Meditation and Neuroplasticity

August 27th, 2023 by Nick Jacobs No comments »

           Back in the 1960s or as the Brits nicknamed it, The Swinging Sixties, lots went on that some of us would prefer to remember as interesting, youthful experiences that created lifetime memories.  Besides the British music invasion, drugs became popular and commonplace among the hippie generation, but I missed out on all of that because my education took place at a conservative school.

          Being a traditional student heading toward a teaching career also meant that my career would be significantly jeopardized had I not stayed within the parameters of expected behavior. Unfortunately, the movie, Animal House, was not a realistic depiction of my college experience.

          One phrase that did catch on during that liberal era of the late 60s and early 70s was “Don’t bother him, he’s contemplating his navel.” It’s thought that it became popular in Western culture during a time when the Beatles and other luminaries were practicing transcendental meditation.            This navel-gazing phrase related to introspective thinking and mindfulness through meditation. It  implied the person in question was engaged and completely focused on their own thoughts or mental silence. If done correctly, one’s emotions often feel disconnected from the outside world.

            Since that time, numerous well-known people have found meditation to be an important part of their lives. Meditation practicing entertainers include Hugh Jackman, Ellen DeGeneres, Jerry Seinfeld, Katy Perry, and the late basketball great Kobe Bryant who practiced meditation to enhance focus and mental resilience as part of a daily training routine. Of course, there are also thought leaders like the Dalai Lama, Drs. Deepak Chopra and Dean Ornish, publisher Arianna Huffington, the entrepreneur Russell Simmons, and former NFL player Ricky Williams who are famously recognized for using these mindful practices.

            Individuals who practice meditation regularly credit the practice with positive outcomes ranging from better sleep, stress reduction, relief from both anxiety and depression, much-improved focus and concentration, enhanced self-awareness, better relationships, lower blood pressure, pain management, enhanced creativity, spiritual growth, and one of my favorites, neuroplasticity.

            Several studies have shown that practicing and playing musical instruments can significantly contribute to neuroplasticity. Music can enhance fine motor skills, auditory processing, memory and pattern recognition, multi-sensory integration, cognitive flexibility, brain connectivity, and brain reserve.

            Neuroplasticity is the underlying property of the brain that includes learning, adaptation, and recovery from injuries. It truly represents the brain’s ability to rewire itself. With that in mind, neuroplasticity contributes significantly to education, therapy, and overall cognitive health.

            If I recommended that you meditate for 10 or 20 minutes in the morning and again at night, you might snicker and suggest that not only do you not have time, but more bluntly that you also think it’s a waste of time. If I told you that by doing so you could significantly impact the creation of new neural connections that would modify your brain’s function in ways that would permit you to improve and optimize your performance while adjusting to new circumstances, you also might suggest that I move on.

            Let’s, however, look at the list of positives related to further development of neuroplasticity beginning with the fact that it will allow you to acquire new skills, knowledge, and behaviors. It also enables you to adjust, and more importantly, to adapt to changes in your environment.  It contributes significantly to more efficient memory storage, the capacity to adapt and remain functional as we age, and the ability to shift perspectives and respond to new challenges. And the list goes on and on.

            If you’re a type A, hyper-active person, meditation may provide you with a welcome relief from yourself. Find a peaceful, quiet space, force yourself to focus on the present, breathe deeply and use that breath to anchor. Acknowledge external interferences but don’t dwell on them and remember that contemplating your navel by deep breathing alone will create a natural relaxation response that is good for your health. Try it. You might like it.


Tops in Care in PA

August 14th, 2023 by Nick Jacobs No comments »

If you were to see a list that included UPMC Shadyside, UPMC Passavant, St Clair Hospital, Geisinger and Chan Soon Shiong Medical Center, but no other local hospitals in this immediate geographic region, your initial question might be something like, “What’s this list represent?”

Here’s the succinct answer to that question for people living in the Greater Johnstown Area. This is part of a list of the top rated hospitals in Pennsylvania.  

 Let’s be perfectly clear about this, too. When you consider every aspect involved in evaluating a hospital for elite status, it’s very relevant that this is not some type of purchased PR accolade meant to create a smoke-screen for publication. It is, in fact, the result of serious patient analytics by the Centers for Medicare and Medicaid. More importantly, it is a sincere recommendation meant to assist patients in their healthcare selections.

 No, Chan Soon-Shiong Medical Center is not in the same league clinically as the hospitals listed above in range of services, but the services offered there do contribute significantly to one very important aspect of evaluation. When patients are asked if they would recommend CSSMC, their sincere answer to many detailed questions is “Absolutely, yes.” In other words, the range and scope of services offered at CSSMC are top-notch.  

 If you’re wondering how an achievement like this is possible, there is only one answer, teamwork, teamwork under the umbrella of incredible clinical leadership that is endorsed at the very top by the CEO, Tom Kurtz. Dr. David Csikos, MD, Chief Medical Officer, and Sherri Spinos, Vice President of Nursing are two of the hundreds of members of the CSSMC staff who should be standing in the winner’s circle accepting this Gold Seal of approval.

 Not only did Tom Kurtz, CEO turn around a small rural hospital that, like all of its peers in the State at that time, was heading toward either merger or closure, he did it with a spirit of good humor, compassion, kindness and positive energy. His positive energy was passed on to CSSMC’s physicians and staff in ways that create patient satisfaction at the highest levels.

 Congratulations to Chan Soon-Shiong, to Tom Kurtz and the Windber clinical leadership, staff, and physicians involved in this significant accomplishment. They have achieved “Best of Show” as Blue Ribbon winners in this national recognition. As the former Windber Medical Center continues to achieve these incredible quality standards as a small, rural hospital, we need to recognize and thank them for their efforts to provide quality healthcare to our region.

 They’ve done it again. Keep up the magic.     


Becker’s Hospital Review

The top recommended hospitals in every state

Mackenzie Bean (Twitter) – Friday, August 4th, 2023

Becker’s has compiled a list of the hospitals patients are most likely to recommend in every state using Hospital Consumer Assessment of Healthcare Providers and Systems data from CMS.

CMS shares 10 HCAHPS star ratings based on publicly reported HCAHPS measures. The recommended hospital star rating is based on patients’ responses to the question, “Would you recommend this hospital to your friends and family?” Hospitals must have at least 100 completed HCAHPS surveys in a fourth-quarter period to be eligible for a star rating. Learn more about the methodology here.

The star rating is based on survey data collected from hospital patients from October 2021 through September 2022. The figures are from CMS’ Provider Data Catalog and were released July 26. Asterisks denote that CMS included a footnote about the organization’s data, which are summarized below.

The hospitals that received five stars for patient recommendations in every state:

Advanced Surgical Hospital (Washington)
AHN Hempfield Neighborhood Hospital (Greensburg)
Bryn Mawr Hospital
Chan Soon-Shiong Medical Center at Windber
Chester County Hospital (West Chester)
Doylestown Hospital
Edgewood Surgical Hospital (Transfer)
Evangelical Community Hospital (Lewisburg)
Geisinger Jersey Shore Hospital
Geisinger St. Luke’s Hospital (Orwigsburg)
Hospital of the University of Pennsylvania (Philadelphia)
James E. Van Zandt VA Medical Center (Altoona)
Lebanon VA Medical Center
OSS Orthopaedic Hospital (York)
Paoli Hospital
Physicians Care Surgical Hospital (Royersford)
Rothman Orthopaedic Specialty Hospital (Bensalem)
St. Clair Hospital (Pittsburgh)
St. Luke’s Hospital-Anderson Campus (Easton)
Surgical Institute of Reading (Wyomissing)
Troy Community Hospital
UPMC Passavant (Pittsburgh)
UPMC Presbyterian Shadyside (Pittsburgh)


Patient Centered Care

July 5th, 2023 by Nick Jacobs No comments »

The moves on my personal career chess board went something like this: Band director to arts manager, then tourism director to health care executive. Looking objectively at my employment progression, one might struggle to identify some type of intelligent connectivity and continuity that makes sense, but it was indeed a rich experience pathway that resulted in a unique brand of leadership that could not have been predicted.

First and foremost, it armed me with a very deep level of understanding and experience in human relationships that addressed things like personal growth, happiness, and positivity. As a junior and then senior high school band director, I learned compassion, patience, and persistence, and was forced to become a master counselor to help my students achieve sometimes incredibly challenging goals.

When I entered healthcare management, my most often replicated thought was “Why do they do things this way?” It took me a while to find the answer to my question. The vast majority of the individuals involved in healthcare were adept in things like math, science, and other left-brain skills. My career path was heavily weighted in emotional quotient skills, and human interactions that nurtured my students, encouraged artists in creativity and uniqueness, and promoted entrepreneurial activities through our tourism business membership.

One of my first healthcare administrative fellows quoted a line from one of his professors that became our mantra, “Don’t give people what they will like. Give people what they will love.” There was also a masculine/feminine component to this philosophy as well because the vast majority of healthcare leaders were men, but the majority of employees were female, the majority of healthcare decision-makers were women, and the road to recovery and healing always included nurturing. These realities resulted in my taking a very different view of what healthcare leadership should look like, and it was opposed to many of the traditional “Dr. House” approaches that had been followed for many years.

The absolute power of humanness in healthcare had to be the core of the relationships between the patients and caregivers. That human touch is what fostered healing. This meant developing programs with empathetic understanding relating to the patient’s emotional needs. It also meant encouraging genuine connections between our healthcare professionals and their patients. That required pointing out over and over again that it may be the employee’s 127th tumor, but it was the patient’s first, and that meant compassion, tenderness, and empathy had to be part of the care.

The capacity to understand and share the feelings of others represented a very challenging new world order because that sharing also meant vulnerability, personal exposure to emotional pain, and transcendence of traditional roles as the caregivers embrace the holistic care of their patients. The acknowledgment and validating of patients’ emotions, fears, and concerns, allowed our healthcare professionals to create an environment that promoted healing. It also reassured the patients that they were being seen, cared for, and heard. Most importantly it instilled hope and reduced anxiety. That alone allowed white blood cells to do their work.

It didn’t take long to realize that with the establishment of provider-patient relationships, healing could begin more quickly. These relationships required the providers to understand their patient’s uniqueness. What were their cultural backgrounds, family circumstances, and personal preferences? By doing this type of homework and then allowing patients to actively participate in their healthcare decisions, a bond was formed that resulted in a patient-centered type of care that created incredibly positive statistical outcomes that still hold today.

By our acknowledging the psychosocial impact of illness, healthcare professionals were able to offer support, guidance, and resources to help the patients get through their challenges. By addressing these spiritual and emotional needs, our patients experienced resilience which facilitated their recovery and added to the overall quality of their lives. Honestly, as the neurosurgeons used to say, “This is not rocket science.”


No One Can Do This Alone

May 10th, 2023 by Nick Jacobs No comments »

            My career has been a roller coaster ride, but I learned early on that persistence, patience, creativity, and luck are all factors in business survival. So is blood pressure medication, Tylenol, and an occasional glass of something that does not emanate from the spigot in the sink.

            If you trace my work history, it was rather interesting. My first adult full-time job was in an already successful program that had been established in the Pittsburgh area. Because it was a fully functional program, all I had to do was maintain what I believed to be a good thing. Then, when I first moved to Johnstown, I landed in an incredibly successful program that, in comparison, made that initial job look mediocre at best. My new challenge there was to attempt to find ways to make this amazing organization even better. That’s when the persistence, patience, creativity and luck really came into play.

            For the next two decades, however, I was thrust into at least four failing, failed, or forgotten organizations that were described in my graduate program at Carnegie Mellon as “dogs.” I’m not sure why they chose such a noble descendant of the wolf to describe a deteriorated or destroyed business situation, but their teaching revolved around what you might do in order to turn a dog-like corporation into a winning one. That, my friends, became my life’s primary work, and thank goodness, it forced me to develop skills that were hidden deep within me. Fortunately, I had mastered a formula from my teaching days that was replicable and allowed me to do just that.

            That plan involved having an open door and an open mind, allowing people to enter my office and my life with sometimes outlandish, over-the-top, and even bad ideas. My secret was to never assume that any idea was a loser until I had a chance to hear it out and, in some cases, to implement it.

There was one very good idea I had stolen from a former CEO who, due to his hubris on both sides of the equation, first built and then destroyed a business/healthcare empire. According to legend, when he became the CEO for the first time, he cancelled all of his meetings and spent weeks interacting one-on-one with every one of his employees to introduce himself and get their input. Well, that was an amazing idea that had broad implications. (I didn’t steal his other idea of eventually misappropriating donated funds.That’s the one that resulted in his eventual imprisonment.)

            On the first day of my new job, I had my assistant clear my schedule, asked that she arrange for each employee to come into my office where I invited them to sit across from me at either my desk or the conference table while I introduced myself and my philosophy of transparency and openness. Then I got up and had them change seats with me as I asked them what they would do if they were president.

Not only did I hear a boatload of amazing ideas, but when I also got around to implementing many of the good ones, I gave them credit for it being their idea. Many of their suggestions were things I had planned to implement anyway, but having their name attached to the implementation of those ideas was a tremendous hit.

            Over the next 11 years, I received a lot of professional kudos that sometimes resulted in my own personal misappropriation of hubris. In fact, near the end of my CEO tenure, I began to believe my own press and sometimes failed to recall that had there not been a powerful local Congressman, an incredibly supportive staff and family, and a least three or four amazing local civic leaders who also contributed to this success.

The take-away? None of us, not one of us can do this alone. It truly is a team effort.


Gen Z

April 19th, 2023 by Nick Jacobs No comments »

Many of us are counting on the Gen Z kids to fix this mess, to help make this world a better place for everyone. It really is up to them. So, here are a few things to consider that may help them on this journey.

            First, and foremost, it really is all about choice. We spend our days making choices. We pick out the clothes we want to wear, and we decide how we want to fix our hair. Well, here’s a secret. Each and every day, we can decide if we want to be happy, angry or sad. It is absolutely a choice, sometimes a tough or complicated one, but it is ours to make.

            When someone says something hurtful, we can decide to let it hurt and react accordingly, but that’s a choice we are making. Just because one thing goes wrong, we don’t have to decide to allow that to dominate our feelings. How often have you heard, “That ruined my entire day.” One sentence, one comment that took seconds ruined hours of time. Don’t let someone kidnap your feelings.

            Also, purposefully seek out the things that make you happy, that make you feel okay about yourself, and make you smile. Life is so much better when you’re not throwing yourself against a brick wall and making yourself  miserable.

            Surround yourself with people who are nice, who care, who are loved and give love. The more time you spend with negative people with low self-images, the more miserable you personally will be. Seek happiness, but you also need to be honest with yourself and learn to manage your expectations.

            Take advantage of every opportunity that comes your way to better yourself. Everything will not always go your way. Look for opportunities that will allow you to grow and to learn. That will give you an edge, by making you better at what you’re doing.

            Also, if you work outside your comfort zone in some areas, you will grow both emotionally and intellectually. That way, you’ll have a better chance to be successful at whatever it is that makes you feel good about you, too. Remember, you must like you before other people can or will. Everyone likes a positive person.

            Nothing and I mean nothing, lasts forever. The only thing we can count on in life is change. Change is that one constant that will be with us from the time we are born until we are gone. Don’t fight change. Learn to embrace it, to understand it, and to go with it. Make sure you try to ride the wave rather than fight the ocean. Life can change in a milli-second. You can hold onto the things that make you feel comfortable like those old shoes, or your favorite sweater, but understand that everything changes no matter if you want it to or not.

 Sam Walter Foss once wrote a poem about a medieval calf that went for a walk. The next day a dog followed the trail made by that calf. Then a bellwether sheep came along with all the other sheep behind it. Finally, a person saw the path and walked that same meandering trail that innocent little calf had made.

            The difference was that the person assumed it had been made by other humans. And even though his complaints were never-ending, he continued to follow it. Later the winding path became a road, and towns were built along it.

            We’ve all followed calf paths both physically and intellectually. You need to question the paths you take. Make sure you’re not wasting your life following some nonsensical path, and be sure the paths you create make sense, too.


Cobalt Red

March 27th, 2023 by Nick Jacobs No comments »

           Under the category, “There’s no free lunch,” Siddharth Kara, a British Academy Global Professor, has written “Cobalt Red,” the ultimate expose about the underbelly of today’s progress.

            Like historical books regarding the human toll movements like the Industrial Revolution represented in the name of progress, this book reveals the hidden cost of our current technological advances. It also exemplifies and uncovers the brutal realities that accompany this current technological transition.

            All our battery powered devices require cobalt. As the author states, “Although the scale of destruction caused by cobalt mining in the name of renewable energy is without contemporary parallel, the contradictory nature of mining is nothing new.”

            When I first became the CEO at a small hospital originally built for coal miners and their families, it seemed like a good idea to create an historic wall of fame featuring the portraits of the original presidents of the hospital. Immediately after having our maintenance employees hang those pictures of the leaders from the height of the Industrial Revolution, I began getting complaints.

            I was angrily informed that some of the still-surviving widows of deceased coal miners objected to any glorification of these men. They accused them of having hired some physicians to lie and say their husbands had died of asthma rather than black lung. That was done, according to them, so the families would not get black lung insurance benefits post-mortem. Some of the offended spouses even told me they had to have their husband’s bodies exhumed to prove they had died of black lung disease.

            Of course, the gory details of progress created by the Industrial Revolution as it related to the humans involved in mining coal or making steel were often either taken for granted, overlooked, or simply accounted for like the first wave of warriors in a war involving only bows and arrows. They were considered “the arrow catchers,” collateral damage, the price of progress.

            “Cobalt Red” does a deep dive into the current horrors our contemporary revolution is causing. With climate change deniers on one side and world ending climate catastrophe predictors on the other, it feels like the rock and hard place we’re currently faced with regarding the future of mankind has once again put us in a no-win position fed by greed in the name of progress. This journey to create a new world order sans fossil fuels, though potentially unavoidable, is also creating enormous levels of suffering and dying.

            Because internationally, most of these mines are considered artisanal or small-scale mines, they are referred to as ASM mines. Unfortunately, these are not small, well controlled and properly run mines. Not unlike the little coal mines that were all over Western PA at the turn of the Twentieth Century, these mines are typically staffed with a workforce that is exposed to hazardous conditions with only rudimentary tools.

            There are currently about 45 million people around the world directly involved in ASM mining which, according to Kara, represents about 90 percent of the world’s total mining workforce. Of course, their work does not just involve cobalt. They are also mining for tin, gold, diamonds, sapphires, and tantalum.

            The author states his findings in this book very clearly, “There are many episodes in the history of the Congo that are bloodier than what is happening in the mining sector today, but none of these episodes ever involved so much suffering for so much profit linked so indispensably to the lives of billions of people around the world.”

            The next time you look at your smart phone, your smart pad or watch, or you fire up your computerized car, just understand that the billion- and trillion-dollar companies who are buying the products of these miners must be aware that there is no clean supply chain that ameliorates the “suffering from oppression accompanied by unimaginable barbarities responsible for the destruction of life.” Once again, corporate greed is a matter of life and death. 


A Possible Solution to Local Rural Physician Shortage

February 23rd, 2023 by Nick Jacobs No comments »

The Association of American Medical Colleges (AAMC) projects that a physician shortage could reach a high of 124,000 by 2024. The strain this will cause will not be borne equally.

“The COVID 19 pandemic has highlighted many of the deepest disparities in health and access to health care services,” said AAMC President and CEO David Skorton, “and exposed vulnerabilities in the health care system.”

Gerald E. Harmon, president of the American Medical Association, also raised alarms about the future of U.S. health care.

 “Because it can take up to a decade to properly educate and train a physician,” Harmon said, “we need to take action now to ensure we have enough physicians to meet the needs of tomorrow.”

He added, “The health of our nation depends on it.”

This bleak scenario recently was presented to Indiana Regional Medical Center, Indiana University of Pennsylvania (IUP), and Indiana County leadership.  As a local response, it was suggested that IUP, as one of the larger state universities in Pennsylvania, should take a lead role in creating a rural family practice medical school. Such an initiative would be a game-changer for not only the university but also for the entire Commonwealth.

Over the past ten years, universities throughout the United States have seen declines in student enrollment. These decreases have led to painful programming cuts as well as other downsizing initiatives. Still, most of the exceptionally strong programs still thriving at IUP are heavily directed toward STEM (Science Technology, Engineering, and Math). These programs have had continued robust enrollment numbers in healthcare and science-oriented degrees.

In December, IUP President Dr Michael Driscoll confirmed that the IUP Board of Trustees has approved exploration of this medical school initiative. The caveat? Funding will be a major factor in determining a “go or no go” decision.

The financial challenge may be exacerbated by Duquesne University’s decision to build a College of Oseopathic Medicine, which has garnered support from some Pittsburgh-based granting organizations. This might limit those organizations’ enthusiasm or capacity for an IUP medical school. That would be unfortunate because, although Duquesne University’s medical school is a positive addition to the area, the reality is that urban-trained physicians tend to remain in urban areas, and city training and resources are not always ideally suited for a rural setting.

Therefore, the most critical major potential source of support for this project is the Pennsylvania State System of Higher Education (PASSHE). Working with state legislators,  PASSHE could muster resources that would help create a Western Pennsylvania Medical School based at IUP.

Moreover, each year entry-level seats could be held for students from each of the 14 state universities that come under the PASSHE umbrella: West Chester, Slippery Rock, Shippensburg, Millersville, Mansfield, Lock Haven, Kutztown, Edinboro, East Stroudsburg, Clarion, Cheyney, California, Bloomsburg, and IUP

Numerous potential critical players in this scenario. Including private and community foundations, have not yet fully realized the extent to which a school like this would improve our region. The primary question they should ask is “How do we fill the dozens of physician openings we already have in this area?”

Without a plan to address this challenge, the number of openings will only grow.

Another regional asset that could provide significant depth and impact to this medical school is the Chan Soon-Shiong Institute for Molecular Medicine. CSSI currently houses not only 500,000 donated tissues samples for research, but also has on staff talented PhDs in genomics, informatics, and tissue banking who could contribute extensively to the educational research needed to support a medical school.

Finally, consider the cost we all bear when hiring physicians locally. Because the competition is intense, we must employ recruiters. Other expenses including advertising for the position; fees to locum tenens (substitute docs) during the hiring process; candidate interview costs; time spent on interviewing, onboarding and credentialing the doctor; candidate relocation costs; primary care physician salary and benefits, and incidentals. This list, according to the UNC Solutions blog, totals about $341,000.

Being able to locally source and train physicians from 30-plus graduates a year over a ten-year period would pay for itself three-fold.

We desperately need physicians in our region. We need this medical school. We need to support IUP in this initiative to help give students from Pennsylvania an opportunity to go to medical school in our region because that will ultimately benefit everyone in our region.


A Time Traveler?

January 5th, 2023 by Nick Jacobs No comments »

For the past 30 years, I’ve felt like a healthcare time-traveler.

Maybe that was because I took such a circuitous route getting there through education, the arts, and tourism, or maybe it was because I’m a musician whose brain was just wired differently.

Regardless, I’ve spent the past three decades proposing ideas that may or may not someday be implemented.

This afternoon, I ran across an article that I had written a decade ago that began with an idea I had been cultivating for 16 years.

It started with this sentence: Periodically, my life intersects with certain realities that previously did not seem to even be a consideration.

This article was about a potential project that involved the networking of approximately 20 rural hospitals via web connectivity.

The purpose of the network was to create a virtual health system that was not dominated by one super tertiary power, the normal health system model which is an ego-centric model that typically takes away the “Community” from community health care.

The network of small rural hospitals that I was studying had, in order to meet their overnight radiology needs, spent about $21 million for teleradiology connectivity to Australia.

My proposal suggested not limiting this to radiology. With that in mind, I proposed the viability of web based technology for cardiology, dermatology, oncology, and a dozen other specialities via telemedicine.

That very day, I saw an article by Christopher Lawton of the Wall Street Journal, who wrote “Cough, Cough. Is There A Doctor in the Mouse?” regarding the use of web services that allows patients to communicate with doctors via online video, text, chat or phone.

The year was 2009.

The organization I proposed this solution to rejected it as too progressive and today those 20 hospitals are still struggling to provide advanced specialty services.

Meanwhile, as we attempted to navigate COVID-19, telemedicine became not only popular but was also funded by insurance and has become extremely essential and life-saving.

About five years ago, I was tasked with creating an international seminar on integrative psychiatry which was aired on PBS in the Greater New York City area.

We had psychiatrists, psychologists, social workers, counselors, patients, and patient families who heard medical doctors from numerous foreign countries and the United States describe the incredible progress they had made with patients when they introduced integrative modalities to their practices.

These included music, art, movement, and meditation as part of their treatment plans.

Nothing big came out of that ground-breaking program either.

My next big effort was in pharmacogenomics where scientists test 300 of your 30,000 genes and then can tell you definitively which medications will or will not personally work for you. Twenty years later, that science is just beginning to be taught in pharmacy schools.

These types of rejected ideas have often made me wonder what my purpose was here on this planet. If leadership didn’t respond, if they listened but didn’t act, what good was it to be a thought-leader whose programs were clearly directed toward the future?

Then it hit me. I was put here to plant seeds, to make people think, to explore not what is but what could be.

It was only a few years ago when I offered two programs on Blue Zones at the Connellsville Canteen and Fayette County picked up on that theme and is making progress in this area of healthy living.

Consequently, I’m going to continue to try to get people to look ahead to ideas that could make our lives better, to challenge our status quo, to think positively.

Maybe like Johnny Appleseed who was credited with planting apple trees in Pennsylvania, Ohio, Indiana, Illinois, West Virginia and Ontario, that vision to plant trees that would flourish after he was no longer there to enjoy them seems like a reasonable plan with a positive outcome.


Health and Wellness, “The Role of Integrative Health and Medicine in Rural Hospitals”

December 27th, 2022 by Nick Jacobs No comments »

           Recently, I had been invited to address a selective group of  Deans and Directors from a local university and independent hospital. My presentation was centered on, “The Role of Integrative Health and Medicine in Rural Hospitals,” and it was  based on my work in wellness and prevention. I defined our efforts at both Windber Medical Center (now the Chan Soon-Shiong Medical Center Windber) and then nationally with the Academy of Integrative Health and Medicine.

            Because my goal was to help build a stronger commitment to preventative health and wellness at both organizations, I addressed how a combined effort between these two strong neighboring not-for-profits could foster improved health in their workplace for their employees, for their patients and university students, for the citizens in the communities they served, and finally, for the students in their local school districts.

In the book “Why Zebra’s Don’t Get Ulcers” Robert Sapolsky exposes us to the concepts of stress management and biology. When addressing diet and stress management, he gives the example of a young lawyer who decides that “red meat, fried foods, and a couple of beers per dinner constitute a desirable diet, and the consequences are anything but clear. Half a century later, maybe that attorney is crippled with cardiovascular disease, or maybe he’s taking bike trips with his grandkids.”

As Sapolsky stated in Zebra’s, “We are certainly aware of the extraordinary amount of physiological, biochemical, and molecular information available as to how all sorts of intangibles in our lives can affect very real bodily events.” My presentation was directed toward the steps we, as education and healthcare professionals, can take to assist our stakeholders in their life-journey.

Because “sustained psychological stress is a relatively recent invention mostly limited to humans and other social primates, we can experience wildly strong emotions linked to mere thoughts.” These fight-or-flight emotions were originally intended to assist all mammals during their lives but especially when being chased by saber tooth tigers. (That doesn’t happen much anymore.)

            The purpose of my presentation was to provide them with the tools needed to help deal with our daily ongoing stressors. It’s all about diet, moderate exercise, non-judgmental social support, and stress management via mindfulness activities. In many cases, we can decide every day in every way what should be worth dying over and, for the most part, determine what types of things knock us out of our homeostatic balance?

            Inactivity can be as harmful as smoking a pack of cigarettes a day. Obesity kills as many people as smoking which is life-ending annually for over 450,000 people in the United States alone, but stress? There’s no limit to the amount of people who are harming their health and limiting their futures by not learning any type of mind-calming, stress management techniques. It doesn’t matter if it’s yoga, the rosary, worry beads, meditation, or calmly nurturing a pet.

            Sapolsky goes on to explain the various “nuts-and-bolts factors” that will help determine which of these outcomes will occur. He explores the liver’s role in the making of cholesterol, the enzymes in fat cells, and potential congenital weaknesses. Then he hits the motherload, which is personality and how we individually deal with the stress generating problems between the mind and body.

            We know that the predominant diseases we deal with today are those resulting from, as the author explains “a slow accumulation of damage—heart, cancer, and cerebral vascular disorders.” We’ve also come to learn the fact that these inflammatory diseases are fed by a “complex intertwining of our biology and our emotions.” And there is zero doubt that “extreme emotional disturbances can adversely affect us.” In other words, “stress can make us sick.”

            Bottom line? Find what stops your amygdalae from pushing your emotional buttons to stop making you think that a tiger is chasing you.

            My former Chief Operating Officer, a former emergency room physician, used to look at me when I was stressed and say, “Everything’s okay. No one died.”  And, indeed, it was, and even I’m still here.


High Conflict

August 28th, 2022 by Nick Jacobs 1 comment »

High Conflict: Why We Get Trapped and How We Get Out by Amanda Ripley is a book about the trap of high conflict. It’s described as a guideline to reconnect with our enemies and opponents while allowing us to revive our curiosity as we continue to advance our own beliefs. The book illustrates how people can escape the high conflict characteristics of indignation and recrimination. It is expertly defined as a mind-opening, new way to understand high conflict and help us transform our acts and responses.

         High conflict is that moment in time when discord evolves into good vs. evil, and that is when the conflict itself takes over and our brains begin to function very differently. At the other end of the spectrum, good conflict is the necessary disagreements that force us to become better human beings.

         One of our greatest challenges in the United States is the binary system. It seems that almost all parts of our belief systems are set up in a way that force us to take sides. Be it in a divorce, labor strikes, neighborhood feuds, or our political parties, we are forced into a specific camp, and all those other positive things that connect us and that make us care about each other are pushed aside as the high conflict takes over.

         As a country, we have fallen into this binary trap, one that Washington, Jefferson, Hamilton and Adams all warned us against, a two-party system. Over 330,000,000 Americans are being pushed to one side or the other, good vs. bad, and we then generalize about either side. We are primarily forced into them vs. us. It’s like a giant gang war where, even if we disagree only about specific aspects of either party’s philosophy, we are in an all or nothing situation, a conflict trap. We know we have much more in common than not, but we become either a Blood or a Crip.

         The most disturbing part of high conflict is its magnetic pull. We get sucked into it, and, not unlike the thousands of animals who died in the La Brea Tar Pits in Los Angeles, it’s almost impossible to get out. When we fight, we have spikes of cortisol, but when we are in high conflict, cortisol can become a recurring phenomenon that over time impairs memory, concentration and even the immune system. It also contributes to the onset of disease.

         There are plenty of individuals who have become very rich by feeding conflict. These conflict entrepreneurs and fire starters like Alex Jones who made $800,000 a day could not care less about us, our beliefs or our future. They care only about their income and power. Like the military-industrial complex, there is a conflict-industrial complex that benefits tremendously by keeping us separated.

         The other things that pull us into high conflict are public humiliation, false binaries, the human tendency to blame other people’s behavior on natural character flaws, and the always present truth that the problem is never the problem.

         By some estimates, 38 million Americans stopped talking to a family member or friend due to the current politics of the United States. The book points out platforms like YouTube, Facebook, Twitter, and their trolls, plus media sensationalism as fire starters that fuel endless conflict loops by design. They convert outrage into profit. But there was much more to this than just those areas mentioned. “Technological change, demographic shifts, globalization, badly regulated markets, and rapid social change have caused waves of anxiety and suspicion. Humans do not seem wired to manage change at this pace.”

         In summary, these are a few ways Ripley suggests to begin to get out of high conflict. Use looping, a form of interactive listening technique where the listener reflects back what the person seems to have said to check to see if the summary was correct. Magic ratio – remember that a five to one ratio of positive interactions between people will significantly outweigh the negative. Use mediators who ask these types of questions. Imagine your lives ten years in the future, visualize the kinds of relationships you want to have with your kids and with each other. Find new purpose and new goals.

         “Remember that anger holds out the possibility for resolution, but hatred’s logical outcome is annihilation.”

         Sufi poet Jalal al-Din Muhammad Rumi in the 13th century said, “Out beyond ideas of wrongdoing and rightdoing, there is a field. I’ll meet you there.”