Dr. Bradly Bundrant: Cycles within cycles

Bradly Bundrant, MD, MPH
Health and Wellness Coalition for Runnels County

There is a rhythm to everything that is natural and healthy. The seasons of the year, the sleep/wake cycle of every animal on the planet and the cycle of contraction and relaxation in a beating heart. There are even cycles within cycles.

Dr. Bradly Bundrant is the chairman of the Health & Wellness Coalition of Runnels County. The coalition is gearing up to start hosting health screenings, public education classes and podcasts.

Not only does the human heart have one to two cycles of contraction and relaxation every second, the heart rate itself fluctuates smoothly when we are calmly resting. It gradually speeds up from say 70 beats per minute to 80 beats per minute and then back down to 70 beats per minute, about every 10 seconds. The variability that is manifested in these cycles is a key indicator of health, because it reflects a capacity for compensation in the event of emergency.

Heart rate variability (HRV) is an indicator of both physical and emotional/mental health. A patient with heart failure does not show good HRV, because their heart is not able to perform adequately at rest; by definition, it is constantly in failure and cannot compensate for any additional load. In these cases, we often we see an unvarying heart rate while the person is inactive. On the other hand, we see wide and erratic variations of heart rate in a person with high anxiety and a healthy body, while they are physically at rest.

Every healthy society also has rhythms, including communal celebrations that are often called “Feasts,” Festivals” or “Fairs.”

This past weekend (on April 30, 2022) Ballinger followed in this tradition when it hosted the Texas State Festival of Ethnic Cultures Arts and Crafts Show. Disruptions in the cycles of society are also reflective of disease in the communal body, as we witnessed in the last 24 months. The stress of COVID resulted in many annual events being cancelled for the first time in memory. The reason I mention these things is related to the fact that I could not be present for the Festival, due to a prior commitment to attend the annual meeting of the Texas Medical Association (TMA). If I had been in Ballinger on April 30, I would have done my best to assist the Noon Lions Club with the Bike Fest and to also help with the booth of the Health and Wellness Coalition (HAWC).

I was acutely aware of my absence from these when I attended the 6:30 AM Lone Star Caucus meeting on Saturday, and perhaps that is why I was so struck by what one of the speakers said.

Dr. John Flores was speaking of the work that he and many of us are doing in our communities, through small non-profit organizations where, “…If you say, ‘This should be done….’ Guess what…You’re doin’ it!” He was not complaining, and neither am I. What he and I are doing is trying to change things for the better, both in and through TMA and in numerous other ways. Everyone in our society today is overwhelmed and distracted. There may be exceptions, but I don’t personally know of any.

Some people are overwhelmed with activity, and some by consuming depression, addiction, worry or pain, and all of us are distracted by the electronic devices that are ever more ubiquitous and more cleverly engineered to guide our thoughts and actions in ways that we would not consciously choose or condone. According to Richard A. Swenson, we lack “margin” (Margin: Restoring Emotional, Physical, Financial, and Time Reserves to Overloaded Lives). Margin is one of the primary resources that allows us to compensate in times of added stress, thus it increases our resilience.

Evidently the morning of Saturday, April 30, 2022 was the last one for Naomi Judd, who the family says was a victim of the mental illness with which she struggled, and about which she wrote (River of Time: My Descent into Depression and How I Emerged with Hope, and other books). Depression is a chronic, relapsing, fatal illness and it shares this and other similarities with drug/alcohol addiction.

These conditions are often hidden, and they can rarely be successfully treated long-term without addressing mental, physical, emotional and spiritual factors. If a resilient life of balance and margin with regular cycles of activity and rest is healthy, and an overburdened life of constant activity is like a heart in decompensated failure, the life of the addicted or mentally ill is like the erratic heart of the anxious.

Suicide has been called a permanent solution to a temporary problem. It is because their behavior is erratic that these are the people most likely to commit suicide. One of the best ways to address that is to engage them in regular activity, giving them social contact and purpose. Perhaps the most tragic aspect of all of this is that work of the proper type and in the proper proportions is not only a benefit to the society, it is valuable to the one who works. However, people who are suffering from addiction or severe depression etc. often are not able to hold gainful employment. They need a circumstance which allows them to be productive on an a la carte or ad hoc basis. Volunteering opens up a lot more possibilities for them.

This is just one of the reasons why I believe it is crucial that we develop a plan to organize and vet potential volunteers and volunteering opportunities in our County. There is work that needs to be done, and there are people that need to work. The importance of service work is often stressed in Alcoholics Anonymous, and the first type of service work people are encouraged to engage in is, “emptying the ashtrays, setting up the chairs and making the coffee.” There are also highly skilled and responsible people that would be glad to volunteer, in the right setting, and just need to be asked.

We are truly blessed to live in a great place, in the great State of Texas, in the greatest country on earth. We have problems, and our neighbors have problems that include but are not limited to mental health. Already many individuals and organizations are providing vital support and assistance in this area and other aspects of health and safety. There is more to do, but it will take organization, planning, resources and effort. Establishing a network of volunteers is part of the answer and we also need to remind people of the importance of face to face social connection, balance, rhythm and margin in their life.

Over the next few weeks we will have the opportunity to get a better picture of the problems we face, and what can be done about them. As President of the Health and Wellness Coalition for Runnels County I know that this is an organization which seeks to help individuals as well as other organizations in Runnels County to be healthier and more effective in doing what they aim to do. We hope that you will come back here to learn more, and will consider joining with us.