When wealth can become injurious to health

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Dharma, Artha, Kama, Moksha are the four basic purposes of life. It means earning righteously with a desire to fulfill the inner happiness. The word ‘Artha’ relates to righteous earning. Any unrighteous earning can put one into danger.

There are enough references in modern medicine describing “property disputes” as one of the main causes responsible for heart blockages. The other being “marital disharmony”.

Many Vedic texts also give reference to the meaning of ‘Artha’. As per Vedic philosophy desire only begets desire. The desire of accumulating wealth is dangerous and infectious.

As per Yoga Sutras of Patanjali, any wealth acquired more than one needs cannot make one sleep properly.

Vidur in Vidur Niti in a dialogue with King Dhritrashtra described five basic reasons for not getting sleep. Two of them being “if one has stolen somebody’s money” and “if one has lost all his or her wealth”.

Chanakya Niti mentions that any wealth acquired by unfair means will not last for more than eight years.

Adi Shankracharya in his book Bhaj Govindam, Shloka 6 warns the rich community to beware of even their own sons. He mentions, “One should regard wealth always as danger as there is not even an atom of happiness to be really derived from it. To the rich there is a fear even from their own sons. This is an established law everywhere.”

Jesus in Bible also said that the rich lacking contentment can never reach the heaven.

Every wealth one acquired should be treated as a property of the trust of whose one is the trustee and this trust should be only for the welfare of the society, said Dr. Karan Singh in one of his lectures.

Sathya Sai Baba said that wealth is like a shoe. If it is small, it brings difficulty, if it is big, then also it makes one uncomfortable.

In Bhagavad Gītā, Lord Krishna said that those who cook for the sake of their body alone, eat only sins.

Wealth is the womb of all other types of vices, said Rishi Narad in Shrimad Bhagwad. He said that along with wealth come vices like gambling, drinking and sexual perversions.

Taittiriya Upanishad also said that food will eat up the eater who eats without sharing. The Upanishad talks about importance of sharing the food with others.

Lord Krishna in Bhagavad Gītā said that whatever elders do, others follow the same. If one acquired money out of unfair means, it is likely that the next generation will follow the same.

Wealth should be treated as a flow of money in the universe, said Dr. Deepak Chopra. Your purpose should be only to make sure that this flow not gets diverted through your river.

Accumulating money serves no purpose unless one uses it properly for the purpose it was collected. I recall an example of a lady who let her son die for financial constraints. When asked if she had any ancestral belongings, she said she only had some gold lying in her house but that was only to be used for bad time.

Isha Upanishad also starts with the same message.

IshAvAsyaM idaM sarvaM yatki~jcha jagatyAM jagat |

tena tyaktena bhu~jjIthA mA gRudhaH kasyasviddhanam || 1 ||

All these, that are part of this world, are abodes of God. Leaving them and thus protecting (yourself).

Do not desire the wealth of anyone!

In Jainism, the term Aparigraha also says that one should not keep anything more than what is necessary.

Dr KK Aggarwal

Padma Shri AwardeeVice President CMAAOGroup Editor-in-Chief IJCP Publications

President Heart Care Foundation of India

Immediate Past National President IMA

Mandatory public health CMEs Dr KK Aggarwal, 27 April 2018

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Recently, the government of India has proposed mandatory MDR TB centers in all medical colleges. Why focus only on MDR TB? Ideally all colleges should have a mandatory Antimicrobial Resistance (AMR), which also incorporates MDR TB.

Dr Balram Bhargava, Director General ICMR has also said that every medical college should have a tobacco cessation clinic along the same lines. I will again go a step further “why only a tobacco cessation clinic and why not a substance abuse clinic’ in every college?

Every Medical College should also have a separate Department for national health programs, which should look after exposure and training of students in all National Health programs during MBBS. Education about the National Health programs should not be limited just to Community Medicine. All those who have passed their MBBS examination, should be given a mandatory one hour video CME on National Health programs and new government health policies.

Dr KK Aggarwal

Padma Shri AwardeeVice President CMAAOGroup Editor-in-Chief IJCP Publications

President Heart Care Foundation of India

Immediate Past National President IMA

President Trumps Health

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President Donald J. Trump underwent his first official health check-up since he entered the White House in January 2017.

Age 71 Examined on: January 12, 2018 Examined at: Walter Reed National Military Medical Center in Bethesda, Maryland Physician: White House physician, Navy Rear Adm. Ronny L. Jackson, MD Report made public by: Dr Jackson and Sarah Sanders, the White House press secretary

Report: Healthy

His last health information: September 2016 by Harold Bornstein, MD.

  • Height: 6 feet 3 inches     ·         Weight: 236 pounds     ·         BP: 116/70     ·         Fasting sugar: 99     ·         HDL: 63     ·         LDL: 94     ·         TG: 61     ·         Coronary artery calcium score (in 2013): 98     ·         Chest X ray and ECG: Normal     ·         PSA: 0.15     ·         Colonoscopy (in 2013) found no polyps     ·         Testosterone: 441.6     ·         LFT and TFT: Normal     ·         TTE: Normal

Medications: Rosuvastatin, low-dose aspirin, finasteride (baldness) and antibiotics for rosacea.

This 2016 as well as 2018 information does not mention cognitive health.

The mental health of the President has come into question several times in the first year of his Presidency in his speeches, his Tweets and TV appearances.

The day before the physical, a group of 75 physicians had urged the President’s physician to evaluate Trumps neurological health, including cognitive and mental health functions, as is called for in Medicare guidelines.

In a letter, they expressed what they called “increasing concern” over what they said was Trumps “declining faculties for complex thought, rambling speech, difficulty completing a thought; episodes of slurred speech; failure to recognize old friends; frequent repetition of the same concepts; decreased fine motor coordination; difficulties reading, listening and comprehending; suspect judgment, planning, problem solving, and impulse control; and, markedly declining vocabulary in recent years, with over reliance on superlatives.”

Trumps father died at 93, after having developed Alzheimers disease in his 80s. Suspecting that President Trump may have early Alzheimer’s disease, they recommended that the exam include a basic dementia screen.

However, it is not clear whether cognitive health was also evaluated in the annual exam. The President has been declared in excellent health, although no details have been released. The results of his physical exam are likely to be made public by next week with the consent of the President.

The question here arises whether it is right to comment on the mental health of a person without actually examining the person. Can the mental health of a person be judged simply on the basis of a person’s behavior?

The American Psychiatric Association (APA) does not think so and has called clinicians out for making “armchair” diagnoses, and recommended they heed the APAs Goldwater Rule, which proclaims it unethical to diagnose without examination.

APA guidelines

  • “A proper psychiatric evaluation requires more than a review of television appearances, tweets, and public comments,”
  • Diagnosis requires a review of medical and psychiatric history and records, and a complete examination of mental status.
  • “The Goldwater Rule embodies these concepts and makes it unethical for a psychiatrist to render a professional opinion to the media about a public figure unless the psychiatrist has examined the person and has proper authorization to provide the statement

Section 7 of the APA’s Principles of Medical Ethics is widely referred to as the Goldwater rule and it says as follows: “On occasion psychiatrists are asked for an opinion about an individual who is in the light of public attention or who has disclosed information about himself/herself through public media. In such circumstances, a psychiatrist may share with the public his or her expertise about psychiatric issues in general. However, it is unethical for a psychiatrist to offer a professional opinion unless he or she has conducted an examination and has been granted proper authorization for such a statement (3)”.

New guidelines adopted by the American Medical Associations Council on Ethical and Judicial Affairs for Ethical Physician Conduct in the Media in November 2017 also state that physicians should “ Refrain from making clinical diagnoses about individuals (e.g., public officials, celebrities, persons in the news) they have not had the opportunity to personally examine”.

To an extent, things are open in the public in the US. The reports of the annual physical exam of the Presidents are released by the White House, of course, with their consent.

Individuals such as Presidents are important public figures. Their decisions and statements, while in office, affect not only their country, but also have an impact on world affairs. Hence, they should be in the best of health, physical as well as mental, as they are at the helm of affairs.

But this is not the case in India.

Should public figures, politicians in particular disclose their health issues or release results of their annual physical exam to the general public?

Dr KK Aggarwal

Padma Shri Awardee Vice President CMAAO Group Editor-in-chief IJCP Publications

President Heart Care Foundation of India

Immediate Past National President IMA

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