Saints and Sages of the Healing World

Rabbi Lord Jonathan Sacks  describes these so eloquently :  The sage follows the “golden mean,” the “middle way.” The moral life is a matter of moderation and balance, charting a course between too much and too little. Courage, for example, lies midway between cowardice and recklessness. Generosity lies between profligacy and miserliness. The saint, by contrast, does not follow the middle way. He or she tends to extremes, fasting rather than simply eating in moderation, embracing poverty rather than acquiring modest wealth, and so on.”  

Here you can see two version of living and two versions of recommendations for healing as well.   There are times when you need take on the both of these versions of living.   My teacher of blessed memory, Gerald Epstein, MD (Jerry) would often recommend people adopt the complete opposite behavior for a period of time to correct a character trait, in this case, adopting an extreme in order to correct an extreme so that you can then become a sage for yourself.   There are also those, like Jordan Peterson who to heal his body has adopted the behavior of the saint in adopting an all meat diet.    I explained these extremes in another post where I discussed raw vegans and those who choose the 100% carnivore diet.    

What we have here are two ways of being for those embarking on a path of self-mastery, a life of your own making, where you become your own authority.   You can’t blame people who wish to gain control over their lives to choose the way of the saint, in a way it is the easiest to understand and is a bold way of proclaiming your intentions to the world and to yourself.    The sage, on the other hand, which is what I advocate for the long run is done by learning balance which is much harder, but as stated in a previous post is the “long shorter way.”  

Those who choose neither for themselves are constantly as my teacher Jerry used to say “laying themselves down on the alter of another’s desires or the desires of the man-made world.”   What I love about the distinction above is that it presents for the one that is looking to gain mastery of their life and health a very distinct and understandable choice, the choice between saint and sage.   The way of the saint might be worth it to correct excesses of the past but for your own health, it’s really the task of most of us to become our own sage, understanding the middle road.   

Palate Rehabilition

Unless you live in the woods, grow and hunt for your own food, your palate, your ability to appreciate natural foods has been damaged.  As discussed previously, your palate is like a thermostat.    Give it artificially sweetened foods and the set point, like the temperature setting on your thermostat is raised.   What this means is that the pleasure you could be getting from natural fruits like blueberries is diminished.    It’s really quite simple, just give your palate a rest from overly sweet foods for a couple of weeks and you will see that your appreciation for mother natures bounty is increased.  You will be healthier as well.   Many artificial sweeteners are toxic.

This doesn’t just pertain to sweetness, it’s also important for salt.   One anecdote that really comes to mind.  I had a patient that I saw for a drug reaction in the hospital.  He was in the hospital for malignant hypertension.  After he was discharged, he came back to see me to follow up on the rash and he said to me that he needed to stop eating so much salt but nothing tasted good without salt.  I explained this principle to him and understanding it, had the motivation to stop for two weeks, as I told him “Your palate will wake up in a couple weeks, and you will start appreciating foods without so much salt.”    He came back ecstatic, the principle worked for him and he now knows he has more control over himself than before.

As an aside, there seems to be a lot of misinformation on the internet now stating that salt is not dangerous at all.   Well, for some it isn’t as dangerous as once thought but if you have a specific variant of the ACE gene which many have, your risk for high blood pressure is greatly increased with increased sodium intake.

As you can imagine, this thermostat like function of your palate is also impacted with fatty foods as well.    In this case there is also a genetic variant here as well, called the CD36 gene.    On top of this is the brain effects of the combination of excessively fatty, sugary, salty foods that cause your brain to release dopamine and experience pleasure, when it is bad for your body.    

My point discussing these is to show you that with only a little knowledge, you can see you have quite a bit of control over this and you don’t need more than a couple of weeks to prove it to yourself.    Cut out all artificial sweeteners for 2 – 3 weeks, then take a bite of an apple or have some berries, and you will taste the difference.   While sodium is a required nutrient, try reducing your sodium for a few weeks, and taste some celery and you will note how naturally salty it tastes.   

This experiment is easy and is only a few weeks long but the knowledge you have for your body and the reserve of motivation you have will be well worth it.   Become your own authority, you are your own best doctor.

If you are interested in testing your gene’s or have done 23andme and would like a review of your results, just contact me.

The Ranch Dressing Puzzle


Yep, it happened again.   I was discussing with a patient that they need to increase their vegetable intake and they said, “Doc, I love vegetables, but I need ranch dressing to eat them.”   Well, Ranch Dressing is not good for you and what sort of vegetables are we really talking about?  Is it that plate of raw vegetables like broccoli, carrots, celery, and cauliflower that you see to the side at an event, so the event planners can say they put something healthy out.   Right next to that boring set of raw vegetables that people general don’t like to eat, is that big bowl of ranch dressing and next to that is usually someone who looks unhappy that they are eating those vegetables, with the Ranch as the only consolation. 

I am not suggesting anyone have a raw plate of cauliflower and broccoli, but that seems to be what people think of.  Its like they are suffering from some kind of post traumatic disorder made from eating these things, from that dreaded plate at the mixer or event.   

If you can’t make vegetables tasty, then you haven’t been exposed to high quality fresh vegetables, or quality cooking.  I am sorry but that is the reality.   A few weeks ago at Keto Con, there was a lecturer (not representative of most there) who basically said almost all plants are poisons to the human body.   As he said this I reflexively looked around to see the reactions, and I saw in their faces many people feel vindicated in their dislike for vegetables.  

Which dislike is it?  Is that dreaded plate of raw veggie crudités?  Is it from being force fed canned or frozen veggies as a child?    I don’t know but it’s time for you to realize you’ve got issues 🙂  Congrats, we all do.  Just to pre-empt the messages I might get.  Yes, there are vegetables that don’t agree with everyone for valid scientific reasons, I am not talking about that issue.  


Raw Vegan = 100% Carnivore

Well, they are obviously not the same but the motivation behind both is the same for most people.   People are in search of gaining control over their health and seek it in absolutes and ideals.    The pursuit for perfection and imposing ideals over nature which is what this is, has in the past lead to disastrous outcomes.    It is a slow process, you start looking for perfection and those high ideals (read idols) make you want to make your diet perfect, understandable, clean in a way that is not reflective of reality, history, or science.  

A few weeks ago, I attended Keto Con, it wasn’t a surprise, I encountered several people who when I asked them about whether they are on a ketogenic diet, said something like “yes, for x amount of time, my goal though is to be full carnivore.”   You used to hear the same thing in the vegan movement but with the goal of being raw vegan.

Especially beware of the 20-somethings who espouse these diets.   At that age, with enough activity, you can look pretty damn sexy no matter what you are eating and in our age of instagram, it can be very seductive for a lot of people, even older, just looking for something easy to understand hyped with sex appeal.   I’ve been watching these movements for over 20 years.   While there are some original influencers that still look great, the majority well . . . . enough said.   Of course, that might have absolutely nothing to do with the diet as we’ve discussed prior. Can you do either of these in a healthy way?  Yes, perhaps, but that doesn’t mean you should.  

Biological Machine? Oh hell no!

The premise that human’s are simply biological machines has unfortunately taken root in many sectors of society, first and foremost in the body hacking community that is becoming mainstream.

Ironically, the truth is more like an economic principle called the 80/20 rule. This was first described by an Italian economist who noted 80% of the land in Italy was owned by 20% of the landowners. And if you think this just pertains to real estate, take a look at your closet and you will see that roughly 20% of your clothes are worn 80% of the time. Am I right? 🙂

Your health is divided generally and simplistically speaking into 4 categories: 1.Mental State 2.Nutrition 3.Environmental Influences 4. Movement / Activity. Well, since there are 4 categories in this case there is usually the 25% that impacts the 75% of your health.

How many ill patients do I have to see who can’t understand why they are ill when they tell me how perfect their diets are? Meanwhile, their faces show the strain of mental stress.

Diet is important and maybe in our society it is the most important, but this an arguable point and is anyway a point of public health and this blog is about YOU, and that means its up to you determine things for you. This blog is not for people who are want to follow “general public policy guidelines.” It is up to you to find out which category is most important for you. Once identified, then start learning and gathering information.

The critic will say that since we have identified categories, then it is just a matter of time before each is fully explained and then it’s just a matter of manipulating them in a scientific fashion. Why is this not so? Because the importance of these categories varies over your life and in some cases by the day. You are a remarkable changing human being and it is something that is wondrous that you can be thankful for. Are you starting to see why only you can be your own authority?

The PubMed Maze

Yes, you can search for just about anything on Pubmed as it related to medicine and health. If you have no background in a good “journal club” then you are being led down a road that is complicated but not impossible. What is this like? For most, it is like the guy at the race track that has a complicated table of data in which he thinks he can figure out which horse is going to win. Maybe that is a slight exaggeration.

That doesn’t mean I don’t see the value in PubMed. It is important that this information is available, so you can become as I say, your own authority for your health, and this involves you doing your own research.

The problem becomes when people make decisions based on just the abstract, which is the summary of the scientific article and they have no background in evaluating the study. What is this like? It is very much like making a decision on what movie to watch based on the coming attractions. For movies, yes, sometimes, for making decisions for your health, not so much.

And what is a “journal club?” It is what we do in medical residency training when we tear apart articles as a group. Most can be humbled like a white belt masquerading as a black belt because for the overwhelming majority, that is exactly the situation you have.

Be cautious with drawing conclusions from PubMed. Enough said! It is a starting point, not a place to draw conclusions.

The Front Line

Imagine the front line of war.    Soldiers battling and pushing forward and back.   At this front line is a no man’s land where the fighting takes place.  This line is constantly moving up and back.   Now imagine a tug of war.  In the middle is that handkerchief as one side pulls and then the other, this handkerchief moves forward and backward.   

The first analogy / parable was used by Rabbi Eliyahu Dessler to illustrate a point and was what he called the “Behira point.”  It is the constantly moving front line where we are being challenged.   When the front line moves forward, what was once a difficult dilemma or decision no longer is a struggle.   The example given is of a person who was raised by thieves and pick-pockets.   While the temptation for you to steal something from someone is minimal and causes you very little stress, for someone raised in that culture who is attempting to grow morally, that temptation is real and difficult.  That is their front line, their “behira point.”  For you, your line of maximal difficulty in growing ethically and morally is somewhere else.

First and foremost, this analogy gives us a deeper compassionate understanding for people.   Often, we see people judging others for things which hold no temptation for the person judgeing, since for them it is so easy to avoid.   But seen through this lens, we can realize that it is simply that they are at their own front line.   

On the other hand, there are people who have advanced their front line so far ahead of us, that the challenges that they have are inconceivable to where we are now.   Each of us is at his point of maximal challenge, some ahead on some issues, some behind.   The battleground of life presents us with challenges in all spheres, so that where we are can never be defined by another by the battleground in one aspect of life if seen through this lens. 

It is often helpful, though, to assess where we our frontline is, our “behira point” is on the levels of our life, those being physical, emotional, intellectual, spiritual and social.   Next time you are tempted to judge someone because they don’t get up at 5 am like you to exercise or are still having trouble giving up that piece of cake that is keeping them from losing weight, or are suffering from addictions of various kinds, realize that they are at their point of maximal challenge as are you.  You only see one behira point, only one in a complex individual with many such points.  

The best advice ever given when you find yourself about to judge someone for being lazy or succumbing to something you find easy to avoid is to remember this parable and to heed the advice of this great (slightly paraphrased) quote by Ian Maclaren, “Be Kind For Everyone is Fighting a Great Battle.” 

Internal vs External Cues

Last week, I stopped at a rest stop on the Florida Turnpike driving back to Miami from a diabetes convention.    I learned so much about the love and heroic measures taken by parents with kids with Type 1 Diabetes to make sure their kids feel as normal and are as healthy as possible. I was hyper-focused on this remarkable aspect of parenting and love in general.  I was also encouraged that they often go above and beyond the recommendations of their doctors.   In fact one of the organizations slogans was, “We aren’t going to wait . . “  Love is a great fuel to break barriers, isn’t it?

The rest stop was packed to the gills.   And while I am still shocked when I see what types of poisons people eat on a regular basis, one particular parent / child combo stood out to me.   The dad was clinically morbidly obese as was his son eating food together watching something on his father’s cell phone.   Here were 2 with statistically significant risk for a shortened life with chronic illness, not just eating deadly food, but they were doing it unconsciously, as their minds were being consumed by what they were watching.

In the 1960’s Stanley Schachter and his team, studied college students in France and Chicago to determine what cues they had to when to stop eating.   Remember that this is before youtube and smartphones, so its probably worse now.   The French students were more likely to use internal cues, like stopping when they felt full (how novel :)), when they were leaving room for desert and the students from Chicago more likely to use external cues, such as stopping eating when the TV show was over (yes, really), when they run out of a beverage, or when they think what they’ve eaten is normal!!

I could be wrong but I see people more and more disconnected from the sensations of their bodies.  This general appreciation and connection with the body can occur on a more and more subtle level with time.  This in fact, is a never-ending process with these miraculous bodies we have.  There is a lot of value in yoga or qigong when it comes to gaining more and more awareness of our bodies.   But you don’t even need to do those if you don’t want to.  It just means that you pay attention more and more to how you feel by mentally checking in with your bodies and extending your awareness to around 3 days ongoing.    It can take up to 3 days post stress or subtle food sensitivity to feel its impact on your body.  I will likely write another post on this subject.

We have access to much more knowledge about our bodies than we think.  It is why you must become your own authority on your health, not just by learning knowledge but by feeling and understanding the sensations of your body.   You must extend your time horizon of observation as mentioned above, slow down, and start listening.  Your body actually does want you to know what’s best for it and remarkably, when you start listening beyond its superficial cries for pleasure and the avoidance of pain, it is also telling you how to discipline it for optimal use.   Pay attention!

Message on a billboard?

I was listening to an interview with Seth Godin on the Tim Ferriss podcast. One of the reasons I am doing this daily blog (well not so daily, there is never a post on Saturday for religious reasons) is based on Seth Godin’s daily blog.

One of the questions he asked him was what message he would put on a billboard. He said the best message on a billboard was by marketing legend name Jay Levinson that said “free coffee next exit.” 🙂

On a more serious note, I was thinking about this and though no one is asking me, on mine it would be a quote from Zig Ziglar that I say is a master quote, which I define as a quote that encapsulates a universal truth. On this blog, I also mention another master quote in my post The Enemy of Art. Zig Ziglar’s quote is “You can have everything in life you want, if you will just help other people get what they want.”

Then today, I came across this quote by the Lubavitcher Rebbe which expresses a similar sentiment. Here it is “Teach and you will learn, give and you will receive, love and you will be loved. In this world, there must not be any person, place, or thing, that only gives or only gets, and if there is, it is for us to heal.”

I really love both of those quotes. Hope you do as well.

Your comments requested, below 🙂

The 4 Dimensions of Fitness

There are 4 basic dimensions of fitness.   

1.  Moving where you are out of breath 
2.  Low intensity but longer duration movement  
3.  Lifting heavy things  
4.  Flexibility.  

You can assess most exercise regimens against these 4 dimensions.   

Walking of course, would fall into the second dimension.   Yoga, depending on the type could fall into all categories as sometimes lifting yourself is lifting something heavy.  Qigong could also fit into all 4 depending on the type. Martial arts would be 1, 3, and 4 but could be all 4.  

On top of these criteria is the time duration.   For 1 – most recent research says that things like marathons actually cause some actual heart damage. It is not recommended, it is extreme from a biological perspective.   Safe upper limit on time duration is probably no more than 20 min.   For 2 – the minimum I would say is 30 min, a goal of getting to one hour of walking is advisable.   For dimension 3 – bodyweight exercises and calisthenics count and are a great way to start  For 4 – this is often neglected, but there are many resources online to enhance your flexibility, its advisable to see if you can incorporate with the other dimensions in some way.

Ideally, you would get in all of the above dimensions in some way during one week  Dimension 1 is not for everyone however and I recommend if starting out, you just focus on dimension 2 and work up to being able to walk for one hour at a time. .  If you can do that, you could try to ramp up the incline for example on the treadmill.  Take it easy – your body appreciates any movement.   Of course, get your doctors advice if you have any heart issues

Flexibility does not mean you need to be a yogi and pull your legs over your head 🙂 it can just be working on full range of motion in the daily range of movement.    This is another reason I like QiGong as a recommendation and practice.   There are lots of resources online.  

And with all that which one is the most important?  By far it is walking!  If you don’t have time or feel like you have the energy.   Go take a walk for 30 minutes, that is the best thing you could ever do for yourself.

Some of the ideas above adapted from the writings of Mark Sisson.