The Season of Insanity

Humans, tropical creatures that we are, have a healthy respect for winter,  Not naturally equipped to survive its wrath, we take shelter from winter's storms and tend to hibernate for much of its course.  While the cold, dark season may be depressing for some and does induce its fair share of injuries, winter keeps us on our guard and, for the most part, out of trouble.

Summer, on the other hand, that carefree season of vacations, picnics and outdoor recreation, is welcomed by most humans and its dangers are too often ignored.  But, contrary to what many believe, the summer heat causes far more deaths than does the winter chill.  The elderly, stressed by excessive heat and too often housed in poorly ventilated apartments, are the primary victims; ironically, young, healthy athletes are the other group at risk.  Driven on by macho coaches and drill sergeants or by their own sense of immortality, they work out or engage in sports on summer afternoons and, as we observe every year, some fall victim to heat stroke..  There is a popular misconception that exercising in the heat, drenched in sweat, is a more effective way to lose weight or to get in shape than is exercising during cooler parts of the day.  This, of course, is false and such behavior invites disaster.

Despite these admonitions, repeated throughout the summer by news and weather reporters, many will ignore the warnings and our current heat wave will be the last for some young athletes.  We may be designed for the tropics but there are limits to our capacity to dissipate heat.  Staying well hydrated is important but common sense is our best means of protection.

Industrial Obesity

Not long ago, we humans could not help but get plenty of exercise.  We had to hunt and spend long hours in the fields to obtain our food.  We had to chop wood to heat our homes and carry fresh water from the well or the river.  Travel was by foot or horseback and almost any task involved physical labor.  Perhaps most significant, we did not have televisions or computers to keep us inactive and entertained for hours at a time.

While many studies have demonstrated a higher rate of obesity in westernized countries, much of the focus has been on the dietary changes associated with our mechanized cultures.  But, while the excessive intake of sodas and cheeseburgers and donuts should raise concerns about our nutrition, it is, in my opinion, a less significant factor in the modern scourge of obesity than is our sedentary lifestyle.

Today, almost every technological advancement is designed to make our lives easier.  We may take our morning or evening stroll to get some exercise but most of our day is spent in cars, elevators and desk chairs.  Even farmers and construction workers have a wide range of machinery and tools that limit their physical labor.  Then, at the end of the day, exhausted and stressed, we plop in front of the television for several hours of mindless entertainment, getting up for a snack during commercial breaks.

A Natural Break

Most evenings, if daylight permits, I head out back for thirty minutes of natural solitude. While mowers may hum in the distance or trucks may rumble on a nearby road, I try to focus on the sights, sounds and fragrance through which I stroll. I also try to ignore problems that may have occupied my day or that await my attention tomorrow.

This natural form of stress reduction has become a vital part of my life and, though I make no attempt to search for any particular plants or animals, I generally encounter something unexpected or see it in a different light. More than anything else, these breaks from human responsibilities make me appreciate the calm patience that typifies the lives of wild creatures and, on most evenings, I seem to absorb some of that serenity.

I could be getting some bills paid or subjecting myself to the endless parade of reality shows on cable TV but those thirty minutes are a cherished part of my day. While these outdoor rambles often provide fodder for future blogs, I seek only the company of our wild neighbors and a chance to enter their world, however brief that visit might be.

Miracle Drugs

Ever since early man discovered natural herbs and resins that seemed to ease his common maladies, we humans have been hooked on drugs. In the modern world, these heavily marketed agents are used to counteract the effects of our sedentary lifestyle or to rescue us from poor choices when it comes to our diet and recreational activities.

Of course, some pharmaceutical products have had a major impact on the health and longevity of the human species: vaccines, antibiotics and chemotherapeutic agents for some cancers (especially childhood leukemias) come immediately to mind. But many of our prescription drugs would not be necessary if we engaged in a healthy lifestyle and they often impose new health problems related to their side effects. Statins, the classic miracle drugs of the past decade or so, have been touted as the ultimate answer to preventing cardiovascular disease and are heavily advertised on American television; yet, within the past few months, evidence has surfaced that associates higher doses of some statins with an increased risk of developing diabetes. And just this week, studies were released that question the long term use of bisphosphonates, drugs used to combat osteoporosis; also heavily marketed on TV, these agents prevent reabsorption of bone, a natural process in the regular remodeling of our skeleton. The new studies reveal that, despite their remarkable effects in the first few years, these agents may be associated with long term effects that could actually increase the risk of future fractures.

These ongoing revelations regarding the long term effects of unnatural chemical agents are hardly a surprise to those of us in the medical profession. We regularly encounter patients who are taking twenty or more drugs, prescribed to combat maladies that are often secondary to inactivity, obesity, tobacco use or the excessive consumption of alcohol. The prevention of disease, including cardiovascular disease and osteoporosis, is best addressed through regular exercise, a healthy, balanced diet and the choice to forgo smoking and other self-inflicted risks. While the use of some medications may become necessary, there is no such thing as a miracle drug.

The Caffeine Pushers

The latest drug craze in the U.S., promoted by numerous television commercials, is the use of high dose caffeine. Offered for consumption, inhalation or absorption on the tongue, these products are marketed as quick and easy solutions to morning or afternoon fatigue.

Of course, caffeine is a stimulant and, like all drugs, has potential side effects that range from mild restlessness to fatal cardiac arrhythmias. It is known to cause tachycardia, hypertension, headaches, muscle cramps, diarrrhea, nausea, stomach irritation, anxiety, tremors, excessive urination, insomnia and tinnitis, all of which vary with the individual; caffeine is also known to exacerbate glaucoma, osteoporosis and irritable bowel syndrome. Many people who regularly use high doses of caffeine develop withdrawal symptoms if the drug is discontinued; these symptoms, however mild, encourage continued use.

Perhaps the most disturbing side effect of this latest drug craze is the social reinforcement that pills, potions and supplements are the best solutions to common human maladies. Daytime fatigue is often due to boredom, poor eating habits or lack of exercise; rather than resorting to a caffeine boost, try taking an early morning or lunchtime walk, eat light, healthy meals and have a mid afternoon snack of fruit, such as an apple or banana; it is also important to establish good sleeping habits, including the avoidance of late evening meals or alcohol. High-dose caffeine is not the remedy for a healthy and productive lifestyle and is frought with potential side effects.

Smart Phone Stress

Always behind the curve when it comes to technology, I use a flip-top cell phone that I bought in 2004. It still provides clear voice communication and texting (which I rarely use) but, of course, does not have GPS, internet service or the numerous applications available on the modern smart phones.

Then again, I check my email twice a day (on my laptop) and can speak with friends, family or emergency services whenever necessary. I don't need GPS to explore the countryside and can't imagine watching movies, sporting events or other programming on the tiny screen of a cell phone. Of course, I'm not on Facebook, have never tweeted, despise computer games and prefer old fashion paperback books.

Most importantly, though, I enjoy a reasonable degree of solitude and am not tempted to instantly review every email that comes my way. While others may scoff at my antiquated concept of modern communication, I suggest that they are being unnecessarily stressed by a bombardment of messages from friends, business associates and spam producers. For the younger generation, who have grown up staring at various forms of computer screens, this lifestyle may be perfectly comfortable but the use of smart phones by older adults likely comes with a price that they do not recognize.

Human Society & Pedophilia

The current revelations at Penn State and the ongoing scandal in the Catholic Church highlight both the insidious and widespread threat of pedophilia and society's failure to adequately address this scourge. While sexual attraction to children, apparently far more common in men than in women, is likely a result of both genetic predispostion and psychological disturbance, it cannot be condoned or ignored by those in a position to protect the innocent.

The Catholic Church, enamored with celibacy, creates an attractive environment for pedophiles, as do other church groups, scouting troops and the varied youth organizations in modern society. While these groups may provide activities, education and counseling that are important to large numbers of children, they are not always structured to ensure that abuse cannot occur. Furthermore, when abuse is discovered, efforts to protect the organization often prevent full disclosure and appropriate intervention.

Parents are the frontline of prevention and should discuss the topic of pedophilia with their children, encouraging them to report any activity that makes them uncomfortable; they must also police, if not totally restrict, travel, overnight programs and home visits with counselors, coaches or youth group leaders. Of course, the organizations themselves must ensure that the potential for abuse is eliminated and society must impose strict regulations governing the activity, structure and oversight of youth groups. Finally, society must enforce the legal protection of children by continuing an aggressive assault on child pornography and child prostitution and by insuring that those adults who do not promptly report incidents of pedophilia are fully prosecuted.

Preventing Disease

Modern medicine has succeeded in treating most human diseases but, with the exception of vaccines, it has played a limited role in the prevention of disease. While early screening for hypertension, hyperlipidemia and some cancers has certainly reduced morbidity and mortality, public health measures to eliminate the contamination of food, air and water have been far more important to the health of the general population.

Beyond the actions taken by governments to reduce pollution and to educate the public regarding health care risks, the prevention of disease relies on the commitment of individuals to choose a healthy lifestyle. The decisions to not smoke, to consume a well-balanced diet, to engage in regular aerobic activity, to drink alcohol in moderation and to avoid risky behaviors are far more likely to prevent disease than anything the medical profession has to offer.

Preventing disease by adopting a healthy lifestyle also prevents the need for medications and therapies that, themselves, are likely to induce other health problems. While some medical conditions are unavoidable and can be eradicated or ameliorated with modern therapies, the state of our general health is primarily under our own control.

Afraid to Live

Catching CNN over lunch, I learned that the American Academy of Pediatrics is now recommending that parents stop using "crib bumpers;" the news report went on to reveal that the deaths of 27 infants have been directly associated with these pads over the past 20 years! While the death of any infant is an unspeakable tragedy, one wonders where crib bumpers rank on the list of risks that these innocent children face.

In the course of any given day, one is bombarded by recommendations from a wide range of experts, warning us to avoid certain foods, activities and products that might harm us in some way. While their points are usually well intended, it is a wonder that any of us open the refrigerator or leave the house. After all, we might choke on food, injure ourselves while hiking or skid on a wet highway.

Unfortunately, the list of risky behaviors and devices is becoming so long that major health risks are trivialized and lost amidst the deluge of warnings. Worse yet, a contagious societal paranoia dilutes the sense of adventure that makes life worthwhile. Too often, we are afraid to live.

The Evolving Nature of Death

For early man, death was often brutal but generally quick. The frail and injured were culled by predators, infections rapidly progressed to sepsis and an acute insult, such as a heart attack or stroke, was a death sentence. With the rise and advance of medical science, we have gained the ability to prevent many diseases, treat most illnesses and offer a vast array of life extending devices; as a result, human life expectancy has greatly increased but the course of dying has been significantly prolonged.

In recent decades, a general enlightenment has spread throughout human cultures and the concepts of refusing resuscitation, foregoing aggressive care and opting for hospice services have taken hold. Nevertheless, large numbers of brain damaged patients, victims of congenital defects, trauma, stroke or dementia, lie in hospital beds for years or decades, subject to indignities that we hope never to experience. Currently, offering them a quick exit from that existence is not acceptable to most humans, a reflection of religious conviction and social pressure.

While governments, insurance agencies and medical facilities should never force a patient's family to proceed with humane euthenasia, it should be an option when the hope for meaningful recovery has passed. I have no doubt that human society will evolve toward the acceptance of that approach; we already provide this humane intervention for our beloved pets and, once human culture is free of the guilt imposed by religious mysticism, we will extend that empathetic service to our fellow man.

Stepping Out

As an outdoors person with an indoor career, I make an effort to get outside at some time during the day. While my walks to and from work are vital to my mental and physical health, they are too purposeful to meet my need for a daily dose of nature.

Of course, my mid-day ventures are only so productive when it comes to wildlife; a group of sparrows in the parking lot, a flock of starlings on a college lawn or a couple vultures soaring overhead may be the limit of my encounter. Natural sounds might consist solely of the crunch beneath my feet, whether from fallen leaves or slushy snow, perhaps pierced by the calls of an arrogant jay. And the smells, sometimes mixed with the aroma of cafeteria food, may arise from fresh-cut grass, putrid mulch or a hedgerow of fragrant lilacs.

Not exactly a chance to immerse myself in wilderness, these brief journeys are, nevertheless, food for my soul. Just the warm sunshine, damp air or frigid wind is a welcome change from the stale, temperature-controlled, infection-laden, antiseptic-tainted environment of the hospital.... to say nothing of nature's role in stress reduction.

Vacation Athletes

Many Americans, having spent most of the year overeating and relatively inactive, decide to get in shape on their vacation. We have all seen them, middle aged, obese men or women, jogging along the beach or trudging up mountain slopes. Such sudden, catch-up exercise is both futile and dangerous.

While all efforts to exercise should be commended, conditioning programs should be gradual and sustained, not crammed into a week at your favorite resort. Attempts to stress an unprepared body will risk muscular injury, heat exhaustion or cardiovascular collapse; lifeguards, park rangers and ski patrol members see these self-induced emergencies on a regular basis.

For those who are truly committed to improving their physical health, dietary and exercise regimens must be sustained throughout the year, should begin at a comfortable level and should be undertaken with reasonable expectations. Walking, biking and swimming are the best options for most deconditioned adults and allow a steady increase in distance and rate over time; of course, a reasonable, well-balanced diet is also essential. Waiting for that vacation to whip yourself into shape is a common but ill-advised practice.

No Equipment Required

Anyone who watches cable TV is subjected to numerous ads for exercise equipment; these infomercials offer a vast array of devices that promise a lean, muscular physique, often with little effort on the part of those who use them. In fact, the human body is already equipped with the features needed to produce and maintain physical fitness.

Our musculoskeletal system, under the control of our nervous system, allows us to walk, run, swim, jump, climb and engage in a wide range of physical activities, all of which combat obesity, tone muscles and improve aerobic conditioning. Stair climbing is an excellent example of efficient, no-cost exercise that burns calories, strengthens muscles and benefits the cardiovascular system. For most adults, walking and swimming are the best forms of exercise, offering many benefits with little risk of injury; younger or more fit individuals might add jogging, situps, pushups and a variety of aerobic exercises but, in the end, no external equipment is necessary.

Of course, humans purchase and use a wide variety of things that are not required for their personal welfare and many succumb to the promise of six-pack abs and tight, muscular butts. It is, after all, better to exercise with that magical equipment than to spend the day on the couch.

The Scourge of Polypharmacy

During the first few decades of television, tobacco ads were beamed into American homes, encouraging all of us to indulge. Thanks to the efforts of public health groups and despite the power of the tobacco lobby, this advertising has since vanished from the airwaves. Alcohol consumption, on the other hand, still receives plenty of encouragement, highlighted by joyous partiers and tempered by the hypochritic admonition to drink responsibly.

In recent years, the American pharmaceutical industry has decided to bypass physicians and market their products directly to the public. We are now deluged with their advertisements which depict happy, upscale drug consumers while, in the background, a narrator lists the numerous potential side effects of their miraculous pill. Such irresponsible advertising, which ignores the complexity of medical therapy, exacerbates the perception that there is a quick remedy for every ailment and that bad lifestyle choices can be erased with a prescription drug. This ingrained message results in the excessive use of medications and many Americans end up on dozens of pills, each with its own array of possible complications.

Polypharmacy has now joined tobacco use, alcohol abuse and obesity on the list of major preventable health risks. We can blame this relatively new problem on the legalized drug pushers of American society, on the media moguls that promote their products and on the legislators that permit this form of advertising.

Human Society & Mental Illness

Throughout most of human history, mental illness remained a mysterious affliction, thought to represent the presence of evil spirits; for this reason, psychotic individuals were either confinded to asylums or put to death. Even today, some religious groups promote the concept that psychosis is the result of demonic possession.

While modern science has uncovered the pathophysiology of mental illness, this diagnosis retains its negative image and the families, friends and associates of afflicted individuals are loathe to acknowledge or discuss its effects. Even though drug companies have succeeded in turning some behavioral conditions, such as ADHD and Bipolar Disorder, into national fads, the diagnosis of a psychotic disorder, such as schizophrenia, is often kept under wraps.

The unwillingness or inability to deal directly with the consequences of psychoses extends beyond the immediate family to society as a whole. Insufficient funding is directed to inpatient and outreach facilities, responsible parties ignore the clinical signs of disease progression, laws prevent confinement of uncooperative patients and untreated psychotic individuals roam our communities. Squeamish about mental illness, human society looks the other way, setting the stage for the tragedies at Virginia Tech, Tucson and many future locations.

Winter & the Elderly

In nature, winter is the culling season. Wild creatures that are old, sick, injured or malnourished often succumb to the harsh conditions; hypothermia, starvation and predation all take a toll. Early man also faced these threats as he emigrated from his tropical home to northern latitudes.

Most older humans will admit that their tolerance to cold weather has decreased with their advancing age and there are physiologic reasons for this perception. As we age our metabolic rate falls, our activity decreases, our calorie intake is reduced and our body fat begins to diminish; all of these factors make it more difficult to retain and generate heat. Furthermore, older persons often have chronic conditions that lead to impaired mobility and balance, making them more prone to falls and injury; the presence of snow and ice only exacerbates this risk. Finally, all of us are more likely to be infected with viruses during the colder months as our indoor lifestyle increases contact with other humans; many of these infections, including influenza, are more severe in the elderly and are more likely to be complicated by pneumonia, sepsis and other potentially fatal conditions.

Sensing all of these factors, older persons with financial resources tend to migrate to warmer climes for the winter months. While longevity is more related to genetics and healthy lifestyle choices, they know that they will be more comfortable in the warm environment. At some deeper level, we may also be experiencing the urge to return to our native ecosystem; we are, after all, a tropical species.

The Benefits of Aging

Aging has its disadvantages. Our physical strength and stamina tend to deteriorate, we are more prone to a variety of illnesses and, for some, our mental faculties begin to fail. When we reach middle age, we begin to notice the early signs of aging and, combined with the other stressors of that period, this observation can induce a sense of resignation and cause some to give up on the joys of life.

But those who remain active, both physically and mentally, come to realize that there are also benefits of growing older. For most of us, the responsibilities of our career and our family life begin to disipate and we have more time to engage in exercise, hobbies and other personal interests. Those endowed with creativity are especially rewarded by this age-induced freedom; indeed, history is replete with famous writers, painters, photographers and other artisans who took up their passion later in life and, possessing the experience and wisdom of advanced age, were especially productive and successful.

Whether or not you possess such talents, the decision to engage in new activities will likely benefit your physical and mental health. The process of learning a new skill exercises the brain and the body, enhancing mental function, improving coordination and inducing a sense of personal satisfaction, all of which make us less prone to illness and injury. Death is surely inevitable but growing old can have its rewards.