Medical Examiner 9-17-21

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KEEPTHESHEEP SEPTEMBER 17, 2021

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

One of the hotly trending insults in this divided nation is “sheep,” along with its portmanteau, “sheeple.” Generally, these words are directed to people wearing masks by those who are not. The implication is that anyone wearing a mask is meekly swallowing the coronavirus

Kool-Aid hook, line and sinker. People who are sheep — aka sheeple — are surrendering their freedom and willingly cooperating with sinister efforts to steal the constitutional rights of one and all.   Naturally, these are not opinions shared by everyone. Perhaps they are shared by a minority, especially as the pandemic rages on unchecked, at least in the United States. But we have to ask: is being a sheep such a bad thing? If you’re a sheep, you are not defenseless. You’ve got someone looking out for you and keeping you safe. The job description of a shepherd is simple: to watch out for

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you 24/7 even if the threat is a ARE YOU A CHRISTIAN? cougar or lion. Shepherding is not   If so, you know sheep are portrayed a 9-to-5 job; it’s around the clock. favorably in the Bible, and that you are   If you’re a sheep, you’re no fool. supposed to apply Bible principles in A stranger — a counterfeit shepyour daily life. Here’s one to meditate on herd — can call to you all day long that applies to the pandemic. and you’re not going to respond.   The apostle Paul wrote that if eating You aren’t even going to raise your meat offended his brother, he would head. You’re going to keep grazing never eat meat again. (1 Cor. 8:13) In contentedly. You know who is on other words, he was willing to forego a your side and who isn’t. perfectly acceptable personal right in   The classic enemy in this ageorder to avoid harm to another person, old analogy is the wolf, whose even if that “harm” was more or less all objective is to kill sheep. in the mind of the other person.   As all of this translates to peo  As a Christian (if you are one), are ple in this historic era, each of us you willing to apply this principle and put should ask, “If I had to be deaside your personal rights (to not wear a scribed as one or the other, which mask, for example) out of consideration would I be, a sheep or a wolf?” for others? +   Wolves in a coronavirus analogy are just like wolves of the 4-footed variety: they are anything but harmless; they can kill. They view mask wearing as weak and foolish; hand sanitizing is unneccessary; distancing is for snowflakes.   On the other hand, it’s hard to think of anything that literal sheep do which poses harm or danger to other living things (except maybe grass). In a coronavirus setting it’s much the same: what sheeple do — wearing masks in public, practicing physical distancing, sanitizing their hands, etc. — couldn’t hurt a fly.   To put it another way, if the sheeple are wrong and their socalled prevention efforts turn out to be completely unnecessary, what harm has been done to anyone? But if the wolves are wrong, their actions will contribute to the spread of the virus. Their actions will sicken some and kill others.   If you’re not a sheep, if you are, in fact, anti- sheep, you have to ask yourself, what is the cost of cooperating with the recommendations versus rebellion? Is the price so high that I can’t pay it for the possible common good of all? + EDITOR’S NOTE: This article ran last summer in an online-only edition of the Examiner. It is one of our favorites and may have been missed by many. A year later, we hope it still offers food for thought.

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THE FIRST 40 YEARS ARE ALWAYS THE HARDEST

PARENTHOOD by David W. Proefrock, PhD

Your 19 year-old daughter is away at college. Her grades have been good and she has been doing very well. However, she just called and told you she is pregnant. What should you do?   A. Arrange to meet with her as soon as possible. Give her your full support and help her with the decisions she will have to be making.   B. Tell her that she got into this mess on her own and that it is up to her to deal with it on her own.   C. Tell her what you think she should do, and then make sure she does it.   D. Help her realize how stupid and irresponsible she has been, and that she has just managed to ruin her life. If you answered:   A. This is the best, and really the only, response. No matter how you feel, she needs your support and guidance.   B. She is an adult and the decisions are up to her. However, she is still your child and you are still her parent. She needs your support. This is not the time to abandon her.   C. She needs your support and guidance, not your judgments. She has important decisions to make for herself and her unborn child, but they are her decisions, not yours.   D. You may think this and fear that it’s true, but this is not the time to say it.   Your children need your support and guidance even after they become adults. Actually, especially after they become adults. And especially when they face serious problems. Between support and guidance, your support is more important than your guidance. She probably knows what is best, but may have trouble doing it. + Dr. Proefrock is a retired clinical and forensic child psychologist.

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SEPTEMBER 17, 2021

PART G OF A 26-PART SERIES

IS FOR GALLBLADDER   When internal body parts are shown in articles and textbooks, they are often shaded for illustration purposes in various pastel colors to help identify them and set them apart from adjoining structures. Our front page story about the skull from a couple of years ago (see far right) is a good example. The various plates our skulls are built with are not shades of pink, tan and baby blue.   The gallbladder is an exception to that rule. It isn’t shaded green for picture clarity; it is green. It may not be the fluorescent green shown in some textbooks, but it’s green. Its role in life might explain its unusual tint. More about that in a moment.   You can’t talk about the gallbladder without including the liver; they work together. And you really can’t talk about the two of them without including the small intestine. As you can see in the illustration (right), they all conveniently live and work on the same block — and you could say they work from home — and all three are key components in the body’s digestive system.   Let’s start our discussion of the gallbladder with a look at its upstairs neighbor, the liver. This amazing organ

is responsible for about 500 different chemically generated functions, but for this article let’s focus on one: its production of bile, a digestive chemical. The liver does this continuously, even when we aren’t eating.   Bile that isn’t needed immediately is shipped a few inches away for shortterm storage in, yes, the gallbladder. Bile is greenishyellow, which might help to explain the gallbladder’s similar hue. When there is a and the vilification of fat digestive job to be done, the in general, fat is absolutely gallbladder contracts, forcing essential for good health bile into the conveniently and life. Many vitamins located bile duct (see (like A, D, E, and K) are illustration), where it then fat-soluble, meaning they feeds into the small intestine. cannot be digested into the   Some may think of the body without bile. Bile is intestines as merely the also the primary vehicle for chute to the outside world cholesterol extraction from for digested food, but it’s far the body. (In literature, the more than that. It’s actually preceding sentence would be where a significant amount an example of foreshadowing. of digestion takes place, and See page 3.) where the nutrients in the   This amazing chemical food we eat are separated and has unusual properties. Did extracted and absorbed into you know, for instance, that the body. bile is recycled? True. Food   This is where bile earns leaves the stomach as chyme its pay. Simply put, bile is (pronounced “kime”), kind of a chemical emulsifier. It a creamy paste, and proceeds dissolves (or emulsifies) large to the small intestine fat globules into millions of where it is injected with tiny fatty droplets that are bile to further the digestive then manageable for fatprocess. In fact, when chyme digesting enzymes. Despite enters the small intestine, the goals of various diets Please see GALLBLADDER page 3

Gallbladder

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GALLBLADDER… from page 2 it automatically triggers contraction of the gallbladder by means of a hormonedriven chemical reaction. As the mixture travels along, vitamins, minerals and water are not the only things extracted into the body; so are so-called bile salts, one of the key elements in bile’s digestive ability. The majority of bile ingredients leave the body through defecation, but bile salts are recycled back to the liver via the hepatic portal and eventually re-secreted as newly formed bile.   In addition to salts, bile also contains “bile pigments.” It isn’t that the body decided some colors in bile might be pretty; it’s simply that there are elements in bile that happen to give it color.   The chief bile pigment is bilirubin, a waste product derived from the hemo portion of hemoglobin. Anything heme- or hemo- is blood connected, of course. When blood cells have finished their working life, more recycling takes place. The globin in hemoglobin stays, transporting the iron in red blood cells (RBCs) back to bone marrow for re-use. Other non-recyclable parts of RBCs are prepared for disposal in the liver, producing the aforementioned bilirubin, which is what gives feces its brown color. In the absence of bile, in fact, feces are gray-white in color with fatty streaks (since without bile, no fats are digested or stored).   The earlier reference to the role of bile in removing cholesterol may have sounded benign and beneficial, but it is a painful aspect of the gallbladder’s work for many people.   What can happen is that cholesterol levels can be so high that the gallbladder can’t effectively take care of it all. The excess cholesterol can crystallize, becoming what is known as a gallstone. That is a very bad thing for two reasons. First, when the gallbladder contracts in response to the presence of food or chyme, it is squeezing down on the gallstones, which under a microscope look a lot like an abstract sculpture made from razor blades. The pain is agonizing. Second, gallstones can block the bile duct, preventing bile from entering the intestine.

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SEPTEMBER 17, 2021

As a result, yellow bile pigments accumulate in the bloodstream, giving the person an unnatural yellow complexion.   There are a number of methods for getting rid of gallstones ranging from surgery to zapping them with lasers and ultrasound. Of course, prevention is vastly better than removal.   Minimizing the risk of gallstones involves eating a healthy diet that includes plenty of foods high in fiber, good stuff like fresh fruits and vegetables, along with whole grains and healthy sources of fat like fish oil and olive oil. Go easy on sugar, refined foods and unhealthy fat sources like fried foods. Regular exercise and weight management are also helpful in prefenting gallstones.   Can you live without a gallbladder? Absolutely. But

do you want to? Absolutely not. Keeping our bodies in their original condition with all their original parts is always the best plan whenever possible. Even so, about a million people join that club each year in the United States alone, and the number one cause of gallbladder removal is gallstones.   Without a gallbladder the bile produced in the liver will drain continuously into the digestive system through the bile duct rather than being stored for use when needed. In some patients that spells stomach pain, sick feelings, indigestion and diarrhea that can last for many months or just a few weeks.   Healthful, salubrious living can prevent gallstones and protect the gallbladder from surgical removal. That’s the best way to go. +

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If I’m pregnant or breastfeeding should I still get the COVID vaccine?   This is a question that many wonder about, and a third group could be added to the questioners: women who are trying to get pregnant or who intend to start a family down the road.  The long and winding road that is COVID-19 has taken a few turns on this topic. When the vaccines were first made available, public health officials were still gathering clinical data, and as a result they took the safe and cautious route and initially advised pregnant and breastfeeding mothers to wait on vaccination. As time progressed they were able to establish the safety of the mRNA vaccines for this segment of the population. Today the American College of Obstetrics and Gynecology, the Society of Maternal Fetal Medicine, and the CDC have all said that pregnant and breastfeeding women can safely receive the vaccine.   One of the specific concerns for pregnant women is the possible effect on the fetus if fever is a vaccine side effect. As one infectious disease expert has noted, fever is easily treatable with products like Tylenol. However, if a person without the protection of the vaccine gets COVID, they may develop fever as the least of their worries. As has been statistically demonstrated in hospitals in Augusta and across the nation in recent days, the severe and even life-threatening cases are happening overwhelmingly to the unvaccinated. Vaccines from the start were announced as around 95% effective, but even when they “fail” and vaccinated individuals come down with the virus, they experience much milder symptoms and recover much more quickly.   There is also preliminary evidence that vaccinated mothers can pass protective antibodies to the fetus through the placenta and to their baby through breast milk.   Of note: the internet and social media is riddled with lies about vaccine safety for pregnant women. One preposterous letter in circulation, allegedly written by a doctor instrumental in developing the mRNA vaccines, claims that vaccinated people are sterilized, and that 80% of pregnant vaccine recipients lost their babies in their first trimester. The letter claims getting the vaccine is like injecting yourself with HIV and offers as proof that vaccinated individuals cannot donate blood. That allegation, like the rest of the letter, is completely bogus. +

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SEPTEMBER 17, 2021

AUGUSTAMEDICALEXAMiNER

#147 IN A SERIES

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

H

ere is yet another doctor who has made significant contributions to medicine whose name is known to only a few. We could probably fill this column with them for the next twenty years.   This particular man didn’t exactly make it easy to be remembered. After all, he was born William Sands but later changed his name to William Brooke O’Shaughnessy, and then finally to William O’Shaughnessy Brooke.   Are you with us so far?   William (whatever his last name was) was born in Limerick, Ireland, in 1809 and studied forensic toxicology and chemistry in Scotland, graduating in 1829 with a medical degree from the University of Edinburgh Medical School.   Conveniently, there was a major outbreak of cholera in the vicinity at the time. William analyzed the urine and blood of cholera patients and found the blood deficient in water, salt, and “free alkali” and suggested that injecting salts would help. That simple discovery by William (at age 22) led to the development of intravenous fluid and electrolyte replacement therapy, a mainstay of medical treatment and prevention to this day. He tested his IV fluid replacement theories on a dog with excellent results.   Being a cholera expert of any kind in the British Empire in those days made you a valuable asset to send off to remote corners of the globe to deal with cholera outbreaks, and that happened to William. In 1833 he was dispatched to Calcutta. There, with assistance from another physician, Dr. Thomas Latta, the practice of IV fluid replacement was refined and put into practice to great effect. Its only drawback was that it was believed to be extremely helpful to people at death’s door but extremely harmful - even potentially fatal - to people who were only mildly ill or moderately dehydrated. In one case Latta wrote about, he decided to administer IV fluids to a woman who was so ill he thought she would be dead before he could start the drip. Thirty minutes later she was animatedly talking and laughing.   William returned to England to introduce another great finding from his days in India: great successes with medical applications of cannabis. He is in effect the father of medical marijuana, performing extensive experiments testing its beneficial effects against numerous illnesses and numerous symptoms while keeping detailed notes.   While on his second tour in Calcutta beginning in 1844, William made a celebrated name for himself in another field entirely: he introduced the telegraph to India and oversaw the installation of more than 3,500 miles of telegraph wires across the subcontinent. For this he was knighted in 1856 by Queen Victoria.   He lived the short remainder of his life in England in relative obscurity, and died in 1860. +

After two weeks of hot weather, today we’re cooling off to 80 degrees and the rest of the week will be in the 70s. It’s not quite fall weather yet, but clearly heading that way. (If you’ve missed an issue or two, I recently moved from Augusta to Michigan.)   I am still coping with way too many boxes to open and things to put away, but life is going well. Yesterday I was able to attend the birthday party of a dear friend who turned 86. I hadn’t seen Ellen in eight years, which made being with her and her family extra special. My daughter Vicki took us, which added to the fun because on the way home we stopped to pick up her twin grandsons, who are nine months old, for an overnight visit at her home. Her granddaughter Ayana was with us too, being her sweet teenage self. She’s in middle school now and although school has started, she hasn’t had any homework yet.   I asked about special accommodations for COVID at her school, and she told me that teachers are able to choose the degree of distancing and masking in their own classes. The fact that there wasn’t a single policy for the whole school didn’t bother her at all. The flexibility is easy for her to follow and comply with.   Going to social gatherings is something I haven’t been able to do in over two years, which made it even more special. I know that is true for most of us, since COVID has curtailed so much of our ordinary lives. In October one of my nieces is marrying her long-time partner and I’ll

be able to attend that too. In addition to Alison and her family, I’m sure I’ll see other relatives I haven’t been able to see since I moved to Georgia in 2009. I would have considered that to be a treat when I was more independently mobile, but now it has become even more special.   Thinking back to family gatherings in the past, I recall loving it when the old folks came, but now I wonder if they too, had become aware of the inexorable passage of time and the inevitability of their deaths. Because they had always been a part of my life, it rarely occurred to me that their presence was limited instead of being permanent. They were all precious to me anyway and time spent with them was a blessing. They were the connectors for me to a time I had not lived through, a way of life foreign to me, and still a hope for the future of a family that continues to evolve.   They had grown up in a time before cars, television, frozen food, indoor plumbing, and even electricity. Nonetheless, the one thing that hasn’t changed very much is how important family is to who we are in the process of becoming. Family is, for many of us, a foundation upon which we construct our lives.   My Aunt Veta’s storytelling significantly added to my awareness by making familiar a few people I had never met. It is her gift to the family in the form of stories she has preserved, a gift that I hope to emulate in the near future. I am the connector for the next generations to come who will look back with me to a time that came before but is still relevant. +

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SEPTEMBER 17, 2021

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AUGUSTAMEDICALEXAMiNER

ADVENTURES IN

Middle Age

EVERYBODY LOVES A GOOD STORY

BY J.B. COLLUM

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The late great singer, songwriter and poet ing our hands when we asked him questions Jim Morrison said, “The future is uncertain, or gave him options of what he wanted. He but the end is always near.” He also said, “One once again told us through this method that he shouldn’t take life so seriously. No one gets just wanted pain relief and not treatment that out alive anyway.” I try to keep both quotes in would prolong his life. mind as I stumble through life.   When my mother, his wife and “girlfriend”   I have shared a lot about my father in as he often still referred to her, first got within this column over the past 21 months. I have his view and kissed him and let her hair drape shared the agony of seeing him slipping away across his face, he smiled and made noises bit by bit, as we all became victims of his that showed his great pleasure at seeing her. It Alzheimer’s disease. This gradual progression was both heart-warming and tragic all at once. lulled us all into the false expectation that He still was so devoted to her and loved her so the descent would follow a smooth slope, but much that her presence and touch could enlivas often happens, things took a turn for the en him, if only for a few moments. He loved worst just a few weeks ago. mom until the very end.   Just since then, Dad went   He also showed his deep from being able to walk with spirituality when we asked if The end the help of his rolling walker, he wanted me to pray and he is always near. talk understandably, and eat and squeezed a yes in response. drink without too much difficulWhen I first said God’s name, ty to quite the opposite. He had he made a long moaning sound greater and greater difficulty walking at all, that seemed to indicate his calling out to him. even with help. His speech was sometimes When I finished the prayer, he moaned what slurred. His breathing was more labored. we know must have been his way of saying He had difficulty swallowing and at times amen in his limited state. chewed on a straw and had to be told to suck   We stood around him and told him how on it instead. He went to the hospital twice good a father he was and how much we loved by ambulance during this time, and to the him. We told stories about him and talked doctor twice. They discovered pneumonia and about places we’d been and things we’d done attempted to care for that with antibiotics. In as kids. Him nimbly crossing wide rivers in the the end, they were unsuccessful. Suddenly mountains across slippery rocks that intimidatand sadly, we lost him to the age-old enemy, ed us kids as we tried to walk in his footsteps. death on Sunday, September 5 at 2:05 p.m.  It will prove even harder for us to walk in his   We were all in the parking lot of the hosfootsteps metaphorically speaking. He is a hard pital to come see him one last time when we act to follow. He was a devoted son, husband, got the call. When we wanted to visit earlier father, grand-father, great-grandfather, friend, in the day we were told to wait until they got and worshiper of God. He wasn’t perfect of him into a regular room, since visitors were course. No one is, but he was the best man I not allowed in the emergency room due to ever knew. He worked diligently at any task COVID-19 restrictions. Thankfully, the night he had to do. He did not eat of the bread of before a nurse and a doctor with big hearts laziness. By his words and example he taught allowed us in anyway. On that night, Saturday his children how to be kind, fair, loving, strong, night, my son went first to see how things hard-working, self-sufficient and honest. were. When he put me on a video call with my   And now, somehow, I am supposed to go father so I could see how bad off he was, I put on living in a world where he no longer exists, my mother in the car and we, along with my except in memories. I am still not exactly brother and his wife, headed for the hospital. sure how I will do that, but I have been told More wanted to come, but we were told we that time will help. Now I am left with a final might not even get to see him, and we also obligation to my father that I will strive to didn’t fully understand how bad it was just carry out in a manner he would be proud of; yet. That became evident once we got to the namely, to take care of our family the way hospital. he did, including my widowed mother. I will  There the doctor told us dad didn’t have strive to do that and hope to not disappoint long. Dad had already established a long time him. I know that I will have to answer to him ago that he didn’t want to be intubated or have one day for that. + a feeding tube or be put on any machines to be kept alive, so there wasn’t much they could do. J.B. Collum is a local novelist, huShe expected him to last two to three days at morist and columnist who wants to most. We stayed as long as we could, and were be Mark Twain when he grows up. able to communicate with him by him squeezHe may be reached at johnbcollum@gmail.com

AND EVERYBODY HAS A STORY. WE’D LOVE TO HEAR YOURS. MEDICINE IN THE FIRST PERSON Send your interesting (or even semi-interesting) stories to the Medical Examiner, PO Box 397, Augusta, GA 30903 or e-mail to Dan@AugustaRx. com. Tell us if you want it “by you” or if it needs to be anonymous. Thanks!

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SEPTEMBER 17, 2021

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


TRYTHISDISH SEPTEMBER 17, 2021

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by Kim Beavers, MS, RDN, CDCES Registered Dietitian Nutritionist, Chef Coach, Author Follow Kim on Facebook: facebook.com/eatingwellwithkimb

EGG-IN-A-HOLE...plus veggies   Any vegetables will work in this recipe, especially leftovers. Last night’s veggies are a perfect way to add vegetables to your breakfast. If you only make 1 serving of this egg-in-a-hole recipe you will have plenty of leftover vegetables for the next meal.

Instructions   Preheat the oven to 350° and line a sheet pan with aluminum foil. Spread the tomatoes, zucchini, and onion out in a single layer on the pan; sprinkle with seasoning and drizzle with oil. Toss the veggies with your hands to coat with oil. Roast for 20 to 30 minutes, turning the veggies about halfway through cooking time. Once done serve or refrigerate for use later.   To make the egg-in-a-hole,

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cut a hole out of the center of the slice of bread with a small, sharp jar top or biscuit cutter. Heat butter and oil in a skillet over medium-low heat and once the oil is hot and butter melted, add the bread and cut-out to the pan and toast on one side. Turn the bread over and if using leftover veggies add them to the pan as well. Lightly spray the inside of the hole of toast with cooking spray and crack an egg in the middle. Cook over low-medium heat for 2-3 minutes or more depending on how well you want the egg to be cooked.

Serve egg-in-a-hole along with the cut-out and a side of veggies for a delicious breakfast meal.

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Yield: 1 Serving (serving size: ¼ cup vegetables plus egg and toast) Nutrition Breakdown: Calories 230, Fat 13g, (4.5g saturated fat), Cholesterol 230mg, Sodium 470mg, Carbohydrate 25g, Fiber 7g, Protein 13g. Percent Daily Values: 15% Vitamin A, 20% Vitamin C, 10% Calcium, 15% Iron Diabetes Exchange Values: 1 Carbohydrate, 1 Vegetable, 1 Protein, 1 1/2Fat +

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Roasted Vegetables • 1 pint grape tomatoes, halved • 1 medium zucchini, chopped into 1/4-inch pieces • 1/2 medium sweet onion, diced • 1/2 tsp Italian seasoning • 1 tsp extra-virgin olive oil Egg-in-a-hole • 1 teaspoon butter • ½ teaspoon canola oil • 1 slice of bread • Non-stick cooking spray • 1 egg

An average person at age 100

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SOLOMON SAYS by Ken Wilson Steppingstones to Recovery

Old wisdom seems better when new wisdom confirms it. The old preacher once said “…a cord of three strands is not easily broken.” (Ecclesiastes 4:12) Even in this zip-tie age, most addicts in recovery will tell you that trying sobriety on their own willpower was a train wreck. I mean, just look around. We’re like Mark Twain who said “It’s easy to quit smoking…I’ve done it a hundred times!”   The advent of 12-step groups in the 1930s and since has resulted in 185 groups using the same steps and traditions, the third tradition of them all being “The only requirement for membership is the desire to stop drinking, or using, or spending, etc.” In a previous column I alluded

to an industry standard which affirms that three things are necessary for recovery to happen: Desire, Accountability, and Support. With desire alone, for instance, nothing happens. You are stuck on third and never get home. The genius of these recovery groups is the utilization of this three-fold cord because riding a unicycle is just hard to do and few master it.   Given, some few people get lucky and just stop… smoking, drinking, drugging. It’s the exception and not the rule, however. I am talking about most people most of the time and not all people all of the time. If you know someone who “just quit,” then know that they just got lucky.   That first strand: DESIRE. Without the desire to stop drinking, families can spend

STRESSED OUT?

hundreds of thousands of dollars on the best treatment in the world and get nothing for it but failure. You can’t pay somebody to de-program you or give you the desire to be sober. You can’t push a rope.   What the motivation for sobriety might happen to be does not matter. It could be legal, marital, vocational, or financial. What matters is that an alcoholic is sick and tired of being sick and tired and desires to be free from slavery. What happened to get him/her there is not significant. What is significant is that he/she feels pain associated with drinking or drugging.   This desire might just be to keep the job, or stay out of jail, but the alcoholic knows that alcohol is in the equation and realizes that alcohol must go.   The second strand is

ACCOUNTABILITY. No man is an island. We need each other. For someone in a weight loss program, accountability is in the weekly weigh-in. For an alcoholic or addict, it’s the random alcohol or drug screen. It is a given that human behavior tends to return to the way things were before change happened. Long term change takes a long time. Weight loss doesn’t happen overnight and neither does the biochemical lure of alcohol and drugs. So check-ups are important. We call aftercare attendance “a check-up from the neck-up.”   The third strand is SUPPORT. In step-groups this comes in the form of discussion, step studies, text studies, and sponsors. In church this comes in the form of spiritual directors or weekly Bible lessons or prayer/

SEPTEMBER 17, 2021

THIS IS YOUR BRAIN A monthly series by an Augusta drug treatment professional

meditation groups. In therapy it involves a counselor. In recovery we can’t rely on ourselves to stay the course. At times we all need a helping hand after hitting the rapids. We are just wired that way.   The wise person learns from the mistakes of others who tried it alone. I saw a sign recently that said “Learn from the mistakes of others because you’ll never live long enough to make them all yourself.”   Three is better than one. You don’t even have to be a Bible student to realize that the old preacher was right. +

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

Other nutrients that may play a role in immune support include folate and iron.   Overall, it is important to eat a variety of foods to promote optimal immune function. Food is the best primary cheapest source for obtaining these nutrients and supplementation should always be discussed with your health care provider or a registered dietitian nutrition before taking them. +

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WE OFFER CREW CUTS Drinking a Green Smoothie can be a simple, fun, and delicious way to increase your intake of powerful nutrients to support your immune system. Recipe: Green Smoothies Prep time: 10 minutes Ingredients: 2 ripe bananas 1 ripe pear or apple peeled or chopped 2 cups chopped kale leaves, remove stems ½ cup of orange juice ½ cup of water 1 – 1 ½ cup ice cubes 1 tbsp of ground flax seed Directions: Place bananas, pear or apple, orange juice ice cubes, water, and flaxseed into a blender. Pulse a few times and puree until smooth. Enjoy! +

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tion is usually not necessary. Fruits and vegetables are the best sources of vitamin C, and some of these include citrus fruits, tomatoes, potatoes, bell peppers, broccoli, and strawberries.   Vitamin E is also an antioxidant that may help support immune function as it helps to fight infection. Antioxidants protect cells from damage caused by free radicals that may lead to the development of cardiovascular disease or cancer. Some foods that are a good source of vitamin E include nuts, seeds, vegetable oils, leafy green vegetables, and fortified cereals.   Zinc is necessary for normal immune function and can be found in many foods, including chicken, beef, yogurt, milk, cheese, almonds, and cereals. It is also found in many cold lozenges and overthe-counter medications used to treat colds and provide relief of mild symptoms.   Selenium has also proved to be of importance for a healthy immune system as it plays a critical role in protection from oxidative damage and infection due to its antioxidant properties. The most common foods in which it can be found include seafood, organ meats, nuts, grains, and dairy products.

Ohio Ave.

During these uncertain times, many Americans are searching for ways to boost their immune system to help combat illness. Nutrition is a key component to build and maintain a strong immune system that may withstand and fight illness. Vitamins and minerals serve vital roles in the human body. No single vitamin or mineral is necessarily more important than the others, however, there are specific vitamins and minerals that play a role in fighting illness by supporting the immune system.   Vitamin A is not only beneficial for vision, but also in regulating the immune system. This vitamin is also known for its anti-inflammatory roles that also contribute to immune health. Foods that provide a good source of vitamin A include dark green leafy vegetables, sweet potatoes, corn, eggs, and milk.   Vitamin C is an antioxidant and the immune-boosting properties of vitamin C is well known. It also plays a role in protein metabolism, wound healing, and regeneration of other antioxidants. Daily intake of vitamin C is essential because the body does not produce or store it. The vitamin is abundant in a number of foods, so supplementa-

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SEPTEMBER 17, 2021

CRASH

COURSE

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

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lease don’t be offended by the sight of a dummy in this column’s header. Unfortunately, though, it is a fact that many crashes are caused by driving behaviors that aren’t simply illegal. They’re also incredibly stupid.   Among the many ways aggressive driving can manifest itself, one of the most unsafe (and idiotic) is tailgating.   Let’s paint a realistic scenario that includes a tailgater driving a huge, ladder-worthy pickup truck, one that shines its 1000-watt headlights into the rear view mirror of every car he tailgates.   Having met the tailgater, we should also introduce the tailgatee. Let’s assume the lead car is being driven by a complete stranger to the tailgater. Despite that fact, the tailgater trusts this unknown person to the extent that he is following so closely that he can’t even see the car’s back bumper or most of its trunk. The car is kind of a clunker. It doesn’t go too fast. It’s in the left lane, the fast lane, not because it’s going fast, but because the driver will be turning left just ahead.

In fact, the driver of the clunker is currently unemployed, and is returning from the 78th place he has applied to for work in the past month. This one, like the others, did not seem promising. Driving back home he is very discouraged. His situation has been desperate. Now it’s beginning to look hopeless.   Ah, but wait! There is an answer! Help has arrived! His financial problems are soon to be over!   All our unemployed friend needs to do is slam on his brakes to avoid hitting that dog in the road. He definitely saw a dog in the road. Absolutely. No question he saw a dog in the road.   Soon after the ensuing rear-end collision, which is 100% the tailgater’s fault, the ambulance arrives to transport the innocent driver to the nearest emergency room. On the way, a phrase suddenly pops into his head. “One call, that’s all.” He heeds the call as soon as he can, which is a good thing, because he suffered debilitating whiplash that simply will not go away despite months of physical therapy. He also suffers much pain and

Sparkle

anguish and mental distress. He’s almost afraid to leave the house anymore, his attorney tells the court. Not that he is physically able to do so. But if he was able. He can’t even look for work anymore in his condition, but with the size of the settlement, he really doesn’t need to. If he plays his cards right, he’s financially set for life. And he feels sure that his neck and back pain will get better any day now. It mainly hurts only in court anyway.   As for the pickup truck driver, he paid a huge fine for speeding and tailgating, lost his truck because he couldn’t afford the astronomical new insurance premiums (it cost his insurance company over $300,000 to close the case, so our hero is relegated to insurers of last resort), and he now drives a car that’s a lot like the one he rear-ended.   Yes, every time someone tailgates, it’s like giving a total stranger a blank check good for all the money you currently have and a sizeable chunk of your future earnings too.   How trusting and generous of you. +

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The blog spot From the Bookshelf — posted by Lisa Cronk, MD, on September 2, 2021 (edited for space)

PHYSICIANS: FROM HEROES TO VILLAINS   I am exhausted. Mentally, emotionally, physically.   I fear we are reaching our breaking point. We have run a marathon, hoping that we were nearing the finish line as we saw numbers decline in June, only to be told to lace up our sneakers and start over.   Work in outpatient pediatrics is always busy in the summer, seeing our patients for school and sports physicals, marveling at how much they’ve grown since we saw them last, and anticipating how to best keep them healthy, thriving, learning, and growing for the year to come. It is busy, but rewarding.   This year is different.   This year, we have our busy winter respiratory illness season in the summer, concurrent with our well-child visit season. We are seeing many babies and children coughing, wheezing, short of breath, with tearful parents begging us to help their child, when sometimes all we can do is support them through it and hope they don’t end up in the hospital, or worse.   We’re seeing rising COVID cases (again), particularly in young children who don’t yet have access to vaccinations. This year even more than last year, the anxiety level is through the roof for parents. I am baffled as to why some schools don’t follow the recommendations of the American Academy of Pediatrics (AAP), thinking they somehow know better than a huge group of pediatricians who have been caring for the physical and mental health of children throughout this pandemic. Nearly every visit these days includes more time for discussion and questions about COVID vaccines, masks, return to school policies, etc. I continue to fight the good fight, but there is only so much I can do. By the time I give each patient and family the time they need, I am far behind, apologizing to every family for the wait, and spending hours after the last patient leaves trying to catch up before going home to my own family.   Every day, I gently and patiently try to dispel misinformation one by one in discussions with my patients and their families. I try to share the AAP, CDC, and state public health department, etc. school recommendations with a school mom’s group. I explain why wearing a mask is a way their child can protect themselves and learn the valuable lesson of caring about and protecting the people around them. I try to explain complex scientific concepts in simple language to dispel the rampant misinformation circulating and keep people from accepting lifesaving preventative measures. I try to appeal to a sense of community by asking people to protect themselves and those around them.   In the end, though, I feel increasingly demoralized as I am buffeted by the epic storm of the dual pandemic – that of a deadly virus and deadly misinformation. Some days it feels like trying to bail water out of the Titanic with a teaspoon. Every day, it feels like we are losing the battle anew.   I am exhausted and sad and disappointed and discouraged.   I am losing faith in humanity. Where is the “love your neighbor as yourself”? Where is the willingness to help each other? Where is the solidarity of those first days? Physicians have gone from being heroes to being villains. We have dedicated decades of our lives to learning how to care for you, but now our knowledge and expertise are being thrown back in our faces as not good enough and not as believable as your cousin’s friend who saw something on social media.   It is hard to keep going. But we do. We keep going because we have dedicated our lives and careers to our

There are really two pandemics raging.

Please see BLOG SPOT page 16

What follows is from a Kirkus Reviews overview of The Gene by Siddhartha Mukherjee:

A panoramic history of the gene and how genetics “resonate[s] far beyond the realms of science.”   Mukherjee (Medicine/ Columbia Univ.; The Laws of Medicine, 2015, etc.), who won the Pulitzer Prize for his history of cancer, The Emperor of All Maladies (2010), begins with Mendel and his “pea-flower garden,” and he never lets readers forget the social, cultural, and ethical implications of genetics research. Indeed, he dedicates the book to his grandmother, who raised two mentally ill children, and to Carrie Buck, the Virginia woman judged “feeble-minded” and sterilized according to eugenics laws passed in the 1920s. After Mendel, Mukherjee describes Thomas Morgan’s fruit fly studies in the 1900s, and he goes on to trace the steps leading to the discovery of the double helix, the

deciphering of the genetic code, and the technological advances that have created ethical dilemmas. Early on, there was recombinant DNA, the insertion of genes from one species into another, and this led to mandates initially proscribing certain experiments. Then, there were the first disastrous attempts at gene therapy, which consisted of arrogant and sloppy science. Meanwhile, the human genome has been mapped, more and more genes have been associated with certain diseases (and even behaviors), and a

new technique has been developed that permits the removing or replacing of specific genetic defects. Are we ready to apply that to an individual patient? Should it apply to sperm and egg cells so as to affect future generations? Mukherjee ponders these issues in the final chapters and epilogue, ultimately seeing the need for more research about the information coded in the human genome, since so much of it does not consist of genes. Throughout, the author provides vivid portraits of the principal players and enough accessible scientific information to bring general readers into the process of genetic lab science.   Sobering, humbling, and extraordinarily rich reading from a wise and gifted writer who sees how far we have come—but how much farther we have to go to understand our human nature and destiny. + The Gene by Siddhartha Mukherjee, M.D; 608 pages, published in May 2016 by Random House.

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But that was the best dinner you’ve ever made.

by Dan Pearson

AN ENCORE PRESENTATION OF ONE OF OUR FAVORITE EDITIONS OF “THE EXAMINERS.”

Even so...

I get that too. But if you ever dump a keg of I thought since it’s Gatorade on me again, so help me... football season now...

I just wanted to show my appreciation. I understand that.

EXAMINER CROSSWORD

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Click on “MYSTERY WORD” • DEADLINE TO ENTER: NOON, AUG. 30, 2021

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N O I Simply unscramble theA letters, T then begin exploring C our ads. When you A find the correctly spelled word V hidden in one ONof our ads — enter at AugustaRx.com

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by Daniel R. Pearson © 2021 All rights reserved.

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

by Daniel R. Pearson © 2021 All rights reserved.

DOWN

30. Spasm; pang 31. WBBQ’s legendary George 32. Minerals 33. Ridge over the eye 36. Basic monetary unit of Ghana 38. Washington Road motel 40. _____ lab 43. Form of wrestling 45. Musical instrument 49. Respiratory malady 50. ________ training 51. Wheat, for example 53. Medic beginning 54. State with confidence 55. _____ out 56. Downtown Bar 58. Lymph _____ 59. Benedict introduction 60. Hard fatty tissue 63. Doctors 64. Maddux’s was 1.56 in 1994

1. Campus org. 2. Luxuriant 3. Otherwise 4. 12th month of the Jewish calendar 5. Lover of Hercules (Greek mythology) 6. Charity founded by Marie Osmond (abbrev) 7. Per 8. Lung membrane 9. Skinny loaf of French bread 10. Leers 11. Meager 12. Untie 13. “Let it stand” 18. Concerning (Archaic) 22. Masters access 24. Mind 26. Grumble 27. Stormed 28. Pitcher 29. Burdened

Solution p. 14

QUOTATIONPUZZLE O T A V

E A Y Y N L U R E A E D H T T B O N O

by Daniel R. Pearson © 2021 All rights reserved

5 2 7 1 L Y A A I O D 6B 9 E E B V W S R 2E 8 1 7 D L L F N A 4 3 Y E E 8 6 9 4 — Dr. Martin Luther King, Jr. (1929 - 1968) 3 5

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

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

O 1 2 3 4 N 1 2 3

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— Dalai Lama

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1.TTBCKWERYS 2.AFOOURHHEN 3.EEEOUNFLL 4.WEEMAL 5.SCK 6.T 7.I 8.V 9.E 10.L 11.Y

SAMPLE:

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

L 1

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by Daniel R. Pearson © 2021 All rights reserved

WORDS NUMBER

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ACROSS

1. Computers have this mode 6. Brown-capped mushroom 9. A large dose given all at once 14. A small ravine 15. Grand ___ 16. Representative 17. Guarantee 19. Open space in a forest 20. North Georgia tourist spot 21. French Protestant 23. Natal start 25. _____ Creek 26. AU library namesake 30. Double-eagle on a par 5 33. Scottish for “excellent” 34. Afternoon drink 35. Engraver 37. Star in Orion 39. Local juv. jail 41. Strange and mysterious 42. Musical dramas 44. Initials of the author of “The Raven” 46. Desmond _____ (the only conscientious objector to win the Medal of Honor) 47. Tie the knot 48. Amounts 51. Common trees 52. Monetary unit of Vietnam (1/10 dong) 53. Common name for high school teams 57. Rule of _______ (in burns) 61. _____ Flu (H5N1) 62. Likeness; equivalent 65. Send money 66. Mire 67. Gardening tool 68. James Brown follower 69. Lou Gehrig letters 70. Outer coat of a seed

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SEPTEMBER 17, 2021

The Mystery Word for this issue: BLOMMSAITE

© 2021 Daniel Pearson All rights reserved.

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SEPTEMBER 17, 2021

AUGUSTAMEDICALEXAMiNER

THEBESTMEDICINE ha... ha...

The

Advice Doctor

“Sounds like she’s easy on the eyes but hard on the pupils,” says the bartender.

A rabbi and a priest who haven’t seen each other for a year due to the pandemic bump into each other on the sidewalk one day.   The rabbi, never one to mince words, tells the priest, “You have put on some weight since the last time I saw you!”   The priest chuckles quietly. “I came up with a new technique,” he says. “Go to a restaurant kid on the way to his first day of school and order whatever you want. Then when the looks worried, so his dad asks him check comes, tell them you already paid.” what’s wrong.   “They won’t believe you!” says the rabbi.   The boy asks, “How long do I have to go to   “Of course not,” says the priest. “That’s school, Dad?” when you loudly and indignantly say, ‘How   “Believe it or not, until you’re 18,” answers dare you doubt a man of faith!’ It usually the father. works and you can leave without paying.”   The child thinks about this quietly.   “Brilliant!” says the rabbi. “I’ll be trying this.”   When they arrive at the school, the kid   Later that day, the rabbi goes to his favorite starts to get out of the car, then stops and kosher restaurant. After ordering all his favorasks, “Dad, you will remember to come get ites, the waiter presents him with the bill. me when I’m 18, won’t you?”   “Oh, I’ve already paid,” says the rabbi.   “I’m sure you have not, sir,” counters the   Moe: What do you call a cat with a lisp? waiter.  Joe: I give. What?   “Can’t you see that I’m a rabbi? I told you,  Moe: A cat! I already paid. How dare you doubt a man of  Joe: What?? faith!”  Moe: There’s no “s” in cat, dummy.  “I am so sorry rabbi, you are right. My apologies. You’re good to go, and thank you.   A college student walks wearily into a bar Please come again.” and orders a beer. He starts chatting with the   Ten minutes go by and the rabbi is still at his table, then 15 minutes... after 30 minutes he’s bartender. still sitting there. Finally the waiter approaches   “Man, what a day. Our physics professor has to be one of the most difficult professors on the and asks him, “Sir, why are you still here?”  “I’m patiently waiting for my change,” says the whole campus. If she wasn’t so spectacularly gorgeous I would’ve dropped the class already.”  rabbi. +

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©

A

Why subscribe to theMEDICALEXAMINER? What do you mean?

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

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

Dear Advice Doctor,   Since you’re a doctor I hope you can help me understand how doctors think. I work in a doctor’s office and have been there for about 8 years. It was great for the first 5 years or so, but this doctor is getting more and more demanding. Oh, he can find some mysterious illness that six other doctors couldn’t, but he can also be the world’s biggest fault-finder. It’s getting really tiresome to work with someone who is so petty and picky. Should I talk to him, find another job, or just learn to live with it? — Tired of Walking on Pins and Needles Dear Tired,   I read through almost your entire letter without getting a true grasp of your situation. Your employer has the advantage of making diagnoses in person; I have to attempt to gather clues from people’s letters and emails, and it’s not always easy. But you did offer one significant clue.   First, I’d like to say that I sympathize greatly with your situation. No one should have to endure this kind of ongoing misery, and that feeling of walking on pins and needles — officially known as peripheral neuropathy — is the worst! The good news is that you can do something about it.   It would probably be a good idea to schedule an appointment with your family physician, but there are also some steps you can take — literally, as in walking — to help minimize neuropathy.   Walking has helped many people. Start with a distance you feel comfortable with; remember also, it isn’t a race. Just get your circulation going. That can help nourish damaged nerves. All walking counts, even if it’s in circles in your living room or up and down the hallway. The important thing is steady regularity.   A couple of other lifestyle suggestions: if you smoke, quit! Smoking is a prime enemy of good circulation. Alcohol is another potential trigger for neuropathy since it can be toxic to nerves. Drink seldom and moderately if at all.   Soaking your feet in warm water with Epsom salt helps many people. Acupuncture is a source of relief for many more. The bottom line: help is available.   I hope this answers your question. Thanks for writing! + 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.

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THE MYSTERY SOLVED The Mystery Word in our last issue was: METABOLISM

! N O I in the p. 15 ad for T ...cleverly hidden in the woman’s hair A READ US ON YOUR SMARTPHONE OR TABLET AC V ON

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

SEPTEMBER 17, 2021

AUGUSTAMEDICALEXAMiNER THE PUZZLE SOLVED B U D S

A S I A

E A L H E S C T J T O U S G E

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H F O A A V Z R A A N G R E O N D O T E N I W P S A L E R A Y P E D I O D I A S P E R D O K E E D E C N E T

R T I A N B B I A L B R E E D N F L D S P A E N C E L G E L O L I O S S

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The Celebrated TheSUDOKUsolution MYSTERY WORD CONTEST 5 2 8 7 9 6 4 3 1

...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.

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

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QuotatioN QUOTATION PUZZLE SOLUTION That old law about an eye for an eye leaves everybody blind. — Martin Luther King

WORDS BY NUMBER Know the rules well so you can break them effectively.

— Dalai Lama

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SEPTEMBER 17, 2021

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AUGUSTAMEDICALEXAMiNER

Headquarters for the well dressed man since 1963

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LIFE IS COMPLICATED Death doesn’t have to be. We know how to help.

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READ US ON YOUR SMARTPHONE OR TABLET Just go to www.issuu.com/medicalexaminer

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PROFESSIONAL DIRECTORY +

ACUPUNCTURE

DERMATOLOGY

Georgia Dermatology & Skin Cancer Center 2283 Wrightsboro Rd. (at Johns Road) Augusta 30904 706-733-3373 SKIN CANCER CENTER www.GaDerm.com

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

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

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TRANSPORTATION AMBULANCE • STRETCHER • WHEELCHAIR

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AUGUSTAMEDICALEXAMiNER

SEPTEMBER 17, 2021

BLOGSPOT… from page 11

patients. We follow our Hippocratic Oath, and we do the best we can for every patient no matter who they are, what they believe, or what choices they make. But many of us are barely clinging to our passion to serve.   Each day, I get out of bed, swallow my frustration and disappointment, and pray for the fortitude and resilience to face another workday, because I know that if I can make a difference, however small, it means something. And I know that my patients and their families bring me joy! But each day, my heart breaks a little more. It shouldn’t have to be this way, but this is the world we live in right now.   I am exhausted.   But yesterday, I got a smile from my sweet patient in the ICU, clawing her way back from death’s door and hugs from her mom. And that is what I needed to keep going. +

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

FREE HEALTH CLINIC for those who have no health insurance and whose income is at or below 200% of the federal poverty level. We provide ongoing primary care, limited prescription assistance, mental health referrals, and more.

Every Second Saturday from 9 AM to 1 PM

Lisa Cronk is a pediatrician

Walk-ins welcome 9am-11am • By appointment 9am-1pm

MODERNA or JOHNSON & JOHNSON

University Hospital POB 1, Suite 2-A First Islamic Center Building 820 St. Sebastian Way 3416 Middleton Dr. Upcoming Next clinic clinic Augusta, GA 30901 Augusta, GA 30907 HERE HERE

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TO MAKE AN APPOINTMENT OR GET MORE INFORMATION:

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YOU ARE ESSENTIAL DON'T DELAY. GET THE CARE YOU NEED.


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