We are a commune of inquiring, skeptical, politically centrist, capitalist, anglophile, traditionalist New England Yankee humans, humanoids, and animals with many interests beyond and above politics. Each of us has had a high-school education (or GED), but all had ADD so didn't pay attention very well, especially the dogs. Each one of us does "try my best to be just like I am," and none of us enjoys working for others, including for Maggie, from whom we receive neither a nickel nor a dime. Freedom from nags, cranks, government, do-gooders, control-freaks and idiots is all that we ask for.
Our Recent Essays Behind the Front Page
Friday, April 28. 2017
Despite this, I do take a Vit D a couple of times weekly during the winter. Maybe it's magical thinking, as are most nutritional fads and theories.
Thursday, April 27. 2017
Out of consideration for the delicate sensibilities of Maggie's readers, I have refrained from including a photo of advanced Toenail Fungus
These unpleasant, common, but generally not-dangerous fungal infections (except, for example, in diabetics or the immunosuppressed) are caused by several species of fungi which thrive in the moist, confined area of shoes. Those fungi are basically everywhere. You do not need to be a barefoot gym rat to pick them up, but most people probably pick them up around pools, gyms, locker rooms, and the like. If you never go anywhere, you probably won't pick these things up.
Put plainly, these are examples of your body trying to rot while still alive - but that applies to any bacterial infection too. Both are associated with the same several fungi, often with Athlete's Foot progressing to Toenail Fungus (aka Onchymycosis).
Athlete's Foot can be just a little itching, but it can get nasty sometimes. It is manageable or even curable with anti-fungal creams used diligently.
The Toenail Fungus infection is more of a problem, because topical treatments have trouble penetrating the nails to attack the infection in them and beneath them. They are not just cosmetically problematic but can be painful because of the distortion of the nails. Toenail infections are the bread and butter of Podiatric practices, partly because of their chronicity. People sometimes think they just have one or two toenails affected, but usually all of the nails have some of it.
Some people just decide to live with it and let a Podiatrist attack it when wanted, but what you want to do for treatment is to treat any Athlete's Foot and then decide to go for a topical nail treatment (sometimes effective, like Jublia Topical), Toenail removal (ouch but most effective) with oral treatment with Jublia, oral Jublia alone, or Laser treatment (of uncertain effectiveness, unfortunately). Jublia is very expensive.
I have always been interested in how psychological disorders/aberrations spread, too. Mass hysterias, fad diseases, and the like. In the 1990s it seemed as if half the hysteric women in New England believed they had chronic Lyme disease and there was no way to dissuade them. Before that, it was Chronic Fatigue. Both are now old hat and no longer in vogue.
I have been reading about the sudden upsurge of trans children. What is that about? It seems rather unusual, and disturbing.
Wednesday, April 26. 2017
The saddest part of the story is how quickly training gains are lost during periods without regular (meaning 3+ days/wk) strenuous activity. There is measurable decline in cardio functioning and muscle strength in weeks, and training gains can be lost in a few months. Use it or lose it. That is just how it is after age 30 or 35.
Physical fitness, like mental fitness, is a life-style choice.
A high-fat meal, or any meal, produces a temporary surge of blood lipids just as a high-sugar or high-carb meal produces a surge in blood sugar. That is normal.
The low saturated fat craze was triggered by a 1950 study by Ancel Keys, a study which is now generally accepted as fraudulent. It spurred many further studies over the years but, as yet, there is no proven causal relationship between dietary fat and cardiovascular disease. In fact, there are very high saturated fat cultures (Eskimos, Masai) with very low cardiovascular disease rates.
Does your cholesterol level matter? Other than in familial hypercholesterolemia, probably not. So why check them on your every-3 year physical exams? Medical advice is conservative, slow to change, and fearful of being wrong so too-often adopts the precautionary principle. Thus when articles like this one comes out: Popular belief that saturated fat clogs up arteries is a myth, experts say, there is always pushback like "Don't tell people that, they'll get confused."
While it is established that arterial disease is related to inflammation in arterial walls, the cause of that is elusive. The known risk factors for arterial disease seem to be smoking, overweight, diabetes, familial hyperlipidemia, and sedentary life style. Almost forgot the biggest one: age. Avoid ageing at all costs because it has a 100% mortality rate.
We are far from settled science with cardiovascular diseases. In recent years, we were advised to eat margarine not butter. Now advised to eat butter and avoid margarine. Now advised to eat olive oil. It's all a shot in the dark and it could be that diet has little or nothing at all do do with it.
Tuesday, April 25. 2017
As government employees, would you really expect them to care about your big problems? According to Dr. Dalrymple, they prefer to spend their time filling out forms and letting the police deal with the acute mental health problems.
The problem with government medicine is that medical care becomes a government job. How much time must modern physicians spend filling out forms? The administrative mantra today is "If it isn't documented, it didn't happen."
Monday, April 24. 2017
If my political history serves me, people in mental health found serious diagnoses for Nixon, Reagan, and Bush 2, but none for Johnson, Clinton, Obama, or Hillary. Is there a pattern here?
Instead of name-calling, I'd like to see some thoughtful policy critiques but I won't hold my breath. Trump Derangement Syndrome (DSM 5006.09) strikes again. We must be kind to the sufferers.
It's a common affliction of the middle-aged (like Frozen Shoulder), and usually there is never an identifiable cause although weight gain seems to be one. It can be in one foot or both. Sometimes it can be easily fixed with ice and stretching but it can be a chronic problem which eventually will disappear as mysteriously and suddenly as it appeared.
The most common symptom is feeling like somebody put thumbtacks in the heel of your shoe. The problem is not your shoe (although arch supports sometimes help it). The problem is inflamed tendons.
The differential diagnosis is Achilles Tendonitis.
Besides the pain of simple walking around, Plantar pain can lead to other joint or lower back problems because of altering one's gait to minimize the foot pain.
More info from the Pain Doctor
Sunday, April 23. 2017
Loneliness is a tough problem. We live in a world full of all sorts of people, but connecting beyond a superficial level takes a special and complex combination of factors, circumstances, serendipity, and opportunity. Another problem is that we aren't necessarily all that appealing to many people, but we can hope we are appealing to a few people who appeal to us. We all reach out to people who we enjoy, and sometimes it works.
As the article points out, loneliness can spiral into excess neediness, or avoidance, distrust, and isolation. That's not a happy life.
Guys need guy buddies to hang out with as much as gals need their gal buddies.
Friday, April 21. 2017
Always be a skeptic.
Thursday, April 20. 2017
These were not issues when 90% of people lived on family farms. In a complex post-industrial society, it's pretty clear that low IQ and character weaknesses can be limiting but there is still plenty of work to be done out there.
As I have mentioned many times, character traits can be more important in advancing one's life goals than IQ. Also mentioned many times, not everybody's life goal is wealth. Wealth is just a default goal for people without other more interesting goals. That said, money is darn useful and I like it.
Wednesday, April 19. 2017
Ultimately, though, he is talking about character traits and American civic culture. Worthy character traits support civic culture, and vice versa. Think Boy Scouts and Girl Scouts. Interesting quote: "The upper middle class is keeping its effective values to itself." Also, his point about "churn" seems important, because in the US lineages go up and down socioeconomically and socioculturally over time. No fixed classes as in most societies and it's not mainly about wealth either.
I posted on this topic previously: Class, Social Capital, and Character Traits
His wonderful speech from 2011 video here. I think it anticipates Trump. The Q&A at the end is good.
Posted by Dr. Joy Bliss in The Culture, "Culture," Pop Culture and Recreation at 16:08 | Comments (2) | Trackbacks (0)
Sunday, April 9. 2017
A little background on the medical studies you read about. Everybody knows now that most are misleading if not entirely in error: ACSH Explains Epidemiology
Friday, April 7. 2017
And few people are entirely satisfied with their souls and minds either. Often, we make reasonable efforts to work on all of those things, but at what point do our goals become crazy? If I need to look like Melania, I am crazy. If I need to look like a man, I am double-crazy and should want help separating fantasy from reality.
Fortunately in the USA it is rare that Psychiatric help can be forced, but it distresses me when people seem to endorse double-crazy as normal. But, as I say, in a free country you are free to be crazy, and free to get help with it if you want to. Lots of people are half-crazy, crazy, and double-crazy, but I see no need for the culture to pretend to deny that reality. Or any other reality.
It is interesting to me that the Psychiatric officialdom is expanding the list of "disorders" to the point that nobody can keep track of them anymore, at the same time that the elite culture is normalizing other ones. Something strange is going on on both sides.
In my view, anorexia is a kind of crazy. In my view, sex-change doctors are unethical and immoral. The Difference Between Sex Change Operations and Severing Spinal Cords.
Thursday, April 6. 2017
Their findings are mainly gross-anatomical, but the connectome mapping goes further. Unsurprisingly, there is some male-female overlap in this effort to define structural sex differences. Anyway, it would be news if no differences were seen in male and female brains.
Wednesday, April 5. 2017
We post here frequently about the components of general fitness and physical training goals: strength, athleticism, power, endurance, etc. The variety of exercises that we recommend are stressing and training neuro-muscular and cardiac systems.
However, while we are stressing and challenging our bodies in all of the ways needed for balanced fitness, we are also training our metabolic energy systems for higher capactiy and efficiency. There is no need to know anything about it, but it is interesting.
It's basic high school biology. Animals (and plants) use ATP as an energy source for cellular functioning. ATP is generated and regenerated in the mitochondria.
However, our resting ATP batteries store very little reserve energy so 5- 20 seconds of high intensity, maximum anaerobic effort (eg 20-second sprints and HIIT sprints, or a set of heavy deadlifts) require instant regeneration of ATP. That's our "emergency" Phosphagen System. After depleted, it takes a couple of minutes to restore itself which is why you rest between deadlift sets or walk ("active recovery") between sprints. The Phosphagen system is trained by stressing it, but it has its limits.
After 10-20 seconds of high intensity, our cells turn to splitting sugar (mainly derived from carbs unless you have a Coke before exercise) - Glycolysis - to produce more ATP. This energy system, also requiring no oxygen, can keep us going for up to 2 minutes of intense effort. Like the Phosphagen system, Glycolysis is trained by short bursts of high intensity exertions of any sort.
A body can't live long, though, without oxygen. Both of the above are anaerobic (oxygen-independent) systems and neither can be sustained for very long without rest and oxygen to restore them. Aerobic exertion (using oxygen to burn sugars and fats - the Aerobic System -) can slowly but almost endlessly produce enough energy to maintain us during less intense activity in which we maintain a pretty good oxygen balance (or at rest, for that matter). Aerobic energy systems are trained and stressed by, say, 1-hour endurance exercises which keep the heart rate continuously well-above a walking heart rate, eg continuous calisthenics, and non-sprinting exercises like swimming speedy but not sprinting laps, treadmill intervals but not HIIT intervals, jogging, and similar exercises when you can breathe uncomfortably but effectively-enough to keep going.
Can aerobic exercise count as "cardio" exercise? Sort-of, maybe. It depends on where you keep your heart rate. High-intensity, high heart-rate bursts are the best heart-stressors and if it doesn't kill you it will make it stronger. Endurance is a different matter. Is normal walking "exercise"? Basically, no. It's just basic functioning unless it's fast and over 5 miles. "Cardio" means heart rate significantly elevated above walking.
Aerobic metabolism is highly efficient, which is why it takes 3 hours on an elliptical to burn the calories (270) in one plain bagel. It is why you can not lose weight by exercising unless you are fast- hiking 8 hrs/day on minimal caloric intake for a week or two. The average sedentary person (meaning under 5-10,000 "steps" daily with no other stressful exercise) probably needs less than 2000 calories per day to maintain their status quo. Remarkably, in the USA, it is not unusual for one single cheap meal to provide that much energy. In all of human history, remarkable indeed. Caloric abundance has a downside, thus the "overweight crisis" especially among our American poor.
A balanced fitness program (resistance, calisthenics, cardio, and endurance) ends up stressing all 3 energy systems without your having to think about it at all. That is just one of the many reasons why we endorse balanced fitness exercise programs instead of a single path (such as all weights, or all aerobics).
Good summary of exercise and energy systems here.
Sunday, March 26. 2017
Over time, fewer Americans are taking responsibility for their medical expenses. Over time, this drives up costs and an entitlement state of mind.
Something similar has happened with education, I think.
So medical "insurance" is no longer true insurance except at the catastrophic end. If the old model was Major Medical insurance against catastrophe, the new model is more of a medical payment system. That has changed everything.
The World’s Most Inefficient Healthcare System, Part II: Created by Government, Financed by Government
The American middle class does not believe in saving up for health care expenses.
Saturday, March 25. 2017
There are many versions and verses.
On a summer day in the month of May a burly bum came hiking
There's a lake of gin we can both jump in, and the handouts grow on bushes
In the Big Rock Candy Mountains, you never change your socks
In the Big Rock Candy Mountains the jails are made of tin,
This song was written and performed by Harry "Haywire Mac" McClintock in the 1920s. The only other hobo/bum/homeless song that competes with this one is Roger Miller's country version of King of the Road - not as good as this song, though.
Friday, March 24. 2017
Legend and anthropology hold that some American Indian cultures believed that, if you rescued somebody, saved somebody's life, or prevented them from disaster, you were indebted to them forever. That is, the saver was beholden to the saved.
My fantasy is that the issue is that you postponed their arrival to the Happy Hunting Grounds.
In Western culture we tend to see it the other way around because of a Christian foundation, or because we want to see this life as heaven (?), but as an American physician who works for nobody - not government, not insurance, not a hospital - except my patients, I see it both ways. If I get you out of big trouble, you sort of own me as long as you want to.
A little gratitude is always welcome, of course.
Friday, March 17. 2017
The stuff is too much with us. You only need one of everything you need and, sometimes, less than one. Except for money, less is more.
Every two years, we do a deep Spring Cleaning. Step one is getting rid of things. Step 2 is deep cleaning with cleaning helpers and fresh painting afterwards, as needed. Some years it takes a dumpster, some years our yard guys with a truck, and some years it's just throwing trash bags full of clothing into the back of the Suburban to go to Good Will, Salvation Army or, if really good stuff, Thrift Shop.
We do have a "storage room" in the cottage. Four antique and beautiful andirons. A "brown", once thought elegant, dining room table. Spare brown dining chairs. Extra bookshelves. Spare beds and bedframes, etc. Why? Waiting for what? Death and the Final Dumpster, the Dumpster of Doom? Or the Garage Sale of Death?
One of our projects this year is to convert a college kid's room into a lovely guest room. This means the kid's books into boxes to the attic, the kid's childhood desk and furniture to charity, a new Queen bed, and painting/redecorating.
- Any book in the house never to be re-read by us or wanted by kids: Recycling or donated
- Any old surplus furniture not tagged by kids (esp old "brown" furniture): Dumpster if yard guys don't want it Can't give that stuff away.
- Carpets: We have enough antigue oriental carpets to furnish a palace. Mostly in a closet with mothballs. Some won't fit in there. Entirely out of fashion and unwanted but we love them and they once had value. We will not buy another house just to use carpets and paintings. Maybe consign them? Probably not worth the trouble.
- Closets of clothing: If not used in one year, it's gone. If ugly, gone. How many sweaters do you need? It is a liberating experience.
- Boxes of old photos and photo albums: Dumpster if nobody in the family wants them. Seems like a shame, but past is past.
- Knick-knacks, goo-gaws, and misc. decorative items and things kids made in grammar school out of clay - dumpster. It's not immortal art. Getting rid of stuff is painful, but the good, cleansing pain like having a wart removed.
- Excess kitchen and serving items: Unload on your kids, donate, or dumpster.
Wednesday, March 15. 2017
Medicine has a long history of unproven and dubious treatments, but it is discouraging to see it approached deliberately. A quote: “[Hospital executives] talk of patients as customers. Customers have demands. Your job is to sell them what they want.”"
No it's not. It's to give them your best opinion on what is best for them, with maybe some choices or maybe not.
Tuesday, March 14. 2017
Only the weak would complain. They need the clinical experience as fast as they can get it. Furthermore, they need to learn how to function under stress and without adequate sleep. Physical and mental endurance need to be learned. When a multi-car crash results in 10 victims in your ER at 3 am and you're on duty, there is no choice but to rise to the occasion. That takes practice, and it is why older doctors are wiser. They have put in the hours. They can find their second wind because they have done it many times.
Nobody in America wants a doctor who would say "I've worked my 8 hours" or "I'm too tired." Maybe they are thinking of socialized medicine or unionized medicine, because those authors seem to feel that working long and hard is something terrible instead of something wonderful. Some people are not aware than some surgical procedures can take over 10 hours to complete, and, just then, an emergency comes into the OR.
Sunday, March 12. 2017
" On Old Olympus’ Towering Top A Fin, A German, Viewed A Hop." That's how medical students memorize the cranial nerves.
Some lucky people just have velcro memories, photographic memory. A sticky brain is an admirable talent. On the other hand, ordinary brains can be trained for feats of memory: Hack your brain to remember almost anything
Thursday, March 2. 2017
Is it helpful to consider addictions brain disease? Addiction Is Not a Brain Disease - The idea that drugs and biology are to blame for addiction has done more harm than good.
Related, Dalrymple discusses More Tools, Less Understanding - Thoughts on the surgeon general’s report on addiction. He is wrong about one thing: drug addiction is not a result of pain meds for people with serious pain. That is very rare.
My view is that substance abuse derives from one simple effect: Some people like it a lot and it makes them feel better than they otherwise feel. Any physiological dependence part is secondary to that. Also, I am not too keen on the criminalization of drugs. The "War on Drugs" has accomplished little good and has many unintended and unfortunate consequences.
Related to that: The Other War — Drugs — May Soon Force Trump To Put Up or Shut Up
Tuesday, February 28. 2017
This is a downer for Mardi Gras and Carnival season, the modern Saturnalias where no rules apply and reckless hedonism is in the air, but I'll post it anyway like a fuddy-duddy:
I am not sure how to define "natural" for human beings when humans are the ultimate culture-building and society-building animal. For humans, relationship-building and relationship-maintenance are complex, demanding, and sometimes seem almost impossible. Perhaps "natural," though.
Being an acceptable member of a bourgeois society and culture requires hundreds of external restraints (laws, rules, conventions, and expectations) and self-restraints (mostly against temptations and impulses and for reputation-protection). Bourgeois Westerners do not do many very "natural" things like pooping in the park, clubbing people who piss us off, grabbing genitalia when the impulse hits us, stealing people's purses, shooting a neighbor's dog to roast on the backyard grill.
As in ancient times when aristocrats and overlords lived without the constraints of the common folk and the stolid gentry, the Western world still has subcultures which are "above" - or you could call it "below" - the respectable bourgeois Judeo-Christian norms. I am thinking of the special subcultures of Hollywood, Washington, and the like where celebrity, money, and power can exist with separate rules. I am also thinking of some Fishtown subcultures, Tattooland, where there are different standards and expectations.
I must agree with Scarlett Johanssen that monogamy is not "natural" for humans although there is much variation in how libidinally- or id-driven people are. It is definitely not natural for me if some of my X-rated fantasies are evidence but, by behaving myself in many "unnatural" ways, I have managed to build a solid happy life without harming very many people, without blowing up my life, and without too much burden of guilt.
Bill Clinton and Scarlett Johanssen and all the others are free to live as they choose. Tabloid fodder is necessary to drive eyeballs. Perhaps that is why Miss Scarlett made her honest statement about her libidinal intentions. As some guy said on some site, "So I still have a chance to get it on with Scarlett?" Yes, maybe you do if you act charming and catch her in the right mood. Buy her a cocktail and act soulful and deep, wounded but brave. It might work on her and, despite talent, she is not overly bright. Seduction is natural and women like love and sex.
Women are far better at that game than men, however. Women have the power.
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