Medical Examiner 6-20-25

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You have probably never heard of Frederic Tudor, but without doubt you have personally benefited from the unique vision and incredible persistence of this New England businessman of the 1800s. He became known as The Ice King at a time when electricity and freezers were still faraway inventions.

As our annual stretch of blazing summer temperatures arrive, let’s raise an ice cold glass of something to Frederic Tudor.

The principles of business at their simplest level involve identifying a need and then filling it. People need shoes; let’s manufacture and sell them. Pretty basic stuff. It is another matter entirely to do that in a world where no one currently wears shoes.

Frederic Tudor was that kind of visionary: he saw a need - correction - he imagined a need — a need for ice (and he did so on a hot summer day). It was a need which no one was serving, and for good reason: the need seemed impossible to serve. Despite that, Tudor proceeded to invent the industry, and did so in the face of daunting odds and countless setbacks. Yet he managed to succeed, and you and I are still reaping the benefits. It’s a cool story, one in which Augusta plays a cameo role.

The cold facts

Tudor was born in Boston in September of 1783. At a picnic during the summer of his twenty-second year, Tudor thought of how much people sweltering in the Deep South and the faraway tropics would enjoy the cold drinks and ice cream he and his friends were savoring that day.

In the middle of a brain freeze, a brainstorm came to him: when winter comes, why not harvest ice from frozen ponds dotting the countryside and ship it to the hot spots of the world?

This was not a new idea: the wealthy and powerful of ancient civilizations like Greece and

Tudor had something else in mind: ice for everyman. More customers meant more profit.

There was just one problem. Well, there were many, actually. For starters, the customers he initially targeted lived thousands of miles away in overheated climates. And ice has an annoying tendency to melt. It’s extremely heavy. And slippery.

Minor details, said Tudor. His scheme was thought to be so hare-brained that no captain would agree to haul his cargo to the Caribbean

and set sail out of Boston on February 10, 1806 with a cargo of 80 tons of ice.

Sailing in cold weather for much of the way, the ice arrived on a warm day in Martinique in perfect condition, but nobody wanted it.

He had no means to store the ice there (although by 1827 he had an icehouse in Augusta and another one in Savannah; Tudor hired Mr. John Beamis to manage the Augusta icehouse for a salary of eighty dollars a month), so his unsold inventory soon melted and any anticipated profits were, well, on ice.

Undeterred (a word that should be on Tudor’s tombstone), he began to plan for a second shipment the following winter, and he expanded his marketing efforts to sell ice to physicians for them to use to soothe patients suffering from yellow fever.

In 1807 he set sail for Havana, this time with 240 tons of ice, but again Tudor was unable to generate enough sales to turn a profit.

Several years of further setbacks followed: the Embargo Act of 1807, the War of 1812, bankruptcy, depression, swindling partners, debtors prison, etc.

By 1825, Tudor was ready to give ice farming another shot — not that he ever really stopped. A partner had developed a better way to cut ice, and Tudor had discovered improved ways to insulate ice in shipment. Sawdust replaced hay. High tech, indeed.

A question: What would you do if you had failed to generate a market for a new product, and had lost your shirt several times over while shipping to customers who were relatively nearby?

If you answered “ship a load of ice 16,000 miles from Boston to Calcutta,” you win. It took four months to get from Boston to Calcutta, but tightly packed blocks and the insulating properties of sawdust meant minimal melting.

Rome sent their servants up into the mountains to harvest ice.
Frederic Tudor

• Irritability

• Impairment in job performance or ability to enjoy social situations

Physical symptoms:

• Problems falling or staying asleep

• Fatigue

• Muscle aches and/or tension

• Unexplained pains

• Headaches

• Twitchiness/trembling

• Overactive startle reflex

• Nervousness

• Excessive sweating

• Diarrhea

• Nausea

• Irritable Bowel Syndrome

• Stomachaches

• Cold hands and/or feet

• Issues with swallowing

• Feeling lightheaded or out of breath

• Frequent trips to the restroom

What Causes Generalized Anxiety Disorder?

Genetics can play a big factor in the development of an anxiety disorder. Research currently shows that 25% to 33% of people with GAD have a parent who also has it.

Additional biological factors, such as disruption of neurotransmitters in the brain, can cause feelings of anxiety and/or depression. In addition, several parts of the brain are involved in fear or anxiety responses, such as the amygdala. The amygdala usually helps control our strong emotional reactions, but it can cause heightened or abnormal responses due to bad or traumatic past experiences that the brain recalls and responds to in new situations, causing an unnecessary anxiety response at times.

Medical conditions, such as diabetes or heart disease, can also increase anxiety responses. The presence of ongoing stress, environmental factors like physical abuse or past trauma, and substance use disorders can all contribute to the ongoing and increased effects of anxiety.

Treatment and Management

Treatment for GAD focuses on addressing the underlying cause and managing symptoms.

According to the National Institutes of Health, a low amount of serotonin system activity and an increased amount of noradrenergic system activity can worsen anxiety, so medical professionals often recommend selective serotonin reuptake inhibitors (SSRIs) and serotonin-norepinephrine reuptake inhibitors (SNRIs) as their first choice for the treatment of GAD.

Physical symptoms can often be more distressing and prevalent in patients with GAD, which makes diagnosis more challenging. However,

tests like glucose and toxicology screening, thyroid function, and other tests can help rule out physical and medical issues. Anxiety screening tools can also help monitor and diagnose symptoms of anxiety.

Cognitive Behavioral Therapy (CBT) and medications are common treatments for GAD. CBT techniques are generally taught by a licensed mental health professional and include teaching patients why they are thinking and feeling the way they do, and learning how to change those thought patterns.

Commonly prescribed SSRIs and SNRIs for anxiety include: escitalopram (Lexapro), paroxetine (Paxil, Pexeva), venlafaxine (Effexor XR), and duloxetine (Cymbalta).

Occasionally, antipsychotics are prescribed, especially for patients who are having behavioral issues related to their anxiety. These can include benzodiazepines such as Clonazepam and Diazepam, which are long-lasting and used when a short-term treatment or immediate reduction of symptoms is needed. Patients with substance use disorders or a history of alcoholism are not considered good candidates for these treatments, due to concerns of dependence or misuse. Buspirone can be a good alternative in this situation, as it is a nonbenzodiazepine, and does not cause dependency.

Triggers for anxiety should also be discussed with a mental health professional, and can often be decreased by improving sleep habits, decreasing alcohol and caffeine intake, increasing water consumption, avoiding nicotine, and learning how to manage stress more effectively.

Prognosis

The prognosis of patients with GAD can often be described as guarded. This is because patients sometimes don’t continue with medication due to costs or side effects. The most important factors in decreasing symptoms of anxiety include medication compliance, implementing cognitive therapy skills, and stopping the use of caffeine or any other stimulants. When left untreated, anxiety disorders can lead to severe depression and substance use disorders, in an attempt to self-medicate. Suicide rates are also higher in patients with anxiety disorders, when left untreated.

Need Support?

IPS provides comprehensive behavioral health services including assessment, medication management, and therapy for individuals and families navigating complex mental health and neurological conditions. To schedule an appointment, call 706-204-1366 or visit integratedpsych.care.

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A CALORIE IS A CALORIE, RIGHT?

“A calorie is a calorie” is a tried and true maxim among dietitians. It means that, as far as our bodies are concerned, there is no difference between eating a tub of butter pecan at 4 pm, or at midnight. Ditto for weight control: you won’t gain more weight eating right before bedtime than you would hours earlier.

New research at Johns Hopkins University School of Medicine suggests that perhaps all calories are not created equal after all. Researchers found that eating a late dinner can negatively impact metabolism. Their study showed that eating a meal at 10 p.m. instead of 6 p.m. led to higher blood sugar spikes, slower fat breakdown, and increased cortisol levels, which could contribute to weight gain over time.

Interestingly, “early birds”—those who typically go to bed around 11 p.m.—experienced even greater metabolic disruptions, while “night owls”—who sleep much later—were barely affected. The findings suggest that meal timing plays a crucial role in metabolic health, and regularly eating late could increase the risk of obesity and metabolic syndrome.

Based on the study’s findings, here are a few simple dietary adjustments that can optimize metabolism and minimize the risks associated with late-night eating:

Eat Earlier – Try to eat your last meal around 6–7 p.m. rather than late at night, especially if you’re an early sleeper. This helps regulate blood sugar levels and supports better digestion before bedtime.

Hydrate Earlier – Drinking enough water earlier in the evening helps prevent hunger signals that might feel like latenight snack cravings.

Limit Late Night Carbs – If you must eat later, avoid large amounts of refined carbs, sugary foods, or high-fat meals, which can lead to higher blood sugar spikes.

Maintain a Consistent Eating Schedule – Sticking to regular mealtimes, rather than frequently shifting dinner later, can help optimize metabolism.

Prioritize Protein and Fiber – A well-balanced early dinner with lean protein (chicken, fish, tofu) and fiber-rich foods (vegetables, whole grains) can help keep blood sugar stable and prevent late-night cravings. +

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Who is this?

This man’s medical accomplishments are nothing short of amazing, almost unbelievable.

His name was Xavier Bichat, and he is often described as the father of modern histology. Let’s stop right there and analyze that statement.

Let’s begin with the definition of histology. In simple terms it’s the opposite of gross anatomy. Gross anatomy, in simple terms, is what any person could see in human anatomy with the untrained naked eye, big stuff like lungs, heart, brain, liver, pancreas, and so forth.

The opposite of gross anatomy could be called (and often is) microanatomy — the study of the microscopic structure of biological tissues.

It is this branch of medicine which Bichat, who lived and died in the late 1700s, pioneered.

His studies identified nearly two dozen individual types of elementary tissues which form various organs of the human body. Without even the most basic knowledge that medical scientists possess today — knowing, for instance, that the cells is the basic functional unit of living things — Bichat was among the first to realize the organs of the body are formed by unique differentiation of various types of tissue.

It was groundbreaking.

Amazingly, Bichat’s discoveries in microanatomy were made without a key ingredient: a microscope. For his own reasons, he distrusted them.

Bichat came to his skills honestly: his father was a physician and was Bichat’s first instructor. By 1793, his training resulted in an appointment to serve as a surgeon in the Army of the Alps, and from there to a position in Paris in 1794 under the noted physician Pierre-Joseph Desault. Desault viewed Bichat as such a genius that he took him into his home and mentored him as his adopted son.

The sudden death of Desault in 1795 was an unexpected blow to Bichat. He felt obliged to contribute to the support and welfare of Desault’s widow and orphaned son, which he did by completing the 4th volume of Desault’s Journal of Surgery

At the time, Bichat was all of 24 years old. That volume and his subsequent works “took both the French and English medical worlds by storm.” The following year he and several other colleagues founded a society for the advancement of medicine through collaboration and the exchange of scholarly information. He also published a concise digest of Desault’s many surgical doctrines into a single volume, a work that played a significant role in shaping medical thought and surgical techniques for a generation of doctors all over the world.

One of the most notable aspects of Bichat’s career was its tragic brevity. In July 1802 he evidently contracted typhoid fever. He initially felt faint, then complained of a violent headache before passing into a coma from which he never recovered. He was just 30 when he died. +

ADVENTURES IN

Middle Age

Sometimes it takes pushing yourself to your limits to convince yourself to change. I think this happened to me this past Saturday. It was the second Saturday in a row that I completely exhausted myself working outside. It wasn’t because I wanted to. It was my sense of duty. More importantly, it was my fear of Lorie (my wife) that made me do it. I’ll explain further.

We have been working for a few weeks to set up an above ground pool. We have done this before, a few times even, for ourselves and for others. However, we were younger then.

{ { Apparently she thought I was dead.

You might wonder why it has taken us so long, but the reason for that is how large this pool is. It has a diameter of 27 feet (8.23 meters), and is 54 inches (137 centimeters) deep. That is 19,400 gallons of water and that weighs over 80 tons. To put this in perspective, that is more than twice as much beer sold at an average NFL football game on an average game day. I’m not kidding. I checked. I found out that the Indianapolis Colts sell about $500,000 worth of beer on any given Sunday and they cost $7.50 each for a 16 ounce cup. That equals a little over one million ounces, or 8,300 gallons. At least I don’t have to pay $60 per gallon for the water.

Now that you have a sense of scale, you might understand the difficulty in getting the ground ready, including leveling it, making sure it is round, rolling out a huge and heavy roll of steel, fastening about 50 zillion screws, bolts and nuts, laying down mats, leveling sand, and doing all of this in the heat and dirt with an army of fire ants, and an air force of horse flies and mosquitoes continuously attacking. Not to mention trying to keep an eye on Freyja, our very special child who never saw a bug or dirt clod she wasn’t happy to eat or a fragile expensive item she wasn’t delighted to break. (You can read more about this in the Special Forces Parenting column to the right, on p. 5)

The previous weekend, I had a devil of a time repairing our driveway after the rash of heavy rains we had gotten for the two weeks prior had washed out an area large enough for me to consider putting up signs and inviting people to come see the newest canyon in the continental United States. I decided against it as I was afraid the national park service might notice and decide to “eminent domain” me out of my property. I spent over eight hours toiling on that, fighting cramps, pains, dehydration, and exhaustion, only to have the state road crews show up on Monday and pour new asphalt aprons to repair driveways they had previously scraped for the road repaving. The scraping that had, in fact, been the cause of the run-off that

gifted me a new wonder of the world. If I had just waited two days, the repairs would have been made for me and I wouldn’t have scared some good Samaritans who passed by and stopped to check on me. I wish I had caught their names, but as I was lying back in the seat of my truck at the road, with my eyes closed while I awaited on the liquids I had just imbibed to re-hydrate me and make my cramps stop, I heard a noise and opened my eyes to see a truck stopped in front of my truck on the road. A nice young woman in the passenger seat had her window down and looked concerned. I rolled my window down and she expressed that they had seen me working earlier and when they just passed, I had my eyes closed and I looked like I might be dead. She put it nicer, but that is what she meant. I thanked them for their kindness but said I was alright. There are still good people in the world and they are proof of that.

I have only told you of about half of the physical activity I had to do over the past two weekends, and if you know me, you know how lazy I am. So that is saying something. The odd thing is that, despite how much this hurt, I feel stronger. Almost like exercise is good for you or something. Who would have ever guessed? Oh, everyone, you say? Okay, maybe it was just me.

In any case, it has inspired me to be more active every weekend. Maybe not to the extreme degree of the past two weekends, but to be active, nonetheless.

I mentioned good people in the world earlier and I wanted to mention someone else. I got a lovely letter from a Mrs. Suzanne M. I won’t share the last name since I didn’t have time to ask permission, but her handwritten letter was very touching both to me and to my wife as she wrote to both of us about her and her husband’s similar experience to a past article. Thank you so much for your kind and considerate words, Suzanne. They meant a lot to us, and my wife even teared up a little. Not me though. No, I never cry. My eyes were just watering because they were dry.

I’m not crying, you’re crying!

If you haven’t yet, please take a gander at my new column, Special Forces Parenting. If my powers of seeing the future are any good, it should be on page 5. The first of these was in the previous issue. Until next time, enjoy the adventure and keep laughing.

J.B. Collum is a local novelist, humorist and columnist who wants to be Mark Twain when he grows up. He may be reached at johnbcollum@gmail.com

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from page 1

India became Tudor’s top market. Having ice readily available in its sweltering climate caused such a sensation that construction of an icehouse to receive future shipments began just three days after Tudor’s first shipment arrived.

But it wasn’t just Calcutta that eventually became a customer of Tudor ice. If you’ve read Thoreau’s On Walden Pond, you may recall this sentence: “The sweltering inhabitants of Charleston and New Orleans, of Madras and Bombay and Calcutta, drink at my well.”

You might have thought was allegorical, but it was actually a quite literal reference to Frederic Tudor and his shipments near and far around the globe, since Walden Pond was one of Tudor’s source ponds during the frozen winters.

As the idea of having ice available in hot summer months caught on, sweltering environments became bearable, even though The King of Cool, air conditioning inventor Willis Carrier (the Medical Examiner’s 2010 Man of the Year), was still just a twinkle in his father’s eye.

In fashionable restaurants in semi-tropical climes like Augusta, Savannah, Charleston and New Orleans, blocksof Tudor ice were used as centerpieces on tables, quietly cooling the air and making life a little more bearable when temperatures soared.

But in more practical ways, nearly everyone benefited from Tudor’s imagination and dogged persistence. Most of us with a year or two under our belts have heard the word icebox, even if we were born into an age of electricity in every home and a refrigerator/freezer in every kitchen.

An icebox was exactly what its name suggests: a box that held a block of ice to keep its contents cool. Iceboxes started out looking like fine cabinets, and over time changed to porcelain-coated steel and other easily cleaned surfaces suitable for working kitchens. Their real significance was in improving food storage and even nutrition. People didn’t have to shop for food each and every day; they didn’t have to discard food that wouldn’t stay fresh without refrigeration; they did n’t need to avoid buying good food that they knew would spoil before it could be eaten. And all of this innovation began more than a century before commercial cooling took the first steps of its infancy in the early 20th century.

By the time Frederic Tudor died in 1864 at age 80, his decades of failure and frustration were long forgotten. He died a millionaire, and the New England ice trade flourished until electric freezers became the norm in the 1930s.

Today, getting all the ice we need for first aid or cooler cooling is a simple matter of going to the store or maybe even just pushing a button on our refrigerator door.

But once upon a time, comfortable summertime living in Augusta and other hot spots around the globe enjoyed “the cool factor” courtesy of Frederic Tudor.

Editor’s note: This article originally appeared in the June 21, 2013 issue of the Medical Examiner.

TRYTHISDISH

HERB SALAD WITH BLUEBERRIES AND ALMONDS

Summer herbs and summer berries! I can’t think of a better reason to eat healthy!

Salad Base

• 1 scant cup mixed herbs; coarsely chopped (parsley, oregano, rosemary, mint, basil)

• 5 cups mixed greens

• 1 small cucumber, cut into bite size pieces

Vinaigrette

• 2 sprigs rosemary, stems removed

• 1 clove garlic, peeled

• ¼ teaspoon kosher or coarse salt of choice

• 3 tablespoons lemon juice (about 1 lemon)

• 2 tablespoons extra-virgin olive oil

• 2 teaspoonS honey

• Fresh cracked pepper to taste

Toppings

1 cup blueberries

½ cup toasted almonds

Directions

Gently toss herbs and mixed greens together in a

bowl. Add the cucumbers. To make the vinaigrette, add garlic, rosemary and sea salt to the bowl of the mortar. Use the pestle to mash ingredients into a paste (this will take about 10-20 seconds of mashing and muddling). Add the lemon juice, stirring and mashing during the addition. Add the honey and oil, and continue to mash/mix as you add. Finally add the pepper to taste and toss with the mixed greens.

Divide equally into 4 portions and top with berries

and almonds.

Yield: 4 Servings

Nutrition Breakdown:

Calories 190, Fat 14g (1.5g saturated, 9.5g monounsaturated), Cholesterol 0mg, Sodium 150mg, Carbohydrate 16g, Fiber 6g, Protein 5g.

Percent Daily Value: 45% Vitamin C, 60% Vitamin A, 8% Calcium, 10% Iron.

Carbohydrate Choices: 1 Carbohydrate

Diabetes Exchange Values: ½ fruit, 1 vegetable, ½ high fat meat, 2 fats

TIME CHANGES EVERYTHING BASED ON A TRUE

Time changes everything. Medicine has changed. Not just the new scientific procedures that we see on TV daily. But how medicine is practiced.

Early in my solo medical practice, I had a front office girl and a part-time nurse. She was an RN and had been a beauty queen just a few years before. She had one child and her husband

STORY

(most of the time)

insurance, etc., prior to being treated. That information was obtained post-care. No patient was ever turned away

ance carrier loved me. I was pure profit for them from day one. Never once was I even threatened with a malpractice lawsuit. For that, I am most thankful.

Needless to say, I was not loved by everyone. Particularly the other doctors in town. They did not like me making hospital rounds twice every day, seven days a week. And then I opened my office 5½

Once in the office, a variety of nameless people wandered through.

pay my bill. They wanted my

Height and weight taken. Blood pressure taken. Another nameless person took a brief history. A third nameless person palpated my ankle and ordered an x-ray. An x-ray technician made some x-rays. Finally, a PA zipped in and said, “You have a fractured fibula. I will order a boot for you and we’ll see you in six weeks.”

The boot-fitting girl came in, slipped the boot on and said, “Stand up and tell me how it feels.” I said, “It still hurts.” She said, “Walk carefully and take Tylenol. You can drive if you wish.” How thoughtfully therapeutic. She did not tell me how to manipulate the gas pedal with a boot on my right foot. It is far from easy.

Hobbling out the door, I realized I could not pick one of the people who treated me out of a police lineup if my life depended upon it. Surely, I heard a name somewhere, but I do not recall any. As impersonal as they were, they did not forget to bill me for over $1,000 from a doctor I do not recall seeing (if I did). Could have been Dr. Jekyll for all I know.

A far cry from my office staff of old who identified themselves to each patient. My staff knew who was kin to whom. How many kids each had. Which school their kid went to. Who the Dawgs played each week, and last week’s score.

My nurse had a disagreeable husband who treated her most poorly, to say the least. For years she did not tell me of this low-rent SOB’s transgressions. When she finally did tell me, I was irate. “Why didn’t you tell me?” She was wiser than me: “Had I told you, you would have done something about it. Probably something drastic.”

He had abused her mentally and physically. And brow beat her about ugly she was.

This was my beauty queen nurse (size 6, 118 pounds, with lots of cargo on the upper deck) who, on a bad day, looked like Sophia Loren at her best.

But let’s give credit where it is due: The Lord works in mysterious ways. The hubby had the good sense to get a rare parathyroid disease (only 16 cases known at the time) and died, even though I sent him to the Medical College of Georgia. The MCG physician commented, “he just wasn’t a really nice guy.” They tried to save him, but failed.

My nurse was right to not tell me. By that time, I had become acquainted with a certain organization (whose name we will not name here) who took it as a sacred obligation to “re-educate” husbands who mistreated wives or children, black or white or whatever. Their “re-education process” was blunt, to the point, and highly effective. I might’ve gotten into trouble for making that referral had the High Sheriff been informed.

I fear the closeness of medical practices of recent decades no longer exist among the modern-day office staff, nor among the patients. I fear there are fewer real doctors and more highly trained technicians. I fear this is a crying shame. Patients have diseases. Diseases don’t have patients.

My beautiful nurse later happily remarried. Her son is a prominent attorney and doing well. He never knew his father’s short comings. Another good decision by his mother. You don’t have to tell everything you know.

My fibula is healing slowly as I relearn proprioception and foot placement. It has been educational for me. Would I have healed faster with more personal medical care? Maybe. But faster or slower, I would have felt more human and less like a number.

FOODISMEDICINE

Tasty tips from registered dietitians with the Augusta Dietetic District Association

Safe & Smart Summer Safety

SAs summer approaches and we spend more time enjoying the outdoors—whether by the pool, at a barbecue, or on a picnic—it’s important to keep food safety in mind. Warm weather and outdoor settings can increase the risk of foodborne illness, so taking a few precautions can help keep everyone safe and healthy.

Why Food Safety Matters

Bacteria that cause food poisoning grow most rapidly in the “danger zone” between 40°F and 140°F. To prevent this:

• Keep cold foods cold (below 40°F) using ice, coolers, or refrigeration.

• Keep hot foods hot (above 140°F) by serving right off the grill or using warming trays.

• Never leave food out for more than 2 hours—or more than 1 hour if it’s above 90°F outside.

The Four Key Steps to Food Safety 1. Clean

• Wash your hands thoroughly with warm, soapy water for at least 20 seconds before and after handling food. A helpful timing tip? Sing the ABCs while washing.

• Rinse fruits and vegetables under running water before preparing or eating them. oKeep surfaces and utensils clean to avoid spreading germs.

2. Separate

• Keep raw meat, poultry, and seafood separate from ready-to-eat foods in your grocery bags, fridge, and during food prep.

• Store raw meat on the bottom shelf of the fridge to prevent juices from dripping onto other foods.

3. Cook

• Use a food thermometer to make sure foods are cooked to a safe internal temperature:

Beef, bison, goat, pork: 145°F

Ground meats (beef, pork, venison): 160°F

Raw eggs: Cook until yolk is white are firm

Seafood: 145°F or until the flesh is opaque and separates easily

Rabbit or venison: 160°F

Leftovers: 165°F

Chicken: 165°F

4. Chill

• Refrigerate or freeze food within 2 hours of cooking (1 hour in hot weather).

• After grocery shopping, promptly chill perishable items to slow bacterial growth.

• Store leftovers in shallow containers to cool them quickly and safely.

Final Tips

• Prepare only the amount of food you plan to eat and store the rest safely.

• When in doubt, throw it out! Don’t take chances with food safety. For more tips and updates, visit FoodSafety.gov.

Enjoy your summer—and keep it safe and delicious!

CRASH COURSE

More Americans have died on US roads since 2009 than in World Wars I & II combined

s everyone knows, Seat Belts Matter. But they matter much more than most of us realize.

Sure, back in the earliest days of seat belts they were little more than straps. In recent years seat belts have gotten far more sophisticated than early automotive engineers could have ever imagined.

Belts in newer vehicles are engineered to work in coordination with airbags to manage and control the forces at play during a collision. Although seat belts permit free movement in normal driving conditions, within nanoseconds of the start of an impending crash — that’s right, even before the crash, triggered by hard braking — embedded devices called crash tensioners lock down, keeping occupants securely in place. But those tensioners are tempered and cushioned by other devices called force limiters. They permit some belt webbing to spool out (within micro-seconds) to help soften the impact and prevent, in particular, chest injuries.

Despite the technological advances and refinements, seat belts are still doing the same basic job they were originally designed to do: make occupants part of the wreckage. As crazy as that sounds, it’s true.

Without seat belts, people in a crashing vehicle suffer multiple collisions with potentially deadly results.

Let’s say a car leaves the road at 60 mph and hits a tree. Car versus tree is collision #1. The car may come to a sudden and violent stop, but the unbelted passenger(s) continue traveling forward at 60 mph for a split second more until collision #2 occurs as they slam into the steering wheel, the dashboard, the windshield, or perhaps they leave the vehicle and hit the same tree the car did. Then collision #3 occurs when internal organs inside the body that have been along for the same 60 mph ride slam forward. The heart plows into the sternum; the brain bangs against

the inside of the skull, and so on.

Seat belts prevent all of that. Cars are designed with so-called crumple zones that absorb and cushion the impact of a crash, in effect slowing down the jolt from sixty to zero. Even without deliberately-created crumple zones, the laws of physics are unavoidably in play as fenders and other structural components collapse in sequence, soaking up kinetic energy and imperceptibly slowing down the crash. And as we established earlier, seat belts further help to cushion the blows. In effect, a belted occupant is part of the structure of the vehicle, not a loose pinball ricocheting around a violent and chaotic scene.

One of the variables in the mix on this topic occurs when some people in a vehicle are belted in and others aren’t. One of the relevant statistics on that scenario: in a frontal crash, an unbelted back seat passenger sitting behind a belted driver raises the risk of death for the driver by 137 percent (as compared to both wearing seat belts).

Seat belts are one of the true success stories in the quest to make driving safer and collisions more survivable. In 1983, roadside studies of observed seat belt use showed a mere 14 percent of front seat occupants used their belts. These days those percentages are well up into the nineties.

The Insurance Institute for Highway Safety, the source of the statistics we’ve just been quoting, conducted a national telephone survey a few years ago to determine the top reasons why people don’t wear seat belts. For people who said they use belts some but not all of the time, the top reasons were driving only a short distance, forgetfulness, and discomfort. Among respondents who said they never use seat belts, the top reasons were discomfort, the belief that they aren’t necessary, and a dislike of being told what to do. +

MYMOST MEMORABLE PATIENT

At the very start of the COVID-19 outbreak in the US, a visibly pregnant young woman and her husband came into the office. I knew they weren’t scheduled patients because we weren’t expecting any. Like most other doctor’s offices we had recently changed our appointment policies. All routine and non-urgent visits were cancelled.

But this young lady walked straight up to my desk and said, “I need to talk to a doctor or a nurse.” She had a strong Spanish accent but spoke English very well. Confused by her words, I told her we only did imaging at this office, and that if she was sick she needed to go to the ER.

“No,” she said, tears welling up in her eyes. “Something is wrong with my baby! I keep trying to talk to a doctor but no one will talk to me!”

Still trying to figure out what was going on, I took her basic information and looked her up in the computer. I went straight to the radiology reports and saw no notes or anything stating that there was a problem. In fact she’d just had an ultrasound recently and everything was fine.

I asked if she was having contractions, etc. She pulled a piece of paper out of her purse and said:”They sent me a letter, something is wrong with my baby!” I took the wrinkled paper from her hand and realized it was from her insurance company. It said that coverage of her most recent scan was denied due to some technicality.

“This is just a letter from your insurance company,” I said. She was sobbing now and pointed at the words that described the ultrasound: “…fetal anatomy, size, dates…” This is the terminology for a standard prenatal ultrasound.

There are many types of pregnancy ultrasounds, so the descriptors outline exactly what is being looked at on the scan and why it was ordered. Finally, the light bulb clicked and I put it all together. She thought the letter was from a doctor telling her that something about the size or anatomy of her fetus was wrong or abnormal.

I smiled and started explaining that it was just an insurance letter. This was her first child. Can you imagine being pregnant with your first in the midst of the COVID madness? It took several attempts to calm her and fully explain what the letter was trying to convey.

“My baby is ok?” she asked. I smiled and nodded. ”Your baby is perfect.” Then she really broke down in tears. The husband chimed in: ”See? I told you!” She practically jumped over my desk to give me a hug and thanked me repeatedly.

The encounter left me stunned. All anyone had to do was take the time to listen and ask some questions. Was she dismissed because English was not her first language? Doctors and other providers wouldn’t know what she was talking about without that letter. I certainly didn’t know at first. Why didn’t the insurance company send the letter in Spanish? That could have saved her so much anxiety.

I’ve worked at my current job 10 years. Patients are constantly teaching me how to improve.

The blog spot

— posted on April 12, 2022

MEDICINE WON’T KEEP YOU WARM AT NIGHT

Life continues in medical school and residency. Engagements, marriages, and divorces. Becoming a parent to a child. Having a dog or cat. Love and loss. Life and death. Then there is the uniqueness and privilege of being in medical training combined with great responsibilities and pressures that set the stage for some of the highest of highs and lowest of lows. Prior to beginning medical school, I was told by a physician to “find something or someone you love outside of medicine because medicine won’t keep you warm at night.”

As it turns out, this was remarkably perceptive advice. It is a simple sentence easily skimmed over and has very little direct meaning or impact unless you have lost something or someone outside of medicine. During the moment that you believe you have lost everything except for medicine, no statement could feel more true than that one. It was one of the most uncomfortable realizations I have had to face.

At my lowest point, I quite peculiarly texted a busy and exhausted general surgery resident on his transplant rotation for comfort. If I didn’t know him better, I would have thought his seemingly unperturbed response was due to his exhaustion and preoccupation with far more important events. But we know each other well, and he knew that there is almost always at least one thing that can keep someone in medicine going. I think everyone in medicine should hear it.

Just hang in there, it’s going to be OK.

You have a lot going for you and a lot to offer.

The world and patients need you.

And the patients come first.

And they’re really going to need you.

You’re too intelligent and compassionate to pass up Medicine does not keep me warm at night, but it does get me up in the morning.

The author is an anonymous medical student.

I just had the most profound thought.

There are people who believe plants have feelings, right? By all means, please share. So I have heard, yes.

EXAMINER CROSSWORD

ACROSS

1. Bowie hit

4. Mamie Eisenhower had one of these in Augusta

9. Comedienne who starred with Goodman

13. Lyric poem

14. Something held sacred (Archaic or poetic)

15. Meadow

16. ______ lab

17. Uncovered

18. Gordon, originally

20. Dietary abbreviation

22. Walton Way bakery of yore

25. Road connecting Walton Way with Boy Scout Road

27. New prefix

28. Sweet _____

29. Category of drinks

32. Customary

35. She went to high school with Snoop

39. Summerville

40. Mona Lisa artist

41. Extinct flightless bird

42. Golfer Nelson

44. Crack

45. Fed. intelligence agcy.

47. Also

49. Litigator

51. Benedict last name

54. Big ____

56. Short letter

58. Susceptible to bribery

60. Prolonged unconsciousness

62. All About_____

63. Found attractive

64. Cotton harvesting machine

65. Type of sale

WORDS

Well, the more likely someone is to believe that, the more likely they are to be a vegetarian.

I thought you said it was going to be profound.

THE MYSTERY WORD

The Mystery Word for this issue: LEICMHCA

Simply unscramble the letters, then begin exploring our ads When you find the correctly spelled word HIDDEN in one of our ads — enter at AugustaRx.com

We’ll announce the winner in our next issue!

E X A M I N E R S U D O K U

DIRECTIONS: Every line, vertical and horizontal, and all nine 9-square boxes must each contain the numbers 1 though 9. Solution on page 14.

66. Technique

67. Young hawk

DOWN

1. Type of group

2. Dental org.

3. Diner on Washington Road

4. Taxi

5. Having wings

6. Avian influenza, in brief

7. Notion

8. Silent signal

10. Budget rival

11. Deep sleep ltrs.

12. R of 11-D 19. DDE nickname 21. Regret

23. Fauci

24. Downtown Augusta watering hole

25. Capitol of the last of the original 13 colonies

26. Georgia county named for U.S. president #4.

29. HPV is one

30. Exclamation of surprise

31. Gave food to

33. Wily

34. Fuss

36. Partridge ____

37. Obamacare acronym

38. Type of code

43. Once Georgia’s largest mall

46. Sickness adjective

48. Globe

49. Walker beginning

50. Money can be spent like this

52. Study in general

53. Local Bridge?

54. Sharply curved

55. Metal fastener

57. Eggs

58. Augusta has two

Shelter 61. Miami airport code

QUOTATIONPUZZLE

DIRECTIONS: Recreate a timeless nugget of wisdom by using the letters in each vertical column to fill the boxes above them. Once any letter is used, cross it out in the lower half of the puzzle. Letters may be used only once. Black squares indicate spaces between words, and words may extend onto a second line.

Solution on page 14.

Use the letters provided at bottom to create words to solve the puzzle above. All the listed letters following #1 are the first letters of the various words; the letters following #2 are the second letters of each word, and so on. Try solving words with letter clues or numbers with minimal choices listed. A sample is shown. Solution on page 14.

ATHEBESTMEDICINE

ha... ha... in full.

Three weeks later the man returns and sees an exquisite chocolate VW Beetle on display. The chocolatier proudly points out all its glorious details: interior, wheels, steering wheel, windows. Everything works perfectly. After the grand tour he asks, “Shall I place it in a nice gift box for you, sir?”

“No need,” said the man. “I’ll eat it here.”

guy walks in to a deluxe chocolate shop a few weeks before Father’s Day and asks if they do custom work.

“Of course,” says the chocolatier.

“Can you make a chocolate Volkswagen Beetle? My father used to have one.”

“A wonderful idea, sir. No problem at all.”

“Would you be able to make it so that the chocolate doors open, and you can see the interior detailed in chocolate, just like a plastic model? The hood and trunk lid would even open?”

“That will take a little more work,” said the shop owner, “but yes, we can manage that.”

”Could the wheels roll? And if I turn the steering wheel, the wheels should turn too.”

“That is very difficult to do in chocolate,” said the owner, “but I believe I can pull it off.”

“I hate to ask, but there’s just one more thing,” said the customer. “Can you make it so that the chocolate windows move up and down when you turn the handles inside the doors?”

“Sir, this will be the biggest challenge of my career, but if you give me three weeks, I’ll have it ready for you.” They agreed on a price, and being custom work, the customer paid up front

Moe: A lot of wives say their husbands don’t listen to them.

Joe: I’m proud to say I’ve never heard my wife say such a thing.

Moe: Back in the day my grandfather owned a thoroughbred racehorse.

Joe: He must have been rich.

Moe: Not really. That horse never won a single race.

Joe: Then why did he keep it?

Moe: That’s the thing. He finally lost patience one day and warned the horse: “Either you win this afternoon or you’ll be pulling a milk wagon tomorrow morning.”

Joe: So what happened?

Moe: Well, that very afternoon, his horse was lined up with all the others in the starting gate. As the race started and the stalls opened, all the horses raced away, but as the gate was removed, my grandfather saw his horse was sound asleep on the track.

Angrily he ran over, kicked the horse and yelled: “Why are you sleeping?”

The horse wearily lifted its head and replied: “Because I have to get up at three o’clock in the morning!”

Staring at my phone all day has certainly had no Effect on ME!

By popular demand we’re making at-cost subscriptions available for the convenience of our

If you live beyond the Aiken-Augusta area, or miss issues between doctor’s appointments — don’t you hate it when that happens? — we’ll command your mail carrier to bring every issue to your house!

NAME

Choose six months for $24 or one year for $46 . Mail this completed form with payment to Augusta Medical Examiner, PO Box 397, Augusta GA 30903- 0397

Dear Advice Doctor,

I read this column every issue and I’m amazed by how many people ask you questions about stuff that isn’t related to medicine. You are a doctor, right? So my question IS about medicine, thank you very much. My doctor is great but his staff is horrible. Every appointment a different annoying person gets under my skin. I think they take turns! Do you think I should find a new doctor, or just ignore his rude and incompetent staff?

— Sad and Sore

Dear S&S,

This is a subject that I think many of us can sympathize with. I know personally, when something gets under my skin, especially this time of year, the culprit is often a mosquito. They are annoying, no question about it.

The question is, what can we do about it?

You can do an internet search and discover dozens of allegedly sure-fire recipes for homemade natural mosquito repellents. They have an undeniable popular appeal because, after all, who wants chemicals sprayed all over their body?

The honest answer to that question is: people who don’t like mosquitoes. The experts say that people who don’t like mosquitoes should think twice about candles, bracelets, and expensive ultrasonic devices that claim to keep mosquitoes away. Researchers at New Mexico State University (and plenty of other institutions) have studied what works and what doesn’t, and they say those chemical sprays do the trick.

As distasteful as that might sound to some, the active ingredient in many sprays (DEET), has been widely used for decades, and studies show it is safe and effective against mosquitoes and ticks carrying malaria, West Nile virus, Zika virus, and Lyme disease, according to the EPA.

Before anyone condemns chemical sprays, consider this chemical: p-menthane-3,8-diol, or PMD. Natural repellant fans would probably automatically avoid it, but p-menthane-3,8-diol is nothing more than the official name for oil of lemon eucalyptus extract. Yes, some chemicals come from plants. Who knew?

And to the point of our discussion, oil of lemon eucalyptus extract (aka PMD) is the only DEET-free spray that New Mexico researchers found to be effective and long-lasting.

Thanks for writing, and I hope I answered your question. Do you have a question for The Advice Doctor about health, life, love, personal relationships, career, raising children, or any other important topic? Send it to News@AugustaRx.com. Replies will be provided only in the Examiner.

THE MYSTERY SOLVED

The Celebrated MYSTERY WORD CONTEST

...wherein we hide (with fiendish cleverness) a simple word. All you have to do is unscramble the word (found on page 12), then find it concealed within one of our ads. Click in to the contest link at www.AugustaRx.com and enter. If we pick you in our random drawing of correct entries, you’ll score our goodie package!

SEVEN SIMPLE RULES: 1. Unscramble and find the designated word hidden within one of the ads in this issue. 2. Visit the Reader Contests page at www.AugustaRx.com. 3. Tell us what you found and where you found it. 4. If you’re right and you’re the one we pick at random, you win. (Winners within the past six months are ineligible.) 5. Prizes awarded to winners may vary from issue to issue. Limited sizes are available for shirt prize. 6. A photo ID may be required to claim some prizes. 7. Other entrants may win a lesser prize at the sole discretion of the publisher. 8. Deadline to enter is shown on page 12.

PROFESSIONAL DIRECTORY

ACUPUNCTURE

Dr. Eric Sherrell, DACM, LAC

Augusta Acupuncture Clinic 4141 Columbia Road

706-888-0707

www.AcuClinicGA.com

CHIROPRACTIC

Karen L. Carter, MD 1303 D’Antignac St, Suite 2100 Augusta 30901 706-396-0600 www.augustadevelopmentalspecialists.com

Floss ‘em or lose ‘em!

It seems that my friends and I have reached an age when physical (or mental) ailments are becoming an everyday concern. However, I can rapidly reach overload when hearing about their various problems and solutions.

For instance someone will say, “Do you know Dr. Smith? He’s in a practice with about thirty-five hip specialists. I hear they can do a replacement in about an hour! People are just lined up in the waiting room. They must be really good. My friend, Julie, had her hip done and she’s playing golf again.”

Then someone else says, “Oh, Edna, you’re thinking about cataract surgery, not hip replacements.” …and on it goes.

When we gather these days, I want to announce, “New rule! We have a limit of ten minutes to discuss ailments, treatments and doctors, then we can move on to more interesting and fun things.”

Even that rule can still be problematic since conversations can quickly take a dive to discussions about grandkids! So precious, so cute, so...stop! And then, the phones come out with photos – many photos – which must be passed around for everyone to see.

“Just look at little Sally. This was her second birthday party – what a darling child. She looks just like me when I was her age – blue eyes, blonde curls. Too bad she was picking her nose in the photo.”

I am always tempted to brag about my (imaginary) grandson who, in spite of spending a year or two in prison has now kicked his drug habit. He’s also studying to get his GED and is living in my basement. I’m so proud. His girlfriend and her twin three-year-olds have moved in also. I think they keep him grounded. So precious.

Can this get any worse? Of course, it can. Now that the phones are out to see every baby, graduate and bride-to-be, no one can pass up the opportunity to check their messages or offer up pics of their cute dog, the neighbors’ wedding photos, vacation trips, and last night’s yummy lasagna. Whoopee!

By this time you are probably thinking why do I even come to these get-togethers? That’s a valid question. My answer: “Well, because we have all been friends for years and I love them. Besides, I want to tell everyone about my gallbladder removal. It was a breeze! Let me show you my scar!”

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