Saturday, December 04, 2010

The Beatles' Genius

I recently have been reading through a special edition of Rolling Stone, "The Beatles 100 Greatest Songs."  It has been a exhilarating trip down the penny lanes of nostalgia and creative genius.

I think the enjoyment comes from recognizing and relishing their genius, which was so unique, so fresh and challenging, so overpowering that, in the span of eight short years, they revolutionized the world of music, and the world generally.  How did they do it?  How did they go from Liverpool to the Ed Sullivan Theatre to Strawberry Fields to Abbey Road, from Yesterday to Tomorrow Never Comes to A Day In The Life to The End in the short span of eight years?  Seeing in pictures the physical transformation of the group is fascinating, from the close cropped hair of the early years, to the mop tops of their American invasion, to the John-Lennon-is-Jesus hippie look of the later years.  What would it have been like to have witness that evolution--no, revolution--in real time.  I remember my dad relating to me the sheer excitement he felt when taking the newest Beatles LP out of its sleeve for the first time.

The creative collaboration between John and Paul was propulsive, ecstatic with energy, and yet some of their very best songs were written by George.  Ringo seemed to be the perfect complimentary personality for the group, congenial and comedic.  What would have happened if they hadn't been pushing each other?  It's interesting that early in their careers, they didn't really even consider themselves talented song writers.

The external rivalries and collaborations with their contemporaries are also fascinating.  Bob Dylan and John Lennon had a decades-long rivalry going.  Paul and Brian Wilson of the Beach Boys were constantly trying to one-up each other:  Rubber Soul begat Pet Sounds which begat Sgt. Peppers which eventually begat Good Vibrations.  Chuck Berry, Elvis, Eric Clapton, the Rolling Stones, and most other contemporary rock and rollers and folk rockers figure prominently in the Beatles' development, yet they also seemed ahead of the curve, pushing and exploding the envelopes, dragging the rest of the musical and cultural universe along with them.  The songs are all forty-plus years old, and yet they sound as energetic and pertinent as ever.  Timeless.

It all happened so fast.  Eight years ago I was just graduating from medical school, which still in some ways seems like yesterday.  But in eight years, John, Paul, George and Ringo changed the world.  They weren't even thirty when they broke up.

There are such interesting parallels in their music that matched their trajectory as a group, from the explosive energy of the early chords that heralded their arrival, to the psychedelia of the middle drug-infused years, to the mature, contemplative ballads of the later years.  And yet the music was sublime every step of the way.  It's as if they simultaneously created and mastered this new form of musical expression.  They couldn't have known that Let It Be would be the title track for their last released album, or that the final song from their final recording session, which would become Abbey Road, would be entitled "The End" and finish with lyrics "And in the end, the love you take is equal to the love you make."  The long and winding road came to a presaged ending.
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But I guess the simplest reason that reading about the Beatles songs is enjoyable is because the music is just so good, and so familiar.  I think we all have imprinted in our brains, in a literal way, the massive original creative output of these four boys from Liverpool.  Hearing these songs, or even just reading about them, instantly trips multiple pleasure switches in the brain.  It's almost like some of these songs exist independent of their creators, like they were melodies and harmonies and lyrics that the Beatles didn't so much write as discover, digging them out of the ether of the cosmos, polishing them, and then leaving their indelible fingerprints all over them.  In some cases, like Yesterday and Blackbird, that is true:  Paul woke up and fell out of bed with the fully formed song buzzing through his brain.  Sometimes, genius is a work of persistence, and sometimes a product of inspiration.  In the Beatles case, it was seemed almost like an organic, synergistic and semi-spontaneous phenomenon.

Here are the top fifty songs from Rolling Stone's list.  I don't quite agree with all of their placements, but how can you argue, when their perfection was so prolific?


  1. A Day In The Life
  2. I Want To Hold Your Hand
  3. Strawberry Fields Forever
  4. Yesterday
  5. In My Life
  6. Something
  7. Hey Jude
  8. Let It Be
  9. Come Together
  10. While My Guitar Gently Weeps
  11. A Hard Day's Night
  12. Norwegian Wood
  13. Revolution
  14. She Loves You
  15. Help!
  16. I Saw Her Standing There
  17. Ticket to Ride
  18. Tomorrow Never Knows
  19. Lucy In The Sky With Diamonds
  20. Please Please Me
  21. All You Need Is Love
  22. Eleanor Rigby
  23. Abbey Road Medley
  24. Happiness Is A Warm Gun
  25. Here, There, And Everywhere
  26. If I Fell
  27. You're Going To Lose That Girl
  28. Here Comes The Sun
  29. Can't Buy Me Love
  30. We Can Work It Out
  31. You've Got To Hide Your Love Away
  32. Penny Lane
  33. I Am The Walrus
  34. Eight Days A Week
  35. Paperback Writer
  36. I Should Have Known Better
  37. She Said She Said
  38. Blackbird
  39. Day Tripper
  40. For No One
  41. Get Back
  42. I Feel Fine
  43. Drive My Car
  44. All My Loving
  45. No Reply
  46. Don't Let Me Down
  47. Things We Said Today
  48. The Ballad of John and Yoko
  49. The Night Before
  50. Got to Get You Into My Life

        Tuesday, August 24, 2010

        Anatomy of an Epidemic

        Could it be that our drug-based paradigm of psychiatric care is fundamentally flawed, that the magic bullet medicines purported to correct chemical imbalances are actually worsening mental illness in America?

        That is the conclusion of Robert Whitaker's new book, "Anatomy of an Epidemic:  Magic Bullets, Psychiatric Drugs, and the Astonishing Rise of Mental Illness in America."

        It is an evidence-based, highly persuasive critique of psychiatry's devastating failure as a medical specialty.  Disability from mental illness has multiplied ten-fold since the the introduction of psychotropic medications in the 1950s. Pharmaceutical giants make billions off patients from whom they have willfully withheld evidence of their addictive drugs' deleterious long-term effects.  And one in eight children in America is started, in childhood, on a pathway towards a lifetime of medication-induced mental disability, some before they are even potty-trained.  Two year-olds are being placed on antipsychotic medications for "bipolar disorder."  Read that last sentence again.

        This is not to say that mental illness is not real, or not that psychiatric medications are not sometimes appropriate.  But how did we get from that point--limited use of psychotropic drugs to stabilize rare, severe episodes of mental illness--to this point:  some psychiatrists now suggest that over half of Americans suffer from a pathological, biochemical mental illness, and virtually all psychiatrists utilize, as their only treatment modality, cocktails of two or five or even seven mind-altering medications.

        Mr. Whitaker's book rips away the curtain from psychiatry's hall of mirrors and gives its distortion of drug studies no place to hide. With even one step backwards to look at the big picture, it is all so ludicrous, so pervasive, and if it continues unchecked, so very calamitous for our children and future of our society . . . yet so very profitable for the drug companies.

        Every physician, every patient struggling with anxiety or depression, every parent with a rambunctious child, should read this book carefully.  I know that in my own practice, I am foregoing the habit of mindlessly refilling my patient's psychotropic medications and initiating the discussion of the mind's capacity to heal, of our need to constantly reevaluate (every six months at a minimum) the use of psychiatric medications.  I've been surprised at how receptive my patients have been.

        Read the book.  It's engrossing, and so important for all of us to try and reverse this destructive paradigm of mental health.

        Sunday, July 18, 2010

        Children: the Antidote to Existential Crises

        First post in several months.  Writing has come with difficulty recently, and I'm not entirely sure why.  The most obvious reason is that life has become busy:  busy at clinic, busy at church, busy at home.  Busy is good, but sometimes it seems hard to, well, catch your breath.

        I believe the more subterranean reason is because I have been battling through what I would term a prolonged existential crisis.  This is nothing new.  These crises have occurred to me periodically throughout my life, but this one seems different, more profound, more enveloping.

        What's different this time?

        In the past, I've always had some focal point, some future goal, a graduation, engineering an escape from Wyoming, writing a novel that, with the perspective of time, now seems in essence to be a scream into the void, a quest for validation.  Point is, there has always been some distraction or project into which I could project my existential frustrations and anxieties.  I don't seem to have that "next big thing" any more.

        By all external measures, my life is great:  great job, relative financial security, lovely wife, cute kids, a good church, a home we love in a state we love.  And yet . . .  and yet . . . I find myself unsatisfied, frustrated, yearning for more.  I don't find myself questioning the existence of God, but I find myself wondering, in spite of that faith, about ultimate meaning, my place in the vast emptiness and benign indifference of the universe.

        Bono said it well:
         
        I have climbed highest mountains
        I have run through the fields
        Only to be with you
        I have run
        I have crawled
        I have scaled these city walls
        These city walls
        Only to be with you
        But I still haven't found what I'm looking for

        I believe in the Kingdom Come
        Then all the colors will bleed into one
        Bleed into one
        But yes I'm still running
        You broke the bonds
        And you loosed the chains
        Carried the cross
        Of my shame
        You know I believe it

        But I still haven't found what I'm looking for
        But I still haven't found what I'm looking for


        (That's from a man who has worldwide fame and colossal fortune.  And now a surgically repaired back.  Coming to Denver May 21st.)

        All of this could fairly be called a midlife crisis.  I am, after all, turning thirty six next month, and I've noticed a few gray whiskers recently.  Cue "Dust in the Wind."  Prescribe me a bottle of prozac.

        But the truth is that I am, perhaps foolishly, still hopeful that good will come of these melancholy ruminations, that there is something powerful, overwhelming, intimate and beautiful to be found on the other side of this abyss, not just echoes reverberating into the chaos of entropy. 

        For those that know me well, this is why the LOST finale struck such a powerful cord.  It conveyed, beyond words or summarization, what I've been feeling:  that this Island of Isolation and Mystery, this life, on which we are all scratching out a sorrow-laden existence, ultimately means something, means everything, in fact, and we are not alone on the journey.  We see through a glass darkly, but the best we can do is to help each other stumble towards grace and redemption, believing that someday we will cross that great divide together and find that something brilliant has been awaiting us all along.

        I could, and maybe should, be writing volumes about this inner weather, as a means of processing and understanding myself.  Perhaps I should spare the blogosphere and my minuscule audience that agony.  Maybe this post is a start.

        But what I want to say today is that I have found a readily available antidote for these crises:  my children.  Especially my three year old.  He lives entirely in the now, in the throes or ecstasy of whatever current emotion or appetite is coursing through his mind and body.  This can lead to tantrums and meltdowns, and also the most hilarious things that he says.

        Brief example:  Justin loves loves loves swords.  Everything--sticks, brooms, pencils, rackets--is a sword.  I made the mistake of getting him a Nerf sword for his birthday, and then had to confiscate it a few days later when the rest of us got sick of being pummeled with it.  We were at a park recently when Justin saw an old man hobbling along with the use of a cane.  Justin, in his adorably uninhibited way, ran up to this elderly man, and with a tone of awe and admiration, pointed to his cane and asked, "Huh?  You got a sword, too?"

        The point is, Justin is real.  Undeniably, flesh and blood, you-can't-ignore-me real.  And the fatherly love that flows from me towards him as I place a bandaid or wrestle with him or carry him from his car seat to his bed, is real.  And that realness becomes an anchor point in this  "liquid fray of consciousness."

        I've been reflecting upon that, how my children, by their very being, can rescue me from this pit of existential despair.  I don't believe that it makes the pit any less valid or real, but the kids provide a counterbalance:  physical mass vs. dark matter, and I'm kept hovering between their gravitational pulls, and maybe that place is not a bad place to be.

        I keep thinking of Darth Vader and Luke Skywalker, and how Anakin's child he sired by the woman he loved became the ultimate force in pulling him back to his innate goodness, fulfilling his destiny and saving the galaxy.  When Justin is old enough, he's going to love Star Wars.

        Especially those cool light sword things.

        Tuesday, March 30, 2010

        Annie Dillard Is A Genius

        (Here is some of the greatest prose ever written, the first paragraphs
        of Annie Dillard's Pulitzer Prize winning essay, "Heaven and Earth In Jest".)

        "I used to have a cat, an old fighting tom, who would jump through the open window by my bed in the middle of the night and land on my chest. I’d half-awaken. He’d stick his skull under my nose and purr, stinking of urine and blood. Some nights he kneaded my bare chest with his front paws, powerfully, arching his back, as if sharpening his claws, or pummeling a mother for milk. And some mornings I’d wake in daylight to find my body covered with paw prints in blood; I looked as though I’d been painted with roses.

        It was hot, so hot the mirror felt warm.  I washed before the mirror in a daze, my twisted summer sleep still hung about me like sea kelp.  What blood was this, and what roses?  It could have been the rose of union, the blood of murder, or the rose of beauty bare and the blood of some unspeakable sacrifice or birth.  The sign on my body could have been an emblem or a stain, the keys to the kingdom or the mark of Cain.  I never knew.  I never knew as I washed, and the blood streaked, faded, and finally disappeared, whether I'd purified myself or ruined the blood sign of the passover.  We wake, if we ever wake at all, to mystery, rumors of death, beauty, violence . . .   "Seem like we're just set down here," a woman said to me recently, "and don't nobody know why."

        These are morning matters, pictures you dream as the final wave heaves you up on the sand to the bright light and drying air.  You remember pressure, and a curved sleep you rested against, soft, like a scallop in its shell.  But the air hardens your skin; you stand; you leave the lighted shore to explore some dim headland, and soon you're lost in the leafy interior, intent, remembering nothing.

        I still think of that old tomcat, mornings, when I wake.  Things are tamer now; I sleep with the window shut.  The cat and our rites are gone and my life is changed, but the memory remains of something powerful playing over me.  I wake expectant, hoping to see a new thing.  If I'm lucky I might be jogged awake by a strange birdcall.  I dress in a hurry, imagining the yard flapping with auks or flamingos.  This morning it was a wood duck, down at the creek.  It flew away.

        I live by a creek, Tinker Creek, in a valley in Virginia's Blue Ridge . . . It's a good place to live; there's a lot to think about.  The creeks--Tinker and Carvin's--are an active mystery, fresh every minute.  Theirs is the mystery of the continuous creation and all that providence implies:  the uncertainty of vision, the horror of the fixed, the dissolution of the present, the intricacy of beauty, the pressure of fecundity, the elusiveness of the free, and the flawed nature of perfection.  The mountains . . . are a passive mystery, the oldest of all.  Theirs is one simple mystery of creation from nothing, of matter itself, anything at all, the given.  Mountains are giant, restful, absorbent.  You can heave your spirit into a mountain and the mountain will keep it, folded, and not throw it back as some creeks will.  The creeks are the world with all its stimulus and beauty; I live there.  But the mountains are home."


        --excerpted from "Heaven And Earth In Jest" by Annie Dillard, 1974

        Wednesday, March 03, 2010

        Parenting Gems

        I know why you came to this blog today.  You came here because, as a parent, you are seeking wisdom from a man who's got it all together.  You want a "How To" list that will help you master the exact science of parenting, boxes that you can check off as you bask in the satisfaction of quantifiable achievement.  You came here because you want to know the secrets of becoming a Super Dad.

        Sorry to disappoint you.  I'm blessed with fantastic children, but as a parent, I'll admit it:  I don't know what the heck I'm doing.  But few things bug me more than hearing by-the-book advice of how to deal with kids, because whoever wrote that book doesn't know my children.  I'll always have these advantages over the book:  I love my kids, I know them personally, and even if its unorthodox, I trust my instincts to guide me in how to deal with them.

        So, sit back and relax as I share with you some of my instinctual, experiential principles that represent the survival concept  we often call "winging it."  It may not be pretty, but it's the best I can do.  (By the way, after you read this list, please disregard it.  Just trust your instincts.)

        1)  Non-interventionalism:  This is my hallmark principle.  It might also be termed laissez-faire:  let them do as they will.  This is not to suggest that you allow your kids to run wild and tear around the house unsupervised, at least not if Mom is home.  This means simply that your should avoid the temptation to solve their problems and micromanage their lives.  (This is especially true when you're doing something important, like reading the paper or watching the Rockies for the fifth night in a row.)  But seriously, let your kids fight sometimes, let them make mistakes and let them navigate their own way to a resolution.  Kids are resourceful, and truthfully, Daddy ain't always gonna be there to help them, so they might as well develop some independence.

        2)  Be Consistent:  If you're like me, you sometimes will succumb to the temptation to make a threat or a promise to get you out of a bind, such as when you're in the store with your two-year old and you've only got three more things to get but you sense the unmistakable warning signs of a thermonuclear meltdown about to occur as clearly as a blaring siren and so you tell your son that if he's good for five more minutes you'll let him ride the penny horse by the check-out line or perhaps you tell him that if he screams one more time then he won't get to have any dessert tonight.  The point is, if you said you were going to do it, then do it. It takes a lot fewer times then you would think for kids to realize that you're going to do what you say you will.  Then they can learn to make rational decisions about the risks and benefits of their own behavior.  The more inconsistent you are with threats and promises, the more erratic their behavior will be.

        3)  Mess With Their Minds:  This may be just my own quirkiness, but I joke with my kids all the time, often in bizarre ways.  In our house, the most important day of the year is always the next upcoming minor holiday, like Groundhog's Day or St. Patrick's Day.  There's always a squirrel-bear in the backyard or the cats are plotting to escape or some other nuttiness.  At nearly every breakfast, there is a shared epiphany that today is the first day of the rest of our lives, and that it's only minus one days until yesterday.  Is there any value in that weirdness?  Probably not, but I'd like to think my kids are growing up with the ability to find humor and excitement in their own imaginations, and also a healthy sense of skepticism about the information they receive, a discernment that they will need to intellectually survive in our age of infinite information.  If nothing else, it sharpens their wit, and I think (hope) they'll develop into interesting adults.  Or they might go insane, which I guess is interesting in its own way.

        4)  Wrestle With Your Boys:  I remember going to the zoo and watching the daddy lions wrestle with their cubs and thinking, "Yeah, that's what I like to do with my boys." Seriously, I think there is an inborn need for Dad's to toughen up their boys, teach them how to fight and be tough and protect themselves and their families.  And the boys love it.  So do I.  If we had our way, we'd pound and pummel each other all night, every night.


        5)  Don't Raise a Girly Girl:  I'm sure this is my bias because I grew up in a home of all boys, but my feeling is that our daughters will get enough messages about their innate girliness from society that they need some potent counter-messages from their Dads to keep them healthily balanced.  Teach them to camp, play sports, wrestle, do math, fix bikes, ski, mow the lawn, etc.  That way, when they have their first boy crisis or feel devalued because someone said they were fat, they will have a deep well of other, less image-centric experiences from which to draw their sense of self-esteem.  It seems to me too much of Barbie dolls and ballerinas could make a girl subliminally feel objectified, and that might transform into a poor self-image once she becomes a teenager.  (Plus, if she learns karate, she can K.O. any fool that tries any funny business with her.)  I don't know.  My daughter is only eight.  I let you know in eight more years how this strategy turns out.

        6)  Do Stuff That's Fun For Both of You:  I remember when my daughter was a toddler, perhaps from some sense of guilt about the above Principal 5, I tried and tried to engage myself in her play with dolls.  I just couldn't get into it.  In fact, I hated it, so our play, of necessity, evolved.  We developed games called Flying Frog (that involved trying to catch Beanie Babies) and Smackdown (that involved lots of tackling and wrestling) and both became big successes.  Because we both looked forward to play time, it was a much more powerful bonding experience.  This translates to boys, too.  I've found that if we're building with blocks, it's much better to invent a game that engages all of us rather than just watching someone else build.  This usually involves building something and then destroying it together.  What fun.

        7)  Forgive Easily and Give Lots of Hugs:  Kids will make mistakes and will need to be disciplined, sometimes sternly, but they should never doubt they are loved.  I've never been a fan of exaggerated punishments, like "You're grounded for a month!".  Make punishments immediate, logical, and brief, and then let everybody move on with life.  A good hug and hair tossle can communicate a lot of love, so do it often.

        8)  Cast a Wide Net With Activities:  Who knows if my kids have the capacity to be the next Mozart or Lindsey Vonn or John Lennon or Madame Curie?  We'll never know unless we expose them to the possibilities.  However, I also believe we should resist strongly over-extending our kids, and that the majority of their childhood should be spent in unstructured play, like we had in Missouri, playing in the creek and woods behind our house every night after school until dinner.  I think there is a balance there.   What we've settled on is having them play one sport at a time or season, and then have them try one other activity like karate or piano or horseback riding.  If they show an interest or special talent, then we stick with it.  If not, then we may decide to move on to the next thing.  Sometimes, for activities like skiing, or supremely important activities like basketball, kids may need some extended motivation.  But don't be afraid to spread the experiences around and see what sticks.

        9)  Know When to Get the Heck Out of Dodge:  as in the above-mentioned two-year old in the grocery store experience, one of the true secrets of parenting is knowing when to hit the eject button.  The meltdown is coming, everyone knows it, so head for the parking lot and deal with the aftermath in the relative private of your own vehicle or home.  Don't try to display good parenting techniques in a public place when you're dealing with the mother-of-all-tantrums.  There is no good solution there, so pack it in--quickly--and minimize the humiliation.

        10)  Don't Spank:  I've done this once or twice, and there may be times when its necessary, but don't do it regularly.  You'll feel horrible, your kid gets some very mixed signals, and everybody loses.  There's got to be a better way to handle the situation than violence.

        There you have it, my ten Parenting Gems.  Spend about ten more seconds reading this, and then forget about it.  Nobody loves your kids like you do, so don't trust anybody else--especially me--to tell you how to raise them.  Trust your instincts.  Find your own style.  Now, go give them a big hug, and find some Legos to play with.  Childhood is magical, and they'll never be this young again.

        Saturday, January 02, 2010

        Chagas Disease and the Exploding Heart

        When I lived in Brazil, long before I knew anything about medicine, I met a man who told me the most ridiculous story.  He said his father had recently died of an exploding heart.  I asked how such a violent thing could happen.  It seems, he said, that years ago his father had reached behind a wood pile and had been bitten by a poisonous bug, the bicho barbeiro, or barber bug.  The bite had healed and the bug had been long forgotten . . . until seven years later, when the poor man's heart suddenly exploded, and he died. 

        Yeah, right, I thought.  Another Brazilian medical myth, like their old wives' tale that if you eat hot cake and then walk in the cold rain, you will drop over dead--BOOM--like that.

        But then I went to medical school and learned a thing or two.  I learned about Chagas disease, an illness endemic to Central and South America which infects over ten million individuals.  This disease is caused by a parasite, Trypanosoma cruzi, that is passed to humans after they are bitten by the Reduvid Bug.  This dreaded bug, also known as the blood sucking assassin bug--or in Brazil, the bicho barbeiro-- lives in woodpiles, and after it bites its victims and sucks their blood, it defecates on the host's body.  The feces contaminate the open wound, and thus the parasite is directly transmitted into the blood stream.  A slow, insidious infection of human tissue ensues, most specifically of the heart.  After a quiescent period that can last seven or more years, the infected heart muscle shows signs of weakening, typically leading to congestive heart failure, with symptoms such as fatigue, swelling, shortness of breath and chest pain.  But in some cases, the heart develops an aneurysm--a ballooning weakness of a heart chamber--which can spontaneously rupture in previously asymptomatic individuals.



        Or in other words, an exploding heart.

        Have you ever been to South or Central America?  Mexico, perhaps?  Were you bitten by an insect while there?

        If so, you could have Chagas disease, and you might not even know it until the day you are taking the trash out and your heart pops like an overfilled water balloon.  The take home lesson here is that life is short and unpredictable, and yours could be in imminent danger. 

        It's enough to make you want to forget it all and eat some cake. 

        Just be sure to stay out of the rain.



        Come check out this and other medical calamities that could be putting your life in danger at www.hypochondriacdream.blogspot.com