Counting and counting
“Let’s count that again!” said the manager, clearly irritated.
He wasn’t the only one. My co-worker was looking at him obliquely with an unmistakable “Are you stupid?” written all over his face. Strangely enough, I didn’t share the feeling, even if counting the same lot of merchandise for the third time in a row isn’t exactly my concept of productive use of anyone’s time. My thoughts were elsewhere.
The truth is, I was concerned. My manager can score high on the PITA scale but stupid, he ain’t. Rather resides on the sharp edge of things if you ask me. But having to count for the third time told me something was not right.
I noted (really noted) his gaunt traits, his remarkable leanness, shoulders hunched forward, tense as a coil ready to spring. His haggard gaze told a tale of wandering deep inward, searching to regain some normalcy, to set anchor in the immediate reality, as if trying to reboot.
I realized I was in this fascinating and quasi-blissful space of mind observer, detached, noting the stream of thoughts evaluating, assessing in an effortless ratiocination. I was seeing, as opposed to merely looking.
“Reboot…because he can’t process.” I thought. “Process information in his short-term memory.”
Now, when does that happen? Medical training automatically kicked in, laying on the table more pointed and informed questions, exploring reasonable answers, eliminating least likely explanations. He was clearly not under the influence of any psychoactive substances, and way too young to experience dementia. I hadn’t noticed anything remarkable about his movements, demeanor or speech recently. Likelihood of a nervous system monster lurking below the surface? Very low indeed; not impossible, but when we hear horse’s galloping steps, let’s not look for zebras in Alaska.
So…something temporary? “He’s lean as hell!” letting loose associations permeate my consciousness. Lean, no fat, no food…does he eat enough? What happened to someone under stress who doesn’t eat enough or goes extended periods of time without eating during the day? Low blood sugar levels. The brain can experience some problems when sugar level is suddenly inadequate.
Assessing and asking
We finally got through the ordeal of counting. Walking away from the warehouse, I took my manager aside, and I ask him:
— “Did you had breakfast?”
He looked at me, surprised:
— “What kind of question is that?”
I lifted my hand, palm open, in a sign of appeasement:
— “In the warehouse, you looked like you couldn’t hold anything in memory. Did you have breakfast? And do you eat very late in the afternoon too?”
— “Just go back to work, OK? Appreciate the concern, I’m all right.”
Unfazed, I thought:
— “Oh well! I tried.”
I didn’t think much of the incident until four days later when my manager came to me and said:
— “You were right.”
— “Come again? About what?”
— “I told to my wife what happened the other day, and she noted the same thing; when I don’t eat regularly, I’m not as sharp.”
He looked at me quizzically: ”How did you know?”
The guy doesn’t know I was a medical doctor, and I wasn’t eager to broach the topic.
I shrugged: “I get lucky once in a while.”
He smiled “Whatever it was, thanks a lot, man! I feel much better now.”
So, how did I know?
It’s not because I hold special powers of extraordinary diagnostic acumen. It is because I stumbled recently upon a new health topic I am passionate about. Becoming interested in this field made me much more aware and alert of what was going on with the counting trouble.
The field I’m talking about is Nutritional Psychiatry, the discipline that aims to study and use nutrition as a mainstay of treatment for both mental illness AND improvement of brain function. Think improvements in focus, creativity, learning etc. The potential is, well, mind-boggling!
There is mounting evidence nutrition does work well in this regard. By the way, this goes way beyond a cluster of anecdotes and stories. We’re talking studies, systematic research that will soon provide treatment where the mental health professional will partner with a Chef and Clinical Nutritionist to prescribe menus instead of (or in combination with) drugs.
I invite you to let this sink for a moment. An activity we must perform to stay alive (eating) would become an important tool, scientifically studied to heal, as well as improve the functioning of the most complex organ we have. Moreover, the accumulating evidence that nature settings are much more conducive to brain health than heavily urbanized areas allows us to envision centers of holistic mental health set in the natural environment where the garden and kitchen takes center stage. I take the word “holistic” in its authentic meaning; an approach faithful to integrating the best of scientific medicine and traditional craftsmanship, in this case, the skills of food growers and chefs.
This vision sure beat the psychiatric hospital settings of drab, depressing buildings and drug regimens that can only claim, at best, moderate success.