Oenophiles strike back!

According to Google AI, an oenophile (pronounced ee-nuh-file) is a connoisseur or lover of wine, derived from the Greek roots oinos (wine) and philos (loving).  While I am certainly not a wine connoisseur (at least not yet), I am a wine enthusiast and someone with a deep appreciation for wine.  As I have discussed a number of times in previous posts (see "Raitis tammikuu", "The world is changed...", and "The bullwhip effect (again)"), the wine industry has been struggling the past few years, as alcohol consumption in general has dramatically decreased.  As I mentioned most recently in my post, "Eat your ice cream", red wine consumption is no longer considered healthy!  The Office of the U.S. Surgeon General released a new advisory last year declaring that there is no safe level of alcohol consumption.  The advisory called out in particular the risks associated with several types of cancer, especially breast cancer in women and cancers of the digestive tract in both men and women.  The advisory states, "The more alcohol consumed, the greater the risk of cancer. For certain cancers, like breast, mouth, and throat cancers, evidence shows that this risk may start to increase around one or fewer drinks per day."

As I mentioned in the same post ("Eat your ice cream"), part of the problem with all of these observational studies on physical health and wellbeing are that they at times can provide conflicting information.  For example, the so-called French Paradox which was popularized in the 1980's and 1990's was based on the observation that people living in France have comparatively lower rates of coronary heart disease, including deaths, despite a higher intake of dietary cholesterol and saturated fat.  The suggested explanation for the French Paradox was that people living in France also consumed higher amounts of red wine.  The anti-oxidant properties of compounds found in red wine negated the negative effects of the higher intake of cholesterol and saturated fats.  Unfortunately for oenophiles everywhere, the purported benefits of these anti-oxidants are negated by the amount of alcohol consumed when drinking red wine.

I suggested that sooner or later, there would be yet another study that suggested that red wine can indeed provide health benefits.  I was therefore not surprised to see another report come out suggesting that individuals who consume even moderate amounts of red wine live longer!  Of course, the study was first reported in the magazine Wine Spectator, who may be a little biased.  However, the report came from a 2026 study of 340,000 British adults, which found that moderate wine drinkers had a lower risk of early death and heart-related diseases compared to those consuming other alcohols, with benefits most pronounced in red wine drinkers.  The study results were presented at the Annual Scientific Session of the American College of Cardiology in New Orleans in March.  The study investigators noted that people who, on average, drank up to 10 (for women) or 20 (for men) 5-ounce glasses of wine per week were 8% less likely to die of any cause and up to 21% less likely to die from cardiovascular causes during a 13 year follow-up period compared to both non-drinkers or occasional drinkers.  Importantly, people who consumed the same average weekly amounts of other kinds of alcoholic beverages (beer, cider, spirits) were 9% more likely to die of cardiovascular disease and had a slightly higher risk of dying from non-cardiac diseases, such as cancer.

In addition to the antioxidants found in red wine, the study investigators suggested that people who drink wine (i.e., oenophiles like me!) live healthier lifestyles than people who consume other kinds of alcoholic drinks.  As Zhanglin Chen, the study's senior author, suggested, "People who drink wine in light to moderate amounts tend to have healthier overall lifestyles.  For example, they may eat more fruits and vegetables, exercise more or be less likely to smoke, and these habits can also contribute to lower risk."  Another recent study showed that regular exercise may actually offset at least some of the health risks associated with alcohol consumption (the study was recently published in the journal Sports Medicine).  It's tempting to speculate that red wine consumption, especially in moderation, could maximize the benefits of the antioxidants found in red wine, while the regular exercise could minimize the risks of the alcohol.

Ezekiel Emanuel, an American oncologist, bioethicist, and health policy researcher, suggested another possible benefit to wine consumption in his book, Eat Your Ice Cream.  Drinking wine is often a highly social activity, and there are definitely health benefits to spending time with friends and family!  As Dr, Emanuel reported, "It's important to cultivate family, friends, and other social relationships for a long, healthy, and happy life."  I've posted a lot about the so-called "Loneliness Epidemic" several times in the last year (see, in particular, my posts, "The Loneliness Epidemic", "To be of importance to others is to be alive...", and "We all need the human touch...").  There are now a countless number of studies that provide convincing evidence that fostering and maintaining close personal relationships through marriage, family, and friendships is one of the most important drivers of happiness and vitality. 

The Harvard Study of Adult Development provides important evidence on this point.  Robert Waldinger, who has led the study for over two decades, states, "The surprising finding is that our relationships and how happy we are in our relationships has a powerful influence on our health.  Taking  care of your body is important, but tending to your relationships is a form of self-care too. That, I think, is the revelation."  Spending time with others, particularly fellow oenophiles, could therefore be one of the secret ingredients to living a long and happy life!

I suspect that there will be other studies providing conflicting evidence.  For now though, I will stick with Dr. Emanuel's recommendation to have the occasional indulgence of things that may or may not be healthy for me (depending on which study you read), including red wine.  But never alone and always with friends and family, of course!

Roddie's Medal of Honor

I see a lot of stories posted on the Internet that appear interesting at first, but after researching further and doing some fact-checking, turn out to be exaggerated or even false.  Not so with a story I saw late last week.  It's worth repeating here.

Roderick W. Edmonds, known to all as his friends as "Roddie" was a soldier in the U.S. Army during World War II.  He fought at the Battle of the Bulge and was captured in December 1944, and he spent the remainder of the war in a German Prisoner of War (POW) camp, Stalag IX-A.  Master Sergeant Edmonds was the highest ranking American non-commissioned officer at the camp, and he was therefore responsible for 1,275 American POWs.  

On their first day at Stalag IX-A, the German commandant told Master Sergeant Edmonds that the next morning, all the Jewish soldiers should assemble outside their barracks.  He had heard rumors that European Jews were being sent to death camps, and he was determined to protect the Jewish servicemen under his command. Instead of following the Nazi’s orders, Master Sergeant Edmonds issued his own: All 1,275 American POWs would assemble outside the barracks in the morning.

The next day, when the Nazi officer saw that all the soldiers were outside, he angrily demanded that Master Sergeant Edmonds identify the Jews.  Instead, Master Sergeant Edmonds told his men that they would not obey the order. Then he turned to the commander and said, "We are all Jews here."

Furious, the Nazi officer took out his pistol and threatened to shoot him. "They cannot all be Jews!" he said, insisting again that Master Sergeant Edmonds identify the Jewish soldiers.

Even with a gun to his head, Master Sergeant Edmonds did not back down.  "WE ARE ALL JEWS,” he repeated. "If you shoot me, you’ll have to shoot all of us and after the war, you’ll be tried for war crimes."

The Nazi officer backed down, and 200 Jewish-American soldiers were saved.  Stalag IX-A was eventually liberated, and Master Sergeant Edmonds and his fellow POWs returned home to the United States.  He never told anyone about his experiences there.

Master Sergeant Edmonds died in 1985.  Shortly after, his children began to read the diary that he had kept during his time as a POW.  Most of the diary just listed the names and addresses for his fellow POWs.  When his son Chris contacted one of those individuals in order to learn more about his father's time as a POW, he learned what had really happened.  Chris contacted several others who confirmed the story.  

In 2015, Master Sergeant Roderick "Roddie" Edmonds was honored by the Israeli Holocaust Memorial Yad Vashem as Righteous Among the Nations. 26,000 non-Jews who saved Jews during the Holocaust have been so honored, but Master Sergeant Edmonds is the only U.S. serviceman on that list.  And after a decade of advocacy from his family, community, and legislators, Master Sergeant Edmonds’s bravery was recognized with the nation’s highest military decoration, the Congressional Medal of Honor, which President Trump awarded posthumously to Edmonds on March 2, 2026.  His citation ends:

Without regard for his own life Master Sergeant Edmonds gallantly led these prisoners in a relentless pursuit of opposition and resistance, forcing the Germans to abandon the camp leaving the 1,200 American prisoners behind. The full extent of his bravery, unbending will, and courageous leadership would be realized when soldiers from 3d U.S. Army liberated the camp on March 30, 1945. Master Sergeant Edmonds’ conspicuous gallantry and intrepidity at the risk of his life, above and beyond the call of duty, are in keeping with the highest traditions of military service and reflect great credit upon himself, his unit, and the United States Army.

Master Sergeant Edmonds' bravery reminds me of one of my favorite poems, "First They Came" by Martin Niemöller, a German theologian and Lutheran minister (I posted about Niemöller's story in my post, "First They Came").  As I wrote in a post from August, 2017 ("A life of privilege - Part I"), "It doesn't matter whether you are white, black, brown, yellow, or red.  It doesn't matter whether you are gay or straight.  It doesn't matter whether you are male, female, or transgender.  It doesn't matter whether you are Catholic, Jewish, Protestant, Hindu, Buddhist, or Muslim.  It doesn't matter whether you first learned to speak English or another language.  It doesn't matter whether you were born here or whether you moved here later.  We are all Americans.  That is what this country stands for - and we need to stand up.  Or some day there will be no one left to stand up for us."

As Master Sergeant Edmonds said, "We are all Jews here."  

We've lost our third places...

Last October (see my post "Connections"), I mentioned a great online article ("How '6 points of connection' can repair our shared trust") by the social entrepreneur Aaron Hurst, who recently co-founded the U.S. Chamber of Connection.  The U.S. Chamber of Connection is a movement to reverse the decline in connection and trust in society today, something that they call the connection gap.  They have called this connection gap the greatest challenge of our time, stating that "We are divided and disconnected.  It is destroying lives, communities, and our country."  In the article, Hurst talked about how the six points of connection can help restore trust in society.  Notably, Hurst's fourth point of connection is what are known as third places.  

Sociologist Ray Oldenburg first coined the term third place in his 1989 book Great Good Place.  If the first place is your home and the second place is your place of work, then the third place describes the places you go to spend time with friends and family, such as church, cafes, bars, clubs, gyms, parks, etc.  Oldenburg argued that these third places are important not only for a sense of place and belonging, but also for civic engagement and, more generally, democracy.  Oldenburg co-authored the 2023 edition of the book with Karen Christensen.  Christensen makes the argument that third places are the answer to our current epidemic of loneliness, political polarization, and even climate resilience. 

Howard Schultz, founder and former CEO of Starbucks, famously wanted to turn his coffee shops into a third place (see my post "It's not about the coffee...").  He once described his vision, saying, "The idea was to create a chain of coffeehouses that would become America's third place.  At the time, most Americans had two places in their lives - home and work.  But I believed that people needed another place, a place where they could go to relax and enjoy others, or just be by themselves.  I envisioned a place that would be separate from home or work, a place that would mean different things to different people."  

Unfortunately, third spaces are disappearing across the United States.  As recently as 2019, nearly two-thirds of all Americans could name a regular, local third place.  However, that number has dropped to just over half in 2022.  An American Social Capital Survey from 2024 indicated that 63% of adults rarely or never visit a library.  Half rarely or never visit a park.  More than 1 in 5 Americans live in communities with no access to third spaces like parks, libraries, or community centers.  And, as I mentioned in a recent post ("The fox, the hound, and the body..."), a Dutch study on changes in personal relationships strongly suggests that the loss of third places is an important reason why many personal relationships fade with time. 

There are several reasons that can potentially explain the loss of third spaces in society today.  Certainly, suburban sprawl has pushed individuals further away from commercial and social hubs that are often located in the downtown areas of cities.  Americans are also spending more time at home in general, and frequently that time is spent alone.   I've also posted a lot about the role that television (see "Amusing Ourselves to Death"), technology (see "The Walkman Effect", "The Quiet Commute", and "Take a Break...") and social media (see "Familiarity breeds contempt...",  "Liberation", and "The truth about connection") have played with the growing trend to spend time alone.  I think we can easily make the argument that the more time we spend on technology (e.g. smart phone, Internet) or social media, the less time we are connecting with others (friends, family, etc).  

With all of this in mind, Aaron Hurst makes an important point in his article on the six points of connection.  Hurst writes, "Third places matter because they invite spontaneous connection - between generations, across cultures, and beyond our usual social circles.  They're where we bump into each other, strike up conversations, and build trust without needing an invitation."

He goes on to suggest, "The simplest and most powerful action is to show up. Visit your local third places regularly. Stay a little longer. Learn the names of the baristas or librarians. Say yes to the community event. When we consistently support these spaces, we keep them alive — and signal that connection matters."

For those so-called civic deserts, communities that lack third places, Hurst suggests that we should become advocates by "asking for benches, plazas, or gathering spots."  A lot of this is under our direct control, if we work together to spend time together.  Together, we can restore our third places, and as a direct result, improve the quality of our own lives and of those around us.  

Is "burnout" burning out?

I don't know how I missed this, but Dr. Tait Shanafelt and his research team published their most recent nationwide survey of physician burnout in the Mayo Clinic Proceedings this past July ("Changes in burnout and satisfaction with work-life integration in physicians and the general US working population between 2011 and 2023").  I've mentioned the burnout issue a few times in the past (see "Don't ask me to to take resilience training!"), and most studies still suggesting that approximately half of the physicians in the U.S. meet at least one of the three criteria for burnout in the Maslach Burnout Inventory (more on this point below).  Dr. Shanafelt has published extensively in this area, and his team has longitudinally measured the prevalence of burnout at 3-year intervals since 2011.  In addition, they conducted an off-cycle survey (about 15 months after the 2020 survey) to assess the impact of the COVID-19 pandemic on professional burnout.

Importantly, according to the MBI, which is the most commonly used scale to measure burnout today, an individual meets criteria for burnout when he or she meets threshold criteria in each of the three categories - emotional exhaustion, depersonalization, and a sense of a loss of personal accomplishment.  The media has erroneously reported in the past that "nearly half of physicians in the U.S. are burned out."  Unfortunately, this statement is technically not correct, and it would be more accurate to state that "nearly half of the physicians in the U.S. meet at least one criteria for burnout."

Using both online and mailed surveys, Dr. Shanafelt and his team surveyed a diverse and representative sample of U.S. physicians.  The response rate was low (less than 10%, or just over 7,600 physicians), but they were able to measure burnout using two of the three metrics included in the MBI - they substituted a previously used survey of personal accomplishment that was more specific to physicians.  They found that burnout in US physicians peaked during the middle of the COVID-19 pandemic with the 2021 survey.  However, relative to 2021 and 2014 (the previous high water mark), burnout at the end of 2023 had decreased and was similar to levels reported in the 2017 survey.  Overall, 45% of physicians reported at least 1 symptom of burnout, compared to 62.8% in the 2021 survey.  When compared physicians to the general U.S. workforce, physicians remained at higher levels of burnout.

Dr. Shanafelt and his team also reported updated survey results of burnout in U.S. residents and fellows (physicians who have graduated from medical school and are training in a particular specialty).  Those survey results were published in the journal, Academic Medicine (see "Changes in Burnout and Satisfaction With Work-Life Integration Among U.S. Residents and Fellows and the General U.S. Working Population Between 2012 and 2023") in December 2025.  Again, burnout among U.S. trainees was lower in 2023 compared to results found in a survey conducted in 2012. Despite this improvement, trainees remain at higher risk for burnout than workers in other fields.

If these results hold up to further scrutiny and follow-up studies, then that is an encouraging development.  Burnout is a major issue that needs to be addressed, and many health care organizations have invested heavily in programs that have tried to address burnout in the entire health care workforce, not just physicians.  However, two results are important to acknowledge.  First, close to half of all physicians still report at least one symptom of burnout, and that is still too high of a percentage.  Second, burnout continues to be higher amongst physicians compared to the general workforce.  We have to do better.

So, back to my question.  Is "burnout" burning out?  Probably not, but perhaps we have reached (and hopefully passed) the peak - and that is progress.  As Winston Churchill once said, "Now this is not the end. It is not even the beginning of the end. But it is, perhaps, the end of the beginning."

"The only clue to what man can do is what man has done..."

My wife and I recently watched the 2025 film, "Nuremburg", starring Rami Malek, Russell Crowe, and Michael Shannon (among other notable stars).  The film is advertised as a psychological thriller and historical drama that tells the story of U.S. Army psychiatrist Douglas Kelley (played by Rami Malek) who was assigned to investigate the personalities and monitor the mental status of Hermann Göring (played by Russell Crowe) and other high-ranking Nazis in preparation for and during the Nuremberg trials, following the end of World War II.  The film is based on the 2013 book, The Nazi and the Psychiatrist by Jack El-Hai.  Both the film and the book are superb, and I highly recommend them.

The film ends with what I thought was an poignant and powerful quote by the English historian and philosopher, R. G. Collingwood, "The only clue to what man can do is what man has done."  The quote comes from Collingwood's posthumously published book, The Idea of History and makes the point that humans are capable of many things, both good and bad (in this particular story's case, very bad), and if you need to be convinced that this is so, all you have to do is look at history.

I really liked the quote, so after hearing it, I did what I frequently do - I wrote it down and looked it up.  As it turns out, the film's production team took the quote slightly out of context.  Here is the entire quote from Collingwood's book:

"Knowing yourself means knowing first, what it is to be a person; secondly, knowing what it is to be the kind of person you are; and thirdly, knowing what it is to be the person you are and nobody else is.  Knowing yourself means knowing what you can do; and since nobody knows what they can do until they try, the only clue to what man can do is what man has done.  The value of history, then, is that it teaches us what man has done and thus what man is."

Did you notice anything different?  The original quote, with the proper context, sounds much more positive.  Even though the shortened quote fit perfectly with the theme of  "Nuremburg", I'm not the meaning I took from the quote at the end of the movie fit with Collingwood's original meaning and intent.  And that is one of the main problems I have with using shortened quotes without providing any context.  Context matters.  Original meaning matters.  We should be more careful when we use shortened quotes from other sources.

Overall, my message today should not detract from how powerful the movie was in conveying what happened during a very difficult period of history.  It's a great movie that I would highly recommend.

"Be an optimist without being a fool"

I read a great book by Heidi Grant recently called Nine Things Successful People Do Differently.  Dr. Grant also wrote an article for Harvard Business Review with the same title which summarizes the book.  To be honest, the book version is relatively short (it's just 112 pages), so I'd recommend taking a little extra time to read the book instead of the article.  There's a lot to discuss about the book, so I will save most of her "nine things" for a future post.  Today I want to focus on what Dr. Grant and others call "realistic optimism" (see also Dr. Grant's 2011 HBR article, "Be an optimist without being a fool").  

Is it better to be an optimist or a pessimist?  Opinions differ.  Norman Vincent Peale, who wrote a best-seller in 2003 called The Power of Positive Thinking once said, "Shoot for the moon.  Even if you miss, you'll land among the stars."  On the other hand, the 19th century English novelist and poet Thomas Hardy wrote, "Pessimism is, in brief, playing the sure game.  You cannot lose at it; you may gain. It is the only view of life in which you can never be disappointed.  Having reckoned what to do in the worst possible circumstances, when better arise, as they may, life becomes child’s play."

Studies show that most of us tend towards being more optimistic than pessimistic.  In fact, the neuroscientist Tali Sharot wrote an article for Time magazine in 2011 and cited research that 80% of the population tends to think positively about the future, even when confronted with evidence to the contrary.  In an article published in the journal Current Biology, Sharot wrote, "When it comes to predicting what will happen to us tomorrow, next week, or fifty years from now, we overestimate the likelihood of positive events, and underestimate the likelihood of negative events.  For example, we underrate our chances of getting divorced, being in a car accident, or suffering from cancer.  We also expect to live longer than objective measures would warrant, overestimate our success in the job market, and believe that our children will be especially talented."  Our brains seem to be wired for positivity and hope (see Sharot's TED talk from 2012 on "The Optimism Bias")!

So, if our brains are truly wired for optimism, wouldn't it be better to stay consistent with our natural biologic state and stay positive?  The answer is not as straightforward as you may think.  The author Chris Loper suggests that optimism and pessimism lie along a spectrum:  

On the far left of the spectrum is unrealistic pessimism, which describes individuals who always believe that the worst is going to happen.  Loper says that this way of thinking is clearly not healthy.  However, just as unhealthy is unrestrained positive thinking, or unrealistic optimism, which lies at the far right end of the spectrum.  Believing that good things will always happen or things will always turn in your favor no matter what is simply unrealistic too.  When you always expect good things to happen, there's a good chance that you will be disappointed when they don't happen (expectations don't always match with reality).

Realistic pessimism describes individuals who always err on the side of caution.  They have an accurate assessment of reality, but at the same time, they can envision positive outcomes, even if they tend to give negative outcomes more weight.  There are likely situations where it is better to be a realistic pessimist.  For example, how many times have I wrote about the high reliability organization principle of preoccupation with failure?  If you are making a decision that involves a lot of risk, being cautious and thinking about all of the bad things that could happen is probably warranted.  However, realistic pessimists are also afraid to leave their comfort zone, take risks, and try new things.  Personal growth and development often requires just that, and we tend to learn when we make mistakes.

Realistic optimism describes individuals who stay positive about the future, yet realistic about what it will take to achieve their success.  Realistic optimists understand the difference between a belief that they will achieve their goals and succeed and a belief that they will easily achieve their goals and succeed.  They acknowledge that careful planning, choosing the right strategy, attention to detail, hard work and effort, and persistence are all critical to making success happen.  

The psychologist Gabriele Oettingen (see "Expectation, fantasy, and weight loss" published in the journal Cognitive Therapy and Research) asked a group of individuals enrolled in a weight-loss program how likely they felt that they would reach their goal weight.  The individuals who were confident that they would success lost 26 pounds more than the self-doubters ("the power of positive thinking").  Dr. Oettingen also asked the individuals to imagine what the road to success would be like and how much effort it would require.  Those individuals who believed that they would easily achieve their goal weight lost pounds less than those who thought it would be hard work to achieve their goal weight, even though they would succeed in the end.  She has found this same pattern of realistic optimism in studies of students looking for high-paying jobs after college, singles looking to find their romantic soul mate, and even adults recovering from hip replacement surgery.  

Dr. Grant writes, "Believing that the road to success will be rocky leads to greater success because it forces you to take action.  People who are confident that they will succeed, and equally confident that success won't come easily, put in more effort, plan how they'll deal with problems before they arise, and persist longer in the face of difficulty."

I will end this post, as I frequently do, with a quote.  Walt Disney once said, "I always like to look on the optimistic side of life, but I am realistic enough to know that life is a complex matter."  Being realistic AND optimistic is one of Dr. Grant's nine key ingredients to success.

Better football, better health?

The 2026 FIFA World Cup is just over a month away!  The Fédération Internationale de Football Association (FIFA) holds the World Cup, a tournament between men's national football (soccer) teams, every four years.  The reigning champions are Argentina, who won their third title at the 2022 World Cup by defeating France.  This year's tournament will take place from June 11 to July 19, 2026, and it will be jointly hosted by the United States, Mexico, and Canada (the first time that the World Cup has been hosted by three countries).  Forty-eight countries will be playing in the tournament this year, which is also the first time that this many teams have played in the tournament.

Bill Shankley, a former World Cup player for Scotland and manager of the Liverpool Football Club (a team that currently plays in the English Premier League) from 1959-1974 reportedly once said, "Some people think football is a matter of life and death...I can assure them it is much more serious than that."  He may have had more of a point than he originally thought or intended.  Researchers John Appley and Andrew Street published a study in the Journal of Health Services Research & Policy in 2001 which compared the rankings for the international teams of 176 countries against the rankings for the same countries on the World Health Organization health performance index.  According to their data, if a national team does well, the country is also likely to have a good health system.

Importantly, the paper started out as a joke.  Andrew Street told Roger Dobson, writing for the British Medical Journal, "The intention was to sow doubt about supposedly sophisticated attempts by the World Health Organization to measure health system performance.  But there are some serious messages.  The most notable is that data can be misused to prove almost anything you like - such as that countries with better football teams will have better health systems.  Just because the WHO analysis looks sophisticated, it does not mean it is right."

I am reminded of the famous association between a country's per capita chocolate consumption and the number of Nobel Prizes received by its citizens, published a few years ago in the New England Journal of Medicine (see "Chocolate Consumption, Cognitive Function, and Nobel Laureates"), which I mentioned in a previous blog post (see "Michael Jordan, Chocolate, Coffee, and the Nobel Prize"):

There are a couple of important take-home points to emphasize here.  First, data can be massaged to show just about anything, so be careful about making any definitive statements or conclusions from any "big data" analysis.  Second, correlation does not prove causation.  The way to improve a country's overall health is not to strengthen the country's national football team.  

Third and perhaps most important, evaluating a country's overall healthcare system is a lot more nuanced than most people think.  As I have stated a number of times in previous posts (see, in particular, "Measure What Matters"), most commonly cited metrics of a country's healthcare performance have more to do with measuring the overall health of the country's population than with the quality of their healthcare delivery system.