Category Archives: Expatitis

Top Ten Wellness Tips For Beijing Newcomers: Part Two

(Click here for part one, with tips #1-5…)

Tip #6: To Every Thing, There Is A Season.

Beijing has a surprising variety of all four seasons, which I think is a great thing. Spring and fall, the best times of year here, are unfortunately short, but in general you can expect the same seasonal variations you would find in New England or northern Europe. But each season has a few particular oddities:

Winter can be monotonously cold, and last year was quite painfully drawn out. The worst health problems usually include colds and influenza, as well as winter depression. The secret to avoiding the winter blues? Pamper yourself! Here are some personal tips:

  • Buy a foot soak. I bought one on Taobao for 320RMB and I love it; there’s nothing better after a cold day than to soak your feet in a warm, massaging tub with epsom salt thrown in. Add a warm brandy and a portable low-back massager, and I’m in heaven…
  • Keep your skin moist. Dry skin is a major hassle in Beijing, and everyone needs to respect this, or soon enough you’ll be scratching yourself crazy. I think a humidifier in important rooms is a must-have, including at your office. And you almost definitely will need daily use of a good moisturizer.
  • Visit a local hot springs. Beijing has a surprising number of hot spring resorts within an hours drive; my favorite is in the south, in Daxing. They have the added benefit of Turkish flesh-eating fish, and you can also stay overnight.
  • Take a weekend break in a hotel. Forecast calls for -13? Check into a city hotel such as the classy Ritz-Carlton (Huamao) on a Saturday night and just relax all day in their plush lobby, then fall asleep after a spa massage.
  • Take vitamin D. There’s growing evidence that vitamin D is an important factor in staying healthy, and since most vitamin D is created in our skin from direct sunlight, it’s easy to be deficient in vitamin D in the winter. Some studies suggest that supplements all winter can help decrease infections like the winter flu — in kids as well.
  • Eat roasted chestnuts and yams. Join your local Beijingers and wait in line on the street corners for a 10 kuai bag of delicious, freshly roasted chestnuts. Also look out for the very common sweet potato/yam sellers on most streets, selling delicious roasted wares for about 2 kuai each. These are some of Beijing’s best traditions.

Spring is a visual feast: in March we get sandstorms blotting out the sun, and in May we have catkin pollen filling the air like snow. OK, it’s not that dramatic, but we definitely have some sandstorm days where the skies are orange and the grit seeps into your nostrils, clothes, bedrooms — everywhere. It actually can be a health hazard, but have a little common sense avoidance and you’ll be fine. As for the catkins, it’s dramatic but not really a health nuisance. However, many Beijingers do have allergic hayfever problems in the spring. Most expats actually have less hayfever problems in Beijing.

Otherwise, you should definitely free yourself from winter’s shackles and join the rest of Beijing by flocking to local parks for the beautiful spring blossom festivals. Enjoy the local outdoors as much as you can, before summer’s always-too-early heat kicks in.

Summer is often dreadfully long; the major health issues are a major increase in gastroenteritis as well as travel-related diseases from expats’ vacations to exotic and malaria-filled southern locales. The best way to prevent a vacation disaster is to do your homework beforehand by researching your destination’s health status on the CDC Travel website; and bring a medical travel kit to help the often-inevitable issues like diarrhea. And prepare early! You may need at least a month or more to get a full course of vaccines like japanese encephalitis, rabies or hepatitis; these are often in short supply in the expat clinics during the summer crunch.

We do get major heat waves as well, but fortunately many July and August afternoons are filled with thunderstorms to cool things off for your after-dinner stroll (another very cool China tradition you should definitely pick up). Other fun traditions include eating the excellent local watermelons and corn on the cob.

If you want a water break (and you will want one), you can drive 3 hours to Beidaihe or take an hour flight to the lovely beach cities of Dalian or Qingdao. And if you just want to cool off, take a drive into the local mountains and visit a temple. I’ve created a small list of my personal favorite local spots.

Autumn is fairly mellow, health-wise, so you should enjoy this all-too-brief moment of perfect weather by exploring Beijing’s mountains and tourist attractions.

Tip #7: Have An Anti-Inflammatory Lifestyle.

I find it useful to picture Beijing as a pro-inflammatory city; we are daily bombarded with air particles and gases both indoors and outdoors, as well as from chemicals in our foods, that are pro-inflammatory — causing free radical damage to our healthy cells, as well as setting off cascades of unhealthy hormones and enzymes that can slowly lead to many illnesses such as heart disease and cancers. So, you always need to think, “what can I do to fight off this damage?” Fortunately, you can do a lot of things:

  • Don’t smoke. Smoking is, by far, the worst toxin you can put into your body. It directly destroys your lung’s membranes, and of course sets off oxidative changes that lead to the cancers and heart and lung diseases we all know about. You’re already breathing in toxins while living here — adding cigarettes will only hasten that inflammatory cascade.
  • Watch your alcohol intake. Your liver is a crucial organ whose main function is to detoxify all the chemicals and pollutants you breathe in and eat. Alcohol should also be considered as a direct toxin to your liver; a moderate amount is fine and fun and may actually lower your risk of heart disease. But the binge drinking and excess daily drinking will definitely wipe out your liver, slowly but surely. Those of you who admit — or are told by loved ones — that your drinking may be a problem, should take heed and find help if needed. Beijing does have an Alcoholics Anonymous branch, and your family doctor can also help.
  • Eat anti-inflammatory foods. Your mother was right — you should eat your veggies. There is overwhelming evidence that healthy foods like fruits and vegetables can dramatically lower risks of developing heart diseases as well as cancers. And some modern foods can be decidedly pro-inflammatory, such as trans-fats and certain red meats like grain-fed cows. Take control of what you put in your body!
  • Consider a supplement. This is a bit more controversial, and there definitely is no medical consensus regarding the effectiveness of many commonly taken supplements — even a simple multivitamin. I personally feel that omega-3 from fish oil (not flax) has a lot of evidence supporting its use to lower risks for heart disease, and its side effects are minimal. Again, supplements are a bit controversial and some may actually harm if taken to excess or combined with certain prescriptions, so you should discuss this with your doctor.

Tip #8: Exercise

One crucial thing to remember is that Beijing may have some unique quirks with air pollution, food issues, etc — but the major diseases and risks are the same here, and China’s #1 killer is the same as all over the world: heart disease. So please keep things in perspective here — you still need to focus on the basics of good body weight, exercise, proper foods, and not smoking.

I’ve posted many articles about exercise for you to review, and a lot of it is obvious, but expats should be especially aware that it can:

  • help manage your stress levels
  • lower your risk of diabetes and high blood pressure
  • help you sleep better
  • fight off depression

How much is enough? You should shoot for at least 150 minutes a week of pulse-racing activity. As for which exercise, you should continue whatever you love. Beijing is filled with gyms and public parks for all sports, and there are many hiking and biking clubs as well. Also, don’t be afraid to exercise outside! As long as the pollution index is reasonable (somewhere way below 200), then exercise outside is still much healthier than no exercise at all. Try to stay at least 200 meters from any major road or highway to minimize pollution.

Tip #9: Take Care of Your Body and Soul.

Last spring I had a series of articles discussing what I called expatitis:

Expatitis (Expat from expatriā “to leave native land” +itis“inflammation, abnormal states, excesses, tendencies, etc”) – a syndrome of multiple physical and mental illnesses brought on by maladaptive coping mechanisms to the stressors inherent to living abroad.

I see a lot of overworked patients who rarely sleep well, are totally stressed and too busy for exercise — all of which lower people’s immune systems and set them up for illness. So I do feel that it’s crucial that we all focus on ourselves — to constantly check in with our heart and soul and ask ourselves, “am I happy here in Beijing? Am I neglecting something or someone, including myself?” For example, it really is a basic that we all need about 8 hours of sleep, and if your lifestyle is constantly preventing that, you increase your risk of more frequent and severe infections, depression and anxiety, as well as more long-term problems like heart disease.

And if you feel that your life is totally spinning out of control, or you are starting to cry often and out of nowhere, or are getting waves of panic attacks, then you should definitely consider getting some professional help. Each clinic in Beijing should have a couple counselors and family doctors who can help you through your tough times. Our clinic has Dr Mike, a psychologist who welcomes anyone to call him on his mobile phone at 158.0131.9796.

Tip #10: Watch Out For Sexually Transmitted Diseases

Beijing is not immune to the worldwide problem of sexually transmitted diseases, and it is frighteningly common here to get exposed to bugs such as chlamydia and gonorrhea. There is also an alarming resurgence of syphilis in China — plus the usual suspects like HIV, herpes, hepatitis and others. So, there are many reasons for you to practice safe sex — that means always wearing a condom with new partners. And be careful where you buy your condoms — there have been recent scares with poorly made counterfeits. Stick to the big chains like Watsons.

And don’t forget that you can carry these infections for many years and feel perfectly healthy, but you can still infect others. One of the major causes of infertility for women is uterus damage from chlamydia, and most women didn’t even know they were infected. That’s why we recommend routine screening tests for sexually active men and women, including the pelvic exam for young women, which is not as routine among Chinese women as it should be. These tests can provide you with a lot of peace of mind, especially if you are entering a new relationship and want “a clean slate”.

People always have a lot of questions about STDs (for example: yes, you can get STDs just from oral sex), so I created an online slide show about the basics of STDs.

Bonus Tip: Immerse Yourself

Many expats eventually leave Beijing feeling they’ve just finished the most rewarding and interesting times of their lives, and a common cause seems to be a deep immersion into Chinese culture. That usually means learning the Chinese language well enough to talk with anybody, and I know how difficult that is (I’m still years away), but clearly you will have a much richer time here.

Even if you can’t chat away with locals, you can still have a wonderful experience by biking around the hutongs; dancing a waltz at night in practically any local park; volunteering to help migrant schoolkids — or countless other small things that add up to a fulfilling and mind-expanding adventure.

(Click here for part one, with tips #1-5…)

Expatitis Spreads to China Daily, and Beyond

I’m glad that my recent series of articles on expatitis has picked up some steam in the community. I’d like to give a big thanks to reporter Todd Balazovic at China Daily for picking up on this. In his article (It’s a wild, wild life for expats), he expands on the basic themes I laid out and adds a bit of analysis:

Having observed an unusually high prevalence of unhealthy behavior amongst my fellow expats, I have to agree with Dr Saint Cyr’s diagnosis. I’ve watched and wondered as expats come and go, what is it about being in Beijing that leads us to abandon self-regard? More so than anywhere else I’ve lived, I see people diving to the bottom of a bottle or to the bottom of a bag of McDonalds…

…Though Dr Saint Cyr’s diagnosis of the symptoms may be correct, I am not entirely convinced that the root of Expat’s detrimental deeds are simply a result of an inability to peacefully settle into a Beijing lifestyle.

I don’t disagree that coping is involved in the wild ways we tend to gravitate towards, but I think that there is more to it than simply not being able to adapt.

The social norms that once upon a time dictated lifestyles back home have been replaced by the mores of a different culture and by an relaxing of social and personal inhibitions.

Overreacting?

I also have heard many comments from the opposite spectrum — people all over China who feel that China actually is less stressful than their home countries, and they’ve never been as healthy as they are here. That’s great news for me, and I am more than happy to admit that maybe my viewpoint is a bit too narrow, or even inappropriately cynical, since as a doctor I am by definition seeing a narrow spectrum of the expat community — the sick. So, thank you to the really fun folks at Raoul’s China Saloon for their always entertaining and insightful feedback. One writer made a very thoughtful claim for positive expatitis:

…As I gather, expatitis is more of a mental/emotional condition which manifests itself in either physical or behavioural symptoms, yes? So, how about Positive Expatitis? I am sure there are lots of foreigners out there who can, in some degree, recognize themselves in the following description of some of the symptoms presented by Subject A, example of Positive Expatitis:

1.Following sojourn to China has experienced a drastic and much healthier change in eating habits. Have come to realize that various vegetables can be eaten without being boiled to smithereens first.

2. Have experienced a drastic yet not unhealthy weight-loss following arrival in China. This can be ascribed to having to walk, run or ride bicycle for great distances every day, instead of the customary car, developing a sudden interest in some kind of exercise (this can range from Tai Ji, yoga, running to such activities as MMA and traditional Gong Fu and your general weight-lifting).

3. Due to the nature of Chinese bars, said subject has slowly begun to seek the solace of local tea houses with a book instead of the noise, smoke-filled venue of your average local bar.

4. Extreme change in eating habits. Following a longer stay in China, say 6 months, the subject went to a Western restaurant and discovered, much surprised, that the food had simply become too heavy and rich for the subject.

There are many other interesting insights in the forum thread. So, “positive expatitis”? What do you all think?

Expatitis Can Hit Families Hard

I’m pleased that my recent articles on expatitis are striking a chord among my readers. Here’s an email I received from a reader in England that I thought deserved its own page. It’s a lovely and personal example of how an entire family can struggle when living abroad:

I wanted to send a thank you for this latest post because I think it is such a prevalent problem in the high powered ex-pat community and so little discussed.

My husband Bob definitely had a case of expatitis, and although we are recovering, it scared the bejeesus out of both of us while it was at its worst because my normally super-man uber-capable husband was so close to a nervous breakdown. Bob is no stranger to stress or travel, and he has traveled extensively for work for years and works more hours than anyone I have ever met. Through our relationship he has managed to keep his humor and equilibrium about him, until we moved here to England, a pretty cushy move compared to China.

Two work aquaintances of ours, both high-powered lawyers like him, committed suicide over the summer. One morning in the fall he told me he thought everyone considered suicide as a way to escape the demands of their life. But the “everyone thinks about it” made me scared and I demanded he take his health seriously and go see a doctor and get help with stress. He had been working hard and traveling non-stop for a couple of months. He was constantly jet-lagged and the time changes contributed to sleep confusion and sleep deprivation as well as a digestive system that didn’t know what time it was. he argues that it was obvious he would be more irritable, have insomnia frequently, and have more stomach pains than usual. He was reluctant to talk to a doctor about stress caused mainly by work.

Although I had been telling him for years to leave his blackberry, computer, and tv out of the bedroom, to make sure he exercised frequently (even though it is much harder here because of the rain/cold/dark), and that alcohol is a depressent, he didn’t listen until he was scared by his own thoughts and a doctor said the same stuff to him. He still hasn’t reduced his alcohol intake, but the other changes we have made have helped a great deal, and the fact that he consciously carves out “down time” away from work and sometimes away from family. (The last one is hard, but we also make demands of him, and although he doesn’t spend enough time with us it is hard for an introvert to get recharged around children with their constant demands.)

I also decided my role needed to be far more traditional (hear me chafing) and supportive of the whole family than it was in the states. So I volunteer instead of get paid for my work, and my secret unsupported job is to keep the kids and Bob sane. Since this happened I try to create down time and family time that re-energizes and doesn’t exhaust. We cancelled a trip to Russia which we were all excited to visit because I could see that it would also exhaust and drain as well as be fascinating and fun. We also unplugged our tv and put it into a closet so that when the kids are not at school and doing homework they are interacting with each other and us (card games, board games). It promotes more laughter and also more fights, but also more sense of family togetherness in an over-scheduled and hectic life. TV took time (which is precious) but gave little back to us in terms of memories and opportunities for emotional outlets. (I’ll let you know if that experiment works!)

We are all much happier since we starting accepting that we ALL have to work as a family to fight stress and anxiety, and make (hard) choices to leave technology off whenever possible, slow down, relax more, exercise more, and support one another. Thought I’d chime in with my thanks and support for this topic/discussion. Thanks for the post…

Expatitis, Part 3: Baby Steps with Mr Indy Spensible

The following is part of the transcript of my first clinic encounter with uber-expat businessman Mr Indy Spensible, diagnosed with expatitis:

Doc: …So, Mr Spensible…
Indy: Just call me Indy.

Doc: OK, Indy. Is that short for Indiana?
Indy: No, for the racetrack. My mother thinks I was conceived there.

Doc: Interesting. I’ll file that under “TMI”. So, Indy, your lab tests are back and —
Indy: Am I gonna die, doc?

Doc: Welllll, yes — you are going to die. But not from the labs.
Indy: That’s a relief, I think. Your jokes are pretty bad, doc. Don’t quit your day job.

Doc: Thanks. Speaking of “not funny”, your labs —
Indy: Uh oh.

Doc. Yeah. Your cholesterol was really high. I mean really up there. Like peel-the-fat-off-with-a-spoon up there.
Indy: I know. My docs chewed me out a few years ago, told me to lose weight and exercise. You know, the usual lecture.

Doc: Well, here’s the lecture again. I figured out your cardiovascular score, and —
Indy: My what?

Doc: Your cardiovascular score. It’s a formula that tells you your risks of getting a heart attack or stroke over the next 10 years. You have a 19% chance of either of those happening. A healthy person your age would have a 5% risk.
Indy: Doc, you’re giving me chest pains.

Doc: Wait, it gets worse. I also figured out that you have the heart of someone four years older than you. It’s called your cardiovascular age.
Indy: So, is this a good news/bad news moment?

Doc: Yes, here’s the good news: you can lower your risk down close to normal, all without medicines. Possibly.
Indy: Great! Possibly. So, all I have to do is…?

Doc: …is to lose 12 kilograms, stop smoking, and get your cholesterol down 25%.
Indy: Oh, is that all? Can’t I just sacrifice my first-born son?

Doc: If only it were that easy.
Indy: You know how hard it is to stop smoking, doc. Besides, I’ve cut way back.

Doc: That’s great! When did you start cutting back?
Indy: Yesterday.

Doc: Well, there’s no better time than the present.
Indy: Actually, I think I peaked in high school. Literally. It’s becoming a lot, uh, harder, you know, to get a good, you know doc —

Doc: I think I do know, yes. That problem is almost definitely because of your heavy smoking all these years. Plus your high cholesterol; it also clogs the blood vessels down there as well.
Indy: Wow. That hits home, doc. A lot more than your cardiovascular age stuff.

Doc: So, what do you think you can do to improve your risk of a heart attack?
Indy: Come on, doc, I’m a very busy man. My company would fall apart if I pulled back, and I have no time to go the the gym. And all those banquets! You can’t just turn down a baijiu toast or a cigar at the KTV. It’s bad guanxi.

Doc: OK, then, let’s put it another way. What do you think is a practical goal for you?
Indy: Well…I suppose I could cut down on my breakfast. Lots of sausage and eggs

Doc: That’s a great idea. Do you think it’s a reasonable goal to lose 2 kilos a month?
Indy: Yeah, probably.

Doc: And for exercise, 150 minutes a week is ideal, but let’s start smaller with you. Maybe you can do a 10-minute routine in the morning, just 100 jumping jacks and some pushups and stretching?
Indy: I could probably try that, sure.

Doc: Great. So, that’s your game plan for the next 3 months. Then you come back here, and hopefully you’ve lost 6 kilos and have a nice morning exercise routine.
Indy: Sounds good. Baby steps.

Doc: Exactly! “Baby steps”, from that Bill Murray movie, What About Bob.
Indy: I liked Groundhog Day a lot better.

Doc: Me, too…

Expatitis, Part Two: Stress

Teen Depression, Tunnel

Yesterday I introduced the concept of expatitis, a syndrome of expat ill health. I also introduced my uber-expat businessman, Mr Indy Spensible, who was having panic attacks, among other complaints. Let’s focus first on stress, a vastly under-appreciated malady affecting expats.

Stress

Let’s face it, doing business in China can be very, very stressful. The demands on some expat jobs are extraordinarily intrusive into a normal life — the hours expected, the evening dinners and networking, the language and cultural barriers to master. I think it’s far too normal and expected that a businessperson misses much of their family’s evening and weekend routines due to work expectations and business trips. These demands also lead to less time for your general health — usually exercise is first to go, as well as a slide in diet choices and a lot more smoking and drinking. This issue of work stress is a hot topic right now, and a new book by Dr John Kennedy, called Healing the Heart of Corporate America, points out how stress leads to heart disease (thanks to Adam Daniel Mezei for the tip).

Stress certainly isn’t expat-specific. If anything, local Chinese workers may have even more health problems due to even more expectations on them — not to mention their relatively less pay. This was detailed quite frighteningly in a recent national survey of Chinese white collar workers:

…80% of the white-collar workers surveyed have irregular sleeping or dining schedules and they feel fatigued during the day; 23.7% of them do not take the time to eat breakfast; over 20% of them often eat fast food; 54.4% of them lack sufficient sleep; and 32.4% of them do not get quality sleep; only 46% of them take even occasional exercise. In addition, over half of the white-collar workers often feel irritated, 20% feel lonely, and over 70% feel a lack of happiness and satisfaction…

Why Should We Care About Stress?

Just suck it up, right? Comes with the territory? Love it or leave it? Well, sure, a bit of stress can be energizing for people and get creative juices flowing. But as Dr Kennedy discusses in his book above, “those with chronic job stress had a 68% higher chance of having a heart attack, developing angina or dying from heart disease.” So stress is not just something you should live with; it could literally be wearing you down — and out. Dr Kennedy goes on:

What’s more, longitudinal studies show those with high workplace stress are more likely to develop blood cholesterol problems and increased body mass index. And increased body mass index is associated with the metabolic syndrome which is a cluster of signs, symptoms and diagnoses including high blood pressure, elevated cholesterol, blood sugar problems, and increased waist size—all known risk factors for cardiovascular disease.

In addition to jeopardizing health, stress leads to decreased company morale increased absenteeism, diminished productivity, employee turnover, and accidents which cost American business more than the annual total net profits of the Fortune 500 companies.

Let’s now learn about good coping mechanisms for that inevitable stress in your job…

What Can I Do To Relieve Stress?

Good question! Fortunately, a lot:

Exercise — Yes, that seems obvious and if you had time you’d exercise more, yes? Well, we all need to stop saying that we have no time, because we only have one life here, and getting used to the concept that business overshadows everything else is simply an unhealthy philosophy — and your body will tell you that, sooner or later. Besides, there is evidence that exercise does indeed help you not only to relax but to deal with stress better. Quite literally, exercise boosts neurotransmitters that help mediate your natural stress response. But this isn’t a one-off event; you need a few weeks of routine exercise to start getting that boost. Exercise also has great benefits on keeping your immune system healthy so you don’t have a productivity-losing cold every few weeks.

SmartPhone Relaxation Apps — Since we’re already staring at our Blackberry or iPhone all day, why not add a couple free apps designed to help you relax? My favorite is Ambiance; it’s a free app that lets you download hundreds of relaxing sounds like waves and rain. To de-stress, you should make a binaural mix: first download the Binaural – Low Alpha sound and mix this with a second sound of your choice — something that transports you instantly into a relaxing childhood memory (a beach? train? I use Rain – Porch) Put the Alpha sound at a low, barely audible level and play the mix any time you feel overwhelmed. It’s best to be in a quiet space; also focus on slow breathing while listening. Just close your office door for fifteen minutes, lower the shades, close your eyes and work on slow breathing while listening to your mix. You are getting very sleepy, very sleeeeeepy…

There’s very little good research on binaural beats, but one well designed (randomized and controlled) study in a hospital showed less anxiety in patients preparing for general surgery. No matter what you think of binaural beats, listening to relaxing sounds certainly does no harm, and it’s free. What may be just as important a message is the idea of a time out personal break during the day — even 10 minutes can reset you.

There’s also another iPhone app called Stress Check where a quick 20-question survey assesses your current state of mind and gives you tips on how to improve your immediate situation.


Yoga and Tai Chi Breathing Exercises–
I discovered yoga and tai chi in college and I am a firm believer that these can not only keep people fit but provide invaluable secondary benefits in stress relief. It’s not just that wonderful relaxing feeling during the sessions; it’s more the long-lasting benefits from proper breathing, and also that wonderfully peaceful mindset you get during yoga. When I’m stressed and I realize my breath is short, I remember my deep and slow breathing exercises from yoga which I immediately try out, and quickly I’ll relax. It’s as easy as counting backwards from 10 to 1 with each slow, deep breath, and then repeating for a couple minutes until you feel more calm.

And for those “too busy” for a one-hour a week yoga class, you can simply watch a 15 minute yoga video online at the above link from the Mayo Clinic. Your body and mind will thank you!

Counseling – Do not ignore this suggestion! Needing counseling doesn’t mean you’re crazy, or a failure, it only means that things are getting out of hand and you need some help. Psychologists and psychiatrists can specifically treat stress in multiple ways. The best counselors will teach you effective and positive ways to cope with your stress. Each expat clinic has a group of counselors.

Sleep – Yes, again this seems obvious, but research clearly shows that lack of sleep leads to a decreased immune system as well as worsening stress.

Reassess Your Life – A small percentage of you should take that long family vacation you’ve been “too busy” to have for five years, and during those quiet moments really think about whether your job is simply too overwhelming. Take a look at your loved ones and check in with your relationships; are they teetering on a cliff? Really think hard about your life priorities; on your deathbed, are you going to be looking back at your awesome expat job that destroyed your marriage, or will you be suffused in the glow of the wonderful family you raised?

Watch Groundhog Day, Again and Again Until You Get It. OK, this is a strange recommendation, but this 1993 Bill Murray film has a wonderfully deep message of self-enlightenment and reassessment of the important things in life. If you’ve never seen it, you’re in for a treat. Download and watch it on your iPhone on your next red-eye flight.

A Final Word From Mr Indy Spensible…

Case One: Follow-up. Mr Indy Spensible returns to my clinic two months later. He looks tanned and happy. “Doc, I finally took that vacation to Sanya with the family. Yeah, the first couple days I didn’t know what to do with myself, but after I locked my Blackberry in the safe I started to get into it, playing games with the kids, swimming in the ocean. I feel like a new man, doc! My wife and I snuck away for long walks. Oh yeah, she wants me, uh, to ask you, um…can you give me a couple of those blue pills…you know what I mean, doc…”