Sunday, April 21, 2013

Marathon Monday

I've always worked on Marathon Monday until this year, when we went to California to visit my sister for the week. Otherwise, since my oldest is now in school and had the day off, we may well have been downtown to see the festivities. For four years I lived about a half mile from where the bombings took place. I've walked down Boylston Street hundreds of times.

Two things folks who have not spent time in Boston may not understand about the events in Boston and Watertown this week: Marathon Monday, Patriot's Day, is a family event. I personally knew hundreds of people who went down to the race, because nearly everyone seems to go. My niece and nephew had watched a bit just down the block, though they had left by the time of the bombing. My sister-in-law knew a woman, a nurse, and her new husband who both lost limbs from the bomb, but so far I've not heard from other friends, family, or patients who were hurt. The "could have been" is sobering.

The second thing to understand is that Boston proper is a very small city. One could walk across it in a few hours. It is just a bit of a walk across the river to Cambridge, more of a hike over to Watertown. Closing down the city to do a confined manhunt in Watertown might seem unimaginable in Manhattan or Dallas or Los Angeles, but it is not so terribly far-fetched in Boston.

I mostly know the medical community, and some people in the law enforcement community. Atul Gawande wrote a good post for The New Yorker online about why so many survived the initial blast despite critical injuries. Today there are more than 50 people still hospitalized. And of course the five who died (including the MIT officer who was shot by the alleged bombers on Thursday night/Friday morning and the older bombing suspect himself). We will go back to work tomorrow and see how people are handling what happened, though I was on call for the practice and spoke with a few people who were very shaken up, particularly on Friday.

It was a good week to have been away, but I am glad to be home. My family is safe and sound, and it is so terrible that so many families were maimed and wounded this week. Thank you to those who reached out to me via social media and email, concerned about us.


Friday, April 12, 2013

Sunlight, ADHD, and Current Events

First off, a brand new post is up on Psychology Today (one never before seen on this blog):

Sunlight and ADHD

Secondly, the blog has been a bit quiet of late because I am busy trying to get some real work done on the book. The deadline for a solid first draft is fast approaching.

In light of some shake-up in the blogosphere and the recent paleo debunking fad, I do plan a little post about what I think of the "paleo-style" diet (though long-time readers probably know my opinion already).

Also, for any of you who speak Polish, many of my articles have been translated…here is the link from Joanna Satula-McGirr:,emily_deans_m_d/

Stay tuned!

Tuesday, April 2, 2013

PaleoFx13 and BA Training

Last weekend I went down to Austin for the PaleoFx13 conference. While I enjoyed PaleoFx12, I had a bit of trepidation at the idea of going back, mostly because the science talks were exceptionally fringe. However, I really enjoyed the people, and since I’m originally from Austin, it’s a nice excuse to get down for a few days and see my family and old friends and escape the horrendous early spring in the Northeast.

Muse: Panic Station (really digging the 21st century Stevie Wonder vibe of this song)

PaleoFx13 was a blast. The venue at the Palmer event center was terrific. Keith and Michelle Norris and all their help (including Corben Thomas among others) organized things very well, and the focus was drawn away from the sketchy science of yesteryear and more towards functional fitness and practical applications. For all the recent acrimony and problems in the paleoblogosphere, PaleoFx manages to make ancestral health a lot of fun. And we definitely needed the fun.

My contribution as a presenter was not fringe at all, but rather the evidenced-based application of behavior theory and stages of change and motivational interviewing on lifestyle changes in general. I use these techniques pretty much every day in my clinical practice in coping with addiction and other lifestyle changes, so it was both straightforward for me and rewarding. Several physicians came up to me after the presentation and spoke to me about their need to really tailor interventions to the particular stage of change of the patient to reduce frustration and prevent wasted energy. My friend, Jacob Egbert DO used the second half of our presentation to talk about his interventions in the gym, his success stories, and the idea of a gym (or any community) as a primary care center for wellness and prevention of chronic disease. He has struggled a great deal with the paradigm of modern medicine and the push for more procedures, more billing, and less holistic care.

I spent a lot of time with my online coach, Clifton Harski of BA training and his amazing girlfriend, Amy. She is a gymnast and he a kinesiology major and former MovNat master trainer along with a ton of experience with other forms of functional fitness. 

The term “functional” merely refers to full body, useful movement, such as getting up from the floor or climbing trees or Olympic weightlifting. I’ve been doing a program designed by Clif for about two months, and my general strength and movement has increased a great deal, even after two years of CrossFit. His BA training “Bootycamp” uses a lot of bodyweight movement and kettlebells to increase lower body stength. It’s high volume and intense, and beneficial, though he backed off and lightened my workouts when I was having a stressful week. Despite an injured shoulder, I’ve been able to do some legit chin-ups since I started his program. Between that and the heavy deadlifts, I can draw a lot of eyes in the globogym.

In person training (with an excellent trainer)  is always best, but with my time constraints and boredom with the standard fare (and the fact that I am just a psychiatrist who can do chin-ups rather than some sort of athlete), the online training keeps things interesting as well as challenges me in a way that local trainers probably wouldn’t. In person, Clif helped me perfect my two-kettlebell swing while Amy helped me achieve the one-armed handstand (against the wall!). Clif, like many of the folks I admired at PaleoFx loves perfecting human movement. It turns out I have an issue with my hip adductors, which my CrossFit trainer had noticed, and kept ordering me to keep my knees out on squats, but that wasn’t enough to fix the problem. 

Clif’s programming of one-legged deadlifts helped me to isolate the problem and start to work on it. He also respected the limitations of my shoulder and programmed specific strength exercises with that in mind. He is thoughtful about movement and functional training, but also recognizes that fitness should not be so deadly serious that we can’t enjoy it (just like paleo food…fun healthy delicious food as opposed to quinoa and textured soy protein? Sign me up!)

At PaleoFx I was fortunate enough to hang out with all the folks who goof off and do stupid human tricks between conference sessions, including Amy, Skyler Tanner (my favorite efficient exercise trainer) and Jacob Egbert. (Photo taken from A Jolly's twitter stream.)

I won’t be able to post before and after pictures of my bootycamp derriere, but rest assured I’m stronger and more shapely after the introduction to Clifton’s program. His brilliant tagline is “turn that applesauce into apples.” I’m going to hire him to give me some extra workouts in the future along with 2X  a week CrossFit training (nothing like the social crew at CrossFit to keep me motivated and coming back for more early morning gym time). 

Hopefully I will be able to attend PaleoFx14 and beyond! Life is becoming incredibly busy…today I presented at Psychiatry Grand Rounds at a hospital in Cambridge and it was very well received. Last week I presented at UT Austin, and flubbed the talk a bit as I am used to presenting a lower-level talk, or to clinical medical audiences. All the criticism and experience is very welcome. My wish is that a medical student and his or her eager mentor will latch hold of the idea of studying fructose malabsorption and depression. And if it is fecal transplants and depression instead, or magnesium and depression, or whatever, I will be a happy camper.