Dating her friend’s Ex

-“Doctor…My girlfriend just dumped him—and I’ve always liked him.”

Amongst the trickiest situations a lady can find herself in modern times is to start dating the former boyfriend or husband of one of her closest friends. And it puts all her counsellors, including us physicians, in a tricky bind.

Unlike many men—who wouldn’t even dither at the real chance of having a romantic tryst with one of his girlfriend’s female buddies—women in general place their close friendship with other women in pride of place. Considering that women are terribly territorial (yes ladies, face the truth), it doesn’t really matter if she had dumped that deadbeat years ago. She still considers him as part of her story and is unwilling to share him in any form except as fodder for continuing criticism and sarcasm in her conversations.

Sandra X. told me about her personal quagmire in my office many years ago. She then proceeded to ask that most dreadful question:” what should I do?” You might be wondering what I said. Surely not a detached: “dunno know.” At the time I was younger and less conservative in my dealings with women.

-“ Well, this is really difficult….But I think that you should be the one that breaks the news to her before even going into the first date with him, eh.”

-“Asking her for permission?”

-“Not that…Just tell her what’s going on and that you’re emotionally torn.”

Following my advice, Sandra told her friend about the possibility of dating her Ex. On hearing the news she got extremely upset, to the point that she never talked to her again. Dismissing her friend’s anger, Sandra went on a date with her former boyfriend. It went so well that they had another one…Then they went on a trip….They finally got married. Now they have a solid family with two beautiful children, something she always wanted.

Sandra was steadfast and valiant in a decision that changed her life forever.Perhaps that valour might be more difficult to muster in our hyper-connected age where you can count on the predictable backlash in all the social media. However I do believe that women are more courageous than men overall; if she believes that he might be a good prospect, she will take that leap of faith.

Les femmes…Celles qui nous poussent a devenir un peu plus courageux.

What do you think? Please tell us.

Don’t leave me alone.

Cannabis in Parkinson’s Disease – Part II

Physicians’ reports, patient surveys and clinical studies have indicated that Cannabis may help alleviate the motor and non-motor symptoms in chronic Parkinson’s Disease as we have discussed in a previous post.However the lack of properly designed clinical trials for Cannabis, and its derivatives like CBD, has limited its acceptance by the medical community.

Two big studies presented in the “21st International Congress of Parkinson’s Disease and Movement Disorders” evaluated the effects of oral cannabidiol (CBD) and inhaled Cannabis in patients that had Parkinson’s Disease.

Dr. Maureen A. Leehey et al. from the University of Colorado in Aurora carried on a phase II, open-label, dose –escalation study to determine the safety and efficacy of Epidiolex (a commercial form of CBD) in humans. The study included 13 volunteers—without a history of drug or alcohol dependence or took cannabinoids in the previous 30 days—who were treated with 5, 7.5, 10, 15 and 20 mg/kg/day doses of CBD for 31 days; they ere evaluated at triage, baseline and 31-days treatment. The adverse effects were usually mild to moderate: fatigue, diarrhea, somnolence, rising liver enzymes and dizziness. Only seven patients finally completed the treatment.

The “Unified Parkinson’s Disease rating scale” (whose acronym is UPDRS) is a comprehensive rating scale for patients with PD that includes:

  1. alterations of intellectual function
  2. alrerations of cognitive function
  3. depression
  4. motivation-initiative
  5. language
  6. salivary function
  7. swallowing
  8. writing
  9. cut the food and handling cutlery
  10. personal grooming
  11. personal hygiene
  12. behavior in bed
  13. falls
  14. gait
  15. tremor
  16. sensory symptoms

For each item the rating scale goes from 0 (no abnormalities) to 4 (presence of abnormalities) The mean total UPDRS score decreased from 45.9 at baseline to 36.4 at the last visit; the UPDRS motor score decreased from 27.3 to 20.3. Mean rigidity subscore significantly decreased from 9.14 to 6.29. Some patients stated that their pain and irritability have also decreased.

Dr. Laurie K. Mischley et al, from the Bastyr University Research Institute, studied the effects of inhaled cannabis (Epidiolex) on the tremors of PD patients by using motion sensors and interviewing the patients themselves. The participating patients wore a device to monitor their movements for two weeks and they logged their impressions in a daily journal. The sensors registered the frequency and amplitude of the parkinsonian tremor during the wakeful state; the patients pressed a button each time they took the drug.

In this study the duration and the magnitude of the tremor was compared one hour before and hour after the inhalation of Epidiolex; after the study ended the patients responded a few questions about their impressions of the effects. Four patients that took more than 10 doses and had a tremor more than 2% of the time in the hour before the use of Epidiolex, showed decreased tremor in the hour after they took the drug. The monitored data showed that the effect might have lasted up to three hours after the use of Epidiolex. In the follow-up, 9 out of the 10 participants said their symptoms had ameliorated. The side effects included: sleepiness, short-term memory loss and dry throat. An unexpected but useful collateral effect was the improvement of sleep.

What do you think? Please tell us.

Don’t leave me alone.

The virtual misogyny

-“Doctor…Most men in my office hate me—not that they say it in my face.”

Kim X. is a successful defense lawyer in one of top law firms in Brickell but in spite of having earned her standing, her male co-workers deeply resent it. Most of the vitriol consisted of whispered asides at the water cooler that she was able to identify; when she showed up men changed the conversation. However she recently had the suspicion that the misogyny migrated online.

The under-representation of women in the top tier of public administration, business corporations and academia has been extensively documented. That concealed discrimination has been buttressed by a workplace culture that discreetly demeans women and their work as objectionable conversations rarely occur in the open. Misogyny is still alive but hides underground. The water cooler setting has been replaced by the computer or the smartphone.

However the use of the digital media leaves an indelible archive behind. Computer experts have refined some machine-learning techniques adapted to explore patterns in large bodies of text, which can quantify some gossip. Alice H. Wu, a student in the University of California at Berkeley, studied more than a million posts from an anonymous online message board known as “Economics Job Market Rumors” that is well visited by the economists.

That forum is completely anonymous and it’s impossible to find out the gender of the person posting a comment, let alone if he/she is an economist. But the subject of each post can be identified by gender: man or woman. Ms. Wu adapted machine-learning techniques to find the terms associated with the posts about men and those about women. Here are the top ones for gals:

  1. Hotter
  2. Lesbian
  3. BB (baby)
  4. Sexism
  5. Tits
  6. Anal
  7. Marrrying
  8. Feminazi
  9. Slut
  10. Hot
  11. Vagina
  12. Boobs
  13. Pregnant
  14. Pregnancy
  15. Cute
  16. Marry
  17. Levy
  18. Gorgeous

The anonymous online discussions of men about women usually involve topics related to their personal behavior, physical attributes or gender issues. In contrast the discussions about men are focused on the field of work or strictly professional issues like job opportunities, career moves or counsel. This data might no be representative of the entire field of economics but an active minority can certainly sour the workplace environment for women.

Gossiping is part of every workplace and we have to deal with it in stride. However the spreading of false or inaccurate information about a colleague can seriously damage her career prospects and skills evaluation process. Once a rumour spreads in an inter-connected place, it takes a life of its own and continues to exponentially grow.

What do you think? Please tell us.

Don’t leave me alone.



New focus in Alzheimer’s research

The sustained search for a treatment for Alzheimer’s disease has created many experimental therapies that target the accumulation of a protein called Amyloid Beta in the patient’s brains. On one hand the clinical results with the available treatments have been mixed because the Abeta levels do not correlate well with the severity of symptoms and on the other hand some studies suggest that the loading of this protein begins two or three decades before the patients’ show symptoms, which makes an early prevention impractical.The deterioration of the patients’ clinical picture seems to correlate well with the loss of excitatory neurological synapses that allow connectivity of cells.

Dr. Margolis et al., researchers at the Gladstone Institute of Neurological Disease at the University of California at San Francisco, found in 2010, that a protein called EphB2, which regulates the NMDA function essential for the proper synaptic connectivity, was decreased in the brains of AD patients. The decay of the Ephexin 5 had the collateral of slowing the function of the excitatory synapses, which could explain Autism’s cognitive dysfunction. Recently that fortuitous finding has been used in some new studies.

When the researchers added Amyloid Beta to the brains of healthy mice, there is an increased production of Ephexin 5. The analysis of brain tissues from the autopsy of patients with AD showed increased levels of EphB2. The researchers hypothesized that if they could get rid of EphB2, the process of degeneration of excitatory synapses could be halted or at least slowed.After using genetic engineering techniques to destroy the gene controlling the production of EphN2, they discovered that the animals with severe damage did not lose their excitatory synapses, which spared their memories.

Even though Amyloidosis cannot be ultimately stopped, the preservation of synaptic function might prevent the onset of memory loss in AD patients. If the scientists can determine how the abnormal protein damages the neurons, they can provide therapeutic alternatives to make them “amyloid-resistant.” These preventive measures can be instituted in later stages of the disease, unlike the ones pertaining amyloid that must be started in the 40s or 50s. As there are no drugs that can be safely given for forty years to AD patients, researchers are now focusing on an earlier stage of the disease and the medical therapies that can help patients avoid the ravages of it.

What do you think? Please tell us.

Don’t leave me alone.

Thank you Readers and Bloggers

Dear friends:

One week ago the Hurricane Irma—the largest and strongest storm ever recorded in the Atlantic Ocean—started to hit the South Florida shores. As there was a mandatory evacuation of Miami Beach, my son and I took refuge in an old apartment in Downtown Miami. The structure was sturdy enough to withstand the more than 150 miles-an hour winds that started howling down the streets on Sunday morning but the windows seemed to be on the verge of exploding and we took refuge for an hour in a small closet. That was only the beginning of our ordeal. In the afternoon the power went out and did not return for days. On Wednesday I had the beginning of a severe “heat stroke” syndrome and my son Gian Luca quickly took me out of that sweltering place to bring me back to Miami Beach, which certainly saved my life.

Now I am slowly, yet steadily, recovering with bed rest, anti-inflammatory medication and good hydration in a properly fitted place to stand the Florida summer’s heat. As my mother Gladys used to admonish us: ” there is nothing like a son in your life.”

Thank you my dearest son Giani for accompanying me and saving me.

As the Whatsapp and Messenger services were never discontinued, we could keep in touch with our relatives and closest friends that supported us. When the Internet service was re-established I accessed many messages from you, the readers of this page, for which I thank you from the depth of my heart.

One of the few benefits of the forced rest of the past few days has been the possibility to catch up with a lot of reading without any work/life pressures. One of the books I read was “Les vertus de l’échec”, a best-seller in France, that deals with the benefits of failure to find the right pathway to success. As I want to share this jewel with you, I decided to start a new series called “Foreign book review” that will discuss new books that have not yet being printed in English.

The solidarity of so many bloggers from the planet prodded me to consider, with the critical stimulus of some enthusiastic ladies, to start the process of forming an association of bloggers and videotubers. We are a quasi-anarchic group of independent writers and filmmakers that prize the freedom of expressing our ideas without the constraint of the cultural establishment. However we work in an imperfect, dangerous world, for which we need assistance and networking for major issues. When the time to negotiate contracts for publicity and other commercial interests comes, the professional advice of a mutual association that backs us might make the real difference. Let’s explore and discuss this initiative together in the next few months.

Thank you all my readers and fellow bloggers for so much sympathy and affection.

May God Almighty bless you and your families.

She likes it too

-“Doctor… when we make love, he’s the only one reaching a climax—not fair.”

Almost all the physicians—as well as their hairdressers—have at one time or the other heard that complaint from some sexually unsatisfied ladies that we were treating.

One of the most perplexing things we found when we arrived in the USA in 1982 is the evident, contradictory, sometimes even baffling disconnect between the open diffusion and distribution of pornography with the prudish reluctance to maturely discuss about our sex lives. In New York you could gorge on tons of sexual displays in “Peepland” of Times Square but common issues of human sexuality were carefully wrapped in secrecy. And the problem of female insatisfaction did not even register in the radar screen. It seems that other modern societies like Australia share the same social challenges.

In a recent study published in the “Journal of Sex and Marital Therapy” researchers of the Kinsey Institute interviewed more than a thousand heterosexual Australians between the ages of 18 up to 94 years old who dared to talk openly about what they usually hide below the bedsheets. The data showed that only 61.6% of women claimed to reach an orgasm during their sexual intercourses while 85.5% of men claimed they did. Almost 38% of the participating women said that they needed stimulation of the clitoris to reach an orgasm in 75% of the sexual encounters they had had; the investigators said that previous sexual studies did not properly address the issue of clitoral stimulation.

Ian Kerner, a sex therapist and NY Times best-selling author, published a great book titled “She comes first” where he patiently describes the female anatomy and how to safely stimulate sexual receptors all over their bodies. It is a practical tool for the modern man who cares about his partner’s pleasure. However the value of experience and good mentorship cannot be overstated.

Long, long time ago, in a country far, far away (before I became a monk of Medicine) a lady took the time to patiently teach me some anatomy lessons. With the passage of time, my memory ebbs and flows…But on a specially sunny day, some of those memories come back like a bubbly wave of sea water hitting the beach and I feel compelled to sit down to write about it. This is an excerpt from my novel “Madame D.C. Book I – Three Voyages” where I dared to write about a subject that I might not have wanted to openly discuss.  Maurizio, one of my three lead characters, has been clandestinely dating a married lady called Renata who used to work as a lap dancer in a strip club.

“In the beginning, Renata allowed Maurizio to have a straight ride in the enchanting routes of her curvaceous anatomy—like in the opening stages of “Il Giro d’Italia”, the most famous Italian cross-country cycling contest.

After a few races to the finish line, it was time for the mountain techniques. Slowly yet steadily Renata wanted to teach him the secrets of how to make a woman reach the heights of erotic pleasure. The Cima Copi. Cunnilingus.

One day Renata decided to start upgrading his skills to a higher level.

-“Hold it, dear,” said she, pushing him aside when they were naked in bed.

-“What’s wrong? Don’t want to make love tonight?”

-“No, silly…Just want to start in a different way…That’s all.“


-“How about if you give me some kissing? You know where.”

-“What? Freud said that clitoral orgasms were infantile—”

-“Did he really? What the hell did Freud know about pleasure? He talked too much about women but never really listened to one…I wonder what his wife felt about his ballyhooed analysis…I’m sure she never had an orgasm.“

-“Stop it! All right… I’ll do it.”

Maurizio slowly positioned his face in front of her vulva, ready to comply.

-“All mine.” With blind bold strokes, his tongue swiped her vulva.

-“NOOO,” Renata said, pushing him aside. “You’re hurting me—get out.”

He straightened in bed. “What? Didn’t you ask for it?”

-“Of course I did…But you got to do it in a more gentle, methodical way… First you must learn the basics—bring that small mirror on the commode.”

Maurizio handed her the item. She placed it in front of her exposed vagina.

-“All right…This fatty mound is my mons pubis…See it?”

Maurizio twinkled his nose. “Yes, teacher.”

-“Pay attention now…We’re heading south …Here we have the start of the labia majora…See? The exterior is rough, hairy, the interior smooth, oily.”

During her sessions, she teaches him the secrets of feminine pleasure.

He watches. He listens. He explores her hidden, humid architecture. Soon the screaming of ‘la figa calda’— camouflaged by the lullaby of the waters—indicates that her pupil is graduating with Honours.”

What do you think? Please tell us.

Don’t leave me alone.


The first blogger

Gilbert Keith Chesterton was born in London in 1874 and passed away in Beaconsfield in 1936. During his prolific professional career, he wrote thousands of articles that were regularly published in the press and also poems, plays, novels, philosophy essays with a clear, easygoing prose. His supposedly verbose verbiage has baffled his readers and critics for decades. He gave his opinion on countless subjects of social importance, without claiming to be the ultimate expert, thus prodding civic debate amongst his readers.

Looking in retrospect at his amazing intellectual output, he can be considered as a pioneer of mass communications in the English language. A blogger. The first one.

G.K. Chesterton grew up in a middle-class family that was politically liberal but adhered to the Unitarian church as well. His happy childhood was shaken by the sudden death of his sister Beatrice, a lasting remembrance. It was the only subject his father refused to ever discuss with him, As such it taught him the value of both memory and silence in the human relationships. Two years after her death, his brother Cecil was born and they remained close throughout their lifetimes; he was the “critical audience” he needed. Cecil and Gilbert often engaged in written sparring over subjects of pressing interest but they knew how to argue them in a civilized manner in an acrimonious age.

Chesterton studied in the Slade School of Visual Art in London, for which his prose is filled with imagery and not too much classical linear argumentation. He tackled almost any subject of importance of his times in his journal articles, sometimes spreading his reach too thin. Critics said that his lack of focus prevented him from attaining a “scholarly depth” for lasting value; he did not pay any attention to them as he openly claimed the mantle of a “popular writer” and not of a haughty academician. He never trusted the persuasive power of “pure reason”, which he associated with insanity, but rather preferred a slightly less focused and more tainted rhetoric that could reach a massive audience and not only the educated elite. Reading “Heretics”, a series of personal essays that support a thesis, we have the feeling of being seated in a Piccadilly Circus café chatting with friends and not listening to a pompous professor at Oxford University.

His taste for paradox prodded him to use the power of popular journalism to make a case in his essays for abstraction; he considered that the most important thing for a man is his view of the Universe, i.e. his philosophy.  The most important thing is not to choose between “the abstract’ and “the practical” but to seize “the practicality of the abstraction” for daily usage.

G.K. Chesterton, quick witted and courageous writer, as well as an honest critic of the prevailing social prejudices, we salute you as the often disrespected pathfinder in the long-term quest for Truth that also we, the modern bloggers, have embraced. Thank you.

What do you think? Please tell us.

Don’t leave me alone.