On St. Paul, Mozart, and CETP

“Monday Musings”, January 9, 2017
Volume VII, No. 2/314

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Conversion of Saul to Saint Paul. The Birth of Mozart. Discovery of CETP.

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

The next couple of week three important events take place. I will elaborate in the order of importance.

Event I The Feast of the Conversion of Saul to Saint Paul the Apostle:

Many biblical scholars and historians of impeccable credentials including Eusebius of Pamphili, Saint Jerome, Saint Augustine of Hippo, Saint Ambrose who converted Saint Augustine of Hippo form pagan pursuits and Manichean beliefs to Christianity in 386, and baptized him on Easter morning 387, and Pope Gregory, have written and attested that the conversion of Saul to Paul took place on January 25. Among more modern historians, I recommend a comprehensive and magnificent book published in 1747 by Oxford Press written by the most formidable historian of early Christian era, Lloyd George Lyttleton (1708-1773). The book uses earlier references to lay down the cornerstone of this historic event, namely conversion of Saul to Paul on this date. Saul was a Pharisee with a precise/dry life style, demanding, draconian, exact and unforgiving. Every “t” had to be crossed and every “i” had to be dotted. He lived a life of exactitude with no love and no joy. Paul on the other hand brought the message of hope, faith, love, charity and forgiveness. The two people, Saul and Paul, were extremely opposite in orientation and life style. In many Christian churches including the Roman Catholic, Eastern Orthodox, Oriental Orthodox, Anglican and Lutheran churches, January 25, is celebrated recounting the conversion. The feast is at the conclusion of the “Week of Prayer for Christian Unity and International Christian Ecumenism” which began in 1908. The feast is an octave (an eight-day observance, not a musical octave!) spanning from January 18 (observed in Anglican and Lutheran tradition as the Confession of Peter), to January 25.

Here is the collect for the occasion.

“O God, who taught the whole world through the preaching of the blessed Apostle Paul, draw us, we pray, nearer to you through the example of him whose conversion we celebrate today, and so make us witnesses to your truth in the world.”

 Event II The birth of Johann Chrysostom Wolfgang Amadeus Gottlieb Mozart:

261 years ago, on January 27, 1756: God wanted to show his mere mortal children, like you and me, what He could do with music. He chose a special child, Mozart, to demonstrate the complex sublimity and eloquence of music. Mozart composed more than 623 incomparable pieces in all genre of music, from symphony to opera, to chamber music, etc., in his short life of 35 years. We will devote the January 23, 2017 edition of “Monday Musings” to the miracle of Mozart.

Event III A New Discovery in Health Care. A Plug for Prevention:

Like any other human endeavor, in medicine, we have hype, hyperbole, hysteria and high drama. Charlatans from every corner claim to use their powder on food to make you burn calories and lose weight. Full page ads for miracle treatment of back pain in both skinny and fat people. It should be known to all obese people who suffer from back pain that taking off one pound of body fat takes five pound off the aching back. Incidentally, in my view, doctors advertising in news media, both print and electronic, violate Oslerian ethical mandate of medicine. It is very distasteful. It is more than distasteful. It is really disgraceful. Medicine is not a commodity. Medicine is not a business. Medicine is a calling. Medicine is a priesthood, and we, as doctors, are privileged to be handpicked servants to help our patients (not clients, not heath consumers) for which we should be grateful.

However, there are some medical discoveries reported in peer reviewed journals that are époque making and worthy of note. The recent discovery of Cholesteryl Ester Transfer Protein (CETP) or Evacetrapid is one. A bit of explanation is in order. In America, cardiovascular diseases are the biggest killers followed by cancer. For over a half of century scientists have implicated excess circulating cholesterol, especially low density cholesterol or “bad” cholesterol is responsible for occlusion of coronary arteries, leading to heart attack. We have produced a class of drugs call Statins that lower the bad cholesterol and increase the good. However, Statins have undesirable side effects. The side effects include muscle and joint pain and muscle damage. In some cases Statins have been known to cause lysis or eating away of muscles called rhabdomyolysis. Other side effects of Statins are liver damage, kidney failure and fatigue/depression. Liver damage caused by Statins occurs by increasing production of digestive enzymes. Other serious side effects may be low libido and pancreatitis. I see quite a few patients with neurological side effects, such as memory loss, depression and sometimes more serious neurologic conditions.

Back to CETP:

A recent paper published in the medical literature describes a new chemical that assists cholesterol lowering drugs or Statins to become more effective and biologically efficient. the name of the agent is Cholesteryl Ester Transfer Protein (CETP) Inhibitor. It is potentially capable of replacing use of Statins altogether doing away with Statins’ side effects. But the best life style is prevention, proper diet; exercise and discipline of what one puts in one’s mouth are the ultimate answer to good health. Medicine does have its genuine miracles. In America, a pill taking culture, we have been brain washed that for every ill there is a pill. A pill to sleep, a pill to stay awake, a pill to focus and concentrate, a pill to cure erectile dysfunction, a pill to cure irregularity, a pill to regulate too much regularity. A pill to cure depressed mood, a pill to tone down elevated mood. Aram Khachaturian or Leonard Bernstein could have done well to compose a piece of music like Saber Dance or Candid to express our ominous pill taking culture. I submit that we should pay more attention to prevention. With 80% Americans ranging from fat to very obese and morbidly obese, no wonder we have so many cardiovascular deaths, diabetes, musculoskeletal, that is back and joint problems. I believe we must invest in prevention and have a major national program of awareness to seriously address health issues most caused by fatness. One of the things that I think is most discouraging is to see so many doctors and nurses (health care providers) who are obese. This is truly an ugly and unacceptable site. Instead of putting something in our mouths, we must learn to take something away from our mouths..

Surely, here we are celebrating the discovery a chemical that will potentially help millions. But the main message is to celebrate prevention. We have had luminous achievements in this field. Salk vaccine against polio is a good example. 2011 was the first year no polio was reported in India with a population of one billion. Malaria is on its way to extinction, same as some 25 other infectious diseases including the big killer small pox. To take responsibility for one’s health is not only a civic, but a moral responsibility. Tobacco, alcohol and obesity kill without discrimination.

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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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