A number of solid studies have found that strong social support improves our prospects for good health and longevity. Conversely, it has been shown that loneliness and lack of social support are linked to an increased risk of heart disease, viral infections, and cancer as well as higher mortality rates. Some research considers friendship to be a "social vaccine" that enhances both our physical and mental health. While the research connecting friendship and health status is impressive the reasons for this connection remain unclear.

FRIENDSHIPS CAN HAVE STRONG CULTURAL DIFFERENCES

Strong cultural differences in how friendships are formed makes them difficult to define...The Germans for example typically have few close friendships, but they tend to last a long time. Loyalty is held in high regard in Germany and friends are expected to help each other whenever possible. Russians also tend to have few close friends, but these relationships can be very intense. In Asia and the Middle East friendships are more reserved, but remain respectful regardless of their attributes or shortcomings.

According to a study in the American Sociological Review close personal friendships are declining in the United States. The study indicates as many as 25% of Americans have no close personal confidants outside their family and the average number of confidants per citizen has dropped from 4 to 2 since 1985. According to the study:

• Americans' dependence on family as a safety net went up from 57% to 80%
• Americans' dependence on a partner or spouse went up from 5% to 9%
• Research has found a link between fewer friendships and psychological well being

The study of friendship has been around since the days of the Ancient Greeks who considered it a topic of "Moral Philosophy"...Aristotle believed that a true friend is another "self" and that friendship opens the door to a belief that the most rational course of action may be to not always pursue one's self interest, which leads to an "enlargement of the self."

"A friend is someone who believes in you, when you have ceased to believe in yourself "

Our research indicates that more social activity generally has a positive impact on health. Belonging to religious and other social organizations can be very powerful ways to improve our sense of well being which leads to longer and happier lives. But we would stop short of equating social activity with intimate and long lasting friendships...one involves more reciprocity than the other which often includes "judgement." Social skills are valuable, but often require behavior that may or may not be natural in order to continue to "belong." Giving of yourself expecting something in return works well for some and not as well for others. True friendships fulfill different needs and tend to occur naturally...they place greater value on honesty, trust, respect, loyalty and a sincere desire to do what's best for the other. Sounds a bit like "love" doesn't it? According to the Bible true friendship is a form of love and when times are tough we need all the love we can get.

During these difficult economic times many people have learned the hard way how many friends they really have and this feeling of lack of acceptance, rejection and isolation is a leading factor in the increased mental illness and suicide being experienced throughout the world today. Of course, having close friends to share our passions and sorrows with leads to greater happiness which increases life expectancy. But studies also show strong friendships reduce stress which is a leading cause of heart disease and many forms of cancer:

A number of theories attempt to explain this link:

• Friends help us cope with our problems
• Friends encourage healthy lifestyles
• Friends help us access services, when needed
• Friends can actually affect physiological and psychological pathways that are protective of health

"Best friends" listen to what you don't say...which makes them hard to come by. If you are lucky enough to have people like that in your life hold them close and don't let go. True friends are hard to find and almost impossible to replace.  Tom LeDuc

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Recently, while searching for a way to comfort a dear friend, I found these words on an old legal pad, but haven't been able to track down the source. They are excerpts from a much longer article, written by a doctor several years ago, who is describing something he called, "the mind forcing its way through a broken brain." I decided to share this with you to honor the memory of my old friend who struggled with these issues at the end of his life and who passed away before I could share it with him...  Tom LeDuc

Saturday morning the sun poured in as I checked the room. The bed was at chest height, made up and empty, with clean, fresh sheets over the vinyl mattress. As I turned to leave, I was blocked by a nurse, an older Irish lady with a doleful look on her face. She had taken care of David last night.

"He woke up, you know, doctor--just after you left--and said goodbye to them all. Like I'm talkin' to you right here. Like a miracle. He talked to them and patted them and smiled for about five minutes. Then he went out again, and he passed in the hour."

Two weeks later I saw Carol in the lobby. It was busy and very public. But before her last "God bless you," I couldn't help asking, "Uh. Carol, did ...?". She knew my question. With a wide, knowing smile, she nodded and said, "Oh, yes, he sure did." And I believed her.

But it wasn't David's brain that woke him up to say goodbye that Friday. His brain had already been destroyed. Tumor metastases don't simply occupy space and press on things, leaving a whole brain. The metastases actually replace tissue. Where that gray stuff grows, the brain is just not there.

What woke my patient that Friday was simply his mind, forcing its way through a broken brain, a father's final act to comfort his family. The mind is a uniquely personal domain of thought, dreams and countless other things, like the will, faith and hope. These fine things are as real as rocks and water but, like the mind, weightless and invisible, maybe even timeless. Material science shies from these things, calling them epiphenomena, programs running on a computer, tunes on a piano. This understanding can't be ignored; not too much seems to get done on earth without a physical brain. But I know this understanding is not complete, either.

I see the mind have its way all the time when physical realities challenge it. In a patient stubbornly working to rehab after surgery, in a child practicing an instrument or struggling to create, a mind or will, clearly separate, hovers under the machinery, forcing it toward a goal. It's wonderful to see, such tangible evidence of that fine thing's power over the mere clumps of particles that, however pretty, will eventually clump differently and vanish.

He describes his frustration that the wonders of medical science can't find the mind this way..."Like our own image in still water, however sharp, when we reach to grasp it, it just dissolves".....

I cannot ignore the internal evidence of my own mind. It would be hypocritical. And worse, it would be cowardly to ignore those occasional appearances of the spirits of others--of minds uncloaked, in naked virtue, like David's goodbye.

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In a March 2010 report entitled, "Reducing Environmental Cancer Risk: What Do We Do," a presidential panel concluded the true burden of environmentally induced cancer has been grossly underestimated. The report's authors wrote in a letter to President Obama, "The panel urges you most strongly to use the power of your office to remove the carcinogens and other toxins from our food, water, and air that needlessly increase health care costs, cripple our Nation's productivity, and devastate American lives."

Speaking of the Environmental Cancer Report...Dr. Jennifer Lowry, a medical toxicologist at Children's Mercy Hospitals and Clinics in Kansas City, Mo., said, " the report finally lends a voice that could be heard that the environment does play an important role in the health of all people of every age."

We believe there are many lifestyle factors that contribute to America's cancer problem, but if there were no environmental factors cancer death rates would be more evenly distributed across the country than they are. We agree with the panel...environmental factors have been poorly investigated in the past and strongly support more rigorous testing in the future. We have prepared a special "Cancer Cluster Map" that suggests where you live can have a strong influence on your likely hood of dying from cancer. It makes no attempt to identify environmental issues, but it does indicate where one might want to take a look. Select any state by clicking on it in the USA Map. Mouse over the counties to see the data and discover the impact cancer has on the people who live there:

The data in the Cancer Cluster Map above is from the CDC years 2002-2006. Multiple years are required to provide a full range of counties and increase accuracy. The current cancer death rate in the USA is 181 per 100,000 population, age adjusted. We believe the new federal environmental report sheds new light on the relationship between lifestyle and cancer. In our opinion cancer death rates in America would be far more evenly distributed throughout the country if lifestyle were the only primary cause. Click on the various States in the Map and see for yourself how dramatic the differences can be and decide for yourself how serious you think the environmental risks are.  Tom LeDuc

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