The Mystery Of The Will: Clan, Tribe and Hope

While this blog is largely philosophical it touches on the essence of how to live long and well.

The agency of the will is what makes us sick or well. The argument between the role of biological determinism- hormones made me do it- and free will- If I can do it then something is wrong with those who can’t- is played out in my office almost every day.

You can guess who takes each side in the discussion by looking at the numbers. I confess to sympathy for both sides of the debate. This blog is my attempt to show you the bridge or middle way between these two positions and to empower those who feel helpless in the face of the demands of their biology.

The universe is immense and beyond our fully knowing. The inner workings of our bodies are also complex and beyond our fully knowing. The will is the interface between the intertanglings of these infinitely complex domains. I will show some of the biological boundaries around the freedom of the will. This is a big topic so please bear with me.

So many people fail at being well that something more than another aphorism-‘eat right and exercise!’- is needed. My patients are not typical, after all my blog is called ‘When You Are Serious,’ and they make very untypical commitment to change and almost all achieve their goals. I’ve heard hundreds of stories about their attempts to get their friends and families to make similar changes and of their frustration at getting others to adopt the same changes; even as their friends and family rave about how well they look and how much they covet their vigor.

The next few sentences are my ‘wink and a nod’ to those interested at the more conceptual level in the ontology of ‘free will’ in human agency. Just get past these few sentences- heck, don’t even bother reading them -and then I will get back to sound and useful reasoning.

Richard Dawkins and Sam Harris imagine that their logic entitles them to circumvent the computational limits that Turing well understood. They imagine that some simple on/off switch allows them escape from the limits of logic that Kurt Gödel so elegantly demonstrated; they imagine that such limits do not apply to the exhaustiveness of their theoretical materialist reductionism.  They don’t even bother to invoke some of Wittgenstein’s linguistic escape hatches. They are wrong in detail to be so deluded. And here is where Elon Musk’s musings about the dangers of artificial intelligence come in: intelligence confers a degree of freedom. Great intelligence, AI, affords that intelligence a functional domain of moral freedom; we cannot see the nature of that moral domain. ‘It’ may well decide to kill us all.

OK, back to earth. That people fail to choose to be well is indisputable. It is further true that they could choose to be well but don’t. My claim is this failure is from not giving biology its due in the failure of the will to freely choose health. The fact that people don’t all just ‘pull themselves up by their bootstraps’ does not mean they don’t desire the end enough or even understand the rewards of the properly chosen end of well-being. It means they don’t honor their ancestors enough. They lack the speculative imagination, actually the cultural reminders don’t exist, to see the long, tortured and elegant chain of life and struggle that is buried in their behavior and genetics.

Humans survived the pageant, the epics of our struggle to become the dominant predator of biological life on earth as clans, as tribes, as social beings. We hunted in packs, we ate as families and clans and tribes. The will of our ancestors ranged freely over many choices; hunt alone, hunt together, eat alone, eat together. Our ancestors were every bit as intelligent as we are and were great scientists of the possible and the actual that worked so that they might live another day to thrive or die in the death haunted beauty of the world. This success story became embedded in our facial recognition coded genetics, in our auditory lie detectors, again genetically encoded, in our sensory world as the oxytocin enhanced desire for the touch of another’s skin. Simply put, our genetics, the bountiful fruit of millions of years of perfect honing, play a powerful role in how and what we choose. Our cortex, our ‘higher mind’ sees the incoming waves, but our biology remains as a riptide to wash us out again into the deep waters of genetic history; the deep ocean of clan, tribe and cultural behavior.

I am not a biological determinist- Eeek, heaven forfend, my genes made me do it! – but I think if we don’t adequately take into account the riptide of the genetic signals we cannot stand, informed by our intelligence and liberated as agents of free will to make the right choices, to choose to be healthy. The genetics pulls as biological determinism, the moral imagination pulls into an unseen but imagined better future; but in this day, this very day, we are balanced between the dreary abyss of our mortality and the eternal longing of our family, clan and tribe: we must survive, work too late, eat too poorly. We succeeded, we lived another day. “I” failed because I died too soon, became unhappy, weak and sad. I chose what my genetics foretold. The problem is that our genetics are lost in this place in time and space. Our clan is lost in this time and space. We must construct a clan deferential to our ancestors, the anthropology of our biology, and informed by the higher mind, the neocortex, but empowered by our very free, very human will.

Smile, Have Fun, God Speed,

Dr. Mike

Print Friendly

Get Well With Aristotle!

Against the backdrop of genetics and environmental hazards like infections and toxins, we become ill as a function of our character.

Before you leap to a valid logical criticism of my claim-essentially that we are sick through our own fault- let me assure you that many of the most tragic illnesses are certainly not the fault of  the patient: childhood cancers and the sequellae of infections like meningitis come to mind.

I will get to Aristotle in a minute but hold on while I clear up my use of terms. The term ‘sick’ is to be understood as applying to the host of diseases that we call degenerative diseases. This list includes adult onset diabetes, high blood pressure, most forms of heart attacks, premature dementia, “old timer’s disease,” and osteoporosis. When I use the phrase ‘backdrop of genetics and environmental hazards’ I mean that there are legitimate predisposing factors that contribute but do not control the expression of most degenerative diseases.

Those familiar with my work know that I advocate changing nutritional and exercise patterns and adopting a spiritual discipline as the most effective medicines there are and with which we can beat back the encroachment of aging and degeneration.

It is clear from this that I hold that changes in behavior going forward in time can alter the effects of already emergent disease caused by past behavior. Simple enough.

Unfortunately it is not as simple as that and here is where Aristotle becomes our physician.

I have a fascinating example to illustrate my general point. I have one member of a pair of identical/maternal twins in my practice. He came to me with out of control adult onset diabetes already with a positive nuclear stress test and he promptly accepted my direction and cured himself of diabetes and completely reversed his nuclear stress test evidence of severe coronary artery disease. ‘Promptly’ was a few years but it was certainly more prompt and efficient than years of medications and a series of stints in his coronary arteries.

Well his identical twin has the same diseases and, by narrative from his brother, to the same degree. Yet he has not adopted any of the healthy lifestyle changes that my patient, his twin, has so successfully undertaken.

A quickly judgmental person, me, I must admit, sometimes, would say ‘what the heck is wrong with that guy? The evidence is right in front of him. What does it take?’

And that is the right question: not ‘what is wrong with that guy?’ but ‘what does it take?’

What it takes is what Aristotle has to offer: an understanding of what moves us to change our minds, to have us see ourselves in a new light.

It takes drama, it takes tragedy, it takes the narrative power of a well told story, a moving hero or flawed protagonist, it takes seeing our lives not as a completed story waiting for the last chapter to be read but one that is dynamic and fluid with the possible and with chapters yet unwritten by our authorship.

Stories have a beginning, a middle and an end; when understood we identify with the protagonist and are moved by his dilemma and long for a just or happy resolution to his story.

Aristotle is the one who vividly dissects the power of plot, character, narrative and the role of the fates (genetics and the like) and helps us understand the role of drama in helping us live our own lives. Someone with time could write volumes just on the power of Aristotle’s “Poetics and Rhetoric” as medicine to help us escape our poorly written lives that lead us to the misery of chronic, degenerative disease and an early, untimely death. We need to stop living in tawdry soap operas or cheesy novellas and recognize the nobility of our lives and imagine, create an heroic future and nobel end.

Thus we come to why you need to sit down and write out your biography; it need not be a full book, but long enough that you can see the encroachment of nihilism on your childhood sense of hope, the gifts that were given and wasted like your imagination, the distortion of hoped for ends by the traumas of adolescent longing that led you to live a life you would not have chosen if you could have seen past your insecurities or arrogance. When you see your past as prologue and the power of narrative to change the future, you will begin to have  the tools to ensure success of the project of creating a healthy future for yourself and your loved ones.

Smile, Have Fun, Godspeed,

Dr. Mike


Print Friendly

Some Fun Facts

The existence of the Ether was crisply disproven by the Michaelson-Morley experiment. Now there are many other cool things it did not dispositively disprove like super-strings, so science fiction lives on.

One of the nearly equally spooky properties of the world is the piezoelectric force. When you squeeze or deform certain things they manifest an electromagnetic force field. How cool is that?

While knowledge of the piezoelectric property of certain materials has been known about for over a hundred years its function in biological systems has only much more recently been understood. Its role in biology was first described in bone and was initially exploited to aid in the healing of fractures that did not heal properly. This was circa mid the 1970’s.

Since that initial discovery of the biological role of piezoelectric properties in bone we have found its role in ligaments, tendons., DNA/RNA expression and environment, regional field effects on enzyme expression and the resulting elastic properties of arteries, the role of shear forces on healing and damage of cells, activation of immune cells, induction of mitochondria in cells, induced apoptosis (death) of cancer cells. Frankly this is where one says ‘on and on and on.’

Other than the gee-whiz factor why do I bring this up? Because in almost all cases recruitment of the piezoelectric effect improves health and increases longevity.

Are you interested? Exercise. Boom! Exercise. Understanding the role of the piezoelectric effect/property on health leads you deeper into the deep science of exercise and closer to the ‘code’ of life.

The short course goes something like this: get your electromagnetic fields all working for you and everything else will take care of itself.

You reasonably might ask how you ‘get your electromagnetic fields all working for you?’

If this feels like an impending lecture on Qi or elan vital or The Force, relax. How those ideas might map onto the piezoelectric effect in biological systems is a task for historians of thought, but it does nicely raise those questions.

Here is how you get those fields working for you: you shock the system. Shock. Shear forces within the arteries, deforming forces across long bones, compressive forces across flat bone. Sudden, forceful, full range movement: ballistic, explosive and full range with as much neurological complexity as you can handle or learn to do.

The more athletic you become the more electromagnetically aligned you will become. Notice the word “athletic” in that last sentence. Simply jogging is not athleticism. Almost everyone can start jogging by just getting out of a chair. Now, sprinting takes some work; proper arm and leg recruitment, body positioning. Oh, and lest we forget, you have to work up to it by recruiting over a prolonged period of time the right piezoelectric fields so that your tendons, ligaments and bones won’t break under the load transients but will have been force-field molded into greater strength and flexibility.

Hmmm…piezoelectric fields. Yum.

Simultaneously you will have improved brain and immune function, cardiopulmonary fitness as measured by increased VO2 max., fired up the hypothalamic/pituitary/thyroid/adrenal/testicular axis and started producing more anabolic hormones, besides testosterone, like insulin-like-growth-factor I and II. The gains in lean muscle mass, not seen in sustained sub-maximal exercise like jogging, will improve stress and cortisol metabolic clearance which decreases the catabolic, destructive, effects of physiological stress on the body, mind and spirit.

OK, so there is this cool property from physics usually associated with crystalline structures, that powers many of the important health benefits of exercise. Why would that be?

Well, I can rehearse the whole story from the emergence of amino acids and nucleic acids from pond scum but the salient part of the story is found in a different part of our history on the earth.

Any of you who have followed my blogs and know how important I believe examining the anthropology of man, culture and biology can be in elucidating the intertwined story of the possible and actual in the long arc of our genetic and existential history. Applying this same principle to the inquiry into the role of the piezoelectric effect in biological systems we see that our environment and capacities and anatomy and physiology all point to our emergence as a species and our current gifts and skills reveal our hunter-gatherer self or being. As a species we are those hearty Norsemen, fishing and hunting, pillaging, plundering, raping and spreading the genetic future, we are those astounding Olympic gymnasts, those Olympic lifters nearly deified in Greek art and culture, those brilliant Russian ballet dancers with impossible leaps and grace, those indefatigable professional basketball players. Sure there are genetic freaks among the Olympian heights but we share the same divine spark: the piezoelectric effect.

Smile, Have Fun, God Speed,

Dr. Mike


Print Friendly

“To Every Thing There Is A Season”

Probably most of us know the title phrase from The Byrds’ cover of the Pete Seeger song usually referred to as “Turn, Turn, Turn.”

Well at least the older of us  know it thus; older still, know this from Ecclesiastes. Those who are Bible literate of any age will recognize the phrase. “…A time to kill, and a time to heal…”

The whole passage from Ecclesiastes is remarkable. My purpose here is to remark on that detail of …a time to heal.

As those of you who have read many of my posts know, I urge attention to rhythms, cycles: biology, human biology, cannot be understood without attention to rhythms, cycles…without paying attention to seasons. From the temperate climates north, the seasons are sensed by the change in the length of the daylight and of the temperature. What you may not have noticed is the change in the color of the light. It too has a seasonal cycle. Winter light is a colder blue, a thinner blue. Even when it is brightest it is a thin blue. There are technical ways to describe this change in the color temperature but for now I only want to refresh your memory of winter skies and their color.

Whatever the geological history of continental shift and genetic drift over the thousands of years of human history, and whether we have the pigment of a tropical ancestry or the absence of pigment of men from the North, our biology is deeply driven by light, its color and temperature and how we adapt to it.

Environmental temperature is the easiest to talk about so I will give that brief attention before I turn to the role of light in our biology and health.

Remember that as our mitochondria generate energy there are many intersecting and interacting metabolic variables, including genetic predisposition, that determine the allocation of that energy to thermoregulation, for example keeping us warm, and to other muscular and metabolic needs like running or hunting or sleeping. The body allocates, directs, energy to these two functions, to others as well, but for now to these two roles. How well it accomplishes this allocation varies: women are always cold and men are always hot. At least something nearing this is true if I am to believe what dozens of couples, and my wife, tell me. If the thyroid hormone levels are low we feel cold; another element in thermoregulation and energy allocation. I don’t want to spend too much time on this but keep in mind that there are deep biological systems at work, and evolved or derived to do the amazing thing of making our entire body adaptable to varying temperatures. Pointing out that Polar Bears have fur and that many equatorial peoples are tall and thin as a way to shed heat doesn’t change my point. Deep biological systems are available and serve deep needs of health and healing in all of us.

As I mentioned what I really want to talk about is light.

There is fascinating chemistry associated with the human body’s ability to detect color, too much of a diversion for me just now, but be clear that the body has developed very sophisticated systems, and not merely the eye, to detect chromophores, the parts of molecules that make them emit visible colored light energy, and that those detection systems are not there just to enhance our appreciation of sunsets, though they do that very nicely.

If I were a better poet or perhaps novelist, I could paint a verbal picture, blurred as the picture, the story is told of movement over thousands of years of mankind through the mountains, valleys, the long treks near starvation, the wonderful summer evenings when well fed in good company, smiling without guile, fear or plans; only happy to be alive because that is not often assured and so loved for the moment when it just is. That picture, even for those blind who were not born so, is sketched in colors, in outlines of contrast and blending colors.

As we have been hewn out of the possible by time, and remain one with the earth rather than cast off as the chips of that time-driven hewing and thus lost as a species to the evolutionary  past; as that has happened nothing was lost, there was no excess of the possible that did not contribute to our survival. The night when we slept was when we were healed and prepared for the next day’s life and death struggle or another day of rest. The change in the light, the herald of fall  coming, was our signal to seek out those biologically necessary foods, rich in chromophores, colorful foods, that would help us survive the winter. The historically original blueberries were hardy fruits of fall, of cold places. They are brightly colored, rich in chromophores, and very nutritious. Our deep biology knew that; we used to seek out the raucous palette of colored foods. We eat white food now and become sick.

Well even this diversion is not what I wanted to talk about, though it illustrates my main point about the importance of light and of the color of light. Food and our need for colorful foods and the amazing meshing of evolutionary and biological necessity are part of my point; but only part.

What I am trying to make clear, to emphasize, is the role of sleep and its need to correspond to the light and day of sun and moon, of short summer nights and longer winter ones. What I am trying to make clear is that we live out of season with the lights of Spring and Autumn at our peril, we are tempting the terrible evolutionary fate of extinction, when we ignore the deep biological rhythms driven by change in the color of the sky.

The nearly funny, no hilarious, truth is we are like a foraging, raging bear preparing to hibernate. But we don’t know when to start or where to begin or what to eat or when to fast, when to run and when to walk, and being so tempts that fate not only for our species but for each of us in this mortal life.

For those of you looking for a simple list of do’s and don’ts this will have been one of my more frustrating blogs. For those of you who are trying to discover how to live in this world, to be healthy in this world and to be happy in this world this blog alludes to the deeply technical and points to where to find practical direction. Pay attention. The color of the light matters.

Smile, Have Fun, God Speed,

Dr. Mike

P.S. Are you sure you need those sunglasses?

P.P.S. Thus, in part, does beauty save us.

Print Friendly


Yes, yes…long time, no see.

I may have mentioned that over the years several, ‘many’ depending on how you want to define that, several people have asked me to write a book about my approach to medicine.

Well one of those who asked year after year when I was going to write a book and finally realized I wasn’t going to decided he would in my stead.

You don’t even need to hyphenate the two words ‘ghost’ and ‘writer’ as they have passed unmolested into the vocabulary as a single word; that is how common the employment of ghostwriters has become.

Now, I have one!

I wind up spending hours and hours working with this most pleasant of men and he is making me do the work a writer needs to do anyway; that is, think about what he wants to communicate.

As Hamlet would say, did say: “Aye, there’s the rub.” I communicate best with graphs, concepts, guidance, conveying my care for my patients in non-verbal ways, iterative testing, diligent reading of the research literature, all the while experientially jaundiced about the pollution level in medical literature and advice and thus skeptical enough to dig deeper than headlines for the guidance I offer my patients. I hope, more than know, that there are other docs out there of whom all of that could also be said.

In any event only now am I being forced to organize in words how my work proceeds.

I want to introduce some of the schemata I use to examine and incorporate protocols into my practice and advice.

When I developed the software program I use in my practice, now dubbed KumarEHR (this title derives from the work Kumar, my associate, went through to get our system certified with one of the national labs) my main almost metatheoretic idea was that in biological systems trends were more important than single time-point numbers; thus the software was a graphing system where various lab variables could be put side-by-side to check for correlations, to probe for causative links and to make visible trend effects of behavior changes.

OK, ‘trends’ matter more than single numbers. Seems obvious but conventional medical practice pays only lip service to this idea.

Next was that you could assess biological age, much more important than chronological age,  by understanding the nexus within a matrix of local, regional, systemic effects on plumbing, wiring and chemistry.

Simple: wiring=nerves, plumbing=vascular system, chemistry=hormones, neurotransmitters, interleukins and the like.

‘Local’ is nanometer to millimeter scale, ‘regional’ is millimeter to centimeter scale and ‘systemic’ is centimeter to meter scale.

Now you can easily guess why I need someone else to write the book; already this seems too abstruse to be of use. Still with this schemata in my head I can read, scan and use or reject tons of basic science and clinical level science and incorporate it within my medical practice in an ongoing manner.

It helps me not get carried away with treatments that are only assessed at the local level, beta-blockers are a good example of how following my assessment principles led me away from this terrible class of drugs decades before they were recognized as suspect by the profession. The concept led me to know there was no such thing as a local injury, the beginning of an atheroma, ‘heart blockage,’ for example and that there had to be systemic signals; now known as BNP, CRP, IL-6, etc. and so on.

Unfortunately I could go on and on about how this technique led me to my exercise protocols, dietary guidelines, the value of spiritual discipline, massage and relaxation and the harm of almost all supplements.

Yes, I did say ‘unfortunately,’ because that ‘going on and on’ is what I would do if I were to write the book, but the brave good man who is writing it has an editor’s eye and a gift for levity that I lack. You will love the book. When I have his permission he will no longer be a ghostwriter but a writer in full.

Just an update.

Smile, Have Fun and God Speed,

Dr. Mike

PS The title of the book is “Renewal.”

Print Friendly