Tuesday, November 10, 2009

Saturday, October 24, 2009

Mind over mind

The Bible tells us "as a man thinketh so is he." Prov. 23.7 A seemingly simple statement, one you hear when you're young, and, if you're blessed with "understanding", you get it, and if you're not, it takes you the rest of your life to grasp it. Like the music of Mozart. Too simple, too effortless to comprise or contain the 'secrets of the universe,' or 'the meaning of life,' right?

But no, not so, too profound, I think. Now science concurs ---- what you think becomes what you are: Check this out: http://www.time.com/time/health/article/0,8599,1929869,00.html

TIME says:

If any pill has been shown undeniably to work in clinical trials, it is the sugar pill, along with its close cousin, the sham treatment. The placebo, as such inert and cost-free remedies are known, can relieve depression as effectively as Prozac, ease discomfort as effectively as acupuncture, and reduce as much disability and back pain as a widely used vertebral surgery that costs up to $5,000.

That the effect of bogus treatments is real has long been known, but the mechanism behind them is still largely a scientific mystery. The standard explanation is that we are just fooling ourselves. In Latin, placebo means "I shall please," which suggests that the placebo effect is just a fleeting mind trick — that the mere suggestion of pharmacologically induced pain relief humors the body into temporary recovery. In trials, every drug response is in fact assumed to be at least partially due to the placebo effect. But the confounding thing about the benefits of the placebo is that the effect is often not beneficial at all. (See the top 10 medical breakthroughs of 2008.)

Consider the negative placebo response, called the nocebo effect. (The term nocebo is also from Latin, this time from the infinitive nocere, "to do harm.") A nocebo response occurs when the suggestion of a negative effect of an intervention leads to an actual negative outcome. When doctors tell patients that a medical procedure will be extremely painful, for example, they tend to experience significantly more pain than patients who weren't similarly warned. And in double-blind clinical trials of antidepressants, even those participants receiving a sugar pill report side effects like gastrointestinal discomfort if investigators have warned them at the outset that those effects are likely.

It's possible that the nocebo response is easily explained: in the antidepressant trials, maybe some patients — given that they already tended toward depression and anxiety — worried so much about the doctor's cautions that their stomach released enough acids to cause pain. That would make sense except that the range of possible nocebo responses stretches far beyond stomachache (in extreme cases, ailing patients who are mistakenly informed that they have only a few months to live will die within their given time frame, even though postmortem investigations show that there was no physiological explanation for early death). In a new paper published in the journal Pain, researchers found that clinical-trial participants have reported a wide variety of nocebo-fueled medical complaints, including burning sensations outside the stomach, sleepiness, fatigue, vomiting, weakness and even taste disturbances, tinnitus and upper-respiratory-tract infection. What's more, these nocebo complaints aren't random; they tend to be specific to the type of drug that patients believe they may be taking. (Read "The Year in Medicine 2008: From A to Z.")

The Pain study, which was led by Italian neuroscientist Martina Amanzio, reviewed 73 clinical trials conducted between 1988 and 2007. All the previously published trials pitted potential antimigraine medications against sugar pills. The medications included nonsteroidal anti-inflammatory drugs (NSAIDs) such as aspirin and ibuprofen (Advil); triptans, which include Imitrex; and anticonvulsant drugs like Topamax. Those three categories of drugs carry different adverse effects: NSAIDs, for instance, often cause stomach problems; anticonvulsants can cause paresthesia (tingling) and memory impairment. Interestingly, patients who took sugar pills tended to report nocebo problems consistent with whatever drug they thought they might have swallowed. No one who thought they could be taking an NSAID or triptan reported memory problems or tingling, but some who thought they might have taken anticonvulsants did. Likewise, only placebo groups in the NSAID trials reported side effects like stomach upset and dry mouth.

Exactly why the placebo and nocebo responses arise is a puzzle, but a fascinating article in Wired magazine noted earlier this year that the positive placebo response to drugs has increased during clinical trials over the past few years. The article speculated that drug advertising — which exploded after 1997, when the Food and Drug Administration began allowing direct-to-consumer ads — has led us to expect more from drugs. Those expectations, in turn, have made us feel better just for popping a pill. (Placebo responses can also occur simply when you book appointments with doctors or psychotherapists.) (See the most common hospital mishaps.)

But the Pain study found that date of publication had no effect on the side effects reported: the placebo and nocebo responses were just as robust before 1997 as after. That leaves scientists still looking for an answer. The Wired story suggested that the act of merely doing something good for yourself may stimulate the body's "endogenous health-care system," perhaps by inhibiting stress hormones. But that wouldn't explain why the same act might lead to phantom nocebo aches and pains.

A final question: What happens now that more of us are onto the placebo/nocebo problem? Will our expectations adjust to reality? Who knows? "The placebo is a trickster," says Ted Kaptchuk, a placebo expert at Harvard Medical School. "We still don't understand how it works." But Kaptchuk says it's possible to defeat placebo benefits and overcome nocebo problems simply by being aware of them. Mind, in other words, over mind.


Tuesday, September 8, 2009

After 9 months on his back


...as part of a 2 1/2 year stint of surgeries and rehabs, and after doctors said he'd never play tennis again, Taylor Dent thrilled tennis fans around the world by advancing to the third round of the 2009 US Open. He achieved this with a stirring fifth set tiebreak win over Navarro. It took no less than Andy Murray, a top 5 player, to stop him, but Dent won a legion of fans and admirers, and told media he was satisfied with his progress. Indeed. Hats off to Taylor Dent, an extraordinary comeback...! Read more

Wednesday, September 2, 2009

Less is more, slower is faster and other paradoxes from the world of sound

Back in 1977, I heard the Philharmonia Hungarica perform at Orchestra Hall (Chicago). I can picture it as if it were yesterday, because one image stands out in my mind. It was the first and only time I ever saw Chef Louis Szathmary wear a tie.

It was that big a deal, at least for the Hungarian intelligentsia in Chicago, of whom Chef Lajos was captain.

I don’t remember the program, but I remember the encore: the Rakoczy March, the unofficial national anthem of Hungarians everywhere. This piece is normally played faster, faster, and then faster still to make its point.

But the P.H. had another idea: they played it plenty fast alright, but at the point of restating the final refrain, they cut the tempo in half, and played with a resolute, martial, relentless inevitability. For those of us sitting in the first balcony, the effect was like speeding along in a top-down sports car, and with no warning, having the brakes slammed on, and being catapulted into space.

I never heard the piece performed that way before – or since. In just one short encore was contained an entire graduate degree’s worth of instruction in style and interpretation.

In later years, the orchestra made their mark by recording all 104 Haydn symphonies, and to great critical acclaim. I purchased a number of them. You can hear some on youtube. Only one ensemble has equaled the feat, the Austro-Hungarian Hadyn Philharmonic, led by Adam Fischer.

I came across a CD by the P.H. recently, works of Kodaly. I went to the Internet to find out where they might be traveling and performing.

Much to my chagrin, the group disbanded.

Here’s what I found in Wikipedia:

The Philharmonia Hungarica was … first established in Baden bei Wien near Vienna by Hungarian musicians who had fled their homeland after it was invaded by Soviet troops. This refugee ensemble gathered together some of Hungary's finest musical talent and was directed by none other than Zoltán Rozsnyai, former conductor of the Hungarian National Philharmonic. Through the ardent efforts of Rozsnyai and honorary president Antal Doráti, the Philharmonia Hungarica quickly matured into one of Europe's most distinguished orchestras. During the 1970s, Dorati and the orchestra, under contract with Decca Records, made a canonical, world-first recording of the complete cycle of Joseph Haydn's symphonies; only one other ensemble, the Austro-Hungarian Haydn Orchestra, conducted by Ádám Fischer, has since repeated this feat.

From the orchestra's inception, the West German government sought to harness its anti-Soviet propaganda potential. As a result, the government generously funded the orchestra throughout the Cold War and continued extending subsidies even after the Iron Curtain fell in 1990. The full withdrawal of state subsidies at the start of 2001, combined with the long-term decline in concert attendances, aggravated the financial problems that threatened the orchestra's survival. The beleaguered Philharmonia Hungarica finally disbanded after giving a farewell concert in Düsseldorf on 22 April 2001, featuring a performance of Anton Bruckner's Symphony No. 9 conducted by Robert Bachmann. It was attended by an estimated audience of 150 in a concert hall meant to hold 2000.


To a hall 93% empty?

Staggering.

Our main topic of conversation here in this blog is the comeback, and the glory that attends.

But not every enterprise ends in glory. Some just end. And when only 150 are on hand to usher such a historic group into musical history, sometimes less is just, well, less.

POSTSCRIPT. Saturday, January 22, 2011. I recently located the Orchestra Hall program for this event that took place Monday, October 24, 1977:

Mozart, Symphony No. 40
Kodaly, Marroszek Dances
Chopin, PC No. 2 (Balint Vasonyi, soloist)
Tchaikovsky, Romeo et Juliette (two dances)
Encore
Liszt, Rakoczy March

The conductor: Zoltan Rosnay

Tuesday, September 1, 2009

Leap of faith


It struck me the other day that the Christian faith may be expressed by this image.

At the behest of our superior, we take a leap, in this case, out of the safety of the plane into rough air.

Some jumpers writhe in fearful agony, all the way down, some relax and enjoy the descent, most go back and forth. And so it is. It's the same trip, either way. We race to the terra firma, to the promised land. Jesus is there holding us, securing us, making certain we don't perish. John 3.16.

The story behind this photo: June 12, 2009, Geo. Bush Sr. celebrates his 85th birthday with a parachute jump, aided and abetted by the US Army's Golden Knights parachute team. Sr. was himself a Navy pilot, and jumped on his 80th, and 75th birthdays, and notably, when his plane was shot down over the vast Pacific in WWII.

Takes a certain courage to do this anytime, especially on one's 85th! Takes a certain courage to believe, any day, and every day. But "God so loved the world...." He said it, and we believe it.

Monday, August 17, 2009

Magnificent Desolation

We watched the film GOODBYE LENIN! where a former East German astronaut is reduced, post-career, to driving a taxi. Can't happen here? Astronaut Buzz Aldrin found himself selling Cadillacs, used and new. He tells the whole story, beginning to present, including his moon walk, in MAGNIFICENT DESOLATION, his on-again, off-again story of disappointment and depression aggravated with chronic alcoholism. What ultimately cements his triumph? Swearing off drink, and the love of a good woman, who herself, undergoes a stunning reversal of fortune, from millions in family bank stock (her father founded Western Savings & Loan in 1929) to zeroes in the same bank stock, when its charter is revoked in the 1989 savings and loan debacle. An apocryphal yet hopeful tale of the fragility of life here on planet Earth as (once seen) from the moon. Many caveats for the close reader. And finally, an extraordinary comeback.

Tuesday, June 30, 2009

Author "chooses" not to buckle

We look for and file away stories of Extraordinary Comebacks, and this one is remarkable on any number of levels. The author suffers a Mahlerian trio of hammer blows of fate, by losing his son, wife and daughter within a 20 month period. He says at the outset: "I deliberately chose not to be destroyed." Cain tells the story of each tragedy, and then turns his attention to exactly "how" he repaired his outlook, the actual nuts and bolts of maintaining his sanity by living in the now, as he puts it. The re-telling carries the story of his own remarkable comeback, and has the capability to restore thousands. Hard to put down, we read it quickly over several days. What more pertinent gift for someone in your circle who is suffering? Buddha said "life is suffering" -- so this book is appropriate for everyone in or (momentarily) out of that status.