cleveland-psychiatrist.com Blog

Solar Roulette

Administrator — Fri, 13 Jan 2012 21:22:40 +0000

People have a hard time doing what is best for them. I would even say people have a hard time refraining from self-defeating or self-destructive behavior. I am not exempt from these human tendencies. I have always had a love/hate relationship with the sun. Despite the sensitivity of my skin to the sun, I logged many hours of sun time without adequate sun protection. I loved the feeling of hot sun on my skin and equally loved having a tan. When I first started seeing a dermatologist for “pre-cancers”, she told me I should be more careful i.e., use sunscreen and long sleeves and hats and stay out of the sun at midday. When I would return periodically to have my pre-cancers frozen I would assure her I was being more careful. She would gently point out my tan lines and tell me not careful enough. Sorry to report, dear readers, that this went on for enough years to add up to more than a decade. Then one of my little pre-cancers crossed over to the dark side and became a squamous cell carcinoma. As luck would have it, this lesion was prominently located on my cheek. I am grateful that it is no threat to my life or well-being. However, the process of having it removed and the long healing time of a one inch incision on my cheek have definitely gotten my attention. Ironically, it is true that over the years I became more and more careful with the sun. Just not careful enough.

This experience has given me much to think about. Any reasonable person, much less a physician who trained as a scientist, would understand that continued sun exposure to pre-cancerous lesions is a game of solar roulette. What psychological explanations are there for this behavior? There is denial: “It won’t happen to me. It will be fine.” Rationalization plays a role: “I am being more careful. The dermatologist’s treatment will keep it under control.” Poor judgment is related to skewed priorities: “I am just running out to the garden for a little while. I don’t have time to put on sunscreen.” How about laziness: “I don’t feel like going to find my sunhat before going out.” I imagine that my readers can submit more explanations. I would be interested to read them.

I have become more humble as a result of all of this. I am subject to the same psychological pitfalls as my patients. Keeping my own behavior in mind helps me to remain empathic in the face of the self-defeating behaviors of others. It is not at all easy to remember long-term consequences when living one’s life in the here-and-now. Wish me luck with the sun. I am determined to do better from here on out.

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How Our Environment Affects Our Brain Chemistry

Administrator — Fri, 19 Aug 2011 17:46:03 +0000

I can accept quite readily that our genes affect how our neural circuits are constructed and how our brain chemistry responds to events. It requires more of my imagination to think of ways that our environments or our life history could make an impact on the chemistry and physiology of our brains. The imaginative reseachers in this study did brain scans on subjects from large cities, small towns and rural areas as the subjects were taking a test and being given negative feedback to raise their stress levels. They found that living in the city correlated with more activation in a part of the brain called the amygdala. This brain region is thought to be centrally involved in emotional processing, especially in terms of fear and evaluation of threat. The residents of rural areas had the calmest amygdalas. Being raised in the city, even if not currently living there, also correlated with increased amygdala activation, suggesting that the effects of city living on brain chemistry are long-term and probably involve permanent functional and maybe structural changes. I wonder what other aspects of our environments affect our brain function?
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But I Love Doc Martin

Administrator — Fri, 10 Jun 2011 19:19:29 +0000

A few posts ago, I wrote about why I hate the series House on TV. I did find a TV doctor that I do like, though. Its Doc Martin from the British TV series of the same name. I am watching the old episodes by streaming them through Netflix. The premise is that this successful surgeon becomes the local GP for a seaside village in Cornwall because he develops a fear of blood. Doc Martin can be as rude as House, but he is not as deliberately mean. He comes across as socially impaired, as though he has an autism spectrum disorder like Aspberger’s syndrome. He is a fabulous diagnostician and a technically great doctor. The medical aspects of the series are down to earth and fairly accurate, not outlandish as in House. His bedside manner is atrocious and sometimes he misses the point because he has failed to connect with the patient well enough to be a good listener. Doc Martin appears vulnerable and dedicated to his community’s well-being in his own rough and sarcastic way. The cast of characters is interesting and the dry British humor abundant. Better than House any day.

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A Little Hawk in the Big City

Administrator — Fri, 10 Jun 2011 16:49:15 +0000

The drama at the red-tailed hawks nest at NYU is coming to its end. The lone chick that hatched late has developed into a nearly full sized hawk that is ready to take off and leave the nest forever. It has been most remarkable to see the growth and maturation of this bird up close and personal. I cannot believe the rapid rate of growth, faster than the bean plants in my garden this chilly rainy spring. I have a new respect for the odds birds face in raising their young and surviving. If you tune in to the webcam these days, most often there is just an empty nest littered with the various pieces of trash that the hawks have collected. The eyas (hawk chick) has been nick-named “Pip”. He is usually somewhere else on the ledge out of webcam range. If you are lucky you will see him stretch and flap his wings or see him snatch a mouse from the adult and devour it. The experts say that the mating pair may return to this site next year for their next go at reproduction. The webcam will be waiting. So will I and the thousands of hawk fans that this feathery family have accumulated.

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The Real Reality Show

Administrator — Tue, 17 May 2011 19:07:53 +0000

I have posted several times about the NYC hawks, last time celebrating their perseverance in hatching one of the three eggs on the 12th story window sill of the president of NYU. Following their drama up close and personal on the web cam has been an emotional roller coaster. The eyas (term for a newly hatched hawk) is doing great. He eats voraciously and is starting to stretch his stubby little wings. The parents are attentive and gentle with their sharp talons and beaks. After the hatching, it was noticed that the female hawk had a grossly swollen leg apparently due to a band and maybe string that had wrapped around too tightly. There ensued a week of controversey and evaluation about whether to attempt to capture her and remove the band. The commentary on the hawk forum and the twitter feed was fast and furious, debating whether to act or not to act. In the end it was decided that the risks of attempting to capture her outweighed the benefits, since the eyas is doing well and she is performing her duties in caring for him admirably given her disability. The commentary veered off into discussions about the downside of possibly needing to keep the female in a zoo, the impact of humans on the other life forms around us, and even a heated debate about whether the mother’s life or the chick’s life should be the focus of rescue attempts. The NYT summarized some of this in a recent article. While this drama was unfolding, I also was checking in on a bald eagle nest in Norfolk, Virginia. Things there were going very well until the mother was hit by an airplane and the three eaglets removed to a rehab facility because they would be too much for the male to handle alone. Plans are to release them in August once they have mastered the art of flying. They can be seen on their own web cam.

Life is hard, folks, especially if you are a bird trying to fulfill your biological destiny and raise young. The world is dangerous and some of the perils are man-made. I have a new found respect for our feathered friends and for their success in populating the world around us. When I see a red-tailed hawk soaring along the side of the highway, I imagine the factors against him. There is inspiration in this story for all of us.

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Perserverance Pays Off

Administrator — Fri, 06 May 2011 16:27:49 +0000

I was going to sit down and write a post today about the sad news that the eggs of the NYC red-tailed hawks were not viable and were not going to hatch. Having observed the ongoing diligence of the parents over the aparently hopeless eggs was poignant. I am happy that I do not have to deliver that dark news because today the eggs hatched. There are pix posted along with info about what the next weeks will bring in the lives of the hawks. Good thing that the hawks were not able to read the dire news in the NYT, it might have caused them to give up too early.

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The Hawks Hit the New York Times….and Have their Own Twitter Feed

Administrator — Fri, 15 Apr 2011 19:13:47 +0000

The drama of Violet and Bobby’s attempt to hatch their eggs on a ledge in NYC has hit the Times and Twitter. See article.

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Raising a Family in the Public Eye

Administrator — Fri, 15 Apr 2011 18:08:14 +0000

I have been tuning into a live webcam feed of the nest of two red-tailed hawks in NYC. They have been named Violet and Bobby and they are tending a nest with three eggs in it on a window ledge of the 15th floor of a library at NYU. There is something strangely compelling about following their story. At lucky moments of checking in, I have seen them rearrange the eggs and take turns sitting on the nest, the changing of the guard so to speak. I have not seen any dinners (mice, sparrows etc) being dropped off at the nest, although other observers say that is a high point. The eggs are supposed to hatch over the next couple of weeks and seeing that would be thrilling. At the moment I am writing this 1334 other people are tuned into the nest. Most of the time, nothing much happens. The wind blows the hawk’s feathers or the bird cleans her feathers or the nest. You can see the hawks softly breathing and observe them blinking their eyes. The drama yesterday was that both birds left the eggs unattended for several long minutes. Todays drama is the plastic that has been brought into the nest. At one point, Violet had the handles of a plastic shopping bag wrapped around her body. More worrisome is the plastic that the hawks seem determined to layer under and over the eggs, perhaps risking suffocating the unhatched chicks. Watching this spectacle is at times relaxing and at other times nerve-wracking. Life is fragile and a long shot. I am rooting for the chicks and their determined parents. Seems like 1330 other people feel the same way.

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Moral Ambiguity Throught the Eyes of a Child

Administrator — Tue, 29 Mar 2011 22:21:06 +0000

I just finished reading Leif Enger’s book “Peace Like a River”. It is set in the midwest in the mid-1960s and told from the point of view of 11 yr old boy during a year of crisis in his family. He struggles with the conflict between family loyalty and morality. He also struggles with courage and cowardice, both his own and that of others. His is an honest portrayal of a child trying to grow up and make sense of brutally difficult circumstances. The style has a touch of magic realism, like Isabel Allende’s early work or the work of Gabriel Garcia-Marquez. I enjoyed it.

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The Value of Older Females

Administrator — Tue, 22 Mar 2011 19:54:21 +0000

It turns out that the oldest female elephants (like 60 years old) in a group are best at assessing risk and implementing protective maneuvers. Experience and memory seem to account for this. Maybe we are missing out on this guidance in our human society.

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