Medical Examiner 6-3-22

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JUNE 3, 2022

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very time there is a mass shooting in this country, everyone from the President of the United States to local butchers, bakers and candlestick makers offer their opinions on the cause and/or the solution. (Well, not every time; these things happen so often that a lot of them sail under the radar.) For all those with such opinions we say good for you. We’re not planning to go down that particular road in this article, however. If you don’t like guns, stay away from them; if you love guns, hang onto yours and keep them safe. (Note: pro-gun reader mail is still trickling in to criticize a cover story we did in February that very pointedly and specifically had by Samantha Bowick, MPH, Board Certified Patient Advocate nothing to do with gun control; it was about gun safety.) For the angle we’re taking to discuss last week’s tragedy in Texas, please imagine you’re a member of some minority group. If you already are such a person, you don’t have to imagine what it’s like. You’re dealing with the steady stream of digs and injustices, big and small, that people of minorities endure on an almost daily basis already. But then a particularly heinous mass shooting takes place, and it happens to be perpetrated by someone of the very minority Going to a doctor’s appointment can be daunting. Whether group of which you’re a member. Suddenly you’re experiencing a lot more animosity and even we go yearly for checkups or several times a year, or even sev- hatred than you were already. Laws are proposed aimed at people like you. Folks don’t want eral times a month, there’s something about seeing that white someone like you living next door. Doors are being slammed in your face that were open before. coat walk into a room that increases anxiety. Perhaps some of You haven’t done a single thing wrong or unlawful, but people look at you with fear and susus who suffer from chronic illness have had a negative expepicion and treat you like you might be the next crazed gunman. rience with a doctor telling us the symptoms we are experiThat might sound like a scenario with no connection to our growing national collection of encing are all in our head or they don’t know how to help us. mass shootings, but it’s actually spot on. Who is the real-life minority group we’re describing in this analogy? See page 9. + Please see ADVOCATE page 3

PATIENT

HERO

HOW TO ADVOCATE FOR YOURSELF AT A DOCTOR’S APPOINTMENT

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THE FIRST 40 YEARS ARE ALWAYS THE HARDEST

PARENTHOOD by David W. Proefrock, PhD

PART W OF A 26-PART SERIES

IS FOR WAVES

It may well be the time of year for trips to the beach, Your 10-year-old daughter has been saving magazines, but the waves we’re about to newspapers, and mail in her room for months now. She says examine are brain waves — as she’s saving them to read later, but you are sure she never you’ve already surmised (using reads them at all. She gets upset if you suggest throwing them away or even moving them to the garage. It has gotten your brain) from the image to so it is difficult to walk around in her room for all the stacks the right. We have all seen pictures she has saved. What should you do? A. This may be a sign of a serious mental health problem. of a person with dozens of electrodes attached to their Take her to a mental health professional for an evaluation. scalp. Those electrodes are B. Set a time limit to solve this problem. Tell her that she measuring brain waves. has to have all the papers out of her room by a certain date The record produced by and if she does not, you will take them out yourself. C. While she is at school one day, take all the newspapers those electrodes is called an electroencephalogram (eeand mail out of her room and throw them away. D. As long as she keeps the stacks in her room, don’t wor- lek-tro-en-SEF-uh--lo-gram), ry about it. This is just a phase she’s going through and she which explains why it’s usually shortened to just EEG. will throw them out herself soon enough. An EEG is a measurement of electrical activity in If you answered: the brain, and it’s kind of A. It is not always necessary to consult a mental health amazing to consider that these professional for childrens’ behavior issue, but this is a measurements are taken from serious sign and should not be ignored. This is the best response. B. This is sure to set up a conflict and it will not go well. She needs help, not deadlines. C. This is sure to be traumatic for her. The newspapers and mail have emotional meaning for her. Take her to a mental health professional instead. D. This is not a phase. It is a symptom of a mental health condition and should be addressed by a professional.

It’s not always easy to differentiate between a phase a child is going through and a true mental health problem, but one of the ways to do it is to judge by the seriousness of the problem and how long it lasts. This behavior has gotten to the point it interferes with normal functioning and it has lasted far too long to be ignored. +

JUNE 3, 2022 the scalp. You would think some kind of probe into the brain might be necessary, but the electrical activity is measurable externally. EEGs are completely non-invasive. That is actually one of the best things an EEG has going for it. While it may not reveal the most detailed information compared to other more sophisticated diagnostic tools, what it offers is a great basic tool that is relatively simple, inexpensive, and very safe. Why would a doctor order an EEG for a patient?

Since the procedure measures brain waves, it’s an effective diagnostic tool to make sure brain waves look normal after a head injury; it might help to diagnose and treat migraine headaches, brain tumors, epilepsy, and sleep disorders. Sometimes when a patient is in a persistent coma, an EEG is used to confirm that there is still brain activity; if there is not, that absence in

turn confirms brain death, an irreversible condition. Barring that unfortunate scenario, brain activity (and therefore brain waves) occurs literally all the time, the proverbial 24/7/365 (and in 2024, 366). Brain waves are as individual as fingerprints, and come in four major varieties: Alpha waves are an indication of a brain that is idling; the person is awake, relaxed and calm, perhaps even has their eyes closed. Beta waves, as the EEG example below shows, are more irregular than alpha waves. They are the brain state of our normal waking consciousness and mental engagement, whether we’re making a grocery list or solving calculus problems; it can also be an indicator of stress or anxiety. Theta waves are the dominant brainwave in REM sleep, dreams, and hypnosis. They represent our brain activity in areas adjacent to that borderline between subconscious and conscious thought. Theta can be a mental state deliberately induced by a trained therapist because it’s an area of our subconscious mind that can provide otherwise inaccessible memories and information. Delta waves, as you might guess from their appearance, are seen in deep sleep (or when under anesthesia), and are where baby brains spend much of their time in utero. Significantly, delta sleep is thought to be instrumental in forming neural connections, a vital trait for humans at every age. EEGs are an instant snapshot of brain wave activity at the moment it’s measured. +

Dr. Proefrock is a local retired clinical and forensic child psychologist.

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ADVOCATE… from page 1 Because of this, it’s important to have a plan in place to advocate for ourselves. To advocate for yourself means a number of things: you can describe the symptoms you are experiencing, what treatments you have tried if this doctor isn’t familiar with your case, whether the treatments helped or not, any testing you’ve had done already so you don’t have to repeat the same testing, specialists you’ve been to, and that you can provide medical records that may be relevant. Advocating for yourself may also mean getting multiple opinions from different doctors. To do this, it may be helpful to make notes before your appointment to make sure everything you need to address is discussed. It’s also helpful to go through your own medical records to see if anything stands out to you. If you think your symptoms are related to your period, for example, it would be helpful to keep track of your cycle either on paper or in an app on your phone. If you think your symptoms could be related to the foods you eat, it could be helpful

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to keep track of what you consume every day. Gather as much information as possible to bring with you to your doctor’s appointment. If you have a loved one who can accompany you, this can be help to reiterate what you’re saying. Unfortunately, sometimes doctors dismiss patients because they simply don’t believe us, so the more facts you can bring to the table, the better. Once you have assembled all of this information, you can save it to your electronic device and add or remove information as needed so you don’t have to start over with gathering information every

time you have an appointment or see a new doctor. I know this sounds exhausting, but once it’s accomplished, the hard work is done; maintenance of your data going forward will be a breeze. It feels like a full-time job navigating the health care system with a chronic illness, but it’s so important for you and your health. I also recommend doing research on your illness before your appointment if you have already been diagnosed. This will allow you to gather information and make an informed decision on what treatment, testing, etc. you would like to explore before a doctor tries to persuade you in a certain direction. Research can include gathering information from specialists’ websites, asking others who have the same illness if they have tried a certain treatment and what their experience was like, and reading books about the illness. Advocating for yourself and your health can seem overwhelming. It may take some time, but you can do it. You got this. +

“And whoever saves one — it is as if he had saved mankind entirely.”

HOW CAN I FIGHT BURNOUT?

It is no accident that burnout is a growing phenomenon, and not just in the field of healthcare. It is actually a function of the structure of today’s society and culture. Consider that many people are “plugged in” every waking hour, and maybe even 24 hours a day. There is the normal workday, of course. That’s a given. But some jobs require employees (some or all) to be on call during off hours. Some bosses send out texts and emails during evening hours or on weekends — or to individual employees who are on vacation — and expect answers. Immediately. We can lay the blame for those issues at the feet of employers, but many people inflict at least the risk of burnout upon themselves by the aformentioned plugging in at all hours. In effect they have no downtime. It isn’t that endlessly swiping away at Instagram screens is particularly stressful; it’s more that someone else is always streaming content into their mind. If it isn’t a computer screen it’s a phone screen; if it isn’t a phone it’s a television. They never have a moment to simply unwind and decompress in peace, alone with their own thoughts. If that previous sentence seems more on-point to half of the reading audience, it’s not your imagination, ladies. According to a 2019 University of Massachusetts study, women report higher levels of burnout than men due to experiencing “greater workfamily conflict.” As the old adage goes, “a man works from sun to sun; a woman’s work is never done.” It’s still true. The causes of burnout suggest ways to prevent or reduce it. Establish phone-free zones in your home: if your phone is on charge overnight, use a plug in the garage, not in your bedroom. Establish phone-free zones in your life: during mealtimes is a great start; weekdays from 8 p.m. to 8 a.m. might be another. In some work environments, deadline pressure is the cancer that eats away at sanity over time. One solution: as much as possible, tackle the toughest jobs early in the day so the day gets progressively easier, not harder. Resist the urge to relentlessly attack the day’s to-do list. As we all learned in first grade, breaks are important. We don’t call it recess as adults, but the principle still applies. Taking breaks improves mood, energy, performance, production, satisfaction and enjoyment. +

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#166 IN A SERIES

Who is this? ON THE ROAD TO BETTER HEALTH

Y

ou probably don’t recognize this man, but we have all heard of him. His name has become part of the English lexicon. He was born in southern Germany in 1734 and studied medicine at the University of Vienna beginning in 1759 (and, incidentally, was friends with Haydn and Mozart). As an indicator of things to come, his doctoral dissertation was entitled, On the Influence of the Planets on the Human Body. He believed that the moon and planets exerted an influence on the human body and disease, but he went even farther, theorizing that transfers of energy occur between all animate and inanimate objects. This theory attracted a wide following for more than a century. His theory of medicine was summarized by one of his disciples as the belief that health requires the free flow of “the process of life” through the body, and illness resulted when the flow was impeded in some way. When nature failed to fix it, someone who could conduct and promote “animal magnetism” would be necessary to restore the flow and along with it, good health. Our subject for this installment was the famous (and in the view of some, infamous) Franz Anton Mesmer, considered by to be the father of hypnotism. In fact, the word mesmerism is more or less synonymous with hypnotism, and it was one of the most important tools in Dr. Mesmer’s little black bag. It all might sound a bit quacky, but in 1774 he treated a woman suffering from “hysteria” by having her swallow a concoction rich in iron, after which he attached magnets to various parts of her body. She reported that her symptoms disAbout three years later he treated the 18-year-old musician, composer and piano prodigy Maria Theresia von Paradis (for whom Mozart is said to have written his Piano Concerto No. 18 in B-flat major), blind since childhood. He was evidently successful to a degree, restoring her sight at some level at least temporarily. So some of his theories and practices worked at times, although they could have been evidence of one of the most powerful healing forces in all of medicine: the placebo effect. In the case of the woman suffering from hysteria, Mesmer himself said the iron solution and magnets were not the source of her temporary cure; it was Mesmer’s own personal “animal magnetism.” For von Paradis, there were suspicions and whisperings of an inappropriate doctor-patient relationship. After Mesmer fled to Paris in the wake of the scandal, her blindness returned, and she died at age 64 without ever regaining her vision. Despite his modest occasional successes, Mesmer had a thriving practice, and sought the blessing of the Royal Academy of Sciences and the Royal Society of Medicine to give his theories an official seal of approval. A commission was appointed to investigate his medical claims, and it contained some definite heavyweights, including Antoine Lavoisier and Benjamin Franklin. Their conclusion: Mesmer’s practices were based on the “imagination” of his patients, an example of the placebo effect (a term which may carry a negative implication, but which does not mean that a treatment was ineffective). Feeling disgraced, Mesmer left Paris for Meersburg, Germany, where he continued to practice his special brand of medine until his death in 1815 at age 80. Hopefully you found this article to be interesting, if not absolutely mesmerizing. +

A PATIENT’S PERSPECTIVE Editor’s note: Augusta writer Marcia Ribble, Ph.D., is a retired English and creative writing professor who offers her unique perspective as a patient. Contact her at marciaribble@hotmail.com by Marcia Ribble

A bunch of us were taking at bingo about things we remember from the World War II era in terms of the sacrifices made by Americans to support the war effort. The question we all had the other day was why aren’t Americans as willing to support the war today in Ukraine? One thing I recall was that our country’s involvement in WWII was quite limited at first. Like many other countries, at first we were determined to stay out of the war, to remain neutral. When Eastern European countries started being overrun, even Great Britain was attempting to remain neutral, but Hitler did not stop there. It wasn’t long before he wanted control over all of Europe, including Russia, the Northern European countries, Western European and Scandinavian countries. At that point, the United States became heavily involved. The Steering Gear plant a few blocks from my childhood home, which had been producing car parts for the American market, switched over to manufacturing war products. That led to making car parts unavailable, and to many forms of rationing as more and more industries switched to producing war supplies. Silk stockings almost instantly disappeared because the silk was needed for parachutes. This led to the invention of nylon to continue to make women’s stockings. Sugar was rationed, so women had to think ahead and make sure they had sugar for those birthday cakes, pies, and other treats. Butter was rationed, and I can remember the white grease to which Mom would add a little capsule of coloring to make it look more like butter. Copper was rationed, so for a while we had red pennies made from heavy cardstock. In many ways, the shortages led to people innovating ways to deal with the many shortages. Kids were

encouraged to go barefoot in the summer because shoes were rationed. Most of the men in my neighborhood either walked or took the bus to work because gas for their cars was rationed, too. Most people pitched in in many ways, and I never heard them complaining because our kids over there needed those supplies to stay alive and hopefully come home alive. There were the disloyal and the traitors, of course, and disgraceful treatment of the Japanese and other groups, but most Americans put aside at least some of their prejudices to work together. In our neighborhood, a man pushed around a cart in which he collected newspapers, cloth, scrap metal, anything that could help with the war effort. Against the cistern wall in our basement there were stacks of newspapers we would save for him. He was a man my mother would never have tolerated coming into our yard before the war, but during the war he was welcomed, because he was working for our kids stationed all over the world. This feels like a similar time to me, when most countries are trying to remain neutral, but there are some big differences! Many of us older folks remember the years of appeasement that allowed Hitler to become more and more powerful, and we know better than to let Putin become the instigator of World War III. In addition, unlike WWII, we would now likely have to deal with nuclear weapons in the hands of unstable dictators who might be crazy enough to actually use them. This is a time when we need to encourage our politicians and companies and their management to drop the posturing and histrionics and come together for the good of our country, one of the very healthiest and life-affirming decisions they could make. After all, we are really just one country, and it shouldn’t have to take WWIII, to pull us together. +

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AUGUSTAMEDICALEXAMiNER

ADVENTURES IN

Middle Age

DEAR READERS

BY J.B. COLLUM

Warning: If a frank but light-hearted discussion of male erectile dysfunction while trying to help others who also face this in silent anonymity is distasteful to you or offends you, skip this column for this and the next issue and go read the numerous other salubrious offerings available in this fine publication. Okay, you have been warned. Don’t blame me later.

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entertaining, usually informative, and mostly PG or PG-13... Mostly. I considered him a raconteur of the highest degree and I am not alone in that estimation. Were all of his stories pure, unadulterated fact? No, of course not, he was a fisherman, after all, but I didn’t care. He told me a story of how the penis injection medication once went very wrong for him. It had worked many times, but just this once had a bad side-effect. Back then, you didn’t give the shot to yourself; you scheduled a visit from a nurse, who did the injection instead. Somehow, that seems even worse to me, but didn’t bother Uncle Larry in the least. He even had a little grin when he was telling me that part. Anyway, this particular time the erection did not go down after intercourse. He waited the requisite four hours and then contacted his physician, but it was a weekend, and it took a while to get things, well, deflated. For most people, this would mean they likely wouldn’t be able to urinate, but for Uncle Larry, who had his bladder removed due to cancer many years before, that wasn’t an issue as he had a bag he could empty. In fact, over his long life, Uncle Larry had many medical issues that would have killed most people, but he lived to be 90. The fact that he was still interested in sex and able (with medical assistance) to take part in it at the age he was when this happened, impressed me greatly. I was young then and thought people over 50 were Methuselah-old. I figured they stopped having sex by then. I’m glad I was wrong. Uncle Larry having ED did not lower him in my estimation at all. In fact, I thought it showed that he was his own man and didn’t need the good opinions of others to stroke or beef up his ego. I want to be like that when I grow up. For me, I have now tried everything, except for the needle (NO), and the penile implant operation, which is scheduled for the end of June. The vacuum still has not worked, but I will continue to try until my operation. I’m told the surgery is very low risk and is nearly 100% effective, but once you do it, there is no going back. They can’t currently reverse it and it is the death knell for ever having a natural erection through some other means. So, think long and hard before you decide on this option. If I do end up having the surgery, I plan on sharing what I learn about it and the recovery afterwards with you, my dear readers —all eleven of you. Except for my mother. I hope. +

This is a continuation of the same subject from the last issue. If you haven’t read that one yet, please go back and do so, because this will make so much more sense that way. In lieu of that, here’s a brief recap; In our last installment, I shared my struggle with ED (erectile dysfunction) in the hopes that others who are suffering with this in silence would feel more comfortable seeking help to resolve it. First, I want to start with a list of interesting facts. Some of these were covered in the last issue, and some we will talk about here. About half of American men over the age of 40 have some degree of ED. It is often caused by: • Diabetes • Heart Disease • Smoking • Prostate Cancer Treatment • Injuries to the nervous system • A side-effect of medications for blood pressure, depression, allergies, ulcers, and others • Psychological factors • The longer a man goes without an erection, the more he loses length in the penis. Yes, if you don’t use it, you lose it. There are effective treatments for almost 100% of the cases out there. Here are a few: • Prescription medications like Cialis and Viagra • A direct injection of a medication into the penis that dilates the blood vessels to create an erection • Vacuum pump devices that draw blood into the penis and then use a large rubber ring to hold the blood in • Penile implants. We will discuss those more in this article As previously chronicled, I have already been through all of the medical options for ED, with the important exception of the one that involves a needle injection directly into the penis right before intercourse. Perhaps you will call me a wimp; I don’t care. I’m not doing that. Two of my uncles used this method, and mostly met with success. I am talking about my Uncle Larry, whom you’ve met in previous columns. Uncle Larry was never shy about sharing stories with me that were perhaps not meant for tender ears, and this is probably a small part of the reason that I loved him so much. I learned about a lot of things from Uncle Larry, well before my parents broached some of those subjects. His stories were always

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Love Sick, Part II

J.B. Collum is a local novelist, humorist and columnist who wants to be Mark Twain when he grows up. He may be reached at johnbcollum@ gmail.com

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BARLEY-BEET GRAIN BOWL Grain bowls are great “assembly-style recipes” that make meal creation both interesting and nutrient rich. The ingredients can be easily changed to whatever you have on hand. Enjoy!

*Batch cook barley to save money and time. • 1 (16 ounce) bag of barley • 5 cups water • 1 tablespoon extra-virgin olive oil • 3/4 teaspoon salt. Barley Instructions Preheat the oven to 375 degrees. Place the barley in a 13 x 9-inch baking dish

that has been sprayed with cooking spray. Bring the water to a boil, add oil and salt and pour the mixture over the barley. Stir to combine, cover tightly with heavy duty aluminum foil and bake for 60 minutes. Once done, remove aluminum foil and fluff barley with a fork. Cover with a clean kitchen towel for 5 minutes; uncover for another 5 minutes then fluff with a fork and serve or freeze as you wish. +

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TWO ARE ABSOLUTELY FABULOUS Instructions To make each salad, place one cup of greens on one side of a bowl and add ½ cup barely to the other side. Layer about ½ cucumber and beets, chicken, ¼ cup carrots and oranges over the top. Sprinkle with one tablespoon pumpkin seeds. To make the dressing, combine the vinegar, re-

served juice, garlic, honey, salt and pepper. Whisk in the oil. Drizzle equally over four bowls. Yield: 4 Servings Nutrition Breakdown: Calories 450, Fat 19g (3g saturated fat), Cholesterol 55mg, Sodium 220mg, Carbohydrate 47g, Fiber 8g, Protein 26g.

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ASK DR. KARP

NO NONSENSE

NUTRITION Lily from Statesboro, Georgia, writes: “Dr. Karp, in our house butter is taboo, but we eat all kinds of cheese. But doesn’t cheese, like butter, contain high amounts of saturated fats? What are your comments about cheese?”

Your question is interesting because it points out the problems that occur when we vilify certain foods, or focus on just one or two

molecules in some food instead of looking at the overall nutrition profile. There is no reason why either butter or cheese should be taboo in your house. We know that choosing vegetable-based sources of foods, higher in unsaturated fat, is the healthier option. However, having some high saturated fat butter and cheese now and then is not a big concern. They are not poisons, you know! Consuming lots of cheese sounds like it may be the nutritional issue in your house. The second point is that although butter and cheese may contain high amounts of saturated fat, they also contain other molecules which are important in your diet. For example, butter may contain significant amounts of Vitamin A. Because I come from a family with very high cardiovascular risk and my uncontrolled LDL and total blood cholesterol levels are extremely high, in our house we choose the lower saturated fat spreads and lower calorie and lower fat cheeses. Sometimes we buy the reduced fat version of those cheeses if they are available, taste good and are reasonably-priced. Remember that if saturated fat is a nutritional issue for you, it very likely

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I would advise you to experiment with lower-saturated fat cheeses that you like. There’s no need to eat foods that you don’t like. If I go to someone’s home and they are serving high-fat cheese for hors d’oeuvres, I have some and enjoy the experience. However, you will not find those cheeses in my refrigerator for everyday consumption. Evolving scientific data is revealing that there is much more about cheese nutrition than simply being concerned about fat and saturated fat levels. For example, cardiovascular health may also be influenced by the type and form of cheese. As the authors of a recent (2022) review paper conclude: “[Our] findings may [influence] dietary recommendations for cardiovascular disease prevention by allowing healthy people with normal plasma cholesterol levels a more liberal consumption

of…dairy foods (including milk, cheese, and yogurt), irrespective of being full- or low-fat. Within this amount of consumption, fermented dairy (like yogurt, for example) should be preferred.” What is the “No-Nonsense” nutrition advice for today? It doesn’t make sense to vilify butter and then ignore the types, forms and amounts of cheese you eat. Read nutrition labels to find out the calories, fat and saturated fat for the different types of cheeses you buy. Remember that what you routinely eat and your own health risk profile are the more important factors to consider in your relationship with cheese. Finally, keep your eyes open for the evolving science about cheese and its role in good health. An important consideration may be how the cheese is fermented, not just the fat content of the cheese. +

Have a question about food, diet or nutrition? Post or private message your question on Facebook (www. Facebook.com/AskDrKarp) or email your question to askdrkarp@gmail.com If your question is chosen for a column, your name will be changed to ensure your privacy. Warren B. Karp, Ph.D., D.M.D., is Professor Emeritus at Augusta University. He has served as Director of the Nutrition Consult Service at the Dental College of Georgia and is past Vice Chair of the Columbia County Board of Health. You can find out more about Dr. Karp and the download site for the public domain eBook, Nutrition for Smarties, at www.wbkarp.com Dr. Karp obtains no funding for writing his columns, articles, or books, and has no financial or other interests in any food, book, nutrition product or company. His interest is only in providing freely available, evidencedDr. Karp based, scientific nutrition knowledge and education. The information is for educational use only; it is not meant to be used to diagnose, manage or treat any patient or client. Although Dr. Karp is a Professor Emeritus at Augusta University, the views and opinions expressed here are his and his alone and do not reflect the views and opinions of Augusta University or anyone else.

DANIEL GREGORY LEOPARD PC AT T O R N E Y

TAKE THESE

NIU

M

“I perform in court, not in TV commercials.”

CR A

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may be an issue for your children, too. That’s why we always focus on family nutrition. For example, reduced fat feta cheese is pretty low in fat and saturated fat, yet it still tastes good, especially sprinkled in salads or sprinkled over fruit. Be aware, though, some of those low-fat or fat-free cheeses taste awful and it makes no nutritional or culinary sense to use them.

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9 +

AUGUSTAMEDICALEXAMiNER

APPLES & ORANGES amounts. For example, the American Journal of Psychiatry pub-

health. Why are we not screening for sane people? Even the US Supreme Court has been swayed by the largely imaginary danger posed by those with mental illness: in a 2008 opinion the high court strongly affirmed a broad right to bear arms while at the same time endorsing prohibitions on gun ownership by two specific groups — “felons and the mentally ill” — due to “their special potential for violence.” Among those unfairly painted as prone to violence are military veterans diagnosed with Post Traumatic Stress Disorder. The American Journal of Public Health observed in 2015 about news coverage that “PTSD increasingly became associated with violent behavior in the public imagination, and the stereotype of the ‘crazy vet’ emerged as a result. [Even] news coverage drawing attention to veterans’ suffering

{ }

There is a minority group that is thrown into the spotlight of blame and suspicion after every mass shooting in the U.S. That group is people with mental illness. Is that fair? It’s a fair point that no one would walk into a mall, grocery store, movie theater or school and start randomly shooting innocent strangers without having a screw loose, if not several. But what about the millions of people diagnosed with mental illness who have never, will never, and would never perpetrate an act of mass killing? The automatic mental illness response categorizes millions of people. We have finally reached a time when stereotypes are rightly viewed with growing contempt. It’s racist and hateful to assume everyone from the Middle East is a terrorist, but it’s still acceptably PC to paint a huge segment of the population as ticking time bombs ready to explode in violence at any moment. The American Journal of Public Health noted recently (well before the events in Texas and Buffalo) that the top two assumptions which arise in the wake of mass shootings — (1) that mental illness causes gun violence, and (2) that psychiatric diagnosis can predict gun crime — are oversimplifications of a complex problem, and are assumptions not supported by actual research — of which there are voluminous

“Those with mental illness [are] more likely to be victims of violence than perpetrators.”

— National Alliance on Mental Illness

lished a study which found that, at most, “3% to 5% of US crimes involve people with mental illness, and the percentages of [such] crimes that involve guns are lower than the national average for persons not diagnosed with mental illness. Databases that track gun homicides, such as the National Center for Health Statistics, similarly show that fewer than 5% of the 120,000 gun-related killings in the United States between 2001 and 2010 were perpetrated by people diagnosed with mental illness.” To put that another way, 95% of the gun-related killings in the US over a 10-year period were perpetrated by people who were evidently the very picture of mental

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CRASH

COURSE

More Americans have died on US roads since 2006 than in World Wars I & II combined

A

Turn a light on Another reason unexpected turns should never happen is that turn signals have been around for more than 75 years. No turn has to take other drivers by surprise. Even so, not everyone has heard the news. Trust us when we tell you: your car is equipped with this amazing device that allows you to communicate your intentions to other drivers. It’s all very high-tech and sc-fi, but it works like this: simply push up (for a right turn) or down (for a leftt turn) on a lever mounted on the side of your steering wheel. Through a magical feat of engineering, an electric signal is conveyed to lights on the appropriate corners of your vehicle (left or right, front and back) and they not only illuminate, but flash on and off to be even more noticeable. And after you’ve made your turn — get this — the flashing lights will turn off automatically! How does this amazing device keep you safe? In many ways. As one example, the driver behind you will be forewarned of your intentions and slow down instead of possibly rear-ending you as you prepare to turn. Even if he slowed down without your blinker, he’s a lot less likely to lay on his horn. +

{ Smooth equals safe, Part II

{

s mentioned in our previous Crash Course session, nothing more complicated than smooth sailing is a foundation principle of safe driving and highway design. When traffic is flowing smoothly, one of the most important accident prevention strategies is in play. By contrast, the lack of smoothness — panic stops, individual vehicles going way faster or slower than surrounding traffic, weaving in and out of traffic, and sudden and unexpected turns — can and does cause accidents every day. For today’s class let’s zero in on that last point: sudden and unexpected turns.

them. For example, someone is in a left turn lane and they have changed their mind and they want to go straight. Maybe they just sit there with their right-turn blinker on when the green arrow appears, blocking the turn lane, or maybe during the red they tried to ease into/

Take turns We all do it, don’t we? It’s impossible to avoid turns. But it should be said that no turn shall be taken before its time — or after its time, for that matter. Have you ever seen a turn taken after its time? That happens when someone realizes they almost missed their turn. Oops! Let me immediately slam on my brakes so I can hopefully still manage to turn where I wanted to go. Version two of this infraction takes place when someone realizes that they need to get into the other lane to make the turn they suddenly realize is upon

squeeze into the straight lane. There isn’t enough room of course, so they still end up blocking the left turn lane. These offenses are not unforgivable sins by any means. They’re minor inconveniences. But they are also completely unnecessary and kind of rude. They lead to frustration and impulsive, impatient acts by other drivers. The mannerly thing to do in such cases without inconveniencing others is to keep things moving: make the turn you didn’t mean to and go around the block to get back on track. As for that sudden turn you didn’t see coming, same thing. Don’t slam on your brakes and maybe cause a chain-reaction rear-end accident. Just accept that you missed it and again, go around the block and do it right on your second pass.

JUNE 3, 2022

APPLES… from page 9

frequently makes its point by linking post-traumatic stress with violent crime, despite the paucity of data linking PTSD diagnosis with violence and criminality.” (Italics ours) NAMI, the National Alliance on Mental Illness issued a statement after the Uvalde shooting which said in part, “Mental illness is not the problem. It is incorrect and harmful to link mental illness and gun violence, which is often the case following a mass shooting. Pointing to mental illness [...] leads to discrimination and stigma against those with mental illness — who are more likely to be victims of violence than perpetrators. People across the globe live with mental illness, but only in the U.S. do we have an epidemic of senseless and tragic mass shootings.” In summary, the common belief that mental illness is a predictor of violence is purely a creation of media and public sentiment, and it is a belief that researchers — anthropologists, sociologists, scholars who study violence prevention, and others — have no data to support. It’s quick and convenient for a newscaster or a politician to wrap up the blame for a senseless crime as the work of a violent madman, but people who carefully and analytically study these events say that mental illness is “statistically unrelated” to community violence — unless you’re talking about the mentally ill being its victims: one study found that “people diagnosed with schizophrenia have victimization rates 65% to 130% higher than those of the general public.” Indeed, some diagnoses that get plenty of blame, schizophrenia as one example, actually reduce the risk of violence, since the affliction is so commonly marked by social isolation and withdrawal. For people who want to solve the problem of mass shootings, the data does not show that keeping guns away from people with a diagnosed mental illness will make any difference at all. If mental health screenings are a primary focus of prevention, none of us should be surprised when events like Newtown, Parkland, Las Vegas, Marjory Stoneman Douglas, Columbine, Buffalo, and Uvalde continue to occur. If you’ve been wondering about the title of this article and the images used, here’s the connection: in a very real sense, comparing people who have a diagnosed (or even undiagnosed) mental illness to mass killers is like comparing apples and oranges. + Headquarters for the well dressed man since 1963

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the blog spot — posted by Ariella Rubel, MD, on May 23, 2022

A SMALL INTERN IN A BIG HOSPITAL I am a gopher. See my tiny paws. See them furiously digging and digging and digging. Little puffs of dirt and soil are thrown haphazardly over my little shoulders. My tiny brain is completely absorbed in the digging of that very inconsequential, very little, very specific hole. Tail in the air, head down, no breaks. Dig, dig, dig. As a small intern in a big hospital, that’s me. Day after day digging, with ever-increasing efficiency, my own series of tiny holes. Working so hard, so diligently, so blindly on patient after patient, task after task. Each little checked-off box means another clump of dirt I throw over my shoulder as I furiously dig each little hole. Each hole is comprised of my best efforts at taking care of this patient today. It doesn’t take very long to become a gopher. Gophers don’t know meaning. Gophers do not dig for a higher purpose. Gophers forget that patients are people. Do gophers dream? Gophers live in days that are dark and short; they traverse hospital hallways and protocols that are dusty and bewildering. They are tired.

Working so hard, so diligently, so blindly.

I am still a gopher, but now, with the end of the year glimmering ahead, the digging has a different tone. The days have lengthened, and the sun shines. Flowers bloom and chiefs talk of graduation and careers. My hands are callused by scut and death and pus. My fellow gophers are now my friends. I try to reflect. It is hard. My gopher brain can only stretch so far. I write a little. I think a little. Dreams hover just out of sight. Lessons learned linger nearby. Then with dirt in my hair and stains on my scrubs, I head home. My patients will need me tomorrow. + Ariella Rubel is a surgery intern.

EVERYBODY LOVES A GOOD STORY

AND EVERYBODY HAS A STORY. WE’D LOVE TO HEAR YOURS. MEDICINE IN THE FIRST PERSON

Send your interesting (or even semi-interesting) stories to the Medical Examiner, PO Box 397, Augusta, GA 30903 or e-mail to Dan@AugustaRx. com. Tell us if you want it “by you” or if it needs to be anonymous. Thanks!

11 +

AUGUSTAMEDICALEXAMiNER

From the Bookshelf We have dozens of words and phrases — some taboo, some acceptable euphemisms — to describe something we’re all quite familiar with: “going to the restroom.” How’s that for a euphemism? Given our reluctance to discuss this subject, The Big Necessity is exactly what The New York Times says it is: an “extraordinary book.” The topic nobody really wants to talk about is incredibly important: “sanitation” and “clean water” — there we go with the euphemisms again — are key elements of health (or the lack thereof) for every single human being on this planet. As you may have noticed, there are billions of us. And you will discover if you read this compelling book that billions of people don’t have access to “sanitation.” Author Rose George says that doesn’t mean they have an outhouse or are forced to use public restrooms. It means they have nothing: not even so much as a bucket or a hole in the floor. They have streets and alleys. We aren’t talking exclusively about the slums

of Calcutta or Nairobi. This is a global issue. In Milwaukee, for example, a sewage crisis made 400,000 people sick and killed more than 100, and this happened, not in 1893, but in 1993. Has the problem been fixed? Well, between 1994 and 2008 (the copyright date of this book), Milwaukee legally discharged 935 million gallons of “fullstrength, untreated sewage” into Lake Michigan. Which, incidentally, is precisely where Milwaukee gets its drinking water. 935 million gallons may sound like a lot, but it’s a

proverbial [fill in your word of choice here] in the bucket: 90 percent of the world’s sewage flows untreated into lakes, rivers and oceans, writes George. The global disease toll is stunning: a gram of feces can contain a million bacteria, 10 million viruses, 1,000 parasite cysts and 100 worm eggs. Yet experts say the billions who live in areas with inadequate sanitation can unwittingly ingest up to 10 grams of fecal matter a day. We are indeed fortunate to live in a part of the world where waste treatment is the norm. Even so, the earth is a closed system. We may never give waste a second thought once the toilet is flushed, but it doesn’t go away. It just travels someplace else so somebody else can deal with it. “It” may be out of sight, but as the book’s title concludes, “It matters.” It matters a lot. It should matter to us all. + The Big Necessity: The Unmentionable World of Human Waste - And Why It Matters, by Rose George; 302 pages, published in July 2009 by Metropolitan Books

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+ 12

AUGUSTAMEDICALEXAMiNER

The Examiners +

Are you going to get I didn’t get the COVID vaccinated against vax, so why would I monkeypox? change now?

by Dan Pearson

Because maybe you have half a brain?

How in the world could a vaccine do that?

I’m not going to let them control me.

Because it contains a microchimp.

PUZZLE

ACROSS 1. Take someone to _____; scold or criticize 5. Imitates 9. Fool 12. Polish coffee cake 13. Mount prefix 14. Free goods, typically for promotional purposes 16. Mentally off 18. Exchange for money 19. Campus org. 20. On the sheltered side 21. Pet follower 22. Leading 23. Chapel namesake? 24. African musical instrument 27. A mother gives this 28. Monetary unit of Iceland 29. Bucket 31. 7th letter of the Greek alphabet 34. Direct 38. Biscuit’s first name? 39. Erikson’s first name 40. With “dog,” a worn book 41. _______ ligation 44. Web locations 45. Became a member of 47. Expert 50. Synonym of 46-D 51. Capital of Western Samoa 52. Big ____ 55. Medecins ___ Frontieres 56. African female feline 59. Legal postponement 60. Warren of the Supreme Court 61. Latin for fault or guilt 62. Ernie of the PGA 63. Hudson River canal 64. Water or war adjective

BY

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We’ll announce the winner in our next issue!

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1 5 4 1

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by Daniel R. Pearson © 2022 All rights reserved.

S U D O K U

DIRECTIONS: Every line, vertical and horizontal, and all nine 9-square boxes must each contain the numbers 1 though 9. Solution on page 14.

by Daniel R. Pearson © 2022 All rights reserved.

DOWN 1. Early astronaut’s drink 2. Super Trouper group 3. Jamaican pop music 4. Desert region in Africa 5. Sleep disorder 6. Wore out a rug? 7. Before, in poetry 8. Glum 9. Declare 10. Honey bunny 11. Simultaneous firing of artillery 12. Multi-passenger vehicle 15. Small secluded valley 17. Malt beverage 21. National standard 22. Operatic melody 23. Fuelperks grocer of yore 24. Hall at Ft. Gordon? 25. Unit of computer memory 26. Unreasonable 27. Marty’s nemesis 29. Dr. _______

Click on “MYSTERY WORD” • DEADLINE TO ENTER: NOON, JUNE 13, 2022

E X A M I N E R

15

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41

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Simply unscramble the letters, then begin exploring our ads. When you find the correctly spelled word hidden in one of our ads — enter at AugustaRx.com

30. Consumed 32. Intro for tops or trunks 33. Increases 35. Pleased 36. Systematic fact-finding 37. Farm wagon (Old English) 42. 7th St. riverfront employer 43. Resting place 45. Singer Stone 46. Synonym of 50-A 47. New Zealand aboriginal 48. First fruit? 49. By way of 52. Augusta Auditorium 53. Excellence in Sports Performance Yearly award (as it’s commonly known) 54. Growing presence at Ft. Gordon (abbrev.) 56. Jeans brand 57. Each one has inner, middle and outer sections 58. Dynamic ending Solution p. 14

QUOTATIONPUZZLE E F M R S S S I H S X Y A U L W I A E P O E T T M O O L E O

P O I O A R E T T I T N Y H U N R R S N

5 8 4 9 1 3 6 7 G 2 5 8 T1 3 H4 9 2 7 6

— Janet Lane

by Daniel R. Pearson © 2022 All rights reserved

DIRECTIONS: Recreate a timeless nugget of wisdom by using the letters in each vertical column to fill the boxes above them. Once any letter is used, cross it out in the lower half of the puzzle. Letters may be used only once. Black squares indicate spaces between words, and words may extend onto a second line. Solution on page 14.

Use the letters provided at bottom to create words to solve the puzzle above. All the listed letters following #1 are the first letters of the various words; the letters following #2 are the second letters of each word, and so on. Try solving words with letter clues or numbers with minimal choices listed. A sample is shown. Solution on page 14.

1 2 3 4 5 6 F 1 2 3 4

1

H 1 2 3 4

1

2 1

A 3 4

5

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7

1 2 3 4

B 1 2 3 4 5 6

1 — Confucius

1 2 3 4 5 6 7

1.DWWAAAPTBF 2.ILIEHIE 3.BAAATTT 4.WHHTMNB 5.LOOE 6.RUNE 7.DT

SAMPLE:

1. ILB 2. SLO 3. VI 4. NE 5. D =

6 2 7 4 3 9 1 8 5

L 1

O 2

V 3

E 4

I 1

S 2

B 1

L 2

I 3

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D 5

by Daniel R. Pearson © 2022 All rights reserved

WORDS NUMBER

1

THE MYSTERY WORD The Mystery Word for this issue: IRUMANC

© 2022 Daniel Pearson All rights reserved.

EXAMINER CROSSWORD

JUNE 3, 2022

3 8 9 1 6 5 2 7 4

2 5 4 3 8 7 9 6 1

7 1 6 9 4 2 8 5 3


JUNE 3, 2022

AUGUSTAMEDICALEXAMiNER

THEBESTMEDICINE ha... ha...

A

n avid duck hunter was in the market for a new bird dog. His search ended when he found one that could walk on water to retrieve a duck. Pleased by his find, he couldn’t wait to show his friends. The first buddy he invited to go hunting was an eternal pessimist who was never impressed with anything. Surely, this amazing dog would change that. As they waited by the edge of a pond at sunrise, a flock of ducks flew by. They fired, and a duck fell. The dog jumped up and walked across the water to retrieve the bird, never getting more than his paws wet. This continued all day long; each time a duck fell, the dog walked across the surface of the water to retrieve it. The pessimist took it all in, but never said a single word. On the drive home the hunter couldn’t stand it anymore and finally asked his friend directly, “Notice anything unusual about my new dog?” “Sure did,” responded the pessimist. “He can’t swim.”

The

13 +

Advice Doctor

Moe: What’s up with your hearing aid? I thought the repairs were supposed to be done by now. Joe: Me too. I took it in three weeks ago and haven’t heard a thing since.

©

Moe: How’s your new job? Joe: At Waste Management? It’s ok. Moe: Did you have to go through a lot of training? Joe: No, they said I could just pick up stuff as I went along. Moe: What motivates grammar Nazis? Joe: Their desire for word domination. Moe: Double-negatives are bad grammar. Joe: Right. They’re a definite no-no. Moe: What’s the difference between face and preface? Joe: One is a four-letter word and the other is a foreward letter. Moe: Why did the alcoholic tell bad jokes at the comedy club? Joe: Probably for the boos. Moe: I’m looking for a quick, easy way to burn a thousand calories. Got any ideas? Joe: Leave the pizza in the oven. Moe: I’ve always thought “Don’t Mess With Texas” was a statement. Joe: It isn’t, Moe. It’s a plea. +

Why subscribe to theMEDICALEXAMINER? Staring at my phone all day has certainly had no Effect on ME!

Because try as they might, no one can stare at their phone all day.

Dear Advice Doctor, I have a question for you. I work with a bunch of idiots. It’s true! Ask anyone! (except them, of course; they’re oblivious.) These people can barely walk and chew gum at the same time, yet some of them earn significantly more than I do. I actually enjoy my job, but I keep wondering: Am I the idiot for staying at this job? — Who’s the real idiot here? Dear Who’s, Your letter raises an important topic that I think many of us wonder about from time to time: is chewing gum healthful? Various negative aspects of this habit can sometimes grab our attention: chewing gum can present a choking hazard; it promotes tooth decay; it can cause or contribute to TMJ; it’s a socially obnoxious and rude habit if not done discreetly. We can’t disagree with any of those viewpoints, but there is another side to the gum-chewing coin. Chewing gum can be a significant factor in weight loss. A number of clinical studies have shown that people who chew gum routinely consume fewer calories at mealtimes, snack less often, and report that chewing gum helps curb their appetite. Last but not least, Obviously no diet with ambitious goals will succeed solely based on chewing gum, but every little bit helps. Contrary to popular wisdom, chewing gum can contribute to reducing tooth decay. Choosing a sugar-free variety is the key starting point, but chewing gum promotes production of saliva. Not only does that (along with chewing itself) help to get rid of food particles in teeth, but saliva helps neutralize and prevent plaque buildup. Another oral benefit is helping to reduce bad breath. Chewing gum is clinically associated with reducing stress, according to a 2014 study published in the Journal of Prosthodontic Research. Gum has helped many people overcome orally-related habits like smoking and snacking. Instead of reaching for a cigarette or a candy bar they go for a stick of gum. It really does work. Finally, chewing gum has been shown to boost alertness, which is why some people who drive a lot use it to help combat drowsiness. That same benefit can be applied at a desk when the afternoon sleepies hit. I hope this answered your question. + Do you have a question for The Advice Doctor about life, love, personal relationships, career, raising children, or any other important topic? Send it to News@AugustaRx.com. Replies will only be provided in the Examiner.

SUBSCRIBE TO THE MEDICALEXAMINER +

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By popular demand we’re making at-cost subscriptions available for the convenience of our readers. If you live beyond the Aiken-Augusta area, or miss issues between doctor’s appointments — don’t you hate it when that happens? — we’ll command your mail carrier to bring every issue to your house! NAME ADDRESS CITY STATE ZIP Choose six months for $20 ____ or one year for $36 ____. Mail this completed form with payment to Augusta Medical Examiner, PO Box 397, Augusta GA 30903-0397

AFTER READING


+ 14

THE MYSTERY SOLVED

THE PUZZLE SOLVED

— Janet Lane

...cleverly hidden up in the trees in the p. 9 ad for OVERHEAD DOOR OF AUGUSTA

WORDS BY NUMBER SEE PAGE 12

The Celebrated TheSUDOKUsolution MYSTERY WORD CONTEST

...wherein we hide (with fiendish cleverness) a simple word. All you have to do is unscramble the word (found on page 12), then find it concealed within one of our ads. Click in to the contest link at www.AugustaRx.com and enter. If we pick you in our random drawing of correct entries, you’ll score our goodie package! SEVEN SIMPLE RULES: 1. Unscramble and find the designated word hidden within one of the ads in this issue. 2. Visit the Reader Contests page at www.AugustaRx.com. 3. Tell us what you found and where you found it. 4. If you’re right and you’re the one we pick at random, you win. (Winners within the past six months are ineligible.) 5. Prizes awarded to winners may vary from issue to issue. Limited sizes are available for shirt prize. 6. A photo ID may be required to claim some prizes. 7. Other entrants may win a lesser prize at the sole discretion of the publisher. 8. Deadline to enter is shown on page 12.

Love to stare at your phone? Visit issuu.com/ medicalexaminer and stare away.

QuotatioN QUOTATION PUZZLE SOLUTION Of all the things you wear your expression is the most important.

The Mystery Word in our last issue was: PALATE

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JUNE 3, 2022

AUGUSTAMEDICALEXAMiNER

Better a diamond with a flaw than a pebble without. — Confucius

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AUGUSTAMEDICALEXAMiNER

JUNE 3, 2022

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DENTISTRY Jason H. Lee, DMD 116 Davis Road Augusta 30907 706-860-4048

DEVELOPMENTAL PEDIATRICS Karen L. Carter, MD 1303 D’Antignac St, Suite 2100 Augusta 30901 706-396-0600 www.augustadevelopmentalspecialists.com

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AUGUSTAMEDICALEXAMiNER

JUNE 3, 2022

TRUE LOVE & HOME GROWN TOMATOES I walk the track every day unless the rain gods chase me away by threatening to disrupt my hairdo … even though I am greatly follically challenged. (A nice way to say my hair line has migrated north with enthusiasm.) I am in the grips of an advanced maturity crisis. Most men have that at one time or another. I also must commit to a more restrictive diet. Either that or buy suspenders. My wife favors the former. I shall heed her advice. My mother would concur. Losing 10 pounds will solve the problem for me. One can never go wrong pleasing his wife and his mother. But as I walk the track, I contemplate things I see about me. Too many people are overweight and don’t exercise enough. A recent study showed that over 40% of Americans are obese and have related physical maladies that increases their medical cost and shortens their lives. That is a bad thing to say the least. ER workers dread seeing an obese person with a myocardial infarction come in. The chance of survival is much lower than in fit people. No

one disputes the statistics. These large people have made long-term “poor menu choices.” Yes, it is a choice they made. Personal self-centered decisions. But there are many other things we as a society do based on the hot trend of the day. Maybe the new bodacious inflation will help out. “Food prices spike 18% in April,” said the headline. And with gas prices jumping over 100% in the past 2 years, food prices will increase even more for a long time to come. Two years ago, I bought blueberries (the healthiest fruit available) for my morning cereal for $2.99 per pound. Now I pay $5.99 for 10 ounces. Time to stretch my breakfast by putting fewer blueberries in the bowl. Money will run shorter and shorter. “Feel good” foods must get trimmed from the grocery shopping list. Less sweets are a good start. Junk foods, too. What constructive things should we do? Planting a garden is a good start. I grow tomatoes in my back yard. For about $20 (bone meal, tomato plants, magnesium sulfate) and some sweat, I can grow about $100 worth of toma-

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toes. 400% profit beats Wall Street to death. Guy Clark had it right when he sang: “Only two things that money can’t buy and that’s true love and home-grown tomatoes.” Home-grown tomatoes cost less and taste better than store bought tomatoes. Our schools do not teach our kids life skills. Things like: How to grow a backyard garden. Save 10% of your

income before you spend any money. Pay off credit cards completely each month. Avoid debt like the plague. Walk at least 4 miles each day. Sleep 7.5 hours each night. Don’t do anything you can’t defend in open court. Don’t do “recreational drugs,” and that includes alcohol and tobacco. Take care of your body and mind. There is no replacement for either. When you eat comfort foods, remember a few bites taste the same as a plate full. The memory is the same. The enjoyment is the same. But the cost is less. And you will live longer with fewer physical disorders. Memorial Day has just come and gone when we honor our military, both dead and alive. In their honor I did baby back ribs on my Green Egg. It takes 6 hours and lots of attention. I love doing it. But even more, I like seeing my family eating happily afterwards. I know I will overeat if I don’t plan well. We also cut up and ate a watermelon. It cost about $0.50 a pound. It keeps my hydration high and my stomach full. And it kept me from eating too many ribs at the

first setting. And I had leftovers for the next day. I skip lunch looking forward to it so I can pig out for supper. Then I will walk a few extra laps on the track for the next several days. It is well worth it. In case you are a beer drinking nay-sayer, beer looks pretty and tastes terrible. (It is an acquired taste, according to my beer drinking friends. I say to them: You could acquire a taste for slimy ditch water, too, if you wanted to. I pass on both.) Beer is a diuretic and the more you drink, the dryer you get. That sells more beer. It is a heck of a business model for the beer companies. Helps out the undertakers, too. They don’t have to wait as long to get your business. I see nothing morally wrong with drinking alcohol. That is up to you and Jesus. Wellbeing, financially and physically, depends to a surprising degree upon menu choices, temperance, and pre-planning. So far Earth is the best place I have ever been. I want to stay here as long as I can. I’m in no hurry for Jesus to critique transgressions in person. Most likely you agree with me on this point. +

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