Mini-Post: Veterans Day!

Way back when I was a young pup, in early college, I had a four year scholarship that turned into a two year scholarship and then disappeared entirely when I changed my major.  This was back when college didn't cost like $30,000 a semester, but still, there was some consternation about how I was gonna pay for the rest of school.  So I thought what the hell, I'll join the Air Force like my dad did.  Then I'll have a job waiting for me when I get out, and school will be paid for, and all manner o'things will be well. 

So I went down and saw a recruiter, as one does. He kind of looked at me funny when I asked about being stationed in Minot, North Dakota but said "Yeah, I'm pretty sure we can do that."  I mentioned all this to my dad. He was happy.  He brought home a bottle of champagne and an impromptu celebration broke out. Everything was going great until my dad suddenly said, "Wait a minute. This is a really bad idea."  

He's only ever said this one other time, that I can remember, so I stopped and asked why. He said I did not have the right stuff for military service. Specifically, he said I had a "low bullshit tolerance."  Which, in the military, can be fatal. So I ended up not joining the Air Force. I think that was probably the right call.  And we found other ways to pay for school and I did not have a job waiting for me when I got out. But I eventually found one and life went on. 

Today is Veterans Day.  If you know a veteran, or a soldier, please take a sec to say thank you to them for getting shot at on your behalf.  If you can, maybe also offer to give that person a hand with something.  Older vets might, say, need their lawn mowed, or need a ride to a medical appointment.  Or maybe you could help them change their light bulbs because they're not very handy getting up on a ladder these days.  Younger vets and soldiers might need a hand with child care, or help understanding tax forms, or just some of the weird stuff in life that a lot of us struggle with.  If nothing else, most of them could use an ear.  It never hurts to ask.  

I'm fresh off a project at work where I talked to a lot of veterans on the phone. Most of them were from the Desert Storm era but some were younger.  All of them had some pretty amazing stories. Like the guy (they were mostly guys, but a few ladies) who participated in a prank that pissed off a superior officer and ended up getting reassigned to Diego Garcia. I had to ask him where that was. (It's a little island in the middle of the Indian Ocean, literally a thousand miles from the nearest land mass.) One guy, when I asked where he was stationed in Iraq, said, "Well, we weren't really stationed anywhere. I mean, we slept on the runway the first few days. Then in some abandoned houses. I stayed at Saddam's palace for a week. That was nice.  And in the Holiday Inn Baghdad. There is one. They didn't have the free breakfast, though."  A couple of them saw IEDs explode and kill people, some at close range, some farther away.  Some had been attacked by angry civilians.  And one guy was captured tortured, and eventually ransomed back to his outfit by some local tribesmen after his convoy was hit by a kind of improvised missile that killed three of his men. "But it's cool. I've had therapy." (!!)

I was doing this project from my house, or from a climate controlled office near downtown Dallas. The closest I ever got to doing anything dangerous in life was working for the U.S. Government when I was younger and more spry, working on disaster relief after Hurricane Katrina. And even then I was doing exciting stuff like proofreading mortgage documents and making sure field agents had good maps and directions in a landscape where many of the road signs had been washed away. I have never flown a helicopter or carried sandbags or pointed a rifle at anybody. I think my dad was right. I do not have the right stuff. I do, however, have a famously low bullshit tolerance. This can only help you in life. 

Also, I vote. And you should too. You can vote because a whole lot of veterans stood up to a somewhat addled English king and an emperor and a guy with a toothbrush moustache and some other emperor and Saddam Hussein and a scad of Karl Marx cultists and and said, "No, I don't think so."  Voting is how we help keep people from having to go fight wars in the first place. I hope that one of these days, the idea of needing armies to be ready to fight people will become sort of a joke, like how we joke now about needing garlic to fend off vampires. But until that happens, we will have more soldiers and more wars and more veterans. So when you can, help them out. Slava Ukranii. Thank you and goodnight.

How Aunt Frieda Did It

In our last blog post, we talked about Aunt Frieda, everybody's best friend's cousin' sister-in-law, who lost a large amount of weight and kept it off forever.  By doing this, Aunt Frieda accomplished something that only 10-20% of people can do (and I’ve seen some studies that say more like 4%). Still, Aunt Friedas do exist.  People with six fingers exist, too, and so do ethical politicians, and I once heard about a guy who was born with only a brain stem, or what we call the “lizard brain,” and the rest of his brain was essentially missing.  He was in medical school and having probable stress-induced migraines when they did an MRI and found this out.  So, you know, weird stuff does happen. 

The reason so few of us can lose weight and keep it off is because we evolved over 2.5 million years to be very good at surviving famines, which were frequent for pretty much that entire time. As a species, we are not good at losing weight.  We’re good at gaining it, so as to survive the next famine and the next one and the one after that.  Getting enough to eat was a constant problem from the time we first stood upright on that African plain.  

First, we invented agriculture in BCE 12,500, approximately.  (It was a Tuesday.)  This helped a lot, and was a huge game-changer both in producing enough food for everybody and for kick-starting the development of civilization. Fast forward to the 1900s, when we fought World War I, then II.  That helped even more. Besides adding essential nutrients to food, which we did because the Army was so unhappy about how many malnourished recruits were showing up to fight, we also made several very important discoveries about farming and fertilizer right around this time. We sort of had to, because much of Europe’s agricultural countryside was either blasted apart by shells or poisoned with mustard and chlorine gas. (In fact, there are areas in France where to this day, one hundred years later, nothing will grow.  Not even crab grass.  And there are signs that say, in French, something to the effect of “Do not walk here,” because some experts are afraid gas could still seep out of the ground and kill people if, say, it rained a lot.)

So that left it up to the Americans, in large part, to grow enough food to feed everybody. Luckily, we had lots of available land.  We spread out into the Midwest, made lots of farms, grew lots of grain.  We’d suffer a major setback in the 1930s, when a lengthy drought created the “Dust Bowl,” but for the most part, we got better and better at growing more and more.  New farming innovations spread around the planet.  Today there are 8.2 billion people, and at no time in history have we been better fed, better educated or better medicated. (But, see also, climate change, and ideal crop temperatures, and cross reference large-scale crop failures.)

Anyway, back to Aunt Frieda.  Yes, there are people who lose weight and keep it off.  I don’t want to suggest that they don’t exist at all.  They’re just rare.  Most people (80-90%) who lose weight gain it back, and usually more.  But since there are Aunt Friedas, and everybody wants to be an Aunt Frieda, let’s take a look at what those ladies have in common.

(Some of them are men, but we’re calling them Aunt Frieda, so we’re going to use female pronouns. You guys don't mind if we use female pronouns, acknowledging they mean both men and women, right? Oh, you do? Too bad. It's my blog post. Go write your own.)

First and foremost, Aunt Friedas were probably a normal size for much of their lives.  They were smallish or average size babies. They weren't fat kids. They probably hit all the growth markers.  They didn't gain the Freshman 15 in college. They reached a certain adult weight and more or less stayed there until Something Happened. 

Aunt Friedas are also pretty active.  They often have jobs that involve a lot of physical activity, like a lot of walking, or manual labor, or they’re on their feet a lot.  Think gardeners, construction workers, postal workers/letter carriers.  If they are desk jockeys, they probably are or once were high school and/or college athletes.  Even if not, they have a sport they love.  They run, they play team basketball, maybe they swim on a swim team. They love their workouts and they’d never miss them.  Some of them are Olympians, or would-be Olympians. They probably eat a lot compared to most folks, to fuel all this activity.

But, for Aunt Frieda to lose weight, she had to gain it in the first place.  So what happened?  Probably something medical.  She got sick, she got hurt, she got pregnant. She had to stay home, on bed rest, couldn’t be as active as she had been previously.  Maybe she was in the hospital.  Maybe even the ICU (which helps you survive the crisis, whatever it is, but it’s really hard on the rest of you, especially your psyche).  So she gained some weight.  Maybe a lot, maybe just a moderate amount. 

Then she got better.  She had the baby, got out of the hospital, recovered from the injury.  Being athletic, she doesn’t want to stay at the higher weight, not because she can’t fit into a size 6 anymore but because it’s messing with her center of gravity when she goes for a layup on the basketball court.  So she embarks upon a campaign to lose weight, maybe medically supervised, maybe not.

So she loses the weight.  Great.  Now what?  Well, Aunt Frieda monitors her weight, her exercise level and her calorie intake every day for, pretty much, the rest of her life. She writes down what she eats.  She weighs herself at least once a week. She charts her workouts.  Again, she’s probably athletic. A big part of how athletes perform at an elite level has to do with what they eat. So monitoring food and exercise is not foreign to her.  She’s probably done it all along.

Aunt Frieda either knows, or is told, that now that she's gained weight and lost it again, she can't eat the way she used to. Every time a person gains and then loses weight, they have to eat fewer calories each time to stay there. For example, say we have a moderately active 40 year old man who weighs 180 pounds. He eats, say, 2600 calories a day. If he gains 30 pounds, and then loses it again, he will gain weight again on 2600 calories a day. To stay at 180 pounds, he can only eat maybe 2300 calories a day.  If you lose a bunch of weight, your 2.5 million year old ancestral body will think you are starving. As soon as food is abundant again, you will want to eat a lot of it to get back to where you were.  And a few pounds extra for security.  Why? So you can survive the next famine, of course. And the next one and the one after that. If our 40 year old man gains 30 pounds a second time, and then loses it again, he may not be able to eat any more than 2000 calories a day. 

And here’s the other thing. Probably the most important thing: Aunt Frieda only does this once.  If she gains it back, it’s going to be harder to lose a second time, and harder still the third time, and so on.  Each time she gains weight back, she’s likely to gain more than she lost, so she’ll end up at a higher weight than she started out. This is called “weight cycling”.  Once this starts happening, we can’t call her Aunt Frieda anymore. She’s becoming one of the rest of us. People aren’t born weighing 300 pounds, you know. People get there by going on diets, losing weight, and gaining more back. It has nothing to do with being lazy or not having enough "willpower." It's about basic biology. You learned this in ninth grade.

We know that weight cycling has this result.  We also know that it's hazardous to your health in lots of other ways. It causes muscle tissue loss, osteoporosis and damage to major organs. It's associated with depression, anxiety and a sense of failure. It's probably the major cause of type 2 diabetes (if, that is, diabetes has 2 types; some scientists think there are more like 4 or 5 types).  Some diseases that are associated with being at a higher weight, like heart disease, are probably more closely associated with weight cycling. If you stayed at the higher weight and didn't try to lose weight, your risk of heart disease would drop proportionally.  At least in theory, because we can't seem to find test subjects who haven't tried to lose weight. They basically don't exist. So we're stuck with algorithms. All else being equal, though, you will be in poorer health after two or three weight cycles than you were when you started out, no matter where you end up weight-wise.

So given all that, I would think that the responsible thing would be to, I dunno, tell people not to go out there and try to lose weight. That it would be better to just focus on getting exercise, because that's good for everybody in lots of ways, and eating better food, more fresh fruits and vegetables.

 But. 

First of all, there’s this huge weight-loss industry out there that is financially vested in making sure you keep trying to lose weight.  Like to the tune of $75 billion a year. That's billion, with a b. This industry even funds scientific studies centered around proving that thinner is better.  Also, most doctors learned in med school that no matter what, thin is better than fat.  So they keep harping on you to lose weight, either unaware or not caring that doing so is actively causing you harm.

Secondly, besides the weight-loss industry, we have the food industry, which has also paid scientists to conclude that it's some other villain causing people to gain weight. It isn't the weight loss industry that created Big Macs or "family size" boxes of cereal. Look at commercials on TV.  All the holidays, family times and "good times" mean there's lots of food.  We even have an entire holiday, Thanksgiving, based on the idea of eating a lot.  The food industry pays "influencers" to try to get you to eat more. Garfield said this first in 1980, and it's still basically true, that a huge percentage of Americans get their pay checks in some way from the food industry.  So there's serious money behind how much you eat.

Thirdly, finally and most importantly, most fat people start dieting as kids.  Just for example, I was nine; my wife was six.  In both cases, the doctors told our mothers that we were too fat and they had to fix us. If you start dieting that young, it isn’t likely that you’re ever going to be an Aunt Frieda. Kids gain weight as they grow. It’s what they do. And since they keep gaining weight, the odds of somebody freaking out and putting them on a diet again and kicking off the weight cycling is, uh, extraordinarily high.  You start doing that at nine,  or God forbid six, honey, you are pretty much screwed.

If you want to be an Aunt Frieda in spite of all this, and you've been fat most of your life, what should you do?

Well: Scientists say that first, you should monitor everything you eat. Write it down and keep track of your daily calorie intake. You can use one of many calorie calculators that float around on the Internet to get an average number to aim for. Try to use one that asks for activity level and age, and remember that whatever "average" is may not work for you. You will have to try it out and move that number up or down. If you've gained and lost weight a bunch of times, the number is going to be way too high, so maybe adjust your activity level down in the calculator or just take the number with a grain of salt.

Second, if you do not have an active job and you don't walk a lot (ie, you drive a car and don't walk to work or school or to public transit), you need to exercise 60 to 90 minutes a day.  Regular people can get away with about 30 minutes, but if you have lost weight and want to keep it off, you will need to do three times that. (Hey. If you have been a couch potato for years, please do not immediately start doing 90 minutes of exercise a day. Please oh please. You will hurt yourself. You will need to start small, like 10 to 15 minutes, and build up from there.)

Third, you are probably going to need some help.  A doctor, for sure; maybe a Regular Doc, but maybe also an endocrinologist, especially if you have diabetes. A nutritionist or dietician to help you design an eating plan is not a bad idea, and if you have multiple food allergies or any known metabolic issues, it's basically a requirement. You might want a therapist if you have major issues with food or dieting. You might also want a coach or a support group. Overeaters Anonymous is a good place to start, if you believe in God. (I don't and I've never been 100% comfortable there, though they are good people and the program did help me.) 

If this sounds like it might be pricey, well, it is. There are programs, especially in Canada, that have all this stuff under one roof, but in Canada they have (gasp!) Socialized Medicine. Down here, you have to cobble it together yourself. Insurance may pay for it and it may not, and if they won't or you don't have insurance, you're talking about thousands of dollars a month, probably.  Oh, and don't forget you have to do all this stuff forever.  Every day.  For the rest of your life. 

Given all that, I can totally see saying, "Fuck it," eating whatever you want, and exercising basically never. But because I'm a Buddhist and this is a Buddhist blog (no really, it is), I have to suggest the Middle Way. That's where you do the best you can to eat healthy foods, especially fresh fruits and veggies, but also have treats sometimes and even maybe share fries with somebody once in a while. Where you don't write down what you eat but you do try to pay attention to your stomach and when you start to feel full, you stop eating, even if there's food left. Where you don't eat stuff just because your mom made it for you special or you got it as a present at Christmas or because it was free at work, but because you actually like it and want to eat it. Where you find an exercise you like and do it as often as you can, but you don't count daily minutes and you just have a good time doing it. Where you don't weigh yourself. Let the doctor do that.

And you may lose weight and you may not, but you are absolutely guaranteed to feel better. 

I'm just sayin'. 

From Australopithecus to the Battle of Verdun

There have, of course, always been some fat people.  Renaissance-era paintings show plenty of big women, and some men.  King Henry VIII was famously fat, as was Henry Knox (George Washington's best friend). George IV, king of England in 1820, was fat. Mae West was certainly not skinny. But, back when most people had very physical jobs, there were no cars, and food insecurity was a real thing and not just something that sounds good in government publications, fat people were kind of rare.

In the 21st century, we keep hearing about an "epidemic" of fatness.  Some 70% of Americans are said to be overweight. (Which makes us the majority. So don't piss us off.)  Health pundits blame different things. It's because of sugar. No, it's because of corn syrup. No, it's because of feeding antibiotics to cows. No, it's actually because of aliens abducting humans and running fertility tests. Well, probably none of those things really help, but I think it's inaccurate to blame the number of fat people on any of them.  

No, we need to blame the "epidemic" on evolution. And the First World War.

Lemme 'splain:

A Brief History of Human Evolution

The first critter that was pretty obviously a proto-human was Australopithecus, which showed up in Africa a mind-bogglingly long time ago. These guys were about 4 feet tall, walked upright, and probably looked like hairy humans, except their faces were more simian. Between then and now, about 30 different kinds of humans sprang up, branched out and died off until 50,000 years ago, when homo sapiens found itself the last man standing. 

(Our nearest cousins, h. neandertalis, lived in the same spaces we did for tens of thousands of years before they were decimated by a pandemic disease, or climate change, or both.  We hunted the same animals, ate the same berries, apparently didn't fight much, and occasionally dated (!). H. sapiens may have also coexisted with h. florensis and h. denisova.)

During most of that entire 2.5 million year time span, which is so much time I really can't even wrap my brain around it, our biggest problem was getting enough to eat.  We hunted, we gathered, we gathered and we hunted, most of our waking hours, for most of our history.  We got better at it, as evidenced by spear points and arrowheads and cave art and beaded objects that indicate we had more spare time as we went along, but a lot of us still starved to death before anything else could kill us.  This pattern didn't really change until about B.C.E. 12,500 (ish), when we invented agriculture. 

It's hard to explain what a game changer was this business of farming.  For the first time in our history, there was plenty of food.  Not only that, but there was enough left over to save some for next year, in case the harvest was bad or the weather wasn't friendly or--whatever. Fertility shot up.  People lived longer, fought off diseases, survived broken bones. Our population doubled and doubled again.  We spread out across the globe.  We made buildings and houses and cities and civilizations.  We invented laws and gods and religions.  We came up with writing and started keeping records.  We created countries and armies and ships and lots of nifty gizmos.  It was huge. 

12,000 years later, we fought World War I, and had another big leap forward.  

A Brief History of World War I

In case you missed this part in history class, France and Germany started squabbling over some land called Alsace-Lorraine, as well as a number of other things. In February of 1916, Germany decided to march through Belgium to attack France. Belgium said the hell you will, somebody shot the Archduke Ferdinand and total pandemonium broke out. 

Unfortunately, before any of that happened, we had the American Civil War.  This occasioned the invention of the machine gun and the explosive shell. We then had sixty years after that to get even better at making efficient weapons to kill people. The Battle of Verdun began on February 2, 1916.  Thirty thousand men died in a single afternoon.

Two years later, having basically lost an entire generation of young men, France appealed to England for help in its war against Germany.  England did what they usually do; they turned around and asked us. I forget how we let them talk us into it. But they did, a draft was instituted, and thousands of American men, mostly the ones that weren't rich enough to get out of it, began pouring into Army camps.  The Army took one look at these guys and got very unhappy. More than half of them were suffering from rickets, pellagra, beriberi and other diseases of nutritional deficiency.  What's more, a lot of them were stunted, having never reached their full height or breadth of shoulders because, simply put, they hadn't had enough to eat for most of their lives. (They also, by and large, had bad teeth. But that's another blog post.) 

The Army complained to the government.  The government passed some laws. After the war, a number of food products sold in the U.S. were enriched; that is to say, they had nutrients added that weren't there before.  Guess what, milk does not naturally have vitamin A and D.  They added that when they put it into cartons.  Wheat does not naturally contain vitamin B complex in it either.  We added thiamin, riboflavin, niacin, and folic acid.  And it worked.  Nutritional deficiency diseases almost disappeared overnight.  Other countries passed similar laws. Between that and significant developments in farming, more babies survived infancy.  Life spans shot up, from an average of 47 years in 1900 to 63 years by 1940.  We invented vaccines for more diseases.  We made better drugs, including antibiotics. Life got a lot better.  

We still haven't completely solved the problem of getting everyone enough to eat. There are still famines, and people still sometimes starve to death.  But by and large, most modern famines are political. It's not that there isn't enough food, it's that we can't, or won't, get it to the people who need it.  Either we can't pry it loose from the people who have it or someone is preventing us from getting it where it needs to go.  But the last hundred or so years has still been a significant reversal in our relationship to food.  

Which is, of course, why we have an "epidemic" of fat people.

Remember that 2.5 million or so years where food was scarce?  Humans who, by some genetic twist of fate, were good at surviving famines were more likely to live long enough to reproduce, and their kids were also good at surviving famines. Do this generation after generation for 2.5 million years and you end up with a bunch of humans who are really good at surviving famines.  Any time we lose significant weight, we quickly gain it back as soon as there's available food again.  By doing that, we're better prepared for next famine, and the next, and the one after that.  Having extra weight is like a bank account for times of unemployment.

In short, we have evolved to gain weight, not lose it.  We did this over 2.5 million years. 100 years of food security are a drop in the evolutionary bucket.

Then, during and after World War I, we suddenly had abundant food for the first time.  Couple that with the improvements in technology and labor saving devices, and the invention of cars and other forms of transportation.  What you get is a lot more food and a lot less energy being expended through exercise, ie, labor. People began to gain weight.  Not just fat people but everybody.  We also got taller.  The average American man is 5' 9" and weighs 200 pounds. In 1900, American men stood an average of 5'5" and weighed about 140 pounds.

By and large, we don't have famines anymore, but human beings still lose a significant amount of body weight (say, 10% or more) with great frequency. It's called dieting. What happens, when a modern human loses lots of body weight?  Well, the same thing that used to happen before we were modern humans. Studies show that regardless of the method of weight loss, 80 to 90% of patients gain it all back, and usually more, in about 3 years' time.  That's evolution in action, baby.

"But my Aunt Frieda lost 90 pounds and kept it off." Sure. Aunt Friedas exist. But we cannot all be Aunt Frieda. In fact, only about 10-20% of us can. That makes about 80% of the population not Aunt Frieda. When the system us not working for 80% of the participants, the problem is not the participants. It's the system. 

(By the way, Americans spend about 70 billion--with a b--dollars on weight loss programs and devices every year. There are a lot of people out there heavily invested in convincing you that you, too, can be Aunt Frieda. The problem is, theyre not interested in your health. They want your money, honey.)

Since our culture values thinness to a degree that's pathological, people lose and gain weight over and over again. It's called weight cycling, and it turns out that weight cycling is really bad for you in the long term, even if it's good at keeping you alive long enough to reproduce.  (Evolution is all about reproduction.  The goal is to pass on your DNA.  Evolution does not care if you live a long and healthy life.  Once you've had your babies, you're a dead end.) 

Look. If evolution wasn't real, fat people could go on one diet once, lose the weight, and be fine thereafter. But that's not what happens. In fact, people who lose weight, then gain it back (ie, basically everybody) often find that they have to eat fewer calories to keep from gaining even more weight. A man who can eat, say, 2000 calories a day at 180 pounds, can only eat 1800 calories a day to maintain the same 180 pounds after he loses 25 pounds and gains them back. 

What's more, weight cycling causes bone loss and osteoporosis, muscle loss, diabetes and heart damage. It probably also causes mental health issues like depression and anxiety.  It is said, and it is true, that fat people get more heart disease than skinny people. But, what's causing the heart disease? Is it being fat? Or is it all the damage done to your heart and your organs because you've lost and gained weight so many times? 

The way to find out, of course, would be to get a bunch of fat people who have never tried to lose weight and follow them around for 40 years to see what their incidence of heart disease looks like. The trouble is, there are no such people.

This Didn't Happen. To Me.

So I’ve been really, really tired for quite a while.  Part of that was because I was having some medical treatment that just makes you tired; I mean, that is a known side effect.  Also, things have been insane at my office.  I won’t go into the whole deal, but the short version is, we had to call 1300 people on the phone, get their consent to settle, verify their demographic info, and stuff like that, all on a very tight timetable.  Which took a lot of hours. But besides all that, it turns out I’ve been sick (!). 

I had emergency dental surgery about 2 months ago.  The dentist took a bunch of X rays, as they do.  After the procedure he told me that my left maxillary sinus looked “weird.”  “I’m not a doctor,” he said, “but I think you should have one check it out.” So I called my Regular Doc.  She said that if somebody needed to poke around with an endoscope in my sinuses, it should probably be an ENT and not her.

She gave me some names and I called around for an appointment.  There was like a 6 week wait for a new patient appointment. In the meantime, of course, I Googled my symptoms, which I kind of hadn’t noticed up until that point. They could have meant a number of things, among them nasopharyngeal carcinoma. (This is the bad side of Dr. Google.  The good side, of course, is that you’ll know the terminology when you get in there.)  A friend of mine died of this. Obviously I didn’t want to have it.

Well, good news.  I don’t.  I have a garden variety sinus infection, which I’ve apparently had for a year or more (!).  I had sinus surgery in 1997 after years of chronic sinus infections, and this is not at all what used to happen. No pain. No fever. Not going to bed for a week and wanting someone to shoot me.  So you can forgive me for not knowing about it.  Anyway, I’m being treated now, and I should start to feel less tired. Also, I’m planning to sleep all day Saturday.  You have been warned.

Speaking of sleep:  I had probably the strangest dream of my entire life a couple of nights ago.  Most particularly, it was strange because it wasn’t strange at all.  When I'm dreaming, about 90% of the time there’s a part of my brain that kind of stays awake and makes pithy observations about what’s going on, especially when things get weird.  That didn’t happen this time around.  What’s more, there weren’t any leaps of logic or brightly colored scenery like there usually are in dreams.  It was all just straight up narrative.  Kind of like it was actually happening, though it didn’t happen.  To me.  That I’m aware of.

So I'm a 28 year old male. I'm in college. I go to a literature class and I'm late because of work. The professor makes a joke about it and everyone laughs; I kind of wave abashedly and sit down. This is one of those dreams where everybody is speaking another language (Spanish, in this case) but it's fine. When class is over I head to the bookstore to pick up some pens and notepads and grab a bite to eat from a little campus restaurant.  Then I hop on my bicycle to ride home.  It's a 1970s era Schwinn, dark green, looks pretty new. Groovy baskets on the back, too.

If I had to guess I'd say I live in Chile or Argentina in a medium-sized city in the early 1970s. I have a modest house in an older neighborhood. My girls run out to meet me.  They look to be 4 and 6. I walk them in while they tell me stories about their day. We talk for a while and then they head off to bed because it's late.  

I sit down on the couch with my wife. Her name is Tonna. I tell her that going to school and working is really hard, and it was a lot easier when I was a younger man.  She pats me on the shoulder and reminds me I'm going to graduate soon, that I'm doing this so my girls can have a better life.  And she knows I can do it.  Some smooching happens.  I fall asleep on the couch.

I wake up because there are men in my house.  I can hear them but I can't see because there something over my head. I hear somebody crying and I think it's one of my girls.  I start freaking out and two or three guys grab me and drag me out down the front steps.

Next thing, we're in a boat.  We're hitting all these waves. Chop. Chop. Chop.  I must be right next to the outboard motor because it's so loud.  It's the only thing I can hear.  This seems to go on for a long time.  I probably pass out again. 

Then I can see a little.  It's still very dark but there's some pink and orange streaks starting to appear in part of the sky.  The boat is a small speedboat, nothing fancy.  We're in the middle of a broad river, probably half a mile across.  The boat has stopped.  There are bright lights in the back and somebody's pounding on the motor with a wrench, swearing.  I glance at the sky and realize it's going to be light soon.  If I'm going to escape, now's the time.

I throw myself over the side of the boat.  The second I hit the water I realize I have a problem.  I can't swim because my hands are tied.  I can't get my head out of the water.  I'm drowning.  I hold my breath as long as I can.  Finally I let out the breath and gasp in water.  I can feel my lungs filling up.  I'm definitely going to die.

Someone lands in the water next to me.  Somebody's grabbing me from the boat and they manage to get a rope around my chest.  (Interruption here for one of those odd observations.  It didn't really feel like a rope.  It felt like a silver chain.  I mention this because people who have had out of body experiences sometimes talk about being tethered to their unconscious bodies by a silver chain.  I'm just saying.  It was odd.)  Two or three guys on the boat and the guy in the water are able to get me back in the boat.   

Somebody pounds all the water out of my lungs just as everything starts going all grey and swimmy.  I manage to get a couple of breaths and maybe I'm not going to die after all.  One of the men is yelling my name. ("Fernando!!" Because of course.  The old ABBA song.)  And I recognize him.  It's my cousin, Miguel.  I start yelling.  "Leave Miguel alone! Don't hurt Miguel!" 

And then I wake up(!).

Only I'm not awake.  I mean, I am awake, because I'm trying to get out of my blanket and pry the plantar fasciitis thingy off my foot so I can stand up. But the dream is still going on. I was looking at the group of men in the boat.  I was looking down the hallway.  I could hear somebody screaming. I could hear a cat meowing.  And I was literally halfway down the hall before I was really all the way back.  And one of my cats was sniffing around my ankles and meowing like where have you been?

I don't know what to make of this.  I don't have dreams like that.  I dream fragmented chunks of stuff with an early 80s dance mix soundtrack.  And sex.  I dream a lot about sex.  I'd almost think past life experience or something, except I was alive in the early 1970s.  I mean, unless time works differently over there.  Or it could have been a 1960s Schwinn and I just couldn't tell the difference.  But I always thought last time around I was a Russian cosmonaut who died in some horrible training accident that they never told the outside world about.  No particular reason, though, except for really wanting to be an astronaut when I was a young kid.

Or, I guess it is possible that my own pet theory about reincarnation, which differs somewhat from the Buddhist theory, might actually be correct.  I could write books about this, but basically. the re are two Buddhist ideas that are totally in conflict with each other where reincarnation is concerned.  There's this idea that we've all lived many times, and it would stand to reason that some of us remember some of that. (I do.) Then there's this idea that there is no ego, no "I".  This notion that we exist as independent beings is just an illusion.  

What I think, briefly, is that we're all the same being, parts of a whole.  When we die, we go back into the soup, and when we're born, some of the soup gets ladled into our craniums and becomes our consciousness.  That's why more than one person remembers being Napoleon, say.  Because we've all been everybody, and Napoleon had a pretty memorable life, so it stands to reason that a lot of us would remember parts of it. There was an episode of Star Trek The Next Generation that explained this pretty well, though I hated it because Q was in it and I hate Q. 

Well, anyway.  Times like this I wish I had a night vision security camera in my room to see if I was actually there the whole night or if I disappeared for a couple of hours in the middle.  Of course, there’s a very good reason why I don’t have a night vision security camera in my room, besides all the other obvious ones.  I am not at all sensitive to paranormal stuff. Not at all. I'm not saying there aren't ghosts out there, because lots of together people I know have encountered them, but I have not. Cameras, however, record what they see.  And I know, I just know that if I had a night vision security camera in my room, it would absolutely pick up a black, menacing, shadowy looking figure coming out of my closet and looming over me in my sleep.  If that happened, of course I’d have to burn the house down and flee with all my possessions and wife and cats in a cardboard box. 

Well, maybe more than one cardboard box.

Unminted Teeth and Medical Gaslighting

Warning:  This is a long blog post.  I didn't mean it to be long, it just kind of got away from me.

I was bemoaning things dental with a co-worker the other day.  I have a lot of things dental; at last count, eight crowns, five root canals, more fillings than you can shake a stick at, one implant, and a bunch of other stuff I forgot.  Partially a bad round of DNA, I think, and partially a bunch of bad dental work long ago that’s causing problems now.  I can’t go in there for a simple cleaning without them finding something else they need to fix.  I have pricey teeth.  (Hey, on the plus side, if they ever find my dead body someplace without ID, they’ll be able to identify me with lots and lots of dental records.) 

 

Anyway, my coworker has a neurodivergent kiddo who is about 5.  She said it had been like World War III getting him to brush his teeth until she discovered mint-free toothpaste.  Apparently, it wasn’t brushing his teeth, but the mint toothpaste that was bothering him.  And not the taste, but the tingly feeling.  (A lot of neurodivergent kids have issues with textures and mouth sensations, which is why they tend to be picky eaters.)

At this point I reached across the desk, grabbed her arm, and said, “Wait a minute.  There’s MINT-FREE TOOTHPASTE?!”  She assured me that not only did it exist, but that there’s also mint-free fluoride rinse.  And I’m like Oh. My. God.  I’m not neurodivergent (unless I am, of course, but that’s for another blog post) but I have Always. Hated. Mint.  For that same reason.  I don’t even like Girl Scout cookies because it feels like a bunch of ants crawling around in my mouth.  I have disliked brushing my teeth for most of the 54 years I’ve been on this planet and now I find out there’s been mint-free toothpaste ALL THIS TIME?!  Why didn’t anybody TELL me?!

 

Well, somebody did, finally.  You can get the toothpaste here (flavor free) or here (fun flavors for kids).  ACT makes a cinnamon, a grape and a bubble gum fluoride rinse, available from Target, Amazon, Wal-mart and probably most drug stores.  You can also get kid-friendly berry, melon or bubble gum flavors from these guys.  So there you go.  You’re welcome.  

So a bunch of you already know that I have bipolar disorder.  If you didn't know, well, now you do.  I do all the right stuff; I see my doc on the regular, I take copious quantities of meds, I take good care of myself (mostly), and I don't drink alcohol.  And for some years, like at least 5 or 6, I've been in remission, meaning few if any symptoms.  Which was pretty cool.

Then this spring, kind of suddenly, I started having symptoms again.  I mean, I had to stop taking one of my meds for various reasons, and we went on a nice vacation, and I was in a car accident, and it was unusually warm, and probably none of that had anything to do with it.  It's just The Nature of the Beast.  So for the past four or five weeks I've been getting some Medical Treatment.  I think my last day is next Friday.  And it's been okay, for the most part.  Really, the worst part about it has been having to drag myself across town every morning in rush hour traffic.  So I can’t complain (but sometimes I still do).  

Part of the deal is that you’re supposed to go see a psychologist or a counselor, because there are certain side effects that can make you hard to live with.  I've had a lot of vague, free-floating anger.  I've also been really tired, and the two probably feed on each other.  So after my doc nagged me for the better part of a week, I made an appointment with a guy I saw some years back when I needed some help with anger management.  (Stop laughing.  Even Buddhists sometimes need anger management.)  He seemed like a decent sort, a bit intellectual maybe.  Of course, things change.  People change.  Haircuts change.  Everything changes, nothing stays the same. 

 So I’m a woman.  I live in 21^st century America. I’ve had my share of being brushed aside by members of the medical profession because whatever I reported was either not believable or not interesting enough to bother with.  You men may not have any idea what I'm talking about, but I'll bet all the ladies are nodding.  Every pregnant woman feels that way!  That pain is normal!  Endometriosis doesn't exist!  Come back when you're really sick!  That sort of thing.  When I was younger I had sinus infections every four months for ten years  (it's allergies!  Get some shots!  Take some Sudafed and you'll be fine!).  I finally saw a surgeon who sent me for a CT scan.  When he saw the results he told me, “You don’t have ethmoid sinuses.  Common birth defect.  I bet you get sick a lot.  We have a surgery that can fix this.” 

 

Lest you think that this is a one-time thing and not a systemic problem, ponder this:  Women have a 50% higher chance than men of receiving the wrong initial diagnosis following a heart attack and are more than twice as likely to die. Of patients reporting severe pain in emergency departments, women are less likely to be given pain medication than men (60% vs. 67%) and are also less likely to receive opiates, the most effective pain medication (45% vs. 56%). Endometriosis, a disease that affects only women, takes an average of seven years to diagnose.  Women are also diagnosed with cancer 2.5 years later than men and diagnosed with diabetes 4.5 years later than men.  Only 8% of girls with autism are diagnosed before age 6 versus 25% of boys.  The average age for a boy to be diagnosed with ADHD is 7 years; for girls, 30 to 40 years.

 

All the same, I have never had an experience with any kind of medical professional that was anything at all like what happened with this guy.  I started keeping a list of bullet points of the stuff he said to me because it was getting so weird.  The parentheses are the things I researched after the fact, plus a bunch of snarky comments that I threw in because, well, that's what I do.  

 

·       Bipolar disorder, especially childhood bipolar disorder, is incredibly rare, so “you probably don’t have it.” (Some 2.8% of the population has bipolar disorder.  That’s 9,800,000 people in the U.S., which is not exactly “rare.”  About 76% of people with bipolar disorder report that their symptoms started when they were children.  Also, clinicians don’t diagnose people by their odds of having something or not.)

·       The serotonin re-uptake theory of psychiatric illness has been “totally disproven.”  (Well, no. New evidence says that serotonin re-uptake may not be as important as once thought, but all that means is that we don’t really know why the meds work, and we didn’t know that before, either.  You don’t need a theory to prove that a medication works.  You need a theory to get funding so you can do research so you can get evidence that a medication works.)

·       “Most” of his patients stop taking all psychiatric medications and “do just fine”  after learning some “emotional and attention regulation skills.” (Okay, so “most” of your patients probably didn’t need them in the first place.  Congratulations?)

·       It’s completely untrue that the brain scans of people with bipolar disorder are different from the brain scans of neurotypical people.  (Uh, no. fMRIs show significant processing differences in key areas of bipolar brains compared to neurotypical brains.  That doesn’t mean there’s a brain scan that can diagnose bipolar disorder, but then there’s no brain scan for pain, either, and we medicate that.  How do we diagnose pain?  Oh right, it exists when the patient has symptoms and says it does.  Hmm.)

·       “The symptoms you’re reporting are not depression but anhedonia, or a loss of interest in formerly interesting things.  You’re not reporting your symptoms accurately.  If you’re not sad, you’re not depressed.”  (Let’s see, what’s the #1 most reported symptom of depression? I’ll give you three guesses.) 

·       “Well, I wouldn’t want to talk you out of thinking you have bipolar disorder, especially since you wear your pathology like a badge of achievement.”

Dude.  I was forty when I was diagnosed.  I entered the medico-industrial complex when I was five, so that’s thirty-five years of people, including numerous docs, telling me “There’s nothing wrong with you.  You’re just lazy, inattentive, moody, hot-tempered, too sensitive, not a hard worker, stupid, ungrateful, overexcitable, hysterical, self absorbed…”

 

Male or female, I hope this sort of thing has never happened to you.   So you know, though, when you keep reporting what you experience and people keep telling you that’s not possible and/or you must be hysterical and/or even if that is what’s really happening, it’s not important anyway; and then one day you stumble on concrete proof that what you’ve been saying all along is actually happening, and it’s not only important, it’s critical;  well, that’s like – that’s like being the guy who finds a Bigfoot in the woods and gets it to follow him back to the middle of town for a press conference and a Q & A with a panel of primate scientists.  

Yeah, not too many people get told “You have cancer” and break out a bottle of non-alcoholic sparkling apple cider in celebration, but plenty of people with neurological conditions get told “You have bipolar disorder / Asperger’s / ADHD / Tourette’s” and reach for that bottle right away.  Because they’ve known there was something going on for years—years—and they couldn’t convince anyone else, and that whole time they could have been taking medication that would have helped with their symptoms and made their lives much better.  Imagine losing years because you can’t make friends, keep up with your schoolwork, cope, get your shit together, interact in an appropriate manner with other human beings, keep a job, or even get out of bed, and then finding out “Oh, we could have treated this all along.” 

And then some guy who's supposed to be a professional comes along and tells you that you're married to your diagnosis.  Oh, I forgot to mention he said that.  That I'm married to my diagnosis.  

 

I had another appointment scheduled, but I texted him and canceled it.  He texted me back and said something like, “Looking forward to hearing from you to reschedule.”  To which I started to reply, “Sure, next time I feel like being dismissed, gaslighted and told I’m hysterical, my badge of achievement and I will be right back in your office.” Joan wouldn’t let me send it though.  Something about not starting wars when a well-placed Yelp review will do.  

Anyway, that's what happened.  Fun times.  Now I'm going to brush my teeth with mint-free toothpaste and go the hell to bed.  

10,000 Pundits

So I just found out that the “10,000 steps” thing is totally bogus.  And I am annoyed.

You probably know what I’m talking about.  That thing a few years ago where you were supposed to take 10,000 steps every day to stay at the peak of cardiovascular health.  It was on TV and in newspapers.  People debated the pros and cons.  There were whole-ass Web sites where people could log their number of steps.  I have heard, and still hear, both doctors and co-workers talking about the need to “get their steps in.”  And pedometers, even ridiculously expensive ones, still sell like wildfire. 

I assumed, as probably most of us did, that this came out of legitimate science.  That somebody did a bunch of studies and took the results to some exercise science geeks and they broke all the evidence down into the optimum number of minutes that a healthy human being should be physically active every day and translated that into walking, and it was maybe 9,883 steps or 10,211 steps or whatever, and they settled on 10,000 because it was a nice round number. 

Nope.  In fact:  A Japanese pedometer company wanted to sell pedometers in China.  They called their product Manpo-kei, which translates to “10,000 steps meter.”  Reason:  The character for 10,000, 万, sort of looks like a person walking.  Also, in Mandarin Chinese, the word for 10,000 means “a whole bunch” or “an awful lot.”  So it wasn’t exercise science.  It was just a marketing ploy.

Hey, walking is good for you.  Nobody’s arguing about that.  But the totality of the 10,000 steps thing, and how it came to dominate fitness chatter for quite some time (and still today), really disturbs me.  We all just decided this was true.  It became gospel.  And I gotta wonder what other accepted truths aren’t true.  Just in the last few days I’ve found out that, contrary to “what I’ve heard,” health insurance companies won’t really refuse to pay for a hospitalization if you sign out against medical advice.  That the European union won’t really require U.S. travelers to have a visa starting in 2024.  Oh, and that J. Robert Oppenheimer’s full name wasn’t really “John Jacob Oppenheimer Schmidt.”  Imagine my disappointment.

Which brings me to something else that’s really been bothering me lately.  (I’ll come back to the 10,000 steps thing.)  This question that should be taken out of the English language, and any other language it’s been translated into: “Why don't you just...”

I dunno about you, but I hear this one a lot.  Usually from someone who has no idea what’s actually going on with a person and who feels the need to state a (to them) screamingly obvious course of action that they think someone should have taken.  Of course, if it’s screamingly obvious and the person hasn’t done it, there’s a good reason, and the reason isn’t “this person is an idiot”.  More likely, the screamingly obvious course of action is impossible. 

Examples abound:

·       To a domestic violence victim--“Why don’t you just leave?” 

·       To a woman undergoing grueling fertility treatments--“Why don’t you just adopt?” 

·       To a fat person, for basically any reason but also no reason whatsoever--“Why don’t you just lose weight?” 

·       To a black gay trans person living in Texas --“Why don’t you just move?”

People, don’t ask this question.  For one thing, you’re going to feel pretty dumb when you hear the answer, because the answer’s just as screamingly obvious as whatever you think the person should be doing in the first place. 

·       The domestic violence victim--“Because he trashed my car and got me fired from my job, and he broke my cell phone, and he says if I try to leave he’ll kill me, and he has a gun, and the police do nothing.” 

·       The woman undergoing the fertility treatments--“Because I’ve had cancer (or a criminal history or I’m single or I’m gay) and no adoption agency will come anywhere near me.”

·       The fat person--“Gee willikers, I live in America in the 21^st century and, like, I never heard of losing weight, I never even knew that was an option, great golly goshes, it’s not like dieting my whole life led me to the weight I’m at now, or anything.”

·       The black gay trans person in Texas--“Sure, I’ll just quit my job, sell my house (if I can), find a new job in a strange place where I know no one, buy another house (if I can), find new doctors to treat my various medical conditions, qualify for new health insurance (if I can), take my kid out of school and away from his/her friends, pull my spouse away from his/her very good career, pack up everything I own, leave behind family members and friends of my own and maybe elderly parents who need care, and just haul ass across the country.  No problem.”

Look.  If someone wants to tell you the issues they’re dealing with, they’ll tell you.  If they don’t, they probably have reasons.  Such as, you’re the kind of person to dismiss someone else’s genuine experience of life by saying, “Why don’t you just…”.  Okay, great, you get to feel superior for five seconds.  Congratulations.  Meanwhile you’ve effectively shuttered any actual connection with that person, maybe forever.  Please don’t do this.  People have enough going on without being minimized, waved aside, and talked to like they’re stupid.

Speaking of being talked to like we’re stupid:  Wouldn’t it be nice if every single thing that comes out of the news media (which now includes scads of independent Web sites, YouTube and TikTok channels, blogs, podcasts, Facebook posts, tweets and tweet equivalents, and tons of other things that 24/7 churn out weird amalgams of wish, opinion and science fiction that really aren’t, and never will be, “news”) wouldn’t immediately be taken as gospel truth and splattered all over every TV screen by every pundit who ever lived?  It’s not really fair to expect people to be skeptical 24/7.  Sure, some of us are (I, for example, am famously skeptical) but why should we have to be?  Why are we being lied to, all the time, about everything, especially in the area of health, fitness and nutrition?  (Remember the four food groups?  Margarine is better for you than butter?  Breakfast is the most important meal of the day?)  

Media needs to do better.  Education needs to do better.  Science needs to do better, too.  Just because it involves weird hard-to-spell chemicals and body parts and physiological processes doesn’t mean it can’t be explained in a clear, understandable way.  Most people aren’t stupid.  (They may act like it sometimes, but that’s another blog post.)  We can grasp this stuff. We are more than sound bites. We can handle ambiguities. We can even handle maybes.  And we can accept that sometimes they don’t have an answer for us yet.  So stop force-feeding us pedometers.  

And stop asking, “Why don’t you just…”.  Or else I’ll tell you.  You have been warned.   

Your Vote, And Health Care, And Why It Matters.

Maybe I ought to update this thing more than once a year.  Like every week, or something.  I keep meaning to do that and then this thing called Life gets in the way.  Something about working two jobs, maintaining a household, keeping a couple of cats happy and, oh yeah, continuing to be sane.  It's not like it gets any easier as you get older, either,  Though, to an extent, as you age you quit giving a fuck about what everyone thinks, which does make it easier, kind of.

Anyway.  I overheard some ladies at the office talking about how expensive health care is.  One of them just had a baby and I think their pay out of pocket portion of a normal delivery was about $4,000.00, if I heard correctly.  The health insurance we have at work (I don't have it because I'm on Joan's insurance, and yes, it's more expensive that way but it's also MUCH BETTER) has a $6,000 deductible so they literally had to have that in hand in order to give birth.  Or, I guess if they didn't have it in hand, the hospital would bill them every month until the kid is five.  

The other lady had just had some emergency dental procedure (I had one myself not long ago) and dental insurance didn't pay for hardly any of it.  She was pretty surprised because she figured if we had dental insurance, there would just be a copay or something.  I explained that all dental insurance sucks.  Some sucks more than others, but none of it is very good.  And when you think about it, it's kind of weird that we even have dental insurance, because teeth are in your mouth, and your mouth is a part of your body, so why isn't it covered by health insurance?  And we pondered that, and then I told them something I don't think they knew.  I told them, "Well, you know what you can do to make it better, right?  Don't vote for Republicans anymore."  

I mean.  The looks.  The wide eyes.  The you've-got-to-be-kidding facial expressions.

People, you may think Republicans are good for the economy (they're not) but they are not good for health care.  You may think they're good for defense (they're not good for that either) but they're not good for health care.  They may be good for warm, fuzzy American values (if you're straight, white, rich, Christian and only care about yourself) but they are not good for health care. They are not good for the cost of health care, they are not good for your ability to access health care, and they are not good for your ability to pay for health care.  

Consider:

• The Affordable Care Act (Obamacare), which allowed the 210 million Americans with pre-existing conditions to buy health insurance without going through an employer for the first time, was passed without a single Republican vote.  Republicans have voted 70 times as of July 2017 to repeal it. There have also been at least 28 lawsuits to declare the ACA unconstitutional on the basis of "state sovereignty." 
• Most abortions are banned in 14 states with Republican-led legislatures.  No states with Democrat-led legislatures have abortion bans. 
• 41 states and the District of Columbia expanded Medicaid, the state health insurance program for people who can't afford health insurance.  10 states did not.  The 10 states are Wyoming, Kansas, Texas, Wisconsin, Tennessee, Mississippi, Alabama, Georgia, South Carolina and Florida, all states with Republican-led legislatures.
• When President Biden announced that he would push for Medicare to negotiate drug prices with suppliers, therefore bringing down prices for 61 million elderly and disabled Americans, a group of Republican senators led the drive to stop him.
• The five most expensive states to get health care are South Dakota, Louisiana, West Virginia, Florida and Wyoming, all states with Republican-led legislatures.  The top 5 states where health care is the least expensive are Michigan, Washington, Nevada, Hawaii and New Mexico, all states with Democratic-led legislatures.
• The five states with the highest amount of medical debt per capita are Mississippi, Arkansas, West Virginia, Indiana and South Carolina, all states with Republican-led legislatures.  The five states with the lowest amount of medica debt per capita are Hawaii, Minnesota, California, Massachusetts and Connecticut, all states with Democratic-led legislatures

I could go on, but you get the idea.  If you're at all worried about the cost of healthcare, your ability to access healthcare, or how you or your family members are going to pay for healthcare, you might want to think long and seriously before you vote for a Republican again.  Or if you do, and you suddenly find that you can't get or pay for health care, you have been warned.  Happy 4th of July!