Do you feel lonely?

Loneliness - a bridge to nowhere!
Loneliness - a bridge to nowhere!

“Loneliness and the feeling of being unwanted is the most terrible poverty.”
-Mother Theresa

According to research, doctors and lawyers are the loneliest professionals. That is not good because loneliness is linked to social isolation and increased risks of cardiovascular disease, dementia, depression and anxiety.

How do you define loneliness?

I went to Wikipedia to look for a definition. It says, “Loneliness is a complex and usually unpleasant emotional response to isolation.”

People may surround you, as doctors are, and still feel lonely. It seems there is lack of connection and/or communication with other people. You may be close to them but still do not feel connected. This can create a lot of anxiety and unhappiness.

According to a survey published in the Harvard Business Review, doctors and lawyers are among America’s loneliest workers, followed by people who work in engineering and science.

Lauren Vogel’s article in the Canadian Medical Association Journal (CMAJ July 20, 2018) quotes a study that says, “Lawyers and doctors were the loneliest by far, reporting levels of loneliness 25 per cent higher than respondents with bachelor’s degrees and 20 per cent higher than those with PhDs.”

What makes doctors lonely?

After high school doctors have to go through a challenging ordeal to get into a medical school and then go through residency and specialisation. That is about 10 years. During that time the doctor gets married and has children. Starting a practice and providing dedicated service takes a lot of years. After all that the doctor has very little time to have friends to unwind with.

All the friends you had in your high school years are not around. And if you do run into them then you find there is nothing much to talk about. There is no common ground.

By contrast, workers in marketing, sales and social work are the least lonely, likely because these fields are highly social. Income is not important when it comes to loneliness. And workers with higher levels of education report higher levels of loneliness.

What are the health effects of loneliness?

Early death is one possibility, says an article in Perspect Psychol Sci. (March 2015). One study showed loneliness has similar health effects to smoking 15 cigarettes a day.

A lonely individual costs the health care system more than those who are in a socially happy environment. As mentioned earlier research has linked social isolation to increased risks of cardiovascular disease, dementia, depression and anxiety.

Social isolation is considered such a growing problem in the United Kingdom that the government appointed a Minister for Loneliness whose tasks will include helping to develop “the evidence-base around the impact of different initiatives in tackling loneliness, across all ages and within all communities.”

What can we do?

It is important for doctors and other professionals to build a social circle. It is easy to face the challenges of loneliness if you have good family and friends to stand by you.

Behaviour experts say loneliness among doctors and other professional depends on how much of a culture of social support is in the workplace. Doctors and lawyers have none of that, as they are independent practitioners.

Loneliness affects someone in every family. That should not be the case as we are biologically designed to be nourished by connections. Let us sing Buck Owens’ lyrics:

Hello happiness, goodbye loneliness
Farewell heartaches and so long strife
No more sadness only gladness…

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Maternal Age the Most Significant Risk Factor Associated with Down Syndrome

“Attacking people with disabilities is the lowest display of power I can think of.” -Morgan Freeman

Down syndrome is the most frequently occurring chromosomal congenital abnormality in Canada. It is a lifelong condition. It adversely affects infant’s life and mortality.

An English physician John Langdon Down first described Down syndrome in 1862, and helped to differentiate the condition from mental disability. Prior to that for centuries, people with Down syndrome have been alluded to in art, literature and science. Many individuals were killed, abandoned or ostracized from society. Many of these children died during infancy or early adulthood.

Humans usually have 46 chromosomes in every cell, with 23 inherited from each parent. Due to the extra copy of chromosome 21 (trisomy 21), people with Down’s syndrome have 47 chromosomes in their cells. This additional DNA causes the physical characteristics and developmental problems associated with the syndrome.

The cause of the extra full or partial chromosome is still unknown. Maternal age is the only factor that has been linked to an increased chance of having a child with Down syndrome. There is no definitive scientific research that indicates Down syndrome is caused by environmental factors or the parents’ activities before or during pregnancy.

The additional partial or full copy of the 21st chromosome that causes Down syndrome can originate from either the father or the mother. Approximately five per cent of the cases have been traced to the father.

Children with Down syndrome experience intellectual delays and are at an increased risk for several medical conditions.

Congenital heart defects and respiratory infections are the most frequently reported causes of death in children and young adults with Down syndrome. Childhood leukemia is also associated with Down syndrome.

Due to higher birth rates in younger women, 80 per cent of children with Down syndrome are born to women under 35 years of age. Women aged 35-39 years have the highest percentage of babies born with Down syndrome (29 per cent).

According to a report on the Government of Canada website, the birth prevalence of Down syndrome in Canada from 2005 to 2013 has remained stable. Approximately one in 750 live born babies in Canada has Down syndrome. Advanced maternal age is the most significant risk factor, says the website.

Prenatal screening for Down syndrome has advanced in both accuracy and early detection. The number of children born with Down syndrome has remained stable due to increased use of prenatal diagnostic procedures followed by terminations of pregnancies.

The Society of Obstetricians and Gynecologists of Canada’s clinical care guidelines for prenatal testing advise against using maternal age as the only criterion for invasive prenatal diagnosis. They recommend prenatal screening for clinically significant fetal abnormalities be offered to all pregnant women, irrespective of age.

There are 45,000 Canadians with Down syndrome, with a very active organization, Canadian Down Syndrome Society (CDSS). The CDSS is a non-profit organization that provides Down syndrome advocacy in Canada, says their website.

The organization helps people with Down syndrome. People with Down syndrome can go to school, finish university, find careers, and get married. CDSS goal is to ensure all people with Down syndrome live fulfilled lives. It is Canada’s voice for Down syndrome.

Start reading the preview of my book A Doctor's Journey for free on Amazon. Available on Kindle for $2.99!

It Takes Three Minutes to Understand Tourette Syndrome

Skaters practicing at University of Calgary. (Dr. Noorali Bharwani)
Skaters practicing at University of Calgary. (Dr. Noorali Bharwani)

My niece’s grandson has Tourette syndrome. How much do we know about this condition?

Youtube has a three-minute video that is quite touching, simple and educational. The disorder was named after a French neuropsychiatrist, Gilles de la Tourette, who successfully assessed the disorder in the late 1800s. Males are affected about four times more often than females. There is usually a family history of tics.

The syndrome becomes evident in early childhood or adolescence between the ages of two and 15. It is manifested by multiple muscle and/or vocal tics lasting for more than one year. The presentation is usually involuntary (outside one’s control). It involves movements (tics) of the face, arms, limbs or trunk. The symptoms may be complicated, involving the entire body, such as kicking and stamping.

Verbal tics (vocalizations) are manifested by grunting, throat clearing, shouting and barking. The individual may suffer from coprolalia (the involuntary use of obscene words or socially inappropriate words and phrases) or copropraxia (obscene gestures). Others may repeat word of others (echolalia), repeating ones own words (palilalia), and repeating movements of others.

Fortunately most individuals with Tourette’s syndrome have mild symptoms. Some may have associated conditions like attention problems, obsessional compulsive behavior, and learning disabilities. For most, there are no barriers to achievement in their personal and professional lives. Persons with Tourette syndrome can be found in all professions.

There is no specific treatment or preventative measure. Tourette Syndrome Foundation of Canada (TSFC) has an educational website worth visiting. The goal is to educate both patients and the public of the many facets of tic disorders. Increased public understanding and tolerance is important to people with Tourette syndrome and their families.

This reminds me of a story I read somewhere.

David, a second-grader, was bumped while getting on the school bus and suffered a two-inch cut on his cheek. At recess, he collided with another boy and two of his teethe were knocked loose. At noon, while sliding on ice, he fell and broke his wrist. Later at the hospital, his father noticed David clutching a quarter in his good hand. “I found it on the ground when I fell,” David said. “This is the first quarter I ever found. This sure is my lucky day.”

In a small or big way, we are all blessed with something good. So keep smiling.

Start reading the preview of my book A Doctor's Journey for free on Amazon. Available on Kindle for $2.99!