August 2010 Archives


I’m working on a book about my weight loss (150 lbs. over the past two years), and have been going over pictures that illustrate how I looked from my peak to where I am now.

Actually, I am still losing, but stabilizing.  Keeping off is not a problem.  Most things people think are problems are not problems, if people would gather knowledge and actually think about it.  They don’t.  They listen to friends  and women’s magazines.

Obama eating

Thinnest President Since Lincoln?

Weight is a tough problem.  It is “multi-factorial.”  There are physiological things, genetic things, environmental things, and lots (I mean lots) of psychological things that are part of this.  I think of them not as tricks or tips but as factors, real factors.  I do not think people should pick and choose what seems “easy;” rather, they should focus on doing what works. Read more on Eating Myself Slim…

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“I see him every day at work and I am attracted to him, really a lot, like I want to be with him all the time.”

She was 25 and hot by most common ways of assessing such matters; with olive skin and dark eyes, well made-up and skirt a little on the short side. A smile  sneaked gently onto her face as she talked about this guy.

Workplace Affair

Workplace Affair

She told me she was happily married, with a three year old at home, and a good husband, one of the husbands everyone else wished they had, and she did not want to screw that up. Her face got dreamy and she kept talking and I could only wonder about one thing.

Is this the best problem she could come up with?

I saw her in a clinic in a poor part of town, where nobody had jobs let alone husbands, and this was her problem. Read more on Hard To Keep An Affair At Work Only…

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There is a story about myself which I don’t enjoy telling.  As a matter of fact, believe it or not, I don’t much like to talk about my own strange history.  But my husband gives me cues.  We were having a pleasant luncheon with a person with whom we wanted to have a working relationship.  Since it was mostly business and financial, and I have never claimed such things to be my “strong suit,” my husband did most of the talking. I think the person we were with, although he said little, wondered at least a little if I were clever enough to do the scientific and medical part of the consulting we were talking about.  So my husband said it.

“Tell him about when you got expelled from 4th grade.”

Nobody asked my age, but after some precocious grade-skipping, I was, as far as I can figure, 8 going on 9.  I was in a local public school, in a city where the school system was of very low repute.  My father of blessed memory had done a little substitute teaching several years before, and the superintendent of schools was a “friend of the family.” Read more on How The Gifted Child Got Expelled…

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I always thought it lovely that people use the most sophisticated technology available in their era and try to describe the brain with it.  A steam engine for Freud.  A computer for the moderns.  Everyone acknowledging that the brain is more complex than anything they can possibly describe.

Sometimes you have to simplify things in order to use a concept.  I always had trouble with this “left brain/right brain” thing.  People have laterality.  They have dominant sides. I am right handed.  Minor medical problems show up on the left side of my body a little more readily.

View of the brain's two lobes - left and rightMy brother of blessed memory, who had Asperger’s syndrome, was diagnosed early on as having an “ambivalent” mind and a laterality problem by an overzealous school headmaster who really believed he had seen it all.  My mother of blessed memory suddenly “remembered” something which I had never heard before, about my brother having tried to write with his left hand, and her thinking it was a bad thing, and trying to make him write with his right hand. My guess is it was an epiphenomenon of the Asperger’s maybe, but dear Harry’s problems obviously went a lot deeper than laterality.

I remember reading some of the “split brain” experiments, stories of poor folks who had a disconnect between the right and left parts of their brain.  Coming up with words to describe things they saw in their left cortical visual fields, coming up with pictures they could describe in their right visual fields. Read more on Left Brain/Right Brain…

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I remember the time when the only person who ever held my hand was my mother of blessed memory, with my father of blessed memory as a rare substitute.  I mean, if the four of us, both parents and my brother and I, went for a walk, my father would get the better behaved child, who was definitely me.

Mommie had told me quite clearly that I could not cross the street without holding a hand.  We lived near an expressway, and cars went fast.

Many years later, when I brought my husband to the parental house to meet her, she was gratified that I did not have to navigate this treacherous place without the anchor of my hand, and that I never had.  A tad overprotective, perhaps, but like a therapist colleague once said after meeting my family, better they are like this than like the ones who don’t give a damn. Read more on I STILL Wanna Hold Your Hand…

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This one is a hoot.  The fattest foods in America?  Are we Californians supposed to feel superior because we do not eat these things? I think something else is going on. If I told you that I have a great diet and the only thing you cannot eat is French pastry, I suspect you would immediately start craving French pastry, planning downtown walks so that you could look at French pastry shop windows, and perhaps most dramatic (and in my opinion, uncalled for) you could start disliking the French and switching to “freedom fries.”
KFC Double Down

The Notorious KFC Double Down

“Forbidden fruit” has become forbidden meat. At least, I think, in California.  I remember when my husband and I first came here, I heard some people call it the “Granola State.”

KFC’s “Double Down” is already out there. Sounds like the nutritional pundits are weighing in on this one.  I never would have believed, in my earlier lifetime, that anyone from Yale would have anything to say about KFC. Read more on The Fattest Food…

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I was at a Midwestern medical center, taking internal referrals.  The referring physician was a medical doctor I had never heard of.  Of course, there was no information about why a 70 year old grandmotherly woman with white hair and a surprisingly pleasant smile had been referred.

She told me she had headaches.  She was very happy that she did not have one on that day.  They were horrible and even an emergency room injection of narcotics did not do anything for them once they started.  They were variable, sometimes brief and sometimes lasting a whole day.  They could be on either side, or both, but most often cut a line from above one ear to above the other ear.  They were getting worse and quickly.

One of the smartest things anyone ever told me (It was an ancient professor in France, who was so experienced he had to say smart things once in a while) was that if a patient could not be diagnosed, or did not make any sense, just spend more time with the patient and get more history.  He said that very often patients knew exactly why they had the problems they had. Read more on Unconventional Cure — Leave The Headache Behind…

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When first we moved to an office in a bohemian section of town, my marketing efforts were as naive as they were enthusiastic.  I walked into every shop in the neighborhood to introduce myself as a physician and psychiatrist who had recently moved in, and did some innovative things.

I especially remember my visit to a salon, where the customers, all male, (I said it was a bohemian section) told me about various troubles with their physical appearance; hardly my specialty, but I am open to doing what I can do in many context.

As soon as I returned to my office, I got a phone call asking if I could do a wart removal, and how quickly.  I declined. I cannot be all things to all people. Read more on Warts And All…

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No small part of the life of psychiatrists (and other doctors, I suppose) is made up of writing papers and reports.  A rather astonishing part of this are reports that are supposed to predict other people’s behavior.

This is basically impossible.  I remember hearing and never forgetting, early in my training, a supposedly ironclad rule of behavior prediction.

“If they did it before, they will do it again.”

Sometimes it had slightly different forms, made to appear more authoritative. “Past behavior is the solidest predictor of future behavior.” Read more on Prediction and Propinquity…

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This is the system we want to run health care.

Civil liberties get lost, people spend a lot of money writing spy reports and then don’t read them.  There is little in government that works.

I know the system that the FDA wants for drugs does not work.

First, you know nobody will use it with diet and exercise as recommended.  They are both dull, not fun, and in the literature I read changes that are increasingly modest seem to be acceptable, and take a team of cheerleaders.  Even “natural” companies, like Metagenics, have gone and credentialed counselors to help with lifestyle changes. Read more on Diet Drugs: The Public Is The Loser…