Monday, October 03, 2011


At the just concluded HFSA ( Heart Failure Society of America ) Annual Scientific Meeting 2011, there was an interesting presentation br Dr martin Samuels of the Bringham and Women's Hospital, Boston. It is not a very scientific paper, no p-values, or hazard ratios, but he outlines his observations that some cardiac deaths are related to natural catastrophies, or severe mental stress. He observed that following natural disasters, there were more cardiac deaths. Following 9/11 there were more cardiac deaths. There was a paper in the New England Journal of Medicine in 2008 by Dr Wilber Lampen U, that during the 2006 world cup, there were more cardiac deaths in Germany following each game that Germany played, than on those days that Germany did not play.
At a parallel meeting, held concurrently with the HFSA meeting, Dr Deepak Chopra, was speaking at a seminar, outlining his theory that the mind has a severe control over the body, and that medical doctors, must have a "holistic" view of the body and its processes. His theory the " the body is not just a structure, but a process" and also the mind. The mind is also not just a structure but a process. At his institute, they have worked out that when a message is given to a patient, depending on how it is received ( good news or bad news ) it triggers different sets of bodily reactions and initiates different biochemical processes as a result of what is heard and how it is received and appreciated. So what is said, is important and how it is said, and to whom, is also important. With each message, the body responses with production of adrenaline, cortisols, with their attendant BP responses and heart rate responses.
Even genes are influence by the mind. At Dr Chopra's institute, in their research on meditation, they found that after 4 months of mindfulness meditation, the level of telomerase ( the enzyme that determines the length of your telomeres in your chromosomes, increase by 30%. The telomeres are that part of our chromosomes that has to do with aging. The shorter the telomeres, the shorter the life, as it were.
I remember when I was just a lecturer ( such a longtime ago ), I had to tell a very nervous patient that he had an enlarged heart from severe mitral incompetence ( leaking mitral valve ), and that he will require mitral valve replacement surgery. Since I broke the news, he did not rest well for a few nights and one night he was found dead on his bed, although he was responding well to medical therapy. I was quite convinced then that he was " scared to death".
Well, what was discuss at HFSA, brings out a rather interesting and important part of medicine. The marriage of western medicine ( with all the clinical control trial results, p-values and hazard ratios ) and the soft part of eastern Medicine with their holistic approach ( not so scientific and hard ), but nonetheless, important and relevant. How can we combine them for the betterment of our patients.
Yes, there is nervous control over all our bodily functions and not all behaviours can be proven, as God made each individual different and so their responses can be so varied, that perhaps no two of us are alike.
Such is the beauty of the human body.

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