May 5, 2016: Bake Off

     A somewhat typical Bake Off today!
    1)  Some recommendations for books:
          Sharleen recommended When Breath Becomes Air  by Paul Kalianthi, the story of a 36 year old neurosurgeon just finishing his 10 years of surgical training when he is diagnosed with inoperable lung cancer.
           Ann recommended Erich Segal's The Doctors, a work of fiction that follows several members of a medical school class that graduates from medical school in 1958. This was just 8 years before my graduation from college. Therefore, I could identify completely with the training. Some of the later events in doctors lives are a bit melodramatic, but I enjoyed reading about the training and about doctor's lives. I think it was accurate in the beginning.
          Someone recommended How To Be Good by Nick Hornby, a very prolific comedic writer, and essayist.
           Dying To Be Me  by Anita Morgany, a story about a near death experience, and a woman with cancer, and how she learns to be herself and actually beats the cancer.

     2) A brief series of comments about palliative care.

     3) A discussion of the difficult patient followed. Certainly every doctor has dealt with difficult patients. When such encounters used to occur in my practice, and the visit didn't go well, I always ruminated over how I could have managed the patient doctor interaction in a better way. But sometimes it just wouldn't work out, and the patient left dissatisfied and the doctor is frustrated.
One physician in the group called these patients "heart sink" patients because when you see these names on your schedule, your heart truly "sinks".

    4)  Mark brought a wonderful pair of art prints showing old fashioned, Victorian tonic ads, background in color and shapes of a man and a woman in black and white labels. They were very striking.

     5) I don't recall how we got into this area of discussion, but we talked about LSD and to a lesser degree marijuana. Several examples of people who took LSD and were able to play as a musician or paint as an artist producing their best work ever. There was some discussion of how LSD achieves this effect. Paul said that LSD does disconnect the default mode network that is something that always is utilizing the ego and is over thinking everything. Without that brain network firing, apparently other parts of the brain can take over more easily. Certainly there have always been hallucinogens, but in the distant past, taking these drugs were often the job of the shamans, of certain approved individuals and there was control, and experience in using these drugs. There was ritual and sacredness, guidance and control. In our society there are none of these controls. This results in more risk of using these substances. There were questions about what happens to various parts of the brain under different influences. Examples are: During dreaming, the prefrontal cortex is disconnected from the default mode network. During lucid dreaming experience perhaps the lucidity is produced by attempt to reconnect to the prefrontal cortex during the dreaming. During meditation, the mid central prefrontal and insula light up and are stimulated.

     You see, a typical free ranging discussion.