Archive for Februar, 2014

Being Mindful

I’ve attended one session of yoga in my life. A free lession at a fancy hotel in Delhi (a treat after completing the Markha valley trek in Ladakh) a few years ago. I remember finding it good, but couldn’t quite wholeheartedly throw myself into saluting the sun or pretending to be a tree. The session ended with a short meditation exercise – requiring you to make your mind concentrate on various body parts. I thought it a bit odd at the time, but went with it.

This week, I learnt that this was a ‚body scan‘. An exercise which allows you to be fully aware of the physical sensations of the body and in this way to reveal the power of the mind. I learnt this quite unintentionally in 2 articles which I happened to come across this week on a concept called ‚Mindfulness‘ – the title story of Time magazine and my daily newspaper the Guardian. Well if the journalists are talking about it, it must be on trend. Whereas meditation is inevitably linked with Buddhism, Mindfulness represents a secular meditation technique which apparently helps people be more aware of their mind, strengthen it and therefore theoretically be more able to face the trials and anxieties which we invariably face in life.

When you prepare for a marathon, you need to train your core muscles. When you play an instrument, you need to increase the strength and agility of the small muscles of the hand. And when we face stress and hardship, it sort of makes sense that we would need to train our mind.

This is not normally my sort of thing at all. But I know that almost anyone can be pushed to the edge. It’s just a case of where the limit is. An 8-week course in Mindfulness is currently said to be the rage. As much as I am intrigued by this, I couldn’t afford the time for this right now. Headspace is a mobile phone app which promises to teach the basics steps.  Well, I’ll admit that my ‚200 sit-ups‘ app didn’t achieve what it said on the cover, but I am willing to give this one a try.  I’ll report back!

How do you stop the time flying?

As the second month of the year hurtles to a close and Spring nudges around the corner, there seems to be one question: how do you stop time flying? One answer may be to do things which are memorable. Things your mind can hold on to. This is easier on holiday, but it should be something to aspire to all the time.

This week I had some free time and collected many impressions for my mind to hang on to. But was reminded of something else; there are few feelings comparable to that of kicking off a heavy pair of walking boots at the end of a day’s walking and the aching muscles which tend to follow the morning after.

wpid-IMG_20140222_144233.jpgLess then 30 minutes from Munich lies the beautiful lake Starnberg. Isn’t this just the perfect spot to stop and think? A few hours strolling along its shores made us wish we could just keep going.

Another area of quiet can be found even closer to the centre of Munich. Arriving by tram to a neighbourhood in the west of Munich does not prepare you for the beautiful grounds at ‚Schloss Nymphenburg‘, a summer residence for royals.

We marvelled at the romance of the swans greeting us on our arrival  – at their pristine white feathers and wondered if it’s true that they mate for life.


We skipped the tour of the Schloss itself, but were rewarded with a huge garden to ramble through.  Joggers, dog-walkers and happy tourists on a quiet weekday morning.



Day 1 back at work, and I am still benefiting from the fresh air, the rays of sunshine and the many impressive images both from nature those man-made. And the memory that for a few days at least, time didn’t fly.

Freediving: an extreme sport that needs a good pair of lungs

One medical recommendation is applicable to almost every patients with lung disease: physical training. (standing side by side with don’t smoke!) When diagnosed with mild asthma years ago, Herbert Nitsch could be said to have taken the advice a little too seriously. Nowadays, the Austrian former airline pilot calls himself ‚the deepest man in the world‘, after breaking record after record over the last decade in the (rather terrifying) field of freediving.

Freediving is basically diving purely relying in breath-holding, without the use of additional breathing apparatus. Why are you not able to hold your breath very long before panicking and gasping for breath? Because breath-holding leads to a fall in blood oxygen levels as well as a steady rise in carbon dioxide. The fall in oxygen, when severe enough, can eventually lead to a blackout. The rise in carbon dioxide however normally  stimulates the breathing centre and triggers the urge to breathe before this occurs. But as with all sports, it’s a question of training.

In his keynote speech at a respiratory conference on Saturday, Nitsch explained how his average sized pair of lungs, with less than average function (due to his asthma) could be trained in order for him to hold his breath for more than 9 minutes in a static position as well as to eventually dive down to a breathtaking distance of 214m. Videos of deep blue seas, the excited nervousness of his safety team upon descent, encounters with sharks and one near fatal episode of decompression sickness (also known as ‚the bends‘) kept an audience of a couple of 100 chest physicians enthralled.

As well as techniques to increase lung capacity and to control the breathing reflex, divers have to deal with the pressure changes under water. Upon descent, the body is subjected to increasing pressures and the lungs are pretty much squeezed. Changes in the behaviour of gas according to pressure laws leads to an increased tissue absorption of nitrogen. When a diver ascends too quickly, the absorbed nitrogen is released back into the blood in the form of bubbles which can block up blood vessels causing everything from muscle pain and skin itching to damage to the nervous system, breathing failure and death.

The path into the world of extreme sports is fascinating. A world of risk, discipline, mental strength and seemingly insatiable ambition: after Nitsch spent 1 week in a coma, 1 month in a recompression chamber and months at a rehabilitation clinic learning to write again after a severe case of decompression sickness.

How making music can make you ill

Sports medicine is a well established field within medicine, with everyone acknowledging how important isotonic fluids/exercise testing/team doctors are to the success of athletes. There are however another group of high performance individuals who are neglected by the field of medicine: professional musicians. Everyone seems to know that running is bad for your knees, but what about musicians who constantly employ certain muscle groups? Musicians can in fact be afflicted by a whole lot more than just overuse muscle disorders.

Who looks out for all these musicians? Well surprisingly there’s no special training, so doctors with a passion for musical instruments just started to co-ordinate the care of musicians in specialised centres. Wolfgram Goertz for example leads the out-patients department devoted solely to the care of musicians at the University Hospital Düsseldorf. At a recent lecture, he spoke about just some of the ailments faced by musicians.


As someone who struggled to blow out a clear note on the school recorder I can only marvel at brass and woodwind players.  Dizzy Gillespie, the American jazz musician, had a particularly special technique, and his cheeks gives us an idea of the sort of high pressures brass players have to build up when playing. In fact, studies have shown that brass players develop pathologically high pressure spikes in their eyes whilst playing (when this occurs permanently, this condition is known as glaucoma). And for a trumpet player, Dizzy Gillespie had an apt nickname. Dizziness can be a complaint for trumpet players caused by the triggering of an oversensitive vagus nerve (and subsequent drop in heart rate and blood pressure) when the valsava manoeuvre is employed during play.

focal dystonia[1]

In every piece of music, there is normally one passage which is especially tricky. The psychological stress occurring in the approach to one of these tricky passages can be huge. Focal dystonia is a sort of cramp and loss of muscle control when practising fine intricate movement, occurring particularly in pianists and violinists. It can occur in difficult passages, even when the rest of the piece can be played perfectly. It is a phenomenon which is often very sensitive to sensory input, so that a violinist having trouble with a passage with the bow may be able to overcome it by simply putting on a pair of gloves. Focal dystonia affecting the facial muscles of woodwind and brass players may respond to the injection of Botox, which serves to weaken muscle spasm. (And as a bonus will obviously get rid of a few wrinkles here and there).

Most of us have experienced stage fright and recognise it as a normal reaction, which can at times be conducive to a good performance. The pathological big brother of stage fright is known as performance anxiety – which can be a crippling condition for musicians. The best treatment for this is cognitive behavioural therapy. Related tremor may be treated with medication such as ß-blockers, although use of this is often frowned upon within musicians. Saying that, used correctly, its probably advantageous to the illicit consumption of alcohol prior to concerts, as practised by some and may help to stop musicians entering the top lists of professions leading to alcoholism.

Sometimes a love-bite can be an innocent case of ‚fiddler’s neck‘. The pressure of the violin as it rests on the neck can cause irritation, swelling and hyperpigmentation of the skin. In some cases, possibly even an allergic reaction to the chin rest.


Knowing to avoid the spot by the speaker at a pop concert comes intuitively to most of us. It’s not so easy for orchestra members to distance themselves from say, the tuba. A good ear is what every musician relies on, yet every musician is at risk of noise-induced hearing loss. Classically, the loudest members of the orchestra are seated at the back and the ‚quieter‘ instruments near the front, so particularly players situated at the front of the orchestra  (with their ‚quieter‘ instruments) or in its body will be exposed to a high level of noise. Regularly rotating the position of orchestra members, could lessen the level of noise exposure, but remains something which traditionally classical orchestras don’t really do.

Clearing your throat before giving a talk is something familiar to most of us. But the compulsive desire to clear your throat can become a hindrance to singers.  In some cases, the underlying reason for this may be acid reflux from the stomach – the treatment for which may be as simple as prescribing an anti-acid tablet.

‚Saturday night palsy‘ is the term referred to  describe the temporary injury of the ulnar nerve as it crosses the elbow often supposedly caused by draping your arm over the end of a couch and falling asleep in an intoxicated state. A violinist, viola or guitar player holding their instrument may suffer a similar fate due to the constantly slightly flexed position of their left arm which my damage the ulnar nerve along its path. This shows itself as numbness and tingling in the inner side of the arm and the little and ring finger.

These cases highlight just a few of the problems faced by musicians. Much like in sport, many injuries can be avoided by warming up appropriately, practising correctly and being aware of the injuries or ailments associated with a particular instrument. What’s clear is that the care of these individuals requires the attention of a truly multi-disciplinary team. Athletes may be over-the-hill at some stage in adulthood, but musicians, we want you to be sharing your talent with the rest of us for as long as you live.



Sunday walks

The restriction on Sunday trading in Germany means that Sunday really does feel more like a day of rest. There’s something refreshing about wandering through the familiar streets of a city emptied of its shoppers and instead replaced by the much slower-pace of couples, groups of friends and families on a Sunday walk. It makes you take notice of shops and buildings you hadn’t noticed before, brings back pleasant memories of a summer evening spent at pavement cafe X or restaurant Y and somehow clears your head as much as if you were miles away from home.

How to keep your marriage together: go to the cinema

Psychologists always seem to spend their time thinking up ways to answer the really interesting questions in life. According to a piece of research from the University of Rochester published in the Journal of Consulting and Clinical Psychology, there’s an easy way to keep your marriage alive: just go to the cinema regularly.

Watching 5 films a month (preferably a romantic comedy) reduced the divorce rate from 24% to 11% in the first 3 years in the 174 couples studied. Discussing the films seen together was part of the package and in this way was said to provide a sort of couple-therapy in itself.

Going to the cinema is a century old activity and refuses to die despite the fact that we can watch most of the films we want from the comfort of our homes for a fraction of the price. The feel-good factor provided by a cinema trip however remains unbeatable: arguing over which film to watch, discussing whether to buy salted or sweet popcorn or if eating an ice-cream is really a good idea and holding hands like teenagers in the darkened hall whilst escaping to another world for a little while.

The divorce rates in this study are worrysome enough, but the message of the importance of joint activities and communicating with one another is worth taking home. And if this is as simple as a cinema trip. Why not?



A little bit of Rheinland culture


I don’t know which part of my first ever ‚Karnevalssitzung‘ (literally carnival session, a hard-to-describe mixture of pantomime, meets parade, meets variety show) in Cologne last night left the biggest impression. The immediate heartiness and joviality of our fellow carnival revelers, toasting to the evening with the ‚kalte Ente‘ somewhat ceremoniously served up by the waiter (cold duck: a punch made up of white wine, sparkling wine, lemon and sugar), the wonderful brass band accompanying the entire 6-hour-long festivities, the ‚Rote Funken‚ chorus dressed in the garb of the 18th century city soldiers marching to the rhythm of the drum and reminding everyone just how old this tradition is, our hosts and fellow guests at the table patiently explaining everything from the influence of Napoleon’s occupation of Cologne to the name used to refer to the sole women in each of these traditionally male choruses (‚Funkenmariechen‚ or ‚Tanzmariechen‚) to offering to translate everything said in the local dialect, the stand-up comedians bringing the hall repeatedly to laughter (and stretching my German listening comprehension skills to the limit), watching on as grown-men (albeit dressed as clowns/Arabs/gladiators and the like) sang along with pride to ‚Ich ben nur n kölsche Jung‘ (the catchy refrain O-O-O-EYO is likely to stay in my head for a while) and swaying arm-in-arm with the crowd at the end of the night infected by their obvious love for their city. All in all, I’m finally a little bit closer to understanding what this whole carnival business is all about. And I’m pretty sure I ‚m not supposed to be saying this as someone living in Düsseldorf, but ‚Alaaf‘!


2012-09-01 11.40.12

I’ve been living in the same place now for the last 4 and a half years. That’s not far from being the longest period that I’ve ever lived somewhere. That’s long enough to look forward to my next haircut mainly because I’m curious to know how my hairdresser’s trip to an Ayurvedic wellness resort in India turned out. Long enough that even the normally somewhat grumpy ladies who work at the local post-office have been known to show on occasion a smile and even to make a joke with me (well it happened once). Long enough to have struck up a pleasant acquaintance with the owner of my favourite toy shop (‚klein aber fein‘) after buying so many presents there that she pressed a small Christmas present in my hand on my way out of the store in December. Long enough to recognise every face at the butcher shop and the greengrocers. And long enough to enquire tentatively about the wellbeing of the elderly, slightly rheumatic and slowed lady normally in charge of the bakery stall at the Saturday market, as her stand today was unexpectedly usurped by a new bakery firm. And to sigh with relief when a fellow regular customer standing in line assured me that she was fine.

I’m not exactly afraid to move on to a new place. But I know I will miss so many of the familiar faces here around my neighbourhood; the names of most I do not even know, but who all the same make me feel somehow at home.

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