Fathers, Sons, Daughters, Paths and Patients

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Part of the AMC Trail Crew in 1976. These are the men with whom I built trails. Nearly 17 years ago, my youngest daughter took her first steps at the airport on the way to attend my father's funeral. That moment, in the sterile hallway of an airway terminal, I experienced a strange crossing of emotions, as grief over the loss of the man who held my hand as I muddled my way through childhood collided into joy and pride as my daughter began her own long walk to independence. I didn't know what to do, really, so I did what my father had always done for me. I smiled at her and told her how very, very proud I was of her.

That's a memory I don't go to often, or willingly, but today it came unbidden and I suddenly realized how  much of my life has revolved around walking, and the paths on which we walk. I was no more than 14 or 15 when, enlisted by my mother and my best friend, I helped to create a woodland trail. Back in the late 1960s and early '70s, when land was less precious and government less war-crazed and more civic-minded, the Corps of Engineers bought up a huge tract of land -- an entire watershed, as a matter of fact -- so that they could build a dam and flood thousands of acres of what had been perfectly arable land. The ostensible reason was as a flood control measure for the downstream Ohio River, but everyone knew that the real reason was to create an outdoor recreation area in what had been a relatively backwater part of the state. I'm pretty sure the governor's  brother-in-law had a lot of real estate in the region, real estate whose value would  see a sharp increase as soon as the dam was completed and the farmland flooded.

But that wouldn't happen for a few years, yet. So in the meantime, I, and my friend Brian, and my mother, and his family, all chopped and cut and sweated and trampled and created many miles of trail to be used by both hikers and equestrians.

My first backpacking trip occurred on that trail, also with my friend. Out of plans found in a Boy Scout Fieldbook, I had built myself a wooden frame, wrapped it in canvas, and hooked onto it a packbag purchased at a local Army-Navy surplus store. Brian and I walked, and talked, and tried to make a no-match fire and cooked some undescribable and barely edible mess of freeze-dried food. It didn't rain, which was good, because our tents, such as they were, were simple tubes of plastic held up by a length of parachute cord. But I so clearly remember walking along the side of the soon-to-be-dammed creek, and seeing the muskrat holes in the banks of the stream, and poplar trees holding themselves violently upright with roots gripped tightly around the sedimentary rocks exposed by the meandering stream.

We knew nothing about trailbuilding, of course, simply cutting through what seemed to be the most reasonable and scenic route along the creek and the alongside the woodlands that lined it. We all knew that it wouldn't last long. The Corps of Engineers' creep to completion was as sure as it was slow. That path -- my first path -- is long gone, a sunken treasure of my adolescence.

I thought nothing of it at the time, for in that headlong rush with which the young meet the future, I had already found another berth. The day after graduating high school, I left my home in Ohio for New Hampshire, where I had secured a coveted spot on the professional Trail Crew of the Appalachian Mountain Club. At that time, it was the only professional trail crew in the country, and had a hallowed 75-year history in the most blue-blood of conservation organizations east of the Mississippi.

As a graduation gift, my parents had bought me a private berth on the Lakeshore Limited, an Amtrak route from Cleveland to Boston. From there I would find my own way to Pinkham Notch, New Hampshire, the place to which my compass would always point for the next several years. My father gave me a kiss, and a hug, and told me that no matter what I did, as long as I did the best I could, he would always be proud of me. As my train pulled out of the station, I waved to my parents. My dad had tears running  past the big smile on his face.

In the White Mountains of New Hampshire, I learned the craft of the trailbuilder. I learned how to drop a pine tree with a double-bit axe and skin the bark off it, sticky sap dripping from the naked wood, making it slippery to carry to its fate as a step or a footbridge or a waterbar. I learned how to quarry rock as large as bales of hay and roll its ungrateful mass to the trail, where I would dig a hole and expertly drop it in, leaving a flat, immutable surface to set foot on and another step in a long staircase up the side of one or another mountain. I remember one week counting in amazement after two of us, working together, had created 122 steps on a trail leading to Mizpah hut. Unlike the creek trail of my youth, these trails were made to last. Our goal was to create masterpieces that would last 100 years.

But building the Appalachian Trail was only part of my education. I also learned how to cook for six hungry men, how to motivate a ragged crew through their fifth straight  day of rain and mud with a little snow mixed in for variation. I learned what it meant to be part of a tribe. I learned to love and be loved. I learned how to absorb the beauty and majestic power of the mountains and make it my own. The trail I was building was to my own manhood.

I emerged four years later, stronger, hardier, and with an  unassailable sense of self. I knew who I was, and I knew the depths of my endurance.

Years passed, as they do, but the path never let me go. As I retooled from my first career to become a doctor, I also became a father. Thursdays, the traditional off day for chiropractors, became Daddy Day, and I soon found myself walking the wooded path holding the hand of Daughter #1, who contentedly ambled with me, stopping frequently to crouch down and intently examine a leaf. Or a bug. Or a pebble. Every week, we would walk along the same path, each trip filled with new discoveries.

One time we were walking along and she pointed to a log. "What's that, Daddy?" she said.

"That's a log, sweetie," I said.

"Where do logs come from?" she asked.

"A log is a tree that died and fell down," I told her.

Her eyes got wide. "It died? Why did it die?"

"Well, they have to make room for the other trees. See, when an old tree dies, it falls down to make room for a new, young tree to take it's place."

She chewed on that for a while. Then she took my hand and we began walking again. But she asked about it a few more times before she could really put her mind at ease about the whole subject.

Daughter #2 was the force behind my return to the mountains of my past. At the ripe age of 9, she decided she wanted to climb Mt. Washington with me. Of course, she thought the summit of Mt. Washington was a half-hour hike like the one to the summit of Mt. Tom here in Litchfield. She was a bit surprised on that June day when I pointed to that snow-capped summit half covered in clouds and told her that was where we were going.

No matter how you cut it, the trip up Washington is arduous. We went via Tuckerman Ravine, where we encountered our first snow, and then as soon as we hit the ridge, we entered the land of ice and clouds and wind. For hours we climbed, carefully moving from cairn to cairn so we wouldn't lose our way, as the path at that altitude was nothing but jumbled boulders and rock. By the time we reached the summit, visibility was down to about 30 feet, the wind was whipping us at 60 mph, and I don't even want to think about how cold it was. This was no simple hike for a nine-year-old. Daughter #2 was pushed hard by the trail, but she pushed right back.

After a short lunch break, we began picking our way down to Boot Spur. And as we reached the edge of the spur, a sudden gust of wind shredded the last of the clouds that had held us in blindness for so long.

"Look, honey, look!" I said, and pointed off the edge of the ravine. From 30 feet our visibility had gone to 30 miles, and you could see the whole majestic spread of the Presidential range and the valley from which we had climbed. My daughter's eyes grew as big as saucers. And I knew she would never look at the world the same again.

Today, I saw a new patient, someone who had been having back pain for several years, and the first thing I did, as I usually do with patients suffering from chronic back pain, was watch her walk. A biomechanically correct stride is important, and that's what I was analyzing, but as I did that, another part of my brain was thinking that how we walk says so much about who we are. And suddenly, I was taken back in time, to my daughter's first steps and my father's last. The friends who walked with me along parts of my path, and the miles I have walked alone. The bear I met in Maine, and the girl I met in Boston, who walks beside me still. And how even after all of these years, I can still skip surefootedly from root to rock and across the stream.

The skills of a trailbuilder are many. These days I no longer build anyone else's path but my own. But I'm putting the skills I learned walking the many paths of my life to good use, helping others walk along the paths they have created for themselves. There is little that could be more gratifying.

Of Reps, Wraps and Payola

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female drug rep 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.

 

Chinese herbs prevent diabetes: As effective as drugs.

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A recent study found that an herbal formula used in TCM can reduce the risk of people with prediabetes from developing Type 2 diabetes by 32 percent. In other words, simple, inexpensive and safe herbs are as effective in preventing Type 2 diabetes as the prescription drugs acarbose and metformin.

If you are concerned about your risk of diabetes, my suggestion is to start with the safe and proven methods that have been in use for centuries.

Reflections from the shallow end of the pool of knowledge.

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We seek the moon but find only its reflection. (courtesy TORLEY/flickr) All creatures, simple to complex, have a limited level of understanding about this world. It is those limitations which make their life bearable, given the manifestation of their form. A dog cannot conceptualize much beyond his immediate environs; the hand of his master caressing his head, the full bowl of food, the warmth of the hearth upon which he lies. To have knowledge beyond that, of the atrocities which exist beyond his ken, would make his life one long terror. A dog is not equipped to cope with such knowings.

Conversely, this same limitation of understanding is a blessing to the dog afflicted by a cruel owner. To know of a better life, to be able to see and understand it and to know it exists, while daily experiencing the inhuman treatment of a heartless master --- that understanding, too, would make the poor mastiff's life even more of an unendurable hell. His ignorance protects him from even greater pain.

Man is no exception to this rule. The limitations of our insight befit our admittedly extraordinary ability to manipulate the world around us. From stone, sand and water, we create objects to extend our knowledge and presence to realms once unimaginable. Nonetheless, our understanding of the universe remains constrained by fetters we cannot see. They are so hidden that, like the dog, we don't even know that they are there.

To attempt to step over these boundaries is to dance toe-to-toe with madness. Those that can expand their horizons and absorb the chaos and heartbreak of fuller understanding yet retain their humanity are few and far between.

But from time to time, it does happen. And what then?

They return to us with their greater knowledge, and we immediately re-encumber them with the handcuffs of our own sad vision. We give them a name — Christ, Buddha, Moses — and anneal their message of dangerous freedom into a form which, by making it comprehensible, strips it of its meaning. The next thing you know, we are baptising, circumcising or prostrating in the pursuit of a reflection of the moon on a pool of water.

Knowledge becomes dogma, perception becomes ritual and teaching becomes liturgy, because we find no way to fit the larger picture into our smaller box.

However, if we discard the playthings of the ignorant worldlings that we are and look at the messages that these teachers have brought back, there are, as others have pointed out, universal truths that stand what we believe to be true on its head.

  • Less is more.
  • There is no I, only we.
  • Belief is the fundamental act of our existence.

These spiritual truths are no less valuable from the perspective of health. How often have I suggested to a patient that they are partaking too much of a good thing, whether that thing is pizza or pantothenic acid? How many hours have I spent explaining that the very microbes that live inside of us are not only critical for our digestive health, but also our immune health and our mental health, and that without our microbial friends or each other, we would die? How often has a patient improved solely because they have confidence in the doctor treating them?

We truly create our health, and the health of the world around us, by our thoughts and our actions. Chronic diseases in particular are susceptible to the metaphysical, and it is here that the future of chronic disease treatment lies.

We have such good tools to create vibrant, healthy selves. But using them means dropping our attachments, and facing the veil of our unknowns without fear or desire. Though the path has been trod, it is a hard path to follow. And you don't have to win to succeed.

Just take a step. And breathe.

The secret of my success: Three principles of disease.

The secrets of health were known long before modern medicine came along. 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?

There is no I, only We.

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.

A disease is only a disease because we make it so.

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.

The man with the empty fire.

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.

RANS Xstream review: Pretty fast for a slow guy.

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Built for speed and long distances, the Xstream fulfills its promise. The RANS Xstream is a bike with a pedigree. Designed by one of recumbent cycling's pioneers, Randy Schlitter, the Xstream was a bicycle born, I suspect, with a single purpose: To, for once and for all, bury the myth that long wheelbase (LWB) recumbents are heavy, slow, and poor climbers.

I can state with a fair degree of certainty that Mr. Schlitter achieved his objectives.

Before I get into the meat of this review, however, permit me to note a few things. Though I knew of the Xstream through reputation, and had actually taken one out for a spin at Basically Bicycles prior to purchasing mine, there were few cogent reviews of this recumbent bicycle to be found on the internet. There is one review at bentrideronline.com, and a couple of "happy new buyer" notes on the cycling fora, but thorough reviews were notably absent.

I feel somewhat justified in taking on the task, as I have been riding recumbents almost exclusively since the mid-1980s, and in fact, my first recumbent bicycle was the first one designed and produced by RANS -- the RANS Stratus Model A. Though I'm no racer, I commute and tour on bikes, and have been known to complete a couple of 200k randos. I pretty much live on my bikes and I do my own wrenching. So, yes, I feel very comfortable around bikes in general, and recumbent bikes in particular.

My interest was drawn to the Xstream during the 2009 Ride Across America (RAAM). RAAM is a grueling, non-stop race beginning in southern California and grinding on, shedding the weak like Darwin on steroids, until the riders that are left reach Annapolis, MD. With many other recumbent bike riders, I watched with pleasure as the 4-man recumbent team, all riding the Xstream, crushed the competition and won their division by more than four hours, taking their steeds across the continent at an average speed exceeding 20 mph. Mr. Schlitter himself said that "The Xstream was designed for this race."

Unsurprisingly, the RAAM win pumped sales of this bike. Oddly, though, after the initial buzz, talk about the Xstream died down considerably.  Though I was favorably impressed by my brief test ride at the time, the performance of this bike was matched by the price tag, and I never could justify the expense. And so the thing sat, at least until this spring, when, with a nudge from a friend, I stumbled on a great deal from a rider who couldn't make the Xstream work for him after his back surgery. He had only ridden the bike around the block a few times, so for all intents and purposes, it was a brand-new bike at a garage sale price. I jumped at the chance.

My Xstream sports a cool gray aluminum frame. Handlebar and stem were stock RANS. Up front is a  RANS Apex 165mm compact double (50/34) and Ultegra derailleur. A SRAM 970 chain drives a SRAM 971 cassette (11-34) through an X-9 rear derailleur. That gives a gearing range of approx. 26-118 gear inches. On the bars are SRAM X-9 twist shifters and Avid 7 Speed Dial brake levers. Wheels are Avid XM317 (559) turning on Deore hubs. Continental Sport Contact tires complete the package. Brakes are Avid 7 Single Digit linear-pull  and the cables and housings are by Alligator.

The front brake is worthy of comment as brake interference with the crankset is a chronic problem with the Xstream. The front calipers are specced with KwickStop low profile pads. These allow the calipers to run in a slightly more closed position. Using a Travel Agent instead of a noodle narrowed the profile more.

I was initially concerned with the gearing. For starters, I have never had a recumbent with less than triple chainrings, and I was worried that the slightly higher low end of the compact double would be insufficient for this slow old guy who lives in the foothills of the Berkshire mountain range. I was also concerned about the slightly higher bottom bracket than what I am used to. I'm at the short end of normal height, and the leg drop required by a high racer recumbent is thoroughly out of my league. With fingers crossed, I hoped I would adapt.

After 300 miles on the Xstream, including the omnipresent hills as well as rolling terrain and flats, and with a couple of metric centuries under my belt, I think I have a handle on this bike. It's worthy to note that during this 300 miles, I set two personal bests, not an easy feat for a man who has been riding for 38 years.

Set-up

Getting the Xstream dialed in is not a task for the impatient. Seat angle affects longitudinal seat position, which in turn affects handlebar height and stem distance, as well as handlebar  angle...you get the idea. That, coupled with the fact that knee interference with cornering is a very real consequence of poor setup on the Xstream had me riding with bloodied left knee and allen wrench gripped tightly in the right hand for the first 50 miles or so. Interestingly, it was at about mile 100 that I finally hit the sweet spot. I popped over a friendly New England pothole, which torqued the handlebars down ever so slightly, and voilà, it all clicked into place. I tightened up the nuts a squidge and let it be.

Though the frame accommodates a wide range of heights and X-seams, I'm a touch shorter than average height. I found that to keep the handlebars correctly place for my north-of-normal seat position, I had to cut away a good 3 inches of stem.

The Xstream also suffers from the RANS shifting seat clamp problem, so that the seat imperceptibly slides backwards under heavy pedal pressure until, after 30 miles or so, you realize that you are stretching a bit too much to reach the pedals. This is a well-known problem with the RANS clamp, and there are various ways to fix it -- the easiest being a piece of innertube situated between clamp and frame.

Surprisingly, I found that I was very comfortable with a fairly extreme reclined position on the Hoagie seat. On my other recumbents, with more standard mesh seats, a highly reclined position makes my neck very sore after 10 or so miles. It was nice to find that the intersection of aero and comfort exists.

Handling

That long wheelbase builds in a lot of suspension, so even with the fairly tight Conti tires, the Xstream runs sweetly on the chipseal and over the potholes of my riding range. Not once did I feel my teeth chattering as it has on other bikes. The LWB design also makes for very stable high-speed handling, and for the first time on a 'bent, I really felt like I was carving the curves at 60 kph.

At the other end of the scale, like any other LWB, the Xstream is not a fan of low speeds. Keeping a line at 9 kph is dicey, though it can be done, and I didn't really feel that I would be easily toppled until I dropped below 7 kph. I had read about people's complaints of the Xstream's low speed handling, but frankly, this is pretty typical for a LWB. If you want to go that slow up the hills, get a trike.

At any speed, though, the Xstream requires your attention. This is a thoroughbred you're riding here, not your typical stable nag, and it's not going to let you get away with sloppy handling. And there's no chance of a low-speed sharp turn. This bike is designed for the open road, not city traffic.

The best way to handle the Xstream, I found, is with a combination of attention and relaxation. Actually, 38 Special put it better than I.

http://youtu.be/vJtf7R_oVaw

Speed

What the Xstream gives in spades, however, is speed. This bike simply leaps at the hills, begging me with its efficient power transfer to bound up them. Once I learned to respond to the Xstream's clarion call, my concern for the lack of an extra-strength granny gear disappeared. Because, quite frankly, it won't let me go slow up the hills, and I don't need the lower gear inches.

This is really the first bike that I found I could appreciably accelerate up hills. It has been a unique experience for me, passing other riders like they were standing still in the middle of a climb. More often than not, in my experience, it has been the other way around, but the Xstream puts the power to the wheel very expeditiously, even when I am deeply reclined, a position traditionally weak for climbing.

The Xstream also wants its own head on the downhills. Because of the extremely aero position I can achieve, my downhill runs have increased by several kph, without me even trying. Since the bicycle feels like its running on rails, I can also corner with greater assurance, and I can lean into a curve at 57+ kph. On rolling hills this is a killer combination, allowing me to outdistance far stronger engines, because I don't even feel the hill until I'm halfway up it, and can relatively easily maintain speed over the crests. On the flats, I've found that I can maintain an average speed of 30 kph comfortably. Let's face it, that's pretty fast for a slow guy.

The brakes work as you would expect from a pair of reasonable Avid V-brakes. They have more than sufficient stopping power, and I've experienced no fade on longer descents.

The Whole Package

athansor-waters-edge

What all of this translates into is the perfect long-distance bike. Both centuries I've ridden on the Xstream have been fast pleasures, in one case setting a long-distance personal best. I can hop on the bike with the intent of rolling for miles and not be dissatisfied.

At the same time, I think I understand better the more recent silence on the part of Xstream owners. The Xstream is a demanding ride. It's not a commuter, it's not an around-town bike, it's not a mosey-down-the-bike-path bike. It is a get on, go fast and go far bike, which isn't everybody's cup of tea.  You aren't going to get away with napping in the saddle on an Xstream, and that makes for a lively and fun ride.

Perhaps the best way I can describe it is that riding the Xstream is like riding a stallion. You have to pay attention and realize that while your steed will demand much of you, it will deliver so much more performance than any other kind of ride.

For me, the Xstream filled a perfect niche in my stable. I have the all-rounder, the tourer, the utility bike and the French country bike that carries wine and baguette to the picnic. What I needed was a bike built for eating miles on the open road, a bike that challenges me to greater performance with performance of its own. The Xstream is all that and more.

Note: There have been some design changes on the Xstream since my model came out. Nothing radical, but you can see the latest specs at the RANS website.

How I protect your confidential health information.

data-security.jpeg

Our security policies protect your health information. In light of the recent disclosures of the U.S. government engaging in massive data collection of private information about its citizens, I am sure that many people are concerned about the security of their medical information, and whether it can be accessed by the NSA or other government surveillance organizations.

The short answer, here at the Center for Alternative Medicine, is no. The health and medical information that we have is protected from government and other unauthorized access in multiple ways, which I will describe below.

Because of the location of my practice and my somewhat unique skillset,  I have  long taken a security-conscious approach to my patient's records, an approach which informed the choices I made when we began digitizing patient data. In light of the news over the past couple of days, I have already made some modifications to the Center's security policies which will further protect my patients' health records.

Operating System Security

As a first step, as we began to put patient charts into digital form, I migrated all of the office's computers to the Linux operating system. Linux is a far more secure operating system than either Windows or MacOS. In fact, because of its secure nature, Linux is the operating system that is used by the vast majority of internet data servers, many of which are under daily multiple attack.

Linux security goes far beyond firewalls and passwords. Linux is designed from the ground up to be largely immune to viruses and "trojan horse" programs. Security is built-in to the system's design, preventing the rather massive security holes which Windows has always exhibited. Furthermore, since all of the software on my Linux systems is open, no secret back doors into the system can exist. They would be immediately spotted by the community which develops and maintains these systems.

 Backup and Online Security

The Center's secured and encrypted local network is also protected by software which immediately informs me if unidentified devices are attempting to access it, even as that access is being denied. Furthermore, none of the computers which store patient data are accessible to any device outside of our local network.

Off-site backup is handled via encrypted VPN and the data is stored on servers outside of the U.S., in a country where data privacy laws are considerably more stringent than in the U.S. The companies operating these servers cannot be coerced by the government into releasing any information.

Email and Patient Communications

Similarly, the email server I use is located overseas in a country secure from U.S. governmental interference or access. Connection to that email server uses end-to-end data encryption, eliminating the possibility of passive data acquisition of both content and metadata.

Though I have not made a habit of it thus far, I have for years been equipped with the ability to send and receive email using PGP encryption. One of the changes I have made in the Center's policy this week is to begin providing my public secure key to patients who wish to use PGP to protect our doctor-patient communications. This provides a second level of security.

And while I have on occasion answered patient questions via Facebook messaging, it is something I have never been entirely comfortable with, and have never initiated. One of the policy changes this week is that neither I nor my staff will communicate health information or discuss health issues with patients via Facebook messaging.

How You Can Protect Your Health Information

There are several steps which you can take to protect your health information, and they are relatively simple.

The first is to drop Gmail like a rock. It is clearly insecure, and Google has been part of the PRISM data collection system for years. There are several other systems which offer free email accounts and which are secure and will not disclose your data to the government. The one I recommend is Zoho, though there are several others.

Second, use a VPN for all of your internet activities. The end-to-end encryption of a VPN prohibits anyone from from watching your passage through the internet (and, yes, disable cookies on your browser!)

Third, use an alternative search engine. The amount of data Google collects on you -- and provides to the government -- is enormous. Your interests are determined by your search habits, and this information is a gold mine for those interested in your health data. There are, however, other search engines that do not collect or store your search data. At the Center, we use DuckDuckGo, a flexible and powerful search engine which also enables you to perform anonymous Google searches. Another popular privacy-oriented search engine is ixquick.

How Secure Are These Measures?

With regard to your health data, I have taken steps to protect your data far and above most other health care providers. Nobody is immune to hacker attack, and I make no claims to that, but I have done my best to ensure that your data remains secure from more than the passive data acquisition that the government appears to be engaging in, as well as typical commercial skullduggery.

Over the summer, I will continue to test and refine our security measures. But rest assured that even at this moment, your confidential health information at the Center is as protected, if not better protected than at any much larger organization.

 

5 ways to absolutely not get hired by me.

job-interview.jpg

None of us really want to be here, do we? It's official. My office manager of 13-odd years, Teresa, is moving on. She will be missed, and I'll write about that later. But right now, I'm in the throes of a replacement search, knee-deep in a swamp of semi-legitimate candidates. And it's getting uglier by the minute.

If I were smart and good, I would probably get a professional, someone like my friend Bob Corlett at Staffing Advisors, to help me find a new admin. But, like an overambitious homeowner with a dull saw, I'm engaging the project by myself. The trouble is, so are the job candidates. And the results are beginning to look ugly:

This is how my search for a new office admin is going.

So, in the interests of humankind, my sanity, and to bolster the increasingly faint possibility of actually hiring somebody before the next equinox, I am going to share with you, dear candidate, the errors that your predecessors have made that have guaranteed them a place in my personal Hall of Amazing Ineptitude, or in other words, the Would Not Hire Ever file.

 

1. If you make an appointment for an interview, SHOW UP FOR IT.

No, seriously. Wednesday night I scheduled two candidates to interview. Neither of them showed up. Neither of them called.

If I wanted to interview myself, I'd at least get a Mountain Dew and a bag of pork rinds.

 2. Don't wear yoga pants to your interview.

So long as it isn't loaded with enough metal to give the TSA the fantods, I really don't care about your body. I do, however, care about what my patients would think about being greeted by someone in the universal I-didn't-get-out-of-bed-in-time-to-get-dressed outfit. How would you feel if you came to the interview and I was wearing my bike shorts? Ewww.

A job interview is not a booty call.

3. For the love of all that's holy, please clean up your email address.

When I am emailing a candidate to schedule a job interview, and I have to send the email to sweaty_pole_dancer@yahoo.com, I'm not going to do it. I'm just not. You could have the best resume in the world, have all the right experience, be willing to sign a 10-year contract and work for $8/hour with no days off, and I'm still not going to do it.

4. And while you're at it, clean up your social media.

You can bet that the first thing I'm going to do if I may hire you is google the heck out of your name. If 37 of the 40 pictures you're tagged in have someone holding a handle of marshmallow-flavored vodka, I'm not going to call, because of the very poor judgement such pictures indicate. Marshmallow-flavored? Really?

"I am a responsible, reliable, hard-working employee. And sometimes sober."

 5. Do not tell me your chiropractor horror stories.

I don't know even why I have to say this, but it's happened. More than once. If you're being interviewed by a chiropractor (me), it is generally regarded as Bad Form to tell me how you, or your nephew, or your Aunt Myrtle had their head almost ripped off by a chiropractor who - gasp! - ADJUSTED THEIR NECK! OMIGOD THE HORROR!

Odds are, I probably adjusted someone's neck less than an hour before seeing you, and that was probably the umpteenth time I had done a neck adjustment that day. It's not dangerous. In fact, it is quite beneficial for many people.

No, this is not how chiropractic adjustments are done.

If you follow these relatively simple guidelines, I can guarantee your chances of getting hired by me will go up exponentially. Of course, then you have to deal with the whole working-with-Dr.-Jenkins-issue. But that part is easy. Just ask Teresa.

 

5 Reasons You Can't Trust Nutrition Research, Part I

research-scientist-lab.jpg

All too often, the research cannot be trusted. If I had a nickel for every time a patient had told me that they  cannot have certain foods, because of an article they saw or their MD told them, I would be a rich man.

A case in point is salt. For years, I have been telling my patients with high blood pressure that salt is the least of their concerns, particularly when they have been scared off of it from their MD. I’ve had patients eating foods that were terrible for their hearts, because their cardiologist had put them on a salt-free diet, and as a result, worsening their condition instead of improving it.

Just last week, “new” research has been reported on which now shows that salt is not an important risk factor for high blood pressure.

The fact of the matter is that physicians such as myself who specialize in nutrition have known for years that only a very small part of the population with high blood pressure is sensitive to dietary salt. That research was done a long time ago.

But the news really never caught on with the popular press, and it clearly didn’t reach the ears of most medical doctors, who have been pressing the no-salt diet for years.

As I read the news online last week, I noted in the comments that several other readers were saying that the research on nutrition is so flighty that they no longer trust any of it, and will just eat whatever they want to.

I have noted before that much of the mainstream medical research cannot be trusted. The majority of it has been tainted by big money from the pharmaceutical industry which has the money to hire its own research organizations and produce “scientific research” that, unsurprisingly, perfectly supports drug marketing plans.

Nutritional research becomes similarly warped, although on a smaller scale and for slightly different reasons.

One of the key problems with nutritional research is funding. Unlike drugs, which have a phenomenal return on investment, herbs and nutrients cannot be patented. So nobody is likely to get rich from, say, a paper which demonstrates that Vitamin C effectively combats the common cold. The return on investment on non-patentable health solutions is pretty low, so research investors are few and far between.

Nonetheless, the research is influenced by greed in a different way. While it is hard to find the money to prove a nutritional intervention is positively therapeutic, there is a tremendous amount of money available for research which will demonstrate that certain nutritional interventions are useless and/or dangerous.

And there is also a tremendous amount of political pressure which can be brought to bear on nutritional therapies, if they are thought to be a threat to pharmaceuticals.

Not but not least in the financial parade are the people which can make money directly by distorting the research. This is the group I am the most familiar with, so they get to be number one in our list:

1. The media: Not getting it right on a daily basis.

It is a poorly-kept secret that, prior to becoming a physician, I was a journalist. In fact, I was a science and technical journalist. My background in the sciences gave me the ability to explain complex technical topics in easily-accessible ways to non-geeks. So I’m familiar with the ways in which reporters, editors and publishers will, both consciously and unconsciously, bend their coverage to suit their needs.

The major problem with the reporting of nutritional research is that the findings of any study are sensationalized to increase the page hits. A relatively minor study of salt and hypertension, for example, becomes the health section’s page 1 news -- and then, for the next 25 years, both diet and medical recommendations are misdirected.

Another problem with nutritional research reporting stems from the reporter’s inability to understand the science itself, or unfamiliarity with the field. It can be difficult to explain scientific-y stuff to a general audience, and to do so well, you must thoroughly understand the science yourself. Too few reporters have more than a basic grasp of the life sciences, much less a basic understanding of nutritional physiology, and fundamentally important data in a study gets flattened, misreported or simply ignored because of the reporter’s ignorance.

Finally, there are a few reporters who have been reported to consciously misconstrue the results of studies on alternative medicine in general.

New York Times health and medicine reporter Gina Kolata is a case in point. The author of hundreds of articles for the Times, Kolata has been uncovered by The Nation and others as using her articles to press her own agenda -- a profitable one, at that. On one occasion, Kolata published an article which strongly hyped a couple of cancer drugs (an article which turned out to be erroneous, to boot) and within hours was floating a book proposal based on buzz generated by her own hype. While this is an ingenious feedback loop for a reporter hungry for a book contract, it is hardly impartial reporting.

Imagine how nutritional research is reported by a writer with the reputation of Kolata, with one hand on the keyboard and the other reaching for the pocket of the pharmacuetical company. It won’t be the unbiased story that many would imagine it to be.

2. Oops, we used the wrong vitamin.

For some reason I've never been able to fathom, the world of mainstream medicine has always been very faddish about vitamins and minerals. One vitamin or another is always "hot" with MDs. When I started practice a couple of decades ago, Vitamin C was the one being recommended by every MD and his brother. I suspect this was based largely on the later work of Linus Pauling, who already had accredited status with the mainstream medical community for his groundbreaking work in molecular biology.

Vitamin C has since cooled considerably since its days as the go-to vitamin for almost everything. Today, that role is fulfilled by Vitamin D. which is currently being touted by the medical community as a second-class cure-all for everything from fatigue to fibromyalgia to heart disease to depression to joint pain (it remains a second-class cure because in mainstream medicine, nothing is better than a pharmaceutical, natch).

Interestingly enough, 10 years ago, before D got big, it was being maligned on many fronts as being a near-useless nutrient which was only being touted by quacks as a remedy for fatigue and fibromyalgia and depression...you get the idea.

Many of these studies suffered from one very significant, very undisclosed flaw: The researchers were using the wrong form of Vitamin D.

The legal definition of Vitamin D includes 2 forms: Vitamin D2 and Vitamin D3. Both are equally useful in preventing rickets in children, which is what all Vitamin D was once thought to be good for. However, when it comes to its effects on the cardiovascular, immune and other systems, the D3 form is much more potent than D2, which often has little to no effect at all in these systems.

However, researchers investigating Vitamin D often neglected to note the difference. Thus, studies would report that Vitamin D was ineffective at treating a certain disorder -- when actually, it was the ineffectual form of Vitamin D that was being used.

A variation on the "wrong vitamin" error is the "lousy vitamin" error. As most people know, there is a great deal of variability among vitamin products. Much of that variability results from how the vitamin is packaged in the tablet -- particularly how well that tablet survives the gastrointestinal tract to dissolve at the right time. Many vitamins just are not digested well, and I have seen on x-rays, vitamin tablets residing unmolested in the large intestine, waiting to be moved out of the body without having given up the slightest amount of the nutrient they were supposed to disseminate. "Pharmaceutical-grade" nutrients tend to be no better in this regard than what you may pick up over the counter at a chain pharmacy store.

So if you are testing the efficacy of a certain nutrient, and not monitoring whether that nutrient is actually getting into the patient's bloodstream, your results are going to reflect more the failure of the nutrient packaging than of the nutrient itself. It has happened more often than you would like to believe.

Coming up in Part II: Dodgy Dosages and Dietary Dilutions.

It's time for cycling in America to grow up.

A mature cycling culture looks like this. (Courtesy Mikael Colville-Anderson) 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.

 

 

25 things you didn't know a chiropractor could do: Chiropractic management of depression.

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Drugs are not the right answer for depression. (photo courtesy of flickr/diannelabora) Many people think of chiropractic care as nothing more than a spinal adjustment. While that is the core of our therapeutic interventions, there are a number of other ways we restore patients to health.

I employ lifestyle and nutrition interventions with almost every patient I see; and when you include the ability to utilize blend custom herbal formulae as well as acupuncture and other modalities, the scope of a chiropractic physician's interventions are wide-ranging indeed. The multidisciplinary skillset of the modern chiropractor makes us unique and uniquely valuable to patients suffering from chronic diseases.

People suffering from depression are frequent visitors to my doorstep because, like most chronic disorders, depression is poorly managed by mainstream medicine. Pharmaceuticals -- medicine's primary response to depression -- really don't work that well, especially over the long term. Prozac and the other SSRI's are based on a scientifically-unsound model of depression; and while more recent innovations, such as ketamine, can in certain cases be more effective than an SSRI, medical management of depression largely remains a crapshoot.

Which is why I have made it a point to study the myriad causes of depression and the most effective drug-free therapeutics for people suffering with this disorder. And what the research shows -- and what any evidence-based doctor should realize -- is that there are many ways to successfully address the problem of depression, ways that are far more effective than taking a drug. In this vein, I also make frequent use of the clinical social workers and psychologists who are truly skilled at diagnosing and managing depression without drugs.

I was recently asked to give a presentation on this topic to the annual convention of the Connecticut Society of Medical Assistants. As always, I immensely enjoyed talking before this group. They are interested, animated, participatory and questioning, which are the best qualities for any audience to have.

At the request of several of my patients and others, I am posting the slides I used for this lecture. While I try to pack as much information as I can on my slides, much of the content of the lecture is necessarily lost. Please contact me if you would like more information on any of the topics I cover.

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Thank you, and happy anniversary.

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Six years ago today, the Center opened its doors. Six years ago, I took a pretty big gamble. At what turned out to be near the peak of the real estate market, I bought a building that had, since the 1960s, been a veterinary office. I spent an ungodly amount of money to convert it from an animal doctor's office to a people doctor's office, and closed my otherwise thriving practice in Kent to focus all of my efforts on an entirely new beginning in Litchfield.

While I enjoyed my practice in Kent, I came to feel that it was too limited. I opened that practice directly from my internship and graduation, and took my first few years in practice to start adding onto my  base knowledge. My first milestone was achieving board certification in clinical nutrition, followed a few years later by passing another specialty board, and becoming a Fellow of the International Academy of Medical Acupuncture.

My goal had always been to become a holistic GP, the physician that people could turn to for drug-free treatment for all types of disorders, not simply back pain, neck pain, or headaches. And in Kent, I was able to acquire and build on those skills. But I realized that to become the type of physician that I wanted to become, I needed a location that needed me.

So when the vet's office in Litchfield went on the market, I jumped at the opportunity. And though it was a massive financial gamble, by that point in time, I had become mildly inured to that sort of thing. After all, I had left a journalistic career that had put me among the top 5% of freelance writers in the country to go back to chiropractic college and start from scratch.

Still, to be honest, I was a little nervy. This time was a bit different. Now I had a family, two kids, and a house with a mortgage; and here I was adding a second mortgage to the list, while rebooting my practice. You would have to be made of stone not to get a little jittery.

To keep disruption to a minimum, I planned to move my office over the course of a weekend, and start seeing patients just a day or two thereafter; and this was all to occur almost minutes after my general contractor pulled his last employee from the building.

The trouble was, I lacked a Certificate of Occupancy.

I scheduled the inspection for two days prior to re-opening. The inspector, a very nice man, was also thorough -- and found one electrical problem which prohibited him from issuing the certificate.

In a panic, I called up my contractor. His receptionist, no doubt used to such calls, assured me that all would be fixed in record time. And to his credit, it was. The electrician was out the next morning, and corrected the out-of-code electrical wiring. I invited the building inspector back for the following morning.

He came. He approved. He issued my Certificate of Occupancy.

And 45 minutes later, on April 6, 2007, my first Litchfield patient walked through the door.

Within months, I realized that I had made the right decision. Growing mostly by word of mouth, patients started coming to see me, not only for what chiropractic adjusting could do for them, but also for nutritional and acupuncture treatments for a variety of disorders. Within the first year, many  of my Kent patients who had stayed behind returned to the Litchfield practice (rightfully grumbling about the longer commute, it might be said).

Six years later, I have co-created, with the help of my patients, the practice of my dreams. I have patients coming to see me, not just from Litchfield county, but from Massachusetts and Long Island. Each new patient is a welcome guest and a new puzzle for us to solve together. Each day, my skills are challenged, my knowledge stretched, my spirit expanded.

And I would be utterly remiss if I didn't say thanks to Teresa Tuz, my oft-suffering office manager. Teresa had run the Kent office, and (probably against her better judgement), decided to continue the fun with me in Litchfield. She has managed the office through blizzards, floods, blackouts, faced head-on the interminable idiocy of health insurance billing, and along the way has become part of the spirit of the office. I mean, let's face it: When was the last time you heard patient and staff erupt in shared laughter at a doctor's office? But that happens many times a day at Teresa's desk.

The office has also been enriched by my tenants: Dave Pavlick, an extraordinary social worker and expert in the field of neurofeedback, and Christine DC Decarolis, one of the most dedicated massage therapists I have known. She is not only dedicated to her craft, but also to her community, to which she contributes in numerous ways.

Last night, after finishing my chart notes for the day, I locked the door, walked away from the office, and turned to look back. Six years ago, there had been nothing but an empty building, a vision, and a willingness to risk almost everything on that vision. Today, that building has become a place of hope and healing for many. My deepest thanks to everyone who has helped make it so.

 

The problem with mainstream medicine is staring us in the face.

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scrutinium My perpetual, self-designed, professional continuing education has taken an interesting turn this year, as I've been stepping past the usual rounds of journal articles and monographs on herbs, and acupuncture, and the manual methods of healing of which chiropractic has become the primary form. Digging deeper into the roots of the traditional healing professions, I'm looking past that data, into the ofttimes misty past of traditional medicine, trying to discern what it was that my forebears saw in, say, the bark of the white willow tree -- which, in the industrial age, turned into aspirin. And just what was it about spinal adjusting that led Hippocrates to recommend it.

In essence, I have been delving into my professional collective unconscious, because that was the mode of thought of the earliest healers. Shamans, alchemists, and both early and modern Chinese doctors all work in the realm of symbols and their meanings; which is the same means of communication favored by our unconscious minds. The earliest herbalists often chose herbs based on their resemblance to the body part or disorder they were attempting to heal, bringing together unconscious associations with empirical evidence.

As anyone who has worked extensively with the unconscious mind can attest, this part of you communicates through symbols. While symbols lack precision -- just what does that young boy standing there holding a ball actually mean -- they pack a powerful emotional punch. Someone who is an expert in the manipulation of symbols, such as an advertising professional, has access to our deepest motivations, which is one way in which we can be manipulated without even being conscious of it.

Symbols are a form of visual shorthand, in which a whole host of ideas or emotions are framed and communicated in one fell swoop. For example, with just a glance, everyone knows that this symbol:

means DON'T DO IT, whatever "it" happens to be.

That's an example of an informational symbol. Other symbols are intended to evoke an emotion. For example, this symbol:

Is a nearly-universal symbol of love, and evokes feelings of warmth and affection.

But then there are the symbols which reach deeper still, which are universal, and which tap archetypes in what psychologist Carl Jung called our "collective unconscious." These symbols go back thousands of years, to the earliest civilizations and beyond. These symbols call forth associations from our unconscious to primal psychological forces, powerful motivators of behavior. For most people in the U.S., you don't have to go much further than the corner church to see one of those archetypal symbols at work:

The Christian cross, however, is much older than Christianity. This is what the cross looked like in ancient Egyptian times:

Back then, however, it didn't belong to the Abrahamic god and his son, but to multiple Egyptian gods, who used it to confer life on the mummies of the dead, permitting them an afterlife.

In its earliest incarnation (if I may be so bold), the cross initially appeared like this:

And in this form, the swastika was used to represent the sacred force of abundance, with the arms of the cross invoking the cycle of death and rebirth. Of course, later the symbol was perverted in Western civilization by being reversed and becoming the symbol of an inhuman killing machine.

You can see, however, the common theme of the archteypal cross. At every stage of its existence, it represents the spiritual quality of rebirth, whether it was Christ rising from his sepulchre or mummies restored to the afterlife.

Throughout humanity, this archetypal symbol holds this same meaning. It is part of our collective unconscious, the psychic commonality which links and motivates all of us, whether ancient Egyptian or modern Baptist.

Which brings me, at last, to the point of this post.

Who, reading this blog, is unfamiliar with this symbol:

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 Even at its most stylized, this is an easily recognized symbol. It is the symbol of the doctor, of the hospital, of the men and women that will heal you when you are ill and tend to you in your demise.

The problem is that this symbol, commonly called the caduceus, is not the symbol of health or healing at all.

It is the symbol of commerce and money.

The caduceus is the staff of the Greek god Hermes. Hermes is the god of the trades and commerce, and he actually acquired the staff after defrauding his half-brother, Apollo.

And that is the symbolic representation of medicine in this country. There are no healers involved in this archetype, no caregivers, none who would freely give of themselves for the well-being of others.

Instead, the medical industry has chosen as its symbolic representation, the archetype of greed and self interest.

In comparison, what have the members of the second-largest whole body health profession in the world chosen as their symbol?

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This is the chiropractic profession's winged angel of health. As you can clearly see, this symbol embodies the cross, that symbol of rebirth and renewal -- and hope. Accompanying the cross is an angel. The angel is another archetype as old as humanity, and its function has been to manifest the divine power to aid mankind. They protect. They guide. They heal.

So let me ask you a very important question. When it comes to your health -- the foundation of your quality of life, the ruler of your longevity --  in whose hands do you trust? The person who chooses to represent himself with greed and unenlightened self-interest? Or the physician who guides himself by the principles embodied by the angels?

It's an important decision. Choose wisely.

Adventures in meditation

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altar-2-roate 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."

 

The Archetypes of Man

King-Warrior-Magician-Lover-Moore-Robert-9780062506061King, 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.

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A Man's Place: The West Street Barber Shop

More than a haircut happens here. 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.

Ode to an older winter.

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.