Often, an old song plays in my mind. I cannot identify the situations that bring lyrics and melodies into my awareness. Somehow, I am reassured and comforted by them.
Say it’s only a paper moon
Sailing over a cardboard sea
But it wouldn’t be make-believe
If you believed in me
Yes, it’s only a canvas sky
Hanging over a muslin tree
But it wouldn’t be make-believe
If you believed in me
Without your love
It’s a honky tonk parade
Without your love
It’s a melody played in a penny arcade
It’s a Barnum and Bailey world
Just as phony as it can be
But it wouldn’t be make-believe
If you believed in me
“It’s Only a Paper Moon” was published in 1933 during the Great Depression, a period in which music and art served as an important means of evading some of the unpleasant aspects of life.
“Paper Moon” had meaning because life and all it contains is false or unreal until love is added.
It exemplifies the concept that appearances may not always align with reality.
The lyrics remind us that real love is truth; their absence makes life less meaningful. Emotional fulfillment plays a critical role in overall well-being and happiness.
My life proves the importance of love. It converts dreams and hopes into reality. Without love, I could not have become a husband, father, physician, Soldier, or ever experienced the happiness with which my life has been blessed.
Dottie’s love, respect, promise, and commitment, in concert with my love, respect, promise, and commitment to her have created a marriage bond that has lasted well into seven decades.
She has a delightful singing voice. I love to hear her sing.
Perry Como (1912-2001), the epitome of peaceful love, sang to our hearts when we fell in love as teenagers.
“Smiling Through,” composed in 1919, remains a meaningful song to us, another melody likely to visit my awareness when least expected, much like a surprise treat:
There’s a little brown road windin’ over the hill
To a little white cot by the sea;
There’s a little green gate
At whose trellis I wait,
While two eyes o’ blue
Come smilin’ through
At me!
There’s a gray lock or two in the blonde of her hair,
There’s some silver in mine, too, I see;
But in all the long years
When the clouds brought their tears,
Those two eyes o’ blue
Kept smilin’ through
At me!
Yes, Dr. Brown, love can make a difference, and pleasant memories of old songs can soothe today’s rough edges, but what, for heavens’ sake, does it have to do with reality?
How do you know love is real? Divorce statistics refute the common meaning of love.
How do you know if the person on the phone is the real, actual person whose phone ID is the number you have called for years?
If you have not yet been scammed, you probably live in a monastery unidentified by phone, computer address, or public recognition by any entity whatsoever.
Several years ago, my adult grandson called me on my cell phone. Immediately, I recognized his phone ID. I also recognized his voice, and I could tell he was in difficulty. He needed $8500 in cash.
My bank let me have the money and I mailed it to him in NY where he was visiting. I felt uneasy about it, called my attorney but he was out of the office.
While standing in line to send a second payment, my attorney called andsaid it sounded like a scam. I did not send the second payment. Finally, I called my grandson. He was not in trouble. He was not in NY. I was scammed. I reported it to the Police and FBI.
Bottom line: what is real? How can one tell if I’ve lost touch with reality?
What is reality? Answer, it is not easy to define! What’s worse? It is getting more difficult to know what is real. Do you think AI (Artificial Intelligence) is going to make it easier to tell what is real?
Reality is complex and examined differently in philosophy, science, and daily life.
In general usage, “reality” denotes things that exist or have actual presence, distinguishing them from what is imagined, invented, or theoretical. It is typically contrasted with fiction or fantasy. Our critical judgment helps make the correct distinction.
Critical judgment is the skill of forming reasoned opinions by thoughtfully evaluating information, weighing strengths and weaknesses, identifying biases, and verifying claims instead of accepting them outright.
Historians may determine that our suspension of critical judgment is significant to our demise.Suspension of critical judgment is required in our entertainment experience, much of what we do and what is done to us. Hypnosis is dependent on the suspension of critical judgment. Ours is the Age of Suspension of Critical Judgment.
Philosophers have examined different theories regarding the nature of reality over time, with several main positions identified:
Idealism: reality is primarily mental or spiritual, influenced by perception, thought, or consciousness. Plato (428 BC-347 BC) proposed that the sensory world is flawed and imperfect, while a separate realm of eternal and unchanging “forms” or “ideas”—such as goodness, beauty, and equality—serves as the true standard for reality.
Realism: reality exists independently of perception or belief; the external world remains regardless of observation. Aristotle (394 BC-322 BC) is linked to realism, a philosophy that holds reality exists independently of human perception. He maintained that the physical world is real and can be understood through observation and experience.
I will not try to impress you with my limited knowledge of the vast field of philosophy’s ceaseless attempts to define what is real.
In summary, the concept of “reality” resists simple definition and can be viewed through various philosophical and scientific perspectives. Whether reality exists independently of human observation remains a debated topic.
What, pray tell, is the relationship between “real” and “normal.”
Normal refers to what is standard, typical, routine, or naturally occurring, and generally free from physical or mental impairment.
In medicine, “normal” means an absence of physical or mental impairment and refers to measurements or conditions within a healthy range, like blood pressure or insulin levels.
In short, “normal” refers to what is typical or expected in a given context.
The average person today, almost without regard to age, swims in a sea of uncertainty. For some, the memory of a meaningful melody, a friendly conversation with a person who wants to listen and interact, or fulfilling tasks such as good parenting or rewarding work is enough, for a while.
It is challenging to remain intact or undisturbed by so much pain, suffering, and frightening and tragic events to which we are exposed.
“Am I losing my mind? Is it me or has the world gone crazy?” Is it normal not to really know how I am doing? The answer has major legal consequences.
“What was the state of mind of the defendant when he committed a capital crime? Did he suffer from a mental disease or defect such that he did not know right from wrong?”
“If the defendant, at the time of the crime, knew right from wrong, did he have the mental capacity to refrain from doing wrong?”
If an “expert” is qualified and admitted by the judge, he or she may render an “opinion.” The jury, of course, determines guilt.
As I sat in the witness chair rendering my professional opinion, I envied the workman trimming hedges outside the window of the courthouse. His labor ended with the seasons. Mine had life-or-death effects.
If concerned about your sense of well-being, talk about it honestly with a trusted friend or minister, priest, or rabbi.Make certain you have no pressing physical ailment by getting a complete physical exam with lab tests.
If a psychiatric evaluation is necessary, ask your physician for a referral to the best three. Do your homework; then choose the most suitable one.
A competent, caring, and kind psychiatrist will likely use the Mini-Mental Status Exam MMSE and the Montreal Cognitive Assessment (MoCA).
The Mini-Mental State Examination (MMSE) is an 11-question test used to quickly screen for cognitive impairment. It takes 5–10 minutes and scores range from 0 to 30; a score of 25 or above is considered normal.
The Montreal Cognitive Assessment (MoCA) is a brief tool for detecting cognitive impairment, especially mild cases. It evaluates attention, memory, language, and executive function in about 10 minutes, with a maximum score of 30.
When a psychiatrist takes the American Board of Psychiatry Examination, he or she must make a comprehensive diagnostic examination in 20-30 minutes or less.
“Doctor, do I have a normal sense of reality? Am I normal?”
Mental health is the overall wellness of how you think, behave, and manage your feelings. A mental health condition may be present when patterns or changes in thinking, feeling, or behaving cause distress or disrupt a person’s ability to do daily activities.
A mental health disorder may affect how well you can: maintain relationships, handle social situations, perform at work or school, participate in typical daily activities, learn at a level expected for your age and intelligence, and handle change or cope with stressful situations. Cultural norms and social expectations also play a role.
Bottom line: mental health is not the absence of symptoms, but the presence of the sense of wellbeing and the assurance of the meaningfulness of your life.
In 1830, Alexis de Tocqueville visited and thoughtfully studied America. His study of our early democracy was similar to a thoughtful forensic psychiatric examination; except he was looking for what was right and real about America. His book, Democracy in America, 1831, richly insightful, is precisely what we need to hear today:
“He argued that Christianity, particularly in its Protestant form, played a crucial role in shaping American democratic values and institutions. Tocqueville believed that the moral teachings of Christianity encouraged virtues such as self-discipline, responsibility, and a sense of community, which are essential for the functioning of a democratic society.
“He noted that Christianity provided a moral foundation that helped to counterbalance the potential excesses of individualism and materialism inherent in a democratic system. Tocqueville observed that religious beliefs fostered a sense of civic duty and encouraged citizens to engage in public life, thereby strengthening democracy.
“Overall, Tocqueville viewed Christianity as a significant force that supported and sustained democratic principles in America.”
William Wordsworth’s poem, The Solitary Reaper, 1807, is about a woman who sings while gleaning the field of its remaining wheat. His last verse informs us that the song is ended but the melody lingers on. Music and art are real, unchanging resources of truth. Welcome them warmly into your being.
Whatever the theme, the Maiden sang
As if her song could have no ending;
I saw her singing at her work,
And o’er the sickle bending;—
I listened, motionless and still;
And, as I mounted up the hill,
The music in my heart I bore,
Long after it was heard no more.
Robert S. Brown, MD, PHD a retired Psychiatrist, Col (Ret) U.S. Army Medical Corps devoted the last decade of his career to treating soldiers at Fort Lee redeploying from combat. He was a Clinical Professor of Psychiatry and Professor of Education at UVA. His renowned Mental Health course taught the value of exercise for a sound mind.