Shame on you, Medtronic

Insulin pumps marketed by Minneapolis-based Medtronic have a serious, life-threatening security flaw, and the company couldn’t care less.

For these two reasons, this isn’t your typical security flaw, and Medtronic’s response–in 30 years, we’ve ever seen a problem that we know of–is beyond deplorable. Ford’s infamous decision to pay lawsuits rather than fix a deadly flaw in the Pinto comes to mind.
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Ugh. I’m beat.

I went in today for a massage, to get my shoulders tuned up so I can get another year out of these two arms without my wrists tingling and aching and otherwise not doing their job. I’ll feel 17 again in a day or two. In the meantime, I feel like I just got beat up. At least this year it was only 3 knots back there. Last year it was more like 5, or something ridiculous like that.

Fathers: Give your family a gift this Father’s Day weekend

I’m sitting here watching NBC’s tribute to Tim Russert tonight. Although he was famous for being the biggest political guru of his generation, he was also the author of two books, both about fatherhood.

He died today of a heart attack. He was only 58.

I would have liked to have asked my dad what to do to minimize the risk of heart attack. Being a doctor, he should know. But I can’t. He died of a heart attack in 1994, age 51.I think I know what Dad would say, although he would say it with a whole lot more authority, having four degrees and the title "D.O." to his name.

I’m sure Dad would point out that not all of the factors are within our control. The best we can do is control the factors that we can control. (Not that he did, sadly.)

I don’t know much about medicine (Dad didn’t want me to be a doctor, and honestly, I never had much interest), but I know plenty about controlling the factors we can, in hopes of minimizing the factors we can’t.

But diet is a big factor, and we can control it. We can (and should) eat foods lower in cholesterol. We can (and should) avoid hydrogenated oils as much as possible. And we can (and should) eat foods that seem to lower cholesterol, such as oatmeal. Soy is also rumored to lower cholesterol, but the question is whether it actually lowers cholesterol, or if it merely replaces lots of foods that are high in cholesterol.

So, here’s the gift I want fathers to give their families this week. Start eating oatmeal for breakfast at least a couple of times a week. And if you’re really ambitious, eat fake soy meat a couple of times a week instead of the real thing.

Trust me on this one. I’m a red-blooded, beef-eating Kansas City native. I grew up on the stuff. Eight years ago I gave up meat for Lent, mostly because it was something that seemed possible but extremely difficult to do. I wanted to see if I could do it. So I did it–barely. Then I went out for BBQ afterward.

Back then, I tried soy burgers. I wasn’t impressed. Trust me. They’re better now. If you don’t like one brand, try another, but my favorites are the Boca Flame Grilled. Soy bacon is good too. It doesn’t look a thing like the real stuff, but it tastes fine.

If there’s a relatively minor and tolerable adjustment that we can make to potentially increase the number of our years, and almost certainly increase the quality of those years, shouldn’t we do it?

How I fought the insurance company and lived to tell about it

My dad was a doctor. Dad told me on several occasions that if I ever came home and said I wanted to follow in his footsteps and become a doctor too, he’d lock me in my room for seven years. One of the reasons for this was because he hated dealing with insurance companies. I vividly remember going out to the mailbox one day and finding a letter addressed to Dr. Farquhar, with a very angry note written on the front of the envelope: PLS LET THE DR READ THE LTR. I asked what this was about, and Dad said insurance was refusing to pay for a patient’s treatment. He said it happened a lot.

Now I’m 33, and my insurance was refusing to pay for treatment my wife needed. The best-case scenario without her medication would have involved numerous hospitalizations. The worst-case scenario? Coma or stroke if a lot of things went wrong. If everything went wrong, death wasn’t out of the question.

Here’s what I did about it.This isn’t exactly how I wanted to tell everyone, but my wife is pregnant. She’s also diabetic, and diabetes and pregnancy aren’t exactly the best combination. It wasn’t long before she was complaining about nausea. That wasn’t anything new; she can get bad nausea at times even when not pregnant. We try to keep a decent supply of Emetrol (or a generic version) on hand because of it. But we didn’t know if it was safe for her to take that while pregnant, so I suggested she ask her doctor. The doctor put her on a generic version of Zofran, a powerful anti-nausea drug.

The difference was like night and day. Without the drug, she couldn’t be up and around for more than 3-4 hours at a time. With the drug, she could function almost normally.

But after a month, the party was over. The insurance company refused to pay for the drug any longer. The doctor protested, but to no avail. So the doctor prescribed alternative anti-nausea drugs.

None of them worked.

She started a rapid decline. Within days, she couldn’t keep food down. Four days after that, she couldn’t even keep water down. She went to the doctor, and her doctor sent her straight to the hospital where she was admitted and treated for dehydration and severe morning sickness (I don’t remember the medical term). They kept her in the hospital overnight.

When her doctor visited, I asked him what to do. He said insurance companies do this all the time.

"Let me get this straight. This guy with no education, who’s never seen her, knows better than you do what’s best for my wife?" I asked.

He said he sees this every day, and he’s sick of it.

"So do I need to look into getting a lawyer and suing this company for malpractice?" I asked. After all, there was at least one time when Dad said a patient needed one treatment, and a different doctor decided to do a different treatment and the patient died. The patient’s family, based on what Dad said, sued the other doctor for malpractice. If a doctor can be sued for practicing medicine badly, why can’t an insurance company be sued when it practices medicine badly?

He said if I did that I’d probably end up on CNN and he’d love to see the public pay that kind of attention to the insurance industry, but it wouldn’t help my wife any.

So I asked about buying the drug outright, without insurance. It was going to cost more than $400 a month. That’s outside of most budgets. I probably could have made it work, by making some cutbacks on food purchases, taking on some extra work, and if all else failed, borrowing some money, but it shouldn’t be necessary. This is why we get insurance in the first place–to cover these kinds of expenses.

So I looked into what it would cost to import the drug from Canada. The best price I found was $330–not much help.

I called my boss and told him what was going on, originally for no reason other than to provide justification for why I wouldn’t be at work the next day. But the more I told him, the more apparent it became that the situation offended him too–and not just because I was missing work over it. And that gave me an idea.

If the situation offended him, then it probably would offend the decision-makers at the company too. I decided I needed to talk to my boss and ask if I would be going over his head by talking to the higher-ups about the situation.

He gave me the OK, so I wrote a letter to my employer’s upper management. It wasn’t very long. In point by point fashion, I described my wife’s medical needs, what the doctor had done about it, what happened after the insurance company stopped paying for the drug, and what risks were involved with my wife not getting the treatment that she needed. I spelled it all out in lay terms. I also tried to be very matter-of-fact about it. They didn’t need my opinions on the matter–the facts spoke for themselves. Nobody would want their wife or daughter to have to go through what my wife was going through. And that was what I was counting on.

My letter climbed up the corporate ladder and over to HR very quickly. Not long after that, the HR director had the insurance company’s representative on the phone. Before the day was over, my wife had her medicine, and by the next day, she had a case manager assigned to her.

I believe this is the only approach that would have worked, and this is why:

1. I have an acquaintance who once worked for an insurance company, in the IT shop. He told me the majority of insurance adjustors who make decisions about what the insurance company will and won’t pay for are frustrated people with minimal education (sometimes just a GED) and they get their jollies by overruling doctors. It’s a power trip, and it’s what gives their lives meaning. Calling up the 800 number on the back of the card and complaining doesn’t do any good because it just proves to them how much power they hold. And calling the number and treating whoever answers the phone to a profanity-laced tirade (or even just asking the person where he or she went to med school) really drives home how much power they hold.

2. I’m just one customer and I have no control. The insurance company doesn’t care if I leave, because all they lose is a bad customer. Remember, customers who pay into the system and don’t take anything back out cause profits to rise. Customers who take money out of the system cause profits to fall. And besides that, I have no say in where my company buys its insurance anyway. The only way for me to change insurance providers is to change jobs, and that’s not only impracticel, it’s also very difficult.

What I had to do was to take my case to the people who do make that decision, and appeal to them. Working from the assumption that none of them would want the same thing to happen to their wives and daughters, I just presented the facts and let them come to the conclusion that the insurance company would do the same thing to anyone else in that situation too–including them. After all, they’re covered under the same plan I am. And of course they wouldn’t want that. What I basically did was raise the stakes. The insurance company wouldn’t be sorry to see me go, but what insurance company wants to risk losing a whole company’s business?

3. I kept my cool. By my own admission, to call me a loose cannon is an understatement. If I don’t like something, everyone around me knows it. But I wasn’t going to make any friends by saying "You guys are idiots for choosing to buy insurance from [company x] because they’re trying to kill my wife and unborn child." My emotions and opinions were more likely to make them get mad at me, and I needed them to be mad at the insurance company, not me. So I trusted them to be reasonable, rational people and come to the same conclusion I would when presented with the same seven basic facts.

So that’s how I got an insurance company to let my wife have a drug they decided they didn’t want to pay for.

Take some steps to improve your health today

So Michael Moore has a new movie out, this time taking on the touchy topic of health care. I was a very outspoken opponent of Hillary Clinton’s plan 15 years ago. I’m extremely disappointed that the alternative plans crafted by the Republicans dropped as soon as the Clinton plan died.

I won’t argue that the U.S. health care system is terrible now. I will argue that some of the fault belongs to the person in our mirrors though. (And I don’t want to be rude, but Michael Moore needs to take some personal responsibility too.)The best editorial I ever saw about the Clinton plan was written by Andy Rooney. What he said then is even more true today: We drag our lard butts to the doctor because we won’t eat right, and we complain when the doctors can’t cure our problems which are to at least a certain degree, self-inflicted. Then he twisted the knife a bit, pointing out that Clinton was fond of going to McDonald’s with camera crews in tow. He said something like, “Health care is in trouble. Now excuse me while I go have a triple-cheesy-greasy with double fries. Do as I day, not as I do.”

Now to be entirely fair, society encourages us to eat out a lot. It tells us that’s how to be good parents, it’s a good way to take a load off and relieve stress, and who knows how many messages–most of which aren’t true. Remember, the originator of the message is selling something. Always always remember that.

I remember John C. Dvorak once remarking on his blog, “Someone wants us fat.” Give the little man a big cigar! The food industry wants us fat because we’ll eat more. The drug industry wants us fat because we’ll take more drugs. And once both of them get us up on that treadmill, they stand to make billions. If not trillions.

I still believe, with everything I have, that the American diet (if it can be called that) is largely to blame. We eat a lot of empty food that does our bodies no good, but does plenty of harm. Dad was saying 30 years ago that biscuits and gravy cause cancer. Today, guess what? They’re saying that sausages and gravies and highly cooked fats cause cancer. Sausage gravy does all the wrong things about as well as anything, but hot dogs are another good example.

Fast-food hamburgers may not necessarily cause cancer, but they sure do a dandy job of giving you a heart attack.

Vegetarians say they have the answer, but I’m not entirely convinced vegetarianism is absolutely necessary, nor is it a panacea. I see plenty of vegetarian cookbooks that do nothing but douse the vegetables in butter and cheese. Eat like that, and you won’t be any thinner or healthier than anyone else.

I do believe the main reason healthy vegetarians are healthy is because they pay attention. They look at the ingredients to make sure there’s no meat in there, and if there’s anything in the ingredients that they can’t pronounce, they probably end up putting it back since they can’t prove it didn’t come from an animal. And as a result, they tend to end up eating lots of fresh fruits and vegetables, breads that don’t have a lot of ingredients in them, and other things that provide a lot of nutrition in their calories.

I’m also convinced this is why most fad diets work initially. If you hopped on the Atkins bandwagon in the early 1990s before it became hugely popular (it had actually been around since the early 1970s), it was entirely possible to lose weight, because you would be limited largely to unprocessed meats and vegetables. But I noticed around 2000 or 2001 that a lot of people were on Atkins and weren’t losing any weight at all on it. Atkins was still saying the same things, but it wasn’t working anymore. The difference? Everyone and his uncle was peddling Atkins-friendly junk foods. Instead of being limited to meats and vegetables you cooked yourself, you could microwave processed Atkins-friendly TV dinners and gorge yourself afterward on Atkins-friendly cookies and ice cream.

People stopped losing weight, their cholesterol soared, and lots of companies made lots of money. Then the gravy train ended, but that’s OK because there’s always another one.

This is a boom for drug companies too. When your cholesterol goes sky-high, the commercials say there’s no need to change your diet. You can just pop an anti-cholesterol pill. What they don’t tell you is that the pill not only lowers your cholesterol, it also wipes out your B vitamins. So now your cholesterol is lowered, but you’re depressed and have carpal tunnel syndrome (just two things a deficiency in B vitamins can cause). So now you need another pill. Funny, the same company that makes the most popular drug for cholesterol also makes one of the most popular drugs for depression.

And that popular drug has some side effects such as abdominal pain and/or headache, sexual disfunction, and other things. But there are pills for that too.

Is it any wonder we never really get better? We take a pill for one thing, and the pill fixes that, but then we get something else. The domino effect starts, and it’s possible to go from being on no drugs to being on five in a matter of months.

About a year ago, my wife was out talking to someone. She mentioned she was diabetic. The elderly gentleman she was conversing with said he was too. They talked some more, and it turned out he became diabetic as a teenager, just as she had. He seemed like he’d lived a long and healthy life to her, so she asked if he had any secrets to share. He did. “Stay away from junk food, and you’ll be fine.”

Good advice. Simple advice. Unfortunately it’s difficult to follow, seeing as every other commercial between the hours of 4 and 8 is for junk food. Most of the rest are for drugs, with the occasional car commercial thrown in.

Here are some starting points my wife and I have picked up from the books of Dr. Mark Hyman.

1. Avoid processed food. Buy your groceries from the outer ring of the grocery store, staying out of the aisles.

2. Avoid high-fructose corn syrup. This ultra-common sweetener is very cheap, but your body doesn’t know what to do with it. Eat lots of sugar and eventually you feel full, but if you eat the same amount of high fructose corn syrup, you’ll only crave more. Is it any wonder food companies love this stuff? It costs half as much, and you eat twice as much. What’s that mean? Profit!

And guess what? Just about anything that comes in a box or a package has lots of it. When I went in search of a loaf of bread that didn’t have high fructose corn syrup in it, I was only able to find one kind, and that included all of the premium brands that promote themselves as healthy. So what did we do? We bake our own bread in a breadmaker now instead.

3. Avoid trans-fats and hydrogenated oils. Partially hydrogenated is just as bad, it just sounds a little better. This process makes food last longer on the shelf, which decreases costs, but again, your body doesn’t know what to do with it. It raises cholesterol levels but gives no nutritional benefit.

Once again, most products that come in a package have lots of them. Fortunately the tide is turning against this trend. Hopefully it lasts.

4. Eat smaller portions of meat and larger portions of fruits and vegetables. Meats aren’t necessarily all bad, although there’s little question that the hormones and other things the animals are given aren’t exactly good for us. There’s also no reason you have to eat meat at every meal, other than status. I usually have meat at one meal.

Fresh fruits and vegetables give more nutrients than meat and fewer undesirable side effects like higher cholesterol.

5. Eat whole foods that are as fresh as possible. Bleached white flour loses its nutrients. Canned vegetables lose most of their nutrients. Cook fresh, in-season vegetables and you’ll be healthier.

6. Watch the salads. How is it that people can eat salads all the time and still not lose any weight? Look at a McDonald’s nutritional guide and you’ll see most of their salads have as many calories as one of their sandwiches. Or more. They put the same junk in their salads as their sandwiches. It just looks healthy.

And even if you have a simple, traditional salad of lettuce, tomatoes, cucumbers and shredded carrots, watch the dressings. A tablespoon of any of the common, traditional dressings has anywhere from 50-75 calories, and odds are you’ll use at least three of them. Possibly more. You could waste 10 percent of a 1,500 calorie diet on a condiment.

I don’t disagree that there’s something wrong with our medical system. That much is obvious. But the health problems that we’re creating and perpetuating with our current lifestyle would bring any medical system to its knees.

Trust me. The doctors aren’t all happy. My dad was one. He told me that if I ever told him I wanted to be a doctor, he’d lock me in my room for 7 years. Dad didn’t mind being a doctor, but he hated dealing with insurance companies and the government.

One day one of my coworkers was arguing with an insurance adjustor about a medical procedure his wife needed. The doctor said she needed it. The insurance adjustor said she didn’t, and insurance wasn’t going to cover it.

I told him to ask the insurance adjustor where he went to medical school.

Doctors go to school for a minimum of six years. I searched for an insurance adjustor job to see what the qualifications were. A two-year degree was all that was necessary. It didn’t specify that two-year degree had to be in biology or anything else relevant.

The current system is great for the drug industry, the insurance industry, and the food industry. If the system changes, I don’t expect it will get any worse for them. They have lots of lobbyists, and lots of money at stake.

I don’t expect it will get all that much better for us. The best thing for us to do is to take steps to need to use it less.

And ironically, if we use the system less and reduce the burden on it, it should get better.

Dave and Emily’s healthy vegan whole-wheat pancake recipe

So Emily wanted pancakes. I didn’t mind cooking but I didn’t want to go to the store for eggs. I don’t think we set out to make a vegan recipe, but that’s what we ended up with. This recipe is cheap, easy, and healthy, with no added sugar, no bad fats, and no cholesterol.

It’s only six ingredients, so it’s not much harder than pancakes from a mix, but much healthier.2 cups whole wheat flour
2 teaspoons baking powder (I recommend premium aluminum-free baking powder)
1 teaspoon sea salt (table salt works but sea salt gives a little more flavor and lower sodium)
1/2 cup applesauce (I prefer unsweetened)
2 cups vanilla soy milk (vanilla soy milk adds flavor and some sweetness)
2 tablespoons olive oil

Combine the dry ingredients and mix thoroughly. Add applesauce, oil, and milk. Don’t worry too much if it’s lumpy. Cook on a griddle until you see bubbles, then flip, using a little olive oil to keep it from sticking if necessary. Recipe makes about 12 pancakes.

Serve as you would any other pancake. Try it with fruit and applesauce if you want something healthier than maple syrup.

Numotizine: The ultimate treatment for a cough

Three decades ago, any time someone walked into the Dicus Drugstore in Farmington, Missouri looking for Numotizine Cataplasm, or, as Dad called it, “Pink Peanut Butter”, they knew they’d been talking to Dr. Farquhar.

It was what my grandfather, Dr. Ralph Collins Farquhar Jr., D.O., a family doctor in Doylestown, Pennsylvania, starting in the mid-1930s, used to use to treat a cough. My dad, Dr. Ralph C. III, D.O., used it to treat my sister and me when we were sick, and anyone else who seemed to be sick.Numotizine

It’s over-the-counter, so I can use it on my kids too. Unfortunately it’s hard to find. I called a few drugstores in St. Louis trying to find it. None of them had ever heard of it, though they had heard of the company that makes it.

These days, the best place to find it is Amazon. Here’s the link for the single pack, if the 2-pack is sold out.  The stuff has a shelf life of something like 5 years, so don’t worry about having to order a 2-pack. You’ll use it before it goes bad.

It was invented by Dr. Samuel Alexander Gotcher to treat pneumonia and typhoid fever. It’s now touted (very quietly, as I’m sure you’ve never heard of the stuff) as a cure-all for cough, mosquito bites, sprains, and for all I know, hangovers. I don’t know about any of that. I just know it loosens up a cough quickly, and that the Drs. Ralph swore there wasn’t much of anything better. Maybe codeine, but Numotizine has a few less side effects, although codeine probably evokes fewer questions.

It’s easy to use. Heat up the jar. Fifteen seconds in the microwave will do. Then smear a thin layer on a washcloth and stick it to your chest overnight. Finally, wash it off in the shower in the morning. After 8 hours of that stuff doing whatever it does internally, and you breathing its fumes–I can’t describe the smell, other than to say it definitely smells like medicine, and strong medicine at that–your cough loosens. Repeat nightly until it goes away.

I’m sure there can’t be more than a few hundred people who know about this stuff and still use it. Maybe I can fix that.

How to remember lots and lots of stuff

I’ve been slogging away in nostalgiaville, writing obscure stuff over at Wikipedia again (once an addict, always an addict, even if the addiction hurts you), and I started wondering about something. Why is 20 years ago easier for me to remember than last week?
I think there are two reasons for that, but if I go off exploring those, I’ll never get back on track. I stumbled across a web site today called Supermem. It extols the virtues of repetition for memory. It’s really heavy reading and not terribly eloquent, at least I don’t think. I think the author’s strategy is showing off how much stuff he can remember and trying to make you jealous, in the meantime arguing that even ordinary people, given enough knowledge, can become geniuses. And maybe the people he cites in his stories are examples of people who became geniuses through knowledge.

And I’ve mostly summed up what he spent pages and pages saying.

The basic premise is that knowledge isn’t everything but it sure can add value to anything else you have, and from the outside, sometimes knowledge can look like everything. But we forget lots of things. The key to remembering things is repetition. The hard part is coming up with a strategy for repetition that works.

Of course he has a solution. As you might have guessed, he wants to sell you something. In this case, it’s a piece of commercial software.

The only reason I didn’t scramble for the back button right then and there was because old versions of the program–specifically, the DOS and Win3.1 versions–are now public domain. And the program inspired a similar Linux program called Memaid. So you can try it out without spending any money.

So here’s how it works. Take some things you don’t want to forget, then figure out how to phrase them in the form of a question. Then you enter those things into the program. It drills you. And it figures out how often you need to repeat something in order to retain it.

The idea is to establish a pattern. Seek out things you won’t want to forget. Then figure out how to restate those things in Q&A form. Enter them into the program, then spend 30 minutes a day with the program. If you do both–learn at least one new thing every day and drill on the old stuff–you’ll accumulate a body of knowledge.

Here are a couple of examples from my job:

Q: What’s the optimal Linux command to create/write images of floppy disks? (The device name will vary in other Unix-like environments)
A: dd if=/dev/fd0 of=(filename) bs=18k
dd if=(filename) of=/dev/fd0 bs=18k

Q: What’s the DOS command to rewrite the boot record on a hard drive that won’t boot or has been corrupted by a boot-sector virus?
A: fdisk /mbr

Q: What’s the web site I can go to in order to find the geographic location of an IP address?
A: www.networldmap.com

And I would do well to add some specific questions to the list as well, such as, “What’s the primary nameserver at our Sunset Hills office?”

So if you want to sound like William F. Buckley Jr. and not come off like an idiot–like one person I know who likes to pepper the dictionary.com word of the day into everything he can, except he frequently misspells or misuses it–add that. If your goal is to lose as many coolness points as possible, put things like Vanilla Ice’s real name in there. If I’d known about this program when I was in college, I’d have put my Spanish vocabulary words and verb conjugations in there, and today I’d be able to say more than just hablo pocísimo español without embarrassing myself. (And for all I know, you’re not supposed to put the -ísimo suffix on poco and when I do it, I come off like someone who would say no sabo. OK, so I guess I do remember a little Spanish, but not enough to hold much of a conversation.)

It’s an interesting idea. I think I’m going to give it more than just a try.

Putting every question I ask Charlie (along with the answer) in there would be a good start.

It’s time for a more holistic approach to depression

Standard disclaimer: I’m not a doctor or a psychologist. I’m a systems administrator by trade and a journalist by training. I write this as a survivor of depression, not as an expert on its treatment. Combined with the experiences of others, I think it’s worth listening to. But it’s no substitute for seeing a specialist.
Earlier this week, after I mentioned my experiences with depression in passing, my mom e-mailed me and asked me a few questions. Thought-provoking questions. Then Dan pointed me to another person’s experience with depression.

It’s been my experience that some people just seem to have a natural tendency towards depression. I don’t think that’s necessarily a bad thing. Some people are moodier than others, and that moodiness can be exceedingly difficult to be around sometimes, but there’s also a gigantic upside to it. Think of the most creative people you know. I’ll bet most of them are also pretty moody. That’s one factor.

While a student at Mizzou in late 1994 or early 1995, I had a conversation with a girl about depression. I knew she’d struggled with it, and I was curious. We had a long talk one day about it. Initially, in the back of my mind, I thought I’d interview a couple of other people who’d battled it, then interview an expert or three, and write a story about it. It was during that first talk that I learned that depression was sometimes caused by a chemical imbalance in the brain. (Interestingly, I don’t remember my lone college psychology class–that’s science of behavior to Dr. Dave McDonald and his students–talking much about depression. Or maybe we did and I just forgot it.)

Over the years I met a lot of people who were put on Prozac or Paxil or any number of other drugs intended to treat a chemical imbalance in the brain. In most cases they didn’t get the dosage right initially. In those cases the adjustment was difficult. In one case, a good friend of mine had been on it in the past and it helped, then he started to feel himself relapse. He called me one day and told me he was going back on treatment. A few months later, I started to hear stories. Stories that were very out of character. My friend, a gentle giant type if there ever was one, was supposedly very detached from reality and sometimes even dangerously violent. His dosage was wrong and it was destroying him. One night he called me, distraught. He was on the brink of losing everything, and it didn’t seem like anyone understood.

I was mad that the stories of his behavior had become public knowledge. I was also a little irritated with him that when his family and friends suggested there was a problem, that he didn’t go back to see his doctor until it reached crisis stage. But I was livid about how the people around him handled the situation. When there’s a problem with your Paxil dosage, it’s a matter between you and your doctor, and you have to be patient about it and so do the people around you. There is no way to measure brain chemistry and figure out exactly the amount of Paxil you need to get the dosage right. (This was news to him and to his family, and when one of his friends, who happens to hold a PhD in psychology, got involved but didn’t mention this, I was more than livid when I found out about it. If I’d known how to call him on the carpet about it, I would have.)

I haven’t been very good about getting to my point here. There’s a lot of guesswork when you get drugs involved. They don’t necessarily kick in right away. Sometimes they kick in too hard. Sometimes they have undesirable side effects. I mentioned the possible psychotic side effects, but they can also increase your sex drive to an uncontrollable level, and they can lead to very excessive weight gain. Those television commercials showing people playing outside on a sunny spring day while extoling the virtues of those drugs don’t mention anything about their dark side. Since brain chemistry isn’t measurable, you’re playing a guesswork game. Hopefully it’s an educated game of guesswork, but unless you manage to get a referral to a psychiatrist, it may not be.

The late, controversial Dr. Atkins took a different approach to treating chemical imbalances. Where do your brain chemicals come from? Your body makes them. What does your body make them from? The nutrients you take in. What happens when your body doesn’t take in the nutrients it needs to make the necessary brain chemicals? Chemical imbalances that lead to depression. What happens when you change your diet and/or start taking supplements that provide those chemicals?

Atkins said, “no more depression,” then moved on to his next topic.

I think there’s something to that. When carpal tunnel syndrome threatened to destroy both of my careers, one of my readers pointed me to Atkins’ vitamin book. I started taking, among other things, Flax Seed Oil or Fish Oil (buy whichever is on sale; chemically, they offer the same benefit) and Vitamin B6 and B complex. I was surprised at the effect they had on my mood. But that combination promotes a generally healthy nervous system. Vitamin B1, Atkins said, is especially effective in treating depression. The B vitamins work best in the presence of each other, so a trip to the local discount store for a bottle of Vitamin B1 and B complex could make a world of difference.

Battling depression via nutrition is imprecise, but the nice thing about that is that you’re not messing directly with brain chemistry. You’re providing your body with the raw materials to make what it needs. Your body knows how to dispose of excess B1. What’s it supposed to do with excess Paxil?

The best thing you can do for your mental health may very well be to visit a nutritionist. Get a copy of
Dr. Atkins’ Vita-Nutrient Solution
, make yourself a shopping list, get a nutritionist’s opinion, then buy. And avoid processed, commercial food if at all possible. I know my moods are much more consistent when I buy fresh fruits and vegetables and actually cook than when I eat tons of fast food or buy heat-up instant meals from the grocery store. Highly processed foods lose most of their nutritional value. They hurt your mood, they hurt your waistline, they hurt your energy level, they rot your teeth, and who knows what else. And when you’re not happy about how you look and you don’t have a lot of energy, and your teeth are falling apart, none of that helps your mood. Nice vicious cycle, eh?

You hear a lot more now about depression than you did in the 1970s and early 1980s. But there were a fraction of the number of fast-food restaurants and grocery stores were much smaller because they were catering to people who cook, whereas today grocery stores seem to cater to people who heat stuff up because everybody’s too busy to cook. I’m thoroughly convinced that these factors are related.

And cooking isn’t as hard as people make it out to be. I can stir up some mean dishes in about half an hour. Trust me, if I can learn how to cook, anyone can. I’m impatient and clumsy and accident-prone. But I’ve still learned how to cook well enough to impress a girl. Not counting my mother and sister, but I’ve impressed them too.

Remember that most doctors have no special training in nutrition. A lot of people are distressed to hear that and think it’s a conspiracy. It’s not. Medicine and nutrition are related, but they’re too complex for most people to be good at both. Asking your regular doctor to be a nutritionist is like asking him or her to be proficient at surgery. He or she is certainly capable of understanding it, but there are so many things a doctor would like to understand, and there are only 24 hours in a day to learn it all.

I believe that counselling and self-help are overrated, but both helped me to a limited degree. I found
I Ain’t Much Baby, But I’m All I’ve Got
by self-help pioneer Jess Lair to be helpful. It’s sadly out of print but widely available used. The biggest gem out of Lair’s book is a question: Do you have five friends? Lair said that if you have more than that, your friendships aren’t very deep. If you have fewer than that, you’re putting too much burden on them. With an inner circle of five or so, the burden seems to be about right.

But when that’s not enough, counselling helps. The problem with counselling is that sometimes people rely too much on it, or solely on it. Often people have issues they need help resolving. Sometimes that means just listening and offering a few suggestions and sometimes it means re-enacting traumatic experiences in order to finish up some unfinished business. It’s work. But it can be helpful, if you’re willing to do the work. But depression is a complex, multifaceted problem, so a one-pronged attack won’t be very effective. Remember the basic difference between a psychologist and a psychiatrist: Psychologists can’t prescribe medicine, and psychiatrists don’t do a whole lot of counseling. Both are aware of the work of the other, and an honest practitioner of either profession ought to know the limits and know when you need the other. But you may have to ask when it’s time to see the other. Human beings tend to get overconfident in the abilities of the tools they have.

Finally, there’s a spiritual aspect. Virtually everything I’ve ever read says you should believe in something. If you’ve ever had any exposure to Christianity, read the books of Luke and John (they’re not terribly long–read a chapter a day and you’ll be through both of them in two months) in a modern, readable translation. You can read them for free at bible.crosswalk.com. For readability, I recommend the New Living Translation. It plays really fast and loose with the translation sometimes, but the point isn’t to make you a Bible scholar–it’s to present the words of Jesus in understandable fashion. Or you can read an out-of-print modern blending of the four Gospels by Charles Templeton titled simply Jesus, online, for free.

Last night I told someone it’s healthier to be an atheist than it is to be in a cult, but it’s healthier to believe in something than nothing. I’m a Christian and make no bones about it. If you’re a not a Christian and you believe something else and you’re struggling with depression, then my advice to you if you’re not really practicing is to get serious. And if you find it’s not helping you, try Christianity.

No single thing will conquer depression for you. But the combination of diet and nutrition, counseling, and spirituality can be potent. Pills are a brute-force approach, and after watching my friend’s bad experience, frankly I believe they ought to be the thing you go to when the other things don’t work, not the thing you go to before trying the others. I know they work because I’ve seen them work, but if anything, the other things can make them more effective, and if you can get by without pumping man-made chemicals into your system, that’s a very good thing, and I don’t think anyone will disagree with that.