Naikan: Gratitude, grace and the art of self-reflection

Dr. Victor Sierpina

Dr. Victor Sierpina

Gratitude opens untold blessings in our lives. The cultivation of gratitude requires constant discipline in an era often surrounded by a mentality of lack, of ever needing more material goods to believe we can be happy, or when we blame others for not meeting our expectations to make our lives better.

A technique that UTMB students and faculty practice as part of the Physician Healer Track comes from Naikan, a book, by Gregg Krech. You might recall my description that the aim of the healer track is to preserve empathy in physicians in training.

A week after my empathy piece, Time magazine ran a feature article on physician burnout, depression, and suicide. It described a program called The Healer’s Art that is being offered at Stanford University to residents to deter these negative spirals into dysfunction. This long-standing program, developed by holistic physician Dr. Rachel Naomi Remen offers reflection, insight, healing, and opportunities for including gratitude in medical education. It offers many similar skills and practices as does the healer track. Continue reading

Obesity and diabetes: Is your gut in control?

Drs. Norbert Herzog & David Niesel

Drs. Norbert Herzog & David Niesel

Medical Discovery News

Your body is like a forest, providing a home to microscopic flora and fauna. In fact, your body is home to up to 100 times more microbes than your own cells, which make up your microbiome. While we provide them residence, these microbes help us out by providing a first line of defense against disease trying to invade our bodies, even breaking down food during digestion and producing vitamins. Now, the microbes that live in the digestive tract are helping us understand diabetes better.

According to the Human Microbiome Project sponsored by the National Institutes of Health, the microbiome plays a huge role in human health. When the microbiome is altered or unbalanced, it can cause conditions like obesity, irritable bowel syndrome, skin disease, urogenital infection, allergy and can even affect emotion and behavior. Continue reading

Oil and vinegar

Dr. Victor Sierpina

Dr. Victor Sierpina

The Latin derivation of the word ‘salad’ simply meant “with salt.” A little sprinkle of salt over green herbs, maybe with a drizzle of olive oil was the essence of a salad. This is a far cry from our current prepared dressings containing hundreds of calories of unhealthy fats and other chemical ingredients.

So instead of store-bought salad dressings, why not do it yourself? You control taste, ingredients, and freshness. The easiest way to make a healthy homemade dressing is whisking your own vinaigrette. Stir in a small bowl: ¾ cup of extra-virgin olive oil, ¼ cup of red or white wine vinegar or add a touch of balsamic, ¼ teaspoon of fine sea salt, 1/8 teaspoon of freshly ground black pepper. Making your own dressing can be as much fun as creating the salad.

You can expand your culinary delight by adding any of the following to the basic mixture: mince a small to medium shallot; add a teaspoon of Dijon mustard; add 2-3 finely chopped garlic cloves; blend fresh or dry oregano, tarragon, or lemon juice. Other interesting ingredients include sun-dried tomatoes, anchovies, or walnuts. Red pepper flakes on top of a salad or in the dressing instead of the regular coarse ground black pepper add a nice extra zest. Continue reading

Salads: Simple is best

Dr. Victor Sierpina

Dr. Victor Sierpina

Often when I called my dad to see how he was doing, he’d start with saying, “I’m making a salad.” He died at 92 and taught me the value of how enjoying a salad regularly is a truly healthy habit. Eating salads is an easy way to get close to our daily goal of 5 to 11 servings of fruits and vegetables. A half-cup of salad is pretty small so a typical lunch or dinner salad can garner 2 to 3 servings of veggies.

These days, making a salad is easier than ever. Pre-washed, pre-cut, packaged spinach, romaine lettuce, mixed greens, arugula, kale, radicchio/endive, collards, mustard greens, and others shave long eclipsed the boring and low nutrient iceberg lettuce most of us remember from childhood. This was perhaps drizzled
Thousand Island dressing or these days Ranch, currently the most popular U.S. dressing. Unfortunately it is relatively high in fats, carbs, and other unhealthy ingredients compared to simpler dressings like vinaigrettes which we will discuss next week.

Remember that the darker, leafy greens are chock full of health-essential fiber, phyto-oxidants, B vitamins, vitamin C, and omega-3 fatty acids, and are tastier by a long shot than common iceberg lettuce. Continue reading

Bottle of Red? Bottle of White?

Dr. Victor Sierpina

Dr. Victor Sierpina

The old Billy Joel song posed the dynamic of choosing the right color of wine. This has long been debated with oenophiles, those that study and love wines, each with strong opinions, including how to pair wines with foods. The classic alignment is white wines with salads, chicken and fish dishes, even desserts. Reds are traditionally recommended for heartier fare such as soups, stews, roasts, red meat, aromatic cheeses, and so on.

Like food, the appreciation of wine incorporates aromas providing character, flavor, mouth feel, and a sense of appreciation or distaste. Most chefs and even snooty sommeliers agree that the best wine for you is the one that you actually like. The vintage, age, color, bouquet, type of grape, and all the other complexities of wine should never stand in the way of your enjoying a glass of wine that you personally enjoy. Continue reading

Some tasty recipes

Dr. Victor Sierpina

Dr. Victor Sierpina

The average American family has about a dozen or less meals they prepare on a regular basis. In my Polish-American working class family, they were chicken noodle soup, Hungarian goulash, ground beef mixed with onions, peppers, and rice, fish sticks, Polish sausage and sauerkraut, hot dogs and baked beans, and a few others that showed up on the table regularly. Of course we always had a mix of cooked vegetables and salads served by my health conscious mom who worked hard to stretch the tight grocery budget.

Like so many things, changing our eating habits is often a challenge. One way I have played with in the past year or two is trying to add a new recipe every week or two just to expand our repertoire. Most recently, my wife and co-chef Michelle discovered an amazing recipe on line that came out even better than expected. It was Rosemary-Garlic-Lemon Chicken. Rosemary from the backyard and some nice organic chicken breasts in the freezer set us up to cook.

• Thaw the chicken breasts, rinse, and pat dry

• In a skillet, gently brown a few cloves of thinly sliced garlic in extra-virgin olive oil

• When the oil is hot and the garlic just turns translucent, put in the chicken and sear it quickly on both sides to seal in the juices

• Slice a couple of lemons and lay them on top of the chicken along with a few sprigs rosemary

• Add ¼ cup of cooking wine for moisture

• Cover and cook gently for 20 minutes or so until done Continue reading

Wellness challenge

Here is a quote by Phillips Brook that emphasizes the value of taking on new challenges in our lives:

“Do not pray for tasks equal to your powers. Pray for powers equal to your tasks. Then the doing of your work shall be no miracle, but you shall be the miracle.”

Dr. Victor Sierpina

Dr. Victor Sierpina

For any of us to grow into a newer, better version of ourselves, we must accept challenges which by definition require us to stretch our limits into our unexplored and possible selves.

Just picture a toddler learning to walk. No longer satisfied with just crawling or cruising the furniture, he or she takes a tentative few steps and then, with a wide-eyed look of delight, plunks down on a soft bottom only to get up and try again. And again. Trip, stumble, fall, get up, get up, and then, miraculously, they just keep going until parents, grandparents, and other loved ones can barely keep up with the little speedsters.

Challenging ourselves to achieve wellness is a similar process.

Start, drop, stop, try again, again, believe, achieve. Continue reading

Kitchen cures for what ails you

Dr. Victor Sierpina

Dr. Victor Sierpina

I invite you to share your story about some remedies your mother may have taken from the kitchen to soothe your miseries as a child. Many of these were stout, traditional applications surviving from the pre-scientific era. Their evidence was their effectiveness, economy and safety. Often given out of hope, history, and even the hysteria of not knowing what else to do, home remedies are truly the first line of primary care.

Think back to your childhood: a skinned knee, an insect bite, a cold sore, a cough, sore throat, toothache, fever. Likely there was a home cure for all of these.

I grew up in a family that today would be considered the working poor. My dad was an auto and heavy equipment mechanic working on commission. My mom was a stay-at-home ‘50s housewife. I never remember going to the emergency room as a child, nor did my three siblings though we had vaguely heard of Blue Cross/Blue Shield. It helped, I guess, when three of us had our tonsillectomies the same day.

When we got sick, I remember going to the doctor but only sometimes. This was usually for shots. Ouch! I also remember many more times when kitchen cures were applied and seemed to do the trick. I guess they had to since we couldn’t afford a doctor visit for every minor complaint. Continue reading

Move On

Dr. Victor Sierpina

Dr. Victor Sierpina

A recent ode to the benefits of tennis by a 74-year-old writer caught my eye. Citing various classical authors, philosophers, and the gradual improvement of his game since his 20s, the author championed the power of vigorous sport on his writing and his mind. Riffing off a Robert Frost poem that ended “Here are your waters and your watering place. Drink and be whole again beyond confusion,” the author concluded: “The tennis court is my watering place where I drink and am whole again beyond confusion — at least for a couple of hours.”

As an aging tennis player myself, I found his essay in The Wall Street Journal’s opinion page uplifting as he described “tennis as a refuge from the racket of everyday life.” We all need some kind of healthy activity and discipline to allow us to shut down the grinding gears of our minds for brief periods and refresh it with the drink of stillness and the water of life.

The Physical Activity Council recently reported 28 percent of Americans over 6 get no physical activity meaning they are totally sedentary in the past year. This report is also included a sharp increase in inactivity for those over 65. These are unhealthy trends. Continue reading

A body in motion

Dr. Victor Sierpina

Dr. Victor Sierpina

In high school physics class, I learned from Sir Isaac Newton that a body in motion will stay in motion. The opposite is true and it is called inertia. The other day in clinic, I went in to see Dylan, a 12 year old. He didn’t look up or say hi to me as I came into the room as he was intently working his thumbs on a handheld device. His mother told him to be polite and say hello. He raised his head briefly, said, “Hi,” then back to the gaming thing. She shrugged apologetically and helplessly. I won’t dwell on how we should socialize the digital generation to learn polite human interaction, though it is quite relevant to bodies in motion.

Dylan’s complaint was a minor one and he basically came in needing a school excuse. It could have been a 5 to 10 minute visit but I noticed he was a bit chunky. In fact, his BMI at 29 was close to the obese range. At mom’s request, we ran a urine and blood test to make sure he wasn’t diabetic. He wasn’t, fortunately, at least not yet.

I asked Dylan what kinds of sports or other activities he liked to do. Mom motioned to me with both thumbs moving rapidly to mime the reality of his activity. Continue reading