Contents
25 On The Cover The Long Goodbye A fathers pain, a sons struggle.
32 Feature Sneaker Head A look into the shoe obsession.
www.dappermag.com 13
15
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In the News World and National news.
18
Healthier You
29
Fashion Forward
Hand Crafted Find Your Fit A Dapper guide to your new suit
Stay Healthy and Look Awesome!
Keep up to date with the latest styles
41
What’s Next? Preview of Nex Month
Clean Bill Improve your Workout Today Make your workout work for you.
12 Cutting Edge How Healthy is the World? World health statistics
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CoverStory
“Dad,” I say when I visit their house that afternoon, “what is it? What’s wrong?” “I want to go home. Please, take me home!” “But, Dad, you are home.” “I don’t know where I am. Please, Jerryboy, take me home. You know the way . . .” “I don’t know where else to take you, Dad. You’ve lived here for twenty-nine years.” “You go to hell! You’re in with them!”
T
here is no walking away now. He is an abandoned child. He searches for his boyhood home on Boarman Avenue, in Baltimore, or perhaps our first family home there, on Forest Park
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Photograph by James
F
ebruary 24, 2006, is my parents’ sixtieth wedding anniversary. My family plans a brunch for them in their home. We are keenly aware that this may be the last anniversary my parents will celebrate together. It won’t be an elaborate party, just a bittersweet one. Seven years earlier, my father was diagnosed with Alzheimer’s disease, and he has gone steadily downhill. At 87 years old, he is now a prisoner of his mind. His agitation and paranoia arise from distorted memories, nightmares he can no longer separate from reality. A few days before the brunch, my mother calls me in a panic. My dad is bellicose and paranoid, accusing. Summoning Yiddish profanities he has not uttered in 75 years, he curses at Yolanda, the caregiver who holds everything together in my parents’ household. He will not be bathed or shaved. He will not eat, refuses his medications. He is raving.
Avenue. He hears voices but can’t decode what is being said, and his mind assumes the worst: My mother is insulting him, planning to run off; his sons are belittling him, his mother scolding him, his older brothers and sisters teasing him. He is lost, with no father of his own to turn to. I see that he has wet himself; a dark ring marks his place on the couch. As a geriatric physician in San Antonio for the past thirty years, I have been through this before. I have been cursed, spit on, bitten, and punched by demented old folks over the decades. A poor woman threw a shoe at me when I stepped inside her hospital room. The day before, she thought I was the devil. As a doctor, I know what to do; as a son, I am uncertain. So I assume my doctor role, retreating into the armor of my starched white coat. I walk to the kitchen and check his daily pill slots to make sure he’s been getting his regular medications. Sometimes my mother, unable to see due to macular degeneration, inadvertently leaves pills in the plastic containers I fill every couple weeks. But everything seems in order. The pills are often as much a part of the problem as the cure. lowering drugs. My father also takes two pills .
CoverStory
drugs for her diabetes, a thyroid disorder, osteoporosis, and depression. This is not unusual for folks their age. I spend my doctoring days prescribing medications for my patients, reshuffling the ones they’re on—a tiny dose change here, a retiming of administration there. By now I have written or refilled hundreds of thousands of prescriptions, but my constant goal is to cut back on medications, stop them altogether if I can: Less is usually more. I spent two hours with Lilly, hearing one story loop into another: bad marriages, kids in jail, ER visits, surgeries, strange diagnoses mostly self-made. I knew what was happening to Lilly, what happens to many people like her in a medical encounter. The physician begins to drown in a sea of conflicting information, feels powerless to alter the circumstances of this person’s life. A wave of helplessness washes over doctor and patient both, and he reaches for his prescription pad. “Here, try this,” he says. “I think it will help.” Then he steps into the hall, picks up the next chart, and moves on, hoping the drug he has prescribed helps but doubtful it will. I could not change the circumstances of Lilly’s life, couldn’t make up for her poverty or lack of education or the poor choices she had made. But she improved significantly when, after some lab work and many more hours of listening, I was eventually able to whittle her medication list down to three. Prescribing for the elderly is complicated. They don’t metabolize drugs at the same rate as younger, healthier patients. The main workhorses of drug excretion—the
KNOW THE SIGNS 10 Warning Signs of Alzheimer’s 1
Memory Loss that disrupts daily life
2
Challenges in planning or problem solving
3
Difficulty completing familiar tasks at home, at work or at leisure
4
Confusion with time or place
5
Trouble understanding visual images and spacial relationships
6
New problems with words in speaking or writing
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Misplacing things and losing the ability to retrace steps
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Decreased or poor judgement
9
Withdrawl from work or social activities
10
Changes in mood or personality
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CoverStory
drugs for her diabetes, a thyroid disorder, osteoporosis, and depression. This is not unusual for folks their age. I spend my doctoring days prescribing medications for my patients, reshuffling the ones they’re on—a tiny dose change here, a retiming of administration there. By now I have written or refilled hundreds of thousands of prescriptions, but my constant goal is to cut back on medications, stop them altogether if I can: Less is usually more.
Photograph by James
I spent two hours with Lilly, hearing one story loop into another: bad marriages, kids in jail, ER visits, surgeries, strange diagnoses mostly self-made. I knew what was happening to Lilly, what happens to many people like her in a medical encounter. The physician begins to drown in a sea of conflicting information, feels powerless to alter the circumstances of this person’s life. A wave of helplessness washes over doctor and patient both, and he reaches for his prescription pad. “Here, try this,” he says. “I think it will help.” Then he steps into the hall, picks up the next chart, and moves on, hoping the drug
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he has prescribed helps but doubtful it will. I could not change the circumstances of Lilly’s life, couldn’t make up for her poverty or lack of education or the poor choices she had made. But she improved significantly when, after some lab work and many more hours of listening, I was eventually able to whittle her medication list down to three. Prescribing for the elderly is complicated. They don’t metabolize drugs at the same rate as younger, healthier patients. The
“The FDA has pulled more than twenty drugs off the market in the past two decades” main workhorses of drug excretion—the liver and kidneys—decline in function with age, as do all our organ systems. The elderly, like my parents, are often on multiple drugs (including over-thecounter preparations the doctor might not even know about), and the incidences of unforeseen interactions begin to mount. We know so little about these interactions. Indeed, the pharmaceutical companies are infamous in geriatric circles for not including our elderly patients in drug trials. These days, between the Food and Drug Administration and Big Pharma, I hang suspended in a netherworld of prescribing
CoverStory
2000 - 2006 Deaths due to disease
Heart disease
-12%
prostate cancer
-18%
stroke
-15%
Alzheimer’s
+66% *alz.org
angst. The FDA has pulled more than twenty drugs off the market in the past two decades, drugs they first assured me were safe to use but then ended up damaging livers or kidneys or hearts. I have always tried to protect my patients, wait if I possibly can for aftermarket studies to bring more data to light. It is one thing, I tell my patients, to judge a drug’s benefits and risks after it has been given to a few thousand patients in clinical trials; it’s quite another after it has been prescribed to hundreds of thousands upon its general release. Now these industries have figured out a way to circumvent my judgment should I fail to join the chorus of cheerleaders for their newest breakthrough. On television, in magazines, they promise an end to arthritis pain, a good night’s sleep, a cure for incontinence, a firm erection. My phone rings off the hook with patients who worry that I may have blocked their path to the Fountain of Youth when I decline their drug requests. Some even change doctors. I have no sympathy for Big Pharma. I
resent its intrusion into the doctorpatient relationship, resent the constant introduction of new—often rushed— products into a marketplace crowded with me-too drugs. Big Pharma is right where it has always wanted to be—smack-dab in the middle of my decision-making process as it tries to influence consumers who also happen to be my patients. And yet here I am, in my parents’ home, rummaging through a basketful of medicines I take down from a high shelf. This is where I store the unused pills—all the psychoactive drugs prescribed by my father’s physician for his recurrent bouts of anxiety or agitation, for his depression and his insomnia, for his memory loss and lethargy, for his confusion and paranoia, for his belligerence and sadness. In hopes of continuing our conversation in person, I returned to see Graves one Wednesday afternoon during visiting hours, when the jail’s reception area was crowded with women and children. Our time was limited to twenty minutes, so I kept my questions simple. I asked if we could talk more about his life now. By Jerald Winakur
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32
CleanBill
improve your daily workout have a plan and sticking to it is most important when trying to get results. Here’s a quick guide to start a plan and stick it out.
diet Get a couple of stylish men’s tailored suits in your wardrobe then match with some men’s slim shirts and men’s formal shoes for the office and you’ll definitely look the business.
sleep Men’s slim fit suits are the most flattering shape for the office or that big day. Choose a coloured suit for maximum style points and match with some good men’s slim shirts.
exercise
The most popular men’s branded suits for every kind of special occasion. Ensure you pick up some smart shoes to match your sharp suit...
For more guides on health and fitness visit dapper.com
31
T
he date was January 14th. The FDA has pulled more than twenty drugs off the market in the past two decades, drugs they first assured me were safe to use but then ended up damaging livers or kidneys or hearts. I have always tried to protect my patients, wait if I possibly can for aftermarket studies to bring more data to light. It is one thing, I tell my patients, to judge a drug’s benefits and risks after it has been given to a few thousand patients in clinical trials; it’s quite another after it has been prescribed to hundreds of thousands upon its general release. Now these industries have figured out a way to circumvent my judgment should I fail to join the chorus of cheerleaders for their newest breakthrough. On television, in magazines, they promise an end to arthritis pain, a good night’s sleep, a cure for incontinence, a firm erection. My phone rings off the hook with patients who worry that I may have blocked their path to the Fountain of Youth when I decline their drug requests. Some even change doctors. I have no sympathy for Big Pharma. I resent its intrusion into the doctorpatient relationship, resent the constant
introduction of new—often rushed— products into a marketplace crowded with me-too drugs. Big Pharma is right where it has always wanted to be—smack-dab in the middle of my decision-making process as it tries to influence consumers who also happen to be my patients. And yet here I am, in my parents’ home, rummaging through a basketful of medicines I take down from a high shelf. This is where I store the unused pills—all the psychoactive drugs prescribed by my father’s physician for his recurrent bouts of anxiety or agitation, for his depression and his insomnia, for his memory loss and lethargy, for his confusion and paranoia, for his belligerence and sadness. In hopes of continuing our conversation in person, I returned to see Graves one Wednesday afternoon during visiting hours, when the jail’s reception area was crowded with women and children. Our time was limited to twenty minutes, so I kept my questions simple. I asked if we could talk more about his life now. “I’ve missed so much,” Graves said. “My children are all grown. I have grandkids I’ve never touched.” His voice broke. “I’ve been alive for the past eighteen years, but I haven’t lived,” he said.
I have no sympathy for Big Pharma. I resent its intrusion into the doctorpatient relationship, resent the constant introduction of new—often rushed— products into a marketplace crowded with me-too drugs. Big Pharma is right where it has always wanted to be—smack-dab in the middle of my decision-making process as it tries to influence consumers who also happen to be my patients. And yet here I am, in my parents’ home, rummaging through a basketful of medicines I take down from a high shelf. This is where I store the unused pills—all the psychoactive drugs prescribed by my father’s physician for his recurrent bouts of anxiety or agitation, for his depression and his insomnia, for his memory loss and lethargy, for his confusion and paranoia, for his belligerence and sadness. In hopes of continuing our conversation in person, I returned to see Graves one Wednesday afternoon during visiting hours, when the jail’s reception area was
Now these industries have figured out a way to circumvent my judgment should I fail to join the chorus of cheerleaders for their newest breakthrough. On television, in magazines, they promise an end to arthritis pain, a good night’s sleep, a cure for incontinence, a firm erection. My phone rings off the hook with patients who worry that I may have blocked their path to the Fountain of Youth when I decline their drug requests. Some even change doctors. This is where I store the unused pills—all the psychoactive drugs prescribed by my father’s physician for his recurrent bouts of anxiety or agitation, for his depression and his insomnia, for his memory loss and lethargy, for his confusion and paranoia, for his belligerence and sadness. time was limited to twenty minutes, so I kept my questions simple. I asked if we could talk more about his life now. “I’ve missed so much,” Graves said. “My children are all grown. I have grandkids a
THE EVOLUTION OF AIR JORDAN
From Air Jordan 1 to 28, things have changed at the Jordan Brand
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Now these industries have figured out a way to circumvent my judgment should I fail to join the chorus of cheerleaders for their newest breakthrough. On television, in magazines, they promise an end to arthritis pain, a good night’s sleep, a cure for incontinence, a firm erection. My phone rings off the hook with patients who worry that I may have blocked their path to the Fountain of Youth when I decline their drug requests. Some even change doctors. I have no sympathy for Big Pharma. I resent its intrusion into the doctorpatient relationship, resent the constant introduction of new—often rushed— products into a marketplace crowded with me-too drugs. Big Pharma is right where it has always wanted to be—smack-dab in the middle of my decision-making process as it tries to influence consumers who also happen to be my patients. And yet here I am, in my parents’ home, rummaging through a basketful of medicines I take down from a high shelf. This is where I store the unused pills—all the psychoactive drugs prescribed by my father’s physician for his recurrent bouts of anxiety or agitation, for his depression and his insomnia, for his memory loss and lethargy, for his confusion and paranoia, for his belligerence and sadness. In hopes of continuing our conversation in person, I returned to see Graves one Wednesday afternoon during visiting hours, when the jail’s reception area was crowded with women and children. Our time was limited to twenty minutes, so I kept my questions simple. I asked if we could talk more about his life now. “I’ve missed so much,” Graves said. “My children are all grown. I have grandkids a
Now these industries have figured out a way to circumvent my judgment should I fail to join the chorus of cheerleaders for their newest breakthrough. On television, in magazines, they promise an end to arthritis pain, a good night’s sleep, a cure for incontinence, a firm erection. My phone rings off the hook with patients who worry that I may have blocked their path to the Fountain of Youth when I decline their drug requests. Some even change doctors. I have no sympathy for Big Pharma. I resent its intrusion into the doctorpatient relationship, resent the constant introduction of new—often rushed— products into a marketplace crowded with me-too drugs. Big Pharma is right where it has always wanted to be—smack-dab in the middle of my decision-making process as it tries to influence consumers who also happen to be my patients. And yet here I am, in my parents’ home, rummaging through a basketful of medicines I take down from a high shelf.
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