Columns

By Elof Axel Carlson

Elof Axel Carlson

Occasionally, I read an item on Facebook that engages my attention. One item asked several celebrities (like successful billionaires) to list the five books they most enjoyed reading and briefly tell why they were important. Here are my five favorite books: 

‘Civilization and Its Discontents’ by  Sigmund Freud

Freud introduces the source of the tensions between creativity and destructiveness. He assigns it to the id/superego conflict. I would use instead our capacity for love, empathy and sympathy versus our capacity for hate, bigotry and violence. Freud calls the process sublimation. He began writing this book in 1929 and published it two years later. He predicted that the rise of Nazism was imminent and would lead to massive death because humanity does not know how to sublimate its discontents into the path of the joys of civilization — its arts, humanity, play and immense scholarship.  

‘Jean Barois’ by  Roger Martin du Gard

This is my favorite novel. It is the story of a young French boy raised by a devout Catholic family who thinks he will become a priest. He discovers instead that the more he learns the more doubts arise not only about his calling but his faith. He teaches biology and is fired for teaching evolution. His wife and daughter separate from him. He throws himself into the Freethinkers movement in France and gets involved in the Dreyfus case. He discovers that reason alone cannot sustain his life but returning to his faith is equally inadequate.  

‘The Essays of Michel de Montaigne’

Montaigne’s essays describe his life and the times in which he lived in the context of a rich appreciation of classical literature. He tries to make sense of a world that is pretentious, at war with itself and filled with irony, contradictions and lessons we can extract from the past. Read a 20th-century translation of these essays rather than the 16th-century English translation. Start with his essay on friendship and his essay: “How by various means we all end at the same place.”   

‘The Diary of Samuel Pepys’

I loved reading Pepys’s diaries and was thrilled that he was an eyewitness to the bubonic plague that swept through England in 1665 and the London fire that destroyed most of the city in 1666. Pepys is an imperfect person — not immune to accepting sacks of gold for awarding contracts for the British Navy, flirting with other women but loving his wife and learning to avoid threats to his career from others drawn to the politics of the time.

‘The Origin of Species’ by Charles Darwin 

Darwin is an excellent observer and narrator. He wrote this book as an abstract of a huge multivolume plan for presenting his theory of evolution of species by natural selection. He is careful to distinguish evidence from theory and uses the facts to derive his interpretations of how evolution works. Darwin did not start with a theory and then seek facts to support it. He went with no idea about evolution and instead allowed the hundreds of observations and findings guide him to the only interpretation that made sense of the relations he found whether it was the work of hobbyists and breeders creating new varieties of plants and animals, the geographic distribution of plants and animals he encountered in his trip around the world, or the fossils he encountered.  

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I have learned to sublimate my discontents and have had 14 books published for which I thank Freud. I find Jean Barois to be the finest writing on the conflict between science and belief, science and politics and the difficulty of finding a life that sustains us. Montaigne taught me that in difficult times, we can find many things to avoid and how diverse the world is for each new generation that emerges. I have kept a diary (now 112 volumes) more years than not since I first read Pepys’s diary in 1949. Darwin’s book taught me how to use a Baconian approach to science, letting the data amass and allowing an unbiased mind to connect the dots that make new findings and interpretations possible. 

Elof Axel Carlson is a distinguished teaching professor emeritus in the Department of Biochemistry and Cell Biology at Stony Brook University.

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Key lifestyle choices may reduce your risk significantly

By David Dunaief, M.D.

Dr. David Dunaief

Happy “Movember!” The Movember Foundation is in its 11th year of raising awareness and research money for men’s health issues (1). What better time to discuss prostate cancer prevention?

The best way to avoid prostate cancer is through lifestyle modifications, which means learning about both detrimental and beneficial approaches. There are a host of things that may increase your risk and others that may decrease your likelihood of prostate cancer. Your family history does not mean you can’t alter gene expression with the choices you make.

What may increase the risk of prostate cancer? Contributing factors include obesity, animal fat and supplements, such as vitamin E and selenium. Equally as important, factors that may reduce risk include vegetables, especially cruciferous, and tomato sauce or cooked tomatoes.

Vitamin E and selenium

In the SELECT trial, a randomized clinical trial (RCT), a dose of 400 mg of vitamin E actually increased the risk of prostate cancer by 17 percent (2). Though significant, this is not a tremendous clinical effect. It does show that vitamin E should not be used for prevention of prostate cancer. Interestingly, in this study, selenium may have helped to reduce the mortality risk in the selenium plus vitamin E arm, but selenium trended toward a slight increased risk when taken alone. Therefore, I would not recommend that men take selenium or vitamin E for prevention.

Obesity

Obesity showed conflicting results, prompting the study authors to analyze the results further. According to a review of the literature, obesity may slightly decrease the risk of nonaggressive prostate cancer, however increase risk of aggressive disease (3). Don’t think this means that obesity has protective effects. It’s quite the contrary. The authors attribute the lower incidence of nonaggressive prostate cancer to the possibility that it is more difficult to detect the disease in obese men, since larger prostates make biopsies less effective. What the results tell us is that those who are obese have a greater risk of dying from prostate cancer when it is diagnosed.

Animal fat, red and processed meats

The risk of developing prostate cancer increases with age. Stock photo

It seems there is a direct effect between the amount of animal fat we consume and incidence of prostate cancer. In the Health Professionals Follow-up Study, a large observational study, those who consumed the highest amount of animal fat had a 63 percent increased risk, compared to those who consumed the least (4).

Here is the kicker: It was not just the percent increase that was important, but the fact that it was an increase in advanced or metastatic prostate cancer. Also, in this study, red meat had an even greater, approximately 2.5-fold, increased risk of advanced disease. If you are going to eat red meat, I recommend decreased frequency, like lean meat once every two weeks or once a month.

In another large, prospective (forward-looking) observational study, the authors concluded that red and processed meats increase the risk of advanced prostate cancer through heme iron, barbecuing/grilling and nitrate/nitrite content (5).

Omega-3s paradox

When we think of omega-3 fatty acids or fish oil, we think “protective” or “beneficial.” However, these may increase the risk of prostate cancer, according to one epidemiological study (6). This study, called the Prostate Cancer Prevention Trial, involving a seven-year follow-up period, showed that docosahexaenoic acid (DHA), a form of omega-3 fatty acid, increased the risk of high-grade disease 2.5-fold. This finding was unexpected. If you choose to eat fish, salmon or sardines in water with no salt are among the best choices.

Lycopene – found in tomato sauce

Tomato sauce has been shown to potentially reduce the risk of prostate cancer. However, uncooked tomatoes have not shown beneficial effects. This may be because, in order to release lycopene, the tomatoes need to be cooked (7). It is believed that lycopene, which is a type of carotenoid found in tomatoes, is central to this benefit.

In a prospective (forward-looking) study involving 47,365 men who were followed for 12 years, the risk of prostate cancer was reduced by 16 percent (8). The primary source of lycopene in this study was tomato sauce. When the authors looked at tomato sauce alone, they saw a reduction in risk of 23 percent when comparing those who consumed at least two servings a week to those who consumed less than one serving a month. The reduction in severe, or metastatic, prostate cancer risk was even greater, at 35 percent. There was a statistically significant reduction in risk with a very modest amount of tomato sauce.

In the Health Professionals Follow-up Study, the results were similar, with a 21 percent reduction in the risk of prostate cancer (9). Again, tomato sauce was the predominant food responsible for this effect. This was another large observational study with 47,894 participants. Although tomato sauce may be beneficial, many brands are loaded with salt. I recommend to patients that they either make their own sauce or purchase a sauce with no salt, such as one made by Eden Organics.

Vegetable effects

Vegetables, especially cruciferous vegetables, reduce the risk of prostate cancer significantly. In a case-control study (comparing those with and without disease), participants who consumed at least three servings of cruciferous vegetables per week, versus those who consumed less than one per week, saw a 41 percent reduction in prostate cancer risk (10). What’s even more impressive is the effect was twice that of tomato sauce, yet the intake was similarly modest. Cruciferous vegetables include broccoli, cauliflower, bok choy, kale and arugula, to name a few.

When it comes to preventing prostate cancer, lifestyle modification, including making dietary changes, can reduce your risk significantly.

References:

(1) www.movember.com. (2) JAMA. 2011; 306: 1549-1556. (3) Epidemiol Rev. 2007;29:88. (4) J Natl Cancer Inst. 1993;85(19):1571. (5) Am J Epidemiol. 2009;170(9):1165. (6) Am J Epidemiol. 2011 Jun 15;173(12):1429-1439. (7) Exp Biol Med (Maywood). 2002; 227:914-919. (8) J Natl Cancer Inst. 2002;94(5):391. (9) Exp Biol Med (Maywood). 2002; 227:852-859; Int. J. Cancer. 2007;121: 1571–1578. (10) J Natl Cancer Inst. 2000;92(1):61.

Dr. Dunaief is a speaker, author and local lifestyle medicine physician focusing on the integration of medicine, nutrition, fitness and stress management. For further information, visit www.medicalcompassmd.com or consult your personal physician.

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By Bob Lipinski

There is little in the world more alluring than a glass of red Bordeaux wine. In Bordeaux, centuries of blending mastery combined with a unique terrain and climate give birth to refinement and equilibrium of a highly enticing nature. Within the region of Bordeaux there are many districts that make red, white, rosé, sweet white and even sparkling wines.

I recently attended a tasting of the wines of Pessac-Léognan, Saint-Julien, Margaux and Sauternes with representatives from each estate pouring and discussing the wines. Here is a list of the recommended wines I tasted including some tasting notes.

Château Latour-Martillac (Pessac-Léognan): The winery makes both red and white AOC wines.

2015 Château Latour-Martillac Blanc (spectacular bouquet of melon, pear and citrus. Mouth-filling with an excellent balance and great aftertaste)

2011 and 2013 Château Latour-Martillac Blanc

2015 Château Latour-Martillac Rouge (dark cherry color; bouquet of black currants, smoke, black raspberry; tannic with a smooth finish and lingering aftertaste)

2010 Château Latour-Martillac Rouge

Château Beychevelle (Fourth Growth Saint-Julien): The winery makes only red AOC wine. On the label of Château Beychevelle is a “Nordic Ship,” with grape clusters on its sails.

2015 Château Beychevelle (dark, almost purple color; bouquet of black currants, oak, black cherries; powerful wine with plenty of tannin and a fruity aftertaste)

2005, 2009 and 2014 Château Beychevelle

2015 Amiral de Beychevelle (second label of Château Beychevelle)

Château Kirwan (Third Growth Margaux): The winery makes only red AOC wine.

2009 Château Kirwan (ruby color with an aromatic bouquet of spicy cherry, menthol and blueberry; medium-bodied, beginning to soften with a smooth refined finish)

2008, 2010 and 2015 Château Kirwan

Château Guiraud (First Growth Sauternes): The winery makes both dry and sweet AOC white wines. The wines are a blend of Sémillon and sauvignon blanc grapes.

2009 Château Guiraud (gold-amber in color; bouquet and flavor of coconut, honey, orange, pineapple, peach, apricot and spice; luscious and sweet finish …Wow! What a delicious wine)

2010 and 2015 Château Guiraud

2015 Petit Guiraud (second label of Château Guiraud)

Bob Lipinski is the author of 10 books, including “101: Everything You Need to Know About Whiskey” and “Italian Wine & Cheese Made Simple” (available on Amazon.com). He conducts training seminars on wine, spirits and food and is available for speaking engagements. He can be reached at www.boblipinski.com OR bkjm@hotmail.com.

A scene from 'Mid90s' Photo courtesy of A24

By Kyle Barr

The real question with films like “Mid90s” and other throwbacks to the days of the childhoods of those born in the ’80s and ’90s is really how far you can get with callbacks and brand recognition. 

It has worked well in some places, such as with the hit Netflix show “Stranger Things,” but a movie still needs a storyline to fill out the space left between brand name dropping and scenes of, “Oh, don’t you remember this? Wasn’t this fun?” Well, “Mid90s,” which opened in theaters Oct. 21, is an interesting take on nostalgia, one that shows the ugly sides of childhood without any kind of judgment.

Sunny Suljic in a scene from ‘Mid90s’

“Mid90s” takes place in Los Angeles during the titular 1990s as the California skating scene was at its peak. Young Stevie (Sunny Suljic) lives in a dysfunctional house with abusive older brother Ian (Lucas Hedges) and his co-dependent mom Dabney (Katherine Waterston). While riding his bike Stevie sees a young group of skaters at a distance and decides to infiltrate that friend group, despite the fact he has never ever skated in his life. The skaters, made up of pro-skater hopeful Ray (Na-kel Smith), party-hopper F**** (Olan Prenatt), lonely Ruben (Gio Galicia) and the reserved filmmaker Fourth Grade (Ryder McLaughlin), start taking a liking to the young kid, who they nickname Sunscreen.

Stevie, while learning to skate, also falls into the seedier elements of the scene, the ones involving drugs and alcohol. He picks up terrible habits, acting out against his family. His friends are tested even harder when it becomes evident Ray is coming closer and closer to becoming pro, potentially leaving all those who look up to him behind.

It’s a movie called “Mid90s,” so it’s obvious that first-time director Jonah Hill, most known for his roles in films like “The Wolf of Wall Street,” is trying to make some kind of declaration of this time period. Unlike something like “Stranger Things,” the brands, music and albums so notorious from the era aren’t just set dressing but are integral to the theme. Stevie goes into his brother’s room and looks through his music, full of recognizable band names, just so he could give him a birthday gift in the next scene, which he then tosses on the table like he’s just received rotten fruit. The recognizable posters on Stevie’s wall are swapped out later once he starts to love the skating culture.

Sunny Suljic and Na-kel Smith in a scene from ‘Mid90s’

But what really drives the film’s forward momentum is the intense theme of skating as a relief from home life. Though it’s not so much an escape from problems, skating is shown as a way to connect with people on a deep spiritual level. It’s revealed relatively late in the film how each of the main characters has an imperfect home life, and that the friendship they have with each other is what keeps them all sane. 

Though it’s not a long movie, running at about the 90-minute mark, Hill doesn’t make this film overstay its welcome. That’s not to say there aren’t moments that makes one think this is a first-time directorial effort, small sequences that don’t add up, camerawork that pushes in a little too close to faces and a few other niggling details.

The film is also explicit in a number of ways, some of which involve the main character who is supposedly 13 years old, according to the film. Be sure to come at this flick without a sense of judgment for the characters, as the film itself makes it plain it doesn’t wish to judge them as well.

I was never a skater as a kid, but I knew those who were. Even if you have some sort of interest to dive into a time and place that few can honestly say they were a part of, then “Mid90s” should be a good run of some vicarious nostalgia.

Rated R for pervasive language, sexual content, drug and alcohol use and violence, “Mid90s” is now playing in local theaters.

Sausage, Peppers, Onion and Tomato Hero

By Barbara Beltrami

Ever since one of my favorite readers suggested I do recipes on sausages, I’ve been combing my files for my favorite and most successful ones. Surely pasta with broccoli rabe and sausage is a staple in my repertoire of easy hearty meals, and kielbasa with potatoes, sauerkraut and apples is another. And for an ever popular sandwich, especially when I’ve got the grill going, there’s the sausage, pepper, onion and tomato hero. None of these recipes is particularly exotic, delicate or light, but each one is a delicious interruption to a string of ho-hum meals.

Orecchiette with Sausage and Broccoli Rabe

YIELD: Makes 6 to 8 servings

INGREDIENTS:

1 pound orecchiette pasta

1 pound sweet Italian sausage

2 bunches broccoli rabe, washed and stems removed

¼ cup olive oil

½ teaspoon or more, or more, if desired, crushed red pepper flakes

6 garlic cloves, peeled and sliced thin

Coarse salt to taste

2/3 cup grated Parmesan cheese

DIRECTIONS:

Cook pasta according to package directions; reserve cooking water in pot. Set pasta aside to keep warm. In a large heavy skillet over medium heat, cook sausages until brown on all sides; remove from skillet and when cool enough to handle cut into half-inch slices. Set aside to keep warm. Drain all but one tablespoon sausage fat.  In reserved pasta water cook broccoli rabe until bright green and tender, 5 to 10 minutes. Drain and transfer to skillet, add olive oil, red pepper flakes, garlic, salt and sliced sausage; stir and cook over medium heat 5 minutes until garlic is cooked through but not brown. Place pasta in a large bowl, add sausage and broccoli rabe mixture, toss, then sprinkle with grated cheese. Serve with a tomato and mozzarella salad and warm, crusty bread and extra virgin olive oil for dipping.

Kielbasa with Sauerkraut, Potatoes and Apples

YIELD: Makes 6 servings

INGREDIENTS:

1 pound sauerkraut, drained

3 medium potatoes, peeled, cut into 1-inch chunks and boiled in salted water 5 minutes

2 medium apples, peeled and cut into 1-inch chunks

½ cup flat beer

¼ teaspoon caraway seeds

Freshly ground black pepper, to taste

1 pound kielbasa, cut into 1-inch slices

DIRECTIONS:

Preheat oven to 375 F. Grease a two-quart casserole. In a large bowl, toss together the sauerkraut, potatoes, apples, beer, caraway seeds and black pepper. Top with kielbasa slices; cover and bake for 10 minutes; uncover and bake for another 20-30 minutes, until kielbasa is brown and other ingredients are heated through and tender. Serve hot with pumpernickel bread and butter, pickled beets and beer.

Sausage, Peppers, Onion and Tomato Hero

Sausage, Peppers, Onion and Tomato Hero

YIELD: Makes 6 to 8 servings

INGREDIENTS:

8 sweet or hot Italian sausages, cut into 4 pieces each 

1/3 cup extra virgin olive oil

3 garlic cloves, peeled, mashed and minced

5 red or yellow bell peppers, washed, cleaned and seeded, and cut into 1-inch-wide strips

3 green bell peppers, washed, cleaned and seeded, and cut into 1-inch-wide strips

1 pound fresh tomatoes, coarsely chopped

2 large onions, peeled and sliced

1 handful parsley, washed and chopped

Salt to taste

DIRECTIONS:

In a large skillet over medium heat, brown the sausage pieces on all sides; leave in pan. In same skillet heat the oil and garlic; remove garlic as soon as it starts to brown. Add peppers, cover pan and cook over low heat until they are slightly limp, about 8 minutes. Add tomatoes, onions, parsley and salt. Toss all ingredients together. Return cover to pan, but leave it slightly askew. Cook 30 minutes, until all veggies are soft. Serve hot on crusty Italian bread accompanied by marinated artichokes, olives, eggplant caponata and provolone cheese.

Adrian Krainer in his lab. Photo by ©Kathy Kmonicek, 2016/CSHL

By Daniel Dunaief

This Sunday, Adrian Krainer is traveling to California to visit with Emma Larson, a Middle Island girl whose life he helped save, and to see an actor who played the fictional super spy James Bond.

A professor at Cold Spring Harbor Laboratory, Krainer is the recipient of the Breakthrough Prize in Life Sciences, which noted Silicon Valley benefactors including Facebook’s Mark Zuckerberg and Google’s Sergey Brin financed seven years ago. Pierce Brosnan will host the event, which National Geographic will broadcast live starting at 10 p.m. Eastern time.

Dr. Adrian Krainer and Emma Larson. Photo from Diane Larson

Krainer will split the $3 million prize money with Frank Bennett, a senior vice president of research and a founding member of Ionis Pharmaceuticals. The duo helped develop the first treatment for spinal muscular atrophy, the leading genetic cause of death among infants, which affects 1 in 10,000 births.

Prior to the Food and Drug Administration’s approval of Ionis and Biogen’s treatment, which is called Spinraza, people with the most severe cases of this disease lost the ability to use their muscles and even to breathe or swallow. Many children born with the most severe symptoms died before they were 2 years old.

“No one deserves it more,” said Dianne Larson, whose 5-year-old daughter Emma has been in a trial for the drug Krainer helped develop since 2015. When Emma started the trial as a 2-year-old, she couldn’t crawl anymore. Now, she’s able to push herself in a wheelchair, stand and take steps while holding onto something. Emma refers to Krainer as the person who helped make “my magic medicine.”

People with medical needs “kind of take for granted that there’s a medicine out there,” Larson said. “You don’t think about the years of dedication and research and hours and hours and money it costs to do this.”

Bruce Stillman, president and chief executive officer at Cold Spring Harbor Laboratory, said that this award was well deserved and was rooted in basic science. Krainer’s “insights were substantial and he realized that he could apply this unique knowledge to tackle SMA,” Stillman wrote in an email. “He did this with spectacular results.”

Dr. Adrian Krainer with the Larson family, Matthew, Diane and Emma. Photo from Diane Larson

Children with the most severe case of this disease had faced a grim diagnosis. “Now those children have a treatment that will keep them alive and greatly improve the prospects for a normal life,” Stillman added.

New York recently added SMA to its newborn screening test.

Krainer, who specialized in a process called RNA splicing during his research training, began searching for ways to help people with spinal muscular atrophy in 2000.

SMA mostly originates when the gene SMN1 has a defect that prevents it from producing the SMN protein,  called survival of motor neuron. This protein is important for the motor neurons, the nerve cells that control voluntary muscles.

As it turns out, people have a backup gene, called SMN2, which produces that important protein. The problem with this backup gene, however, is that it produces the protein in lower amounts. Additionally, RNA gene splicing leaves out a segment that’s important for the stability of the protein.

Looking at the backup gene, Krainer began his SMA work by seeking to understand what caused this splicing inefficiency, hoping to find a way to fix the process so that more function protein could be made from the SMN2 gene.

Collaborating with Bennett since 2004, Krainer developed and tested an antisense olignucleotide, or ASO. This molecule effectively blocked the binding of a repressor protein to the SMN2 transcript. By blocking this repressor’s action, the ASO enabled the correct splicing of the survival of motor neuron protein.

Emma Larson standing during her Mandarin lesson at Middle Country Public Library. Photo from Diane Larson

At first, Krainer tested the cells in a test tube and then in culture cells. When that worked, he went on to try this molecule in an SMA mouse model. He then worked with Ionis Pharmaceuticals and Biogen to perform the tests with patients. These tests went through hundreds of patients in numerous countries, as diseases like SMA aren’t limited by geographic boundaries.

“Everything worked” in the drug process, which is why it took a “relatively short time” to bring the treatment to market, Krainer said.

People who have worked with Krainer for years admire his character and commitment to his work.

Joe and Martha Slay, who founded the nonprofit group FightSMA, helped recruit Krainer to join the search for a treatment.

Joe Slay recalls how Krainer made an effort to meet with children with SMA. He recalls seeing Krainer during a pickup football game, running alongside children in wheelchairs, handing them the ball and tossing it with them.

Krainer brought his family, including his three children, to meet with the SMA community. The trip had a positive effect on his daughter Emily, who said it “subliminally had an impact on wanting to work in this field.” 

Currently a third-year resident in a combined pediatric neurology residency and fellowship program, his daughter is “very excited for him and proud.” She recalls spending Christmas holidays and New Years celebrations at the lab, where she met with his friends and co-workers.

Emily Krainer said a few people in her residency know about the role her father played in developing a treatment the hospital is employing.

The treatment is the “talk of child neurology right now,” she said.

Researchers hope the recognition for the value of basic research that comes with the breakthrough prize will have an inspirational effect on the next generation.

“The idea of prizes like this is to highlight to the public that scientists spend many years working without public recognition but make really important contributions to society,” Stillman suggested.

For Larson, the research Krainer did was key to a life change.

“To me, science is hope,” Larson said. “If we didn’t have this science, we wouldn’t have any hope,” adding that she would like her daughter to become a scientist someday.

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There is a lot of stress in our lives these days. Stress envelops us. One man I know complained that even in his home, he does not feel stress free. When he puts on the television or radio, the now-commonplace partisan viewpoints surround him. And that is the least of it. The horrific shooting in a Pittsburgh synagogue, pipe bombs sent to at least 15 different targets perceived to be Democratic in nature throughout the United States, the shooting at a school in North Carolina and more make up some of the news just this past week. There seems to be no escape. Even conversation with customers or spouses inevitably touches on the daily stressful events.

Surely there have been times of even greater stress in our country. World War II comes immediately to mind. The Cold War, with regular air raids, was another. The Cuban Missile Crisis was yet another. But these were all threats from outside: from the Nazis, the Japanese, the Soviet Union. The stress today, whether rhetorical or physical, is domestic and aimed by Americans against other Americans. Worst of all, as political partisans denigrate opponents and gun violence becomes tragically routine, there doesn’t seem to be an end in sight.

Can we learn to manage the stress in our lives? The Harvard Women’s Health Watch advises that we can. In the August issue, published by a division of Harvard Medical School, physicians offer some information about stress and its effects. They also give some suggestions for coping with stress.

First the information. “It’s not uncommon to feel disorganized and forgetful when you’re under a lot of stress,” the article, “Protect your brain from stress,” explained. “But over the long term, stress may actually change your brain in ways that affect your memory.” Because stress can influence how the brain functions, including not only memory but also mood and anxiety, it can cause inflammation. This in turn can affect heart health. Thus stress has been associated with multiple chronic diseases of the brain and heart, according to Harvard physicians.

The brain is not just a single unit but a group of different parts that perform different tasks, according to the Harvard article. When one part is engaged, researchers believe that other parts may not have as much energy for their specialized functions. One example is if you are in a dangerous situation, the amygdala section takes over to ensure survival, while the energy level in parts having to do with memory or higher-order tasks recedes. Hence you might be more forgetful when stressed.

“There is evidence that chronic (persistent) stress may actually rewire your brain,” according to the research, as if exercising one section makes it stronger while other sections, like that having to do with more complex thought, take “a back seat.” Such brain changes may be reversible.

There are various kinds of stress. For example, one feels differently before taking a big test compared with that experienced in a car accident. More stress is worse, and long-term stress is generally worse than short-term stress, according to the physicians. Unpredictable stress is worse than stress that can be anticipated. Chronic stress can be more challenging than one that will end shortly. Feeling supported by others most likely mitigates stress effects.

So here is some advice from the Harvard publication on how to cope with stress. Establish some control over your situation such as by setting a routine. Get organized. Get a good night’s sleep — hard to do when stressed but going to bed and waking up at the same time each day helps, as does avoiding caffeine and creating a relaxing sleep environment. Get help, sooner rather than later. And try to change your attitude toward stress by striving for healthier responses to stress. Use its effects, if you can, to high power you to a goal. Like voting.

And I say, turn off the television and the instant news briefs on your cellphone for some quiet time each day.

We need a unifying moment. Most of us are good people, most of us care about our families, our neighbors, our communities and the safety and soundness of our lives in America.

We need a moment when everyone can come together, regardless of their faith, background or individual beliefs, and decide that we believe in our city, state and country.

We need a moment when we are all Jewish. We need to show the people out there who are threatened by any one religion or belief that we all stand together, that an attack on one of us is an attack on all of us, and that we will not tolerate any level of violence against a group because we support and believe in each other.

Wearing blue, as my children and their friends did the first day after the horrific attack in Pittsburgh, is a start.

There’s a wonderful climactic scene in the Kevin Kline movie “In & Out,” (1997). A former student of Kline’s has outed him as gay just before his wedding. The town wants to remove him as a teacher, despite his dedication to his students. During a graduation ceremony, people who have known and appreciated Kline’s commitment stand up, one by one, and declare that they, too, are gay, rallying behind a teacher who meant so much to them.

Violence, discrimination and hatred toward any one group will be spectacularly difficult if the group suddenly includes everyone. I’m not suggesting that anyone changes religions. I am, however, suggesting that people stand together with Jews, Muslims, lesbian and gay populations and make it clear to anyone who would target these groups with bullying, hatred or worse that we as a unified group will not allow it.

Pursuing the death penalty against the perpetrator of this violence may be a deterrent to other people who might consider similar acts, although I suspect that the diseased minds who crave relief through murder may not care that much about their fate.

We need to send a signal beyond the death penalty for those contemplating violence. We need to tell them that the group they hate is larger than they think and the actions they are considering are unacceptable to all of us.

Just over 20 years ago this month, Matthew Shepard was killed for being gay. Ideally, today people can express their sexual preference without fear of anger or violence. Unfortunately, we don’t yet live in an ideal world, so we must stand together with this generation’s Matthew Shepards.

This isn’t a political moment. This is a time when caring community members can and will stand, side by side, to make it clear that, despite our differences, despite our frustrations with each other, despite our irritation at someone who takes our parking spot, we are a community that cares.

Most people feel helpless in the face of abominable acts as in Pittsburgh. In addition to finding a time and place to stand together, we should tell people we are gay or Jewish or Muslim. We should wear those labels with pride, the way we put on a new dress, shoes or tie the first day after we buy it.

Perhaps, all week, when we pick up the phone, we should say, “Joe’s Deli, this is John and I’m Jewish. How may I help you?” Or, “It’s a great day at the store. This is Alice and I’m gay. How can I help you”

It’s impossible to hate “the others” when everyone belongs to that group. We need a unifying moment and it starts with each of us.

There are planning tools an individual can employ to potentially safeguard wishes after death. Stock photo

By Nancy Burner, Esq.

Nancy Burner, Esq.

Inheritance is the practice of passing on property upon someone’s death. The rules of inheritance differ from state to state.  

In New York, a decedent generally cannot disinherit his spouse. This principle is governed by Estates, Powers and Trusts Law Section 5-1.1-A (Right of Election by Surviving Spouse) and requires that the surviving spouse receive a portion, or share, of the decedent’s estate. The surviving spouse’s share will be equal to the greater of $50,000 or one-third of the decedent’s estate.

The right to elect to take your spousal right of election is governed by time frames. An election under this section must be made within six months from the date letters testamentary are issued but no later than two years after the date of the decedent`s death. A written notice of the election is required to be served upon the executor, or upon the person named as executor in the will if the will has not yet been admitted to probate. The written notice must then be filed and recorded with the Surrogate`s Court.  

Conversely, a decedent can disinherit a child. However, it is important to note that a child falls into a certain class of individuals who have the right to contest your will even if they are specifically disinherited, whether or not they are named as a beneficiary under your will or if they were left with a disproportionate share of your estate. A disinherited child has the right to challenge or contest your will because, had you died without a will, your child would receive a share of your estate through the laws of intestacy.  

However, there are planning tools an individual can employ to potentially safeguard wishes after death. An in terrorem provision in a decedent’s will “threatens” that if a beneficiary challenges the will then the challenging beneficiary will be disinherited instead of inheriting the full gift provided for in the will. An in terrorem clause is intended to discourage beneficiaries from contesting the will after the testator’s death. New York law recognizes in terrorem clauses, however, they are strictly construed.   

Keep in mind that simply having an in terrorem clause in your will may not be enough to dissuade beneficiaries from potentially challenging your will. Theoretically, however, for an in terrorem clause to have any weight at all, a beneficiary under a will must be left a substantial amount to incentivize their compliance with the will. 

An in terrorem clause may have no effect on a beneficiary who was not left anything under a will as they risk losing nothing by challenging the will. While in terrorem clauses may be effective in minimizing a will contest, for some it holds no power.  

As with many things in life, one size does not fit all. A successful estate plan takes all personal and unique factors to an individual into consideration. The documents are only part of the problem and solution. The fact is, there is no substitute for competent legal advice.   

Nancy Burner, Esq. practices elder law and estate planning from her East Setauket office.

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