Category: Thoughts

Balance and Intention

In the pursuit for healing, health and wholeness, many are those who strive for finding that one gem of knowledge or strategy that will bring them what they desire. Podcast episodes and books are filled with facts and details of knowledge so complex and increasingly arcane that one can wonder if one can ever master the knowledge. One must ask oneself, if perhaps it is really the laws of balance and intention that is all that is required.

Every tradition talks about the intention behind the aim having value. The analogy of looking at the contents not the container abound in both Judaism and Christianity. If you pursue optimal health, your ideal body weight, or whatever your health goal, what is the intention behind it? How deep does that intention go? Have you even evaluated why you want it? It’s ok, if at first it is seems superficial, it could be to fit into an old dress or a pair of pants, whatever, but one must have some intention in mind for success. There is time to formulate a deeper intention because even superficial intention are often like the ripples of water on the surface of a lake where something deep is stirring.

I remember once, water ski-ing in a back water lagoon in Puerto Rico as the sun was on the horizon. While I was waiting for the boat to start the water moved next to me in a quick set of ripples. I had no idea what kind of fish or animal was right next to me. It scared me, quite frankly, it was still just twilight and it was in brackish water where who knows what kind of animals lived there! My imagination got the best of me! What lay below the surface might have been a harmless fish, but I wanted to get out of there!

Most of us what to get out of there like that! We don’t want to see what lies below the surface of our aims as sometimes our un-explored intentions aren’t even consistent with our own stated values. Carl Jung called this our “shadow.”

Looking below the surface of our health aims and goals, one can often find the values we are actually living. What do those intentions communicate and how consistent are they with the life we want to live? Which brings us ultimately to understanding balance in the context of health goals.

Understanding balance has a way of moderating the extremes and even helping to bring to light our unexplored intentions. It serves as a limit to going too far and maintaining a path that is healthy. You don’t need to be a master healer, physician, or guru to understanding balance. This is in the domain of every person no matter your intellectual skill. It is true that learning the art of moderation especially in food is one that is fraught to difficulty as moderation of the type dictated by society in regards to food at least, leads to adverse outcomes.

So how do you find moderation in regards to food. Eat only food eaten historically (sugar or processed food is not food), get your blood work done – I have numerous video’s on my YouTube channel on how to order your own labs and evaluate them, avoid government suggestions, and eat with a higher purpose, a deeper intention, one that is consistent with your values and who you want to be and achieve.

Is there a doctor on board?

“Is there a doctor on board?” I hate to hear those words. Several years ago, while I was working aggressively on expanding @miraclenoodle, I was flying about twice per month. For some reason in one of those spans, I had multiple flights where I heard the above.

On one particularly dramatic one, there was a woman who was having a minor stroke. There wasn’t much to do and the pilot urgently pushed for my decision regarding whether we needed to land the plane. The flight was from Germany back to the US. There was no choice really, I told the pilot, , we needed to land for her sake. The closest airport was Reykjavik, Iceland. Besides the few glaring people upset at the delay, most on board were very understanding. There was really nothing much to do but give her some oxygen and hold her hand. She sent me a lovely note 2 months later when she finally made it back to LA and was doing well. We flew in low into Iceland which was quite dramatic coming from the sea.

Shortly after that, I was on another international flight and this time, as I was getting out of the bathroom, looking directly at me just coincidentally the flight attendant was on the speaker and said “Is there a doctor on board?” In this case, I couldn’t avoid it, I often pause for a moment and look around to see if another doctor is jumping up ๐Ÿ™‚ This time, it was a guy who had hernia surgery 2 days prior and from sitting, the wound swelled up slightly and he passed out after coming back from the bathroom after the look of it made him faint.

A few short weeks later, I was at a sushi restaurant and a similar situation presented itself, I was walking out of the bathroom and a woman literally jumped up in my face clutching her throat as she was choking on sushi. My God, I thought, not again! I gave her the Heimlech but it didn’t work, she passed out, I thought she was going to die because I certainly wasn’t confident doing an emergency tracheotomy. I started doing admominal thrusts and by a real Miracle, really, it popped out and then the EMT’s came, by then she was breathing and ok. When I looked up from the ground, her husband was crying as was the restaurant manager. All I know is I now had a splitting headache, couldn’t really finish dinner with my friends and went home and sat in the bathtub for an hour thanking God it all worked out for her.

Shortly after that, I was on another plane and saw a bunch of people in wheelchairs before a flight, I had a bad feeling and sure enough about 2 hours in, again!! Well, this time another doctor had jumped in and the flight attendant said it was fine. Incidentally, an EMT would probably be better than any MD especially one that is a specialist like me that rarely deals with anything other than some minor bleeders during procedures and people passing out from the same procedures!

I don’t know why all of these things happened to me in a such a short period of time, but with life resuming and travel becoming more popular again, it made we remember these events and think about the role of a doctor in society and how we actually all bear responsibility to know basic first aid in terms of the care of people around us. We also bear some responsibility for the general health of those around us. Whether that is making it known you are open to sharing the ideas of the healthy lifestyle you might be pursuing or serving as an example of someone who is proactive about their health. Never before do we have at our disposal more resources to reclaim our health from chronic disease while at the same time never before have some many institutions been arrayed unfairly against that information. Hopefully, you never have to deal with urgent situations, but we also have people slowly dying from diseases that they don’t have to suffer from. In your family or community it may not be verbally expressed but there is a silent call screaming out “Is there a doctor here?” In this case, maybe it is you who has the information or just the hand to hold while they work on making better choices and healing themselves

The Way Back

Lifestyle and nutritional interventions take time to be perceived by the patient. One can see some of the results within a week on bloodwork, but in the age of drug marketing and excellent trauma care, patients have been conditioned to expect rather rapid results. In a time gone by, our timelines were longer. Many were farmers who knew the value of waiting for the harvest. Making choices to feed yourself natural food that supports it, starts you on a path that puts you back into touch with the natural rhythms of the world. We can navigate the modern world but the healthy and whole individual knows that we must always maintain our connection to our biology and part of that is our connection with the natural world around it.

That is why in the next stage of growth I recommend some sort of reconnection with growing some food, especially something as simple as micro-greens. When you see that nature properly respected is actually designed to support you, a new world opens up away from the opposite tendencies of modern society. You are on your way back, baby! Back from all the pathology of the modern world that attempts to pull us away from the real and the valuable. Reconnecting and supporting your biology by choosing the right foods can be a small step in that direction.

Two Types of Will

Gerald Epstein, MD spoke of will being divided into two types. Desiring will and intentional will. Desiring will is the initial spark of what you want. People often have fleeting moments of this for improved health but even that is often disrupted by modern life. Social media, binge watching TV, alcohol, drugs, all tend to interfere with this. Intentional will which Dr. Epstein said “provides direction and constancy” is often lacking completely. Part of this direction and constancy is to leave the final outcome out of your mind. That is for God to take care of.

Just as the farmer desires a good crop, decides to plant and then works the land constantly, he doesn’t ultimately know the end result. So it should be in your health goals. Find a solid direction, establish new habits, but leave the end result to God. It takes the stress out of it and prevents you from trying to know the future which it is not your place to know anyway. You can always course correct as time moves on and you learn more but that is done in the present and not in some imaginary future. The slow but methodical work of the farmer is a great example. Work your health habits and choices like the farmer works his land and leave the amount and quality of the harvest to God.

We often have to own some of the poor habits we let go. That could be the daily choices away from optimal health of body and mind that we make. We need to be honest about this and admit that there are choices we have made with our health that we just don’t bring to light. It could be late night binging or simple food choices we know that aren’t good for us, but we choose them anyway, because we feel we deserve them. Bring them to the light, fully acknowledge that they don’t serve us, and then adopt the opposite for the next 21 days. If you constantly reward yourself with a sweet snack but know that it is bad for you, work on adopting the opposite, willfully deny yourself for 21 days. This act of denial is acknowledging the habit actively, owning it, so you can let it go. Then you can choose a better reward consistent with your health goals. When you do this you are as Dr. Epstein described “rousing your slumbering free will to life.”

The Importance of Teaching

The Bible in describing the Levites talks about the descendants of Aaron and Moses, but then only subsequently talks about the descendants of Aaron. Rashi, the first commentator Jewish children learn from and quite frankly continue studying for a lifetime, who lived around the year 1040-1105, comments that this teaches us that “Whoever teaches . . the son of his fellow man, the Bible regards as if he had begotten him.”

It is interesting, then, to reflect on this as the Bible is essentially saying that teaching of this type, is providing a type of sustenance that is as if they had actually fathered or mothered a child. I have commented before in another post about how in medical school, the common refrain was “see one, do one, teach one” when it comes to learning medical procedures. This deepens the value to understand how deep and important it is to become a teacher of those around you.

For many the pursuit of knowledge is a selfish pleasure that is for some a way to feel better about themselves. I have encountered these sad folks. They often like to show off and rattle on fact after fact not teaching but trying to impress you with their vast knowledge. In their pursuit to “be impressive” they forgot that there is a difference between knowledge and wisdom. Wisdom leaves traces and ripples outward effecting others. Recitation of facts impresses, but doesn’t leave a lasting impact.

When, however, you are blessed to have been taught by someone who preserves your freedom, isn’t interested in the slightest with impressing you, and challenges you, you can understand why the Bible sees this person as a parent to you. He / she is fact allowing a part of you to be born, waking up a part of you that may have been sleeping.

Such teachers are few and far between but that doesn’t negate YOUR responsibility, which is to teach valuable information you learn. Firstly, the student has to be willing to learn. Shoving food down the throat of a person not hungry does no one good and can be harmful. If they just want that knowledge to show off and build a castle of facts without a firm foundation of respect and a yearning for wisdom, it’s not your place to teach them. It’s also not your place to teach someone because you think they need it to improve their life. People must be ready to learn, not to be imposed upon because you think they “need” it.

I can tell you from my own life that the quote from Buddha that is oft repeated, “When the student is ready the teacher will appear” has been very true in my life both for myself as a student and even more surprising as to being called to teach individuals when I never would have foreseen that. There is a magical bond between a student and a teacher, it is therefore not a surprise for me to encounter this comment from Rashi as I did this morning.

Thank you to Rabbi Yossi Ives for pointing this out in one of his articles.

See One, Do One, Teach One

This is the refrain you would often hear in medical school and medical residency training. Once you learn a new procedure, you are obligated to teach someone who doesn’t know how to do it. I think this is also good advice for living a fulfilled life if we expand its meaning to insights handed over to us from people with greater wisdom than we have.

Unfortunately, we find so often that our negative internal voice, that little devil on your shoulder, the “evil inclination” spoken about at length in ancient Hebraic writings, comes and says that we aren’t qualified or are not knowledgeable enough to hand over and teach others. I can almost hear the thousands of sighs that take place when people who wish to make a difference to others, stop, listen to that negative inner voice, and become despondent over not feeling ready, qualified, whatever, fill in the blank with the adjective or rationalization. Recognize that this inner negative voice, isn’t even you. Yeah, you heard me right! This is just a function of this brain we have, probably some kind of evolutionary protective mechanism that in our day and age, hinders us. Regardless, hear but recognize it doesn’t represent you and rarely gives you good advice. It’s like the random thoughts that pop into our minds, we are not those thoughts. Who we are is much deeper.

The Chassidic mystics have said “One good deed is better than a thousand sighs” and in commenting on this, the Lubavitcher Rebbe, a great mystic and spiritual leader of the second half of the 20th century, said that in this case “sadness is always unacceptable and harmful . . . Especially since naturally when a person sighs, he feels a bit of satisfaction that he is upset about something, and it does not add to his motivation to work to fill what was lacking.”

The life affirming alternative is to work on keeping your mood up and recognizing your obligation to share both your elevated mood and the new insights, techniques, skills, you have gained. And when that little devil on your shoulder made famous in cartoons starts speaking and telling you that you are not an expert enough, good enough, etc to share and teach what you have learned, grab a big cartoon hammer in your imagination and smack him in the nose ๐Ÿ™‚ then “teach one.”

First, Find Your Direction

The last several posts were inspired by the book I am currently reading by Jonathan Sacks, Morality. I find that many of the ideas in this book can be directed towards understanding a healthy path for healing in general. I would say that he would describe his book as a way of healing society and I would say that the lessons of healing society can also be reflected on the physical and psychological healing of people and communities.

In an interview about the book, he describes what it was like growing up among Holocaust survivors in the area of London, I believe, he grew up in. One of the many things that stood out to him was that they all focused first on building the future before tackling the enormity of what happened in their past. This choice would ensure survival for them and for their newly created families, a choice informed by both Jewish values and practicality,

In media, we have all seen scenes in movies and TV that show the person visiting their “therapist” endlessly rehashing what happened to them in the past as a way to gain insight into the present. My main teacher, Gerald Epstein, MD was initially a psychoanalyst but eventually changed once he met his teacher. His perspective on working on people’s “stories” of the past, fell away to work with people on their being more aware of the present and actively working to let go of the past.

When it comes to health of the body and mind, I am not neglecting factors of the past that play a role. Taking a good history is a starting point in any medical examination. What I am suggesting is that when it comes to making decisions for today regarding your health, a focus on finding a direction to move towards after letting go of your past tends to be most effective for individuals.

Forward movement becomes much easier when you have let go of the past. The past can be an anchor dragging you backwards. It’s dead and gone, now is the time to focus on forward movement and the best you can do is to decide on a direction and take your first step. It is liberating and is what your body needs. Take baby steps, it could be after a few baby steps you will need to re-adjust. Maxwell Maltz, MD used to explain that people on pursuit of a goal are like a self-correcting missle that endlessly corrects. In the beginning, you may zig and zag before finding the true direction. The key is to get going and a baby step is the way to go.

And with all I have just said, dealing with your past can eventually be done just as those Holocaust survivors eventually started to discuss their experiences many years later. Gerald Epstein, MD taught many strategies for “reversing” how your body reacts to past memory so it neither defines you nor affects your movement towards the direction you want to go. In fact, whenever I would start to reflexively hypothesize why something was the way it was based on the past, he would just utter the word “STORY” to bring me back to the moment so that I could get back to the present moment to focus on the direction I wished to go. We are quite good at constructing endless narratives / justifications / rationalizations to find reasons why something happened. Perhaps, this endless search for answers to the problems of our past are better left in the past. First, find the direction that is healthy for your mind and body and then take the first step.

A Covenant of Health

There are quite a number of well known physicians who have spoken extensively about how public policy (read politics) should be used to change the dietary patterns of the population to improve the overall health of the nation. Perhaps, there is another way.

In his book “Morality : Restoring the Common Good in Divided Times” Rabbi Lord Jonathan Sacks, describes 3 general ways in the public sphere that one can lead people to a desired goal. There is economic, where one pays for someone to do something. There is political, where one makes one to do something. And there is moral sphere “where we persuade them to do so because they and we are part of the same framework of virtues and values, rules and responsibilities, codes and customs, convention and constraints.”

The problem with failing back on politics and economics to implement change is that it ignores the moral dimension even if that very intention in the first place comes from a place of deep caring and concern for the health of the nation. The economic sphere has also been used through tax penalties to avoid certain foods and then there is the whole world of food subsidies from the government which exposes all too well how families’ health has been damaged by the influence of special interests.

Sadly, like all big institutions the healthcare system tends to depersonalize both those it seeks to service and the service providers, not out of a some evil conspiracy, it’s just the nature of huge institutions like healthcare, big business, big government, large organized religious institutions, and large educational institutions.

Many years ago I read a book on a program called the White House Fellows. Many names you know went through this program. I don’t recall the name of the book. Two names that come to mind that went through this program are Colin Powell and Sanjay Gupta, MD. This program gives talented men and women access to see the workings of government in ways unprecedented in civilian life and those who come through the program go on to make significant contributions to public life. My point here is that there is most certainly a role for people who understand government influence and want to use that system to achieve change. It’s one route to change just like financial. I’d like to look at change from another perspective, the moral one.

In his book Rabbi Sacks talks about society needing a shared morality. This can be extended to the health sphere as health involves alleviating human suffering. While the news everyday makes it difficult to understand dietary guidelines, everyone basically understands what junk food is and that they need to eat fresh or fresh frozen produce. So how do we extend our sphere of influence by including the moral dimension?

I think we do so by empowering people to be able to make their own choices when it comes to health. The first step is clearing up the conditioning around health. As Jonathan Sacks explains, we can’t outsource our morality to the state, and I’d like to add, we can’t outsource our bodies either. It is this mindset that robs our fundamental responsibility we have to ourselves, to become our own authority. We need experts and specialists who understand that the force and effectiveness of treatments and health guidelines are heavily influenced by how involved the person is in their own care not just for themselves but for their loved ones and for society as a whole. Dr. Kelly Turner, in her remarkable book, Radical Remission documents 9 features of people who healed from cancer despite the odds. One of the 9 is “taking control of your health.”

How can we, then, reconfigure the healing relationship between doctor and patient. I think again Rabbi Sacks in his book, Morality gives us an idea in his discussion of the family. The solution is to transform the contractual relationship into one where there is covenant, meaning where 2 come together to form an “us.”

In this relationship, there can be profound healing. I have deep gratitude for the patients I am privileged to establish just such a relationship. Each one changes me forever and allows me a glimpse of the immense possibility, miracle and learning that comes with healing. It recalls to me something from Ethics of the Fathers. “And this is what Rabbi แธคanina said: I have learned much from my teachers and even more from my friends, but from my students I have learned more than from all of them.’ Just change “students” to patients and it expresses just one result of a covenantal doctor / patient relationship.

What is needed are healers who see and cultivate the covenantal relationship with their patients. Patients also play a role, the depersonalization of the healthcare model and the advertising of big Pharma has led to a situation where patients have very high expectations of immediate cure for most of the problems that plague them.

Healing as my teacher, Gerald Epstein, MD would remind me often comes from the root of a word that means wholeness and even holiness. That does not come from a pill but in establishing a relationship with your healer where your healer understands and respects your primary role and the ongoing journey to wholeness that needs to be undertaken.

Honoring Genetic Variation

Use of the word honor in this case should be read as having a high degree of respect. The path that your ancestors travelled is built into you in mysterious ways molded from the challenges they received from the environment. These crafted you in perfectly unique ways, such that you are unique and beautiful.

Epigenetic influences from the environment can turn genes on and off like a switch. There are however, certain genes that code for enzymes that are your unique fingerprint and don’t change. The funny thing is that while CURRENT influences (food availability and choice, stress, hormonal levels etc) won’t significantly change some of these in your life, over many generations they can change. Let me explain with an example.

There are enzymes, FADS1 and FADS2 that convert plant based fatty acids to become long chain fatty acids found naturally in seafood, what you might know as omega 3 fatty acids like DHA and EPA found in an omega 3 supplement. It is hypothesized that as populations started eating more plants genetic pressure led to individuals who could convert better, the plant based fatty acids into the long chain fatty acids. Certain Inuits in Greenland who were eating nothing but seafood and land animals had the opposite pressure. They didn’t need any more of these long chain fatty acids as they were already getting the final product without having to convert plant based fatty acids to long chain fatty acids already found in the seafood and organ meats they ate.

Ancestral cultures even had some knowledge of supplemental importance of these for pregnancy and brain development. Reference needed but I was told by a mentor of mine that there were certain tribes that would send the young men hundreds of miles to the sea to gather fish eggs for the women of the tribe who were pregnant. The basic science of brain development demonstrates the critical need for DHA and is the reason why DHA is incorporated into baby formula.

Similar adaptations, of course, can be found in the genes responsible for processing dairy, which arose due to the need by some communities to rely on dairy as a critical source of calories in certain historical periods. Unfortunately, due to the diet wars, I have to state the obvious, that even if you have the gene to encode for digestion of dairy, doesn’t mean it is healthy for you, it just means that you can digest it better than someone who doesn’t. If you lived a thousand years ago and didn’t have access to Whole Foods and you had to rely on dairy and didn’t possess lactase, it is likely you would have been quite ill. The main difference is of course, that DHA and EPA are what are called conditionally essential nutrients meaning you do need to have them in your body whereas there is nothing in dairy uniquely needed for the body.

As I have discussed at length on my youtube channel and briefly here, there is a very specific difference in physicians like myself who love personalized medicine catered to the beautiful uniqueness that is you and those physicians who advocate for a specific diet for the the masses. As an example, there are doctors who feel that since there is no common absolute disease state from avoiding seafood or omega 3 supplements, that there is no need for even the discussion of supplementation. (Of course, an Greenland Inuit on a vegan diet would absolutely need an omega 3 supplement) One flaw with that logic among many is that as we have learned thus far in other posts, while an overt disease state with a specific ICD-10 code and a chapter in an internal medicine textbook to describe it might not exist for the common individual with even poor conversion rates and a low omega 3 index, failing to thrive, depressive symptomatology, and not functioning at your optimal capacity is also a disease / dis-ease state that can be seen as a result, even if it is not in the majority.

It is why I love personalized medicine and love the evolving field of genomics and advanced diagnostic blood testing. You need to become your own authority in health and for the advanced thriver getting a genomic analysis done (or in this example, an micronutrient analysis also that includes essential fatty acids) and having a sincere conversation with someone who has guided others in understanding the results can be so wonderful. Incidentally, I do these for free, maybe when I hit 300 or 400 of these genomic analyses and feel myself an expert I might charge for the time ๐Ÿ™‚ This knowledge can turn for example, non thriving vegans into thriving vegans due to this analysis and yes, one of the many interventions could just be a DHA supplement based on genetics and symptomatology. There are other genes that impact beta-carotone and vitamin a as well as genes that would influence the choice of which specific type of b12 supplement to take and many others. The field is growing by the day and data shows that changes made as a result of this analysis “stick” more than kind hearted suggestions from a well meaning doctor ๐Ÿ™‚

And yet, those with a population wide mindset will look at these suggestions and say, you are working with such a small population as to be insignificant!! And that even I state that the suggestion for supplemental omega 3’s is very narrow! And to that I would say, each individual needs to be honored, and one person who goes from merely feeling good to great and now thrives can change the world! When you can take a person who is feeling fine and is now feeling great, most never realized that they could feel the way they feel now. There are levels of wellness that most people have no clue about. This, of course also pertains to people who are omnivores like myself. A vegan poster on twitter influenced this post and so I am using this very narrow example to illustrate a point. Population wide suggestions are very important but they intend to move people over the finish line but they often fall short even if major societal health statistics improve. To bring a person over the finish line, though, they need to be empowered to work with their own uniqueness and it is my job to empower them. This is where the magic of medicine starts in my opinion. Once they pass that finish line, new horizons of wellness and achievement open up and quite frankly they start empowering others. Being a part of this process is my path in life.

Competence Downshift

“Be careful about the government, as they approach a man only when they need him. They seem like good friends in good times, but they don’t stay for him in time of his trouble.” Ethics of the Fathers 2:3.

Competence downshift describes the change in language that white liberals use when talking to minorities. White liberals “presented less competence to Black interaction partners than to White ones.” (Dupree, 2018) Reading the whole article is enlightening. I am not questioning their motives, I am more concerned with this phenomenon and what it means for health and the information presented to you.

I have frequently seen this downshift occur based on race, education, and socio-economic status in the medical profession.

Dr. Robert “Rhondell” Gibson taught that there are 4 games being played in the man-made world and this downshift happens in all 4. They are :

  1. The organized religion game – this one tells you who is “good “and who is “bad.”
  2. The power policies game – this one tells you who is “in” and who is “out.”
  3. The healing arts game – this one tells you what is “normal” or “abnormal”
  4. The big business game – this one tells you what is “ugly” or “pretty.”

Competence downshift is not just an isolated peculiar phenomenon of white liberal politicians speaking to minorities, it is rampant throughout society and appears to be more common in liberal minded people. The reasons don’t matter. Be aware of which game is being played and how you are being spoken to / lectured to based on what might be perceived to be your identity regardless of the reality of it. It matters because to become our own authorities in making decisions health or otherwise, we seek to not be caught in these games and not held to abnormally low expectations based on the high priests of these 4 games.

What we seek and sometimes need to demand is what has been taught in all traditions, the presence of a real world interaction and connection where each person is unique and each acknowledges the spark of the Divine in the other and makes them neither higher or lower in terms of their ability to make decisions on their own. Yes, there are experts and mentors that we should seek for help, but the great teacher is one that doesn’t downshift and doesn’t hold expectations. They are the patient teachers our great traditions have spoken of for thousands of years. We sure need more of those! With the above in mind, it certainly isn’t a wonder, is it, that these teachers were held in contempt by those playing the 4 games.