Thursday, October 28, 2010

AARP Bulletin

I was just reading the AARP Bulletin. It's for people in the US over 50. I'm over 50 in Canada. I downloaded the app for free to my Iphone. Great article on Alzheimer's. Turns out the plaques people see on the brain may well be scabs, indicating the brain healing. That's because a scientist has a mouse with Alzheimers. Interesting.
Then the epidemiological data that showed that our group will double in a matter of years was interesting. The problem is that fewer well workers will support an older population. This keeps coming up because increasingly the young come from cultures that didn't share national security ideals but felt it to be a family responsibility. That wasn't in the article but is a concern as right now old age pension and such depend upon taxes. The article did say that given less workers and more older dependents there was a need to rethink how the old would survive. The article didn't mention that the healthy, young and well and those older ones who feel guilty about being a burden are all big on euthanasia too. I used to think people over 30 should just self emolate for fashion sake.
But would euthanasia be what Bill Gates chose at 100. I don't see the Queens and Kings lining up for this.
Then the AARP got into all the politics of American law and health care and insurance and lost me. I liked the article on the cheap hearing aid. I thought maybe I'd get one not because I was deaf but I wouldn't mind snooping at the coffee shop, adding a whole new dimension to people watching.
Then it got into how to save money on burial plots and I thought maybe I'd had enough AARP.
It's definitely a good read. But right now I find all I want to know about burial plots in the literary section of the Globe and Mail.

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Canada rejected by UN Security Council

The UN Security Council has five permanent members. These are the United States, United Kingdom, Russian Federation, China and France. In addition there are 10 non permanent members. Right now these are Bosnia and Hersegovina, Uganda, Lebanon, Gabon, Nigeria, Turkey, Mexico, Brazil, Japan, Austria.

Canada was rejected this year, Germany getting the seat instead. Opposition forces in Canada said it was an humiliating defeat for Prime Minister Harper. Apparently he lost the support of the Middle East for continued support of Israel. I don't know what this says about Germany. But I'm not sure being rejected for companionship with Bosnia, Uganda, or Lebanon is really the "humiliation" that Canada's opposition said it was. Australia was rejected a few years back tool

Canada and Australia have both been major peacekeepers, at home and abroad. I don't know the number, it's far too many, of Canadian soldiers who have died serving the United Nations as peace keepers. There is no doubt that Canada has earned it's place in the security council if security is really what the council is primarily about.

However, what distinguishes the principal members of the Security Council is that they are the world's principal arms dealers. Canada's record as an arms dealer under Harper or the opposition is not what it could be but then Canadians collectively don't think 'war for profit' is the way that the future should be taking.

In contrast if one considers the Security Council from a business perspective, it's members have indeed been the most warring lot on the planet. This isn't to choose right or wrong but simply to look at it all from a "market" perspective. Germany was chosen over Canada so that Japan and Germany are on the security council which excludes Canada. If it's about business, and I'm not saying it is, then clearly Canada can't compete with the likes of those already front and centre on the security council. It's amazing that Israel and Iraq aren't already on the Council, from a strictly business perspective.

Prime Minister Harper applied for the Security Council as the Opposition would have applied if they were on top when the option to apply came up. It's a thing that happens every 10 years. What I don't see is that being rejected is an 'humiliating defeat'.

The sad thing is that the rejection of Canada, it's military having proved itself over and over again as the greatest of Peace Keepers, is a kind of barometer of the continued hawkishness of the UN Security Council. Without Canada we can anticipate more war and more product sales. The greatest hope we have for the Security Council is the membership of Mexico and Brazil. Canada gave the world hockey. The Latin American countries gave the world Dance.

Maybe the Security Council should get out of business.

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Wednesday, October 27, 2010

Gratitude for the day

I am grateful today for this day. When I go to sleep thankful for the completion of a day I am told that I don't know if I will wake in the morning. People die in their sleep. Some people believe that death is a dissolution or end of self. Yet I awake this morning and am indeed thankful to be alive.
Life is complex, entertaining, unusual, and spiked with moments in which I am truly pleased much to my own amazement. I am jaded and sometimes bitter, disappointed and routinely disolutioned, sometimes pessimistic yet surprised at times by the sheer wonder of creation.
I am thankful for my dog. His licking my face in the morning is most irritating yet I appreciate his enthusiasm for our relationship and for this day. He looks forward to walks. I am thankful for indoor plumbing. I am thankful that today the whole constitution was functional. I have too often seen men and women whose bowels and waterworks simply didn't work conveniently or their function was associated with severe pain.
I am thankful for beds. I like sleeping and woke feeling rested. Often that sense of being rested isn't a part of waking from sleep. Pain and injury cause a night to be disturbed with multiple wakening yet this night I slept through and woke not quite refreshed but nonetheless, hopeful.
I am thankful for my clothes. I like my new jacket and hat and am very grateful that I could find a couple of articles of clothing that appeal to me as much as these do right now. I am forever grateful for t shirts and baggy cotton trousers with draw strings. I am also thankful for the slip ons. The dog leash is another very smart invention as is the door and door lock.
The air this morning was crisp. I enjoyed very much that first inhalation. I was grateful it wasn't raining. I am thankful for the walk with the dog and his fun at playing that simple game of toss the ball.
I am further thankful for coffee upon return. The first cup of coffee in the morning is truly a godsend. I love the cuisinart expresso coffee maker. The engineering that went into making a simple efficient reproducible product is never something to take for granted. The coffee maker has given me this morning pleasure time and time again.( I am thankful for electricity. I am thankful for the corner store. I am thankful for the farmers. I am thankful for the transportation people. I am thankful for the buyers and sellers. I am thankful for the whole range of factors that are involved in my having this delicious Starbucks Expresso coffee in my Harley Davidson mug in the morning. I am as thankful for the cream and honey that I add daily to this oral sensation.)
I am thankful for this communication device too. It's a joy to be able to open the windows of communication as one might open the blinds on the house to see and be seen by neighbors. It's a bit like a light flicking on in the morning. I so enjoy the internet and facebook and reading anything from Bible verses to the corny humor my friends share with me this way.
I am thankful for work. I am thankful for being able to go to work instead of say the library. I love to go to the library and read and write and would love to go today but there is no payment for my time there and I like that my activities at work translate into money that I can use to pay debts, add to savings and use to make weekends more enjoyable. I am thankful for this whole system of exchange that saves me collecting cattle and taking them to a friend to get gas for my motorcycle in exchange.
I read the Globe and Mail this morning while having my coffee. I am thankful for the on line news. I am thankful for the media and it's ability to bring me news of interest keeping me abreast of matters that so many others find interesting in my community.
I am preparing to get into a hot shower. I am so thankful for hot showers. With indoor plumbing, hot showers with soap, and coffee and ice cream life is really worth living for. Today I'll be able to drive and I enjoy driving, talk and listen, and I enjoy talking and listening, write, and I enjoy writing,read and I enjoy reading, analyze and problem solve and I enjoy analyzing and problem solving. I'll also drink more coffee and have more food and I enjoy that. It's got high potential for a very good day even when it might be expected that there are going to be some lows along with the highs in the whole world of my day. I am thankful for the day nonetheless.
I pray I can use it most beneficially and see it through with grace and gentleness. I want my day to be a good day and am thankful that I believe that my own participatiion with attitude and activity can help to bring that about.
I am thankful for this day.

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Location:W 13th Ave,Vancouver,Canada

Saturday, October 23, 2010

Lillian Alling Opera

The Lillian Alling Opera, music by John Estacio, libretto by John Murrell, was a tremendous world premiere success for the Vancouver Opera. The packed audience of the Queen Elizabeth Theatre gave the grand performance a resounding standing ovation.

Sue Le Page's sets, with trucks and cabin, unforgettable telegraph men from the Canadian north, city scenes from New York and Vancouver was an inspired backdrop for Kelly Robinson's Stage Direction.

Mezzo-Soprano, Judith Forst, playing principal story teller was coupled with Soprano, Frederique Vezina, as the young and beautiful Lillian , the Estonian woman who in the 1920's hiked from New York to Telegraph Creek, British Columbia. In this tale, adapted liberally from the original mystery, Jimmy,played by tenor, Roger Honeywell is told how his father, telegrapher Scotty MacDonald, played by Baritone, Aaron St. Clair Nicholson contributed to Lillian Alling landing in the Oakalla Prison Farm.

At times the stage seemed filled with the huge cast of thousands of men and women their voices multiplying their numbers. The powerful Forst Mezzo soprano entwined with rich Honeywell Tenor while steady Nicholson Baritone and haunting Vezina Soprano wove deep tales of sound. The Brooklyn Boys with baritones including Gregory Dahl were as delightful as the Telegraph Men were simple genius. The epic music and music of love brought tears to my eyes when music and words united with fully committed voices.

It was an wondrous night. I'd just been in Milan listening to a concert of tenor and piano after visiting the Scala Theatre. I couldn't help but think that awesome bastion of old world opera could only be made richer by this Canadian new world sensation!

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Morning of

There are mornings after and mornings before.
But this is the morning of my day.
What day it is, I do not know
But hope I use it better
Than any day I've had before.

That's not that my will is in it.
I give my day to the Lord.
Lord of Creation! Lord of all. Lord of before and after.
Lord of this day

I would know you more. Be closer to you.
Be gentler, more humble, more skilled and accomplished.
I would celebrate and praise your wonder.
I am in awe of you, this life, this time.

I watched and heard a small bird sing.
I Walked with the dog along the river
Stood under the bridge where traffic passes,
Lovers linger, old men and old women drink from cans,
And teen agers write grafitti.

I am home again, drinking coffee.
There are no mountains to scale or oceans to cross
On this days agenda.
I've laundry to do and errands to run.
Tonight I'll attend a performance of the opera.
I share my company with my lover.

I wonder what all this has to do with martyrdom,
World peace, finding a cure for cancer, and learning to forgive.
If only my thoughts could be more pure and kind
And I could see the good in what I think is evil.
If only I could sit here with another cup of coffee
Reading my book of history
And feel more wrapped in your arms, my Lord.

Maybe then I'd have the courage just to face the rest of this day,
Struggling to recover from a work of war and misery,
Hoping to find the spark within to go another week,
When every fiber in my being screams to run away.

To flee to my own devices, to live in my own shadow.
To take orders from no one and be defiant with all,
To criticize but never give except to my own ,
Who I expect to owe me even when I deny my own
Selfishness and utter fear of mortality.

Self pity. Save me lord from the sour sweet whine
Of my own smallest of violins.
Let me walk tall with angels and stand with those
Who answer good to bad and see the positive in the negative,
Find solutions where others only see problems,
Say nothing if they have nothing good to say.
Help me in my endeavors today
Even if the outsides of my routine are mundane,
Let me be a saint in my soul
Let me know Thee more,
And love my neighbors more,
Especially the stupid, undeserving, angry, whining
Bullying, obnoxious, ungrateful, sullen, ugly, smelly,
Irreverent, yapping,arrogant, sons and daughters of swine.

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Thursday, October 21, 2010

The Way

"I am the way, the truth and the light. No one comes to the father but by me." John 14. 6

This is certainly one of those gospel verses that alot of folk would like to walk around. It's truly where the rubber hits the road in spiritual development. More easy for the commoner to disregard this entirely. Indeed some psychiatrists have pegged their notions of Jesus as having grandiose delusions on just this passage.

Yet when one considers Christology as the study of the nature and being of Jesus, man and God, and the nature and being of those who would live a spiritual rather than material life, it's not that difficult to get an inkling of what Jesus is saying at the most superficial level. The truth of spiritual texts is their unfolding truth upon truth with our own development and deepening spirituality.

When anyone considers Jesus Christ what comes to mind is the 'man on the cross'. My Jewish friends laugh at my wearing a dead body round my neck and joke that were he to have been killed today I'd be wearing a man in an electric chair. My Buddhist friends thinks it so violent. Wearing my Celtic cross with sun and cross showing the growth in spirituality from Sun worship to Son worship has seemed more in tune with the times. The Catholics stand out from the protestants because they usually have some obviously suffering Jesus hanging from nails on the cross. Protestants more often than not opt for just the cross without the body. I'd have to explain to my Hindoo friend that if Jesus were killed today the Catholics would show the body in the electric chair whereas the Protestants would probably just wear empty chairs. It's a matter of taste, really.

I came back from Rome wearing a cross I'd bought at the Vatican Souvenir counter of the so-called 'Risen Christ". It's got the cross, and a little man slumped and suffering ,with sun rays behind him pointing clearly to the resurrection.

The Cross is the Way. The cross is not only a symbol of Jesus but also a more historic symbol of the cross roads. It is a choice. The choice is clearly one we all face daily in life, moment by moment. Spiritual or material or simply moral. Right or wrong. What Jesus is known by all for is the cross. The cross denotes Suffering. Unfortunately, moral decisions don't always end up Barbie and Ken at first glance.

The "WAY" of Jesus Christ was "Thy Will Be Done, Not Mine." The Way that Jesus speaks to is that of "obedience" and further of "suffering". In the story of Jesus the Devil tempts him with high office and luxurious life. Before Jesus is taken prisoner he begs the Father, if possibly, let me pass on this bit of painful life. However he says, If it be your will, I will do it. Jesus is 'obedient' to the father. Life on life's terms is a saying heard on the spiritual path. Jesus meets his obligations and fulfills his responsibilities. He doesn't run away from destiny but accepts the path. The Way of Jesus is acceptance. It's meeting life head on.

The Truth of Jesus Christ is also the Cross. The caterpillar does not know itself to be the Butterfly but in the Chrisalsalis it becomes and painfully separates from the old life to be the butterfly it was born to be. The spiritual know the truth of this process. It's never more clearly stated than in the story of Jesus Christ. It's in the story of the Cross, the humiliating death followed by the Resurrection.

The Light of Jesus Christ is that out of the darkness of the old ways the light of new life is born. The Resurrected Jesus meets his disciples, walks with them, talks with them. He is the human embodiment of the Phoenix Rising. He shows that there is life after death.

The metaphor of life after death is everywhere to see despite our refusal to accept even the sleeping waking cycles of daily individual subjective experience. 365 days for how many years I will have the experience of life after the death of sleep yet somehow I will fear death and think it somehow different because as humans we're basically slow learners.

Which of course is what makes the Jesus story so funny. The disciples really are a group of bozos. They, like us, forever get it mixed up and as I am great testimony to, get it wrong, then find it again, lose it and muddle my way along. The individual muck up of Christian life is grandly exposed in the even bigger political follies and heinous embarrassments that have plagued all religions and nations. It is the nature of being human and evolving.

The spiritual truth of Jesus is not in the religion but rather in the story. It's in the words of Jesus, the teachings and his life. The teachings, not surprisingly are the same as those from all spiritual traditions. The hardest one, of course, is that age old universal, 'love your neighbor as yourself.' Typically Jesus goes further and makes what this means clear by saying 'love your enemy'. The other least appealing aspect of Jesus is his forgiving nature which he says is the nature of God, the Father, as evidenced in the story of the Prodigal Son. Jesus dying says of the government, of the persecutors, of the ignorant, of the silly, "Forgive them for they know not what they do."

It's never surprising that the Way is rejected. It's humanly impossible.

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Wednesday, October 20, 2010

Christology and AA

Christology is the field of Christian theology primarily concerned with the nature and person of Jesus Christ. This concerns the nature and person of Jesus Christ and the nature and person of God as well as the nature and person of the individual. Sub topics in Christology include the incarnation, the Resurrection and the salvific work of Jesus known as soteriology. Christology is related to questions concerning the nature of God like Trinitarianism, Unitarianism, or Binitarianism. Christology is concerned with the meeting of the human (Son of Man) and the divine (God the son or Word of God) in the person of Jesus of Nazareth.

In the first few centuries of Christianity there were many divisions within the Church. Major heresies were defined as a consequence of resolution of conflicts on the way to a consensus or orthodoxy. One of the earliest controversies of Christology was among the Jews regarding the circumcision of followers. These schisms gave rise to actual churches and denominations some of which exist till today. Roman Catholics, Protestants and Orthodox Catholics have differing views regarding Christology.

Early some viewed Jesus as an ordinary mortal. Others including Gnosticism held that he was a spiritual being who only appeared to have a physical body. Ultimately the Creed of orthodox Christianity was that Jesus was "both fully divine and fully human." This is naturally part of the unnatural mystery of the sacred.

In immediate terms this speaks directly to the Suffering of Jesus on the Cross and man's suffering in this life. It further speaks to the alteration of the natures of Christians who follow Christ and are said to become the 'adopted' sons and daughters of God, brothers and sisters of Jesus.

In the day to day experience one asks if they are a material person living in spiritual reality or a spiritual person living in a material reality or in some process, on the up or down elevator, so to speak. The process of recovery is a progression from the base or animal nature to the human or more divine nature. It has been said that man 'invented' God rather than that God invented man. If this were so then it really would be a mute point as man would have to be divine at the point of inventing God. Both God and the Devil are in the details. Practicing the presence of God is seeing the sacred in the mundane. Letting go of fear is to become closer to God in that God is by nature invincible, indivisible, transcendent etc.

12 step recovery programs have been criticized by orthodox faiths with regard to matters of Christology. The Big Book of Alcoholics Anonymous requires individuals develop "a god of my understanding'. This process of reflection on the nature of God and looking up and walking upright metaphorically is no different than the church's own process in 'Early Christianity'. The Oxford Movement which begat Alcoholic's Anonymous was Christologically speaking, 'first century' Christianity.

Dr. Carl Jung saw everyone as interconnected and archetypal and part of the Collective Unconscious. A moving Christian song goes, "Were you there when they crucified my Lord". It asks that we consider ourselves as Shakespeare did, all actors on a stage, but at any point, which part are you playing in this primal drama. Throughout spiritual history the killing of the king has been a favored subject.

Kurtz' famous history of AA is called "Not God". Addiction causes a person to become a Legend in their Mind while in the world they cause increasing devastation and failure. The main purpose of the requirement that an addict or an alcoholic seek a "god of your understanding' is to simply get them out of their 'minds'. Their addiction has caused them to believe what Rabbi Dr. Twerski called "Addictive Thinking", the fundamental brain disease associated with addiction. Addiction, theologically is idolatry and the key feature of that idolatry is that the worshipper or addict has made alcohol or the drug their God.

Now in terms of Christology the question arises for the individual, what is their relationship to God. The story of Jesus Christ is essentially the story of God's relationship to man and Man's relationship to God. The Trinitarian view of three god's in one is simply that of Creator or Father, Creation or Son and Holy Spirit which to a psychiatrist is the Maternal glue that unites these two. Christology encourages the contemplation of God and the individual. To the Christian Jesus Christ is that bridge. When an Alcoholic or an Addict lets go of their addiction and bridges the gap between themselves and a god of their understanding they will likely find themselves well situated in the first centuries of Christianity. To my mind that is no heresy.

James: 4:8 "Draw nigh to God and he will draw nigh to you.

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Tuesday, October 19, 2010

Zero History

Bill Gibson's descriptions of the exterior world are extraordinarily rich.

"Half an hour earlier, across the North Ocean Boulevard, he'd watched harshly tonsured child soldiers, clad in skateboarding outfits still showing factory creases, ogling Chinese-made orc-killing blades, spiked and serrated like the jaws of extinct predators."

"In the amusement arcades, he judged, some of the machines were older than he was. And some of his own angels, not the better ones, spoke of an ancient and deeply impacted drug culture, ground down into the carnival grime of the place, interstitial and immortal; sun damaged skin, tattoos unreadable, eyes that peered from faces suggestive of gas-station taxidermy."

He challenges any idea that the camera can replace the pen. The breadth of his associations and those of his characters are beyond anything that a camera could do except in collage or with pictures as part of a greater tailored tapestry of art.

His characters are some from an earlier novel, Hollis and Bigend, with Milgrim a new tabula ross a, a new born man per se, the resurrected Christ of street culture spin dried in the clean Swiss clean hospital organic spa.

There are bits of near future present day cutting edge technology that we've come to rely on from Bill. His imagination predates cyberspace and facebook and the drama queen realities of our self timer digitals. In this book there's digital and tactile expansion into the next world order of thing.

What's intriguing though is the mystery. His characters are a bit like Waiting for Godot people in incomplete sentences as events transpire about them and they get caught up in the determinism of science freely willed by unanimous assent. His theme though is again fashion and the perversion of likes. He captures the mystique of the SS uniforms appeal to a certain generation that might find Hugo Boss exciting while suggesting Chanel might add to the choice of fabric in camouflage patterns. After Bill Gibson's foray into the sexiness of military I can't look at any 'branding' without concern about what it says of my own unconscious.

Thedialogues are incomplete then completed with actions. "I want you to know," she said,"that's it's okay not to tell me any more. I'll understand."

Later, "That's why I can't trade her name for my shoes."

What a twisted winding tale with an odd hodge podge cast of characters. I loved the build up as bits and pieces came together and rock band entertainers collided with computer geniuses. The baby carriage was a down to earth utterly brilliant bit of what we all might want to do with snoopers and yet it's outcome only appears entangled much later in another layer of plot.

The ending seemed a bit rushed to my mind. Kaleidoscoped through different points of view and yet acceptable in it's totality but more down to earth and present day than a younger Gibson's ending might have been. The reverberations and lingering ideas were no less than any novel before. As usual Bill Gibson changed my view of the world. The depth of his characters and their struggles at freedom mirroring the world I live in.

It's simply another amazing novel from Bill Gibson, but probably the most feminine one to date. It's the Devil Wear's Prada dining with 007 and the setting is mostly London.
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Friday, October 15, 2010

Relics of St.Peter and St.Paul

St. John Lateran church had two urns displayed above the altar and claimed to be the heads of St. Paul and St. Peter.  I looked on the web for information regard the body of St. Peter and was impressed with the above link. A fascinating story of diggings during WWII under the Basilica.  Mistakes.  A papal pronouncement of veracity but maybe that body isn't the same as the one whose head is in St. John Lateran. This whole uncertainty regarding the veracity of relics was quite similiar to the uncertainty about which 'places' were the places in the New Testament where Jesus had been.  Faith is the acceptance of things unproven. My own faith is that some are true and some aren't.  I like that there has been such a search for the historical truth.  Relics don't change my faith.  Places aren't critical to my belief. The mystery is still a mystery.  I like though that people over the ages have studied these things and searched.  I wonder too what will and won't be known about our time a couple of thousand years hence.  What I wonder as a Canadian is whether bits and pieces of the apostles ever crossed the Atlantic.  Did any church in North America get some of the cross? One of the Popes sent some of that relic to one of German princes.  Swapping relics was better than swapping baseball cards at one time in history.  I have bits of an asteroid and it makes me feel awe and humility in my own right. I expect a bit of the nail that was supposedly used on Jesus would have that much greater effect.  I was profoundly moved by the whole experience of Rome.

Spannish Steps

"The first guide book of Rome I looked at showed a picture of Spanish Steps." she said. The DK Eyewitness Travel Rome Pocket Map and Guide was small enough to fit into my shirt pocket so had become the de rigor of travel guides for me since I actually carried it. The heavier bulky ones stayed in the room. This guide said Spanish steps were near the Piazza di Spagna, "built by the French in 1725 to link the Trinita del Monti church with the Piazza di Spagna". It was described as Rococo design.
We had been very close on two occasions and just missed finding the Piazza di Spagna. We were trying to remember the piazza name by saying the Spanish steps were by the Spagetti place. On the way back from the Vatican I actually saw that there was a metro stop there. Because of the crush of people we missed the stop and got off at the Barbarinni Piazza.
It turned out the walk to Spagna from there was chalk full of history and sights. First we had coffee and sandwiches looking at the old pair of churches before exploring them and wandering into several more along the route to Piazza di Spagna. Each church was a unique museum of painting and scupture and all were juxtaposed to shops selling Prada, Gucci and Chanel. The whole area was the finest uptown shopping with prices to match. But between two modern boutiques would be a door to a great cavern of an ancient church.
We found Spanish steps at the end of the walk and Laura had her chance to sit there. We even climbed up to Trinita del Monti for a great view of the city. Fabulous ice cream sold at a vendor by Trinita so we got some cones and walked down to savor them on the steps. I liked that the poet Keats house looked down on these. I carried a book of Keats around with me and read his poetry religiously when I was in my 20's.

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Thursday, October 14, 2010

Definitions and Diagnosis in Addiction Medicine, Dr. Raju Hajela

Dr. Raju Hajela, who has been president of the Canadian Society of Addiction Medicine has always been one of my favorite speakers. His presentation, Definitions and Diagnosis in Addiction Medicine, Implications for Treatment, Past, Present, Future given at the 2010 International Society of Addiction Medicine, 12th Annual Conference, Milan, Italy was just such a thought provoking presentation. He began by explaining how his background experience covering military medicine, family medicine, public health, and Addiction Medicine had served to shape his thinking on the concept of labeling. He has always had a deep interest in spirituality and showed how spirituality was more physics these days than anything else. Heisenberg had shown how the observer observing affected the observed and objectivity was really only shared subjectivity as facts were always processed subjectively. Ideas and opinions therefore were a product of consensus and restrained two fold by the fact that not only is Seeing Believing but Believing is also Seeing.
Substance Abuse as a term didn't exist in the ICD and the DSMV appeared to moving backwards in their definitions partly because abuse meant different things to different people as evidenced by the various amounts and frequencies sometimes put forward. The fact remained that substance abuse was still seen in a moral sense as a choice by many, especially those who would not acknowledge this outmoded idea.
Alcoholism as a disease had been proposed in 1935 by Bill Wilson and Dr. Bob S. with Dr. Jellineck in 1960 at the American Medical Association declaring it a disease, physically, spiritually, socially and mentally. Dr. Hajela said that despite all the evidence to date in support of this view he had teachers at the Harvard School of Public Health who 'didn't believe'. He went on to describe several case studies of predictive significance and several generations of transmission from his own practice to underline the biological disease evidence. He described Dr. John Savage introducing him to AA which addressed the disease as a disease alone and didn't subscribe it to any 'underlying disorders'. Use of substances was clearly shown to lead to Thought Disorders, Mood Disorders, Perceptual Disorders, Neurological Damage, and End Organ Damage making it sufficient unto itself as a primary disorder.
He spoke to the persisting Stigma associated with the diagnosis and how this affected definitions and epidemiological data.
DSMIV attempted to separate Dependence from Abuse. The notion of a spiritual disorder was related to the loss of meaning, values, relationship with self and the rest of the universe that went along with the experience of addiction.
Addiction as a brain disease was put forward by NIDA's Dr. Allan Leschner from 1994 to 2001. Dr. Twerski wrote a book 'Addictive Thinking' demonstrating the 'underlying self deception' which was a product of the brain disease of addiction. Anger by others only increased the resistance while protection by others only allowed the disease to progress. Willpower had no meaning in this process.
ISAM and CSAM maintain that the disease of addiction is a primary chronic disease. This was well documented in 2004 Scientific American showing common reward pathways. Volkov's work in 2006 demonstrated effects on dopamine ultimately.
ASAM 2010 defined addiction as a primary chronic disease of the brain reward, motivation, memory and related circuitry. It resulted in the such phenomena as inability to abstain, impaired behavioral control, craving or craving equivalents,, diminished recognition of significance of the problem etc.
Harm Reduction was a useful means to an end not dissimiliar to the treatment of hypertension which is associated with steps 1, 2 and 3 to be used in the event the problem persists or worsens. In addition there is naturally a continuing care model, with detox, rehab, and recovery associated with standard medical models for other disease entities.
Dr. Hajula concluded by discussing the addictions of the famous and quoted Gandhi who had been unable to help his eldest son who died of addiction, and was the person he'd not been able to help to his greatest regret.
Gandhi: Be the change you want to see in the world."

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European Monitoring Centre for Drugs and Drug Addiction

Dr. Paul Griffith, gave a most fascinating talk at the 2010 International Society of Addiction Medicine, 12th Annual Conference, Milan, Italy. EMCCDA stood for European Monitoring Centre for Drugs and Drug Addiction and had put out a State of the Drug Problem in Europe, Annual Report, 2009. www.emcdda.europa lead to their website.
Dr. Griffith stated that the traditional drug situation was relatively stable however there'd been a lot of market innovation.
With regard to Cannabis it was interesting that there was a decline in younger age cohorts. More resin was being produced with higher potency and more crime associated with it. In the world, in comparison to Europe, Australia lead in terms of Cannibis use. The concern however was that daily users were mostly young males and the concern was how this was affecting their development across the board.
With regard to Cocaine, it was now the second most commonly consumed drug second to Cannibis. It was further a concern because there was increasing deaths associated with Cocaine. Cocaine use was at 5% compared to 3% in US, and less than 1% in Eastern Europe. In Eastern Europe methamphetamines had been major stimulant abuse but now there was a movement of methamphetamines west and cocaine use east. Age 15 to 34 was the age of greatest use.
Heroin was the principal reason for entering treatment, followed by cannabis and next cocaine. 1000 deaths in Europe were associated with cocaine and this figure was thought grossly underestimated. There was further an increased problem of cocaine complicating chronic opiate use.
Heroin use remained stable against a background of decreasing injection and increasing numbers in treatment. There was a dramatic increase in substitution treatment. This had impacted on the general use in society but was still lacking to a large extent in prison populations. HIV was declining in association with injection. There was an increased number of overdose deaths associated with the aging cohort of problem opioid use, polydrug use and other high risk behaviors such as alcohol abuse and increasing overdose in prison as a consequence of treatment interruption
Synthetic drugs were a major problem. Ecstasy use was stable or declining, the declining quantities of MDMA a result in restrictions on precursors. However there had been innovations in supply and already the precursors themselves were being chemically prepared. It was mostly a drug of the nightlife crowd.
Methamphetamine was a major problem with Europe as a major producer. Increasingly lots of small labs were producing them in countries such as Checkoslovakia and Lithuania. The Synthetics were a problem because the market was changing and synthetics were a 'moving target'. The EU had set up an Early Warning system following 'events' and "internet' putting out public health alerts. 24 new psychoactive substances were identified with 9 synthetic cannabinoids. Increasingly the designer drugs were not just illicit but illicit and licit. Suppliers were adapting fast to any new controls with 170 onlines shops selling "legal highs" as of 2010. SPICE of 2008 to 2009 was an example of this phenomena. Commonly substances were added to herbal mixtures.

The good news was that while drug use was still high in Europe, cannabis use was declining in the young and services for drug users were increasingly available and increasingly being diversified.

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Duomo di Milano, Galleria and La Scala

Because I was at the ISAM conference the days we were in Milan, Laura was exploring the area near our hotel enjoying the fine shopping in that area. The area around Ibis Hotel was uptown and most populated by locals, not really a tourist centre perse. The conference gave participants an afternoon off so Laura and I caught a taxi to visit the Duomo di Milano. It's listed as the only Gothic Cathedral in Italy, begun in 1300 and completed in 1800.
We were simply awestruck when the taxi came round a corner and we saw this glorious church in this huge piazza. I was reminded of the central square of Mexico City. The sizes boggle the mind. I think the taxi driver anticipated and enjoyed our reaction. It certainly influenced our tip. Humbled is a fine word for the experience.
We had lunch there. Hamburger Italian Style, fries with a burger paddy but no bun. Condiments on the side. A great way to stay slim. A magnificent view to enjoy a meal and gracious company. Fun watching the tourists, especially the young women, posing for each others pictures. People watching in Italy seems unsurpassed given the consciousness so many people have of their appearance. Milan, especially, as a fashion centre for the world.
The Galleria Vitorrio Emmanuelle II was juxataposed to the cathedral and lead to the Piazza della Scalla. The Galleria had been built in 1865 by Mengoni so that shoppers could avoid street vendors and beggars.
Laura was especially fascinated to learn this as she had a very unpleasant experience just outside the Gallery. While my back was turned talking to petitioners for a drug free Milan, Laura 20 feet away had been stopped by two men ostensibly offering to sell her 'woven' arm bracelets. However using the bracelets as a justification for taking her wrist the one wouldn't let her go while the other blocked her escape and demanded 20 Euros for the bracelet. Laura was frightened as she couldn't see me, the men blocking her view, and even though it was in plain daylight she was instantly afraid at being held against her will and quickly gave them 20 Euro. All the while the men smiled as if it was a huge joke.
When I caught up to Laura, she'd run a ways ahead looking for me, she told me this.
I, being macho, accosted the men selling bracelets who said that I should have given them 100 Euro. I told them I'd give them their lives this day, forgetting I was old, and that there were six of these fellows from Senegal who had probably served as mercenaries or served time in jails already for rape of women. Naturally I'd be hurt no matter how many I hurt, still it was good to stand inches from this man's face and say, "Don't touch my woman. Don't ever touch my woman." It probably helped that I was wearing my Harley hoodie and am on such occasions prone to insaniety. They backed down and I took pictures.
Laura being wiser didn't want the police involved and didn't want me to confront the men but I explained simply "All my life I've believed that evil will persist only if good men don't do anything." When I walked up to the men I'd already thought it was a good day to die, praying to God to protect me as I did. Laura spoke to the young people nearby and was told that they were upset at the men doing this. The police had been notified but the men just moved around. Later we actually read a description of this particular scam, men offering to sell bracelets to women, then holding them and extorting money to let them go free.
As the books told her Laura got angry with the street vendors the moment they approached her thereafter, anger being the only emotion these uncivilized brutes knew. Still it was frightening for her and I felt badly.
Later reading the history of the glass ceilinged Galleria being built in 1865 just to address this problem of shoppers being accosted by street predators we appreciated that this wasn't just a here and now phenomena. The same thing occurs to tourists in Vancouver and the world over. The difference here was that in Milan they'd actually built and architectural wonder to address the problem. All the merchants we met in Italy were terrific but the street peddlers were a decidedly questionable lot, but no different than others the world over. I certainly wouldn't judge Laura negatively for getting caught in a scam because later I'd read about a taxi scam which cost me 50 euros for a 2 block ride from the Rome station to our hotel, the taxi driver taking us on a most interesting circuitous journey, not having a meter and asking us repeatedly what the name of the major street we were looking for.
Past the Galleria was the Teatro all a Scala. The present La Scala had been built in 1778 after the old opera house had burnt down at that spot. This is the major opera house in Milan world famous for it's performances. To get tickets you have to book two months in advance on line. Laura and I settled for posing for pictures as singers outside the main entrance which looked onto the statue of Leonardo da Vinci.
In the Gallerina I bought Laura a pair of gloves which would have paid for a second Harley Davidson. She liked them. I wanted her to have a most positive memory of this incredible day and place.

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Wednesday, October 13, 2010

International Society of Addiction Medicine Awards Ceremony

The International Society of Addiction Medicine, 12th Annual Meeting in Milan Italy held it's awards ceremony in the Auditorium of Milan. It was a gala evening. Opera solo with piano gave us a dozen or more of Opera's classics in the finest black tie performance including Figaro. Following that thanks and awards were given. The organizers especially deserved praise as this was a conference celebrated for the high level of science in the friendliest of atmospheres. The University of Bicocca setting Milan was terrific. Next year the conference will be in Oslo, Norway.

Milan Italy - First Impressions

British Airways flight from London was excellent with safety and service. Given that there was an Underground Strike the morning we left it was a delight to check in after taking the Double Decker bus to Victoria Station where we caught the coach bus to Heathrow. The roads were jammed and other travelers were doing what we were so lineups and chaos were everywhere. That all stopped at the British Airways desk where everyone was professional and helpful.

Milan airport was terrific. Customs and luggage went off without a hitch. Then the airport cappuccino was the best. I'd dropped my itinerary and the military security were helpful directing me to lost and found. Later British Airways would phone to say they had my tickets to Rome and would hold till I returned. My assistant, Aim was thoughtful enough to keep an itinerary duplicate and sent this off to my email.

The only downside was that in the rain and dark we couldn't find which was the bus to central Milan and I was tired and irritable so opted for a taxi. The bus is a pittance. The taxi was 86 Euros. That's well over a hundred dollars Canadian so taxis at this moment aren't recommended.

This hotel has a 15 Euro pet fee which is about twice what is the fees we've paid to have Gilbert with us.

It's dark outside. It's raining. I haven't seen any of Milan but the inside of a taxi. I'm going downstairs to eat in the hotel. The reception here was terrific, speaking English immaculately and offering helpful information as well. There's WiFi in the room but I'm not sure how I'll hook it up.

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Catching Airplane Flights early morning.

It's 5:30 am. I have a car picking us up for the plane at 6:00 am. The plane leaves at 8:45 am. The gate closes at 8:10 am. The coffeeshop at this hotel opens at 6:30 am. Laura woke at 3:30 am. She said she couldn't sleep so might as well get ready. The wake up call she'd put in the night before was for 4:30 am. That went off, ringing at 4:30 am. I wasn't sleeping too well from 3:30 anyway anyway.
We'd gone to bed at 10 pm after having ravioli I'd brought up to the room. We watched a husband and wife with two baby twins detective show on Italian Television. I want it in Canada with subtitles. Worrying we'd not wake for the flight and worrying that the front desk wouldn't call and worrying that the bags are too heavy and worrying that the car wouldn't arrive made for a restless sleep. We'd had an Underground transit strike leaving London. 5 hours to get to the plane with only 10 minutes before gates closing when we arrived.
So I'd like to say that being an international traveller I'd normally have slept fitfully till say 5:30, having packed my bags the night before, jumped in for a quick shower and dressed to be down as the car arrived. Laura is new to this thing so I could blame this all on her. Of course, Laura takes more time to get ready. I don't even shave my face. Society places more expectations on women in this regard. Laura likes the time in the bathroom alone. Alot of women who have had kids report 'bathroom time' as 'time of solitude'. A mother's 'room of my own', sometimes.
The fact is I've not been nearly as nonchalant on this trip about planes and travel as I've been when I was younger. Security, traffic, and decreased airport flexibility makes me less casual than when I was younger.

So here we are. Waiting. Alot of travel is waiting. Especially planes and buses. The more third world the more waiting. Time is relative. A girl is sleeping in the lobby. Her bags are beside her. My suspicion is that she came down at 3:30 am and hopes the driver will wake her. Someone coming to pick her up for the airport must know her. A stranger knows to get a doctor from the International Society of Addiction Medicine conference here at 6 am.

Next time I'll ask if they can bring coffee. Where's an A&W drive through take out when you need it. I love Italy. Milan has been terrific. The conference was superb. Laura has had a ball. We're going on to Rome. I'm looking forward to the churches and history. Our taxi driver bringing us home from the Opera Singer Pianist Concert at the Auditorium de Milan put on by the ISAM organizers, when we told him we were going on to Rome, said. "Rome is a museum in a city!" I like that. We've had too little time to wander through museums so I'm looking forward to wandering through this city.

In 1971-2 bicycling across Europe early snow in the passes between Germany and Italy diverted us to Spain and eventually northern Africa. All these years I've wanted to go to Italy and here I am. I've really wanted to go to Rome since my pilgrimage to Jerusalem. Laura says she's looking forward to being blessed with the holy water in the Vatican. Given her penchant for bathing I'll keep a close eye on her so she doesn't wade right in.

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Abstinence versus Controlled Drinking

Dr. K.F. Mann, Professor and Chair of Addiction Medicine, Heidelberg University, Germany, at the 12th Annual International Society of Addiction Medicine conference, Milan, Italy, 2010, presented on Abstinence versus Controlled Drinking. It was a most informative and enlightened presentation by a brilliant researcher and teacher.
He looked at the types of evidence available to study this question. He reported on the studies of the stability of drinking patterns outcomes in 5, 10 and 16 year follow up studies. These clearly showed that those abstinent after five years were most likely to be abstinent at 10 and 16 years. The other groups were separated into improved and unimproved. The unimproved showed stable unimprovement. At first the 10 year follow up of the 'improved' had shown what appeared to be good results however continued follow up showed that half of these were dead a few years later. This pointed indeed to the benefits associated with abstinence.
PROJECT MATCH study showed that those who sought abstinence were mostly likely to achieve abstinence and if they didn't were most likely to have improvement. In contrast those who thought only to "control" their drinking didn't have as good outcomes.
The UKATT study he quoted was most interesting in that it showed clearly that 1 pound spent on prevention and treatment resulted in 5-6 pounds of financial savings.
PREDICT Study (Mann et al, 2009) showed that people who believed and aimed for abstinence had better outcomes with the use of Naltrexone.
The NESARC study was interesting in that it did show that a large group of people with alcohol problems but not alcohol dependence could get out of their alcohol problems without the need of professional help.
Dr. Mann discussed the Sobell & Sobell study of 1976 that had caused such confusion and misinterpretation. It was a controlled drinking study but what it really showed was that those who were going for abstinence did better.
The Current Standard of Knowledge therefore was that
1. Severely dependent persons show go for abstinence
2. There are those who are low risk drinkers who may be treated differently. This is the conclusion of Sobell in Paris in 2010
The DSMV aims to help such people where the main role is for moderation goals.
Dr. Mann said that one of the major problems surrounded the term "controlled drinking". The WHO has long identified three distinct categories. High Risk, Moderate Risk and Low Risk. It is clear from the research that the High Risk need to be separated from the Low Risk. The Severely addicted are a distinctly different population from the less severely affected. This distinction is significant because each of the different categories can be shown to have distinctly different presentation in regards to risk and influence of drug and alcohol abuse on such diseases as cancer and heart disease.
The European Medicine Agency recognizes that there is a need for Full Abstinence in addiction and that Intermediate harm reduction may be a goal towards that.
Not surprisingly patients preference on first visit separates into 54% wanting abstinence and 46% wanting non abstinence. Those wanting abstinence are mostly female, unemployed and have more alcohol related problems.
Dr. Mann reported that while there was wide exceptance of 'controlled drinking' throughout European care givers it was interesting how this divided. More psychologists than physicians favored 'controlled drinking'. Psychiatrists versus physical doctors had the greatest acceptance of 'controlled' drinking. Acceptance of controlled drinking was greatest in inpatient versus outpatient care givers.
Patient characteristics that influenced the choice of controlled drinking versus abstinence were a) that it was the patient choice b) there was an absence of previous relapses c) the patient had significant social stability d) there was low severity of dependence.
Most importantly, Dr. Mann said that 'controlled drinking' could be seen as a 'stage' towards abstinence. This was most beneficial in Motivational Interviewing where controlled drinking could be a first choice which was great if it worked but if it didn't then the therapist was in a strong position to say, 'well we tried it that way, now what about trying it this way."
Dr. Mann reported that he had changed his own opinions over his years of practice based on reflecting on the evidence of research, seeing that there was a need as with other disease categories to offers options to patients, and consider at what stage a person's disease was by careful assessment.

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Drug and Alcohol Practice, Policies and Research in Europe, ISAM, 2010

Dr. Uchtenhagen, at the 12th Annual International Society of Addiction Medicine Conference, Milan, Italy 2010, presented on the Drug and Alcohol Practice Polices and Research in Europe. He made a strong point that the history of Europe had resulted in progressive and humanistic laws in this regard. There was no unified drug legislation across Europe though most nations conformed with UN conventions. Possession was sanctioned with only fines in 6 countries and admonished in another 7 countries. 25 to 90% of countries didn't have sanctions.
The EU Drug Strategy 2005-2012 set frameworks for Drug Action Plans aiming at reduction in the prevalence, harm and availability. When these were evaluated there was increasing focus on harm reduction. There was also noted a gap between public policy and public behaviour and a knowledge gap regarding drug supply. The EU Drug Action Plan 2009 to 2012 had specific actions encouraging support groups such as European Citizens Alliance on Drugs and specific action 21 which systematically aimed to provide access and improve coverage of harm reduction strategies.
The EMCDDA 2006 showed no single format on drug strategy in EU. The trend was to shift from substance use to addressing the consequence of substance use. There was further shift from abstinence only to moderate use options. The diversified treatment models included opioid replacement which clearly showed prevention of blood borne infection. Evaluation showed 27 members have diversification. The recommendations were for drug free treatment as well as appropriate substitution treatment. Opioid substitution showed overall coverage as very diverse across Europe from 5% to 83% with available substitution even lower in prison populations. Further there was further divergence around availability of syringes and condom and availability at most in 18 states. Supervised consumption rooms developing in 1986 at the height of the Aids epidemic showed 62 rooms in 36 European cities.
In 2007 it was noted that harm reduction as a concept was accepted now as part of a balanced approach. Follow up studies of harm reduction showed that they lead to decrease in AIDS in users and no harm to greater community. Opiod Substitution Treatments were shown by the WHO 2004 and 2008 to reduce mortality and morbidity and be most cost effective.
Peer approach interventions were part of the Harm Reduction programs IRETREA was such an example.
The Seventh Framework Program (FP7) was a key pillar for European Research Area and had an open call for research in the area of drug and alcohol abuse and treatment.

Dr. Uchtenhagen has published his ethical perspectives in Intern. Rev. Psych 22, 2010

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Does Underage Drinking Cause Brain Damage?

Dr. Howard Moss, US NIAAA Assistant Director of Clinical Research, presented , "Does Underage Drinking Cause Brain Damage - Convergent Evidence from Imaging Research" to a packed audience at the 12th Annual International Society of Addiction Medicine Conference, University of Bicocca, Milan, Italy, 2010.
He noted first that there was a distinct phase of development distinguishing Adult from Adolescent and that this was in agreement with other mammalian research.
This phase was typified by 1. Engagement in disproportionate amount of risk taking behaviour 2. Increased Appetitive Drive 3. Emotional Volatility 4. Greater autonomic and neuroendrocrine reactivity to stress. 5. Greater cognitive disruption during stress (eg. impulsive responding) 6. Decreased sensitivity to behavioral effects of psychosomatic substances (Note, paradoxically, Decreased not increased) 7. Decreased sleep drive and phase delay
Adolescent brain development was studied and reviewed by Tapert and Schwienburg. There was first increased growth, especially in the preadolescent period followed by pruning which resulted in synaptic refinement. Synaptic pruning: there are many connections between neurons and those not used get pruned away and this results in improvement in attention. By end of adolescence half of the synapses have been pruned. Grey matter is replaced by white matter. 1% of the brain's gray matter is pruned per year during teen years. Glutaminergic neurons are replaced.
Adolescence is the highest risk period for initiation of regular drug use in the US. Cigarettes, for instance have their peak initiation by age 16.
Drug use prevalences in 8th grade show 17 % use alcohol, 8% use illicit drugs, 8% use cigarettes. By 12th grade 45% use alcohol, 21% use illicit drugs and 22% use cigarettes.
Adolescent drinking is less frequent than adults but adolescent drinking is associated with high dose, they drink to get drunk. Adults drink more frequently at a lower dose.
Morphometry studies of the brains of adolescents comparing heavy drinkers with controls show that heavy drinkers have smaller hippocampus. The hippocampus is associated with memory and learning. Morphometry studies also show that heavy drinkers have smaller prefrontal cortexes. The prefrontal cortex is what makes homo sapiens different from other species in planning, goal direction etc. Mylenization studies, using Defusioin Tensor Imaging ( D.L. Thatcher, S. Pajtec, D.B. Clark, 2010) show that the brains of adolescents in the substance abuse samples show decreased myelinization and brains which don't function in a synchronous way. The Fractional Anisotrophy studies show the region of impairment most in the Superior Longitudinal Fasciularis. Heavy drinking adolescents have deficits in large white matter areas.
P Magnetic Resonance Spectroscopy studies brain metabolism showing the energy use of the brain by following phospholipid turnover. The studies of adolescents with alcohol, conduct disorder and Substance Abuse Disorders show that their synapses are not be pruned which explains well the attentional problems and executive function failure seen behaviorally.
Functional MRI studies show regional changes in Oxygen use and can identify areas involved in a task. The Spatial Memory Task changes rapidly in pre adolescents. Heavy drinking adolescents actually did better on this test but the MRI studies showed that they had to use many more areas of their brain to accomplish the task.(Tapert et al, 2004). However after 4-5 years of heavy drinking Spatial Memory Tasks evidence decreased performance, and less activation in superior or inferior parietal areas. Heavy drinkers showed less memory retrieval and poor spatial memory while heavy marijuania users showed decreased learning of tasks, decreased sequencing and increased error. Heavy drinkers showed decreased hippocampus and decreased prefrontal development and decreased white matter integrity. f MRI studies showed decreased performance.

Dr. Moss in conclusion said that the evidence collectively points to negative brain changes as a consequence of alcohol and drug abuse. These negative brain changes constitute brain damage. The question he said that the studies didn't show was whether this was delayed development which could potentially 'catch up' or more permanent deficits. The other question the research did not answer as yet was whether these changes were precursors to later dependence. However he said the epidemiological evidence to date shows very clearly that the heavier the drinking in early adolescence the greater the likelihood of later dependence. What was further not shown was how these changes impacted on other psychopathology. The conclusion remained though that these changes associated with alcohol and drug abuse looked like brain damage.

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Monday, October 11, 2010

Leaving Rome

It's 7:40.  The Shuttle arrives at 8. Laura's just doing the last packing in her bag.  I've got my shirt to put on. Last thing so I don't spill something on it right off.  I've made coffee in the room. I was woken to bells. Laura says they sound every hour.  I slept well then.  British Airways to Heathrow then 4 hour wait till the 9 hour flight  back to Vancouver, Canada.
Asked what were the highlights, I'd have to say to begin with Westminster Abbey in London.  I also liked Parliament and Big Ben.  Returning to Picadilly Circus after so many years and remembering being 20 there was a bit of nostalgia considering my grey beard in a shop window.  The Scotch House Steaks were the best meal because it was so rainy and we were so tired and hungry. Laura loved Buckingham Palace and the boat ride on the Thames.
Milan was a great conference. International Doctors in Addiction Medicine put on a good show. I really enjoyed the lectures.  Laura and I loved the gala dinner and opera concert. What would Italy be without opera.  Then there was the most amazing Cathedral and Galleria at the downtown square Duoma.  We were simply blown away by it's grandeur, beauty and size.  The shopping, even just looking at the fashions, was a joy in Milan too. All the people were so friendly and it really seemed that everyone spoke English.
Rome was spectacular. Hotel Mondial, Best Western was a joy and a safe friendly retreat from days of walking and sight seeing. St. Peter's Basilica was surely the highlight.  Then the Vatican Museums Tour was a close second. Stumbling on the Colosseum at night was a find. Then there was Spanish Stairs. Laura was so happy to sit on them after first seeing them in her guidebook. I loved that Keats had a house there.  I loved best renting a Vespa and driving out to St. John Lateran with Laura. That Minerva, Santa Maria Maggiore and St. Paul's outside the wall were the churches that most caught our breath after St. Peters. Worshipping in Rome, sitting quietly in prayer, contemplating life and death in the midst of this fast paced city was something else. So many places for solitude and reflection. Imagine three grand churches along the length of Robson Street and it might capture something of what we experienced. 
I love Roma.  The Vatican is fabulous. The food was great.  It's hard to leave.  Family, friends, Gilbert the dog, Angel and Tiffany the cats, and of course work all wait. I'm looking forward to the new world beauty of Vancouver.  I'm so ever grateful though that we could make this journey and pilgramage.  Praise be to God. Thank you Jesus.,

Vatcian Museums Tour

We learned from guides that the tour was a must.  So we did the tour.  It was fantastic.  Amazing.  Incredible. What else can be said. Not only was it a step back in history but it was also going through the homes of the Popes.  It was Michelangelo, Rafael,  and much much more.  I loved it. Laura loved it.  It was all and more than we could have hoped for. At the end we went into the basilica and gave thanks. The church this time was just that. Our first visit we'd come mostly as part of the hustle bustle tourist crowd. This time we came to worship. It was good.  Thanks be to God.