1. Narcissism: the secret sauce of self-delusion
2. Body dysmorphic disorder
3. The summer school lesson educators need
4. A sneak peek of USA 2.0

This seemingly desultory article is not the mishmash it appears to be, but a carefully crafted journey that could take us from where we are, to where we want to be.

Commenting on the beautiful woman syndrome, a reader submitted the following brilliantly incisive comment:

Arrogant Young Woman Looking Down On You (according to the photographer)
A model portraying an arrogant woman—not the person who submitted the comment

“I study disorders like narcissism, and this topic interests me greatly. I am generally considered an attractive woman, but I also have a form of body dysmorphic disorder, so my case is a little different (I've grown up feeling ugly). I am writing to you though because I find it interesting that it's not just the really beautiful women who are narcissistic and arrogant, it's ALL OF THEM.

No really, I'm not kidding. I have some acquaintances who are rather plain, and even they think they are gorgeous or somehow special, and they will write this about themselves in the open, and say that someone else is "jealous" of them because they are so pretty (in their own warped view of themselves I suppose).

I also used to work with clients who were somehow brainwashed by society's "positive affirmations" kind of conditioning, that they are special and beautiful, no matter what they look like or what kind of people they are (personality, character, etc.) I think it's really an American thing. You don't see this sort of behaviour in other societies, but I see it a lot in my American friends (both male and female) who think they are the greatest people ever, even if they are not that beautiful or even nice for that matter.

I also see this in men too, not just women. I know one man who is nearly thirty, has never been on a date, and complains there are "no women." He is a rather handsome young guy, and I truly believe he has beautiful man syndrome (or narcissism). I don't see this going on in other countries though, especially Third World countries. It's an entire generation coming now that's been raised to think they are GREAT, no matter what, and I think this is very dangerous to society as a whole—this epidemic of narcissism.”

REPLY FROM DR. PEZZI: I think you hit the nail on the head in identifying one of the fundamental reasons why the United States is failing. Almost everywhere I look, I see people, politicians, and corporations who think they're great, but aren't.

Possessing an accurate self-image is key to optimizing performance and hence success. Those with an unduly positive assessment of themselves are more apt to rest on their laurels, no matter how imaginary those laurels are. Any person or corporation who truly wishes to get up to speed won't reach overdrive by entering neutral.

I could fill several books listing all of the problems I've experienced with exasperatingly inferior products and services. Even Microsoft and Google—the poster children of success—do things that are boneheaded, not brilliant (the last two links give examples). Worse yet, they are often too obtuse to recognize glaring mistakes that persist year after year, even when they could be corrected in less than a minute by a semi-competent programmer.

Possessing an unduly positive assessment of their appearance is likely one reason why so many Americans are fat. When one thinks he or she is hot or at least OK, why put down the fork? Why not have dessert? Why exercise?

I've seen young girls at the mall wearing clothing obviously intended to proudly display their bellies even though it was rolls of jiggling fat cascading over their jean tops. I once was so fat that I couldn't see my feet when I stood up, but during those years I did my best to conceal my blubber. Thank goodness for doctor smocks! And thank goodness I discovered easy ways to lose weight without willpower, because when it comes to food, I have none. Less than a year later, with plenty of pizza, breadsticks, oh-so-satisfying Big Macs, and never any hunger, I went from being a blimp to looking like this:

(text continues below this image)
washing my car in 1990

Jessica Biel opines that she is too beautiful to work in Hollywood. Worse yet, some women claim they are too pretty to work, period. That means us ugly ducklings should work overtime so they have more time to stare in the mirror.

JC Penney sold a girls' T-shirt garishly emblazoned with “I'm too pretty to do homework so my brother has to do it for me.” The marketing copy rhetorically asked, “Who has time for homework when there's a new Justin Bieber album out? She'll love this tee that's just as cute and sassy as she is.”

I'm too pretty to do homework T-shirt

The message that sent was disgustingly inimical, and so patently offensive it is difficult to believe anyone thought it was a good idea.

In my dating life, I've met a few perfectly normal, down-to-earth women who were genuinely nice, considerate, and cared about others. However, I met many more who thought their appearance or other (often imagined or unduly magnified) attributes earned them the right to sit as I made a meal or cleaned up afterward.

Or to take a lifelong vacation while I worked two jobs: the too pretty to lift a finger attitude.

Or to make fun of others who were less attractive, or had the misfortune of not being born to rich parents.

Or to arrogantly act as if they were royalty with a license from God to treat others as members of an inferior species.

Or to nitpick at minor faults in others while not seeing conspicuous ones in themselves.

You made an excellent point in observing that the beautiful woman syndrome isn't confined to beauties. One of my friends, a psychologist who works in a hospital, told me many stories over the years to illustrate how even Plain Jane women—and their male counterparts—act as if they are so hot or otherwise so special (imagined brilliance, etc.) they deserve special treatment. Some of their ideas are pathologically wacky, such as expressing annoyance when patients cry for help when they're busy talking on a cell phone to their honey.

And this, believe it or not, is a supposedly Top 100 hospital!

Incidentally, that hospital is so busy patting itself on its back that it seems oblivious to its many flaws that should mortify even Bottom 100 hospitals. I was so incensed by some of their many mistakes that I spent months digging into the hospital award business. I concluded that such awards are often just cleverly obfuscated scams indirectly purchased by hospitals to make them look good, and to help their brass justify ever-larger salaries and bonuses for themselves. Saying that hospital is one of the Top 100 Hospitals is like saying that I am one of the Top 100 hunks in the country. I could fill a book with mistakes I know about at that hospital, which are surely just a small fraction of the total ones.

I went into that hospital worried out of my mind because I had signs and symptoms of a neuroendocrine cancer. The last thing I needed was another worry, but that is exactly what that Top 100 hospital gave me. Their phlebotomist either didn't know about germs or didn't care. If he screws up while drawing blood from a doctor, he likely repeats his mistake on others.

Drawing blood is about as basic as it gets. It is a routine procedure so simple that even kids could be easily trained to do it on people like me, with a prominent antecubital vein (I'm no longer a butterball). Hence, if a supposedly Top 100 hospital has an incompetent phlebotomist, what other horrors might patients face there? Plenty. I accompanied a friend who asked that I serve as her patient advocate during a transvaginal ultrasound, and I was horrified by the ultrasound technician's multiple mistakes.

Most medical mistakes are never detected or litigated because attorneys aren't tempted by cases without a potentially large jackpot. However, cases that never get off the ground from a malpractice standpoint can still create plenty of misery for patients, not to mention extra expenses that inflate the cost of healthcare.

The negative effect of positive affirmations

Regarding your comment about people, especially Americans, “who were somehow brainwashed by society's "positive affirmations" kind of conditioning.” I often wonder if we wouldn't do better if we adopted the opposite approach.

Imagine if attractive girls were not incessantly lauded by their fathers and many others for their appearance. When the “you're so pretty” message bounces around inside their heads long enough, the echoes generalize from “you're so pretty” to “you're so great” and “you're so special.” Don't special people deserve special treatment? People who think they're great have no reason to pursue greatness; they're already there. Let the others sweat as they burn the midnight oil in pursuit of greatness. Their attitude is: “I'm too pretty to lift a finger, give a 100% effort, or even be nice. I can be an absolute bitch and get away with it, because I'm so hot.” Or so they think.

With one exception, the most attractive women I dated were not nice people. Some were even gratuitously nasty and filled with venom. Some had genius-level IQs, but only one did anything noteworthy. The less brilliant yet still bright ones frittered away their often amazing potential—doing what, I don't know. Years and even decades passed without them doing anything extraordinary or even enough to earn an honorable mention. They squandered their potential, depriving themselves and society of what they could have accomplished. They seemed satisfied with commonplace achievements when some could have won Nobel Prizes.

The lost potential of the miniscule slice of women in the U.S. I dated can be seen as a microcosm of that country, partially explaining its dwindling greatness. Thinking one is great when one is not is the primary ingredient in not fulfilling one's potential. Thus, narcissism is the secret sauce of self-delusion that curbs success but gives free rein to inflating one's self-image to the point it blocks accurate self-assessment.

Most educators need this summer school lesson

Many educators mistakenly believe they're doing their students a favor by giving unearned praise and grades not commensurate with performance. I'd give those educators a big, fat F, while I'd award an A+ to my sixth-grade teacher, who called me “slow.” Receiving such a rebuke from an authority figure catalyzed a burning desire to prove him wrong. He would have been astonished by what I later did, such as graduating in the top 1% of my class in medical school and inventing many things, at least one of which will change the world.

However, transforming myself from dunce to doctor was no easy task. That intellectual metamorphosis was incentivized by my teacher—and Mom—but remained a pipe dream until I serendipitously stumbled upon ways to significantly boost intelligence, memory, and creativity. Implementing some of those brainpower catalysts was easy, but others took years of hard work. Without them, I likely would have continued my lawn service business or sought a job in one of the Detroit auto manufacturing plants. The latter was my big dream as late as the end of 10th grade, when I still had such difficulty in school that my plan to deal with it was to drop out.

So what did Mom do? Whenever she needed to know something, she would invariably call for my brilliant brother, even if I were next to her and he was upstairs on the opposite end of our farmhouse.

When she yelled for him to come down and help her with something that required intellect, she may as well been screaming at me, “He's very smart. You're not.”

Although I was “slow,” I got the message loud and clear. I knew what she and my sixth-grade teacher thought of me: not much.

Just as people praised for their appearance often conclude they're more than attractive, individuals belittled in one way often generalize the negative assessments. For example, I came to think that I wasn't just stupid, but hideously ugly, too. When I once heard a nurse tell a patient that I had “the most beautiful smile,” I was incredulous, wondering what on Earth made her think that. When various patients said I was “cute,” I knew that a white coat—and what went with it—could make anyone more attractive.

I sometimes felt sorry for people who had to look at me; I had the luxury of averting my gaze when I encountered a mirror or other reflective surface, which I came to hate so much I'd often go out of my way to avoid them. Constant fretting about my appearance didn't begin to dissipate until I dated a blind woman who was beautiful inside and out. Years earlier, my poor self-esteem made me blow chances, such as when a medical school classmate said I was “so good looking.

I disagreed. Years before, ashamed of my appearance, I hid out in our doghouse when relatives came to visit. Our Belgian Shepherd tilted his head, knowing something was wrong. Why didn't my Mom?

Another manifestation of body dysmorphic disorder was when I performed dermabrasion on myself twice to correct acne scars. I couldn't afford to see a doctor, so I did it myself, grabbing sandpaper that sat on a garage shelf for years, collecting dust and undoubtedly germs. Concerned about the latter after I sanded the skin off my face, I saturated a washcloth with rubbing alcohol and quickly plastered it on my raw skin. The pain knocked me to my knees.

Pondering events like that undermined my enthusiasm for conservatism and forced me to sheepishly admit that liberals or progressives may be correct, after all. During my conservative years, I—like many conservatives—would have bristled at the suggestion that government should tell parents how to raise their children. The common response is, “How dare they interfere! I know what is best for my child!”

But do they? Rarely. Their errors of omission and commission add up to a level of ignorance so profound that they usually don't even know they don't know. Metacognition is a fancy word for thinking about thinking, so ignorance about ignorance might be termed metaignorance.

The Dunning–Kruger effect manifests as the metacognitive inability to recognize one's mistakes, which gives unskilled people illusory superiority while the highly skilled underrate their abilities, producing illusory inferiority. Thus the least competent tend to be the most confident. (Since voters are drawn to confident politicians like bees to honey, might this explain why we elect so many incompetent politicians?) Incompetent people overestimate their ability yet fail to recognize genuine ability in others.

“The whole problem with the world is that fools and fanatics are always so certain of themselves, but wiser people so full of doubts.”
Bertrand Russell, British philosopher, logician, mathematician, historian, and social critic

Interestingly, cross-cultural variation in the Dunning–Kruger effect shows that Americans are the most likely to think too much of themselves and too little of others. They need to read Dunning and Kruger's paper (Unskilled and unaware of it: how difficulties in recognizing one's own incompetence lead to inflated self-assessments), but their metacognitive defects blind them to the need.

“Ignorance more frequently begets confidence than does knowledge.”
Charles Darwin

“One of the painful things about our time is that those who feel certainty are stupid, and those with any imagination and understanding are filled with doubt and indecision.”
Bertrand Russell

Research: Brain Activity Levels Affect Self-Perception: 'Rose-Colored Glasses' Correlate With Less Frontal Lobe Use
Excerpt: “The less you use your brain's frontal lobes, the more you see yourself through rose-colored glasses …”

My Mom was hardly alone in making grievous errors. She struggled and did the best she could, but with more guidance, she could have done much better and I would have benefited greatly had the government stepped in and “interfered.” Please!

I could fill a very thick book listing all of the parental mistakes I witnessed as an ER doctor. One might be tempted to dismiss my observations by saying the ER patient population is skewed towards less educated people. Yes, but most everyone ends up there eventually. I've seen fabulously wealthy and famous people do things that were fabulously stupid. Many mothers living in a ghetto would not have done what one of my rich neighbors did: place raw chicken on a platter and return it to the same platter after grilling without first washing or even rinsing the platter! Before I saw that, I was mystified by why their seven children frequently had abdominal pain; now I knew.

Although my zeal for conservatism was waning when I participated in Facebook, most of my online friends were smart, educated and often successful conservatives who dearly loved their children yet did things that made, or will make, their kids very miserable. When I see over 99% of such parents striking out in countless ways (more often errors of omission than commission), I shudder when politicians now vying for votes get thunderous applause by suggesting that government should get out of our lives. If they won't meddle, then who will? Most parents take less kindly to being told they could do something better than they would if they were punched in the nose. Gentle suggestions floated their way often elicit a defensive wall that prevents them from seeing and hearing. Even the super-involved parents determined to get their kids into Ivy League schools miss 1001 ways to optimize intelligence and health, which is integrally related to brainpower.

Ever see what meningitis does? An old Dateline program showed many college students who were either killed or horribly disfigured from Neisseria meningitidis, the bacterium that causes meningococcal meningitis. According to the CDC and The National Meningitis Association, there are approximately 3000 cases of meningococcal meningitis every year in the United States. About 15% are fatal, and 15% of the survivors end up with brain damage, organ damage, multiple amputations, or other atrocious permanent effects.

I discussed meningococcal disease in another article in which I mentioned how a local college student died from meningococcemia. Her death was preventable. If you see her Facebook page, and if you know what everyone should know about that disease, you will identify one of her behavioral characteristics that heightened her risk of meningococcal and other infectious diseases. Unfortunately, almost no one pays attention to this. Instead, people who saw her pictures just marveled at her beauty. Another college student, Aimee Copeland, lost parts of her body due to a flesh-eating bacterial infection. Scientists know that various factors, such as nutrition, can significantly improve resistance to infection and its horrific effects, but most Americans are too busy frittering their lives away on things that don't make a difference to learn about things that do make a difference.

Blowing another chance in St. Johns, MI

When my family passed through St. Johns, Michigan in 1977, we stopped in a McDonald's restaurant. Standing in front of me in line was a woman whose appearance ideally matched my teenage love map: slim, nice legs, pretty face, and brown or blondish hair. She was perhaps 16, accompanied by a girl I judged too young to be a friend, probably a sister. They were alone, so I assumed they lived locally.

In my family, the older one who electrified me became known as Miss St. Johns, not because we knew she entered or won a beauty contest, but as a reflection of how enamored I was with her, and as a tacit reminder of yet another lost opportunity.

We ate outside at a table adjacent to hers, and my brothers and I made no effort to conceal the conversation that began as we waited to place our order. My older brother said something commenting on how smitten I was, and my younger brother rejected my offer of $1000 (money I'd saved for college) to ask her if she would go on a date with me; I simply didn't have the courage to do it myself. I could hear most of the adjacent conversational stream, part of which was that she agreed to say yes if “he” asked her out, but—not hearing all of that conversation—I feared “he” might refer to some other man. Wouldn't it be terrible if Mr. Ugly—later to become Dr. Ugly—asked out Miss St. Johns?

Thus we finished our burgers and went on our separate ways, with me heading off to college and medical school, and her undoubtedly into the arms of a man with a better self-image.

In 1977, I didn't know about body dysmorphic disorder or what causes it, such as neglect that is considered to be a contributing factor. I never felt neglected as a child, but kids view the world through a prism in which normal is defined by what happens in their families.

What happened in mine was that my parents divorced when I was young, forcing my Mom to work multiple jobs. She usually couldn't afford to hire a babysitter, so I did my own thing, such as traveling on my bicycle, equipped with training wheels, to a distant city, at the ripe old age of … what was I? About 5. I don't think she ever knew of that trip until I mentioned it to her shortly before she died. During junior high school, I scraped all the exterior paint off our house and then painted it, going up 2½ stories on a rickety wooden extension ladder with a bucket in one hand and a brush in the other, using my knees to hold on.

Lack of money for medical care forced my older brother and me to sometimes endure conditions that caused agonizing pain for days on end until we got better on our own, just as they did in my Mom's family when she grew up during the Great Depression—except for two brothers who committed suicide. After being taught that medical care is for rich folks, it never occurred to me at age 11 to call for help one day when my brother smacked into a tree while sledding. He couldn't walk or talk, just moan, so I pulled him home on the sled, ascending hills that seemed impossible obstacles for a kid my age. Milk does a body good, but so does adrenaline.

Before I became a doctor, my Mom sometimes fed us food she found on the side of the road. Other times I had only half a jar of peanut butter and some apples to live on for two weeks. I numbed the residual hunger with free sugar packets, wistfully thinking of Christmas, when my Mom always made enough cookies for a small town. Too much sugar and insufficient nutrition led to a vitamin A deficiency and even scurvy, a disease now rare but once common in sailors “aboard ships at sea longer than perishable fruits and vegetables could be stored.

In my mind, rich people were ones who could eat at McDonald's whenever they wished. Most of the McDonald's products I saw were just wrappers on the floor of the family car: telltale evidence I interpreted to mean that kids usually didn't deserve such treats. Determined to break this cycle, I later bought a snowmobile for neighborhood kids to use and gave them many pizzas, other restaurant food, cookies and breads I baked, and even a multicolored “Get Well Soon!” Jell-O® dessert I cast in a custom mold I made for a child recuperating from surgery.

One of my motivations for becoming a doctor was so I could finally afford to quench my appetite by going to McDonald's and eating until I was full, instead of broke. I was given free food during my residency after graduating from medical school, during which time I unleashed pent-up desires to eat … and eat. My gorging on something I once was deprived of reminded me of a friend's father who always kept his home at 85° F because he endured years of numbing cold as a POW.

Connecting the dots

These seemingly rambling, disconnected stories have a valuable take-home message hidden in their common denominator: how a life filled with put-downs, hardship, and even neglect can inspire a burning desire to succeed and not repeat mistakes of the prior generation. For me, becoming a doctor wasn't enough; what I want to achieve will make becoming a doctor seem like a walk in the park. Although I enjoy what I'm doing as I labor seven days per week creating something bound to be The Next Big Thing that will be as difficult to sell as dates with a friendly beauty queen, the desire to prove my Mom and sixth-grade teacher wrong may also explain while I'm still in overdrive while others my age are coasting or running out of octane. My poor self-image was rough on me but a blessing for the world because I've done more than my share in adding to it instead of parasitically sponging off others.

spot a typo?
If so, please tell me about it.

Here's just one illustration of the difference I made: Years ago, a very pretty nurse repeatedly called me for a date, but I repeatedly turned her down so I could devote more time to improving the success rate of cardiopulmonary resuscitations (“codes”). In baseball terms, the average ER doc batted less than .050 (striking out over 95% of the time), while I batted 1.000 (never striking out) for “hitting streaks” (so to speak) that lasted up to 1½ years in a row even while sometimes handling up to three codes at the same time. The difference in our success rates makes it inevitable that I helped people live who would have died had they been treated by average (or worse) ER docs. Some of the lives I saved were young people: infants, children, teenagers, and adults young enough to have children of their own. Thus, in saving one life, I gave all of their potential descendants a chance to live. That could be thousands of people.

So was it worth it to skip the dates with Miss Hot Nurse? I think so. I later dated her after I figured out the secret to success in coding patients, and she turned out to be just another dysfunctional person who needed a psychologist more than a boyfriend. Perhaps she would gotten the help she so desperately needed had she not drawn men like a magnet, with always a new guy to replace the one who just left after seeing the depth of her beauty.

Although my initial refusals to date her were primarily motivated by a desire to save more patients, I was also desperately searching for a reason to feel good about myself; having an MD after my name wasn't enough. I still felt unworthy.

not the local pharmacist
This model is gorgeous, but the local pharmacist is even hotter

My brother told me that a local pharmacist asked him if I were single and other questions expressing a personal interest in me. Most men would jump at the chance to proceed after being given this green light, but I did nothing because I concluded she was too beautiful for me. To “deserve” someone that hot, I needed to do something great; being a doctor wasn't nearly enough.

The desire to overcome feelings of inadequacy compelled me to say “yes” to work and “no” to friends or relatives on numerous occasions. I have some wonderful brothers and cousins who I love and would love to spend time with, but I kept postponing my good intentions to connect with them because there was always just one—or 100—more things to do before I could gain some measure of self-acceptance.

In a flash, I could figure out synthetic pathways in organic chemistry that took two dozen steps, but I could never understand how so many people could think so highly of themselves with such little justification. I had girlfriends (enamored with my wallet, no doubt) who acted as if they were royalty and virtually everyone else—including their parents and siblings—were inferior. Those lofty egos were inflated with hot air, not substance, yet they soared so high they could make me feel small just hours after I brought a seemingly dead child back to life.

And the life I saved that I remember the most? The one my boss gave up on, writing him off as dead, until I took over the case. That boss was handsome, with a beautiful wife who was the daughter of one of the richest men in town. They had beautiful children and hobnobbed with the elite at the local resorts, with my boss finding plenty of time to rub shoulders with other beautiful people but never enough time to become competent. I've had some challenging code cases, but the case I took over from that boss wasn't one of them. Anyone who couldn't save that kid didn't deserve to be called “Doctor.”

Thus, this narcissistic self-love that is often fueled by exaggerating the importance of one's appearance (real or imagined) has myriad negative consequences, from a faltering national economy to a failure to live up to one's individual potential, including the repercussions of the latter, which may include children leaving the hospital in a body bag headed for a funeral home instead of going out to play and later having children of their own.

“People put too much emphasis on looks.”
Olympic gold medalist gymnast Shawn Johnson

Research showing another way people inflate the value of appearance: Looks Matter More Than Reputation When It Comes to Trusting People With Our Money based on Unfakeable Facial Configurations Affect Strategic Choices in Trust Games with or without Information about Past Behavior

What the Amish could teach us

Many educators and others think that self-esteem is so important that it warrants undeserved praise. I have some advice for those folks: get out of your office, spend some time with Amish people, and then try praising them. Every time I did that, they deflected the praise by saying, “All praise to the Lord.”

I don't believe in buttering up people or giving unwarranted compliments, but if the praise is justified and heartfelt, I strongly believe in the value of positive feedback—something that is paradoxically too infrequent in our culture permeated with undeserved praise. By not reinforcing meritorious achievements or conduct and lavishing unearned praise, we squander opportunities to culturally encourage behavior that is most adaptive to individuals and society. It's a crying shame.

Amish child

Are Amish children suffering from this lack of positive reinforcement? Hardly. The Amish kids I've seen are happy, pleasant, cooperative, attentive, respectful, obedient, precociously mature, sweet, and genuinely nice. In short, they are absolute gems: a dream come true for parents and everyone they meet. Most of the other children I've met are behaviorally closer to being a holy terror, with prevalent crankiness, peevishness, disobedience, defiance, obstinacy, unruliness, disrespectfulness, inattentiveness, immaturity, petulance, impatience, stinginess, self-centeredness, nastiness, and meanness. I've seen kids throw a conniption fit when they didn't get their way over even trivial matters, such as if the onions weren't sliced thin enough.

Some non-Amish children are also very wonderful, but their parents have succeeding in doing what most parents cannot accomplish even if they listen to child-rearing experts. Dr. Benjamin Spock, dubbed “The Man Who Raised America” based on his best-selling The Common Sense Book of Baby and Child Care, led a bizarrely dysfunctional life in which he was arguably his own worst enemy and normal human emotions—from sex to grief and plenty in between—could be swept under the rug. The New York Times reported that his wife Jane was an alcoholic addicted to prescription drugs (notably Miltown) who experienced several breakdowns and was “in therapy all her adult life.” His grandson Peter committed suicide. When reporters asked him how he felt about that, he responded, “I don't feel it.”

What did he feel? Any normal human emotion? How could someone so mentally screwed up become so revered in America as a paragon of behavioral advice? Oh, I know: this is the same America that often seeks weight loss advice from obese physicians and economic leadership from politicians who almost flunked Economics 101.

Parents who don't wish to raise bratty kids could learn valuable lessons from the Amish. Crossing cultural boundaries can confer other benefits, too. Amish folks taught me a weight loss secret you'd give your right arm for if you cared about your appearance, health, or energy level. However, the United States is brimming with arrogant know-it-alls who think they have all the answers—folks who think they are so erudite and sophisticated that people they perceive as backward (the Amish) couldn't possibly teach them anything valuable.

The Amish lead simpler lives, but behaviorally they are not backward; they are rocket scientists who could teach us many things. Instead, we flock to Dr. Spock and his modern-day counterparts who, judging by the track record of their results, know as little as he did. America, it seems, is an indelibly narcissistic country in which we often look to narcissists for advice on becoming better people. The results are predictably abysmal. For proof, just look at the mess around you.

The pot calling the kettle black?

Some people may think, “What about you, Dr. Pezzi? In mentioning your achievements, aren't you a narcissist, too?”

No. Mentioning where I began and where I ended up is necessary for people to assess whether they should devote their valuable time to listening to me or someone else. My primary goal in writing is to help our country and people in it. I think that advice is more valuable when it comes from someone who succeeded against all odds instead of coming from people who figuratively were born on third base, yet act as if they just hit a triple. Many smart people write books about boosting brainpower, but how many of them were called “slow” by a teacher and dreamed of being a high-school dropout? Many people in great shape write weight loss books, but how many of them were so fat they couldn't see their feet when they stood up? How many people can quickly lose all that blubber without giving up the foods they love?

My upcoming book on rapidly overcoming racism and bigotry will also be a road map to becoming a better person. I once was cold and self-centered, perhaps not surprising considering my childhood filled with some memories too painful to mention. However, I later became warm and focused on helping others, such as by giving them free meals, free firewood, and by selling my Sea-doo, Ski-doo, and shed to help a deported person reenter the United States.

I know that bragging repels most people more effectively than Off!® repels mosquitoes. One of my pet peeves is wasting time, so if bragging were my goal, I could find an infinite number of better things to do.

You care about you and your family. You want to help them, and so do I. The experts America looks up to are striking out left and right, yet we still return to them for advice. They haven't helped us lose weight, become significantly more intelligent or creative, or kick-start our economy, yet we usually don't perceive the need to look to a new generation of experts. Instead, we keep flocking to ones who make Dr. Spock seem like a sage.

We're paying a high price because we value celebrity, not substance. We return to thought leaders who've had years in the limelight yet haven't made a noticeable impact in helping us or our nation. Most prominent people have big egos but no big ideas. We gravitate to them because many are narcissists who naturally rise to the top in a narcissistic nation.

Some of my sheds:

my sheds
See more >

If I were narcissistic, I wouldn't have wondered “why would anyone care?” when my Mom asked me what my favorite songs were. If I were narcissistic, I wouldn't have needed repeated prodding from my neighbor Ellie to let my readers know what I look like. I didn't understand why anyone would care what I looked like, and even if they did, I wondered why anyone would want to look at me.

I have good reason for patting myself on the back for a few things. I'm good at cleaning and organizing, good at building sheds, and often good at putting others ahead of myself, such as when I stopped my car to give money to kids selling Kool-Aid® even though I wanted nothing to drink, when I paid a programmer in India twice what our contract specified, and when I decided to sell my Sea-doo, Ski-doo, and shed to help a deported person reenter the United States.

I've also spent years helping others become doctors (such as by answering questions on my ER-doctor and ERbook sites); some of the ones I helped are now in medical school, while others are professors of medicine. I was good at coding patients in the ER and I'm good at thinking; billionaires pay me to sit home and think up ideas.

I'm evidently good enough at writing that I've been contacted by television and Hollywood producers and directors, and when I discuss politics, people who disagree with me are so desperate that they make up lies about me, such as by suggesting I am happy about the subjugation of Native Americans even though I am part Native American and have written extensively why that subjugation was an inexcusable moral abomination. Thinking that two lies are better than one, the folks who presumed I was an enemy also suggested that I lure people “to a page where he tries to sell you his anti-spam software,” but I don't sell anti-spam software; I never did, and never will. I developed a FREE site (MySpamSponge) that anyone can use to eliminate spam.

Since even pre-teen children can figure out that site and use it to contact others or me (with “how do I become a doctor?” questions), the ones who presumed I was an enemy are evidently so flustered by how I make my points that they can't think or see straight. If they could, they'd realize I'm no enemy because I am just as good at criticizing the Right as I am the Left (example 1 and 2). No country as great as ours could have fallen as fast and as far as we have if just one political party was screwing it.

I created another free site (Microhomeliving.com) and free book (Microhome Living) to describe the many personal and environmental benefits of living in very small homes. I wrote another free book, Gas Saving Tips, to also help people and the environment. I wouldn't be surprised if they also trigger more lies from “can't see straight” opponents whose ultimate goal isn't the truth, but working as willing partisan pawns of the establishment to help it continue to decimate our prosperity.

We can have our cake and eat it, too

As a doctor, I know the “just say no” approach is woefully ineffective. The affinity for pleasure is too strong to resist for long, so I don't base my advice on anything that requires superhuman effort. With my ways, you can have your cake and eat it, too. You can eat yummy food at McDonald's and still be slim. You can have a much better mind without spending many years holed up in a library cloistered from your family. You can have a warm house while spending much less to heat it.

We could have a country in which people on the Left and those on the Right could get most of what they want, as in this example, but people often don't like creative ideas. They say they do, but researchers found that creative ideas elicited strongly negative reactions. They said that creative ideas “can trigger feelings of uncertainty that make most people uncomfortable.” Even when there is a desperate need for change and the creative solution is wholly positive, most folks prefer to cling to the old way of doing things.

Judging by what's happened, bouncing political control from one party to the other and back again is getting us nowhere. Can we break out of this cycle? Yes.

To treat myself while working two jobs in college, I ate lunch in a McDonald's in Lansing, Michigan: the state capital. The restaurant was packed. A man approached and asked if he could sit at my table. I said yes, of course, smiling as my mind raced, wondering if he were Richard Austin, then Michigan's Secretary of State.

I just had to ask him. He said no, but with a twinkle in his eye, a wink, and a playful smile that let me know this was his way of blending in with common folks. Mr. Austin was an icon in Michigan and his face and voice were indelibly etched into my memory. The man sitting in front of me matched him to a T. I felt more than honored to eat with him; I was giddy with delight. His intelligence and charm were evident during the conversation, from which I learned a very valuable lesson. Teaching it to others could help our nation end the divisive fighting and usher in a new spirit of cooperation as well as help extinguish narcissism.

Just think what I would have missed had the McDonald's restaurant not been so busy that day. I still would have had the tasty burger, but not the priceless lesson.

The Golden Arches, indeed.

While McDonald's arches will always be golden, they could soar to unimaginable heights, making that corporation more valuable than Exxon Mobil, Wal-Mart, Microsoft, Apple, and GE—combined. But will they? Almost certainly not. That success will instead go to the corporation headed by someone with enough vision to see that The Next Big Thing I created will transform the world in myriad ways, with surprising but not immediately obvious economic and other benefits that will accrue from its primary function, like ripples in a pond. The latter can diffuse from a pebble, but I will throw in a boulder, creating a tsunami of change.

Henry Ford said that if he “asked people what they wanted, they would have asked for a better horse.” Figuratively, I will not give the world a better horse; I will give it something much better. CEOs now looking for a better horse may soon be looking for new jobs because they look to the future but don't see what is coming.

Jeff Bezos at the Wired Disruptive by Design conference:

“We've made many errors. People over-focus on errors of commission. Companies over-emphasize how expensive failure's going to be. Failure's not that expensive. [...] The big cost that most companies incur are much harder to notice, and those are errors of omission.”

Indeed. Ditto for parents and their aspiring brainiacs, most of whom never achieve their dreams due to errors of omission. Collectively, that lost potential adds up to trillions of dollars in economic losses in addition to inestimable other ways in which unrealized potential goes down the drain. It's a crying shame.


  1. 3 types of narcissism and how they affect behavior, according to mental-health experts
  2. Narcissists don't learn from their mistakes because they don't think they make any
  3. The Narcissism Epidemic
  4. How narcissists climb the career ladder quickly
  5. Research tracks narcissism from young adulthood to middle age
  6. Excessive posting of selfies is associated with increase in narcissism
    Comment: I've seen some people, usually young women, post thousands of photos of themselves, many almost carbon copies with trivial differences. Betcha they won't do that when they're 88 years old: aging stamps an expiration date on narcissism founded on appearance.
  7. Do western societies promote narcissism?
  8. Narcissists less likely to support democracy
  9. Just one simple question can identify narcissistic people
  10. Many women go for narcissism, Machiavellianism and psychopathy in their men
  11. Are women more attracted to ‘dark and brooding’ men?
  12. How to Raise a Narcissist
    Excerpt: “Children of parents who "overvalue" them are much more likely to become narcissistic …”
  13. State of the Nation's egotism: On the rise for a century, analysis finds
  14. Not everyone [with low self-esteem] wants cheering up, new study suggests
  15. Facebook: Has it created a generation of 'self-absorbed spin doctors'?
    Excerpt: “Facebook … has helped to create a culture of narcissism, says academic Victoria Mapplebeck from Royal Holloway, University of London.”
  16. Entering adulthood in a recession linked to lower narcissism later in life
  17. Americans love narcissists, until they see behind their often charming veneers. Lance Armstrong is just the latest hero Americans worshipped, feeding his ego that felt entitled to cheat his way to fame and fortune—for riding a bicycle! For Pete's sake! This article paints a shocking picture of Armstrong being callously despicable and oblivious to his many flaws that Americans should have seen long ago; he is more than a narcissist. I predict that another great American narcissist, still very popular with many Americans, will one day be almost universally loathed. Unlike Armstrong, who did nothing to hurt you, he is. Big time.
  18. Why Are People Overconfident So Often? It's All About Social Status
    Excerpt: “People who believed they were better than others, even when they weren't, were given a higher place in the social ladder. … falsely believing one is better than others has profound social benefits for the individual. … these findings suggest one reason why in organizational settings, incompetent people are so often promoted over their more competent peers. [People] did not think of their high status peers as overconfident, but simply that they were terrific. … overconfident individuals were more convincing in their displays of ability than individuals who were actually highly competent. … Prof. Anderson hopes this research will give people the incentive to look for more objective indices of ability and merit in others, instead of overvaluing unsubstantiated confidence.”
    Comment: I hope the same thing. The downfall of the United States is partly attributable to how too many of us are duped by overconfident, narcissistic leaders.
  19. Self-deceived individuals deceive others better
    Excerpt: “Over-confident people can fool others into believing they are more talented than they actually are, a study has found.”
  20. Narcissists don't hunt for partners who are already taken -- but it doesn't stop them
  21. The Highly Sensitive Person and the Narcissist
  22. Commonly held belief about narcissism debunked: Overuse of 'I' and 'me' not associated with pathology
  23. Psychologists Say 'Group Narcissism' Linked to Negative Attitudes Toward Immigrants
  24. Too Much Undeserved Self-Praise Can Lead to Depression based on Emotional costs of inaccurate self-assessments: Both self-effacement and self-enhancement can lead to dejection
  25. The Perils Of Overconfidence based on Overconfidence in an Objective Anticipatory Motor Task
  26. Narcissistic, broke, and 7 other ways to describe the Millennial generation
  27. Beautiful stars with body dysmorphic disorder: Sarah Michelle Gellar and Hayden Panettiere. The late Michael Jackson likely suffered from it, too. Sadly, he began as a handsome young man but negatively affected his appearance by repeated plastic surgeries.
  28. Body Dysmorphic Disorder symptoms improve, relapse preventable with sustained medication: Groundbreaking study of this chronic disease affecting millions
  29. Why Are Narcissists So Charming at First Sight? Decoding the Narcissism-Popularity Link at Zero Acquaintance
  30. Graduation address by David McCullough Jr.: You’re Not Special
  31. Middle School Students 'Extremely Overconfident' In Their Own Learning
  32. How a big ego can lead to a small brain: Overconfidence Among Teenage Students Can Stunt Crucial Reading Skills
  33. Think You'll Ace That Test? Think Again, Then Start Studying
  34. Overconfidence effect
  35. Illusory superiority a.k.a., the Lake Wobegon effect, named after Garrison Keillor's fictional town where “all the children are above average.”
  36. Pseudocompetence
  37. Brain Activity Levels Affect Self-Perception: 'Rose-Colored Glasses' Correlate With Less Frontal Lobe Use (Excerpt: “[People] who viewed themselves in a very positive light ... used their orbitofrontal cortex less than the other subjects. This region of the frontal lobe is generally associated with reasoning, planning, decision-making and problem-solving.”)
  38. Book: The Narcissism Epidemic: Living in the Age of Entitlement
  39. Book: Generation Me - Revised and Updated: Why Today's Young Americans Are More Confident, Assertive, Entitled--and More Miserable Than Ever Before
  40. People With a 'Sweet Tooth' Have Sweeter Dispositions
  41. Too Much Undeserved Self-Praise Can Lead to Depression (Excerpt: “People who try to boost their self-esteem by telling themselves they've done a great job when they haven't could end up feeling dejected instead. High and low performers felt fine when they assessed themselves accurately, probably because the high performers recognized their strengths and low performers acknowledged their weaknesses and could try to improve their future performance, according to a study in the October issue of the APA journal Emotion®”: Emotional costs of inaccurate self-assessments: Both self-effacement and self-enhancement can lead to dejection.)
  42. Self-Esteem Declines Sharply Among Older Adults While Middle-Aged Are Most Confident (based on Self-esteem development from young adulthood to old age: A cohort-sequential longitudinal study)
  43. Self-Worth Needs to Go Beyond Appearance, Experts Say based on A Body Image Resilience Model for First-Year College Women
  44. High Self-Esteem Is Not Always What It's Cracked Up To Be
  45. Psychiatry: When The Mirror Becomes An Enemy
  46. Humble People Are More Likely to Lend a Helping Hand
  47. Humility Key to Effective Leadership
  48. Lower Classes Quicker to Show Compassion in the Face of Suffering
  49. Narcissism Impairs Ethical Judgment Even Among the Highly Religious, Study Finds based on I’m Number One! Does Narcissism Impair Ethical Judgment Even for the Highly Religious?
  50. Narcissistic Students Don't Mind Cheating Their Way to the Top, Study Finds
  51. Narcissism May Benefit the Young, Researchers Report; But Older Adults? Not So Much based on Narcissism, Well-Being, and Observer-Rated Personality Across the Lifespan
  52. Forget Modesty, Narcissists Best Suited for Job Interview Success
  53. How Do I Love Me? Let Me Count the Ways, and Also Ace That Interview
  54. The Mirror-Free Bride: Kjerstin Gruys, an attractive woman sick of the American obsession with physical perfection, shuns mirrors for a year and blogs about it.
  55. 'Too Fat to Be a Princess?' Young Girls Worry About Body Image, Study Shows
  56. The Person Inside the Present: Narcissists Buy to Big Themselves Up
  57. Social Networks May Inflate Self-Esteem, Reduce Self-Control
  58. Connection Between Narcissism and Envy Explained
  59. After committing a crime, guilt and shame predict re-offense
    Comment: Not surprising.
  60. Can narcissists be moved to show empathy?
  61. Narcissists not necessarily satisfied with themselves
  62. Extraversion may be less common than we think
  63. Millennials Admit to Being Narcissists but Don’t You Dare Call Them That
  64. Quiz: Are You A Narcissist?
  65. Why Do Narcissists Lose Popularity Over Time? The costs of narcissism are seen primarily in the “enduring zone."
  66. Narcissistic adolescents may perform better at school -- Queen's University Belfast researcher
  67. March 25, 2021: Narcissism driven by insecurity, not grandiose sense of self
The views expressed on this page may or may not reflect my current opinions, nor do they necessarily represent my past ones. After reading a slice of what I wrote in my various websites and books, you may conclude that I am a liberal Democrat or a conservative Republican. Wrong; there is a better alternative. Just as the primary benefit from debate classes results when students present and defend opinions contrary to their own, I use a similar strategy as a creative writing tool to expand my brainpower—and yours. Mystified? Stay tuned for an explanation. PS: The wheels in your head are already turning a bit faster, aren't they?

“The test of a first-rate intelligence is the ability to hold two opposed ideas in mind at the same time and still retain the ability to function.”
F. Scott Fitzgerald

Reference: Imagining dialogue can boost critical thinking: Excerpt: “Examining an issue as a debate or dialogue between two sides helps people apply deeper, more sophisticated reasoning …”

Comments (1)

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Comment #183 by Anonymous
September 26 2011 05:50:22 PM

That is a very well researched, and detailed analysis of some very thought-provoking topics.

What concerns me the most is why parents praise their children (re: their looks) to such a degree. But I wonder myself if the average IQ of an adult is so low that they don't realize themselves what they are doing by perpetuating the Beauty Myth and narcissism itself.

What perpetuating myths about beauty also does is that sometimes the roles can even be reversed. While most of society worships attractive people, sometimes I've noticed the opposite too. I was a cute kid but never knew it, because my parents never emphasized those kinds of things, but I remember being picked on a lot by my more "homely" cousins. (I was very quiet and kept to myself, so I guess being picked on like that made me think the complete opposite of myself! :D )

I know I don't have any right to interfere with other peoples' personal lives, but sometimes I wonder if parents should have a license to have children. I know that sounds terrible and people might say even fascist in some ways, but look at the general mess people are because of their parents. They keep perpetuating stereotypes and continuing the same destructive ways. It's not just the way they might praise their "beautiful children" that is wrong, it's that they also teach their children to be complacent and subservient to society's so-called mores. People are not very individualistic these days, even if they think they are. That's what I see actually. I see lots of people who think they are individualistic, but they all seem the same with their cell phone addictions and doing everything the same way to adapt socially.

It is said that people have to adapt socially to survive, but, while we technically ARE animals, we have a brain to think with; so why should we just continue down the same path that our parents taught us? Why should we just say "well, I'm a social animal so that's the way things are"? It shouldn't be that way.

As you said in some of your other articles about genius, genius actually "stands alone" a lot, so this means that man in general is capable of being greater than he really is. We're not just meant to be social animals whose main goal is to "fit in," yet people treat those who stand alone, as geniuses do, as "weird." That's a comment people often get who do stand alone -- "weird."

Where does this come from? I think it comes from parents, otherwise where would they come up with this idea? Most parents just teach their children the same thing, generation after generation, and those unquestioning, complacent children grow up to do the same with their own children.

I know this doesn't sound very positive about humans in general, but the truth is, if you stand alone at all from the general crowd, you're going to find some very unpleasant truths about humanity in general. :(

REPLY FROM KEVIN PEZZI: Parents praise their children for their appearance because that means so much to them—the parents. After their child was murdered, I've heard several parents on television saying it was such a shame because “she was so beautiful.” Would it be any less tragic if she weren't especially attractive?

Regarding “a license to have children”: Many (most?) states require licensure for people who sand fingernails or apply nail polish to them, which requires considerably less knowledge and responsibility than being a good parent. Americans would never accept licensure as a condition of having children, but parents need to know much more than they do. Perhaps the best compromise is to mandate child-rearing classes in high school in place of some of the fluff, such as mythology—a subject that helped my teacher pay her bills, but did nothing for me. Another prime target to axe is singing classes. I love to sing and do it every day, yet I didn't begin doing that until decades after I left high school.

I agree that people are not very individualistic; they're more cookie-cutter clones. They tend to differentiate themselves from others based on trivial things, such as team or brand loyalty. Of all the clothing people could wear, they tend to prefer middle-of-the-road, boring things that don't stand out, as I found out in dating two doctors.

“When people are free to do as they please, they usually imitate each other.”
Eric Hoffer

What amazes me about the United States is how so many of its citizens passionately speak of the importance of freedom, yet are intolerant of others with different ideas, beliefs, or practices. Behavioral bigotry is rife in the U.S. Those bigots think freedom permits them to do whatever they wish, yet they don't want to give others equal freedom to be themselves.

Years ago, an ex-girlfriend visited me and wanted to dance in my living room. All went well until she decided she didn't like how I danced, so she'd grab part of my body and roughly jerk it into the position she thought it should be in. If I placed a foot in the “wrong” spot, she'd stomp on it. And no, she wasn't drunk or even drinking. What began as something fun turned into less enjoyable than working in a busy ER.

A year later in that same room, I put my arm around my new girlfriend (guess why?) as we sat side-by-side on my couch. How I did that bugged her for some odd reason, so she made fun of me by repeatedly and dramatically exaggerating what I did, laughing at me as she drew parallels between what I did (or what she thought I did) and how it is done in Hollywood when actors portraying nervous young men put an arm around a girl on a first date in a movie theater. I think Miss Intolerant was perceptive enough to realize that I could never relax around her. She seemed to possess a very narrow, rigid range of acceptable behavior, so I never felt free to be who I was. Ironically, her two husbands felt free to be who they were. One was a small-time criminal and the other beat her. I bent over backwards to treat her like a queen. According to my friends, that was my mistake; they opined that she wanted to be treated roughly. Perhaps. Or perhaps she was just bored by the plain-vanilla young doctor role I played. I never felt free to reveal to her what my personality was like, yet with many other women I dated, I felt very comfortable with them and had a great time on the first date. It's amazing how some people click and some people clash.

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