WISDOM 2013

Years ago Simon and Garfunkel wrote and sang that "The words of the prophets are written on the subway walls, and tenement halls."  Today, the greatest wisdom and stupidity can be found on T-shirts and bumper stickers.  Examples of these include the ubiquitous "YES WE DID" implying that the driver of the car ahead of you, who obviously has not figured out life based on their obvious circumstances, is joyous over another four years of messianic rule by the great provider of free cell phones, unemployment insurance for 99 weeks, and more welfare than you can shake a stick at.  All this high-fiveing celebrates the preservation of the status quo for the aforementioned driver and her smoke-belching Toyhonkiazuki. Thank God there is also a "Save the Environment" sticker on the bumper or a person could assume that she did not care.

Every opinion possible can be found on the bumper of a car in front of you if you are stuck in traffic enough.  Once you exit your car you have to rely upon T-shirt wisdom.  Some of it is simple and quick to read like a giant Polo Pony with the words POLO in 8" high letters.  It means " bigger is always better and I have no taste."  Or "CHOICE" as in "Biatch, we all wish your mother had made a different one."  The T-shirt pictured above says a lot but it is too wordy to be read on a quick walk-by.  Maybe if it were on the back of the shirt, the fashion equivalent of a bumper sticker one could get through all the words.  Then again if some Sofia Vergara-esque woman were wearing it facing front, the words might be bigger and easier to read and most men would not mind struggling with the wordiness to get the message.   Go ahead, call the P C Police...see if I care.

HE'S the MANN

No, that is not a typo or a misspelling of "man."  I went to high school in the 50s and 60s, not today in America so I actually received an education.  I did however not have the benefit of attending a class called "Heather Has Two Mommies"  like our modern secondary school students have. To get an award, I actually had to do something special or, excuse the expression, "win."  This postage stamp honors Horace Mann, who is considered by most historians to be the founder of compulsory government sponsored secular education in the United States.  As the expression goes, he must be spinning in his grave over the wreckage of K-12 in 2013.

Even back over a decade ago, student-athletes in senior high school would come to my office where they were asked to fill out a brief questionnaire about their vital statistics, and health history.  These must have been very difficult questions, things like "Where were you born and on what date?" seemed to baffle them.  It was apparent that their reading skills were at a first grade level yet they managed to get into the 12th grade and were on the cusp of graduation.  Someone in Florida state government came up with the "radical' idea of statewide testing to assess schools to see if local schools and teachers were preparing their students  to enter the world, the job market, or go on to higher education.  You would have thought they wanted to do body cavity searches on all the teachers.  "OMG. I am going to have to teach to a state standard? I will be judged by others and  have to follow some master plan?"  The outcry from the teacher's unions was deafening.  "Imagine trying to impose a one size fits all model on our students.  Well, I never."

Accountability is a bitch. When I grew up in New York in the Paleolithic era, We had a course curriculum in EVERY course with a final exam that came from the Board of Regents.  Surprisingly these tests were called the "Regent's" tests.  If you did not pass that test you did not pass the course no matter how much the teacher liked you or how well you did in his or her exams.  We had a near 100% graduation rate, no shootings in class, there might have been one pregnancy (we are not sure but Ellen went away to live with her grandmother for a year), and everyone went on to military service or employment, or further education at some level of college or vocational school.  If you failed, you were an outcast. Everyone DID NOT get a trophy for showing up.

Horace Mann was born in 1796 in Massachusetts.  He was a farmer, a legislator and a lawyer.  He went on to run the Massachusetts Board of Education and a national spokesman for how important public education would be for the future of our country. He modeled our education after the Prussian (German) system.  "Character development was just as important as reading, writing and arithmetic. Obedience to authority, promptness in attendance, and organizing the time according to bell ringing helped students prepare for future employment."

Fast forward to 2013 and we see that the K-12 system no longer cares about character development in the traditional sense but does spend a disproportionate time teaching about cultural diversity, sex education, and Liberal politics.  Our graduation rates are abysmal, as low as 50% in some major cities, even though it costs $15,000 per student per year to support one child in public school in places like New York City. Nothing new has happened in education that has made us more competitive in the world.  We spend so much time worrying about the sensibilities of our students and building self esteem in those who think they deserve it for "Showing up" that there is little time for Readin', Writin' and 'Rithmatic." Everyone does have a computer or an iPad and we have  gaggles of graduates ready for employment, as long as they start in management where their teachers have told them they deserve to be because they "showed up" and the only job skills required are the ability to play video games and spend all day on social media.    

SHAKE SHAKE SHAKE

In the past year or so, the Oracle has been living with a type of high blood pressure called "Isolated Systolic Hypertension" where the upper number, the SYSTOLIC pressure is elevated but the lower one is normal or even low.  I wrote about this in previous posts.  When a person has this condition, there are several things that are necessary for normalizing the  blood pressure.  There are pills which work, to a varying degree with some side effects.  Reduction of stress, by avoiding other people problems for example and resigning as General Manager of the Universe, is another. Moderate exercise helps.   Reducing the SODIUM (salt) content of one's diet is very important.  As in almost everything in life, a four legged stool stands better than a one or two  or three legged one, so I chose to do all four.  It seemed to be working, mostly.  

I put a picture of a salt shaker at the top of this post.  I NEVER shake salt on my food and am not particularly fond of salted peanuts or french fries.  I figured if I just watched out for obvious sources of salt, like "saltines" I would be able to reduce the sodium content of my diet and I would be able to maintain a good blood pressure on minimal medication, serenity, and physical fitness. Au contraire, my friends.  My pressure remained a bit elevated, sometimes more, despite these steps.  I started looking at the nutrition labels on the back of every store bought product in our pantry.  Some things have so much sodium in them that one serving put me over the sodium limit for the day...approximately 2000 milligrams. Innocent products that you would not even think had any salt in them at all are loaded with it.

Last night I had a very healthy dinner at our club consisting of poached salmon, a green salad with olive oil and vinegar dressing, and snagged some of the Kitty's pickled beets off her plate.  The beets were delicious.  I began to wonder what they were pickled IN.  And at the same time I researched why, when I look at processed food labels I would see such a high sodium content in almost everything. I found the answers.  When something is corned, pickled or cured, it is either packed in salt or soaked in salt water (brine).  Why do that?  Are people so in love with the taste of salt ?  Many folks are, but no, it's because the presence of salt and sugar prevents bacterial growth. Extra salt is added for this reason  to most foods that need a reasonable shelf life.   Salting food to preserve it is as old as civilization itself. One would think that in the modern world we would have something else to keep food longer lasting.  Apparently not.

So, I guess it's a good thing that I don't live in times when salt pork, salt cod, and pickled everything made up most of our diet.  I might not be alive to write this post, then again I would be sending it out by smoke signal because there was no electricity.  I would have had more exercise chasing down dinner or running away from what I though was going to be dinner.  There would have been more roots and berries in my diet.  I doubt the stresses of the day would have been the same.  They probably would have been more about real things like having enough food and a cave roof over my head. There were no pills but perhaps I would have been lucky enough to find some natural solutions...chewing the bark off the right tree, or finding the right fruit or vegetable with all those nutrients that we are told are good for us when we shop at Whole Foods.

So, don't forget to look for the hidden salt in everything.  Our government in one of it's saner moments required that food manufacturers list the sugar, calorie and salt content of packaged foods. Restaurants don't have that requirement but the chain restaurants like Wendy's and McDonald's, for example, each have a website where all of their products are listed, along with the nutritional or non-nutritional information.  What you will find out is scarier than a Stephen King movie. A small Mickey D's cheeseburger (one dollar) has about 800 milligrams of sodium in it.  That's almost half your daily allowance.  Chick-Fil-A sells a grilled chicken sandwich that tastes healthy but somehow they manage to put 1000 milligrams (mg) of sodium in it. We (used to) stop there when we are on the road because it is so seemingly healthy. Wendy's spicy chicken sandwich...don't even ask.  

NEW Wonder Drug

Aspirin is probably the best drug ever invented.  If you are allergic to it or have certain bleeding tendencies, ulcers, and many other conditions, it is NOT FOR YOU.  You can die from taking aspirin. Most people don't die or get sick from it and most people get all sorts of benefits from fever reduction (don't forget about Reye's Syndrome that has been associated with aspirin) to pain relief and reducing the tendency to get blood clots in your circulatory system.  Many folks who have heart issues are advised to take low dose (baby size) aspirin daily.  In a well respected orthopedic journal that I just received, there is a featured article that states that aspirin is a better drug post-surgery to prevent the side effects of deep vein thrombosis (blood clots in your veins) than the more expensive anti-clotting drugs.  And it has fewer side effects.  I used to prescribe aspirin (acetylsalicylic acid or ASA) following total hip or knee surgery, then the expensive drug protocols became the "party line" and if you did not use Warfarin and heparin and other drugs, you were a dinosaur.  Now it seems we might be going back the other way.  While I am on the subject of blood thinners and anti-clotting drugs, there are some really expensive ones out there that are used to prevent clots in Atrial Fibrilation and other conditions.  They are often wonderful until they are not.  If you get bleeding from some of them, it can't be easily reversed by giving an antidote like  you can with some of the old fashioned and cheaper drugs. Ask your doctor.  I am not giving you medical advice, I just want you to ask questions of those who are caring for you.  

MEDICAL FLIP FLOPS

"NOT ALWAYS RIGHT, BUT NEVER IN DOUBT." The medical profession is very dogmatic. Just thinking back over my years in the field, I can think of some major 180 degree reversals.  Take for example the  dogma of how your baby should sleep.  When my children were infants 35 plus years ago, our pediatricians scared us to death with admonitions against letting our babies sleep on their backs.  We were told to roll them over instantly on their bellies so that if they spit up, they would not aspirate milk and food into their lungs and get pneumonia or worse yet, choke and be unable to breath.  in 2013, if you let your child sleep on his stomach, the Department of Children and Family Services will be called because the American Academy of Pediatrics says that babies have to sleep on their backs, NEVER on their bellies.

Older people can get a high blood pressure problem called systolic hypertension. This is different from  other types of high blood pressure disorders.  When you get your blood pressure checked with a sphygmomanometer cuff that is blown up on your arm, there are two numbers registered.  The upper one is the systolic pressure which is how much pressure is in your blood vessels when the heart contracts, and the diastolic number (lower one) is when the heart is between contractions (beats).  Isolated systolic hypertension is when the lower number is normal but the upper one is too high, over 140. It was medical dogma, undisputed truth, that as long as your lower number was below 90 you were OK and it was fine if the upper number were a little high all the time or occasionally even higher. in 2013, doctors now KNOW  that having a high upper number and a normal lower number can be even more serious, leading to heart attack, stroke, dementia, and kidney failure. The difference between the upper and lower number is called the pulse pressure and that can do a lot of damage if it is too great. We were certain 20 years ago that it was not important, and today that is it very important. Who knows what will be true in 10 years.

When I was training in surgery there were a lot of partial gastrectomy operations being done (stomach removals) for ulcer disease.  Today we believe that ulcers are caused by the presence of a bacteria, Helicobacter pylori, and we treat it with antibiotics and drugs like Zantac, and Prilosec.  Partial or complete stomach removals are rare.

Every other medical ad on TV is for either Erectile Dysfunction or low T (testosterone).  We have a "pill" solution for everything that ails you, except that most medications when studied, are not much more effective than PLACEBOs.  Placebos are sugar pills.  Medical trials for drugs always involve dividing patients into two groups, one that gets the real drug and the other that gets the sugar pill. It should come as no surprise  that sugar pills are effective a large percentage of the time, sometimes more than the real drug, and have no side effects. The FDA reports the sugar pill success rate and compares it to the real pill success.

This list is endless.  From the "remission" rate for chemotherapy, in which oncologists don't tell you that it is often not much better than alternative medicine , yet can kill you with side effects, to the promise that a pill can help you stop smoking but one of the minor side effects is that you might commit suicide.  The smart yet profit driven drug companies no longer go as often to doctors offices with armloads of samples like they used to, they market directly to patients on TV and the internet.  They want you to go to your doctor and demand their product.  Depressed? Fat? Smoke? Tired? We got you covered.  Just ask your doctor for XYZcillin, and you will feel better and live forever even if you continue to eat three meals a day at McDonald's.  Unless, you get one of the side effects like acne, itching, death, etc.  I just love it when they advertise antidepressants and one of the side effects is depression and suicide.  As for the sleeping pills (the one with the butterfly for example) you might get out of bed in the middle of the night, without knowing it, a go out and hold up a convenience store.  Now that's a side effect I can do without.  There are safe alternatives to most medical care.  There are some medical procedures and drugs that are absolutely life saving.  Knowing the difference and not just accepting medical dogma without doing your own research can cost you dearly.  If you are smart enough to shop online for a new computer or fashions, you are smart enough to learn about your health.  Pick wisely and go to websites that are government of famous universities like Mayo Clinic for example.  You will get the best information available today, but tomorrow the medical dogma may be a complete 180 degree reversal.  It's happened before.

MIRACLE in the Liquor Department

T E X T I N G WHILE DRIVING

If you are driving along in traffic and you are tempted to TEXT while driving, remember that sometimes the vehicle in front of you can come to a stop and you may run into or under a big truck like the Corvette in the photo above unfortunately did.  The outcome to the driver in the Corvette is obvious.  Use your head, don't lose it.