Tag Archives: medicine

BOOK REVIEW: The Psychobiotic Revolution by Scott C. Anderson, et. al.

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The Psychobiotic Revolution: Mood, Food, and the New Science of the Gut-Brain ConnectionThe Psychobiotic Revolution: Mood, Food, and the New Science of the Gut-Brain Connection by Scott C. Anderson
My rating: 5 of 5 stars

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For centuries there have been cases in which a change in diet –often accidental– led to relief from a mental illness. However, given the sporadic nature of such effects and the complete lack of understanding of microbes, the enteric nervous system (i.e. the gut’s own “brain” that communicates with — but is also autonomous of — our “first” brain,) and the complexity the symbiotic relationships involved, these anecdotal cases had limited influence on the state of medicine. However, recent years have seen an explosion of understanding in this domain. This has resulted in a vast number of books being written on the role of microbes in the gut for overall health, the role that changing diet can have on changing our microbiota, and related topics such as how the overuse of antibiotics can have a deleterious effect on health by tossing out the microbial baby with the bath water. This book touches on all those topics (and more) as it explores the role of our bacterial hangers-on on our mental health.

The book consists of nine chapters. The chapters are organized so as to first present one with the necessary background to understand how changes to one’s gut microbiota can improve one’s health —particularly one’s mental health (though many of the mental illnesses influenced by microbiota are linked to physical ailments)— before moving on to the specifics of what microbes have been shown to have a given effect and what diseases can be influenced by consumption of probiotics.

The first five chapters give the reader an introduction to the topic and an overview of information one needs to know to understand the later chapters. Chapter three gives one an overview of the changing profile of one’s microbiota over the course of one’s life. Particular emphasis is given to one’s youth and to the transfer of bacteria to infants. [Readers may be aware of the problem that c-section births result in a failure of babies to receive a dose of beneficial microbes imparted by passage through the vaginal canal.] Chapter four takes one on a quick ride through one’s alimentary canal from mouth to rectum, with particular emphasis on questions such as how bacteria survive the stomach’s acid bath, and which parts of the digestive system contain which microbes (and to what effect.)

The last four chapters dig deeper into the specifics. These chapters look at specific probiotics, how one can get them into one’s system, and what science has found out about probiotics and psychobiotics (like probiotics, but specifically ones that influence mood and mental states) effects on specific ailments. Chapter eight, which deals with major diseases, does cover physical ailments as well as mental ones because – as mentioned— these afflictions often go hand-in-hand. The last chapter (Ch. 9) looks at where this body of knowledge is going. It delves into practices that are presently well-established, such as fecal matter transplants, but also into challenging works-in-progress such as attempts to develop narrower spectrum antibiotics so that we can get the life-saving benefits of these medications without their crippling side-effects.

The book has many graphics, as one would expect from a work that investigates such a complex scientific topic. I can’t really speak to the quality of the graphics as the review copy I read didn’t have completed graphics. However, the subjects of the graphics seemed appropriate and well-placed. The book also has a glossary, annotations, and a further reading section to assist the reader in the study of this subject.

I found this book to be informative and engaging, and would highly recommend it for anyone interested in the role of microbiota on mental health. The text was well-organized and readable. Given the scientific nature of the material, it’s easy for such a book to become ponderous, but the authors made attempts to keep the tone light and the presentation non-intimidating.

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BOOK REVIEW: The Lost City of the Monkey God by Douglas Preston

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The Lost City of the Monkey God: A True StoryThe Lost City of the Monkey God: A True Story by Douglas Preston
My rating: 5 of 5 stars

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Preston tells the story of his participation in an expedition into the Mosquitia region of Honduras in search of a lost city, alternately called the White City (i.e. La Ciudad Blanca) or the City of the Monkey God. Preston was acting as a correspondent for National Geographic and was part of a larger team including a photographer, filmmakers, archaeologists, and a team of ex-Spec Ops escorts. It’s not a simple and straightforward tale of Indiana Jones types chasing after the artifacts of a long collapsed civilization (though it does capitalize on that sense of intrigue greatly from the title to the telling of both the historic and contemporary searches for this fabled lost city.) The book tells several stories that occur about and around this search, and they are arguably more interesting.

One of these side stories is the historic accounts of past explorers who searched for the White City. Those were the individuals who more closely corresponded to Indiana Jones–both because they didn’t have an airplane with a state-of-the-art Lidar system (lidar is the light/laser version of radar or sonar), and because they were more likely to engage in tomb-raiding and artifact robbery. This isn’t to say that the expedition that Preston was on didn’t have its share of snakes, quickmud, and other hazards that are the only reason that a huge city from a past civilization would remain undiscovered in the present day. The region in which the expedition took place had not only all the natural hazards of dense jungle, but the human hazards posed by operating in territory controlled by drug cartels. That said, they didn’t have to machete through hundreds of miles of jungle with no idea of where they were likely to find their objective.

One of the most interesting side stories occurred when Preston and many of the members of the expedition came down with leishmaniasis, a nasty tropical disease vectored by sandflies. The disease has a treatment that’s almost as likely to kill one as is the disease. It’s almost impossible to completely get rid of the disease. One can be cured in the sense of being made asymptomatic, but one may remain a potential carrier waiting to be bitten again and to pass the nasty parasite onto another sandfly so they can infect someone else. There are several elements of the disease story that are intriguing. The most interesting is speculation about the role that disease might have played in the sudden evacuation of this lost city. This is informed by a broader discussion of how “Old World” diseases spread through the “New World” with crippling effect. Another is how diseases are neglected when they almost exclusively infect poor and rural people (until a National Geographic correspondent tracks it back to the continental US, that is.)

For those outside of archaeology, one of the least interesting, but still interesting, side stories is that of the intense controversy in the field. Preston is very forthcoming about his talks with scholars who were angered and outraged by the use of terms like “Lost City” which hearken back to a period in which tomb-raiding was the norm and Westerners stole and shipped priceless artifacts back to the West by the ton. These internecine wars of academia reinforce the idea that this isn’t just musty history, but involves questions that many people feel intensely passionate about.

There is a photo section that provides images of both the cast of highly discussed people and a few of the artifacts uncovered. There’s also a section of sources and citations.

I found this book to be fascinating and I’d highly recommend it. Those interested in exploration and adventure tales will find it of obvious interest, but those with a curiosity about public health may find it unexpectedly of interest.

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5 Books to Introduce You to Your Gut Microbiota

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5.) The Wild Life of Our Bodies by Rob Dunn: This book takes a broad look at the role that hangers-on have on  human life.

 

4.) The Psychobiotic Revolution by Scott C. Anderson et. al.: This book focuses on the role that our gut microbiota have on our mental well-being–which increasingly appears to be substantial.

 

3.) Missing Microbes by Martin J. Blaser: The focus of this book is on how our love of antibiotics in every form– from pills to antimicrobial soaps–is killing us by denying us microbiotic diversity and robustness.

 

2.) 10% Human by Alanna Collen: Collen’s book addresses many of the same issues as the other books mentioned, but–as the title suggests–it emphasizes the fact that a human has 10 times as many hangers-on of other species as it does cells that are contiguous to the body. (If you’re wondering how this could be, it’s because the human body has some pretty big cells [some macroscopic, in fact] and the bacteria and other single-celled species tend to be relatively tiny.)

 

1.) I Contain Multitudes by Ed Young: This is probably the most highly-regarded of the books on this subject. It was considered one of the best science books of 2016.

BOOK REVIEW: Lumbar Herniated Disc by Veritas Health

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Lumbar Herniated Disc: The Essential Guide to Finding Back Pain ReliefLumbar Herniated Disc: The Essential Guide to Finding Back Pain Relief by Veritas Health
My rating: 3 of 5 stars

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I picked up this 60 page guide when I was having low back problems involving a slight nerve impingement. The good news is that it provided enough information to eliminate lumbar herniated disc as cause of my particular problem. That’s not saying nothing because low back problems are notoriously difficult to pinpoint and a cause often remains undiagnosed. The bad news is that this, inexpensive but not free, guide didn’t offer anything that couldn’t be found at respectable online sites like WebMD or The Mayo Clinic for free.

The guide is organized into 11 brief chapters that run from understanding what a lumbar disc is and how it becomes herniated through various treatments (self- and doctor-administered.) It also explains when the situation warrants seeing a doctor.

There are plenty of graphics in the book from computer-generated anatomical imagery to simple line drawings. They are beneficial to understanding the nature of the condition.

My recommendation would be to consider whether you need to have access to this information at times when you don’t have access to the internet. If that’s the case, it’s worth the small cost. If not, you’ll probably feel it didn’t really offer any value-added over free online sites.

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BOOK REVIEW: Better Balance by Salamon and Manor

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Better Balance: Easy Exercises to Improve Stability and Prevent Falls (Harvard Medical School Special Health Report Book 6)Better Balance: Easy Exercises to Improve Stability and Prevent Falls by Suzanne E. Salamon
My rating: 4 of 5 stars

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Balance is one of those qualities that one takes for granted until it fails. Actually, given our bipedal stance, it’s extraordinary that we aren’t falling down all the time. Achieving a stable upright posture takes a lot of complex anatomy and physiology operating flawlessly. I picked up this book because I believe a yoga teacher should be cognizant of the range of capacities for balance that might be seen while teaching. If one teaches students in their 20’s to their 40’s, the need for balance modifications and capacity building might not come up much. It’s when one deals with the very young as well as older students that one sees flawed balance in large measure. [And—let’s face it—the very young can fall down 30 times, pop right back up each time, and be all the stronger for it, and so mature students are the major concern.]

This isn’t the first book in this series of Harvard Medical School Guides that I’ve read and reviewed, and probably won’t be the last. (see: “Your Brain on Yoga,” “Guide to Tai Chi,” and “Low Back Pain.”) I’ve found the series to be beneficial because it presents scientifically sound information, but isn’t afraid to give alternative approaches—such as yoga and tai chi—their due when the studies show that said activities are of benefit. This book is no exception. At several points the authors mention tai chi as being beneficial, and the book includes a yoga balance workout as one of the six that it contains.

The book is organized into 13 sections (i.e. chapters.) The first chapter describes how our vestibular (inner ear), visual, and proprioceptive (the nervous system elements that track where one’s body parts are) systems interact to keep us upright.

Chapter 2 presents an overview of a range of conditions that affect balance. Some of these influence balance specifically and exclusively, but many are conditions that one might not associate with balance problems though they’ve been shown to increase the risk of imbalance. There are sections about which medications have side-effects adversely affecting balance as well as what your doctor may be able to do about balance problems.

Chapter 3 is a “Special Bonus Section” and is of particular importance to mature readers or those who care for said individuals. The topic is preventing falls, and this section describes common causes of falls and offers checklists of considerations for setting up the environments in which those with balance problems will be active.

Chapter 4 introduces various types of activities that improve balance, and chapter 5 is a brief guide to considerations relevant to beginning a balance workout such as whether to consult one’s doctor and what safety precautions should be considered.

In chapter 6, the authors propose how balance workouts can be merged into one’s overall fitness plan. A lot of this chapter is an introduction to exercise—e.g. how much is needed, and what the benefits are. Then there are some tips about how to smoothly merge balance with other exercises.

Chapter 7 presents more specific considerations for beginning balance workouts. Unlike chapter 5, this section provides information about equipment, warm-ups, and how to interpret the instructions for the workouts. The latter is beneficial because the workouts are in a one page per exercise format, and this section negates the need to be needlessly repetitive.

The next six sections (chapters 8 through 13) are various balance workouts that are organized in an easiest to hardest format. The first is a beginner’s workout, which is performed with a chair—used for sitting in some exercises and as a prop in others. The second is a standing balance workout that features simple static balance maneuvers. The level of challenge is similar to that of the first workout, except that one is without a chair prop. The third workout adds in movement to help maintain balance through steps and motion. The next workout is similar but utilizes another prop, a 360 step (a circular step of similar height to the more common Reebok rectangular step, but circular.) The penultimate workout uses a pseudo-balance beam. The author’s mention a product put out by Beamfit, but other manufacturers produce a similar product. It’s a low, dense foam beam that sits on the floor. The last workout utilizes classic Hatha Yoga poses, and features both expected poses like tree pose (vrksasana) and others such as down dog (adho mukha svanasana) that might come as a surprise.

There’s a resources section and glossary at the end. The book presents many graphics, most notably photos of each of the exercises in the six workouts.

I’d recommend this book for anyone who needs an overview of the problems of balance and what can be done about them. It’s short, readable, and user-friendly.

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BOOK REVIEW: The Science of Breath by Swami Rama et. al.

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Science of BreathScience of Breath by Swami Rama
My rating: 4 of 5 stars

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This is an oldie, but a goody. The first edition came out in 1979, but as its intent is to provide an overview of the anatomy and physiology of breath for yoga practitioners, the fact that it doesn’t access the bleeding edge of respiratory science isn’t all that detrimental.

This short book consists of four chapters. Two chapters are by the famous yogi Swami Rama, and the other two are written by medical doctors. The first chapter is an introduction to breath from the yogic perspective. It both explains why it’s so important to understand and work with breath and introduces the mythic physiology (prana, nadi, chakra, etc.) that has historically been used to explain pranayama (breath exercises.)

The second chapter is written by Dr. Alan Hymes and it explains the mechanics of respiration. While Chapter 2 focuses on the anatomy of breathing, it begins with an explanation of cellular respiration to introduce the role of breath in powering muscles. There is a fine explanation of the operation of the diaphragm and the intercostal muscles in breathing.

Chapter 3 is written by Dr. Rudolph Ballentine, and it delves into the role of the nose and nasal cavities in respiration. Breathing through the nose is emphasized in both yoga and many other systems of breath training (e.g. the Buteyko and Wim Hof methods.) This is because the nasal cavities perform many useful functions such as moisturizing and warming air, capturing pollutants, and extract heating and moisture from exhaled breath. Besides exploring nasal anatomy and physiology, Dr. Ballentine describes jala neti shatkarma (nasal cleansing with salt water) and nadi shoudhana (alternate nostril breathing.)

The final chapter, written by Swami Rama, mostly describes various techniques of pranayama (breathing exercises) and related practices bandhas and mudras (locks and seals in which bodily parts are contracted or constricted.) However, the chapter begins with a mix of physiology and mythic physiology. That is, it explains some topics not addressed earlier–such as the interaction between the nervous and the cardiovascular systems as well as chakra.

My standing complaint about books that weave together science and pseudo-science is mitigated a bit herein. My problem with putting these ideas together is that it can be difficult for the reader to determine what concepts reflect reality and which offer models to help one visualize energy. However, except for the last chapter, this book does a good job of keeping these ideas separate. The chapters by the medical doctors present the science with minimal intrusion of unscientific concepts. Swami Rama does present science and mythology together, but not so much scrambled together in a confusing mish-mash.

Chapters 2 through 4 use a number of graphics to help present the material. In the middle chapters these largely consist of line drawings to convey the relevant anatomical features or physical actions. The last chapter adds photographs to demonstrate relevant postures. There is a page of recommended readings, but it’s more of an advertisement for other books put out by the Himalayan Institute than the recommendation of books on the science of breath.

I found this book to be educational. It packs a lot of useful information into a concise package and is readable to a layman. I’d recommend it for yoga practitioners and others who are engaged in breath work.

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BOOK REVIEW: The Checklist Manifesto by Atul Gawande

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The Checklist Manifesto: How to Get Things RightThe Checklist Manifesto: How to Get Things Right by Atul Gawande
My rating: 5 of 5 stars

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Checklists have a bad, bureaucratic rap. Like Taylor’s time and motion studies and forms filed in triplicate, checklists seem to exist only to compound the drudgery of the workplace. Furthermore, many of the sectors in which checklists are most necessary are also those in which they are certain to be resisted—i.e. places in which there is a strong leader who is unused to having his or her instructions challenged: e.g. operating rooms and airplane cockpits. The element that ties those two locations together (along with other places where checklists are found) is that they are domains in which extremely complex activities take place, and in which one missed detail can have tragic consequences.

While the main story being told in this book is about the author’s experience leading a task force to build a surgical checklist and research its efficacy via a global study. However, Dr. Gawande takes us on the rounds of industries that found checklists before medicine did, and which had a thing or two to teach doctors about building and using them—notably the construction and air travel industries.

The book consists of nine chapters. After an Introduction that features a surgical case exemplifying how unexpected case characteristics can easily be overlooked when seconds count, the problem of extreme complexity is described as a rationale of the need for checklists in Chapter 1. While we tend to think we humans are tailor-made for complexity, the fact of the matter is that we aren’t. Mother Nature gives no capabilities that aren’t demanded to survive in the environment in which one evolved. So while we’ve done a great deal of cultural evolution to increase our capacity to deal with complexity (checklists included), the fact of the matter is that our minds and bodies are limited instruments. We can only hold a few items in short-term memory at once. We are no good at multi-tasking—despite the fact that most people feel otherwise. And when stress throws us into “fight or flight” mode, we develop tunnel-vision, not helping our capacity to see the minutiae in the big picture.

Chapter 2 delves into the checklist as solution to the aforementioned problem of extreme complexity. This chapter begins with the story of a bomber aircraft that had awesome capabilities but was deemed too complex for a single pilot to fly. (All it needed was a checklist.) The chapter then goes into medical examples. The first is a study of one of the major cause of infections: central line insertions. This offers a prime example of a procedure in which medical staff members know exactly what to do, but often small details are overlooked leading to disastrous outcomes. Then there is the case in which a little girl was saved against apparently impossible odds, in part due to a checklist performance.

Chapter 3 is entitled “The End of the Master Builder,” and as that name suggests, it’s largely about the role of checklists in construction. Construction can be compared and contrasted with medicine. The major similarity is that both fields have such high degrees of complexity that many specialists must be involved. The major difference is that time isn’t so critical in construction. (Just stopping and mulling over a solution is frequently not an option in surgery.) The biggest takeaway of this chapter is that it’s not only the tasks to be performed that need to be on the checklist but also the communication between team members.

Chapter 4 explains how centralized decision-making can be death in complex environments. The principle case discussed was how Wal-Mart out-performed the government in the wake of Hurricane Katrina in large part because leadership supported but did not dictate to managers of the stores in the storm-damaged area. However, the most fascinating piece of information for me was the explanation of why Van Halen had its infamous contract rider about having a bowl of M&M’s with all the brown ones removed. Apparently, no one cared about the candy. It was just an easy way to see at a glance whether anyone had been through the minutiae of the document–minutiae that included critical information such as how much weight the stage had to accommodate—i.e. safety issues not so easily observed but which would be potentially devastating if missed.

Chapter 5 tells the story of the World Health Organization (WHO) contacting Dr. Gawande and his first attempt at building and implementing a surgical checklist. As to be expected, there was a lot about that initial trial that wouldn’t work.

This led the author to go to what he calls “The Checklist Factory” in Chapter 6. Said “factory” is at Boeing, and it writes and updates all the checklists for Boeing aircraft—which are then modified by the individual airlines, presumably within limits governed by regulatory agencies. While the construction people taught Gawande that communication had to be on the checklist, the aircraft people taught him the need to simplify. One can’t put every detail on the list, only those that could be easily overlooked with devastating consequences. (i.e. One doesn’t need to write “Make an incision” because that’s impossible to forget, but one does include “Ensure antibiotics were delivered.”) Boeing also taught the author that there are two different flavors of checklist: READ-DO and DO-CONFIRM.

Chapter 7 describes the pilot study of the revised surgical checklist in eight hospitals in eight different countries (four developed and four developing.)

Chapter 8, “The Hero in the Age of Checklists,” explores the problem mentioned above about there being resistance in a many sectors (including medicine) because those leaders have rock star vibe going. We admire risk-takers and those who excel under pressure, but checklists seem to run counter to those traits. Thus, even when it’s clear that checklists save lives, there can be a reluctance to adopt them. Of course, as in the airline industry, eventually the checklist becomes accepted, and its use becomes second nature.

Chapter 9 tells of one of the author’s own surgical foibles, and how it led him to work to improve the procedure in order to reduce the risk of that kind of accident. It’s also an example of how the checklist kept the tragedy from being much worse.

This book has its sources annotated, but contains no graphics or other ancillary matter.

I’d recommend this book, particularly for those who work in the domain of complexity. However, I read it because it was referenced in a book I’d read on decision-making under fear. So it may also be of interest to you if you’re into questions of optimal human performance.

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BOOK REVIEW: Altitude Illness by Stephen Bezruchka

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Altitude Illness: Prevention and Treatment (Mountaineers Outdoor Expert)Altitude Illness: Prevention and Treatment by Stephen Bezruchka
My rating: 5 of 5 stars

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I picked this book up after my third, and most recent, trek at high altitude. On each trek, I felt the altitude at some point along the trail, but the most troubling and persistent issue for me has been sleep disruption—what I learned in the book was called periodic breathing. That was one of several useful lessons I learned from this book.

Altitude illness is an odd affliction. There’s a clear logic to what is happening inside your body. There’s a lack of sufficient oxygen to get said oxygen distributed throughout your body by way of your body’s business as usual operations. Homeostasis is out of whack, and the body does a number of things at once to rectify the problem. Because of this, in practice the ailment is actually a range of disparate illnesses that can seem to act in an arbitrary manner. Different people feel altitude in different ways. Some have no problems if they acclimate a few days, but others hit a ceiling beyond which they can’t travel no matter what. One’s level of fitness has little to do with how well on acclimatizes. For some, like myself, it can be a nuisance, but for others it can turn into a threat to survival in a flash.

This book is a concise introduction to altitude illness that covers: acclimatization / adaptation [ch. 1], the various forms of altitude illness [ch. 2], prevention [ch. 3], diagnosis [ch. 4], treatment [ch. 5], the effects of altitude given common preexisting conditions [ch.6], and a guide to preparing for a high altitude jaunt [ch.7.] In addition to the chapters mentioned above, there are two final chapters that make for nice features. Chapter 8 presents case studies of various true instances of altitude afflictions. The cases not only make for interesting reading, but also may help one connect the dots as to what is happening with oneself or someone in one’s party. The last chapter is a frequently asked questions (FAQ) collection that helps to summarize and restate issues addressed in the main chapters. The FAQ may also help one find needed information more quickly, rather than having to flip through the entire book while someone is having trouble.

There are some graphics in the book. Most of the graphics are photos of high or extreme elevation environments—and mostly the latter. (fyi: The book calls 12,000 – 18,000 feet [3660m to 5490m] high altitude, and over 18,000ft [5490m] is extreme altitude.) There are also several tables and a line drawing or two. There’s a short bibliographic section that is nicely divided into two sections, one for health care professionals and the other for lay readers.

I found this guide to be useful and well-presented. It’s well organized, concise, and easy to navigate (bullet points are frequently used to good effect.) This is the kind of book that is meant to help you get to the information you need quickly. There’s not a lot of use of the narrative approach beyond the case study chapter and a few anecdotes in the chapters to liven the discussion. I don’t mean to make is sound dry, but it’s a book with a purpose and that purpose isn’t entertainment. The lack of extraneous information and the keeping of blocks of text small is a good idea for this kind of guide. Having said all that, it’s quite readable by a layman. Jargon is explained and there is a glossary. (There are only a few medical terms—e.g. edema (fluid build-up), ataxia (incoordination), and syncope (fainting)that one needs to be concerned with repeatedly.)

If you will be traveling at altitude (and remember that may not be high or extreme elevations, some people have problems at as low as 6000ft [1800m.]) I’d highly recommend this book. I’d further recommend one re-read it on subsequent high elevation travels. It’s a short book and is broken up into tight subsections.

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BOOK REVIEW: Siddhartha’s Brain by James Kingsland

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Siddhartha's Brain: Unlocking the Ancient Science of EnlightenmentSiddhartha’s Brain: Unlocking the Ancient Science of Enlightenment by James Kingsland
My rating: 5 of 5 stars

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Kingsland builds his niche by connecting the dots between the teachings of the Buddha and scientific discoveries about meditation and mindfulness. There are many books that tell the life story of Siddhartha Gautama from various perspectives (e.g. famously the books by Hermann Hesse and Karen Armstrong.) There are also a number of books reporting the science of meditation (e.g. Herbert Benson and Sat Bir Singh Khalsa.) However, it’s not so common for the subjects to be overlapped.

There’s a reason that this middle path hasn’t been more widely studied. While Buddhism is arguably the most science-friendly of the major world religions, there’s always a gulf between spiritual and scientific thinking. The writer has to figure out how to chart a course through rocky waters. Books appealing to spiritual seekers are likely to come across as insubstantial fluff to the scientifically minded reader, and books appealing to skeptics are likely to feel materialistic and cold (and, perhaps, naive) to the spiritualist. The Buddha’s teachings about the need for the practice to be experiential, rather than faith-based, offers a unique opportunity to tread this tightrope. Furthermore, the Dalai Lama’s willingness to facilitate a dialogue between science and Buddhism has been crucial as well. One can easily set aside controversial issues like reincarnation and karmic law as they aren’t essential to the value of mindfulness.

The book consists of twelve chapters. The chapters generally begin with a story or teaching from the life of Buddha, and then go on to investigate the relevant lesson in more detail with particular emphasis on any relevant scientific discoveries that support said teachings.

The story of Buddha begins in a wealthy, high-caste household with young Siddhartha Gautama being kept from seeing the effects of aging, illness, and death. When the young Siddartha, nonetheless, sees these things, it is a powerful introduction to the concepts of impermanence and suffering that will play a central role in his future teachings. Chapter 1 starts this introduction and also offers an overview of the book. Chapter two continues it. In Chapter three, Kingsland describes a little of the known history of meditation, though its origins are lost to time.

Chapter 4 is entitled “The Second Dart” and it discusses the Buddha’s teaching of the same name—the second dart being one’s mental reaction to an event (i.e. the initial dart.) Chapter 5 investigates the question of whether there is a self—and, if so, of what manner. A core idea within Buddhism is that the self is illusory.

Chapter 6 gets to the heart of the matter by explaining the mechanism of mindfulness meditation and what has come to be known as MBCT (Mindfulness Based Cognitive Therapy)—a secular approach to the use of mindfulness to improve well-being. The next chapter tells the story of how a group of fire worshippers came to follow the Buddha after he made clear that everything (their senses, thoughts, and emotions) were aflame with craving, hatred, and delusion, and that springboards into a discussion of how mindfulness is used to reduce craving and addiction.

Chapter 8 tells the story of an attempt to kill the Buddha via an angry, drunk elephant, and the Buddha’s thwarting of the plot by way of calm and compassion. As one might have guessed, the chapter is about moderating emotions, just as the Buddha controlled his fear before the elephant.

Chapter 9 takes a jaunt into evolutionary biology to question how the mismatch between what humans evolved to do and what we do in the modern world causes mental illnesses and how mindfulness can help mitigate the problem. Chapter 10 is about metacognition, or the ability to observe and reflect upon our own mental experience—i.e. thinking about thoughts. Chapter 11 is about cognition and decision-making, and the role that meditation can play in improving our performance in this domain. The last chapter discusses the Buddhist conception of death and enlightenment. It isn’t until this point that there’s a major divergence between the Buddhist and scientific viewpoints. There is a discussion of the Buddha’s teachings emphasizing that belief in ideas from on high is not so important as experience.

Six of the chapters (2, 4, 6, 8, 10, & 11) are concluded with guided meditations to offer the reader an introduction into the basics of mindfulness. These are simple practices that many readers will already be familiar with in some variant or another. (e.g. breath awareness, bodily awareness, and mindful eating.)

There are only a few graphics (e.g. maps and diagrams—mostly of the brain) but there is no need for additional graphics. The book has references annotated.

I found this book interesting and thought-provoking. It uses the stories of Buddha as well as some stories from the present day to make the reading more engaging and approachable. The discussion of scientific research is easy for a neuroscience neophyte to follow.

I’d recommend this book for anyone interested in learning more about the science behind Buddhist practices.

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BOOK REVIEW: Low Back Pain ed. by Jeffrey N. Katz, M.D. [A Harvard Med School Guide]

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Low-Back Pain: Healing Your Aching BackLow-Back Pain: Healing Your Aching Back by Harvard Health Publications
My rating: 5 of 5 stars

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This guide is one in a series put out by Harvard Medical School. It’s the second one that I’ve read, and I found them both to be beneficial reads. The first was on the health benefits of tai chi chuan (a Chinese martial art / system of health exercise [qi gong.])

Harvard Medical School’s willingness to report findings about unconventional approaches and self-care was part of the appeal of this book. When I first developed lower back problems, I went to the doctor, was diagnosed with arthritis via x-ray, and all I got was an offer for pain killers. To me this was much like going to the mechanic because the check engine light came on, only to be told that all they could do for me is unplug the pesky indicator light. At any rate, that’s why this kind of book can be useful, because one can’t always expect a given doctor within the modern medical establishment to be on top of treatments not involving drugs or surgery. This isn’t to denigrate those options, often times they are the best or only option, and they are covered in this guide as well. However, back pain is one of those rare areas in which sometimes the best option is outside medical norms. Much as many doctors hate having information thrust in front of them by patients, at least Harvard Medical School may garner more respect than a WikiMD post. There’s even a box talking about the mind-body connection, and options in that domain.

Low back pain is both extremely common and often still poorly understood. That’s because there are so many problems that can cause similar symptoms. [I guess this shouldn’t be a surprise because our pelvis had to rotate through evolutionary changes to take us from quadrupedal to bipedal. It makes sense that our nerves and blood vessels might be routed in such a manner as to cause troubles.]

While this guide is short, it does take on a range of issues, including: who’s most at risk, how the spine works [and doesn’t], what the basic categories of back injury are, how one’s specific ailment may be diagnosed, how to evaluate treatment options, what one can do on one’s own to help heal a problem back while preventing future injury, what medicines may be prescribed, what surgical options may be offered, and advice on facilitating a recovery.

As far as ancillary features are concerned, there are a number of line drawings. This artwork is generally either anatomical drawings used to show how the spine works or is injured, or show exercises that one can use to strengthen the back. There are a few pages each of resources and glossary. The resources are not so much printed resources (there’s only one of book, and that one is authored by the editor of this guide,) but rather organizations and even websites.

I found this guide to be informative and helpful. I would recommend it for anyone who has low back problems, or who might benefit from learning more about them (e.g. yoga teachers.)

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