Autoimmune diseases cause chronic disability and are poorly managed using mainstream medicine techniques. At this lecture, you will learn the underlying problems that create or worsen autoimmune diseases, and how you can take control of your health problems.
Send me an email at alj@docaltmed.com to reserve your seat.
The Old Ways: A Journey On Foot by Robert Macfarlane
My rating: 5 of 5 stars
This book has taken its place in the top five of my pantheon of books. Macfarlane's lyrical prose allows us to see the mundane footpath placed in a greater cosmos, integrating the geographic passage of the path with its passage through time and community. For all paths are a statement of community, of the close passage of people to work, to home, to sea and to places unknown.
Read, from one of his closing paragraphs: "Images arise, gleaned from the miles on foot. White stones, white horses, flying islands, glowing eyes, mirages, drowned lands, dreams of flying, reversals and doubling, rights of way and rites of way, falcons and maps: the images move as brass spheres in an orrery, orbiting and converging in unlikely encounter. There is a flickering to order; gathered details are sealed by the stamp of the anterior. The land itself, filled with letters, words, texts, songs, signs and stories. And always, everywhere, the paths, spreading across counties and countries, recalled as pattern rather than as plot, bringing alignments and discrepancies elective affinities, shifts from familiar dispositions."
As excellent writing is wont to do, Mafarlane inspired in me a torrent of composition, some of which I have published and some of which remains to be seen.
I have been involved in trails, trail construction and hiking for most of my life, but Macfarlane's British perspective on paths and walking them was novel to me. Like most other things American, our trails are functional, utilitarian, planned. Starting with the name, they are "trails," not "paths." They have been designed for most efficient ascent, most pleasant passage with eye to overlook and flora and fauna, and engineered to handle literal parades of people (while working on the Appalachian Trail in the Franconia range, above treeline just past Greenleaf Hut, I once observed 145 people walk by me in a single day). Macfarlane's Old Ways are different entirely. These are paths that are organic to the land and the people living in them, winding, wandering and loosely arriving at a destination, or destinations that may or may not have been their original intent. One ambles along them, not to achieve a summit or capture an overlook in pictures, but to experience their passage through landscape and time.
I hope someday to walk a path like Macfarlane has. Reading this book has instilled in me a new way of thinking, a new way of experience the woods to which my life has been so closely tied.
I've never been one to hide my disdain for the tendency of mainstream medicine to allow financial incentives to color medical research and decision-making. In fact, what the record industry once called "payola" -- and which rocked that industry to its core in the 1950s -- is accepted practice in the medical industry.
As former Editor-in-Chief of the New England Journal of Medicine Marcia Angell has pointed out in her books and elsewhere, medical research has been virtually overrun by checkbook research -- with Big Pharma paying the Big Money to get the results they need.
“It is simply no longer possible to believe much of the clinical research that is published, or to rely on the judgment of trusted physicians or authoritative medical guidelines. I take no pleasure in this conclusion, which I reached slowly and reluctantly over my two decades as an editor of The New England Journal of Medicine,” Angell said.
She's not the only one to have seen first-hand the corruption of medical research. Take, for example, this quote from an abstract of a paper on vaccinations. This article was published by a group called the Cochrane Collaboration, an international collection of scientists who have volunteered to review medical research in the effort to develop evidence-based practice guidelines. And this is what the scientists had to say about the research on the influenza vaccine:
"Fifteen of the 36 trials were funded by vaccine companies and four had no funding declaration. Our results may be an optimistic estimate because company-sponsored influenza vaccines trials tend to produce results favorable to their products."
But the real problem of Pharmaceutical Payola occurs much further down the food chain, at the offices of individual doctors. Multiple studies have found that pharmaceutical marketing has dramatic impact on doctor's prescribing habits. One of the most effective ways of influencing doctors is through providing continuing medical education credits for free through company-sponsored seminars.
I've seen this influence more directly through the eyes of others. I once knew a woman who worked for a specialist group practice; her sole job was to review drug company studies, and advise the practice as to which ones in which they should participate. Her decision algorithm, however, had nothing to do with scientific advancement or patient wellbeing. Rather, her recommendations were entirely based on which studies would prove most lucrative to the practice. Because what the doctor doesn't tell you, dear patient, when he offers you a chance to be cured by this new breakthrough drug that they are testing, is that he is getting paid anywhere from $6,000 to $18,000 for each patient he enrolls -- plus another $20,000 when he hits the 20-patient mark.
Not surprisingly, all of this kind of bothers me. It bothers me mostly because detractors of alternative medicine routinely claim that mainstream medicine is "based on science" and alternative medicine is not. Nothing could be further from the truth.
In fact, the opposite is likely to be more consistent with reality. According to one study, fewer than 20% of mainstream medical procedures are supported by research. Only one-half of medical interventions are therapeutic. And very, very few surgical procedures are subjected to double-blind trials before widespread acceptance.
In contrast, chiropractic care for a variety of musculoskeletal ailments is well documented in the scientific literature. Acupuncture has an exceedingly long trail of research, and nutritional interventions are "alternative" only in the minds of troglodytes.
Whether I am adjusting someone for their headache, using acupuncture to treat a child with Tourette's, or using diet and nutritional supplementation to help a patient eliminate their arthritis pain or control their autoimmune disease, I can in every case point to research supporting my use of those procedures. And, unlike in mainstream medicine, nobody -- but nobody -- makes money from research into nutritional therapy or chiropractic. So it is unlikely to be tainted by money, even if the players in the industry had the finances to do so.
Which, at long last, brings me to the point of this post. (In journalism, this is called "hiding the lead." When I was a newspaper editor, I regularly chastised my reporters for doing this.)
Coupled with my scorn for mainstream medicine for allowing itself to be bought by the highest bidder has always been my admittedly sanctimonious opinion of my own ability to stand above the fray. I have even bragged that the largest gift I have received from any nutritional company was a case of apples (It was from Douglas Laboratories, back in the 90s) and a bottle of honey.
All of that changed yesterday, however, when a rep from one of the nutritional vendors whom I use for patient's supplements stopped by. My relationship with this company is less than a year old, but not for lack of interest. I first encountered them several years ago at a nutritional conference I was attending. Impressed by their products at the time, I have intermittently contacted them for more information, but never received any response. I'm not surprised; in the larger scheme of things, my little practice in Podunk, Connecticut is not going to bring out the big marketing guns.
Purely by serendipity, however, that changed last year. One of their reps stopped by, unannounced, saying that she had seen my sign in passing, and wanted to introduce herself. I'm pretty sure that she was on the way for Someone Else's Office and just got lost, but it was a serendipitous visit nonetheless. In a short introductory meeting, I let it drop, without qualification, that what would sell me was science. And quality. And if their products did not stand up to either, #thankyouverymuchbutbutnothanks.
A few weeks later, she showed up again, armed and ready. She dropped journal after journal in my hands, explaining how it fit into her company's products and the benefits provided. I was impressed. She left, and I did some homework; she wasn't just blowing me smoke.
So I ordered a few products, and began using them. Patient feedback was good, but more importantly, patient improvement, documented objectively, was impressive. I know, there's always the problem of confirmation bias when a clinician reviews his own work, so I can't conclude from a truly objective standpoint that the products worked. But you have to go with what you've got, sometimes.
This company offers a number of conferences, and at her last visit, I asked the rep why they don't include CEU credits for doctors attending them. Her answer was simple, blunt, and honest.
"We won't," she said. "We talk about our products."
Compare that answer to that of the pharmaceutical companies, which routinely spend millions of dollars sponsoring CEUs for medical doctors, and consider it a routine cost of doing business. I have attended some of those lectures, all of which have been extended infomercials for one or another miracle drug. The fact that this nutritional supplement company specifically delineated a difference between education and marketing was impressive.
At this visit, she also plopped another inch of independent research on my desk, and we talked about the scientific backing for some of their new products. I was so engrossed by the information, that I completely forgot about the wrap she had brought from some deli.
I shouldn't have; this was unique. During her previous visits, she had never provided me with a free sample of anything, except as a quick taste test when I had mentioned that other, similar products had been met with unhappy looks from my patients.
So engrossed was I with the data that I forgot about the sandwich. Sandwiches, by the way, fall well within the guidelines for proper behavior for representatives visiting doctors, so I did not feel any gross or subtle moral violation for accepting the food.
After the rep left, I got around to opening it up, and discovered, perhaps, the Best Wrap I Have Ever Had In My Entire Life. I immediately emailed the rep to get her source; she demurred, however. So I still don't know where The Wrap came from.
So I have to confess. In addition to having been courted by a case of Red Delicious apples, I have now been waylaid by a chicken wrap of unknown provenance but undisputed tasteworthiness. That is the full extent that any company has sought to influence my prescribing behavior.
So the next time I recommend a supplement to you, I want you to have full and transparent knowledge. I'm doing it for the wrap.
Half of all new drug formulations in the US were approved without companies having to demonstrate a tangible benefit http://t.co/fBbLZuS804
— Dr. Avery Jenkins (@averyjenkinsdc) January 23, 2014
When it comes to understanding health and disease, there are three fundamental precepts which must be acknowledged. These principles fly against much of what passes for common wisdom in medicine, but understanding and utilizing these principles have been the secret to my ability to find solutions for my patients where others have failed.
The first tenet is that a disease cannot exist in isolation. The way we structure our language about disease has always bothered me, because it reflects the outdated view that a disease is a thing, an entity that we must combat and control. When we are ill, we say that we "have" the disease; "I have a cold," or "I have arthritis," as if our ills were something that we pick up and plop into the shopping bag of self.
Nothing, of course, could be further from the truth. Diseases are not isolated entities, they are ongoing processes in which we play a part. Even with infectious diseases, illness cannot exist separate from our participation in the process. How can a fever exist without a body to become hyperthermic? Where is a headache without the head? Where is the bruise without the swelling? How can a cancer exist without the cells to grow into a tumor?
As I keep telling my patients (and anyone else who will listen), there is no "I", there is only "we". As I type this, millions of commensural bacteria are helping me to digest my last meal, eliminating the detritus on my skin, and challenging not-so-friendly bacteria that want to get into my lungs. Without them I would be dead. Extending the sphere of my existence outward, the air filling my lungs and the food filling my stomach are all part of my health environment, and exert profound influences for good and ill.
What it comes down to is that any disease is a dance between ourselves and our external and internal environment. For better or for worse, we are full participants in our disorders. Unfortunately, the culture and custom of medicine leads us to distance ourselves from our illnesses, thereby putting many of our tools for healing out of reach as well.
The second tenet is that, disease, as well as health, is not static. The fluctuation from healthy to ill, and back to healthy again, even within the limited range of a chronic illness, is a constantly changing process. But again, our language reflects a fundamental disconnect with this particular nature of illness. Labels that allegedly describe a disease, such as arthritis, or irritable bowel syndrome, attempt to tag and bag something which exists only as a process. Arthritis isn't a thing; it is the gradual erosion of joint surfaces as the body fails to create new joint material to replace what is worn away. Irritable bowel syndrome isn't a bucket full of symptom post-it notes, today presenting as diarrhea and fatigue, tomorrow as constipation and depression. IBS is the process of opportunistic bacteria overtaking the intestinal milieu, altering the environment to better suit their needs.
Again, by misrepresenting diseases as static entities rather than ongoing processes, we lose the ability to alter them. You can only change a "thing" by cutting away at it, or attaching things to it, or by removing it; a process, however, has multiple points of entry where changes can be introduced, any one of which that can result in an altered process with an entirely new outcome.
The third tenet is the most important, and perhaps the most difficult to grasp, because to understand it we have to step outside of our cultural predispositions. The essential fact is that any disease is primarily a social construct. That is, we have decided to connect disparate data points together, each point representing a symptom, or lab value, or observation, and give this conglomeration a name, not unlike the ancients would look at the night sky and create pictures from points of light connected only in the imagination of the astronomer. These constructs are created at the convenience of the tools we have on hand; in the case of a disease, it reflects the tools which we have to address it, whether that tool is a drug of unknown mechanism in the case of the modern MD, or the pantheon of gods and their consorts, in the case of the ancient astronomer. Were it not for the story of Orion, that constellation would not exist; similarly, were it not for the existence of the microscope, there would be no such thing as a Staph infection. Our tools of observation and correlation are what make diseases possible.
Which is why different cultures, with different analytical systems, have different diseases. The Western diagnosis of clinical depression does not exist in Chinese medicine. Multiple Eastern diagnoses partially overlap the clinical entity we call "depression," but none are an identical (or even close) match.
The same culture will also alter diseases with the progress of time. What we now call fibromyalgia has a long and storied history going back over 100 years. But back then it had a different name, and different aspects of it were emphasized according to the prevailing views of biology at the time. What you have today is certainly not your grandfather's fibromyalgia.
Interestingly, I think that this is one of the reasons that the chiropractic profession proved to be such a threat that the AMA has spent over 100 years and millions of dollars trying to quash it. For the first time in the history of Western medicine, the chiropractic paradigm of illness focused on the key intersystemic command and control system of the body -- the nervous system. To do this, early chiropractic researchers developed a new language and a new allegory to explain an individual's health status. This was during the time when medical doctors were still bloodletting their patients and dosing them with arsenic in the race to rid the body of "vile humors," and such an entirely different way of thinking posed an intolerable threat. It had to be stopped.
Politics aside, consider for a minute how applying these fundamental precepts of disease can dramatically alter our approach to health problems.
Let's take, for example, a possibly fictional patient sitting in my exam room. He has come to me with a history of uncontrollable high blood pressure. He has, per his MD's instructions, dropped excess weight and engaged in a regular exercise plan. For the most part, he is eating what the medical profession calls a "heart healthy" diet -- lots of vegetables and grains, and avoiding "unhealthy" fats and cholesterol-containing foods, like eggs.
Despite his efforts, his blood pressure remains high, and is only precariously controlled by an unhealthy brew of anti-hypertensive medications, providing a dose of fatigue and flat-lined libido on the side. This patient is not a happy man.
The process of figuring out what is wrong begins with a recombination of the data. For the most part, I am not availed of any secret information that wasn't also available to the physicians preceding me. But perhaps I look at it in different ways.
For example, I've noted over time that the majority of people with high blood pressure have a very distinctive feel to their pulse. So why is it that the patient in front of me presents with uncontrollable high blood pressure, yet his pulse lacks that unique signature? My further examination, while not necessarily uncovering anything new, will occur in the context of trying to answer that question. And slowly, the dots will connect in a constellation that hasn't been seen before. I note a ruddiness to his complexion. He complains of fatigue, yet speaks in a loud, emphatic voice and exercises regularly. He is a large man, and despite his controlled diet, demonstrates a rotund abdomen. He is firm, with a layer of cutaneous fat overlying muscle. In my midwest childhood, we called people like that "milk fed." Everything about this man speaks of paradox.
So what's going on here? Let's ignore the diagnosis that the man walked in with, and think about the person himself. The most obvious thing about this man is that he is on fire. He is active, engaged, refusing to sit still, and refusing to accept his condition. Yet underneath that, there is...not much. An empty stomach. Fatigue.
What else in the world is like this? My mind is immediately drawn to the image of a cup of alcohol burning. The flame is hot, but not long lasting, and the flame is difficult to see. Unlike a wood fire, long lasting, even tempered, creating coals and ashes as it burns, this fire is empty underneath. And that -- an "empty fire" -- is what describes the man in front of me.
So what would cause that sort of blaze in a human? Well, an empty fire depends upon ready fuel that is easily combusted and leaves nothing behind. Which is exactly the sort of fuel that this man has been using. His "heart healthy" diet is dependent on grains -- in other words, easy-to-access carbohydrates, which are burning and leaving nothing of value behind.
So I tell my patient that we are going to modify his diet. For him, a paleo diet makes more sense, with its slow-burning fats. We discuss the particulars of his plan, and send him off with instructions to monitor his blood pressure daily. And, sure enough, a month later, his blood pressure is out of the danger zone and stabilizing at a healthy level. He owned his involvement in his disease process, and danced with it, eventually leading it off the dance floor altogether.
Do not mistake this approach to finding solutions for an intuitive one, because it is actually highly analytical. As I go through my day, I am constantly reminded of the words of scientist/philosopher Alfred Korzybski.
"The map," Korzybski said, "is not the territory." And when it comes to human health, it is important to have a variety of maps on hand; where one shows impassible mountains, another might show a lowland path.
For decades, cycling in America has struggled to roll beyond the pitifully small number of cyclists who ride on a regular basis. Despite the facts that regular riding can slash your transportation costs, improve your health and longevity (cyclists live 2-5 years longer than non-cyclists) and reduce infrastructure expenses for cities and towns, cycling remains a backseat activity for most people.
There are many reasons cyclists want to see more of us on the road. Some for perceived safety reasons -- citing studies showing that the more cyclists there are on the road, the safer it becomes for all cyclists. Some because a larger cycling population means that more funding will be allocated to cycling-specific infrastructure. Some wish to see cycling increase because of its undeniable environmental, economic, and health benefits.
Certainly, there are areas showing cycling growth. New York, San Francisco, Portland, Denver and a few other cities have seen a rather dramatic upsurge in the use of bicycles on a daily basis for commuting and running errands. But outside of the urban environment's hip pocket, there's not a lot happening.
Take Litchfield, for example. I can count on one hand the number of people I've seen in Litchfield using their bicycle as anything more than a recreational device. There are maybe 2-3 people, in a town of 8,000 who commute by bike, and I have never, ever seen another bicycle parked in front of Stop and Shop, CVS, or along West Street.
Is it unfeasible to use a bicycle for transportation in Litchfield's suburban/rural environment? Certainly not. If you live in much of Litchfield, you are, by definition, within only a few miles of the town's center. The town's facilities and shops are also within easy cycling distance of parts of Bantam. I am quite willing to concede that cycling from Northfield, however, may be an uphill slog that fewer are willing to do.
Geography is not the problem. So what is?
There's certainly interest in the state of cycling in Litchfield. There is an active group shepherding a recalcitrant multi-use path into existence. Once completed, this path would connect the center of Litchfield with Bantam, allowing cyclists to avoid Route 202 .
And I confess to being both surprised and dismayed at a few bicycle advocacy meetings I attended in the past couple of years. I was surprised in that the turnout for both meetings, to discuss ways to improve the state of cycling in Litchfield, was significantly higher than I thought it would be . My dismay stemmed from the fact in that I was the only attendee who actually rode a bicycle to the meetings.
Just so that it doesn't slide by, let me repeat that: I was the only person to ride a bicycle to attend two bicycle advocacy meetings.
There's something so dismally wrong with that fact that I have been a little bit afraid to do anything but squint at it sideways for fear of what I might find. At least I was, until I realized that this problem isn't a local one. It's a national one. It's a problem that has infected every cycling advocacy program in the U.S., and it has remained largely ignored:
The problem with cycle advocacy lies at the feet of cyclists themselves and the cycling industry in North America.
The problem is that cyclists need to grow up.
I have been involved deeply in cycling since my teens, when I built my first "10-speed" from junked parts at age 17, to my twenties, when I discovered the joys of recumbent bicycles, to today, as one of the League of American Bicyclist's 3,000+ certified cycling instructors. But while I have grown up with cycling culture, the cycling culture hasn't grown up with me.
Looking back to the cycling renaissance of the 70s, even though it was stirred by gasoline shortages and skyrocketing prices, the appearance and culture of cycling was completely built around the sport of cycling. Movies such as Breaking Away personified the cycling zeitgeist of the 70s.
Fast forward with me through the next 25 years. The next current that dragged cycling again into the public eye was a man by the name of Lance Armstrong. America loves a winner, particularly a winner in a sport dominated by Europeans, who even after 200+ years of independence from the UK, still make us insecure. Armstrong's winning streak, it was thought by many in the cycling community, would bring a flood of riders onto the road. This, of course, was long before we discovered that Armstrong was drugged to the gills and winning more by pharmaceutical fiat than by true talent.
Regardless, the projected jump in numbers never materialized. Sure, there were a few more cyclists on the road than there were before, but hardly enough to make a statistical difference.
Jump to today, and once again, economic conditions have conspired to make cycling a potentially valuable mode of transportation. In fact, it just makes raw common sense to hop on a bike instead of in a car. Without even trying, I saved $3,000 last year by riding a bike a lot of places instead of taking an automobile. Do you have enough spare change to throw away a cool three grand for no reason? I don't. And it's not like I'm some sort of athlete. I'm just a guy on a bike going to work or the store.
And while a few isolated parts of the country have seen a substantial uptick, the seeds of cycling elsewhere in the country have not only failed to blossom, they haven't even taken root (e.g., Litchfield). In many countries of Europe, everyday cycling is becoming a reality as it did long ago for the citizens of the Netherlands, where 86% of the residents hop on their bikes daily to run errands or go to work.
The difference between there and here, and then and now, is the behaviour of the cyclists themselves. Watch, for a few seconds, the cyclists of Copenhagen:
http://youtu.be/xsDxOx7PUP0
What do you see? The first thing I'll bet most people saw was the lack of helmets. Then there is the clothing -- everybody seems to be wearing everyday work or casual clothing. Then there is the behavior, on the part of both motorists and cyclists. The bikes look comfortable, and nobody is bent double in an uncomfortable, pseudo-aerodynamic position. Racks for groceries, briefcases, kids. Everything in that video speaks to what it is like to cycle in a mature cycling culture. Safe. Family-friendly. Gentle.
Compare that to what you've seen of cyclists in the U.S.: Cycling helmets, hi-viz gear, running red lights, running stop signs, making left turns from the right-hand side of the road, riding on sidewalks. Crouched down on uncomfortable-looking bikes stripped down to virtually nothing. Pounding their way to the next stop light. Cycling in the U.S. is almost the converse of cycling in a bicycle-rich environment.
In a cycling-rich environment, the cyclists behave as if cycling is a normal activity. They wear normal clothes. They don't bother with unnecessary safety gear, like hi-viz jackets or helmets. They don't ride like they are pretending to be racing. They ride like -- well, they ride like normal people on a bike. Cycling is the normal way of life.
American cycling, unfortunately, is stuck in the unprofitable, dead-end rut of promoting cycling only as a sport, not as a lifestyle. From manufacturers to advocacy groups, the vision of cycling in the U.S. is still built around the young, macho cyclist forging his way through danger and adversity.
But if you really want cycling to grow, you have to abandon that shrinking demographic. You have to attract different people to the activity, and in particular, you need to make it appealing to women. The percentage of female cyclists is closely correlated with the growth of cycling in a number of countries, to the extent where women cyclists are considered the canaries in the coal mine. When their numbers drop, cycling dies.
So here are the steps cyclists need to take to ensure the growth of the activity.
1. Stop selling fear. Selling an activity as risky and adventurous works very well on the 14-28 male demographic. It doesn't work so well with women, whose number one reason for not cycling more is that they feel it is unsafe. And why wouldn't they? All of this special safety gear that you allegedly need to ride a bike practically screams DANGER!
The fact of the matter is, cycling is one of the safest activities you can engage in. Injuries requiring medical intervention are relatively rare for cyclists, and those who do suffer injury are not infrequently riding unsafely. The alleged danger of cycling has been highlighted by the focus on racing and exaggerated by an industry focused on selling to their slender demographic.
So, for crying out loud, quit preaching helmets. They aren't necessary and you won't die riding without one. Anyone who has thoroughly examined the literature will reach the conclusion that helmets can do little to protect you against serious injury. So if you want to wear one, wear one. If you don't, don't.
On virtually any ride that I encounter a large number of other cyclists, I am bound to get at least one comment about my lack of helmet. And, invariably -- I know, because I have made it a point to track them -- the people who castigate my bareheadedness proceed to run the next red light or blow through the next stop sign. Which brings me to point number 2:
2. Start riding like adults. Motorists don't respect cyclists, in part, because most cyclists ride like children. The majority of cyclists treat the rules of the road as if compliance was voluntary, not mandatory. It ends up making cyclists look like self-absorbed children, and who wants to be like that? If cyclists start to behave in a manner that makes them look like adults, then it is much more likely that other adults will find the activity interesting. And while we're talking about looks...
3. Save the spandex for when you need it. I agree that when I'm on a long ride on a hot day, cycling-specific clothing makes cycling more pleasurable. But that same apparel drives potential cyclists away in droves. There is nobody on the planet Earth who has not looked at a pair of Lycra shorts and said to themselves "There's no way in hell I'm gonna look good in that."
Trust me, I don't. So, unless it's a longer ride or the weather forces my hand, I don't wear cycling-specific clothing. When I'm going to work in favorable weather, I'm in dress slacks, shirt and often my tie. To the grocery store? It's shorts or jeans and a comfortable shirt and jacket. Remember those Copenhagen cyclists in the video? They're looking pretty fly. In fact, there's a whole website, called Copenhagen Chic, dedicated to the classy men and women cyclists of that city.
4. Be nice to others. In pursuit of the macho road warrior image, most cyclists speed down the road, looks of determination set on their faces, ignoring walkers and runners alike. You want more people to ride bikes? Say hi to the runner that you pass. Wave to the kid on the sidewalk. Slow down to just a few miles per hour when you're on the path and passing pedestrians. It's called being nice, and it works phenomenally well, if you want to encourage others to join you.
5. Tell industry leaders to embrace the reality of a mature, cycling rich culture. I've been a member of the League of American Bicyclists for years. As part of that membership, I receive a complimentary subscription to Bicycling magazine. It is the largest cycling magazine in the country. It is also one of the worst. It depicts cycling in all of the immature stereotypes that restrict its growth. Far better would be a complimentary subscription to a magazine like Bicycle Times, which is a far more adult publication.
Similarly, what few audio/video media outlets that cover cycling need to change their focus. Podcasts such as David Bernstein's The Fredcast need to shift gears into a format less racing-centered and more about the cycling lifestyle. While I admire David and his revolving crew of participants on both The Fredcast and The Spokesmen, I began to lose interest when his coverage of Armstrong's fall and its effect on cycling dominated episode after episode, while topics of real meaning to cyclists, such as funding, politics and other news was virtually ignored.
It all comes down to this. If we want cycling to grow beyond its small, homogeneous niche, all of us cyclists need to change our behavior to reflect the cycling culture that we want to bring about. In other words, if you want an environment where most of the population rides a bike -- then you should ride your bike as you would in that environment.
Not the least of my challenges in sitting zazen are the dogs. The year-old puppy likes nothing better than to sit in the room with me, gnawing on his bone and occasionally trying to share it with me, although in his puppy brain "share" is spelled "let's play tuggies." Of course, playing tug of war is not conducive to the spiritual process of letting go, but the puppy doesn't seem to mind.
I try to remember how fortunate I am. After all, how many people around the world, sitting and meditating at the same time I am, have the opportunity to seek enlightenment against the backdrop of teeth scraping across femur? Not many, I suspect. I'm a lucky man.
My 12-year-old dog, though, mostly minds his own business. He and I -- well, we've been through the wars together. He was a rescue pup I met when he was one year old. When we first met, he looked at me as if to say "Well, what took you so long?"
He and I have been inseparable ever since. He was beside me on that long, lonely drive across the country after my mother died. When the oak tree tried to kill me by falling on my head, he did his best to take care of me. And when I got hypothermia while rolling logs in a foot of snow during a blizzard, he was the first one to say, "Dude, you're a wreck. Get inside."
He's been there for the good times, too, like when my then-10-year-old daughter conquered Mt. Washington, and when I caught a monster-sized rainbow trout in a stream that shall forever remain unidentified. He helped me raise my girls; I always counted on him to be my proxy, ensuring my family's safety when I wasn't around. Yeah, the old guy is part of the warp and woof (so to speak) of my life.
Old age isn't being friendly to him, though. His joints hurt in the morning, and he's got some sort of tremor, and more damn lipomas than a billiard table has balls. He has also gotten a little curmudgeonly, a bit stand-offish. He'll come if you call, will welcome a tummy rub, but rarely requests my affection.
So his behavior when I sat down to meditate this morning came as a bit of a surprise. As I was settling myself in with my first few conscious breaths, he came over to my side, and leaned up against me. He didn't lick me or look up at me. Just leaned in on me.
Without breaking rhythm, I pulled my hands apart and draped my arm about his shoulders, feeling the warmth of his body against mine. In the flickering of the candlelight I looked down at the old guy, thinking about all of the breaths that we had shared in the making of a home and the raising of a family.
"Well," I thought to myself, "I guess today's meditation will be about love."
King, Warrior, Magician, Lover: Rediscovering the Archetypes of the Mature Masculine by Robert L. Moore
My rating: 5 of 5 stars
An excellent exploration of the male psyche from a Jungian perspective. If one has done much interior exploration, such as that through the Mankind Project NWTA, some of these archetypes will be (sometimes uncomfortably) familiar.
I was happily surprised by the last chapter, which concisely described ways of utilizing the book's insights, as well as an uplifting invocation of what it means to be a man. In these days in which men are constantly being degraded, it is quite refreshing to be reminded of our immense power and value.
If you are planning to read Iron John, read this first. It makes an excellent prequel.
When I was a boy, every few weeks my father and I would take a walk up Far Hills Avenue, in Oakwood, a "suburb" of Dayton, Ohio. I put "suburb" in quotes, because it was nothing like the suburbs that we think of now, with sidewalk-free winding roads ending in cul-de-sacs with names like "Willow Court" or "Elm Drive," and a good 40 minutes from any city and a 25-minute drive to the mall.
Oakwood was nudged up right up against the city, and only a 15 minute ride by trolley car to central Dayton. It was an electric trolley, with overhead lines, and we used to throw snowballs at them in the winter, trying to knock the connecting arms off of the powered lines. One of its stops was a block away from our family's house.
Back in those days, streets had sidewalks, because people didn't feel the need to hop in their cars to ride a quarter-mile down the road to the pharmacy, or the florist -- or the barber shop. Which is where my father and I would walk to every few weeks. I had nearly forgotten those walks until today, lost somewhere in the 45 subsequent years of family, career, losses and wins. Dad and I would amble up the road -- he was the man who taught me how to amble like a boss -- sometimes talking, sometimes not, sometimes Dad just whistling the aimless tunes that marked the man at his leisure.
We would step inside the barber shop and take a seat. I can still hear in my mind the clatter of scissors, and the rustling of papers, as my father and other men would peruse the Dayton Daily News. Somebody was always talking sports. In the fall, it was Ohio State football, and to what heights legendary coach Woody Hayes would take the team this year. In the winter, the University of Dayton's basketball team was scrutinized for deficiencies.
During the "funny season," the relative merits of LBJ, Nixon, and an ever-changing sideshow of minorly-corrupt state governors would be discussed, often with vigor. Against this backdrop of men enjoying each other's company, the barber would invite me into his chair. He would always ask me if I wanted my ears lowered, and I would smile and say, "yeah, just give me the usual."
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Then I went to college, and the world changed, and all of that was lost. Men no longer went to barbershops, they went to hair stylists, or salons. The stylists were inevitably women, and the clientele mixed. Mostly women, with a few men peppered about. There was no newspaper, no sports section, but style and celebrity magazines on the table. Aside from the fact that there was no-one to discuss sports or politics or other topics of interest around, you couldn't hold a conversation over the noise of hair dryers.
I never felt fully at home at a salon, a feeling I suspect is shared by many men. This was women's territory, the land of looks and locks, of Farrah Fawcett and Dorothy Hamill. This was no place for men. And, frankly, I thought that the old barbershop was lost, relinquished to that quaint-but-long-gone closet of Mayberry and John-boy Walton.
Until today. When, on my way back from the bank, I stumbled upon the West Street Barber Shop, in the center of Litchfield. It is in the collection of buildings known as the Yard, next to the paint store. And it is there that Aaron Devaux has created, not just a place to cut your hair -- but a man's place, a reclamation of one of those public spaces that yielded to the encroachment of gender neutrality when I was in the strength of my early manhood.
I walked in and sat down. In the reclined barber's chair, a man sat, his face swathed by hot towels. In the cold air which I brought in with me, I could see the steam rise from them. Gradually, and with the unhurried skill of a sculptor, Aaron brought lather and a straight razor to the man's face, reducing stubble to a shiny gleam.
Beside me sat an older man, who abruptly harrumphed at the newspaper he was reading. "Look at that idiot," he said, thrusting the newspaper at me, showing me an article about Newtown murderer Adam Lanza. We talked about gun control for a few minutes, and then it was his turn in the chair.
I sat back, intermittently scanning the paper, and watching ESPN highlights on the flat screen TV across from me. The three of us chatted about weather, business and the price of things. We all agreed that the first could be better, as could the second, and well, what could you say about the third? Everything's too expensive these days.
After a bit, Aaron called me up. I didn't say "give me the usual," because I'd never seen him before. But he pretty much knew, through that unspoken osmosis that carpenters use to build houses, what I wanted. As he cut my hair, we talked about the trials and tribulations of being fathers, particularly being fathers of daughters. About the state of Litchfield schools (pretty good, but could be a little better), and the teachers that made an impact in our lives and that of our children. I mentioned how much I missed a good shave with a straight razor since I'd grown a full beard, and he volunteered a trim so I could experience a bit of that pleasure once again.
So then it was my time to lie back, wrapped in the warmth of moist towels, listening to the play-by-play of some game in Cincinnati. And my mind drifted back to those walks and talks with my father, that I had almost entirely forgotten. And in that remembering, I realized that I had found again something that had been lost, and that I needed, but I hadn't known it until now. It wasn't just the excellent haircut, or the trim, or the expertly-wielded straight razor.
It was the kinship of gender, the opportunity to trade insights and opinions with other men who, though different than me, are also very much the same, that made this haircut better than any I have had in years. There aren't too many places left like this. The bar, perhaps, if you have enough money and like the booze. Maybe the gym, though men have lost their singularity there, as well. There just aren't many places for a man to just be a man and, if you'll excuse the awkward metaphor, just let his hair down.
If you are a man, I cannot more strongly recommend that you pay a visit to Aaron at the West Street Barber Shop. I'm not going to give you Aaron's phone number, because you don't need an appointment, and if he's with a customer he'll just ignore your call. His shop is at the bottom of the hill on West Street, in the Yard. If his barber pole is lit, he's there. Walk in, sit down, and grab a section of the newspaper. And rediscover -- or discover for the first time -- a place that was once lost.
This afternoon, in the interstice between yesterday's grand journey and tomorrow's return to the mundane, I spent a few hours splitting the remains of our woodpile. Cleanup from the recent blizzard had covered most of it, until the warmer temperatures and rain exposed the upper half once again. I decided to take the moment to split and stack what I could yet reach, as my remaining-winter versus split-wood calculations were leaving a gap which would only be closed by a truly abnormally early spring or the addition of more wood under the deck. Not choosing to gamble on the former, I grabbed my maul and headed out back.
It was the quintessential late New England winter afternoon. Sullen clouds sat above the trees, outlining the dark, leafless tree limbs below them. I stood at the bottom of a gravel driveway, now half mud and half ice, bounded at the end by a dirty pile of snow with my last remaining row of unsplit wood poking out. It was cold, but a half-hearted cold. The biting, challenging cold of January was nowhere to be seen. A sweatshirt was sufficient outerwear, though I decided against the kilt, primarily because of the depth of the snow I would have to clamber through to get to my wood.
"Winter's getting old," I thought.
I hefted the maul. "So am I."
I had grabbed my 8-pound maul. It's not really my favorite maul. It's just a touch too heavy to wield for the longer splitting session I had in mind for the afternoon, and lacks the finesse of my 6-pound maul. But the handle of the six-pounder has gotten a bit too dry this winter, and the head wobbles to the extent that I'm sure I'll leave it deeply buried in the maw of some slightly-split piece of stringy wood, leaving me to flail about with wooden handle and frustration.
I wish I had remembered to let it soak in a bath of neatsfoot oil overnight, but I hadn't. The eight-pounder, though, is equipped with a fiberglass handle which must be attached to the head with some sort of NASA space glue, because nothing I have ever done to it has ever so much as loosened it. And I've managed to behead virtually every handled tool in existence, from a double-bit axe to a pick mattock.
As it turned out, the bigger maul was the right call. At this point, I'm splitting wood a little past it's prime. Not yet punky, but dried past the point where grain has much governance over the split. Frozen as it is, when hit from a blast from Big Boy The Maul, the wood explodes apart, making me feel like a cross between Paul Bunyan and the Terminator. Pieces fly for 3 feet before landing, and I secretly hope someone is watching my display of lumber prowess.
Nobody is, though, except for the puppy who comes out to visit and request a piece of freshly-split wood to chew on, and the birds hiding in the bushes, having their pre-supper conversations at an unusually exuberant volume. It is that chatter, as much as anything else, that tells me that, although spring may not yet be here, winter's strength is waning and his power fading. A month ago, they were largely silent, conserving every ounce of energy for the enormous task of keeping warm and staying alive. I'm not that anxious to see old winter go; like most New Englanders, at least those of us outside the cities, winter brings his own pleasures along with his trials. Few memories are so strong for me as that of drinking my morning coffee next to a flaming wood stove, feeling its heat ripple past me into the rest of the house. Those silent moments are a treasure.
Without warning, the birds' chatter silences, as a cold north wind kicks up. Winter's assertion that he's maybe not so old. Well, neither am I, for that matter, and I ignore the sudden temperature drop, splitting a few more logs to reach my goal, which is to bring the woodpile even with the top of the snow. Just to teach him who's boss.
After splitting, I carry a dozen or so wheelbarrows of split wood and stack it under the porch, where I hope it will dry out enough to be useful for me by the time I need it.
I lean the wheelbarrow against the wood, and then go back out to retrieve the maul. Picking it up, I feel the muscles in my back. They aren't sore, and they probably won't be, but they've been used just enough to feel wanted and loved.
I look one last time to the low clouds of a stale winter sky. They still aren't talking.
I turn to go inside. It's been a good afternoon.
This month being national Heart Health month, I'll be doing a series of articles on heart disease and how to avoid it. I mean, how to really avoid it, as opposed to the have-this-scan take-this-pill approach to prevention. In fact, it is just that approach to health that has got most of the population walking straight toward the heart attack guillotine. In 20 paragraphs or less, I'm going to show you how to reverse that death march.
The problem is that mainstream medicine has failed miserably at reducing the rate heart disease. After billions of dollars and a half-century of research, heart disease remains this country's number one killer, causing 36% of all deaths. The claim is often made, based off of a CDC report, that there are fewer people dying from heart disease, and that is true; but that's not because fewer people have heart disease, it's because we can keep people alive longer after heart attacks. They still have heart disease, and are usually very sick, but at least they're not dead. Which is wonderful for those people who are living with heart disease, but honestly, wouldn't it be far better to stop the disaster from happening in the first place?
A more honest method of measuring our ability to prevent heart disease is to measure it's prevalence, or what percentage of the population has heart disease. In terms of the percentage of the population that has heart disease, "Among adults 18 years and older, the prevalence of heart disease and stroke between 1997 and 2009 has remained essentially the same," according to this report. So, in fact, we aren't really winning the war against heart disease. Instead, mainstream medicine is simply propping up the corpses and declaring victory.
While mainstream medicine pats itself on the back for its "success," the science-based skeptics among us can plainly see that they have been an utter failure at preventing heart disease. The heart of the problem, if you'll forgive the allusion, is that mainstream medicine has built its "prevention" approach on a shaky therapeutic foundation, one predicated more on profitability than on true prevention. These heart disease myths, while they are making lots of money for high-cost, high-tech clinics, surgeons, and pharmaceutical companies, are ignoring the scientific research which conflicts with the profit imperative. The sooner we recognize these myths for what they are, and discard them in favor of evidence-based prevention, the sooner we can reduce the number of Americans dying from heart disease. At the current rate, one American dies from heart disease every 40 seconds. I think we can do better than that.
This may sound spectacularly absurd, but the fact of the matter is, most heart disease does not begin as a pathological process. Heart disease is not a disease in the same way that multiple sclerosis, thyroid disorders or many forms of cancer are diseases. What we call heart disease is actually an unholy conglomeration of lifestyle choices. Stop, for a second, and think about how evolution has molded our bodies. We are designed to live in physically-demanding environments where energy is obtained only with significant energy output. Our ancestors of only a few thousand years ago lived in places where the energy balance between alive and dead was as thin as the edge of a stone blade. Nutrition varied tremendously, from place to place and from season to season. Our bodies developed to adapt to them all. Our systems were honed to provide the best possible performance in those circumstances.
Simultaneously, historical evidence shows that heart disease was not prevalent in pre-industrial societies, from the medieval English to nomadic Ethiopians. What these unlettered, unhygenic people did that we do not is make use of one of the basic premises of medicine, Davis' Law. In non-technical terms, Davis' Law, and it's logical brother, Wolff's Law, boil down to this: Use it or lose it. The heart is a muscle, and the less you use it, the weaker it becomes. What happens to weak hearts? I don't think I really have to tell you.
The real truth is that heart disease is, first of all, the beginning of the failure of a weak, underused muscle: Your heart. What the research actually shows, as opposed to the faux science you have been handed, is that the number one risk factor for heart disease is cardiopulmonary fitness, or in other words, how strong your heart and circulatory system is. The stronger your heart, the less chance you have of having a heart attack or stroke. This influence is so strong that it overrides genetic influence, smoking history, cholesterol levels and weight. For example, if you smoke and do regular, vigorous cardiac activity, you will have a lower risk of heart disease than an unfit non-smoker. If you've got an extra 25 pounds around the middle, but can pound out 50 miles on a bicycle, you are unlikely to die of a heart attack, even though your BMI would make a cardiologist gasp in fear. Our hearts are designed to be used, and used hard. We are made to chase our food with foot and spear, lift logs, roll stones and dig dirt. And the less we do that, the weaker our hearts become. Once a week on the stationary bike while reading the Sunday funnies doesn't turn the trick. You have to pant, sweat and push on an almost daily basis.
You can do this by going to the gym, or by engaging in a home bodyweight/cardio workout. But that takes a lot of self-discipline, more than most of us have. So my suggestion is to incorporate high levels of physical activity into your everyday activities.
Am I suggesting that this we turn our lives into a daily replay of some Scottish highland games? Well, not completely. But if you do want to actually prevent heart disease, it's time to make some changes. Keep the car in the driveway for any trip less than 1 mile. Chop wood to supplement your normal house heat. Ride a bike to work every day, shovel snow instead of blowing it, rake leaves instead of blowing them, and quit blowing away time in front of the television. In our society, we have made physical activity the special time, the consecrated time of the modern American. It's time to reverse that, by integrating high levels of physical activity in our lives and sitting down for our sacred space.
Diet is another lifestyle choice that contributes to heart disease. The confusion that the mainstream medical community faces is that it has no idea what a healthy diet really is, though it hasn't prevented them from promoting an ersatz "heart healthy diet" that fails to do much for anyone. The research shows that vegetarians have a much lower risk of heart attack; it also shows that people eating a meat-heavy Adkins diet also have a lower risk of heart disease.
So, if you want a healthy heart, what are you supposed to do? Become an omnivorous vegetarian?
The problem with the studies purporting to demonstrate the components of a heart-healthy diet is that they fail in two regards. First, they do not take into account what I call individual biochemical diversity, something that I have seen to be of tremendous importance in the nutritional treatment of disease. Second, they ignore the rather extraordinary fact that we do not absorb only energy and nutrients from our food; we also absorb information.
Individual biochemical diversity simply means that we all process our food differently. Some of those differences are genetic, making an eastern European's nutritive processes significantly different from those of a Maori. As a result, though both may suffer from the same malady, the nutritional therapeutic intervention will be different for both. So, yes, for some people, a heart-healthy diet is a vegetarian diet. For others, avoiding heart disease means lots of protein. The trick is finding out what kind of diet (and there are more than just two) will best prevent heart attacks for you.
Secondly, and perhaps more importantly, is the concept of xenohormesis. Living things produce certain molecules in response to certain stressors. When those organisms become food, we ingest those molecules, and our body recognizes the signal that the food is giving us. For example, an animal produces certain molecules when it is stressed because its food supply is low. When we eat that animal, we are informed that a famine may be on the way. So guess what? We start storing energy. And energy is stored as -- wait for it -- fat. And, just for giggles, guess how stressed out an animal that has spent the last month of its life in the execrable conditions of a feed lot is? Guess what its meat is full of? Yup. All those chemicals that tell us that a famine is coming.
The study of xenohormesis is in its infancy, but its a safe bet that the "food as information" paradigm plays a much larger role than we currently understand. The trick is, if you want to stay healthy, eat healthy foods.That means locally grown, locally raised, and if not FDA-approved organic (which is the worst kind of organic, mind you) at least raised with no help from Monsanto.
This is the part where all of the pseudo-skeptics start getting the vapours and call up the quackwatch hotline. But the fact is, when it comes to heart disease, cholesterol doesn't matter.
I have come to that conclusion, in part, after examining the epidemiological data over the past 30 years, which demonstrates that, although we've reduced cholesterol levels on a nationwide basis, the rate of heart disease, as I mentioned above, has not budged. My conclusion has come after reading multiple studies, often cited in the literature as a justification for the creation of a cholesterol panic, and finding that in many cases, the researchers' own data does not support their conclusions. And, in some cases, the data has been fabricated, or massaged, to produce the desired outcomes.
And I'm not the only physician to arrive at that determination. Marcia Angell, former Editor-in-Chief of the New England Journal of Medicine, is among many prominent doctors who have looked behind the cholesterol curtain and found the same thing I have -- biased research, bad science, and a public health policy more interested in your wallet than your health.
I could write entire chapters on the damage that the cholesterol myth has done, and perhaps someday I will. Suffice it to say now that, whatever your medical doctor has told you about cholesterol, just ignore it. And, though I risk bringing the wrath of the FDA on my head for saying this (I would certainly never say this to a patient, as recommending pharmaceuticals is not part of my scope of practice), if you have no heart disease, and your MD has given you pills to bring down your cholesterol levels under the guise of prevention, just chuck them. They are likely to do you no good at all.
So I promised you an effective preventive strategy for heart disease in twenty paragraphs, and this is number 20. So here's the deal. Turn off the TV. Hide the car keys. Whatever it is, pick it up yourself and carry it with your own two feet. Sweat and gasp for breath at least once every day. Sprint to the mailbox like you're waiting for your lover's letter. Quit eating crap. Plant or mammal, if it died more than 60 miles from you, don't eat it. Eat anything that's fresh or unprocessed unless it disagrees with you. And one other thing: Ignore most of what you've been told about how to prevent heart disease.
Dr. Avery Jenkins is a chiropractic physician specializing in the treatment of people with chronic disorders. He can be reached at alj@docaltmed.com or by calling 860-567-5727.
The Cochrane Collaboration is considered the "gold standard" in evidence-based medicine. Cochrane researchers analyze the published studies on health and medicine topics and produce sound, objective reports that practicing doctors such as myself use to guide our decision-making.
In 2010, the Cochrane group analyzed "all trials which compared vaccinated people to unvaccinated people." And this is what they concluded:
"Vaccine use did not affect the number of people hospitalised or working days lost but caused one case of Guillian-Barré syndrome (a major neurological condition leading to paralysis) for every one million vaccinations."
In case you missed it, let me repeat that. "Vaccine use did not affect the number of people hospitalized or working days lost."
On the other hand, while flu vaccines are useless at keeping people from getting the flu, vaccines did cause at least one case of paralysis, and presumably more.
The report went on to say that "fifteen of the 36 trials were funded by vaccine companies and four had no funding declaration. Our results may be an optimistic estimate because company-sponsored influenza vaccines trials tend to produce results favorable to their products."
As if that wasn't enough, the authors added "reliable evidence on influenza vaccines is thin but there is evidence of widespread manipulation of conclusions and spurious notoriety of the studies."
Now, if anyone, after reading these conclusions by some of the brightest minds in medicine, wants to get their flu shot, be my guest.
But if you care about your health, listen to the research, not the people who are going to make money by scaring you into getting a demonstrably useless, and proven harmful flu vaccine.
And do your friends a favor. Pass this information along.
Dr. Avery Jenkins is a chiropractic physician specializing in the treatment of people with chronic disorders. He can be reached at alj@docaltmed.com or by calling 860-567-5727.
Like everybody else across the state and across the country, I have been struggling to find a way to respond to the pure horror of last week's tragedy at Sandy Hook.
My tears are not enough. They do nothing to alter a staggeringly sad reality, a reality so terrible that a seasoned police officer who was one of the first responders to Newtown's call for help, walked away with tears in his eyes, saying "my soul is stained."
Prayers are not enough. Any god capable of hearing and responding to such prayers would never have allowed the events to happen in the first place.
Public policy debates are not enough. Gun control, mental health care...yes, we need to talk about these things. But how does that change the memory of a parent's riven, tear-stained face? It cannot.
As a father, who has always regarded his primary duty to be the defense of his children, I could do nothing to alter those childrens' fates, nor that of their teachers. As a doctor who has always striven to be my patients' SWAT team against disease, I am powerless against the gunman's destruction.
Yet this situation demands some response, some thought, some act that, to the extent that a middle-aged chiropractor in podunk Connecticut can effect any change, will constitute my response to the abyss.
And this, in my very small, very teeny-tiny way, is what it is going to be. I call it the "26 for 26."
Between now and Dec. 14, 2013, I'm going to commit 26 acts of random kindness. They won't necessarily be big things -- I won't be sending any random kids to Harvard -- but they will be, in their own small way, meaningful. They will be acts of opportunity -- if I see a chance to help someone, I will. One act of kindness for each one of the victims, large and small.
I know that this is such a diminutive response in the face of such enormous iniquity. But it's all I've got.
26 for 26.
I hope you will join me.
In the early 1980s, I moved to Boston with my girlfriend at the time as did several of our college friends. I remember, after having lived there for some time, going to visit another couple whom we had known in Oxford.
The second half of my top 10 mythical disease list is sure to stir up some contention, as I will be taking on some sacred cows of both the mainstream and alternative medical communities. Regardless of the controversy that it might cause, addressing these myths directly will help us -- both doctor and patient -- to arrive at more accurate understandings of the health problems that we encounter and struggle with.
Why do I call these "mythical" diseases? Because they exist only to wrongly describe a phenomenon which we insufficiently understand. Sort of like Zeus chucking thunderbolts about the heavens until we discovered that lightning is only an electrical discharge. Once we knew of lightning's true origins, we became more able to protect ourselves from it, rather than scurrying about in fear of an unhappy god.
The same thing applies with these diseases. So long as we ascribe them to poorly-fitting taxonomies, we will be unable to create effective solutions. If we throw away our distorting glasses, seeing them anew, we can investigate and apply new solutions. My first item on the second half of my top 10 is a perfect example. (I've waited for years to write that sentence.)
6. Chronic Lyme disease. If I ever met a disease that wasn't, this is it. Chronic Lyme has as many possible symptoms as fibromyalgia. What makes it particularly difficult to uproot is that chronic Lyme is bolstered, in the opinion of many, by the fact that the sufferer has already experienced a documented illness. The argument that the the Lyme bacteria hides itself within its host is derived from the same argument in the 1980s which postulated that HIV was actually a form of syphillis, a chronic spirochete infection eventually invading the host's brain and nervous system. However, with syphillis, the patient continues to show signs of active infection, whereas none are found in the chronic Lyme patient.
What better fits the available evidence is that many of the symptoms of chronic Lyme can be traced to gastrointestinal dysfunction induced by the antibiotics used to treat acute Lyme. It is not unusual for a GI tract, denuded by an antibiotic of its beneficial bacteria, to create a constellation of symptoms difficult for many doctors to categorize, from neurological to immunological alterations. This theory does not fit all of the cases of chronic Lyme, but many of those cases that I have seen have been resolved by restoring normal gut function.
7. Celiac disease. Speaking of gut dysfunction, if I had a nickel for every patient who walked in my door having been told that they have celiac disease by their mainstream primary care doctor, I'd be a rich man. The fact of the matter is that what is often mistakenly diagnosed as celiac disease is usually simple gut dysfunction or leaky gut syndrome. There's no need for a life spent in fear of wheat. Simply fix the underlying problem and move on.
8. Osteopenia. This isn't a disease, and never has been. It is only a radiological finding indicating mild decreased density of the bone. That decreased density does not indicate that the individual is in any imminent risk of a fracture; it only means that the person may, at some point down the road, and not necessarily, develop osteoporosis.
Osteopenia is a normal feature of aging. It did not become a disease until the bisphosphonates like Fosamax hit the market, and they tried to enlarge the population of potential Fosamax recipients by reclassifying osteopenia as a disease that needed to be treated.
Fortunately, since all of the lawsuits hit as a result of Fosamax & Friends causing bone death instead of bone strength, I've been seeing a lot fewer patients in my office carrying the weight of this imaginary disease.
9. Chronic Fatigue Syndrome. This is just another way of a doctor saying "I don't know what's wrong with you except you appear to be very, very tired." Like fibromyalgia, it's a wastebasket diagnosis that stands in place for many other disorders, from subclinical hypothyroidism to hypothalamic-pituitary-adrenal axis dysfunction to Vit. B deficiency. If a doctor tells you that you suffer from CFS, just go find another doctor who is willing to dig a little deeper. I really dislike this diagnosis, because it unnecessarily burdens people with what they believe to be an incurable disease.
10. Gastro Esophageal Reflux Disorder. The only reason we have GERD on such a wide scale is because of that little purple pill. Until then, it was heartburn, and readily fixed by not eating junk, not eating too late, not drinking too much alcohol and keeping your gut healthy. And before the purple pill, cider vinegar and baking soda seemed to take care of most cases of GERD. Yes, there are a few people with valves in their GI tract that aren't working properly; however, the vast majority of GERD is not GERD at all but just crummy eating habits.
Frankly, it says everything to me that the medical "cure" for this "disease" is to inhibit the proper functioning of the stomach, impairing both your digestion and your immune system in the process. If you have to fix a problem by breaking something else, you probably don't know what you're doing.
I could go on, and I may do so in another post. But I hope that in reading this list over, you've recognized the common denominator in all of them. These "diseases" are actually dysfunctions that stem from either improper medical intervention or inappropriate lifestyle choices. And that concept is what lies at the heart of much of my approach to treatment. The sooner we learn that we control our diseases -- not the other way around -- the sooner we can become healthy.
Meadow Street -- normally a quiet, residential street in a small rural town in sleepy northwest Connecticut -- had been turned into a 3-ring circus. There were now so many so many police cars that the road was closed to traffic, and two cops were standing in the middle of the road, discussing the difficult, dangerous situation they were facing. That situation would be me.
In a previous post, I mentioned the Golden Age of Cycling, which occurred at the beginning of the 20th century. And from the most current numbers, it looks as if we might be poised for a second Golden Age.
Rutgers University professor John Purcher has crunched the most recently available cycling data, and his numbers are pointing to a renaissance in cycling. Here are the highlights:
(Source: "Bicycling Renaissance in North America?," Pucher, J., et al., 2011, Transportation Research A, Vol. 45)
What does this mean to you? Well, if you are thinking about jumping into cycling -- particularly transporation cycling -- it means that you are beginning to see a variety of bicycles and gear designed for this purpose. When first lived car-free, as a dazzling young urbanite in Boston, there was no such thing as a "commuter bike." I had to make do with a faux-racing bike with its drop handlebars and uncomfortable-but-speedy design. Now there are dozens of brands that make commuters, from Jamis to this fine selection, including a very classy Pashley.
It also means that your safety, which is already pretty good, will get even better. Because multiple studies have shown that the more cyclists there are on the road, the safer it is for all cyclists (there is also some evidence that suggests that more cyclists make the roads safer for motorists as well).
For me, cycling makes a wonderful transition from work to home. Instead of remaining compressed and tense behind the wheel of my automobile, my ride home is now filled with sunsets, stars, the smells of the seasons and the gentle hiss of my tires on the road.
And that is what makes my daily commute a daily pleasure.
Dr. Avery Jenkins is a chiropractic physician specializing in the treatment of people with chronic disorders. He can be reached at alj@docaltmed.com or by calling 860-567-5727.
This is the most common reason I hear from people who otherwise might take my advice, dust off their bikes, and go for a spin.
While it might seem dangerous -- being on the road next to the 2,000-lb behemoths that can crush us like a bug on tile -- in fact, the opposite is true. Cycling is *so* safe that the average cyclist actually lives several years longer than a non-cyclist.
Let me repeat that, with flair: Cycling is so safe that the average cyclist lives several years longer than a non-cyclist.
Sure, lots of cyclists (in this country, at least) wear those silly foam hats, and talk about all of their close calls with motorists, potholes and dogs, but these should be viewed for what they are -- campfire goosebump stories. The fact that the cyclist in question is around to tell the story should give you a clue that perhaps, just perhaps, the danger value has been cranked up a notch or two.
So let's look at some cold, hard (and rather pleasant) facts about cycling:
Let's compare lifetime risks. Your risk of dying from:
The simple fact is this: Cycling is a very safe activity. It is safer than every other form of transportation except flying, and orders of magnitude safer than riding in a car.
The problem with cycling safety is one of perception, not reality, so fear not, hop on your freedom machine and roll down the road.
Don't forget to wave at the folks in the gas station. I always do.
Dr. Avery Jenkins is a chiropractic physician specializing in the treatment of people with chronic disorders. He can be reached at alj@docaltmed.com or by calling 860-567-5727.
In today's installment of Bicycle Month posts, I am going to ever-so-briefly mutate from being a physician and bon vivant to (very) amateur historian.
You know that road out in front of your house? The (probably) paved road that takes you and your resource-hogging, squirrel-killing automobile to work, to school, and to the grocery store?
Well, you can thank this country's cyclists for that road.
You see, back during the turn of the century, cycling was an enormously popular activity. By the 1880s, the "safety bicycle" design, essentially the same shape as the modern bicycle, had replaced the dangerous penny-farthing, and John Dunlop had invented the air-filled tire. These two advances converted the bicycle from a silly toy for the young, adventurous and rich, to a useful transportation and recreational device for the masses. The use of the bicycle exploded among the middle class, and what is now known as the Golden Age of Cycling began.
(I cannot go further without noting that the bicycle was an enabler of the nascent feminist and suffrage movement in the U.S. In fact, Susan B. Anthony called the modern bicycle the "freedom machine." But we'll get back to that later this month).
As the American populace became truly mobile for the first time, they found the conditions of our dirt roads somewhat less than adequate for their speedy new machines. And, as Americans tend to do, they banded together to advocate for improved cycling conditions. The most prominent face of this social force was the League of American Wheelmen (which continues to be the largest voice for cyclists today as the updated League of American Bicyclists). The League successfully lobbied both local, state and federal government to engage in a massive upgrade of the nation's rutted roads.
Thus, the paving of American roads began long before the mass-produced automobile was even a gleam in Henry Ford's eye. The paved road that you drive on today exists because the cyclists of the early 20th century demanded the infrastructure needed for middle-class mobility.
Next time you get angry at some bicycle who is blocking "your" road, remember this. It was originally his road. And in law, custom and practice, the cyclist has the same rights to use the road as you do.
In fact, instead of honking at him, you should thank him, for making your passage possible.
Dr. Avery Jenkins is a chiropractic physician specializing in the treatment of people with chronic disorders. He can be reached at alj@docaltmed.com or by calling 860-567-5727.
