The Bigger Picture

    

I really hate being the prophet of doom and gloom as the things I sometimes write about seem to represent...

It is all relative to one's overall world view I suppose. I can still recall as a kid my older sister telling me that there would come a day in the far distant future when the polar ice caps would melt and the land would eventually be covered by water. That thought was frightening but I always felt it was hundreds of years into the future. Today's scientific data is suggesting that it will definitely happen in this century if we don't succeed in finding alternate energy sources to burning fossil fuels to curb the rate of the greenhouse effect and global warming. Satellite imaging has shown a section of ice the size of the United States totally melted in one arctic region after several thousands of years of stability. The Greenland glaciers of the North can be seen to be rapidly vanishing. So far Mother Earth has been able to compensate but I've learned that scientists believe that a point of no return can be reached where the ice that melts continues to progressively melt and not return to the previous total amount of ice again. When and if this happens we will lose most of Florida and most of the coastal cities of the east. This isn't science fiction.

A relatively pessimistic person might argue the scientific fact that every few thousand years the orbit of the earth around the sun changes from circular to elliptical and sets off another ice age, thus making the occurrence of global warming irrelevant. I once heard that scientists of this school of thought have been advising the Bush administration about the environment. An ultra pessimistic individual might conform to the argument that in a few million years the sun will run out of fuel anyway and swell in size and heat so much that it will engulf the earth and burn it to a cinder long after all life is gone. This view makes the case of absolute inevitability of destruction. If this isn't enough, the argument may digress to that millions of years before the sun dies there is close to a 99.9 % chance that at some unknown point the earth will be struck by at least one of the millions of the deadly asteroids now moving about the solar system in the asteroid belt located between Mars and Jupiter. So mankind may go the way of the dinosaurs long before the planet is cooked by the sun. According to an ultra optimist, we will have colonized space long before any of these things happen. Whatever is left of mankind may have moved on to other parts of this and other galaxies when the technology advances enough to make it feasible.

I sometimes allow myself to mentally trip this way to try and find some type of context to help me understand thoughts or situations that may be troubling me at the time. Some people do the same through religion, and I know that they would not hesitate to label me as using heretic thinking. Galileo spent the last years of his life locked up by the church of his day for teaching that the world was round when all the wise and God fearing men of the day knew that it was still flat. Eventually, most of the religious community accepted that the world is indeed round after all. I see myself as a highly spiritual and open minded individual, and am more educated in religion than the average Joe but I too believe that God gave us a brain for a reason. Part of that reason includes learning and using science for the advancement of mankind. I do not wish to attempt any discussion of the slippery slope of religion. I know that it would eventually end up as usual with a tip from a concerned individual that I am going to hell.

What led me to today's topic was facing a week with numerous cocaine related issues. Most of the people encountered don't even know what cocaine looks like but they have a spouse, child, or relative totally strung out on the stuff. I can't help but ask myself why is this happening and why does no one really seem to care? I start to wonder if I'm blowing things out of proportion because of the special population I'm exposed to, then the conclusion is reached that I probably am not. Why is this problem not a higher priority? Why are most budgets for the prevention and treatment of drug abuse being reduced or eliminated? How can tons of drugs come through our borders undetected continuously? Is our homeland security that bad? Is someone being paid to look the other way? What good does it do to arrest the users and do nothing to deter the suppliers? We can never lock all of them up. It seems to just assure that the addict will be banned from the work force for good because with a record they will probably never be hired for a decent job. I know that these questions won't be answered until the problem becomes so severe that it can no longer be overlooked, and that will eventually happen. For now, it really bothers me to see people go to the justice system for help for a family member spiraling out of control to the point of endangering themselves, others, and the home and be told by the magistrate not to contact the police anymore because they cannot do anything to help. An involuntary substance abuse commitment taken out for an addict by a doctor who considers that person to be dangerous is not really worth the paper it is written on. Usually within 72 hours or less that person is right back on the streets using and committing crimes again.

We, as a society, have witnessed this problem spill over from the inner cities to rural America where it now affects middle and upper middle class people of every ethnic group. I believe that this epidemic will hurt us as a nation far greater than terrorism. Having a front row seat yet having little or no power to effectively intervene saddens and worries me often. In one way or another this problem will impose among most of us at some point. At that time we won't be able to run hide or look the other way any more. I wish I had some answers.

A Look at Relationships

       

According to Freud, for one to be truly happy they must first be happy in their primary relationship and with their employment...

Without happiness in these two areas, for most people, there is little else that really matters in this ever changing human journey. Couples and marriage counseling is one of the areas of my work that I enjoy most. It's hard sometimes for me to understand how someone with a track record as bad as my own can counsel so well in such a difficult area. I don't toot my own horn that often but this is something I like doing and feel I am pretty darn good at. It may be the fact that clarifying and diagnosing relationship problems is the easy part that may only require a short amount of time. The really hard part falls on the couple who have to dedicate themselves to looking inward and making a perpetual commitment to change certain behaviors for the common good. A national divorce rate of about 60% is evidence of what a challenge this is.

Maslow was a Behavioral Scientist who gave us a hierarchy of needs that must be met in order for humans to be healthy and happy. I can't recall every need but following the basics of food, shelter, and clothing came the emotional requirements including a means for providing feelings of security, affection, and self esteem. There was an experiment done with lab mice that involved two identical sets of baby mice. One set was nursed by a female who wasn't the biological mother and the other set were nursed by a fake mouse mother that used the identical same milk. The experiment found that all of the baby mice in the group with the live mouse mother developed healthy with no problems, whereas all of the mice in the group with the dummy mother failed to thrive and eventually died, though there was no difference in the quality and amount of nutrition. It was concluded therefore that the missing ingredient for healthy mice was nurturing. Could this case be similar for humans? We all know of instances where an elderly spouse dies shortly after the death of their partner even though their physical state of health should not warrant death. Affection and companionship are crucial ingredients for life it might be concluded here. Random chance is not a satisfactory answer for me here.

People come to me in all stages of relationship failure, from having a hunch that something may be wrong to discovering their spouse has been having an affair, or worse. Rarely does a couple present with a chief complaint of "we need marital counseling." It is more likely that an individual presents with symptoms of depression or anxiety and relationship problems are identified as one of the main stressors. Usually, after some exploration it becomes obvious that there are major problems. Eventually, after a few sessions the idea of couples therapy may be raised. If the patient answers that the spouse is willing to do whatever it takes to save the relationship the prognosis is usually favorable. If the reply is that the spouse "will never go for that" the prognosis is usually dismal. I usually view the spouse and support system as either part of the solution or part of the problem. When, as a therapist, you haven't even met the spouse of a patient after a year there is a chance that significant problems may exist. The worst signs to hear from an unhappy wife include: "My husband doesn't want me to come anymore," "He calls me crazy," "Everything is always my fault," "He doesn't want me taking medications," "He says he doesn't have a problem,"... If the wife remains clueless at this point your work is cut out for you.

The most important ingredient for a couple to have hope for reconciliation is a mutual willingness to listen to the others' point of view and compromise or give them what they seek, if it is reasonable. If this is lacking in just one of the partners and no willingness to change exists then it is time to close up shop and go home. This relationship lacks the potential for further growth at this time. If that more stubborn partner doesn't even see what they are doing as counter-productive, selfish, or wrong, there is little or no hope and the next stop may be divorce court. Often I try to redefine another essential ingredient or tool known as communication. Most people don't really understand the true essence of communication and think of it as simply talking to each other or at each other. True communication involves mostly a skill of listening and hearing what the other person actually feels. Skillful communicators are able to picture themselves in the other persons position or from their point of view. If successful from both sides, the avenues are present for effective communication. From the perspective of the other (if reasonable) the decisions made will most likely be the best decisions or interactions. From a self centered point of view there will more likely be chaos and dissatisfaction in the relationship.

Many couples stay together for long periods of time despite disproportionate degrees of satisfaction. I call this a "Taker Giver" relationship. The Giver gives and gives and gives and the Taker takes and takes and takes until the giver is tired of giving or gives completely out. The Taker will usually criticize and be angry at the Giver for not giving as much or totally stopping giving. Repeated unresolved arguments are the norm in this situation. Communication and compromise have never been a part of this relationship. An effective therapist can help them get on track to growth and eventual harmony if Mr. or Mrs. Taker are willing to comply. It is extremely rare that a Taker will surrender his or her perceived entitlement without a fight or at least a threat of abandonment. He will usually try sending his wife in to the shop alone for repair because in his eyes she has the problem not him. The new age has brought a crisis for many men with old school beliefs. In the past, due to social and cultural restrictions women once had to depend on a man (generally speaking) for her security and survival. Over time that reality has become a thing of the past. Regardless of how viewed, today most women have the potential to take care of themselves and their children without male assistance if necessary. This was not the reality of our grand parents.

In every relationship there will be disagreements and sometimes arguments. The number one precipitant has been identified as money problems. Almost any problem can be resolved through the use of communication, compromise, and negotiation if both parties are willing. Unfortunately, many have never completely developed these skills. Without them an emotional handicap will exist in regards to potential for growth in a relationship. Those who adopt the coping strategy of avoidance may tend to run away when the heat gets too hot and get into another relationship that takes them to the very exact same point. This cycle can be repeated many times and the individual still may not seem to get it. If knowledge of the principles and ideas presented here were all it took to be happy in a relationship I would surmise that marital therapists are the happiest people on earth. Knowledge, however, is just the begining and without action is pretty much useless. Commitment, compatibility, and practice, practice, practice are the key.

In Recognition of Black History Month

    

  _{^{Booker T. Washington}}

February is Black History Month...

I think the largest misconception of the majority population is that something special is being given to a select group of people. The core truth is that education is what it's really all about. It's remedial history to rectify omissions from American History. My opinions usually clash with those with more conservative views and I don't expect anything different here. Personally, I don't care to complain or whine because I'm aware that despite all things considered that I have been blessed and for the most part am quite proud to be an American who happens to be categorized as African American. I wouldn't have it any other way.

One thing that makes America great is its ability to pursue justice perpetually and to right the wrongs of the past. Our democracy is an experiment that is less than 250 years old patterned much after the ancient Greek democracy developed by wise men and scholars of a different era. Ours remains a work in progress with endless potential for further greatness. We cannot deny several episodes of ugliness in our history that did include a race of people that did not arrive here for anything having to do with freedom but quite the opposite.The premise of this deprivation of basic human rights eventually led to a bitter division of the Union that resulted in the greatest bloodshed ever on American soil and still has political impact to this very day. It wasn't about black and white but was about wrong and right.

I find it interesting that the conventional wisdom of the South is that most white people hate black people when 80% of my patients are white. For the vast majority of cases I find that it seems to make no difference at all what my ethnicity is. Racism seems to be a non issue when people are in pain or suffering. It has been said that we all bleed red regardless of our race. I think this is profound because there was a time in my lifetime when it was inconceivable by both whites and blacks that a practice like the one I have could exist. I celebrate Dr. King Day every year by just going to work and remembering excerpts from his many speeches. I know that this is what Dr. King would want me to do based on his character and purpose. In his last speech he spoke of wanting a short simple funeral with minimal fanfare and for it to be mentioned that he was a drum major for justice and that he tried to love somebody. I respect Dr. King because he was above petty ideology and his mission was greater than race. That is why killing him could not stop his dream from continuing to take root. Regardless of what his critics say, I know that he was not a communist anymore than I am a communist. I'm glad that he lived because his life helps me to know who I am and what I stand for.

Dr. King wanted us to be an educated nation so that we would not continue to repeat mistakes of the past. He patterned his protests and marches after Gandhi who successfully led his people to freedom in India through non-violent civil disobedience and appealing to the consciences of the oppressor. Many have fought for King's birthday to be a national holiday which has helped to spread what he was really about. His desire was that all men of every race get along as brothers in a society with equal opportunity for all. The Civil War had barely been over for 100 years at the time King was assassinated. If that fact is taken into consideration it becomes clear that overall progress has been significant for American Society, though many will still see the glass as half empty.

There will come a day when Black History Month will no longer be considered necessary but that day is not in sight. I have heard critics state that there should be no ethnicity attached to the word American, such as African, Chinese, Latino, etc.. That would be beautiful but at this time not practical. I can only speak for African American. I know for a fact that I have and do receive special treatment when people know that I am a doctor. When I roll in cognito I am rapidly reminded of how I am perceived by the majority. Sometimes I will go into a resturant alone where usually I will get the low waitress or waiter on the totem pole. I always leave them a big fat tip to send a message. The last car I purchased was transacted with the newest and youngest salesman who came and talked to me as I was overlooked by the more experienced salesmen. It felt good driving the car off the showroom floor, something I had never done before. When such opportunities come my way, I usually think of those less fortunate and who may never have a taste of the American Dream.

I suppose my main point about Black History Month is that it is still so important because it can clarify the history of the Black American so that we will not be looked at as far less than what we really are. Most African Americans just want the stereotypes to come to an end. This can only become a reality when all Americans of all races become knowledgeable about the true facts of our history and heritage. The original purpose of this special month also includes Blacks learning to love themselves and each other where necessary and providing an opportunity for Whites and others to overcome the stereotypes mostly perpetuated by the mass media. The vast majority of Black people are good and decent folks. Despite that fact, I believe that if an alien from another world studied our society using the American media as the only source of information, that alien would probably come to a much different conclusion. Well, the secret is out. We celebrate Black History Month because we know the planet is being observed by space aliens and it has been determined that we must provide fair and balanced representation.

P.S. Just in case someone doesn't get it. That last line was suppose to be a joke.          

Update on Sun, February 11, 2007 at 07:24PM by HEADoc

Art Imitating Life

The Cornell University Blog is ranked # 3 on Blog Top Sites, one of the largest communities on the Internet. They did a post about some white college kids in Texas that was so outrageous that I couldn't help but laugh out loud and roll on the floor. Then I wanted to cry, mainly because it seemed that they simply just didn't know any better. The social gathering at this institution of higher learning involved a MLK celebration party done in a similar spirit to a Halloween party. Featured were Aunt Jermima, pimps, ho's, doo rags, gold teeth, medallions, dread locks, 40 oz malt liquors, fried chicken, gang signs, posturing, etc... There was a photo album documenting every detail. When contacted by a representative of the NAACP, the leaders of the party commented that no offense was intended. The sad part is that they were probably being truthful.

All I can ask is where have we as a country gone wrong? I blame mostly the mass media and secondly the ignorant blacks who cooperate with those who exploit. Of course there is enough ignorance to go around, but I think those kids are imitating a distorted reality. Many Rap artists claim they are imitating reality of the  streets but this has to be done with a certain amount of responsibility and accountability. Most of their fans are white. To whom much is given much is expected. Maybe imitating reality isn't always the best thing to do. It must be remembered that reality is always relative to ones perspective.