Mysteries Encountered-Questions Followed

In the mid 80s, Frank, a patient of mine, was in the hospital’s intensive care unit because of a massive heart attack. He died. A couple of minutes after he was pronounced dead, his second wife and his 50-something-year-old son from his first wife, went into Frank’s room and began to scream at each other. But that was not all. They each grabbed Frank’s hand and tried to remove a gold and diamond ring from his fourth digit. During the struggle, Frank’s hand and arm moved all over the place. In fact, they moved his limb so much, one had the impression Frank was alive and had joined the fight with them.

A nurse supervisor stopped the confrontation. I never knew what happened to the ring, and it doesn’t matter. What was important to me was the behavior of Frank’s widow and his son. How could they act like that, showing no respect for their husband and father? What was more intriguing to me was to ask what kind of psychological backgrounds these two people had that led them to behave the way they did?

Not everyone reacts negatively to tragic events. I once treated an octogenarian, British woman who had been in London during WWII when the Nazis dropped tons of bombs on her city. She was educated and bright. She told me she “had had a beautiful experience during the blitz.” I asked her, “I don’t get it, how did you find something beautiful while people were being killed or maimed by the bombs?” She answered, “Yes, it was beautiful, indeed, to see how people who didn’t know each other helped those who were wounded, risking their own lives in the process. I never saw anything more beautiful than that!”

You can appreciate how different the emotional-psychological response of different individuals may be. This extraordinary woman gave me the impression that she had actually enjoyed, not the devastating destruction and carnage, but the fact that she was able to assist people with very serious physical and emotional damage, and share heroic performances with other courageous individuals. Skin scars last forever, unless a plastic surgeon removes them with a scalpel. Emotional scars seem to have the same fate, unless a psychologist frees one from burdensome and damaging effects. Scars of the mind may range from minor to terrible. They may be tolerable and not significantly disruptive, or they may evoke bitterness, sadness, disappointment, pain, frustration, hatred, and other unpleasant reactions.

For many years in my cardiology practice, I observed people’s gestures, arguments, and actions. These observations left me with a preoccupying collection of question marks. I also dealt with an assortment of clients: intellectuals, corporate executives, policemen, antiterrorist experts who defused bombs every week, artists, physicians, politicians, psychologists, engineers, attorneys, CIA operatives, plumbers, construction workers, taxi drivers, window-cleaners of New York highest skyscrapers, members of mafia families, drug dealers, men and women with abject poverty, and others who had so much money they didn’t know what to do with it.

I do not remember even one of these individuals who presented without some sort of emotional disorder or behavioral dysfunction. Over the years, I interacted with numerous US veterans of World War II, the Korean War, the Vietnam War, and more recently, the Gulf War. It would take volumes for me to relate their experiences to you. A few of their struggles included the Normandy invasion or D-Day, life (and death) in concentration camps, airplane dog-fights, the fear of being in a submarine that was the target of depth charges exploding nearby, hand-to-hand fighting with the enemy in the jungles of Southeast Asia using machetes and bayonets, and the survival of marines lost in places where they had to eat what they could, such as insects and the fluid of a snake’s body.

It was not easy; first, the marine killed the snake, then with a knife, he opened up the middle part of the snake’s body and suctioned the juice of the reptile with his lips. Most of these veterans suffered from Post traumatic stress disorder (PTSD), and in some of them, the condition reached disabling proportions. We sometimes live in a difficult world—I do not hesitate to call it a crazy world. It may often appear full of violence and polluted with angry and destructive minds, including an abundance of greed and corruption in governments and corporations.

Many individuals have erroneous thinking, disturbed emotions, and behavioral dysfunctions; some are worse than others are, but a certain degree of emotional or mental dysfunction may be universal. Those who appear and sound normal may have mental issues they have to reckon with. We sometimes watch as drugs, rapes, and wars destroy people’s lives. Some married couples do not know how to reach harmony and happiness, let alone peace of mind.

Many have to deal with marital or extramarital relationships, personal lives, parents and in-laws, children, sibling rivalry, jealousy, financial hardships, unemployment, loss of their homes because of an inability to afford mortgage payments, serious illnesses, disabling accidents, legal battles, conflicts with coworkers (bosses and subordinates), and let me not forget, their sex lives. As you read the questions I posed to Dr. Paul in this book, it will become obvious to you that I am not particularly interested in the facts and realities about each story of the participants.

We all know, a liar is a liar, a bank robber is a bank robber, and a rapist is a rapist. What we often may not know, and what I want to know is, why and how do these dysfunctional behaviors occur? What caused the minds of these subjects to became so twisted, so crooked, and so abnormal? Did family, cultural, educational, or social problems affect them, or were they born with dislocated genes? We often see suffering and dysfunctional behavior of noble people, whose parents provided them with a less than effective upbringing. The parents were probably good people, but had no idea what was required in their children’s development. They may have lacked knowledge, time, motivation, or the ability to raise children; they made mistakes.

Good people sometimes have an array of personal, interpersonal, intimate, and family conflicts that generate expressed or repressed unhealthy emotions. My basis for writing this book is to honor the truth by finding answers to my questions that are a reflection of my ignorance, not my knowledge. Over the years, I have amassed many unanswered questions on human behavior. They have piled up and now resemble the shape and size of an Egyptian pyramid. I am equating the top of the pyramid with my desire to understand human behavior.

I often saw myself climbing the pyramid, but never able to reach the top. It reminds me of the mythological story of Sisyphus, where he was condemned by the gods to roll a boulder uphill, only to watch it roll back down again. He was sentenced to do this for all eternity. The story of Sisyphus is mythological, mine is not. Recently, I decided to engage a prominent, senior psychologist and master therapist in a dialogue that would help me get answers to my questions and maybe put the pieces together in the puzzle that is human behavior.

The learned psychologist I enlisted was Dr. Howard Paul, a very experienced clinical psychologist, medical school professor, and supervisor of other psychologists and psychiatrists. Dr. Paul is renowned internationally and enjoys prominence for his academic achievements, multiple scientific publications, and book reviews. After 45 of years of experience in private practice, he continues to exert remarkable influence on his patients, colleagues, students, and society. Throughout his career, Dr. Paul has provided support to thousands of concerned patients and dealt with situations and complications, almost all manageable, even if difficult to treat. During my conversations with Dr. Paul, he explains why and how negative emotions occur. He tells us what may be the best way to prevent them and offers guidance on ways to positively deal with them.

I invite you to read our conversations, and give some thought to his comments. Take your time. Do not read his words too quickly. He has many cryptic metaphorical phrases that teach us valuable lessons. His friends and those he counsels call them, Howardisms. Most are his, although some are borrowed.

Here are but a few that he has shared with me:

• It isn’t a good idea to keep putting your finger into an electric pencil sharpener ·
• If you really want to mess up your day, start off with a wish you know won’t come true ·
• People who argue with freight trains are called casualties. Sometimes it is best to simply get off the tracks ·
• The biggest tiger that people face is the fear that their inadequacy will be discovered and eat them up ·
• There are big deals, medium deals, and small deals. Most of what people think are big deals are just highly aggravating little deals ·
• If you do not know where you are going, you are sure to get there! ·
• We are creatures of habit, not of knowledge ·
• If people really did what they knew was best, psychologists would all be unemployed ·
• Never speak unless you have a pair of ears ready to listen ·
• The mind is a dangerous place. Don’t go in there alone

In this book, Dr. Paul shares a lifetime of experience, knowledge, and the wisdom that results from them. Let us get immersed together in this exploratory journey as we learn more about the origin of feelings, thoughts, and behaviors and try to unravel the mysteries of the mind.
Eduardo Chapunoff, MD, FACP, FACC