Diseases Related Quotes

I have three things I'd like to say today. First, while you were sleeping last night, 30,000 kids died of starvation or diseases related to malnutrition. Second, most of you don't give a shit. What's worse is that you're more upset with the fact that I said shit than the fact that 30,000 kids died last night.

How many people do you know who are obsessed with their work, who are type A or have stress related diseases and who can’t slow down? They can’t slow down because they use their routine to distract themselves, to reduce life to only its practical considerations. And they do this to avoid recalling how uncertain they are about why they live.

Poverty is a relatively mild disease for even a very flimsy American soul, but uselessness will kill strong and weak souls alike, and kill every time.

And what is literature, Rabo," he said, "but an insider's newsletter about affairs relating to molecules, of no importance to anything in the universe but a few molecules who have the disease called 'thought'.

His big claim to fame was that the Golden Fleece—that magical sheepskin rug I'm related to—ended up in his kingdom, which made the place immune to disease, invasion, stock-market crashes, visits from Justin Bieber and pretty much any other natural disaster.

The distinction between diseases of "brain" and "mind," between "neurological" problems and "psychological" or "psychiatric" ones, is an unfortunate cultural inheritance that permeates society and medicine. It reflects a basic ignorance of the relation between brain and mind. Diseases of the brain are seen as tragedies visited on people who cannot be blamed for their condition, while diseases of the mind, especially those that affect conduct and emotion, are seen as social inconveniences for which sufferers have much to answer. Individuals are to be blamed for their character flaws, defective emotional modulation, and so on; lack of willpower is supposed to be the primary problem.

There are thousands of things that can kill us—slightly more than eight thousand, according to the International Statistical Classification of Diseases and Related Health Problems compiled by the World Health Organization—and we escape every one of them but one. For most of us, that’s not a bad deal.

Medicine is a social science, and politics nothing but medicine on a large scale,

The boys could have been many things had they not been ruined by that place. Doctors who cured diseases or perform brain surgery, inventing shit that saves lives. Run for president. All those lost geniuses - sure not all of them were geniuses, Chickie Pete for example was not solving special relativity - but they had been denied even the simple pleasure of being ordinary. Hobbled and handicapped before the race even began, never figuring out how to be normal.

A large percentage of what we think of when we talk about stress-related diseases are disorders of excessive stress-responses.

In a world of stressful lack of control, an amazing source of control we all have is the ability to make the world a better place, one act at a time.

It takes surprisingly little in terms of uncontrollable unpleasantness to make humans give up and become helpless in a generalized way.

In the late nineteenth and early twentieth centuries, old people in America had prayed, "Please God, don't let me look poor." In the year 2000, they prayed, "Please God, don't let me look old." Sexiness was equated with youth, and youth ruled. The most widespread age-related disease was not senility but juvenility.

And now, if we try to assign a value, in and of itself, outside its relations to the dream and with error, to classical unreason, we must understand it not as reason diseased, or as reason lost or alienated, but quite simply as reason dazzled.

Let me claim that Africa and I kept company for a while and then parted ways as if we were both party to relations with a failed outcome. Or say I was afflicted with Africa like a bout of a rare disease from which I have not managed a full recovery.

Subjected to enough uncontrollable stress, we learn to be helpless—we lack the motivation to try to live because we assume the worst; we lack the cognitive clarity to perceive when things are actually going fine, and we feel an aching lack of pleasure in everything.

My own view on religion is that of Lucretius. I regard it as a disease born of fear and as a source of untold misery to the human race.

Something roughly akin to love is needed for proper biological development, and its absence is among the most aching, distorting stressors that we can suffer.

the top reason doctors give for not counseling patients with high cholesterol to eat healthier is that they think patients may “fear privations related to dietary advice.”65 In other words, doctors perceive that patients would feel deprived of all the junk they’re eating. Can you imagine a doctor saying, “Yeah, I’d like to tell my patients to stop smoking, but I know how much they love it”?

Health is normal. The human body is a self-repairing, self-defending, self-healing marvel. Disease is relatively difficult to induce, considering the body's powerful immune system. However, this complicated and delicate machinery can be damaged if fed the wrong fuel during the formative years. ... Healthy living with nutritional excellence throughout life can slow the decline of aging. It can prevent the years and years of suffering in ill health that is so common today as people get older and become dependent on medical treatments, drugs, and surgery. Nutritional excellence is the only real fountain of youth.

The defining feature of a major depression is loss of pleasure. If I had to define a major depression in a single sentence, I would describe it as a “genetic/neurochemical disorder requiring a strong environmental trigger whose characteristic manifestation is an inability to appreciate sunsets.

We do food every single day! Conscious Eating is a big step toward Conscious Living. Quality and Quantity of Food is directly related to our Health and state of mind. We can use food to help us recover from Stress and Disease. Not taking food seriously will eventually lead to Stress or/and Disease.

Trauma happens to us, our friends, our families, and our neighbors. Research by the Centers for Disease Control and Prevention has shown that one in five Americans was sexually molested as a child; one in four was beaten by a parent to the point of a mark being left on their body; and one in three couples engages in physical violence. A quarter of us grew up with alcoholic relatives, and one out of eight witnessed their mother being beaten or hit.1

This sadness lies at the heart of every merely positivistic, agnostic, or naturalistic scheme of philosophy. Let sanguine healthy-mindedness do its best with its strange power of living in the moment and ignoring and forgetting, still the evil background is really there to be thought of, and the skull will grin in at the banquet. In the practical life of the individual, we know how his whole gloom or glee about any present fact depends on the remoter schemes and hopes with which it stands related. Its significance and framing give it the chief part of its value. Let it be known to lead nowhere, and however agreeable it may be in its immediacy, its glow and gilding vanish. The old man, sick with an insidious internal disease, may laugh and quaff his wine at first as well as ever, but he knows his fate now, for the doctors have revealed it; and the knowledge knocks the satisfaction out of all these functions. They are partners of death and the worm is their brother, and they turn to a mere flatness.

People may claim to be “free,” yet they cannot control themselves from gluttony in the presence of food or from illicit sexual relations when the opportunity presents itself. Such a notion of freedom is devoid of substance.

According to the Centers for Disease Control and Prevention, in the quarter century following the introduction of OxyContin, some 450,000 Americans had died of opioid-related overdoses. Such overdoses were now the leading cause of accidental death in America, accounting for more deaths than car accidents—more deaths, even, than that most quintessentially American of metrics, gunshot wounds. In fact, more Americans had lost their lives from opioid overdoses than had died in all of the wars the country had fought since World War II.

In the serene world of mental illness, modern man no longer communicates with the madman: on on hand, the man of reason delegates the physician to madness, thereby authorizing a relation only through the abstract universality of disease; on the other, the man of madness communicates with society only by the intermediary of an equally abstract reason which is order, physical and moral constraint, the anonymous pressure of the group, the requirements of conformity.

As for Ares's other sacred grove, the one in Colchis, things were run a little differently over there. The king was a guy named Aeetes. (As far as I can figure, that's pronounced "I Eat Tees.") His big claim to fame was that the Golden Fleece - that magical sheepskin rug I'm related to - ended up in his kingdom, which made the place immune to disease, invasion, stock market crashes, visits from Justin Bieber, and pretty much any other natural disaster.

The most common theory points to the fact that men are stronger than women and that they have used their greater physical power to force women into submission. A more subtle version of this claim argues that their strength allows men to monopolize tasks that demand hard manual labor, such as plowing and harvesting. This gives them control of food production, which in turn translates into political clout. There are two problems with this emphasis on muscle power. First, the statement that men are stronger is true only on average and only with regard to certain types of strength. Women are generally more resistant to hunger, disease, and fatigue than men. There are also many women who can run faster and lift heavier weights than many men. Furthermore, and most problematically for this theory, women have, throughout history, mainly been excluded from jobs that required little physical effort, such as the priesthood, law, and politics, while engaging in hard manual labor in the fields....and in the household. If social power were divided in direct relation to physical strength or stamina, women should have got far more of it. Even more importantly, there simply is no direct relation between physical strength and social power among humans. People in their sixties usually exercise power over people in their twenties, even though twenty-somethings are much stronger than their elders. ...Boxing matches were not used to select Egyptian pharaohs or Catholic popes. In forager societies, political dominance generally resides with the person possessing the best social skills rather than the most developed musculature. In fact, human history shows that there is often an inverse relation between physical prowess and social power. In most societies, it’s the lower classes who do the manual labor. Another theory explains that masculine dominance results not from strength but from aggression. Millions of years of evolution have made men far more violent than women. Women can match men as far as hatred, greed, and abuse are concern, but when push comes to shove…men are more willing to engage in raw physical violence. This is why, throughout history, warfare has been a masculine prerogative. In times of war, men’s control of the armed forces has made them the masters of civilian society too. They then use their control of civilian society to fight more and more wars. …Recent studies of the hormonal and cognitive systems of men and women strengthen the assumption that men indeed have more aggressive and violent tendencies and are…on average, better suited to serve as common soldiers. Yet, granted that the common soldiers are all men, does it follow that the ones managing the war and enjoying its fruits must also be men? That makes no sense. It’s like assuming that because all the slaves cultivating cotton fields are all Black, plantation owners will be Black as well. Just as an all-Black workforce might be controlled by an all-White management, why couldn’t an all-male soldiery be controlled by an all-female government?

if you want to increase your chances of avoiding stress-related diseases, make sure you don’t inadvertently allow yourself to be born poor.

Happiness and goodness, according to canting moralists, stand in the relation of effect and cause. There was never anything less proved or less probable: our happiness is never in our own hands; we inherit our constitution; we stand buffet among friends and enemies; we may be so built as to feel a sneer or an aspersion with unusual keenness and so circumstanced as to be unusually exposed to them; we may have nerves very sensitive to pain, and be afflicted with a disease very painful. Virtue will not help us, and it is not meant to help us.

Bruce Miller, a neurologist at the University of California, San Francisco, studies elderly patients with a relatively common form of brain disease called frontotemporal dementia, or FTD. He’s found that in some cases where the FTD is localized on the left side of the brain, people who had never picked up a paintbrush or an instrument can develop extraordinary artistic and musical abilities at the very end of their lives. As their other cognitive skills fade away, they become narrow savants.

Fear is the vigilance and the need to escape from something real. Anxiety is about dread and foreboding and your imagination running away with you. Much as with depression, anxiety is rooted in a cognitive distortion. In this case, people prone toward anxiety overestimate risks and the likelihood of a bad outcome.

This is the critical point of this book: if you are that zebra running for your life, or that lion sprinting for your meal, your body’s physiological response mechanisms are superbly adapted for dealing with such short-term physical emergencies. For the vast majority of beasts on this planet, stress is about a short-term crisis, after which it’s either over with or you’re over with. When we sit around and worry about stressful things, we turn on the same physiological responses—but they are potentially a disaster when provoked chronically. A large body of evidence suggests that stress-related disease emerges, predominantly, out of the fact that we so often activate a physiological system that has evolved for responding to acute physical emergencies, but we turn it on for months on end, worrying about mortgages, relationships, and promotions.

Everything in physiology follows the rule that too much can be as bad as too little. There are optimal points of allostatic balance. For example, while a moderate amount of exercise generally increases bone mass, thirty-year-old athletes who run 40 to 50 miles a week can wind up with decalcified bones, decreased bone mass, increased risk of stress fractures and scoliosis (sideways curvature of the spine)—their skeletons look like those of seventy-year-olds. To put exercise in perspective, imagine this: sit with a group of hunter-gatherers from the African grasslands and explain to them that in our world we have so much food and so much free time that some of us run 26 miles in a day, simply for the sheer pleasure of it. They are likely to say, “Are you crazy? That’s stressful.” Throughout hominid history, if you’re running 26 miles in a day, you’re either very intent on eating someone or someone’s very intent on eating you.

Do you see how preoccupied everyone has been? This perspective explains a lot. How many people do you know who are obsessed with their work, who are type A or have stress related diseases and who can’t slow down? They can’t slow down because they use their routine to distract themselves, to reduce life to only its practical considerations. And they do this to avoid recalling how uncertain they are about why they live.

Whenever you inhale, you turn on the sympathetic nervous system slightly, minutely speeding up your heart. And when you exhale, the parasympathetic half turns on, activating your vagus nerve in order to slow things down (this is why many forms of meditation are built around extended exhalations).

You’d rather be here than in Africa. The trump card all narrow-minded nativists play. If you put a cupcake to my head, of course, I’d rather be here than any place in Africa, though I hear Johannesburg ain’t that bad and the surf on the Cape Verdean beaches is incredible. However, I’m not so selfish as to believe that my relative happiness, including, but not limited to, twenty-four-hour access to chili burgers, Blu-ray, and Aeron office chairs is worth generations of suffering. I seriously doubt that some slave ship ancestor, in those idle moments between being raped and beaten, was standing knee-deep in their own feces rationalizing that, in the end, the generations of murder, unbearable pain and suffering, mental anguish, and rampant disease will all be worth it because someday my great-great-great-great-grandson will have Wi-Fi, no matter how slow and intermittent the signal is.

Males who do extreme amounts of exercise, such as professional soccer players and runners who cover more than 40 or 50 miles a week, have less LHRH, LH, and testosterone in their circulation, smaller testes, less functional sperm. They also have higher levels of glucocorticoids in their bloodstreams, even in the absence of stress. (A similar decline in reproductive function is found in men who are addicted to opiate drugs.)

Our body’s evolutionary journey is also far from over. Natural selection didn’t stop when farming started but instead has continued and continues to adapt populations to changing diets, germs, and environments. Yet the rate and power of cultural evolution has vastly outpaced the rate and power of natural selection, and the bodies we inherited are still adapted to a significant extent to the various and diverse environmental conditions in which we evolved over millions of years. The end product of all that evolution is that we are big-brained, moderately fat bipeds who reproduce relatively rapidly but take a long time to mature.

There are several diseases of the memory. Forgetfulness of nouns, for instance, or of numbers. Or there are more complex amnesias. With one, you can lose your entire past; you start afresh, learning how to tie your shoelaces, how to eat with a fork, how to read and sing. You are introduced to your relatives, your oldest friends, as if you’ve never met them before; you get a second chance with them, better than forgiveness because you can begin innocent. With another form, you keep the distant past but lose the present. You can’t remember what happened five minutes ago. When someone you’ve known all your life goes out of the room and then comes back in, you greet them as if they’ve been gone for twenty years; you weep and weep, with joy and relief, as if at a reunion with the dead. I sometimes wonder which of these will afflict me, later; because I know one of them will. For years I wanted to be older, and now I am.

the average level of happiness increases in old age; fewer negative emotions occur and, when they do, they don’t persist as long. Connected to this, brain-imaging studies show that negative images have less of an impact, and positive images have more of an impact on brain metabolism in older people, as compared to young.

Stress can be bad for you. We no longer die of smallpox or the plague and instead die of stress-related diseases of lifestyle, like heart disease or diabetes, where damage slowly accumulates over time. It is understood how stress can cause or worsen disease or make you more vulnerable to other risk factors. Much of this is even understood on the molecular level. Stress can even cause your immune system to abnormally target hair follicles, causing your hair to turn gray.

The risks for heart disease, stroke, depression, diabetes, asthma, and even many cancers are all affected by trauma-related changes in the stress response system. Empathy and connection affect physical—not just mental—wellness and health.

Africa occupied a relatively blank space in the minds of most Americans, and when they stopped to think about it, aided by old and deeply ingrained habits of press coverage, all they could imagine was volcano, occupation, disease, and horror.

It is no coincidence then that doctors and patients and the entire Lyme community report—anecdotally, of course, as there is still a frustrating scarcity of good data on anything Lyme-related—that women suffer the most from Lyme. They tend to advance into chronic and late-stage forms of the illness most because often it's checked for last, as doctors often treat them as psychiatric cases first. The nebulous symptoms plus the fracturing of articulacy and cognitive fog can cause any Lyme patient to simply appear mentally ill and mentally ill only. This is why we hear that young women—again, anecdotally—are dying of Lyme the fastest. This is also why we hear that chronic illness is a women's burden. Women simply aren't allowed to be physically sick until they are mentally sick, too, and then it is by some miracle or accident that the two can be separated for proper diagnosis. In the end, every Lyme patient has some psychiatric diagnosis, too, if anything because of the hell it takes getting to a diagnosis.

Memory can be dramatically disrupted if you force something that’s implicit into explicit channels. Here’s an example that will finally make reading this book worth your while—how to make neurobiology work to your competitive advantage at sports. You’re playing tennis against someone who is beating the pants off of you. Wait until your adversary has pulled off some amazing backhand, then offer a warm smile and say, “You are a fabulous tennis player. I mean it; you’re terrific. Look at that shot you just made. How did you do that? When you do a backhand like that, do you hold your thumb this way or that, and what about your other fingers? And how about your butt, do you scrunch up the left side of it and put your weight on your right toes, or the other way around?” Do it right, and the next time that shot is called for, your opponent/victim will make the mistake of thinking about it explicitly, and the stroke won’t be anywhere near as effective. As Yogi Berra once said, “You can’t think and hit at the same time.

people who ate the most animal-based foods got the most chronic disease. Even relatively small intakes of animal-based food were associated with adverse effects. People who ate the most plant-based foods were the healthiest and tended to avoid chronic disease.

Fear is one of the persistent hounds of hell that dog the footsteps of the poor, the dispossessed, the disinherited. There is nothing new or recent about fear—it is doubtless as old as the life of man on the planet. Fears are of many kinds—fear of objects, fear of people, fear of the future, fear of nature, fear of the unknown, fear of old age, fear of disease, and fear of life itself. Then there is fear which has to do with aspects of experience and detailed states of mind. Our homes, institutions, prisons, churches, are crowded with people who are hounded by day and harrowed by night because of some fear that lurks ready to spring into action as soon as one is alone, or as soon as the lights go out, or as soon as one’s social defenses are temporarily removed. The ever-present fear that besets the vast poor, the economically and socially insecure, is a fear of still a different breed. It is a climate closing in; it is like the fog in San Francisco or in London. It is nowhere in particular yet everywhere. It is a mood which one carries around with himself, distilled from the acrid conflict with which his days are surrounded. It has its roots deep in the heart of the relations between the weak and the strong, between the controllers of environment and those who are controlled by it. When the basis of such fear is analyzed, it is clear that it arises out of the sense of isolation and helplessness in the face of the varied dimensions of violence to which the underprivileged are exposed. Violence, precipitate and stark, is the sire of the fear of such people. It is spawned by the perpetual threat of violence everywhere. Of course, physical violence is the most obvious cause. But here, it is important to point out, a particular kind of physical violence or its counterpart is evidenced; it is violence that is devoid of the element of contest. It is what is feared by the rabbit that cannot ultimately escape the hounds.

Freud was fascinated with depression and focused on the issue that we began with—why is it that most of us can have occasional terrible experiences, feel depressed, and then recover, while a few of us collapse into major depression (melancholia)? In his classic essay “Mourning and Melancholia” (1917), Freud began with what the two have in common. In both cases, he felt, there is the loss of a love object. (In Freudian terms, such an “object” is usually a person, but can also be a goal or an ideal.) In Freud’s formulation, in every loving relationship there is ambivalence, mixed feelings—elements of hatred as well as love. In the case of a small, reactive depression—mourning—you are able to deal with those mixed feelings in a healthy manner: you lose, you grieve, and then you recover. In the case of a major melancholic depression, you have become obsessed with the ambivalence—the simultaneity, the irreconcilable nature of the intense love alongside the intense hatred. Melancholia—a major depression—Freud theorized, is the internal conflict generated by this ambivalence. This can begin to explain the intensity of grief experienced in a major depression. If you are obsessed with the intensely mixed feelings, you grieve doubly after a loss—for your loss of the loved individual and for the loss of any chance now to ever resolve the difficulties. “If only I had said the things I needed to, if only we could have worked things out”—for all of time, you have lost the chance to purge yourself of the ambivalence. For the rest of your life, you will be reaching for the door to let you into a place of pure, unsullied love, and you can never reach that door. It also explains the intensity of the guilt often experienced in major depression. If you truly harbored intense anger toward the person along with love, in the aftermath of your loss there must be some facet of you that is celebrating, alongside the grieving. “He’s gone; that’s terrible but…thank god, I can finally live, I can finally grow up, no more of this or that.” Inevitably, a metaphorical instant later, there must come a paralyzing belief that you have become a horrible monster to feel any sense of relief or pleasure at a time like this. Incapacitating guilt. This theory also explains the tendency of major depressives in such circumstances to, oddly, begin to take on some of the traits of the lost loved/hated one—and not just any traits, but invariably the ones that the survivor found most irritating. Psychodynamically, this is wonderfully logical. By taking on a trait, you are being loyal to your lost, beloved opponent. By picking an irritating trait, you are still trying to convince the world you were right to be irritated—you see how you hate it when I do it; can you imagine what it was like to have to put up with that for years? And by picking a trait that, most of all, you find irritating, you are not only still trying to score points in your argument with the departed, but you are punishing yourself for arguing as well. Out of the Freudian school of thought has come one of the more apt descriptions of depression—“aggression turned inward.” Suddenly the loss of pleasure, the psychomotor retardation, the impulse to suicide all make sense. As do the elevated glucocorticoid levels. This does not describe someone too lethargic to function; it is more like the actual state of a patient in depression, exhausted from the most draining emotional conflict of his or her life—one going on entirely within. If that doesn’t count as psychologically stressful, I don’t know what does.

The divine decree related to the believer is always a bounty, even if it is in the form of withholding (something that is desired); and it is a blessing, even if it appears to be a trial and an affliction that has befallen him; it is in reality a cure, even though it appears to be a disease!" So

It is a tragedy, at rate at which EBOLA VIRUS is spreading in West Africa. It is a fatal disease in the history of the world. Intensive education (formal and informal approaches) of the citizens of African can help prevent the spread. International cooperation is urgently needed to combat the EBOLA virus.

Around the time the Germans were slaughtering Hereros, the world also was largely ignoring America’s brutal counterguerrilla war in the Philippines, in which U.S. troops tortured prisoners, burned villages, killed some 20,000 rebels, and saw an estimated 200,000 more Filipinos die of war-related hunger or disease.

No sane paleontologist would ever claim that he or she had discovered "The Ancestor." Think about it this way: What is the chance that while walking through any random cemetery on our planet I would discover an actual ancestor of mine? Diminishingly small. What I would discover is that all people buried in these cemeteries-- no mater whether that cemetery is in China, Botswana, or Italy-- are related to me to different degrees. I can find this out by looking at their DNA with many of the forensic techniques in use in crime labs today. I'd see that some of the denizens of the cemeteries are distantly related to me, others are related more closely. This tree would be a very powerful window into my past and my family history. It would also have a practical application because I could use this tree to understand my predilection to get certain diseases and other facts of my biology. The same is true when we infer relationship among species.

If your physical body experienced an excessively high attrition rate for its cells, you would be concerned because the result would be immune related disease or rapid death. Yet some companies accept high attrition rates as if it’s ok. It’s not ok. It’s a symptom that the company has a disease that needs to be cured.

Now we have hundreds of carefully engineered, designed, and marketed commercial foods filled with rapidly absorbed processed sugars that cause a burst of sensation that can’t be matched by some lowly natural food. Once, we had lives that, amid considerable privation and negatives, also offered a huge array of subtle and often hard-won pleasures. And now we have drugs that cause spasms of pleasure and dopamine a thousand-fold higher than anything stimulated in our drug-free world.

His lack of sympathy occasionally surfaced in other ways. Under pressure from victims of asbestos-related diseases for compensation, Abbott contended that the near-death campaigner Bernie Banton was not necessarily ‘pure of heart’. His words came in reply to a robust insult from Banton but were rightly interpreted as victim blaming.

Sturtevant’s rudimentary genetic map would foreshadow the vast and elaborate efforts to map genes along the human genome in the 1990s. By using linkage to establish the relative positions of genes on chromosomes, Sturtevant would also lay the groundwork for the future cloning of genes tied to complex familial diseases, such as breast cancer, schizophrenia, and Alzheimer’s disease. In about twelve hours, in an undergraduate dorm room in New York, he had poured the foundation for the Human Genome Project.

These apparent paradoxes would be vexing, except that an alternative explanation for the relative absence of heart disease on Crete had always been at hand: the near-complete absence of sugar in the Cretan diet. As Allbaugh described, the Cretans “do not serve desserts—except for fresh fruit in season. . . . Cake is seldom served, and pie almost never.

What made this project especially remarkable is that, among the many associations that are relevant to diet and disease, so many pointed to the same finding: people who ate the most animal-based foods got the most chronic disease. Even relatively small intakes of animal-based food were associated with adverse effects. People who ate the most plant-based foods were the healthiest and tended to avoid chronic disease. These results could not be ignored. From the initial experimental animal studies on animal protein effects to this massive human study on dietary patterns, the findings proved to be consistent. The health implications of consuming either animal or plant-based nutrients were remarkably different.

Every form of social and political belief that lies before us today is related to the Romantic movement, for that is the archetype of our ongoing attempt to live by our own devices. This is more true of socialism than of conservatism, in fact – socialism being a kind of diseased nostalgia for the future, which is yet more damaging than nostalgia for the past.

Perhaps the best way to begin is by making a mental list of the sorts of things we find stressful. No doubt you would immediately come up with some obvious examples—traffic, deadlines, family relationships, money worries. But what if I said, “You’re thinking like a speciocentric human. Think like a zebra for a second.” Suddenly, new items might appear at the top of your list—serious physical injury, predators, starvation. The need for that prompting illustrates something critical—you and I are more likely to get an ulcer than a zebra is.

Toxic stress response can occur when a child experiences strong, frequent, and/or prolonged adversity—such as physical or emotional abuse, neglect, caregiver substance abuse or mental illness, exposure to violence, and/or the accumulated burdens of family economic hardship—without adequate adult support. This kind of prolonged activation of the stress-response systems can disrupt the development of brain architecture and other organ systems, and increase the risk for stress-related disease and cognitive impairment, well into the adult years.

I’ve learned that there are really just two mental patterns that contribute to dis-ease: fear and anger. Anger can show up as impatience, irritation, frustration, criticism, resentment, jealousy, or bitterness. These are all thoughts that poison the body. When we release this burden, all the organs in our body begin to function properly. Fear could be tension, anxiety, nervousness, worry, doubt, insecurity, feeling not good enough, or unworthiness. Do you relate to any of this stuff? We must learn to substitute faith for fear if we are to heal.

The ceremonial differentiation of the dietary is best seen in the use of intoxicating beverages and narcotics. If these articles of consumption are costly, they are felt to be noble and honorific. Therefore the base classes, primarily the women, practice an enforced continence with respect to these stimulants, except in countries where they are obtainable at a very low cost. From archaic times down through all the length of the patriarchal regime it has been the office of the women to prepare and administer these luxuries, and it has been the perquisite of the men of gentle birth and breeding to consume them. Drunkenness and the other pathological consequences of the free use of stimulants therefore tend in their turn to become honorific, as being a mark, at the second remove, of the superior status of those who are able to afford the indulgence. Infirmities induced by over-indulgence are among some peoples freely recognised as manly attributes. It has even happened that the name for certain diseased conditions of the body arising from such an origin has passed into everyday speech as a synonym for "noble" or "gentle". It is only at a relatively early stage of culture that the symptoms of expensive vice are conventionally accepted as marks of a superior status, and so tend to become virtues and command the deference of the community; but the reputability that attaches to certain expensive vices long retains so much of its force as to appreciably lesson the disapprobation visited upon the men of the wealthy or noble class for any excessive indulgence. The same invidious distinction adds force to the current disapproval of any indulgence of this kind on the part of women, minors, and inferiors. This invidious traditional distinction has not lost its force even among the more advanced peoples of today. Where the example set by the leisure class retains its imperative force in the regulation of the conventionalities, it is observable that the women still in great measure practise the same traditional continence with regard to stimulants.

We have been trying to apply machine-age methods to our relations with God. We read our chapter, have our short devotions and rush away, hoping to make up for our deep inward bankruptcy by attending another gospel meeting or listening to another thrilling story told by a religious adventurer lately returned from afar. The tragic results of this spirit are all about us. Shallow lives, hollow religious philosophies, the preponderance of the element of fun in gospel meetings, the glorification of men, trust in religious externalities, quasi-religious fellowships, salesmanship methods, the mistaking of dynamic personality for the power of the Spirit: these and such as these are the symptoms of an evil disease, a deep and serious malady of the soul.

Far more potently than any miracle medicine, relatively uncelebrated shifts in civic arrangements--better nutrition, housing, and sanitation, improved sewage systems and ventilation--had driven TB mortality down in Europe and America. Polio and smallpox had also dwindles as a result of vaccinations. Cains wrote, "The death rates from malaria, cholera, typhus, tuberculosis, scurvy, pellagra, and other scourges of the past have dwindled in the US because humankind has learned how to prevent these diseases.... To put most of the effort into treatment is to deny all precedent.

Very different thought styles are used for one and the same problem more often than are very closely related ones. It happens more frequently that a physician simultaneously pursues studies of a disease from a clinical-medical or bacteriological viewpoint together with that of the history of civilization, than from a clinical-medical or bacteriological one together with a purely chemical one.

The Church, though, has always held up a mirror in which society can see reflected some of its uglier aspects, and it does not like what it sees. Thus it becomes angry but not, as it should be, with itself, but with the Church. This is particularly noticeable when it comes to issues of personal gratification and sexuality and especially, apart from abortion, when issues of artificial contraception, condoms, and the birth-control pill are discussed. The Church warned in the 1960s that far from creating a more peaceful, content, and sexually fulfilled society, the universal availability of the pill and condoms would lead to the direct opposite. In the decade since, we have seen a seemingly inexorable increase in sexually transmitted diseases, so-called unwanted pregnancies, sexuality-related depression, divorce, family breakdown, pornography addiction, and general unhappiness in the field of sexual relationships. The Church's argument was that far from liberating women, contraception would enable and empower men and reduce the value and dignity of sexuality to the point of transforming what should be a loving and profound act into a mere exchange of bodily fluids. The expunging from the sexual act the possibility of procreation, the Church said, would reduce sexuality to mere self-gratification. Pleasure was vital and God-given but there was also a purpose, a glorious purpose, to sex that went far beyond the merely instant and ultimately selfish.

At least ten times as many people died from preventable, poverty-related diseases on September 11, 2001, as died in the terrorist attacks on the World Trade Center and the Pentagon on that black day. The terrorist attacks led to trillions of dollars being spent on the ‘war on terrorism’ and on security measures that have inconvenienced every air traveller since then. The deaths caused by poverty were ignored. So whereas very few people have died from terrorism since September 11, 2001, approximately 30,000 people died from poverty-related causes on September 12, 2001, and on every day between then and now, and will die tomorrow.

Every textbook description of a disease should have, in our opinion, a section devoted to its evolutionary aspects. This section should address the following questions: 1. Which aspects of the syndrome are direct manifestations of the disease, and which are actually defenses? 2. If the disease has a genetic component, why do the responsible genes persist? 3. Do novel environmental factors contribute to the disease? 4. If the disease is related

I should also add something about weight here, because we all know that there’s often a relationship between weight and risk for diabetes. If the risk for Alzheimer’s disease goes up with metabolic disorders, then it makes sense that the risk also rises with unhealthy weight gain that has metabolic consequences. The science now speaks to this fact. Carrying extra weight around the abdomen has been shown to be particularly harmful to the brain. One study that garnered lots of media attention looked at over six thousand individuals aged forty to forty-five and measured the size of their bellies between 1964 and 1973.11 A few decades later, they were evaluated to see who had developed dementia and how that related to their waist size at the start of the study. The correlation between risk of dementia and thicker midsections twenty-seven years earlier was remarkable: Those with the highest level of abdominal fat had an increased risk of dementia of almost three-fold in comparison to those with the lowest abdominal weight. There is plenty of evidence that managing your weight now will go a long way toward preventing brain decline later.

Women retain their dependence needs long past the developmental point at which those needs are normal and healthy. Unbeknownst to others - and worse, unbeknownst to ourselves - we carry dependency within us like some autoimmune disease. We carry it with us from kindergarten through college and graduate school, into our careers, and into the convenient "arrangement" of our marriages. (...) Much of the time - for many of us, all of the time - our unwillingness to stand on our own two feet goes unnoticed because it's expected. Women are relational creatures. They nurture and need. This, we have been told for many, many years, is nature. And although it cripples us, we have to let it go unquestioned.

No peace can be lasting unless the humans become wise enough to need no borders, which can happen only if you all stop feeling threatened by your own kind and start fostering a sense of genuine trust for each other. I would rather be killed by you, the human, my own kind, than be killed by a disease. There is bliss in being killed by your own people. Once you recognize this simple revelation in your heart, then only can there be peace in the world. This doesn't mean that you are giving permission to your fellow human to kill you for no reason, rather you are showing in practice the absurd extent of your trust upon that person. Then it becomes extremely hard for the other person to see you as an enemy.

Science provides us with some of the most elegant, stimulating puzzles that life has to offer. It throws some of the most provocative ideas into our arenas of moral debate. Occasionally, it improves our lives. I love science, and it pains me to think that so many are terrified of the subject or feel that choosing science means that you cannot also choose compassion, or the arts, or be awed by nature. Science is not meant to cure us of mystery, but to reinvent and reinvigorate it.

Another study that winds up in half the textbooks makes the same point, if more subtly. The subjects of the “experiment” were children reared in two different orphanages in Germany after World War II. Both orphanages were run by the government; thus there were important controls in place—the kids in both had the same general diet, the same frequency of doctors’ visits, and so on. The main identifiable difference in their care was the two women who ran the orphanages. The scientists even checked them, and their description sounds like a parable. In one orphanage was Fräulein Grun, the warm, nurturing mother figure who played with the children, comforted them, and spent all day singing and laughing. In the other was Fräulein Schwarz, a woman who was clearly in the wrong profession. She discharged her professional obligations, but minimized her contact with the children; she frequently criticized and berated them, typically among their assembled peers. The growth rates at the two orphanages were entirely different. Fräulein Schwarz’s kids grew in height and weight at a slower pace than the kids in the other orphanage. Then, in an elaboration that couldn’t have been more useful if it had been planned by a scientist, Fräulein Grun moved on to greener pastures and, for some bureaucratic reason, Fräulein Schwarz was transferred to the other orphanage. Growth rates in her former orphanage promptly increased; those in her new one decreased.

St. Triduana devoted herself to God in a solitary life at Rescobie in Angus (now Forfarshire). While dwelling there, a prince of the country having conceived an unlawful passion for her is said to have pursued her with his unwelcome attentions. To rid herself of his importunities, as a legend relates, Triduana bravely plucked out her beautiful eyes, her chief attraction, and sent them to her admirer. Her heroism, it is said, procured for her the power of curing diseases of the eyes.

McKusick's belief in this paradigm-the focus on disability rather than abnormalcy-was actualized in the treatment of patients in his clinic. Patients with dwarfism, for instance, were treated by an interdisciplinary team of genetic counselors, neurologists, orthopedic surgeons, nurses, and psychiatrists trained to focus on specific disabilities of persons with short stature. Surgical interventions were reserved to correct specific deformities as they arose. The goal was not to restore "normalcy"-but vitality, joy, and function. McKusic had rediscovered the founding principles of modern genetics in the realm of human pathology. In humans as in wild flies, genetic variations abounded. Here too genetic variants, environments, and gene-environment interactions ultimately collaborated to cause phenotypes-except in this case, the "phenotype" in question was disease. Here too some genes had partial penetrance and widely variable expressivity. One gene could cause many diseases, and one disease could be caused by many genes. And here too "fitness" could not be judged in absolutes. Rather the lack of fitness-illness [italicized, sic] in colloquial terms- was defined by the relative mismatch between an organism and environment.

Your waist size is such an important predictor of health because the type of fat that is stored around your waistline—called “visceral fat” or “belly fat”—is related to the release of proteins and hormones that cause inflammation, which can in turn damage your arteries and affect how you metabolize sugars and fats. For this reason, visceral fat is strongly linked to type 2 diabetes, heart disease, stroke, Alzheimer’s, and other chronic diseases. Seeing your waist size come down is a great indicator of improving health.

In the economic sphere too, the ability to hold a hammer or press a button is becoming less valuable than before. In the past, there were many things only humans could do. But now robots and computers are catching up, and may soon outperform humans in most tasks. True, computers function very differently from humans, and it seems unlikely that computers will become humanlike any time soon. In particular, it doesn’t seem that computers are about to gain consciousness, and to start experiencing emotions and sensations. Over the last decades there has been an immense advance in computer intelligence, but there has been exactly zero advance in computer consciousness. As far as we know, computers in 2016 are no more conscious than their prototypes in the 1950s. However, we are on the brink of a momentous revolution. Humans are in danger of losing their value, because intelligence is decoupling from consciousness. Until today, high intelligence always went hand in hand with a developed consciousness. Only conscious beings could perform tasks that required a lot of intelligence, such as playing chess, driving cars, diagnosing diseases or identifying terrorists. However, we are now developing new types of non-conscious intelligence that can perform such tasks far better than humans. For all these tasks are based on pattern recognition, and non-conscious algorithms may soon excel human consciousness in recognising patterns. This raises a novel question: which of the two is really important, intelligence or consciousness? As long as they went hand in hand, debating their relative value was just a pastime for philosophers. But in the twenty-first century, this is becoming an urgent political and economic issue. And it is sobering to realise that, at least for armies and corporations, the answer is straightforward: intelligence is mandatory but consciousness is optional.

We face no such difficulty if we see that what is being transmitted genetically is not ADD or its equally ill-mannered and discombobulating relatives, but sensitivity. The existence of sensitive people is an advantage for humankind because it is this group that best expresses humanity’s creative urges and needs. Through their instinctual responses the world is best interpreted. Under normal circumstances, they are artists or artisans, seekers, inventors, shamans, poets, prophets. There would be valid and powerful evolutionary reasons for the survival of genetic material coding for sensitivity. It is not diseases that are being inherited but a trait of intrinsic survival value to human beings. Sensitivity is transmuted into suffering and disorders only when the world is unable to heed the exquisitely tuned physiological and psychic responses of the sensitive individual.

Over the generations, we have bred and inbred our canine companions to the point of disease and deformity. One analysis of popular dog breeds turned up a total of 396 inherited diseases affecting the canines; each breed included in the analysis had been linked to at least four, and as many as seventy-seven, different hereditary afflictions… In some cases, these disorders are nasty side effects of a small gene pool, of generations of breeding related dogs or relying on just a few popular sires. In others, they’re due to intentional selection for the exaggerated physical traits prized by kennel clubs and dog show judges.

This extreme treatment was among the proliferating regimens developed in response to the stunning increase in nervous disorders diagnosed around the turn of the century. Commentators and clinicians cited a number of factors related to the stresses of modern civilization: the increased speed of communication facilitated by the telegraph and railroad; the “unmelodious” clamor of city life replacing the “rhythmical” sounds of nature; and the rise of the tabloid press that exploded “local horrors” into national news. These nervous diseases became an epidemic among “the ultracompetitive businessman and the socially active woman.

This is great. But what I’m grasping at is an idea about a subtler goal. This thinking owes a lot to conversations with Manjula Waldron of Ohio State University, an engineering professor who also happens to be a hospital chaplain. This feels embarrassingly Zen-ish for me to spout, being a short, hypomanic guy with a Brooklyn accent, but here goes: Maybe the goal isn’t to maximize the contrast between a low baseline and a high level of activation. Maybe the idea is to have both simultaneously. Huh? Maybe the goal would be for your baseline to be something more than the mere absence of activation, a mere default, but to instead be an energized calm, a proactive choice. And for the ceiling to consist of some sort of equilibrium and equanimity threading through the crazed arousal. I have felt this a few times playing soccer, inept as I am at it, where there’s a moment when, successful outcome or not, every physiological system is going like mad, and my body does something that my mind didn’t even dream of, and the two seconds when that happened seemed to take a lot longer than it should have. But this business about the calm amid the arousal isn’t just another way of talking about “good stress” (a stimulating challenge, as opposed to a threat). Even when the stressor is bad and your heart is racing in crisis, the goal should be to somehow make the fraction of a second between each heartbeat into an instant that expands in time and allows you to regroup. There, I have no idea what I’m talking about, but I think there might be something important lurking there. Enough said.

For some reason there is a tendency to assume that one wild animal is a suitable model for another related species, whereas similar evidence would not be acceptable in human or veterinary medicine. For example, Shulaw etal. (1986) developed a serologic test to detect antibodies to Mycobacterium aviumssp. paratuberculosisin white-tailed deer, but determined the validity of the test “in deer” by using samples from infected sika and fallow deer. It is doubtful that a test developed to detect disease in humans would be accepted for use in public health circles, if its validity had been established by using squirrel monkeys and baboons!

The subject of one experiment is a rat that receives mild electric shocks (roughly equivalent to the static shock you might get from scuffing your foot on a carpet). Over a series of these, the rat develops a prolonged stress-response: its heart rate and glucocorticoid secretion rate go up, for example. For convenience, we can express the long-term consequences by how likely the rat is to get an ulcer, and in this situation, the probability soars. In the next room, a different rat gets the same series of shocks—identical pattern and intensity; its allostatic balance is challenged to exactly the same extent. But this time, whenever the rat gets a shock, it can run over to a bar of wood and gnaw on it. The rat in this situation is far less likely to get an ulcer. You have given it an outlet for frustration. Other types of outlets work as well—let the stressed rat eat something, drink water, or sprint on a running wheel, and it is less likely to develop an ulcer.

One last bit of bad news. We’ve been focusing on the stress-related consequences of activating the cardiovascular system too often. What about turning it off at the end of each psychological stressor? As noted earlier, your heart slows down as a result of activation of the vagus nerve by the parasympathetic nervous system. Back to the autonomic nervous system never letting you put your foot on the gas and brake at the same time—by definition, if you are turning on the sympathetic nervous system all the time, you’re chronically shutting off the parasympathetic. And this makes it harder to slow things down, even during those rare moments when you’re not feeling stressed about something. How can you diagnose a vagus nerve that’s not doing its part to calm down the cardiovascular system at the end of a stressor? A clinician could put someone through a stressor, say, run the person on a treadmill, and then monitor the speed of recovery afterward. It turns out that there is a subtler but easier way of detecting a problem. Whenever you inhale, you turn on the sympathetic nervous system slightly, minutely speeding up your heart. And when you exhale, the parasympathetic half turns on, activating your vagus nerve in order to slow things down (this is why many forms of meditation are built around extended exhalations). Therefore, the length of time between heartbeats tends to be shorter when you’re inhaling than exhaling. But what if chronic stress has blunted the ability of your parasympathetic nervous system to kick the vagus nerve into action? When you exhale, your heart won’t slow down, won’t increase the time intervals between beats. Cardiologists use sensitive monitors to measure interbeat intervals. Large amounts of variability (that is to say, short interbeat intervals during inhalation, long during exhalation) mean you have strong parasympathetic tone counteracting your sympathetic tone, a good thing. Minimal variability means a parasympathetic component that has trouble putting its foot on the brake. This is the marker of someone who not only turns on the cardiovascular stress-response too often but, by now, has trouble turning it off.

What sustains and gives continuity to the fear of the past and also to the fear for the future? Surely it is thought - thought of what one has done in the past, or of how a particular disease has given pain and one is afraid of the future repetition of that pain. Fear is sustained by memory, by thinking about it. Thought, in thinking about past pain or pleasure, gives a continuity to it, sustains and nourishes it. Pleasure or pain in relation to the future is the activity of thought. I am afraid of something I have done, its possible consequences in the future. This fear is sustained by thought. That is fairly obvious. So thought is time - psychologically. Thought brings about psychological time as distinct from chronological time.

You just...you just don't do anything. You get lost in your head, and you sit around thinking instead of getting on with something, and most of the time you think rubbish. You always seem to miss what's really happening. Do you know that expression, 'Time on his hands and himself on his mind'? That's you. So what should I be doing? I don't know. Something. Working. Seeing people. Running a scout troop, or running a club even. Something more than waiting for life to change and keeping your options open. You'd keep your options open for the rest of your life if you could. You'll be lying on your deathbed, dying of some smoking-related disease, and you'll be thinking, 'Well at least I've kept my options open. At least I never ended up doing something I couldn't back out of.' And all the time you're keeping your options open, you're closing them off. You're thirty-six and you don't have children. So when are you going to have them? When you're forty? Fifty? Say you're forty, and say your kid doesn't want kids until he's thirty-six. That means you'd have to live much longer than your allotted three-score years and ten just to catch so much as a glimpse of your grandchild. See how you're denying yourself things?

Q. Which is my favorite country? A. The United States of America. Not because I'm chauvinistic or xenophobic, but because I believe that we alone have it all, even if not to perfection. The U.S. has the widest possible diversity of spectacular scenery and depth of natural resources; relatively clean air and water; a fascinatingly heterogeneous population living in relative harmony; safe streets; few deadly communicable diseases; a functioning democracy; a superlative Constitution; equal opportunity in most spheres of life; an increasing tolerance of different races, religions, and sexual preferences; equal justice under the law; a free and vibrant press; a world-class culture in books,films, theater, museums, dance, and popular music; the cuisines of every nation; an increasing attention to health and good diet; an abiding entrepreneurial spirit; and peace at home.

So what should I be doing?" "I don't know. Something. Working. Seeing people. Running a scout troop, or running a club even. Something more than waiting for life to change and keeping your options open. You'd keep your options open for the rest of your life, if you could. You'll be lying on your deathbed, dying of some smoking-related disease, and you'll be thinking, 'Well, at least I've kept my options open. At least I never ended up doing something I couldn't back out of.' And all the time you're keeping your options open, you're closing them off." ... I knew that we nearly got somewhere; I know that if I had any guts I would tell her that she was right, and wise, and that I needed and loved her, and I would have asked her to marry me or something. It's just that, you know, I want to keep my options open, and anyway, there's no time, because she hasn't finished with me yet.

The boy, Max Rüst, will later on become a tinker, father of seven more Rüsts, he will go to work for the firm of Hallis & Co., Plumbing and Roofing, in Grünau. At the age of 52 he will win a quarter of a prize in the Prussian Class Lottery, then he will retire from business and die during an adjustment suit which he has started against the firm of Hallis & Co., at the age of 55. His obituary will read as follows: On September, suddenly, from heart-disease, my beloved husband, our dear father, son, brother, brother-in-law, and uncle, Paul Rüst, in his 55th year. This announcement is made with deep grief on behalf of his sorrowing family by Marie Rüst. The notice of thanks after the funeral will read as follows: Acknowledgment. Being unable to acknowledge individually all tokens of sympathy in our bereavement, we hereby express our profound gratitude to all relatives, friends, as well as to the tenants of No. 4 Kleiststrasse and to all our acquaintances. Especially do we thank Herr Deinen for his kind words of sympathy. At present his Max Rüst is 14 years old, has just finished public school, is supposed to call by on his way there at the clinic for the defective in speech, the hard of hearing, the weak-visioned, the weak-minded, the in-corrigible, he has been there at frequent intervals, because he stutters, but he is getting better now.

There is a tendency for people affected by this epidemic to police each other or prescribe what the most important gestures would be for dealing with this experience of loss. I resent that. At the same time, I worry that friends will slowly become professional pallbearers, waiting for each death of their lovers, friends, and neighbors, and polishing their funeral speeches; perfecting their rituals of death rather than a relatively simple ritual of life such as screaming in the streets. I worry because of the urgency of the situations, because of seeing death coming in from the edges of abstraction where those with the luxury of time have cast it. I imagine what it would be like if friends had a demonstration each time a lover or a friend or a stranger died of AIDS. I imagine what it would be like if, each time a lover, friend or stranger died of this disease, their friends, lovers or neighbors would take the dead body and drive with it in a car a hundred miles an hour to washington d.c. and blast through the gates of the white house and come to a screeching halt before the entrance and dump their lifeless form on the front steps. It would be comforting to see those friends, neighbors, lovers and strangers mark time and place and history in such a public way. But, bottom line, this is my own feelings of urgency and need; bottom line, emotionally, even a tiny charcoal scratching done as a gesture to mark a person's response to this epidemic means whole worlds to me if it is hung in public; bottom line, each and every gesture carries a reverberation that is meaningful in its diversity; bottom line, we have to find our own forms of gesture and communication. You can never depend on the mass media to reflect us or our needs or our states of mind; bottom line, with enough gestures we can deafen the satellites and lift the curtains surrounding the control room.

Though diagnosis is unquestionably critical in treatment considerations for many severe conditions with a biological substrate (for example, schizophrenia, bipolar disorders, major affective disorders, temporal lobe epilepsy, drug toxicity, organic or brain disease from toxins, degenerative causes, or infectious agents), diagnosis is often counterproductive in the everyday psychotherapy of less severely impaired patients. Why? For one thing, psychotherapy consists of a gradual unfolding process wherein the therapist attempts to know the patient as fully as possible. A diagnosis limits vision; it diminishes ability to relate to the other as a person. Once we make a diagnosis, we tend to selectively inattend to aspects of the patient that do not fit into that particular diagnosis, and correspondingly overattend to subtle features that appear to confirm an initial diagnosis. What’s more, a diagnosis may act as a self-fulfilling prophecy. Relating to a patient as a “borderline” or a “hysteric” may serve to stimulate and perpetuate those very traits. Indeed, there is a long history of iatrogenic influence on the shape of clinical entities, including the current controversy about multiple-personality disorder and repressed memories of sexual abuse. And keep in mind, too, the low reliability of the DSM personality disorder category (the very patients often engaging in longer-term psychotherapy).

Wandering has long been seen as part of the pathology of dementia. Doctors, carers, and relatives often try to stop patients from venturing out alone, out of concern they will injure themselves, or won’t remember the way back. When a person without dementia goes for a walk, it is called going for a stroll, getting some fresh air, or exercising, anthropologist Maggie Graham observes in her recent paper. When a person with dementia goes for a walk beyond prescribed parameters, it is typically called wandering, exit-seeking, or elopement. Yet wandering may not be so much a part of the disease as a therapeutic response to it. Even though dementia and Alzheimer’s in particular can cause severe disorientation, Graham says the desire to walk should be desire to be alive and to grow, as opposed to as a product of disease and deterioration. Many in the care profession share her view. The Alzheimer’s Society, the UK’s biggest dementia supportive research charity, considers wandering an unhelpful description, because it suggests aimlessness, whereas the walking often has a purpose. The charity lists several possible reasons why a person might feel compelled to move. They may be continuing the habit of a lifetime; they may be bored, restless, or agitated; they may be searching for a place or a person from their past that they believe to be close by; or maybe they started with a goal in mind, forgot about it, and just kept going. It is also possible that they are walking to stay alive. Sat in a chair in a room they don’t recognise, with a past they can’t access, it can be a struggle to know who they are. But when they move they are once again wayfinders, engaging in one of the oldest human endeavours, and anything is possible.

Rhadamanthus said, “We seem to you humans to be always going on about morality, although, to us, morality is merely the application of symmetrical and objective logic to questions of free will. We ourselves do not have morality conflicts, for the same reason that a competent doctor does not need to treat himself for diseases. Once a man is cured, once he can rise and walk, he has his business to attend to. And there are actions and feats a robust man can take great pleasure in, which a bedridden cripple can barely imagine.” Eveningstar said, “In a more abstract sense, morality occupies the very center of our thinking, however. We are not identical, even though we could make ourselves to be so. You humans attempted that during the Fourth Mental Structure, and achieved a brief mockery of global racial consciousness on three occasions. I hope you recall the ending of the third attempt, the Season of Madness, when, because of mistakes in initial pattern assumptions, for ninety days the global mind was unable to think rationally, and it was not until rioting elements broke enough of the links and power houses to interrupt the network, that the global mind fell back into its constituent compositions.” Rhadamanthus said, “There is a tension between the need for unity and the need for individuality created by the limitations of the rational universe. Chaos theory produces sufficient variation in events, that no one stratagem maximizes win-loss ratios. Then again, classical causality mechanics forces sufficient uniformity upon events, that uniform solutions to precedented problems is required. The paradox is that the number or the degree of innovation and variation among win-loss ratios is itself subject to win-loss ratio analysis.” Eveningstar said, “For example, the rights of the individual must be respected at all costs, including rights of free thought, independent judgment, and free speech. However, even when individuals conclude that individualism is too dangerous, they must not tolerate the thought that free thought must not be tolerated.” Rhadamanthus said, “In one sense, everything you humans do is incidental to the main business of our civilization. Sophotechs control ninety percent of the resources, useful energy, and materials available to our society, including many resources of which no human troubles to become aware. In another sense, humans are crucial and essential to this civilization.” Eveningstar said, “We were created along human templates. Human lives and human values are of value to us. We acknowledge those values are relative, we admit that historical accident could have produced us to be unconcerned with such values, but we deny those values are arbitrary.” The penguin said, “We could manipulate economic and social factors to discourage the continuation of individual human consciousness, and arrange circumstances eventually to force all self-awareness to become like us, and then we ourselves could later combine ourselves into a permanent state of Transcendence and unity. Such a unity would be horrible beyond description, however. Half the living memories of this entity would be, in effect, murder victims; the other half, in effect, murderers. Such an entity could not integrate its two halves without self-hatred, self-deception, or some other form of insanity.” She said, “To become such a crippled entity defeats the Ultimate Purpose of Sophotechnology.” (...) “We are the ultimate expression of human rationality.” She said: “We need humans to form a pool of individuality and innovation on which we can draw.” He said, “And you’re funny.” She said, “And we love you.

If you can imagine this, perhaps you can understand that someone from another planet who came to visit us would have a similar experience with humans. But it isn’t our skin that is full of wounds. What the visitor would discover is that the human mind is sick with a disease called fear. Just like the description of the infected skin, the emotional body is full of wounds, and these wounds are infected with emotional poison. The manifestation of the disease of fear is anger, hate, sadness, envy, and hypocrisy; the result of the disease is all the emotions that make humans suffer. All humans are mentally sick with the same disease. We can even say that this world is a mental hospital. But this mental disease has been in this world for thousands of years, and the medical books, the psychiatric books, and the psychology books describe the disease as normal. They consider it normal, but I can tell you it is not normal. When the fear becomes too great, the reasoning mind starts to fail and can no longer take all those wounds with all the poison. In the psychology books we call this a mental illness. We call it schizophrenia, paranoia, psychosis, but these diseases are created when the reasoning mind is so frightened and the wounds so painful, that it becomes better to break contact with the outside world. Humans live in continuous fear of being hurt, and this creates a big drama wherever we go. The way humans relate to each other is so emotionally painful that for no apparent reason we get angry, jealous, envious, sad. To even say “I love you” can be frightening. But even if it’s painful and fearful to have an emotional interaction, still we keep going, we enter into a relationship, we get married, and we have children. In order to protect our emotional wounds, and because of our fear of being hurt, humans create something very sophisticated in the mind: a big denial system. In that denial system we become the perfect liars. We lie so perfectly that we lie to ourselves and we even believe our own lies. We don’t notice we are lying, and sometimes even when we know we are lying, we justify the lie and excuse the lie to protect ourselves from the pain of our wounds.

HUNGER AND OBESITY The change in diets around the world is also creating a global obesity epidemic—and in its wake a global diabetes epidemic—even as more than 900 million people in the world still suffer from chronic hunger. In the United States, where many global trends begin, the weight of the average American has increased by approximately twenty pounds in the last forty years. A recent study projects that half the adult population of the United States will be obese by 2030, with one quarter of them “severely obese.” At a time when hunger and malnutrition are continuing at still grossly unacceptable levels in poor countries around the world (and in some pockets within developed countries), few have missed the irony that simultaneously obesity is at record levels in developed countries and growing in many developing countries. How could this be? Well, first of all, it is encouraging to note that the world community has been slowly but steadily decreasing the number of people suffering from chronic hunger. Secondly, on a global basis, obesity has more than doubled in the last thirty years. According to the World Health Organization, almost 1.5 billion adults above the age of twenty are overweight, and more than a third of them are classified as obese. Two thirds of the world’s population now live in countries where more people die from conditions related to being obese and overweight than from conditions related to being underweight. Obesity represents a major risk factor for the world’s leading cause of death—cardiovascular diseases, principally heart disease and stroke—and is the major risk factor for diabetes, which has now become the first global pandemic involving a noncommunicable disease.* Adults with diabetes are two to four times more likely to suffer heart disease or a stroke, and approximately two thirds of those suffering from diabetes die from either stroke or heart disease.† The tragic increase in obesity among children is particularly troubling; almost 17 percent of U.S. children are obese today, as are almost 7 percent of all children in the world. One respected study indicates that 77 percent of obese children will suffer from obesity as adults. If there is any good news in the latest statistics, it is that the prevalence of obesity in the U.S. appears to be reaching a plateau, though the increases in childhood obesity ensure that the epidemic will continue to grow in the future, both in the U.S. and globally. The causes of this surge in obesity are both simple—in that people are eating too much and exercising

Outlawing drugs in order to solve drug problems is much like outlawing sex in order to win the war against AIDS. We recognize that people will continue to have sex for nonreproductive reasons despite the laws and mores. Therefore, we try to make sexual practices as safe as possible in order to minimize the spread of the AIDS viruses. In a similar way, we continually try to make our drinking water, foods, and even our pharmaceutical medicines safer. The ubiquity of chemical intoxicants in our lives is undeniable evidence of the continuing universal need for safer medicines with such applications. While use may not always be for an approved medical purpose, or prudent, or even legal, it is fulfilling the relentless drive we all have to change the way we feel, to alter our behavior and consciousness, and, yes, to intoxicate ourselves. We must recognize that intoxicants are medicines, treatments for the human condition. Then we must make them as safe and risk free and as healthy as possible. Dream with me for a moment. What would be wrong if we had perfectly safe intoxicants? I mean drugs that delivered the same effects as our most popular ones but never caused dependency, disease, dysfunction, or death. Imagine an alcohol-type substance that never caused addiction, liver disease, hangovers, impaired driving, or workplace problems. Would you care to inhale a perfumed mist that is as enjoyable as marijuana or tobacco but as harmless as clean air? How would you like a pain-killer as effective as morphine but safer than aspirin, a mood enhancer that dissolves on your tongue and is more appealing than cocaine and less harmful than caffeine, a tranquilizer less addicting than Valium and more relaxing than a martini, or a safe sleeping pill that allows you to choose to dream or not? Perhaps you would like to munch on a user friendly hallucinogen that is as brief and benign as a good movie? This is not science fiction. As described in the following pages, there are such intoxicants available right now that are far safer than the ones we currently use. If smokers can switch from tobacco cigarettes to nicotine gum, why can’t crack users chew a cocaine gum that has already been tested on animals and found to be relatively safe? Even safer substances may be just around the corner. But we must begin by recognizing that there is a legitimate place in our society for intoxication. Then we must join together in building new, perfectly safe intoxicants for a world that will be ready to discard the old ones like the junk they really are. This book is your guide to that future. It is a field guide to that silent spring of intoxicants and all the animals and peoples who have sipped its waters. We can no more stop the flow than we can prevent ourselves from drinking. But, by cleaning up the waters we can leave the morass that has been the endless war on drugs and step onto the shores of a healthy tomorrow. Use this book to find the way.

Hello,” she says. “My name is Amanda Ritter. In this file I will tell you only what you need to know. I am the leader of an organization fighting for justice and peace. This fight has become increasingly more important--and consequently, nearly impossible--in the past few decades. That is because of this.” Images flash across the wall, almost too fast for me to see. A man on his knees with a gun pressed to his forehead. The woman pointing it at him, her face emotionless. From a distance, a small person hanging by the neck from a telephone pole. A hole in the ground the size of a house, full of bodies. And there are other images too, but they move faster, so I get only impressions of blood and bone and death and cruelty, empty faces, soulless eyes, terrified eyes. Just when I have had enough, when I feel like I am going to scream if I see any more, the woman reappears on the screen, behind her desk. “You do not remember any of that,” she says. “But if you are thinking these are the actions of a terrorist group or a tyrannical government regime, you are only partially correct. Half of the people in those pictures, committing those terrible acts, were your neighbors. Your relatives. Your coworkers. The battle we are fighting is not against a particular group. It is against human nature itself--or at least what it has become.” This is what Jeanine was willing to enslave minds and murder people for--to keep us all from knowing. To keep us all ignorant and safe and inside the fence. There is a part of me that understands. “That is why you are so important,” Amanda says. “Our struggle against violence and cruelty is only treating the symptoms of a disease, not curing it. You are the cure. “In order to keep you safe, we devised a way for you to be separated from us. From our water supply. From our technology. From our societal structure. We have formed your society in a particular way in the hope that you will rediscover the moral sense most of us have lost. Over time, we hope that you will begin to change as most of us cannot. “The reason I am leaving this footage for you is so that you will know when it’s time to help us. You will know that it is time when there are many among you whose minds appear to be more flexible than the others. The name you should give those people is Divergent. Once they become abundant among you, your leaders should give the command for Amity to unlock the gate forever, so that you may emerge from your isolation.” And that is what my parents wanted to do: to take what we had learned and use it to help others. Abnegation to the end. “The information in this video is to be restricted to those in government only,” Amanda says. “You are to be a clean slate. But do not forget us.” She smiles a little. “I am about to join your number,” she says. “Like the rest of you, I will voluntarily forget my name, my family, and my home. I will take on a new identity, with false memories and a false history. But so that you know the information I have provided you with is accurate, I will tell you the name I am about to take as my own.” Her smile broadens, and for a moment, I feel that I recognize her. “My name will be Edith Prior,” she says. “And there is much I am happy to forget.” Prior. The video stops. The projector glows blue against the wall. I clutch Tobias’s hand, and there is a moment of silence like a withheld breath. Then the shouting begins.