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The Flawed Hero Within Us

8/26/2016

 
By Richard P. Holm, MD​

In a world of selfishness, dishonesty, and discrimination, how do our children find their way? Conventional wisdom says that we only learn by example, and just look at what examples abound: selfishness with criminals like Bernie Madoff and other Wall Street scoundrels; dishonesty with blatant false marketing by actors on TV; and discrimination by politicians against people of other religions, other sexual orientation, other cultures, other anything. Indeed, if our children only learned by these kinds of examples, we would be in big trouble. But here is where mental health and choice comes in.

During our lives, especially when young, every one of us must be on a quest for meaning, and experts say that mostly we find our way by choosing examples for living. I learned first from my parents' and then there was the farmer who taught work ethic, the football couch who taught toughness, the debate couch who taught intellectual curiosity, the college classmate who taught kindness, and the med school professor who taught the importance of honest science. It is true that we grow most, not from books, conferences, lectures, or rules, but rather by example from the heroes around us.

The religious expert Joseph Campbell taught us that the “hero’s quest” is a story that comes from every culture as a metaphor to help us in our search for meaning. The classic hero story of Greek mythology begins with an innocent baby, born from one mortal parent crossed with a god, who somehow escapes an evil menace, and as a young adult embarks on some quest to find meaning. This adventure commonly finds the hero selflessly slaying an evil dragon to save an innocent damsel while bringing back truth and justice to the nearby village.

The modern hero story is different from the Greek myth. She or he is a flawed ordinary person, someone with whom each of us can relate, who comes up out of the morass of our modern troubled society to stand for something that gives direction and meaning to our lives.

The modern hero is someone each of us could be. We can try, even in a flawed way, to live a life that is not selfish, but helpful to others; not dishonest, but truthful while considerate; not with cruel discrimination, but respectful of the rights of others who may be different.

There could be a hero within every one of us.

The feminine mystique

8/19/2016

 
By Richard P. Holm, MDIs equality between the sexes good for men and women and society?

Of course, men and women are different in very important ways! Yet some people exploit the differences to make subservient generalizations about women. I've heard it said that women are, or should be: shy, passive, want-to-please, adoring, doting, and happy as homemakers serving their children and husbands. Sigmund Freud the psychoanalyst said, "Nature has determined woman's destiny through beauty, charm, and sweetness... in youth an adored darling and in mature years a loved wife." Freud even went so far as to suggest that women who wanted careers were neurotic and imbued with "penis envy."

As Betty Friedan observed in 1963, Freud's ideas had became especially popular in the mid 1940s, suggesting women are only fulfilled as housewives and mothers, and unhappy having a career. She decries Freud's error-in-judgement in her book The Feminine Mystique. Friedan noted that in the early 1900s there had been grand advances made for the rights of women, especially for higher education, for pursuit of career, and for the right to vote. Except for the right to vote, much of this went away after World War II, when men came home from war and took away jobs from women who had been employed to support the war.

The returning soldier longed for a comfortable home where he was the bread-winner and his wife the house-keeper who raised the children. Friedan said this caused great unhappiness in the some households when women who wanted a career were strongly discouraged to do so. Injustice and inequality beget disharmony.

Since then, due to the effort of Friedan and many others, women have choices and are coming close to equality in career work. Currently new physician graduates are about 50-50 women to men. Studies show satisfying careers and/or choices for all the adult members of a family results in happier children. Outside-the-home careers are not for everyone but the operative word is choice. Equality begets family and societal harmony.

Take it one step further, experts state that empowering and educating women in developing countries, or where there is great poverty, allows for the most effective way to bring the region in the direction of prosperity. Empowered and educated young women... (better yet mothers AND fathers,) raise girls AND boys to become more effective and respectful members of society. Equality between men and women does not subtract from the success of men, it increases success for everyone.
 
When women and men are equals, society becomes healthy.

Civil War Surgery

8/12/2016

 
By Richard P. Holm, MD

About 150 years ago, one in four fighting in the Civil War died, amounting to some 620,000 deaths. Two-thirds were due to disease, not injury, and a full half of non-traumatic deaths were from diarrheal illness, unknowingly due to contaminated water. The rest were from respiratory illness, particularly lethal because 90% of the soldiers were weakened by chronic diarrhea and malnutrition.

That said, 1/3 of the deaths that came from injury would have been worse, except for surgeons that became experienced during the Civil War.  There had been radical improvements in weaponry at the time with new rapid-fire rifled muskets, which caused cone-shaped bullets to spiral, giving impressive accuracy at 300-500-yard range. In the face of such deadly weapons, smart soldiers hid behind trees, rocks, earth-works, but too often had exposed legs or arms. It’s no surprise limb injuries accounted for 70% of all wounds. These bullets tore enormous easily infected wounds with shattered bones, pieces of clothing, and non-sterile skin pulled into the wound.

Most trauma surgery had to be performed during the first 24 hours after injury in open air field tents. The value of sterility was not yet realized, and there was no understanding of clean instruments, clean wounds, or even clean hands. The world would have to wait ten more years before Joseph Lister popularized sterile surgical technique, and the value of clean water was understood.

One description: “They would work for days without washing.  As he waited for the next man to be placed on the table, the surgeon would stand back… holding his knife in his boot or even in his teeth.” Another description: “The surgeons and their assistants, stripped to the waist and bespattered with blood… cut and sawed away with frightful rapidity, throwing the mangled limbs on a pile nearby as soon as removed.”  Without sterile technique to repair a wound, amputation actually gave a better chance of survival. 

Although no sterility, anesthesia was available during the Civil War. Ether had been discovered in the 1840s, and by 1861 chloroform became popular by field surgeons because it was less flammable, less nauseating, and more portable.  Records indicate that during the entire war, general anesthesia was given 80,000 times with only 43 recorded anesthesia deaths. Screams coming from surgical tents were not from anesthetized patients, but from wounded soldiers about to have surgery.

Then, after the war, some 15,000 experienced surgeons went home to even the most rural areas. Who would have thought that from the horrors of war, lifesaving knowledge of anesthesia and surgery would spread throughout this country?

Why Vitamins?

8/5/2016

 
By Richard P. Holm, MD

More than 50 percent of adult Americans take a dietary supplement or vitamin. We spend something like $35 billion dollars a year on non-regulated pills, powders, or patches hoping to lose weight, to improve function in sports or the bedroom, or just to prevent illness. 

But what are we getting for our money? Stephen Barrett, MD, head of a non-profit organization to prevent health fraud, states that, "Consumers often fall victim to products and devices that do nothing more than cheat them out of money, steer them away from useful proven treatment, and sometimes do more bodily harm than good." 

This important warning should not subtract from the fact that there are important benefits from vitamins and minerals, and there is a rich history how scientists studying malnutrition brought us to understand the value of vitamins and minerals.

Vitamin C deficiency was discovered while analyzing a deathly diarrhea illness called scurvy, which affected British sailors. It was the limes and lemons containing vitamin C that helped the British "Limeys" avoid scurvy and win battles on the sea. 

Vitamin B1 or thiamine deficiency was discovered while analyzing a neurodegenerative illness called beriberi, which affected Japanese sailors after they switched from brown rice to white. By removing the brown coating, they unknowingly had removed the vitamin laden protein coat. In the early 1900s, scientists discovered the vital-amine on the rice coating that would prevent the neurologic illness beriberi. Now all white rice is fortified with thiamine, the vital-amine, which is also the source for the word vitamin.

Micro-mineral iodine deficiency was discovered while analyzing both goiter, a thyroid enlargement condition, and cretinism, a childhood condition of mental deficiency, each occurring in land-locked areas without exposure to iodine-laden sea-weed and deep-sea fish. By iodizing salt we prevent goiter and demented children in millions throughout the world.

But too much can be as bad as too little. Later scientists also discovered too high of a dose of iodine, and other minerals, as well as fat-soluble vitamins A, D, E, and other supplements can be dangerous. For example certain supplements like chaparral, coltsfoot, comfrey, yohimbine and others can cause liver damage, heart trouble, and increased risk of cancer. Obviously the whole nutritional supplement story is very complicated, and we should be careful not to swallow everything advertisers promote. 

When it comes down to it, the best plan should be to eat a balanced diet with enough fish, nuts, fruits and vegetables, and maybe to avoid joining the British or Japanese Navy.

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