There is almost always something interesting in the world of research and this weekend is no exception. One article caught my eye because it details a secular research project about prayer and self control.[i]  It describes a research project in Germany with 79 participants who were made up of 41 who identified themselves as Christian, 14 atheists, 10 agnostics and 14 who came from other religions. 
 
The test subjects were asked to either pray or think about anything intently and then were asked to watch some comedy video clips. One half of the group was asked to repress their emotional response to the clip and the other was encouraged to laugh. Then both were tested for the ability to carry out a task that required some self control. They were asked to look at words such as blue that were written in red ink and then identify the color of the ink not the word. 

The goal was to not answer too quickly as a result of reading the word instead of identifying the color of the ink. The
study found 2 things that are interesting. The people who tried to suppress the laughter/emotions seemed to struggle later doing the name that color test. They also found that the people who prayed instead of intently thinking about
whatever they wished did better with regard to self control. Those who prayed could resist the temptation to jump to the wrong conclusion about the color of the ink. 

The idea of praying that we might resist temptation is not particularly original. Our Lord and Savior, Jesus Christ said
just that to the remaining eleven disciples in the garden of Gethsemane. “And when he was at the place, he said unto them, Pray that ye enter not into temptation.” (Luke 22:40 KJV) 

Two things just jump out at me. One is that Jesus did not tell his disciples to get their acts together so that they could
resist the temptation that was coming. He told them to “pray that they would not enter it.” Unfortunately instead of praying intently about the coming test, they fell asleep. Jesus told them to ask for help because they would certainly need it. 

Second, our Lord did not then and does not now intend for us to face temptation alone in our own strength. And, so Paul tell us  “No temptation has overtaken you but such as is common to man; and God is faithful, who will not allow you to be tempted beyond what you are able, but with the temptation will provide the way of escape also, so that you will be able to endure it.” (1Cor 10:13 NASB)

The results are interesting because they match what we would expect if we read what Jesus said and then did it. I always encourage readers to keep in mind that this is not a case of research proving the Bible to be correct. It is correct, inerrant, inspired, infallible and sufficient! Instead the research outcome merely illustrates what you expect to
happen when someone follows what the Bible says. 
 
So, prayer is important. In prayer we can ask God for help in temptation in the name of Jesus. We can expect that God will enable us to pass through it and endure. We should all start our own research projects today!   
  
[i] http://www.dailymail.co.uk/sciencetech/article-2515637/Does-prayer-help-resist-temptation-Talking-God-boosts-self-control-emotional-stability-claims-study.html Does prayer help us resist temptation? Talking to God
boosts self-control and emotional stability, claims study. Mail Online,  By Robin Yapp PUBLISHED: 10:56 EST, 29 November 2013 | UPDATED: 10:58 EST, 29 November 2013 
 

Tomorrow is the big day. Thanksgiving is wonderful time when we get to remember the blessing of freedom that God has given us here in the United States. In the process most of us will nearly eat ourselves into a coma with turkey, dressing, mashed potatoes, gravy, deviled eggs, green bean casseroles and then, pie of all kinds. I always tell my patients who must diet that they get two days off a year and Thanksgiving Day is one of them. With all the food
we are going to eat it might comforting to know that there is a way to reduce the adverse effect of all those excess calories. 
 
In today's New York Times Gretchen Reynolds tells us that even if we hardly move an inch all day and eat 10000 calories or more,1 we can keep all of it from going to notorious fat deposits in special places on our bodies.
The antidote is binge exercising! In a study done at the University of Bath in England, test subjects were told to walk no more the 4000 steps a day and to eat 50% more food each day. 
 
The subjects were divided into two groups. One group consisted of strict couch potatoes and the other would run for 45 minutes each day. The runners were also instructed to eat an extra 25% more food than the couch riders. The study found that the bad effects of eating way too much food and doing next to nothing all day were present within 7 days and included changes in their fat cells and their insulin production and effectiveness. 
  
The runners on the other hand did not suffer these changes to the same degree. Indeed, it appeared that a seven day binge of eating could be offset by a similar seven day binge of exercise. Blood sugar control and changes in fat cells were greatly reduced in those who binged on exercise along with the pie. 
 
I know this is true. I have been a runner for 44 years now and I started running for one simple reason. I liked to eat, and hated to diet. I also knew that while I was not going to get any taller, that I could be bigger. So I ran and I still do. And, I weigh about the same as I did when I left high school. 
 
So tomorrow, while you are thanking God for His goodness toward us and eating that second piece of pie, you might want to think about taking a walk after lunch. 
 
God bless you and yours as you serve Him. 

1. The Power of a Daily Bout of Exercise, Gretchen Reynolds, New York Times, November 27, 2
 

I have been practicing medicine for 38 years and that has allowed me to see amazing changes in the way we deliver health care. Some of them have been revolutionary in the way they save lives. Heart, lung, liver, kidney
transplants come to mind along with bone marrow transplants and innovative cures for cancer. Other changes have been more of a double edged sword. Of those my favorite has been the internet.

I would not want the reader to think for a moment that I want to return to some golden age of pre internet existence. There is not a day that goes by that I do not use internet based reference material as I look for the best answers and treatment for the patients I see. When I research to write blogs or books, the place I go first is...the internet. In my college days, all writing began in the library in front of a card catalog looking in rows of drawers with small cards that directed me to books, and articles and their bibliographies. It was a time consuming labor intensive pain in the process and I do not miss it for a minute. When I have to do research, I love the internet.

It does require something of us that is forgotten at our own peril. Not everything that is posted in the internet will be true or accurate. And very little of it is posted without some kind of purpose behind it. This seems so obvious that no one should have to say it. The recent State Farm commercial with the young woman who meets her French Model
date on the internet stands as the comedic warning. As she stands there with a fellow who looks more like the Neanderthal man with anything but a French accent she says, "You know they can't put anything that isn't true on the internet!" Well, "they" can and they do.

In medicine the most recent and discouraging example involves a website that I have referred patients to for
general information about medical problems. WebMD seemed to be a place where reasonably reliable information could be found by the public free from bias. Well, this past week it was revealed that in the campaign to bring the
Obamacare/ Affordable Care Act to life, WebMD received a contract for 4.8 million dollars to “teach doctors about Obamacare.”[i] What appeared to be an unbiased journalistic opinion turned out to be little more than an advertisement for a government program that was paid for with our tax dollars.

It really doesn't matter which side of the Unaffordable Care Act question you find yourself on, it should outrage us when tax dollars are used this way. When I was a youngster I read our local paper from front to back and I remember full page advertisements that looked like news articles back then. But, at the top and bottom there was always a small but very visible statement in parenthesis that said (this is an advertisement). Because of the disclaimer, I knew I was not reading an unbiased account written by a journalist who intended for me to know who, what, where, when, and why something happened. 

WebMD has given away the trust I placed in them to write about medical issues free from commercial bias. In exchange they received several million more dollars than I would have ever given them. But, I won't
send patients there again without the warning.

And it is that warning that I am writing about today. Caveat Imperator or let the buyer beware! The internet is a marvelous place to do research about medicine as long as you carefully look at the source to make sure what you’re reading is not an unidentified paid advertisement. When looking at research the first question I ask is who paid for it? It's the medical equivalent of show me the money! If the website that offers to diagnose your problem also has banner ads for the drug to treat it, you might want to look someplace else.  And, if the website that tells you how great government healthcare will be is being paid millions of dollars to do it, you might want to look someplace else for the facts.

As the Old Testament writer said, "the bribe perverts justice!"



 

 
  
  
[i] “Concierge Medicine: WebMD pockets
millions from Feds to promote Obamacare,” Washington Times, Tuesday November 12,
2013, by Jim McElhatton, retrieved electronically at www.washingtontimes.com. 

A friend asked me to watch an interview with Dr Sanjay Gupta on CNN in which Gupta says that he has been wrong about marijuana. He has opposed legalization of marijuana for years and has changed his mind. Now he thinks it would be good to legalize it for medical use. 
 
I know the friend asked me because from a distance he heard conversation that I had with an individual who wanted to know if I thought it would be reasonable to have patients smoke pot who had a medical problem that it seemed to help. At the end of the conversation my friend came over to talk, and said that he wanted me to watch the CNN interview because he did not know who to believe. A rather smart, articulate neurosurgeon has said that medical marijuana is probably a good thing and perhaps it should be legalized. So, I watched.[i] 

Dr Gupta said many things that were interesting. He said that 95% of the research done looked at the adverse effects
of smoking marijuana including the effect it can have on a developing brain. He said that very little of the research looked at what could be the benefits. In his defense, the doctor said that he was NOT advocating the recreational use of marijuana because he has children. He did not offer any studies that showed the benefits of smoking pot. 

When he was pressed by the interviewer as to why he made the change from being against legalization of pot to being for it, Gupta said that his experience talking with patients was the motivating factor. He told the stories of two patients who used marijuana or one of the substances derived from it. One was a child with seizures whose story is heart
rending.  

The reason I don’t find Dr Gupta convincing and I could not agree with the person who wanted me to give my approval to medical marijuana in certain circumstances is the same. Both wanted me to agree based on the stories of patients that they had heard. It is the difference between anecdotal evidence and research. 
 
Anecdotal evidence is the story of one person about the benefits marijuana or any other kind of treatment. Research on the other hand has looks at disease & treatment in large populations. Medical research is supposed to look at a drug, procedure or a question in medicine and answer it by looking at in large populations, thousands if possible. It is also supposed to be objectively measured in a way that is reproducible. A treatment or drug given today should offer the same benefit in 6 months in a different population. All of these studies should have a control group that shows a statistically significant difference between the outcome of being treated and not being treated. 

Remarkably there is at least one person out in cyberspace who has the same reservations I do about “medical marijuana” and the need to legalize pot smoking. In the Huffington Post, Sue Rusche, the CEO of National Families in Action wrote an excellent article which gives a reasonable answer to Gupta’s call for legalization. The article is titled “What Dr. Sanjay Gupta Doesn’t tell Us About Weed”[ii] and in it Rusche presents several things  that we know about marijuana that make using it less inviting. 
 
While there are 400 ingredients in marijuana, Dr Gupta only talked about 2, THC and CBD. Rusche explained that THC
is the “cannabinoid” that the recreational user desires and CBD is the ingredient that seems to hold any medical benefit. The catch is that most marijuana in the US is grown to reduce CBD and increase THC. THC or  tetrahydrocannabinol is the part of marijuana that is credited with the mind altering effects.  
 
The problem with most pot being sold as medical marijuana is that it is grown for it intoxicating effects. THC
concentrations in marijuana in 1970 averaged 3 percent. Today that average is 13% with some samples as high as 36%. Gupta says that marijuana has a relatively low risk of addiction at 9% when compared to cocaine at 25%. Rosche points out that the rate for adolescent user addiction is 17% and for regular daily users it can be from 25% to 50%. That meets or exceeds the rate of cocaine addiction. 
 
Marijuana is not a minimal risk medication like aspirin or Tylenol that we can take with a reasonable expectation of safety and benefit. In an excellent review in this week in the Psychiatric Times, the risk of psychotic episodes is 40% greater for uses than for non users, and the risk for schizophrenia is higher among teens who smoke it than those who do not.[iii] 

So why would we want to legalize a drug that has rather limited medical use without real research? Rosche proposed what I think is the most reasonable response. Instead of a wholesale legalization for medical use that will turn into the circus that now is California and Colorado, why not do real research? The following is a quote from Rosche.

“The government should provide research grade CBD to patients like Charlotte under a compassionate use program while science catches up with and improves the folk-medicine approach(that is generating millions of dollars in profits) we have now. Patients and their families should sign a hold-harmless contract so taxpayers won’t have to shoulder lawsuits from unexpected side effects that might result from being medicated with an experimental, untested drug.” 
 
That makes so much more sense than legalizing a dangerous, addictive, psychosis causing drug because a notable
articulate neurosurgeon has decided that it ought to be on the basis of incomplete science and anecdotal patient stories. Let’s do real research and let the facts decide the best course.   
  
[i][i] You can find Dr Gupta’s comments on CNN under video.  Search Sanjay Gupta and Weed!   
[ii]“What Dr. Sanjay Gupta Doesn’t tell Us  About Weed” Sue Rusche. Huffington Post 08/19/2013.   
[iii] The Cannabis-Psychosis Link June 27, 2012 | Schizophrenia, Alcohol Abuse, Psychotic
Affective Disorders By Marie-josee Lynch, MD, Rachel A. Rabin, MSc, and Tony P.
George, MD, FRCPC - See more at:  http://www.psychiatrictimes.com/schizophrenia/cannabis-psychosis-link-0#sthash.pARp70VE.dpuf