Medical Examiner 10-1-2021 by Daniel Pearson

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OCTOBER 1, 2021

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PATIENCE Twenty months ago (February 7, 2020) the novel strain of coronavirus that has plagued all our lives ever since was first mentioned in this newspaper. COVID-19 seems in no danger of disappearing anytime soon, but there is something that will: our nearly 40-issue campaign in favor of masking up and more recently, getting vaccinated. It isn’t that we have changed our editorial position about these two measures; we haven’t. But no one else has either. The people who aren’t yet vaccinated probably never will be, and no amount of anything is likely to change their minds. They aren’t going to wear masks either, and will fight any and all efforts to force them to comply. It’s time — past time, really — to at least attempt to inject some civility and acceptance into this highly volatile arena. The healthcare community should be well equipped to do

this from decades of practice. Cancer patients routinely refuse chemotherapy and other treatments even when these hold out the hope of remission or cure, or at the very least an extension of life. Everyone in medicine has encountered this scenario and we learn to accept it, sometimes even within our own families. Jehovah’s Witnesses famously refuse blood

transfusions even when they’re told it’s a life-anddeath matter. Doctors have gradually learned that bloodless surgery has its advantages and benefits. Millions of people carry advance medical directives that, without knowing the when or why of some future situation, nevertheless instruct DNR. Do. Not. Resuscitate. We accept and respect that as the patient’s wishes. It’s time to put all those lessons and others to work in the COVID landscape. Just calmly accept the other person’s viewpoint, no matter which side of the debate their opinions happen to fall upon. Is this likely to happen? We would rather address a different question: Does this need to happen? Yes, times infinity. We recently ran across a website entitled www. sorryantivaxxer.com. The site posts links to news stories Please see PATIENCE page 16

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TAKING CONTROL Guest column by Dr. Chuck Cadle

After reading the latest Medical Examiner and reflecting on the fascinating and salubrious news articles, I decided to share some of my musings with the readership, assuming the posted request for “semi-interesting” stories is valid. I woke up this morning wondering if I had lost the remaining pounds necessary to achieve my weight goal. The day before, I exercised and completed projects around the house. I thought about the day before that when I had somehow gained three pounds, bringing me to 170.5 pounds, pushing me farther away from my 165-pound goal. Should I give up and just up my range by ten pounds? That would remove the dreaded daily challenge of meeting my self-imposed weight goal. Or would it? Yesterday was Saturday, and with my chores completed for the week (I like to call them husband duties), I was looking forward to a day of relaxation. Then I weighed myself. Oh no! Somehow I had added another 1.7 pounds, bringing me up to 172.2. How could this be? What could I have done that would have this result? My step count was more than 9,000 the previous day. Then my memory kicked into gear. Butterfinger candies are a weakness of mine. At the grocery store this past week (since the Covid-19 Pandemic started, weekly grocery shopping is another one of my husband duties), they had a sale on candy. Somehow, mini-Butterfingers made their way into my cart. Outside of my “Atkins-like” meals, I enjoyed five of these treats along with a peanut butter snack during an afternoon Mel Gibson movie. After recognizing my calorie and carb intake was much higher than planned, a feeling of defeat came over me. How are you at taking control of life’s challenges? I should be an expert. My doctoral dissertation was a dePlease see TAKING CONTROL page 10

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PARENTHOOD by David W. Proefrock, PhD

If you answered: A. There is a legitimate reason for school dress codes. There are rights that should be defended, but this is not one of them. B. There are ways to deal with rules you do not agree with. Help him find ones that are appropriate and will not get him in trouble. C. This is what you should do in this situation.It supports both the school and your child. D. This does show support for him, but it is probably not the best way to show it. There are reasons for a dress code. The school should be supported too. Dress codes are written as part of an effort to establish a safe and orderly environment for learning. The school should be supported in this. Support for your child is best shown by helping him learn to abide by rules and still express himself. + Dr. Proefrock is a retired clinical and forensic child psychologist.

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IS FOR HEAT People in this part of the world are very familiar with heat. But we’re going to focus on the kind of heat that every human, even people in the Arctic, are very familiar with: body heat. How the body manages heat is a fascinating topic. The machine that is the human body operates best within a very narrow temperature window, and that is the case whether we live in an igloo or we’re digging a ditch in Georgia at high noon on a summer day with no shade in sight. Igloo dwellers and ditch diggers have something in common: we’re all packing heat; we’re all running a temperature. From the worldwide norm of around 98°, the typical variation in either direction, up or down, is a mere 2 degrees. You may have experienced this yourself within the past few days. Let’s say you work at AU Health and have been assigned to park in a lot 3 miles away (or at least it seems that far). You trod through Augusta’s blazing heat and broiling sun and finally get to the building where you work all hot and bothered, only to be greeted by someone at the door with a thermal scanner. You’re expecting your temperature will register roughly 108°,

but no, it’s normal, maybe even a cool 97°. How does the body manage to pull off this feat? Humans have a complex dual network of thermoreceptors that constantly monitor their internal temperature. One set takes surface temperatures from the skin, the other measures the all-important inner core temperature. These thermoreceptors constantly relay information to the brain’s hypothalamus, the main office of temperature regulation. Depending on the data it receives, the hypothalamus activates the appropriate heat-loss or heat-promoting mechanisms.

And if those two steps don’t work, the brain will send a message to muscles that results in shivering, a very effective means for producing large amounts of heat. When it comes to being hot, the body has cooling strategies too. If vasoconstriction warms us up, vasodilation logically accomplishes the opposite objective. Additional blood circulation near the skin’s surface makes us look red and flushed, but that’s a clue that the body is trying to cool itself. Another strategy is to dial up the amount of sweat we’re generating (or for those in upper management, perspiration). As sweat evaporates, it is a very efficient means of ridding the body of excess heat — unless the ambient humidity is high. That dramatically slows evaporation and its cooling effects. Just as people take various actions when they’re cold (like putting on a hat, gloves, and a coat), we can also take steps to address heat: seek shade, a fan or an air conditioner. Lightcolored, loosely fitting clothes also help. People who live in the hottest desert climates don’t wear the least amount of clothing possible: bare skin absorbs most of the radiant energy from the sun that strikes it, which is why people in those regions often cover up head to toe in loose, light garments. One of the most puzzling aspects of body heat is fever. We’re sick, burning up with fever, and then we start to shiver. It makes no sense. Here’s what’s happening. An infection results in the release of pyrogens, chemical substances that, as their name suggests, heat things up,

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Your 13 year-old son won’t stop complaining about his school’s dress code. He often pushes the limits and has already been in trouble for minor violations. He claims that the dress code has nothing to do with education and is just there to oppress the students. What do you do? A. Encourage him to stand up for his rights. Intervene with school officials when he gets in trouble for violations. B. Tell him that you agree with him, but there’s nothing you can do about it. C. Explain to him that being able to follow rules and standards of behavior are important life lessons that are valuable for him to learn. Help him find other, more appropriate, ways to express his identity and creativity. D. Show him you support him. Make an official complaint to the Board of Education about the dress code being unfair to students.

PART H OF A 26-PART SERIES

Why do we shiver when we have a fever?

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If we’re cold, a number of systems are activated, starting with vasoconstriction. In simple terms, blood vessels near the skin are automatically restricted. That accomplishes two objectives: it diverts more blood to the body’s all-important central core, home to some fairly important organs; second, the less blood circulation there is near the skin’s surface, the less heat loss there will be. This partial circulatory shutdown explains why we can look almost blue in really cold weather, or when injury or trauma occurs. Maybe vasoconstriction is where the term “cold hands, warm heart” comes from. Bodily cold also stimulates the release of chemicals which increase metabolism, in effect stoking the body’s furnace.

Please see HEAT page 3

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HEAT… from page 2 in effect resetting the body’s thermostat to a higher temperature. In response, the hypothalamus obediently launches some of the aforementioned heatpromoting mechanisms, one of which is vasoconstriction. That causes skin to become markedly cooler, and shivering results. We’re wracked with fever, and at the same time we have the chills. Shivering in such a case is a sign that the body temperature is rising, and shivering furthers the process along. The temperature will continue to rise until the new thermostat setting marked “fever” is reached, and there it will stay until the the immune system or medications (or both) conquer the infection. Fever can be dangerous, if not deadly. Humans can withstand very cool core temperatures, especially in controlled settings, which is why body cooling is employed during certain surgeries. The same can’t be said when temperatures go up. Most adults will go into convulsions if their temperature reaches 106°, and getting to around 110° is usually fatal. Having said that, moderate fever is a good and beneficial thing. Higher body temperatures speed up metabolism, thereby accelerating various healing processes, and there is also evidence that fever helps to inhibit bacterial growth.

The final curious thing about this aspect of body heat occurs when a fever “breaks.” Sometimes it seems to occur fairly suddenly. The brain resets the body thermostat back to its normal setting, which means all the internal signals say “activate cooling.” Patients often break out in a sweat when their fever breaks, their skin, ironically enough, flushed and warm. That’s the body sending blood to the surface where optimal cooling occurs. This topic would be incomplete without answering the question, “where does all this heat come from in the first place?” In some ways it’s kind of amazing that the human body generates enough heat for a constant temperate very close to 100°, and as we’ve discussed, it has multiple mechanisms to ensure its temperature stability, known as homeostasis. On the other hand, just about every machine with moving parts generates heat as it runs, and the human body is no exception. All body tissues produce heat, but at rest, most of our warmth comes from the organs that are most active metabolically: the heart, brain, liver, and endocrine organs. When not at rest, muscular contractions from walking, lifting, running, climbing stairs, unloading groceries, etc., generate significantly more heat than anything else in the body. As it turns out, heat is a pretty cool subject. +

Michael Sharkey, MD Lauren Ploch, MD Caroline Wells, PA-C Chris Thompson, PA-C John Cook, MD, Emeritus GENERAL, SURGICAL & COSMETIC DERMATOLOGY

Will taking vitamin supplement or zinc help me avoid contracting COVID? Well, maybe. But the odds are definitely not in your favor if this is your complete COVID avoidance strategy. Vitamins and minerals are essential for good overall health, but their specific role and direct benefits don’t include interfering with the ability of a virus to take up residence in the body. To illustrate the benefits and limitations, severe respiratory problems are among the worst effects of COVID-19. If someone is a smoker before contracting COVID, they are going into battle against the virus with lungs that are already damaged to some degree. But that doesn’t mean being a non-smoker would protect a person from getting COVID. The two situations are completely different. Similarly, although some vitamin deficiencies are associated with a higher risk of becoming infected with COVID-19, there is no clinical evidence that taking vitamins would be an effective preventive measure. +

Last week the CDC approved booster shots for those who previously received the Pfizer vaccine. What about people who received Moderna or Johnson & Johnson’s /Janssen vaccine? From the CDC, dated September 24: “The Advisory Committee on Immunization Practices (ACIP) and CDC’s recommendations are bound by what the U.S. Food and Drug Administration’s (FDA) authorization allows. At this time, the Pfizer-BioNTech booster authorization only applies to people whose primary series was Pfizer-BioNTech vaccine. People in the recommended groups who got the Moderna or J&J/Janssen vaccine will likely need a booster shot. More data on the effectiveness and safety of Moderna and J&J/Janssen booster shots are expected soon. With those data in hand, CDC will keep the public informed with a timely plan for Moderna and J&J/Janssen booster shots. +

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#148 IN A SERIES

Who is this? ON THE ROAD TO BETTER HEALTH A PATIENT’S PERSPECTIVE Editor’s note: Augusta writer Marcia Ribble, Ph.D., is a retired English and creative writing professor who offers her unique perspective as a patient. Contact her at marciaribble@hotmail.com by Marcia Ribble

very now and then a pioneer emerges in one field of endeavor or another who is decades ahead of his or her time. They are often dismissed as lunatics and subject to the scorn of their colleagues, only to be proven right one or two or ten years down the road. The medical pioneer pictured above wasn’t like that. He wasn’t decades ahead of his time, or even a hundred years ahead. Try sixteen centuries. His name was Herophilos, and he was born about 335 BC in what is now Istanbul, but he spent most of his life in Alexandria, the ancient center of higher learning. That was fortuitous: Alexandria was one of the only places in the ancient world where the dissection of cadavers for medical study was not banned. Herophilos and another noteworthy name from the past, Erasistratus (royal physician under Seleucus I Nicator of Syria; see our next installment for more about Erasistratus) founded a school of anatomy there. Due to their studies, Herophilos is considerd the first scientist to systematically and accurately explore human anatomy. He is considered to be the father of anatomy. The two anatomists lived and practiced at a time when the humoral theory was all the rage in medicine. This concept went through a number of transformations over its centuries of popularity, but Hippocrates condensed it down to the four vital body fluids (blood, yellow bile, black bile, and phlegm) for which humorism is most often remembered. By contrast, Herophilus practiced scientific, empirical methods, meaning that facts were gathered and conclusions drawn based on direct observation and experience rather than mere theory. Using this approach, coupled with dissection, Herophilus found that veins carried only blood, not air as many in his day believed, and he discovered the difference between arteries and veins. He discovered the heart to be a pump, not the seat of intellect, another conclusion that was radical at the time. He discovered the differences between motor and sensory nerves. He was also a pioneer in revealing the physiology of the female reproductive system (including the first to discover the ovum), and recorded his findings in Midwifery, one of his nine books on a variety of medical topics, all lost to time but extensively quoted by other authors of ancient times, notably Galen. No medical practioner who lived more than 2,000 years ago got everything right, and Herophilus was no exception. He believed, for example, that disease struck when an excess supply of one of the four humors blocked signals from reaching the brain. He also reportedly practiced dissection on living people (prisoners), which revealed the true colors of body landmarks, not the uniform dull grey-red of corpses. As advanced as Herophilus (usually) was for his day, dissection for medical and anatomical insights largely fell out of favor after his death until the work of Vesalius, more than 1,600 later. As late as the mid-1850’s, MCG used a grave robber “off the books” to obtain freshly buried bodies for anatomy classes. +

Some people laugh about old folks playing bingo. They act as though it’s a kind of dumb game, but really it’s very a smart game. Why? Because it’s good for both physical and mental health. Our physical health is improved because we have to get out of our chairs and move our bodies just to arrive at the bingo parlor. Our eyes must focus on our cards to ensure that we mark every number called. Our blood pressure rises slightly when we win and call “BINGO!” Our nerves tingle with pleasure when we win. We have fun talking with one another and I often hear gales of laughter from the mild teasing that can occur when someone gets more than one win, or when multiple players bingo at the same time. Every part of us gets mild exercise at bingo. Clearly, it’s not the kind of exercise we might have at a fitness class, but it is nonetheless more movement than we would get watching TV. More important are the mental health benefits from leaving our homes and just going out. Because of Covid, many social activities have been off limits to most of us. We have spent days, weeks, months, and even years in isolation. Isolation for all of us is a struggle. For many, playing bingo was among the activities that could not be enjoyed. So to be able to play bingo again takes us out of isolation. That’s a good thing. Social activities are often a sure cure for depression caused solely by isolation. For many seniors, because we were so vulnerable to Covid’s worst effects including long term loss of function and even death, staying alone has been lifesaving, but now,

because we have gotten the vaccine, it is more safe to be with others who have also been vaccinated. That means senior living facilities are again allowing bingo and other social activities. One of the benefits, especially for new residents in senior communities, is that going to bingo is a great way to meet people and learn names. It is so much fun to watch as someone calls “bingo” and folks ask, “who got it?” That person’s name will be called. It was Pat, or it was Bob, or it was Sabine who bingoed. It also helps folks who may have trouble remembering names to refresh that name in our memories. Even though many of us live alone in our apartments, we feel less isolated when people know us by name and can say hello to us if we see one another outside of bingo. We also begin to know people on more than a superficial level. For example, my neighbor Becky has a life-like doll named Noah, who she takes for rides in his stroller. I instantly knew, when I was introduced to Noah, that he gives her great comfort. Becky is younger than many of us and is only a few weeks from her 57th birthday. She has arthritis in her shoulder, for which she gets shots regularly to relieve the pain and aid in mobility. Becky loves the role of caregiver and regularly visits and checks on those who need someone to do that for them. She checks on another neighbor, Rose, as many as three times a day. Playing bingo is one simple way in which seniors can reconnect to social lives. We have bingo in our complex, which means that even in bad weather, we can hike down the halls to play bingo without getting too hot or too cold or rained on or snowed on. +

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Middle Age

EVERYBODY LOVES A GOOD STORY

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AND EVERYBODY HAS A STORY. WE’D LOVE TO HEAR YOURS.

ADVENTURES IN

BY J.B. COLLUM

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Lately, I have been told by a few readers that is the key to staying sharp. Keep learning new I seem to have lost my sense of humor. I do not things all the time. I’ve always tried to do take offense at these remarks. I have certainly that. Just ask my wife. If hobbies were girlgiven readers ample evidence of just such a friends, I’d have a trail of jilted lovers behind crime over the last few weeks. Therefore, we are me a mile long but that might still have been going to turn this ship around and get it back on cheaper than some of my hobbies. I used to track (there I am, mixing metaphors again) by want to become an expert at everything. Now offering some observations about middle-aged I’m happy with being merely competent before people. Some I am closely related to, and at I get bored and move on. Most of my hobleast one of these observations is about me, bies have taken a back seat to obligations, so but with the exception of yours truly, they shall now I am trying to turn those obligations into remain nameless to protect the guilty, the innohobbies. Things like working on my house. To cent, and the complete idiots. make it seem more like a hobby, I got into a nostalgic mood I buy new tools all the time to If hobbies were make the work easier and more recently and started friending all my old school chums and acinteresting. My wife has recquaintances on social media. I’m girlfriends, I’d have onciled herself to taking me to not great with names, but I do Home Depot at the start of any a trail of jilted remember faces, soin some cases, new project. I get to pick out a lovers a mile long. tool. She just hopes it’s only one I inadvertently tried to friend the children of my old schoolmates before the job is done instead because they look so much like of the two or more new tools their parents when they were younger. At my I have sometimes squeezed out of a single age, our children are mostly in their thirties, so project. it isn’t such an outrageous mistake. Once I dis- Yes, instead of expensive high-tech hobbies, covered this it did make me feel somewhat like I have turned to more mundane but practical a creep. And those younger people probably and satisfying pursuits, and I continue to grow had the same word in mind as this old stranger fonder of the simpler things in life. My father tried to friend them. The good news is that the was a simple man. Not a simpleton, mind older I get, the less I care what people think, so you, but a simple man, with simple tastes who there is that consolation. appreciated what he had. When I was a kid, he Now that I have expanded my list of friends would sometimes sing the “Bear Necessities” on social media, I see how badly many of them from The Jungle Book. Then he would talk to use technology. I am a techie person who grew me about what it meant, and that lesson has up at the dawn of affordable personal comnever left me completely. Sure, I may have hidputers, and I have the expectation that anyone den it away for a few decades, but it was there around my age or younger should know their when I needed it. I’m pulling it out and dusting way around modern technology. Alas I usualit off, and it is just as valid now as then, if not ly end up disappointed. Did they never learn more so. Part of its message is to enjoy the these things or are they just slipping? I admit humor in everyday life. My father laughed a lot, that my son has advanced far beyond me on even when things went wrong. Especially when newer technological platforms, but if anyone things went wrong! Instead of getting angry or out there needs an expert on programming upset, he’d laugh and move on. computers from the early eighties in languages Just this past Sunday, I waded knee-deep long since abandoned, I’m your guy! in the ocean and was about to scatter some Somehow, I have become the go-to tech of his ashes. In what had been a very calm support person for people around my age and sea, a rogue wave soaked me up to my waist. older. They ask me a question and I do my Everything in my pockets got at least a little best to stay patient enough long enough to wet. Tears had been streaming down my face, help them figure it out. I give it my best shot but after the wave, I remembered my dad and anyway. Well, okay, maybe not my best, but I just started cackling like he would have done. have started to expect less from myself and be People nearby probably thought I had lost my satisfied with it. Let’s just say that I give it my mind. It lifted my spirits. I finished scattering “best-ish” shot. I have also started forgiving his ashes and marched back up the shoreline myself for giving up on some things. It is quite soaked to my underwear, but in a better frame liberating. You should try it. of mind. Some of you may say that my father’s Wait just a second! Is that what these other spirit did this, but I don’t believe in that. I do folks are doing? Could they actually figure it out believe that the lessons he taught me and the on their own, but have discovered that younger example he showed manifested themselves at people expect less out of them and so they just that moment though, so in a way, my father give up? That puts a new light on things. Maycomforted me that day and his be those folks I tried to help aren’t as stupid as memory will continue to do so I thought they were. Maybe I am instead. Oh until I too am just ashes. + well, at least I am still learning. Then again, some of those folks think flat-earthers have a J.B. Collum is a local novelist, huvalid point and wearing masks is a political morist and columnist who wants to be Mark Twain statement, so they couldn’t be that bright. when he grows up. He may be reached at johnbcol I think continuing to learn as we grow older lum@gmail.com

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by Kim Beavers, MS, RDN, CDCES Registered Dietitian Nutritionist, Chef Coach, Author Follow Kim on Facebook: facebook.com/eatingwellwithkimb

PINTOS UNDER PRESSURE These old fashioned pinto beans can be flavored multiple ways after cooking. When cooking beans, it’s best to soak them overnight first, which improves the digestibility of the beans. But using a pressure cooker makes it possible to cook beans even if you forget to pre-soak. Whether you planned ahead or — oops! — you forgot, the pressure cooker has you covered. Ingredients • 1 pound pinto beans • 6 cups water • 1 tablespoon extra-virgin olive oil • 1 cup diced onion (sweet onion preferred) • 2 cloves garlic, minced • 2 teaspoons smoked paprika • 1 bay leaf • 1 vegetarian bouillon cube (860mg sodium for 2) • Garnish with chopped red onion and parsley Start by rinsing the beans and sorting out any pebbles or shriveled beans. Add the rinsed and sorted beans to the inner pot of the electric pressure cooker with 6 cups of water, oil, onion, garlic, smoked paprika, bay leaf and vegetarian bouillon cube. Select bean setting and adjust time to 25 minutes. Once cooking time is done, allow pressure to naturally release

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for about 10 minutes. Then manually release pressure and carefully remove the lid (always tilt the lid away from your face when opening). Check beans for tenderness and enjoy in multiple ways. Yield: 12 servings (serving size: ½ cup) Nutrition Breakdown: Calories 140, Fat 2g (0g saturated fat), Cholesterol 0mg, Sodium 170mg, Carbohydrate 25g, Fiber 8g, Protein 8g. Diabetes Plate Plan: 1½ Starch, 1 Lean meat Kim’s note: The electric pressure cooker is great for cooking beans pre-soaked or not. But

pre-soaking is the ideal way to cook beans for easiest digestion. The best way to soak beans is actually to brine them (this method produces tender beans that do not burst when cooked). To brine beans dissolve 2-3 tablespoons of salt in 8-12 cups of water, add your pound of beans and soak in the refrigerator overnight. After the overnight soak, drain the beans, rinse and cook as described above. No pressure cooker? No problem. Simply add the drained and rinsed beans to your slow cooker with 8 cups of water and seasonings above; cook on low for 8 hours. +

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NO NONSENSE

NUTRITION Paul, from North Carolina, writes: “Dr. Karp, right now I’m eating a hot dog at the state fair. Is this going to reduce my life expectancy? That’s what I keep hearing and reading lately.”

I’ve gotten a lot of questions about hot dogs these last few weeks, ever since publication of a study that concluded that each hot dog you eat reduces your life by 36 minutes. Is it true? Are hot dogs really a life expectancy diminisher?

The fact is that hot dogs are not a great choice of foods to eat on a regular basis. That does not mean that you can’t eat a hot dog every now and then. But if eating hot dogs and other types of processed, delicatessen meats (sausages) are major foods in your diet, especially this time of year during weekly football tailgating parties, you need to reconsider your food choices. Processed delicatessen meats are usually high in fat, saturated fat, and salt, and low in fiber, vitamins and minerals. In addition, these “meats” usually contain nitrites, which turn into nitrosamines when grilled. Nitrosamines are suspected carcinogens. In fact, the World Health Organization has classified processed delicatessen meats as Group 1 carcinogens. There is strong evidence that they increase colorectal cancer risk, especially when grilled. In addition, because of all the saturated fat and salt, hot dogs are pretty unhealthy for your brain, your heart and your peripheral vasculature. Processed meats have also been linked to increasing your risk of Type 2 diabetes. Finally, have you noticed that hot dogs end up being recalled quite often because of bacterial contamination or

STRESSED OUT?

OCTOBER 1, 2021

To eat, or not to eat. That is the question. the presence of bone fragments, insect parts and other things that have no proper place in good food? Now, with all that being said, can you actually subtract 36 minutes of your life for every hot dog you have eaten? That’s a pretty silly idea. This calculation was meant to apply to entire populations of peoples as a very rough and general guide in comparing the risks of different foods. It is not a calculation that is supposed to be applied to you or me as individuals. As a funny anecdote, I’ve gotten panicky notes from readers that they approximated how many hot dogs they have eaten in their lives and figured they should have been dead about 10 years ago. The fact is that vilification

or glorification of specific individual foods is very foolish and without merit. However, it does make good “click bait” for media companies. In addition, one study is never a reason to take action. It is not definitive proof of anything. Important data needs to be verified in different, independent laboratories and a meta-analysis performed. Your longevity is related to many factors, certainly not just simply to how many hot dogs you have eaten. Hot dogs have only been around since the late 1800’s. They are a very clever way of marketing and selling all the leftover “super cheap” meat and meat by-products (do I even want to know what that includes?) that would otherwise be discarded. Just grind it all together,

add preservatives, food coloring and flavoring agents, stuff it in a casing (originally intestines) and, voila, you end up with something you can sell! How clever! How unhealthy! What about the processed meats that are advertised as being healthier? Don’t fall for the advertising. It is true that they may have fewer preservatives, no nitrites, lower salt, etc., but the fact is that processed meats, no matter the marketing, are never considered a food that fits into any description of a healthy food. Processed meats fit in the “other” category, foods that have very little nutrition, and are mainly a source of calories, fats and salts. What’s the “No-Nonsense Nutrition” advice for today? If you want a hot dog at a ballgame, go ahead and enjoy it. It is almost un-American not to. But if you think that hot dogs are a good meat substitute or something that should be eaten regularly, then re-think this. And if you eat them at home, instead of having them with fries and onion rings, serve them with a watermelon-arugula-cherry tomato salad with a drizzle of vinaigrette dressing. +

Have a question about food, diet or nutrition? Post or private message your question on Facebook (www. Facebook.com/AskDrKarp) or email your question to askdrkarp@gmail.com If your question is chosen for a column, your name will be changed to ensure your privacy. Warren B. Karp, Ph.D., D.M.D., is Professor Emeritus at Augusta University. He has served as Director of the Nutrition Consult Service at the Dental College of Georgia and is past Vice Chair of the Columbia County Board of Health. You can find out more about Dr. Karp and the download site for the public domain eBook, Nutrition for Smarties, at www.wbkarp.com Dr. Karp obtains no funding for writing his columns, articles, or books, and has no financial or other interests in any food, book, nutrition product or company. His interest is only in providing freely available, evidencedDr. Karp based, scientific nutrition knowledge and education. The information is for educational use only; it is not meant to be used to diagnose, manage or treat any patient or client. Although Dr. Karp is a Professor Emeritus at Augusta University, the views and opinions expressed here are his and his alone and do not reflect the views and opinions of Augusta University or anyone else.

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DON’T LET THIS HAPPEN TO YOU!

PACK MY CHILD’S SCHOOL LUNCH? OR NOT? by Donna Martin, EdS, RDN, LD, SNS, FAND. Director, School Nutrition Program Burke County Board of Education

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tional standards applied to school meals. Studies have found that lunches from home may contribute to higher fat and added sugar intake among young children because of the higher prevalence of dessert items, snack items and sugar-sweetened beverages. One study found that school lunches had fewer calories than packed lunches (512 vs. 608), more protein (26g vs. 18g), less fat (13g vs. 21g), and more fiber (7.2g vs. 4.8g). The study added that homepacked lunches were “less likely to contain fruits (54% vs. 67%), vegetables (17% vs. 61%), juice without sugar (10% vs. 22%) and milk (20% vs. 96%),” and more likely to include chips or crackers and sugar-sweetened drinks. More shocking was that almost a quarter of the packed lunches lacked what would be considered an entrée, such as a sandwich or leftovers, and were instead made up of a variety of packaged snacks and desserts. School lunches typically offer many choices for students which ensures they have something they like to eat. School lunches now offer more salads, more farm-to-school products, more whole grains and zero trans fat. They typically offer a number of choices that most parents can’t offer when packing a lunch. You also don’t have to worry about food safety if your child eats school lunch, whereas if you are sending a packed meal from home you have to worry about keeping it hot or keeping it cold. Just think of all the time you will save in the morning not having to pack a lunch, and you don’t have to worry about you child forgetting their lunch either. So eating school lunch is a no-brainer. It saves time, offers more choices, ensures food safety and is super healthy. +

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Parents and guardians who want the best for their children are always faced with the age-old “Should I pack my child’s school lunch or let them eat at school?” question. Unless the person packing your child’s lunch is a Registered Dietitian Nutritionist, eating school lunch each day is the best option. Recent studies have shown that trends in nutritional quality of foods consumed from major US grocery stores and restaurant sources have shown modest improvements for foods, but the quality of foods provided by schools improved significantly, especially after 2010. Why is that, you ask? It’s because the Healthy Free Hunger Act of 2010 focused on improving child nutrition in schools. School breakfast and school lunch programs are a critical nutrition and hunger safety net for millions of children. Research shows that students who participate in school meal programs consume more whole grains, milk, fruits, and vegetables during meal times, and have better overall diet quality compared with nonparticipants. And eating breakfast at school is associated with better attendance rates, fewer missed school days, and better test scores. Meals served through these programs must meet specific nutrition requirements that were revised and upgraded in 2012 to include more fruits, vegetables, whole grains, and to decrease the amount of sodium and trans fats. Research shows that these changes have helped make school meals more nutritious than any restaurant in America. Many parents mistakenly imagine that a lunch packed at home is the healthiest option. In fact, it is far easier to get the necessary nutrients in a school lunch meal since only 1% of packed lunches meet the nutri-

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CRASH

COURSE

More Americans have died on US roads since 2000 than in World Wars I & II combined

k, it’s time for a pop quiz. We have to see if you’ve been paying attention during our Crash Course sessions. But relax. This quiz has only two questions:

{

1. What is the #1 cause of death in the U.S. for people between the ages of 1 and 44? A. Diabetes B. Suicide C. Accidents D. COVID-19 E. Cancer

that were caused by some mechanical issue? The brakes suddenly failed. The gas pedal got stuck in the floored position. A wheel flew off at 70 mph. Never? That’s what we thought, although there may be an “almost never” or two out there. That doesn’t mean every crash is the victim’s fault. The world’s safest driver might be killed when an oncoming driver veers into her lane as he answers a text on his DumbPhone. It happens. But that’s another example of human error, of the fact that the vast majority of all accidents are preventable. What did you put down as your answer for question 2? Class, we hate to tell you that most of you are going to get this wrong. We hate even more to tell you that the correct answer is E: 66%, two-thirds! Two out of every three fatalities in Georgia involve unsecured occupants. That statistic is courtesy of the Georgia Governor’s Office of Highway Safety (GOHS). And that statistic is utterly shocking. Are there that many of us still driving around without seatbelts on? Seriously? Or are that many of us allowing our children and passengers to ride unbuckled? A study published in Lancet examined the effect unbelted back-seat passengers had on frontseat passengers. The finding: “The risk of death [for] belted front-seat occupants with unbelted rear-seat passengers was raised nearly five-fold.” Over the past three years for which numbers are available (2016, 2017, and 2018), Georgia has averaged slightly more than 1,500 annual traffic deaths. The GOHS figure means that nearly 1,000 of those deaths each year were unbelted occupants. Would they all have survived with seat belts? Statistically, wearing seat belts reduces the odds of death and serious injuries by about half. In other words, by the simple act of buckling a seat belt, 500 lives could be saved in Georgia every year, probably far more. That’s a very valuable return on a twosecond investment of time. +

{

2. In Georgia, what percentage of highway fatalities involve vehicle occupants who are not wearing seatbelts? A. 10% B. 25% C. 33% D. 50% E. 66%

POP QUIZ!

Did you answer B for both questions? If so, you have in-school suspension. Let’s take them one at a time. The correct answer for question 1 is C, accidents. More specifically, car crashes. For the 1 to 4 age group, accidents are four times higher than the second-place killer, and for 5- to 9-year-olds they’re nearly double the next biggest cause of death. It doesn’t really get better over time either. For 25to 34-years-olds, for instance, road deaths are almost three times higher than the second leading cause of death. Those numbers represent a huge and tragic toll on families and society as a whole. No wonder the Medical Examiner has a series devoted to traffic safety in every issue! This is serious business, and in all likelihood you, our reader (readers if we have more than one), have been personally affected if a friend or someone in your family has died in a highway accident. This huge death toll is also largely avoidable. Consider: what fatal accidents do you have personal knowledge of or have you heard about

Sparkle

Wash

OCTOBER 1, 2021

TAKING CONTROL… from page 1

tailed manuscript about strategies to achieve long-term goals. Yet, much to my chagrin, I find myself thinking about phrases such as “practice what you preach” and “the cobbler’s children have no shoes.” In May of this year, my book, The Coherence of Wisdom, was published by Westbow Press (www.thecoherenceofwisdom.com). This book was one of my most outstanding long-term goal achievements. I now can fully appreciate the sacrifice writers make to share their stories with the world. My book is a para-scriptural narrative that compares events during my life journey to the Bible’s teachings, and shares the lessons I’ve learned as a corporate executive, father of three, husband, and volunteer as advice to readers. So in keeping with the stated purpose of the Medical Examiner newspaper — to offer salubrious information — I would like to provide five strategies and suggestions for avoiding distractions and succeeding in goal achievement. 1. Christians often talk about a change in one’s way of life resulting from penitence or spiritual conversion. There’s a word for it: metanoia. Sometimes when the world around you seems crazy, it could be healthy to look it up. Prayer can help make your mind the President over the body’s desires. When faced with a challenge, force yourself to turn off the autopilot and seek control with the help of prayer. 2. I am a creative and curious person. Did you know that someone developed solar panels from studying a butterfly’s wings? Imagine the focus required to use biomimicry to bring green energy to the forefront of technology. Someone was very focused on solving the problem of creating energy from the sun. Take that lesson and consider setting up a website about your goal, write a daily blog post about your journey, or start a diary. My point is to use creative ways to stay focused, be mentally aware, and avoid known distractions. 3. Consider path-thinking. Stephen Covey, author of The 7-Habits of Effective People, posited to “begin with the end in mind.” Compare this way of thinking to a path toward goal accomplishment. Take some time to give life to your goal. Find pictures or stories and attach them to your bathroom mirror or refrigerator to remind you daily of the path you have chosen. 4. Fail forward. Engineers love this phrase, as it reminds them that design is a process. Thomas Edison is famous for stating, “I have not failed. I have found 10,000 ways that won’t work.” As the CEO of an organization that teaches the creative process, I used the Marshmallow Challenge (see www.marshmalllowchallenge.com) to help people learn that failing is part of succeeding. Don’t let failures distract you. Remember the distraction by placing a note in your smartphone or other can’t-miss spot and then taking time to review these notes at the beginning of each day. 5. Finally, take your goal(s) to bed with you. At bedtime, take a few moments to think about your plan. What have you learned about yourself in your journey toward your goal so far? Think about the success you are making and dream about the benefits of achieving your goal(s). Hopefully, these words of wisdom will help you in your journey. They sure have helped me: this story is a reminder to exercise and renew my diet commitment. + I know I can lose these last few pounds.

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The blog spot From the Bookshelf — posted by Anonymous, MD, on September 3, 2021 (edited for space)

I’M SORRY IF YOU THINK I’M TAKING YOUR FREEDOM The past year has been sad. Sad for the lives lost, sad for the isolation, sad for the hostility that has somehow occurred over measures to protect public health. To those who continue to spin a story that vaccines and masking take away your freedom: I’m sorry. Sorry you feel this way and sorry for all the other things you feel we do to restrict your personal freedom to protect you, others, and the wellbeing of this country. I’m sorry you feel we’re taking your freedom while our true priority is to protect the innocent, protect those who can’t protect themselves, and minimize lives lost to preventable things. I’m sorry you can’t see how masking is helping you save the lives of those you don’t even know. I’m sorry you can’t see how our recommendations to get vaccinated are intended to help all of us get back to the life we once knew – a life no longer restricted because of an unpredictable virus. I’m sorry that, while you will turn to a mechanic for car advice, a lawyer for legal advice, and an architect for building advice, you refuse to use experienced physicians and public health experts for medical advice. I’m sorry you are offended by our enthusiasm to get people healthy and keep them healthy. I’m sorry you’ve chosen to rely on social media and unqualified individuals for medical advice – individuals who have never stepped foot in a hospital as a health care professional. I’m sorry you think your higher power will save you when the time comes while, in fact, your higher power has already provided you a lifeline in the form of a vaccine. I’m sorry you continue to refuse our best protection against this virus despite its well-established success, but then, when you get sick from that same virus, beg us for medical treatments that have little to no proven success. I’m sorry that when you bring your school-aged child to me for their annual check, I’ll screen them for scoliosis instead of letting their spine be free to grow how it wants. I’m sorry we take away your freedom to drive fast through work zones so those helping to create safer roads can stay safe themselves. I’m sorry your child’s school may require a pre-participation physical so we can detect issues that, if gone undetected, might rob your child of the hopes and dreams they have. I’m sorry you can’t see how being unvaccinated is analogous to drunk driving – placing others at risk because you felt compelled to do things your way. I’m sorry smoking is restricted in public spaces, so you don’t have to be exposed to harmful carcinogens of cigarettes should you choose not to partake yourself. I’m sorry you think a public health department’s diligence to trace contagious diseases is a method to track your every move and action, while in reality, it is to save you and your loved ones from preventable disability and death. I’m sorry times of a pandemic disease call for shared sacrifice, which you’ve spun into an imposition on your individual freedom. I’m sorry your feeling entitled to individual freedom has superseded your duty to the greater good of this country so that we all may be free again. I’m sorry you can’t take a step back to see that a refusal to mask and vaccinate based on individual freedom is actually keeping the rest of us from our freedom.

I’m sorry.

Please see BLOG SPOT page 16

The central character in Breakthrough is an elevenyear-old girl. But not just any eleven-year-old girl. This one happened to be the daughter of Charles Evans Hughes. If that name rings a bell, you’re probably something of a student of American history, and Mr. Hughes holds a fairly prominent place on the pages of U.S. history. He was Governor of New York, served as U.S. Secretary of State, as Associate Justice of the Supreme Court, and was finally the Supreme Court’s Chief Justice. In the middle of all that, he also found time to run for President. (He lost to our own Woodrow Wilson.) But aside from all those things, Charlie Hughes (as we used to call him) was a father, and he was the father of a very sick child, the aforementioned eleven-yearold. In 1919, Elizabeth Hughes was diagnosed with juvenile diabetes, which at the time was not only incurable and untreatable, but also usually fatal. Fortunately, at about that same time, researchers were

making a breakthrough — which just might explain the title of this book — that led to the isolation and mass production of insulin. Elizabeth was one of the first to benefit from this new discovery. Incidentally, we’ve written about this amazing discovery process before. Check your family’s Examiner scrapbook for the February 5, 2010 issue on page 7 for a brief “Insulin bio.” Although there was a fair amount of wrangling between rival scientists and competing claims of discovery, the story ends happily: the Canadian

scientists credited with discovering how to extract and mass produce insulin sold the patent to the University of Toronto for exactly $1. The university, in turn, granted license without royalty to any company producing insulin (which for many years was Eli Lilly Co. and only Eli Lilly Co.). One of the cool things about this book is that it tells the story of a disease once thought to be a death sentence. As was the case with polio and any number of dreaded diseases of the past, there is always hope that in some laboratory someplace — maybe tomorrow or even later today — some researcher might make the key discovery that will lead to the conquest of cancer or another similar bane to humanity. Maybe even the breakthrough that leads to permanent end of coronavirus. One can always hope. + Breakthrough: Elizabeth Hughes, the Discovery of Insulin, and the Making of a Medical Miracle by Thea Cooper and Arthur Ainsberg, 320 pages, published in September, 2010 by St. Martin’s Press.

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The Examiners +

Do you know anyone who has COVID?

Not a one, thankfully.

by Dan Pearson

You know me, right? Ergo, there’s no way I could have it.

Good. Then that means I don’t follow you. I don’t have it.

I’m pretty sure that’s not how it works.

PUZZLE ACROSS 1. Aiken school, in brief 5. Tiny particles 10. __buse (Drug given to alcoholics) 14. Cargo 15. West Point attendee 16. Type of estate 17. Invalid 18. Vedic warrior god 19. William of fame 20. _____ Health (medical support profession) 22. A suit everyone owns 24. Splash with small drops 26. UK TV 29. Objective 30. America’s Cup competitor 34. Bring up 36. Evils 38. Steps for scaling a fence 39. Air sacs 41. Inflammation of the ileum 43. Undergarments 44. Hawaiian goose 46. Mr. Ballesteros 47. Augusta hospital 49. Charleston med. school 51. What follows many officers’ names 52. Self-centered hunter of Greek mythology 55. An utter coward 58. Engraver 62. Capital of Western Samoa 63. Word before front or liner 65. Swiss river 66. Final word in Gone With the Wind 67. Decatur/Atlanta Ave. (as it’s commonly known) 68. Baseball team

24 26

30 36

44 48 52

38 42

51 54

58 64

DOWN 1. Forearm bone 2. Inner self 3. Phone 4. Improvise 5. Dirt with low pH 6. Convert into leather 7. Weirdo 8. Worth 9. Fits partner 10. Joint inflammation 11. Requirement 12. Rhythm in Indian music 13. Supporter 21. Electroencephalography (in brief) 23. Tantalize 25. Former Alaska governor 26. Ft. Gordon leaders 27. Southern ______

We’ll announce the winner in our next issue!

EXAMINER SUDOKU 1 2 3 6 5 3

9 2 1

5 1 2 7 9 3

8 6

6 2 5

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

69. Narrow strip of wood 70. Satisfied 71. Old

Click on “MYSTERY WORD” • DEADLINE TO ENTER: NOON, AUG. 30, 2021

N O I Simply unscramble theA letters, T then begin exploring C our ads. When you A find the correctly spelled word V hidden in one ONof our ads — enter at AugustaRx.com

28. Petty objection (verb) 31. About 1.75 pints 32. Augusta road with a noted bridge 33. Adjust again 35. Remorseful 37. Nasal cavity 40. Academy award 42. Diminished 45. Distinguished 48. Ppeople under the 26-D 50. Incision 53. Type of butter 54. SC utility acquired by Dominion Energy 55. Cushions 56. Libra gemstone 57. Capital of Peru 59. Man who said “I am in control here.” (at The White House in 1981) 60. Sea eagle 61. Dr. Walter 64. Bandage type

QUOTATIONPUZZLE 9 7 8 2 9 6 5 1 - Arthur Koestler 1905 — 1983 7 3 8 5 6 4

S E A R S M A B V V R R S G T S A 4 L M H M D I O R O E O W Y R I N E 1 T E E E D T 3 O C T I E U I O R A I H 2 O S F E

ACROSS 21 Small com1 reflex munity 3 solid 7 Jawless DOWN fish 13 Conno- 2 oxidant isseur of 3 ObjectO K case T W ive wine 1 2 1 2 3 4 5 6 7 8 9 1 2 3 1 2 3 1 2 3 4 1 2 3 4 1 2 3 4 5 of I 15 Fish E 1 2 1 2 1 2 1 2 3 4 5 6 1 2 3 4 4 Formiceggs 1 . LT T T S F O E W T T I 2 . H H N O O S O O N A I O 3 . LT Y E S L E M 4 . T M E Y K E 5 . S E R 6 . T N 7 . A 8 . I 9 . N ary 16 Quick!!! I S B L I N D L O V E SAMPLE: 1. ILB 2. SLO 3. VI 4. NE 5. D = 1 182 3Mobile 4 1 2 1 residents 2 3 4 5 5 Annoyed home Solution p. 14

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.

— Kin Hubbard 1868 — 1930

WORDS NUMBER

THE MYSTERY! WORD The Mystery Word for this issue: BLOMMSAITE

EXAMINER CROSSWORD

OCTOBER 1, 2021

s s 9B 10 3 5 6 7 8 4 1 9 2

6 3 8 4 5 2 9 7 1

11 12 13 14 16

4 2 9 1 7 3 8 6 5

OCTOBER 1, 2021

AUGUSTAMEDICALEXAMiNER

THEBESTMEDICINE ha... ha...

fish walks into a bar. Took him 450 million years.

Moe: What are your plans today? Joe: I’m going to pick up a friend of mine and we’re going to get new glasses. Moe: What about after that? Joe: After that, we’ll see. Two buddies were in the middle of a round of golf one day when one, Bob, sliced his drive way off the fairway. He got up to about the spot where the ball went into the woods and looked down into a fairly deep ravine. He grabbed an 8-iron and climbed down a steep embankment to try to find his ball. Swinging the iron through the underbrush he spotted something shiny. Looking closer, he discovered that the shiny object was an 8-iron in the bony grasp of a skeleton lying near an old golf ball. “Joe!” he called up to his friend. “I got big problems down here!” “What’s wrong, Bob?” replied Joe. “I don’t think I can get out of here with my 8. Throw me my 7-iron, will ya?”

The

13 +

Advice Doctor

Sylvester Stallone: Guys, I’m making a movie about composers. I’m going to play Vivaldi. Jean-Claude Van Damme: I’m in! I’ll be Mozart. Arnold Schwarzenegger: Forget it guys! I’m not going to say it!

Moe: Hey, I’m helping my kid with a science project. Can you help me out? Joe: If I can. What’s up? Moe: Which weighs more, a ton of feathers or a ton of rocks? Joe: Moe, they both weigh the same, a ton! Moe: Ok, yeah. Duh. That makes sense. Also, what weighs more, a gallon of water or a gallon of butane? Joe: Water does. Butane is a lighter fluid. Moe: Did you get that job you applied for? Joe: At Old McDonald’s Farm? I sure did. Moe: What’s your job title? Joe: I’ll be their CIEIO. Moe: I can always tell when Halloween is right around the corner. Joe: How so? Moe: All the stores put their Christmas decorations up. Moe: They say gators can grow up to 15 feet. Joe: Wow. Four is the most I’ve ever seen. Moe: So how did it go at your doctor appointment? Did this one finally figure out what’s wrong with you? Joe: He did. Moe: What is it? Joe: He said I have hypochondria. All I could think of was, “Dear Lord, not that too.” +

Why subscribe to theMEDICALEXAMINER? What do you mean?

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

Because try as they might, no one can stare at their phone all day.

Dear Advice Doctor, Sometimes I think people are put in management so that they won’t get in the way of those of us who actually get the job done. I have a boss who is totally and completely out to lunch on just about every decision he makes, yet his pay is almost double what mine is. We do what it takes to run this place, and sometimes that means doing exactly the opposite of what he tells us. Just curious: is that loyalty to the company or is it insubordination? — Trying Not to Put Dys Before Function Dear Trying, It’s good that you’re trying. I admire that. But I want you to try a little harder, and I promise that if you do you will reap benefits. Not immediately, but in time. And I’m talking multiple benefits, too. Let’s look at this objectively. Anyone who is out to lunch all the time is facing two issues: a shrinking wallet and a growing waistline. And if they’re out to breakfast all the time too, these dual problems are compounded. I talk to patients who are concerned about their weight all the time about this very issue. They say it’s hectic and rushed in the mornings. They don’t have time to sit down and eat breakfast and pack a lunch too. But somehow they always find the time to sit in a fast food drive-thru line for ten minutes. And very often twice a day, at that. Sometimes again in the evening. That same expenditure of time could be spent throwing some nutritious lunch items that will literally cost pennies into a bag. Or just scooping the bag out of the refrigerator because you got it ready the night before. It would be very difficult to do this and not save significant amounts of money and calories, not to mention such undesirables as the large doses of sodium and fat that fast food is known for. You will undoubtedly lose weight and save money doing this, and if you stick with it the beneficial results will grow over time. And all the benefits will be compounded if this is done for both breakfast and lunch. Transform that slow once or twice a day drive-thru trip to a once a week treat. I hope this answers your question. Thanks for writing! + 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.

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OCTOBER 1, 2021

PATIENCE… from page 1

from around the country about people who were vocal antivax and/or anti-mask campaigners who then got COVID and in most cases died. It includes many screen shots of posts these people made before they got sick ridiculing the recommended ways to protect ourselves from the virus. The stories themselves are heart-breaking. Moms or dads (or both), some in their 20s and 30s, dead from COVID, leaving behind young children. But what is even more disheartening are the brutal comments left in response to each story. “Too young to die; to dumb to live,” was one. “Good riddance!” was another, reflecting a common theme. “This is what Darwin called natural selection.” “Unmasked. Unvaccinated. Unafraid. And now, Unresponsive.” Referring to a couple from Denmark, SC who both died, leaving behind young 7 children, someone posted, “Can we sue the corpses for child abuse and child abandonment?” There are literally thousands of comments on the site, and probably 1% of the ones we saw offered words of consolation and sympathy. The rest were scathing, cruel denunciations. Have we sunk that low? Meanwhile, news reports continue to be sprinkled with accounts from across the country of violence and death threats erupting at school board meetings as mask guidelines are pondered and sometimes passed into policy. Minimum wage workers, in some cases teenagers on their first jobs, are getting shot and killed for asking customers to mask up, as instructed to do per company or store policy. Adult airline passengers are throwing childlike tantrums in response to masking requirements. The rancor and debate and accompanying vitriol are out of control, and very little if any of it is productive. It isn’t convincing members of the opposition viewpoint to change. People are digging in on both sides of the debate, becoming ever more entrenched in their views. Does this mean this is the final article about COVID-19 in the Medical Examiner? That is not possible. The biggest story in health and medicine in a century cannot be ignored. But it’s one thing to report the facts and disseminate news of what’s happening on the COVID front, and another matter entirely to attempt to change opinions between idealogical camps that are miles apart. Been there. Done that. Failed. That’s not to say that the occasional appeal from a physician or someone else in the public health sector will not appear on our pages (including in this very issue; see page 11), but we’re going to try our best to not add to the din of disrespectful debate in the days to come. The best policy for one and all is to simply accept that others have their personal opinions — for and against — and they’re unlikely to change. +

BLOGSPOT… from page 11 I’m sorry you are living a delusion of being bulletproof and believe that a virus cares about your supplements, keto smoothie, or dedication to the gym. While consistent healthy behaviors are important to a strong immune system, pathogens of pandemic diseases could care less. I’m sorry your kids are learning that individual entitlement supersedes shared sacrifice on the moral continuum. I’m sorry your tightly held grip on the word “liberty” has blinded you to the efforts our very own founding fathers made to keeping the public safe from epidemic diseases – including the encouragement of vaccination and quarantine when needed. But mostly, I’m sorry that you’ve chosen to create stories about medical prevention, safety, and public health measures. Because the rest of us are out here just trying to save lives – every life. You’re the one choosing to make it something more than that. + The author is an anonymous physician.

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