What do I mean by Thanksgiving perspective? As everyone knows, Thanksgiving is a day when we show gratitude and thanks for what we have, especially family and friends, though it was originally a religious holiday.

However, even on Thanksgiving Day, we sometimes spend much of our time feeling rushed and stressed. For several days leading up to Thanksgiving, I often see people complaining and worrying about all they have to do for the big party. I admit that I have sometimes been one of the complainers. I’ve gone to Costco twice this week and my beloved Lunds and Byerlys grocery store three times. At both stores, people were stressed and upset. A man in front of me at the Costco liquor store complained about how long the lines were at Costco. He had a cart full of food and was buying several bottles of wine, yet he couldn’t wait a few minutes longer than usual to buy them without complaining.

I overheard several other people complaining about the cost of food. Yes, I know that we have had an increase in some food prices. The cost of beef, coffee, soda, and other items has gone up dramatically in the last year or two. But Costco had a fresh turkey for $1.09. I just checked online, and Target has fresh turkeys for $0.79 a pound. A spiral ham is $1.49, and green beans are about $3 a pound. And if you spend $50, you get ten dollars back. You could feed ten people for under fifty dollars. I don’t think the cost of food was something worth complaining about. Yes, the price of a standing rib roast was over a hundred dollars, so we’re having turkey.

Rather than complaining about the hassles around the holiday dinner, we should be thankful that we live in this country, where we have easy access to food. In fact, few Americans need to worry about finding food. One look around will tell you that the majority of people have more food than they need.

In America, we have much to be thankful for. In addition to access to food, we have clean water, shelter, cars, television, streaming services, mobile phones, computers, and many other things our grandparents didn’t even dream of.

More important than anything I’ve mentioned is that we should be thankful for being alive.

Being born was not your only good fortune. You had to survive until today. We all know how many times our lives could have ended before now. And it was much worse a hundred years ago. In 1925, our life expectancy was about 58, and it was even lower in 1900. Now, we consider someone young when they die at 70. That’s in the United States. In several countries in Africa, the life expectancy is under 60.

It took extremely good fortune for any of us to be alive right now. My parents had to get together at the perfect time for me to be born. The same had to happen with their parents, their parents’ parents, and so on for millions, literally millions of generations. Had any of my ancestors died without children, I wouldn’t be here at all, and no one would have known the difference. The same is true for everyone in the world today.

One of the things that bothered me in my practice was when a patient in their 80s or even 90s complained about getting old. Really? There are only two things that can happen to a person: get old or die young. Which would you prefer? Yet, many people don’t do much to try to live into old age. Read about my book, The Six Rules for a Longer, Healthier Life, if you want to increase your chances. Just a few days ago, I complained about pain in my arthritic left thumb while I was playing piano. How silly. First, I should be thankful I have a piano. More importantly, I should be thankful I have lived long enough to develop age-related arthritis. That is one of countless things I’ve complained about that I shouldn’t have. Enough complaining.

Now, the most important thing.

If you have a single person in your life whom you love, be thankful. I am fortunate to have several such people. How my wife puts up with me is beyond my comprehension. Yet, as much as I love them and am thankful to have them, I have not always shown my gratitude. I have sometimes been short-tempered and have complained when they’ve done something that wasn’t ideal for me.

That is what I mean by Thanksgiving Perspective, showing your gratitude for what you have, especially your loved ones, on Thanksgiving and every day. Try to be thankful for all the good things, and accept that we will have things that don’t seem good when they are happening. In retrospect, what bothers us in the moment is usually not a big deal. (Keep a copy of Don’t Sweat the Small Stuff on your desk.)

I hereby make a Thanksgiving resolution.

I will work as hard as I can to keep the Thanksgiving Perspective, showing my gratitude for everything good in my life, and avoiding complaining about anything that is not perfect. Please consider joining me in a resolution to keep the Thanksgiving Perspective.

What is autism? It depends.

How can it depend? In Medicine, definitions change rapidly. According to the National Institutes of Health (NIH), “Autism spectrum disorder is a neurological and developmental disorder that affects how people interact with others, communicate, learn, and behave. Although autism can be diagnosed at any age, it is described as a “developmental disorder” because symptoms generally appear in the first two years of life.”

In medical school, we never heard of “autism spectrum disorder (ASD).” In fact, the Diagnostic Statistical Manual of Mental Disorders (DSM-5) did not use the term until 2013. I am not questioning the term. I don’t have nearly enough experience or knowledge of autism even to comment. This post is about definitions.

The definition of autism has changed in the last thirty years to the point that there is a new name. Now, you can say “on the spectrum,” and people know you are talking about the autism spectrum. A spectrum is “a continuous sequence or range,” according to Webster. Why is this important? Historically, people with autism were usually unable to care for themselves. Most were nonverbal and needed constant care. This severe form of ASD still exists, but now, many or most children and adults affected with ASD have milder forms.

These milder forms of ASD existed in the past, but medical professionals and laypeople did not identify them as autism. The problem is that those with the severe forms and the mild forms are now often grouped together. I have a friend who has been diagnosed with a milder form of autism. He has difficulty receiving adequate medical and dental care because the practitioners assume he won’t be able to follow instructions and care for himself. On the other hand, those with severe forms can’t care for themselves and may also not receive the care they need.

Again, I have no opinion on whether autism spectrum disorder is the correct name for people with mild forms of the condition. Perhaps there will be another name at some point. What matters is that when we try to study the condition, we must research and discuss the same thing. There is much discussion about the increase in diagnoses of ASD. Some blame vaccines, food dyes, or other environmental factors. I don’t know whether the actual rate of autism is increasing. I only know that there is a significant increase in diagnoses. It is critically important that we determine whether all forms of ASD are growing in numbers or whether only the rate of one type is increasing. Once we know whether the number of affected people is growing, we can study the causes.

Autism is not unique in this definition problem. Pneumonia is a straightforward condition—an infection of the lung. But there is a broad spectrum. I had pneumonia in residency. It was caused by Mycoplasma pneumoniae. I had a constant cough and a low-grade fever. I missed no work and was much better after two days of oral antibiotics. Nationwide, pneumonia is a leading cause of death, but I was never at any risk. It would be important if you could cut Mycoplasma infections by ten percent, but it would be nowhere near as important as preventing the really dangerous causes of pneumonia.

The same holds for autism. I don’t believe that vaccines cause autism, but I don’t have enough information to rule it out completely. We have to agree on what autism is before we decide if vaccines have an effect. It is possible or even likely that not all children diagnosed with autism spectrum disorder actually have the same condition. Perhaps various forms of autism have different causes. I hope we can eventually prevent all cases of autism and similar disorders. Before we can do that, we first have to agree on what autism is.

The need for a good definition is true in everything. Some scientists argue that body mass index (BMI) is not a good definition of obesity. (See my book, The Three Rules to Lose Weight and Keep It Off Forever). At least it is better than the current definition of autism. Lack of a good definition is also a problem outside of Medicine. AI is a good example. People ask me whether I am worried about AI. Before I answer, I need to know what they are talking about. I am not at all worried about the AI Grammarly uses to rephrase a clunky sentence. I worry some about rogue AIs, like the one in The Terminator. I would love to meet an AI like Data.

What is autism? I don’t know. I don’t believe anyone knows. We need to decide what autism is before we come close to determining whether vaccines and other environmental factors are a cause.

Keep an eye on haroldoster.com for an update coming in mid-May.

I hope I can convince you that using someone else‘s account is stealing.

Everyone knows that if you go to Target and walk out with a liter bottle of olive oil without paying, it is stealing, right? How does Target make money? It buys the olive oil from the wholesaler and sells it to the consumer for more money. They lose money if you steal the olive oil they paid for.

How does Costco make money? Most of their revenue comes from their yearly membership. They make enough money from membership that they don’t have to make as much money selling their bottles of olive oil. That is how I can buy a two-liter bottle at Costco for the same price as Target’s one-liter bottle. When you share your Costco account with others, Costco doesn’t make as much in memberships. One of two things happens—they raise membership fees, or they raise the prices of their products. If you use someone else’s account, you are getting the services that Costco provides without paying for them. It is obvious when you steal olive oil, but less so when you steal a service. But using a service without paying is the same to a company as stealing a product.

Costco started scanning membership cards on entry a few weeks ago. I am thrilled. Get rid of the thieves. My price will go down.

Look at Spotify, one of the greatest inventions in my memory. They provide an incredible service. They link a gazillion songs to my phone. I don’t pay for each song. My wife and I have the Premium Duo membership, which I highly recommend. She gets whatever songs she wants, and I get mine. If we didn’t have a membership, and I used my son’s membership, I would be stealing the service Spotify sells. See? Simple.

Netflix, Sling, and Audible are the same. Everyone knows that stealing a book from a bookstore is stealing. Stealing an audiobook from Audible or some other source may not seem like stealing because there is no physical product. Who cares? People who buy books don’t care about the paper or pretty colors on the cover. They want the book’s content. If you take it without paying——Stealing. If someone stole the Kindle version of my book, I would be upset.

My son is a computer engineer. I know he’s good because his online color palette app, Tincto is super-cool. I use Tincto when I make greeting cards, but I didn’t understand what he was doing on the computer when I saw him writing the code. It may have been magic. Anyway, he also writes code for a company, and they pay him for it. He and other engineers provide a product to the company, which provides a service to customers. What if my son did this work for a month, and they refused to pay him? I‘m not sure that stealing is the right word for it, but it would be wrong. Same thing.

Taking a good or service without paying for it is stealing, and it hurts everyone. If ten percent of people who use Sling or YouTube TV use someone else’s account, then all the honest members will have to pay more. The same thing would happen if ten percent of people stole their olive oil from Target.

Appeal to Authority Fallacy

The Appeal to Authority or Argument from Authority fallacy is when someone claims something is true because some authority figure said it was so. It is among the worst mistakes that one can make because it prevents further discussion on the issue in question. Carl Sagan said, “One of the great commandments of science is, ” Mistrust arguments from authority.” … Too many such arguments have proved too painfully wrong. Authorities must prove their contentions like everybody else.” This is a good site for the explanation of common fallacies.

Think about how many experts have been proven wrong—you don’t have to go back very far. Advice on masks during the initial outbreak of COVID-19 changed several times. I don’t believe Dr. Fauci or anyone else purposely deceived us. It was just that our knowledge changed. Authorities must prove their contentions like everybody else.

Certainly, I pay more attention to a scientific opinion from a scientist speaking in their field than a celebrity on the risk of vaccines. Still, I don’t believe something valid until there is better evidence than a pronouncement. Scientists are fallible. Health experts thought margarine was healthier than butter for many years. Now we know that trans-fat in margarine was far worse than butter. We used Crisco shortening because doctors claimed without evidence that it was healthier than lard. Trans-fat from margarine and shortening killed people.

The appeal to authority fallacy only says that you cannot trust something just because it was said by an authority. It doesn’t mean that what is said in a particular instance is untrue. A related error is the ad hominem fallacy, where something said by a non-expert or even a charlatan is said to be false because they were the ones who said it. You may hate President Biden or former President Trump, but if one of them said that lead is heavier than air, it doesn’t mean it’s false. Some say I am an authority on weight loss because I wrote a book. I believe I back up my recommendations with evidence. Don’t ever take my word on anything unless I present the data. Buy it at Amazon.

Major news websites post an appeal to authority argument almost every day. The headline starts, “According to expert…” The story will talk about the next pandemic or what will happen when China launches a cyberattack on the United States. Last year, news sites reported on military pilots who claimed to have seen alien spacecraft. No evidence was presented except that the authority said so. “Extraordinary claims require extraordinary evidence” is another quote by Carl Sagan. Before I believe in aliens visiting us, I need more evidence than what a pilot saw.

A form of the appeal to authority fallacy is an explanation that parents make to their children. I cringe when I hear a parent say, “Because I said so.” Yes, there are times when a parent doesn’t have time to give a better explanation, but there are better reasons for your teenager to wear a seatbelt than that their father said so. We shouldn’t necessarily believe everything our parents or anyone tells us until we have some supporting evidence.

Sometimes, the appeal to authority fallacy hurts people. A current example is when experts claim vaping nicotine is as dangerous as smoking cigarettes. They say that nicotine is addictive as if that answers the question. Caffeine is addictive, yet it is legal for anyone of any age. Vaping nicotine can affect brain development in adolescents, and I am not saying that vaping, is safe, but smoking cigarettes kills over 400,000 Americans per year. I have not seen evidence that vaping does that. Since vaping can help some people quit smoking, so maybe we should tell people that if they can’t quit smoking, vaping could be a safer option. Telling them vaping is just as bad could keep more people smoking cigarettes.

The point of this post is that you should not believe what people say, even an authority, just because they said it. In medical school, I checked what the professors said if it didn’t sound right, and it was not uncommon that they were wrong. It is rare that professors or authorities purposely spread untruths, but everyone makes mistakes, even the President of Harvard. If you read an article online and the only evidence presented is the word of someone else, don’t believe it.

These are easily found examples. We tend to believe the experts we want to believe, and disregard the rest. We should listen to experts because they are usually correct, but we should confirm what they say when possible. Always keep in mind that extraordinary claims require extraordinary evidence.

Would you go to an obesity doctor if they were obese? Would you go to a cosmetic dentist if their teeth looked horrible? I wouldn’t. I wouldn’t go to a smoke cessation clinic if the doctor and staff reeked of cigarettes. I wouldn’t go to a lawyer who’s been in jail three times for fraud. Then why should your kids listen to you about smoking if you smoke yourself? Why should my son wear a seatbelt or a bicycle helmet if I don’t? Why should my kid listen to me about their weight if I regularly eat unhealthy foods?

People aren’t stupid. We recognize the hypocrisy of people who say we should do something but don’t do it themselves. Celebrities are the most obvious culprits. Steven Spielberg lectures us on global warming and then flies on a private jet. Oprah Winfrey does the same.

My wife and I are in Las Vegas right now with our son and his girlfriend. We went to a movie at Sphere. Darren Aronofsky created it. Sphere is a strikingly beautiful venue with technology and video that were beyond anything I have seen. The movie, called Postcard from Earth, talked about how humans are destroying the world with our growth and industry. Yes, another lecture about environmental change. But think about it. The movie was played in a two-billion-dollar theater, disrupting the environment more than anything I can think of. U2, with Bono as the lead singer, is headlining Sphere, making millions with his shows. Yet, Bono lectures us on climate change. What is the climate impact of all the energy expended to build Sphere? If he hadn’t committed to headlining the theater, would it even have been built?

Don’t tell me to avoid carbon emissions when you play at Sphere. Really, you shouldn’t tell me to avoid carbon emissions if you play a concert anywhere in Las Vegas. I enjoy going to Las Vegas once in a while for a few days. But there is no question that it is wasteful and damaging to the environment. Either Bono doesn’t really believe that climate change is a crisis, or he thinks he is better than us and doesn’t have to follow the same rules. Darren Aronofsky shouldn’t tell me what to do and then do the opposite. 

I have been hypocritical in many things during my career. I have talked about healthy eating and have eaten unhealthy food. I occasionally smoke a cigar after telling people about the harms of tobacco. I try to live the best life I can and present the evidence to my adult son and my patients. If he wants to gamble, I tell him that it is up to him, but most gamblers lose. I tell my patients that drinking alcohol daily has significant health risks, but it is up to them. The same goes for smoking and eating foods that can lead to obesity. 

I know that I have helped some people eat better and lose weight, some with my book, and some in the office. I doubt I would have been as persuasive if I were a hundred pounds overweight with a donut in my hand when I greet my patients. Darren Aronofsky would be more convincing if he refused to work on the Sphere project, and Steven Spielberg would be more convincing if he didn’t fly on a private jet, burning five thousand gallons of fuel per hour. That’s 125,000 miles in my Honda Pilot.

You are what you do

One of my favorite scenes in Total Recall with Arnold Schwarzenegger was with Kuato, the weird creature growing out of some guy’s abdomen. Kuato said to Arnold’s character, “You are what you do. A man is defined by his actions, not his memory.” I was only 21, and I thought that the writer of the movie first wrote that line. Now, I know that many philosophers and writers said it. Aristotle said that you are what you repeatedly do. But that is not what Kuato meant. He meant that what you do now is what defines you.

Carl Jung said, “You are what you do, not what you say you’ll do.” That is my favorite non-movie interpretation of the sentiment. Ryan Holiday, the modern-day philosopher who changed my life, says it many times in many ways, and I learn something every time I read it. But I still prefer what Kuato said.

You are what you do.  You make errors and recover by acting today. Starting now, you can be a good person. You can stuff your face on Thanksgiving and eat healthy the next day. In medical school, when someone said they had quit drinking, we asked when. If they said, “Today,” we scoffed, thinking they were joking. We thought it was funny or that they didn’t mean it. Yet, that is all it takes. Do it today. Start now. Be a good person now.

You are what you do also means that promises don’t mean anything unless they are kept. You can say you care about something, but if you don’t make the effort or pay the price for it, then you don’t care enough. I can say I care about my son, but if I don’t make an effort to be with him and support him, then I don’t care enough. Patients say they care more about their health than anything else, but they don’t quit smoking, drinking, or eating junk food. They won’t pay for a medication or procedure that can help them, but they go on an expensive vacation.

You are what you do. If you visit friends and treat them well, you are a good friend. If you don’t, then you aren’t a good friend. If you exercise, eat well, and avoid alcohol and smoking, then you are a person who cares about your health. Saying you care about your health is nothing. Do something about it. I have been an unhealthy person. For years, I didn’t exercise, and I ate fast food several days a week. That is what I did, not what I do. Now, I eat healthy, I exercise, and I avoid drinking and smoking. I am a healthy person. 

You may not be able to entirely recover from your past unhealthy habits. But you can be healthy now. You may not be forgiven for everything you have done wrong, but you can be a good person now. Ryan Holiday quotes Marcus Aurelius. “Waste no more time arguing what a good man should be. Be one.” 

Words are nothing. You are what you do.