June 1st, 2013

Tornado Deaths Preventable

Oklahoma Tornado Tragedy

The  senseless deaths from the recent Oklahoma tornado tragedy could have been avoided. This is not to say that the tornado could have been avoided. Our weather and meteorology technology is not that advanced.  But many of the deaths and much of the destruction were senseless and absolutely avoidable. As often happens with lasting solutions to huge problems, this solution is readily available and quite simple.

Oklahoma Tornado – One Proven Solution

Monolithic Domes are the most energy efficient and safest buildings that can be built and that can be designed for many uses. Many schools now conduct their classes in Monolithic Domes. Some are designated as tornado shelters. Others have Monolithic Dome gymnasiums, auditoriums, multipurpose centers, libraries, cafeterias, etc. Because Monolithic’s technology meets FEMA criteria for a structure that can provide near-absolute disaster protection, some schools have received FEMA grants of 75% of their construction costs. These schools will save 60% to 75% of the energy costs as compared to conventional buildings. The energy savings will pay for the building in total in less than 20 years. And in most cases, they save money on first cost for the construction.”

Oklahoma Tornado Tragedy: An Opportunity

My purpose in sharing this information is to gain the attention of individuals who are in a position to influence how such natural disasters are handled in the future.  This recent  Oklahoma tornado tragedy also provides an opportunity for us to protect the lives of other innocent children, adults, and valuable property. Now is the time to address the issues that will determine if others will die during future storms. And there will be future storms. The issues to be addressed include rebuilding plans, private and government funding, insurance company support, and the requirements placed on future construction by governing bodies. Right now – today – is the time to make better decisions than in the past – while the gut-wrenching pain of loss is still agonizing, and the evidence of destruction so very visible for the world to see.

Oklahoma Tornado Tragedy: The Small “Safe Room”

One popular term we hear from TV reporters and local officials is the “safe room.” This refers to an area within or adjacent to a home that is either underground or reinforced to withstand the high winds that often accompany storms such as hurricanes or tornadoes. Having a properly constructed safe room is a definite step in the right direction. But is it enough? There are alternatives to consider as well. Safe rooms are typically designed to provide shelter for an average sized family, and intended to accommodate up to approximately eight to twelve people. They are very limited in what else they contain, and serve no useful purpose when a storm is not present.

Oklahoma Tornado, Safe Schools, & Safe Churches

Consider the following: Instead of, or in addition to individual safe rooms, should our government bodies construct community safe rooms – including safe schools, safe gymnasiums, safe churches, safe sports arenas, and other public safe buildings? Can we do this before the next Oklahoma tornado tragedy can occur, or a similar tornado in Missouri, Kansas, Arkansas, Texas, or other tornado-prone area? Properly designed and constructed, such structures can provide near-absolute protection for hundreds or even thousands of children and adults. And they cost no more to build than with conventional construction.

The Next Oklahoma Tornado Tragedy – When, or If?

Will there be a future Oklahoma tornado? Almost certainly yes. Must there be a future Oklahoma tornado tragedy? Absolutely not.  Knowledge is power. And the know-how is available today to avoid such tragedies in the future.

Oklahoma Tornado Tragedy & The Monolithic Dome Institute

The Monolithic Dome Institute is an information generating branch of the Monolithic Family. It’s mission is to educate average citizens and government bodies about a proven alternative to the death and destruction that our nation has witnessed from the recent Oklahoma tornado tragedy.

Oklahoma Tornado Victims & Families: What Do You Want?

As an example, the Monolithic Dome Institute offers several proven solutions to avoid what occurred to the school that was destroyed in Moore, Oklahoma. To quote from their website:

“What does a community need and want in a school structure? We think the number one answer to that question is Safety. A Monolithic Dome makes a school that can’t be beat for safety. It not only meets but exceeds FEMA’s requirements for a structure that provides near-absolute protection.

Monolithic Domes are successful survivors of tornadoes, hurricanes and earthquakes. They can withstand most man-made disasters and are fire-resistant, termite-proof and rot-proof.

In addition to safety and durability, with a Monolithic Dome school, a community gets an ultra conservative energy-user that can be operated and maintained economically.”

The Monolithic Family Mission

The website of the Monolithic Dome Institute also explains:

“Monolithic is dedicated to improving people’s lives worldwide by introducing and constructing Monolithic Domes, for personal and public use, that are disaster-resistant, energy-efficient and cost-effective.

One paragraph from above bears repeating: “Monolithic Domes are the most energy efficient and safest buildings that can be built and that can be designed for many uses. Many schools now conduct their classes in Monolithic Domes. Some are designated as tornado shelters. Others have Monolithic Dome gymnasiums, auditoriums, multipurpose centers, libraries, cafeterias, etc. Because Monolithic’s technology meets FEMA criteria for a structure that can provide near-absolute disaster protection, some schools have received FEMA grants of 75% of their construction costs. These schools will save 60% to 75% of the energy costs as compared to conventional buildings. The energy savings will pay for the building in total in less than 20 years. And in most cases, they save money on first cost for the construction.”

Monolithic Dome Safety

As regards safety of monolithic dome structures during a tornado, the following is taken from an article by Dr Arnold Wilson, a leading engineer in thin-shell concrete construction:

Building Survivability: The Strength of the Monolithic Dome. The Monolithic™ Dome is the most disaster resistant building that can be built at a reasonable price without going underground or into a mountain.

A wind of 70 miles per hour blowing against a 30 foot tall flat walled building in open flat terrain will exert a pressure of 22 pounds per square foot (see sidebars). If the wind speed is increased to 300 miles per hour the pressure is increased to 404 pounds per square foot (psf). Wind speed of 300 MPH is considered maximum for a tornado. It is far greater than that of a hurricane.

Cars can be parked on 100 psf. The side pressure on the building could equal the weight of cars piled 4 high. No normal building can withstand that much pressure. Many Monolithic Domes are buried up to 30 feet deep. They must withstand pressures up to 1 ton per square foot (2000 psf)].

Against tornado pressure a Monolithic™ Dome 100 feet in diameter, 35 feet tall would still have a safety margin of nearly 1½ times its minimum design strength. In other words, the stress created by the 300 mile per hour wind would increase the compressive pressure in the concrete shell to 1,098 psi. The shell is allowed 2,394 psi using design strengths of 4,000 psi.

The fact is the Monolithic™ Dome is not flat and therefore never could the maximum air pressure against it of 404 pounds per square foot be realized. Neither is the concrete only 4,000 psi. It is always much greater. The margin of safety is probably more like three or four.”

Oklahoma Tornado Tragedy & Tornado Alley

God bless those families who’s children or other loved ones died during the recent tragedy in Oklahoma. Your town and your local, state, and federal officials had not prepared for such a forceful storm. I pray that you will insist that they begin to properly prepare now for the next one. And there will be a next one, either in your community or a similar town or city somewhere in our nation. We know from past experience one area so likely to be hit that it is known as “tornado alley.” If we believe that future tornadoes will occur, and we know that monolithic dome structures survive tornado-force winds without significant damage, when should we start to prepare for the next big one?

Oklahoma Tornado Tragedy – One Viable Solution

Please spread the word. There is at least one viable solution to avoid such needless deaths and extensive property damage in the future. Ask yourself, “Of those children who lost their lives in the recent Oklahoma tornado tragedy, how many would be alive today if the local schools had built monolithic domes as their gymnasiums or libraries? How many others would be alive today if local churches had provided shelter inside their monolithic dome buildings?

These structures must be rebuilt in the near future. Why not learn from our past mistakes before a needless disaster happens again?

To view examples of what other communities have done, visit: Monolithic Dome Schools.

For more information about the benefits of such construction, visit: Monolithic.

God Bless you,

Oklahoma Tornado deaths


May 21st, 2013

Oklahoma Disaster Totally Preventable

Oklahoma Tornado Disaster Was Preventable

Death and destruction from an Oklahoma tornado is absolutely preventable. This current tragedy from the most recent Oklahoma tornado should never have been allowed to happen. As with many issues, information is the key to finding a proper solution. Such information was available prior to the recent Oklahoma tornado, and is still available now. I pray that individuals in a position to use this information will do so to prevent similar disasters in the future.

Oklahoma Disaster News Report

Before discussing the solution, allow me to quote from a current article in the NY Times. The bold print is added to emphasize key points.


“MOORE, Okla. — A giant tornado, a mile wide or more, killed at least 91 people, 20 of them children, as it tore across parts of Oklahoma City and its suburbs Monday afternoon, flattening homes, flinging cars through the air and crushing at least two schools.

Tornado Leaves a Trail of Destruction in Oklahoma
Mapping the Devastation Along the Tornado’s Path in Oklahoma
KFOR-TV, via Associated Press

The injured flooded into hospitals, and the authorities said many people remained trapped, even as rescue workers struggled to make their way through debris-clogged streets to the devastated suburb of Moore, where much of the damage occurred.

Amy Elliott, the spokeswoman for the Oklahoma City medical examiner, said at least 91 people had died, including the children, and officials said that toll was likely to climb. Hospitals reported at least 145 people injured, 70 of them children.

Plaza Towers Elementary School in Moore was reduced to a pile of twisted metal and toppled walls. Rescue workers were able to pull several children from the rubble, but on Monday evening crews were still struggling to cut through fallen beams and clear debris amid reports that dozens of students were trapped. At Briarwood Elementary School in Oklahoma City, on the border with Moore, cars were thrown through the facade and the roof was torn off.

“Numerous neighborhoods were completely leveled,” Sgt. Gary Knight of the Oklahoma City Police Department said by telephone. “Neighborhoods just wiped clean.”

He said debris and damage to roadways, along with heavy traffic, were hindering emergency responders as they raced to the affected areas.

A spokeswoman for the mayor’s office in Moore said emergency workers were struggling to assess the damage.

“Please send us your prayers,” she said.

Brooke Cayot, a spokeswoman for Integris Southwest Medical Center in Oklahoma City, said 58 patients had come in by about 9 p.m. An additional 85 were being treated at Oklahoma University Medical Center in Oklahoma City.

“They’ve been coming in minute by minute,” Ms. Cayot said.

The tornado touched down at 2:56 p.m., 16 minutes after the first warning went out, and traveled for 20 miles, said Keli Pirtle, a spokeswoman for the National Weather Service in Norman, Okla. It was on the ground for 40 minutes, she said. It struck the town of Newcastle and traveled about 10 miles to Moore, a populous suburb of Oklahoma City.

Ms. Pirtle said preliminary data suggested that it was a Category 4 tornado on the Enhanced Fujita scale, which measures tornado strength on a scale of 0 to 5. A definitive assessment will not be available until Tuesday, she said.

Moore was the scene of another huge tornado, in May 1999, in which winds reached record speeds of 302 m.p.h., and experts said severe weather was common in the region this time of year.

But the region has rarely had a tornado as big and as powerful as the one on Monday.

Television on Monday showed destruction spread over a vast area, with blocks upon blocks of homes and businesses destroyed. Residents, some partly clothed and apparently caught by surprise, were shown picking through rubble. Several structures were on fire, and cars had been tossed around, flipped over and stacked on top of each other. Kelcy Trowbridge, her husband and their three young children piled into their neighbor’s cellar just outside of Moore and huddled together for about five minutes, wrapped under a blanket as the tornado screamed above them, debris smashing against the cellar door.

They emerged to find their home flattened and the family car resting upside down a few houses away. Ms. Trowbridge’s husband rushed toward what was left of their home and began sifting through the debris, then stopped, and told her to call the police.

He had found the body of a little girl, about 2 or 3 years old, she said.

“He knew she was already gone,” Ms. Trowbridge said. “When the police got there, he just bawled.”

She said: “My neighborhood is gone. It’s flattened. Demolished. The street is gone. The next block over, it’s in pieces.”

Oklahoma Disaster Should Never Have Occurred

The horror described in the above article should never have occurred. More importantly, a similar disaster should never be allowed to occur in the future.

Oklahoma Disaster Questions

Allow me to answer a few obvious questions. Can such disasters be prevented? Absolutely! Can tornadoes be prevented? Not to my knowledge. Can tornado-prone areas be identified? Yes. Can individuals prepare for future storms so that they and their children will be safe even if another tornado hits their area? Absolutely Yes! And doing so is easier and more practical than one might think.

Oklahoma Disaster In The Future?

Lastly, can communities, towns, school districts, and city or state officials rebuild devastated structures such as schools, gymnasiums, churches, public buildings and more with construction methods that have been proven to provide “near-absolute” disaster protection? The answer to this question is a definite yes!

Oklahoma Disaster Solution

One structure and construction method stands above all others, and literally cries out for notice today. It is the safest structure available, virtually tornado proof, fireproof, cheaper to build, more energy efficient, less expensive to insure. and on and on. It’s called the Monolithic Dome. And, by the way, this is NOT the same as a Geodesic Dome, popularized by Buckminster Fuller many years ago. The monolithic dome is far superior in every way.

Oklahoma Disaster and “Tornado-Proof” Construction

I intend to write additional articles on this subject in the hopes that people will take this information and run with it. I pray that you will share my information with building contractors, city officials, state representatives, mothers and fathers who lost their children in this recent disaster – anyone in a position to save lives of innocent children whose future safety may be in your hands.

Oklahoma Disaster Prevention

In my opinion, every school and public building in tornado prone areas in Oklahoma, Kansas, Texas, parts of Arkansas, and more, should either be of monolithic-dome construction, or contain a sizable monolithic dome structure as part of its overall footprint.

NOTE: I have no financial interest in this cause. This information must be shared with those who may be in a position to make a difference today and in the future. Please share this with anyone who might help.

Oklahoma Disaster and Monolithic Domes – Facts and Figures

To confirm what I have claimed here, and for additional details, visit:

Monolithic Dome

Be sure to also check out Dome Safety.


If you wish to help avoid such useless deaths  from an Oklahoma tornado or any other future storm, please pass along the link to this article to everyone you know.


God Bless you,
oklahoma tornado


May 14th, 2013

Tinnitus And Dental Issues

The following article from Quiet Times was written by my friend and fellow tinnitus expert, Barry Keate. Thank you, Barry. I will reserve comment until near the end of this post.

“Dental Issues and Tinnitus

By Barry Keate

There appears to be a correlation between certain dental procedures and tinnitus. Dental work has the ability to mitigate some types of tinnitus but can also exacerbate and even cause it. Over the years I have heard numerous stories and been asked many questions about the possibility of dental work causing tinnitus. There are several mechanisms by which dental issues can cause or worsen tinnitus. Here is my best effort to untangle some of the mystery of how and why this can happen.

Dental Drills

The high-pitched noise of dental drills is the most prominent way tinnitus can be caused or worsened. When the dentist is drilling in teeth, the sound is transmitted by bone conduction directly into the inner ear. It sounds much louder than it normally would because bone conduction has essentially no loss of intensity over short distances.

Some difficult procedures including tooth extraction and others where drilling is intense and long-term can cause noise damage to the cochlea. Wearing earplugs in this case will not be helpful; it will not prevent the damaging sound from reaching the cochlea. Anesthesia will also not be helpful as the damage will continue even though the patient is unconscious.

Dr. Jack Vernon, of the Tinnitus Center at Oregon Health Sciences University (OHSU), states that the best way to avoid hearing loss and tinnitus is to ask the dentist to drill in short spurts. Drill for five seconds then stop for ten seconds, drill for five seconds and stop for ten seconds, and so on. “The exacerbation of tinnitus by sound is a time-intensity function and by reducing the time of each drilling episode, the degree to which this kind of insult will influence the ears is also reduced.” (1)

Ultrasonic Plaque Removal

Ultrasonic cleaning tools for plaque removal can also be a cause of noise-induced hearing loss and tinnitus. These tools operate at a frequency of 12,000 to 15,000 Hz and emit bursts of high intensity sound that lasts for about ¼ to ½ second. Many people have complained of tinnitus due to these instruments.

Many technicians, if asked, will clean patients’ teeth with non-mechanical scaling implements. I have been having my teeth cleaned this way for many years as the ultrasonic devices were worrisome and also were very uncomfortable for me.

Dentists with Tinnitus

High-speed drills affect dentists much more than their patients. Dentists who work with high-speed drills for year after year in their practice are much more likely than those in other professions to acquire hearing loss and tinnitus. Estimates range from a low of 30% of dentists to a high of 100%.

One study conducted in Italy in 2012 compared hearing loss in general dental practitioners (GDPs) and general medical practitioners (GPs). Results were that 30% of GDPs had hearing impairment compared to 15% of GPs. (2)

On the other hand, Dr. Jack Vernon of OHSU reports that a dentist patient of his surveyed all the dentists in Oregon, Washington, Idaho and Northern California. He found that all who had purchased a high-speed drill, which became available in 1955, had high frequency hearing loss and tinnitus. (3)

“Most of the current high-speed hand pieces, such as high-speed drills and scalers used by dental professionals are between 90 and 100 decibels,” says Robert Folmer, PhD, a study leader on hearing loss and high-speed dental tools. “That’s the equivalent of a gas lawnmower or other power tools, which are loud enough to cause hearing loss over time.” (4)

None of the 54 dental schools nationally are known to require dental students to wear ear protection while treating patients and very few dental professionals wear earplugs.

Abscesses, Impacted Wisdom Teeth and TMJ

It is reported that tooth abscesses or impacted wisdom teeth can cause tinnitus. (5) In such cases further dental work may curethe condition. Other times the tinnitus will gradually fade over time. One way this can occur is by aggravation of existingTempero-Mandibular Joint (TMJ) dysfunction. Infection in the tooth or impacted wisdom teeth can cause inflammation that affects the TM joint.

TMJ dysfunction can be treated by dentists who specialize in the condition. They begin by fitting a mouth guard that aligns the lower jaw with the skull. When needed, more advanced, non-invasive therapies are developed to relax the muscle tissues.

There have been isolated cases of bilateral sensorineural hearing loss and tinnitus that occurs following dental surgery to remove impacted wisdom teeth. (6)

Another way that tinnitus can be caused is by the prolonged neck bending that occurs during dental surgery. This is referred to as somatic tinnitus and happens when bodily signals due to muscle strain can influence normal auditory pathways.


Unconsciously clenching the jaw or grinding the teeth is known as bruxism. This is one of the primary causes of TMJ dysfunction and often leads to tinnitus. It is a habit, which can be broken, not a reflex chewing activity. It can originally be caused by a number of conditions including allergy, trauma or high stress. Once bruxism becomes a habit, the original stimulus can be removed and the bruxism will continue.

Bruxism can also be treated with mouth guards, much like TMJ therapy. Further treatments may involve biofeedback or hypnotherapy to promote relaxation.

Mercury Amalgam Fillings

Dental amalgam fillings are commonly referred to as “silver fillings.”  However, they contain approximately 50% mercury and only about 25% – 35% silver. Mercury is a neurotoxin and leads to numerous neurological problems including hearing loss and tinnitus.

There is a great debate about the safety of mercury amalgam fillings. The American Dental Association insists they are inert and safe. However, many researchers have found undeniable evidence that these fillings outgas mercury vapor and people inhale it, whereby it is absorbed into the body.

The World Health Organization proceedings of 1991 concluded the average person in the industrial world with an average number of amalgam fillings and no occupational exposure to mercury would absorb, on average, 10 micrograms of mercury per day from the fillings, with a high of 17 micrograms per day. For a 170 lb man, the maximum allowable dosage of mercury is 7.5 micrograms per day, Many scientists think even this allowable dosage is much too high.


(1)  From Questions and Answers, Reprinted from Tinnitus Today, June 1998.

(2)  Messano GA, Petti S. General Dental Practitioners and Hearing Impairment, J Dent. 2012 Oct;40(10):821-8.

(3)  From Questions and Answers, Reprinted from Tinnitus Today, June 1999.

(4) Folmer, R. Hearing Loos and High-Speed Dental Drills. http://www.medicalnewstoday.com/releases/49678.php

(5)   Tinnitus: Theory and Management, J.B. Snow, ed. (2004) pp 115-7.

(6)  Wilson RH, Witkowski CE, Wilson AA. Bilateral Idiopathic Sensorineural Hearing Loss Following Dental Surgery. J Am Acad Audiol. 2009 Mar;20(3):180-6.”

— — —

The above information is accurate and extremely important for everyone in order to prevent hearing loss and tinnitus. It is especially important for anyone who already suffers from these conditions. For more information, visit: TINNITUS CONTROL.

God Bless you,


April 13th, 2013

Jonathan Winters: My Serious & Funny Friend

Dr David Fort called yesterday to ask if I had heard about the death of my dear friend, Jonathan Winters. I had not. John Jackson  (JJ) called me moments later to ask the same question.  Both knew how much I cared for Jonathan, and how much our 35 year friendship has meant to my wife Deb and to me.

JJ said,  “Charlie, you have to know that there will be a lot of laughter in heaven tonight. Moses will be there, and Jesus, and the disciples – all holding their sides with laughter. God created this genius that we knew, and shared him with us for a few years. Today it was time for him to go home.”

Dr Fort and JJ both asked if Deb and I would be flying out to California for the funeral services. We will not. For one reason, Deb has some medical issues at the moment that won’t allow her to travel. For another, John would not want me to come. Nor would he have attended my services if I had passed before him. We knew each other this well.

Some 20 years ago, John told me, “Charlie, when I die, I don’t want a headstone on my grave. Instead, I’d like a parking meter installed. And when people come to visit – if anybody ever does – I’d have a sign that instructs them to insert a quarter into the meter. When they do, a recording of my voice will play, and I’ll say something like, ‘Thanks for the quarter. Was that a quarter? It’s really dark down here, so it’s hard to see. And it’s cold, too. You better enjoy that sunshine up there while you can, my friend. It helps the grass grow. By the way, have you ever seen grass from this view? It’s very strange. Okay, in return for your quarter, I have some advice for you. Be sure to laugh at everything you can while you’re up there. Have some fun. There aren’t a lot of folks down here with a sense of humor.  See ya soon.'”

Who else besides Jonathan would have thought of placing a parking meter on his grave? I can’t help but wonder if he ever recorded the messages from beyond that he described. Probably not.

It’s especially fitting that when Dr Fort told me about Jonathan’s death being on the news, I had just ordered shrimp tempura in a Japanese restaurant. I was immediately taken back several years to  when I lived in Santa Barbara California. John often called me with a brief invitation, “Charlie, what say we go get us a little fish for lunch? ” It was sort of a joke that both Jonathan and I always seemed to be on a diet. We loved to eat. And John had decided that we might control our weight better if we ate more seafood. So our excuse to go out for lunch as often as possible was to eat fish. We had our favorite little restaurants on the docks in Santa Barbara. Never pretentious. Friendly mom and pop restaurants with fair prices and fresh food.

Jonathan was not into pretense. Nor status. He enjoyed his fame, but it never went to his head. He loved all people, but he identified most with the working man. His comedy routines illustrated this over the years. And he was brilliant. Probably the quickest mind I have ever observed in action. And it was always in action. Even when he was depressed, his mind was quicker than anyone might expect. And yes, I often shared time with him when he chose to sit motionless and stare at the walls. John suffered from manic-depressive illness, known today as bipolar disorder. And this  condition pulled him into some extremely dark periods. His opposite extremes – manic periods – were fascinating to watch, if sometimes downright scary.

John also had tremendous insight into himself, including his moods and motivation – greater than anyone I ever witnessed in my 40 years of practicing medicine. He even understood his bipolar disorder better than most physicians. This condition was well controlled with medication for years, but he hated taking the medication. Said it made him feel as though he had “lead in my ass.” By contrast, he loved the euphoric feeling of the manic state. He described  this to me as though he was soaring high above whatever was going on, watching as the world and everything in it moved in slow motion. In fact, he sometimes used this perspective to great advantage for his audiences.

He would often stop his bipolar medication about 48 hours before a live performance. On numerous occasions I had the privilege of watching him hold thousands of admirers spellbound at a live concert for 1-1/2 hours or more of nonstop sheer genius. Never with a script. Virtually every routine you ever saw Jonathan Winters do, was created on the spot. His photographic memory enabled him to replicate facial expressions or voice inflections that he had observed many years earlier. With superhuman accuracy, he filed away everything he ever saw or heard, and could recall it whenever it fit with whatever message he chose to deliver.

Some of the most special times for me were following a live performance, when he craved privacy and a feeling of safety while coming down from his high. Unlike so many performers who use drugs to attain an unnatural high, John was the opposite. His innate brilliance  so energized him that he required medication to function in a world where the rest of us were too slow to comprehend.

Before anything else, John was an observer of the human condition. He interpreted with uncanny insight all that he observed. His unique ability as a performer allowed those of us who were blessed to know him – even for a few moments during a TV show or live concert – to better understand ourselves.

On one episode of The Tonight Show, Johnny Carson said, as he literally fell out of his chair laughing and wiping tears from his eyes, “Johnny Winters is unquestionably the funniest man on the planet.”

I could not agree more with Mr. Carson. And I feel certain that Carson would  agree with me that Jonathan Winters was also a serious, brilliant, and highly sensitive man who cared deeply about his family, his country, and his world. He cared about injustices of every kind.  His way of dealing with his super-sensitivity was to point fun at virtually every ethnic group, every religion, organized groups of every kind – in short, at all of us. And he was an equal opportunity comic. He made fun of everybody. The truth is, he observed the strengths and follies within each of us – including himself. Perhaps especially himself. And he loved us all in spite of our universal shortcomings.

Jonathan cared enough to help us take an in depth look at ourselves. And he was so clever as to make us laugh at his characters, often without realizing that we were actually laughing at ourselves. His humor expressed itself on several levels at the same time. There was something funny – a funny face, or sound, or gesture – for the mind of a child to enjoy. He could simultaneously create a situation or character, or paint a scene with words to delight and amuse the average adult.  And he would slyly inject into the same exact moment a comment or message of deep importance to those who saw beyond the surface what he was really about.

John used to say, “Charlie, this ain’t no dress rehearsal. If we don’t get it right the first time, they might make us come back and do it over again.”

All I can say, Mr. Winters, is this: If anybody ever got it right here on earth, my friend, you did. And I thank God for sharing you with me, and with others who’s lives you touched, for the short while that you were here. Out of pure selfishness, I sorta wish you would do it over again down here,  so we could spend more time together.  But I feel confident this will not be necessary.

Thank you, Jonathan for being you. I laughed at you. I’ve laughed with you. We laughed at ourselves and at each other. We even cried together on occasion.

I loved you, my serious and funny friend. And I miss you.



January 10th, 2012

Possible Cause of Tinnitus: Medications

It’s well known that certain medications can cause tinnitus. In most instances, the tinnitus goes away when the offending medication is stopped and clears the system. Occasionally, a medication can cause permanent damage to the hair cells in the inner ear. In such instances, the symptom of tinnitus as well as any accompanying hearing loss may also be permanent.

Aspirin is one of the most common culprits–typically when taken in large doses. Some blood pressure medications often cause tinnitus as well. If you are experiencing tinnitus of recent onset, and are taking any medications, search the medication online to see if it’s known to cause tinnitus. The Physician’s Desk Reference (PDR) is a good source for information.

If you feel that a prescribed medication is responsible for your tinnitus, discuss it with the doctor who prescribed the medication. Do not discontinue a prescribed medication on your own. Ask your doctor about the possibility of discontinuing it or substituting another medication in place of the offending one.

Should your tinnitus persist, good TINNITUS TREATMENT options are available today.

When taken at recommended dosages, the following prescription and over-the-counter drugs have caused tinnitus in a small percentage of patients.

NOTE: Not all medications on this list cause tinnitus in a significant number of people. Only the ones marked with an asterisk–*– appear problematic, producing tinnitus in 3% or more of patients.

These drugs were not specifically tested on people who already had tinnitus. More information about these listed drugs can be found in the Physicians’ Desk Reference (PDR).

Abelcet Injection
Abilify Tablets
Accutane Capsules
Aceon Tablets
Acifex Tablets
*Actonel Tablets
Adalat CC Tablets
Aggrenox Capsules
Agrylin Capsules
Alferon N Injection
Aloxi Injection
Altace Capsules
Ambien Tablets
Amerge Tablets
Amnesteem Capsules
*Anaprox Tabs
*Anaprox DS Tabs
Anzemet Injection
Anzemet Tablets
Aricept Tablets
Aricept ODT Tablets
Arthrotec Tablets
Asacol DR Tablets
Atacand HCT Tablets
Atrovent Nasal Spray
Avelox IV
Avelox Tablets
Axert Tablets

Bayer Arthritis Pain Formula
Bayer Aspirin
Bayer PM Aspirin
BC Powder
BC Allergy Sinus Cold Powder
BC Powder Arthritis Strength
Biaxin XL Filmtab Tablets
Biaxin Granules
Blocadren Tablets
Buprenex Injectable

Campral Tablets
Capastat Sulfate Injection
Carbatrol Capsules
Cardeen IV
Cardizem LA Extended Release Tablets
*Cataflam Tablets
Caudeut Tablets
Celebrex Capsules
Celexa Oral Solution
Celexa Tablets
*CellCept Capsules
*CellCept IV
*CellCept Oral Suspension
*CellCept Tablets
Cipro IV
Cipro Oral Suspension
Cipro Tablets
Cipro XR Tablets
Clinoril Tablets
Colazal Capsules
Copaxone IV
Coreg Tablets
Cosopt Opthalmic Solution
Covera HS Tablets
Cozaar Tablets
Cuprimine Capsules
Cytovene Capsules
Cytovene IV

Dapsone Tablets USP
Daranide Tablets
*Depacon Injection
*Depakene Capsules
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November 5th, 2011

Ringing In The Ears and Tinnitus Retraining Therapy (TRT)

Tinnitus is often referred to as ringing in the ears. When considering tinnitus treatment options, Tinnitus Retraining Therapy (TRT) relieves suffering from tinnitus in approximately 85% of trainees, but it requires 12 to 18 months to become effective. Developed in the 1980s by Dr. Pawel Jastreboff at the University of Maryland, this therapy works through a process called habituation. TRT consists of two closely integrated and equally essential parts:

A) The use of sound therapy, and

B) Counseling by a knowledgeable professional.

To understand tinnitus causes,  tinnitus treatment, and how TRT works, you first need to understand that tinnitus involves not just the ears, but multiple structures within the ears and brain. Ringing in the ears can be secondary to many problems.

Sound is collected by the external and middle ear as vibration, converted to electrochemical energy in the cochlea, and transmitted as nerve impulses along the acoustic nerve to specialized brain cells called auditory centers in the temporal lobes of the brain. Brain cells then interpret these nerve impulses as sound. It’s these interpretations that determine how you hear the sound. Even more significant, these and other centers in your brain determine the relative importance of that sound.

Think about this for a moment. Your conscious mind can pay attention to only a few hundred bits of information (stimuli) at any given instant. There are thousands of bits of information constantly bombarding you, some deemed by your mind to be more important than others. To avoid sensory overload, your conscious mind chooses to ignore stimuli not deemed threatening, stimulating, challenging, exciting, rewarding, essential to your survival or well being, etc. That is, your brain ignores things it considers unimportant, so you remain unaware of them until something changes to make them become important. Some of these bits consist of auditory (hearing) stimuli. Others are kinesthetic (touch,) olfactory (smell,) gustatory (taste,) and visual (sight.) The relative importance of each stimulus changes frequently, so the degree of attention you grant them also changes.

Any new stimulus–such as ringing in the ears–will always be noticed and evaluated by our brains as to whether it presents a threat or warns of danger. Your mind learns to ignore any recurring stimulus that it considers unimportant. This is called habituation. One of the goals of  any tinnitus treatment, including TRT, is to teach your brain to consider any remaining tinnitus, or ringing in the ears,  so unimportant that you will automatically ignore it unless and until you choose to hear it. Pretty neat choice, huh?

A) Sound therapy in TRT consists of presenting a second or new intruding sound (NIS) to your ears, with that sound being far less intense than the tinnitus in your head or ringing in the ears. The NIS typically consists of a constant low level of white or pink noise, a balanced broad spectrum perceived as a gentle hissing. When a NIS is first presented, you notice it because it’s new, and the limbic system in your brain needs to determine if it’s threatening or warning of danger. Because this NIS is constant, innocuous, and fairly faint compared to other environmental sounds, your limbic system quickly determines that it’s not important, so it pushes it into the background. Your conscious mind then switches focus and actively listens for other sounds. In so doing, you ignore the NIS as though it doesn’t exist. This process is slow, but while training your mind to ignore this artificially induced, unimportant NIS, your mind also learns to ignore other unimportant sounds inside your head–your ringing in the ears, or tinnitus. A word of advice: Tinnitus sufferers must avoid silence at all times. Beginning right now, keep some sound around you at all times-something you enjoy such as music, a waterfall, etc. Not loud, just at a “background” volume you find pleasant.

B) Professional counseling is an essential component of TRT as a tinnitus treatment. Studies have shown that sound therapy alone results in far less improvement for tinnitus sufferers than the combination of sound therapy and professional counseling. The primary aim of professional counseling is to remove negative emotions associated with tinnitus, such as anxiety, stress, and fear. Understanding the roles of the auditory system and brain plays an important part in removing fear surrounding tinnitus. 75% of all people with tinnitus automatically habituate the sound and generally ignore it. 85% of those who initially suffer show significant improvement following 12 to 18 months of TRT.

Along with anti-anxiety medications, TRT has become accepted by physicians in mainstream medicine as a valid tinnitus treatment  for patients suffering anxiety from tinnitus. My issues with this therapy are the cost involved and the length of time required for relief.

Cost: TRT trainers typically recommend that a professional sound-generating device similar to a hearing aid be worn 24/7. These devices are quite expensive, often costing upwards of $2000. My personal experience is that patients can enrich their own environments with pleasing sound just as effectively and for far less money. This can be accomplished by playing soft music, white noise, or nature sounds on a CD, through a computer, via special CD-player pillows at night, or through sound generating devices from electronic or specialty stores such as Radio Shack or Brookstone.

Time: Patients typically require 12 to 18 months of TRT before obtaining maximum relief from this form of tinnitus treatment. Exceptions certainly exist, but it seems likely that the majority would spontaneously habituate the noise without costly therapy within this length of time. Any stimulus such as ringing in the ears that’s  repeated day and night for this long will surely be determined to be non-threatening. As soon as this occurs, the conscious mind literally becomes bored with the noise and automatically begins to ignore it.

All emotions, including anger, fear, frustration, and anxiety reside in the subconscious mind. Psychologists often recommend tinnitus treatment with counseling. Counseling–or cognitive-behavioral therapy–involves direct communication between counselor and patient using words and diagrams-an activity of the conscious mind. Attempting to correct a subconscious problem with a conscious solution is like trying to paint a wall with a hammer. Please stop and picture attempting to accomplish this. It can be done, but is terribly inefficient because you are not using the correct tool for the job.

Hypnotherapy and relaxation techniques may relieve some of the anxiety associated with tinnitus, but require a therapist familiar with the causes of tinnitus itself. Very few of these exist. As a treatment for ringing in the ears, the results from hypnosis alone are generally quite  disappointing.

Energy psychology methods such as  Anxiety Relief Techniques® (ART) directly unhook the subconscious fear response from any thought held in the conscious mind. In so doing, anger, fear, frustration, and anxiety associated with tinnitus can be eliminated within hours, rather than weeks or months. These methods utilize the body’s meridian system, and are similar to acupuncture only in this regard. Acupuncture alone is not generally effective for relieving fear and anxiety from tinnitus. ART is consistently effective.

November 3rd, 2011

Tinnitus and Noise Exposure

This article focuses on the relationship of noise exposure and the development of tinnitus–ringing in the ears. The hearing mechanism is very delicate in all animals.

Also called the auditory or audio-vestibular system, this system is generally thought to be composed of three parts. In actuality, there are four.

1. The External ear consists of the auricle, the skin covered cartilaginous appendage that protrudes from the side of the head and collects and funnels sound toward the ear canal. The ear canal then directs sound inward toward the delicate ear drum, or tympanic membrane.

2. The middle ear consists of the tympanic membrane and three tiny bones of hearing-the malleus, incus, and stapes. These bones modulate and transmit sound vibrations from the tympanic membrane to the fluid contained within the inner ear.

3. The inner ear consists of two distinct systems: the snail-shaped cochlea, for receiving sound, and the vestibular apparatus with its three semicircular canals, for regulating equilibrium, or balance. In each system, physical vibrations are converted into electrical impulses. The eighth cranial nerve then transmits these electrical impulses to respective auditory and vestibular centers in the brain.

4. Auditory and vestibular centers in the brain interpret electrical impulses from the eighth cranial nerve as sound or conditions of relative balance or imbalance.

The loudness of sound is expressed as sound pressure, and measured in decibels (dB.) All sound received in the inner ear results in vibrations of delicate cells known a “hair cells.” These cells rest upon a delicate membrane suspended within the inner ear fluid. Sound above known safe levels vibrates the membrane and hair cells so violently that individual cells may be disrupted or damaged beyond repair. Badly damaged cells cannot function to receive and transmit sound to the cranial nerves and brain. They no longer “hear” sound. The function of cells in the auditory centers of the brain is to receive and interpret electrical impulses as sounds. These cells determine whether given impulses represent a bird singing, a piano playing conversation, traffic noise, or other.

In the absence of sound impulses, these cells become extra sensitive to any received stimulus, regardless of its source. In the presence of silence, from whatever cause, they literally strain to interpret sounds of any type. When silence is extreme, they become so sensitive as to pick up stimuli from the normal energy flow of adjacent brain cells, and interpret these sensations as sound. This is thought to be the primary mechanism of the most common type of tinnitus.

Anything that interrupts the normal transmission of external sound vibration from its source to the auditory centers in the brain, results in a “hearing loss.” In turn, any significant hearing loss may result in tinnitus. We typically hear normal speech in the frequencies of 500 to 2000 cycles per second (cps.) Even when hearing seems to be normal for speech, however, tinnitus may occur because of a loss at higher frequencies.

The most common cause for hearing loss in our society is exposure to noise loud enough to damage hair cells in the inner ears. Repeated exposure or our ears to noise levels above 80 to 85 DB often inflicts permanent damage. This is known as acoustic trauma. Such damage generally occurs in the higher frequencies around 4000 cps. Hair cells that receive vibrations in this frequency range appear to be more vulnerable than others. The damage from acoustic trauma is often permanent. Rather than search for tinnitus treatments or tinnitus cures after the damage is done, it’s far more sensible to avoid such damage.

While help is definitely available, there are no miracle cures for tinnitus. In my opinion, the best solution to remove the suffering from the noise of tinnitus is Anxiety Relief Techniques® .

To avoid ringing in the ears from acoustic trauma, prevention is a far better solution. I will detail the average levels of common noise sources in a subsequent article.

November 2nd, 2011

Tinnitus and Tinnitus Treatment

Tinnitus is defined as a phantom auditory perception. This means a noise that someone hears inside his ears or head when that noise does not exist externally. It’s also known as ear ringing, ringing in the ears, and head noises. The word tinnitus is derived from the Latin word ‘tinnire” which means “ringing.” It’s estimated that between 10% and 20% of adults over the age of 50 experience tinnitus. Of these, approximately 25% report that they suffer. Suffering means that the noise in their ears or head interferes with their normal activities, such as sleep, the ability to concentrate, mood changes, the ability to perform their usual activities. The remaining 75% gradually develop a habit of consciously ignoring their noise so that it does not interfere with their lives. This habit state is known as habituation.

Tinnitus treatment has ranged from simple home remedies such as instilling drops of warm oil into the ear canals to radical surgery. Even today, suggested tinnitus treatment often includes specific herbs, vitamins, bioflavonoids, exercise, dietary modifications, meditation, Yoga, sound recordings, making sounds, and electrical-stimulation devices, While exercise and a proper diet are important components of a healthful lifestyle, none of these so-called “treatments” has proven effective to eliminate the noise of tinnitus.

Why do you suppose so many treatments existed for pneumonia or syphilis before the discovery of penicillin? Because none of them worked. When penicillin proved to be so effective, the ineffective treatments disappeared. Most tinnitus treatments today are similar-many claims exist, desperate tinnitus sufferers rush to try them, but they don’t work. One reason is that there are many different causes of tinnitus.

Tinnitus cures are sometimes reported where the noise completely goes away; however the cause of tinnitus in these instances is very significant. For example, aspirin and numerous prescription medications can cause ear ringing. When the offending medications are discontinued, the ringing in the ears typically goes away. Eliminating neuro-toxic substances from food can also eliminate the noise. Substances such as MSG and aspartame are frequent offenders.

It’s extremely important for anyone who experiences only one ringing ear to undergo a thorough examination by an ear specialist. A benign growth on the acoustic nerve inside the skull typically presents with the symptoms of ringing in one ear, hearing loss in that ear, and vertigo. Called an acoustic neuroma, such a growth often requires surgical removal.

Endolymphatic Hydrops is a condition caused by an increased fluid and pressure within the boney compartment of the inner ear. This increased pressure also causes the same three symptoms listed above-tinnitus, hearing loss, and vertigo. This symptom triad was described in 1861 by Dr Prosper Meniere, and is often called Meniere’s Disease. One tinnitus treatment in the past included surgery to relieve the pressure within the inner ear. Doctors today have discovered that many instances of Endolymphatic Hydrops are secondary to food sensitivity-especially to wheat. Corn, dairy, and soy sensitivities have also been implicated.

Our hearing mechanism is designed to receive, process, and transmit sound vibrations to the brain for interpretation. Hearing is one of our five primary senses that inform us of conditions in our immediate environment. In the absence of external sound, our hearing cells become super-sensitive and literally search for sound. When not receiving an external stimulus, these cells may pick up the normal energy flow between adjacent brain cells and interpret this as sound. As evidence of this phenomenon, when placed in a totally silent room for five minutes, 95% of adults with normal hearing report the onset of tinnitus. Tinnitus treatment in this instance simply requires reintroducing normal sounds into each individual’s environment.

Any type of hearing loss can cause ringing in the ears. One common cause of tinnitus follows exposure to loud noises-called acoustic trauma. When the noise is loud enough and the resulting damage to delicate inner ear nerve cells is sufficient, hearing loss and accompanying ear ringing may also be permanent. Prevention is far better than any treatment for this condition. Treatment requires an understanding of what generates the associated suffering that accompanies tinnitus.

The conscious mind is bombarded constantly by many thousands of stimuli from our environment. To avoid sensory overload, it separates those that are considered threatening to survival from those that are non-threatening, or relatively unimportant. Attention is then focused on the more important stimuli, and the others are largely ignored. In regard to the noise of tinnitus, any sound determined to be non-threatening will automatically be ignored by the conscious mind.

Fear is the key point that determines what sounds can be ignored. It is impossible to ignore any stimulus that causes a fear response. Tinnitus-especially near the time of onset–can certainly cause us to feel fear. Thus, an essential component of any effective tinnitus treatment must include the removal of fear from the sound of tinnitus. Regardless of its specific cause, the conscious mind will not be able to habituate the noise of tinnitus until the associated fear is totally removed.

Visit TINNITUS TREATMENT for up to date information about tinnitus treatment.

Dr Charles Smithdeal MD, FACS is a former tinnitus sufferer and tinnitus specialist. He is also a board certified Otolaryngologist (Ear, Nose & Throat specialist,) now retired from the practice of medicine.
Visit my tinnitus resource site at TINNITUS CONTROL CENTER.

October 11th, 2011

Tinnitus Treatment and Fear

Millions of adults worldwide experience tinnitus. Of these, approximately 25% suffer greatly from it. Why? Or just as importantly, how do 75% of the people with tinnitus not suffer from it? How can one person seem to simply ignore the noise inside his or her head, while another finds it nearly impossible to carry on a normal existence?

What do you suppose is a typical reaction when someone develops tinnitus? Let’s say you’re going along nicely, with no big problems in your life, and then, one day—your ears suddenly begin to ring. Perhaps the noise is rather faint at first, and then grows louder Why? What’s going on? When this strange noise persists for a few hours or days, you become really concerned. Oh my God—am I about to go deaf? Do I have high blood pressure? A brain tumor? Am I having a stroke? What’s going on in my head? Why won’t this noise stop?

This is fear, my friend. And it builds upon itself. The more you focus on the noise, and the more frightened you become, the louder and more intrusive the noise becomes.

A visit to your primary care doctor brings no relief.  Without a satisfactory explanation, s/he refers you to an Ear, Nose, and Throat specialist. Once you finally get an appointment, and after a thorough examination and numerous tests, you’re told that there’s no obvious reason for the noise in your head, and no tinnitus treatment. Perhaps you have a slight hearing loss from being around loud noise sometime in the past. Maybe that’s the cause. You were hoping for a tinnitus miracle cure, and you received nothing. Not even a believable explanation for the cause of tinnitus.

This makes no sense. There must be a better explanation. You say that you were exposed to loud noise in your work many years ago. Why did the noise start last week? Surely there is something we can do to stop this noise. “Sorry,” you’re told. “That’s the way it is. You’ll simply have to learn to live with it.”

How do you think you would feel? Frustrated, perhaps? Angry? Afraid? Desperate? You may not realize it, but each of these emotions represents fear. Each response floods your system with adrenalin—the fear hormone. And each manifestation of fear makes your tinnitus impossible to ignore.

Returning to my original question regarding the 75% of individuals with tinnitus who do not suffer from it—these people automatically habituate the noise inside their heads. Habituate means to automatically grow accustomed to and consciously ignore a recurring stimulus. Just as you might ignore the noise of a refrigerator’s motor in your kitchen, or the sound of an overhead fan in your office, your mind will ignore any recurring stimulus that it considers non-threatening and unworthy of your conscious attention..

A stimulus that causes a fear response, however, becomes impossible to ignore. This protective response is hard-wired into the primitive part of your brain—the limbic system. For example, if you were crossing a busy city street, could you ignore the sound of screeching tires advancing rapidly toward you? Obviously not. But what if you crossed at that same intersection every day for several months, and learned that the sound of screeching tires came from a recording at a brake shop on one corner. It’s an advertising promotion for their services. If you were crossing at that same intersection several weeks later, while having a heated conversation with someone, might you be totally unaware of the recorded sound?

Understanding the relationship between fear and the noise of tinnitus provides a firm basis to eliminate the suffering from tinnitus. In my personal experience as a highly respected ear surgeon and former tinnitus sufferer, Anxiety Relief Techniques® is the single most effective method available today to consistently remove the suffering from the noise of tinnitus. Once the suffering is gone, the noise seems to disappear all by itself.

For a complete explanation of tinnitus , tinnitus causes and tinnitus treatment, visit TINNITUS CONTROL CENTER.

The absolute best solution available today to relieve the suffering from tinnitus is available at TINNITUS TREATMENT.

October 6th, 2011

Steve Jobs: Stay Hungry–Stay Foolish


The following  is a prepared text of the Commencement address delivered by Steve Jobs, CEO of Apple Computer and of Pixar Animation Studios, on June 12, 2005.

“I am honored to be with you today at your commencement from one of the finest universities in the world. I never graduated from college. Truth be told, this is the closest I’ve ever gotten to a college graduation. Today I want to tell you three stories from my life. That’s it. No big deal. Just three stories.

The first story is about connecting the dots.

I dropped out of Reed College after the first 6 months, but then stayed around as a drop-in for another 18 months or so before I really quit. So why did I drop out?

It started before I was born. My biological mother was a young, unwed college graduate student, and she decided to put me up for adoption. She felt very strongly that I should be adopted by college graduates, so everything was all set for me to be adopted at birth by a lawyer and his wife. Except that when I popped out they decided at the last minute that they really wanted a girl. So my parents, who were on a waiting list, got a call in the middle of the night asking: “We have an unexpected baby boy; do you want him?” They said: “Of course.” My biological mother later found out that my mother had never graduated from college and that my father had never graduated from high school. She refused to sign the final adoption papers. She only relented a few months later when my parents promised that I would someday go to college.

And 17 years later I did go to college. But I naively chose a college that was almost as expensive as Stanford, and all of my working-class parents’ savings were being spent on my college tuition. After six months, I couldn’t see the value in it. I had no idea what I wanted to do with my life and no idea how college was going to help me figure it out. And here I was spending all of the money my parents had saved their entire life. So I decided to drop out and trust that it would all work out OK. It was pretty scary at the time, but looking back it was one of the best decisions I ever made. The minute I dropped out I could stop taking the required classes that didn’t interest me, and begin dropping in on the ones that looked interesting.

It wasn’t all romantic. I didn’t have a dorm room, so I slept on the floor in friends’ rooms, I returned coke bottles for the 5¢ deposits to buy food with, and I would walk the 7 miles across town every Sunday night to get one good meal a week at the Hare Krishna temple. I loved it. And much of what I stumbled into by following my curiosity and intuition turned out to be priceless later on. Let me give you one example:

Reed College at that time offered perhaps the best calligraphy instruction in the country. Throughout the campus every poster, every label on every drawer, was beautifully hand calligraphed. Because I had dropped out and didn’t have to take the normal classes, I decided to take a calligraphy class to learn how to do this. I learned about serif and san serif typefaces, about varying the amount of space between different letter combinations, about what makes great typography great. It was beautiful, historical, artistically subtle in a way that science can’t capture, and I found it fascinating.

None of this had even a hope of any practical application in my life. But ten years later, when we were designing the first Macintosh computer, it all came back to me. And we designed it all into the Mac. It was the first computer with beautiful typography. If I had never dropped in on that single course in college, the Mac would have never had multiple typefaces or proportionally spaced fonts. And since Windows just copied the Mac, it’s likely that no personal computer would have them. If I had never dropped out, I would have never dropped in on this calligraphy class, and personal computers might not have the wonderful typography that they do. Of course it was impossible to connect the dots looking forward when I was in college. But it was very, very clear looking backwards ten years later.

Again, you can’t connect the dots looking forward; you can only connect them looking backwards. So you have to trust that the dots will somehow connect in your future. You have to trust in something — your gut, destiny, life, karma, whatever. This approach has never let me down, and it has made all the difference in my life.

My second story is about love and loss.

I was lucky — I found what I loved to do early in life. Woz and I started Apple in my parents garage when I was 20. We worked hard, and in 10 years Apple had grown from just the two of us in a garage into a $2 billion company with over 4000 employees. We had just released our finest creation — the Macintosh — a year earlier, and I had just turned 30. And then I got fired. How can you get fired from a company you started? Well, as Apple grew we hired someone who I thought was very talented to run the company with me, and for the first year or so things went well. But then our visions of the future began to diverge and eventually we had a falling out. When we did, our Board of Directors sided with him. So at 30 I was out. And very publicly out. What had been the focus of my entire adult life was gone, and it was devastating.

I really didn’t know what to do for a few months. I felt that I had let the previous generation of entrepreneurs down – that I had dropped the baton as it was being passed to me. I met with David Packard and Bob Noyce and tried to apologize for screwing up so badly. I was a very public failure, and I even thought about running away from the valley. But something slowly began to dawn on me — I still loved what I did. The turn of events at Apple had not changed that one bit. I had been rejected, but I was still in love. And so I decided to start over.

I didn’t see it then, but it turned out that getting fired from Apple was the best thing that could have ever happened to me. The heaviness of being successful was replaced by the lightness of being a beginner again, less sure about everything. It freed me to enter one of the most creative periods of my life.

During the next five years, I started a company named NeXT, another company named Pixar, and fell in love with an amazing woman who would become my wife. Pixar went on to create the worlds first computer animated feature film, Toy Story, and is now the most successful animation studio in the world. In a remarkable turn of events, Apple bought NeXT, I returned to Apple, and the technology we developed at NeXT is at the heart of Apple’s current renaissance. And Laurene and I have a wonderful family together.

I’m pretty sure none of this would have happened if I hadn’t been fired from Apple. It was awful tasting medicine, but I guess the patient needed it. Sometimes life hits you in the head with a brick. Don’t lose faith. I’m convinced that the only thing that kept me going was that I loved what I did. You’ve got to find what you love. And that is as true for your work as it is for your lovers. Your work is going to fill a large part of your life, and the only way to be truly satisfied is to do what you believe is great work. And the only way to do great work is to love what you do. If you haven’t found it yet, keep looking. Don’t settle. As with all matters of the heart, you’ll know when you find it. And, like any great relationship, it just gets better and better as the years roll on. So keep looking until you find it. Don’t settle.

My third story is about death.

When I was 17, I read a quote that went something like: “If you live each day as if it was your last, someday you’ll most certainly be right.” It made an impression on me, and since then, for the past 33 years, I have looked in the mirror every morning and asked myself: “If today were the last day of my life, would I want to do what I am about to do today?” And whenever the answer has been “No” for too many days in a row, I know I need to change something.

Remembering that I’ll be dead soon is the most important tool I’ve ever encountered to help me make the big choices in life. Because almost everything — all external expectations, all pride, all fear of embarrassment or failure – these things just fall away in the face of death, leaving only what is truly important. Remembering that you are going to die is the best way I know to avoid the trap of thinking you have something to lose. You are already naked. There is no reason not to follow your heart.

About a year ago I was diagnosed with cancer. I had a scan at 7:30 in the morning, and it clearly showed a tumor on my pancreas. I didn’t even know what a pancreas was. The doctors told me this was almost certainly a type of cancer that is incurable, and that I should expect to live no longer than three to six months. My doctor advised me to go home and get my affairs in order, which is doctor’s code for prepare to die. It means to try to tell your kids everything you thought you’d have the next 10 years to tell them in just a few months. It means to make sure everything is buttoned up so that it will be as easy as possible for your family. It means to say your goodbyes.

I lived with that diagnosis all day. Later that evening I had a biopsy, where they stuck an endoscope down my throat, through my stomach and into my intestines, put a needle into my pancreas and got a few cells from the tumor. I was sedated, but my wife, who was there, told me that when they viewed the cells under a microscope the doctors started crying because it turned out to be a very rare form of pancreatic cancer that is curable with surgery. I had the surgery and I’m fine now.

This was the closest I’ve been to facing death, and I hope it’s the closest I get for a few more decades. Having lived through it, I can now say this to you with a bit more certainty than when death was a useful but purely intellectual concept:

No one wants to die. Even people who want to go to heaven don’t want to die to get there. And yet death is the destination we all share. No one has ever escaped it. And that is as it should be, because Death is very likely the single best invention of Life. It is Life’s change agent. It clears out the old to make way for the new. Right now the new is you, but someday not too long from now, you will gradually become the old and be cleared away. Sorry to be so dramatic, but it is quite true.

Your time is limited, so don’t waste it living someone else’s life. Don’t be trapped by dogma — which is living with the results of other people’s thinking. Don’t let the noise of others’ opinions drown out your own inner voice. And most important, have the courage to follow your heart and intuition. They somehow already know what you truly want to become. Everything else is secondary.

When I was young, there was an amazing publication called The Whole Earth Catalog, which was one of the bibles of my generation. It was created by a fellow named Stewart Brand not far from here in Menlo Park, and he brought it to life with his poetic touch. This was in the late 1960’s, before personal computers and desktop publishing, so it was all made with typewriters, scissors, and polaroid cameras. It was sort of like Google in paperback form, 35 years before Google came along: it was idealistic, and overflowing with neat tools and great notions.

Stewart and his team put out several issues of The Whole Earth Catalog, and then when it had run its course, they put out a final issue. It was the mid-1970s, and I was your age. On the back cover of their final issue was a photograph of an early morning country road, the kind you might find yourself hitchhiking on if you were so adventurous. Beneath it were the words: “Stay Hungry. Stay Foolish.” It was their farewell message as they signed off. Stay Hungry. Stay Foolish. And I have always wished that for myself. And now, as you graduate to begin anew, I wish that for you.

Stay Hungry. Stay Foolish.

Thank you all very much.”


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