Women's Wellness Blog

“I’m not kidding; it’s Miracle-Gro for the brain!” The statement reminded me of some ridiculous infomercial infecting late night TV. In this case however, it was generated from the mouth of a world class neurobiologist, so I took notice. He was speaking of a substance called Brain Derived Neurotrophic Factor (BDNF). What immediately intrigued me was he claimed that BDNF was the link between exercise and improved brain function. For years I had read articles in both the medical and running journals touting the psychological benefits of fitness, yet here was proof that fit folks were happier folks. Dr.John Ratey, a clinical professor of psychiatry at Harvard, outlined in his amazing book “Spark: The Revolutionary New Science of Exercise and the Brain” how exercise increased the production of BDNF which in turn stimulated nerve cells to grow and connect in the Hippocampus, a tiny area in the brain responsible for a number of high level functions. This growth of new cells actually translated into better memory and quicker learning. He went on to claim that certain other chemicals were released by exercising muscles that improved functioning in the amygdala, the emotional center of the brain. The implications of this and other research are monumental.

Twenty-five years ago when I was in medical school we were taught that we were born with a set number of neurons (brain cells) and there were no more to be made…period. I remember joking in college about taking another late night excursion to the disco (yes, I am that old!) to “kill some brain cells” with Singapore Slings and Jack and Coke. We didn’t fret about the wholesale slaughter of brain cells as we all knew from biology class that we only used 20% of our brain anyway. In our way of thinking, that gave us a pretty good cushion! It was the unlucky folks born with fewer brain cells, and we all knew a few of those, who had the most to fear. We were wrong on all accounts. Now research is proving that new brain cells can be created, and formed in areas that have a major effect on cognition and emotions. Don’t take this as permission to guiltlessly get plastered; I don’t need to tell you of the disastrous effects of that, but it does open the door for medical miracles. The study of such alphabet soup as BDNF, IGF-1, and VGEF and other neuropeptides has given hope to developing successful treatments for senile dementia, Alzheimer’s and Parkinsonism. Medicine is not there yet, but we can conclude that getting fit by exercising regularly can reduce the incidence of these diseases as well as certain cancers and diabetes.

The great news is that you don’t have to train for a marathon to reap the benefits of fitness. The studies indicate that a brisk walk for 45 minutes three to four times a week can elicit these life enhancing outcomes.

One of the most exciting applications of this knowledge is illustrated by the Naperville school district. A middle class suburb south of Chicago, Naperville has been the focus of a real-life experiment documenting the benefits of fitness in kids. It is no surprise that kids who are active are more physically fit than their sedentary counterparts, but what has been found in Naperville is that these fit kids are also smarter! Over the past seventeen years the school district, consisting of 11 elementary schools, five junior high schools and two high schools, has made physical education an integral part of the school day (unlike the national average where only 6% of high schools have a daily PE program). Their gym class is not your typical dodge ball, basketball, softball curriculum (the average student in the typical hour long PE class spends 16 minutes actively moving). It is a program that promotes and measures fitness, not competition, and grades based on effort, not ability. They regularly run or ride bikes using donated treadmills and stationary bikes measuring effort by heart rate monitors. And they do it at a lower cost per student than comparable school systems! The results have been amazing. In 2002, 97% of entering freshmen were at a healthy body mass index (BMI) as compared to the national average of 65% and most striking was the impact that fitness had in the classroom. In that same year 96% of the eighth graders took the Trends in International Math and Science Test, an instrument designed to compare student’s knowledge level in different countries around the world. On the science part of the test the Naperville students scored the highest…in the world! Through a strict and comprehensive analysis it was shown that regular physical activity and fitness level correlated with the academic success of the Naperville students!

The message is clear. For adults and kids alike, regular aerobic exercise is not only good for the body, but it is great for the mind.

Norman Cousins, while struggling with a severe neuromuscular disease, said, “Laughter is like internal jogging. Ten minutes of genuine belly laughter had an anesthetic effect and would give me at least two hours of pain-free sleep.” Those of you who regularly scan Reader’s Digest remember a column titled, “Laughter is the best medicine”. Indeed it is, and sometimes we forget that. So here is my prescription for surviving everyday stress…laugh three times a day! Some of the most effective laughter is that which we do at ourselves. The less serious we take ourselves, the less burdensome everyday stresses and strains. For example, I recently attended a local high school football game and quickly lapsed into a flashback when the bands took the field for the halftime entertainment. No, I wasn’t in the band in high school. The idea of walking backwards in circles while reading music was a bit overwhelming, but my mother was convinced that I had the potential to be the next John Philip Souza. She felt that one way to navigate the treacherous waters of a new high school was to join their celebrated band. I had just been uprooted from a comfortable middle school existence in Memphis to the mountains of East Tennessee , replete with orange painted outhouses, to begin my high school years. I was the size of a Hobbit, and about as good-looking, so my social integration options were vastly limited. I certainly was not a candidate for football (a religion in Knoxville) although; in retrospect, I would have made a wonderful tackling dummy. Track was not an option as I had the speed of an anemic sloth. Basket ball…well let’s just say dribbling at the level of other’s knees didn’t fare well for a stellar career. So maybe the band was a way that I could find my niche in an otherwise niche-less existence. At least my mother thought so. So the first day a school she set up an appointment with the band director to discuss my future musical career. Unfortunately, she made me come along. Once we arrived in the hallowed sanctuary known as the “band room” , Mr.Jenkins, the band teacher, granted us an audience.

“Now exactly what instrument does your boy play?”, he asked condescendingly. I felt this was a rather appropriate question and a reasonable place to start the discussion until it dawned on me that I didn’t play an instrument. I suspected that my mother also knew this as she had not seen or heard me with anything other than a kazoo since kindergarten, but she was not fazed by the inquiry.

“He doesn’t…yet”, she confidently replied. This obviously was not the response Mr. Jenkins was expecting as he stared at her with a look that said, “Well what in the name of Beethoven are you doing here then?” Mom, ever the perceptive sort, picked up on his incredulity and explained that before we invested in lessons or instruments, she wanted to get his impression as to which instrument I was best suited to play. At this point I was busily plotting both my escape and my plan for putting mom on medication. I had read of studies that looked at a person’s likelihood of being a criminal based on their physical traits, you know, beady eyes, big forehead etc, but I had yet to see any research correlating a person’s physical appearance and their ability to master a band instrument. I felt myself slowly sinking into “Music Man” hell. Mr. Jenkins composed himself, obviously trying to pacify the crazy woman sitting before him, and shot a glance at my face, as if to say, “Is she serious?” I cocked my head, subtly conveying the dual message that yes, she is serious and she may be armed, so do what she asks. He then proceeded to survey my mouth, fingers, eyes and anything else he could possibly think of that would indicate the ideal instrument for me. It was like being scrutinized for lice after being accused of infecting the whole school.

After what seemed like hours, he stopped, grunted, and said “trumpet…yes, trumpet”. A huge grin crossed mom’s face as this seemed to validate her quest. All I could think of was Dizzy Gillespie, that huge, old guy who puffed out his cheeks to the size of a steroid laced chipmunk whenever he played his horn. I didn’t want to walk around school with the cheeks of a bloated rodent, so I instantly expressed my apprehension. Of course, my protest fell on deaf ears as mom was already negotiating horn rentals and lesson fees.

How was I supposed to get the girls playing something you have to clear spit out of every few minutes? Neil Diamond never wooed a woman with his classic marching tunes! As I walked out of the room, visions of chapped lips and elastic cheeks dancing in my head, I realized that maybe I needed to find a better way to fit in. I wonder if girls dig science projects?

The one question we are asked in the office most often, other than how to improve libido, is how to eat healthy. Since 45 million people in this country are overweight, it is no wonder that this is on everyone’s mind. Simple is better, so here are some simple guidelines for eating healthy.

Rule number one: Eat balanced meals. What your mother always taught you is true. There is no one super food, in spite of what the algae lovers claim, and there is likewise no naturally evil food (well, maybe Spam qualifies as evil). We were created to survive on a variety of nutrients and no one food can provide everything you need, so mix it up to guarantee proper health. Balance proteins, carbohydrates, and fats by selecting a wide variety of foods. Spice up your life! Get crazy and try foods that are different from burgers, bacon, and barbecue! Travel the world by making one night a week “ethnic night” and sample various foreign cuisine. There are three sub rules in this category: eat whole foods whenever possible, mainly plants, and prepare them in as close to the natural state as you can. In other words don’t fry, fritter, and fracture your food! And one final caveat, don’t overdo it. One given in proper weight management is watching total calorie intake. How much you eat is just as important as the mix.

Rule number two: Eat low fat meals. This is not to demonize fat but to remind you that too much of some stuff is just not healthy. In spite of the cacophony of nutritional advice out there, there is not a reliable expert around who tells you to eat more lard. Some fat is necessary but we should all limit saturated and trans fats. These include margarine, salad dressings, processed cakes, chips,cookies, and gobs of other nasties. Become a label reader. It’s right there in black and white. If the serving size contains more than 5 grams of saturated fat, put the item down and run away screaming. Total fat in your diet shouldn’t exceed 25% of total calories. There are a number of fat counters available in Apps and online so it is relatively easy to calculate how much of the grease is sliding down your gullet. Don’t forget there are some good fats. For example, the omega 3 fatty acids found in abundance in some plants (flaxseed) and cold water fish (tuna, halibut) are critical in assuring good health and are essential for their anti-inflammatory actions.

Rule number three: Eat low sugar. The average person will consume 160 pounds of sugar a year! Most sodas will contain 40g of sugar in each can! Sugar, or glucose in fancy doctor talk, is necessary for energy, yet most of us eat enough sugar to power a high school soccer team. The low carb craze of recent vintage did make us aware of the evils of consuming to much sugar (carbohydrates=sugar); and the data supports that a low carb lifestyle is healthy. Keep in mind that your need for sugar and energy is directly proportional to your activity level. Marathoners need more carbohydrates than chess masters.

Rule number four: Eat more fiber. This rule may be a bit of a surprise because it doesn’t get the airplay that the other rules seem to enjoy; however, fiber, both soluble and insoluble, is a key component of a healthy diet. These are things that aren’t actually metabolized in the system put serve a variety of vital functions such as binding excess cholesterol, promoting bowel health, and regulating hormone levels. The American Heart Association has stated that consuming 28 grams of fiber a day can reduce your risk of heart disease, the number one killer of both men and women. Fiber is abundant in fruits and vegetables, grains, nuts, legumes, and tree bark. (Just seeing if you were paying attention). Choosing foods high in fiber not only fulfills the need for roughage, but these foods also tend to be low in calories and filling.

“The doctor who fails to have a placebo effect on his patients should become a pathologist”

J.N. Blau, M.D.

The lines between the art and science of medicine are often blurred. Many years ago, when the earth was cooling and I was a medical student, I was assigned to shadow an older Ob/Gyn in private practice. The goal was to gives us young medical pups a sense of real world medicine. Dr.Koronik was a gifted clinician as well as a crafty student of human behavior. One afternoon we were speaking with a patient, a recently married young female, who was completing her yearly exam when she reported her libido, or sex drive, had driven off and she didn’t have the map! Dr. K had done a thorough physical exam and knew anatomically everything was intact, and so he talked with her at length about her life situation and decided to get some baseline blood work. She was to return when the blood work was back and review the results and discuss any treatment options. After she left, Dr. K pulled me aside and said he felt her problem was more from the neck up and not the waist down. He was not patronizing or minimizing her problem, it was just an honest assessment of what he surmised was the source of her lack of desire. Upon her return, they reviewed the blood work which supported the idea that all was well physiologically, and Dr.K had a long discussion about stress, relationships, and other important factors in sexual well being. At the conclusion he presented her with a bottle of tablets and told her that taking one on a daily basis may increase her libido. I was taken aback and after she left I questioned his prescribing of a medication for what he seemed to think was an emotional issue. He explained, in what was to be the first of many lessons in healing as opposed to curing, that the “medicine” was nothing more than sugar pills, and that he felt they would aid in minimizing her psychological issues with intimacy. There are a number of ethical and legal issues involved with this “treatment” but remember this was almost 30 years ago and in a small town in East Tennessee.

I didn’t see the young lady in follow up, but a few days later Dr.K reported a Ford 350 pickup truck backed up to the rear of his office around closing time. A burly, six foot something cowboy straight off a movie set ambled out of the truck cab and sauntered to the back door of the clinic.

“Hey doc,” he offered as he thrust his hand in greeting. “My wife came to see ya a few days ago about this...eh...problem she been havin’ ”. No doubt, this was the husband of the libido challenged patient.

“I just wanted to come shake your hand for them pills you gave her cause, let me tell ya, I don’t ever want to run out of them things! I brought my truck here to load up a batch!”

Say what you may but the placebo effect is a real and powerful scientifically validated phenomenon. There are some amazing studies done with PET scanners, machines that “light up” areas of the brain that are functioning in thoughts and emotions, that confirm that feelings can be translated into physical changes in the brain. When we feel happy or sad, specific areas of the brain are activated and in turn set off a cascade of hormones, neurotransmitters, and a cavalcade of substances that elicit amazing physical effects. There is a branch of science called psychoneuroimmunology that studies how our thoughts and emotions effect our immune system. For example, if you get int an argument with your spouse or yell at your kids getting dressed for school, not only do you feel stressed, but you are more susceptible to catching a cold! There is even some evidence that chronically stressed or angry individuals are more at risk for certain cancers because their emotional state impairs their immune system’s natural ability to eradicate early abnormal cells.

The Mayo Clinic issued a series of findings on research done on the reasons the placebo effect is genuine:

“A patient whose doctor is supportive and positive may benefit more from any treatment, active or placebo.

A patient who believes a treatment will work is more likely to experience the placebo effect than one who doubts it.

Some patients respond well to frequent and intensive medical attention, whether or not a drug or treatment is potent.”

Indeed, the placebo effect is “all in your head” but it is just as real and often as therapeutic as a drug.

Now if I could just find some of those “libido” pills!

Boyfriends are like Ebola in Sierra Leone, just when you think they’re are gone forever, they come weaseling back in. Now I am talking about my daughter’s boyfriends of course. This is not going to be some coming out of the closet confessional reporting after 58 years I am switching teams. No, my ire in comparing young men to a blood-letting scourge is directed at those who would court my beautiful and innocent offspring. Let me say at the outset, mainly because I want to eventually be welcomed back into my house, that this rant is reserved for boyfriends past. I have been on the receiving end of the looks of death after writing about current beaus, so with aspirations of self preservation I will limit my remarks to those who have gone the way of the DoDo bird and are extinct, at least from my daughter’s lives. It also is a compilation of boyfriends and not one in particular, again for preservation purposes.

There are certain warning signs when observing suitors that should send shivers down the spine of any self respecting dad. Red flag number one is not coming to the door to pick up the young lady. This tells me either you look like a motorcycle gang poster boy, were raised by wolves, or had a “couple” of beers before coming over. Not only should you come to the door, but you should expect to come inside and attempt to carry on a semblance of a coherent conversation. A couple of pointers are warranted here. Try to make complete sentences without using “like” fifteen or twenty times and if you have a nose ring, either take it out or come up with a story about completing your graduate degree in Bushman anthropology and you are in an immersion semester. Do not show up late unless your grandmother just died, and only tell me your grandmother died once. Red flag number two is the boyfriend beginning the conversation with a pitch to join him in a multilevel marketing scheme. Yes, it shows initiative, but also a hefty load of stupidity with a side of arrogance.

I was pretty benign towards boyfriends until I saw one of my daughters actually shed a few tears over one’s actions. This was unacceptable as my daughters usually only cry when I embarrass them by my wearing short shorts to run in. I reserve the right to exclusive tears and will not tolerate any behavior leading to sadness in my babies. The first time one of them came home sobbing over “nothing” I had to be restrained by my wife or I would have committed a genocide of one. I dreamed of using my surgical skills to smash their nose then sew it back up and have it look like a vagina; would you expect anything less from a gynecologist? Only a dad can appreciate the rage elicited by seeing the fruits of his loins crying their eyes out because some scum monkey boyfriend forgot their 2 month anniversary. If the insensitive boob can’t even remember a simple, irrelevant fact like that, what good is he?

Boyfriends who try to hard are also annoying and destined to work the night shift at Target. Know from the start, I don’t want to talk to you, I simply want you to be sober and take care of my baby. I want to talk with you long enough to know if you have any felony convictions or are a fan of Justin Bieber, both of which are a game ender. I want to know if you made it past the fifth grade and you have a current non suspended drivers license. I must say at this point I don’t want to give the impression that these are the kind of folks my daughter’s elect to date, quite the contrary. They have amazing taste and generally pick with aplomb, but every now and then, much like a termite, someone sneaks in who will eat you out of house and home, literally and figuratively. I remember one massive hunka-hunka burnin’ love who ate so much at our house I thought I was going to have to take a second job to pay for the extra groceries. Then there was the Mensa member who ordered the biggest steak on the menu at a local restaurant as we treated my daughter and he to a dinner out. That was fine, expensive, but fine; however, he also ordered what ended up being the equivalent of a six pack of craft lager. I was underwhelmed by both his choice and lack of cash to chip in. I wrote if off as being nervous, but the eventual truth was he was a sot.

I have been blessed with two intelligent, beautiful daughters who, for the most part, pick judiciously who they date. They have finally warmed to the idea that no boy they bring home can ever or will ever meet my expectations. If they could only find a younger me. But, alas, I would never allow them to date someone like me. As Groucho once said,”I would never join a club who would allow someone like me as a member!”

Could I possibly be warm enough in my Elvis outfit?

This question does not plague me often, but prior to the Memphis Marathon it was paramount. I have always eschewed the wearing of costumes, tutu’s, face paint, or edible underwear in races, but Memphis screamed out for a running Hunka Hunka burning love. With the latest check of the weather, my intuition about shedding the white bejeweled jumpsuit for an Under Armor cold gear ensemble was verified. I donned my black tights and compression shirt as my wife giggled and said I looked like an aging ninja in tennis shoes. Not dissuaded, I self satisfyingly sat on the bed knowing I would be toasty and compact. I would put Elvis on hold until the Las Vegas Marathon later in the year.

I had grown up in Memphis, left after grade school, then returned for medical school. I began running in medical school, largely in response to coffee and an impossible biochemistry course, so I was returning to familiar running turf, so to speak. The medical school is about a mile from the Mississippi River, on which whose bluffs Memphis is perched, so after flunking another biochemistry test I would head out in my Adidas trainers and run to the river (after a particularly bad test even considering jumping in) and back. It was not particularly far, but cathartic none the less. Needless to say the downtown had changed over the past 30 years. No longer did I see the friendly homeless guy I had treated for DTs in the ER hanging out in the downtown park nor did I have to dodge the broken beer bottles and used needles. Now the downtown area was ripe with hipster bars and upscale bistros. They had even built a baseball stadium smack dab in the middle of the city, right across from the hallowed Peabody Hotel. The Peabody ducks now had to compete with quarter beer night and bad organ music. I won’t say I missed the needles, but it did have somewhat of a yuppie feel, for better or worse.

The St.Jude Memphis Marathon has grown over the years and now spawns about 20,000 runners traversing everything from a mile fun run up to the marathon. We were told to self segregate into waves based on our projected pace as to facilitate the start. Let me say asking a marathoner to predict his likely pace throughout the race is like asking Donald Trump to predict which way his hair will lay on any given day. I am as guilty as anyone as I often start a race as a Kenyan and end as a spastic jellyfish. I lined up with my fellow Ethiopian wannabes in wave 5, the 9 minute a mile pace group, and imagined my winged feet carrying me to a new PR, given what I had gleaned from the topography graph of the race course. What I learned is that those dreaded topographers are demon possessed liars whose sole mission in life is to make my quads scream for glycogen like a lawyer screams for billable hours. I mistakenly thought there were only three small hills, going as far as to memorize where they fell in the course, only to find that the map makers (those hounds from Hades) “smoothed out” the graph for “simplicity”. In other words there were a heck of a lot of small rolling hills in between the mountains (okay, I exaggerate). I don’t like hills. I like leprosy more than I like hills. As I get older my major criteria for choosing marathons are which ones have free beer at the end and which ones don’t have the damned hills!

As a young medical student running on the asphalt of downtown Memphis I was immune to much of my environment. Today I took in the various landmarks like Charlie Vargo’s Rendezvous, home of dry rub pig parts (some refer to it as barbecue), sixteen places where Elvis slept (it seems he had trouble finding Graceland at night), Rhodes College (It was Southwestern when I was there but they got all full of themselves and became a Yale wannabe, but it was a pretty campus), and Beale Street, home of the Blues, and black toenails by the time I made it to that point of the race.

Probably the most memorable moment, besides the beer at the finish, was running through the St.Jude Hospital campus. There were patients and employees lining the route making sounds that rivaled the girls of Wellesley at the Boston Marathon, and they were much better looking! Having those folks cheering us was surreal. They are the heroes every day.

The race concluded in the minor league baseball stadium in the middle of the downtown. It was a great finishing spot as it was literally steps from the hotel and a hot shower. I will never forget walking to my first marathon years ago. We were walking with a girl we had just met and she found out it was my first race. She told me that the shower after a marathon was better than sex. It does feel good, but all I can say is that poor girl has had a very disappointing sex life.

Two thirds of adults and one third of kids are either overweight or obese. This comes as no great revelation to most of us as it is a simple matter of looking around. I find it tedious and unproductive to badger someone about their weight. Let’s be honest. If you are overweight, you know it. You don’t need some self-righteous, “thinner than thou” doctor harping on you to lose weight. That accomplishes nothing, and I should know because I did that for 20 years. I would admonish a patient to lose weight at their yearly checkup only to have them return a year later twenty pounds heavier. I was shirking my responsibility as their physician, and possibly even worsening the problem because I really didn’t understand the problem to begin with. Gaining weight and losing weight is a very complex undertaking involving physical, emotional, and even spiritual aspects. I have come to realize that out thoughts and emotions play at least as much if not more a role than our DNA. There is no question that genetics, hormones, and physiology contribute to thickness or thinness, but happiness, stress, and depression also contribute mightily to the equation. To simply tell someone to eat less and exercise more to lose weight is akin to telling the Arabs and Israelis to just get along. It’s not that simple.

A good friend of mine who has been in the weight management field for many years says, “To change your weight, you have to first change your mind.” There is great wisdom in that simple statement because it summarizes a terribly complex effort. Changing one’s mind is like turning the Titanic for some of us. I can’t even begin to address the complexity of emotions, beliefs, unconscious imprints, desires, and needs that go into mind changing, but suffice it to say each of us has a roadmap to change that only we can navigate. In other words, no one can change your mind for you, or tell you exactly how it is done. What I can do is give you some tools and insights as to the process and maybe outline a path for you to begin your journey towards better health.

Psychologists tell us that we humans are motivated largely by two opposite drives. We want to avoid pain and we desire pleasure. What is fascinating is that often we will spend much more time and effort avoiding perceived pain than seeking pleasure. I realize this goes against the grain of a society that promotes things like “Hedonism” and “Naked Dating”, but the impact of emotional pain in particular is a very powerful agent for change. I have seen this play out in my own practice when working with folks on weight loss. I will never forget the middle aged lady who had come to me wanting to lose forty pounds. On her first visit she looked across the table at me and tearfully said, “If I don’t get healthy, I’m not going to be able to play with my grandkids.” She was ready, and by gosh, she has done it! I could have screamed at her incessantly about her risk of heart disease, diabetes, and stroke from being overweight, and it would have all been for naught. She wanted desperately to avoid the pain of missing time with her family, and that was monumental motivation.

Often, with our weight management folks, I will have them do a simple exercise that crystallizes their motivations. I have them make two simple lists. On the left side of the paper I have them write three things they will gain by losing weight and on the right side of the paper I have them write three things they will lose by not losing weight. The key is the things have to be very personal and real. Then I have them sit quietly and imagine how they would feel if each of the things came true. I insist that they visualize each thing, good and bad, as vividly as possible and try to truly experience the emotions that it elicits. The I have them post this list somewhere where they will see it daily. I ask them to feel the emotions when they think of the bad things, as well as the joy from the good things. These emotions become massive motivators. It works, as these feelings often become the key that unlocks the desire to make changes.

Changing your mind can change your weight.

Men are wimps. Okay, maybe I need to clarify that a bit. Navy Seals are not wimps…Ultimate Extreme Martial Arts fighter people are not wimps… Chuck Norris is not a wimp…but many men are wimps when it comes to being sick. Maybe this is just some type of deep psychological rationalization on my part because the honest truth is that I, me, myself am such a pitiful soul when I am sick, I only hope and pray other men are as ridiculous as me. The only way I can fathom being as wimpy as I am is to only assume all others graced with the XY chromosome pair are similarly endowed. It has to be a genetic thing, because it is too universal to be just limited to me. Besides I am told by all the women I know that it is true.

So let me be very clear, men in general are courageous in battle, will protect their offspring with the voraciousness of a badger in heat, will heroically sacrifice life and limb for their fallen brothers, and will even spend an afternoon shopping with their wives in a fabric store, but if they get a sniffle or a tummy ache, God help them! I consider myself a pretty healthy dude. I run marathons, work out with weights, eat tofu and kale, and take enough vitamins to support a small refugee village, but occasionally I get sick. This illness is generally not anything like leprosy or flesh eating bacteria sick, it usually is your run of the mill sinusitis. The stuff all of us get now and then (living in the pollen killing fields of Augusta, Ga.) but when I get sick I turn into a whiney, wisp of my former self.

It begins with a sore throat, and generally I assume I have throat cancer or some other malady rather than a cold. Ever since medical school I have had the strange proclivity to develop any disease I was currently studying. At least I developed it in my head. I remember reading about a parasite called Naegleria fowleri. It had the unpleasant habit of burrowing in the brain of unsuspecting, paranoid hosts and gnawing on their cerebrum. The nose is the pathway of the amoeba, so infection occurs most often from diving, water skiing, or performing water sports in which water is forced into the nose. But infections have occurred in people who dunked their heads in hot springs or who cleaned their nostrils with Neti pots filled with untreated tap water. I always knew Neti pots were tools of the devil and this just confirmed it. Even though I had not recently dunked my head in a hot spring (do people really do this?) I had been in a lake, so when I developed a headache I naturally assumed I had a brain eating parasite. Given that this sort of logic was akin to thinking you really had a chance to win the Lotto jackpot, I laid in bed for a day until my headache subsided and reluctantly put writing my will on hold.

I won’t go in to telling you what happened to me when I first started studying yeast infections!

Needless to say, I took this tendency to catch the disease de jour into my older years, modified with the wisdom of aging (yea…right!) so now instead of imagining I am dying of some exotic disease, I simply imagine I am dying of a common disease. My wife could walk into the house with a hatchet in her head and she would not be complaining, in fact she would get the wash out of the dryer, start dinner, and do an online search for Masters rentals before thinking about removing the offending yard tool. I, however, can have a stuffy nose and I lay on the couch, unable to raise my head to sip life giving water, convinced I am hypoxic from oxygen debt, begging for IV Afrin infusions, and complaining about the roughness of the facial tissue. And don’t think about me performing any vital functions like taking out the trash or carrying on a civil conversation. I am near death man! Can’t you see I can’t be bothered with the fact that the kids are setting up a meth lab in the basement.

I have long maintained that the female of the species is both wiser and stronger in constitution than the male. Yes we have more hair, generally. Yes, we are more proud of our body odor and belches. Yes, we relish the role of protector of the hearth and provider of food, shelter, and a diversified 401K. And yes, we like making babies, but the female trumps us majestically when we are weakest; i.e. sick with a cold or tummy ache. She can have a brain eating parasite and still go to work, breast feed, fix the cable, and still look amazing!

7 Things About Things

Baby boomers like myself remember the perennial bestseller “7 Habits of Highly Effective People” as the consummate self help guide and author Dr.Steven Covey as the lifestyle guru extraordinaire. It spawned a plethora of sound alike and look alike tomes that all were based on 7 “somethings.” (7 rules, 7 guides, 7 pillars, 7 elevens, etc) I always wondered what was so special about 7 other than it sounded better than 16 Habits of Very Tired People, but from numerology to the Bible, 7 seemed to have a mystical book selling ability, so, in honor of 7, I humbly present the 7 Habits of Highly Healthy People. (To be distinguished from Snoop Dog’s autobiography, The 7 Habits of the High and Healthy People.)

1) They eat moderately and modestly.

There is no magic food! Eating kale and bean sprouts all day will make you boring and rabbit like. Eat a balance of protein, fat, and carbohydrates. It really is that simple. Many studies suggest that lowering the simple sugars and high glycemic carbohydrates (Google it!) will help you lose weight and maintain that loss. Going to extremes in your diet is unhealthy, expensive, and will give you bad breath. Also, eat fewer calories. If you like steak, eat steak…but don’t put two pounds of butter on your potato and keep the dessert under wraps. If you have your own private table at Dairy Queen, you need to cut back.

2) They are active.

You don’t have to run a marathon to be healthy. You don’t even have to run at all (I can’t believe I just said that!) You just have to get up off the “Couch of Doom” and move. You are designed to be in motion, all your muscles and bones are crying out to be pampered. A brisk walk or a Zumba class in ridiculous spandex will add years to your life if it is consistently practiced, and, more importantly, your children will be able to make fun of you later when they see your pictures.

3) They laugh at themselves.

This one is easy for me as my daughters continually provide reasons for me to laugh at myself. They are quick to point out I am not as cool as I think I am, which should be obvious as I am still using coolness as a human trait. Taking yourself and your horrible, stress filled life too seriously leads to physical and emotional stagnation. That doesn’t mean that a laissez faire attitude at all times is optimal, but lighten up to add years to your plight. Who knows…things could get better.

4) They join stuff.

Dan Buettner famously pointed out in his inspiring book on longevity, The Blue Zones, that people who live the longest tend to be social animals. They participate, whether it’s social clubs, scooter races, jello wrestling, or nude skydiving, people who continually engage tend to be healthier and live longer. This must be tempered by a heavy dose of common sense as joining a Justin Bieber fan club will immediately result in brain atrophy.

5) They are religious.

This one surprised me, given the whole martyr thing, but people who attend some form of religious service once a week tend to be healthier, as a group, than those who stay at home and do secular humanist things. No one religion has a monopoly on this characteristic (sorry Rev.Osteen) but it seems having faith, practicing your beliefs, and living by the creeds of your particular orthodoxy has a beneficial effect on health. That is assuming you are not a devotee of the Crusades or a militant extremist as their lifespans tend to be about as long as a Kardashian marriage.

6) They de-stress.

Stress kills. From hypertension to depression, daily stress can put more holes in your body than whiskers on a gerbil…and that’s a lot by the way. Some studies have shown that up to 70% of visits to primary care doctors are due to stress. If Obamacare would get rid of stress it might even work, unfortunately it seems to be having just the opposite effect. There are a number of ways to minimize stress and none start with X A N A X. Flower arranging,counseling, exercise, yoga, meditation, hunting, full contact karate, and attending city council meetings are just a few stress relieving activities available to the general public.

7) They serve others.

Volunteerism confers as much health benefit as a daily vitamin and generally cost less and won’t constipate you. The data is conclusive, if you focus on the needs of others and help them meet those needs, you will improve your health. You will be better psychologically, physically, people will like you, and dogs will lick your face. Believe me, no matter how miserable and decrepit your life is, someone, somewhere has it much worse, and it behooves you and the universe to find that person and help make their life just a bit more tolerable.

The United States never has to worry about Europe rising to conquer the world like Alexander the Great did once because this current generation will all be dead in 30 years or less. The reason…cigarettes.

I just returned from a couple of weeks in France and Italy (much different from my usual vacation to Statesboro!) and everyone smokes! I realize this is a monumental generalization, but the appearances cannot be wholly deceiving. Everywhere, and I do mean everywhere we went, folks -young and old- were puffing away like a never ending coal smokestack. Even though they had the decency to limit smoking in restaurants and hotels, half the service staff were standing outside their respective places of business on what seemed to be a permanent smoke break. Has the society that spawned Michelangelo and Leonardo not heard the message…this stuff is bad for you? Do the same people who carry the genes of Dante Alighieri and Augustine not get the fact that their lungs are turing into black goo? Maybe it’s their undying sense of carpe diem - living fast, dying young, and leaving a smelly corpse - that propels them toward small cell carcinoma. But whatever the reason, if I wanted to get rich I would open a boutique tobacco shop in every small Italian city.

And what is it with the miniature coffee cups? I realize expresso is very concentrated and “flavorful” but when I was given a cup that looked like it came from my daughter’s doll house, I longed for a simple Starbucks Super Grande Mocha. I hope I am not coming off as an ugly American, but if I am going to pay for a coffee, then give me a dang coffee, not some barely liquified sludge in a thimble.

Okay, maybe I do sound like a culturally insensitive lout, so I will temper my discomfort by something I did find extremely wonderful in Europe and that is the practice of not tipping. I am a terminal cheapskate, so I found this cultural concept refreshing and wise. Of course they build the tip into the cost of the meal, so it all comes out in the wash. If your service is exemplary you are free to reward the staff, but you are not compelled, as in the US, to shell out an extra 15% to a prepubescent, tattooed, and pierced waiter who hasn’t bathed in a week and brought you fish sticks instead of a fish fillet. In general, service was excellent as they knew it had to be to at least gain the possibility of getting a reward, whereas in the US some impudent waiters simply assume they are getting a minimum and the idea of actually working for a tip is lost in their entitlement attitude.

The street vendors in Europe, Italy in particular, are a hearty but respectful bunch. Unlike their counterparts in the Caribbean, where you can feel violated by simply walking through the market, these folks selling their wares generally leave you alone if you express no interest. If you stop to admire their Sistine Chapel painted on a plate, all bets are off. Once you acknowledge their existence you are a willing participant in the ballet of bargaining that characterizes this type of transaction. I bought both my girls scarves from a sweet older lady who didn’t berate me but explained in sensible rationale why her scarves were 2 Euros higher than her next door neighbor. Whether it was true or not was left to the gods, but I believed her and paid the extra. My daughter’s loved them so I felt the transaction was a success and relatively painless.

It is quite sobering to walk through a small enclave and realize people had been living there, in the same houses, for 500 years before the United States was even a glimmer in Jefferson’s eyes. We in the West have such a short term perspective. I distinctly remember walking through colonial Williamsburg a couple of summers ago and thinking how ancient and primitive the development was, yet walking the streets of Florence and Rome simple exaggerated the absurdity of that. 300 years is but a nap for most European cities and old is measured in millennia rather than decades. There were paintings in the world famous Uffizi Gallery in Florence that were older than Columbus’ fateful voyage to an aptly named New World. Walking through the ancient Roman Forum commanded both awe and respect for not only the ancient’s creativity and ingenuity, but also their love of aesthetics. These were amazing people and it saddens me that for years, during the Dark Ages, they were forgotten and left to crumble on the heap of history. I wonder if there had been a direct line of development from the Roman era to today, delving straight into the Renaissance and not wasting a few centuries in betwixt, would we be in a place of higher appreciation for art, philosophy and wisdom, as opposed to who the next Kardashian will marry?

That musing I will leave for another day.

I normally enjoy going to the bookstore, but today, while there, I inadvertently gazed into the abyss. I saw a series of books that made me wretch with disgust. So profane were the titles alone that I had to run screaming from the store as if escaping an oncoming fire. It was a group of books entitled "The Thirty Second_________" and you filled in the blank with Philosophy, Religion, Economics and so on.

These books professed to give you a thirty second explanation of all the great ideas, religious beliefs, economic theories, etc. so as to prepare you as a well read Bohemian. In fact, the book cover specifically asks the philosophical question, "Do you know enough about things to join a dinner party debate or dazzle the bar with your knowledge?" So the new standard of knowledge appears to be your ability to ruminate on it with a drunken colleague at the Wild Wings bar.

Call me old fashioned, but knowing more than a headline about, say, Kant's Cosmological Constant is a worthy goal. That is not to say everyone needs to be a PhD in philosophy, but neither is it helpful to just know enough to be profoundly ignorant. I would rather know nothing about Einsteins Equilibrium equation than know it's name so I can respond "What is Einstein's Equilibrium?" in a parlor version of Jeopardy. Knowing just enough to be dangerous is in itself a precarious situation. Suppose I had read the "Thirty Second Guide to Circumcision" and you were next on the chopping block. I think you would prefer I get the five volume course before sharpening your little tyke's pencil.

We live in a sound bite world. Some of us have the attention span of a hummingbird. We flit here and there and only ever reap a tiny amount of nectar. I don't blame the individuals, they are merely products of the environment. As with most things wrong with the world, I trace this fascination with anything superficial and fleeting to the subversively satanic MTV. If it couldn't be said, sung, or smoked in a two minute time span, it was not relevant. At its inception in the seventies, people would sit for hours mesmerized by the parade of spandex wearing, midriff bearing, puffed hair musicians with the occasional "news" report from the world of rock. The explosion of MTV clones ushered in the era of the thirty second sound bite which has forever changed our culture.

The science of neural embodiment looks at how cultural and societal shifts change not only our behavior but also the physical structure of the brain. Pre-1974 the part of the brain devoted to attention and reasoning was a substantial part of the neocortex. Today, this area is so small it makes Kim Kardashian's bikini look like a burka.

The demon possessed MTV was not the only culprit however. TV news broadcasts and video journals also specialized in "Wham bam, thank you mam" information dissemination. Imagine an expose on the abortion debate crunched into a one minute network news report. Can you say superficial?

Newspapers have always depended on headlines for readership and interest. I know I am guilty of scanning headlines and taking their half baked information as gospel and never delving into a more in depth discussion in the body of the work. For example, for years I thought Barney was a purple dinosaur puppet that appeared on a kids TV show. If I had read pass the headlines I would have realized he was an alien shape shifter sent by Xenon from the planet PBS-13 designed to infiltrate your child's mind and convince them that a single payer health system was best for the country. See what you miss if you stay only on the headlines!

How can you possibly do an ounce of justice to a topic like Buddhism or macroeconomic theory in thirty seconds? The headline answer is that you can't, but is there some value in knowing a little about a lot? The long answer is ...no. A jack of all trades and master of none is another way of describing a liberal arts graduate working at McDonalds. We live in an increasingly complex world and the idea of being a trivia whiz may get you kudos at the local watering hole but it will also get you a place in the unemployment line. I am not advocating for the dissolution of the Renaissance man/woman. A proper understanding of that term is someone who knows a lot about a lot, but for those of us with an IQ a few hundred points below Leonardo DaVinci I suspect it is better to follow your passion, get good at it, then branch out.

It took more than thirty seconds to write this, although you may disagree based on its content, so it is hard to believe that a thirty second education in anything is much worth pursuing.

     Words are powerful and powerfully funny at times. I just returned from a medical mission trip to the island of Jamaica. I have been going here with a team for several years and it is an ever challenging and amazing experience. The people are wonderful and so appreciative of the little things we do, and there is no question that the blessings that fall on the team dwarf the good that is doled out in the form of antibiotics and steroid cream. Every trip and team has its unique personality and their are stories to tell and embellish after each seven day sojourn on the island.
     We partner with a ministry that has been firmly planted in the poorest parish in Jamaica, and we return year after year to the same ramshackle “clinics” to find a warm and joyful population eager to see the doctors and nurses from the States. One of the great benefits to our team is the fact that Jamaicans speak English which greatly simplifies our diagnostic querying. There remains some challenges as the words are heavily accented and often flush with the native Patois, a mixture of Latin, Spanish, Portuguese, Chinese, Japanese, Amerindian, and English along with several African languages. At times I feel somewhat akin to a southern East Tennessee hillbilly (which I am) trying to communicate with a Jersey shore bling queen.   Needless to say there are occasional consequences to misuse and misinterpretation of phrases.
     On our first trip to Jamaica, many of us were in the habit of using the term “little buddy” when referring to a small male child. Those of us who are old enough to remember also recall the Skipper’s favorite name for the hapless Gilligan was “little buddy”. This expression was almost automatic for me to employ as a young man would hesitatingly sit in the chair across from me wondering what the white doctor from the US was going to do to him. (Thank goodness none of them knew I was a gynecologist!) I would routinely start each encounter with, “Hey little buddy”, or “How’s my little buddy today?” Since I generally have the observational skills of a blind rodent, it took me a while to pick up on the confused and often surprised expressions on their face. I just thought that they were apprehensive about their impending exam. Due to the matriarchal nature of the Jamaican culture, virtually all the parents we saw in the clinics with their kids were mothers; however, I had the good fortune (and as you will see the ultimate humiliation) of having a father bring in a young boy about midway through the clinic. I greeted the tyke with my traditional, “So, how’s my little buddy today?” The child, about 12 I guessed, looked at me, looked at his dad, and burst out laughing. I get that occasionally, especially from my own family, so I didn’t think it that unusual until the father pulled me aside and reset my cultural sensitivity button. It turns out that “little buddy” in the Jamaican culture is a slang name for the male genitalia. So all morning I had been asking young children how their wee wee was doing, and even more troublesome, how my wee wee was doing! After effusive and voluminous apologies I contemplated how many young men I had traumatized that day, but I suspect none more than I.
         One afternoon we were asked to go the a local primary school in Jamaica and do a brief presentation on why we were there and a bit about what we did at the health clinics. It was a great opportunity to interact with the kids and begin to build relationships that form the foundation for the ministry. There was a variety of ages, mostly first through fifth grade, so we knew we needed to keep the explanations on a relatively simple level, much as we would do if we were talking to a room full of congressmen. I opted to just say I was a doctor who delivered babies and did surgery and elected not to go into detail of the life of Ron the Roto-Rooter, and other folks on the team followed suit. David talked about fixing bones, Susan talked about nursing and Ben, our pharmacist, talked about his job. Being a jokester, he began by saying he sold drugs. This got an interesting reaction from the teachers, so he quickly countered as to what kind of drugs and why he was not carrying an assault rifle. Shifting gears fairly rapidly (I think the principal was close to ending the session prematurely at this point) he decided to talk more about what we were doing in Jamaica. He talked about the medicines we brought with us in our suitcases and how we divided them up and placed a three month supply in little sandwich baggies for distribution. We gave a three month supply to last the folks until the next team came, and the most efficient way we have been able to accomplish this is to buy out all the baggies at Target and use the zip lock style as our pill bottles. So he said, “We take all the medicines, put them in baggies, and give them out to people we see in the clinics.” At this the kids burst out into uproarious laughter that was so loud it was heard in the next parish. It turns out, we learned later, that baggies was slang for women’s underwear! The kids thought it was great but puzzling why we placed Tylenol in Aunt Jameka’s underdrawers.
    These embarrassing but entertaining incidents remind me that everything we do has to be viewed in the cultural context of where you are. Watch your words, and be careful where you put your medicines!

I'm getting ready to take a road trip with my oldest daughter. She is in college in Chicago and is coming home for the Summer, and she has to return with her car as she will be spending a substantial portion of next year studying abroad. Studying overseas is a bit of a stretch for me as when I was in college the only study abroad was literally studying a broad (for anyone under thirty, that is a slang name for a woman).
    I am a bit leery of her driving 15 hours by herself so I am flying to the Windy City and driving back as her wing man. We plan on stopping in Knoxville for the evening and then plugging into Augusta the next day. I am really excited about spending time with her as she is much brighter than I, and she always teaches me something interesting. For example, did you know that henna tattoos date back to the Roman Empire? They were used as makeup, decoration and to advertise fertility and availability. Today we simply use Facebook. Anyway, she is majoring in journalism and theatre, basically unemployable professions, but she will be very well spoken and confident. Actually I am envious of her choices as I would love to have had a better college experience. She is going to London and Florence, while I went to a windowless lab at the basement of the biology building. I've often said that true happiness is knowing that your kids are following their passion. Well, I should be ecstatic then.
    It's a 14 hour drive that will take us through Indianapolis,Cincinnati, and Lexington before arriving in Knoxville for the evening. I went to high school and college in Knoxville so it will be special to share that with her.   She will get to see where I walked 10 miles through the snow barefooted to get to school and visit my house where we went to the bathroom outside until I was thirteen. Of course none of that is true, but she has to understand how good she has it by me fantasizing about had bad I had it. Actually Knoxville was a wonderful place to grow up and my middle class, non abusive upbringing was about as free from trauma as an episode of Leave It To Beaver. But I do feel a certain obligation to embellish a bit if it leads to a greater appreciation of my offspring's fortunate station in life.
    My daughter is like me in many ways. We are both introverts and would choose a good Grisham novel over a cocktail party. I mentioned to my wife the other day that I was loading my iPhone with podcasts to listen to on the trip. She immediately chastised me stating that I should not listen to anything at all and spend the entire 14 hours engaged in meaningful dialogue with my daughter. My wife is an extravert if you couldn't tell. She sees this as an amazing opportunity to quiz, interrogate, and otherwise hassle my daughter with the sole purpose of bonding. I honor and respect her opinion as she is right in most everything, but in this situation she is horribly misguided. Both my daughter and I also see this as a bonding experience but one that is cemented in silence with the occasional burst of conversation. This is antithetical to everything extraverted, as their idea of hell is more than 10 minutes of silence. When my wife is out of town and I am not at work, I can go days without uttering a word. My eldest is much the same.
    My daughter has made this trip with her mother before, so I will be interested in her perception of the contrast. It's not that we won't talk, it's just that we won't talk about drivel and silly things. When we do converse, I suspect it will be meaningful and fascinating, something along the lines of where to eat or which Stop and Shop has the cleanest bathrooms. I get giddy at the thought of it. I do think we will have a grand time, just in our own introverted way.
    We probably won’t have to worry about directions on the way home. We now have fourteen different devices to guide and confuse us. We have a Garmin, a Tom Tom, Mapquest, OnStar, iPhone App, and an ancient document called a road map. I find it is telling that if any of the digital directors disagree I always go back to the US Road Atlas from 2000. It’s never led me astray whereas that dang English accented woman from the Garmin has sent me down a number of rabbit holes. The iPhone App is great as long as you are in a service area and you don’t have a finger tremor. Have you ever tried to follow the route if there is the least bit of shake in your fingertip? All of the sudden you are looking at a map of Sudan. I can shake all I want and my Atlas still points me to home.
    Maybe I’ll just let my daughter guide us while I withdraw into my introverted cone of silence.

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Ron Eaker

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