The gigolo

-“Doctor…It’s so much easier than a real relationship—it’s a transaction.”

Carol X. is a successful real estate agent and entrepreneur that has confided to me that she regularly patronizes the services of a discreet escort agency. After meeting a male stripper in a bachelorette party that offered his after-hours services to her, she got hooked on a young, muscular company. .

After a long marriage with an indelicate man that only wanted to achieve a quick orgasm and then left her wanting, both physically and emotionally, she got a divorce a few months ago and vowed never again to marry a man. She has experienced with several occasional partners, even with a woman. But the daily pressure of comforting somebody’s needs is too much for her extremely busy life.

She has only shared that secret with a gay confidante, her coiffeur and moi. In a modern woman’s world the attendance to church to give a confession to a priest has been replaced by a visit to the salon or the medical office. Not a single one of her friends, even women, have an inkling of those escapades. The web has given that newfound opportunity to women who are not rich. In general they want the perfect combination between sexual performance and affection, their own gladiator in bed who knows how to cuddle them right.

Sometimes the feminine interest in a man transcends her mere erotic desires.

Long, long time ago (before I became a monk of Medicine) I happened to work in a medical clinic owned by a wealthy and widowed Russian lady. She seemed to like me enough to pay me generously, including some living expenses, and she invited me to fine restaurants. She enjoyed my company and conversation but she did not want sex.

-“Mommy, she doesn’t want to sleep with me,” I told my mother by telephone.

-“Really? That’s perfect…She gives you a lot and asks for nothing, dear.’

-“You think so?’

-“Of course…Just find a young, eager girl to enjoy that largesse without remorse.”

What do you want me to say? That episode of redistribution of wealth from one privileged lady to a needy one may have sparked my monastic vocation…

What do you think?” Please tell me.

Don’t leave me alone.

Need for community health workers

When I was a medical student I studied the novel Chinese experience of the “barefoot physicians”—community health workers in its vast countryside. With a basic training and a lot of enthusiasm they provided critically needed access to clinical and obstetrical services for its impoverished population. In the years that have passed by, the Chinese central government has made a big investment in economic and human resources for the medicalisation of maternal care, which now occurs usually in well-equipped care centers.

Community health workers now play a pivotal role in most health care initiatives around the globe as they provide preventive and curative care to underserved, poor communities in far away regions with difficult access. The scarcity of health care personnel has given new impetus to their training and deployment in order to complement and even spearhead care initiatives. They are responsible for the great strides in malaria control and eradication.

An editorial in “The Lancet Global Health” says, “a quick look at the CHW panorama shows great success as well as missed opportunities. Large-scale government-led programmes in countries like Brazil and Tanzania, where CHWs are part of the formal health system, trained, and remunerated, have led to increased health care coverage and improved health indicators. Conversely, man local smaller-scale programmes that lack the necessary support system—clear financial and administrative planning and coordination—have proven to be unsustainable or misaligned with local needs, and have fallen through attrition or lack of utilization.”

Even though they often shoulder the burden to provide access to basic health services to underserved communities, the CHWs dwell in a “grey area” of the formal care systems as their professional role is not properly formulated and they are not efficiently trained to obtain a final certificate or diploma. The World Health Organization (WHO) has promoted a labour strategy to streamline and rationalize their training to integrate them into the systems. These good Samaritans need resources, good pay and a clear career pathway.

What do you think? Please tell us.

Don’t leave me alone.


The social stalker

-“Doctor…He’s madly in love with me—he just doesn’t know it yet.”

Sylvia X. is an attractive young secretary that believed her supervisor was interested in her, even though he had had a steady girlfriend for many years. She followed his movements all over the social media and spent hours dissecting all the details of her search, trying to find an edge to ensnare him.

This modern possibility to spy on other people’s lives on a constant basis has brought privacy issues to the stalked individuals but also mental health issues to the stalkers: paranoia, loss of self-worth and delusional behaviour. The social price of this unhealthy snooping is shared by both ends of it.

The stalking patterns run a gamut between a rather innocent interest in knowing “what the other person is up to” through many intermediary stages until the more morbid attitude of creating a wholly false internet personality. The latter can include the use of insults and threats to coerce the recipient. The stalker picks bits of information and creates a collage of information that might not be completely accurate or even remotely pertinent for its use.

Dr. Walter H. Ghedin says “the imagination of the hurt person starts to fill up with a myriad data that starts to mesh into a painful platform in the mind. And what in other persons produces just emotional pain, in others can trigger a desire of vengeance. Of course all of us have psychological defense mechanisms to face an amorous deception, doubts about faithfulness or even emotional dependence. But the permanent, voluntary exposure to images and texts that speak of ‘the other person’s life’ often invalidate any recoveries.”

Sylvia X. came back to my office with a distraught appearance last week.

-“Oh my…What happened to you?” I asked her.

-“Er…It happened…We went to an office party and then he took me home.”

-“Then you should be ecstatic and not in this sour mood.”

-“The next day he ignored me completely—going to get back at him.”

There’s only one entity worse that a social stalker. A spurned social stalker.

What do you think? Please tell us.

Don’t leave me alone.

The need for sex

We can certainly agree that good and frequent sex is a healthy human habit. However when people are asked if having a lot of sex is important for the couple’s sense of well being they will say that it is not the determining factor to consider. A recent study explains the disconnect between these attitudes.

Dr. Lindsey Hicks, a psychological researcher at Florida State University, found that the frequency of sex is not directly related with people’s reporting of their satisfaction in their steady relationships but it does influence their more spontaneous and automatic responses when they are asked about it. As those automatic responses don’t require a conscious vetting, Hicks et al. believed that they might uncover some implicit perceptions and associations.

Initially they studied 216 newlywed-couples with a comprehensive survey that measured the satisfaction in their relationships. The participants rated different qualities of the marriages, their agreement or lack of it with certain statements and their satisfaction with their partners in a marriage setting. After completing the survey, they were tasked with a computer classification of responses to certain words after their partners’ pictures appeared briefly. The response time indicates how firmly two items are linked automatically; the faster the response time, the stronger the association between the two, If, after seeing the picture of their partner, the person responded more slowly to negative words than positive ones, it signified positive implicit attitudes.

Dr. Hicks did not find any direct association between the participants’ frequency of sex and their satisfaction levels, as happened in other studies. But the sexual frequency was directly related to their automatic responses; the more sex they had, the more positive attitudes towards the partners were.

This finding happened in both men and women. Another longitudinal study (extended in time) that studied 112 newlyweds confirmed that sex frequency was related with the participants’ automatic responses to the visual stimuli.

Some people are so profoundly unhappy that they can’t even admit it to themselves.

What do you think? Please tell us.

Don’t leave me alone.

A most royal sale

Dear friends:

There is a privileged individual that happens to have two birthdays. Queen Elizabeth of Britain has her biological birthday on April 21st but will be officially celebrated with a big parade of the Horse Guards that has been nicknamed as “Trooping the Colour” on June 17th; it will feature more than 1,400 officers and soldiers and 400 musicians in full dress rehearsals. The London weather prodded British royalty to delay celebrations until summer.

Many readers all over the United Kingdom have been faithfully following our blogged articles ever since we started our web page in May 2016. They are a discreet bunch, hardly ever writing a commentary, but their presence is noticed when the flags of England, Wales and Scotland pop in our statistics. We would like to correspond their politeness with a special deal for our first novel: “Madame D.C. – Three voyages.”

Starting on June 12th 2017 there will be a special 1-week countdown sale of it in with an initial affordable price of 0.99 pounds sterling; every 2 days the price will slowly rise until reaching its regular one on June 19th. Don’t procrastinate and take advantage of this sale to sample our prose, share it or gift it away. We’re confident that you’ll find it unusually exciting. Thank you very much for your silent yet strong support for our writings.


The secret trigger

-“Doctor…After so many years, my husband still doesn’t open up to me.”

One of the commonest concerns of ladies in steady relationships is the one expressed by Jane X. in my office a while ago. Their partners do not show the same willingness to share their innermost feelings as they are with their bodies in the bedroom’s intimacy. And they have emotional frustration.

It is far more difficult for men, especially of mature age, to confide their most intimate secrets, fears, desires as they had been often reared with the silly motto that “men don’t cry” or that “men must toughen up at all times.” Well, we all know that men do cry and it has nothing to do with our sense of manhood as there are many circumstances in life that alter our equilibrium.

For many years I’ve been pondering whether the fabled “secret trigger” that makes males forfeit their usual defensiveness and open their hearts to a particular person exist as a constitutional feature. I know I have one. But do men of all stripes and backgrounds possess such a hidden emotional lever?

Wandering the magical streets of Venice I had the sudden inspiration to write a scene of my novel where two characters inebriated with love find it. If science cannot yet confirm our assumption of its existence, the women’s sentimentality and writers’ imagination can start to shape it in our minds.

“Chiara and Saul arrived at the ‘Ponte della Donna Onesta’, a small bridge that spans the ‘Rio della Frescada’, uniting Dorsoduro with San Polo. A legend affirms that a cutler lived with his beautiful wife nearby; a young patrician ordered a knife so he could get close to her. When the artisan was absent, he raped her. Full of shame, she took her own life with the same tool.

As they were crossing it, Chiara suddenly stopped and turned around.

-“Tell me…Can a woman love a man so much as to die for him?”

-“Hu-huh…Don’t really know…It could have been more plausible in other times when women were less empowered—much more dependent on men.“

-“What do finances have to do with a woman’s feelings?”

-“ C’mon, Chiara…. I’m not the right one to answer that—”

-“What? Can’t you appreciate the devotion of a woman in love?”

Saul averted his eyes, watching the slowly moving brackish watercourse.

-“Forget it,” Chiara said, tearing a piece of krapfen. “Open your mouth—“

Caressing his face, she gently placed the morsel inside. He closed his eyes.

A Swann moment paralyzed the neural networks of his sensory grid.

Saul is tightly holding his mother Rebecca’s hand, shopping together for groceries in the Venetian quarter, right after the Sabbath ended. After they left the bakery, she pauses. “Wait, dear… Have a bite.”

She takes a crisp pastry out of the bag and gives it to her eager son. No futile words or judgements. Only categorical motherly affection. Opening his eyes, Saul grabs Chiara by her waist and kisses her.

Chiara, the bookish spinster with little life experience, finds what his late wife did not in their twenty years of marriage: his secret trigger.

Nature’s sentimental ruse that forever attaches a man to a woman.”

What do you think? Please tell us.

Don’t leave me alone.

Cannabis in PTSD – Part I

We can still remember that great scene in Oliver Stone’s “Platoon” movie where the stressed-out grunts dance in their tent while passing around a bamboo pipe. The association of marijuana with the U.S. military dates back to the Vietnam War where it was a good, ready solace for the terrified and tired soldiers in the field.

The diagnostic term “Post-Traumatic Stress Disorder” (PTSD) refers to a series of psychiatric symptoms secondary to an unusually stressful/traumatic emotional event, a common occurrence in the military. The fifth edition of the “Diagnostic and Statistical Manual” (DSM) has these criteria categories:

  • Criteria A: the person was exposed to death, threatened death of threatened serious injury or sexual violence by direct or indirect ways.
  • Criteria B: the traumatic event is consistently experienced.
  • Criteria C: avoidance of trauma-related stimulation after the trauma.
  • Criteria D: frequent thoughts or feelings that began or worsened after the trauma.
  • Criteria E: trauma related arousal and activity that began or worsened after the trauma.
  • Criteria F: symptoms last greater than one month.
  • Criteria G: creates distress or functional impairment.
  • Criteria H: symptoms are not due to medications, drug abuse or medical illness.

The PTSD complex can include the syndromes of Depersonalization (observers consider that the individual is dreaming) and Derealization (the individual feels things that do not have an external stimuli) Exposure to high explosive blasts account for a considerable number of PTSD cases, for which physicians must always suspect and rule out structural brain changes before using the PTSD label as a primary psychiatric – not physical disorder.

In PTSD there is an endocannabinoid deficiency, as the body does not produce enough to fill all the brain receptor sites; by replenishing them, the CB-1 signals deactivate the traumatic memories, avoiding the impaired fear extinction, aversive memory consolidation and chronic anxiety of PTSD. Cannabis can produce acute anxiety reactions and panic attacks, especially in individuals not used to THC. Is it an adjuvant cause or a needed relief?

A paper by the “National Center for PTSD” said that the effects of cannabis use vary according to the concentration and potency of the cannabinoids. “The concentration of THC in the marijuana plant can range in strength from less than 1% to 30% based upon strain  and cultivation methods…Cannabis extract products, such as waxes and oils, have been produced and sold in which the concentration of THC can be as high as 90%.” Even though the prolonged use of Cannabis may reduce the worst symptoms of PTSD, it can produce a steady physiological tolerance and eventually drug addiction.

We will continue this discussion in an upcoming second part of this article.

What do you think? Please tell us.

Don’t leave me alone.