Medical Examiner 8-19-22 by Daniel Pearson

ers reach a terminal velocity (literally) of 75 mph in just 4 seconds. The impact is almost a sure guarantee to get the job done. In fact, one analysis stated “every jumper has a 98% chance of sucess.” That is considerably higher than any other method, higher even than shooting yourself in the head.

But as you noticed, the guarantee is not 100%. It’s so close that the number of people who have survived the jump is a very exclusive club. A study from 3 years ago put the grand total at just 29 people. They all have one thing in common (other than jumping off the bridge): 100% of them regretted their decision as soon as they jumped.

What is all about survival? Why suicide, of course. We’ve been thinking about this topic ever since our recent cover story about the new national number for mental health emergencies rolled out a few weeks ago. Don’t call 9-1-1. Call 9-8-8.

As a follow up to that story, let’s examine a leg-

endary spot for suicide, the famous Golden Gate Bridge, and glean a powerful lesson about life and survival.

Why is this bridge the weapon of choice for the despondent?

One strong selling point is its height, 225 above the surface of San Francisco Bay. From that elevation, jump-

One jumper who lived, Ken Baldwin, said that as soon as he let go of the railing he immediately thought, “What am I doing? This was the worst thing I could do in my life.” He instantly thought of his wife and daughter and didn’t want to die. He recalls realizing that everything he thought was unfixable was totally fixable — except for having just jumped.

His sentiments are echoed by two groups: everyone else who has ever survived as mentioned earlier, and another group composed of people who went out onto the bridge but couldn’t jump.

DILEMMA

A strong argument could be made against body shaming in any form — and it can take several. There is the “I am my own worst critic” variety, wherein we judge our appearance, weight and shape by an unrealistically rigid standard. Body shaming can also be aimed at someone else, either behind their back or right to their face.

Believe it or not, there are proponents of body shaming. It has its advocates. They don’t necessarily endorse being rude

Please see QA page 3

PARENTHOOD

by David W. Proefrock, PhD

Over the summer break your children have gotten into the habit of staying up very late and sleeping until noon. It has not been a problem, but you are worried about them being able to get up on time when school starts. What do you do?

A. Start making them get up even earlier than they will need to when school starts. Then it won’t be such a shock when they need to start getting up for school.

B. Get them out of the habit of staying up late by making them go to bed earlier at night. Starting tonight.

C. About a week before school starts, put them back on their regular schedule. Tell them that they should get back on schedule so they will be ready for school when it starts.

D. Don’t worry about this. Kids are flexible and will make the adjustment quickly when they have to.

If you answered:

A. This is only a partial solution. They need to get back on their regular schedule both in the morning and at night. Not only that, when you get them up so early you will have some pretty grouchy kids to deal with.

B. This is also only a partial solution. Again, they need to get back on their regular schedule both at night and in the morning. Be aware that you will probably be in for some battles at night.

C. This is the best response. It will make the transition back to school much smoother. Explaining why you are doing it will cut down on their resistance.

D. Kids are flexible, but it takes a while to transition schedules. They will need some time to adjust.

Children do better when they have a chance to adjust to changes, and they adjust better when they know why the changes are necessary. It is always best to explain to them when you are going to make a change.

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

Some myths are harmless; others lead to tragic results.

Have you heard this one about sharks? Many people believe it, but as anyone can find out by simply asking your neighbor, the one who is a marine biologist (or if you keep missing him or her, do a web search), it isn’t true.

The medical myth holds that since sharks don’t get cancer, taking a shark-based supplement will help prevent, slow, or reverse cancer.

Sharks absolutely do get cancer, but the false belief that they don’t has contributed to two separate tragedies.

First, sharks are paying an extremely high price for this pseudoscience: North American shark populations have dropped by 80% in the last decade. One study found that cartilage companies were harvest-

ing up to 200,000 sharks per month; a single cartilage plant in Costa Rica processed some 2.8 million sharks annually.

Second is the human toll: cancer patients are being diverted away from effective treatments in favor of a treatment that isn’t simply unproven; it’s disproven

Birth of a Myth

If sharks do get cancer, then how did this myth get started? During the 1970s, two researchers at Johns Hopkins School of Medicine were pursuing a common theme in cancer research: angiogenesis. As the name suggests, angiogenesis describes the creation (-genesis) of blood supply (angio-). Tumors are great at angiogenesis; they have to be in order to

survive and multiply, creating their own network of self-feeding arteries. But cartilage has no blood vessels, so it must contain some kind of signaling molecules that prevent even capillaries from forming. Initial studies inserted cartilage from cows and bunnies into tumors with success. Another researcher reasoned that since shark skeletons are 100% cartilage, they would be a better source than the smaller amounts of cartilage available from baby rabbits and cows.

These very small, preliminary studies ended without being able to demonstrate any benefit for cancer patients from shark cartilage. But the 1992 best seller Sharks Don’t Get Cancer: How Shark Cartilage Could Save Your Life opened the floodgates. A follow up book in 1996 was titled Sharks Still Don’t Get Cancer.

University of Hawaii researchers responded with an oceanographic survey that found 42 sharks with tumors, including tumors in their cartilage. The FDA and independent researchers have repeatedly published studies showing that shark cartilage does not treat or cure cancer in any way.

Sharks do get cancer. Even if they didn’t, there is no evidence that shark cartilage prevents cancer. The myth has cost the lives of millions of sharks, and an untold number of people.

The Money Doctor

PASSING REAL ESTATE DOWN TO YOUR HEIRS

There are many ways to leave a legacy. Ultimately, wealth is much more than simply what you see on a net worth statement; it’s a combination of both the financial side of things and the intangible items like time, memories, lessons, and values.

One of the ways you can leave a financial legacy for your loved ones is by passing down real rstate to your heirs. This article will give insights and advice on the best methods of passing down real estate from one generation to the next.

Using a Will versus a Trust

Typically, real estate will be passed to heirs through a Last Will & Testament. However, some people choose to use a trust in order to minimize costs and avoid delays in transferring assets. The decision to use a will versus a trust depends on a few factors. The first question we would ask is, “How complicated and expensive is the probate process in your state of residence?” When anyone dies their estate must go through a process called probate. In some states, the process is simple, fast, and inexpensive. In those states, a will is usually fully adequate. In other states, it is a bit more complicated, and using a trust can minimize costs and avoid delays when transferring assets at death. Another question we often ask is regarding estate taxes. If your parents are in an

estate tax situation (assets over $12.06 million per individual or $24.12 million per couple for 2022) they may want to consider planning with trusts to minimize estate taxes at death.

Talking with a local estate planning attorney is the best first step to answering many of these questions.

What to think about if you are considering selling or gifting a home to your children

If you are thinking about selling your home to your children as part of your legacy there are a few things to consider.

One thing to consider is the tax basis in your home. Are you selling the house or gifting the house? These situations are treated differently from a tax standpoint.

Selling the primary residence will often have a minimal tax impact. However, if the house has appreciated more than $250,000 for a single parent or $500,000 for a married couple, you may run into a taxable situation. You should discuss the sale with your CPA or financial planner. Selling your primary residence to your children if you need the profits may be tax efficient, provide parents with additional liquidity, and keep things simple. If you are selling a non-primary residence, be aware that selling a non-primary residence does not have the same tax exclusions. Each situation is

Continued from page 1 or blunt, but their argument goes something like this: with some sources saying 80% of Americans are either overweight or downright obese, isn’t it time somebody said something? Especially people in healthcare? Or are we just going to politely let these people eat themselves into an early grave?

That might be a well-intentioned, semi-valid argument as far as it goes, but it’s a little simplistic. For starters, not everyone who is overweight is a habitual over-eater. As many people have found out the hard way, some medications cause weight gain regardless of diet, and for some reason that weight never goes away when the medication is stopped. But no matter what the reason for someone’s weight might be, shaming should not be part of the equation. That’s never appropriate, but even the most mannerly approach to the subject of weight is a place where wise people fear to tread.

Speaking of wise people, excessive weight is undoubtedly a topic more physicians should discuss with their patients. Every list of contributors to salubrious living on the planet includes “maintain healthy weight” with elements like moderate exercise, sufficient sleep, a healthful diet, etc. So why don’t more doctors discuss it with their patients?

The only person other than our doctor who has a right to express an opinion about our weight is looking back at us in the mirror, and even that is a slippery slope. As alluded to above, we can be our own worst critics, and some people whose figures are absolutely skeletal view themselves as fat. Others shame themselves into imagining they are hideously heavy and therefore treat themselves to constant dieting, social isolation, and zero self esteem. That isn’t healthy.

Sometimes people don’t do those things to themselves; their parents, classmates, co-workers, and perfect strangers take care of it for them. Can we all just stay in our lane and display some manners and civility? You worry about your body. I’ll worry about mine. Maybe my doctor will help me, but other than that I’m good.

Body image issues can be hazardous to our health, even without a healthy dose of manners, reasonableness and balance.

Who is this?

At first glance, some of the opinions of this British physician might seem to be relics of racism so often seen in times past. Sometimes universally held beliefs from past centuries are nothing short of cringe-worthy today.

For example, in 1866 this man published a paper entitled “Observations on an Ethnic Classification of Idiots.” His classifications of idiots included both “Caucasian” and “Ethiopian” varieties. But there were others he identified, including a “Mongolian” type of idiot.

That last classification is a major clue to this man’s identity: in the not too distant past, certain people with learning disabilities were known as “Mongolian idiots” based on his research. That may sound like an insult, but it was simply the accepted medical terminology of the day, a vocabulary that pulled no punches. This man, for instance, held a position at a hospital known variously as The Asylum for Idiots, and The Royal Earlswood Institution for Mental Defectives.

But about those Mongolian idiots... Mongoloids and Mongolism were other synonyms for Down’s Syndrome, named after this man, John Langdon Down, who first described the condition in 1862. He based his classifications of idiots on what he perceived as facial features reflective of various ethnic groups. In the aforementioned 1866 paper, Down argued that if a disease can erase the uniqueness of this race or that race enough to cause one to look like another (such as whites looking like “Mongolians”), then clearly the human race must be a single species, a radical thought at a time when different races were each viewed as separate species.

Down pioneered humane treatment and medical care for patients with mental disabilities. He and his wife transformed the Earlswood Asylum for Idiots from a house of horrors where patients were cruelly treated into a clean, bright and open place where patients were treated with kindness. Their diet was improved, and pursuits like gardening, horse riding, crafts, and occupational training were the order of the day. Illustrating both the changes made and Down’s passion for his work was his resignation from Earlswood when its administrators (officially known as “Commissioners for Lunacy”) refused to provide funds to display artwork by some of its patients at an exhibition.

He and his wife opened their own facility, Normansfield, that was an immediate success, quickly growing from 18 patients on opening day to 160.

Down lived from 1828 to 1896. He met his wife, Mary, while living with his sister and her husband to save money while attending medical school. Mary was his sister-inlaw. They had two sons, Reginald and Percival, who both grew up to be doctors. In a strange twist of fate, Reginald’s son, born in 1905, had Down Syndrome.

In closing, which do you say: Down Syndrome? Or Down’s Syndrome. The only charity in the UK devoted exclusively to the syndrome is the Down’s Syndrome Association. In 1975, the National Institutes of Health recommended Down Syndrome as the preferred term in the U.S. Both versions remain in common use on both sides of the Atlantic. +

ON THE ROAD 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

I just celebrated my 79th birthday. The day started when one of my friends brought over a beautiful brown metal cross with the word FAITH cut out of it for me. But that wasn’t the actual beginning of the celebration. The day before, my daughter Vicki came with Richlynd and Ayana to cook a birthday dinner of steak, mashed potatoes, and broccoli for me. They also worked to put together my raised bed for flowers and vegetables outside. I felt wonderfully cared about! Then on Wednesday, there were also the awesome calls and notes of congratulations. I pretty much thought it was all over when I got ready and went to bingo.

Boy, was I wrong! About fifteen minutes before bingo was to start suddenly Vicki was coming in the door with Richlynd and Angelo, two of my grandsons, along with my great grands, Ayana who is thirteen and the twins who are 18 months, along with cupcakes for everyone at bingo. They got me! I had not suspected any of it at all. The whole room sang Happy Birthday to me. I blew out my candles. I almost cried, but actually I was too delighted to cry!

The twins were their usual charming selves, licking the icing off their cupcakes, but not really making a mess. Reaching up for me to pick them up. Giving me big baby smooches. There was so much laughter as the folks I play bingo with surrounded the table where I was sitting, enjoying my family as much as I was. It is probably fifty years since I experienced that kind of

celebration for my birthday, maybe even longer than that. I will carry that glow around with me for a long time.

One lovely aspect of the celebration is that my family is multiracial. I am white as much as anyone can truly be thought of as white, now that we can trace our ancestries back for centuries. My daughter is white and Native American. My grands are all multiply-mixed with African, European, Native American, Asian and who knows what else in their heritages. Given that where I live now is 90 plus percent white, my mixed family could have raised eyebrows, could have received shocked rather than loving reactions from the elders there, most of whom are in their 70s, 80s, and 90s. That simply did not happen. The happy eyes and happy faces and approving looks told a much better story, a more open story of an America where love counts more than skin color. Where family is a superior value above prejudice and friendship opens a path to receiving blessings and giving them in return.

This is the America I can be proud of. This is the America which offers hope in a dark time. This is the America our Founders may not even have guessed could be possible but is real and growing more real every day. This is the America that July 4th signifies. What better gift could anyone receive for their birthday than signs that the scariest aspects of human nature aren’t as threatening as some recent events would encourage us to believe. This undercurrent of love in the world makes it possible to really celebrate growing older with joy.

Middle Age

BY J.B. COLLUM

Welcome to part two of our story of how, with the help of some friends, I survived a major medicine mistake. When we last visited each other, I was left passed out in the yard with an ambulance on the way. As I mentioned then, my brother’s friend, Mark was next door, and he and my brother, along with my wife and kids somehow picked me up and got me on the back porch under the roof with some shade and a fan blowing on me. I came to as they were picking me up. At first, they placed me in a rocking chair, but as I was starting to lose consciousness again, they had the very good idea to just lay me down on the floor of the porch. I passed out a total of about five times we think.

At some point they put a blood pressure cuff on me, but weren’t able to get it to register anything other than giving an error message. After several attempts, they put my legs up in a chair and then got a very low reading. Somewhere in the 50 over 40 range. I passed out again, and this time when I woke up it was to Mark performing chest compressions (CPR). I didn’t pass out again after this. I was told that I had stopped breathing and had no pulse. I only remember one compression since that is the one where I went from mostly dead to mostly alive. Not too long after that, the ambulance arrived. They checked me out, hooked me up to an IV, and with the help of everyone there, lifted me up on a large piece of what seemed like canvas, and placed me on the gurney. My first trip in the back of an ambulance! About halfway to the hospital, I started feeling human again and they elevated the head of the gurney, and I could see my family riding behind the ambulance in my wife’s car. I didn’t have my phone with me, but I wanted them to know I was a lot better so they wouldn’t worry. They essentially had emptied my pockets, but they missed my Apple Watch. I have the one that has its own cellular data, so I texted the fam that I was feeling much better.

Once we got to the hospital and in a room in the ER, they did all of the typical things they do, like take my blood pressure, draw blood, do an EKG, etc. It took a while before they let my family in, but I was glad once they were able to come in. Due to Covid restrictions, I could only have two visitors per day, but my best friend and his wife drove all the way in from Atlanta just to see me and they somehow got around the restriction. I was very grateful for that. It took until around midnight to get me into a regular room, and I had sent everyone home long before that. They insisted on waiting until I was in a room, but I know what it feels like to be the person sitting around waiting with a sick loved one, and I didn’t want them to experience that any longer than they had to. I also didn’t

want them leaving the hospital so late at night. Plus, there is something to be said for being able to rest a while alone.

One of the most uncomfortable things at this point was how dirty I was. I had been cutting grass for hours in the heat before this happened, and I had fallen into the dirt when I passed out, so I felt disgusting with the sweat and dirt on me. I even mentioned to my wife and friends that maybe they could hose me off before the ambulance arrived, but to no avail, just a few laughs. It was a nice light moment in the midst of so much life and death drama anyway. So, when they got me into the room, I asked if the room had a shower because I simply had to get myself cleaned up before I would get into the clean bed. I was met with initial resistance by the nurse because I had a band on my wrist that indicated I was a fall risk since I had passed out earlier. Once I made it clear that there was no possible way that I was getting into that clean bed without getting a shower first, he relented, and showed me to a nearby room that had a real shower with a bench in it. After getting cleaned up and dressed in a fresh gown, I felt like I could finally relax, so I settled in for the night.

The next day, Sunday, was a day for more advanced tests, like an echocardiogram, and a nuclear stress test. For one of these, I forget which because I had them both given in parallel, you take a medicine that makes you feel like you’ve been running uphill for a solid hour with a heavy pack. It was hard to get enough breath and was, in fact, a little scary. They give you the choice of a coffee or a cola afterwards since this helps alleviate the side-effects. I chose both. I can be a somewhat difficult patient; in case you hadn’t already figured that out.

By Sunday evening, they were ready to send me home, as all of the test on my heart came back with flying colors, but since I had similar results from stress tests in the past, even though a heart catheterization later showed me to have 98% blockage (the so-called widow-maker), I wasn’t convinced. After all, why had I had chest pain and why did I nearly die? Since I insisted, they decided they would go ahead and do the catheterization on Monday, so I had to stay one more night. I didn’t like that, but the peace of mind the additional testing would bring would be well worth it.

Monday came, and they got me in far ahead of schedule. So much so that my wife and kids didn’t make it in time to see me in my room before they took me for the test. Once again, my watch came to the rescue, as they had taken everything else. I called my wife from my watch and helped her find me on the way to the test

Please see MIDDLE AGE page 7

WRONG!

BASED ON A TRUE STORY

(most of the time)

A series by

Flatwoods Frankie

Yeah, we get some things wrong from time to time.

Two Moderna vaccines prevent Covid. Wrong.

Two boosters prevent Covid. Kinda wrong. (You can still get covid, but it will be milder.)

Covid vaccines reduce your chances of hospitalization or death. Mostly right.

If Trump was elected president in 2016, we would have a recession. Wrong.

Penicillin and sulfa drugs will wipe out infections. Wrong. Germs got smarter

and became mostly immune to penicillin and sulfa. Presently, we are in a continuing race. So far, we are slightly ahead of germs.

If Biden was elected president in 2020, the Green New Deal would save the world. Wrong

Electric cars are the immediate answer to get rid of the need for oil and coal. Wrong. If it works out, it will take decades, and we’ll need lots of oil to get there. Electric cars need asphalt streets. Asphalt is made from crude oil.

Birth control pills will greatly decrease populations, but increase immorality. Well, at least one prediction was certainly wrong.

If you read it, it is history. If you hear it on radio or TV, it is news. Wrong. Our news sources have become activist,

slanting one way or another. No one wants to be a reporter anymore; they want to be journalist. Be careful what you believe, whether you read it or hear it.

Water has been necessary and drinkable for millions of years. True. But now, bottled water has an expiration date. Wrong. Water doesn’t expire.

When invented, telephones were thought to have no future because women and children would be too frightened to use them. Oh, how very wrong that was

Dick Tracy’s two-way wrist watch was not possible. Wrong. Cell phones destroyed that myth. Everybody and two of his brothers have one.

Emergency Rooms are for emergency visits only. Wrong. According to a recent study 80% of ER visits could be handled in a doctor’s office.

A liberal arts education teaches you to hate the money it prevents you from making. True. Look at student

loan crisis. It seems students hate to pay back the money they borrowed.

Marriage lasts “’til death do us part.” Wrong. 41% of US marriages end in divorce. Average US marriages last 8 years. In Washington DC, 80% of children are born to “single parent homes.” Not a good sign.

When people know what and how much to eat, their health improves. Wrong. The US is the only country in human history where obesity is a major health problem. In most countries, the wealthy are overweight and the poor are skinny. In the US, the opposite is true.

Visits from a wellness doctor once a year will make you healthier and increase your longevity. Wrong. You must follow the doctor’s advice for it to work. Knowing what to do is not the same as doing. Example: A birth control RX will not prevent pregnancy.

Limiting the number of free condoms per visit given by public health departments saves money. Wrong. The cost of one unplanned baby over its lifetime will pay for a ton of condoms. The cost of preventable VD is humongous.

Increasing corporate taxes

will not cost average people anything. Wrong. When the government taxes business, consumer prices have to go up for businesses to continue providing products. I drink 2% milk daily. My neighborhood homeowners association frowns on cows grazing in my front yard. I need milk companies even if the government taxes them and I have to pay more for milk. The same goes for medicines. Any and all tax increases come out of consumer pockets, regardless of the consumer’s income. That means you. Period.

All fairy tales begin with, “Once upon a time.” Wrong. Many begin with, “If elected, I promise...”

Outlawing gun will end killings. Wrong. If it were so, outlawing cars with back seats would end pregnancies.

Making more money will make you rich. Wrong. Managing your money makes you rich.

Medical education makes you healthy. Wrong. Practicing what you learn about good health makes you healthy.

Sacrifice to get the things you want. Wrong. Sacrifice to get the things you need. And there are not many things you actually need.

TRYTHISDISH

by Kim Beavers, MS, RDN, CDCES

Registered Dietitian Nutritionist, Chef Coach, Author Follow Kim on Facebook: facebook.com/eatingwellwithkimb

This quick and super-easy recipe is not only nutritious and delicious, it’s also portable, making it perfect for taking to school or the office.

Ingredients

• 1 (6-ounce) can solid white or light tuna in water, drained and flaked

• 1 small carrot, shredded (about ½ cup)

• 3 to 4 Tbs. light canola mayonnaise

• Salt and freshly ground black pepper

• Scoopers: Baked tortilla chips, cucumber wheels, mini whole wheat pitas, whole grain crackers, etc.

Instructions

Combine the tuna, carrot, mayonnaise, and salt and

MIDDLE AGE

pepper to taste in a medium bowl and mix well. To pack for a school lunch, place the tuna salad in a plastic container with a tight fitting lid. Pack scoopers in separate containers.

Yield: 2 servings

Nutrition Breakdown: Calories 200, Fat 9g (0.5g saturat-

… from page 5

where she gave me a kiss and took my watch for me.

As it turned out, my heart had no significant blockage and that was a great relief. But that left the question of what had happened, and here is where I have some advice that could save your life. I had been losing weight for some time, so my need for high blood pressure medicine had lessened. But since I don’t check my BP on a regular basis, I didn’t notice that my blood pressure was getting too low. That, plus me spending about three hours in the heat, which also dilates blood vessels, is probably why I passed

out the first time. Lifting the mower was probably why I had chest pain. Passing out a few more times and even having my heart stop was almost certainly due to me taking three nitroglycerin pills. You see, the way they work is, they dilate blood vessels, so you have the same amount of blood flowing through bigger pipes, thus your pressure plummets. When it gets too low, it can’t get enough blood to your brain, and you pass out.

Moral of the story: check your vitals regularly, especially if you are middle-aged or older. Also, don’t overdo it.

ed, 1.5g Omega-3), Sodium 530mg, Carbohydrate 6g, Fiber 1g, Protein 20g. Carbohydrate Choice: ½ Carbohydrate

Diabetes Exchange Value: ½ Carbohydrate, 3 Lean Meats

Recipe reprinted with permission from the authors of The Moms’ Guide to Meal Makeovers.

Recognize your limitations. And whatever you do, don’t casually take nitroglycerin. But don’t take it from me. Consult with your physician. After seeing how good my heart was, mine basically said to throw out my nitroglycerin. They also greatly reduced my blood pressure medication. Well, that is all for now. Until next time, take care of yourself, and stay mostly or fully alive.

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

ONE MORE RULE...

As a young boy, my parents instilled the fear of God in me by making me memorize the 10 Commandments, which often worked at keeping me walking the straight and narrow. Sometimes it didn’t…I knew the rules but broke them anyway, hoping to not get caught. As a hippy back in ’69-’70, I detested rules. As a recovering one at age 70, I’m still not so fond of ‘em!

But I recognize the need for them, especially, for instance, the need for traffic rules. I’d be anxious about driving home after work if there weren’t stop lights and speed limits. I still live on the edge sometimes, but have learned to restrain my heavy foot and go with the flow of traffic instead of being ahead of the pack. Don’t ask how much pain I felt to learn that!

For the past 6 months we’ve been looking at the

ASAM (American Society of Addiction Medicine) rules (ok, they call them Dimensions) for placing a client in the proper level of care for substance abuse treatment. As the framers of the Dimensions have evolved, some have suggested a need for yet another measurement: spirituality. In an official publication the organization defined addiction, in part, as having “biological, psychological, social, and spiritual manifestations.” That was way back in 2011, yet that last element of the dimension is still officially absent.

The problem of quantifying that dimension is severalfold: How does a clinician assess a person’s spirituality? Plus insurance companies aren’t known for paying for their policy holders to go to free Sunday School! And they’re not paying for someone to stay in treatment until

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they have developed positive spirituality, either. That can take years.

Spirituality...what is it, anyway? Religion? Nope. We all know very religious people who are committed to dotting the i’s and crossing the t’s of their religion but who are miserable to be around. (Is that you that I see out there, nodding your head affirmatively?). In self-help programs such a one is called a dry drunk; they aren’t drinking but are miserable in recovery.

A frequent saying in programs is “Religion is for people who are afraid of going to hell; Spirituality is for those who have already been there.” I’ll not subject that statement to religious scrutiny!

If spirituality can be seen as “peace with God (or higher power if you’re not a ‘believer’), self and others, I think we can all agree that one can be very religious but not have positive spirituality. And one can have positive spirituality

but not be religious. But one can also have both! 12-step programs purposely tout spirituality as being a cornerstone of recovery. Entire books have been written about the subject so I am unable to do an exhaustive definition of it here, but it is referred to in various ways. Some call Spirituality “peace with God, myself, and others.” It is certainly an exercise of reaching out beyond ourselves to a higher power, and atheists can do this too. I mean, if you hold a mirror up to such a one and he or she believes that what they’re seeing is the highest power there is, they certainly do need help! I know of some who name the law as their higher power; some even call their spouse their higher power (they just might profit from marriage counseling!).

A sponsor in a recovery program can be seen as a higher power too.

It could be called the act of reaching out beyond self to

connect with guidance and hope. As distasteful as that may sound to some conservative church-going people, it works for some, and is often a starting point for spiritual growth unknown to many.

The last time I checked, Divinity doesn’t have a one-size-fits-all method. The apostle Paul could’ve written the song “I Saw the Light”; Timothy was a slow-growth project. Who am I to judge either? Spirit can work any way it wants to and I’m not Spirit.

If I have positive spirituality, I don’t need or even want a drink or a drug! If I follow this rule, I really don’t need all the others.

your CPA and financial planner.

If you are gifting the house, you may want to think twice before doing so. With a gift while living, the tax basis will transfer to your kids, giving them a potential unexpected tax bill if they sell the property in the future. With a transfer at death, your kids will get a step-up in basis. Then if they sell the property in the future, the higher basis will help minimize taxes.

Another option to consider is a transfer-on-death deed (TOD deed). Most states now offer this option and it is an easy and effective alternative for transferring real estate upon your death. A TOD deed allows you to decide who receives ownership of the property at your death. It can be helpful if you do not want the property to pass through your will and the probate process. In states with a complicated probate process, this can be a great strategy.

Family Conflict

If there are multiple siblings who don’t get along, we encourage families to speak with a local estate planning attorney. They help people through these situations all the time. The worst thing you can do in a high-conflict family situation is to avoid creating an estate plan. The best gift you can give your family is a well-thought-out and documented estate plan. It will clearly define who gets what or controls what asset. In high conflict situations, you can consider using corporate executors and trustees to help. It increases the expenses but puts a third party in place to help minimize family conflicts after you pass away.

We have helped many clients work through settling estates. Some are complete disasters, while others are very smooth and simple. Benjamin Franklin said it best, “By failing to prepare, you are preparing to fail.” Don’t set your family up for failure, take responsibility and get your estate in order before you pass away

by Clayton Quamme, a Certified Financial Planner (CFP®) with AP Wealth Management, LLC (www.apwealth.com). AP Wealth is a financial planning and investment advisory firm with offices in Augusta, GA.

CRASH COURSE

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

he National Highway Traffic Safety Administration (NHTSA) recently released preliminary numbers for traffic safety statistics for 2021, and the numbers are absolutely appalling.

The fatality projections come in just shy of 43,000 highway deaths, a whopping 10.5% jump from the 2020 number, which was 38,824 deaths. As recently as 2011 the nationwide highway fatality total was 29,867.

Some might think that it’s automatic to see a massive jump in anything that’s compared to 2020. After all, the roads were deserted for good chunks of the year during lockdowns, and many people worked from home or lost their jobs altogether. So naturally the 2021 numbers are high compared to 2020.

Unfortunately, however, the 2021 numbers are the highest in well over a decade, the highest since 2005, in fact. The pandemic cannot be implicated as an excuse. The more than 10% one-year increase is the highest ever recorded in NHTSA’s fatality reporting system.

To address this alarming jump in fatal accidents, traffic engineers have teamed up with a bipartisan group of Congressional leaders to... Ok, that last paragraph was pure fantasy. We were just kidding, but then, you knew that: there is no such thing as a bipartisan group of Congressional leaders. The very idea!

But seriously folks, who really cares what they do in Washington or Atlanta or Columbia when it comes to traffic safety? None of it matters unless you and I do our part. They could pass a million laws — actually they probably already have — and unless and until drivers start scrupulously observing them, what does it matter?

To illustrate, what percentage of the population over the age of, say 4, knows that green means go and red means stop? The

number is no doubt pretty high. If you limited the poll to licensed drivers only, the figure might be 100%.

But how many times have you and I seen multiple cars run the same red light? Three runners is not at all uncommon. It happens all day, every day. Sometimes through street drivers already have a green light or a green arrow and cars are still crossing in front of them.

The situation is the same for most traffic laws. The speeding driver usually knows the speed limit; he knows he is speeding. But he is in a hurry or is impatient or just got into an argument with somebody and he’s taking his frustrations out on his gas pedal. Not to mention every other driver on the road. You might be one of those drivers who often sees a traffic offense and mutters, “where’s a cop when you need one?”

No doubt about it, with the practically universal disregard for various traffic laws, traffic enforcement needs to be everywhere at once, and that’s an obvious impossibility. And we all must admit, if they really were everywhere at once, most of us would have a few citations on our record. Like we said, it’s nearly universal. We want the other guy to be caught and fined, and we would like a friendly warning at worst and a blind eye at best.

As the statistics reveal, these unsafe habits exact a deadly toll. But statistics are pretty cold and sterile. Yet right here in the CSRA there are crosses at the edge of the road all over the place. Each one marks the spot where someone was on the way to the store or to work or to meet someone for lunch and wound up dead. Those crosses are kind of like statistics. And like the victims from those sites. They’re lifeless.

The same thing could happen to anyone. The best prevention is safe, defensive driving. The life we save could be our own. +

SURVIVAL from page 1

Oh, they wanted to. They didn’t chicken out. But it just so happened that the bridge’s elaborate surveillance system of ever-present police and constantly monitored cameras spotted them in time and forcibly prevented them from jumping, sometimes at the last possible second, dragging them back over the railing to safety.

That group, in a study by Stacey Freedenthal, Ph.D., LCSW, numbered 515 people over a considerable period of time. Dr. Freedenthal conducted a “where are they now?” follow-up study and discovered that among these people stopped in the very act of suicide, only 7% went on to actually finish the deed later in life.

What do we learn from these numbers? That the trite old cliché, “suicide is a permanent solution to a temporary problem,” carries much truth. That isn’t to say that the problems that drive people to the brink of suicide are imaginary, meaningless or trivial, molehills that have been transformed into mountains. They may in fact truly be colossal.

But in the overwhelming number of cases, they are temporary, or if time doesn’t remove them, time provides a way to fix them or at least cope with them.

These numbers also tell us that if all the suicide victims in the U.S. — nearly 46,000 in 2020 — could have a do-over, the vast majority would happily and gladly still be with us today.

It’s sad to consider that the beautiful Golden Gate Bridge is not the only landmark that has become a destination for death. New York City’s stunning Vessel sculpture (above), which opened a little over 3 years ago, is closed indefinitely due to multiple suicides there, the most recent case a 14-yearold boy with his family who jumped to his death on July 29 of last year. Discussions have been underway for more than two years about how to make the structure safer, but the permanent closure or demolition of the Vessel are also options under serious consideration.

There is no getting around the fact that suicide is one of the top causes of death in the United States. In fact, it is the second leading cause of death among people ages 10 to 14 and from 25 to 34; the third leading cause of death among individuals between the ages of 15 and 24; and the fourth leading cause of death among individuals between the ages of 35 and 44 (all 2020 figures).

As much attention as murder and mass shootings receive, there were nearly twice as many suicides (45,979) in the United States as there were homicides (24,576).

For anyone who feels like they’re in a life or death emotional crisis, hang on. Reach out. Get help. It is out there and readily available, from close friends and complete strangers. And never forget the lesson from people who have been in your shoes and are still here. If they could chat with us, the message they would personally offer right now is: the crisis will pass. Things will get better. Life will be sweet again. Just hold on. You can make it.

the blog spot

August 15, 2022

HOW TO ADDRESS A PATIENT’S PAIN

From medical school to residency, I’ve worked with colleagues who don’t prescribe pain medications for their patients who truly need them. Or they are just very hesitant about doing so. Some simply don’t believe in them. Others fear the legal implications like being named to a malpractice or wrongful death lawsuit. And several avoid pain meds, specifically opioids, like the plague because of possible addiction risk even when their long-standing home med is an opioid prescribed by their PCP.

To shrug off a patient’s pain is heartless.

When it came to working with residents who didn’t believe in the efficacy of pain meds, it became a literal pain (pun intended) for me, the nurses, and the patient. The pain ladder exists for a reason: Tylenol to Tramadol to Norco. Not believing a patient is in pain, or worse, believing they can tough it out, is dangerous. Poor wound healing, infections, heart strain (even worse for patients with heart problems), poor sleep, anxiety, and depression are only a fraction of the possible complications. More doctors need to realize that not treating a patient’s pain can lead to a rabbit hole of consequences.

So how should a doctor approach pain? Of course, we start with the basics: Is the patient on any pain meds currently? Any opioids? Is this pain different from their usual pain? How bad is their pain?

But even before that, we must think about the cause because pain is an underdiagnosed diagnosis. Or diagnosed but grossly undermanaged. Often, the cause is clear-cut. A patient just had surgery, or a patient has cancer. A patient was in an accident or had a fall. But what if the patient has pain stemming from a less clear or more complicated cause? Like psychological distress or CRPS (complex regional pain syndrome)? What about radiculopathy or drug toxicity? And sometimes, a patient has pain with no identifiable cause or pain due to overall poor health (smoking, obesity, sleep deprivation, etc.).

Coming down to it, the approach to pain should be the physician at the very least showing sympathy to the patient. Every single one of us has been in pain at some point in our lives. So we all know what pain feels like and what it can do to a person’s physical body and mental state. To shrug it off when a patient asks for something for pain because it isn’t the main problem is careless and disheartening. Pain should be taken seriously because it can be debilitating to the patient.

Yes, as doctors, we must be aware of how many pain meds the patient is getting, does their regimen consist of an opioid, and what their exact history of taking pain meds happens to be. We have to do our due diligence while at the same time not ignoring what the patient in front of us is saying and how they appear to our eyes. If a patient’s pain is uncontrolled, it can quickly lead to them distrusting the care team and medicine. They would no longer want to participate in their own care, which defeats the patient-centered care model we all like to champion (but perhaps only a few of us do). Let’s do better when it comes to addressing our patient’s pain.

Ton La, Jr. is a physician

From the Bookshelf

Medicine is full of antidotes. Afflicted with this? Take that. Accidentally swallowed that? Then swallow this.

This book is 300+ pages of antidote. For what, you ask?

This book is the antidote to the doctor you barely know; the doctor who rarely spends more than five minutes with you; the doctor who doesn’t really know your name; the doctor whose fees can run into the thousands of dollars.

This book is about the only surgeon on a small island. Timothy Lepore (which rhymes “peppery”) is that doctor, and the island is Nantucket.

Ah, you say. Nantucket. No wonder he has time for every patient. He’s probably rich. No wonder he doesn’t bill some patients, and accepts payment in oatmeal raisin cookies from some others. After all, what does he treat? Sunburn? The occasional fish hook caught in some angler’s finger?

It won’t take you many pages to discover that a lot happens on Nantucket Island that requires every skill the

most capable doctor could bring to the task: “[Over time] hundreds of people would have died if he wasn’t there, if not thousands,” asserts another doctor who knows Lepore.

Aside from his serious medical skills —you’ll get to know those both on the island and in his preNantucket days — Lepore has what author Pam Belluck calls “his patient-centered approach, once much more the nor m, [which] now strains to survive in towns and cities across the country as health care costs skyrocket, medicine becomes more corporatized and monetized, and extended face time with doctors is

an increasingly vanishing commodity.”

So yes, there is a little bit of sermonizing in this book, but it’s much more a fast-reading peek into the everyday life of a busy, if somewhat eccentric doctor. Along the way you’ll get to know a number of his more noteworthy patients, from Jimmy Buffet to the titular Underground Tom, and the downright weird Billy Dexter.

Part of Lepore’s duties involve expert testimony in court cases, and being crossexamined by lawyers who know he might have to save their life one day.

There are first-hand accounts of mass casualty fires, open heart surgery, colon obstruction operations, cancer, stabbings, shootings, and ticks, one of the banes of island living.

Yes, Nantucket is just a nice quiet island where nothing ever happens — until it does. All those times are what this book is about.

Island Practice: Cobblestone Rash, Underground Tom, and Other Adventures of a Nantucket Doctor, by Pam Belluck, M.D., 304 pages, published in July 2013 by Public Affairs +

posted by Ton La, Jr, MD, on

Marriages are deadly.

You watch too much true crime TV.

EXAMINER CROSSWORD

PUZZLE

ACROSS

1. The former 51-A

6. It can be dull

10. Literature, music. etc.

14. Experiencing fatigue

15. Ethereal

16. Emperor of Rome 54-68

17. Greek epic poem

18. Often confused with a gator

19. Lean

20. Alliance, especially a temporary one

22. Woody tropical vine

23. Quantity of bricks?

24. _____ Girl cornstarch brand

26. Definition

30. Positions; places (technical)

31. Like yogurt cultures

32. It comes after sales

33. Car brand from 1897 to 2004 (as used informally)

37. Common cell addition

38. Color with Sea or Square

39. Type of pigeon?

40. Unspecified in number

41. Get hitched

42. Tapering mass of ice

43. Of the ear

45. Duped

46. Having a notched edge, as a leaf

49. Basketball net holder

50. Person who prefers solitude

51. The previous one was 1-A

57. Med. prefix meaning within

58. Pierce with a knife

59. Reduce or narrow gradually

60. Port city of Yemen

61. Seep or leak slowly

62. Mountain ridge

How is that relevant?

by Dan Pearson

There is also a 100% fatality rate among people who eat and breathe.

THE MYSTERY WORD

The Mystery Word for this issue: IFTUR

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

We’ll announce the winner in our next issue!

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

63. Traveled by horse

64. Star ____

65. AU’s Summerville campus library

DOWN

1. Auricular 2. Vanishing grocery chain

3. Melody for Jessye Norman

4. Repast

5. STP, or FD&C Yellow No. 6

6. Walking back and forth

7. Air prefix

8. Strong, as a guarantee

9. MSG location

10. Penicillin, for example 11. Walton _______

12. One-third, as of a circle

13. Echolocation

21. ____-deaf

22. Fond du ___, Wisconsin

25. Smoked salmon

26. Geographic diagrams

27. Reflected sound

28. Type of bomb

29. Emergency numbers

32. Talk type

34. Key receptacle

35. Deal out sparingly

36. Winter conveyance

38. Organ or cell capable of responding to external stimuli

39. Sword with a curved blade

41. Mental sharpness and humor

42. What surrounds a pupil

44. Tobacco component

45. Legendary Jeopardy! host

46. Distinct

47. Musical composition

48. Terminated

52. Tear down 53. Challenge 54. Fencing sword 55. Takes home

56. House type

Drunkard

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.

by Daniel R. Pearson

ATHEBESTMEDICINE

consultant dies and goes to heaven. When he meets Peter at the Pearly Gates, he protests, “I am only 53! Why did you bring me up here so early?”

“Don’t flatter yourself,” said Peter. “You’re 83. It was time. Get over it.”

“I’m 53! I have my birth certificate to prove it,” the consultant replied. “83? Where in the world did you get that number?”

“We added up your time sheets,” Peter said.

Moe: I can’t figure this out.

Joe: What?

Moe: NOVOCAINEZILDJIAN, the password for this new account I’m setting up, keeps getting rejected.

Joe: You’ve got a number and a cymbal, which is what they asked for. Huh. Beats me.

Moe: What’s keeping you busy these days?

Joe: I’m actually making a movie, a documentary about flying.

Moe: Cool! How soon will I be able to see it?

Joe: Right now we’re just filming the pilot.

An Indian chief had three wives, and they were all pregnant.

When the first one went into labor and gave birth to a baby boy, the chief was overjoyed and built her a beautiful new tepee from deer hide.

The next day, the second wife also gave birth to a baby boy. The chief was so happy he made her a new tepee from antelope hide.

When the third wife went into labor the following day, the chief was so elated that he built her a lavish new tepee from hippopotamus hide, but he kept the details of the birth secret and invited the entire tribe to guess what had happened.

Days went by without anyone guessing correctly. Finally one young brave said he had figured out the mystery. “Your wife gave birth to twin boys,” he told the chief.

“That is correct,” said the chief. “How did you figure it out?”

“Easy,” said the brave. “The value of the squaw of the hippopotamus is equal to the sons of the squaws of the other two hides.”

Moe: Something amazing happened today.

Joe: What?

Moe: My mother-in-law fell into a wishing well.

Joe: Why is that amazing?

Moe: I never thought those things worked.

Moe: I wonder why there’s no record in the Bible of Noah fishing.

Joe: He only had two worms.

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

try as they might,

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

Dear Advice Doctor,

My brother and his girlfriend just announced their engagement — and their wedding date, which is in just two short months! Whatever happened to year-and-a-half engagements? Even worse, the wedding will be at a beach resort in Aruba. Going there is not the problem. It’s the beach setting. I have to lose at least 20 lbs by then, which is definitely easier said than done. Ironically, I need a can’t-lose diet to lose this weight. Suggestions, please!

Dear Lose Weight,

I would like to commend you for your openness and honesty in bringing this issue to light. When people say something is easier said than done, it calls to mind the opposite: people for whom words are not easier said. Although it isn’t normal for an adult to experience difficulty speaking, it’s not exactly rare.

There are a number of common speech issues. Perhaps the one that comes to mind first is stuttering. About 5% of children stutter, with boys about twice as likely to stutter as girls. Most kids grow out of it or conquer the disorder with speech therapy. Only about 1 in 100 adults have trouble with stuttering, although it can be episodic, only happening under extreme stress or nervousness.

There are various other speech disorders that range in cause from mechanical problems (such as tongue, vocal cord, and tonsil issues or facial paralysis) to brain injuries and degenerative neurological conditions related to stroke, dementia, autism, Parkinson’s disease, Huntington’s disease or other issues. Even memory issues and hearing loss can significantly affect a person’s ability to effectively communicate.

Speech therapists are experts at evaluating and assessing what’s behind speech issues and devising the best ways to eliminate or minimize the problems. Their jobs are extremely important, since talking is a fundamental human characteristic. We take it for granted, but its loss or impairment can be devastating.

Help is available and can be as simple as breathing exercises, working to strengthen oral muscles and practicing proper pronunciation.

I hope this answers your question.

— Lose Weight? Can’t Wait. +

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 be provided only in the Examiner.

THE MYSTERY SOLVED

...cleverly hidden in the corner of the p. 3 ad for FREE MAMMOGRAMS!

THE WINNER: GENEVIEVE RAMSEY! If that’s your name, congratulations! Send us your mailing address using the email address in the box on page 3. The new Mystery Word is on page 12. Start looking!

...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.