and encourages paying attention to detail of what one sees, as well as memorizing facts, have made me a quite aware human being. We (my brothers and sisters) have all read the Holy Quor’an over and over. Do we know how many times the name Allah has been invoked in the 114 Surahs –2,698 times. How many times the name Buddha is invoked in Bhagavad Gita, the Hindu holy book? Do we know how many words are in the 66 books of the Old and the New Testament, especially in the 1611 King James Translation? In the Old Testament there are 593,493 words and 181,253 in the New Testament giving a total of 774,746 words in the 66 books. I know many members of our families have travelled extensively. Well, in celebrating my heritage, I have set out to count the number of times the names of the Kings of Persia are invoked in the 66 books of the Bible. The result is astounding. Isaiah is the best press for the Old Persian kings. For example, Isaiah 45 is almost singularly devoted to the doings of King of Persia whom they called Messiah. Isaiah is pure PR and good press for the liberator King of Persia…In the book of Esther 3, Haman, assistant or Vizier to King of Persia, Ahashuerus, who hated Mordecai, shows how the wise king handled the dispute…At any rate according to my count there are dozens of references to the Kings of Persia in the Bible. The origins of the Persian months starting with Nisan (see my Monday Musings for Nowruz, March 21, 2017 which lists all the months of the Old Persian calendar) are all recorded in the Old Testament.

Today, as I recall my mother and with intoxication and spiritual élan, I celebrate that lady’s birthday. I wish all to be infused with love of knowledge, love of wisdom, love of sensitivity to the needs of others with beneficence and altruism. That would satisfy Kobra Meymandi, our Janbibi, and our Lady of The World. She was a magnificent teacher and learner. Right up to the last moment, she sang and wrote poetry. She had faith in herself, in her God and in her children.

Salute to all mothers.

Kobra Hanjari Meymandi died in 1994 at age 101. The Raleigh Concert Hall, home to the North Carolina Symphony which opened on February 21, 2001, was named for her.

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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 Significant Birthdays

“Monday Musings” for Monday May 1, 2017
Volume VII, No. 18/329

Liszt

Holy Week: Beethoven and Al Ghazali’s Birthdays

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

(Editor’s note: There are many Holy weeks throughout the year, Starting with the fall season, there is Raas-ol- Sana (Rosh Hashana), Yom Kippur, Ramadan, Thanksgiving and now Advent leading to Christmas, followed by Easter. But I submit that there are other holy weeks, among them Beethoven’s birthday.  Beethoven was born on December 16, 1770, and the incomparable Persian Theologian and poet, Al Ghazali was born on December 19, 1058. This edition of Monday Musings, a reprint, is dedicated to Beethoven and his glorious interpreter, our own North Carolina Symphony (NCS) Music Director, Maestro Grant Llewellyn. 

Maestro Llewellyn conducted Beethoven ninth on three occasions last week here in Raleigh which prompted me to write him this note:

Dear Friend, Maestro Llewellyn:

‘…I have deep regards and respect for your talents, dedication to your family and profession, combining knowledge of music with Maazalian precision and Bersteinian facility and passion to communicate.  What a marvelous combination.  Good for us, your loyal and loving audience.

Throughout of many years of watching you conduct, I believe Beethoven and Mahler extract the most out of you.  I am privileged to not only watch you conduct, but also while watching, take a tour of your brain.  I write this note to celebrate these delightful tours, your brain and its trillion plus synapses. A brief explanation is in order:

We have powerful instruments for viewing what is going on inside of the skull, namely visualizing the anatomy of this truly wonderful but mysterious organ, the two to three pound brain.  These instruments are Magnetic Resonant Imaging (MRI), Positron Emission Tomography (PET) and functional MRI (fMRI) which not only enable us to view the anatomy of the brain but see and learn how the brain functions,  NO, it is NOT with these instruments that I view your brain fully engaged  while you conduct, but with the knowledge of neuroanatomy and neurohormonal circuitry of the brain.

It is an enchanting and marvelous site to see your brain’s biochemical neruonic interplay and the anatomical juxtaposition of your brain’s vital organs, such as the Limbic system, thalamus, hypothalamus, amygdala, hippocampus, fornix, mammary bodies and the length of your corpus colosseum.  Watching you conduct,, especially the music of Beethoven and Mahler,  infuses the viewer with spirituality and invites entrance to the ether of transcendence…What a feat!  Thank you for those fascinating tours and thank you for bringing your gifts to North Carolina by being Music Director to our most talented and admirable NC Symphony artists/musicians.  Below is for your reading enjoyment,,,’

Love, Joy and Blessings

AM

 

Beethoven 9 Connects my soul with deepest humanities.  Here is an explanation:

The next time you go to Musee d’Orsay in Paris, that unpleasant piece of railroad station, that the former Minister of Culture of France, the late Andres Malraux, transformed into a magnificent museum, go all the way down the hall to the last gallery on the left. There, you will see several paintings of various groups. One of them that stands out is a painting by the 18th century French painter Dan Hauser. It is the picture of a Parisian salon in the 1830s. It shows Franz Liszt at the piano, and at his knee with her face covered is Countess Marie D’agoult, a socially prominent Catholic lady who left her husband and children to be one of many Liszt’s mistresses-scandal galore– Next to Marie is Alexander Dumas, next Chopin and his inseparable girlfriend Aurore Dudevant (George Sand) smoking her fat cigar; next to her, the violinist magician contortionist Nicholas Paganini; next, Rossini, the bell canto opera composer (he composed Barber of Seville in 1816), and Victor Hugo. They are all gathered to hear Liszt play Beethoven, and way on top above everybody’s head is a bust of Beethoven in the background of clouds roiling into infinity. Yes, the painting shows Beethoven high above with the Gods…This is how Beethoven was worshipped after his death.

Ludwig van Beethoven was born December 16, 1770, fourteen years younger than Mozart. His childhood was dreadful. Almost every night, he and his brothers, Kasper (Karl) and Nickkolaus had to go on the streets and cajole their drunken father to come home. The gentleman was a severe alcoholic and on a church pension. The family was one step ahead of welfare. Beethoven fought suicidality most of his life and at one point after becoming deaf he actually planned suicide. He wrote a long letter, Heiligenstadt, complaining bitterly about his miserable life and reasons for ending it. But thankfully, he did not go through with his plans. It was after 1799 that he began composing his famous nine symphonies culminating in the incomparable Ninth. Beethoven’s music is not classic, it is not romantic, it is just Beethoven, expressive, full of power, full of life and full of promise and possibilities, something like the writings of Paul and Pauline theology.

Beethoven’s immortal 9th Symphony composed in 1824 is a summation of his life, a summation of all he had learned and had lived for. Almost anywhere in the world, reference to the 9th is without doubt or question Beethoven’s 9th. It is NOT any of the other symphonists such as Schubert, Bruckner, Mahler, etc. It is always Beethoven’s Ninth. No matter where on earth from Ethiopia, Sub-Saharan Africa, to countries of Eastern and Western Europe, and to the countries of South America and down under, Australia, in the circles where there is the slightest familiarity with classical music, when you mention the 9th Symphony, the listener will reflexively say Beethoven. They might not know his full name, they might not know how to spell his name, they might not know anything about his birth date, birth place, the miserable childhood he had with a drunken father, a long suffering violated and abused mother and several younger brothers, but they know it is Beethoven! The 9th Symphony became immortal when it was chosen/adopted to be the National Anthem of the United Europe in 1989 after the fall of the Berlin Wall. Later, because of the national pride and momentum of the newly adopted National Anthem, the currency of Euro was created which is now being used by 320 million people. Beethoven’s nine symphonies are eponymous with might, excellence and inimitability of Beethoven style. In word association games, tissues are associated with Kleenex, cars with Chrysler, psychoanalysis with Freud, chewing gum with Wrigley and yes the 9th with Beethoven. The dean of music critics, Joseph T. Kerman, ordinarily parsimonious in praise and use of adjectives, refers to Beethoven “as belonging to the same salon with Gods, and merging with Gods.”

In the annals of human history, the power of Beethoven’s music, especially his symphonies, most of them curiously composed in minor key, is unparalleled. His 9th is indeed the apotheosis of vigor, vitality, hope, redemption, and possibility, yet it is imbued in sublimity, transcendence and beauty. Reviewing other notables’ remarks about Beethoven’s 9th is equally interesting. Hector Berlioz, a failed medical student, yet brilliant composer and writer, admitted that in some ways the 9th “remained unfathomable to me.” He continued, “In composing the 9th, Beethoven broke some musical laws, and frankly it is so much worse for the law!” Stuart Isacoff, a contemporary NY music critic suggests that “Beethoven’s new forms, new visions, explored new ways in what music could do and what music could say. Beethoven had begun early in his career to construct his compositions out of small cells, which are organically, as if governed by a kind of musical DNA, matured. The 9th unfolds a psychological drama in which themes are declared only to become subsumed in the flame of heavenly bliss.”

The NC Symphony recently performed the 9th under the baton of its talented and energetic music director, Maestro Grant Llewellyn. Beethoven’s 9th, with its final movement for chorus, four vocal soloists and orchestra set to Fredrick’s Shiller’s poem “Ode to Joy,” left the audience ecstatic with extended spontaneous ovations. The RTP audience was blessed by the hundreds of voices of the NC Master Chorale, directed by Dr. Alfred Sturgis, and the Choral Society of Durham Chamber Choir, directed by Rodney Wynkoop, and the four soloists, soprano Jane Jennings, mezzo-soprano Stacey Rishoi, tenor Richard Clement and bass Raymond Aceto. When the celestial voices of the Chorales were 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.” I felt like I was floating among myriads of angels of hope, comfort, promise and beauty. The magic of the 9th approaches Biblical mystery of how miracles occur.

The extensive literature compiled by theologians of repute, among them Dietrich Bonhoeffer (the German theologian imprisoned and executed by Hitler in Flessenburg Concentration Camp at age 39) and the late Paul Tillich of Harvard University, refer to Beethoven’s music as an essential intellectual tool to understand how “magic” turns into “miracle.” The miracle is described as a man, Beethoven, in 1824, at age 53, in spite of his deafness, cantankerous and increasingly world weary and clinically depressed, living in an apartment with leaky roof and minimal toilet facilities, “he bared his soul in a work so stunning in originality, scale and emotional power that virtually every great composer who followed has lived under its shadow.” And in my view, the miracle continues the shadow cast by the 9th is protective and not destructive. It is nurturing and not condescending, it is life giving and not burdensome. That is the miracle of Beethoven’s music. Some theologians compare Beethoven’s personal life to the life of Job, the violated, abused and tortured soul in the old Testament. Yes, Beethoven’s music, especially his 9th, is a miracle.

I have been fortunate to have heard the 9th since my childhood conducted by greats of the music world, Eugene Ormandy, George Szell, George Schulte, Arturo Toscanini, Leonard Bernstein (he conducted the 9th in 1989 when the Berlin Wall came down), Loren Maazel, just to name a few. I believe what Llewellyn and the NC Symphony musicians and the combined Raleigh and Durham chorales produced in Raleigh’s Concert Hall with its superior acoustics, was a memorable and transcendent experience, comparable if not superior to other programs.

Beethoven 9th is scheduled to be performed by the North Carolina Symphony and NC Master Chorale on April 20, 21, 22, 2017 in Raleigh.

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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 the 2016 recipient of the NC Awards, fine Arts.

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On the Legacy of Dietrich Bonhoeffer

Monday Musings” for April 24, 2017
Volume VII, No. 17/328

Bonhoeffer

Dietrich Bonhoeffer – His Legacy of Noble Writing, Justice and Moderation

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

 

We could not let April to pass without remembering the phenomenal life of theologian Detrick Bonhoeffer:

Seventy two years ago April 9, 1945, on a gray morning during Easter week, Dietrich Bonhoeffer was hanged. He was 30. Germany was on the verge of total defeat. But Hitler’s killing machine was still operating. Bonhoeffer was charged as a traitor to Hitler and to the Nazi regime. We are dedicating today’s “Monday Musings” to honor the memory of this outstanding scholar, theologian, Lutheran pastor and writer. Bonhoeffer was the son of a well to do and prominent German neurologist, professor of neurology and psychiatry at the University of Berlin and the director of the psychiatric clinic at Charité Hospital in Berlin, Dr. Karl Bonhoeffer. Dietrich, with his twin sister, were the fifth and sixth of eight children. His mother, Paula von Hase, was a daughter of Klara von Hase, a Countess by marriage who had been a pupil of Clara Schumann and Franz Liszt Paula was a college graduate and home-schooled the children. The family was full of classical musicians and music advocates. He was in America in 1930, and later pastored miners and common people in Barcelona as a pastor and not academic theologian. He was interested in ecumenism. He concentrated on removing and neutralizing Hitler and his despotic regime.

Dietrich was an exceptional pianist, and his parents thought he might pursue a music career. He was also athletic and played championship tennis and chess. He was expected to follow his father into neurology and psychiatry, but he surprised and dismayed his parents when he decided by age of fourteen to become a theologian and later a pastor. When his older brother told him not to waste his life in such a “poor, feeble, boring, petty, bourgeois institution as the Church”, 14-year-old Dietrich replied: “If what you say is true, I shall reform it!” What we learn from his later life, he was a martyr, too. Just like Socrates who had a chance to escape the prison where he was awaiting death sentence on charges of corrupting the youth of Athens, Dietrich, too, had a chance to accept the help of the World Council of Churches and flee to US. But he did not. He waited his trial, spending two years in jail before his execution. During his time in jail, he wrote a series of articles and treatises about human rights and humanities that approach Socratic dialogues in their eloquence and Plato’s Republic in the beauty of poetry and linguistic supremacy. From prison, he also wrote love letters to his twin sister. The collection of these letters and the ones written to other members of his family and friends provide superb reading to understand the potential strength of conscience and man’s devotion to the truth. And the truth to him was that the Nazi Regime was despotic in need of elimination. He was a participant in the German resistance movement against Nazism and a founding member of the Confessing Church. His involvement in plans by members of the Abwehr (the German Military Intelligence Office) to assassinate Adolf Hitler resulted in his arrest in April 1943 and his subsequent execution by hanging in April 1945, 23 days before the Nazis’ surrender. However, recent research now challenges the assumption that he was directly involved in the assassination attempt. His view of Christianity’s role in the secular world is well-known. He did not advocate theocracy, but strongly suggested that humanity ought to be governed by laws that are fair, righteous and moral. As a matter of fact, the last thing he did before approaching the gallows, he was reading from his pocket edition of Plutarch, and was quoting from Bible. Faithful readers of this space recall that we reviewed Plutarch book “Moralia”. Dietrich Bonhoeffer was reading passages from that book before his execution.

Bonhoeffer has written 25 books all worth reading and re-reading. From the collection, I find myself going back to two volumes, Act and Being. Like any classic literature, Bonhoeffer’s writings have a theme, are written with elevated and noble language, and change the lives of the readers. His pen continues to speak to us today.

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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 the recipient of the NC Award, Fine Arts.

 

 

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