“If ye have the faith as a grain of mustard seed”

This is the second of a series of presentations discussing the remarkable support that modern science provides for the teachings of the New Testament. It is written to stand alone fairly well, but if you have not yet read the first, it would be best it would be best if you did so before proceeding.

To begin, I will review some important conclusions from my first presentation in this series.  First, I demonstrated how sophisticated scientific research methods can be used to test the truth of certain spiritual ideas.  Then, I also showed how the teachings about “The Good News” of the New Testament manuscripts, taken together as a large group of healing insights, have been scientifically verified in their healing power for those who have incorporated these teachings into their lives.  Finally, I explained that while other sacred scriptures and faith traditions also have healing power, I have found the Christian scriptures to be the most comprehensive in their exposition of spiritual healing.  Therefore, for the remainder of my presentations, I will be concentrating on the Christian scriptures as a guide to the exploration of the pertinent scientific research that supports them.

Next, let us look at some of the content of the Gospels where Jesus taught about the power of the human mind.  In many passages, in all four of the Gospels, we are told he travelled around the cities and villages of his land healing every disease he encountered among the people in the area.  We are also told that when he sent his disciples out to do the same, they also were able to heal people’s diseases.

But Jesus did not stop there, he proclaimed this healing power is available for everyone:

               “…He that believeth on me, the works that I do shall he do also; and greater works than these    shall he do…”      (John 14:12)

  

In the next passage, Jesus reaffirms our potential power, and offers some guidance about how we can access it.  The quote follows the description of a man’s son who was suffering from what was most likely a seizure disorder.  Jesus’ disciples had tried to heal the man’s son and failed.  They then asked Jesus why they had failed, and he replied:

               “And Jesus said unto them, because of your unbelief; for verily I say unto you, if ye have faith as great as a grain of mustard seed, ye shall say unto this mountain, remove hence to yonder   place: and it shall remove; and nothing shall be impossible unto you.”    (Matthew 17:14-20)

           

Further, Jesus explains that it is not just the faith of those who would heal others that is important, the faith of those who wish to be healed also plays a major role.  We see this when a blind man called out from the crowd to be healed by Jesus:

               “And Jesus answered and said unto him, what whilt thou that I should do unto thee?  The blind man said unto him, Lord, that I may receive my sight.  And Jesus said unto him, go thy way, thy faith has made thee whole.  And immediately he received his sight.”    (Mark 10:46-52)

           

Note that Jesus did not explain that the healing was due to his own power.  He could have said something like: “Because you asked me, I am going to heal you.”  Instead, he clearly tells us that it was the blind man’s own faith that healed his blindness.

Can our faith in our own healing bring it about, as the Gospels clearly tell us? I will begin my exploration of the scientific literature that bears on this topic by presenting a well-documented and verified case study that demonstrates the power of one man’s mind in changing the course of a deadly illness.     

The story of “Krebiozen”

In 1957, this story about a terminally ill patient (given the pseudonym Mr. Wright) was published in the Journal of Protective Techniques.  Mr. Wright was in the last stage of a rapidly progressive lymphoma.  He had tumor growths as big as an orange on his neck, in his armpits, and on his groin.  He was so weak he was bedridden and gasping for air.  All conventional treatments had failed to control the cancer, and his physician, Phillip West MD, had told him he had only a few weeks to live. 

Of course, Mr. Wright was desperate, and when he heard of a new treatment his hospital was helping to evaluate through an experimental drug trial, he asked to be enrolled.  However, he failed to qualify since he lacked one of the requirements of the study design: he was not expected to live another 3 months.  He was so persistent, though, that he was able to convince Dr. West to obtain some of the treatment drug, called Krebiozen (a compound extracted from the blood of horses), to be injected into him even though he had not been accepted into the trial.

Three days later, the tumors had shrunk to less than one half their previous size, and he was able to walk around the hospital ward without assistance.  He was in such good spirits that he was joking with the hospital staff.  Then, two weeks after he was given his first dose of Krebiozen, he was discharged to home as a “miraculous cure.”

The story does not end here, however.   Two months after this cure, Mr. Wright read news reports that Krebiozen was found to be a complete failure in the formal experimental trials.  He relapsed; the tumors returned.  Dr. West concluded that his remission had been a placebo response, and since his patient was terminally ill again, there was little to lose if he lied to Mr. Wright about the Krebiozen he had been given.  Dr. West told him that he had been mistakenly given a “weak batch” of Krebiozen, and he had obtained a “new, super-refined, double strength version.”  But, in fact, he was injected with distilled water instead of krebiozen.

In response to this second treatment, his tumors once again shrank away to nothing, and Mr. Wright was again discharged to home in good health.  Several months later, though, more news reports about the Krebiozen trials appeared.  It was disclosed that the trials had been an elaborate hoax and the drug’s manufacturers had been indicted for fraud.  Mr. Wright’s tumors returned, and he died within a week.

The “mere placebo”

It would be hard to imagine a more dramatic case report demonstrating what medical scientists call the placebo effect, than the one I just described.  But, despite cases like this that show such potent responses to inactive drugs or treatments, physicians and medical researchers often describe such healing responses as “merely the effect of a placebo.”  Labeling them in this fashion implies that improvements due to the placebo effect are somehow less than real.   This attitude is easily understandable.  We know that the results of any experimental trial can be misleading since research subjects almost always want the results to be successful and researchers themselves usually prefer to show their theories to be correct through the successful outcomes of their experiments.  While using placebos to minimize these potential biases is an effective and important way to control for them, the extensive use placebos, almost exclusively for this purpose, tends to distract us from appreciating their most important action.

To start a deeper exploration of the nature of the placebo effect, let us consider a surgical procedure that was originally developed to relieve the disabling angina of patients with advanced coronary heart disease.  In 1960, an article was published in the American Journal of Cardiology about a surgical procedure to block off arteries in the chest wall of angina patients that was believed to improve the blood flow to their heart.  Subjects were randomized to either undergo arterial ligation or to a placebo sham surgery that did not change any arteries.  At the end of the study, it was shown that patients that had their arteries tied off had dramatic improvement in both their angina and their exercise tolerance, and greatly decreased their use of nitroglycerin for chest pain.  This improvement lasted for months.  But it was the response to the sham surgery that was most notable in this trial.  Instead of providing little or no benefit, it resulted in an improvement that was as dramatic as that of the active experimental surgery.  This was a clear demonstration of the placebo effect: completely ineffective surgery resulted in dramatic improvement in a serious medical condition.

In research studies designed to explore the mechanism of action of placebos, their beneficial effects have been shown to be separate and independent of any physical action due to the drug or treatment being studied.  This has been clearly demonstrated in studies that employed the hidden infusion of pain-relieving medications and then compared their effectiveness to infusions of the same medications whose purpose was clearly explained to the patient as it was being infused.  As expected, the hidden infusions did show active pain-relief actions.  Openly described infusions, though, were considerably more powerful than those that were hidden.  This shows that the active drug and the patient’s beliefs about how the drug should help them have different mechanisms of action, and these add to each other in relieving pain.  Even though there is no actual placebo being administered in this kind of trial, it confirms and the power of the placebo effect itself and clarifies for us that its action is completely a response to an individual’s awareness and belief about how they are being treated.

Similar research designs that utilize intravenous pain-relieving drugs after surgical procedures demonstrate that the information given to patients about their treatment strongly affects how well that treatment works.  For example, in one study, the patients were all given continuous infusions of inactive saline solution to which they could add boluses of pain-relieving narcotics often enough to comfortably control their post-operative pain.  The subjects were then randomly assigned to three different groups, with the only difference being what each group was told about the contents of their continuous intravenous infusions.  The patients in the first group were told nothing about their infusion.  The second group was falsely informed that they may or may not receive extra, continuous pain relief from an extra ingredient in their saline infusion and, as part of the study design, this information would be unavailable to them.   The third group was falsely told that their baseline infusion would always include a powerful pain-relieving medication.  The effects of their beliefs about their continuous infusions were indirectly measured by how much bolus narcotic was needed to control their pain.  Subjects told nothing about their continuous saline infusions needed the most bolus medication to adequately control their pain.  Those told they may or may not be getting continuous medication needed less.  The group of subjects that were deceived by being told that their infusion was a powerful pain reliever needed the least extra bolus medication for comfortable pain control.  These kinds of studies show us that the stronger our beliefs, the stronger the impacts they will have on our bodies and further confirm that our expectations have effects that are independent of the physical actions of pain-relieving medications.

These research studies clearly demonstrate that it is not the placebo that matters, it is our expectations and beliefs concerning the medication, procedure or course of action that provides the treatment benefits.  Once this is clearly understood, it becomes clear that every aspect of a person’s involvement with a health care facility and its staff impacts how effective they will be.  The reputation of the physicians and staff, how respectfully and courteously they are treated by everyone involved in their care, and even the appearance of the facility makes a difference in their treatment outcome.

Other research extends this understanding by demonstrating that the beliefs a study subject holds about the possible benefits of a given treatment results in changes in the structure and metabolic pathways of their body.  Clear examples are research designs that use brain imaging to follow the changes in the human brain in response to either antidepressant drugs or identical looking placebos that have been randomly assigned to be given to depressed subjects.  In these studies, multiple images are done and the changes in the level of the subjects’ depression are compared to any changes in brain function and structure that may occur as the studies progress.  In these studies, quite remarkable associations are found.  If the subject’s depression is not improved by either the active drug or placebo, no changes in structure or function of the brain are observed.  In contrast, when either the active antidepressant or the placebo was found to be effective in relieving the depression, changes in both brain structure and function were found to be associated with this improvement.  What was most remarkable, though, was that the pattern of changes in the brain were different for active drug when compared to the changes found to be due to the placebo!

From these kinds of studies, we see that what research scientists often dismiss as just a nuisance that complicates drug development trials is quite remarkable in its own right: the ideas and beliefs we hold to be true about various drugs and other treatments physically change our body’s structure and function, even when the physical intervention itself has no direct metabolic effect of its own.  The weight of the evidence even suggests that our beliefs and expectations about our medical treatments are often even more potent than the physically active treatments.  For example, comprehensive reviews of research studies involving anti-depressant medications show that about 75% of their action is due to the placebo response and only about 25% is due to the active drug being tested. 

In contrast to the healing power discussed in the studies above, the power of our beliefs can also have negative effects (often called nocebo effects), as conclusively demonstrated by other well-designed research studies.  For example, it has been shown that the expectation of possible side effects of a drug increases the number and intensity of unpleasant or harmful results.  The more you warn about side effects, the more they appear. 

All the research involving placebos, taken together, gives strong scientific support for statements like those in the New Testament when the blind man was told after receiving his sight: “Thy faith has made thee whole.”   Our mind is quite powerful in both its positive and its negative effects on our bodies and our health.   It seems clear to me that what is called faith in this quotation is what I have called beliefs and expectations in my discussion of the placebo effect research.

Next, I will turn to another area of scientific research that further supports this biblical teaching: the unexpected reversal of terminal illness.  I will also introduce it with another well-documented and quite dramatic case history.

Anita Moorjani’s story

For four years, Anita was unsuccessfully treated for Non-Hodgkin’s Lymphoma.  Finally, toward the end, she was admitted to the hospital in a last-ditch attempt to prolong her life.  IV fluids were started, a feeding tube was placed, and her chemotherapy was put on hold due to her severely emaciated condition.  As her condition further deteriorated, and at the point when she lapsed into a coma, she had large tumors all over her body, she had huge open wounds in her skin eroded through by the cancer, and her weight was down to about 85 pounds from muscle wasting.  Then, on the evening of February 2, 2006, her physicians told her family that her major organs had shut down and not only would she never come back out of her coma, she had only a few hours left to live.

Instead of dying during the night, the next morning she opened her eyes and began to tell her family of her experiences while in her coma.  She tells us that the most significant was her contact with what she called the “essence” of her father who had long passed.  She explains that her relationship with her father had always been strained, and she felt judged by him, and she never felt “good enough” in his eyes.  As she tells us, during her coma, her father showed her how he always loved her and told her if she chose to return to her body, it would be completely healed of her cancer.  She goes on to say she felt she had more to learn and more to do in her life, so she agreed, and this was when she awoke from the coma.

Within 4 days, instead of continuously growing as they had for years, her tumors had shrunk dramatically.  Five weeks later, all tests for any residual lymphoma cells were clear, and she was discharged to home.   Once it was clear she was going to survive, plastic surgery was planned to close her huge skin ulcers.  This surgery was never needed, though; they had healed on their own.  She remains cancer-free to this day.

When I was in my medical training learning about the extremely limited expected survival of people with aggressive cancers that were not curable by surgery or chemotherapy, the possibility of a “spontaneous remission” like Anita’s was never even mentioned.  From what I have been hearing in recent continuing medical education classes that discuss these kinds of terminal illnesses, I doubt this has changed in today’s medical training.  A few researchers, though, have begun to collect reports and case histories of people who have survived what should have been a fatal illness, and what they have found is further scientific confirmation that the human mind has a direct, powerful effect on our health.

There is nothing “spontaneous” about the spontaneous remission of predictably fatal illness

Case reports of what has been called the spontaneous remission of terminal illnesses have been appearing in the medical literature for at least two centuries.  In the past, since we were not aware of any way to predict when they would occur, and they also seemed to be exceedingly rare, they have been almost completely ignored.  Several researchers, though, who have searched the medical literature and have gathered these anecdotal case reports have found that they are more common than most people think.  Unfortunately, since the already existing reports in the historical literature have usually lacked much information about the life circumstances of these unusual survivors, finding commonalities had been nearly impossible.  More recently, though, a few medical investigators have searched for and located unlikely survivors whom they could question about their lives prior to the onset of their disease as well as the details associated with the reversal of their illnesses.  In reviewing what they have found, it is quite clear that those who experience a remarkable reversal of a deadly illness often share certain characteristics that set them apart from those who succumb to their illnesses as predicted by their treating physicians.

I have selected several stories to present here from Kelly Turner, Ph.D.’s book: Radical Remission: Surviving Cancer Against All Odds.  As the focus of her PhD thesis, Kelly interviewed over 100 people who unexpectedly outlived a dismal prognosis of terminal cancer.  From the cases Kelly chose to present in her book, I have selected brief excerpts from several stories to share here because they so clearly illustrate important common themes that Kelly and other researchers have found in their in-depth exploration of this phenomenon. 

John’s story.  For over 10 years, John had struggled with a difficult marriage, a stressful divorce, and constant financial troubles.  At age 50, prostate cancer was diagnosed, and he underwent the surgical removal of his prostate.  Five years later, the cancer returned, and he started on radiation and chemotherapy.  After being controlled again for a while, the cancer came back once again, and John rejected the restart of chemotherapy that was recommended by his physician.  Instead, he began diet changes, increased exercise, yoga, acupuncture, and meditation.  He also found a new “lady friend” that he loves to be around.  It is interesting that he used the feedback he received from periodic PSA measurements to decide whether to continue the various alternative self-treatments he tried, or to continue his search for others.  Seven years after he rejected restarting chemotherapy and began his own alternative treatment approach, John’s cancer has been well controlled.

Shin’s story.  Shin grew up in post-war Japan when duty, responsibility, and hard work were expected of everyone.  He started a consulting firm and dedicated virtually all his waking hours to this business, only sleeping about 3 hours per night out of his commitment to his work.  By age 46, he found that he was extremely fatigued and noticed blood in his urine.  Kidney cancer was found, and Shin underwent radiation and chemotherapy.  Despite these treatments, the cancer spread to his lungs and rectum.   All therapy was then stopped, he was enrolled in a hospice program, and he accepted that he would die soon. He tells us that in response to this realization, everything changed for him.  He began to see: “Every sunrise as a gift.”  He quit his consulting work and began to spend time with his wife and children.  When he began to: “Send love to his cancer” in meditation, he noticed that this practice decreased his pain.  He also started playing his cello again, which he had greatly enjoyed as a young man, but which he had stopped because of work demands. Three years after his chemotherapy was stopped, remnants of his tumor can still be seen in his follow-up scans, but he is greatly enjoying his new life and has far outlived the life expectancy associated with such an advanced cancer of this type.

Susan’s story.  Before her cancer was discovered, Susan had felt “stifled” by her job decisions.  She was bored and felt unfulfilled, but her upbringing had taught her to always focus on the needs of others and ignore her own needs and feelings.  When she was diagnosed with metastatic pancreatic cancer, she heard an “inner voice” that said “no way” to surgery, chemotherapy, or radiation.  She began focusing on her own welfare, attended healing retreats, and studied with “energy medicine” healers. She also increased her walking, changed her diet, avoided negative and critical people, and quit the job that bored her.  While using her alternative routines, and despite refusing the treatments her doctors insisted were necessary to prolong her survival for a year or two, five years later she is alive and well and her symptoms are gone.

Saranne’s story.  In 1993, Saranne was 29 years old and dealing with a strained marriage, caring for a blind mother, and an ill grandmother.  Over the next few years, both her mother and grandmother died, and she suffered through a painful divorce.  In 1999, she was diagnosed with a malignant breast tumor that had metastasized to lymph nodes, spots near her aorta, and to her neck and spine.  Before starting palliative chemotherapy, which would be expected to prolong her life for a year or so, she started a “laughter therapy” regimen as recommended in Norman Cousin’s book: Anatomy of an Illness.  Then, on the first day of chemotherapy she threw a “Chemo Comedy Party” for herself and the hospital staff who would be providing her treatment.  She also used spiritual techniques designed to release suppressed anger and other stressful emotions.  As she began to feel some improvement, she reported feeling empowered by her cancer diagnosis rather than victimized.  She also felt that through the illness she had discovered her life’s mission: starting the Comedy Cures Foundation to help others with terminal illnesses.  Then, in 2001, after an 18-month treatment course of a Tibetan Doctor’s herbs, her follow-up scans showed she was completely free of disease.

One of the common threads in these stories is the almost universal presence of chronic, major life stresses that precede the development of terminal illnesses.  For example, one frequently reported type of stress is feeling trapped in a job that is greatly disliked while other employment options are believed to be unavailable or unacceptable in some way.  Another common stress is feeling stuck in what might be called a toxic marriage while divorce or separation are not perceived to be viable options.  A third frequently reported source of chronic stress is the life-long habit of always putting the needs of others before one’s own needs and welfare.  Religious beliefs are also reported by some to be quite stressful, especially if the individual is convinced that his way of life or past actions will eventually be judged as improper and will result in eternal punishment after death.

In addition to finding frequent reports of major life stressors in people with terminal illnesses, researchers have also found that the diagnosis itself is often a catalyst to change that leads the person with a grave prognosis to take action to eliminate the source of their stress.  Sometimes the person who receives such a diagnosis makes changes they would not have otherwise considered since “there is not much time left.”   The change might have been a divorce, quitting a hated job, or some other means of taking back control of the life circumstances and attitudes that have caused them to feel trapped.   Of course, these kinds of life stresses are common, but when you look over the reports of a large number of people who have had terminal illnesses that have completely and unexpectedly resolved, it is remarkable how frequently the resolution of major life stresses is followed by the surprising resolution of what is expected to be a rapidly terminal illness.  It is also remarkable how often people with terminal illnesses report that the changes they made in response to their diagnosis were an enormous relief, and how they became more satisfied and happier as a result.  A few have even gone so far as to say their terminal illness was a gift!  Their quality of life was much better after their diagnosis motivated them to eliminate the main source of stress from their lives and the resolution of the illness itself was felt to just be an added benefit.

Another common pattern is how a diagnosis of a terminal illness can cause some people to assert more control over their lives by refusing to comply with strongly recommended treatments such as chemotherapy and the surgical resection of tumors.  Instead, alternative approaches are embarked upon, much to the consternation of their physicians, family, and close friends.  Typically, the individual with the devastating diagnosis selects several changes and courses of action that they believe will help control or cure their disease.  These might involve strategies like radical diet changes, greatly increased exercise, ingesting herbs or nutritional supplements, a new practice like meditation or yoga, or more frequent prayer.  It is notable that two things are almost always present in situations where traditional therapies are rejected in favor of alternatives.  One is that the individual with the disease usually takes complete control over their effort to find a cure.  The other is the depth of commitment and the strength of their belief in their chosen courses of action.

There is an important message from these studies of “spontaneous remission” that we can apply directly to our lives, should we be faced with the diagnosis of an illness that is likely to be terminal.  Each of us has unique needs that apply only to us and to our life, and there are no specific rules about what course of action is best that applies to everyone.  Instead, what these remarkable survivors are teaching us is that we should listen to our intuition and what our body is telling us about what we need if we are to be healthy and whole.  If recommended treatments have a high likelihood of success, and the risks and costs they entail are reasonable to us, our decision should be simple.  Just follow the recommendations.  If, however, we are not confident in what is recommended, or what was recommended has already failed, or if we are told there are no known effective treatment options, we need to pay careful attention to how we are feeling about our life circumstances.  These stories show that dramatic changes in life circumstances or alternative treatment strategies can sometimes be highly effective, especially if we have a lot of faith in them. 

Another message these stories are providing is almost an extension of the first: how we are feeling in any moment is either creating disease and disability or promoting health.  A positive state of mind is supportive of the body and promotes healing if disease is present.  In contrast, a daily struggle, constantly putting up with unpleasant feelings, and ignoring emotional distress is damaging; the body often eventually reacts with illness.  These things are cumulative.  The longer you remain in distress the more disruptions your body responds with.  In contrast, the longer you remain in a positive state of mind, the more your body will return toward its natural state of well-being and health.

A final message is a suggestion based on the commonalities I observe through these inspiring stories and many others like them.  While disease for some people can be beneficial by creating an impetus to needed change, we do not need to be given a terminal diagnosis to get some of this kind of helpful guidance.  We can imagine ourselves in the situations of these remarkable people who have managed to survive hopeless illnesses.  You might ask yourself: “What might I change about my life if I knew beyond any doubt that I had only one more year to live?”  You might also get useful insight, and maybe even a different answer, by asking: “What if I had only three weeks left?”  In my opinion, these questions, if considered in a serious fashion, can put us more in touch with what truly matters most to us in life, and this can be healing.

In a sort of summary to both this presentation and my first presentation, I will reflect on a conclusion that certain neuroscientists have arrived at about the human brain.  They have said that we use only about 10% of the potential power of our brain.  I think this statement is wrong in one way and right in another.  It is wrong in that it is not actually the brain that has all the potential power.   But they are right in implying that we are on the threshold of accessing enormous power.   As these stories demonstrate, once we understand how to use the power of human conscious intent and expectations more effectively, we will greatly increase our power for healing.  Jesus, in the New Testament Gospels, anticipated these research findings by thousands of years.  What he taught was profoundly healing, and he pointed the way to further enhance this healing power by explaining that it is our faith that is the true key to it all.

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In the next presentation, I will dig deeper into the effects of the chronic life stressors that have been found to be so damaging to our health.  This will be an important understanding that will set the stage for later presentations that will explore what scientific research has shown to be effective for minimizing or eliminating their actions in impairing our well-being and health.  I will subtitle it: “Power against unclean spirits.”

                                              References

A classic research report that shows that a completely ineffective surgical procedure can successfully control angina in cardiac patients

Dimond EG, Kittle CF, et al. Comparison of internal mammary artery ligation and sham operation for angina pectoris.  Am J of Cardiology 1960; 5:483-486

Articles demonstrating both the potency and complexity of the placebo effect:

Finniss DG, Kaptchuk TJ, et al.  Placebo effects: biological, clinical and ethical advances.  Lancet 2010; 375:686-695

Kam-Hansen S, Jakubowski M, et al. Labeling of medication and placebo alters the outcome of episodic migraine attacks.  Sci Transl Med.2014; 6:1-15

Jensen KB, Kaputchuk TJ, et al.  Nonconscious activation of placebo and nocebo responses.  PNAS 2012; 109:15959-15964

Here is a research report that conclusively shows that administering a physically inactive placebo changes the structure and function of the brain when the subjects of the study believe it is an active drug:

Leuchter AF, Cook IA, et al.  Changes in brain function of depressed subjects during treatment with placebo.  Am J Psychiatry 2002; 159:122-129

Here is a book that thoroughly documents the power of human belief in changing the health and functioning of the human body.  It is professionally written and comprehensive:

Dispenza J,  You are the Placebo: Making your Mind Matter.  Hay House, Inc; 2014

If you want an in-depth understanding of the power of the human mind in completely reversing terminal illnesses, you should start with this book:

Turner KA,  Radical Remission: surviving cancer against all odds.  Harper One; 2015

The following articles are by independent investigators who examine the same phenomena researched by Kelly Turner, and who arrive at similar conclusions:

Roud PC,  Psychosocial variables associated with the exceptional survival of patients with    advanced malignant disease.  J Nat Med Assoc  1987; 79:97-102

Peters R,  The connection between spontaneous remission of cancer and mindbody medicine.  Cancer Strategies J  Summer 2013; 1-8

Another professionally written and researched book about extraordinary healings and what they can teach us:

Hirschberg C, Barasch MI,  Remarkable Recovery.  NY,NY: Riverhead Books; 1995