life

THAT MOTHER THING

These days, it is difficult to forget Mother’s Day as there are plenty of reminders on TV, radio, newspapers, billboards, and now even the internet.  Although the holiday (it even seems disrespectful to call it that) has been a boon to florists, candy companies, and greeting card businesses, it also generates a type of sentiment not found in other celebrations.  According to Mr. Google, there have been times set aside to venerate mothers and motherhood since ancient times, but our modern version is said to have its origins in Grafton, West Virginia in 1908, when Anna Jarvis promoted the idea of a day to honor mothers. She was soon to be disappointed when the day which was sacred to her became commercialized.  Anna spent the rest of her life attempting to correct the image which she felt dishonored her Mother, and died penniless in an institution.

DON’T MESS WITH MOM

We are all aware that motherhood is necessary for the propagation of the species, but the relationship between a mother and her offspring is like no other.  Mothers will fight to the death and endure any amount of hardship to protect and nurture their offspring.  This is true for most of the animal kingdom, but especially for humans.  Most animals who have live births nurture their young until the kids are able to make it on their own, but human moms never stop mothering.  You might think since they are around for a couple of decades it might be that they simply become like an old pair of shoes which you don’t like to get rid of, but there seems to be much more to it than that.

Back in the old days, when country doctors did pretty much everything except major surgery, I delivered a lot of babies.  Many times I would hear my patients in labor crying out that they would never go through this pain again, but when that baby was delivered into her arms the room would brighten with her smile.  The ordeal of birthing would soon be forgotten and often at the six weeks checkup there would be talks of having another child.  The mother of my children describes her feelings of holding our babies as a feeling of joy which she could not find words to describe.

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Kids do grow up and leave the nest, but they carry a piece of Mom with them for the rest of their lives.  No one or no other relationship will have such a profound effect on their lives.  Without nurture, it has been shown that children will grow up with significant deficits similar to those seen in Harlow’s monkeys when they were deprived of maternal contact.  With that in mind, it seems clear that mothers’ roles involve much more than merely giving birth and providing sustenance.

When children are born, they have no sense of who or what they are.  One can see an infant at times appearing to discover his toes and other body parts.  Likewise, in their early years, they will need help to develop an identity, and to do so, they will depend upon those with whom they spend the most time. However, perhaps the most important issue they learn concerns their lovability.  In my practice, those who felt as if they were unlovable were among the most unhappy.  They found it virtually impossible to establish meaningful relationships.  They lacked self-esteem, often to the point of self-loathing; consequently, they were vulnerable to exploitation of all kinds.  They were often used and abused, which they felt they deserved.  This opinion of self, which appears to have its origins in childhood, resists change and seems to persist throughout life even when told their picture of themselves is inaccurate.

ALL YOU NEED IS LOVE

Obviously, the only way one can know they are lovable is to be loved, which brings us back to the subject of mothers.  Traditionally, they are the ones in charge of loving.  Their love is constant, unremitting and lifelong.  They continue to love even when their children are total jerks or perpetrate the most dastardly of deeds.  It has been said that a father’s love is conditional.  I have always resented that characterization, for I felt I loved the kids as much as did Barb, yet I must admit that her capacity for forgiveness and tolerance exceeds mine.  After all, I was only an observer and not a participant in their entry to this world.

If you think mothers are lovers, take a look at grandmothers.  With the responsibilities of teaching kids manners, discipline and societal survival skills gone, there comes an avalanche of unimpeded love.  For me, grandparenthood has been an opportunity to enjoy the kids without feeling any responsibility.  I have concluded that grandparenthood is God’s reward for enduring the vicissitudes of parenthood.

It is true that in the past mothers have received a bad rap from we psychiatrists.  Mothers have been accused by us of causing everything from autism to homosexuality.  This fad began with Freud, who attempted to unravel some of the mysteries of early childhood.  Although his work provided an impetus to learn more about the effects of childhood experiences on later life, many of his conclusions have been discredited.

IT DOESN’T GET EASIER   

In the past, motherhood was a full time job.  Although mothers would engage in activities outside the home (my grandmother helped with the milking), their primary function was to care for their families.  Today’s mothers amaze me in that a majority of them also have full time jobs outside the home.  That puts an exclamation point after the time honored phrase “woman’s work is never done.”  Granted, fathers are now more involved in domestic activities than in the past, but I seem to remember reading something about a study that indicated the duties of the woman of house have changed little over the years.  Without our so-called modern household conveniences, it would probably be impossible for the hardiest of souls to accomplish what these warrior mothers do.

However, the most amazing mothers, to me, are the single moms who take on the total responsibility for feeding, clothing, teaching, disciplining and loving their children.  The fact that many single mothers accomplish this without any outside help is inspiring, especially when one considers the number of kids who grow up to be good people.  Unfortunately, these mothers are often derided rather than praised.

THEY AREN’T ALL MUSHY

You should not be surprised to learn that I too had a mother.  She loved me for no good reason that I could fathom, and I loved her too (although I would never admit it when I was growing up).  Mom was not a hugger.  She was a patter—i.e. when she was glad to see me, or pleased with something I had done, she would wrinkle her nose and pat me on the arm or shoulder a couple of times.  I suspect this was a result of her childhood, for her family was not demonstrably affectionate and never wanted to be “showy.”  She was a great cook and enjoyed feeding us.  In later years, a visit would see her “throw together some leftovers” with little obvious effort, and they would always be delicious.  I was a child of the Depression and barely recall my parents on occasion telling my brother and I they wanted us to eat first.  It would be years later before l realized why they did that.

SUPER MOM

It has been my good fortune to meet and marry someone who was born to nurture, and I have watched her in action for quite a few years.  When we were married, she announced that she wanted to have four children.  I thought two would be plenty, so we reached a Barb-type compromise and had four.  Since they were all exceptional from the very get go, I agreed to keep them all.  It was a good decision.

As with most mothers, Barb continues to exude love from a reservoir that never runs dry.  Every now and then, she will reminisce about those days when she had them all fed, bathed and tucked in, and how she felt “so rich.”  When we see a baby in the grocery, she tells me how she would like to hold it.  If there is a young one in a restaurant, she will approach the mother ask its age and tell her how beautiful is her baby (she seems to have never seen an ugly one).  Those tear jerking ads on TV featuring small kids do a number on her.  She insists were she a little younger she would adopt some of those starving African kids.

As for the grandchildren, don’t ask unless you have some time to spare.  It takes a while to tell you how wonderful they all are, but you will be able to see those tired brown eyes come to life.  Like it or not, you will probably also hear the complete package which includes their parents who are also “above average.”

SHE WILL JUST SAY YOU SHOULD SAVE YOUR MONEY 

Meanwhile, it is nice to send your mother flowers and stuff, but all she really wants from you is love.  She deserves all you have to give.

FAMILIES

FAMILIES

In previous blogs I have discussed the importance of relationships in our lives; however none are more important than our relationships with our family of origin. They will be a powerful influence as to how we view the world and other people.  More importantly, these experiences will be major determinants in the development of our personalities.  Those fortunate enough to grow up in nurturing environments will find it easier to nurture their offspring.   To feel loved is likely to protect one’s self-esteem, and allow one to experience the joy of loving others.  Our values are in many ways shaped by family for even if one is rebellious and rejects what he has been taught, his new found truths often originate from the nature of his family relationships.

Apprenticeship to Adulthood

We humans are unique among mammals in the length of time required for us to reach maturity. Not only is our rate of growth slow, but there is much to learn if we are to survive and thrive in a complex society.  Although much is determined by our genetic make-up, we learn behaviors and perceptions primarily by unconsciously mimicking others.  In that sense, growing up is much like an apprenticeship.

The 21st Century Family

An accurate definition of family is now difficult to pin down. There are no longer traditional roles for family members, such as were the norm in my generation.  Since most parents work, there are fewer stay-at-home moms.   We now see an occasional stay-at-home dad, something unheard of in my time.  Other than widows, single mothers were not nearly as prevalent during my youth as they now are.  Modern mobility has limited the number of nuclear families who can experience the support of extended family members.  Many of our children grow up barely even knowing the names of their cousins.  Blended families composed of his, hers and their children can face special challenges.

The Power of the Family Bond

In spite of these changes, the bonds between family members are among the strongest of all our relationships. This is evidenced by the fact that one of the first phases of recruitment by cultists is to alienate the prospect from family members, usually leaving siblings and parents confused and devastated.  The same tactics are used by those who would attempt to relieve the elderly and infirm of their possessions.  In both cases, they discredit the families of origin and attempt to break the bonds between the victim and the victim’s biological family.  Those in positions of leadership of all stripes realize the strength of familial relationships, and seek to provide an atmosphere in which a surrogate family can develop.  Street gangs likewise are said to provide family like bonds, which have been lacking in the lives of those they recruit.  The search for the type of relationships found in families seems to be a common human need.

“I found it difficult to remain therapeutic while feeling homicidal.”

Although families offer the best environment for rearing children, they can also be the scene of horribly abusive behaviors. I have had little experience dealing with such problems, especially when they involve children.  I generally avoided treating such cases as I found it difficult to remain therapeutic while feeling homicidal.  In like manner I find that the understanding of other cultural practices such as honor killings, genital mutilation and such to be way above my pay grade, and in spite of being paid quite well.  Consequently, I will confine my remarks to treatment of more mundane problems.

Who is the “real” patient?

Most families seeking help are usually concerned about the behavior or mental status of one of their members. They are often coerced into treatment by the identified patient’s therapist.  That term (identified patient) is useful in that one may find that the person in treatment may be the healthiest member of the family, and labeled as sick because he is out of step with the rest of the family (i.e., the identified patient is actually the most emotionally healthy of the group who is reacting to an unhealthy family dynamic).

The importance of family therapy

There are multiple reasons that I believe involvement of family is critical in the treatment process:

  1. Family members may be able to provide valuable information about the patient’s behaviors.
  2. It allows the therapist to view family relationships first hand and thus provide insights as to the stresses in the patient’s environment.
  3. Family members may provide a more complete family history
  4. It allows the therapist to assess the level of support available, and to encourage such support
  5. Perhaps most importantly, it is a mechanism in which the dilemma of providing family with needed information about their loved one’s illness without violating the confidentiality inherent in the doctor-patient relationship. This becomes even more important in those cases where there are paranoid tendencies, or there has been a great deal of conflict.

The Complexity of Family Relationships

Although the average family size has shrunk considerably over the last century, relationships between members can still be complex. It must come as no surprise that there are often conflicts within families.  Since it is difficult to walk away from one’s family, those conflicts are not easily resolved, and over time may escalate.  To be chronically angry can be debilitating and painful, and as such, blaming another for those feelings comes easily.

The Blame Game

As mentioned in previous blogs it is important that the therapist avoid joining in the search to establish who is at fault, for to do so merely perpetuates the problem. He must be able to analyze the problem from the outside looking in, that is, learn how to be a meta-communicator. Hopefully, the members will find it difficult to continue blaming each other if the therapist redefines the problem as blaming rather than defining the problem as identification of who is at fault.

The Power of Brevity

In order for the therapist’s comments to be effective, they must be brief if they are to be remembered. The importance of brevity as with most things in my practice was learned from a former patient during a chance encounter, during which he thanked me for having helped him several years previously.  He credited his recovery to one statement of mine.  He said: “The thing that helped me most was when you said ‘you think too much’ and now whenever I start to worry about all the things which could go wrong those four words come into my head and I am able to move on.”  I cannot take credit for any brilliant insights for I didn’t even remember the incident, but it is an example of how an offhand comment may be more effective than hours of therapy.  The same principle applies to our everyday lives, as the most memorable comments are those expressed in a few words.  The lengthy ones are often forgotten before they are completed.

Obviously there are many reasons for families to seek counseling other than to deal with hostility, but no matter the problem it is helpful to look at it as a communication system gone awry. Imbedded in many different behaviors is a message, and thus can be seen as a form of communication.  For example, what is the message being sent by a teenager who is acting out?  It could be that they are angry about limits set, unrealistic expectations from parents, lack of trust by parents, sibling rivalry, or resentful that not enough limits have been set, or for reasons which have nothing to do with the family.  Of course, the teenager is almost certain to be the last person likely to divulge such information.  Disclosure can many times offer a pathway to an understanding, which may be therapeutic.

Can’t see the forest for the trees

It was not my intent for this paper to be a treatise on family therapy; however I thought it might be useful to see how some of the concepts could be useful in understanding not only our own families, but relationships in general. As I mentioned in a past blog as with marital relationships, it is almost inevitable that one will be so caught up in seeing the trees that he will become oblivious to the forest.  That is, he will not realize what is going on even though he can hear the words.  This was brought home to me several years ago when following a party a colleague said “Smith I can’t believe how you treat your wife.”   I was shocked, could he be talking to me, the couples therapy and family expert?  After all, I had no doubt that I was among the world’s best husbands, but Barb later confirmed that my friend was correct in his assessment.  As has been said, “None are so blind a those who will not see.”

Reframing

For example though all have separate personalities, they also have different roles to play as family members. For example it is common for families to have a star and a black sheep.  Parents may lament that they don’t understand why the black sheep can’t be more like the star, and continue listing all of black sheep’s misdeeds and faults.  In such a case the therapist might address the black sheep kid by saying, “That is such a loving thing, doing all that stuff to make your sibling look good.” No matter the response the system is changed, and this is apt to open up some different dialogue. This is a process therapists call “reframing.”

Scripting

There are many roles that kids and parents may unconsciously adopt. There are the placaters or people pleasers, the mascot or clown, the lost child or withdrawn person, and as mentioned in the previous vignette the hero or achiever, and the black sheep or scapegoat, to mention a few.  Family roles may develop in order to fill a need or may come about by the process of scripting.  I mentioned previously the role families play in the development of our identity, and when they convince us we are a certain type of person, we are apt to follow that script.  Some have gone so far as to say if you can convince someone he is a homicidal rapist, he is apt to become a homicidal rapist.  Obviously, there are many influences other than our families which affect our identity; however, the opinions of our parents and siblings are undoubtedly the most powerful.

Disagreements

In this time of rapidly changing mores, it is not surprising that there will be frequent disagreements between we old folks and the kids. Of course disagreements between siblings seem to be written into their DNA, and disagreements between parents is certainly not unusual.  When family members cannot agree to disagree, an argument is likely to occur, and such arguments often lead to verbal or even physical attacks.  I don’t mean to suggest that disagreements are all bad for as Walter Lippmann famously said, “Where all think alike, no one thinks very much”.  When we tell our kids what to think while telling them we want them to learn to think for themselves it is little wonder they become frustrated for that is a classic double bind, or in today’s vernacular a no win situation.

Systems of Conflict Resolution

If a disagreement reaches the point that one feels threatened or under attack, either verbally or physically, he may respond in a variety of ways.

Attack/Attack system

He may retaliate in kind which is an attack-attack system. This is almost guaranteed to increase the level of anger, as each participant attempts to outdo the other.  These are the types of interaction which can lead to violence.

Attack/Placate system

The attack-placate system is often seen in cases of spouse abuse, when the abused attempts to talk hubby out of his anger by reassuring him and in other ways spreading oil over the troubled waters. This too usually fails as the abuser may feel patronized.

Attack/Divert System

Another type is the attack-divert system which as you might imagine can become rather bizarre. This might be effective in minor skirmishes, but simply changing the subject in the face of overt hostility is weird, and leaves the problem unresolved.

Acknowledge the Affect

For the best method to deal with such emotionally laden situations, I hearken back to my mantra of “acknowledge the affect.” In such cases, the message the attacker is trying to send is that he is feeling some kind of negative affect such as: anger, hurt, envy, jealousy, or fear.  Statements such as “I can see you really feel strongly about that” or “are you angry with me?” will often defuse the situation.  It is not necessary to change your opinion or point of view, but simply to communicate that you understand how he feels.  If your attacker’s affect is not available then one can use his own such as: “I feel …………” The concept has wider application, for in any emotionally charged situation it only makes sense to deal with the emotions rather than to ignore them.

What’s Next?

In my next blog, I plan to focus on child rearing. I am well aware there are probably hundreds of books written by people who are convinced they know better than you how you should raise your kids.  I don’t plan to do that since I have made plenty of mistakes in that department; although my kids all turned out well in spite of my screw-ups.   Rather than directions as to how one can raise perfect little people, I plan to provide helpful hints on how to screw up your kids lives: I call it “How to screw up your kids without even trying.”

Thanks for reading!

DO YOU HEAR ME NOW

Editor’s Note: Image not approved by e-shrink, but I needed some eye candy 🙂

In a previous blog, I promised an encore presentation on the subject of interpersonal communication. Your patience is about to be rewarded for I will now set about to fill these pages with the words of wisdom promised.

Actually if one excludes extrasensory communication and similar spiritual phenomena, there is little mystery about how we communicate with each other, but it is amazing how we can screw it up. It appears that all creatures have some means to communicate. Some plants are said to communicate with each other, and I just read an article in Scientific American presenting evidence that some bacteria send signals to others of like kind.

The Dawn of Communication

It is impossible to know exactly how earliest man communicated, but it can be assumed that job one as they came together as groups and then tribes, was to be able to communicate with each other. They would soon find that gestures and other nonverbal means were not sufficient for them to be successful carrying out joint efforts, like gathering food, providing shelter, and protection. Sound would prove to be the most effective means. Messages could be carried over distances without interrupting the sender’s activities. For example a certain sound may have been agreed upon to sound a warning. Meanwhile, man would be evolving physically with very versatile machinery to produce a variety of complex sounds which we now call words and language was born.

Necessity is the mother of invention

Since our Great, Great, Great, Great………..and so on grandparents, like us, were never satisfied with the latest technology, they would undoubtedly start looking for ways to communicate distances beyond their range of hearing. It would also be nice to save and share messages. Smoke signals and other such signaling procedures would have little useful utility. They solved that problem by devising symbols for each word thus enabling them to not only hear, but also see all those words. Fast forward a few thousand years, and here I sit recording words in this mysterious black box. As you are all aware this is not the end of that story, but more about that later.

Most of us talk better than we listen

Of course humans have developed the most complex system of communication centered on our verbal language skills. As a matter fact, many anthropologists rate our ability to use language as the major factor which allowed man to become the dominant creature on the planet. It is language that allows me to write this paper, and to communicate ideas, opinions, directions, knowledge, feelings, or indeed any thoughts which come into my head to anyone who is inclined to listen, and therein lies the most common flaw in any communications system, i.e., most of us talk better than we listen.
Psychiatrists listen, it is what we do, as a matter of fact sometimes that is all we do. It has always amazed me how therapeutic listening can be. There are many times when patients have left my office saying they felt much better after venting their particular problem, in spite of sparse verbal responsiveness on my part. It makes me sad to think that some people find it necessary to spend money to have someone listen to them. Come to think of it, if we all would be better listeners it might save a lot on shrink bills.

 

I can identify with those people who feel no one listens for I have always envied those guys with deep commanding voices who are able to dominate a discussion. In those situations I am rather soft spoken and sometimes feel excluded. My attempts to change the timbre of my voice have been unsuccessful; consequently; I am usually content to let my wife take the lead in those social situations as she is very good at social repartee.

The Nuts and Bolts of Communication

Everyone knows that in order to have a communication, one must have a transmitter and a receiver. For the sake of brevity (my readers seem to appreciate that quality in these blogs), I will limit my comments to communications between people; although, I realize there are now many machines that communicate, and that animals communicate with each other and with us. It is important to remember that in the presence of other people it is impossible not to communicate, for paradoxically not to communicate sends a message: therefore a communication has taken place. When one ignores another person, it may send a powerful message, but one which can be interpreted in many ways. The message may be clear depending on the situation or context, but can also be confusing.

An outstretched middle finger pointing skyward will rarely be misinterpreted

Verbal conversations are the most versatile and intimate of our means of messaging while written messages are less likely to be misunderstood. Non-verbal messages can also be very precise, for example in our society the presentation of an outstretched middle finger pointing skyward from an otherwise closed fist will rarely be misinterpreted. In spite of such exceptions, words are generally the more precise tool. The superior quality of verbal versus non-verbal communication is evidenced by the difficulty those born without hearing experience as compared to those who are blind. It is well known that a person’s lack of one special sense will result in a compensatory increase in acuity of its opposite. The result for deaf people is that they can become markedly adept at sign language, but to converse with hearing people becomes very difficult. They must either use crude gestures, or depend on written messaging, the first being ineffective and the second inefficient. Lip reading is apt to be fraught with errors and may not even be possible for those born deaf. Blind people however converse with little difficulty and their enhanced hearing may allow them to hear inflections which might go unnoticed by those with normal vision which could help make them superior communicators. The result is that deaf folks often prefer to relate to others who are deaf, while blind people find it easier to assimilate into ordinary society.

The Art and Science of Listening

As I mentioned previously, I believe that failure to hear is usually due to a failure to listen. Listening requires effort. In order to be an effective listener one needs to use all of his faculties, including not only his ears, but also eyes, touch, and sometimes even his sense of smell. It goes without saying that it is essential to be attentive, and to maintain eye contact unless the one talking seems uncomfortable. Observing a person’s posture and movements are all part of the listening process. For example, folding one’s arms across their chest indicates they are not likely to be receptive to your comments. Of course there are many less obvious non-verbal cues which are delivered unconsciously, to which we may respond to without awareness they have occurred.
People who study non-verbal communications can gather amazing amounts of information by simply watching a person. While teaching both individual, couples, and family therapies, we often would show a video tape of a session without sound, and speculate as to what the body language revealed. If the therapist who conducted the session was present he/she would usually be surprised at his/her lack of awareness of some their own non-verbal behaviors. Although a thorough review of the subject is way beyond the scope of this paper, we can learn some things which can be helpful to enhance our abilities to really listen just by watching.

Listen with your eyes

Most cues will be obvious, the breaking of eye contact, leaning forward or backward in a chair etc. One very telling clue as to our engagement is the shifting toward or away from symmetrical positioning e.g. the mirroring of postures. If the person with whom we are conversing mimics our sitting position, it is likely that they are engaged in the conversation, and to change positions will indicate disengagement. We are likely to sense those changes in others more easily than in ourselves. Leaning forward toward the conversant will indicate interest and encourage more talk on the subject while leaning back can be interpreted as: “enough of that subject.” At the same time it may be helpful to remember that if you are bored you probably will look bored, and you will give off the same signals as your bored companion. As mentioned previously, words are still your best shot to receive a clear message, and the non-verbal stuff should be viewed as ancillary.

The Transmission

Now that you know everything there is to know about being a receiver, we can move onto how you may become a talented transmitter. If you are to become a scintillating conversationalist, or a raconteur par excellence you must learn how to deliver a clear and succinct message. This must not be as easy as it sounds for even when listening as hard as I can, I sometimes have no idea what is being said. The KISS acronym (keep it simple, stupid) is still a good rule when it comes to personal conversation. Complexity tends to obscure rather than illuminate. Most contemporary poetry violates this rule in my opinion. My attempts to understand it leaves me with the same feeling I get after spending a half hour working on a rubric’s cube. I confess that I carry a few big words around to use when I want to impress; however long multisyllabic words should be avoided if a little one will do. (You may notice that I have used some of my favorite fancy words in this paragraph, and I trust you are duly impressed).

Direct vs Indirect

Conventional wisdom is that one should always be direct with one’s communications, and “not beat around the bush” as my grandmother would say. In general that is a good rule to follow; however there are times when one might need to deviate from that practice. It brings to mind the solution that my wife Barb found to a vexing problem. It involved a young man who did some office work for her from time to time. The problem was that he had a persistent very strong body odor. She was concerned for him, and suspected the B.O. might well have something to do with his limited social life. Of course, she was reluctant to confront him directly. Although her maternal instincts had kicked in, she did not feel close enough to him to be comfortable discussing his problem directly. After considerable deliberation she resolved her dilemma by giving him a box of deodorant soap for Christmas. Unfortunately, she had no follow up with which to judge the success of her coded message.
There are times however when a direct communication is the best choice in embarrassing situations. One personal example happened while I was giving a lecture to a group of nurses. I noted some snickering among them which was puzzling since grief was the subject of the talk. I later learned that my fly was unzipped. It would have been an act of kindness to have been informed of my zipper problem. To make matters worse, I was forced to endure taunts by colleagues that this was an obvious Freudian slip.

Sending manure and roses in the same box

Although words are of the utmost importance in communicating, we must not forget the music that goes with them. By that I mean the tone, volume, cadence, pitch, and other elements produced by the noise maker in our windpipes. The mechanisms we use to produce sound is remarkable in its versatility and is capable of expressing innumerable emotions which can accompany our words. What we say can be modified, enhanced, diminished or even totally changed in their meaning by our voices. When the words fit the music it can add clarity, but when they don’t it can be confusing. This also applies to visual clues as previously discussed. In those situations in which sound contradicts the words, we have two conflicting messages in one. The purpose of double messages is usually to express hostility, but make it difficult for the recipient to respond as we used to say at the lab: “to send manure and roses in the same box”. In such cases it may be difficult for one to decide which is the more pungent odor.

Sarcasm and the double message

Sarcasm is probably the most recognized form of the double message; however there are some who are masters of the technique. Some women are said to be “catty” in their conversations with other women For example at a dressy social function Miss Catty might say, “What a nice dress, I saw one just like it on the dollar rack at K-mart the other day.”The recipient of this message is apt to remain speechless unless she is quick enough to come up with an equally sarcastic response. In any event the two are unlikely to become friends. There are words and phrases which can be interpreted differently. Some idioms can be confusing and even suggest opposite viewpoints. Since language is never static some may change in their meanings as for example the phrase, “cute as a bug” usually referring to a younger person now seems to be accepted as complimentary; however I don’t believe many people would consider bugs cute.

Anger vs Hostility

Many people find it difficult to deal with anger either of their own or others. This can be limiting in their ability to form lasting and honest relationships for there will always be reasons for anger towards others whether real or imagined. Unexpressed anger will result in either hostile behavior or depression.

In our so called civil society it is often deemed inappropriate to express anger directly, but rest assured it will be communicated by all those non-verbal means we have talked about in spite of our best efforts to conceal it. Contrary to public opinion anger and hostility are not synonymous. Anger is an emotion while hostility is a behavior. Hostility is unlikely to resolve the issues which perpetrated the anger, and furthermore the response to hostility is apt to increase one’s anger.

The efficient and healthy way to express anger

There is a very simple and efficient way to express anger and that is to say “I am angry with you.” This will allow the source of your anger the opportunity to ask about your anger and consider options other than fighting. As I mentioned before, you are the only expert on your emotions so they can’t be refuted by others. If he shows no interest in resolving your differences, you are best off to just dump the sucker.

When you’re on the receiving end of anger

The opposite side of the coin is when you are the recipient of the anger or hostility. If the person is sufficiently enlightened to open the conversation with their feelings of anger, you have a good chance of resolving the issue, but it is more likely that it will be hostility, e.g., name calling, accusations, jealousy, or even physical assault. In the latter case just run unless you have a ball bat handy.

Acknowledge the affect

In other circumstances you may be able to diffuse the hostility by acknowledging the affect. The affect for you non-shrinks is the word we use for feelings. As a matter of fact that phrase: “acknowledge the affect” became my mantra when teaching psychotherapy. Phrases such as, “you must be very angry, or you really look mad,” may lead to a more productive discussion. In some cases it may be more effective to use your own affect especially if there is no response to your acknowledgement of his anger. Whatever you say must be honest, like “I feel sad, this hurts my feelings, or you are scaring me.” Although these strategies do not guarantee success, they are less likely to result in escalation of the conflict. Of course sometimes we would rather fight and in such cases that remains a prerogative; although it is often difficult to determine the winner.

Being assertive without hostility

Many of us have grown up in homes where we were taught to be submissive. This is probably true for women more often than for men. Then we grow up and find that we must be assertive or be ignored. Our childhood experiences of assertiveness was usually linked with anger, but as we grow up we learn that to be accepted into society we must learn civility. The result is that in this competitive world we must assert ourselves or be left in the dust. The problem is that we don’t know how to be assertive without being hostile. This was a problem for many, many of my patients. As women strived for more independence, and learned to work alongside men who were accustomed to being considered the dominant gender their need for assertiveness training increased, and this need is not confined to women. Learning to recognize feelings will help one to compartmentalize them and learn how to communicate without unwanted hostility. In other words acknowledge the affect.

The Awesome Complexity of Communication

The subject of interpersonal communications is obviously much more complicated than what is presented here. It is estimated that our vocabulary includes between 10,000 and 17,000 words depending on age and education level. When the myriad non-verbal modifiers are added coupled with the thousands of ways words can be arranged we become aware of the awesome complexity of this function which we take for granted.

P.S. I am a bit anxious about submitting this for publication as I have a grandson who is about to graduate with a major in communications. I can only hope he will be merciful in his critique.
Next time, I hope to share some thoughts about families.

MY LEFT FOOT

My left foot is under assault by some nasty little microscopic creatures. I like both my feet, but my left one is my favorite. Since I am left handed, it naturally follows that I should be left footed; consequently, I find that such activities as kicking something or someone, stepping on an insect, climbing a stair, or putting on my pants are always led by my left foot. If I am dancing or tapping my foot to music, my left foot leads the way, and the right one follows. When I feel the need to show my anger at having been bested in an argument with Barb, it is my left foot which will be loudest as I stomp out of the room. Of course these are minor functions when compared with its utility along with its companion on the right in providing a convenient means of getting from point A to point B. For these and many other reasons, I would very much like to keep my foot as I do need it.

The problem first appeared two weeks ago when I noticed redness and swelling on the dorsum (that’s doctor talk for top) of my left foot. I thought it looked like a cellulitis, a condition which can progress rapidly with very serious consequences. With that in mind, I talked my way into a next day appointment with my doctor’s colleague (my doctor was on vacation). He agreed with my diagnosis, and started me on an antibiotic with instructions to return “ASAP” if there were any signs the infection was spreading. There was no change after two weeks so he changed antibiotics and informed me that he would admit me to the hospital for IV antibiotics if there was no improvement after a week on the new bug killer. I was a bit shaken by this new game plan.
You may be thinking: what is the big deal about going to the hospital for a relatively benign treatment? Surely I would submit to the harshest of treatments if I thought there was the slightest risk of losing that left foot of which I had become so fond. Although I had spent thousands of hours working in that hospital, I felt some trepidation about becoming a patient there, simply because a hospital is a dangerous place.

One study reports 440,000 preventable hospital deaths annually, making such errors the third leading cause of death in the U.S. I believe these numbers are inflated somewhat, as preventable does not necessarily mean they could have been foreseen in time to intervene. Even so, if these numbers are even half accurate, one must consider hospitals as dangerous. They are further contaminated by including hospital infection rates. We are currently experiencing an epidemic of infections in hospitals. The CDC reports 724,800 such cases in 2015. 4% of all patients admitted will contract an infection while in the hospital. This in itself is scary enough, especially when one considers that hospital infections are apt to be treatment resistant.

The problem of hospital infections continues to bedevil the medical community, and most experts believe that it has evolved due to the inappropriate use of antibiotics which results in the development of bacteria which have become smart enough to develop immunity to the effects of antibiotics. The most common of these organisms are: MRSA (methicillin resistant staphylococcus aureus) and clostridium difficile which is usually referred to as C. diff. The elimination of these bacteria from hospitals has been a daunting task on which most hospitals expend a lot of resources. Such infections do present a significant danger to those whose immune systems are impaired or patients who are weak and infirm. They appear to be spread throughout the hospital by caregivers who are at risk of carrying an infectious agent from one patient to the next.

The VA reported they were able to reduce hospital induced infections by 40 percent by the simple expedient of requiring all staff members to use an antibacterial lotion on their hands when leaving or entering a patient’s room. Compliance was carefully monitored in the study. It is now common practice to have antibacterial dispensers near the entrance of every room; however, there are always those who will not follow protocol. It is also true that lotions are ineffective against most viruses.

Sometimes the mode of transmission is less obvious, for example in one case a number of patients all belonging to a particular surgeon contracted a MRSA infection. Eventually the source was traced to the surgeon’s necktie after it was noted by a nurse that when bending over to examine his post op patients his tie came in contact. A culture confirmed that the tip of his tie was contaminated. Some post-surgical wound infections have been traced to closed circuit ventilation systems commonly used in surgical suites with a mechanism of spread similar to that seen in Legionnaire’s disease. The increase in the use of medical devices, and other invasive procedures, both in diagnosis and treatment, also undoubtedly increases the risk of infection. Although it seems probable that lack of caution is responsible for many of these infections, I submit that if an event is not predictable it is not likely to be preventable, and I don’t believe the statistics I have quoted take this into account. However; whatever the cause, the numbers are frightening.
A few years ago (I dare not say how many), my wife Barb’s first job after nurse’s training was what was then called private duty. As such, she was employed by her patient to provide nursing care exclusively for him, and therefore, except for very brief periods, was in constant attendance during her shift. I suppose such care is still enjoyed by the super-rich but is beyond reach for most of us. Besides, if one arranged for such a nurse, it is unlikely said nurse would be welcomed by the hospital.

Now, many wisely suggest that if hospitalized, one should arrange for an advocate. The wisdom of such an arrangement was brought home to me when I was hospitalized a few years ago. When I did not get an adequate response after pushing the nurse call button to get help for what I believed to be a serious problem, Barb channeled the tigress within her and attention was immediately forthcoming. It appears to me that the most highly trained of the caregivers, the RNs, spend much of their time with administrative functions, while the hands on care is delivered by others, yet the RN is in charge and is expected to know all about the patients under her care. As Barb says “I learned more about my patients while giving a back rub than from taking a formal history.” But alas, back rubs are mostly a thing of the past.

None of this is meant to disparage hospital nursing staffs, for I believe nearly all are fully dedicated to the most noble of all professions; however, many to whom I have talked complain they are not able to spend enough time with their patients, and consequently worry that they might miss something important.

There are several factors that may contribute to the problems of medical errors.

Due to cost cutting efforts by third party payers (a code word for insurance companies), the criteria for admission to hospitals are more stringent than they have been in the past, and there is intense pressure to discharge patients. The result is that the typical hospitalized patient is sicker and therefore more vulnerable to even minor mistakes.

Modern miracles in medicine require many people to get in on the act. Diagnostic and treatment procedures are much more complex and require the involvement of those with specialized skill sets and knowledge. In addition to consulting doctors there are therapists of many disciplines, and others trained in specific diagnostic procedures who are likely added to the mix. It is generally accepted that the more people involved in an activity the greater is the chance of a screw up.

The latest statistics on hospital errors suggest that those involving medication top the list. The most common as you might expect is due to misidentification of the patient, although errors in the pharmacy are certainly possible. Any who have been hospitalized in the past year or so probably noted that whatever was done to them was preceded by a question as to their name and birthdate, which was then verified by reading the hospital wrist band. The fact that mistakes still occur in spite of all these precautions confirm the impression that as humans we are all fallible.

Mistakes in the operating room can be especially disastrous. One of my closest friends, who also happens to be a retired orthopedic surgeon was forced to have back surgery twice because his surgeon picked the wrong vertebral level on the first try. This confirmed my impression that whatever status I thought was conferred on me as a doctor would do little to make me immune from an unwanted assault on my body.

Other mistakes can be even more serious. I recall hearing of an instance in which a person had the wrong kidney removed, necessitating her being put on chronic renal dialysis. There have been similar rare reports of people who have returned from surgery to find their good leg has been amputated, and the bad one remains. I once had a patient who was scheduled for X-rays, but realized she was taken to the wrong place when she found herself surrounded by people with caps, masks and long gowns. The transportation person insisted he was told to take the patient in bed two to surgery, and the charge nurse was equally adamant that she had instructed him that surgery was waiting for the patient in bed one. Fortunately, the surgery staff discovered the error at about the same time as did the patient, but the incident raises the issue of how important those repeated questions about name and confirming birth date can be. I also remember having three patients by the name of Smith in one room back in the days when most hospitals had a few four-bed wards. You can imagine the problems that situation could cause.

Now that modern medicine has contributed to an average longevity greater than nature intended, we have a much older population and since the prevalence of many illnesses is directly proportional to the amount of aging, hospital populations have become older, weaker, and susceptible to many problems which may interfere with their equilibrium. They are also more likely to be on medications that may affect their balance. Put these factors together and it is easy to see why falls are more common amongst the elderly. Since old folks are more susceptible to injury, falls are a serious problem and nowhere more so than in the hospital.

Recently, I visited an old friend who has had unsuccessful back surgery. He was in a rehab facility to get physical therapy, and has been unable to walk. It was a nice day so I got help and placed him in a wheelchair and took him out for some air and sunshine. As I got ready to leave, I noted that he was slumped over a bit in the chair and I was concerned about leaving him there without something to prevent him from falling out of it. I was especially concerned as he has had a couple of falls since his surgery, one time by falling out of bed. When I asked for something to keep him from falling out of the chair, I was told that I couldn’t do that as it would be considered a physical restraint which could not be used in their facility. I thought that was the dumbest thing I had heard since the last presidential debate, and decided to do a little research on the subject. What I have learned is that there has been a great deal of debate about the use of physical restraints, and that some courts have issued rulings about their legality. Some researchers insist that restraints cause more injuries than they prevent. They insist that even bedrails designed to keep people from falling out of bed are dangerous as patients will often try to climb over them and sustain serious injuries. They point to cases of strangulation by so called “soft” restraints often used to prevent confused patients from pulling out catheters, endotracheal tubes, chest tubes, etc. sometimes causing serious damage. I am always bothered by such research, for although it documents carefully the injuries caused by such restraints, there is no way to know what injuries if any they may have prevented. Of course the best solution would be for the patients to have someone in attendance constantly, which is unlikely to happen.
In the interest of full disclosure, I must confess that I have been guilty of using “full leather” restraints on a few occasions when dealing with severely agitated violent patients who are determined to do harm to themselves or others. It was never for very long and I was usually surprised at how well they tolerated it. It may have been because there was someone assigned to be with them, that they realized they had needed to be subdued, or simply that it gave the medication time to work.

Ordering such treatment always made me shudder for I am quite claustrophobic for which I blame my older brother, rest his soul. When we were kids he delighted in putting a blanket over my head and pinning my arms until I panicked. I have dealt with homicidal patients in the past without totally losing my cool, but find that anything which prevents free movement of my arms takes me all the way to the edge of a panic attack. The thought of being handcuffed with my hands behind my back fills me with dread. The only fear I have of surgery is that I will wake up restrained as is often the case when complications result in a patient being attached to a respirator. A couple of years ago l was forced to have my left arm pinned against my chest and to lie flat for 24 hours following a procedure. I, the one who feels nerve pills are for everyone else, begged for Xanax. And you thought psychiatrists didn’t have hang-ups.
No treatise on hospital errors would be complete without mentioning the current fad of electronic medical records, and as you can imagine I have a lot to say about that subject. In addition to reducing costs, and increasing the quality of care, these systems are touted to dramatically reduce hospital errors, but for now I will spare you my ruminations about that subject as Maggie has chastened me about making these things too long. As for my favorite foot the current medication seems to be working and hospitalization seems unlikely.

LIFE on a SUNDAY MORNING

Editor’s Note: This is a post from last year that I’ve transferred from dad’s previous blog. Enjoy!

June 8, 2014

It is Sunday morning and I have been sitting on the patio surveying my miniscule portion of the universe. It is a beautiful balmy summer morning. I am surrounded and engulfed in the sounds and sights of life. Birds seem to be especially vocal, Charley the chipmunk who has outsmarted me at every turn in my attempt to capture him brazenly runs past my feet chasing a new found friend, which probably means I will soon have an entire family with whom to contend. Lilly runs off to add her voice to the chorus of dogs probably in objection to someone’s use of the street without their permission. I notice that the Christmas tree which I planted a short time ago (it seems like a short time) is only a couple of feet shorter than the electric pole which stands beside it. The hibiscus plants which I had given up for dead due to my neglect have made a remarkable comeback and are about to shower us with more beauty.  A sprout has suddenly appeared at the side of the stump of a tree which had cut down nearly two years ago, but it has performed its Lazarus like miracle and refuses to stay dead.

As I focus more intently on my environment, I suddenly become aware that within my view is every shade of green imaginable.   There is a cloud moving toward me, and it will soon be dropping more of the blood of all this life. That huge ball of fire so powerful that we dare not gaze directly at it provides the energy to keep it all moving. What an awesomely miraculous thing, this phenomenon we call life. I have spent most of my life studying life as it exists in my own species, but rarely have I taken the time to appreciate the ways that it surrounds, engulfs and nurtures me. I do recall lying on the grass, and staring in wonder at cloud formations as a child, with a feeling of reverence almost spiritual in its intensity. Many of the questions from those days still remain without answers, but as I recently told Carter (one of my exceptional grandsons) I believe there is more wisdom in questions than in answers.

Surely as I see my own personal supply of it dwindle, life becomes more precious, and I suspect that is not unusual for we old buggers.   I hear much about “finding the meaning of life”, and such similar claptrap, and I suppose I have also engaged in such fool’s errands, when it would have served me well to spend more time simply enjoying and appreciating it, much as I did this morning.  I have in the past made the cynical remark that I would rather go to a funeral than to a wedding. But as with most cynical statements there was a grain of truth in that with funerals I was forced to confront my mortality, and come away vowing to make the most of my time. Those promises to myself however were short lived and I soon returned to my charge through the trees while losing sight of the forest.

Take it from a guy who has been there “the good old days” were not all good, but in my opinion one of the traditions worth saving was the Biblical admonition to use the Sabbath as a day of rest, and as a time to reflect on things beyond our control and understanding much as I did this morning.   In other words there was more to Sunday than just going to church.   There were the “blue laws” which actually made certain activities illegal when carried out on Sunday. Since all religions did not use Sunday as their Sabbath, these laws were obviously discriminatory; however they did serve to promote time for reflection, and family cohesiveness. But, it was not only the blue laws that limited activities. In those days my soliloquy would not have been interrupted as it was this morning by the sound of a neighbor mowing his lawn. It was considered very poor taste bordering on sacrilege for one to engage in any kind of work on Sunday. There were exceptions of course for positions vital to the community functions such as medicine, law enforcement, firemen etc.

There was an oft quoted saying that one should “make hay while the sun shines’; however if the sun was shining on Sunday the hay would have to wait until Monday. No farmer “worth his salt” would want to be seen working his fields on the Sabbath. Some women were so extreme in their views that they even refused to cook on Sunday; consequently would spend much of Saturday preparing food for the Sunday after church meal which was usually the grandest of the week.   Even though the industrial age was in full swing, factories were expected to shut down unless there were compelling reasons not to do so. Business transactions were to be avoided on Sunday and almost all businesses were closed. It was a day for family activities such as picnics and visiting, though often the afternoons consisted of sitting on the front porch watching what could be seen of one’s own part of the world.

If I sound nostalgic, it is because I am, but I suspect most octogenarians suffer from some degree of that malady. Sundays now seem to be a time to catch up on all the work not finished during the week. It has become the favorite time for shopping. The only thing restful about the “day of rest” is that some may get to sleep in a little longer, that is if they don’t have a job which requires them to work on Sunday. I miss front porches which seem to no longer to be necessary, and if present rarely used.   I miss seeing children playing out in their yards on Sunday. I would like to see them abandon their electronic toys occasionally to lie on the grass and look at the clouds, maybe even play hop scotch or hide and seek. I have no desire to go back to those days of my youth, for undoubtedly this is the best time to be alive in the history of man at least in this part of the earth, but I do believe we have much to learn from what has gone before. During my brief time on the planet, I have seen many so called innovations which were actually recycled from the past, and I believe there is still much to be learned from our ancestors. One such lesson could be regarding the value of a weekly day of rest and contemplation. If readopted, such a tradition might even result in some reconciliation of the tree huggers and money grubbers which would undoubtedly help us to become better stewards of our planet.

Those who know me will undoubtedly note a bit of hypocrisy in this essay for I have been a chronic violator of this biblical injunction since my teen years. I too felt that I could not “waste a day”, but now am convinced that a regularly scheduled goof off day would have served me well.

Love Good

 

The Big C and Me

Editor’s Note: This is an excerpt from the book “Reflections for the Future” that includes many of my dad’s writings (e-shrink). You can order it on lulu.com (hard back) or download the pdf of the book for free. Dad referred to this article in a recent blog post so I’ve copied it here.

They faxed the results of my CT scan the other day, and it showed no signs of reoccurrence. Briefly I felt a sigh of relief, such as I imagine the men on death row must feel when they get a reprieve to delay their execution. This journey began nearly a year ago, only a few weeks after my brother died of a rapidly progressing lung cancer. Fortunately, he had little time to suffer as he died only three weeks after he was diagnosed. My wife insisted that I should have a chest x-ray, and there it was, “a right upper lobe mass.” My hopes that it might be a benign lesion were dashed when the follow-up scan was interpreted as “Probable bronchiogenic carcinoma” and confirmed when the PET scan “lit up.”

One would think that my training and research interests would have prepared my to deal with this problem, for back when I was an academic my colleagues and students jokingly referred to me as the “Angel of Death.” This was due to my interest in thanatology (death and dying). At least on a conscious level I was interested in how awareness of our mortality affected such things as personality, super ego development, motivation, mood problems, suicidal and other self destructive behaviors. I now wonder if much of my interest had more to do with my own personal conflicts than a strictly scientific interest. My research led me to the believe among other things that Freud was correct when he stated that people generally were unable to imagine their own non-existence. He was also quoted as having said while he was dying of a painful malignancy that he envied those who believed in an afterlife. Billy Graham seems to have something in common with the Islamic suicide bombers in that he has said that he is looking forward to death for he is convinced that he will have another one much better than his current one. I have also seen many patients who yearn for or even attempt to hasten their death in order to rid themselves of unbearable physical or emotional pain. For some my studies seemed to indicate that there may even be a sexual component to their fantasies of death, and for others a reunion with loved ones who have “gone before’. These are attitudes which I labeled as thanatophilic.

Unfortunately, I am not a thanatophile, On the contrary I am quite thanatophobic, I love my life and as is the case with most things, with the threat of its loss it becomes more precious. My education in the sciences has given me an appreciation for the awesome complexities of life, and some understanding of its fragility, but it is more than the sum of its parts. Now more than ever I look out our kitchen window and marvel at the birds as they all struggle to sustain their life and are programmed to replace themselves so that “life goes on”. I am overwhelmed with their beauty and grace. Is life just a complicated chemical process or does it house something spiritual? I am certainly not the first person to pose that question. When I attempt to understand the physicists as they theorize about the nature of matter and the vastness of the universe, it seems my life must be very insignificant; however sometimes I act as if the world could not get along without me. I guess Freud really was right in that I can’t imagine myself as being dead.

When I first received the shocking news that I had cancer, it suddenly became very clear that my musings and “scientific” investigations into how people think about and cope with death were of little use to me. Kubler-Ross was a researcher at University of Chicago who had beaten me to the punch with her book on death and dying; consequently I had always criticized her for what I considered an overly simplistic explanation of the dying process. Much to my chagrin I found myself to be a poster boy in following her descriptions of people’s behaviors as they faced death. The 1st stage she described was one of grief, and I did that one well all the while attempting to hide it out of a sense of embarrassment. Initially I tried to regain control by trying to “get my affairs in order”, but that rapidly gave way to a feeling of intense sadness which was most severe when I thought of my Grandchildren. I found myself suppressing tears whenever I thought of them. I told myself this was ridiculous, for how could I anticipate feeling this sense of loss if I were dead. If I were dead I wouldn’t feel anything or would I?

It has been said that ignorance is bliss, and also that a little bit of knowledge is dangerous. I knew my body had betrayed me and that my own cells were attempting to destroy my vital organs. I could picture them as they would look through a microscope with their bizarrely shaped nuclei, many of them in the process of dividing as they rapidly reproduced themselves. I knew the traitors had spent the last several years quietly multiplying in my lung preparing for the final assault. The obvious defense against this army was to totally destroy them, and this could be accomplished only with surgery. There would be collateral damage of course, but pulmonary function studies indicated that my body could survive the loss of a lobe (approximately ½ of my right lung). Barb made me promise to “fight like hell” and I vowed to do just that; however as the day of surgery came closer I became more fearful. My fear was that I would wake up attached to a ventilator with my arms restrained and unable to speak, or of some other complication ( I could think of many) that would render me helpless. The idea of such helplessness had always been terrifying to me. The ultimate horror I could think of was quadriplegia with right sided stroke a close second. It turned out those fears were groundless and I tolerated the surgery well for an old bugger. The epidural almost completely eliminated the post operative pain for the first few days, and other than being tethered to a couple of garden hoses protruding from my chest wall I was reasonably comfortable, after Barb had raised enough hell to get me a more comfortable bed than the slab on which they initially placed me.

The pathology report was favorable with no tumor cells found in the lymph nodes ( the most likely route through which the they could spread) and although the tumor involved the visceral pleura ( the covering of the lung) it did not appear to have penetrated into the pleural cavity. This invasion of the pleural cavity is what had killed my brother. The five year survival rate with this type and stage of lung cancer is sixty seven percent. I am told that this could be improved by seven more percent with chemotherapy: however the side effects from the extremely toxic drugs designed to kill those little devils that might have escaped can also do serious damage to healthy parts of my body. I decided to take my chances without it.

My spouse who has been a cancer survivor for twenty years has been a rock, and we have rather deftly switched roles with me now dependent on her for support. She acknowledges my fears, discourages my somaticising, and encourages me to live in the here and now. I have gone through Kubler- Ross’s “bargaining stage”. In my case this involved pleading with God to allow me to stay here to see my grandchildren grow up. I have been amazed at the number of people who knowing of my illness say they are praying for me. This includes friends, casual acquaintances, and even patients all of whom seem to know of my ordeal. I have decided that with all of the problems facing God it is presumptuous for me to expect special treatment, so I have decided to keep my eye on the ball and do what I can to follow his will as I imagine it to be. I hope to stick all these death and dying fears back in some corner of my mind. It has been my experience that one of the major problems with worrying is that we usually worry about the wrong things and the bad things that happen to us are the ones of which we never thought. The fact that I don’t want to die is a testament to how fortunate I have been to have such a wonderful life. Maybe my luck will hold and I will die in my sleep in another twenty or thirty years.

SUCCESS

carterThe other morning I awakened to a pleasant surprise. CNN had someone on the screen other than Donald Trump. Jimmy Carter was holding a news conference about his illness and plans for the future, a future that one could safely assume was rather limited since he acknowledged that he was about to undergo treatment for a melanoma with cerebral metastases.

As a cancer survivor myself (see: THE BIG C AND ME) I felt my admiration grow even more for this man who had always been my hero. This 91-year-old man of unshakable faith, showed no bitterness or self- pity, but was determined to carry on with his life’s work as long as he could function. His response to questions about how he felt about his illness was typical Jimmy Carter: “I will hope for the best and accept what comes.”
As I considered the accomplishments of this person who had come from inauspicious beginnings as a peanut farmer in a small town in Georgia, a feeling of awe came over me. As a young man he left the small town of his childhood to attend Annapolis, bent on a career in the Navy. Subsequent to that, he attained an engineering degree and was involved with Admiral Rickover in the development of nuclear submarines. After returning home, he not only was elected governor of his state and then to the highest office in the land, but won a Nobel Peace Prize after negotiating a treaty between Israel and Egypt that may have saved thousands of lives. It would also seem unlikely that a son of the deep south would become an outspoken foe of bigotry and a strong supporter of human rights throughout the world, but he did. A failed attempt to rescue American hostages in Iran is said to be responsible for his defeat for a second term as president.

Mr. Carter’s presidency was labeled by many as a failure, and his many achievements in economic and foreign policies have been largely ignored. His integrity however has never been challenged. His fulfillment of his promises to “never tell a lie” and to “never avoid a controversial issue” did not enhance his popularity, for as any successful politician will admit, truth telling is not a winning strategy in the political arena. His successor however could have used the tune “don’t worry, be happy” as his theme song.

The loss of his presidency would prove to be the beginning of even greater exploits. Most ex-presidents build libraries which are more like monuments to themselves. They seem to be very concerned about their legacy, which shouldn’t surprise us, after all those with weak egos are unlikely to ever make it to the top spot. Mr. Carter; however, used his monument as a platform on which to establish a center to “wage peace, fight disease, and build hope.” He did confess in his news conference that he has cut back his schedule somewhat, but still plans to remain involved in The Carter Center’s operation. When asked about his most fervent wish, he replied “to outlive the last guinea worm.” For those not familiar, the guinea worm has been a prevalent cause of much suffering throughout many parts of the world and has been almost totally eliminated through the efforts of the Carter Center.

Not only was I impressed with his vigor and enthusiasm, but by his abiding concern for issues he obviously considered more important than his own. Now I ask you, how could you not love a guy like that? For me, listening to him was very emotional. I experienced an intense feeling* of respect. A few days later, a grandson happened to be visiting and we were discussing my blog. As reigning patriarch, I have issued a hard and fast rule that all family members must read this stuff whether they like it or not. Accolades are appreciated, but not required. On the other hand, those who are critical should expect to move down a notch or two on the Christmas gift list. After successfully passing the quiz on the contents of my last blog (although not a fan of Ronald Reagan, I do subscribe to the trust but verify policy) he went on to suggest that I do an essay on success.
Since both my grandsons are beginning their senior year in college, I could understand why such a topic might be on their minds. I also felt the topic particularly serendipitous due to my recent encounter with Jimmy Carter. An analysis of his career brings up the problem of defining exactly what we mean by the word success, and how do we make that judgment? What do we mean when we say a person is a success or a failure? Does it make any sense to make such all encompassing judgments about people since the inconsistent conclusions arrived at by those who are judging would seem to prove that such distinctions are quite subjective. Is success like many other things in life in the eye of the beholder?

There generally seems to be a consensus that Carter was the most successful ex-president in our history, but the agreement ends there. As to the rest of his life, there are those who applaud and those who consider him a failure in many ways. One could say that his political career was a mixed bag. He lost his first bid for governor of Georgia, and his Camp-David_wareelection for president. His presidency was mired by so called “stagflation” for which he was blamed by some while others gave him credit for initiating policies that got the economy back on track. I believe most historians would agree that the negotiated peace treaty between Israel and Egypt was his most laudable success. In spite of this, he was accused of anti-Semitism for his book on Israeli politics: “Palestine Peace not Apartheid” in which he presented the Palestinian side of the story.

With this in mind one must conclude that the distinction between success and failure very much depends upon one’s values. Those of us of a more liberal position are more likely to judge Mr. Carter as a successful person than those of a different political persuasion. Our success in competitive activities such as sports can be more easily determined by winning. We also have developed tools, even though crude, to help us measure academic success. In business, success is generally measured in terms of profits generated, but we have no way to assess the most important facets of life such as honor, compassion, fidelity, fairness, integrity, parenting, and citizenship to mention a few.

The term success is usually viewed favorably by society, but can also have negative connotations. The most succinct definition I could find was “the accomplishment of an aim or purpose”. Obviously if that goal is nefarious in nature the accomplishment will not be viewed in a positive light. For example there are successful criminals, con-artists, and other asocial people. There may also be an issue with the means of accomplishing the desired goal. There may be not only illegal but unethical factors contributing to an individual’s success. Unfortunately such behaviors are many times ignored as successful people are often idealized.

Is the Key to Success Linked to the Courage to Fail?

With all this in mind I have come to the conclusion that each individual is the only one who can judge his success. Of course we need to set goals if we want to be successful in reaching them, but if the goal is to leap tall buildings in a single bound our chances of success are diminished. I have known people who are reluctant to set goals for themselves presumably due to fear of failure. I can only assume their life must be very boring. Success requires risk, and one must be prepared to accept failure for in spite of our best efforts we will not always succeed. It is said that many of the most successful people throughout history have had multiple failures prior to achieving their goals. In my own case, although I have never aspired to lofty goals, I figure my success rate to be about one success for every 10 failures. It is therefore logical that success usually requires a certain amount of determination, and the ability to not be dissuaded by failure. It also lends credence to the age old admonition: “If at first you don’t succeed, try try again.”

Flexibility in interpreting results may also be helpful. At times it may be necessary to revise or reframe one’s expectations. There may be unintended consequences of reaching one’s goal which may exceed or diminish expectations. If a goal is not attainable, it may be possible to modify it in such a manner that one can still enjoy the feeling of success. I have a brilliant close friend and colleague who has written much about psychiatry both for lay and scientific consumption, most of which has remained unpublished. I sense that he thus feels as if he is a failure even when I point out to him that he has been successful in producing thoughtful extremely well written material, and further remind him that his judgment is at least as good as the editors who reject his writings. It is always dangerous to allow someone else to be in charge of one’s self-esteem.
Most successes go unnoticed so it is important that we acknowledge our successes to ourselves. Patting oneself on the back does not necessarily denote arrogance, and will help us develop the confidence needed to pursue more successes. Failure sucks, but even an occasional success will rid us of that feeling. Mankind has undoubtedly been motivated by the search for that feeling one associates with reaching a goal.
At this point in my blogging career, I find it necessary to modify my goals for success. I have come to accept that my writings will not be appearing in the New York times, be going viral or be considered for a Pulitzer Prize; consequently my quest for fame and fortune must end. To that end, I will reread this thing and convince myself that it is worth reading, and crown myself a success.

*One of my friends who reads this stuff has questioned my definition of respect as a “feeling” in my last blog . The highlighted word is for her.

FAMILY

Does parenting make us unhappy?

In a recent conversation, I heard about a young couple who was quoted as saying that they had decided not to have children.  They had allegedly made this decision based on their belief that childless couples were happier.  It is true that one gives up a lot of freedom when they choose to become parents. Children are a long term financial liability not to mention the fact that at times they can drive you crazy.   In spite of the downsides, I strongly disagree with the premise that parents are unhappy because they have kids.  Granted, as children go through the terrible teens, they may not seem to be very interested in their parents’ happiness.  Nevertheless; in the many years I have spent attempting to help people deal with unhappiness,  I found those without children were by no means happier.  One of my patients who had never conceived once said to me that she felt “incomplete.” Conversely, I don’t recall ever hearing anyone say they regretted having children.

The benefits of parenting.

Some may suggest that the urge to reproduce is simply due to a pursuit of sexual satisfaction; however, I submit that the need to nurture is an even stronger emotion.   My wife frequently mentions the wonderfully warm feeling she experienced when those little guys had been bathed and tucked in for the night; although I recall she looked exhausted.  We were fortunate that it was possible for her to be a stay-at-home mom until the kids reached an age of relative independence (a situation that is frequently impossible to implement in today’s families).

Children are also useful in helping enhance our personality development.  I have long insisted that having a child is the most effective treatment for narcissism.  They teach us to look outside of ourselves.  They provide us with an opportunity for a “do over” to correct our mistakes and to vicariously act out our failed accomplishments.  Although they often disappoint and anger us, we continue to care about them, protect, encourage, and sacrifice for them.  These qualities are ones that I once read somewhere as the definition of love which went like this: “love is caring for another as much or more than for oneself with knowledge and without compulsion.”    Nowhere is this statement more apropos than in the feelings we have for our children.

Oh yes, there are glaring exceptions and I have witnessed the crippling effects of child abuse, but even in the most abhorrent of these cases one often finds examples of love gone awry.   One horrible example of this received my attention when a mother was brought to our hospital after she had drowned her two children.   She had a history of mental illness, but had always been overprotective of her children.  She turned out to have been delusional and convinced that demonic forces were coming to sexually abuse and torture her children, and that their death was the only way to protect them from the horrors which she thought were inevitable.  As has been noted by many, victims of child abuse frequently become abusers, but one might consider that by being denied a loving relationship with their children, second or third generation abusers continue to suffer by being denied the most gratifying experience of life.

Children become even more important to people like myself who have been fortunate enough to reach a “ripe old age” (when I hear this phrase I am not comforted by the thought that when things ripen they soon begin to rot).  As our limitations increase and we find ourselves spending more time in doctors’ offices and funeral homes, we become more dependent on others.  I recall responding to a young man who said he did not want children with,  “Who will come visit you in the nursing home?”  An occasional visit from social worker types is not the same as one of your own flesh and blood. The idea of growing old alone is very frightening to many people (myself included), but even when their offspring are not particularly attentive, older folks seem to find some solace in the knowledge that they exist.  Even those who have been totally neglected may continue to have rescue fantasies, and even in the midst of their angst often make excuses for their children’s neglect.

Our brains are hardwired to repress most painful memories; consequently, if you want to know what is most important in life, ask an old person to reminisce.  You will find them to be very accommodating: reminiscing is a favorite pastime for us old folks.  In most cases their reminiscences will be largely dominated by the good times in their lives.  You will also note that many of these resurrected memories will be times with family.

Family vacation

It was during a time of my own reminiscing that I was motivated to write this essay.  The process was triggered while planning for our family’s annual vacation which has become a tradition with my gang, but has become increasingly difficult to initiate as grandchildren grow older and develop more commitments. This year was especially difficult as it turned out there was only one week in the entire year when everyone would be able to attend, and then only after manipulating schedules.  At first it had seemed unlikely that everyone would be able to go, and we might be forced to cancel.  I found that thought very depressing.

Now that everything has been ironed out, and I am trying to decide whether to pack my bathing trunks and risk the derisive comments of the kids about my less than magnificent corpulent body, my thoughts have turned to all those prior vacations.  It has been over 50 years since the first, and it was monumental.  We checked into a hotel with its southern traditions intact in Nags Head.  This was a place where the family was introduced to their waiter who would care for them the entire time they were there, and dinner was a grand affair with everyone expected to “dress.”  Barb was in her glory, dressing up the kids  and showing them off.   Later there would be trips with four kids in a station wagon without air conditioning or video games, but the misery of getting there was dwarfed by the excitement of finding a motel with a pool.

Vacation from hell.

It has been more than 40 years since we went on our last sightseeing type vacation.  I had terminated my general practice, and we had decided to have a grand adventure prior to my starting a psychiatric residency.  It was destined to go down in the annals of Smith history as an unforgettable experience, and indeed to this day remains a topic often mentioned when we are all together.  The kids refer to it as the “Vacation from Hell.” It all began as most disasters do, innocently, when a friend showed me his new motor home.  Now at that time this was a new innovation in the travel business and I was most impressed.  It presented an opportunity to be closer to the flora and fauna, and would save money on hotel and food expenses.  I also was naïve enough to think that with more space when on the road the kids would fight less, and I would not need to scream as much.  Indeed, I pictured us becoming an on the road version of the Cleaver family.

Further  investigation revealed that these motor homes were very expensive.  I was convinced  I could build one myself for much cheaper.  With that in mind, I bought a retired dry cleaning truck and set about to make it habitable.  After the installation of a stove, refrigerator, and toilet, it suddenly looked a little tight spacewise.  I think one of the kids used the sardine analogy  to describe it.  There would be many other smart ass remarks before this trip concluded.   Nevertheless; the vehicle (which would come to be known as Smith’s folly) was packed and stocked with  provisions .  As an added measure of security, I hung my  motorcycle on the back and we were on our way determined to explore all points of interest in the wild west.  Unfortunately, this trip would rival that of the Griswald’s in the Chevy Chase movie Vacation.

We made remarkably good time our first day on the road.   We made it past Chicago, and I was feeling vindicated.  The kids had engaged in only minor fisticuffs, but that may have had something to do with the fact that we had managed an early start, and they had slept a good part of the day.  We had lunch in the “motor home” (some might suggest that I use that term lightly),  and the self-contained facilities solved the problem of poorly synchronized bladder functions.   As we were looking for a place to hook up to water, electricity and sewage disposal, it suddenly became very cloudy and we found ourselves in the midst of a thunderstorm with rain so heavy that it was difficult to see the road.  Suddenly the idea of spending the night in a campground lost its appeal, and we checked into a motel.

The following day began uneventfully.  It was bright and sunny, with not a storm cloud in sight.  All went well until the late afternoon when we decided to pull off the highway in Galena, Illinois, the mention of which never fails to elicit a chuckle from Barb.  Like most vehicles of its vintage, ours had a gear shift lever attached to the steering column.  While pulling away from a traffic light, I attempted to shift gears, and found myself holding the unattached gear shift lever in my hand.   Even in the face of this catastrophe, Barb was overcome with laughter at my facial   expression as I struggled to understand what had happened.   With the gear shift lever broken off at its base, the truck (at this point I no longer addressed it as a motor home ) was stuck in low gear which created some significant problems for the traffic following us and not surprisingly, they became impatient as our top speed was about 10 miles per hour.

It turned out that God had not totally forsaken us, for we stumbled upon a Chevrolet auto agency after “driving” only a few blocks.  I must have still had a silly look on my face for as we pulled into the service department, the mechanic who greeted us supressed a smile as I held the lever in my hand and asked if they had one of those.  Of  course they didn’t, but I was told they could probably have one by the following day.  With that we limped at 10 mph to the closest motel.  Although the savings I had projected by sleeping in Darell’s folly was taking a hit, the kids were happy because the motel had a pool. The replacement part arrived later that next day, and we were back on the road after our second night in the motel.

Are we there yet?

If you are thinking it could not get any worse, you would be wrong.  After a few hours on the road the sun disappeared never to be seen again for the next three days.  As a matter of fact, it became dark enough that I decided to switch on the headlights. One black cloud to my left looked particularly ominous, and as its funnel shaped appendage moved down towards the earth, I figured correctly that we were in big trouble.  Now, as a native of the southern Ohio hill country my acquaintance with tornadoes was limited to what I had read, which wasn’t much.  As it advanced straight across the cornfield toward us, I attempted to tone down the terror from my voice to utter some hollow platitudes. Of course as every parent knows, kids read us like a book and my attempt to reassure them only caused more fear.

It only made sense to me to seek some shelter, so I stopped under an overpass, but was soon interrupted by a siren and flashing red light which had pulled up next to me.  I was thinking, “Can this guy be serious about giving out tickets in this situation?”  Then I noted that he was waving and pointing ahead apparently wanting me to move on.  I was angry that he was forcing me to go back out into the storm, but being a law abiding compliant soul, we struck out again.  I would later learn that under a bridge is the worst  possible place to be in a tornado, and perhaps that patrolman saved our lives.

After vacating what I thought was a safe haven, I found I could only see where I was going by straddling the center line. The wind was so intense that it blew water right through the rubber seal of the windshield. Then suddenly I realized that we were traveling on the berm  of the road.   The highway was  perfectly straight and I had been white knuckling the steering wheel to keep on that white line; consequently, I was confident that we had been simply lifted off the road and set gently back down on four wheels.  In a short time the wind died down, and it was evident my promise that this trip would be a grand adventure was being fulfilled.

The tornado had moved on, but the sky still looked  ominous and once again the idea of sleeping in the camper lost its appeal.  Clouds and rain continued to dog us for the next couple of days and we continued to hear that conditions were right for tornadoes. These announcements were meaningless to us as we had no idea where we were, so the wisest thing to do seemed to be to turn off the radio and hope for the best.  The kids were not impressed when we drove through the badlands.  We did manage to catch a glimpse through the fog and mist of Mt. Rushmore but the kids were still not impressed.

Soon the sky would brighten and I was convinced that we would still salvage this vacation.  I was hopeful when we got to Wyoming, bought cowboy hats all around, and stopped at a dude ranch which advertised trail rides for five dollars.  It turned out as you might suspect: it was a short trail, which became shorter when I heard Barb scream for help.  She was bringing up the rear and her horse decided he would rather go back to the barn at a rapid pace.  Unfortunately, there was no dashing cowboy on a white charger to run her horse down and rescue her. I was having my own problems hanging on.

Our next major attraction was to be Yellow Stone park, and I was looking forward to finally testing the sleeping accomodations of the camper and awakening to the smell of bacon frying.  It was a gorgeous night and after getting the kids bedded down, Barb and I decided to sleep under the stars.  I quickly fell asleep, but was  awakened by loud clanging sounds. Upon closer observation, the sound was coming from bears on a foraging expedition and had knocked over all the garbage cans they could find. Barb beat a hasty retreat to the camper with me close behind.

At that point, we decided we had experienced enough adventure, and after an uneventful swing south to glance briefly at the Grand Canyon, and an equally brief visit with Barb’s brother in Phoenix,  we headed back north for home.   Through all her travails our trusty land schooner had performed admirably, save for the minor gearshift problem. As we rolled along Kansas, confident the rest of the trip would be smooth sailing, I noticed a lack of responsiveness when I depressed the accelerator.   It soon became apparent the clutch of the “motor home” was going out.  This did not present much of a problem in the flatlands, but as we got into the hill country , the steeper ascends were a challenge.  With the clutch slipping, and the engine racing we were barely able to top most of the hills.  In  spite of this minor impediment we were finally relieved to arrive home with no  lives lost.

Flashforward

Since those days our group has doubled in size and family vacations have consistently been for me the highlight of each year.  They were suspended for the past year following the untimely death of my oldest, yet the family T shirt commemorates this one as the 21st of such get togethers.  They have all been deliciously chaotic affairs, but none that could match the “ vacation from hell.”  We were forced to leave a day early from a South Carolina beach due to a hurricane, and there have been the usual sunburns, jelly fish bites, a broken leg, a sizeable gash from attempts to break up a dog fight, and a fall down the steps resulting in my eyeglasses having impaled my head; otherwise, they have been relatively benign afffairs.  Most have involved a week at a beach and they have all been at different places as we always seem to wait too long to make reservations.

This year’s family vacation is only a few days away, and I find my feelings analogous to those I experienced as a child a few days before Christmas.  I always look forward to seeng the progeny of course, but to witness them all together interacting not only with me, but with each other is a most exhilarating experience.

photo

Here I sit three days later with a magnificent view of the Gulf.  The trip down here was relatively uneventful.  There was a minor issue in a parking garage in which one of the grandkids who is learning to drive ( and who shall remain nameless ) backed into a parked  car.  Her Mother violated every tenet I had ever taught her by leaving a note with her phone number.   Well maybe I might have inadvertinately mentioned that “honesty is the best policy” rap when she was little, but never thought she would take iit seriously.  Meanwhile the kids have managed to trash the place in short order.  They are at times loud, argumentive,  constantly in motion, and in short wonderful.

By the way, I feel compelled to mention that one of those guys who said he did not want children was my son who is on course to be nominated as Father of the century.

NOTE FROM ESHRINK’S Editor. We recently returned from our 21st Annual Smith Family Vacation (these are the vacations dad discussed above…a tradition started when Simon and Carter were babies in 1994). Unfortunately, I don’t have pictures from the “vacation from hell” but I’ve added some pictures for family of previous trips during our 21 year vacation history.

vaca2010 group shot

This is the vacation where dad impaled himself with his glasses when he fell down the steps. Jim pulled them out, and we took the picture BEFORE dad went to get stitched…we Smiths don’t let anything get in the way of the family photo 🙂 but maybe that’s why the picture is so blurry.

 

 

This was vacation we took in Michigan. Jim proposed to Trudy on this vacation. I think it was 2005.

This was vacation we took in Michigan. Jim proposed to Trudy on this vacation. I think it was 2005.

 

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Vac072009_family_steps

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Horseback riding at the ranch. Summer 2007.

Horseback riding at the ranch. Summer 2007.

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

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Life

There was a fly on my bathroom window this morning.  As I prepared to swat him, I was reminded of my mother saying “He wouldn’t hurt a fly,” a complimentary phrase used to describe a person of gentle character. Although my mother was a gentle soul herself, that saying did not apply to her as she was an avowed hater and ferocious killer of flies.  Her swatter was always within reach and during times of heavy infestation, she would hang a fly catcher from the ceiling light.  The latter was in the form of a sticky tape which would attract flies and then hold them until they stopped fluttering, a sort of weapon of mass destruction.  The flies did not appear to be very smart for they continued to land on the fly paper in the midst of hundreds of their dead buddies.

As I stood poised to murder that poor little guy with my bath towel, it also occurred to me that to see flies in the house is now rather uncommon, compared to my childhood when it seemed they were everywhere; undoubtedly a testament to indoor plumbing and pesticides. A frequently heard admonition delivered in semi-panic mode was: “Close the screen door, you are letting in all the flies,” and believe me there were often a lot of flies to let in.  Once in the house, the only solution was death by whatever means available.

We are a culture which professes a reverence for life, but I doubt even the vegans among us would feel much compunction about swatting that fly. The rest of us find only the lives of our own species or perhaps those of our pets to be important.  I am told there are some eastern religions which forbid the taking of any animal life no matter how small or insignificant, which leads me to believe they find life itself to be a holy condition.

As I grow older, I find that I no longer take life for granted.  This shouldn’t be surprising since economists explain that as a commodity becomes less plentiful, it accrues more value. I suspect that is one of the factors which has inspired me to write this little ditty.  Life is one thing that fly and I have in common; although, our experiences with it obviously differ considerably.  Much has been written about the mystery of death, which is understandable since we have not experienced it personally, but I submit that life is much more complicated and mysterious.  As a matter of fact, when I consult my favorite reference (Wikipedia), for a definition I become even more confused until I find it defined as the opposite of death.  That was not very helpful as I think I already knew that.  I believe my tenth grade biology teacher did a better job when she described life as the ability of an organism to respond to its environment, and to reproduce itself.  Using these criteria one must conclude that Mr. Fly is indeed alive.

Life and Consciousness

In the midst of plotting my strategy as to how to take him out without breaking the window, I found myself wondering if the fly knew he was alive, or if he was even aware of his own existence. Recently I have been reading about some exciting research that attempts to understand how our brains work, but there still appears to be a lot of questions about consciousness.  In addition to the imponderables of why am I here and how did I get here, man is also faced with the even more vexing question of how do I know I am here?

The earliest recorded writings on the subject of consciousness were contained in an essay by John Locke in 1690 (side note from editor: this connection won’t be lost on devotees of the television show Lost).  He defined it as “The perception of what passes in a man’s own mind.”  There has been much disagreement even in the description or definition of the word.  The one I liked best was the translation from the original Latin namely: “knowing that one knows,” but then I have always been a sucker for simplistic answers to complex questions. Not so with the world’s greatest philosophers who have found the subject fertile ground for their speculations and opinions.  I tried googling some of that stuff and found that I had no idea what they were talking about, but felt a great sigh of relief when I stumbled upon a quote from Stuart Sutherland in the 1989 Macmillan Dictionary of Psychology where he wrote “Consciousness is a fascinating but elusive phenomenon: it is impossible to specify what it is, what it does, or why it has evolved. Nothing worth reading has been written about it.”  That last line made me feel much better.

With the marvelous advancements in discoveries about the brain, and the ability to actually witness its functions via scanning techniques, neuroscientists have now thrown their ideas into the mix; however, they are limited by the problem of objectively measuring a subjective experience.

Recently I wrote a spoof abut a future in which robots populate an earth where the human race has become extinct.  My wife thought it was crazy, but I now feel vindicated after discovering that Alan Turing (credited with inventing the computer) had written a paper on the subject of computer intelligence in 1950.  Now there is much discussion about artificial intelligence, but one wonders, “What is the difference between artificial intelligence and the genuine article?”  There is some debate as to whether computers can actually be programmed to be conscious.  Many learned people dismiss this idea as preposterous, but then people shared that same attitude about going to the moon.  After living on this planet long enough to witness many “preposterous” discoveries, I have learned that the adage “never say never” makes a lot of sense.

What about the fly?

Those of you who are still reading this may wonder what this has to do with the fly on my window, and I don’t have a very coherent answer, other than I have a tendency to wander off on tangents when I am thinking “great thoughts”.  This is a phenomenon we psychiatrists call loose associations often found to be a harbinger of impending psychosis.  I prefer to think that I am perfectly sane; however, if I am suffering from an altered state of consciousness I may be totally unaware of my mental problems, and as a matter of fact this is one of the factors which often makes it difficult to treat the more serious mental illnesses. After all, it would make no sense to undergo treatment for an illness that does not exist; consequently, should we be surprised that many seriously ill patients resist treatment as have I?

Consciousness and animals

Consensus among the experts regarding consciousness in animals seems to be lacking.  Some are convinced that this is an exclusively human function while others feel that some mammals and birds are so endowed.  Others believe that only subhuman primates, chimpanzees in particular, exhibit consciousness, and that other creatures including insects like my fly friend operate on instinct.  Of course we don’t know much about instincts either.  Although instincts are thought to be encoded on the organism’s DNA, we still face the mystery of how that process occurred. The limited research I performed to help me answer my housefly question has convinced me that the fly in the window, although satisfying the criteria to be called alive, almost certainly could not experience consciousness.  I did learn a lot about flies for example: 1) they only live from two to four weeks, 2) they undergo a complex life cycle as maggots, pupae, etc, 3) they have large protruding eyes with multiple lenses which allow them to see in all directions at once which explains why you can’t sneak up on them, 4) they have been aggravating us humans throughout history, 5) they can carry a variety of diseases from the garbage and feces on which they feed, 6) enlarged photographs show them to be truly ugly.

Obviously, in order to be conscious we must have a functioning brain, an organ of such marvelous complexity that it defies our total understanding. Most experts agree that the ability to experience emotions is essential for consciousness, and this is what sets us apart from other life forms, yet we know that elephants for example go through an elaborate period of mourning at the loss of a family member, and many of us remain convinced that our pets demonstrate all kinds of feelings based on their behaviors.  The idea that the brain is the seat of emotions is fairly recent, and for most of our history had been ascribed to the heart.  The tradition lives on; however with phrases like; “my heart goes out to you” or “her heart is broken.”

Consciousness and theology

Discussions of consciousness are almost certain to lead to theological considerations.  Indeed some philosophers would contend that the soul is simply the state of being conscious. Throughout history, man has left evidence of his belief in a spiritual component to his being, which is separate from and survives his death. Such a belief has crossed all boundaries and cultures throughout the world; although with different versions of the same theme.  Of course without consciousness, man would have been incapable of conceptualizing a spiritual aspect to his being or for that matter even the realization that he was mortal.   One might ask, is it not possible that our conscious mind is incapable of perceiving the “soul within us,” or as some insist, is this idea simply a fairy tale devised by man to deal with the awareness of his mortality?

There are those who operate under the assumption that if you can’t see it, hear it, smell it, taste it or touch it; it doesn’t exist.  I submit there are many things which we cannot perceive which are known to exist.  Gravity for example, does not pass that test for we cannot perceive it directly, although we are certain that it exists because we can witness its effects.  We even have an equation to describe it.  As a matter of fact our universe is so well ordered that theoretical physicists insist that everything can be explained by mathematics. By making use of these principles, they have been able to predict the discovery of many things in our universe both in the field of particle physics, and the other end of the spectrum namely, astrophysics.  One of the more famous examples of this was the discovery of black holes in the universe 55 years after Einstein had predicted their existence based on his calculations. It is little wonder that a guy like me who struggled with ninth-grade algebra has difficulty understanding these guys.

If you thought Einstein and his relativity theories containing terms like a fourth dimension, space time continuum, and how straight lines are actually curved  strange, take a look at quantum mechanics which is really weird.  Among other weird things, devotees to this line of thought explain with a straight face that an object can be in more than one place at the same time.  In an earlier time if someone presented me with a story like that, I would probably have suggested he come with me and spend a few days in the psych ward.  Some also postulate the existence of parallel universes.  While all this is going on subatomic studies are turning all we learned about the atom and the nature of matter on its head.  We were taught that the atom had protons, neutrons and electrons, now we are told there are quarks and leptons and other kinds of things in there doing weird stuff.

You may be thinking “here he goes off the deep end again” but the point I am attempting to make is that there are many things going on which our brain can’t contemplate due to the limitations of our special senses.  With that in mind it doesn’t seem like a big leap to think there may be spiritual stuff going on both within and around us of which we are totally unaware.   I would not be shocked if some modern day Einstein would not come up with an equation some day that would confirm the existence of a spirit world, God included.  In the meantime we are left with the admonition to believe.  This has always been difficult for me as I have always been a skeptic by nature and like things to be proven.  In spite of this, I try to believe as I am told that only believers will get their tickets punched to the pearly gates and the other option does not sound good at all.

Meanwhile the question remains unanswered as to what all is involved in consciousness.  Is it simply a byproduct of life, the end result of the evolutionary development of the human brain?  Is the condition unique to humans?  Is there a mystical component involved?  I know these are all questions I raised early in this writing, but did you really expect answers?  As I have said in a previous blog, more wisdom is usually found in questions than in the answers.

By the way, in case you are wondering about the fly, I swatted him.