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That Gateway We Call Death

I’ve spent the majority of my professional life in the acquisition of knowledge, wisdom and skill to treat illness and help heal disease.  I’ve spent almost 30 years in the practice and application of that wisdom.  That’s nearly 100,000 hours of my life, dedicated to health and healing of my patients. 

My greatest foes over the years are and have been ignorance, disease, distress, anxiety, depression, disability, apathy and ultimately, death.  I come in contact daily with those who are seriously ill facing the very real prospect of death.  Of necessity, I have come to look upon death as a formidable foe to be fought.  For all conscientious doctors, death’s gateway from life threatens us as the prospect of individual defeat.

I attended the funeral of a friend today who was only a few years older than me.  His life was cut short.  His passing has been weighing upon my mind, as similar events occurred in the life of my brother-in-law last year, my sister a few years ago and my father before that.  I find myself re-reading the words and passages I wrote a number of years ago at the time of my father’s death. I re-post them again, partially for myself, but also for any who may be pondering the gateway we call death. 

The famed scientist Madame Marie Curie returned to her home the night of the funeral of her husband, Pierre Curie, who was killed in an accident in the streets of Paris.  She made this entry in her diary:

Madame Marie Curie

“They filled the grave and put sheaves of flowers on it. Everything is over. Pierre is sleeping his last sleep beneath the earth. It is the end of everything, everything, everything.”

BUT IS IT?

What is this thing that men call death,

This quiet passing in the night?

Tis not the end, But Genesis

Of better worlds and greater light.

O God, touch though my aching heart,

And calm my troubled, haunting fears.

Let hope and faith, transcendent pure,

Give strength and peace beyond my tears.

There is not death, but only change

With recompense for won;

The gift of Him who loved all men,

The Son of God, the Holy One.

(G. B. Hinckley)

This blog is intended to help those struggling with their health, in particular, weight gain, diabetes and the diseases of civilization.  One of those diseases frequently affecting weight is the depression and fear that accompanies the death of a loved one.  Often, the answers science offers are only cold and empty, and we are required to rely upon our faith.  I share some of that with you here.Every patient of every doctor, if followed long enough will pass away. 
The first rule I learned in surgery is that “all bleeding stops eventually.” The inescapable rule of life is that no matter how good your treatments are, all patient’s will meet the undertaker, eventually.  None of us get out of this alive. 

When this happens, and it happens to all of us, a sense of sadness naturally prevails regardless of the age or nature of the deceased.

If death is to happen to all of us, then why do we feel sadness at the death of a friend or loved one?

This sadness is caused by the feeling of loss tied to three age-old unanswered questions:

  1. Did you and I exist before we were born, and if so, where were we?
  2. Why are we here together and what is the purpose of this life?
  3. Where do we go when we die?

Are there answers to these questions?

When science does not have the answers, I have found great hope and answers in hidden within the teachings of my faith. I share them with you, not to preach, but in hopes that you might find peace and solace in your life as I have in mine.

The spiritual leader Wilford Woodruff said “that if the people knew what was behind the veil, they would try by every means . . . that they might get there, but the Lord in his wisdom has implanted the fear of death in every person that they might cling to life and thus accomplish the designs of their creator.” (The Gateway We Call Death, Russell M. Nelson, p.96)

The Lord explained to Moses, “For this is my work and my glory, to bring to pass the immortality and eternal life of man.” (Moses 1:39)

This work and glory is referred to by a number of names including The Plan of Salvation, The Plan of Redemption, The Plan of Eternal Progression, The Plan of Happiness and others.

I often speak with people that say to me, “I just want to be happy.” Or they question me asking, “Will I ever really be happy?”

Happiness is the object and design of our existence . . . and well be the end thereof if we pursue the path that leads to it.  Along this path lies virtue, uprightness, faithfulness, holiness and keeping the commands of our Creator.  So how does this help us find happiness in the face of the death of a friend or loved one?

The answers are found in contemplation of the the three age-old questions.  First, where were we before we were born?

The Old Testament prophet Job, one of the more ancient writers of the Bible, gives us some insight. The Lord asked him the same question: “Who is this that darkeneth counsel by words without knowledge? Gird up now thy loins like a man; for I will demand of thee, and answer thou me. Where was thou when I laid the foundation of the earth . . . when the morning stars sang together, and all the sons of God shouted for joy?” (Job 38:2-7)

You and I must have been somewhere – the Lord asked us where we were. And, who were all the “sons of God shouting for joy?” Why were they shouting? Where were they?

The apostle, Luke, in the New Testament answers those questions years later as he lays out the genealogy of the human family.  He starts at Christ and then names each subsequent father leading up to ” . . . Enos, which is the son of Seth, which was the son of Adam, which was the son of God.” (Luke 3:38)

The apostle, John, must have had some idea of a pre-mortal existence because of the way they phrased the question to Jesus Christ about the man who was born blind, “Master, who did sin, this man or his parents, that he was born blind?” (John 9:2) The question was not “could he have sinned before he was born?” but instead, “who did sin?” Christ’s answer implied that both were possible, but neither was the case in this situation.

Paul writes to the Hebrews, “Furthermore, we have had fathers of our flesh which corrected us, and we gave them reverence; shall we not much rather be in subjection to the Father of our Spirits, and live?” (Hebrews 12:9) We are also given instruction to open our prayers with a phrase like, “Our Father in Heaven.” Hence, He is the Father of our Spirits, our Heavenly Father, our spiritual Father.

We then are brothers & sisters in the spiritual sense, and Jesus Christ is our elder brother, being the firstborn spirit child of God.  If this is the case, then all of us, including you and I, were among the sons and daughters of God who shouted for joy along with Adam.

The Lord explained to Moses, “I have created all things, of which I have spoken, spiritually before they were naturally upon the face of the earth . . . for in heaven created I them.” (Moses 3:5) In addition to this, we learn from Moses that a council was held in heaven in which you and I were present. At this grand council, the plan to create this earth, including the fall of Adam, and the Atonement of Jesus Christ was presented and accepted.

There was, however, someone who opposed this plan. Lucifer rebelled and was cast out of heaven with those who chose to follow him.

If all this is true, then it means you and I accepted this plan and here we are. Accepting this plan as described by the prophet Abraham is defined as accepting our First Estate.

So, the first question is where did we come from? We came from the presence of God, the pre-mortal spirit world, in the company of all our spirit brothers and sisters.

Second question, why are we here? Trying to wrap the whole of this question into a nutshell gives us the following answer.

First, on the eternal perspective, progression requires that we each have our own physical mortal body that has the capacity of becoming refined, immortalized or glorified through the process of death and subsequently resurrection.

Second, we had to be sent somewhere outside of the presence and powerful righteous influence of God our Father to prove ourselves, to exercise our own agency, and determine in this life the nature of our life to come – the life after death. One of the prophets, Jacob, tells us that Adam & Eve were expelled out of the Garden of Eden into a “lone and dreary world” and on a probation of sorts, where a person could chose from a myriad of different things that were either good or evil. It is necessary for man to taste the bitter to enable him to appreciate the good, is one way to explain it.

The ancient prophet Alma calls this a probationary state, a time to repent, to grow, to learn responsibility, and to prepare for the next life. (Alma 12:24, 42:4)

Said the Lord, “And thus did I, the Lord God, appoint unto man in the days of his probation – that by his natural death he might be raised in immortality unto eternal life, even as many as would believe.” (Doctrine & Covenants 29:43)

Obtain a Body . . . Prove Ourselves . . . Get Experience . . . this is your first estate.

Some of us live 80 years, some of us live 50 years, some of us live 39 years, and some live only a brief few years on this earth. Will you and I be given as much time? There are laws to be learned and lived, ordinances to experience, and covenants to be made and kept, and faith and obedience to demonstrate in this life.

Third, where do we go from here? Where will I go when I die? Where have friends and family that have passed on gone to?

The penitent thief on the cross being crucified with the Savior, Jesus Christ, asked the Him the same question. The Savior responded with this answer, “Today shalt thou be with me in paradise.” (Luke 23:43)

Christ died in the literal sense that you and I will die. He underwent a physical dissolution by which His immortal spirit was separated from His body of flesh and bones, and that body was actually dead. While the corpse lay in Joseph’s rock-hewn tomb, the living Christ existed as a disembodied Spirit. Where was He?  We naturally assume that he went where spirits of the dead ordinarily go. He was in the disembodied state a Spirit among spirits. He went to the Spirit world.

We know that the spirit world is not heaven, as the Savior, on the third day after his crucifixion, met the weeping Mary Magdalene and said: “I am not yet ascended to my Father.” He had gone to Paradise as he told the penitent thief, but not to the place where God dwells. Sprit Paradise, therefore, is not Heaven, or the place where God the Eternal Father and his celestialized children dwell and make their abode. Spirit Paradise is a place where dwell

righteous and repentant disembodied spirits between bodily death and resurrection. Another division of the spirit world is reserved for those disembodied beings who have lived lives of wickedness and who remain impenitent even after death.

The ancient prophet Alma explained to his son Corianton who was confused on this matter, “Now there is must needs be a space betwixt the time of death and the time of resurrection.” (Alma 40:6) “Now concerning this state of the soul between the death and the resurrection, behold it has been made know unto me by an angel that the spirits of all men, as soon as they are departed from this mortal body, yea, the spirits of all men, whether they be good or evil, are taken home to God who gave them life. And then shall it come to pass, that the spirits of those who are righteous are received into a state of happens, which is called Paradise, a state of rest from all their troubles and from all care and sorrow.”

“And the spirits of the wicked, yea, who are evil – for behold they have no part nor portion of the Spirit of the Lord; for behold they chose evil works rather than the good; therefore, the spirit of the devil did enter into them, and take possession of their house – this is the state of the souls of the wicked, yea, in darkness, and as a state of awful, fearful looking for the fiery indignation of the wrath of God upon them; thus they remain in this state, as well as the righteous in paradise, until the time of their resurrection.” (Alma 40:11-14)

The Spirit World is therefore quite a unique place.

Another apostle and scriptural historian, Bruce R. McConkie, explains from the Savior’s parable of the rich man and Lazarus, “The spirit world is divided into two parts: Paradise which is the abode of the righteous, and hell which is the abode of the wicked. Until the death of Christ, these two spirit abodes were separated by a great gulf, with the intermingling of their respective inhabitants strictly forbidden.” (Luke 16:19-31)  We know that Christ visited this spirit world because the apostle Peter’s biblical account tells us the following: “For Christ also hath once suffered for sins, the just for the unjust, that he might bring us to God, being put to death in the flesh, but quickened by the Spirit: by which also he went and preached unto the spirits in prison; Which sometime were disobedient, when once the long-suffering of God waited in the days of Noah, while the ark was a preparing, wherein few, that is, eight souls were saved by water.” (1 Peter 3:18-20)

When Christ visited the Spirit world, he also organized the affairs of this kingdom such that the righteous spirits began teaching the His gospel to those who had not heard it and those who were disobedient or wicked.  Although, there are two spheres within the one spirit world, there is now some intermingling of the righteous and the wicked that inhabit those spheres; and when the wicked spirits repent, they leave their prison-hell and join the righteous in spirit paradise. Hence Joseph Smith said, “Hades, Sheol, paradise, spirit prison are all one: it is a world of spirits. The righteous and the wicked all go to the same world of spirits until the resurrection.” (Teachings, p. 310).

Life, work and activity all continue in the spirit world. Men and women have the same talents and intelligence there which they had in this life. They possess the same attitudes, inclinations, and feelings there which they had in this life. They believe the same things, as far as eternal truths are concerned: they continue in effect, to walk in the same path they were following in this life. (Mormon Doctrine, Spirit World, McConkie) The prophet Amulek said, “That same spirit which doth possess your bodies at the time that ye go out of this life, that same spirit will have power to possess your body in the eternal world.” (Alma 34:34) Thus, if a man has the spirit of charity and the love of truth in his heart in this life, that same spirit will possess him in the spirit world.

Family and friends who have passed away with the spirit of joviality and happiness will find it will carry them forward in the gospel and in the teaching of the gospel to many others on the other side.

When I leave this frail existence,

When I lay this mortal by,

Father, Mother, may I meet you

In your royal courts on high?

Then at length, when I’ve completed

All you sent me forth to do,

With your mutual approbation

Let me come and dwell with you.

(Eliza R. Snow, “O My Father,” Hymns, #292)

This post mortal world is a place to await resurrection. All will be resurrected. The Atonement of Jesus Christ ensures a universal resurrection. “For as in Adam all die, even so in Christ shall all be made alive.” (1 Cor 15:22) Judgment will then, after the resurrection, be passed on all according to individual works and obedience while in mortality. The great prophet Nephi says, “For by grace are they saved after all they can do.” (2 Nephi 25:23) Said the Savior to His disciples, “Yet a little while, and the world seeth me no more, but ye see me because I live and ye shall live also.” (John 14:19)

Inheriting the glory that Christ has been resurrected into is conditional and is based upon the laws by which individuals choose to govern their mortal lives.

Said the prophet Alma, “The plan of restoration is requisite with the justice of God; for it is requisite that all things should be restored to their proper order. Behold, it is requisite and just, according to the power and resurrection of Christ, that the soul of man should be restored to its body, and that every part of the body should be restored to itself.

“And it is requisite with the justice of God that men should be judged according to their works; and if their works were good in this life, and the desires of their hearts were good, that they should also as the last day, be restored unto that which is good.” (Alma 41:2-3)

The righteous who understand and live the truth will be resurrected to receive a glory in heaven referred to as Celestial and Paul refers to this as comparable to the glory of the Sun. In this celestial kingdom also known as the Kingdom of God, marriages and eternal family relationships are secured, eternal progress and progression is uninterrupted forever and ever.

The less valiant who choose the lesser law will be resurrected to receive a glory Terrestrial that Paul compares to the glory of the moon. They chose not to enjoy that which they could have enjoyed. These would not accept the words of the prophets in this life and died in their sins, but accepted afterwards.

And to the undisciplined, wicked, liars, sorcerers, adulterers, whoremongers, and the unrepentant who are shut out in spirit prison until the Savior finishes his work (D&C 76:85), they will be resurrected to a glory Telestial or that equivalent, as Paul puts it, to the “glory of the stars, for one star differeth from another star in glory.” (1 Corinthians 15:40-44)  The remainder will become attached to Perdition, those who refuse any part of the Atonement of Christ – those that are cast off forever, as the scriptures say, into outer darkness.

What of those that have taken their lives prematurely when the Lord has said, “Thou shalt not kill”? Are they consigned to spirit prison and later a telestial glory?

Another of the Lord’s modern day apostles, M. Russell Ballard, recently stated that there are “some things we know, and some we do not . . . [the] judgment for sin is not always as cut and dried as some of use seem to think. . . the Lord recognizes differences in intent and circumstances: Was the person who took his life mentally ill? Was he or she so deeply depressed as to be unbalanced or otherwise emotionally disturbed? Was the suicide a tragic, pitiful call for help that went unheeded too long or progressed faster than the victim intended? Did he or she somehow not understand the seriousness of the act? Was he or she suffering from a chemical imbalance in their system that led to despair and a loss of self control? Obviously, we do not know the full circumstances surrounding every suicide. Only the Lord knows the details, and he it is who will judge our actions here on earth.” (Liahona, March 1988, Suicide: Some Things We Know, and Some We Do Not)

Said the prophet Joseph Smith: “While one portion of the human race is judging and condemning the other without mercy, the Great Parent of the universe looks upon the whole of the human family with a fatherly care and paternal regard . . . He is a wise Lawgiver, and will judge all men, not according to the narrow contracted notions of men, but ‘according to the deeds done in the body whether they be good or evil,’ . . . We need not doubt the wisdom and intelligence of the Great Jehovah; He will award judgment or mercy to all nations according to their several deserts, their means of obtaining intelligence, the laws by which they are governed, the facilities afforded them of obtaining correct information, and His inscrutable designs in relations to the human family; and when the designs of God shall be made manifest, and the curtain of futurity be withdrawn, we shall all of us eventually have to confess that the Judge of all the earth has done right.” (Teachings of the Prophet Joseph Smith, Salt Lake City, Deseret Book, 1938, p218)

When we are judged, the Lord will take all things into consideration: our genetic and chemical makeup, our mental state, our intellectual capacity, the teachings we have received the traditions of our fathers, our health, and so forth.

That is the plan. Those are the answers. Death, then, is a gateway.

Upon the cross he meekly died

For all mankind to see

That death unlocks the passageway

Into eternity.

(Hymns, #184 – “Upon the Cross of Calvary”)

“The keeper of the gate is the Holy One of Israel; and he employeth no servant there; and there is none other way save it be by the gate; for he cannot be deceived, for the Lord God is his name.” (2 Nephi 9:41)

To live, to love, and to be loved are the essence of what is important in this life.  Those we have known and passed on have lived great lives, they were loved and are still loved.

Mourning and tears are normal – in fact, they are a healthy reaction. Mourning is one of the purest expressions of deep love. It is a natural response in accord with divine commandment: “Thou shalt live together in love, insomuch that thou shalt weep for the loss of them that die.” (D&C 42:45)

By mortal standard time, it’ll be much longer than we like till we see our loved ones again. By eternal standard time – “We’ll see you soon.”

Until then watch. There are another set of hands you should look for, pierced at the palms and at the wrists. You will recognize His hands when you see them. You will recognize Him when you see Him. His hands are always open. The brightness of His eyes and smile will warm the darkest recesses of your soul. When you meet Him, touch his hands, feel the mark in his side, and bow at His feet. He knows you by name. He knows each of us by name. He will offer you the peace, the rest and the love that you seek.

“To everything there is a season, and a time to every purpose under heaven: A time to be born and a time to die . . . A time to weep, and a time to laugh, at time to mourn, and a time to dance . . . a time to get and a time to loose . . . a time to embrace . . . and a time to love.” (Ecclesiastes 3:1-8)

This death of which I speak eventually comes to all. It comes to some in childhood, to some in ripe old age, and to others in the prime of life. To some it comes by natural means, anticipated and expected, to others it comes without warning, unannounced. It may come quietly in the peace of the night, or it may come violently in the confusion of an instant, but assuredly, it comes to all.

To you my beloved friends and patients and family, remember His invitation.  “Come unto me, all ye that labor and are heavy laden, and I will give you rest. Take my yoke upon you, and learn of me; for I am meek and lowly in heart; and ye shall find rest unto your souls. For my yoke is easy, and my burden is light” (Matthew 11:28-30).

This yoke is a conviction, a way of life; it is called the Gospel of Jesus Christ. It does not take away challenges, disappointments, frustrations, pain or sorrow. But, when lived, it lifts burdens, lightens loads, and makes life bearable. It empowers you with light and strength from on high to learn and grow from experiences in spite of whatever life brings.

This is my conviction. This I know to be true. It is what brings hope in the battle against that inevitable foe, death. May it bring you the warmth of heart and the solace of soul that it brings to me as I ponder its meaning in my life and the lives of my family. May the knowledge of the Plan of Salvation bring you comfort in knowing that those we care about have passed through the gateway we call death to look forward upon immortality and the Glory of the Savior Jesus Christ.

Living With Pandemics and Potential Nuclear Warfare

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[Adapted from “On Living In An Atomic Age (1948), by C.S. Lewis]

Too many of us spend way too much time thinking about the global pandemic, economic collapse and nuclear war.

“How are we to live in this era of nuclear threat, escalating inflation and rampant viruses?”

I am often tempted to reply, “The same way you would have lived in the early twentieth century when the great depression hit, or like you would have lived in the sixteenth century when the plague visited London almost every year, or as you would have lived in a Viking age when raiders from Scandinavia might land and cut your throat any night; or indeed, as you are already living in an age of cancer, an age of tuberculosis, an age of paralyzing polio, an age of syphilis, an age of air raids, and age of railway accidents or an age of motor vehicle accidents.

In other words, don’t begin by exaggerating the novelty of our situation. Believe me, you and everyone you love have already been sentenced to death before the threat of viral pandemics or nuclear warfare was ever invented: and a high percentage of use were going to die in unpleasant ways.  You and I have a great advantage over our ancestors – antibiotics and anesthetics – to this day we still have them.

It is perfectly ridiculous to go whimpering about the day with long drawn faces because the great scientists of our time have added one more chance of a painful and premature death to a world which already bristled with such chances and in which death itself was not a chance at all, but a certainty.  None of us get out of this alive.  None.  Not one.

My first point in this monologue is that you and I must pull ourselves together.  If we are all going to be destroyed by a virus, skyrocketing inflation or a nuclear bomb, then let that destruction, when it comes, find us doing sensible human things like praying, working, teaching, reading, listening to music, bathing the children, playing golf (scratch that – I hate golf), chatting to our friends over a pint and a game of chess or darts – not huddled together like frightened sheep, thinking about viruses or nuclear warfare or gasoline prices.  They may break our bodies (in my experience, any microbe can do that) but, they need not dominate our minds.

“But,” you will reply, “it is not death – not even painful and premature death – that we are all hot and bothered about.  Of course, the chance of that is not a new thing.  What is new is that the virus or the bomb or climate change may finally and totally destroy civilization itself.  The lights may be put out forever.”

This brings us much nearer to the real point.  Let me try to make clear exactly what I think that point is.  What were your views about the ultimate future of civilization before the pandemic appeared on the scene? What did you think all this effort of humanity was to come to in the end?   The real answer is clear to almost everyone who has even a smidgeon of scientific background; yet, oddly enough, it is hardly ever mentioned.  And the real answer (almost beyond doubt) is that with or without viruses, nuclear warfare and economic collapses the whole story is going to end in NOTHING.

The astronomers hold out no hope that this plant is going to be permanently inhabitable. The physicists hold out no hope that organic life is going to be a permanent possibility in any part of the material universe. Not only this earth, but the whole show, all the suns of space, are to run down. Nature is a sinking ship, and we are but passengers.

Nature does not, in the long run, favor life. If Nature is all that exists — in other words, if there is no God, and no after-life of some sort somewhere outside Nature — then all stories will end in the same way: in a universe from which all life is banished without any possibility of return. It will have been an accidental flicker, and there will be no one even to remember it.

No doubt a nuclear bomb may cut its duration on this present planet shorter that it might have been; but the whole thing, even if it lasted for billions of years, must be so infinitesimally short in relation to the oceans of dead time which preceded and follow it that I really feel no excitement about its curtailment.

What the wars and the weather and the pandemic have really done is to remind us forcibly of the sort of world we are living in and which, during the prosperous periods before 1914 and 2021, we began to forget.  And, in reality, this reminder is actually a good thing.  We have been awakened from a pretty dream, and now we can begin to talk about reality.

We see at once (when we have been waked, no “woke”) that the important question is not whether a virus or a nuclear weapon is going to obliterate our “civilization.” The important question is whether “Nature” — the thing studied by the sciences – is the only thing in existence? Because if you answer yes to the second question, then the first question only amounts to asking whether the inevitable frustration of all human activities may be hurried on by our own action instead of occurring at its own natural time. That is, of course, a question that concerns us very much.

Even on a leaking ship that is known to certainly sink sooner or later, the news that the boiler might blow up now would not be heard with indifference by anyone.  But those who knew the ship was sinking in any case would not, I think, be quite so desperately excited as those who had forgotten this fact, and were vaguely imagining that it might arrive somewhere.

It is, then, on this second question that you and I really need to make up our minds.

Let us begin by supposing that Nature is all that exists. Let us suppose that nothing ever has existed or ever will exist before or after except this meaningless play of atoms in space and time: that by a series of hundredth changes it has (regrettably) produced things like — conscious beings who now know that their own consciousness is an accidental result of the whole meaningless process and is therefore itself meaningless – though to us, it feels quite significant.

In this situation (in which the Oxford Handbook estimates 25-50% of civilized countries seems to believe is the present reality), there are really only three avenues of action:

(1) You might commit suicide. Nature which has blindly & accidentally given me for my torment this consciousness which demands meaning and value in a universe that offers neither, has luckily also given me the means of getting rid of it. I return the unwelcome gift. I will be fooled no longer.  (I do not recommend this avenue.)

(2) You might decide simply to have as good a time as possible. The universe is a universe of nonsense, but since you are here, grab what you can. Unfortunately, however, there is on these terms, with inflation and gasoline prices so high so very little left to grab — only the coarsest sensual pleasures is really left. You can’t, except in the lowest animal sense, be in love with a girl if you know (and keep on remembering) that all the beauties both of her person, and of her character, are a momentary and accidental pattern produced by the collision of atoms, and that your own response to them is only a sort of psychic phosphorescence arising from the behavior of your genes.

You can’t go on getting any very serious pleasure from music if you know and remember that its air of significance is a pure illusion, that you like it only because your nervous system is irrationally conditioned to like it.

You may still, in the lowest sense, have a “good time”; but just in so far as it becomes very good, just in so far as it ever threatens to push you on from cold sensuality into real warmth and enthusiasm and joy, so far you will be forced to feel the hopeless disharmony between your own emotions and the universe in which you really live.

3) You may defy the universe. You may say, “Let Nature be irrational, I am not. Let it be merciless, I will have mercy. By whatever curious chance it has produced me, now that I am here, I will live according to human values. I know the universe will win in the end, but what is that to me? I will go down fighting. Amid all this wastefulness I will persevere; amid all this competition, I will make sacrifices. Be damned to the universe!”

I suppose that most of us, in fact, while remain materialists, adopt a more or less uneasy alternate position between the second and the third attitude. And although the third is incomparably the better (it is, for instance, much more likely to “preserve civilization”), both really end up shipwrecked on the same rock. That rock — disharmony between our own hearts and Nature — the is obvious in the second. The third seems to avoid the rock by accepting disharmony from the outset and defying it. Yet, it won’t really work. In it, you hold up your own human standards against the idiocy of the universe.

That is, we talk as if our own standards were something outside the universe which can be contrasted with it; as if we could judge the universe by some standard borrowed from another supposed realistic source). But if Nature — in the space–time–matter system — is the only thing in existence, then of course there can be no other source for our standards. They must, like everything else, be the unintended and meaningless outcome of blind forces. Far from being a light from beyond Nature whereby Nature can be judged, they become the only the way in which anthropoids of our species feel when the atoms under our own skulls get into certain states — those states being produced by causes quite irrational, unhuman, and non-moral. Thus, the very ground on which we defy Nature crumbles under our feet. The standard we are applying is tainted at the source. If our standards are derived from this meaningless universe they must be as meaningless as Nature.

For most modern people, thoughts of this kind must be thought through before the opposite view can even get a fair hearing. All Naturalism leads us to this in the end — to a quite final and hopeless discord between what our minds claim to be and what they really must be if Naturalism is true. They claim to be spirit; that is, to be reason, perceiving universal intellectual principles and universal moral laws and possessing free will. But if Naturalism is true, they must in reality be merely arrangements of atoms in skulls, coming about by irrational causation. We never think a thought because it i s true, only because blind Nature forces us to think it. We never do an act because it is right, only because blind Nature forces us to do it. It is when one has faced this preposterous conclusion that one is at last ready to listen to the voice that whispers: “But suppose we really are spirits? Suppose we are not the offspring of Nature . . ?”

For, really, the naturalistic conclusion is unbelievable. For one thing, it is only through trusting our own minds that we have come to know Nature itself. If Nature when fully known seems to teach us (that is – if the sciences teach us) that our own minds are chance arrangements of atoms, then there must have been some mistake; for if that were so, then the sciences themselves would be chance arrangements of atoms and we should have no reason for believing in them.

There is only one way to avoid this deadlock. We must go back to a much earlier view. We must simply accept it that we are spirits, free and rational beings, at present inhabiting an irrational universe, and must draw the conclusion that we are not derived from it. We are strangers here. We come from somewhere else. Nature is not the only thing that exists. There is “another world,” and that is where we come from. And that explains why we do not feel at home here.

A fish feels at home in the water. If we “belonged here” we should feel at home here. All that we say about “Nature,” about death and time and mutability, all our half-amused, half-bashful attitude to our own bodies, is inexplicable on the theory that we are simply natural creatures. If this world is the only world, how did we come to find its laws either so dreadful or so comic? If there is no straight line elsewhere, how did we discover that Nature’s line is crooked?

But what, then, is Nature, and how do we come to be imprisoned in a system so alien to us?

Oddly enough, the question becomes much less sinister the moment one realizes that Nature is not the end all be all. Mistaken for our mother, she is terrifying and even abominable. But if she is only our sister — if she and we have a common Creator — if she is our sparring partner — then the situation suddenly becomes quite tolerable.

Perhaps we are not here as prisoners but as colonists: only consider what we have done already to the dog, the horse, or the daffodil. Nature is indeed a rough playfellow. There are elements of evil in her. To explain all that would carry us far back: I should have to speak of Power and Principalities and all that would seem to the modern reader most mythological. This is not the place, nor do these questions come first.

It is enough to say here that Nature, in her different way, is much alienated from her Creator, though in her, as in us, gleams and rays of the old beauty remain. Yet, they are there not to be worshipped, but to be enjoyed. She has nothing to teach us. It is our business to live by our own law, not by hers: to follow, in private or in public life, the law of love and temperance even when they seem to be suicidal, and not the law of competition and grab, even when they seem to be necessary to our survival. For it is part of our spiritual law never to put survival first: not even the survival of our species. We must resolutely train ourselves to feel that the survival of Man on this Earth, much more of our own nation or culture of class, is not worth having unless it can be had by honorable and merciful means.

The sacrifice is not so great as it seems. Nothing is more likely to destroy a species or a nation than a determination to survive at all costs. Those who care for something else more than civilization are the only people by whom civilization is at all likely to be preserved. Those who want Heaven must have served Earth best. Those who love Man less than God do most for Man.

You Are the Shark

A few years ago, my son and I were scuba diving the “Fish Bowl” just off the coast of the beautiful island of St Thomas in the Virgin Islands.   This dive was 60-80 feet below the surface and was some of the most beautiful coral reef and aquatic life I have ever seen.  The water was crystal clear with unlimited visibility and there were hundreds of schools of fish in this area.

As we dove into this amazingly beautiful depressed bowl-shaped area of coral that was about the size of a football field, more and more aquatic wildlife came into view.

We saw thousands of fish – the most colorful fish I’ve ever seen, hundreds of different species.  We saw sting rays, barracuda, lobster, and some of the most beautiful coral I have ever witnessed.   It was exhilarating, breathtaking and peaceful all at the same time.

However, as we swam over and around the ocean floor and through the coral caverns that lined it’s walls, I noticed something very unique.  All of these species of aquatic life would swim, then rest.  Many of them would rest for a period on the ocean floor or in a cove or cavern of the beautiful walls of coral reef.

Then, every few minutes, I’d catch the view of a group of reef sharks as they swam by.   As they swam, they would watch us, and swim over or under our diving group.  Yet, the sharks never stopped.  They never rested or waited quietly on the ocean floor like the other aquatic predators we saw that day.

Majestic and fearsome creatures with the beautiful waving motion of their tails, sliding smoothly through the saltwater along the edges of the reef. These reef sharks and the other nurse and hammer head sharks we saw never stopped.

I learned a fascinating lesson that day.  If a shark stops swimming, it dies.

The ocean may be its home . . .

And, the shark may be one of the most fearsome creatures under the deep blue . . .

But, without forward movement, the shark will drown.  Sharks rely upon obligate ram ventilation of water passing through their mouths filtering oxygen as it is rammed against the gills.

If they stop swimming, they stop receiving oxygen.  If they stop moving, they die.

It was a powerful life lesson.

You and I are much like the shark, we survive on a diet of protein, fat and movement.

You are a fearsome collection of appetites, powers, and instincts made for constant forward movement.

If you do not grow . . .

If you do not evolve, risk, or expand . . . Slowly but surely, you will die a spiritual or emotional death.

You may wish and pray it were otherwise.  You can try to will yourself content with stagnation and starch . . .

You can try to force yourself to be satisfied. Believe me, I’ve tried.

Yet, as you know by now . . . it doesn’t take. It doesn’t work. Your hunger increases, and you start gasping for air.

You are the shark.

To whatever extent you have failed to move forward, that lack of momentum is drowning you in a deep blue sea of “what if’s,” “could have’s,” and “if only’s.”

You and I are not overwhelmed.

You are not suffering from too much.  You and I suffer from TOO LITTLE.

Underwhelm frequently masquerades as overwhelm, and it stifles the life-giving apparatus.

You’re not over stretched. You’re not tapped out.  You are profoundly under-utilized . . . bored, rotting & stymied.

The narrow walls of your life begin crushing your heart when you’re not moving. You know it’s true.

Even when everything within you wants to retreat . . .

Fin your tail, flair your vents and MOVE FORWARD.

Do not be afraid to play the bigger game, take the wild risk, make the bold move.

I gained four life lessons from this experience. These make more sense when viewed with this perspective:

  1. Happiness is not the absence of problems; it is the ability to deal with them, swim at them head on.
  2. Feeling sad after making a decision doesn’t mean you made the wrong decision. You decide and you keep moving.
  3. You’re not stressed out because you are doing too much.  You are stressed because you are doing too little of the things that make you feel most alive, the thing that keeps the oxygen moving across your gills.
  4. The lesson you struggle with will repeat itself until you face it and learn from it.

Be the shark you were meant to be, and, at last, watch your life begin.

 

 

 

 

Adam Nally, DO

@DocMuscles

Are More Children Dying From the COVID Vaccine than the Virus Itself?

In the last 12 months I have seen sixteen significant and severe reactions to the COVID-19 vaccine. I cannot be alone in seeing this trend. However, physicians and providers around the world seem fearful in even talking about it with their colleagues. And, as of this week, there is VAERS data implying that more children have died from the vaccine than from the virus itself.

I have always been a big proponent of vaccines. But, that advocacy for vaccination has been based on good research and data demonstrating that both the short and long-term risk is greatly outweighed by the benefit of vaccination. I have been in practice long enough to have seen multiple vaccinations and therapeutics pulled off the market 1-5 years after they were released because of severe adverse events relating to the drug or vaccine (ie – thalidamide, DES, Baycol, Accutane, Redux, Seldane, Zelnorm and Vioxx just to name a few.)

In my family practice clinic over the last 22 years, I’ve rarely seen acute cases of myocarditis show up on my doorstep. However, in the last 12 months I’ve had eight cases of myocarditis (inflammation of the wall of the heart) and eight cases of prolonged colitis (inflammation of the colon that did not respond to antibiotics) directly related to COVID-19 vaccination. Because I practice in the midst of a retirement community on one side of the street and a city of young families on the opposite side of the street, my practice is predominantly newly marrieds and people over 60 years old. I don’t see nearly as many children as other family practitioners or pediatricians. But, the numbers don’t lie.

I’ve been patiently waiting to seen the journal articles about this topic. Yet, it has not been written. Why must a family practitioner be writing about this, when this should be front page news on every website? Of course, I have my biases, to which I will openly admit. Yet, I seriously don’t know the answer to that question.

We live in a time when medicine has become a politicized weapon. The medical and political leadership on both sides of the isle keep moving the goal posts. Both sides appeal to false authorities. Those who are supposed to be authorities flip flop their position on the clear evidences. And, medical journals have become less and less trustworthy for a number of reasons. It leaves the physician in the trenches scratching his or her head.

Elevated D-Dimers, Fatigue, Colitis & Palpitations

All sixteen of these cases above had elevated D-dimer tests (the protein marker in the blood for significant inflammation and clotting risk) lasting 6-8 months. Four of these sixteen patients had blood clots in the lungs. Most of these cases occurred after the second vaccine dose, but a few occurred after the first dose. Six of these patients have been so fatigued, they could not work and could barely function for over four to six months.

I provide below two of the actual ultrasound images I completed while examining these sixteen patients:

41 year old male with 2 months of fatigue and palpitations starting 30 days after his first dose of COVID vaccine.

Why is this significant? Because in 22 years of medical practice, I can count on one hand the number of severe vaccine reactions I’ve personally seen in my office in all vaccines combined. Then, suddenly in the last 12 months I have 16 severe reactions to the COVID-19 jab?! It makes a person think . . .

Let’s Stop Pretending that COVID-19 Vaccines are Perfect

To date, Dr Anthony Fauci, CDC Director Rochelle Walensky, and Surgeon General Vivek Murthy remind us that 97% of new covid-19 hospitalizations or 99% of covid-19 deaths are among the unvaccinated. I’m sure the message is well-intentioned: “Vaccines will protect you from severe disease, so go get vaccinated!”

The problem is that the message is not true. Initially, there was an 81-89% reduction in severe hospitalization in the first 2-3 months of vaccination according to the studies we had. However, this protection has dramatically decreased. Hence the introduction of boosters. Yet, the studies on boosters have only looked a antibody levels, not at hospitalization risk reduction or reduction of death from COVID-19.

We saw this in the UK, where deaths among the vaccinated went from “rare” to two-thirds of all delta variant deaths by July. We saw this in Israel, where literally no fully vaccinated people died of covid-19 for 3-4 weeks in June, but by August over 60% of the severely ill were fully vaccinated.

As of today, Pfizer and BioNTech’s Covid-19 vaccine is just 39% effective in Israel where the delta variant is the dominant strain according to the recent report from the country’s Health Ministry.

Is there some effectiveness to the vaccine? According to the studies we have to date – yes. However, does that benefit outweigh the long-term risk? That is the $1 million dollar question.

How Do We Know What the Risk of Vaccination Actually Is?

Other than the very short term vaccine trials conducted by Pfizer, Moderna and Johnson & Johnson lasting 6 months, we really don’t know what the long-term real world risks are. The only data we have is the CDC’s ongoing VAERS data reporting system.

Established in 1990, the Vaccine Adverse Event Reporting System (VAERS) is a national early warning system to detect possible safety problems in U.S.-licensed vaccines. VAERS is co-managed by the Centers for Disease Control and Prevention (CDC) and the U.S. Food and Drug Administration (FDA). VAERS accepts and analyzes reports of adverse events (possible side effects) after a person has received a vaccination. Anyone can report an adverse event to VAERS. Healthcare professionals are required to report certain adverse events and vaccine manufacturers are required to report all adverse events that come to their attention.

VAERS is a passive reporting system, meaning it relies on individuals to send in reports of their experiences to CDC and FDA. VAERS is not designed to determine if a vaccine caused a health problem, but is especially useful for detecting unusual or unexpected patterns of adverse event reporting that might indicate a possible safety problem with a vaccine. This way, VAERS can provide CDC and FDA with valuable information that additional work and evaluation is necessary to further assess a possible safety concern.

Jessica Rose, Ph.D., a research fellow at the Institute for Pure and Applied Knowledge in Israel, was interviewed about what the VAERS data tell us about the COVID vaccine risk. Rose stated that the average number of adverse event reports following vaccination for the past 10 years has been about 39,000 annually, with an average of 155 deaths. That’s for all available vaccines combined.

The COVID vaccines now account for 983,756 adverse event reports as of December 17, 2021, including 20,622 deaths—and this doesn’t include the underreporting factor, which we know is significant and likely ranges from five to 40 times higher than reported. Most doctors and nurses don’t even know what VAERS is and even if they do, they chose not to report the incidents.

Data as of January 14, 2022, reports 9,936 deaths in the U.S. due to COVID-19 vaccination.

In the case of the COVID vaccinations, data demonstrates that 50% of the deaths occur within 48 hours of injection. It’s simply not conceivable that 10,000 people died two days after their shot from something other than the shot. Though fact checkers around the world discount this site as not official “because anyone can report” and claim it is coincidental. It cannot all be coincidence. Especially since so many of them are younger, with no underlying lethal conditions that threaten their lives. 80% have died within one week of their injection, which is still incredibly close in terms of cause and effect.

Children Are At 80% Greater Risk

Aside from the immediate risk of death, children are also at risk for potentially lifelong health problems from this vaccination. Myocarditis (heart inflammation seen in the two adult ultrasound images above) has emerged as one of the most common problems, especially among boys and young men.

In early September 2021, Tracy Beth Hoeg and colleagues posted an analysis of VAERS data on the preprint server medRxiv, showing that more than 86% of the children aged 12 to 17 who report symptoms of myocarditis were severe enough to require hospitalization.

Cases of myocarditis exploded after the second shot, Hoeg found, and disproportionally affecting boys. A full 90% of post-injection myocarditis reports are males, and 85% of reports occurred after the second dose. 

Said Hoeg, “The estimated incidence of CAEs [cardiac adverse events] among boys aged 12-15 years following the second dose was 162 per million; the incidence among boys aged 16-17 years was 94 per million. The estimated incidence of CAEs among girls was 13 per million in both age groups.”

According to Steve Kirsch, doctors are seeing an increase in myocarditis, but few are willing to talk about it. 

In October 2021, Jessica Rose and Dr. Peter McCullough submitted a paper on myocarditis cases in VAERS following the COVID vaccination to the journal Current Problems in Cardiology. Everything was set for publication when, suddenly, the journal changed its mind and took it down.

You can still find the pre-printed article on Rose’s website. The data clearly show that myocarditis is inversely related to age. The younger you are the higher the risk of myocarditis. The risk is also dose-dependent, with boys having a six-fold greater risk of myocarditis following the second dose.

While our health authorities and the CDC are shrugging off this risk saying cases are “mild,” that’s a blatant and frightening lie. The damage to the heart is typically permanent.

https://vaersanalysis.info/2022/01/14/vaers-summary-for-covid-19-vaccines-through-01-07-2022/

In the most recent VAERS report, you and I can see that in just six months, deaths in children and young adults from the COVID vaccine under the age of 29 years old has now surpassed the total number of deaths in this age group from COVID-19 in the last two years.

Why is this not being shouted from the rooftops? I still don’t have the answer.

COVID-19 Vaccines Double Your Risk for Acute Coronary Syndrome

Researchers have also found that Pfizer and Moderna mRNA COVID-19 vaccines dramatically increase biomarkers associated with thrombosis, cardiomyopathy and other vascular events following injection.

People who have received two doses of the mRNA injection more than doubled their five-year risk of acute coronary syndrome (ACS), the researchers found, driving it from an average of 11% to 25%. ACS is an umbrella term that includes not only heart attacks, but also a range of other conditions involving abruptly reduced blood flow to your heart.

In a Twitter post November 21, 2021, cardiologist Dr. Aseem Malhotra wrote: “Extraordinary, disturbing, upsetting. We now have evidence of a plausible biological mechanism of how mRNA vaccine may be contributing to increased cardiac events. The abstract is published in the highest impact cardiology journal so we must take these findings very seriously.”

Yet, all you and I’ve heard from the “experts” is . . . crickets . . .

What Does the VAERS Data Actually Say?

As of December 17, 2021, looking only at U.S. reports, excluding the international reporting, VAERS had received:

  • 308 cases of myocarditis among 18-year-olds
  • 252 cases among 17-year-olds
  • 226 cases in 16-year-olds
  • 256 cases in 15-year-olds
  • 193 in 14-year-olds
  • 132 in 13-year-olds
  • 108 in 12-year-olds

In total, that’s 1,475 cases of myocarditis in U.S. teens aged 18 and younger—five times the background rate in just six months! And again, this does not take into account the underreporting rate, which has been calculated to be anywhere from five to 40.

The CDC claimed that myocarditis was a possible rare side effect of the COVID infection itself.

Now, assuming the COVID hospitalization rate for adolescents is 21 per million, and we have 73.1 million adolescents, we could expect there to be 1,535 hospitalizations for COVID in this age group in a year. If 0.146 percent of those 1,535 teens develop myocarditis (the CDC’s quoted percentage of myocarditis found in adolescents), we could expect 2.2 cases of myocarditis to occur in this age group each year, among those who come down with COVID.

In summary, based on CDC statistics, we could expect just over two teens to contract myocarditis from COVID-19 infection. Meanwhile, we have 1,475 cases reported following the COVID vaccination in just six months (shots for 12- to 17-year-olds were authorized July 30, 2021). That’s a pretty big difference.

Based on the data we have in the last 12 months, there is absolutely no medical rationale or justification for children and teens to get a COVID shot. It’s all risk and no gain. 

And, as an adult, unless you are very high risk with diabetes, asthma, heart disease, morbid obesity, I’d think twice about getting a booster.

If your child experiences any symptoms of a cardiac or cardiovascular problem, seek immediate medical attention.

In my clinic, we use the following protocols to treat the elevated D-Dimer and lessen the adverse effect on the heart.

  1. Colchicine 0.6 mg daily
  2. Resveratrol 250-500 mg daily
  3. Vitamin D 2000-5000 IU daily

I’ve written about the potential risks of vaccination here and here. Want additional information? Listen to Collette Martin’s testimony before the Louisiana State Senate about this issue last month:

Sources:

  1. OpenVAERS Myocarditis cases by age as of Dec. 17, 2021
  2. Louisiana Government Archived Videos 2021 (see Health and Welfare)
  3. Louisiana Health and Welfare Committee Meeting, Dec. 6, 2021
  4. Dare to Seek the Truth Dr. Peter McCullough
  5. SteveKirsch.substack, Dec. 30, 2021
  6. Journal Pre-proof, A Report on Myocarditis Adverse Events in the U.S. Vaccine Adverse Events Reporting System (VAERS)
  7. Census.gov 2020 Statistics
  8. CDC MMWR Sept. 3, 2021; 70(35);1228–1232
  9. https://vdmeta.com/
  10. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8714120/
  11. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8159193/

Is Mandatory Vaccination Worth The Risks?

As of today, there are 6,183 COVID-19 vaccine related deaths in the United States according to the CDC’s VAERs website. We as health care providers are required to report vaccine related injury to the VAERs site.

And, yet, when we site this data (being the ONLY DATA available to us as clinicians required to make judgement calls in real time on the use of these vaccines) we are labeled “conspiracy theorists.”

Many of you have been very vocal, threatening me and stopped following my social media channels recently,: “Dr. Nally, why do you keep harping on this vaccine risk issue? I used to trust you . . .”

In fact, Facebook has consistently blocked me from doing any “live-streaming” for the last six months. They keep finding posts from 1-2 years ago that “violate community standards” and extend my ban on live-stream posting privilege’s.”

The Answer: Because, two more of my patients have been hospitalized with life-threatening blood clots in the lungs after vaccination, both of which have never had any history of clotting problems. “Houston, THIS IS A PROBLEM! Are you listening?!”

https://wonder.cdc.gov/controller/datarequest/D8;jsessionid=6D180E77E02D9533F8867A5708ED

Are there errors in public reporting? Of course. That is to be expected. However, some researchers that use these data sets state that VAERs reporting may be under-reported generally by up to a factor of 5. That means that the number of vaccine related deaths could between 6,000 – 39,900 as of today.

Of course, Reuters.com, FactCheck.org and Snopes.com have no medical malpractice risk looming over their heads when they make their “fact checking” statements, nor do they have the life and health of a family member depending on their recommendations sitting in front of them in the exam room.

So, you be the judge. Just remember, the Swine Flu vaccine got pulled off the market after 450 cases of Guillain-Barre Syndrome (GBS) appeared and 3 deaths in elderly patients were reported within days of vaccination (https://www.cdc.gov/vaccinesafety/concerns/concerns-history.html).

Influenza and Menactra vaccines increase the risk of GBS by 2 per 1,000,000 doses (https://www.cdc.gov/vaccinesafety/concerns/guillain-barre-syndrome.html).

Currently the CDC admits that COVID-19 vaccines have been directly implicated in:

Blood Clots (life-threatening thrombosis and thrombocytosis syndrome) like blood clots in the lungs occur in 7 per 1,000,000 vaccinations.

Anaphylaxis occurs in 5 per 1,000,000 vaccinations.

Guillain-Barre Syndrome (GBS) has occurred in 137 patients vaccinated.

Myocarditis/Pericarditis has been confirmed in over 700 cases of those vaccinated. (https://www.cdc.gov/coronavirus/2019-ncov/vaccines/safety/adverse-events.html)

It is hard to imagine a more dangerous and asinine way of making decisions than by abdicating those health decisions into the hands of people who pay no price for being wrong.

So, for a virus that has a 99.98% unvaccinated survival rate across the US population, is the risk of giving up your freedom of choice worth taking?

Well, that’s really your choice. My job as your physician is to give you the pros and the cons. That’s what I’ve done. You’ve probably already commented to me about how you either agree or disagree with me. That’s OK. Because, unlike many other medical professionals, I’ve done my job.

Now, you need to decide, is the risk of a mandated vaccine worth defending your freedom over, or do you give up this hill, tuck your tail between your legs, roll up your sleeve and then retreat?

As for me, I may be alone, but I’m standing on this hill. You’re going to have to bury me to take it.

Coronavirus, Mask Wearing & Death – Similarities to 1918 Flu

Isn’t it interesting, back in April and May, 2020, those of us closely watching the data stated that this virus would look much like the influenza pandemic of 1918.  Look closely at the numbers of deaths in St Louis (who participated in the 1918 quarantine – red line) and Arizona, who has done much the same in our approach (in the 2nd graphic below).

The death count curves are nearly identical.   Interestingly, the numbers of those that died St Louis are almost identical to Arizona’s graph below, directly from the Arizona Department of Health Website.  We know that the rates of infection differ between the two viruses and a number of things including domicile proximity, health of the city or state, transportation methods, sanitary condition, etc. play a significant role in the infection rates.  My point is not to compare the two viruses, but to point out that the effect of quarantine did exactly what we expected it to do.

We expected the resurgence of the virus.  Let’s say that again.  We expected it.  However, the media and many health professionals that I interact with seem horrified that it occurred.

 

We predicted this pattern months ago.

I am surprised at the number of health professionals that are just beside themselves about this virus.  I recognize that, in its most severe form, this virus can be deadly.  And, so is the flu, RSV and other RNA viruses.  Do these professionals not read history?  Do they not read the actual scientific literature?  Do they not see the patterns that diet and control of hyperinsulinemia have on this virus?

Instead, these medical professionals have remained quiet, and in some cases cheered, as our government over-reach and personal liberty infringement took place.  We’ve lost our ability to travel, participate in group gatherings and church services.  Quarantine, mask wearing and social distancing has essentially done nothing for our community in the last 3 months.

Our initial reasoning for quarantine was to take the peak off of hospitalizations.  That was done.  Yet continued suppression of personal liberties has done nothing for the overall health of our society.  The second wave of infection was going to occur no matter what we did.

Instead, the media fear mongering, social distancing and force wearing of masks has lead to increased risk of suicide, overdose and drug addiction.  Estimates are as high as 150,000 deaths due to the effects of quarantine and social distancing mandates.  In fact, much of the anxiety and PTSD that is expected will not be seen until 4-6 month after the quarantine occurs.

According to a recent JAMA report, “It is possible that the 24/7 news coverage of these unprecedented events could serve as an additional stressor, especially for individuals with preexisting mental health problems.” Our routines have been completely upended and even things like wearing a mask or waiting in lines at the grocery store can make you feel tense.

Some common signs of pandemic-induced stress are:

  • Fear and worry about your own health and the health of your loved ones
  • Changes in sleep or eating patterns
  • Difficulty sleeping or concentrating
  • Worsening of chronic health problems
  • Worsening of mental health conditions
  • Increased use of alcohol, tobacco, or other drugs

What we know from research after the SARS outbreak is that post-traumatic stress (PTSD) is possible, especially in front line healthcare workers. In one particular study, about 10 percent of the hospital employees had had high SARS-related PTSD symptoms post-outbreak. And about half of them still had symptoms three years later. Other studies have shown that when a person’s PTSD symptoms persist for more than 6 months after an event, they are very likely to continue to persist over the long term.

A significant part of the problem in both the lay public and among health care workers is confusion about actual risk of disease, what can be done to prevent/treat the disease, and how to access treatment.  I see this confusion today in many physicians and nurses I interact with in my community.

If you are having symptoms of anxiety, stress or depression, don’t be afraid to reach out for help.  Knowledge is power.  The more you know, the less fear and anxiety you will have.

Wear your mask if you want.  Initially, when we didn’t know how invective this virus was, I was all for using any protection available.  But, since the end of April, the data has changed my mind.  Wearing a mask isn’t doing anyone any good.

Some cities and states have mandated mask wearing. I’m not telling you to break the law.  I am saying that the mask mandate has done nothing to “slow the spread” as so many people have now bought into.  Research demonstrates that homemade masks to little to stop the spread of viral infections and surgical mask that have been properly fitted and worn correctly decrease this risk of viral spread by only 2-5%.  In the most recent review of the mask wearing literature, the authors stated, “The evidence is not sufficiently strong to support widespread use of face-masks as a protective measure against COVID-19. However, there is enough evidence to support the use of face-masks for short periods of time by particularly vulnerable individuals when in transient higher risk situations.”

What is effective is washing your hands regularly with soap and water, avoiding those who are actually sick or have fevers over 101 degrees, eating a healthy diet that prevents diabetes risk and getting adequate sleep.  Those at high risk for infection can and should be vigilant about avoiding exposure.

 

 

 

Is Ketosis Really Bad For You?

The Look When Told Ketosis is Bad For You

A patient recently asked me how bad being in nutritional ketosis was for her.  I responded that the worse problem I’ve seen recently is the patient that broke his toe when he slipped on bacon grease.  Are there risks with a ketogenic diet? Yes, but these usually only occur when you cheat or fall off the wagon.  What problems can arise?  Lets talk about them individually.

First, as I stated above, make sure you don’t slip on bacon the grease.  It really can be an issue if you’re not used to using increased amounts of fat in your kitchen. So, be prepared for how to cook and use fat.  Grandma understood this well, we could learn a great deal from her if you ask her about using bacon grease.

Second, let’s define the difference between ketosis and keto-acidosis and try to clarify the misinformation that is being spread around the blogosphere.

A ketone is a molecule the body produces from the breakdown of fat (specifically triglycerides) and some proteins (amino acids).  There are specifically three types of ketones: beta-hydroxybutyric acid, acetoacetic acid and acetone.  If ketosis was “bad,” then why would our bodies produce these molecules?  They are not bad, and in fact, multiple studies show that the body is often more efficient in weight loss, inflammatory reduction, bowel function, epigenetic influence and maintenance of lean body mass more effectivly when it functions on ketones rather than glucose as its primary fuel source. You can see these studies here, here, here and here.

The body can only supply a limited amount of sugar or glucose for fuel.  If you talk to runners, marathoners or triathletes, they will tell you that after about 45-90 minutes of continuous endurance exercise the glucose supply runs out and they will experience what is termed a “bonk” (have a low-blood sugar or hypoglycemic episode).  Unfortunately, our bodies can only store about 18-24 hours of glucose.

However, the body can store days upon days of fat in the form of triglyceride in the fat cells.  Triglyceride is broken down into ketones.  If glucose is the “unleaded” fuel, you can think of ketones as the “diesel fuel” that is easier to store and runs longer.

The average body functioning on ketones as the primary fuel will have a ketone level measured in the blood somewhere between 0.4 and 4 mmol/L.  Because of a balance that is created by the use of ketones and a feedback mechanism that kicks in when the ketone level rises, the body will maintain a pH of around 7.4.

Ketoacidosis is dramatically different.  If you are a type I diabetic, you don’t produce any insulin.  The feedback mechanism regulating ketone use is broken and the ketone levels and triglyceride breakdown speeds up because the body can’t access glucose and can’t produce insulin.  The ketone levels spike and the level can rise to > 25 mmol/L.  In the presence of a high blood sugar and high ketone level, the acid level in the blood shifts to a pH of less than 7.3.  This is referred to as metabolic acidosis and can be life threatening as the low pH shuts down the bodies’ enzymatic processes and a person becomes critically ill and without treatment, can die. Further information on ketoacidosis can be found here.

If you’re not a type I diabetic, you have nothing to worry about.  Regardless of what the “ketogenic nay-sayers” blog about, your liver makes approximately 240g of glucose per day, 24 hours a day, 7 days per week, this stimulates a basal release of insulin which keeps the pH in check. It’s also what keeps weight loss at a consistent pace of around 2-10 lbs per month.

If you are a type I diabetic, don’t fret.  Carbohydrate restriction can still be used very effectively.  It just takes some balancing and understanding of your individual metabolism.  It does require close blood sugar and insulin monitoring.  If you are a Type I diabetic, please talk to your physician, obesity specialist and/or bariatrician about how to follow a carbohydrate restricted diet while using insulin. It can be done and it can be done very effectively, but monitoring is essential.

What are the other potential problems that can arise when you follow a ketogenic diet?

Gastrointestinal (GI) Disturbances – Yes. Any time you change your diet you may experience diarrhea, constipation or gassiness.  Most of the time, this is because you are either 1) not eating enough leafy greens (fiber) or 2) you’re using a supplement that contains an artificial sweetener.  Most of the studies on ketogenic diets did not incorporate fiber and the studies used to make this point were on children who used a ketogenic fat supplement shake or liquid preparations containing these artificial sweeteners to make them palatable.  If you have spoken to any obesity specialist, they will tell you, the best way to follow a ketogenic diet is to eat real food.  If you want to read about the anecdotal GI effects of sweeteners, read the comment section in Amazon about the Haribo Sugar Free Gummy Bears.

Oh, by the way, 65% of patients in my practice following ketogenic diet see improvement in gastroesophageal reflux (GERD) symptoms.  This was seen in a 2006 study looking at ketogenic diets and reflux.

Hair Loss/Thinning – Yes.  This does happen initially and if you are not eating enough fat. It is important to note that hair loss/thinning can occur with any form of weight loss.  You can see data on this here.  Hair loss is very common if you are restricting calories, which was occurring in a number of the ketogenic dietary studies previously published.  You do not, and should not, need to “restrict calories” if you are following a ketogenic diet correctly, and in fact, most people take in more than 1800 calories on a ketogenic diet.

Inflammation Risk – In every patient that I have placed on a ketogenic diet in the last 10 years, all inflammatory markers including CRP, Sedimentation Rate, Apo B, HOMA-IR and Uric Acid have all decreased.  Inflammation gets better on an appropriately formulated ketogenic diet. The older studies of ketogenic diets in children contain most of their fat from Omega-6 fatty acids from vegetable oil which will increase inflammation and oxidative stress, spike the cortisol levels and have the secondary effect of actually raising the triglycerides. You can find more information on this here & here.

Kidney Stones/Gout – These (kidney stones & gout) are both commonly caused by spikes in uric acid.  As noted above, I’ve seen multiple cases in my practice where a ketogenic diet lowers uric acid. Only a small clinical trial has been published in the literature (and it wasn’t truely ketogenic), but the results point to the potential for ketogenic diets to lower uric acid.  Ketogenic diets also have the capacity to lower the formation of calcium oxalate stones through a secondary mechanism where calcium oxalate formation is driven by uric acid formation. Older small case reports in the pediatric seizure literature identify calcium oxalate stones, however, dehydration (too little fluid/water intake) is the primary cause of kidney stones.

So, are ketogenic dietary patients at risk?  Only if you cheat on your carbohydrate restriction and you let yourself get dehydrated.  So, I warn patients.  Don’t cheat and make sure your drinking adequate amounts of water.

Muscle Cramps/Weakness – The process of weight loss occurs by burning fat into CO2 and water. We breathe the CO2 out, but the water produced has to follow salts out through the kidneys.  Hence, we lose water and salts.  This can cause weakness and muscle cramps.  The solution?  Stop restricting salt on a low carbohydrate diet.  We are the only mammal that restricts salt and we do it because low-fat diets cause us to retain water.  Low carbohydrate diets do the opposite.  Use sea salt or sip beef or chicken bouillon broth with your dinner.  You may consider adding magnesium to your diet. The use of yellow mustard also helps (the small amount of quinine in yellow mustard stops the cramping).  If you have congestive heart failure, talk to your doctor about monitoring your salt intake in balance with your diuretic or water pill.

Hypoglycemia – If you read the ketogenic diet research, most of it was done on epileptic children.  The diets called for a period of starvation, and then the introduction of a ketogenic liquid based shake following the John’s Hopkin’s protocol.  It is a well-known fact in medicine that starvation in children can frequently cause hypoglycemia, especially in children with other genetic or congenital defects leading to forms of epilepsy.  In clinical practice, with ketogenic diet use in adults, hypoglycemia is rare.  The only time I see hypoglycemia is when patient’s with significant insulin resistance or diabetes cheat on a large amount of carbohydrate and get a secondary insulin surge leading to hypoglycemia 3-5 hours after cheating.

Adapt Bar Berry

Low Platelet Count (Thrombocytopenia) – Again, this was seen in epileptic children who were placed into starvation first, then introduced a liquid fat replacement shake to stop intractable seizures. These liquids or shakes were often nutrient deficient in other essentials.  Folic acid, B12 and copper deficiency can occur when not eating “real food.” Low platelet counts are rarely seen on ketogenic diets based around “real food.” Many children in the ketogenic studies had been on or were concomitantly on valproic acid for their seizures.  Valproic acid is commonly known to cause thrombocytopenia and this is another reason that thrombocytopenia was seen in this population. (Barry-Kravis E et al, Bruising and the ketogenic diet: evidence for diet-induced changes in platelet function. Ann Neurol. 2001 Jan;49(1):98-103.;  Kraut E, Easy Bruising, http://www.uptodate.com, May 2015.)

Impaired Concentration/Mood – A number of patients starting carbohydrate restriction will go through 2-4 weeks of carbohydrate withdrawal.  This carbohydrate withdrawl can be experienced just as powerfully as morphine withdrawal in some patients. Sugar is a drug and has a powerful effect on the same hedonic receptors that morphine does in the brain.  Some patients will experience headache, tremor and decreased concentration while “withdrawing” off of starches and carbohydrates. Studies show that after the 4-8 week period of keto-adaptation, cognitive function dramatically improves.

Metabolic Acidosis – As described above, metabolic acidosis can occur in a type I diabetic who is not getting adequate insulin, and metabolic acidosis has also been shown to occur in young children placed on severe carbohydrate AND protein restriction, as was the case in some of the ketogenic dietary trials with epileptic patients. (Saxena VS, Nadkarni VV. Nonpharmacological treatment of epilepsy. Annals of Indian Academy of Neurology. 2011;14(3):148-152. doi:10.4103/0972-2327.85870.; Freeman, et al., The Ketogenic Diet: One Decade Later, Pediatrics March 2007; 119:3 535–543).  

Osteoporosis/Osteopenia – If your ketogenic diet is “shake” or “meal replacement” based, you run the risk of mineral deficiency that could lead to Osteoporosis, however, if you are using real food, the opposite is true and most patients have improvement in their Vitamin D levels and bone density. (AG Christina Bergqvist, Joan I Schall, Virginia A Stallings, Babette S Zemel, Progressive bone mineral content loss in children with intractable epilepsy treated with the ketogenic dietAm J Clin NutrDecember 2008 88: 1678–1684; doi:10.3945/ajcn.2008.26099)

Easy Bruising – This is usually due to inadequate protein supplementation as was the case in much of the ketogenic literature where protein levels were also restricted. (Kraut E, Easy Bruising, http://www.uptodate.com, May 2015.)

Infections/Sepsis/Pneumonia – Increased susceptibility to illness has never been an issue in the 10 years I have been using ketogenic diets with my patients.  These issues were seen in the John’s Hopkins protocol with children who had not only epilepsy, but other congenital disorders predisposing them to infection, who were placed on a diet low in protein and carbohydrate. (Saxena VS, Nadkarni VV. Nonpharmacological treatment of epilepsy. Annals of Indian Academy of Neurology. 2011;14(3):148-152. doi:10.4103/0972-2327.85870.)

Pancreatitis – Patients who are insulin resistant or have impaired fasting glucose commonly have high triglycerides.  Elevation in triglycerides itself is a cause of pancreatitis.  Ketogenic diets lower the triglycerides. However, if a patient has not been following their diet as directed, spikes in the triglycerides can occur placing the person at risk for pancreatitis.

Long QT Intervals/Heart Arrhythmias – The list of things causing Long QT intervals and abnormal heart rhythms is long and variable (Acquired Long QT Syndrome. Berul C et al. www.uptodate.com, May 2015). It is well know that starvation, rapid weight loss and liquid protein diets can cause a delay in the conduction signal in the heart.  Anyone wishing to start any diet should have an electrocardiogram (EKG) through their doctor to ensure that the diet (of any type) doesn’t exacerbate a prolonged QT interval.

Cardiomyopathy – Prolonged QT intervals have been associated with cardiomyopathy and the former can stimulate the later.  Any diet that has the potential to prolong a QT interval has the potential to cause cardiomyopathy.  Hence the need for regular EKG monitoring on any diet (Acquired Long QT Syndrome. Berul C et al. www.uptodate.com, May 2015).

Lipid/Cholesterol Changes – In the 10 years I have been prescribing ketogenic diets to patients, I have seen dramatic improvement in the triglycerides, small dense LDL particle and HDL levels.  The only time triglycerides rise over 100 is if the patient is using artificial sweeteners, is cheating on the carbohydrate restriction, or is taking in too much protein.  Total cholesterol commonly rises, however, this is indicative of the fact that there is a shift in the LDL particle size and this affects the calculation of both total cholesterol and LDL-C.  In light of this, most of my patients have dramatic improvement in triglycerides and small dense LDL particle number.

Myocardial Infarction – In older papers, elevated total cholesterol was noted and the authors made the “assumption” that myocardial infarction “could” be a risk. We now recognize that elevated Total Cholesterol is NOT a causitive risk for heart disease.

These previous assumptions have been interpreted by the blogosphere ketogenic “nay-sayers” as actual risk.  However, a correlation and causation was never made.  Again, in the 10 years I have been using and prescribing ketogenic diets, I have seen dramatic improvement in cholesterol profiles, inflammatory markers, atherosclerosis and carotid intimal studies (Shai I et al, Circulation 2010; 121:1200-1208).

Menstrual Irregularities / Amenorrhea – It is well known that any diet causing protein or other nutritional deficiency will affect the menstrual cycle first and growth in stature second.  The only time menstrual irregularities occur with a ketogenic or Low-Carb diet is when a patient is not taking in enough protein and/or fat, and is not eating real food.  What amazes me is that a properly applied ketogenic diet actually causes normalization of the menstrual cycle, and in my practice, I’ve had a number of women successfully be able to conceive after making a ketogenic dietary change.

Death – All cases of death related to ketogenic diets have been documented in children while using liquid based carbohydrate and protein restricted formulas for ketosis to treat epilepsy.  These cases revealed the formation of a prolonged QT interval leading to cardiomyopathy due to deficiency in selenium.  This was later solved by the addition of selenium to the ketogenic supplement. (Stewart WA et al., Acute pancreatitis causing death in a child on the ketogenic diet, J Child Neurol. 2001 Sep;16(9):682.;   Bergqvist AG et al, Selenium deficiency associated with cardiomyopathy: A complication of the ketogenic diet. Epilepsia. 2003 Apr;44(4):618-20.;  Kang HC et al., Early and lat onset complications of the ketogenic diet for intractable epilepsy, Epilepsia. 2004 Sep;45(9):1116-23.;  Kang HC et al, Efficacy and Safety of the Ketogenic diet for intractable childhood epilepsy: Korean Multicentric Experience, Epilepsia. 2005 Feb;46(2):272-9.) Selenium deficiency does not happen when the diet is based on the use of real food instead of supplementation, and has never been seen in adults.

Is a ketogenic diet bad for you?  You be the judge.

If you are following a ketogenic diet correctly and with real food, the only thing you really need to worry about is slipping on bacon grease.

Slip On Bacon Grease

In an era where over 70% of us (35.7% obesity & 34% overweight in 2015 according to the CDC) have started to resemble the food pyramid, seeing the effect of a carbohydrate heavy diet should give a clue.

FoodPyramidSimlarity

Our bodies were meant to burn ketones. We have a parallel system within us designed to use ketones as an energy source. Ketones are faster and more efficient than the way our bodies use glucose. Ketones give you 38% more energy than you can get from glucose. We as a society are following a deceptive food pyramid.

When we limit or remove carbohydrate from our diet, we are left with ketones as a primary fuel.  It is time that we recognize what Dr. Yudkin was trying to tell us in 1970’s, that our carbohydrate and sugar intake is the driver for heart disease, diabetes and the diseases of civilization. (Yudkin, John. Sweet and dangerous: the new facts about the sugar you eat as a cause of heart disease, diabetes, and other killers. PH Wyden, 1972.)

 

KetoOS
KetoOS – Drinkable Exogenous Ketones