Albert Provocateur

Sunday, July 05, 2015

PROUD TO ANNOUNCE MY NEW BOOK!

I am proud to announce the publication of my new book (see below), which can be pre-ordered now on Amazon.com, and which is to be formally released tomorrow on July 6, 2015.

http://sunstonepress.com/cgi-bin/bookview.cgi?_recordnum=932

Friday, April 11, 2014

While we wait for "A Bachelor Party for Odysseus" to hit the presses and the airwaves, something lurks beneath the Eternal City. I am well into my new Roman vampire novel, "Sangrus," and I thought I'd give you, the reader, a "taste" of the book's initial paragraph.

Sunset was there, so faraway, bringing the evil, here and now, too close for comfort. The ivory cross on the mountain summit bled red. The city would follow. Granite, marble, and reinforced cement would be powerless to stop the onslaught of crimson steel. The time had come. The planets were aligned. Even the weather had predicted the arrival. He was here, alive, anxious to unleash horrors far more sinister than anything borne in the mind of Caligula. As summer tourists poured into the boot's Italian playground to fulfill ageless fantasies, winter was about to descend suddenly, with a fury to make Vesuvius look and sound like a pop-gun, and Pompeii, a carnival.

Thursday, April 10, 2014

My New Book, "A Bachelor Party for Odysseus"

My new book is imminent:

www.facebook.com/ABachelorPartyforOdysseus

http://maddoctorb.wix.com/albert-m-baleshs-a-bachelor-party-for-odysseus

Monday, June 13, 2011

Countdown

The count to “down” has begun, and we’re all strapped in to take that power surge to lethargy, hopelessness, and feelings of worthless. No one is immune, in these times of economic hardship, when selling a mother-in-law for a tank of gas becomes not such a bad idea. How did it all start? Where did it come from? Why are the air waves and magazine ads so full of the trance-like visages and the artificial smiles of mental zombies hawking the wares of pharmaceutical leviathans bent on addicting us all to powdered sunshine, in the form of pills, capsules, and tablets, to the tune of greenback or euro billions in treasure trove earnings?

Down for the count, or count as we go down. Let’s face it, life is no picnic, and it’s getting no easier, as our worries mount and our life’s savings go the way of the horse and buggy. Sending our troops to war to keep them employed and off our streets has created an enormous financial shortfall and an army of the homeless and destitute middle class back home, who have no jobs, no health insurance, and no viable nest eggs to cover mortgage payments, spiraling gasoline costs, and the high price of sending junior to college. It’s no wonder that depression has become a best friend and bed partner, as we pray in Chinese to puppet masters across the Pacific, who produce everything today but our children. So, let’s do the math, as countdown numbers decrease, and our anticipatory downward trajectory begins.

Ten. Let it be known that depression affects 1 in 6 Americans, with women bearing the brunt of its weight. Diabetics are particularly vulnerable, although no one is sure what actually causes the illness. A sudden life event, a serious illness, or simple everyday chronic stress may trigger depression-causing biochemical changes in the brain, and then that’s all she wrote. In addition, the association of depression with diabetes, heart disease, stroke, HIV/AIDS, cancer, and Parkinson’s disease leaves the door open to a wealth of exotic theories on its origins.

Nine. The definition of depression has been hashed and rehashed ad nauseam. While we know that its signs and symptoms must last at least two weeks to fit the paradigm, we are often caught off guard when the former are atypical and run the gamut from irritability, restlessness, and anger to physical symptoms such as headaches, digestive problems, and a worsening of chronic pain symptoms.

Eight. While depression is often a subtle companion whose talons don’t draw blood, its toll on the ability to work, develop and maintain friendships, establish intimate relationships, raise families, and engage in self-improvement is undeniable. Swallowing a barrel and pulling the trigger is extreme in most cases; eating too much and cutting out physical activity to the point of obesity is not. When blood sugar goes up, depressive symptoms worsen, to the joy of cavity-drilling dentists caught in an economic slump, and the chagrin of those of us who cast daily headlong stares into our bathroom and dressing room mirrors.

Unlucky seven. Teaching a depressed person to think or behave differently, in order to shut down negative thoughts and actions, is not as easy as it sounds. Sad, sleep-deprived, emotionally exhausted patients with chronic aches and pains are fertile terrains for failure of behavioral modification. It’s not that they don’t want to improve and feel better. They just don’t have the bag of tricks at their disposal to be successful.

Six, and we’re halfway there. So, when teaching fails, it becomes necessary to call in the big guns, namely, the antidepressants. They come in all shapes and sizes, and one size does not fit all. Trial and error is the name of the game here, as only 6 out of 10 people feel better after following the treatment regimen with their first antidepressant. The most common and widely used antidepressants are selective serotonin reuptake inhibitors (SSRIs), which all of us have seen advertised between segments of our favorite morning news programs or at Sunday half-inning, quarter, or film intermission. Household names like Prozac (fluoxetine) and Zoloft (sertraline) work by increasing available serotonin in the brain, whose shortage is postulated to cause depression.

Five. Antidepressants do not kick into high gear immediately. In fact, they are downright slow, and can take up to several weeks to elicit their desired effects. Their ultimate success may come at a price, however, as weak and depressed patients may then find the force to carry out their suicidal ideations, or, at the least, fall victim to the potpourri of side effects inherent in the antidepressant beast. The latter encompass a daytime plethora of unfriendly fellas such as constipation, daytime sleepiness, diarrhea, dizziness, dry mouth, headache, nausea, sexual problems, shakiness (with exotic names such as tardive dyskinesia and others), lip smacking, trouble sleeping, and weight gain. While side effects may disappear in a few weeks, there is no guarantee that they will not last until discontinuation of the medication.

Four, and we’re getting there. We’ve heard the horror stories, and we decide to go the herbal route. So, we mount our trusty, gas-guzzling SUVs, and go down to our local neighborhood Walgreens or Wal-Mart pharmacies to pick up the newest installment of St. John’s wort or some such other herbal magic bullet in the good fight against depression. What we fail to recognize is the fact that such over-the-counter herbal supplements, which require no prescription or authorized professional supervision, can be dangerous if used with certain drugs.

As the countdown reaches three, we make one last stand, before lowering our colors and hoisting the white flag. We begin an exercise program to alleviate the symptoms of depression. Many studies have linked physical activity to improved mood. Not only does exercise boost spirits, but it takes no Oprah, Doctor Phil, or Doctor Oz to attest to the innumerable ways in which it can improve general health.

Two. Almost there. Our engines begin to rumble, and we try to reign in stress. Actually, taking on too much stress, whether that be in the workplace, at home, or in our day-to-day relationships, can make us vulnerable to depression. Carefully monitoring our stress levels, whether that be via timeouts, vacations, yoga, or an “unplugging” at the same time everyday, can go a long way to aborting the count.

Finally, one. Sometimes God helps those who cannot help themselves. A simple distress call to the Almighty or to our friends and family will set the wheels in motion on the road to recovery. We can’t solve the problem unless we acknowledge its full ramifications, admit our inability to go it alone, and call in the necessary players to act in our behalf and in concert with us.

If we permit the countdown to reach zero, blast-off will take us to new heights. Unfortunately, they will not be of this world!

Saturday, June 11, 2011

Sugar Plum Fairies

Ask any layman what diabetes is, and chances are that he or she can give you a somewhat accurate answer. Not so for the connection between type 2 diabetes and sleep, as the sugar plum fairies of Tom, Dick, or Harry are anything but innocuous. With 35 percent of Americans reporting less than the recommended seven to nine hours of sleep each night, the gate has been flung open to a horde of health problems on the morning’s horizon, ranging from sleep apnea and compromised immunity to high blood pressure and diabetes mellitus. This wasn’t always the case, however, as Americans used to sleep more in the good old days. Between 1959 and 2002, as the story goes, with the good life becoming ever so much more difficult to attain, and with a shift in the collective psyche toward a workaholic paradigm, the percentage of people sleeping fewer than seven hours a night on a regular basis more than doubled. At the same time, the number of cases of diabetes grew precipitously, and almost overnight the young at heart went from dreaming sugar plum fairies to becoming plump, highly sugared, diabetic patients. Recent studies bear this out.
In a 1999 study published in The Lancet, when a group of healthy young people was restricted to just four hours sleep for six nights in a row, its collective ability to use sugar shifted dramatically to that of old men, demonstrating that adequate sleep promotes not only sound minds but also healthy bodies. Then came a study published in the 2008 Proceedings of the National Academy of Sciences demonstrating the influence of deep, or slow-wave, sleep on the risk of developing diabetes. When deep sleep was restricted, metabolic changes increasing the risk of diabetes occurred. Voilà! It became clear that not only the amount but also the quantity of sleep were key to diabetes prevention. Now, while these and other studies show that sleep can affect sugar metabolism, there has been no definitive proof to date that inadequate sleep causes diabetes. To assert anything else would be tantamount to laying claim to being an eyewitness to unicorns, fairies, or the Loch Ness monster. The jury is still out, however, and the evidence is mounting. For example, a 2010 study in Diabetes Care found that people with sleep problems or some form of chronic insomnia are more likely to develop type 2 diabetes than sound sleepers. So, the next time the boss at work catches you taking a snooze or an afternoon siesta, just claim you’re increasing your productivity by preventing type 2 diabetes.
Now, this is all well and good, but let’s not place the cart before the horse in all cases. What about those unfortunate souls that are already prey to diabetes? How does sleep affect their conditions? The relationship between adequate sleep and enhanced immunity has been shown time and time again, but what about the connection between sleep and hemoglobin A1C (or average blood sugar over two to three months)? The reader knows where this is going. Otherwise, the author would have never brought it up. A 2006 study published in the Archives of Internal Medicine, in fact, found that diabetics reporting poor quality sleep were victim to higher A1Cs. Not only that, but a chain of events is set in motion that leads to high blood pressure also, and we have all heard in our favorite televised news programs that lack of sleep makes dieting that much more difficult.
The brain has an internal clock, or circadian rhythm, as it is commonly known, that is closely linked to sugar metabolism and other bodily functions. When the clock is out of synch, due to too little sleep, sleep at the wrong times, or unnatural sleep, as well as a high-fat diet, the normal harmony between the clock and behavior is disrupted. Instead of the pancreas producing more insulin by day and more glucagon, an additional hormone to keep the body fueled, at night, chaos ensues. So, once again, sleep becomes a major protagonist, center stage, in the drama of diabetes. The question remains, however, does better sleep in habitually poor sleepers prevent or improve diabetes? Can something as simple as sleep be a magic bullet in the arsenal amassed against this chronic malady? While it is still too early to tell, studies have shown that treatment of obstructive sleep apnea (OSA) improves both sleep and blood sugar levels. There may be a direct connection, indeed!
To ensure that sugar plum fairies are the food of our dreams, and not the result of our dreams of food, we can make a concerted effort to get more and better sleep by scheduling bed and wake-up times at the same times each day, avoiding nicotine, caffeine, and alcohol, exercising early, not late, in the day, removing the television from the bedroom, not going to bed on a full or empty stomach, and, when all else fails, seeking professional help for prescription or over-the-counter sleep medications. Being a dreamer has had a bad connotation for far too long now!

© 2011, Albert M. Balesh, M.D. All rights reserved.

Wednesday, March 30, 2011

Glue Factory

I come to you, my readers, in my 100th piece for the West Texas County Courier Newspaper, a broken man. Life has not been what I or many of us envisioned for ourselves, in this age of medical miracles, information super highways, quick-draw plastic, and the burning of Stars and Stripes and Mom’s apple pie. As unbridled imagination seeks to establish a beachhead and the complexions of kindergartens become an experience in the color spectrum, niches become harder than ever to carve in the human collectivity. With laptops plugged into walls, earphones into any orifice that will take them, and cellular phones into our privacy, something as simple as reading a good book on a lazy Sunday afternoon becomes tantamount to SAT calisthenics for disenfranchised youths bred on a healthy diet of white noise versus productive brain waves. Whoever said the meek will inherit the earth? That primacy will rest with the unqualified of stellar résumé legions of under-thirty stamp, whose English is heavily accented, intelligible only in the darkest recesses of remedial ESL classrooms, and written correctly only to the rattle, hum, and glow of spellcheck and Google Search. And all the while Baby Boomers are looked upon with disdain, called “old” and “bald,” and readied for 21st century furnaces, “soylent green,” or the glue factory.

Nothing new. It has always been that way, you say. Well, I say, “Enough!” Sometime, someone, somewhere must draw a line in the sand, and with the world currently on a downward rollercoaster spiral toward Sodom and Gomorrah, perhaps it is time to roll out the old and reign in the new. Unrealistic, you protest. Well, so was $5.00 a gallon gasoline several years ago. And while a cure for cancer goes the way of the horse and buggy, we continue to be held hostage by a generation whose only claim to fame is a resting on forefathers’ laurels and a relentless conviction that “honor student” bumper stickers are a true sign of worth and gauge of future success. Bah, humbug! My dog is smarter than your honor student! Then, again, maybe the 78 million Baby Boomers, born between 1945 and 1964, don’t have what it takes to compete with the current trade school or college-age population, as they are prepared for entry onto or continued longevity on U.S. employment scrolls.

God help us, and God help this country of ours! It is a sad commentary on life and times when chronological age is equated more with a readiness for the glue factory, than with experience to not only be passed on to others but also to increase productivity in the workplace. While 50- and 60-year-olds continue to be discarded from the job market, in favor of twenty- or thirty-somethings whose nimble fingers make laptops, iPods, iPads, smart phones, and every imaginable (and, most often, totally useless) electronic gadget dance, literacy, math, and science skills, and the ability to read and write clearly and coherently, continue to be outsourced to China, India, and Pakistan. America, shame on you! The worth of a nation is not measured by how it values the new, but by how it treasures the old. The Japanese would most certainly attest to that assertion, while at the same time having done away with the traditions and inner nobility of the Samurai. The American Indian admonishment should be chiseled in the stone of the Washington Monument, that “That which you take will always be taken from you.” Fast forward to twenty or thirty years from now, and I’ll be gone, leaving the so-called “young and able” to write the follow-up piece, in God only knows what language and with how much incorrect syntax.

When young and playing fast-pitch on a brick wall with only enough money in the pocket for a soda pop, one longs for the day when adulthood brings riches and the American Dream. That shiny red sports car that zooms by is not seen as an object of envy to be coveted, but rather a goal to be reached with hard work at the coming of age. No longer true today, however, as financial solvency walks a tightrope between soup kitchen and fast-food restaurant, as prescription medications are cut in half by the sick and indigent to make them go farther, as families must decide between winter heating oil and sending junior to college, and as a missed paycheck marks the beginning of the yellow brick road to invasion of privacy by collection agencies, as the number of unemployed workers 55 and over continues to swell to 2.2 million and beyond. That is triple the 2005 figure, with half the vagrants, unemployed, homeless, jobless, migrants, old bags, welfare cons, hand-out abusers, or whatever else one chooses to call the innocent out of work for more than six months. All the while, establishment big-wigs tell the rest, “You should be grateful to have a job in these times.” Translation: be miserable, earn a minimum wage not commensurate with your educational level, pay off those expensive student and high interest credit card loans, and with the change in your pocket be glad you’re alive. After all, you brought this on yourselves.

Is “recareering” the answer for laid off auto workers, engineers, bankers, builders, and doctors, like myself? Not in a long shot, especially in the current economic climate of heartless foreclosures, devastating tsunamis, readily available iodine pills to forestall the immediate effects of fallout particles on the thyroid while placing the subsequent leukemias twenty years down the road on the backburner, and a bloated and ravenous military fighting losing battles on three fronts in order to keep its uneducated masses gainfully employed and out of sight, out of mind of job recruiters and Ivy League-trained economists in a sputtering civilian job market. The latter echoes the “Let’s make war, not love” mentality that has made American great in times of economic downturn.

In 1905, world-renowned physician William Osler stated in no uncertain terms that ages 25-40 were the golden years of productivity, with workers aged 60 and above being basically useless. The fight for survival, lack of food, and scarce resources made Darwinian logic a mantra during the subsequent Great Depression, with older Americans refusing to retire and causing great unemployment among younger workers. After that, it became all too evident that the only way to get old people to stop working was to pay them enough to stop working. Now, however, you cannot either pay them enough to stop working or work them enough to start paying. The “glue” will just continue to flow.

The history lesson and venting are over. I guess I’ll just make my way down to the factory.

Tuesday, February 08, 2011

Hospital-ity

There you have it! Go in with something, come out with something else, or not at all. The game of Russian roulette has begun, in a casino called a hospital, with dealers dressed in white, all in the name of “hospital-ity.” This game is different, however. Lives are at stake, and you, the crap shooter, not the house, are in control of your own destiny. With 98,000 people dying each year in hospitals due to medical mistakes, the stakes are quite high. The cards are stacked against you, and unless you play with something up your sleeve, namely, the trump card of information, you are destined to see your pile of chips dwindle, as the lack of hospital electronic medical records, the longer working hours of physicians and nurses, and the lack of simple precautionary measures like handwashing all contribute to a nasty stay or your ultimate demise. Even in a best case scenario and in topnotch hospitals, hospital-ity is at a premium, with 18 percent of patients hurt as a result of a medical procedure, medication, infection, or other cause, a euphemism for “blunder.” While counting cards is prohibited, some numbers simply cannot be overlooked. The lion’s share of hospital harm, over 63 percent by some estimates, can be prevented, and the name of the game, pure and simple, to do this is getting educated. Whether a patient is hospitalized for diabetes or surgery, the rules for maximum patient satisfaction and pay-out are similar, as are the consequences for failure to abide by them. How many times have we heard horror stories about wrong limbs being amputated, wrong operations being performed, patients going into hypoglycemic shock, and antibiotic-resistant strains of bacteria having free reign in hospital wards? In most cases, a throw of the dice is just that, when an ounce of prevention would have most certainly yielded a seven or eleven. And you say you’re not a gambler?

So, what can be done to turn the tide on the house, and stack the deck in favor of the bird to be plucked, namely, the patient? First of all, stay informed. Don’t be intimidated by your surroundings or by the air of importance generated by your health dealers in white. They are there to serve you, and not vice versa. The more questions you ask and the more informed you are, the smoother your treatment will be. You can take that to the bank! Secondly, don’t hide cards up your sleeve, when it comes to allergies, alcohol use, sexual activity, medications and supplements, and any other piece of relevant medical information that you consider too personal or too embarrassing to reveal. Remember, anything your doctor or nurse doesn’t know can kill you! Another bit of information to carry with you to the cash-out cage or discharge desk is a full understanding of any prescription your physician has written for you. Doctor’s scrawl is akin to hieroglyphics, and don’t expect your friendly neighborhood pharmacist to possess the Rosetta Stone or read your physician’s mind. Whether it be the name of a drug, the dose, its frequency, side effects, the availability of a generic version over a brand name, or any special instructions, make sure you cut the cards openly and cut your losses, too, by holding both your doctor and your pharmacist to the letter of the label. Pills, capsules, and tablets are like colored poker chips. Sometimes they get lost in the heat of the shuffle or the intensity of play. So, be sure on that score.

It goes without saying that you should move around the hospital as if it were a casino, and as if you were looking for just the right slot machine. Bedsores, blood clots, and infections have a tendency to make losers of the immobile. It is a no-brainer, therefore, to at least take that walk down the hall once a day. Don’t be afraid to speak up either, if you happen to run into your doctor or nurse, and wish to ask a question, get something off your chest, or obtain clarification on some aspect of your care. That’s what they’re there for, and the worst they can do is ban you from the casino for life, in which case you’ll choose a future hospital with better health care providers, management teams, educators, dietitians, and ancillary staff. You hold the four aces as a consumer, and it is up to the pit boss and hospital administration to retain your health care dollar and your health care business. Something as apparently inconsequential as a caregiver failing to wash his or her hands, and then subsequently not complying with your gentle germophobic reproach and reminder to them to do so, is a serious matter and grounds for changing the table you are playing at.

Taking your personal health matters into your own hands will not only cut down on iatrogenic errors and unintentional cheating by the “whitecoats,” but will guarantee a pay-out measured in numerous disease-free years and improved quality of life. Don’t get taken to the cleaners by failing to do so!

Wednesday, February 02, 2011

Articular Attack

Like a toy in the attic, collecting dust until polished and thrown back into the mainstream of the temple’s hallowed halls, rheumatoid arthritis (RA) subtracts luster and adds exquisite pain to muscles and joints long ignored in a restful and tranquil hibernation. Dormancy breeds contentment, especially in the fairer sex, until some as yet unknown trigger unleashes a symmetric articular maelstrom that rivals a perfect storm and leaves its hapless wayfarers cursing the day they were born. In short, RA is no fun, and its countless victims, currently estimated at 0.8% of the U.S. population with three times more women than men suffering its ravages, to second that attestation. Most cases, 80% in fact, develop between the ages of 35 and 50 years of age, with the onslaught attributed to a possible infectious agent such as the measles virus or the virus causing infectious mononucleosis. Whoever or whatever the culprit initiating the skirmish, the ebb and flow of battle results in devastation of joint linings and their associated blood vessels, along with an unhealthy dose of inflammatory cell invasion and edema. The latter cells release a barrage of activated substances and destructive enzymes that are up to no good, degrading the joints even further. If that were not enough, reserves are called up from the rear to discharge a battery of antibodies, which attack self-proteins called antigens that have no other fault than being in the right articular zone of combat at the wrong time.

Hostilities begin with vague symptoms of fatigue, loss of appetite, and muscle, bone, and joint pain, that gradually progress over the course of weeks or months to a more specific chain of cataclysmic events. Several joints, especially those of the hands, wrists, knees, and feet become involved symmetrically, with no prisoners taken in that 10% of the combatants who wage an acute and losing battle against fever, enlarged lymph nodes, and a spleen that roars its resentment to its increased girth. Pain in affected joints, aggravated by movement, is the alarm sounded and call to arms, with morning stiffness of greater than an hour duration interdicting immediate obedience to the bugle’s blare. Inflamed joints are held in a flexed posture, resembling a “Z,” the neck of a swan, or a buttonhole, in order to maximize their volumes and consequently minimize the hurt. Laboratory surveillance, counterintelligence, and a sending in of skirmishers to scout the terrain and lay of the land do little to extend the beachhead, as 5% of healthy recruits demonstrate rheumatoid factor, an autoantibody whose presence is not necessarily specific enough to warrant capitulation. In fact, RA may be mimicked or camouflaged by any number of conditions harboring rheumatoid factor; those being lupus, hepatitis B, tuberculosis, leprosy, syphilis, chronic liver disease, malaria, infectious mononucleosis, bacterial endocarditis, and a host of others all to ready to swing into action.

So, what to do? What weaponry in the possession of a modern-day bombardier or rheumatologist can slow the progression of disease, while at the same time lessening its cost in blood and treasure? Obviously, exercise directed at maintaining muscle strength and joint mobility is the first line of defense and stopgap measure to halt RA invasion. When lines are overrun, bigger guns are called to bear on troop movements of autoantibodies that if left to rape, pillage, plunder, and otherwise wreak havoc on the articular landscape, will inevitably result in disabilities so grave as to compromise daily activities and quality of life. Enter the fray, low-dose anti-inflammatory steroids, and, if need be, disease modifying anti-rheumatic drugs (DMARDs) such as methotrexate and sulfasalazine, to temper RA destructive capacity. Symptom mitigation and pain relief via nonsteroidal anti-inflammatory drugs (NSAIDs), simple analgesics, and cycloogenase (COX) inhibitors (or Coxibs) may additionally be drafted into service. Finally, when all else fails, a resort to nukes, in the form of potent biologics, is authorized to control signs and symptoms of RA, slow damage to joints, and limit disability, all at the expense of a crippled defense budget.

Make no bones about it. When the dogs of war are unleashed by RA on unsuspecting joints, their bites are inevitable, at the cost of sometimes muted barks.

Wednesday, December 08, 2010

Brickfish Social Media: Rome Wasn't Built in a Day

Brickfish Social Media: Rome Wasn't Built in a Day My entry to the Centers for Disease Control (CDC) "The Flu Ends With U" poster contest. Please take a look at my poster via its link, and, if you like it and its message, vote for it. First prize is $2,000, a part of which I will give to charity and the rest of which I will use to throw one heck of a party for all my Blogger and Facebook friends who get vaccinated. Many thanks for your support. Remember, the flu is a serious illness, which can lead to death in some cases. So, GET VACCINATED!

Sunday, December 05, 2010

White Man Speak with Forked Tongue

The United States has long prided itself on being a guiding light and the bastion of democracy in an ever-hostile and tyrannical world. The founding fathers conceived of a government “…by the people and for the people” with “…freedom and justice for all.” Wonderful words and beautiful thoughts, but are they still applicable in a changing world in which it is sometimes felt that a circling of the wagons and a ducking of heads behind Fort America is the best course of action. Should a government’s leaders, indeed, provide full disclosure of facts to the public, when, in fact, such “coming clean” might compromise a country’s defense, a population’s safety, a nation’s intelligence services, industry, infrastructure, and agriculture, not to mention popular opinion and faith in one’s political leadership? This is a question that has either dominated or occupied the wings of the U.S. stage since its inception, over 200 years ago. The U.S. continues to wrestle with the issue, in the face of world terrorism, a burgeoning China and a loss of manufacturing jobs to that juggernaut that continues unabated, disillusionment on the home front due to a failing economy and rampant unemployment, and a higher education system floated on false hopes and staggering student loans.

Yes, the world has become extremely complicated, but Americans like to think that certain unalienable rights, principles, and doctrines remain immutable in the face of cultural, technological, religious, social, and moral upheaval. The “holier than thou” attitude cultivated by America and Americans is perhaps based on a myth and on the hope that things really aren’t as bad as they appear. After all, this is America, the “…land of the free and the home of the brave,” as well as of Ma’s apple pie. Those terrible things that happen in other countries couldn’t possibly occur on home soil. After all, U.S. politicians and leaders come from the same stock as the populace, and they would never lie to the people. Little white lies, perhaps, but never those black “ops,” shady dealings, and dark innuendos that threaten to shake the foundations of democracy and the moral backbone of the American people. Think again! Further fresh revelations on the John F. Kennedy assassination, which occurred almost 50 years ago, are, in fact, just coming to light today, and that is just the tip of the iceberg; lest we forget the mysterious circumstances surrounding the attack on Pearl Harbor, the assassinations of Robert F. Kennedy and Martin Luther King, the U.S. involvement in Vietnam, the Oklahoma City bombing, the “9-11” terrorist attack on New York’s World Trade Center, and the rush to judgment and rush to action in the first and second Gulf Wars.

Psychiatrists and psychologists tell us that lying is socially expedient. Many feel that we are all natural-born liars, and that an innocuous fib or a “little white lie” here and there not only helps our day-to-day conversations flow more smoothly, but keeps them from stalling, sputtering along, or just plain boring our listeners. It has been estimated that in an average 10-minute conversation with a stranger or a new acquaintance, approximately 60 percent of us lie three or more times. Men and women are equally prone to stretch the truth, with the former fibbing to make themselves look better, and the latter to make another person feel good. Lies, for better or worse, just slip out of us, and we simply don’t realize how dishonest we are until we make a conscious effort to analyze our motives or stop.

On a grand and national scale, there is a growing suspicion and permeating mentality among scientists, political thinkers, philosophers, religious leaders, and the citizenry that the U.S. Government is “holding back,” so to speak, from the general public. National defense concerns are often quoted as justified or unjustified motives for reticence on the part of those who have taken a solemn oath to protect the U.S. Constitution, while at the same time giving the people what they want and not pulling the wool over their eyes. The price tag of the subterfuge involved in cover-ups and national defense excuses is not only backbreaking and heartbreaking, however, but also bank-breaking, as countless years, dollars, and human productive capacity is wasted, trying to unravel mysteries as diverse as Area 51, the Roswell landing, the Watergate debacle, and any number of other national concerns, past and present, that drain precious resources better devoted to finding solutions to problems that threaten to severely damage any legacy left to American children. Wouldn’t time, money, and manpower be better spent finding solutions to the energy problem, the continuing destruction of the environment, and the growing religious and social intolerance between peoples of different race, creed, and national origins?

If the answer to the question of whether U.S. and world politicians and leaders should come clean in all cases is to be in the affirmative and free of all shades of gray, then not only the U.S., but also her partners and enemies, must band together to create a kinder, gentler world. It has often been said that, “The truth will set you free,” and nowhere is this more true than on the political scene. So, if you ask me in no uncertain terms whether U.S. and world leaders can and should always tell the truth to their people, my answer is a resounding “Yes!” Not only will the truth free up monies better used to solve far more pressing national and world problems, but a spirit of trust among the people of a single nation and between peoples of diverse nations will go far to increasing the cost-effectiveness of those remedial measures; in other words, our money will go farther, if we spend more on solving the problems themselves, rather than putting accompanying safeguards in place to protect the actions and measures we deem necessary. While national borders and the idea of countries themselves may be fading away, as technology breaches territorial beachheads, no one would argue that truth, and nothing but the truth, from the mouths of political leaders would go far to making the process as painless and productive as possible. Not only is the pen, but also the “un-forked” tongue, mightier than the sword!

Monday, November 15, 2010

Editorial Edict or Evict?

The argument made by marketing directors to the editorial departments of television news programs, that editorials presented at the end of newscasts cost the programs both viewers and substantial revenues, in terms of sponsors and advertisers, is a particularly cogent one. Marketing directors base their assertions on statistics that viewers either switch stations or turn televisions off entirely, when end-program editorials are presented. They are very much convinced of their opinions, and make it clear that news programs and television stations are in the business not only of presenting news, but also of making money to stay on the air. After all, no program can afford to stay on the air without both a viewer base and committed, enthusiastic sponsors who are confident that their wares can be peddled, so to speak, to the former. News programs, and the news stations and networks to which they answer, can only charge top dollar to advertisers, if the latter feel that their products receive adequate exposure to a wide and informed audience willing to pay a fair price for their services and/or products. Although marketing directors do not usually come out and say this in no uncertain terms, they imply it, along with bottom lines. They usually keep their statements to a minimum and to the point, and oftentimes convince editorial departments already cautioned by management to keep editorials brief, easy to comprehend, interesting, informative, and, most importantly, entertaining, if that is possible, in order to retain viewers long enough to the view commercials and advertising spots of the program’s sponsors.

There are some flaws in the marketing directors’ logic, however. While their statistics may and often do demonstrate a loss in viewership during the editorial portion of news programs, that might be due to other contributing factors, which they fail to investigate sufficiently. The final portion of news programs, for example, usually herald the dinner time of most households, and coincide with mass migrations to the dinner table, at the expense of editorials that are many times lackluster in their breadth, scope, and subject matter. Furthermore, editorials are usually read or recited verbatim by newscasters who are dry in demeanor, perhaps not stylish in presentation, and who the viewers feel are not relevant to personal taste due to language, dress, mannerisms, culture, past points of view, or any number of critical, unconscious cues that make us love to love or love to hate someone, and, yet, for those reasons, keep us glued or unglued to the television screen.

Were that not enough, enter the playing field and the mindset of the viewing public of what is commonly known as “information fatigue syndrome.” In fact, the barrage of information to which we are constantly exposed carries a cost, both mentally and physically. The spotty memories, short attention spans, and drawn out, tired feelings to which many of us are subject are fertile terrain for the syndrome and its host of symptoms. The latter run the gamut from increased cardiovascular stress, due to a rise in blood pressure, weakened vision and the Japanese prediction of nearly universal nearsightedness in the future, confusion and frustration, impaired judgement, and decreased benevolence to others due to an environmental input glut.

What marketing directors fail to realize, even though they constantly research and statistically analyze viewer numbers, is that most people today get their news from news programs and the Internet, not from traditional news media sources such as newspapers and magazines. Were they to think about that for a moment, they would come to the conclusion that news programs have captive audiences, and that all that might be required to stop the hemorrhage of viewers at the end of news programs is a simple tweaking of formats, perhaps with the addition of those audiovisuals that we are all so very fond of. Also, a simplification of the form and content of the news would go far in the quest to ease information fatigue syndrome. After all, we have become a visual society that reads less, and both editorial departments and marketing directors need to come to terms with that. Both are in the business of informing the public and getting the news out. They just approach that end-result from a different perspective. Both need one another, like a right hand needs the left, and both cannot remain in business without financially solvent, viewer-friendly news enterprises based on mutually symbiotic and beneficial relationships.

Now, while all this is well and true, and while the moral high ground of editorial staffs often trumps the bread-and-butter of marketing departments, it must be reiterated that the news is a business in and of itself. Programs cannot survive, even with the best of intentions, if the revenues are just not there to buttress continued sustainability. Failed and failing newspapers throughout the country will attest to that fact, as every day we read or hear about decreased newspaper circulations, bankruptcies, and prestigious news and editorial staffs that have gone the way of the horse. If news programs are to fight the good fight, and if news journalists are to continue to present unbiased, informative news to a public starved to be informed but overloaded by the superfluous, then bottom lines need to be met, and that in itself is what marketing directors continue to insinuate, if not come right out and say. While we would all like to be moral and ethical in our choices, oftentimes that becomes the birthright of the rich. Without sufficient profit margins, marketing directors teach us, not only does capitalism on a wide scale suffer, but the right to inform becomes dangerously monopolized by the business “haves,” at the expense of easily manipulated news consumer bases of “have nots,” who have no real choice in their selection of news outlets or networks. End of case. End of unbiased journalism and consumer choice. End of this news story.

Sunday, October 31, 2010

Odd Job

It is the job of outside efficiency experts to measure productivity in the workplace, and employers are increasingly turning to them to gauge employee competency, in the form of increased or decreased productivity, with a subsequent eye to improvement. In these times of increased technology and computer literacy, and with the transformation of the majority of American workers into providers of services rather than skilled laborers and manufacturers, employers have witnessed a tendency for worker productivity to decline, because of both the sedentary nature of most jobs and the hours spent before computer monitors emailing, surfing the World Wide Web, playing online games, and interacting remotely with distant friends and colleagues via Facebook, Twitter, MySpace, and a host of other Internet web sites and portals. While outside efficiency experts have been summoned in many cases to determine why employee efficiency has declined, it has sometimes been difficult for them to put a finger on the reasons for decreased employee productivity. The reasons behind increased productivity have also been difficult to measure in some cases, when the experts called in have not been familiar with the service or industry being examined. Landmark legal cases brought by disgruntled employees against industry giants, and immortalized by popular news media anchors, the press, and the tabloids, for consumption by the public to the tune of higher ratings, bear this out.

While outside efficiency experts continue to believe, in no uncertain terms, that employee work-related behaviors and productivity improve when the workers themselves knowingly come under direct observation and scrutiny, and while that may contain an element of some truth, it in no way illustrates the entire picture. Improvement in employee productivity may be due to any number of reasons in the workplace. To assume that worker conscientiousness is directly related to a Big Brother mentality is not only nearsighted, but also counterproductive to open-mindedness and a sense of fair play. It places the workforce in the position of spoiled little children, not only ill-equipped and reluctant to perform the job-related duties for which they were hired, but also requiring a mother, a mother superior, a mother hen, or some such other disciplinarian to guarantee compliance with the stated goals, duties, performance tasks, and productivity stated implicitly and mandated by individual job descriptions.

Rather, outside efficiency experts would better spend their time understanding the workers themselves, their needs, the specific company and what it requires of its employees, the points of view of management, union, and employees on the reasons for the decline or failed improvement in productivity, the mental status of the workers, the work environment, and a plethora of other motivators for and detractors from healthy increases in productivity over time. Now, granted, human nature being what it is, employees will tend to stray a bit if they are not held to account for their performance. No one argues that. A Big Brother in the workplace, however, can only serve to have a detrimental effect on productivity, leading to employee resentment of management and a further decline in company productivity and profit margins. Passive aggression between employees and between employees and management is a terrible thing in the workplace, and “spying” by management and/or outside efficiency experts can only make an already tense situation unbearable, to say the least, leading to frayed nerves, absenteeism, lack of motivation, and a host of occupational-related maladies that put money in the pockets of labor attorneys, occupational medicine physicians, and those psychologists and counselors that no company would be complete without.

On the other hand, a vested interest in the company demonstrated and sincerely felt by employees who sense fair and equitable treatment by management, makes for a healthy symbiosis that can only be beneficial to the company. Diverse corporations such as Microsoft, IBM, Starbucks, Samuel Adams Brewing, Humana, and numerous others have successfully instituted and obtained outstanding results with employee-management models in which workers are treated more as partners than as servants. They have found that workers are not lazy, and that they will, indeed, increase their efforts and productivity when they feel that they are being treated honestly, being cared for by upper management, believe in the product or service they represent, and have open lines of communication, and perhaps even an open-door policy, with their supervisors, managers, and upper level management. Outside efficiency experts, who should know better and who are privy to the company success stories mentioned above, need to examine all the possibilities mentioned earlier for possible employee malcontent and decreased productivity. Playing the “easy” surveillance card, for whatever reason, and attributing past, suboptimal performance to a lack of observation, surveillance, and disciplinary control begs the question and misses the mark entirely.

In this age of new cultural awareness and social correctness, outside efficiency experts would find their time better spent examining the actual, multifaceted causes for employee and management malcontent, instead of hiding behind past stereotyped generalities for declining motivation and subsequent productivity shortfalls.

Good for the Goose

Today’s society is in a constant state of flux. We move faster today than ever before, what with new advances in communication and society’s incessant need for instant gratification. Laws, too, must change with the times, being constantly adapted to new contingencies, while at the same time maintaining certain unalienable principles. Indeed, life has become complex, and perhaps laws should be enacted to keep pace with those complexities. It is obvious that any statute or law enacted cannot possibly be applicable to a multivariate playing field, but nonetheless must maintain a certain degree of malleability in both application and interpretation, in order to provide for a modicum of simple justice in a world tinted by shades of gray. Some examples will serve to bear out this point.

Let’s take, for example, the case of handgun laws and registration. While states in the Midwest and Northeast of the United States have adopted a particular negative posture in their regard, said point of view is not applicable to other areas of our great nation, where handguns and rifles are viewed as a necessary quotidian tool, in much the same manner as an automobile jack is to the trunk of our cars. While a jack is not something we think about on a daily basis, we are grateful for its place in our vehicles, when the time comes for that unexpected change of the “rubber guard.” Perhaps handgun laws should be viewed in the same light, providing a certain lenience and understanding in their application to those instances, individuals, and areas of the country where a certain degree of deterrence on the part of the common citizenry is warranted. While it is certain that the closed living spaces of the Midwest and Northeast, with their higher populations and greater numbers and visibility of law enforcement personnel, demand a stricter code of application and enforcement of handgun laws, areas of the West, Southwest, and Northwest of our great nation require perhaps a looser interpretation, if not an all together different codification of those laws. The matter is complicated, but adapting handgun laws not only to a changing society but also to changing demographics, geography, and population migrations just makes good sense.

On the other hand, lest we forget their potential to rain on parades, it goes without saying that handguns are an all but necessary evil. In 2007, for example, a total of 12,632 people in the United States were murdered with firearms, and it is estimated that 48,676 were treated in hospitals for gunshot wounds received in assaults. Now, we must ask ourselves, how many of our troops placed in harm’s way have succumbed to the power of the black powder? It appears that our civilian casualties far outweigh their body bag count. Physicians, in particular, are well aware that gun violence is a major public health concern, and one that hits home not only in the torso, but also in the pocketbook. It has been estimated that society bears the brunt of annual gunplay to the tune of over $100 billion.

Cries of “self-defense” echo throughout the land, and the great State of Texas holds some preeminence in that regard. For years now, we have seen Texans raise their collective fists in outrage and heard their collective cry, if not roar, of defiance, when Northern politicians have only alluded to the possibility of stricter control of their handguns. The argument of the Lone Star State’s vast gun-toting population has been that every man and woman has the right to bear arms and defend his or her homestead against possible invasion from without. Laws have been enacted to guarantee this right to the homeowner, and jurisprudence teaches us that test cases in Texas have always favored the defender’s use of force to protect family. In fact, there is a running joke in Texas that if someone violates your property and trespasses, you are to shoot first, ask questions later, and be sure to drag the body into your home, in order to cut your losses. Should an ambitious prosecuting attorney decide to make an example of your rush to judgment and violence, hold firm, as the National Rifle Association (NRA) will most certainly come to the rescue. Now, while that explanation of Texas law may be slightly exaggerated, statistics show that retail sales of firearms appear to corroborate the cultural wisdom of a large-scale Texas vigilante movement. Cross-border violence, with Mexican neighbors to the south of the Texas border, has also fueled the flames of the local and national gun lobby.

The two instances and laws mentioned above appear to confirm a tendency to adapt laws to current societal and cultural trends, in their enactment, applicability, interpretation, and enforcement. It nonetheless should be realized, however, that there are dangers inherent in a body of laws that is dynamic and in a constant state of interpretive flux. Referring back to our previous examples, without a uniform legislative standard of handgun availability, purchase, registration, transport, use, and storage, we run the risk of “returning to the future” and transforming ourselves into trigger-happy patriots with sophisticated weaponry that our forefathers could not have imagined in their wildest dreams. Also, who speaks for the “little people,” in other words, those innocent bystanders who are wounded, maimed, and killed by stray bullets that false pride and fear coerced us into firing at the sound of a creak, crack, or scratch in some far off place in our homes in the middle of the day or night. Many an innocent bystander out on the sidewalk or street has paid the ultimate price for devil-may-care interpretation, implementation, and justification of a Bill of Rights that perhaps is too antiquated to be applied in its letter to a 21^st century population of descendants who face challenges all together different from those of their forefathers.

So, it must be said that laws that are too strict in their vision do as much damage as those too loose for their and society’s own good. Society and even culture changes on a continual basis, and perhaps laws themselves, if not in their immediate substance, at least in their interpretation and application, must be constantly molded and adapted to meet the ever-changing social challenges of melting-pot population dynamics. While the backbone of a federal law must be as straight in Nevada as it is in New York, the lengths and breadths of its limbs can be as diverse as a population’s body shapes and sizes. When it comes to law and white shirts or blouses, one size does not fit all. A slight modification or a trip to the tailor, however, can make us all presentable, and then we can truly say that what’s good for the goose is, indeed, good for the gander.

Sunday, September 05, 2010

Beguiling Guilt

It accompanies us throughout life, taking its seat at our right hand from an early age, and leaving us not, even in sleep. We come to cherish it as a best friend, not because of any particular attribute it might possess, but because we’ve grown so accustomed to its presence, that we would be utterly lost if it got up and walked out on us one day. Plainly speaking, guilt is just no good, but if we can learn to bury the hatchet and place it on an unconscious backburner, then our lives can proceed on an even keel. After all, the conventional wisdom and a host of psychiatrists, psychologists, social workers, ministers, shamans, and new-age gurus tell us that we were not placed on this earth to punish ourselves. The trite ring in the confessional that we cannot begin to love others until we love ourselves may take on new luster and dynamism, if applied to everyday guilty pleasures that paralyze the mind, in much the same manner as the obsessions and compulsions of he who would like to cast the first stone but is wont to find a suitable geologic specimen. Rid the mind of guilt in the quotidian, and quality of life can only improve. In short, bad can achieve that end, and bad can, indeed, be good. Perhaps a few examples will convince you, the reader, of the wisdom of those words. After all, sages are not born. They are constructed on the foundations of years and years of trial and error.

Let’s look at something as simple as cursing or swearing. We all do it, but whoever thought that it might be good for us? A volley of f-words can be as therapeutic as a stream of consciousness on a shrink’s couch. Cursing has been found to minimize physical and emotional pain by stepping up our inherent physiological fight-or-flight mechanism and releasing natural pain relievers. Researchers in England have found that people who immerse their hands in ice water tolerate it longer when they swear up and down. Damn those ice cubes!

We often turn to alcohol, or worse, when our coping mechanisms short circuit. Guilt has driven many a good man or woman into the arms of Johnny Walker, Jack Daniels, or Jim Beam, and many of us have pursued or been pursued by a Wild Turkey. Whoever thought, however, that a bartender’s poison might lift the Sword of Damocles from our hearts, if not from our minds? In fact, moderate alcohol intake, while remaining guilty as charged for increasing detox and rehabilitation center reservations and DWI dockets, nonetheless reduces the risk for cardiovascular disease, the leading cause of death in the United States. The challenge comes from building both a salubrious psyche and a tamed ticker, preferably at the expense of no more than one drink a day in women and two in men.

Smartphones and multitasking have taken their toll on dog days and downtime. The rat race we run in has become ever more frenetic, as we juggle appointments, sprint errands, and rush to the finish line, all in the name of keeping up with the Joneses and putting away that nest egg for our golden years. While we do more and more each day, we learn less and less, as our long-term memories have been sacrificed for a semblance of betterment in the here and now. Our minds no longer wander, with the daily so goal-directed, and that simple game of Monopoly on a back porch, so popular just yesterday, is disparaged as an utter waste of time today. Lo and behold, we couldn’t be further from the truth! Researchers at New York University, in fact, have found that relaxing not only helps the memory but also aids the brain in processing prior experiences during periods of awake rest. So, the next time someone guilt trips you for laying around and doing nothing, be sure to declare in no uncertain terms that your brain made you do it. Who knows, being a little lazy might even be fun!

Leaving our beds unmade provides instant gratification in the short term, only to engender self-recrimination and feelings of worthlessness, indolence, and filthiness in ourselves hours or days later. But what if we could justify those unmade beds? Researchers across the great pond in England appear to have heard our collective call. They have found that the average bed houses 1.5 million dust mites, and, abracadabra, leaving the sheets turned down is a potent weapon against them, as mites can’t survive in the dry conditions of an unmade bed. Children, the next time your mothers scold you for not making you beds, just stand your ground and tell them you are doing your fair share in the good fight against dust mites.

While we’re having so much fun debunking fallacious assertions and simultaneously ridding ourselves of pent-up guilt, let’s throw a few more logs on the therapeutic, soul-searching fire set to consume the dry branches and cobwebs of mythical “do’s and don’ts.” Whoever thought that actions as bad or deleterious as chewing gum, venting, fidgeting, or eating fat at every meal could be good for what ails us? Nonetheless, sugar-free chewing gum is relaxing and can help us eat less; venting our anger can lower our blood pressures; fidgeting and moving around can aid circulation and burn extra calories; and a tablespoon of “good” fat, such as nuts or avocados, at every meal can help our bodies absorb nutrients and vitamins.

Finally, and perhaps the most important means of combating and eradicating guilt, if the latter is indeed possible, is catharsis. While women may be from Venus and men from Mars, they can find common ground here on Earth in the sanctimonious confines of a religious retreat methodology and surroundings. The Catholic Church, for example, has exorcised the guilt of many of its followers through a retreat called ACTS, the acronym standing for “adoration, community, theology, and service.” Without going into the details of ACTS, for both lack of space and the sincere desire on the part of the author for the readers to discover the same peace he found last month on his retreat, suffice it to say that we are all broken toys, and whether it takes a retreat or a witchdoctor to repair that damage, the important thing is to begin the work of beguiling guilt. Becoming one’s own best friend is the lion’s share of a good start.

Bad can be good, but only if guilt has seen better days.

Stuck Up

Stuck, prodded, poked, and goaded! Is there no limit to the invasion perpetrated by modern medicine in the name of good health, clinical, and preventive medicine? And now it’s the turn of alternative and new-age remedies, with an old, but not so old, friend bringing up the rear. You know his name, and growing numbers are feeling the pinch of his bite, as acupuncture holds sway on a field of both unabated enthusiasm and spined skepticism. The poster child of more than a decade ago has again come to the fore in informed enclaves of the United States, in the wake of dissatisfaction with the pills, potions, procedures, and pronouncements from on-high of allopathic medicine. Perhaps the Chinese got it right the first time. After all, there is strength in numbers, and 1.3 billion of them can’t be wrong. With an estimated 70 percent of people in Western industrialized countries having low back pain, the descendants of Chairman Mao have had their work cut out for them up to now, and are finally starting to receive the credit and a handsome profit, to boot, for technologies developed eons ago.

In 1997, 6.8 million U.S. adults either lamented or demonstrated physical disability associated with back pain, which was nonspecific low back pain in most cases. The financial shortfall resulting, and bringing smiles to the pusses of those affectionately called “orthopods,” in the jargon of the trade, was more than $90 billion annually in health care expenses. Of that amount, $26 billion was directly attributable to the treatment of back pain. Enter, from stage left, the new protagonist and darling of the grimace-in-pain set, namely, acupuncture, which had been heretofore mysterious in its ramifications, therapeutic results obtained, and modality of use. Might the reader, at this point, provide some elucidation on the subject? Probably not, unless, of course, belonging to the growing legion of converts.

Actually, a licensed practitioner will advise a patient to relax and leave the probing to him or her, with the acupuncture needles left in place after insertion for 15 to 30 minutes. During that brief period of time, which may seem like ages for some, the practitioner may stimulate the needles manually, with electrical current, by burning an herb on the ends of the needles, or with heat. All of these methodologies elicit a dull, localized, aching sensation in the patient, and a tugging sensation perceived by the acupuncturist, as mechanical interaction occurs between the needles and connective tissue of the “pin-cushioned” guinea pig, hapless victim, or satisfied customer, whichever term is preferred. One treatment is considered inadequate by most practitioners, and a series of 12 sessions of acupuncture, starting with 2 sessions a week and tapering off after 4 weeks to once weekly, is just what the doctor ordered. Booster treatments, monthly or every other month may follow.

Silver linings are never 100 percent, and the cost of acupuncture is not negligible, ranging from $65 to $125 per session. To make matters worse, Medicare and Medicaid do not cover acupuncture. On the positive side of the ledger, however, the proportion of third-party health insurance plans providing coverage for the procedure has increased from 32 percent in 2002 to 47 percent in 2004. Major adverse effects of acupuncture are close to nil also, and significant minor adverse events occur in less than 0.1 percent of cases. The latter include needle-site pain, nausea and vomiting, and dizziness or fainting. So, the end may, indeed, justify the means, when impalement on small needles terminates that nagging, sinking feeling, lumbar stiffness, or aching that heralds the new morn or accompanies the setting sun of a day lived badly.

The American College of Physicians and the American Pain Society have also put in their two cents, recommending acupuncture for refractory low back pain not responding to self-care and conventional treatment modalities. The U.K. National Health Service has even taken the matter one step further, providing a maximum of 10 acupuncture sessions over a period of 12 weeks for people with low back pain that has persisted for more than 6 weeks.

When chronic back pain does not respond to reassurance on the part of the health care provider, physical activity, and a number of conventional medical treatments, then being “stuck up” takes on an all together entirely different connotation from that immortalized by yesteryear’s prom queen. A course of 10 to 12 acupuncture treatments over a period of 8 weeks from a licensed medical professional can take the sting out of being “on one’s back,” and make it pleasurable again.

Sunday, August 15, 2010

Transylvanian Tango

"I did the mash. I did the monster mash

. I did the mash. It was a graveyard smash!"
Count Drabalesh

For Fear of Porphyria

Carpathian Mountain ice chills the bones, but something far more sinister curdles the blood. It is a name that must not be spoken, even when exhumation of the “undead” reveals scalp and facial hair grown longer, fingernails fit for a wolf’s paw, and an unholy glean to the skin.

Premature burial, you say. Oh, yes, it happens. No freak accident, however, or erred pronouncement of death can exculpate the sawbones, tame peasant superstition, or ground flights of fancy.

The Count has risen, and the dawn’s solar flares are no match for another force of nature, one that bides time in the crypts of body cells while bedtime stories, ornate crucifixes, and silver bullets promulgate a myth. He walks among us, and, for those unknowing and hapless victims whose blood has been tainted by Count Porphyria, the quotidian suddenly becomes a race against the disfigurement, skin blistering, swelling, forehead hair growth, and utter havoc wrought by his growing legions.

How could this have happened? If God exists, how could He have given full sway to a creature ingenuously entombed in a permeable, protective vault? Why have Professor Van Helsing and his modern-day counterparts been powerless to halt the scourge?

Perhaps protoplasm and her offspring, ectoplasm and endoplasm, like native soil and a coffin’s nurturing bosom, shield the beast in some way. We can only surmise that the story must go something like this. Be forewarned, reader. It is not pretty!

Back in 1985, when cool wits and steady nerves did not prevail, a biochemist and fearless vampire hunter, named David Dolphin, theorized a connection between the physical appearance of patients suffering from porphyria and the traits of folkloric creatures of the night. He postulated that porphyria, a group of rare, largely hereditary blood diseases, may have afflicted the so-called vampires of yesteryear, in other words, ordinary people whose resulting facial scarring, mutilated noses and fingers, receding lips and gums, and subsequent elongated canines could be directly attributed to the malady. While holy water and a bell’s toll did little to halt the death march of these hapless hordes, an extraordinary sensitivity to sunlight became their constant adversary, forcing them underground and restricting activity to nightly jaunts.

If that were not enough, other characteristics inherent to porphyria provided further food for thought, or perhaps for fertile imaginations. For example, garlic was found to worsen the symptoms of porphyria, and, while injections of blood products treat the illness today, centuries ago its victims may have sought relief drinking blood.

A link to stress has also been expounded. We know that porphyria is inherited, but perhaps a stress of some sort may have been required to unleash its symptomatology. Just imagine, in ages gone by, a stricken sibling or other family member biting you to quench a thirst for blood. Suddenly, that stress would jumpstart your own latent porphyria, and, lo and behold, you would grow your own set of matching fangs.

Nonsense, you say! Let’s debunk the myth and shed light on the argument, no pun intended. Porphyria comprises a series of seven disorders, only the rarest of which, called congenital erythropoietic porphyria, causes skin blistering, itching, swelling, and disfigurement. Just 200 cases have been documented, far too few to account for the widespread belief in vampires. Enter the imaginative element of human nature. Furthermore, porphyria victims do not crave blood, and even if they were to drink blood, digestion in the stomach would render it useless. And garlic, an ally in the fight against the unholy host? That has never been proven.

So, what are we left with, scientifically speaking and keeping medical jargon to a minimum? In congenital or acquired porphyria, body cells lack the basic enzymes required to process porphyrins, which are components of heme, in turn a component of blood hemoglobin. Because they are neither degraded nor biosynthetically processed, porphyrins accumulate in the body and are toxic to tissue in high concentrations. Throw alcohol, antibiotics, certain foods, sunlight, and fasting into the recipe, and you have concocted a surefire way to trigger an attack and befriend the night.

It does not end there, however. Count Porphyria’s little brother, Prince Catalepsy, may have a hand in the matter. Catalepsy affects the central nervous system of epilepsy patients, freezing muscles, slowing heart rate and respiration, and giving new meaning to the term “living dead,” for those of us who inadvertently stumble upon a cataleptic “corpse.”

We must stake a conclusion here. When the horrors of everyday living take their toll, when we seek scapegoats to cover our own evil tendencies, and when choosing between right and wrong is tempered by shades of gray and the color of money, we must find the courage of those prematurely buried. A return to consciousness, a brush of dirt from our clothes, and a return home demonstrate, to the surprise of our adversaries, that we are not down for the count. Unless, of course, long hair and fingernails, reddish mouths and teeth, receding skin, expanding and engorged abdomens, and the pungent smell of decomposition indicate broken springs in our biological time clocks. At that point we can expect a knock on the door from our parish priests or a new generation of Van Helsings.