Journal April 9, 2001

"The Brain is wider than the sky--
For put them side by side---
The one the other will contain---
With ease, and You beside....

The Brain is just the weight of God---
For heft them, pound for pound---
And they will differ, if they do---
As syllable from Sound."

ooooooooo

Allan Hobson, a physician and Professor of psychiatry at Harvard Medical School, quotes the above verses by Emily Dickinson as a prelude to his book "The Chemistry of Conscious States" which I have been reading recently.

Hobson's general thesis is that we are the embodiment of brain-mind states and that those brain-mind states are all we are. Our states control our faculties, yet with consciousness we can control our states. "The mind", he writes, "is all the information in the brain", and "consciousness is the brain's awareness of some of that information.....The brain-mind has the ability to heal itself by changing states; we can harness this power by voluntarily altering our state of being".

"As we all know", Hobson points out, "the key to good health is not to get sick. The best way to stay well is to elect behaviors associated with health. The best Doctor is the self....Of all the practices known to be associated with good health, sleep is the most fundamental. First, it is a built in state-change, and a physician in that its intrinsic healing mechanism has been detailed at the level of brain cells and molecules. Second, its curative function is beginning to be specified as an enhancement to the immune system. Third, the rules that are emerging from sleep research can be extended to other curative conditions....Of course there is a great deal of variation in our unconscious states; some people need very little, others need a great deal [of sleep].....Attaining good health is our own responsibility, and we can control it to a great degree by consciously investigating and manipulating our brain-mind states".

While acknowledging that drugs may be appropriate in certain debilitating disorders such as schizophrenia and mania, he observes that although a drug may be aimed at the brain-mind, the patient cannot avoid circulating it through the whole body and all of its many physiological control systems. Hobson points out that there is a certain risk of unknown and undesirable "side effects" as well as the dangers of habituation and addiction. Further, drug treatments are unnatural; none of the chemicals in use today are made by the body.

"There is nothing more unsatisfying to me", he writes, "than treating with a drug a disorder that has been created by another drug....I am a reluctant chemist because, the truth is, that when I prescribe most drugs, I don't really know what I am doing". Hence he prescribes drugs reluctantly and prefers, in as many cases as possible, to manipulate a patient's chemistry by natural means.

I was especially interested in Hobson's comments on the placebo effect. In Latin, the word means "I shall please". Hobson writes: "We all expect to be helpd by a Doctor...even a disenchanted person is likely to come away from a consultation feeling better....It is a very powerful force accounting for between one-third and two-thirds of the perceived benefits of medical care....New drugs cannot be presented to the FDA for approval until they have been tested against a control group---people who are given what they are told is a new cure but in reality is only a sugar pill. Any new treatment must overcome the uphill battle of proving that it provides a significant improvement in outcome statistics over those obtained with sugar pills.

"How should we think about this phenomenon?" asks Hobson. "One response that I would not recommend is to devalue it by saying it's not "real" medicine....The worst thing of all would be to suppose that the placebo effect is no effect at all....another mistake would be to get rid of it. You can't kill hope. If a placebo works---it works, somehow. Meanwhile let us prescribe, take, and enoy the benefits of as many placebos as we can find".

Hobson's thoughts were of great interest to me. My parents were anti-drug persons, from religious beliefs, and I also followed those early imprintings for some of the reasons that Hobson mentions as negative side-effects [which are really just effects!]. I have also read the disturbing statistics about the high number of deaths due to improper prescriptions. Fortunately, at the moment, I am both ailment free and drug free!

My own sleep requirements and habits have greatly changed during recent years. My current physical energies have become minimal after noon; a 2 hour nap is essential. Most evenings I retire before 8 PM. As a result I have become an early riser; I am usually awake before 3 AM. Fortunately our daily newspaper arrives about that time. I arise, read the paper, browse the Internet for an hour, doze briefly, and then, about 06:30, depart regularly on a 3 mile, hour long, morning walk.

That leaves only about 5 hours in which my physical energies will certainly be high enough to enable accomplishment of essential house and yard maintenance activities, or other tasks requiring thoughtful awareness and concentraion. For such activities I am well aware that my productivity has declined. The cause is a decline in physical energy and mental motivation. Accomplishment no longer seems as important as it did in my younger days.

As noted above, Hobson observed that "The best Doctor is ourself". I have already mentioned my own concept about self responsibility [Journal February 28] "What I BE is up to ME". But I have also found, as Hobson did for himself, "that the decision to focus, to concentrate, and to select and direct my thoughts, requires an almost herculean effort". Sometimes, now, it seems easier to take a nap instead!

ooooooooo


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