The Checklist Manifesto – by Dr. Atul Gawande
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Dr. Gawande, himself a general surgeon, uses checklists a lot. He is, unequivocally, an expert in his field. He “shouldn’t” need a checklist to tell him to do such things as “Check you have the correct patient”. But checklists are there as a safety net. And, famously, “safety regulations are written in blood”, after all.
And, who amongst us has never made such a “silly” error? From forgetting to turn the oven on, to forgetting to take the handbrake off, it takes only a momentary distraction to think we’ve done something we haven’t.
You may be wondering: why a whole book on this? Is it just many examples of the usefulness of checklists? Because I’m already sold on that, so, what else am I going to get out of it?
Dr. Gawande also explains in clear terms:
- How to optimize “all necessary steps” with “as few steps as possible”
- The important difference between read-do checklists and do-confirm checklists
- To what extent we should try to account for the unexpected
- How to improve compliance (i.e., making sure you actually use it, no matter how tempting it will be to go “yeah this is automatic for me now” and gloss over it)
- The role of checklists in teams, and in passing on knowledge
…and more.
Bottom line: if you’ve ever tried to make tea without putting the tea-leaves in the pot, this is the book that will help you avoid making more costly mistakes—whatever your area of activity or interest.
Click here to check out the Checklist Manifesto, and make fewer mistakes!
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Dealing with Thirst!
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Busting The Myth of “Eight Glasses Of Water A Day”
Everyone knows we must drink 8 glasses of water a day, or else we’re going to get a failing grade at being a healthy human—like not flossing, or not using adequate sunscreen.
But… Do we? And does tea count? How about (we dare but whisper it) coffee? And soda drinks are mostly water, right? But aren’t some drinks dehydrating? Are special electrolyte drinks really better? There are so many things to consider, so many differing advices, and it’s easy to give up, or just choose what to believe in as a leap of faith.
A quick brain-teaser for you first, though:
If coffee and soda don’t count because they’re dehydrating, then what if you were to take:
– A concentrated tiny cup of espresso, and then a glass of water, would the glass of water count?
– Or (we don’t relish the thought) what if you took a spoonful of soda syrup, and then a glass of water, would the glass of water count?
If your answer was “yes, it’s a glass of water”, then why would it not count if it were taken all at once (e.g. as an Americano coffee, or a regular soda)?
If your answer was “yes, but that water might only offset the dehydration caused by the coffee/syrup, so I might only be breaking even”, then you were thinking about this the right way:
How much water you need depends on many factors that can be affected by what else you are consuming and what else you are doing. Science loves averages, so eight glasses a day may be great if you are of average health, and average body size, in a temperate climate, doing moderate exercise, and so on and so on.
If you’re not the most average person of all time? You may need to take into account a lot of factors, ranging from what you ate for dinner to how much you perspired during your morning exercises. As you (probably) don’t live in laboratory conditions, this can become an impossible task—and if you missed (or guessed incorrectly) even one factor, the whole calculation will be thrown off. But is there any other way to know?
What of the infamous pee test? Drink enough to make your urine as clear as possible, and if it’s dark, you’re dehydrated, common wisdom says.
In reality, however, that tells you not what’s in your body, but rather, what got ejected from your body. If your urine is dark, it might mean you had too little water, but it also could just mean you had the right amount of water but too much sodium, for instance. A study of this was done on athletes, and found no correlation between urine color and actual bodily hydration when measured directly via a blood test.
So, if we can’t just have an app tell us “drink this many glasses of water”, and we can’t trust urine color, what can we do?
What we can do is trust that our body comes with (for free!) a wonderful homeostatic system and it will try to correct any imbalances. If you are thirsty, you’re dehydrated. Drink something with plenty of water in, if not plain water.
But what about special electrolyte drinks? If you need salts, you will crave them. Craving a salty snack? Go for it! Or if you prefer not to snack, do a salt lick test (just put a little salt on your finger, and taste it; if it tastes good, wait a minute or two, and then have a little more, and repeat until it doesn’t).
Bonus Tip:
- Make sure you always have a source of hydration (that you enjoy!) to hand. Maybe it’s chilled water, maybe it’s a pot of tea, maybe it’s a sports drink, it doesn’t matter too much. Even coffee is actually fine, by the way (but don’t overdo it).
- Make a personal rule: “I will always make time for hydration”. That means, if you’re thirsty, have something with water in it now. Not when you’ve finished what you’re doing (unless you really can’t stop, because you are a racecar driver mid-race, or a surgeon mid-operation, or something), but now. Do not postpone it until after you’ve done some other thing first; you will forget and it will keep getting postponed. Always make time for water.
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Purpose – by Gina Bianchini
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To address the elephant in the room, this is not a rehash of Rick Warren’s best-selling “The Purpose-Driven Life”. Instead, this book is (in this reviewer’s opinion) a lot better. It’s a lot more comprehensive, and it doesn’t assume that what’s most important to the author will be what’s most important to you.
What’s it about, then? It’s about giving your passion (whatever it may be) the tools to have an enduring impact on the world. It recommends doing this by leveraging a technology that would once have been considered magic: social media.
Far from “grow your brand” business books, this one looks at what really matters the most to you. Nobody will look back on your life and say “what a profitable second quarter that was in such-a-year”. But if you do your thing well, people will look back and say:
- “he was a pillar of the community”
- “she raised that community around her”
- “they did so much for us”
- “finding my place in that community changed my life”
- …and so forth. Isn’t that something worth doing?
Bianchini takes the position of both “idealistic dreamer” and “realistic worker”.
Further, she blends the two beautifully, to give practical step-by-step instructions on how to give life to the community that you build.
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What is PMDD?
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Premenstrual dysphoric disorder (PMDD) is a mood disorder that causes significant mental health changes and physical symptoms leading up to each menstrual period.
Unlike premenstrual syndrome (PMS), which affects approximately three out of four menstruating people, only 3 percent to 8 percent of menstruating people have PMDD. However, some researchers believe the condition is underdiagnosed, as it was only recently recognized as a medical diagnosis by the World Health Organization.
Read on to learn more about its symptoms, the difference between PMS and PMDD, treatment options, and more.
What are the symptoms of PMDD?
People with PMDD typically experience both mood changes and physical symptoms during each menstrual cycle’s luteal phase—the time between ovulation and menstruation. These symptoms typically last seven to 14 days and resolve when menstruation begins.
Mood symptoms may include:
- Irritability
- Anxiety and panic attacks
- Extreme or sudden mood shifts
- Difficulty concentrating
- Depression and suicidal ideation
Physical symptoms may include:
- Fatigue
- Insomnia
- Headaches
- Changes in appetite
- Body aches
- Bloating
- Abdominal cramps
- Breast swelling or tenderness
What is the difference between PMS and PMDD?
Both PMS and PMDD cause emotional and physical symptoms before menstruation. Unlike PMS, PMDD causes extreme mood changes that disrupt daily life and may lead to conflict with friends, family, partners, and coworkers. Additionally, symptoms may last longer than PMS symptoms.
In severe cases, PMDD may lead to depression or suicide. More than 70 percent of people with the condition have actively thought about suicide, and 34 percent have attempted it.
What is the history of PMDD?
PMDD wasn’t added to the Diagnostic and Statistical Manual of Mental Disorders until 2013. In 2019, the World Health Organization officially recognized it as a medical diagnosis.
References to PMDD in medical literature date back to the 1960s, but defining it as a mental health and medical condition initially faced pushback from women’s rights groups. These groups were concerned that recognizing the condition could perpetuate stereotypes about women’s mental health and capabilities before and during menstruation.
Today, many women-led organizations are supportive of PMDD being an official diagnosis, as this has helped those living with the condition access care.
What causes PMDD?
Researchers don’t know exactly what causes PMDD. Many speculate that people with the condition have an abnormal response to fluctuations in hormones and serotonin—a brain chemical impacting mood— that occur throughout the menstrual cycle. Symptoms fully resolve after menopause.
People who have a family history of premenstrual symptoms and mood disorders or have a personal history of traumatic life events may be at higher risk of PMDD.
How is PMDD diagnosed?
Health care providers of many types, including mental health providers, can diagnose PMDD. Providers typically ask patients about their premenstrual symptoms and the amount of stress those symptoms are causing. Some providers may ask patients to track their periods and symptoms for one month or longer to determine whether those symptoms are linked to their menstrual cycle.
Some patients may struggle to receive a PMDD diagnosis, as some providers may lack knowledge about the condition. If your provider is unfamiliar with the condition and unwilling to explore treatment options, find a provider who can offer adequate support. The International Association for Premenstrual Disorders offers a directory of providers who treat the condition.
How is PMDD treated?
There is no cure for PMDD, but health care providers can prescribe medication to help manage symptoms. Some medication options include:
- Selective serotonin reuptake inhibitors (SSRIs), a class of antidepressants that regulate serotonin in the brain and may improve mood when taken daily or during the luteal phase of each menstrual cycle.
- Hormonal birth control to prevent ovulation-related hormonal changes.
- Over-the-counter pain medication like Tylenol, which can ease headaches, breast tenderness, abdominal cramping, and other physical symptoms.
Providers may also encourage patients to make lifestyle changes to improve symptoms. Those lifestyle changes may include:
- Limiting caffeine intake
- Eating meals regularly to balance blood sugar
- Exercising regularly
- Practicing stress management using breathing exercises and meditation
- Having regular therapy sessions and attending peer support groups
For more information, talk to your health care provider.
If you or anyone you know is considering suicide or self-harm or is anxious, depressed, upset, or needs to talk, call the Suicide & Crisis Lifeline at 988 or text the Crisis Text Line at 741-741. For international resources, here is a good place to begin.
This article first appeared on Public Good News and is republished here under a Creative Commons license.
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Hack Your Hunger
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When it comes to dealing with hunger, a common-sense way of dealing with it is “eat something”. However, many people find that they then eat the wrong things, in the wrong quantities, and end up in a cycle of overeating and being hungry.
If this gets to the extreme, it can turn into a full-blown eating disorder:
Eating Disorders: More Varied (And Prevalent) Than People Think
…and even in more moderate presentations, the cycle of hunger and overeating is not great for the health. So, how to avoid that?
Listen to your body (but: actually listen)
Your body says: we’re running a little low on glycogen reserves so our energy’s going to start suffering in a few hours if we don’t eat some fruit, kill something and eat its fatty organs, or perhaps find some oily nuts.
You hear: eat something bright and sugary, shout at the dog, eat some fried food, got it!
Your body says: our water balance is a little off, we could do with some sodium, potassium, and perhaps some phosphorus to correct it.
You hear: eat something salty, got it, potato chips coming right up!
…and so on. Now, we know 10almonds readers are quite a health-conscious readership, so perhaps your responses are not quite like that. But the take-away point is still important: we need to listen to the whole message, and give the body what it actually needs, not what will just shut the message off the most quickly.
Here’s how: Intuitive Eating Might Not Be What You Think
Bonus: Interoception: Improving Our Awareness Of Body Cues
About those cravings…
As illustrated a little above, a lot of cravings might not be what they first appear, and in evolutionary terms, our body is centuries behind industrialization, in terms of adaptations, which means that even if we try to take the above into account, our responses can sometimes be inappropriate in the age of supermarkets.
See also: The Science of Hunger, And How To Sate Cravings
Natural appetite suppressants
Eating more is not always the answer, not even if it’s more healthy food. And hunger pangs can be especially inconvenient if, for example, we are fasting at present, which is by the way a very healthful thing for most people:
Learn more: Intermittent Fasting: What’s the truth?
One way to suppress hunger is simply to trigger the stomach into sending “full” signals, which involves filling it. Since you do not want to overeat, the trick here is imply to use high-volume food.
Consider for example: 30 grapes and 30 raisins have approximately the same calorie count (what with raisins being dried grapes, and the calories didn’t evaporate), but the bowl of fresh fruit is going to physically fill your stomach a lot more quickly than the tiny amount of dried fruit.
More on this: Some Surprising Truths About Hunger And Satiety
Protein is of course also an appetite suppressant, but it takes about 20 minutes for the signal to kick in. So a “hack” here is to snack on something proteinous at least 15 minutes before your main meal (for example, a portion of nuts while cooking, unless you’re allergic, or some dried fish unless you’re vegetarian/vegan; you get it, pick something high in protein and good for snacking, and have a small portion before your main meal).
Nor is protein the only option!
See also: 3 Natural Appetite Suppressants Better Than Ozempic
Scale it down
Related to the above, there is a feedback loop that occurs here. The more you eat, the more your stomach slowly grows to accommodate it; the less you eat, the more your stomach slowly shrinks because the body tries hard to be an efficient organism, and will not maintain something that isn’t being used.
So, there’s a bit of a catch-22; sate your hunger by filling your stomach with high volume foods, but filling it will cause it to grow?
The trick is: do the “eat until 80% full” thing. That’s full enough that you have had a nice meal and are not suffering, without stretching the stomach.
Enjoy your food
Seriously! Actually enjoy it. Which means paying full attention to it. Eating can and should be a wonderful experience, so it’s best savored rather than inhaling a bowl of something in 30 seconds.
Have you seen those dog bowls that have obstructions to slow down how quickly a dog eats? We can leverage that kind of trick too! While you might not want to eat from a dog bowl, how about having a little bowl of pistachio nuts rather than ready-to-eat peanuts? Or any shelled nuts that we must shell as we go. If you’re allergic to nuts, there are plenty of other foods with a high work-to-food ratio. Take some time and enjoy that pomegranate, for instance!
Not that we necessarily have to make things difficult for ourselves either; we can just take appropriate care to ensure a good dining experience. Life is for living, so why not enjoy it?
See also: Mindful Eating: How To Get More Out Of What’s On Your Plate
Enjoy!
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Anti-Cholesterol Cardamom & Pistachio Porridge
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This tasty breakfast’s beta-glucan content binds to cholesterol and carries it out of the body; there are lots of other nutritional benefits too!
You will need
- 1 cup coconut milk
- ⅓ cup oats
- 4 tbsp crushed pistachios
- 6 cardamom pods, crushed
- 1 tsp rose water or 4 drops edible rose essential oil
- Optional sweetener: drizzle of honey or maple syrup
- Optional garnishes: rose petals, chopped nuts, dried fruit
Method
(we suggest you read everything at least once before doing anything)
1) Heat the coconut milk, adding the oats and crushed cardamom pods. Simmer for 5–10 minutes depending on how cooked you want the oats to be.
2) Stir in the crushed pistachio nuts, as well as the rose water.
3) Serve in a bowl, adding any optional toppings:
Enjoy!
Want to learn more?
For those interested in some of the science of what we have going on today:
- The Best Kind Of Fiber For Overall Health? ← it’s beta-glucan, which is fund abundantly in oats
- Pistachios vs Pecans – Which is Healthier? ← have a guess
- Can Saturated Fats Be Healthy? ← coconut can!
Take care!
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The Disordered Mind – by Dr. Eric Kandel
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We don’t generally include author bios in these reviews, but it’s worth mentioning that Dr. Kandel won the Nobel Prize in Physiology/Medicine, for studies related to the topics in this book.
The premise in this book is as per the subtitle: what unusual brains tell us about ourselves. He assumes that the reader has a “usual” brain, but if you don’t, then all is not lost, and in fact he probably talks about your brain in the book too.
Examining the brains of people with conditions ranging from autism to Alzheimer’s, schizophrenia to Parkinson’s, or even such common things as depression and anxiety and addiction, tells us a lot about what in our brain (anatomically and physiologically) is responsible for what, and how those things can be thrown out of balance.
By inference, that also tells us how to keep things from being thrown out of balance. Even if the genetic deck is stacked against you, there are still things that can be done to avoid actual disease. After all, famously, “genes load the gun, but lifestyle pulls the trigger”.
Dr. Kandel writes in a clear and lucid fashion, such that even the lay reader can quite comfortably learn about such things as prion-folding and inhibitory neurons and repressed transcription factors and more.
Bottom line: if you’d like to understand more about what goes wrong and how and why and what it means for your so-far-so-good healthy brain, this is the book for that.
Click here to check out The Disordered Mind, and understand more!
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