Medical Examiner 6-18-21 by Daniel Pearson

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HEALTH • MEDICINE • WELLNESS • HEALTH • MEDICINE • WELLNESS • HEALTH • MEDICINE • WELLNESS • HEALTH • MEDICINE • WELLNESS • HEALTH • MEDICINE • WELLNESS • HEALTH • MEDICINE • WELLNESS • HEALTH • MEDICINE • WELLNESS • HEALTH • MEDICINE • WELLNESS • HEALTH • MEDICINE • WELLNESS

JUNE 18, 2021

AIKEN-AUGUSTA’S MOST SALUBRIOUS NEWSPAPER • FOUNDED IN 2006

WHAT IS A

PA? If you answered Physician’s Assistant, you are slightly behind the times. Earlier this month the American Academy of PAs announced “Physician Associate” as the new official title for the PA profession. Doctor shortages, particularly in primary care settings, have made PA’s role in medicine a vital one, and reflects their founding values. The profession was created in response to physician shortages by Dr. Eugene Stead at Duke University Medical Center in 1968. The first PAs were Navy Hospital Corpsmen with extensive medical training. According to an AAPA press release, there are currently more than 150,000 Physician Associates practicing in all medical and surgical specialties in all 50 states, the District of Columbia, U.S. territories and all branches of the armed services. Under a physician’s authority, PAs can diagnose and treat illness, order and interpret tests, develop treatment plans, prescribe medication, perform procedures, and assist in surgery. AAPA said that PAs should refrain from calling themselves physician associates until legislative and regulatory changes can be made. Until the name rollout is complete, AAPA says using the name prematurely could confuse patients, and might be interpreted as stepping beyond the scope of current PA licensing. +

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can stand for many things, but today, A is for amnesia. We’re going to offer a broad overview of amnesia and several of its manifestations and then focus on a particular type of amnesia that is a serious problem in the healthcare field in 2021. In case you forgot, amnesia is defined as complete or partial memory loss. It can be temporary or permanent and is usually the result of injury or illness, although there are sometimes psychological causes too. Broadly speaking, there are two main types of amnesia. The first is the inability to store fresh new memories. Known as anterograde amnesia, a typical case might be an older person who cannot remember what they had for lunch (or if they even had lunch), but can recount events in their life from decades ago in great detail. Retrograde amnesia, on the other hand, is the lack of memories before a certain date or incident, such as a car accident or other trauma. Sometimes an event can be so psychologically traumatic that it causes all memories of the event to be erased even though no physical trauma has occurred. It is possible to have both anterograde and retrograde amnesia, and all of us have had at least one form, childhood amnesia, which is why we can’t remember nursing or having our diapers changed. So-called source amnesia is another benign and common variety: you know some fact, In September of 2016 the Medical but you have no idea when or where Examiner launched an alphabetical or how you learned it. series which, over the following 26 issues, Public health experts in 2021 are contained 26 articles about 26 topics concerned about a fresh global related to health, wellness, medicine and outbreak of another type of overall salubriousness. amnesia that can be particularly Of course, there are far more than 26 interesting topics dangerous. to explore, so we’re starting all over again in this issue. For more about this variety, We hope you’ll please turn to enjoy the journey. page 2.

A is for amnesia

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AMNESIA… from page 1

PARENTHOOD by David W. Proefrock, PhD

You picked up your 13 year-old daughter’s phone by mistake and happened to see a very inappropriate text from the youth minister at your church. Your daughter said it just showed up and that she has not been texting him. She also said it was “yucky.” What do you do? A. Call the pastor of your church and report the text. B. It’s time to find a new church. C. Save the text and report it to the Sheriff’s Department. D. Have a talk with your daughter and make sure that she is not saying or doing anything that would lead the youth minister to send such texts. If you answered: A. You should do this, but not before you notify the Sheriff’s Department. You should do both. B. This might very well be the case, but you should first notify law enforcement. C. This is the correct first step. Call the Sheriff’s Department immediately. Then call the pastor. D. Your daughter is the victim in this case even if she was flirting. She needs protection and support, not questioning of her behavior. This is a case of abuse and it should be reported to law enforcement immediately. There are other things that need to be done in addition, but none take precedence over reporting a sexual predator in a position of trust with children. You cannot let this pass. +

JUNE 18, 2021

Both medical and social scientists are quite concerned about a current phenomenon called historical amnesia, loosely defined as the inability to remember the lessons of the past. Every student of history knows the danger of this type of amnesia, as summarized in the famous quote, “Those who cannot remember the past are condemned to repeat it.” What does historical amnesia look like in everyday life? It’s usually a form of selective amnesia. For example, “When I was a kid we could go out on the lake without having to wear a bulky life jacket. We didn’t need a helmet to ride a bike or have to wear a seatbelt to go two blocks to the store. And we did just fine.” That may be an accurate memory for that one person, but it fails to factor in the thousands of people who died because they were thrown through a windshield after a car accident, suffered permanent brain damage because they fell off their bicycle or motorcycle and were not wearing a helmet, or who drowned because personal flotation devices were not required equipment back in the day. Historical amnesia is looking at the past through rose-colored glasses, remembering the good things without acknowledging the downside and the drawbacks. Of course, reminiscing about our childhood through a hazy lens is pretty harmless. But the type of historical amnesia that concerns medical science is potentially lethal. To illustrate, in the 1950s diseases like polio, mumps and measles caused a tremendous amount of pain, misery and even death. Then vaccines were developed and those plagues gradually became distant memories, especially in this part of the world. The same thing happened with smallpox and chickenpox, rabies, typhoid fever, cholera and other

diseases that once killed millions of people. In the developed world these diseases are no longer a major threat due to advancements in hygiene, medical treatment, and preventive measures like mass vaccinations. That’s the good news. The bad news is that through the magic of historical amnesia, people have forgotten those horrible diseases that plagued mankind for centuries. They are on the forgotten pages of dusty history books, and along with the forgotten diseases are the measures taken to conquer them. What’s the point of getting a potentially dangerous vaccine to protect yourself from a disease you’ve never heard of? Why inconvenience yourself to avoid some illness that only happens to people on the other side of the world? Even a cursory study of the past century shows that kind of thinking is not uncommon. It was around long before the 20th and 21st centuries, but this is the first time you and I have seen it in person. It shows up in parents who refuse routine vaccinations for their children. They simply don’t see the need, and that’s understandable: there are parents walking around right now who were born since the year 2000. Their frame of reference does not include what happened 50 or 75 years ago. What has taken historical amnesia to the next level in the past year is that the occasional random family who refused vaccines suddenly turned into millions of people who don’t remember what the prevaccine world looked like. As our ancestors would tell us if they were still around (see life expectancy article on page 3), the pre-vaccine world is not one we want to ever see again. +

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

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Scientists would like to know the answer to this question. It’s a global phenomenon, although the gap varies from country to country. Currently women have a nearly 4 year advantage over men, but in the mid-1970s it peaked at well over 6 years. The evidence suggests a combination of biological, behavioral and environmental factors which are still under study, but there is an amazing and fascinating body of facts about life expectancy in general. In 1860 the life expectancy at birth for men in the U.S. was a mere 35 years and change. For women it was 40.6 years. Despite the Civil War, for the next 30 years there were steady gains as measured every ten years. In 1890 women had gained over a decade (to an average of 51.2 years) and men even more, up to 49.5 years. But for some reason by 1900 there was a significant drop: men down to 46.4 years and women dropped to just under 49 years. Curiously, life expectancies steadily rose through the World War I years, but plummeted in 1918 during the Spanish flu pandemic. From 1917 to 1918, the life expectancy for women dropped from 55.9 years to 49.0, and for men from 52.1 years to 45.3. Somehow that makes us think about our cover story related to historical amnesia. Anyone who has studied the Spanish flu era has discovered a climate amazingly like our own: anti-mask protests, conspiracy theories, premature re-openings, concern for the economy and political expediency over public health, and irrational tales about what caused the pandemic and how to stop it. History really does repeat itself, and the results are often deadly. One of the most astonishing things about life expectancy statistics is their dramatic rise in recent years, and by recent we mean within the context of the grand sweep of time and human history. By that definition, 100 years qualifies as very recent. So what was a lifespan a century ago (2014 numbers)? For women the U.S. average was about 56 years; for men about 53. 100 years later it was over 76 years for men, more than 81 years for women. Much of the gain can be attributed to better prenatal and infant care (including vaccines), better nutrition and improved healthcare. +

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www.AugustaRx.com The Medical Examiner’s mission: to provide information on topics of health and wellness of interest to general readers, to offer information to assist readers in wisely choosing their healthcare providers, and to serve as a central source of salubrious news within every part of the Augusta medical community. Direct editorial and advertising inquiries to: Daniel R. Pearson, Publisher & Editor E-mail: Dan@AugustaRx.com AUGUSTA MEDiCAL EXAMINER P.O. Box 397, Augusta, GA 30903-0397

(706) 860-5455 www.AugustaRx.com • E-mail: graphicadv@knology.net www.Facebook.com/AugustaRX Opinions expressed by the writers herein are their own and/or their respective institutions. Neither the Augusta Medical Examiner, Pearson Graphic 365 Inc., nor its agents or employees take any responsibility for the accuracy of submitted information, which is presented for general informational purposes only. For specific medical advice, diagnosis, and treatment, consult your doctor. The appearance of advertisements in this publication does not constitute an endorsement of the products or services advertised. © 2021 PEARSON GRAPHIC 365 INC.

JUNE 18, 2021

AUGUSTAMEDICALEXAMiNER

#141 IN A SERIES

Who is this? ON THE ROAD TO BETTER HEALTH 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

or someone who wasn’t even officially a doctor, this man did all right for himself on the pages of medical history. In fact, he is remembered as one of the two founding fathers of gynecology. The other man, a semi-local doctor, will take the spotlight in our next issue, and his story is not exactly the prettiest life story you’ll ever read. In fact, they both left legacies that are less than stellar. This man, Lawson Tait (1845 — 1899), had a reputation as an “offensive and invidious” medical doctor. Why was he known as a doctor in the first place, good or bad? Fair question. He did study medicine in the city of his birth at the University of Edinburgh, Scotland. In fact, he studied under the pioneering Scottish surgeon James Syme, who held the university’s Chair of Clinical Surgery and who could claim the great and noted James Lister among his preTait students. (More about their connection in a moment.) Tait graduated in 1866 and received a licentiate (more or less a certificate of competence) from the Royal College of Physicians, but not a Bachelor of Medicine degree. Even so, he immediately took up a position as resident surgeon in the British West Yorkshire city of Wakefield. He continued to offend people as a very active and vocal member of the British Medical Association, whose members viewed Tait as antagonistic and meddlesome. He came by it somewhat honestly: his university mentor, Dr. Syme, had a well-known affinity for controversy, and Tait similarly stirred the pot as often as he deemed necessary (which was often). He was an outspoken opponent of vivisection (operating and experimenting on live animals), a common practice then (and now). He also was not a fan of Lister’s (and Syme’s) advocacy of antiseptic conditions for surgeons. Antisepsis required sterilization using chemicals like carbolic acid. Asepsis, endorsed by Tait, involved nothing more than boiling water to achieve the same objective. Before we completely run out of space, Tait’s contributions to gynecolgy were significant. He transformed the removal of ovaries from a procedure with more than a 90 percent mortality rate to one with a 90 percent survival rate. He developed new surgical techniques to deal with ectopic pregnancies, tranforming a condition that was almost always fatal to one with a single-digit mortality rate. He was also an early pioneer in matters that were not gynecologic in nature, procedures like appendectomies, gallbladder surgery, the invention of new surgical instruments, and the practice of meticulous surgical cleanliness without the use of chemicals. Tait was also an early advocate of an entirely new concept: hospitals dedicated solely to the care of female patients. By the time of Tait’s untimely death from chronic nephritis at age 54, his abrasive nature in opposition to common practices like vivisection and antisepsis had slowed down his career trajectory. +

I need to clean off my dining room table. It has become a repository for lots of “stuff” of which little has any socially or otherwise redeeming value. Why do I need to do that? Well, because I need some flat space in which to do jigsaw puzzles. Puzzles not only require flat surfaces, they also require a place where they can sit, undisturbed, for as long as the puzzle takes to complete. I haven’t done puzzles in many years, but our Columbia County meals on wheels is providing them with meals for those of us who are housebound and alone. When I was asked if I’d be interested in doing puzzles, at first, I thought it was referring to puzzle books, which I already like and have written about. But she was referring to 300-piece jigsaw puzzles. This is going to require me to stretch my skill levels to another type of mental exercise, and to test my arthritic hands to see if I can perform fairly exacting maneuvers with little bitty pieces. Fun for an old lady living in a vacuum of solitude! My life doesn’t provide me with much entertainment which means just like in my youth, we had to provide ourselves with fun. So my fun has to come from my own imagination, my own willingness to try new things like puzzles. Although fully healed now, my hip still hurts, especially on rainy or cold days. It limits what I can do, even with the help of both physical and occupational therapists who come to the house and ask me to do what is close to impossible for me. Doesn’t

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matter. They can be very insistent. Their latest big effort is to help me learn how to graduate from my slow-moving plain old walker to my fancier and much faster rollator. The surgery to repair my hip took two inches of length off my right leg, so walking is challenging enough without using the rollator. They aren’t being mean, though. Using the rollator will give me the ability to do much more standing up. The old walker wasn’t something I could easily use to do laundry with, although Justin helped me to figure it out. The rollator, with its seat, gives me a platform for carrying things from place to place. It also takes me from sitting in my wheelchair to standing up more of the time. I remember being able to walk around the grocery store for long enough to shop for my own groceries, and then using the rollator to bring in the groceries. It’s been nearly a year since I could do that. I believe I can do it again if I work hard enough and become strong enough. I am determined enough to master the fear which puts the brakes on relearning what used to be easy skills. Breaking my hip caused enormous and long-lasting pain from which today’s fear arises. I had more confidence about walking when I was a toddler, when I was an awkward teenager, even when my knees were riddled with such severe arthritis that I had two knee replacements. I believe I can regain that confidence, so my later years are less confined to my home, as lovely as it might be. +

JUNE 18, 2021

5 +

AUGUSTAMEDICALEXAMiNER

ADVENTURES IN

Middle Age BY J.B. COLLUM

THE

{

Loss naturally goes with aging. Even when ing, but somewhat unrelatable lyrics for a high we are young we lose things. In fact, losing stuff school kid. It describes a dancer and a writer is somewhat symmetrical. The older I get, the who are both suffering the loss of their abilities more I lose stuff, and little kids are always losdue to age. Here is an excerpt: ing things. I lost count of the number of remote The writer stares with glassy eyes — controls my kids lost. In many cases we never Defies the empty page, saw them again, even after turning the house His beard is white, his face is lined upside-down. I can only imagine they must And streaked with tears of rage. have gone out with the garbage, or they lie at Thirty years ago, how the words would flow the bottom of our septic tank. With passion and precision, Lately, I can’t seem to hang on to my pre But now his mind is dark and dulled scription glasses. In fact, as I write this, they are By sickness and indecision currently lost for the second time in a month. I It is certainly relatable now. I am learning lost them a couple of weeks ago how to be more patient with and have already retraced my myself. I have written about steps to no avail. The prior time this in past columns. I still need they were lost, I found them in Kids lose things reminders from my wife to do this the base of my recliner. That though. Our minds have a hard all the time. So do time accepting the limitations chair seems to eat things that I put in my pocket. If we are ever on as we age. us older people. brought hard up for money, my plan is to Another facet of loss related tip the recliner over and live off to aging is losing our friends all the change and other items and family to the age-old enemy, I’ve lost inside it over the years. death. This past year has seen a Of course, the losing can’t lot of that for many of us, I am always be blamed on my hungry recliner. It sure. I personally have lost several dear friends is usually related to forgetfulness. How many and family members since the beginning of the times have you found something only to then pandemic. Not all of them were directly from remember placing the item in that very spot the pandemic, but I believe that the side-efwith the thought that it was a nice safe spot fects of the pandemic are responsible for at for it? My phone is a prime example. I’ll put it least some of them. In one case, treatment was down somewhere before I do something that delayed while the hospitals figured out how could put it in a precarious position, then five to balance safe pandemic practices against the minutes later wonder where it is. I’m getting needs of patients, and while all that was going good at retracing my steps. I have left the house on a cancer spread that perhaps could have a lot without my wallet during this pandemic been stopped. We will never know for sure. because I forget to put it in my pocket. Why In another case, my favorite great uncle, the keep it in my pocket all the time, which makes one I previously wrote about in a four-part it less comfortable to sit down, when I rarecolumn, was isolated because of the pandemic. ly leave the house anymore? That said, after He lived in a city about three hours away, and having to turn around and come back home a I couldn’t visit since I had to balance the need few times in a row to retrieve it, I am back to to see and help him with the need to protect keeping it in my pocket all the time. my vulnerable parents who live with me. I Then there is the much more tragic loss we honestly believe that he would have survived suffer as we age, and it has many facets. The had we been able to visit and help him more. I song “Losing It” by the band Rush (lyrics by the could tell from our telephone conversations that late Neil Peart) certainly has more poignance he was getting tired of living with his infirmifor me now than it did when I first heard it as a ties and in the end, he opted to sign a Do Not teenager in the early eighties. Back then it was Resuscitate order before his final illness took just a nice song with great music and interestPlease see MIDDLE AGE page 10

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NO NEED TO STOP WRAP This is the best travel wrap ever. It is so good you will not need to or want to stop for a meal, just unwrap, eat and keep on truckin! I added fruit to this because it is delicious, but also because I had a little left over fruit when I was cleaning out the refrigerator before leaving for a road-trip. Ingredients • 1 tablespoon mango chutney • 2 teaspoons mustard • 2 whole-wheat tortilla wraps • ½ cup spinach leaves, divided • 4 ounces shaved high quality ham, divided • ½ cup sliced cantaloupe (mango, pineapple or apple) • 2 slices reduced fat cheddar or Swiss cheese Instructions In a small bowl mix the mango chutney and the mustard, then spread half this mixture over each tortilla. Place a layer of spinach

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Yield: 2 Servings Nutrition Breakdown: Calories 140, Fat 3g (0.5g saturated fat), Cholesterol 20mg, Sodium 560mg, Carbohydrate 23g, Fiber 12g, Protein 14g. Percent Daily Value: 30% Vitamin A, 20% Vitamin C, 6% Iron Diabetes Exchanges: 1 Starch, ½ Fruit, 2 Lean Meats +

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Finally, the fifth stage of change! What could it possibly be? The one we’ve all been waiting for! Precontemplation is over, Contemplation lasted too long, Preparation couldn’t come soon enough, somebody finally took Action, and now we’ve arrived at Maintenance! where practice makes perfect. This is the transitional stage. Change itself without transitioning to new ways spells relapse, and transitioning takes time, time, time. I joined a weight loss group a few years ago and successfully dropped 50 pounds in 6 months by doing all the things they told me to do. When I reached my target weight, I bid them farewell while they beckoned me to stay for weekly follow-up meetings and accountability weigh-ins. They said “you still need us” and I replied “I’ve got this!” I didn’t. Six years later my weight is back where I started in 2015! Last Thursday I re-joined and attended my first meeting - again. My second first meeting. I had changed, but I had not transitioned by maintaining what I had learned. The slimmer me was great but short lived because stinking thinking found its way back into my brain. “One doughnut won’t hurt me.” You can guess the rest. All addic-

tions follow the same cycle. You can’t out-think it. In the maintenance stage people intend to practice what they’ve learned in treatment or self-help groups to avoid relapse and repeating the stages of change all over again. How painful. In this stage the recovering (note the ing…ongoing behavior…one is never recover-ed!) alcoholic drives home from work on a road that has no red dot store. He or she doesn’t shoot pool at a bar to test his or her sobriety. They may even take a medication to reduce cravings for a short time, or even take Antabuse if the latest treatment attempt wasn’t their first rodeo. They go to support meetings, encouraged by the bumper sticker saying “I’m not an alcoholic – I’m a drunk! Alcoholics go to meetings.” They are in it for the long haul, realizing that though Rome wasn’t built in a day, the workers worked every day. They may have thoughts of drinking again but they realize it’s only a thought, not a mandate. They realize they have a propensity to regress, but they resist by implementing the skills they’ve learned, using the memory of their past pain to navigate them through troubled waters. Which brings me to the family, the spouse, of the newly recovering one. How can you help? Answer: Ask him! Or her.

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Expect to hear something like this: Please don’t ask me where I’ve been and if I’ve been drinking. Please don’t sniff my breath when I get home from work late. Give me time and space to attend my support meetings. Don’t ask me about my sobriety unless I bring it up. Don’t smother me or try to control me even in subtle ways. I won’t ask you to stop drinking but please, no alcohol at home. Please get a life of your own without my being your center of attention. I hope you go to support meetings, too, for families of alcoholics. Keep my sobriety story lowkey; if I want to talk about it to others I will. Hopefully you won’t have to take away their beer anymore. But wait! Could there possibly be a sixth stage of change? +

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DON’T LICK THE BEATERS Useful food facts from dietetic interns with the Augusta University MS-Dietetic Internship Program

PROBIOTICS VS PREBIOTICS by Haley Newton, Graduate Student Intern, Augusta University

More and more products in the grocery store claim to have probiotics or prebiotics. But do you know what they are and the difference between the two? With only one letter separating these two terms, it’s easy to get them confused. Knowing the difference will help you, because both are needed in your diet for optimal health benefits. Both probiotics and prebiotics are found in everyday foods and beverages, but they are also available as dietary supplements.

Prebiotics Prebiotics are non-digestible food components, such as high-fiber foods, found naturally in food. They promote the growth of helpful bacteria in the gut and improve gastrointestinal health. They also help with calcium absorption. The three most important groups of prebiotics are fructo-oligosacchardies, inulin, and galacto-oligosaccharides. The best sources of prebiotics include fruits (particularly bananas and apples), vegetables (especially garlic, onion, and

asparagus), and whole grains (such as oats and barley). Probiotics Probiotics are live and active microscopic bacteria, which are considered the “good” bacteria found naturally in the gut. Their role in the gut is to compete with the “bad” bacteria to eliminate any pathogens, to boost our immune system, and improve our overall health (especially our gastrointestinal health). One role of probiotics is to manage symptoms of irritable bowel syndrome (IBS). With probiotics, there is no “one size fits all” since there is a wide range of probiotic genera with hundreds of species, and even greater amounts of strains. Recommended doses for probiotics are listed as colony forming units (CFUs) per day. Each one has a different benefit to the body, with the most researched genera of probiotic bacteria including lactobacillus, bifidobacterium, and streptococcus. The lactobacillus genera are commonly found in the Please see PRO V. PRE page 10

Michael Sharkey, MD Lauren Ploch, MD Caroline Wells, PA-C Chris Thompson, PA-C John Cook, MD, Emeritus

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More Americans have died on US roads since 2000 than in World Wars I & II combined

important territory. By signing it a teen driver agrees to never drive under the influence, to always wear their seatbelt, to never engage in racing, to never text and drive or talk on their phone while driving, to only drive when they have their parents’ permission, and to be financially responsible for all parking tickets and traffic citations, among other things. Parents, you are as important to teen driving safety and your teenager is. Be sure to conscientiously shoulder your responsibility.

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t is no secret that teenage drivers are at heightened risk for accident and injury and death when driving (or being a passenger when another teen is driving). There are at least two key players in making driving safer for teens, maybe three: the teenage driver, or course, but also one or both parents. It could even be argued that the parents play the most important role. After all, the parents are the adults. They are the guides, the life coaches, and in this case, they need to be the driving instructors too. It’s up to parents to clearly convey the family ground rules about driving. Teen drivers must know the rules of the road, not only as established nationwide and statewide, but also know mom & dad’s rules. Breaking the family road rules, just like the ones police enforce, must result in consequences. Mom, dad, give these penalties some thought. Consider what is fair for first offenses, and how much the penalties will escalate for repeat offenses. It’s worth noting that parents should know the state law as it applies to teenage drivers as though they were teens again themselves. If Junior asks for the keys to give a friend a ride home at 10 pm, in some states he’s breaking at least two laws: driving after dark and driving without an adult in the car or with another teen. GDLs or Graduated Drivers Licenses are the norm in all 50 states, restricting teens and new drivers in several ways and only gradually removing the restrictions over a period of a year or more. Parents need to know those rules, and also be generous with their time. Going on errands? Ask your newly-minted driver to chauffeur you so you can offer supervised driving, and needed guidance if you see any bad driving habits they’re developing. The CDC website contains a downloadable parent-teen driving contract that covers a lot of

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KIDS & CARS Part 5

Sparkle

To review this 5-part series, in the April 16 issue we covered the dreaded child-left-in-ahot car topic and all the assorted ways that can occur. Turns out this happens far more than just when a parent forgets to drop a child off at daycare on the way to work. And it’s also the kind of accident where no one ever thinks in their worst nightmares that this could ever happen to them — until it does. The article ended with 5 solid tips to prevent hot car accidents and deaths. In the May 7 issue the subject was backover accidents. Were you shocked to read that the U.S. Department of Transportation says this kind of accident happens more than 17,000 times a year? Were you even more shocked by the experiment where a safety organization decided to see how many little kids would fit in the blind spot behind an SUV? They were able to place 62 children behind an SUV before the first one became visible in the vehicle’s rearview mirrors! In the May 21 edition we tried to simplify the often confusing guidelines on child safety restraints/car seats/seat belt use, etc. Then in our last issue we turned the spotlight on teen drivers, examining the safety factors that uniquely apply to them. These issues (plus more than 200 others) are available to read, print, and download at www. issuu.com/medicalexaminer. +

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MIDDLE AGE… from page 5

him. I did get to have a final conversation with him over the phone and I got to tell him I loved him. It’s funny because I probably had never told him that before even though I always had. He was a surrogate grandfather to me after I lost both my grandfathers by age seven. This loss really hurt. As I write this, we just lost a dear young friend who was like a nephew to me. We just buried him last Saturday. He left a wife and two young daughters, so they too, at their tender age, have experienced one of the most terrible losses anyone can face. And now a new young widow and two little girls must move on without one of the most important people in their lives and a mother has buried her child. Something we are not meant to have to do. Now I am standing on the precipice of the worst loss of my life so far, the loss of my father. He has been drifting away because of Alzheimer’s for years now, but he has reached the stage where we are having difficulty taking care of him and are now contemplating something that just a year ago was unthinkable: placing him in a nursing home. I am crying as I type this. I urge you to make plans for this eventuality. As hard as it is emotionally, it is compounded by having to deal with government agencies, insurance companies, and a mass of paperwork and phone calls as you scramble to find the best care for your loved one, all while anguishing over the feeling that you are abandoning them. You have to weigh their needs against your capabilities and face the fact that you have to make a choice that balances their health and happiness with the rest of your family’s. Over the years I’ve had lots of friends and some family who had to make the awful choice to put their loved one in a nursing home. I must admit that, although I assured them that they did all they could, I secretly held on to the conceit that I would never take that route with my parents. Age and time have a way of humbling a person as one more thing is lost: your youthful arrogance. That is something I wish I could have lost much earlier in life. + 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

PRO V PRE… from page 9

gastrointestinal and urinary tract. They are used as probiotics in foods such as yogurt. Bifidobacterium is found in the gut and mouth. This microorganism helps with the digestion of food and reducing inflammation. There are many types of probiotics and they all have different effects: one type of lactobacillus won’t have the same effect as a type of Bifidobacterium probiotic. Probiotics are found in many different foods including fermented vegetables, sauerkraut, kefir, yogurt, tempeh, pickles, wine, and sourdough bread. Recently probiotic supplements have become widely available in chewable, powder, and pill forms. Both prebiotics and probiotics work together synergistically. Food products that combine both are called synbiotics. Some examples could include raspberries with yogurt, or broccoli and tempeh. When aiming to include prebiotics and probiotics, remember to prioritize food sources first because of the many additional health benefits and antioxidants. For those who have gastrointestinal conditions, probiotic supplements may be better tolerated, as well as provide bacterial diversity, and high CFUs. When deciding on what is best for you, experiment with food first and then supplements to see what is better tolerated. For more advice on probiotics and prebiotics for your specific health needs, contact a registered dietitian nutritionist. + Sources: https://foodandnutrition.org/from-the-magazine/the-potential-of-probiotics/ https://www.eatright.org/food/vitamins-and-supplements/nutrient-rich-foods/prebiotics-and-probiotics-creating-a-healthier-you https://www.todaysdietitian.com/newarchives/031115p14.shtml https://www.nccih.nih.gov/health/probiotics-what-you-need-to-know

JUNE 18, 2021

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AUGUSTAMEDICALEXAMiNER

The blog spot From the Bookshelf — posted by Katharine Modisett, MD, on June 10, 2021 (edited for space)

THE WORLD SHOULD BE MORE LIKE A CHILDREN’S HOSPITAL For 15 days, we lived at Children’s National Medical Center when our daughter Evelyn was diagnosed with leukemia. Evelyn sat on my lap when we heard that her bone marrow biopsy showed leukemia. We talked about it with her team, and later that night, I stepped out under the guise of getting Evelyn her post-dinner treat to call family. The only place I knew to go where she wouldn’t see me crying (again) was the hospital lobby. I was on the phone with tears dripping down my face sharing the news with the crisscross of the day shift to night shift around me. Despite this influx of people, no one stared at me or side-eyed me for such a public display of emotion. I felt a communal understanding that bad news had been received and bad news had to be shared. When I was still red-eyed and trying to pick out Evelyn’s peanut M&Ms, another family showed me how to use a credit card without swiping on the vending machines. There was no obligatory, “Are you OK?” because clearly, it was not. Everyone in this space has a diagnosis, an appointment, a procedure, a test, a result, a hope to cling to, and a fear that they cannot possibly entertain. The world outside the hospital feels naively aloof – unaware of the center of my world. It’s not that I am secretive about this burden or wanting to hide what my daughter is facing. In fact, I wanted to hold up a sign to the truck driver staring down at me from his cab on the interstate – the tears streaming down my face are not from some petty loss – rather, I’m going through the better part of a half-crushed Kleenex box we keep at the foot of my daughter’s car seat because, despite the chemotherapy, the daily medications, the physical therapy, and the vital signs monitoring at home, our four year old has been given a number for her five-year survival that I can not push up any higher. And to get to that number, she will have to endure so much. I had an equal urge to share with the Target cashier that my frustration over the discrepancy between what blackout curtains were in-stock online versus what was actually in the store was not entirely rooted in being a privileged white woman shopping mid-week in suburbia, but because of a hope that those blackout curtains might help my child exhausted from chemotherapy just sleep a little while longer. This eagerness to explain and be understood is blissfully suspended while we are at the hospital. I don’t worry about being judged by another adult for the diaper poking above my daughter’s waistline – maybe they’ve also convinced their child that these aren’t Pull-Ups, but rather this is special underwear some kids wear because of chemotherapy’s side effects. When she’s tired and we are on our way to clinic, I don’t hesitate to pick up my almost four-foot-tall girl and carry her the same way I carry her 18-month-old sister. Caregivers here transport kids any way possible – in their arms, wagons, wheelchairs, or hospital beds. The undercurrent of a children’s hospital is not one of the outside world, which you wonder might have caused you to put off a child’s doctor’s appointment for a few days to get work and school done – but, is rather one of a quiet understanding, an empathy, and judgment-free. It would serve us all well to operate under the assumption that everyone has a loss or a challenge or just an ache in their heart and to convey to others the same empathy we feel when we walk into our children’s hospital. +

The world outside the hospital feels naively aloof

Katharine Modisett is an emergency and critical care physician.

The subtitle of this book is, in part, “The Making of a Medical Examiner.” I know what you’re hoping for: a fascinating book about the birth of this newspaper. So sorry to disappoint you. This is a book about the other kind of medical examiner, the kind, as the author puts it, “who cuts up dead people.” It’s a unique calling. After all, most people get into medicine to prevent death, or at least delay it. Not everyone is cut out to handle a patient caseload that is approximately 100% dead on arrival. Still, it’s an important and necessary specialty, and judging by decades of popular TV shows focusing on forensic medicine — both drama and reality — it is one many of us are fascinated by. In the case of our author, Dr. Judy Melinek, surgery was her chosen career, but it soon became apparent that a life of surgery would be, well, a life of surgery: mere 12-hour shifts were a rare luxury. More than once she wielded a scalpel for 60 straight hours, relieved only

by a few brief stolen naps. 108-hour weeks were the norm, although 130-hour weeks were not uncommon. Her schedule included exactly one day off every two weeks. Something had to give, and it did. She quit. But not before fainting at the end of a 36-hour shift and on another occasion performing surgeries while enduring a full-blown case of flu. Taking stock of things in unemployment, she thought about the pathology rotation she had enjoyed so much in medical school: “The science was fascinating, the cases

engaging, and the doctors seemed to have stable lives.” In fact, the director of the pathology residence program at UCLA had tried to recruit her during her last year of medical school. Maybe she could direct her to a pathology position somewhere that would accept a failed surgery resident. “Can you start here, in July?” the director asked. Raised in the Bronx, Melinek left New York for UCLA and the promised pathology residency, then returned to New York City to ply her new trade. This book details her two years of training as a newly minted forensic pathologist. Was this finally her ticket to the stable life she had abandoned surgery to find? Sort of. Except that two months into the job September 11 happened. And then the anthrax attacks. And then American Airlines flight 587...and then... + Working Stiff: Two Years, 262 Bodies and the Making of a Medical Examiner by Judy Melinek, MD; 272 pages, published in August 2014 by Scribner

BINGEREAD VISIT ISSUU.COM/MEDICALEXAMINER, WHERE MORE THAN 230 ISSUES OF THE EXAMINER ARE ARCHIVED FOR YOUR READING PLEASURE.

MEDICALEXAMINER

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The Examiners

JUNE 18, 2021

THE MYSTERY WORD

They actually banned you from the library? Why?

by Dan Pearson

Because I answered a call on my cell when I was there.

Well, it was my boyfriend calling to break up with me.

That’s it?

For crying out loud.

The Mystery Word for this issue: NURBUNS

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

EXAMINER CROSSWORD

PUZZLE

We’ll announce the winner in our next issue!

EXAMINER SUDOKU

15 17

18 21 25

8 5 1 7 3

28 34

40 44 47

55 59

4 2

61 64

5 6 1

9 3

9 1

5 8

2 5 7 3 1

7 3

29. HPV is one 30. Exclamation of surprise 31. Gave food to 33. Wily 34. Fuss 36. Partridge ____ 37. Obamacare acronym 38. Type of code 43. Once Georgia’s largest mall 46. Sickness adjective 48. Globe 49. Walker beginning 50. Money can be spent like this 52. Study in general 53. Local Bridge? 54. Sharply curved 55. Metal fastener 57. Eggs 58. Augusta has two 59. Shelter 61. Miami airport code

Solution p. 14

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

QUOTATIONPUZZLE 9 2 5 4 8 1 9 1 3 4 6 — Cicero 2 7

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.

O 1 2 3 4 5 B 1

’

1 2 3 4

1 2 3 4 5 6 7

3 1

1 A 2

V 1 2 3 4 5 6 7

— Leo Rosten

1.BBPCCMNH 2.AAAEOOUU 3.TVPINNNY 4.PEETT 5.HIRY 6.NET 7.RYE 8.S 9.S

SAMPLE:

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

L 1

O 2

V 3

E 4

I 1

S 2

B 1

L 2

I 3

N 4

D 5

19 20 ACROSS 1. Bowie hit 22 23 24 4. Mamie Eisenhower had 27 one of these in Augusta 29 30 31 32 33 9. Comedienne who starred with Goodman 39 13. Lyric poem 41 42 43 14. Something held sacred (Archaic or poetic) 45 46 15. Meadow 49 50 16. ______ lab 54 17. Uncovered 18. Gordon, originally 56 57 58 20. Dietary abbreviation 62 63 22. Walton Way bakery 65 66 of yore 25. Road connecting Walton by Daniel R. Pearson © 2021 All rights reserved. Way with Boy Scout Road 27. New prefix 66. Technique 28. Sweet _____ 67. Young hawk 29. Category of drinks 32. Customary DOWN 35. She went to high school 1. Type of group with Snoop 2. Dental org. 39. Summerville 3. Diner on Washington Road 40. Mona Lisa artist 4. Taxi 41. Extinct flightless bird 5. Having wings 42. Golfer Nelson 6. Avian influenza, in brief 44. Crack 7. Notion 45. Fed. intelligence agcy. 8. Silent signal 47. Also 10. Budget rival 49. Litigator 11. Deep sleep ltrs. 51. Benedict last name 12. R of 11-D 54. Big ____ 19. DDE nickname 56. Short letter 21. Regret 58. Susceptible to bribery 23. Fauci among friends 60. Prolonged 24. Downtown Augusta unconsciousness watering hole 62. All About_____ 25. Capitol of the last of the 63. Found attractive original 13 colonies 64. Cotton harvesting 26. Georgia county named for machine U.S. president #4. 65. Type of sale

WORDS NUMBER

Click on “MYSTERY WORD” • DEADLINE TO ENTER: NOON, JUNE 28, 2021

6 1 7 3 2 4 9 8 5

4 7 2 9 6 1 8 5 3

8 6 5 2 4 3 7 9 1

JUNE 18, 2021

AUGUSTAMEDICALEXAMiNER

THEBESTMEDICINE ha... ha...

horse walks into his favorite bar. “Hey,” says the bartender. “You read my mind,” says the horse.

A man took his family to the zoo. They were walking around looking at all the animals when his 8 year-old daughter excitedly pointed at one huge beast and said, “Daddy, look! A frickin elephant!” Several people nearby turned toward the girl in shock, and her father was also appalled. He had never heard her use that word before. Maybe he heard her wrong. He bent down and asked, “What did you just call that elephant?” “A frickin elephant,” she replied. “It says so right there on the sign.” The man looked, and sure enough, the sign read AFRICAN ELEPHANT. Moe: 2020 was so miserable. I hope nothing like it ever happens again. Joe: I hate to break the news to you, but next year will be 2020 too. Moe: As long as we’ve been married my wife has never stopped complaining that

The

Advice Doctor

I always forget to put the cap back on the toothpaste. Joe: Wow, for ten years. Moe: Yep. So I finally decided to really make an effort and always always put the cap back on, and I’ve been doing it for more than a week now. Joe: Does she really appreciate your effort? Moe: Nope. This morning she asked me why I quit brushing my teeth.

A man who worked as a statistician and traveled a lot for his job sat down one day back in the 70s when hijackings seemed to happen every other day. He calculated the odds that a bomb would be on the next flight he took, and the number he came up with scared him. So from that day on he always carried a bomb in his briefcase on every flight he took because he figured the odds of two bombs being on the same flight were astronomical. Moe: What do you call it when a group of crows start to gather together but then something scares them and they all scatter? Joe: That’s an attempted murder. Moe: How’s that new rescue dog you got from the pound? Joe: Great. I think maybe his previous owner was a blacksmith. Moe: What makes you think that? Joe: As soon as I got him home he made a bolt for the door. Moe: What did Kermit say at Jim Henson’s funeral? Joe: Nothing. +

Why subscribe to theMEDICALEXAMINER? What do you mean?

Staring at my phone all day has had no Effect on ME!

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

13 +

Dear Advice Doctor, Because of the pandemic I have fallen behind on every payment I have: car payment, house payment, credit cards, everything. Now that things are opening back up my full-time job is back again, and I also have two new part-time jobs. Despite all that I’m making almost no headway catching up. I’m just grasping at straws, treading water, getting nowhere. Plus, I am exhausted working my fingers to the bone. How can I get off this treadmill? — Broke and Broken Dear Broke, You’ve brought up a number of vital subjects. I’d like to focus on one in particular that is important even though many people don’t realize why. It’s about grasping at straws. As you have probably heard, straws have been banned in many places. Across the country, more and more cities and states are passing legislation making straws illegal, and some restaurant chains aren’t waiting: they no longer offer them to their customers. Incidentally, all the negative attention is being aimed only at plastic straws. Paper straws are not objectionable. What’s the problem with plastic straws? Although some people have made a joke out of the whole thing, it is a very important issue. One source says some 175 billion plastic straws are used every year, most for just a few short minutes before they’re thrown away. They are not easily recycled, and plastics never fully disappear from the environment. They degrade down to microplastics that contaminate water, but in non-biodegraded form are found in the stomachs of turtles, fish, and other marine life. It is estimated that over a million seabirds die every year from ingesting plastic. Globally, more than 90 percent of plastic is not recycled, and it accounts for approximately 90 percent of the rubbish found in the world’s oceans. Straws are in the top ten of items collected in ocean clean-ups, and the amounts of plastic contaminating the oceans are prodigious, an estimated 46,000 thousand pieces of plastic in every square mile of ocean. What’s bad for seabirds is bad for humans. We’re all in this together, and all forms of life deserve to exist salubriously. Thanks for writing, and I hope I answered your question. + Do you have a question for The Advice Doctor about health, life, love, personal relationships, career, raising children, or any other important topic? Send it to News@AugustaRx.com. Replies will be provided only in the Examiner.

SUBSCRIBE TO THE MEDICALEXAMINER +

Why read the Medical Examiner: Reason #217

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

BEFORE READING

AFTER READING

+ 14

THE MYSTERY SOLVED

THE PUZZLE SOLVED

...cleverly hidden on the ROOF in the p. 9 ad for OVERHEAD DOOR CO. OF AUGUSTA/AIKEN

— Cicero

WORDS BY NUMBER Money can’t buy happiness 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: There is no duty more obligatory than the repayment of kindness.

The Mystery Word in our last issue was: BRAILLE

THE WINNER: JOHN TSOPANARIAS! Want to find your name here next time? If it is, we’ll send you some cool swag from our goodie bag. The new Mystery Word is on page 12. Start looking!

JUNE 18, 2021

AUGUSTAMEDICALEXAMiNER

but neither can poverty. — Leo Rosten

READ EVERY ISSUE ONLINE WWW.ISSUU.COM/ MEDICALEXAMINER

JUNE 18, 2021

SPEND A HALF HOUR PER DAY EXERCISING AND THIS IS HOW MANY HOURS YOU STILL HAVE LEFT. SPEND THEM ANY WAY YOU WISH.

WILD WING CAFE & SCRUBS OF EVANS They’re the prize sponsors of our Mystery Word Contest.

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ALLERGY Tesneem K. Chaudhary, MD Allergy & Asthma Center 3685 Wheeler Road, Suite 101 Augusta 30909 706-868-8555

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TRANSPORTATION AMBULANCE • STRETCHER • WHEELCHAIR

706-863-9800

YOUR LISTING HERE Your Practice And up to four additional lines of your choosing and, if desired, your logo. Keep your contact information in this convenient place seen by thousands of patients every month. Call (706) 860-5455 for all the details!

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AUGUSTAMEDICALEXAMiNER

JUNE 18, 2021