Medical Examiner 9-16-22

As you may have noticed, the pursuit of happiness — specifically healthy happiness — is a major concern for many people. It’s big business. Food labels are liberally festooned with health claims. Even if it’s a package of Jumbo Twinkies, the label will still announce that it’s non-GMO, or vegan, or “Now with Less Fat!” You know how products are being down-sized while keeping the price the same? We’re halfway expecting to see a 14 oz. package of salt that used to be 16 oz. announce, “Now With Reduced Salt!” It could happen.

As we have said on these pages more than once, being a label reader is a good thing, especially the Nutrition Facts portion. Every one of us should give health all the attention it deserves.

But are we taking it too far?

A couple of years ago, Swedish researchers mea sured the health-conscious community against ten identifying characteristics of religions — things like a strong sense of community, a priesthood of some kind, sacred beliefs, places, and rituals viewed as uniquely superior and true, and a clear path to salvation, liberation, or deliverance — and discov ered that by every single measure, health is indeed a religion.

It’s got it all, including a plethora of both certified and self-appointed preachers; various interpretations of the one real set of truths; holy places where the faithful go to work out their salvation; and even its own set of backsliders and outcasts who gave it a try but fell by the wayside, some overwhelmed by shame and guilt and determined to return to the fold, others who will never be back.

In the world of faith, there are people whose zeal moves them to actions that can only be described

as extreme. The September 11 attacks were perpetrated by religious zealots. More recently, faith has moved some to vandalize or bomb synagogues and abortion clinics, or murder those who operate them. They see no conflict be tween the ideals of their faith and their criminal actions.

Their counterparts in the religion of healthcare might be typified by militant vegetarians who throw bags of fake (or real) blood on people who work in meat packing plants, or are simply carnivores. In less objectionable fashion, many proponents of this or that approach to health view everyone who doesn’t subscribe to their particular brand of healthy living with condescension.

Can we all just get along?

Most people realize that extreme approaches to health (or faith) are not usually sustainable over the long haul, and also tend to scare away potential converts.

For a modest example, a determination to lose weight and get fit that involves going to the temple — strike that — gym — at 5 o’clock every morning would not survive long for many of us. It might be a little extreme. In fact, one journal quoted a doctor who was asked the question, which is generally more important, fitness or sleep? His answer: sleep. That doesn’t mean it’s extremist for some one to schedule pre-dawn running or fitness sessions, but it probably wouldn’t last very long for many.

British cardiologist Rohin Francis has cautioned that some people actually get addicted to exercise, and The E Word definitely qualifies as a wonder drug. But as with any drug, there is an optimal dose. Not too little. Not too much. For E addicts, excessive exercise can cause sore knees, Achilles tendonitis, tennis elbow, and more.

Of course, most of us needn’t fear getting too much exer cise; 90% of us don’t get enough.

The sad story there is, as mentioned above, exercise tru ly is a wonder drug. Dr. Francis isn’t anti-exercise. “It has such a multitude of benefits, not just on your heart, but for Please see DRAW THE LINE page 3

Renea Soos • Serving Georgia & South Carolina

MEDICAL MYTHOLOGY

PARENTHOOD

by David W. Proefrock, PhD

Your 10 year-old son has been in therapy with a mental health professional for a few months since your divorce. Now his therapist is recommending that he be started on an anti-depressant medication. You aren’t sure you want him on medication. What do you do?

A. The therapist is the professional and knows what is best. If you aren’t going to take their advice, why did you hire them in the first place? Agree to the medication.

B. Get a second opinion before you agree to medication.

C. If you are worried about the recommendation, stop the therapy or perhaps seek out a different therapist.

D. Ask the therapist to explain to you in detail the recom mendation. Make sure you know the reason for medication, the goals and the risks, any possible side effects, and an estimate of how long he will need to take the medicine. Agree only after you understand the recommendation in detail.

If you answered:

A. The therapist is the professional, but you are the parent and it is your responsibility to make an informed decision.

B. You might decide that a second opinion is necessary, but first make sure you understand the recommendation in detail.

C. You shouldn’t stop his therapy just because of the rec ommendation. Make sure you understand the recommenda tion completely and then make an informed decision.

D. This is the best plan of action. You can only make an informed decision if you are appropriately informed.

The fact that your child is seeing a medical professional does not relieve you of the responsibility of making informed decisions about your child’s care. An informed decision means understanding the recommendation completely.

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

KNUCKLE-CRACKING AND ARTHRITIS

Chances are pretty good that most of us know — despite our mothers’ warnings — there is no connection between cracking knuckles and getting arthritis. Speaking on a Merck Manual podcast about this very subject, one doctor said he would be more worried about people going blind from wiggling their ears than about getting arthritis from cracking their knuckles

A noted study on the issue was actually published in Arthritis & Rheumatology in 2004 based on 60 years of research by Dr. Donald L. Unger of Thousand Oaks, California. Dr. Unger recruit ed himself as the main participant for his study, which consist ed of cracking the knuckles

on his left hand every day for six decades, but never once cracking those on his right hand. His conclusion was the same as the Merck doctor. In a speech accepting an award for his study (the Ig Nobel Prize, if you must know), Unger said, “Mother, I know you can hear me. Mother, you were wrong! And now that I have your attention, can I stop eating my broccoli, please?”

Unfortunately, there hap pens to be a lot more about

knuckles that is the subject of med

ogy. Probably common is that arthritis

fecting only old

That is false for several reasons.

Even children can get arthri tis, particularly the kind that results from inflammation, the kind a rheumatologist would treat.

Older people can and do get that version (rheumatoid arthri tis or RA), and also osteoarthri tis, which in simple terms is a joint or mechanical issue more than one of inflammation.

Have you ever heard the old wives’ tale that people with ar thritis or other joint issues can predict the weather? Well guess what? It’s not an old wives’ tale. While temperature and humidity have no bearing on the matter, barometric pressure does. Research subjects have been isolated in rooms where the pressure could be raised and lowered, and they were able to accurately report those fluctuations based on how their joints felt.

Some people think runners subject themselves to the risk of arthritis by punishing their joints with every jarring step. Not necessarily true. It can cer tainly elevate the risk, but with quality footwear and above all, good running mechanics, a person could enjoy pain-free running for decades.

Some forms of arthritis have no known cure, but others, such as gout, can be managed very successfully and even cured by compliant patients.

The key to treatment of any form starts with an accurate diagnosis and following treat ment guidelines while avoiding fad diets and quack cures. Stay active, maintain healthy weight, avoid smoking, and feel free to crack your knuckles.

mental wellbeing, diabetes, blood pressure, chronic pain, and cancer risk. These are all based on good evidence. The list goes on and on.”

Getting what should be a daily dose of this wonder drug can be a challenge. Over the past 30 months, many people have transitioned to work-from-home jobs, and the majority of us sit for a living.

But as Dr. Francis writes (at medpagetoday.com), “If you go from sedentary to building-in any form of regular exercise, you will reap incredible bene fits because there is probably nothing else you can do in your life to improve your health more, aside from maybe giving up smoking.”

Did you notice that he said any form of regular exercise? In other words, in the religion of fitness and health you don’t necessarily have to attend ev ery Sunday and always go to the Wednesday night prayer meeting. For just about all of us, virtually anything we can add that involves movement or exercise is an improve ment.

The key word is balance. Perhaps you recall a past issue of the Medical Examiner where a question was raised about hot dog eating. Dr. Karp, in his aptly named column (No Non sense Nutrition, which appears on page 8 in every other issue) gave it his blessing. The same would go for a donut, a corn dog, or one of those Twinkies we referred to earlier. If our health regimen is so fragile that it will collapse under the weight of an occasional donut or hot dog, we need to re evaluate and retool pronto.

Writing for the Ameri can Council on Science and Health, David Lightsey, MS, writes about the need for moderation and balance:

“On the one hand we have the growing obesity accep tance movement, even though the health consequences [of obesity] are worse than smoking, drinking, or poverty.

On the other hand, we have those who pursue physiques unattainable for most without cosmetic surgery, daily exer cise regimes lasting hours in the gym, often requiring ste roid use to obtain them, and a dietary protocol [with an] endless list of dos and don’ts.”

It shouldn’t take a degree in medicine or nutritional sci ence to live a salubrious life, nor should it require a life of constant deprivation and self-denial.

We’ve got to draw the line somewhere. We can’t live on alfalfa sprouts and steroids, nor on cookies, cokes and couches.

In sum, if salubrious living isn’t balanced and reasonable, it really isn’t salubrious.

QUESTIONS FROM READERS

It’s a wonderful thing to hear from readers. Here are an swers to some of the questions we often get.

Who writes this thing? There are hardly any bylines. That is no accident. The publisher of the Medical Examiner, Dan Pearson, had the idea to create this publication decades ago. Back then he often saw an Atlanta-based health publication called Pulse. Although Pulse was an insert in the Atlanta Journal-Consti tution, it was largely the work of a single person. Virtually every article was bylined, and they were all written by the same person. It was monotonous and seemed unnecessary and made the pub lication look like what it apparently was: a one-person operation. This paper is also essentially a one-man operation with the nota ble exception of our sterling collection of columnists. They all get the bylines they deserve. Anything that doesn’t have a byline — like this article — is written by Dan Pearson. Mystery solved. What happened to my Examiner newsstand?

Print is dead. Well, a lot of it is. We just haven’t gotten the memo here at the Medical Examiner. Most cities have a newsstand problem, and Augusta is no exception. Publications like Buzz on Biz and Metro Spirit went out of business years ago and they aban doned their newsstands, which litter the landscape to this day.

From time to time, various entities finally decide these eyesores need to be cleared away, and actively maintained Examiner boxes can get caught up in these sweeps. That happened recently to our newsstands at the Medical Collage of Georgia. We responded by resuming in-person delivery to all floors of the hospital, some thing we did years ago. Recently Eisenhower Hospital rescinded its permission for our box that had been in their lobby for years. Their reason: they said that Medical Examiner advertisers were in direct competition with healthcare providers on post who offer the same services

While such developments are disappointing, we have altered and adjusted our distribution to make sure the Medical Exam iner is still available to everyone who wants to read it on paper (and of course, online is alway available). In fact, our press run and copies delivered has actually increased since the recent loss of the newsstand locations mentioned above. We don’t plan on going away anytime soon.

Augusta, GA 30903-0397 (706)

“I’m very healthy, an absolutely perfect physical specimen!” said Donald Trump last week.

Who is this?

ON THE ROADON 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

Editor’s note: as regular readers of this column know, Marcia Ribble recently moved from Augusta back to Michigan where she was raised.

Students and practitioners of neurology no doubt recognize this man, considered the founder of modern neurology and one of the greatest teachers and clinicians in the history of medicine.

Born in Paris in 1825, Jean-Martin Charcot (shar-KO) had such influence that he left behind more than a dozen medical eponyms (syndromes, conditions or diagnoses he discovered or that are named after him), including Charcot’s disease, Charcot-Bouchard aneurysm, Charcot’s triad, Charcot-Leyden crystals, and so on, plus Charcot-Marie-Tooth disease (CMT), which has nothing to do with teeth; it is a hereditary form of peripheral neuropathy named after Charcot, his resident Pierre Marie, and British neurologist Howard Henry Tooth.

Charcot attracted students from all over the world, providing another major element of his legacy. His students included Sigmund Freud, Pierre Janet, Charles-Joseph Bouchard, Alfred Binet, and Joseph Babinski. Another student was Georges Gilles de la Tourette, discoverer of the syndrome named in his honor by Charcot.

While only Tourette and Freud may be household names, each of the students above (and a number of others not listed) were and are noteworthy in their own right as they went to on to distinguished careers after being trained by Charcot.

Upon Charcot’s death in 1893, Freud made a very perceptive observation about his teacher: “Of the many lessons lavished upon me in the past by the great Charcot, two left me with a deep impression: that one should never tire of considering the same phenomena again and again (or of submitting to their effects), and that one should not mind meeting with contradiction.”

As would be expected of anyone who practiced any branch of medicine more than a century ago, some of Charcot’s

The sun is shining and there’s a mild breeze making it fairly comfortable despite temperatures in the upper 80s and higher levels of humidity today. Tomorrow it will be skirting the 90s with high humidity and thunderstorms predicted. However by Tuesday, the humidity will drop into the pleasant range and the temperatures will be in the low seventies.

For many years the weeks before and during Labor Day week were vacation days. That meant packing up the big old Chevy Beauville van and heading out to play in whatever location we’d chosen. Like in the South, Michigan offers an incredible wealth of choices. Over the years we took advantage of many of the possibilities available to us. Vacationing is one of many mental and physical health options we have, and our family took those options as a great way to spend two weeks.

Camping was a family favorite. We camped in lower Michigan, upper Michigan, and in Canada, and wow, did we do a lot of fun things! One year we chose to focus on the Upper Peninsula. There we visited the Locks at Sault St. Marie. The huge freighters needed to move from Lake Superior to the lakes below, Michigan, Huron, Erie, and Ontario. Those routes allowed the ships to carry iron ore, lumber, grain, and other goods from port to port capturing all the growing and manufacturing from the entire region to gain access to other ports within

regional trade to international trade. Many people don’t realize that the interior of our country carries on trade as important to our nation’s economy as ports like New York City.

Soybeans grown in Michigan could be sold to foreign countries, as well as corn, wheat, rye, etc. In return, those emptied ships could bring in cargo important to the entire Midwest. The freighters are huge and in Bay City, where I live, they often move up and down the Saginaw River causing our bridges to open and close, stopping traffic from one side of the city to the other. It is fun to get out of the car while traffic is stopped for the bridge to go and wave to the sailors aboard, to guess about the contents, and to read the ships’ names. There are also places along the river where we can go to watch the freighters load and unload their cargo. Huge mountains of salt for winter are piled up from a freighter’s interior to keep our roads passable. At another site grain is lifted up from trucks and deposited in the ship’s cargo holds.

Labor Day is nearly time for sugar beets to be carried on huge trucks. One thing my children enjoyed was watching those trucks go over bumps and seeing sugar beets fly off to the side of the road. On occasion we’d stop and pick one up. Raw sugar beets are just a little sweet because they must be processed to make sugar. They are not small like regular beets, but often weigh more than 10 pounds apiece.

One vacation over two weeks provided our family with a year’s worth of educational experiences and connections, and the Locks took only one day to explore. The locks raise and lower the boats so the can move from one body of water to another, but that is not all there is to see there. I’ll have to tell you more about it next time.

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BY J.B. COLLUM

It’s been a year now since my father died. As others have told me, you don’t ever get over it, but it gets a little easier. Of course, that is only if you average it across time, because sometimes, at least for a little while, it hurts just as bad as it did that day a year ago.

This anniversary has caused me to pause and reflect some on all that has happened in this past year. Besides my father dying, I had three surgeries and almost one more. I was mostly dead for a brief time until a friend revived me with CPR. My entire immediate family and I got COVID-19. Just this past week end, we found out that one of our dearest friends has leuke mia. It never seems to end. As we age, ill ness or injuries befall us. Eventually, some thing gets us all. I’m pretty sure of that since I don’t know any folks that have gotten too far past 100 years on the earth. I never met Methuselah, but I’ll take the Bible’s word on his advanced age. That said, it doesn’t work that way anymore, for sure.

Another affliction of growing older, if you can call it that, is that time passes by fast er and faster. This past year was a blur. If someone told me as a young man that I had to wait a month for something, I’d be pretty anxious and impatient over it. Now, I’m still impatient, but I’ve noticed how my mind has adjusted to a different time scale. Just a little while back (it seems like yesterday but could have been last year...that’s another part of the affliction) my wife said we would need to wait a couple of years before we could make a certain large purchase I was wanting to make, and that seemed like a short wait to me.

Of course, a lot of good stuff happened this past year too. My Georgia Bulldogs final ly won another national championship after being so close so many times during the past 41 years. And on top of that, our Atlanta Braves won the World Series. I wish my dad

could have seen that. He had been waiting patiently for both of those to happen. I’ll just have to tell him all about it later I suppose. It is hard to believe that football season is back upon us again, and the baseball playoffs are just around the corner. Maybe lightning will strike twice. Who knows?

So, what do we do with this information? We can’t change time, at least not unless we can find a DeLorean and a 1.2-gigawatt ca pacitor. All we can do is slow down when and where we’re able and enjoy the moment without spending our time an ticipating some future moment. It is okay and even therapeutic to do a little of that, as it is nice to have special things to look forward to. We really should strive to be happy in our everyday life, not just on weekends. Not just on vacation. Not even just when we are healthy and feeling good. This year has taught me to do all that. I have a long way to go, but I’m still working on it, and I’m getting better at it.

For starters, I’m going outside a lot more. I’m trying my best to walk in the woods every day, as often as our summer pop-up thunderstorms will let me. I also gave up a lot of hobbies that didn’t make me as happy as I thought they would, and I’ve narrowed down my pursuits to just a few that bring the most joy. I also spend a lot more quiet time without doing anything in particular except maybe listening to music, or even just listening to the wind and the birds singing as I sit on my porch with my beautiful wife and sip on a nice cold beverage. I hope that you too are adjusting to the new time scale that each year of your adventure into middle age brings you and finding something to be happy about every single day.

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

A CENTURY OF PROGRESS

Most people celebrate their personal birthday about once a year. I say about once a year because those of the XY chromosome persuasion tend to be less that accurate about their exact number of birthdays. But I have the solution to their problems. After a woman turns 39, she can then celebrate the anniversary of her 39th birth day.

I began celebrating the an niversary of my 49th birthday some years ago. I can’t rightly remember exactly how many. And for the record, I don’t care. Actually, I am not completely sure of my birthdate. I was very young at the time and have to take the word of others regard ing that.

To celebrate recent birth date anniversaries, I cooked on my Green Egg, ate too much, took a nap in my favorite chair, and finished off the rollicking date by watching depressing TV news. I could almost hear my arteries harden. I could have gone out to the Redneck Olympics and entered the belly flop contest. But I didn’t. I’m

BASED ON A TRUE STORY

Mechanical engineers made about $5,000 per year.

The US had 8,000 cars and 144 miles of paved roads.

The speed limit in most cities was 10 mph.

Fuel for cars was sold in drug stores only.

14% of homes had a bathtub.

Coffee was 15 cents a pound.

Women washed their hair once a month, and used Borax or egg yolks for shampoo.

Canada passed a law that prohibited poor people from entering their country for any reason.

The Five Leading Causes of Death were:

1. Pneumonia and influenza

2. Tuberculosis

3. Diarrhea

too old and ugly for that. Us old codgers should step aside and give young guys a chance to impress their girlfriends.

Now that I am mostly awake, I think back about things that have changed in my lifetime, or more accurately, in the last hundred or so years. As usual, I made a list:

120 or so years ago

The average life expectancy for men was 47 years.

The average US hourly wage in 1910 was 22 cents per hour.

The average US worker made $200 to $400 per year.

Competent accountants made $2,000 per year.

Dentists made $2,500 a year.

Veterinarians made $1,500 to $4,000 per year.

8% of homes had a tele phone.

It was believed that tele phones would never be a commercial success because women and children would be too frightened to use them.

18% of households had at least one full-time servant or domestic help.

The tallest manmade struc ture in the world was the Eiffel Tower (1,050 feet tall)!

95% of all births were home deliveries.

90% of doctors had no college education! Instead, they attended so-called medical schools, many of which were condemned in the press and by the government as “substan dard.”

Sugar was 4 cents a pound.

Eggs were 14 cents a dozen.

4. Heart disease

5. Stroke

Penicillin and other antibi otics had not been invented. Pneumonia had a 90% death rate if the victim was over weight. Only 50% died if they were skinny. (With penicillin, pneumonia patients had a 95% survival rate.)

Only a disgraceful man beat his wife any more than she needed, and never with a stick bigger than the circumference of his middle finger. (Skinny husbands with small hands were in demand.)

The American flag had 45 stars.

The population of Las Vegas, Nevada was 30. There were no show girls or flashing lights.

No one had ever heard of silicone breast implants.

Tough football players played without helmets.

Crossword puzzles, canned beer, and iced tea hadn’t been invented yet.

There was no Mother’s Day or Father’s Day.

20% of adults couldn’t read or write.

6% all Americans were high school graduates.

Marijuana, heroin, and morphine were sold over the counter at corner drugstores. Back then pharmacists said, “Heroin clears the complexion, gives buoyancy to the mind, regulates the stomach and bow els, and is a perfect guardian of health.”

Coca Cola contained cocaine and was commonly called, “Dopes.”

Women’s panties were fre quently homemade from flour sacks.

Bras had not been invented.

There were about 230 re ported murders per year in the entire U.S.A.

A mouse was a four-legged rodent that made women scream and act crazy.

If a kid got a spanking in school, he got a worse one when

(most of the time)

A series by Bad Billy Laveau

TRYTHISDISH

by Kim Beavers, MS, RDN, CDCES

Registered Dietitian Nutritionist, Chef Coach, Author

Follow Kim on Facebook: facebook.com/eatingwellwithkimb

A tasty treat perfect for fall and winter holidays: Halloween, Thanksgiving and Christmas.

Ingredients

• Vegetable oil cooking spray

• ½ cup water

• 1½ cups sugar

• 1½ cups slivered almonds, toasted

• 1 cup pumpkin seeds

• 2 tsp. margarine

• 2 Tbsp. semi-sweet chocolate chunks, melted

Instructions

Cover surface of cut ting board with parche ment paper; lightly spray paper with cooking spray. Set aside.

Heat water and sugar in a large heavy saucepan on high heat for 8-10 minutes or unitl the sugar turns a dark amber color, stirring frequently. Swirl pan and brush down sugar crystals on sides of pan with a wet pas try brush just until the sugar comes to a boil.

Meanwhile, in a medium bowl, combine almonds and pumpkin seeds. Remove saucepan from heat; quickly stir

in almonds, pumpkin seeds and marga rine. Immediately pour mixture onto parch ment; spread evenly into a rectangle using a wooden spoon. While warm, cut into 24 piec es of candy. Let cool completely.

Microwave chocolate in 15 second intervals stirring after each 15 seconds until it is melt ed. Transfer chocolate into a ziptop bag and move the chocolate to one corner. Snip the end off the corner and drizzle a thin layer of chocolate over the brittle.

Yield: 24 servings (serving size 1 2-inch square)

Nutrient breakdown: Calories 188, Fat 12g (6g monounsaturated, 2g saturated); Choles terol .3mg, Sodium 2mg, Carbohydrate 12g, Fiber 2g, Protein 2g.

Carbohydrate Choice: 1 Carbohydrate Diabetes Exchange Value: 1 Other Carbohy drate, 2 Fats (mostly good fat).

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30909

If you enjoy the please tell a friend.

MEDICALEXAMINER

IF YOU DON’T ENJOY IT, PLEASE TELL US.

Medical Examiner contact information is in every issue. We’d love to hear from you.

DON’T JUDGE A BOOK...

by Ken Wilson Steppingstones to Recovery

...By its cover, right? I must admit, I’m a sucker for pretty book covers. They seem to jump out at me in a used bookstore, and they look better laying around my house! LOL! Publishers have a special department whose only job is to make their books stand out in a crowd to insure a better chance of purchase! I just finished reading a book about the fos sil layers found in the Grand Canyon and sure enough, the ploy worked in my case.

I’m sure I’ve passed up some good reading material in the past because of a plain cover. But we humans make

snap judgments sometimes and fail to consider that what’s inside is really what counts. Before I understood addiction and alcoholism, I did the quick-judge thing. Over the past 35 years that I’ve been in the rehab voca tion, though, I’ve come to realize that what meets the eye isn’t necessarily the true presentation of the human document.

For instance, I’ve lost count of the number of cases that have come through my door that go like this: Jane Doe is 35 - 40 years old and used to drink socially, like most Americans do, just a glass of wine at dinner... maybe two. But being the soccer-mom that she is,

working a full-time job plus carrying on full-time duties as a mother, sometimes she can’t sleep. She’s had problems sleeping since her teen years and now, over a period of 15-20 years, that one glass of wine has turned into a whole bottle after work because she learned that wine brings her sleep, blessed sleep. When she wakes up in the night she needs more wine to get back to sleep because her toler ance has increased. Inevita bly she gets a DUI taking her kids to school. One DUI for her and another one added for each child in the car. It’s Georgia law! Picture in The Jail Report. Probation. DUI school. Increased insurance

premiums. Lawyer fees, fines, community service. To tal cost: about $10,000. Jane Doe agrees with the court that she needs treatment and obediently enrolls.

Certainly the alcohol dependence needs to be ad dressed before other personal or mental needs can be ad dressed. But what is/was the real issue? We have to look inside the book covers of the human document. An observant licensed counselor realizes the original primary diagnosis: a sleep disorder!

Sends Jane to a sleep disor der clinic and presto .. .in weeks she can now sleep without drinking wine! It does take weeks, sometimes months, but rarely much longer. Patience, patience. If only it had happened 15 years sooner.

It’s what we call “under the iceberg” in treatment-ese.

And the list goes on ... sim ilar pattern, different story, different client. Abused as a teenager. Inherited chronic anxiety. Grief after the death of a loved one. Religious abuse. (Yes, you read cor rectly!). Unipolar Disorder. Bipolar Disorder. And for it all: alcohol to the rescue.

A wise counselor opens the plain-Jane book cov er, sees past the suffering alcoholic and addict and sees

THIS IS YOUR BRAIN

something beautiful inside, trite as it may sound. If I’ve seen it once I’ve seen it thou sands of times.

To note and to dispel a misconception: treatment may identify under-the-ice berg issues, but make no mistake, it is malpractice to open up some of these issues and think that during treat ment these lifelong struggles can be resolved. Some, yes. All, no. Sometimes opening such a can of worms can lead to relapse very early in treatment, or make an alcoholic dive into a dark place and not come back up for air. It is incumbent on the therapist to identify and then seek to stabilize the suffer ing addict before addressing some serious muck. It takes time.

I think I’m going home to dust off some ugly-cov er books and look inside. They’re calling my name, begging me to have an un biased glance after all these years.

A monthly series by an Augusta drug treatment professional

he

5th graders could actually do math, long division, and make change at the store.

Every man and boy carried a pocket knife at all times, including at school and church. A pocket knife was a tool, not a weapon.

By age 12, every self-respect ing boy had a dog, a gun, and a knife.

By age 12, girls could sew, crocket, iron, plus kill, dress, cut up, fry and serve fried chicken for Sunday dinner. (Dinner was at noon. Supper was at dark.)

Girls were expected to remain a virgin until married. Boys? Well, that was a different question and subject to much lying, one way or the other.

Virginity was a virtue. Pregnancy before marriage was a family disgrace and the girl was sent far way to have the baby, which was put up for adoption. “Baby Momma” was unheard of in family circles.

Single parent homes indicat ed the husband died in a war or in some other tragedy.

Birth control was a mental exercise; now it is chemical or mechanical.

Men smoked in public. Women did not. The same with voting.

Soldiers were admired and respected.

Only war veterans and crimi nal had tattoos.

Being on welfare or getting a government check was a disgrace.

Not paying one’s bills and filing for bankruptcy was un heard of.

Every decent person went to church regularly.

Presidents and presidential candidates always appeared in public wearing a coat and tie.

Yes, much has changed since 1900. We have made much progress, medically and me chanically.

But are we better off socially or morally? I think not.

CRASH COURSE

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

hen it comes to crashes, children are much safer than they used to be. The rate of motor vehicle crash deaths per mil lion children younger than 13 is less than a quarter of what it was in 1975. The rate at which children die as passenger vehicle occupants has decreased 56 percent, while the rate at which they are killed as pedestrians and bicyclists is less than one-tenth of 1975 rates.

Proper restraint use can reduce crash deaths and injuries even more. Appropriate child safety seats provide signifi cantly more protection in a crash than seat belts alone.

Choose the right restraint for your child’s age and size, and always seat kids in the rear.

All infants and toddlers should ride in the back seat in rear-facing seats until they reach the height or weight limit of their child restraints, which may not be until age 2 or older.

Once they outgrow rear-facing restraints, children should ride in a harness-equipped forward-facing child restraint until they reach the height or weight limit of the child re straint. Top tethers should be used whenever a child restraint is installed forward-facing. When children outgrow child restraints, they should use belt-positioning booster seats until adult seat belts fit properly.

By the numbers

Motor vehicle crashes remain a leading cause of death for children. A total of 845 children younger than 13 died in motor vehi cle crashes in 2020; nearly three-quarters of these deaths were children riding in passen ger vehicles.

The number of child passenger deaths has declined by more than half since 1975. The rate of child passenger deaths per million

children also has fallen dramatically to 11.8 deaths per million children in 2020, a 61 per cent reduction from 1975.

Proper restraint use can help reduce deaths even more. Although the majority of children ride restrained, 212 children killed in crashes in 2020 were un restrained, and others were improperly restrained.

Transporting children safely Children are safest when they ride in the back seat in the right re straint for their age and size, until they are big enough for adult seat belts to fit properly. That means starting out in a rear-facing re straint before moving up to a forward-facing restraint and then a booster seat.

Restraining children in rear seats instead of front seats reduces fatal injury risk by about three-quarters for children up to age 3, and almost half for children ages 4 to 8 (Durbin et al., 2015). In the front seat, children, par ticularly infants in rear-facing child restraints, may be at risk of injury or death from an inflating front airbag.

Any restraint is better than none at all, but an appropriate child safety seat provides the best protection in a crash until children are large enough for adult seat belts to fit prop erly, usually when a child is about 4 feet 9 inches tall and 80 pounds.

Appropriate child safety seats provide significantly more protection in a crash than seat belts alone. Harness-based child re straints reduce fatal injuries by 58-71 percent for infants (younger than 1) and by 54-59 percent for 1-4 year olds compared with no restraint (NHTSA, 2009). In comparison, adult seat belts reduce the risk of death in a crash among 1-4 year-olds by 36 percent.

Source: The Insurance Institute for

Safety (iihs.org)

the blog spot

A SILENT MOMENT WITH A DYING PATIENT

I used to work as a nurse in a medical-surgical floor a few years ago during the night shift. I met a patient who changed the way I look at and treat patients. She was in her 50s, and was just diagnosed with metastasized lung cancer that was likely terminal. She had just found out that same day, and she was flooded with a million emo tions. I worked the night shift and came into the room to hand out that evening’s medica tions. Now that her family mem bers left for the night and she was alone, she finally broke down in front of me and began to say ev erything that was on her mind.

To be honest, it was emotionally difficult to be with her. Patients in the hospital often share these horrible life outcomes, and it was a true shock for me to learn about seemingly healthy individuals succumb ing to rare diseases and having strokes and heart attacks at an unlikely age, many dying but many permanently disabled, a shell of who they used to be, prolonging the suffering of their family members. To survive, medical workers somehow need to be OK with these situations every single day yet feel like a normal, happy functioning person on the inside. The only way to do this is emotion ally distancing yourself from patients.

But this woman was different, and I will likely never forget her. She broke through all my defenses, and I found myself stopping everything I was doing in order to be in that moment with her. She reminded me of my mother; they were almost the same age. She told me about her children and how she didn’t know how they would cope with having their mother gone at such a young age. She talked about dying and how she was not afraid, that she wasn’t going to give up, and that she was going to contin ue fighting every day until the end. She would often laugh during her conversation, perhaps as a defense mechanism when she realized the despair was too great, and so the mind convinced her to do the opposite. She would de scribe the good times in her life but would suddenly be reminded of her likely fate and cry again. This happy, sad, angry cycle continued for about 30 minutes. I felt frozen. What could I possibly say to this woman that would help her?

No amount of training could have prepared me to deal with this patient reaching out to me just inches away. Her sadness and complete despair radiated towards me like a heat wave on hot summer day, and I felt the deepest emp tiness, like having a golf ball stuck in my stomach, unable pass through.

Then, she stopped talking and looked at me, her eyes glassy and red. I suddenly became lucid and aware of everything that was going on around me. I looked around, and it was as if the room was gray. I could have sworn it had no colors. I heard my own breath deep in my ears. It was very shallow, yet low in pitch. I felt the weight of my own hands as gravity pulled down on them and my shoulders carried the weight. I heard the roughness of her breathing from her inflamed lungs and bronchus. I felt complete stillness. I couldn’t feel my heart. Was it beating? It was as if the world had suddenly stopped spinning and someone hit the pause button. The universe perfectly still. Nothing else mattered at that point. It was her and me in that room, connected by an invisible yet powerful bond between her mind and my own. The human connection.

I knew then that I didn’t need to say anything.

Ramses Perez is a medical student

From the Bookshelf

This is the harrowing story, says Kirkus Reviews, of two brilliant immunologists, one Christian, one Jewish, who were separated during World War II yet found heroic ways to turn their typhus vaccine research against the Nazis.

In a twist of irony not lost on the author (who also wrote, Ripe: The Search for the Perfect Tomato in 2010), the Nazis were deathly afraid of lice. The little insects were known to carry typhus, a dreadful contagious disease that could cause hallucinations, terrible headaches, raging fever, and often death. Typhus ravaged communities forced to live in subhuman conditions, including soldiers on the war front, as well as inmates in concentration camps and ghettos. It therefore became a wartime imperative to eradicate lice and the disease.

In Poland, scientist Rudolf Weigl (1883-1957) and his assistant, Ludwig Fleck (1896-1961)—who would later write the seminal text The Genesis and Development of a

Scientific Fact—were both enlisted to develop a typhus vaccine: Weigl in the service of the German army and Fleck under SS guard at Buchenwald. Weigl, after all, had created the first typhus vaccine in th 1920s. The dual stories of Weigl and Fleck, beautifully told within the devastating tumult of Poland’s unfolding history, describe the war from a vivid perspective: that of the laboratory saboteur.

Weigl secretly used his lab to smuggle vaccines to the Polish ghettos and recruited many intellectuals as lab workers, saving their lives. (Frequently, these respected

thinkers would be hired as louse-feeders, letting the creatures feed on their own blood—a surreal scene.)

Meanwhile, Fleck’s lab was also a center of conspiracy, and his sabotage was even more dangerous and cunning: He produced a fake typhus vaccine for German troops and Nazi experimenters while sneaking real doses to desperate inmates. Both scientists risked terrible deaths to defend the idea of moral good despite the corruption, bloodshed and evil surrounding them.

Allen is unflinching in his retelling of this monstrous era, but he manages to avoid writing a depressing narrative. Instead, Weigl, Fleck, and their vaccines illuminate the inherent social complexities of science and truth and reinforce the overriding good of man.

AUGUSTAMEDICALEXAMiNERSEPTEMBER 16, 2022 11 + +

An unforgettable book, concludes Kirkus.

The Fantastic Laboratory of Dr. Weigl, by Arthur Allen, 400 pages, published in 2014 by W.W. Norton & Company.

BINGEREAD

VISIT ISSUU.COM/MEDICALEXAMINER, WHERE MORE THAN 10 YEARS OF EXAMINERS ARE ARCHIVED FOR YOUR READING PLEASURE.

MEDICALEXAMINER

posted by Ramses Perez, on April 2, 2018 (edited for space)

She had just gotten the news that day.

Cleaning lady?

You and me both. She’s been “working from home” for months now.

That’s crazy. So what does the note say?

THE MYSTERY WORD

The Mystery Word for this issue: CIEHTS

©

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

Click on “MYSTERY WORD” • DEADLINE TO ENTER: NOON, OCT. 2, 2022

reserved.

X A M I N E R

We’ll announce the winner in our next issue!

Solution p. 14

by

R.

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

U D O K U QUOTATIONPUZZLE

by

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

by Dan Pearson

by

THEBESTMEDICINE

the teacher had him write it on the board.

Abcdefghijkmnopqrstuvwxyz, he wrote.

The teacher realized this was going to be an impossible situation for her and the children for the entire school year. “Do you have a nick name?” she finally asked.

“Noel,” said the boy.

Moe: What do they call glass cookware in Jamaica?

Aman moved to a new town, so he found a new dentist and made an appointment. When the day came he noticed for the first time the dentist’s name from the diploma on the wall: Ferdinand Q. Slurzwinski, the very same name as a kid he went to high school with years before.

“It’s got to be him,” he thought, “There can’t be two people with that name,” but when the dentist came in he changed his mind: the guy was way too old. But he asked the ques tion anyway: “By any chance did you go to Springfield High?”

“I sure did,” replied the dentist.

The man was in disbelief that this geezer could have been his classmate, but despite his shock he said, “I think you were in my class.”

“Really?” said the dentist. “What subject did you teach?”

On the first day of school the teacher had all the children stand and introduce themselves.

One boy said “My name is Abcdefghijkm nopqrstuvwxyz.”

It was very hard to understand, so after ask ing the boy to repeat his name several times,

Joe: I give. What?

Moe: Pyrex of the Caribbean.

Moe: My wife and I laugh sometimes about how competitive we are.

Joe: Oh yeah?

Moe: Yeah. But I laugh more.

Moe: My friend called me at work to tell me he’s changing his name to Spinal Column.

Joe: That’s strange. What did you say?

Moe: I was really busy. I told him I would call him back.

Jokes that should be heard, not read:

• How do you get a blind man to see? By boat.

• How do you get a deaf man to hear? Just bring him over.

• Why are Saturday and Sunday the best days to go to the gym? Because Monday, Tuesday, Wednesday, Thursday, and Friday are week days.

• Moe: This is weird, but whenever I serve my kid alphabet soup he only eats the vowels.

Joe: Why? Moe: Sometimes.

Advice Doctor

©

Dear Advice Doctor,

I’ve always had a hard time saying no. It’s a skill I need to learn, but so far, it’s still mission impossible. Take a neighbor to a doctor appointment and wait with them for two hours when I’m already slammed? Sure. Provide snacks for the kids’ entire class? No problem. Do a co-worker’s job for them and then watch them take credit for it? Just ask. I know what I need to do. But I knew that five years ago and here I am still biting off more than I can chew almost every day. What’s the secret to making this change?

Dear Too,

— Too Agreeable

You are certainly not the only person who grapples with this issue. We live in a fast-paced world, and many people eat on the run, in a rush, while driving, at their desk, etc. Anyone trying to eat in a hurry is at risk of biting off more than they can chew in the interests of speed. Another related problem in rush-rush eating is not chewing food adequately.

Why are these matters of concern?

The process of digestion is how our bodies access the nutrients in the food we eat. Shortchanging that process is like stealing from our own body and shortchanging our own health.

It’s easy to forget that digestion is not something that starts after we swallow. There are chemicals and enzymes in our saliva that start the process of digesting food as we’re chewing it. What you describe is one of two ways people interrupt this important step in digestion. First, what you do: take bites that are too big. It’s almost impossible to properly chew a huge bite of food, which leads to the second issue: chewing too fast and too briefly. For many people, this is how they eat all the time, big bites or small.

There are all kinds of ridiculous strategies offered as solutions, like counting how many times you chew each bite of food. Can you imagine? You can’t even have a conversation with friends or family because you’re counting your chews!

A better answer is to focus on the enjoyment of eating. Slow down. Savor the flavor. Set your fork or your sandwich down after every bite. Take your time. Don’t talk on the phone or do work while eating that divides your attention. Your job for those few minutes is eating, and doing so mindfully (not mindlessly). Bon appetit!

I hope this answers your question.

Do you have a question for The Advice Doctor about life, love, personal relationships, career, raising children, or any other important topic? Send it to News@AugustaRx.com. Replies will be provided only in the Examiner.

Why read the Medical Examiner: Reason #381

BEFORE READING AFTER READING

ha...

THE MYSTERY SOLVED

...cleverly hidden on the bench in the p. 1 ad for SCRUBS OF EVANS THE WINNER: MALLORY STINSON! 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!

WORDS BY NUMBER

...wherein we hide (with

word (found

contest link

SEVEN

entries,

ACUPUNCTURE

Dr. Eric Sherrell, DACM, LAC Augusta Acupuncture Clinic 4141 Columbia Road 706-888-0707 www.AcuClinicGA.com

CHIROPRACTIC

Evans Chiropractic Health Center Dr. William M. Rice 108 SRP Drive, Suite A 706-860-4001

www.evanschiro.net

COUNSELING

Resolution Counseling Professionals

3633 Wheeler Rd, Suite 365 Augusta 30909 706-432-6866

www.visitrcp.com

DENTISTRY

Jason H. Lee, DMD

116 Davis Road

Augusta 30907 706-860-4048

Steven L. Wilson, DMD

Floss ‘em

Family Dentistry 4059 Columbia Road Martinez 30907 706-863-9445

DERMATOLOGY

Georgia Dermatology & Skin Cancer Center 2283 Wrightsboro Rd. (at Johns Road) Augusta 30904 706-733-3373

SKIN CANCER CENTER

www.GaDerm.com

DEVELOPMENTAL PEDIATRICS

Karen L. Carter, MD

1303 D’Antignac St, Suite 2100 Augusta 30901 706-396-0600

www.augustadevelopmentalspecialists.com

DRUG REHAB

Steppingstones to Recovery 2610 Commons Blvd. Augusta 30909 706-733-1935

EMF PROTECTION

EMF Safe Homes Sheila Reavill Certified Building Biology Specialist 209-625-8382 (landline)

SURVEY•ASSESSMENT•REMEDIATION

IN-HOME CARE

Everyday Elder Care LLC Certified Home Health/Caregiver 706-231-7001 everydayeldercare.com

Zena Home Care Personal Care|Skilled Nursing|Companion 706-426-5967

www.zenahomecare.com

LONG TERM CARE

WOODY MERRY www.woodymerry.com Long-Term Care Planning I CAN HELP! (706) 733-3190 • 733-5525 (fax)

PHARMACY

Parks Pharmacy 437 Georgia Ave. N. Augusta 29841 803-279-7450 www.parkspharmacy.com

SLEEP MEDICINE

Sleep Institute of Augusta

Bashir Chaudhary, MD

3685 Wheeler Rd, Suite 101 Augusta 30909 706-868-8555

P ARKS HARMACY

Khalil Al Soutary, MD Endocrinology

Julian Nussbaum, MD Ophthalmology

Jamie Steinsapir, MD, PhD Endocrinology

Janaki Nadarajah, DPM Podiatry

Diabetes Center