Category Archives: The Writer

The writer is a Distinguished Life Fellow, American Psychiatric Association, Adjunct Professor of Psychiatry, University of North Carolina School of Medicine at Chapel Hill. He is the Founding Editor and Editor in chief, Wake County Physician Magazine (1995-2012).

On Brain Series

“Monday Musings” for Monday June 18, 2018
Volume VIII. No. 2
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DNA

Epigenetics, Depression Gene, Book of Genesis and Pauline Theology of Faith, Hope, Love and Redemption

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

Part 2

Faithful readers of this space recall the article on epigenetics that defies Darwinian Theory of Evolution. Darwin asserted that it takes millennia to evolve changes in an organism. The studies of the families in northern Sweden, sparsely populated Norbotten, just six people per square mile, reveal that it takes only a couple of generations to effect evolution. The ancient biblical story in Genesis chapters 41 through 47, which describes the Egyptian Pharaoh’s dream of “seven years of plenty and seven years of famine,” prove to be relevant to the science of epigenetics and the rapid two-generation-evolution-cycle instead of two millennia. Epigenetics, a 21st century science, is the study of changes in gene activities that does not involve alteration to the genetic code but is passed down to successive generations. Many scientists including British colleague, neurologist/polymath, Raymond Tallis, a former Meymandi Fellow, National Humanities Center, call this phenomenon as “Darwinits.” Here is a summary of research described previously.

In the 19th century, a province in northern Sweden called Norrbotten literally experienced seven years of famine followed by good harvest and abundance of food. The feast and famine period that occurred in this sparsely populated province (only six people per square mile) has offered astonishing epidemiologic and scientific data that have given birth to the science of epigenetics. The years 1800, 1812, 1821, 1836, and 1856 (the year of potato famine in Ireland) were years of total crop failure and famine for the people of Norrbotten. But in 1801, 1822, 1828, 1844, and 1863, there was excellent harvest and an abundance of food. Scientists of the renowned Karolinska Institute, Stockholm, Sweden, have undertaken the painstaking work of evaluating this history of famine and feast to see how it affected the lives of the children born then.

They have found that “life conditions could affect your health not only when you were a fetus, but also well into adulthood,” concluding that parents’ experiences early in their own lives change the traits they pass on to their offspring. The result of the study shows that the years the children were well fed, their own subsequent offspring grew up to be healthier and physically bigger. Epigenetics makes it possible to enhance the activities of the good genes and silence and discourage the activities of the bad genes. The task is not very difficult. To chemically flip the “good” switch on, one must introduce a methyl group (CH3) to the side chain of DNA—a very simple procedure; or vice versa, to flip it off, introduce a demethylate compound to suppress the activities of the bad genes. The exciting science of epigenetics is very much like a switch on the outside of the genetic circuits and genome that influences the behaviors of a gene. The very prefix epi, which means to lie outside of the root structure, helps explains that, while not an integral part of an organism’s genetic code, epigenetics can influence the gene’s activities from the outside. Flipping the switch enhances (turns a gene on) or inhibits (turns a gene off) DNA activity.

Now we are learning that genetic configuration and longevity of a cell is very much related to telomeres. In 2009, Elizabeth Blackburn, Jack Szostak, and Carol Greider, won the Nobel Prize in Physiology or Medicine for their elucidation of the structure and maintenance of telomeres (the tips of chromosomes). These investigators discovered that telomeres are DNA sequences with a structure that protects chromosomes from erosion and that a specific enzyme, telomerase, is involved in their repair after mitosis. In daily psychiatric practice one wonders why the incidence of suicide is so high in so many families irrespective of socioeconomic and religious orientation. Here is an examination of depression.

Is there a depression gene?

Suicide of Ali Reza Pahlavi, 44 year old son of the late Shah of Iran (Jan. 4, 2011) which followed by the suicide of his sister, Leila Pahlavi in 2001, has stirred many questions regarding the genetic aspect of depression. We have known depression as a distinct clinical illness since the days of Hippocrates (460 BC-370 BC) and Galen (129 BC-217 BC). It was called melancholia with the fascinating etymology of melon, black; cholia, colon, or black bowel. The ancient clinicians thought the origin of depression was in the intestines.

It was not until the Persian physician-polymath, Abu Ali Sina (Avicenna 980-1037 AD) and Abū I-Walīd Muḥammad bin Aḥmad bin Rušhd (Averroes 1126 – December 10, 1198), and contemporary colleague, the Jewish physician, Rabbi, theologian and philosopher, Moses Maimonides of Cordoba (Rambam 1135-1204) who stirred up academic kerfuffle and forwarded the basic thesis that depression had to do with the brain and not the gut.

Rambam in 1150, not yet 25, a physician to the Muslim Caliph, described depression, obsessive compulsive disorder (Vasvas), and designed methods of treatment that we today continue to use, namely cognitive behavioral treatment (CBT). Of course, they used many herbs and botanical products. Their pharmacopeia is replete with plants, herbs and roots. Edinburgh University in Scotland, around 350 years ago, created the famous Edinburgh Botanic Garden with nearly 400 acres of plants with the single purpose of copying Avicenna’s pharmacopeia. Avicenna’s medical textbook Canon of Medicine was taught in all European medical schools well into the nineteenth century.

Sir William Osler’s writings have many references to these giants of medicine. Three learned colleagues interested in history of medicine, Mohammad M. Sajadi, MD; Davood Mansouri, MD; and Mohamad-Reza M. Sajadi, MD, of Baltimore, Maryland, have written a comprehensive article in Ann Intern Med. 2009;150:640-643. Visit www.annals.org for further details about the genius of Avicenna as a clinician, teacher, author and polymath. Avicenna’s brilliance continues to shine and give guidance to the teachers of medicine even a millennium after his death. Fast forward to present the clock of medical science and technology.

We now know that DNA provides powerful clues to understanding disease. Data from the National Institute of Mental Health strongly suggest a particular gene may increase the risk of depression. The scientists have found that people with one form of a protein that transports serotonin, one of the many mood-related neurotransmitters, are especially prone to depression when faced with traumatic events, such as alienation, loss of power, country and princely positions. The displacement is especially consequential for members of disposed royalties. In exile, these privileged children often forget their native tongue and do not learn the language of their adopted country which exacerbates the sense of alienation and social isolation. The version of the particular depression gene prevents the neurons (brain cells) from re-absorbing serotonin, which leads to feelings of sadness and negative mood and may make it harder for them to recover emotionally from a crisis. Depletion of the good juices of the brain such as dopamine, indoleamine, serotonin and catecholamine, epinephrine and nor epinephrine leads to depression.

Untreated depression often leads to poor quality of life, addiction to, abuse of, substance and other forms of self-destructive behavior including suicide. Just as there are families predisposed to paucity of brain dopamine and familial suicide, I know of many families genetically predisposed to an abundance of brain dopamine, especially in the Locus Coeruleus and the Limbic system, particularly hippocampus, the seat of memory in the brain. This is the biochemical and neuroendocrinological equivalence of Pauline theology of hope, love, faith and redemption. Fortunate folks with well-endowed dopamine circuitry face adversities and vicissitudes of life with optimism and possibilities.

Science has accumulated enough knowledge about the mechanisms of cognition, mentation and perception and their molecular underpinnings at the synaptic junctions that we can make bold advancement in the area of understanding the nature of depression gene. We reviewed the book by the learned science journalist Sharon Begly, Train Your Mind, Change Your Brain, in which she cited her work with Dalai Lama and the interest His Holiness, has exhibited in neuroplasticity. One of the strongest findings in neuroplasticity, the science of how the brain changes its structure and function in response to input, is that “it is almost magical to observe the ability to physically alter the brain and enlarge functional circuits…” We may have depression genes. But we also have a plastic brain, and chromosomes that have flexible telomere length, even making us live longer. We now are learning the molecular biochemistry and endocrinology of joy, a constant running brook of dopamine, producing Straussian symphonic poem of life.

Let it be known that joy is not the same as happiness. Happiness is the uncorking of a bottle of wine and celebrating an evanescent moment. Joy, on the other hand, is steady, permanent, and life giving. Like a running brook, it is constant and it refreshes. Joy changes the morphology and molecular structure by our brain. And these changes may be brought about by a simple change in our attitude and approach to life. Scientists have shown that by just showing purpose and determination, and by merely uttering positive words and intentions, the level of brain dopamine is raised. Think joy. Read Saint Paul’s writings and replenish your brain’s dopamine.

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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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“Monday Musings” for Monday June 11, 2018
Volume VIII. No. 24/388

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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 “Brain and Behavior” to observe Father’s Day which is coming on Sunday, June 17, 2018. We will resume the neuroscience series next week.  Now a few reflections on Father’s Day

: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 the Brain and Behavior

“Monday Musings” for Monday June 4, 2018
Volume VIII, No. 23/387

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Brain and Behavior

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

Brain and Behavior, Part one

“As humans we can identify galaxies light years away, we can study particles smaller than the atom, but we still haven’t unlocked the mystery of the three pounds of matter that sits between our ears,” said the 44th US President Obama in one of his last White House press conferences. Obama followed up by announcing that he will seek $100 million for brain research in the budget he is presenting to the Congress. He came through with his promise.  The research proposal includes approximately $40 million for research at the National Institutes of Health, $50 million at the Defense Advanced Research Projects Agency and $20 million for the National Science Foundation. We have precedence. Scholarship and literature about the brain expanded rapidly, thanks to a federally funded $2 billion-per-year research effort organized by Congress in 1990 dubbed “The Decade of the Brain.” Mind/brain” exploration has also been driven by advances in basic knowledge and by new imaging and biochemical technology. This knowledge and technology allow scientists to watch the brain as it orchestrates the functions of life. Here are a few considerations:

Brain is not just as an organ of mentation, perception, cognition, and memory, but is a marvelous, even mysterious, complex structure. This structure is responsible for our rich repertoire of feelings, such as anger, jealousy, hatred, love, fear, hostility, sadness, compassion, generosity, kindness, guilt, pleasure, altruism, peace and joy. Traditionally, science has been more concerned with understanding mechanisms than with appreciating personal meanings. However, to understand the brain in totality, we must pay attention to both. As a consequence of this attention, we have learned that the brain is also responsible for our complex spiritual and cosmological pursuits. When an outfielder leaps up to snag a fly ball, we admire the ballet-like performance and ponder it. The moment the ball is hit, the outfielder’s brain begins to receive visual inputs. The eye tracks the ball; the brain computes its trajectory. Within milliseconds, millions of instructions are flashed to hundreds of muscles, telling each the exact degree of tension or relaxation required to move the body to the spot where the ball will descend. A flood of signals feeds back to the brain indicating whether each muscle is responding correctly. Finally, in a flurry of rapid-fire calculations that would outstrip the most powerful computer, the brain orders muscles to propel the body upward and extend the arm. Gloved hand and baseball arrive at exactly the same point at the same time.  On the other hand, take the case of Rajang Srinivasen Mahadevan, a native of Mangalore, India, who manages to remember the first 31,811 digits of the number pi. This feat is achieved through the function of hippocampus and amygdala (please see my review of the book by psychiatrist and Nobel Laureate Eric Kandel which appeared in this space two years ago), two anatomically small portions of the limbic system and nucleus ceruleus.

What part of the brain is responsible for the sudden and overwhelming feelings of warmth and spirituality that sweep one’s soul when listening to a favorite composer? Does the brain contain the soul? What goes wrong with the dopamine and acetylcholine neurotransmitting systems in the brain of an Alzheimer’s patient with no memory, feelings, or personality, producing the unwelcome transformation of a person into a human object? What happens to the brain’s indoleamine and serotonin system in clinically depressed patients whose pain of living is so great that death becomes welcome? What about the ascetic dervish who fasts for 40 days and finds ecstasy in solitude and meditation? And what goes on in the brain of the violinist Medori (she last performed in Meymandi Concert Hall of Raleigh on January 16 and 17, 2009), who at age six was able to play classical music without looking at the notes?

These are but a few examples of the myriad secrets of this three-pound organ we call the “brain.” The spin-off of the “Decade of the Brain” is a better understanding of its role in healing, spirituality, and wellness. For example, meditation has been shown to enhance healing.  It is hoped that our knowledge of the brain will continue to expand and cure for Brain diseases, such as schizophrenia, Alzheimer’s, autism, and other neurologic diseases will be achieved.

The neurophysiology of meditation has been worked out since in studies from London’s Maudsley Hospital, Sweden’s Karolinska Institute, New York’s Columbia Hospital, and the National Institute of Mental Health. Those studies have demonstrated that meditating for 20 minutes, morning and night, decreases oxygen consumption and the heart rate below the heart rate found in sleep. It also increases the blood flow to muscles and organs, decreasing the level of lactic acid and low-density lipoproteins.

The brain—containing 100 billion neurons, 900 billion glial cells, 100 trillion branches, and 1,000 trillion receptors—reacts to stimuli in a series of electrical bursts, spanning a complex map of connections. To keep this fascinating machine functioning and intact, it must be constantly stimulated and exercised. Whether it is calculating an algorithm or memorizing Lorenzo De Ponte’s libretto for Mozart operas, the poetry of Wordsworth, or the prose of Ibn Khaldoun, the brain must keep working to stay alert and fresh.

As physicians, we are blessed with the gifts of intellect and compassion. Our patients are getting grayer. We must encourage them to continue to exercise their brains, and, as their role models, we physicians should continue to be avid “memorizers” ourselves.

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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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“Monday Musings” for Monday May 28, 2018
Volume VIII. No. 22/386

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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.  Both 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 15 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 the 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’s Birthday

 “Monday Musings” for Monday May 21, 2018
Volume VIII, No. 21/385

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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*

Tomorrow is Richard Wagner’s 205th 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 201 years, almost all of his operas including Flying Dutchman, Ride of Valkyries, Tannhauser, and Die Meistersinger Von Numbergare a steady diet of most opera houses and symphonies throughout the world. several years ago, the North Carolina Symphony played in the first half of the program, Prelude to Act I, Lohengrin. The second half featured the memorable performance of virtuoso violinist, Itzhach Perlman playing Violin Concerto in D Major, Opus 35, by Peter Ilyich Tchaikovsky. As an aside, on May 12, 2015, 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 a special program of classical music with Conductor Grant Llewelyn featuring Joshua Bell this coming fall. Raleigh has an extraordinarily rich cultural life.

Back to Wagner:

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.  Wagner was a superb writer and philosopher

On the local scene in Raleigh, the transfer of Dix property to the city of Raleigh was accomplished on May 5, 2015.  A group of citizens is working very hard to create a world class destination park on the 303 acres of land in the heart of downtown Raleigh for all to enjoy.  Personally, I am looking forward to the day we will have an opera house built on Dix Park, NC’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 205th 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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On Gun Violence

Monday Musings for Monday May 14, 2018
Volume III, No. 20/384

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Gun Violence Control, Where is the Wisdom?

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

The former President Obama called the massacre of 20 innocent children and six adults on Dec 27, 2013, in Sandy Hook Elementary school in Newton, Connecticut, the worse day of his presidency.  History tells us that every president since GW has had a/the worse day.  For George W Bush it was September 11, 2011, for FDR it was Pearl Harbor, December 7, 1941.  All our 44 presidents have had the worse day in their presidencies.     It would be a meritorious project for some PhD candidate in history to compile a volume on every US Presidents’ worst day in the office.

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

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

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

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

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

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

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

What to Do?

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

There is a glimmer of hope.  UNC system President, Dean of UNC School of Medicine at Chapel Hill, Dr. William Roper, and WakeMed administration have agreed to provide a psychiatric unit of 40+ psychiatric beds for Wake County.  With the projected population growth in our area, to do an adequate job, we need a facility with 500 psychiatric beds.

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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 serves as a Visiting Scholar and lecturer on Medicine, the Arts and Humanities at his alma mater the George Washington University School of Medicine and Health.

 

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On Mother’s Day

Monday Musings” for Monday May 7, 2018
Volume VII, No. 19/383

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Happy Mother’s Day

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

(Editor’s Note: This year, Both Mother’s Day, May 13, 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 Immigration

Monday Musings for Monday April 30, 2018
Volume VIII, No. 18/382

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Some Thoughts on Illegal Immigrants and the Moral Dimensions of Ethics

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

(Editor’s Note:  Our inbox is full of requests for a ‘Musings’ about immigration.  Here are a few thoughts.)

The illegal immigration is a daunting issue that does not go away. If anything it gets bigger and more complex as time goes by. We are told that the President and US congress are finally trying to offer a solution.  But because of the mercurial nature of the administration nothing including the humanitarian promise of solving the status of some 800,000 children who came to this country illegally and now live in uncertain status called Deferred Action for Childhood Arrivals (DACA) remains up in the air

As an American by choice and not by birth, I have the privilege of seeing both sides of the picture.  The public perception of a stereotype immigrant enhanced by media is a fellow who is here earning good wages, not paying taxes and being a burden on our schools and health care.

Let us not forget that nearly 80% of all the Nobel Laureates in the twentieth Century were immigrants who chose to come to America and become US citizens. The vast majority of Nobel Laureates in the past 113 year history of the Prize have come to America as immigrants. America has greatly benefited by the constant infusion of brilliant, motivated and idealistic immigrants to its shores. Many immigrants who come here do not come for the search of a job, a proverbial brick house with two car garage and a beach place. We come to America because this county remains the last haven for the lovers of freedom and seekers of liberty. We come to America because of the attraction of the supremacy of rule of law and not rule by whims of kings, Shahs, Ayatollahs and dictators.

The opinion on the subject is diverse. One group advocates that illegal immigrants ought to be caught, treated like criminals and deported. Another group, sounding humane, recognizes the sacrifice, risk taking and inspirational motivation of the immigrants. These are good honest family men and women. They assert that illegal immigrants are dedicated people here to work hard, take jobs that native Americans would not, and support their families back home. And there is a third group, the realists that know the value of illegal immigrants in our economy.

Since the dawn of Neolithic man, people have immigrated to improve their lot. Remember America itself is an immigrant nation. A recent report available online, prepared by Kofi Annan, the former United Nations (UN) Secretary General, submits that immigrants not only benefit themselves and their families, they also benefit the economy of their host country as well as the economy of the country they leave behind. Moneys sent back to their country are spent to improve their families’ standard of living. The report cites the immigrants’ contribution to the economy of their native countries was 225 billion dollars in 2005 and 167 billion dollars in 2004. It further documents that the families of the immigrants spend more on education and health care at home than do others.

Also, there is an invisible and intangible benefit not easily quantified that the families of immigrants left at home are more motivated and inspired to lift themselves from poverty by educating their children and instilling hope in the future of their younger generations. Lastly, this group of economic pragmatists sees that successful immigrants, such as financier George Soros, the hedge fund mogul, benefit their native countries by investing and transferring skill, knowledge and entrepreneurship back home. The burgeoning software industry in India which emerged as the result of intensive interaction between immigrants from India and the universities and industries in America is an eloquent testimony to the positive and global impact of immigration. The cover story of the recent issue of The Economist magazine, is about “India becoming a Great Global Power”.

I hope the US Congress and the President engage in a dispassionate, reflective and altruistic debate on this critical issue to examine all arguments and produce laws that are fair, just and generous to all immigrants.

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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 serves as a Visiting Scholar and lecturer on Medicine, the Arts and Humanities at his alma mater the George Washington University School of Medicine and Health.

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On Textonics

“Monday Musings” for Monday April 23, 2018
Volume VIII. No. 17/381

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James B Hunt Library, North Carolina State University

Textonics: Democratizing Knowledge

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

One of the most exciting events of the twenty first century which holds much promise for the future of this country and the world is Textonics.  The first half of the twentieth century saw many inventions including the flight of the Wright’s brothers, Salk vaccine, and the discovery of antibiotics.  The second half of the century saw the stunning and most important discovery in the ten thousand year history of Neolithic man, namely DNA, in February 1953. Its discoverers, American James Watson and British Francis Crick were awarded the Nobel Prize for Chemistry in 1962.

Already 16 years into the 21st century, we have begun to see the possibilities of offering mankind the most important undertaking of Textonics.  It is digitizing the literature of the world and making it available to every child even in the most remote villages in all corners of the world. Just think, it will bring the content of the world’s libraries to students everywhere.  One is reminded of Al Gore’s comment, several years ago, that we should strive to bring the content of the Library of Congress to every student in America.  The Librarian of Congress, James Billington, who stepped down from his post in September 2015, in several commentaries emphasized the staggering problem of copyright laws, just to mention one drawback.  But over the past several years an enormous amount of progress has been made to overcome these barriers.  There are a number of incentives in the form of awards created by academic centers and devoted to the fostering and encouragement of rapid development of this field.  Among these awards are the A. R. Zipf Award and the Richard Lyman Award given by the National Humanities Center, RTP.  Dr. Jerome McGann, Chair, Department of Textonics at the University of Virginia was the recipient of the 2002 Lyman Award.  He has a large department with no fewer than 16 doctoral candidates working on various aspects of this exciting field. The 2003 Lyman Award winner is Dr. Roy Rosenzweig of the College of Arts and Sciences of George Mason University.  He is known as “Digital Democratizer”. The Award ceremonies were held in the Great Hall of the Library of Congress, an elegant venue.  Those of us privileged to attend were witness to an exciting event not dissimilar to the first flight of the Wright Brothers at Kitty Hawk, North Carolina.

The field of Genomics, which has produced eight Nobel Prize winners, and Proteomics, with its three Nobelers, are merging with the field of Textonics (no Nobel Prize yet) and asymptotically approaching the holy grail of artificial intelligence.

One of the best kept secrets of NCSU is its program of Textonics. Through an intense labor of love and costly initiatives North Carolina State University’s  D.H. Hill Library has become a leader in the digitizing world.  In my travels, I have spent much time at the British Library, conferring with its Director and the person in charge of its information technology and digitization.  I can tell you that we are far ahead of UK.  I am also in touch with the University of Paris and the Sorbonne.  They, too, are nowhere near where NCSU and UNC Libraries are.  NC’s program of digitization is admirable and most progressive.  We applaud the leadership of Susan Nutter, her able staff, and the leadership of Chancellor Randy Woodson. In addition, University of North Carolina at Chapel Hill has initiated a program where documents are not only digitized but according to its program director, Dr. Nick Graham, “sometimes we need to take the archive to the people…”  What they are doing in UNC and NCSU Libraries in archiving books and historical documents to the public reminds me of the days doctors made house calls.  Nick Graham and his staff will deliver digitized material to the public and communities, from Manteo to Murphy, on demand.  So, no school child s left behind because of lack of material.  Congratulations to the UNC Library system and its leaders.

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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 Dreams, Psychoanalysis and Neuroscience

Monday Musings for Monday April 16, 2018
Volume VIII.  No 16/380

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On Dreams, Psychoanalysis and Neuroscience

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

Interest in dreams goes back to Sumerian recordings some 8,000 years ago. There are abundant references to dreams in Torah, the Bible, the Holy Quran, and other celestial books, such as Avesta, the book of Zoroaster, written 500 BC. But it was not until early last century, when Freud published his work on understanding and interpreting dreams, that a firm connection between dream, memory, and “mental” history began to evolve.

Fast-forward the clock. Neuroscientific interest in dreams started in 1953 with the discovery of rapid eye movement (REM) sleep by Aserinsky and Klietman, taking psychophysiologic findings of dream into the realm of biology. There are many exciting discoveries in the area of psychoendocrinology of dream and memory coming out through many sources and laboratories both in the United States and abroad. In fact, an article by Mauro Mancia, the enormous sage of the Italian academia, neurobiologist, and psychoanalyst, was recently published in the American Journal of Psychiatry entitled, “The Role of the Interrelation Between Serotonin (5-HT), Muramyl Dipeptide, and Interleukin-1 (IL-1) in Sleep Regulation, Memory, and Brain Regulation.”

This brings me to a most interesting read: Psychoanalysis and Neuroscience, which was edited by Dr. Mancia. Dr. Mancia is Professor Emeritus of Neurophysiology, University of Milan, Italy, and Training Analyst of the Italian Psychoanalytical Society and has written extensively on the subjects of narcissism, dreams, sleep, memory, and the unconscious. This particular work by Mancia, Psychanalysis and Neuroscience [Springer, 436 pages, 2006] is organized into four parts that propose a link between neuroscientific knowledge and psychoanalytic theories of mind.

Overview

Part I—Memories and emotions. Part 1 of the book consists of eight chapters written by experts in their respective fields and examines one basic message: Memories stand out and last longer when they are accompanied and highlighted by emotional experience. The message conveys the importance of interconnection of memory with emotions. With scientific detail and elaboration, the authors demonstrate the proteins in the amygdala and hippocampus are responsible for retention of memories, which are parts of the limbic system that is, overall, responsible for housing emotions, denoting the common neuronic pathway for memory and emotions. It was Paul D. McLean in the 1940s, while mapping specific components of the limbic system, who invoked the romantic notion that the limbic system is “the anatomy of emotions.”

Part II—The shared emotions. The second part of the book examines the sensorimotor side of “empathy pain,” the role of the anterior cingulate cortex in affective pain, and social cognition and response to embodied stimulation.

Part III—The dream. The third part of the book, which is perhaps the most exciting, deals with the dream in the dialogue between psychoanalysis and neuroscience. One chapter dissects the neurobiological and psychoendocrinological anatomy of dreams and memory formation. In recalling events of the past as practiced in psychoanalysis, the brain’s physiology and even anatomy and morphology stands to be changed. This part of the book reminded me of another significant book recently published, Train your Mind, Change your Brain, in which author Sharon Begley, a Wall Street Journal neuroscience reporter, showed how thinking can change the brain functionally and anatomically.

Part IV—The fetus and the newborn. Part IV discusses fetal behavior. While the word embryology is seldom used, the authors of these two chapters examine in detail the onset of human fetal behavior and the neurophysiologic impact and influence of nursing on the early organization of the infant mind.

Discussion

With the knowledge that the basic instrument in the discipline of psychoanalysis is recall of memories, dreams, and transference, the 21 contributors to this book make a good case as to why there should be a robust and constant conversation between psychoanalysts and neurophysiologists. It is time for these disciplines to learn about and from each other. The book’s contributors invite readers, in the most scholarly and convincing manner, to consider that psychoanalysis is a powerful reservoir of volumes of memories and should integrate resources with neurophysiology and enjoy the mutual fertile and rich products. It is the expressed purpose of the book to further elaborate and understand the relationship between memory, dreams, and neurobiological changes occurring during the experience and the course of psychoanalysis. This holy partnership is encouraged, and the book’s contributors, like priests, are willing to bring about this holy matrimony to the world of science.

The downside of the book is that it is a rather difficult read, likely owing to the fact that it is a translated work. I do not know how much education on psychoanalysis and neurophysiology the translator, Mrs. Judy Baggott, has had. To a linguist, such as myself, who is conversant with a variety of Eastern and Romance languages, the slip of the translator shows fairly frequently. Her skirt should be longer! However, this minor flaw should not dissuade anyone from tackling this enormously informative and scholarly work.

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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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