What I'm Reading (Aug. 30)

By Chuck Dinerstein, MD, MBA — Aug 30, 2019
Here's what we have this time: Is evolution a "struggle" or "snuggle" for survival? ... Any profound loss, in this case of a father, ripples across our lives like a pebble on a lake. ... Physicians are often asked for advice. But do people want instructions or coaching? ... Finally, "mindful" consideration of one of the true vital signs: the breath.
Courtesy of the Cleveland Museum Portrait by Berthe Morisot

“Tho’ Nature, red in tooth and claw,” those words of Tennyson are taken by many as aptly characterizing Darwinian evolution. As a writer, and in particular a lover of metaphor, one cannot fail to see the power of metaphor to shape concepts and ideas. But over the nearly two centuries since Darwin’s voyage on the HMS Beagle, evolution has come to be understood as more than a struggle for survival. More and more frequently, we now see how cooperation between species permits both to thrive when by themselves they would be lost. Martin Nowak, a mathematical biologist, gave this collaboration a name of sorts, “snuggle for survival.”From Nautil.us, a 5-minute read, Survival of the Friendliest.

“My father, eighty-three, had been declining for several weeks. The late-night phone calls had tightened in frequency and enlarged in amplitude, like waves ahead of a gathering storm: accidents were becoming more common, and their consequences more severe. This was not his first fall that year.”

As published in the New Yorker, a reverie, My father’s body, at rest and in motion, by Pulitzer Prize-winning author and physician, Siddhartha Mukherjee writes on the time surrounding the death of his father and the memories it brought forth.  .... He writes so well

When someone is found to have specialized knowledge that provokes public engagement and interest, you can bet she will be asked to offer suggestions as to how others might follow in her footsteps. And you can bet those suggestions will be useless.”

Physicians are frequently asked for their medical advice. In Against Advice, by Agnes Callard, she makes a distinction between instructions and coaching. Often times we provide the former, instructions, when really people are seeking the later. Of course, coaching requires a bit more work. 

“Slow, deep breathing is probably the oldest folk remedy on Earth. It is so ingrained in us that people will find themselves doing it instinctively ahead of public speaking, or while enduring the pain of a wound being disinfected. Such careful breathing is always associated with an experience of cooling, of decelerating. It works in almost any scenario where the mind is being catapulted by the body, and we want control.”

Breathing, so natural, and vital that it quickly fades into the background, not so much ignored or forgotten, but unnoticed. But breath is one of two voluntary ways we have of altering the response of our nervous system. From Aeon, Breathtaking, an essay exploring our breathe and its history.  



Chuck Dinerstein, MD, MBA

Director of Medicine

Dr. Charles Dinerstein, M.D., MBA, FACS is Director of Medicine at the American Council on Science and Health. He has over 25 years of experience as a vascular surgeon.

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