Keeping the marital flame alive

– “Doctor…We’ve been married for so many years—we hardly ever make love anymore.”

Sheila X. is a nice, successful lawyer “d’une certaine age” that has had increasing doubts about her marriage during the past few months; every time she comes to my office, I can see the tired look in her face with an evident readiness to say a lot of things but with an unwillingness to do it. She has been complaining of multiple minor ailments of various systems in the past few months that, after a complete medical work-up with referral to specialists, turned out to be “somatization.”

One of the most persistent misconceptions in our society is that the progressive decline in marital passion of married couples is directly related to the loss of libido and/or interest in their partners. Even though there is certainly a dearth of sexual activity in these “bored couples”, we believe that it is usually a symptom of a larger problem that needs novel solutions that go beyond the bedroom. So, recurring to our humble, limited but intense experience with the marital bliss, we recommended her the following:

1 – Watch the communication modes

In the beginning of every relationship, we tend to be obsequious and mellifluous with our partner; unfortunately, the daily routine and the wear-off from labor and family obligations will ultimately sap our readiness to say nice things, progressively drifting into rudeness and worse, indifference. We shake our torpor and try to see our romantic partner in a new light. We must listen to their concerns. We must talk to them as adults, not talk down like children. We must speak softly in their left ears. Why the left? Because the sensory input from the left side of the body goes to the Right Hemisphere, the center of affection, where there is no Right or Wrong (read more in my upcoming book) Never underestimate the soothing effect of the right word of encouragement at the right time.

2 – Respect the differences

When a romance starts we value the differences in our “significant other” as a nice challenge of our sentimental status quo and offer us some needed excitement to “feel alive.” However, that attitude might change over they years as we become less tolerant of previously accepted features. We strongly believe that it is almost impossible to “change someone”, a fallacy that many young women believe when they supposedly marry “the man of their lives” and start tinkering a little. When you love someone, you are ready to change your ways. A little. Sometimes may be more. But don’t you start vacuuming the living room when the football game got finally interesting.Or pester me that you want a salami sandwich when “gorgeous” is about to pop “the question” to her. Ca va de soi!

3 – Encourage the individual initiatives

Perhaps one of the most difficult and yet easier recipes is the fact that, in order to keep a healthy couple relationship, both women and men must have separate activities, either in the labor or social spheres, including reserved times for personal hobbies, old friendships, new business ventures. Of course, there were always couples that “do everything together” but that smacks of other times when women were more compliant and followed the lead of their men and relegated their wishes. Moreover, after some time spent apart, the yearning to be with the loved one gets even stronger.

4 – Surprise your partner regularly

One of the funniest ways to break the routine that might asphyxiate any kind of long-term relationship is to do something completely unexpected to surprise your partner. Perhaps one day you decide to stop by a florist shop on you way back from work and buy her a bouquet of red roses; maybe you even dare, not to use one of those lame pre-printed cards, but to write a few simple lines telling her how much you love her and appreciate all she does for you. Say it. Loud and clear…Or perhaps you decide to wait your hubby with a new dish that you learned from a TV program even if you got all the ingredients from Blue Apron. What’s the matter? Is cooking beneath you? Just do it.

5 – Watch your personal hygiene

This is one of the trickiest issues. Of course. we know that we must take a shower every morning and get ready for our interaction with our work or study mates. But how about at bedtime, eh? We should avoid late feasts with too much red meat difficult to digest, carbohydrates that swell your belly, beans and broccoli that encourage the colon bacteria to produce malodorous flatulence. For years I have had the habitude of “moving my bowels” (Yes, I can talk at ease about this subject because I am a physician, remember?) at least once in the morning before going to work and at night before I take a quick shower to get to bed squeaky-clean. Try it. You’ll smell the difference. And, exuding lavender from Provence, your partner might be enticed to “take a bite out of you.”

6 – Maintain family and friendly relationships

The interaction with other people brings a much-needed breeze of fresh air to the couple, besides cementing their attachment to their family members and their friends. Humans are supposed to live in association with other individuals, not only the lifetime companion they have chosen. We know that it is sometimes tough to bear the relatives or fellow workers of our “significant other” but we have to remember that he/she/sie might feel the same. By agreeing to accompany them along in stride, we are helping them to ease the burden. They will be grateful for our gesture. And we might get cookie points.

What do you think? Please tell us.

Don’t leave me alone.

Cannabis in Epilepsy – Part II

Recently there have been several large, well-controlled studies of the use of Cannabidiol in children and adolescents but it was used as an adjunctive therapy, not in a standalone way. What would happen if patients were only taking a cannabinoid as some activists for the legalization of Cannabis are vociferously demanding in many American state capitals?

Emily Stockings et al., researchers at the National and Alcohol Research Centre at the University of South Wales in Sydney, reviewed the data of several clinical trials of Cannabidiol, focusing on 36 studies that studied the use of the drug in drug-resistant Epilepsy. Two double blind studies on the use of CBD—one with 120 patients with the Drayet syndrome and the other with 171 patients with Lenox-Gastaut syndrome—showed that CBD was 75% more likely than the placebo to reduce the number of seizures by more than half. In the largest pool of almost a thousand patients that were observed, almost half of them got some significant reduction of their seizure frequency.

The researchers admitted that the quality of the data was mixed as there is no reliable evidence of which preparation of Cannabis—either Cannabis sativa or CBD-THC extracts or oral cannabis extracts—is more suitable. Three randomized clinical trials studied the possibility of seizure-free by just taking CBD compared to placebo; even though they found an encouraging six-fold increase in the number of patients that ended up seizure-free, their data is not completely reliable. Half of the patients treated with CBD reported that the quality of their daily activities had improved. The overall data suggested that almost half of the patients reported some significant improvement.

The greatest gains were observed in patients with Drayet syndrome or Severe Myoclonic Epilepsy of Childhood (SMEC), a tragic condition that begins in the first year of life and produces constant seizures; we can understand the relief experienced by those parents when they noticed a change. However, all the studies with Drayet syndrome were case series with a 100% response, which should be interpreted with extreme caution. The Sydney researchers also studied the number of participants that dropped off the study, which could be an indicator of their tolerance to the drug; they found no real difference between the participants receiving CBD and those with placebo.

There was a significant increase in the rate of adverse events in patients receiving CBD compared to placebo, including the dangerous status epilepticus and elevated aminotransferase levels. The most common adverse effects were drowsiness, diarrhea, fatigue and lack of appetite. This fact should make clinicians ponder whether the addition of CBD is warranted in the med schedule. The use of Cannabis should not be taken lightly or “to see what happens. What’s there to lose anyway?”

Many policy pundits and media charlatans are jumping in the bandwagon of the medical benefits of Cannabis in the American states that have long approved it like Colorado and those like Florida that are just beginning to regulate its use. We should fund serious studies in prestigious centers; moreover, the parents of children with grave, chronic neurological diseases should have priority access to them. There is a fine blue line between the medical benefits of Cannabis and its purely recreational use. But sick children should not be taken as hostages by the perpetrators of this media driven-frenzy.

What do you think? Please tell us.

Don’t leave me alone.


Please welcome the sage words of Harbans Khajuria, a great Indian thinker and writer, besides being a close spiritual friend of mine across the oceans. This beautiful poem is an homage to the redeeming power of an honest, affectionate and stimulating relationship.

This reproduction of the tableau called “Supper of Emmaus” by Caravaggio shows a total stranger arriving at a roadside tavern and chatting with Luke and Cleopas, two of Jesus Christ’s disciples. Cleopas extends his right arm to touch him and the left arm towards us–a visual challenge as the stretched arms go in and out of the frame of reference. Jesus Christ is appearing to buttress their wavering faith. After this encounter, he will vanish.

The messenger may leave but the message stays behind. The essence of true friendship.

We are lucky if we can claim a few good friends in life that make a real difference. Harbans is one of them for moi. Thank you for your unique friendship, caro Il Chiaro. Enjoy his writings.





When nothing significant works for us

Every door for coming out

We find closed fatefully

No course of action

Seems open for us naturally

A fellow comes to our succor

Opens with own helping hands

The closed doors ajar

And provides the possibility of openings for us

This alliance so supportive

To pull out of any state

That ‘time’ presents itself  

For each other so caring

When the need arises.

Once amity is established

Then the friendship is further cemented

By the basketful of trust

Which gives the friendship

The stamp of permanency

This friendship could be between those who meet us daily

Or, possibly

From beyond the borders, we have not traversed ever

Between. those whom we have not met any time personally

This thread of closeness is felt by us instinctively

Because the indelible stamp of the God is affixed on this friendship.


View original post

L’abus au petit feu

– “Doctor…It’s not how much he pisses me off—but rather how often he does it.”

Sheila X. is a jovial, good mannered and efficient nursing aide that has been suffering from chronic migraines for years; almost all the therapies we tried have failed and now she is participating in a clinical trial for a new medication. But her main trigger is located home.

She has a nice husband who nonetheless does not cooperate with any of the housekeeping and child rearing, preferring to slump in the sofa with a beer and the TV remote control after work. Their two teenage children scold him for his archaic behavior, but he ignores them altogether. Occasionally she bursts out in anger fits, which does not change his bad attitude but only exacerbate her headaches. Lately she has given up and tolerates his bad behavior in silence. However. we have watched how the summation of all those episodes is sapping her joie de vivre.

A French chef recently explained in a TV program the advantages of a slow burning fire to tenderize supposedly hard to cook meats like game and fowl; when I watched his explanation, I couldn’t help thinking about how Sheila’s husband is undermining her strength at home and also at work.  Often, I had to write a certificate, so she could skip work and lay down in her bed with lights out. I always asked her if he ever became physically abusive and she vehemently denied any incident.

A flutter of the hand that never lands on a woman’s face but still frightens her into submission. Or perhaps of a not-so-subtle-threat in the middle of a perfectly routine conversation of the couple. Or even worse still, a stony silence after the wife asks for some rational explanation to his deed. Women have been subjected to vast amounts of verbal and physical abuse all along their lives. Oftentimes it does not reach the threshold of intensity that will provoke a radical response. But these low-intensity encounters can slowly erode the self- esteem of the woman and even constitute a terrible example for the daughter. If Daddy frequently does that to Mom, is it then acceptable?

Without claiming the mantle of “political correctness’ in our relationship with women in general and our family members, we believe that we are doing better than our parents and grandparents did in other times when society tolerated little abuses in stride. And our children should be even better than us. There is no excuse for the mistreatment of women and children. None is acceptable. My father Mario always taught us: “the man that raises a hand against a woman is a coward.”

Occasionally we witnessed how such a silently suffering woman suddenly erupts in a fit of rage that breaks the status quo in a supposedly “happy marriage” to the dismay of all. But hardly ever they take the extra step. Nora’s move. Leave slamming the door behind.

In some traditional societies like Japan, more and more young women are refusing to get married or have children. They even suffer from the “Narita syndrome.” Named after the Tokyo airport for international flights, it refers to their reaction towards their inexpressive men once they come back from a trip and realized there is another way. They dump them right at the arrival gate. Hopefully they will put them on probation.

What do you think? Please tell us.

Don’t leave me alone.

Countdown sale is about to start

Dear readers and fellow bloggers:

Good morning. In a few minutes the countdown sale of my novel “Madame D.C.-Three voyages” will start in the Kindle bookstore at 8 AM Pacific Standard Time, The price will drop to U$ 1.99 and for a week it will progressively rise to the list price of U$ 9,99.

If you’re interested in my writings, you will certainly like this saga with a mix of romance, science fiction and a political thriller. Especially the sensitive ladies. Before undertaking the printing of the book, which will certainly cost much more, I would like to give you the chance to sample it and spot mistakes, suggest changes, etc. You are the most enlightened editors that I could possibly ask for; please write your commentary in the Kindle page of my novel.The game is afoot. And it has to offer a bespoke prize.

In order to show my gratitude to all the readers of the novel, I am setting up a raffle with a prize consisting on an ultra-romantic stay for a couple  in one of the most beautiful and welcoming French chateaus during a relaxed week-end at the beginning of 2019. It has comfortable suites with all the amenities, including a reliable Wi-Fi of course, polite but discrete room service under the supervision of the owner, a good restaurant that serves a delicious continental breakfast and beautiful surroundings with a majestic park. Within walking distance there are restaurants that use the local, healthy ingredients. But the best feature is that it has a resident ghost–the disgraced wife of a former seigneur that caught her with a lover in fraganti and killed them right away. Will you meet her? Someone that stayed there told me that she likes to snoop on lovers in action…

Thank you for your continued support and kindness in reading my writings. Au revoir.

A rehab therapy useful for MS

When patients with Multiple Sclerosis—and other chronic debilitating diseases—start losing the motor function of the upper and/or lower extremities, they feel rightly frustrated. The inability to write steadily, grab a cup, walk without falling and similar common activities will limit their interaction with family, friends and co-workers, leading to anxiety and depression. The chronic pain can be managed more efficiently than the forced isolation due to the above.

Some clinical trials have suggested that MS patients might benefit from several rehabilitation techniques, but they were short in duration and did not answer the fundamental question; can the techniques learned in the rehabilitation clinic be transferred to the patients’ homes efficiently? A new study claims that the “Constraint-induced movement therapy” (CIMT) used in the rehab of stroke patients can be useful, even with short practice runs, in the care of MS motor limitations.

VW Mark et al. designed a Phase II randomized clinical trial with 20 participants that had hemiparetic MS and were assigned either to a 35 hours-training in CIMT or alternative medicine. The CIMT intervention, done on ten consecutive days, had the following components:

  1. Intensive training with the limited extremity for basic activities for three hours/day.
  2. Training with “behavioral shaping”: try to achieve motor goals progressively and with constant encouragement from the therapist, even for small gains.
  3. Restraint of the less compromised limb to prod the use of the affected one.
  4. Use of a “transfer package” to stimulate the practice at home, which included a contract, practice homework, keeping a diary and a 30 minute-daily interview with the therapist.

The participants were evaluated with the “Motor Activity Log” (MAL), a scripted interview to compare the gains from the use of the technique with the previous functional baseline. The participants in the control group did aquatic therapy, yoga and other relaxation techniques. For the group that underwent CIMT there was a mean change in MAL of 2.7 after one year, compared to 0.5 in the control group. A change of 1.0 was considered clinically meaningful for participants; auspiciously, all the CIMT patients and three of the control group reached that clinical goal.

In the second stage of this same study, the researchers studied whether the practice of CIMT could promote changes in the white matter of MS patients with Magnetic Resonance Imaging (MRI) techniques such as T1 weighted scans and whole brain diffusion tensor scans. They found that there were improvements in the white matter of the corticospinal tract, temporal and visual areas. These extraordinary findings were in line with previous data obtained form monkeys in labs. If the neuroplasticity of the nervous tissue can warrant significant clinical changes after just a few days of focused, personalized rehabilitation for MS patients, this technique must be transferred home with a special package. Patients and their families would certainly be more than willing to try it.

Patients with MS should be aware that physical defeat only comes when they “throw the towel into the ring.” They should never, ever give up hope.

What do you think? Please tell us.

Don’t leave me alone.