Lee and Davis Opposed Post-Civil War Memorials and Flags

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Robert Lee was the senior general of the Rebellion. Jefferson Davis was the president of the CSA. Both men opposed any use of the Confederate flag after the war ended, and Lee opposed any memorials or preservation of battlefields from that war. When Lee presided over Washington College (now Washington and Lee), that flag was not flown, and at his funeral, he forbade the wearing of military uniforms.

In their letters, these men wrote:

“I think it wisest not to keep open the sores of war, but to follow the example of those nations who endeavored to obliterate the marks of civil strife, and to commit to oblivion the feelings it engendered.” (Lee’s letter to Gettysburg identification committee, 1865)

“My pride is that that flag shall not set between contending brothers; and that, when it shall no longer be the common flag of the country, it shall be folded up and laid away like a vesture no longer used.” (Davis, in his book, “The Rise and Fall of the Confederate Government,” 1881)

Obviously, quite a few people — North and South — ignored the wisdom of these comments, which leads us to the current, absurd situation.  Both men wanted to heal the country, and felt that memorials and showing the flag would encourage continued hatred and strife. In that, they were right.

Sources:

  1. C. E. Miller, “Robert E. Lee and Jefferson Davis Wanted The Confederate Flag To Come Down In The 1800’s, According To These Books,” Bustle, https://www.bustle.com/articles/96114-robert-e-lee-and-jefferson-davis-wanted-the-confederate-flag-to-come-down-in-the-1800s
  2. Daniel Brown, “Here’s what Robert E. Lee thought about Confederate monuments,” Business Insider, 16 August 2017. http://www.businessinsider.com/robert-e-lee-opposed-confederate-monuments-2017-8
  3. Jonathan Horn, “What Robert E. Lee can teach us about Confederate memorials,” CNN, 11 June 2016. http://www.cnn.com/2016/06/11/opinions/confederate-symbols-opinion-horn/index.html
  4. Smithsonian Special Report, “Making Sense of Robert E. Lee,” July 2003. http://www.smithsonianmag.com/history/making-sense-of-robert-e-lee-85017563/

Being Safe or Insane?

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Arguably, politicians and celebrities have grossly inflated egos. The more minor the Mickey-mouse-photos-and-flags-nb6340politician or celebrity, the more hysterical this gets.

I live in a small suburban town in New Jersey, sandwiched between New York City and Philadelphia. The county in which my town is located had 2 murders in 2016, and none in 2017. My town had 1 robbery in 2016 and 1 in 2017, neither involving a gun. There have been no crimes involving guns in the town in either year.

So, what does the Township Committee do? They buy bullet-proof glass to protect their committee meetings.

Yep. They spend a small fortune on bullet-proof glass. Clearly more vital than buying another shuttle bus to help the elderly get to their doctor. Such remarkable thinking.

No one shoots anyone in this town, much less one of these idiots.

Now let’s shift to the other side of New York City — the summer playground of the rich and perhaps not so famous, the Hamptons. Think of the rich battling over landing space for their helicopters. A decadent area made famous by F. Scott Fitgerald. That’s the Hamptons.

Now the area sees some real celebrities — JLo and Laura Bush have been there this month. However, they’re notable as exceptions. The bulk of residents include corporate execs, gang and Mob attorneys — the kind of people who have money to toss around and don’t care so much for publicity.

So what’s new in the Hamptons this year?  According to The Wall Street Journal, it’s the creation of anti-terrorism squads to protect the rich and their parties from . . . ??

No kidding.

“The Southhampton Police Department has formed a counterterrorism unit to add specialized protection for the dozens of large soirees held in the town during the summer that often draw hundreds of attendees, including top executives, politicians and celebrities.” WSJ 14 August 2017, p. A10.

Now, the Germans did land saboteurs on a beach on Long Island during WWII. That plot lasted a few minutes with no damage to anything. Prior to that, the last notable warlike act on the Island was circa 1778.

Definitely sounds like grounds for emergency action, don’t you think?

Unlike other parts of the world, kidnapping and extortion don’t work well in the US. There are few if any ways to transfer money that the FBI can’t trace. So those crimes just don’t happen any more.

A terror attack on a party? Really?

This is your tax dollars at work. This is what happens when no one pays attention to what local officials do with tax revenue.

For those who are fans of reducing the power of the national government and shifting responsibility to the state and local level: well, doing that requires having competent people in local government. Case closed.

The Kentucky town of Rabbit Hash now has a pit bull serve its fourth term as mayor. Originally, I thought living in a town named Rabbit Hash was crazy, but maybe they’re onto something. The pit bull is less likely to make stupid decisions.

I’ve never heard of a pit bull with an inflated ego.

Opioids: Where Your Doctor Is Trained Impacts What He/She Prescribes for You

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A new study by economists at Princeton University shows that where a doctor is trained effects the prescriptions he or she writes.

The study focused on opioids, and differences in prescription-writing between graduates of top and bottom-ranked medical schools. Key findings:

  • Doctors graduating from lower ranked medical schools write a much larger volume of opioid prescriptions than those from top medical schools.

From 2006 to 2014, “If all general practitioners had prescribed like those from the top-ranked school [Harvard], we would have had 56.5% fewer opioid prescriptions and 8.5% fewer overdose deaths,” said Janet M. Currie, the Henry Putnam Professor of Economics and Public Affairs at Princeton’s Woodrow Wilson School of Public and International Affairs. Currie conducted the study with Molly Schnell, a Princeton Ph.D. candidate in economics.(1)

  • Doctors who receive additional training in pain management write fewer opioid prescriptions than their peers.
  • Doctors trained in the Caribbean write more opioid prescriptions than foreign-born doctors trained elsewhere outside the US.
  • More recent medical graduates are writing fewer opioid prescriptions than are older physicians.  That again raises the question of how well some veteran doctors are keeping up with new trends and issues.

A counter-argument is that doctors lack good alternatives to opioids for management of pain.(3) However, according to the Princeton research, many doctors may simply not understand the choices they are making in writing a script or the options that may be available.

Why should the impact of training be limited to opioid prescriptions? Why shouldn’t it impact other treatment and drug choices?

What you need to consider:

The framed degree on your doctor’s wall is more than a decoration. You need to read it. If the degree is from a school with which you are unfamiliar, you need to get a conversation going about what other training he/she has taken. If the answers aren’t suitable, you need to consider finding another doctor.

A list of the top medical schools for primary care is available at

https://www.usnews.com/best-graduate-schools/top-medical-schools/primary-care-rankings

In the 2017 rankings, the top 20 for primary care (there are separate rankings for research, but the focus in this article is on patient care) are (4):

  1. University of Washington
  2. University of North Carolina – Chapel Hill
  3. University of California – San Francisco
  4. Oregon Health and Science University
  5. University of Michigan
  6. University of California – Los Angeles
  7. University of Minnesota
  8. (tie) Baylor
  9. (tie) University of Colorado
  10. (tie) University of Pennsylvania
  11. (tie) University of Texas, Southwest Medical Center (Dallas)
  12. University of California – San Diego
  13. University of Pittsburgh
  14. (tie) University of Massachusetts – Worchester
  15. (tie) University of Wisconsin – Madison
  16. Harvard University
  17. University of Nebraska
  18. (tie) University of California – Davis
  19. University of New Mexico
  20. East Carolina State University (Brody)

 

Sources:

  1. Molly Schnell, Janet Currie. Addressing the Opioid Epidemic: Is There a Role for Physician Education? NBER, August 2017 DOI: 10.3386/w23645
  2. Princeton University, Woodrow Wilson School of Public and International Affairs. “Doctors trained at lowest-ranked medical schools prescribe more opioids.” ScienceDaily. ScienceDaily, 14 August 2017. <www.sciencedaily.com/releases/2017/08/170814134811.htm>
  3. Malcolm Thaler, MD, “Why Is Opioid Addiction Happening to So Many of Us?” Live Strong, 29 August 2016. http://www.livestrong.com/article/1012275-opioid-addiction-happening-many-us/?utm_source=aol.com&utm_medium=referral&utm_content=opioid-addiction-happening-many-us&utm_campaign=AOL-Wellness
  4. https://www.usnews.com/best-graduate-schools/top-medical-schools/primary-care-rankings

 

FYI – Stress and cell phone addiction

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There are articles from the US and UK regarding smartphone addiction. This isn’t just a Korean issue. I recommend reading this article.

Broken Brain - Brilliant Mind

child with smartphone sitting on a benchSmartphone addiction is real.

And it can also make TBI recovery more difficult by affecting your sleep and getting you cranked up into a constant fight-flight state. Not having a lot of “screen time” after a concussion is a good idea for a lot of reasons. This is one of them.

Thanks to Ken Collins for sending along this great research paper:

Exercise rehabilitation for smartphone addiction

Hyunna Kim*

Abstract

Internet addiction after launching smartphone is becoming serious. Therefore this paper has attempted to sketch out the diverse addiction treatment and then check the feasibility of exercise rehabilitation. The reason to addict the internet or smartphone is personalized individual characters related personal psychological and emotional factors and social environmental factors around them. We have shown that 2 discernible approaches due to 2 different addiction causes: that is behavioral treatment and complementary treatment. In the behavioral treatment, cognitive behavioral approach…

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Health: the pH Debate

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pH is a measure of the acidity of a substance — food, water, human tissue, whatever. It is measured on a scale of 1 to 14, where 1 is extremely acidic, 14 is extremely non-acidic (alkaline) and 7 is neutral.

Here’s what we know:

  • The tissue in the human body around cancer cells is acidic. That’s true not just for cancer but for other diseases as well. Low pH is associated with illness
  • Different parts of the body have different pH levels, depending on function. For example, the stomach is highly acidic. Blood in a healthy individual has a pH of 7.35 to 7.45, slightly alkaline.

Here’s what we don’t know:

  • Does cancer/illness cause excess acidity, or does an excessively acid environment depress the immune system and enable disease to take root and develop? (Yes, this is a “which comes first, the chicken or the egg?” question. However, in this case, it matters.)
  • Can diet affect the pH of human tissue?
  • What’s a reliable measure of pH?

Traditional medicine says there is no scientific research supporting the role of pH in cancer development. That’s true. In fact, I haven’t been able to find any research at all on the topic. Who would fund it?

Non-traditional medicine relies on anecdotal information — which may not be generalizable to most people — and says that one can measure pH simply through testing saliva or urine. Using either as a test of whole body pH is silly, as both can be affected by level of water consumption as well as by foods eaten recently. There are other tests doctors can perform, but remember that some parts of the body are supposed to be acidic.

There are a lot of articles online, which I haven’t cited here, discussing pH in the context of pushing one supplement or another of unknown health value. Charitably, some of these might have some value, but many are probably just ways of taking your money. These are the modern versions of patent medicine “elixirs” that were sold in the 1800s by traveling salesmen.

There is an oncologist here who swears that anyone who drinks a smoothie made up of kale, green apple, pineapple and water will not get cancer. The mixture is rich in antioxidents and affects pH. Is there scientific evidence supporting this claim? No. Do people do it anyway? Yes, because there is no harm in this concoction.

Alkaline diets became a fad in 2013 after Victoria Beckham tweeted about them. As part of that, some celebrities have been promoting and consuming high pH water. There is evidence that this water can help with acid reflux by breaking down pepsin, but whether it has any other benefits simply isn’t established.

In fact, the consumption of any kind of water may have health benefits. However, uncertainty remains about how much water is appropriate for different body types as well as what the benefits really are. (1)

What you need to consider:

If something may be helpful and there are no risks associated with it, why not? There’s no harm in drinking water or broadening the array of vegetables you eat. However, the truism still applies — “everything in moderation.”

The bibliography below lists some of the more intelligent articles addressing both sides of the issue regarding hydration and pH.

Sources:

  1. Barry Popkin, Kristen D’Anci, Irwin Rosenburg, “Water, Hydration and Health,”
    Nutrition Review, 2010 Aug; 68(8): 439–458.doi:  10.1111/j.1753-4887.2010.00304.x. Abstract at https://www.ncbi.nlm.nih.gov/pmc/articles/PMC2908954/
  2. https://familydoctor.org/hydration-why-its-so-important/
  3. Jami Foss, “The Benefits of Alkaline Water, Unfiltered,” Shape, 31 August 2015. http://www.shape.com/healthy-eating/healthy-drinks/benefits-alkaline-water-unfiltered
  4. https://my.clevelandclinic.org/health/articles/avoiding-dehydration
  5. Vicki Vanarsdale, “Signs of Poor pH Balance in the Body,” Livestrong, 18 July 2017. http://www.livestrong.com/article/30086-signs-poor-ph-balance-body/
  6. Sonya Collins, “Akaline Diets,” WebMD, 2016. http://www.webmd.com/diet/a-z/alkaline-diets
  7. Marcelle Pick, “Digestion & GI Health – The Truth About pH Balance,” Women to Women, 2017. https://www.womentowomen.com/digestive-health/digestion-gi-health-the-truth-about-ph-balance/
  8. Oliver Childs, “Don’t believe the hype – 10 persistent cancer myths debunked,” 24 March 2014. http://scienceblog.cancerresearchuk.org/2014/03/24/dont-believe-the-hype-10-persistent-cancer-myths-debunked/
  9. Pawel Swietach, Richard D. Vaughan-Jones, Adrian L. Harris, and Alzbeta Hulikova, “The chemistry, physiology and pathology of pH in cancer”,

    Philos Trans R Soc Lond B Biol Sci. 2014 Mar 19; 369(1638): 20130099.
    doi:  10.1098/rstb.2013.0099

Antidepressants, Alzheimer’s and Brain Injuries: making bad worse

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What we knew:lights-1088141__340

  • Use of antidepressants with Alzheimer’s patients increases the risk for falls and hip fractures
  • There is a protein found in the brain cells of persons with dementia and brain injuries that causes the Axon in the cell (electronic message transmitter) to swell and shut down. This protein is absent from normal cells. Elimination of the protein can cause the axon to start functioning again. (References are in previous blog.)

What the University of Eastern Finland has added to what we know:

  • Use of antidepressants with Alzheimer’s patients results in an increased incidence of traumatic brain injuries among these patients

The mechanism for the injury is probably falling. With slower mental processing and thus slower reflexes, these patients are less able to protect themselves when falling. That means a higher rate of concussions.

This ties back to another previous post on this blog — “deprescribing”. Drugs may have a value in one stage of a person’s life and be counterproductive at another stage. Doctors know how to prescribe drugs, but there are few protocols (apart for drug interactions) regarding when to stop taking a drug.  There is a group in Canada developing guidelines for deprescription, and while NIH has published articles on the topic, I’m not aware of any similar projects to develop guidelines in the US. Some US physicians appear to be doing this on an ad hoc basis.

I suspect deprescription is not a popular topic among pharmaceutical executives, but it needs to be addressed. Continuation of unnecessary medication is just one of many factors that bloats medical costs in the US — and why spending level no longer indicates quality of care. Unnecessary medication poses risks to some patients.

Sources:

  1. Heidi Taipale, Marjaana Koponen, Antti Tanskanen, Piia Lavikainen, Reijo Sund, Jari Tiihonen, Sirpa Hartikainen, Anna-Maija Tolppanen. Risk of head and traumatic brain injuries associated with antidepressant use among community-dwelling persons with Alzheimer’s disease: a nationwide matched cohort study. Alzheimer’s Research & Therapy, 2017; 9 (1) DOI: 10.1186/s13195-017-0285-3
  2. University of Eastern Finland. “Antidepressant use increases risk of head injuries among persons with Alzheimer’s disease.” ScienceDaily. ScienceDaily, 9 August 2017. <www.sciencedaily.com/releases/2017/08/170809073627.htm>.
  3. Gurusamy Sivagnanam, “Deprescription: The prescription metabolism,”
    J Pharmacol Pharmacother. 2016 Jul-Sep; 7(3): 133–137.
    doi:  10.4103/0976-500X.189680
  4. http://deprescribing.org/
  5. http://www.drjohnm.org/2014/10/to-deprescribe-adding-a-new-verb-to-the-language-of-doctoring/
  6. Joaquín Hortal Carmon, IvánAguilar Cruz, FranciscoParrilla Ruiz, “A prudent deprescription model,” Science Direct, Medicina Clínica, Volume 144, Issue 8, 20 April 2015, Pages 362-369.