Build your cities on the slopes of Vesuvius! A fourth-generation physician in an old New York family with an illustrious medical tradition, Ben is quick to describe himself as a cynic: Yeah, I'm cynical about medicine. How can you not be? The medical-legal crisis makes all of us run scared--not just of malpractice, but failure to provide fully informed consent about medications, and even maloccurrence [lack of improvement]. What a world. Everyone expects to get better. No one is supposed to become a chronic case, an invalid, or die. Frankly, I'm tired of it all. The only thing to do in a bad time like this is keep your head down, don't make waves, and try like the dickens to not make any mistakes--and cover your ass in case you do or think you might have. You write defensive explanatory notes in the chart with one eye on peer review, the other on a potential jury trial. Then share the collage with your therapist. A HEALTHY LIFESTYLE AS A STRATEGY FOR COPING Taking the best care of yourself you possibly can may be the most practical coping strategy there is. Eating properly, getting enough sleep, and including time for relaxation every day is a must. Exercising at least three times a week will help regulate your mood and will increase your overall level of well-being. Exercise is a great energy booster. Do what you can to eliminate negative habits. Decrease or totally eliminate caffeine from your diet, recognizing that caffeine can increase your anxiety level, cause headaches, and disrupt your sleep. If you smoke, ask your doctor about ways to quit or contact the Hazelden Foundation in Center City, Minnesota, about resources for quitting (see appendix B).

Consider taking a daily vitamin supplement and drinking plenty of water (eight glasses a day is recommended) to clear your body of toxins and replace the necessary minerals needed for good health. Send your ships into uncharted seas! Live at war with your peers and yourselves! Be robbers and conquerors as long as you cannot be rulers and possessors, you seekers of knowledge! Soon the age will be past when you could be content to live hidden in forests like shy deer! At long last the search for knowledge will reach out for its due: -- it will want to rule and possess, and you with it! To find danger and the excitement of adventure, you have to take risks. It doesn't mean stupidity or ignorance, but taking the necessary actions that your goal require. That's risk. It's time and effort, it's danger and audacity, it's facing fears and going against the grain. It may mean debt and despair that you're alone with, that no one around you can really relate to. You try to avoid angering patients for fear they will turn on you. You go by the article. Which means you are more involved with paperwork and phone calls to drug firms, consultants, and your insurance company and lawyer than with patients. You try to size up high-risk families and refer them elsewhere. I mean high-risk in terms of quarrels and legal actions. What a way to practice medicine. It's not the way I was taught, and goes against my family tradition; As for your chronic illness, everyone seems to be pushing something. Take irritable bowel syndrome in adolescents.

I see lots of cases, lots. Work slowly on making these changes. It is too overwhelming to attempt to change your lifestyle completely, and this is usually easier to address later in therapy. A healthy lifestyle will equip you to handle stress better when it does invade your life. Even small attempts at lifestyle change can help. You can start by setting small goals that you can practice one day at a time. Initially, such goals can increase stress because you are asking yourself to do something different. Most people can name at least one thing they do to relieve stress that is not very healthy. It is never easy to stop using that favorite coping technique. If you live on junk food, cigarettes, and caffeine, you will find that your body begins to flush toxins from its system when you start eating healthier foods. Physically, this process can feel like a crisis, but if you stay with it, you will find that response is truly short lived. They don't understand why you're aiming so high, why you're working so hard, why you're doing something that doesn't seem to be working. I've been there. I've been working long hours at a business that had yet to bear fruit. Everyone wanted me to quit out of kindness and caring, but you can't. You have to pivot and adjust course from time to time but the direction you're heading in and the effort you're giving is consistent, it has to be consistent. While we've talked at length about being disciplined, too many equate that with being safe, with confining yourself to a set of rules and principles, never accepting that daring, audacity, and living dangerously have to be a part of those principles. Discipline gives you the freedom to pursue danger with courage, and with the abilities you need to be successful with your dangerous endeavor. There is no more safety. There cannot be any ounce of mediocrity in what you aspire to achieve and conquer any longer.

Dare mightily. Well, one pediatrician says it's stress. Another, it's food allergy and diet generally. Another, it's family problems or school problems. The child psychiatrists say one thing; If you are a true-believer sort, you talk yourself into a single cure. That's how you make money, too: push a gimmick. The fact is, nobody knows the cause. The course is uncertain. The treatment is even more so. If you're honest with patients, they feel disappointed and leave your care for the latest fad. In addition, the payoff is enormous. By practicing a healthier lifestyle, you actually begin to experience less emotional stress. You might also want to consider adding a spiritual practice at least once a week and connecting with friends at least that often as well. Andrew Weil's Eight Weeks to Optimum Health gives such practical suggestions as having fresh flowers in your home and listening to inspirational music daily. He also suggests taking a news fast from time to time so that you are not constantly polluting your mind with negative thoughts. It can feel very empowering to recognize that you have the ability to set a mood of health and positive intention both within and throughout your environment. Self-help and coping techniques are an essential part of therapy for people who dissociate. Not only do these techniques help you to stay safe, but they also aid you in gaining mastery over difficult situations. With each positive step, you will feel more self-empowered.

You can begin by using the techniques discussed in this article, but feel free to adapt them in whatever way is most useful for you and then begin to add things you come up with on your own. Live dangerously. And do each, successful, with discipline. A fight isn't a fight until there's something to overcome. Teddy Atlas The article was written, edited, and ready for print. And then I listened to Joe Rogan and Teddy Atlas talk. I've read Teddy Atlas' article, if you don't know who he is, he's a great trainer, the former trainer of heavyweight champion Michael Moorer and one of Mike Tyson's original trainers when he was a young, powerful buck. The quote above is applicable to the end of this article where we've talked about persistence and consistency, discipline and focus, and where we live in a world or a society that is getting soft. We're more entitled than ever before and we've discussed some of the reasons for this, including the fact that we can compare a perception of someone else's life with ours without having to talk to them or get to know them, but simply by viewing the images they choose to publish online. We've also talked about how we have to stay in our lane. I see lots of problems like that: tension headaches, back pain, asthma, fatigue following the flu, you name it. Take eczema. I must have heard a dozen different theories from dermatologists. And the psychosomatic theories! My population is big on psychology, holistic medicine, massage, group therapy, lectures on mind-body connections, psychoneuroimmunology, acupuncture. They know all the psychoanalytic and behavioral medicine theories, including ones you never heard of. It makes me terribly skeptical and negative. All right, I'm cynical--about a lot of things in life. I find myself doubting what patients say, especially parents of patients.