e have all seen the same scenes far too many times all over the country, and now it has happened just up the road in Winder. Parents hear the awful and unimaginable news that there has been a shooting at the very school their child attends. It’s hard to imagine the nightmare scenarios that play through parents’ minds as they race to the school, and the instantaneous and overwhelming relief and happiness when they get to see and embrace their child, safe and unharmed.
No matter how terrible a school shooting may be, there can be a feeling that it could have been so much worse. Some may privately console themselves that maybe a thousand or more students walked away uninjured, including their own child. In a few days or a few weeks, they think, things will begin to return to normal. Let’s examine that hope, and take a fresh look at who the victims of school shootings really are.
The hard lesson being learned over time is that almost no one emerges from a school shooting unscathed. Long after news crews pack up and move on, those exposed to the event — whether seasoned educators or little kids — suffer negative effects for years thereafter. Thanks to the frequency of school shootings, there is no shortage of carefully collected data. One study determined that in 2018 and 2019 alone, more than 100,000 children in America attended schools where a shooting took place.
A 20-year (1992-2018) Texas study conducted by the National Bureau of Economic Research found that public schools where there had been a shooting subsequently experienced years of chronic absenteeism; students in such schools were more likely to have to repeat a grade than students at schools that hadn’t experienced a shooting. High school students at shooting schools were about 3% less likely to graduate compared to the “non” schools, and they were more than 5% less likely to enroll in a 4-year college. Years later, students exposed to a school shooting were less likely to even have a job in their mid-20s compared to those who hadn’t attended a school where a shooting occurred. The study estimated a lifetime reduction in earnings of more than $115,000 for each and every shooting-exposed student. Considering the large numbers involved — an average of 50,000 American students are exposed to some act of school gun violence each year — researchers estimate the total lifetime lost earnings nationwide at well into the billions of dollars.
A 6-year study completed in 2020 analyzed 44 school shootings and measured antidepressant prescription data among youth in the affected communities. The data showed an increase in antidepressant use of more than 20% immediately following the shootings, a rate which persisted more than three years afterward. Keep in mind that these negative effects observed and documented are all among the physically unharmed. Nearly three-quarters of all U.S. school shootings in 2018 and 2019 resulted in no fatalities. In one study of 33 school shootings, eighteen resulted in no fatalities, and none of the fatal shootings resulted in more than one death. Despite that, the broad-reaching negative impacts on people’s lives were profound and long-lasting, impacting the school community directly as well as the entire community’s sense of safety and security.
It’s one thing to survive a school shooting without being shot. Statistically, that is by far the most likely scenario. But nearly everyone involved in one of these unfortunate events will live with significant consequences for decades at least, if not the rest of their lives.
PARENTHOOD
by Dr. Warren Umansky, PhD
Your teenage son’s behavior has changed recently. He has become more secretive. He spends most of his time in his room. He doesn’t want to talk about school, but from checking the parent portal online you know that his grades are not good and he is missing many assignments. His sleep habits are very poor. Over the years, you have dealt with kids bullying him. Your son always has had a hard time getting along with other children. He didn’t do well in sports when he was young and wasn’t interested in other extracurricular activities. You are not sure who his friends are these days, or if he even has any. What do you do?
A. Take the changes seriously. Make an appointment with a mental health specialist (child psychiatrist, psychologist, or professional counselor) as soon as possible.
B. It’s just a phase he is going through. Don’t overreact by worrying too much about it.
C. Ask your friends for advice or go on Facebook to see what others think.
D. Increase your vigilance at home. If you have weapons at home, be sure they are locked up. Monitor his social network activities. Notify the school counselor of your concerns.
If you answered:
A. This is not a time to be casual and take a “wait and see” approach. Sirens should be going off to say your child is in need of help. Professional help should be engaged quickly, either through private sources or through your local community mental health center, which usually provides free or discounted services based on ability to pay.
B. Rather than taking a casual approach, let a professional make the call on the seriousness of the behaviors. You want your child to be successful. Your concerns about his behavior changes are real and have to be addressed immediately.
C. Asking others for advice will delay important action. You need professional advice and you need it now.
D. While this response might appear extreme, it is important to protect your child and others.
Isolation reinforces mental health problems. Your child has a history of being bullied and now has been spending a lot of time alone in his room. Your concerns are very justified. Parents can help their children, beginning at very young ages, by being sure the family eats together at the dinner table at least several times each week, by having game or movie nights, by getting children involved in extracurricular activities (sports, music, theater, crafts, etc.), and by keeping up with daily school performance. But you don’t want to wait when something appears that worries you. Seek help quickly.
+
Dr. Umansky has a child behavioral health practice in Augusta.
MEDICAL MYTHOLOGY
Carnivore Myths
Seriously, who doesn’t like a nice tender, juicy steak?
Actually, a lot of people don’t. And a lot of people do. The entire broad subject of eating meat versus not eating meat is about as divisive as today’s political scene.
The rest of this newspaper could be filled with all the pros and cons, but let’s do a quick overview.
For starters, beef may be what’s for dinner, as a wellknown ad campaign reminded us, but ask any cardiologist or certified nutritionist what they think. The best that can be said is that a modest intake of unprocessed red meat is relatively neutral for health. The occasional serving of beef or pork isn’t harmful, but it isn’t particularly healthful either.
However, a steady diet of red meat (and eating processed meat even occasionally) is strongly linked to colorectal cancer.
But you can get around all that by eating lean meats and grass-fed beef right?
Well, not exactly. First, “grass-fed” is a marketing term without oversight from any agency, such as the Food & Drug Administration. Nutritionally, analysis of grass-fed versus conventionally produced beef shows only slight differences. There are currently no studies that would prove a health benefit from eating grass-fed beef.
Nutritional experts also say it’s far more important health-wise to pay attention to sodium and preservatives in
processed meats like salami, sausage, bacon, and cold cuts than to put the focus on lean meats.
As stated at the outset, plenty of people avoid red meat like the plague. They aren’t necessarily in a better place nutritionally. To offer an extreme example, a diet of Lucky Charms, Red Bulls, Twinkies, French fries and chocolate chip cookies is 100% meatfree and 110% unhealthy.
“Plant-based” is not an accurate description of a more salubrious diet. More specificity is required.
For instance, plant-based meat alternatives, a growing option, are widely considered to be better for the environment, but their health benefits are not as well established. There are trade-offs. They may be quite high in sodium, for example.
Nutrition experts often suggest the spotlight shouldn’t be on eliminating red meat as much as it should be on cutting out foods that are ultra-processed, high in salt, refined starch, and added sugars, particularly in sugary drinks. The replacements for these items: fruits, vegetables, whole grains, nuts, seafood, beans.
Yes, some unhealthy foods are downright delicious. But healthier alternatives can be just as tasty.
Who is this?
This man changed our vocabulary and the way we live our lives, yet few among us know his name. And if we heard it, most of us still couldn’t connect it to his life’s work.
Let’s see if that statement is correct. His name is Casimir Funk. Ring any bells? No surprise if it didn’t.
Funk was born in Warsaw in 1884, the son of a dematologist. At age 20, he earned a doctorate in chemistry from the University of Bern in Switzerland, and subsequently worked around Europe at places like the Pasteur Institute in Paris and the Lister Institute in London before emigrating to the United States in 1915. He became an American citizen in 1920, although he worked back and forth in the U.S. and Europe until the outbreak of World War II
Funk was among the first scientists to conceive the idea of certain elements in our diets that had a direct connection to human health. In 1912 he published a landmark paper about these largely theoretical substances. He had isolated one such element that included an organic compound called an “amine,” and because he recognized their vital importance, he called them “vital amines.”
When the previous sentence refers to “their” vital importance, the plural is used because although Funk had only isolated one vital amine, he postulated that there were at least four of these crucial substances. His proposals were similar to astronomers of the past hundred years or so who theorized that certain planets exist in our solar system even though they had not yet been discovered.
Funk believed that at four vital amines — a term that was soon shortened to vitamine, and then to vitamin — existed, possibly more; one to prevent scurvy, one that prevented pellagra, another which prevented rickets, and one that prevented beriberi.
The substance Funk isolated and labeled a vitamine is what is today known as vitamin B3, commonly called niacin. Funk had expected the substance to be thiamine, or B1, an “anti-beri-beri factor,” as Funk described it. His working theory was that various diseases could be cured, or even prevented by vitamins, specifically rickets, pellagra, beriberi, and scurvy. And of course, he was on target.
Even before he and other vitamin discoverers were born, sailors had finally figured out that oranges and lemons could prevent scurvy. But no one knew what it was about those fruits that made the health benefit possible.
Funk was one of the earliest investigators into the causes of and cure for pellagra, blamed in the early 20th century for causing more deaths than any other nutrition-related disease in American history. It was a particular problem here in the South and was often linked with rural poverty.
As the problem worsened and came to be known as “the pellagra scare,” 100,000 deaths were eventually blamed on the disease. More than 27,000 of those deaths occurred during the first decade of official pellagra monitoring, from 1915 to 1925.
Casimir Funk had accurately identified the cause of the disease in a paper published in 1913 in The Journal of Physiology. Unfortunately for thousands, no one noticed. +
FUZZY LOGIC
The problem with living several decades with a fairly reliable memory is that one recalls dire predictions made by people who should know what they were saying. Well, at least some of them were supposed to be knowledgeable.
Do you recall these knee-knocking predictions:
• 1960s: Oil will be gone… within 10 years
• 1970s: A new ice age… within 10 years
• 1980s: Acid rain will destroy all crops…within 10 years
• 1990s: Ozone layer gone… within 10 years
• 2000s: Glaciers melted… within 10 years
• 2010s: East & west coasts will be under water…within 10 years
• 2020s: Human race gone… within 10 years without the Green New Deal
All of these profound and dire warnings turned out to be wrong … but they did get Congress to raise your taxes.
Based on these events, it seems the solution to all major problems is to raise taxes. Our founding fathers warned us to guard our pocketbooks whenever Congress is in session. Sage advice for sure. Profound statements, even by those usually in the know, may or may not be accurate. Sometime conclusions are mere speculations based on fuzzy logic rather that hard proof. Fuzzy logic is when you have some, but not all, of the facts. You extrapolate what a reasonable conclusion might be. We use fuzzy logic all the time. Stock market investment is based on fuzzy logic. Poker is fuzzy logic. Football is fuzzy logic. Marriage is fuzzy logic. Otherwise, why would your significant other marry you inthe first place?
Medical advances are based on fuzzy logic. Phase I studies. Phase II studies. Phase III studies. But they are not perfect. Remember Thalidomide for pregnant women? A great cure for morning sickness, it was
BASED ON A TRUE STORY
(most of the time)
A series by Bad Billy Laveau
claimed, but some babies were born without arms.
On the other hand, thousands of drugs have been safely approved for human consumption. The FDA is not perfect, but I have faith in their fuzzy logic. They sometimes catch a lot of static for being too slow to approve a given drug. The media, as well as multi-national corporations, look critically over their shoulders. The media needs controversy to drive viewership. Corporations need profits immediately if not sooner to drive up their stock prices.
And on top of all that, we have people in the public eye who desire to be providers of super-bad news to justify their self-imposed position of importance.
Twenty-four-hour cable news access was invented by Ted Turner and CNN. Along with that came Infomercials where anyone with money can have a half hour worldwide TV show. Or a 30 second TV commercial. Remember Ron Popiel’s Magic Spring Chernobyl Water that cured cancer? Or his Magic Water packets that you sleep with and huge amounts of money will surely arrive in the mail?
And now we have political cycles that are as endless as car horns in Jamaica. Or maybe as endless as the stream of “undocumented workers” at our southern border. The only fuzzy logic therein is guessing the number of crossings tomorrow when we are not sure how many crossed yesterday.
But fuzzy logic is necessary for progress. We must take some chances. Calculated risks. And hope for the best. Hopefully, unfolding
events will justify our faith in fuzzy logic.
For example, when a new drug is known to cause nosebleeds in one patient out of a thousand, we take the drug with faith we will not get the next nosebleed. A thousand-toone chance is a reasonable risk.
We must separate these reasonable risks based on the scientific method from proclamations made by wild-eyed camera-seeking talking heads with questionable agendas. Sometimes reasonable risks have rough edges. One example is the breast implants used in the 80s and 90s. A huge lawsuit destroyed a company even though it was later shown that women with implants had no more depression, fibromyalgia, arthritis, etc. than women without implants. At present, our TVs are loaded with lawyer ads regarding Roundup weed killer and contaminated water at Camp Lejeune, both now reportedly linked to all sorts of horrible diseases.
Be careful with vaguely associated events. I can find someone who drank water last week and died this week. Both events will be true. And supporting data will be true, but being related does not equal cause and effect. You need not give up drinking water.
Accordingly, we have not plunged into a new ice age, run out of oil, starved because of acid rain, drowned from rising tides, nor suffered demise due to lack of the Green New Deal.
Fuzzy logic is a necessary evil loosely tied to science. Tread lightly. Only the Good Lord knows when one of these conclusions might be right.
But also be encouraged. Medical advances and education, extrapolated from fuzzy logic, has doubled the U.S. life expectancy in the past hundred years.
Editor’s note: This column originally appeared in a June 2023 issue of the Medical Examiner
Middle Age
BY J.B. COLLUM
Last weekend was the third anniversary of my father’s passing. He died on the Sunday before Labor Day, and though the dates didn’t line up, the setting put me in a funk. It was a Saturday night and I was watching Georgia play Clemson. That was the same scenario when I got the call three years ago that he didn’t have long to live, which came as a complete surprise.
He had been in the hospital for a few weeks earlier with pneumonia, but had healed well enough to be moved to a nursing home for rehab, and we expected him to recover. However, the week he was in rehab, the nursing home was hit with a Covid outbreak and we weren’t allowed to visit, so his condition deteriorated. I have wondered if that made the difference. When he was in the hospital, I and other family members visited and made sure he ate his food and drank plenty of fluids and kept his spirits up. We don’t know what happened behind closed doors at the nursing home during lockdown, and though I have no evidence, I am cynical about how well he was cared for. He was taken to the hospital on Friday and passed away Sunday in the early afternoon. I will be eternally grateful to my son, who went to the hospital Saturday evening to check on Dad and then called me when he saw how bad off he was. Several of the family went straight there and spent what ended up being our final moments with him. He couldn’t speak, but we had worked out a way to communicate with hand squeezes and we all took turns telling him how much we loved him and how sure we were of our hope to see him again one day in a better situation when no disease would ravage him.
Time does make things a little easier, but you never get over it. However, one of the many penalties of reaching middle age is the increasing number of friends and family that you lose and the resulting long list of those loved ones because it is a cumulative thing too. The other night I made an effort in my bedtime prayer to thank God by name for all of the good people I’ve had in my life that I have lost. I am sad to report that it took a while. My father, grandmother (Dad’s mom), grandfather (Mom’s dad), my Uncle Larry I have written about here before, various other aunts, uncles, cousins, friends, mentors, teachers, employers, ministers, etc. It got to the point where I stopped saying their name and just pictured them in my head, knowing that God could understand that form of communication just as well as words spoken or thought.
There are some people whose absence seems to make a greter impact than their presence did when they were alive. One example that occurred to me was my great aunt Merle who was always nervous and
got upset with me quite often. You see, I could be an irritating child. I’m sure you are shocked by that, but my wife and kids are not. My great aunt Merle was known to all of us simply as Merle. Even though she fussed a lot and got on to us, she devoted her life to her family, including me. She was the kind of person made for bad times. In good times she didn’t know what to do with herself except to imagine what bad could happen, but when things did go south she was there for whatever you needed. She and my grandmother were fraternal twins, so they didn’t look much alike, and their personalities were even more different. Whereas Merle was always running around in a nervous fugue, my grandmother was the safe harbor in the storm, and if she fussed at you about anything, it would have been considered a sign of the end of times because I don’t think I can even recall a time she did that. They contributed to the family circle in their very different ways though, and are both sorely missed. They lived with each other for most of my life, right up until the day my grandmother passed away.
Merle died a couple of years later. I hate that I didn’t visit her more, but when I did it just caused so much pain because she reminded me of my grandmother who wasn’t there anymore. If I had it to do again, I would fight through that pain and be there for her more.
And there is the lesson. Don’t put off being with the people you love. Especially if you or they are in the fall or winter of life. I know it is a cliché, but it is for a reason; tomorrow is not guaranteed for us or them. Because of that, I have begun to think about the other side of the equation more and more. By that, I mean about my family losing me one day. So, maybe I can help them spend more time with me by being a little less annoying to them and making time for them. I admit that I have flirted with letting the encroaching crusty old hermit-like curmudgeon persona win out more and more, and I even revel in it at times. I’m also still quite into my hobbies, but maybe I could carve out more time for friends and family. I wouldn’t want them to regret not spending time with me. Come to think of it, If I am irritating enough to them, maybe that would also help them not to miss me much in the first place. Food for thought. Don’t tell my wife though. She still thinks she can change me.
J.B. Collum is a local novelist, humorist and columnist who wants to be Mark Twain when he grows up. Reach him at johnbcollum@gmail.com
HOW CAN I CONQUER MY DENTAL ANXIETY?
People who fear going to the dentist make up a pretty decent segment of the population. It isn’t exactly a rare phenomenon. As a result, it’s something dentists deal with on a daily basis, so they are experts at helping their patients manage and control their anxieties.
There may not be a one-size-fits-all solution, but there should be a there’s-something-that-fits-everyone solution. As is the case with anxiety in general, the best solutions are internal. In other words, chemical intervention in the form of nitrous oxide or a calming drug like Xanax should not be the first line of defense. Of course, there are dental procedures for which sedation is a routine matter. But for ordinary dental care, the best antidotes for undue anxiety come from the patient, not the doctor. At least to start with.
Many people use deep breathing exercises to control anxiety. Just breathing in a certain way might seem too simplistic to actually be effective, but those who have mastered the techniques know deep breathing works, even in highly stressful situations. Meditation is another effective and free technique that can be perfected to great advantage. Some people talk to their dentist or family doctor ahead of time and arrange for a prescription medication to address their anxiety. Such prescriptions are often small, as few as a single pill sometimes. They may require taking the drug a set time before the dental appointment as well as having a driver, and have the disadvantage of being all for naught if the appointment is canceled for some reason.
As mentioned, dentists are experts at helping their patients deal with anxiety, so don’t hesitate to convey your concerns to your dentist.
Oh, and another very important thing to not hesitate about: going to the dentist. The longer someone postpones dental care, the more complicated and challenging the care may become. Sooner is simpler, quicker, easier, and faster. That is a great anxiety preventer all by itself.
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My story begins with the diagnosis of a paralyzed vocal cord. I had already been to the hospital for a CT scan of my chest and throat in an attempt to determine what had caused this condition. No tumors were found and nothing that revealed a clue as to why this happened.
Later I received a call from the physician’s office giving to me the time and location for an appointment at an imaging center. I assumed this would be another attempt to find an answer to solve the mystery. When I arrived I was taken to an exam room by a young man who introduced himself as a student. He asked for my permission to perform the basic examination, and then he would call his supervisor in to complete it. That was fine with me.
To begin he told me lay on the exam table and pull my pants down to my hips. Still assuming this was all about my throat, I was speechless but complied with his instructions to turn on my left side toward the wall. I was in a daze as he began scanning front and back below my waist. When he told me to turn over to my right side facing him I finally found my voice. I asked, “What has this got to do with my vocal chord?” Now it was his turn to be stunned! He answered, “I...don’t...know,” but he continued the exam. Then, turning the attention to my back, he went lower to scan my bladder.
At that point, he went for his supervisor. When she came in, before she could say a word, I asked again, “What has this got to do with my vocal chord?”
She asked for my name, date of birth, and doctor. Then said told me he had requested a kidney scan. I replied, “He’s an ENT. I’ve never discussed my kidneys with him!” She called the doctor’s office and we waited it seemed eons for them to return the call.
Finally, she returned and told me that when I had the CT scan at the hospital it had shown the top part of the kidneys and my doctor saw something that he wanted to check out. As she completed the exam I could only say, “Well, I wish he had told me!”
As it turned out, everything was fine, and I have laughed out loud about it ever since.
— by Mary Carson Aiken, South Carolina
TRYTHISDISH
You scream, I scream, we all scream for peaches and cream!
Ingredients
• 2 ripe but firm peaches, cut in half and pitted
• 2 cups good quality vanilla ice cream
• 2 teaspoons organic canola oil
• Mint leaves
• Waffle cookie (optional garnish)
Directions
Preheat your grill to medium heat. Clean and oil the grill grates. Oil the cut sides of the peaches and grill for 2 minutes. Carefully rotate a quarter turn and grill 2 more minutes to get “good” grill marks.
Remove from heat and serve with ½ cup ice cream and mint garnish.
I was raised in a poor family as the oldest of a constellation of 3 children, and it was my responsibility to get my younger brother and sister up in the morning, lunches made with sandwiches wrapped in wax paper from cereal boxes, dropped into paper bags, and then all of us off to school, then get all of us back home safely again in the afternoon.
All of this involved a one mile walk each way in one town we lived in, and in another it involved a network of connecting the dots using buses, church friends who had cars, or relatives watching us after school ‘til our folks got home.
In one town we went to the public library every day after school and hoped our dad wouldn’t forget to
I will never forget her.
She had one prior C-section when very young, and this, at age 40, had been a healthy second pregnancy. Within minutes of presenting to the ED, she spontaneously delivered a baby along with pieces of her shattered uterus and started bleeding out buckets of blood. Her baby was rushed to NICU and she was rushed to surgery where she was given over 100 units of packed red blood cells over the course of 24 hrs, exhausting all our local blood banks, even after rolling in the cell-saver machine typically used in orthopedic surgery to recycle/save a patient’s own blood.
It took surgeons hours to close all of the highly vascular bleeding areas where the placenta adhered. She required resection of bowels. That the surgeons worked tirelessly for what for many would have considered a lost cause is a testament to our wonderful MDs. It was their fierce determination, combined with hours of painstaking work along with the pure artistry of their craft
pick us up! He never forgot, but sometimes it was 6:59 and change when he finally tapped on the outside window to signal his arrival! For those long days we saved some of our lunch back for snacks.
Like her or not, Hillary Clinton was spot-on nearly 30 years ago when she borrowed an African proverb to title her book, It Takes a Village: and Other Lessons Children Teach Us. The same is true in the village called Recovery, as alcoholics and addicts usually fail at attempts to get well if they go it alone. In order to get well from the Bio-Psycho-Social illness of substance use disorders, three things are required: Desire, Accountability, and Support.
In a treatment program, for instance, there are various professionals trained to cover the biological aspect:
the need for detox with medical supervision, nutritionists to restore the body to health, and recreation therapists to help with physical conditioning.
There are also counselors and chaplains to assist with psychological and spiritual restoration. Interestingly (and significantly), when Bill Wilson, the founder of the original 12-step self-help group, AA, spoke about recovery, he rarely mentioned drinking alcohol, but spoke instead of restoration to sanity!
Because alcoholism and addiction is often a disease of isolation and secrecy, the social aspect of recovery is addressed through peer support and involvement in self-help groups. Many substance abusers drink or drug to loosen themselves up in order to function in a social atmosphere for a number of
reasons. People in recovery are pivotal in this aspect of getting well, since alcoholics trust other alcoholics more than they do “regular” people, who they feel don’t understand them and have never “been there, done that.”
Personal desire is crucial for anybody to get well. Without it, a treatment program turns into a 28-day stay at the Best Western. I know of many parents who have spent fortunes paying professionals to treat their children who have no desire to stop drinking – all to no avail. It seems that in the recovery village, desire is best achieved through the pain of loss – engineered or by default.
Few get well without accountability through witnessed (oh yes!) drug screens — and follow-up treatment sessions. For. A.
Long. Time. Don’t ask me how long! But for a long time.
And fewer still get well without support. At times we all need a helping hand from people who understand missing the mark sometimes, and who know how to help without enabling (a whole column in that last word!).
If you haven’t been successful in going it alone, just know that the recovery village can’t wait for you to call! And know that it’ll take a few of them to get you home safely!
that allowed her to survive that initial rupture and loss of blood.
She came up to my ICU open and packed in ice. She stayed on a ventilator for weeks. She had many complications, infections, blood clots and episodes of rebleeding. All during that time, she gave us many near codes and basically required one-on-one nursing care. During that time we would pump her milk and run it down to her preemie baby.
I was one of her primary nurses and became very close to her. She would shake her head “No” and mimed cutting her throat and pulling her vent when we gave her a sedation vacation. She went through grueling and painful procedures, and through it all constantly expressed that she no longer had the will to live. She didn’t want to see her baby or her man or even her older child, family or clergy. She stayed with us for months, requiring both intensive mental and physical care. We all cared for her with great love and encouragement. She was such a
MYMOST MEMORABLE PATIENT
AN OCCASIONAL SERIES
hard patient to care for for many reasons I cannot detail and she tested me as a nurse. I am a better nurse for having cared for her. I was always expecting to come on shift hearing she had expired. Yet, little by little, she got better. Once physically stable, we actually did some ECT (shock therapy) because her postpartum/PTSD was so severe. For months we were unsure if either she or the baby would survive and while our primary focus was on their survival, we also did a lot of work supporting her mental health. As a nurse I have a new appreciation for psychotropic
medications as well as mental health practitioners. I also have a renewed admiration for her many sitters —mostly nursing assistants—our CNAs who are often undervalued, yet who did a phenomenal job protecting her and her baby when she was most vulnerable, and who always had such wise life experience to share with her when she lashed out verbally. It is a testament to her MDs and all the supporting staff that both mama and baby left the hospital alive, healthy and happy.
For many of us she was the patient that will define our
purpose. Why we do what we do. Everybody from dietitians to respiratory therapist to clergy to social workers to physical and occupational therapist to transport techs to nurses to doctors to housekeeping …..to all support staff too numerous to mention, just performed to their maximum abilities on this case and it resulted in two healthy and mentally intact humans—two miracles— leaving our doors. According to our thoracic surgeon who recently talked with her at a follow-up visit, she and her baby continue to thrive.
FOODISMEDICINE
Tasty tips from registered dietitians with the Augusta Dietetic District Association
THE BLUE ZONE BLUES
by Gina Hedrick RD, CDCES Outpatient Registered Dietitian Charlie Norwood VA
Blue Zones are places where there are unusually high concentrations of individuals living longer than the expected average. Sardinia (Italy), Okinawa (Japan), Loma Linda, California (U.S.), Nicoya (Costa Rica), and Ikaria (Greece) are the five original Blue Zones. Studies have identified broad lifestyle choices thought to increase the life span of people living in these areas. These include physical activity, low stress, rich social interations, and eating wisely. In this article, we will focus on three principles that contribute to healthy eating.
These Blue Zone principles are worth pursuing because, although the field of medicine has made great strides to increase life expectancy over the last century, overall the U.S. population still lags behind much of the developed world in life expectancy, especially considering to how much we spend on health care.1 And what about the quality of life? Much of what cuts the quantity and damages the quality of our later years is related to non-communicable diseases such as heart disease, stroke, cancer, and diabetes. Consider this:
• Up to half of the premature deaths in the U.S. are due to lifestyle choices and other preventable factors: tobacco use, lack of activity, and poor diet.2
• Only about 20% of how long the average person lives is dictated by genetics.3
This means we have power in our lifestyle
choices. Here are three important principles connected to eating wisely.
The 80% Rule: Stop eating when you are 80% full. This principle originates from Okinawa, Japan. It helps to distinguish between “satisfied,” meaning no longer hungry, and “100% full.” There is a delay between how our stomach and brain feel. Eating more slowly and pausing before going back for second helpings can help us stop eating when we are simply satisfied, that is, about 80% full. This prevents excess calorie intake that can cause weight gain. Obesity is a risk factor for many of the non-communicable diseases plaguing the U.S. Slow down and take a pause before going back for more.
Plant Slant: Plant-based eating patterns are often rich in minimally processed legumes, whole grains, fruits, nuts, vegetables, and seeds. They have well-established health benefits from the multitude of vitamins, minerals, antioxidants, and fiber they provide. Plant-based eating patterns are also beneficial for the things they include less of: animal products and meats. Think cancer prevention, reduced inflammation, and lower risk of heart disease and diabetes. Legumes (beans, peas, and lentils) and high fiber starches like sweet potatoes, are staples in most Blue Zone diets. Meat, in portions of 3 to 4 oz, is only consumed about one to two
times a week, if at all. Remember, plant-based doesn’t have to be all or nothing. Periodically challenge yourself to do a little more plant-based, and a little less meat than you were doing before. (A note of caution for highly processed plant-based products that mimic meat: sometimes they have extra unhealthy additives vs. minimally-processed or whole plant foods.)
Wine in Moderation: If you have been told to avoid alcohol, of course, don’t start. One to two ( 4oz.) glasses of wine a day, usually in the company of friends, as a part of a meal, was the observed pattern in Blue Zones. Moderation is key. Saving up for a weekend binge does not count. Consider having a glass of wine with some company at your next evening meal.
There will always be the next latest and greatest diet pattern appearing to cure everything. Let us not forget the basic lifestyle principles that have withstood the test of time. Blue Zones reveal lifestyle choices from the world’s longest living people, options we can apply in our own lives to improve the quantity and quality of life we have. Eat wisely.
1) How does U.S. life expectancy compare to other countries? - Peterson-KFF Health System Tracker
2) Up to Half of U.S. Premature Deaths Are Preventable; Behavioral Factors Key | PRB
3) Herskind AM, McGue M, Holm NV, Sørensen TI, Harvald B, Vaupel JW. The heritability of human longevity: a population-based study of 2872 Danish twin pairs born 1870-1900. Hum Genet. 1996 Mar;97(3):31923. doi: 10.1007/BF02185763. PMID: 8786073.
4) Buettner D, Skemp S. Blue Zones: Lessons From the World’s Longest Lived. Am J Lifestyle Med. 2016 Jul 7;10(5):318-321. doi: 10.1177/1559827616637066. PMID: 30202288; PMCID: PMC6125071
CRASH COURSE
The subject of car seats for children can seem more complex than quantum physics. Is a rear-facing or forward-facing seat best? A combination seat? A convertible seat? An allin-one seat? A booster seat?
Frankly, we’re exhasuted already. And this isn’t a one-and-done endeavor. The proper seat for a child changes as they get bigger and taller and heavier.
What is a conscientious parent supposed to do?
Your first thought may be to enroll in a 2-year program at a nearby community college to get the basics.
Please. Stop with the dramatics. It isn’t that complicated.
front console (the glove compartment area) at the moment of a collision can experience severe injuries. That position can transform a wreck that would have been injury-free into one that requires surgery and months of rehab.
Returning to car seats and the back seat, there is plenty of help available to simplify the seemingly endless array of options.
Americans have died on US roads since 2006 than in World Wars I & II combined { { KNOW YOU KNOW
For starters, check out the handy chart below. As you can see, infants should start out in a rear-facing seat, optimally through age 3, but there is some overlap on rear versus forward starting at age 1. Every child is different, so it’s impossible to create rigid rules that apply to every child.
One exception to that statement, however, is the answer to the front seat versus rear seat question. Traffic safety engineers and car safety experts have just one answer: the back seat is the only recommended place for kids until they become teenagers. 12 and under should always be in the back seat, even in newer cars with so-called advanced airbags. These devices inflate explosively, completely deploying within 1/20th of a second. They sometimes seriously injure full-grown adults, so smaller, more fragile kids definitely belong in the safer confines of the back seat.
Admittedly, that is not an easy habit to maintain because no one ever expects that this particular errand will result in a crash. But when the unexpected does happen, it’s too late to do anything about it.
As long as front seat safety is on the table, this is a good time to go briefly off topic and say that adult front seat passengers who have their feet on the dashboard or against the
One good starting point is the website for the National Highway Traffic Safety Administration, nhtsa.gov. If you don’t see something about car seat safety on their landing page, just type “car seats” into the search bar for a helpful guide. With the abundance of choices available, NHTSA has a simple maxim: “Don’t think you know. Know you know.” And their website can help anyone do just that.
They have simple recommendations based on a child’s age and size, as well as helpful installation tips and videos.
Have you ever gone to a store and as you get out of your car you notice some mother walking toward her nearby car with a baby bucket? And have you ever proceeded into the store and bought various items, paid for everything, and walked back out to your car only to see that same mother still trying to get her car seat properly placed into the back seat of her car? Answer: yes, we all have. There are some car seats that are so complicated to use that you feel like you really do need that community college class.
But fear not: nhtsa.gov also has ease-ofuse ratings that compare various types and brands. They also have a simple tool that allows people to register their car seats so they will be notified of any recall or safety update pertaining to their particular model.
The right car seat properly installed is important: nearly 40% of the children who died in car crashes in 2022 were unrestrained. Car seats matter.
• ½ c up diced onion
• 1 red bell pepper, chopped
• 1 clove garlic, minced (about ½ teaspoon)
• 1 (14.5-ounce) can no-saltadded diced tomatoes
• 1 teaspoon smoked or sweet paprika
• 1 teaspoon ground cumin
• 2 teaspoons chili powder
• ¼ teaspoon ground cinnamon
• 1 (15-ounce) can no-saltadded chickpeas (garbanzo beans), drained and rinsed
Directions
1. Heat a large skillet over medium heat.
2. Add the oil and heat until shimmering.
3. Add the onion, bell pepper, and garlic.
4. Sauté, stirring frequently, until the onion and peppers are soft, about 4-5 minutes.
5. Add the diced tomatoes and their liquid, paprika, cumin, chili powder, and cinnamon. Stir to combine.
6. Increase the heat to high and bring to a simmer, then reduce the heat back to medium.
7. Continue cooking for 2-3 minutes, stirring frequently.
8. Add the chickpeas and stir to combine.
9. Reduce heat to medium-low and simmer for 15-20 minutes to allow the flavors to blend.
10. Taste and adjust seasoning as needed.
11. Serve warm.
Will he ever get one right? Probably not. Questions. And answers. On page 13.
NEXTISSUEOCT
The blog spot
— posted by
Ahmet Güngör,
MD on Sept. 16, 2024 (edited for space)
A PEDIATRICIAN FIGHTS VACCINE MISINFORMATION IN A SMALL TOWN
When I took the final exam after years of pediatric training, hearing my professors say, “You are now qualified and equipped to manage a pediatric clinic; congratulations” was a deeply touching moment for me. I felt fortunate to experience the profound satisfaction of seeing my efforts to help children recognized and appreciated. I began my journey as a specialist in a small coastal town. Happy people, a peaceful life … and then, bam! I was confronted with some harsh realities early on.
A 4-year-old boy had been diagnosed with atopic dermatitis at six months old. He had not received any routine vaccinations since his sixth month. The family had been strongly advised against vaccinating him. At this point, the patient came to my clinic with upper respiratory infection symptoms. While taking his medical history, I discovered that his vaccinations were incomplete and learned the reasons behind it. I addressed the family’s concerns and explained the benefits of vaccines. They agreed to proceed with vaccinations. I outlined the catch-up vaccination protocol and referred them to their family physician
I initially thought this was an isolated incident, but a week later another case emerged. A 6-month-old boy presented with symptoms of a respiratory tract infection. Upon examining the patient, who was coughing and feverish, I detected fine crackles in the basal regions of both lungs. I learned that the patient had not received any vaccinations, including those scheduled for the second month. When I inquired why, the family explained that they did not trust vaccines and cited anti-vaccine sentiments shared by doctors on social media. Curious, I wondered: who were these anti-vaccine doctors? Upon researching the names provided by the family, I was disheartened to find that many were indeed licensed physicians, some even holding academic titles. This revelation left me questioning the sources of misinformation and my own previous assumptions. Had I been living in a cocoon during my education at a well-resourced institution surrounded by scientists? Was the dissemination of truth being drowned out by the noise of misinformation? With these thoughts weighing on my mind, I explained the scientific facts about vaccines to the family. I spoke of the eradication of smallpox, the near disappearance of diseases like polio and tetanus, and how tuberculosis was no longer an insurmountable problem. The family was convinced, but I could still sense lingering doubts. How could I compete with a popular opinion they encountered daily?
At the end of a long day, I called the family physicians in my town, one by one. How prevalent was vaccine refusal among their pediatric patients? I learned that every family physician had at least five patients who refused vaccines, despite being informed about them. Most refusals stemmed from things read online or consultations with anti-vaccine doctors. As the only pediatrician in town, I reinforced my knowledge by reading up on active immunization, providing patients with more detailed information about vaccines, and referring patients to other specialists in the same field, steering them away from antivaccine doctors while explaining my reasons.
Vaccination is a fundamental right for all children and societies with numerous benefits: reducing mortality from infectious diseases, providing herd immunity, decreasing secondary infections, protecting against certain cancers, lowering health care costs, preventing epidemics, ensuring equitable access to health services, and enhancing both the length and quality of life. But all these benefits can quickly be overlooked due to the power of social media.
Perhaps we should turn our attention to social media as much as any we would any life-threatening disease.
Ahmet Güngör is a pediatrician in
What are you reading?
This terrible story about corruption at some charities.
ACROSS
1. Hippocratic follower
5. Augusta’s Earth ____
9. Smoke and fog
13. Walton ________
15. Mountain goat
16. Famous Laker
17. The A of 34-A
18. Finn craft
19. French notion
20. Alkali
21. Famed crimefighter
23. Comparison word
25. Former acorn
26. Family of famous artists
27. It’s at one end of an arrow
29. Move to and fro
32. Sewing case
33. Ancient physician
34. Largest venue in Aug.
36. Contractions
40. If can follow stone or iron
41. Canoe propeller
42. Self-esteem
43. Rods partner
46. Long-running NBC show
47. Flashdance star
49. Michigan is one
51. 2012 presidential candidate
52. Intervening (in law)
54. Swoon
56. Energy
57. Otherwise
58. Dark Angel star
59. Bad cholest.
62. Killer whale
64. Augusta _____
66. Noted architect
68. Greek god of love
69. Otherwise
70. Cinemas’ name
71. Legendary story
72. Observed
by Dan Pearson
The worst offenders are charities that are supposed to help blind people. The people they’re supposed to be helping never see one penny of the donations.
Why are they the worst?
The Mystery Word for this issue: ALAIARM
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.
73. Wish for DOWN
1. By mouth
2. Ethereal
3. Of thou
4. A dynasty in China
5. Earliest
6. Embarrass
7. Field official (in brief)
8. Still existing (esp. of a document)
9. Snow runner
10. Lakeside town (in SC)
11. Caribbean sorcery
12. Nerd
14. Fig tree that can cover acres
22. Brain current meas.
24. Downtown Bar
26. Acronym for pro wrestling
28. Stroke abbrev.
29. Augusta talk radio station
30. The villain in Othello
31. Small secluded valley
32. Tiger’s dad
34. Guitarist Feliciano
35. Prohibit
37. Legume
38. Look at amorously
39. Promising, as an outlook
44. Ernie of the PGA
45. Last name of a Hill Section street?
47. Grand local hotel of yore
48. Ambulance worker (abbrev)
50. Red dye
51. Word with eye or cage
52. Local furniture vendor
53. FL tourist destination
54. Positive start?
55. Congressman Rick
56. Composition in verse
59. ANWA winner destination?
60. College department head
61. Pleasant, cheerful tune
63. Powdery residue
65. The A of IPA
67. Cry of a cat
1 7 T o
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.
1 B r a n d y
c o c k ta il
1 3 M is c h i-
e v o u s
c h ild
1 5 L a tte r p a r t o f
th e m o ri A n g e l s ta r
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.
ATHEBESTMEDICINE
Two old drunks left a bar one night and staggered out to their car. After driving a couple of minutes, the face of an old man appeared at the passenger window and tapped lightly. The passenger screamed, “There’s a ghost!”
The driver stepped on the gas, but the face stayed in the window. Finally the passenger rolled his window down an inch and cried, “What do you want”?
man had been experiencing headaches for a few weeks, so he went to see his doctor. After an examination, the doctor concluded that the headaches weren’t caused by anything serious, so he told the man to simply take Tylenol and to come back in two weeks.
When the man returned, the doctor asked him if his headaches had gone away.
“No doc,” said the man wearily. “They’re the same. No better at all.”
“Have you been taking Tylenol I suggested?” asked the doctor.
“No sir,” the man said. “Nothing.” “Nothing?” sputtered the doctor. “How can you get better if you don’t take the medicine?”
The man looked confused. “I thought you told me nothing works faster than Tylenol.”
A 60-year-old billionaire announced to a friend that he was engaged to a 20-year-old model.
“How in the world...?” began his friend.
“I lied about my age,” he said.
“What did you do, tell her you’re 40?” asked his friend.
“No, I told her I was 90.”
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“Can I bum a cigarette?” the old man said. The passenger quickly handed him a cigarette and told his friend to step on it as he rolled up the window.
A few minutes later they calmed down and laughed at their silly, drunken imaginations.
“We’re going 80 miles an hour now,” said the driver, “so I don’t think we have anything to worry about.” But just then the old man’s face appeared at the window again. The terrified passenger cracked the window and asked, “What do you want now?”
“Can I bother you gentleman for a light?” the ghostly old man calmly asked.
The passenger threw a lighter out the window and the driver floored it. Just as they hit 100 mph, the man reappeared at the window.
“NOW WHAT?” screamed the passenger in terror.
The old man calmly asked, “You boys need any help getting out of this mud?”
Moe: I think I was born upside down.
Joe: What do you mean?
Moe: It’s the only logical explanation: my nose runs and my feet smell.
Moe: I wish I’d put ketchup on that burger before I ate it.
Joe: Yeah, Heinz-sight is always 20-20.
Staring at my phone all day has certainly had no Effect on ME!
If you live beyond the Aiken-Augusta area, or miss issues
appointments
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 $24 or one year for $42 . Mail this completed form with payment to Augusta Medical Examiner, PO Box 397,
Dear Advice Doctor,
I am a big fan of your column, Advice Doctor. It reminds me of all the knowledge out there just waiting to be discovered and applied so we can live healthier lives. It always seems like no matter how much we learn, we still have only scratched the surface — and that’s a good thing. I’m looking forward to continuing to learn.
— Lifelong Learner
Dear Lifelong,
Don’t let me stop you! I hope you never lose your insatiable curiosity and love of learning.
But a word of caution: you seem to suggest that scratching the surface is not merely ok; you go significantly farther and call it “a good thing.”
Trust me when I tell you, even a small scratch can be a very, very bad thing. I’m not trying to be an alarmist. Realistically, it’s quite rare for a little scratch to become serious or even fatal, but it definitely happens.
It can all start with a tiny scratch that seems insignificant. It’s nothing to worry about, so it’s left untreated. It might display a little redness, but that’s normal, right? It will go away on its own.
Except when it doesn’t. The redness spreads, the pain and swelling increase, and pus reveals the presence of an infection. This little scratch needs to be treated! The best time is immediately after the cut happens; the second best time is as soon as you realize you messed up by not treating it right way. In extreme cases, an infection that started from a tiny scratch can spread to other parts of the body, leading to conditions like sepsis, which can be life-threateing.
There are other grounds for concern. A scratch caused by a rusty object or contaminated surface can introduce tetanus bacteria into the body, which can have serious and even fatal consequences.
There are plenty of people among us with compromised immune systems from disease or chemotherapy, and people with diabetes and other chronic health conditions which put them at risk of complications caused by simple and normally innocuous triggers.
There are also allergic reactions to small skin injuries (bee stings, for example) that can turn into medical emergencies.
So: to keep learning, give prompt attention to any scratch, no matter how insignificant it seems.
+
Thanks for writing, and I hope I answered your question. Do you have a question for The Advice Doctor about health, life, love, personal relationships, career, raising children, or any other important topic? Send it to News@AugustaRx.com. Replies will be provided only in the Examiner.
THE MYSTERY SOLVED
The Mystery Word in our last issue was:
...cleverly hidden in a doctor photo in the p. 16 ad for AIYAN DIABETES CENTER
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!
The Celebrated MYSTERY WORD CONTEST
...wherein we hide (with fiendish cleverness) a simple word. All you have to do is unscramble the word (found on page 12), then find it concealed within one of our ads. Click in to the contest link at www.AugustaRx.com and enter. If we pick you in our random drawing of correct entries, you’ll score our goodie package!
SEVEN SIMPLE RULES: 1. Unscramble and find the designated word hidden within one of the ads in this issue. 2. Visit the Reader Contests page at www.AugustaRx.com. 3. Tell us what you found and where you found it. 4. If you’re right and you’re the one we pick at random, you win. (Winners within the past six months are ineligible.) 5. Prizes awarded to winners may vary from issue to issue. Limited sizes are available for shirt prize. 6. A photo ID may be required to claim some prizes. 7. Other entrants may win a lesser prize at the sole discretion of the publisher. 8. Deadline to enter is shown on page 12.
PROFESSIONAL D
ACUPUNCTURE
Dr. Eric Sherrell, DACM, LAC
Acupuncture Clinic 4141 Columbia Road 706-888-0707 www.AcuClinicGA.com
Evans Chiropractic Health Center
William M. Rice 108 SRP Drive, Suite A 706-860-4001
DENTISTRY
SHORT STORIES
EVEN SAD STORIES SOMETIMES HAVE HAPPY ENDINGS
There was a 36 year old woman who I admitted who was severely bulimic, and she ended up puncturing a lung while purging. During the same episode she aspirated her vomit, so she was in a bad state. I was assigned to be her nurse every day that I worked during her 28 days in the ICU. I became super-close with her family. I’d even paint her nails and comb her hair while she was in her drug induced coma. We ended up putting a trach in her because we couldn’t get her off the breathing tube. We still had her sedated when we finally transferred her to a long-term care facility once we found a place that could take her with the trach and sedation. I always wondered what happened to her.
Fast forward almost 3 years later, I was at Target and this random woman comes up to me and gives me a huge hug, starts crying and thanking me. I had no idea that it was the bulimic woman since I had never seen her awake, much less standing upright with hair and makeup done, not having a ton of medical equipment attached to her. I was so confused until I saw her husband and kids come up behind her. Then I was in tears. She made it. She was home. There was no apparent brain injury that was caused from the incident. She was in remission from her bulimia. She recognized me. It was an awesome day for both of us.
HAPPY ENDINGS, PART II While working as a Hospice Nurse I had a patient who was a real fireball. She had liver
cancer but you would never know it. She was putting on a brave face and I knew it. One day I came into her room unexpectedly and caught a glimpse of her agony before she switched to her happy facade. She was probably at least a 9 on the pain scale. I got her morphine ready and she had a fit. I told her what I had seen and that I knew she was in pain. She didn’t have to fool me any more, so she agreed to have her meds.
I got her a nice hot sand mattress to relieve her poor aching bones. We soon became friends. She told me that she had already given her family their inheritance early, so they had stopped visiting her; they would only call her. I stayed with her a lot.
One day a lawyer came to see her and I was excused for the day. I figured she was getting toward the end and wanted to make sure everything was in order. Over the next two weeks she got progressively weaker and was sleeping more. Her blood work was really bad.
I was with her when she died. I tried to call her family, but they were in Europe and would fly back in a few days. I called the funeral home and told them exactly what she wanted, and hand-delivered the letter she wanted given to them.
My service to her completed, I saw assigned to another patient. About six months later I was called into the Director of Nursing’s office. I wondered what I had done. The Director of Nursing and a lawyer were in the office. I thought “Oh Lord, I must be getting sued.”
Come to find out my little lady knew that I could not accept money, so she gave our county animal rescue enough money to keep them going for years and she left instructions to make sure I was told. I later went to talk with the nice lady at the shelter and when she saw who I was she almost cried. She said with that money they will finally be able to build new larger, nicer kennels and runs. She was also going to hire two new employees to help her. It was a wonderful legacy for my patient to leave.
