The Chinese New Year begins today – time for miscellaneous thoughts and new resolutions! 龙年快乐 read character by character, means “dragon year happy happy” – pronounced long nian kuai le. What I find fascinating is that both “happy” terms are spoken with a down tone. In my ear that double happy-happy sounds less than a Western easygoing, lucky-feeling happy but grimly determined: You better be happy – or else! I might be over-stating it, but to me the Chinese kuai! le! shows perfectly the difference in the Chinese approach to ours: We expect happiness, well, to “happen”, for instance in a relationship. The Chinese know it is hard work … Just finished the Scripps Conference on Natural Supplements here in San Diego – taking advantage to me being right here in California (for only another week now!). Here are some thoughts I am carrying home from that wonderful conference: • Listening to the results of modern science (the conference was for physicians and health practitioners and the talks were evidence-based – using modern science; no touchy-feely mumbo-jumbo). It seems, my thoughts on health have well held up during those many years I am thinking about what our bodies and souls need. The only point where I am more radical is in fat consumption: Most health practitioners are still fat-phobic. I am not talking bacon dripping fat, ice cream and cream puffs here – I am talking olive oil, coconut oil, fish oil, and never say no! if somebody puts foie gras on your plate – it doesn’t happen that often! - George Bernard Shaw (1856 to 1950) had this to say: “No diet will remove all the fat from your body because the brain is entirely fat. Without a brain, you might look good, but all you could do is run for public office“. • Let’s correct that touchy-feely part: Turns out, we alternative practitioners know that body and soul belong together, and at the conference there was a healthy amount of hugging, laughter and tears going on. Because if one thing has become clear – through our old failings and brand-new science: One can’t go it alone. As a physician, I need like-minded colleagues; as a fat person, you need friends, family, community around you to make a dent in your weight – or whatever health problem you are tackling in the moment. • Obesity is a good guess of mine because, firstly, now more than a quarter of Americans are grossly overweight – half are only overweight - and all conditions that physicians usually label as single diseases are coming together: heart disease, diabetes, depression, arthritis, obesity (Mark Hyman called it aptly “diabesity”), cancer – they are ALL ONE, namely a wrong lifestyle. Wrong food, heavily subsidized and advertised by your own government, with your own tax dollars. Time to take matters into your hands and “own your health”! “Own Your Health”, of course, is the title of Roanne Weisman’s book about alternative medicine. She wrote it after overcoming a stroke with the help of many different alternatives, after mainstream medicine had told her she would stay disabled and had to adjust to it. Boy, were they wrong! • The old excuse that it is “all in the genes” cannot be used anymore. Yes, a lot of your weight might be determined by your genes – but only if you allow it to be so. The new science of epigenetics teaches us that genes can be switched on and be switched on – and guess, who does the switching? Your food does it, and you moving your butt around, that does it. Isn’t it marvelous? • It takes a village to raise a child – you have heard it. It also takes a village, or a tribe, or your church group to change your health habits. Line up with a friend to start walking during lunch hour – five minutes in one direction, five minutes back. And be part of the solution, not the problem: Whenever you bring cookies or brownies or a potluck – don’t go to the old recipes! Explore new options without sugar, dairy, white starches. I always see that deviled eggs are the favorite of everybody – and they is nothing wrong with eggs, especially if the are organic, from free-walking hens. Bring cooked greens with olive oil and garlic, pepper and salt – they are delicious cold or hot! Educate your friends – don’t give in to their sugar-icing cravings! They will thank you. • If we would not eat alone and always at a table (not in the car, not in front of TV, not in bed), we likely would be slimmer. In olden times, if you grabbed the biggest piece of meat, your mom would slap you and say: “Don’t be greedy!” If you asked for your fifth pancake, your grandma would say sharply: “Now is enough, dear!” And since nobody catered to their little hurt feelings, children found home less congenial than the outside and their friends. We always asked if we could go “outside” – whatever it was, it was not inside with the parents (your parents made you uncomfortable because they always wanted to prepared you for life), and it was not in front of TV, computer or game boy. When I was a child, our first TV came with a key – whatever happened to THAT technology?? - and we children could not even turn it on when the grown-ups were out working. Of course, we children soon figured out that the key was kept in the bar, behind the bottles. But it was a high-risk gamble – and TV was never half as exciting as our friends outside. We had one fat girl in class, in all of my thirteen years of school. And that poor girl, we all pitied her – but we wouldn’t play with her. • “This body is not a home but an inn, and that only briefly.” Seneca (4 BC to 65 AD) said that. I think we have to start talking about what is needed: That people take their own health in their hands. Your doctors can only assist you – not do the work for you. So let’s start by calling fat “fat” – no more pussyfooting around it; physicians have long enough colluded with patients and avoided the “F” word: “I won’t call you fat, if you stay my patient”. The health care system is falling apart under the burden of health care costs brought about by overweight people (don’t forget – I still am for a national health care system!), the Earth is brought down under the burden of too many people who consume too much, and all our wealth so far has brought us very little real happiness it seems – if we judge by how many people are on anti-depressants. • Bad news: Before you die of being overweight, the Earth might have died of pollution. Definitely, future generations – they are your kids, my kids, our kids and grandkids! – are in danger. Newborn babies have been found to have more than 200 industrial chemicals in their umbilical cord blood, right when they are born. The womb has not protected them. We are finding out the hard way that you can’t dump dirt there, and assume you are safe here. We all have only this one Earth – and do you want to be responsible for babies born with birth defects? Global warming is real – so is overpopulation and increasing environmental diseases. • And what do they mean by “natural supplements”? I am glad to report that they do not mean artificially manufactured vitamins or new-fangled molecules, but they promote (mostly – no industry is perfect!) clean, whole, fresh herbs preserved in a bottle of tincture or capsule as well as possible. And if you are waiting for that miracle pill that might do the work for you – dream on! Real health is work. And didn’t you know it: Being sick sucks much worse. Real health takes very little: A bit clean water, a few simple, fresh foods, a good night’s sleep – every night, a few herbs to treat little things early, abundance and walking and dancing and laughter with friends. Music, art, books. Ask more of this life just than a heavily mortgaged house, a car and a career! A happy, hard-working New Year to you! Read More
Blog: On Health. On Writing. On Life. On Everything.
Minimal Exercise Program
December 5, 2011
Reasons why I keep my exercise program as minimal as possible:
1. Exercise is boring.
2. Too much exercise may easily lead to injuries: We now have a medical specialty called “sports medicine”. If we didn’t overdo exercises, we would not need sports medicine. Using those modern gym machines while watching TV is a mindless enterprise. And as things go around, they come around – you could end up hurting yourself.
3. Definitely, there are more interesting things to do – playing cello, writing a book, reading tons of books, dabble with colors and brushes, being with family and friends, learning Chinese – to name a few.
On the other hand, I do have bad posture – inborn (many years of unrecognized gluten intolerance that weakened my muscles), and from years of being bedridden as a young person. Movement creates fire and warmth inside, without which we would not be alive. We need to move yes, but nowhere is it written that we need to jog or overexert ourselves in bad ways.
My exercise program changes all the time – I am always on the lookout for something faster and better. You might remember how much I liked the Five Tibetans – until I developed lower back pain. Recently I had to abandon my laps in the unheated Californian pool; the temperature got too low. I still jump in from time to time, just to get the immune-stimulating jolt of the cold water. But I can’t get my exercise that way anymore - danger of hypothermia and ruptured muscles.
Of course, back in Boston, I work in the garden and go to yoga classes, and have a house to tend to. Here, in this tiny apartment, I had nothing comparable – so far. Until last week , when I joined tai chi classes – or as it is called in proper pinyin Chinese: tai ji. In German, tai chi is called “shadow boxing” – and that describes well those flowing, artful movements I now try to learn. Emphasis on “try”: This is not my first time; in the past, I always had trouble remembering the sequence of movements. This time around, I will not even try to learn the sequence; I will just mimic my teacher and lose myself in the flow of gestures. Because, in the two more months we will stay in San Diego, how much can I really learn? Not much.
But in the first lesson, I already learned an important movement, which I now practice every time I pass by a mirror and notice how bent I have gotten up from my studies. Which makes two little exercises which I do in en-passant, not putting in extra time:
1. This squeezing of my shoulder blades that immediately makes me more upright. Firstly, it is a simple reminder; secondly, the squeezing loosens the muscles of the upper back and prevents that my head slowly vanishes between my shoulders like the head of a turtle in its shell.
2. Standing on one leg – especially while brushing my teeth, or waiting and whiling time away. This is good for balance, and for strengthening leg and pelvic muscles. Imbalance is what kills the elderly: Imbalance – fall – hip fracture – pneumonia – death; we physicians see it all the time. This exercise also increases bone mass in legs and spine, thus counteracting osteopenia and osteoporosis, thus preventing those nasty hip fractures. Standing on one leg is far more interesting and effective than Kegel exercises! Keeps your sex alive!
Not everything can be done on the go. So, I have this daily program – and don’t hold your breath! - each of these exercises takes less than a minute, and presently, I am doing six of them, each of them repeated 21 times. Twenty-one: That is the number of repetitions I have kept from the Five Tibetans. You can’t overdo much in twenty-one times, and twenty-one brings me just to the border of utter boredom.
1. Knee bends: Done wrongly, knee bends can hurt your knees. Therefore make sure that you are doing them right: Keep feet and knees together, keep knee caps over your toes, and don’t go deeper than you can easily do, but challenge yourself to go deeper with time. 21 times. Or, in the beginning, you might want to do this by holding on to something stable.
2. Arm exercise: Done with a small heavy ball. I have one of those weighted exercise balls – six pounds. When traveling, I am using my whale of a laptop – has nearly six pounds, too. Fill a plastic bottle with water (this is lighter), or find a heavy book. Slowly lift the ball (or whatever) with both hands and arms out-stretched, and bring it up above your head. Then bend your arms backward and down. Bring up your arms again, over your head and then down in front. Repeat this 21 times. It is good against arm flab, and strengthens the muscles of your upper back.
3. Back exercise: Stand tall. Take the ball in both hands behind you back and lift it upward 21 times. That will squeeze your shoulder blades and improves posture.
4. Swimming on dry: I started this after I had to leave the pool, because I missed the exercise that built up my upper back muscles. Come down on the floor on your belly, lift arms and legs slightly from the ground, and make swimming movements 21 times. A boon is that you are massaging your bowels in this position, which is good against constipation. Getting down on the floor daily acts also anti-aging.
5. Neck strengthening: This I do mornings and evenings in bed: Dig your heels and the lower part of your back head into the mattress. It feels like you arch your back in this position. Breathe in and out. It strengthens all back muscles, especially the upper back. It also works like a charm against a double chin.
6. Tongue exercise: This also helps to eliminate a double chin. Stretch out your tongue, 21 times.
One would think that a program this trifling would do nothing for the health of your body. On the contrary – I was never as toned and nimble as I am now, on this program. If however you are already doing triathlons or marathons: Stick with it, don’t listen to me … at least not until you come home injured. Then turn to my gentler method.
A big part of why this works is the mindfulness you practice all day: You stand on one leg while waiting for the bus. You get up from the computer and squeeze your shoulder blades. You are in the bathroom and stick out your tongue a few extra times. This program keeps you aware that you have a body, and your body needs attention and pampering, too. Moving your body gently pampers it. Lying down and doing nothing pampers your soul. There needs to be a balance between the two!
The other activity we do as often as we can, is walking. Here in San Diego, we have the beautiful Black Beach. If one removes shoes and socks and walks at the water line, in and out of the waves, it is great fun, and another great provocation to the immune system! And by walking and talking we keep our marriage afresh and alive. Read More
My Hospital Manifesto
October 30, 2011
If I would decide how hospitals are governed (and I don’t), these would be important points for me:
1. Food: Thy food be thy medicine – and vice versa – Hippocrates said. What is served as “food” in hospitals these times, is mostly abysmal and just goes to show that conventional medicine is not interested in really finding out the root cause of disease. In many cases, it is nutrition, stupid!
2. Cafeteria: Same for the place where all the visitors come and eat. It could be an educational experience, instead just another gorging with inferior foodstuff, filled with chemicals, trans-fats, sugars and dairy.
3. Quiet: When I was a child in Germany, and my father was a doctor, he used to take me on his rounds. Hospitals then were very quiet places. The nurses (often nuns) would walk on their rubber soles like on cushions, and they spoke with low voices. The doors to patient rooms were double doors – the patient had privacy and quiet.
4. What hasn’t changed much: That the hospital routine is not geared toward patient recovery but to a ward schedule convenient for doctors and nurses: Then as now patients are pulled out of sleep to measure their temperature or draw blood tests at four am. I would like to see more concern for the patient’s wellbeing than for the organization’s.
5. No TV in patient rooms: My guess is that at least seventy percent of all illness is self-inflicted. It used to be that being in the hospital was a time for contemplation about what brought one there. Not any longer – as TV is squeaking and squealing day and night.
6. Conventional and complementary medicines are BOTH used. There should be no bias toward the one or the other – what has been proven to work should be applied: Hydrotherapy, movement therapy, food, herbal medicine and art, music, journaling, acupuncture, massage, and so on – they all should be used to make patients better. As they are in most European hospital. And paid for by national health insurance. And, no, they are NOT going to be broke …
7. More cleanliness in the facilities. More cleanliness of the patients. Used to be that hospital were spic-and-span places where you could eat from the floor; not any longer. Instead of on cleanliness we trust in antibiotics – to our detriment. Same with patients’ cleanliness: Used to be that nurses washed the patients daily; not any longer. Nurses have gone scientific (necessarily so – but who is now responsible for caring?); the paperwork has become overwhelming. Housekeeping has been out-sourced. And simple ideas like a washing and cleaning have become obsolete. But hospital infections are skyrocketing.
8. More friendliness and caring toward the patient. The patient has become a moneymaking device.
9. Less care and resources to be spent on very old, very sick people in their last days of life – more on pediatric and under-served populations. DNR (Do Not Resuscitate orders discussed with every patient and/or every family). It will lead to savings of money and will allow people to die with dignity.
10. In medical schools, only half of the students should be A+ nerds; the other half should be people who really want to become doctors and patient advocates from all walks of life. We need very brilliant students because they push medicine’s frontiers ahead. But we also need caring primary care physicians. And putting them together in medical school will hopefully lead to a dialogue between them.
As I am thinking more about this, I might come up with more ideas. What would you wish to implement in the hospitals of the future? Read More