Doctor; Your Diagnosis. My Death


copyright © 2010 Betsy L. Angert.

Dearest Doctor, I have come to my senses.  Days ago, when you offered your diagnosis, I died.  No, not literally.  Had you done me in, I would not be here to write what I hope will help inform your bedside manner.  Well, in my case only the way in which you approach a patient who merely sits in an examining room chair near you is the concern.  You may recall our time together began so innocently. We sat down to review the results of annually scheduled blood-work.  I had not felt sick all year or on that day.  You had even expressed, it had been so long since we last saw each other.  You scanned the pages, and proclaimed, that I must have returned to my bulimic ways. My spirit perished.  I had done nothing of the sort!  Yet, you said you were sure I had.

The pain you inflicted killed what could have been a relationship built on trust.  Today, I realize your proclamation was but part of a pattern.  Indeed, you reminded me that during our last consultation, a year ago, you also decided that I must be near death.  In August 2009 you insisted that I arrange for an appointment, which you openly stated, would affirm your fears. I must be seriously ill. Yet, once that test was done, it affirmed that I was as I am better, than fine.

Upon further reflection, and after the telephone conversation I initiated hours after my appointment, I thankfully, feel more serene.  No, you did not change your diagnosis nay your assertion that I must be vomiting.   Still, the talk helped me, although it seemed to alienate you.  I wonder if you now have a sense of how I felt and feel since you pronounced me dead and a liar, or do you merely believe of me, “The lady doth protest too much.”

Might you ponder that my grievance is grounded.  Oh, how little you know of bulimia, and me.  In the two plus years we have had an acquaintance, I see you for maybe, ten minutes a visit.  Since only once did I come to your office for other than a check up, what you observed this week is true. I rarely visit.  When I do, you are booked.  Patients arrive back-to-back.  We chat for a bit, but not really.  All is said and done rapidly.  I wonder, might the speed of conversation and the shallow nature of a consultation affect your appraisal.  After all, you too are human; although from what you said to me today, it seems at times such as this you define yourself as a trained medical professional, more perceptive than a mere mortal.

During my most recent appointment you admitted, you did not even recall what I had shared so often; I disdain exercise.  I was never amongst the anorexic/bulimics who think they must work out endlessly. Only injuries incurred late in life took me to my current routine, a daily swim in the pool.

I know you recall that I swim, only because I often come dressed to swim.  Even that concerns you, exposure to the sun.  Do you remember that I switched to an indoor facility.  Probably not.   While the truth of the locale and my loathing exercise may not be memorable or visible in an office visit, what can be seen is a sign of bulimia.  My teeth.  

Doctor, did you notice what my Dentist and Dental Hygienist have?  My once translucent boney choppers are now denser.  The color has returned to white.  For so long, even when you and I first met, the hue was dark gray.  Other dental conditions were already on the mend when I first entered your sphere.  Deep groves, once etched into the enamel, gone.  With my tongue, or a look, I can tell, the surface is smooth once more.  As I said in our phone conversation, less than twelve hours after you declared me dead,   Charlene stated with delight, “Your teeth finally look alive.”

Funny. Charlene, my dental hygienist, detects a difference in my body and being since I left bulimia behind.  Yet, you are intent on my being ill.  Charlene sees and speaks of how my life without food benders and bile has helped me be healthier.  Yet, you dear Doctor, only see standards, the stats that you think are real, more real than me.  

You do not see, hear, or open your mind to who I might be.  I marvel as recall the day Charlene had expressed a doubt.  She offered, in Dental School professors taught the conventional wisdom.  Teeth do not substantially re-mineralize.  Enamel and density loss are permanent.  However, Charlene wonders aloud.   She has come to accept that what she learned may not be valid.  Months earlier she mused, “Well” after much assessment, “I have witnessed the metamorphosis.”  There is a change.  

Transformation from bulimia to health has occurred for Charlene, for me.  Then there is you, dear Doctor. Apparently, what was, will always be in your mind.  Oh, Doctor, if only you had truly engaged me in the past two years . Had you looked and listened or even spent more than a scant few minutes with me in any of our sessions, just maybe you would have learned that supposed facts and figures may not mean whatever it is medical professionals teach.  

Might you think to speak to me rather than seek the “expertise” of more and more specialists [sic] before you declare me to be on my deathbed?  I know not what to say.

I tried to talk to you, to share my reality, my family history, and myself.  My words fell on deaf ears. You so sweetly fight me at every turn.  When I worked to offer an analogous story, you scoffed.  Might I assume that you see me as less knowledgeable, credible, or just crazed.  Perchance, I might try to tell the tale again?  Perhaps, the read will help you to authentically relate.  

As I said, the day after you delivered your diagnosis I traveled to the dentist to have my teeth cleaned.  By the way, dental visits last for well over an hour and I go every few months.  Charlene and I talk the entire time.  This week, since I had just seen you and was so devastated, my exam and your evaluation were the topics of discussion.

Charlene smiled and stated she is all too familiar with Doctors such as you.  While she has had her own experiences her Mom’s was most worrisome to her.  While under the care of her Doctor, Charlene’s mother’s organs were forever damaged.   The Doctor thought it wise to bring this adult female’s blood levels to “normal.”  However, with age her heredity set in.   What had been usual for the patient was no longer as it was.  

Yes Doctor, I acknowledge that you listened to this story, for seconds, and then, abruptly interjected your disregard of my attempt to share personal accounts, or the details of my family history.  Doctor, you preferred the argument, “Charlene is not a Physician.”  Might you trust the words of others Physicians, those who have misdiagnosed me or correctly assessed my well-being?

Please indulge me.  Allow me to present a nonfictional narrative.  Eight years ago, after a serious automobile accident, an Orthopedic Surgeon told me I would not be able to walk for at least a half a year, probably more.  He assured me that one leg would be shorter than the other for the rest of my life.  I needed full bed rest for at least six months, maybe seven.  The specialist said he could not speak to the pain I had in my chest and ribs.  He saw nothing in the X-Rays.  Weeks later, another bone MD whom I thought it wise to consult, was shocked to discover my broken sternum and four fractured ribs.  

That Surgeon, I will call Doctor Thom, was more than a second opinion; he saved my leg, heel, my life.   Dr Thom told me that I needed to begin an exercise regime immediately!  He then showed me exactly what he wanted me to do as soon as possible.  While he concurred, I could not walk or bear even the slightest weight on my heel, I could get around on my hands and knees.  My father, relieved went to the store and purchased the best fluffy-filled cotton kneepads money could buy.

Dr Thom helped me realize that the pain in my chest was very real.  He helped me to feel safe, secure in the knowledge of what I could to.  Dr Thom spoke of a means for stability, and provided time frames.   Most importantly he attended to my needs, not as just another “patient,” but as me, Betsy!

Thankful that this physician asked of my history, and accepted that two past injuries necessitated a regular daily swim, I was able to feel comforted by his care.  Indeed, months before I was authorized to walk, with a promise from me that I would not place my leg on the ground, not even in water, Dr Thom prescribed a return to the pool.  Yes Doctor, he wanted me to swim unlike you who said, stop the swim or at least cut the time in the water done to near nil.  Fifteen minutes or less a day?  Doctor, have you read the research and recommendations for minimal daily exercise? Perhaps you have no desire to do other than prove yourself right.

For me, what is right is a healthy relationship with one’s body and other beings.  If only we had genuine caring, sharing exchanges.  I believe we do not.  In each of our talks, your trepidation for what you feel is my impending death, is inescapable.  It seems to shade your every diagnosis..

Doctor, I know you are not G-d. You do not have the power to give me life.  However, a professional such as you, can cause my demise.  The innumerable reports that document a patient’s passing at the hands of his or her physician cannot be ignored.  

Certainly, I may have over-reacted or reacted as any healthy person would to your decree; I lie or I die, possibly both.  Imagine my surprise, I entered your office the picture of health, and was pronounced a perishable commodity.   You said, were you to review my chart in a hospital, you would order a full body transfusion.  Until you were certain why results of the blood tests were so dire, you wanted me to see four specialists and a therapist.  A therapist?  

That statement alone spoke volumes; however it was a hush in comparison to the stated accusation.  You were concerned that I had returned to the world of bulimia.  Oh had you, or most any Doctor who diagnoses, what professionals call an eating disorder, experienced the thrill of leaving that past behind, you might understand how wonderful it is to have my life back.  

For years now, days, weeks, months, decades, devoted to food do not consume me.  Close to a decade has passed since I spent more time bingeing and purging than you do sleeping or working. Can you imagine? What might you feel if you were finally free of all that constrained your very being?

Oh Doctor, I know you cannot conjure up such a connection.  Were you able to relate to my reality you would not have said and done as you did.

You dismissed my words, my truth, all that I had learned, felt, and experienced in the twenty-five years and three months that I battled with the bulimia.  More significantly, you concluded that the many years since I last vomited were null and void.  In your infinite wisdom, you decided that a Doctor knows much more about an individual than the person, his or her self, does.

With few visits in our past, and little conversation, you know what is real for me?  You think practitioners who have never met me before will assess my health more accurately.    Based on what, more standards of “normal.”

Your counsel crushed any sense of a connection.  Your stated distrust of me is as a surgical knife; it cuts to the core.  When a Doctor doubts a patient, the effect is profound.  At least it has been in my experience.  However, it seems you are not truly interested in my experience or that of others.  Oh, how I wanted to explain my truth when we spoke on the telephone today.  Your response, “He, she, or I am not a trained medical Physician.” may have cured me of that desire.

However, happily I was able to sneak in one thought whilst we chatted.  A Doctor I am acquainted with has often expressed, medical school is like a technical college.   Practitioners and Surgeons are analogous to Mechanics.  For each, diagnosis is the greatest challenge.  An educated guess, or “evaluation” only captures what is typical.  You offered no thought on what another Physician pronounced his truth.  Perchance, you are still of the mind that you know what you know.  

As an Educator and an observer of humanity, I share what I believe.  Knowledge is not power!  Empathy empowers.  If only you chose to be empathetic, to consider what is beyond book knowledge. Perhaps, then, people, patients, might be real to you rather than fall into one or two categories. Terminal or test-proven fit as a fiddle.

Dear reader, you may wish to peruse Chapters One through Seven. Please do. These reflective diaries discuss my life as an anorexic, bulimic, a person.

Or Similar Discussions . . .

Reference for review and reflection . . .

Meet the Meatrix

copyright © 2010 Betsy L. Angert.

As you gobble that fine food, be it steak, a frankfurter, roasted chicken, or an omelet, please, sit back relax. Put your feet up and stay a while.  I will furnish the entertainment in the form of a film. Meatrix is fun, fascinating, and far from folly.  This presentation is playful; the message profound.  

You may recall the fairy tales you loved as a child.  The plots varied, although all had elements of mystery.  Adventures were abundant.  Tots were often so engrossed in the tales, they barely noticed that the themes taught a life lesson.  Meatrix is as the fables you once anxiously awaited and even asked others to read aloud to you.

The main characters move you through the story.  Moopheus leads Leo through the world of rolling hills, the family farm, and into . . . Well, I do not wish to tell you the ending.  Please travel with the pair as they stroll along.  Follow them into the meadows and fields.  Allow yourself to suspend disbelief, or embrace mistrust.  Just as Leo, you and I, and the person who shares a meal with you, have a choice.  We can take the blue pill or the red one.  Fantasy or reality; either may be hard to swallow.  Nonetheless, let us indulge. The travel could be delicious . .  . or dreadful.  Are you ready to explore?  If so, let us go.  Let us meet Meatrix.  He will show you the way.  The decision to travel is yours.

If you choose, to meet The Meatrix and Learn About the Issues, you may want to Take Action.  What can you do?  If you wish to, Spread the word.  At least, consider what you eat, where it came from, and what sacrifices were made for your breakfast, lunch, snack(s), or dinner.  Perchance, the “Happy Meal” is not such a bargain or worth the price we pay.

A Weighty Issue


copyright © 2009 Betsy L. Angert.

On February 15th, Barry boarded the plane.  He was deep in thought and noticed few of the people around him.  The prior evening had been exceptional.  This sensitive man celebrated Valentine’s Day with friends, with family, and best of all with himself, a person he had grown to love and respect, an individual he barely knew for all of his life, himself.  

More recently, Barry had become a more balanced individual.  He is now constantly on the move, not merely in a physical sense, but in a more real manner.  The successful businessman, the sensational father, the phenomenal friend, the scholar who climbed the career ladder well, in the not so distant past, never felt truly fulfilled.  Now, he thought of himself as a work in progress, a being who has transitioned beyond his wildest dreams.  Yet, he trusted there were still many roads to travel.  He wondered; would he make it.  On this day, unbeknownst to him, Barry would find his answer.  Yet, he would also be prompted to ask more questions.

Before the plane left the gate, Barry marveled; he had grown, and not in width.  No longer was his priority to please others, even at his own expense.  Barry believes now, as he always did.  It is best never to cause harm, not to others or to himself.  Self-sacrifice was once the way Barry barricaded himself.  He hid his emotions, his feelings, in truth, his fears.  When with others, he acted as though he was empathetic.  The people pleaser wanted to be identified as benevolent.  In a desire to avoid more authentic associations, Barry binged on food.  Early in his life, he grew fat.  Better to blame his weight for what he could not do, then place the onus on others.

As he approached the plank, Barry became aware of those near him.  He began to ponder the persons in his presence.  He observed, in appearance, many of the passengers, were as he once was. Only two short years ago, he was among them.  He was an obese American, one of the almost 90 million exceptionally overweight citizens.  Then, when he thought of his weight, and all the ill effects his bulk caused he felt hopeless. Over time Barry has lost most of his bulge, today he again felt the pain of excessive pounds.  The plane full of people was too heavy to fly out as scheduled.  The weight of the aircraft dictated a necessary change.  

The flight pattern would need to be altered.  Customarily, jets left to the East.  Aircraft passed over a power plant before the highest speed and preferred altitude was reached.  As a precautionary measure, a plane as heavy as the one Barry now sat on could not be allowed to soar low over an electrical grid.  Were the airbus to crash, surely, it would explode.  Sparks would set off fires.  Everyone on the plane would be killed.  Over the intercom, the pilot proclaimed, excessive weight could be a deadly issue.

The crew and air traffic controllers would do what was needed to ensure safe travel. The plump passengers would not be publicly embarrassed.  Nor would any commuter be forced to feel responsible for the situation.  No one person or his or her poundage would be singled out.  Politely, the pilot presented the problem and assured all abroad, he and the tower had taken great care to secure a suitable solution.  The plane would take an alternative route over water, and all would be well.

Barry reflected on what the aviators feared might be the future of those persons anxious to depart from south Florida.  He thought of how similar this situation was to his past.  The once rotund man understood.  In his own life, when he carried extra pounds, there was much he could not do safely.  Then, just as he did now, Barry accepted what was an awkward truth.

In the initial moments, while on the taxiway, Barry was patient.  He endured as he had for most of his years.  Adjustments would be made.  Hours later, he, and the others would move forward, albeit a little more slowly than they would have was the plane not redirected.  Barry and the more bulbous passengers were comforted by the care and attention to detail.  A safe runway for departure, given its current weight, was all those on the aircraft wanted.

Had the plane or more accurately the people on it, been a bit lighter the whole adjustment and delay would never have happened.  Nonetheless, what was, was, and that was alright for those aboard this plane, or at least it had been

Nearly forty minutes earlier, the formerly corpulent Barry was among the hordes of people who boarded the aircraft.  Barry noticed a family, or three persons familiar with each other, were as he once was.  Each weighed over 275 pounds.  He thought; “There but for the grace of G-d go I.”  Barry noticed others of various sizes and shapes, all large.  Yet, he thought nothing of their conditions or circumstances at the time they entered the plane.  He had other thoughts on his mind.  He wanted to return home.  Cuddle with the kitties.  Clean his house, Prepare for a busy workweek.  Life, liberty, and the pursuit of happiness were his only concern as the Valentine’s Day holiday week ended.

The more he had learned to accept himself as a unique and complete person, the less he allowed food sand drink to be his distraction.  He felt no need to dive into the free chips or cocktails the airlines offered.  Barry realized other sought solace in these complimentary sweets.

People seemed pacified by food and the opportunity for greater folly.  Funny, Barry thought, in the past, if a plane were stuck on the ground, during last night’s Valentine’s Day festivities, or on any other occasion he too would have ingested chocolates as he suspected most on this plane would do.  On a day devoted to travel, as this one was, or on an evening dedicated to love, as last night was, Barry, his beloved, or the big woman who sat beside him on a 737, might have exchanged, “Sweets for the sweet.”

Thoughts of his blood-sugar and the adult onset diabetes that became his life long ago would have been ignored. A meal, a chance to steal a bit of snack time, life might be an excuse to celebrate togetherness.  One little innocent confection could do no harm.

Not too long ago, Barry may have sipped an alcoholic nectar with those he cares for and who are fond of him.  Intoxicating beverages that build blubber certainly would have passed his lips.  He might have believed as many he knows still do.  People are less inhibited when drunk with delight.  Intimacy is more possible when the fruit from the vine imbibed.

Many courses of flavorful fattening foods, a meal fit for royalty, surely would have graced a Valentine’s Day table.  Today, on his tray table, condiments would have collected.  The best way to the heart is through the stomach.  The airlines knew that.  Perhaps, that is why the flight attendants walked through the cabin with baskets of peanuts and crackers.  No one would be upset by the delay if hunger was staved.  Surely, 24 months earlier, Barry would have been content to wait as long as the food kept coming.  He too might not have thought of a potential crash or the hazards of a weighty plane.  

Barry pondered.  Possibly, for most of this crowd on the plane, his past habits were their present reality.

Up until recently, Barry believed the pounds poured on to him as if by osmosis.   He did not deliberately seek out sweets, starches, or saturated fats.  They found him.  His refrigerator was full with what he saw in the markets.  Grocery stores were stocked with gooey goodies.  Restaurants served sumptuous delicacies.  Friends and family feasted upon fodder, all of it filling.  Wherever Barry went, it seemed he needed to only look at food, and the weight gain would follow.  

Today, while on an airplane immobilized by the load it carried, he thought of his earlier bulk and that of others.

Barry empathized.  He felt the pain of those who carry unwanted pounds.  He understood the challenges.  It is difficult to develop new habits or to think you can rise above the clouds when you are fat and forlorn.  Barry recalled how he had accepted much that was dealt to him when he was flabby.  What else could he do?  Not long ago, his options were limited, or so he believed.

With much encouragement from the one he shared his Valentine’s Day with this year, last year, and on the February 14th before that, he learned to believe in possibilities, in his own ability to eat, drink, and move through life differently.  His best friend had also faced weighty issues in her lifetime.  His life-partner’s lengthy struggle with food, folly, and an inability to move forward was one he witnessed firsthand.  Barry watched the woman he knew so well work through her inertia.  She languished, anguished, and ultimately left her hefty sense of helplessness behind.  Her efforts helped Barry to believe that his life could be better.

It was not so long ago, Barry began to exercise, to eat healthy foods, to free himself from the habits that hurt him.  Were he a plane, in the past, Barry’s weight would have grounded him.

Today, Barry knew he could not do as he had done years earlier.  He would not stay motionless.  Nor would he say nothing of the circumstances.  He would not resign himself as the load of commuters had.  He wondered whether his own history taught him that extra weight need not be a reality.  A heavier load need not be a burden to be endured.

Unlike the 100 plus others, who seemed settled with the fact that they could not leave the ground, at least not for another two hours, Barry was not.  Just as he had decided not to settle for a life in which he battled his bulge, Barry concluded he would speak to the Captain.  He would ask the pilot to invite ten to fifteen passengers to leave the aircraft.  If this number deplaned, the usual traffic pattern could be put in place.  The persons who remained on the vehicle could travel safely and in a timely manner.  Those who voluntarily exited would not only receive recompense, they would also be assured a safer travel on a lighter plane.

Once Barry voiced his willingness to make a change, to lighten the load, and to leave the aircraft, he was able to garner support from other travelers.  The pleased pilot said he would return to the terminal and allow the few to exit.  The crew was grateful for the diversion. They knew how the temperature and the tempers of those stuck on a plane, still, on the tarmac could rise.  The persons who stayed on the plane were elated.  Fat though most of these may have been, at least they would be able to move a bit more freely through the air with thanks to the benevolence of one who used to be as they were.

Barry pondered the parallels as he walked through the airport.  He had hours to wander and muse as he waited for the next flight.  Determined not to be idle; a circumstance he disdained since he lost his own excessive weight, Barry walked.  As he strolled, he realized he would need to find nourishment.  His breakfast would not hold him through the day and into the evening when he would again board a plane.

As he unsuccessfully searched for other than starchy, fatty, sugary foods in the airport, he became frustrated.  Barry realized there was not a restaurant in the building that carried healthy victuals.  He rented a handcart, placed his luggage on it, and briskly sauntered to another terminal.  He had time.  Besides, it was good to be able to move about and enjoy the sunlight.

As he ambled about, Barry thought of how obesity affects the life of a plane or person.  He saw the many who sat stationary in the terminal.  Most of these individuals were chubby just as those on the plane were.  Barry realized he had been so concerned with his own weight issues he had not noticed what now seemed obvious.  In America, overweight was the new normal.  This point became more real as a security guard approached him.

The officer told Barry he appeared suspicious.  Who was he to walk around the airport, to move about so freely?  People did not do that, not today, and certainly not in a terminal.  Barry shared the story of the plane too heavy to fly the normally prescribed route.  He explained it would be hours before he could board the next flight.  Barry said he last ate very early in the morning.  He was desirous of fruit, or some healthy food to eat.  The sentinel said, Barry was to do as the others, more weighty passengers had.  Sit.  Be still.  Pack on the pounds.  Build the bulge, and be satisfied with confections, soda filled with high fructose corn syrup, and starchy foods.  The security guard assured Barry, there was no fresh produce to be had on the premises.  “I have some Valentine’s Day candy,” the official said.  “Here, have a piece.”  Barry smiled.  He said, “No thank you.”  He walked on and wondered.  When is weight an issue for an individual, a culture, a country, or better still, why is it not?

References for a weighty reality . . .

Condition; “Critical”


copyright © 2008 Betsy L. Angert.

Twas the night before Election Day and my mind, heart, body, and soul were filled with fright.  I fear I did not do enough; nor could I have, to truly bring about change.  I more needed time with those that trust me or were still open to reflection.  When last I made calls for candidate Barack Obama, I was slammed, damned, and spoken to with much disdain.  Similar occurred when I stood on a street corner and waved my signs.  Granted, I saw and heard there was much support.  Still, I had friends who would not vote for Senator Obama.  Several were sure that they preferred John McCain and Sarah Palin.  Then, there was John Michael Rubens.  John is eligible, older; he is registered.  This fine fellow has cast many a ballot in his lifetime.  Doctor Rubens is prominent pillar of the community.  The well-trained physician is a scholar.  He cares.  Yet, he would not cast a ballot for either candidate.

John’s positions affected my faith.  Everywhere I went, other people told me to believe, to be hopeful.  However, I knew that no matter who entered the Oval Office, blood would be spilled.  On battlefields abroad and on the streets of America, brutality born of terror would continue to flow.  For some people weapons wield strength.  Innumerable individuals use words to kill.  Some take advantage of signatures on insurance forms, benefits no longer offered with salaries, or just the Health Care system.

Hours before Americans went to the polls, my very close friend, a man familiar with the field of Health Care and the coverage necessary to treat illness and injury, spoke of what time, or a national election tally would not easily erase.  Doctor Rubens avowed, the tangible that he thinks is in need of serious attention, is  the way in which medicine is taught, practiced, and paid for.

John believes the Health Care system is a mess.  He fears it is too far-gone.  No Doctor, Democrat, or Republican, can revive a lifeless body that is virtually dead.  Doctor Rubens offers his diagnosis; the institution known as medicine is virtually dead.

Doctor Rubens has long felt antipathy for elections.  For years, I have endeavored to persuade him to vote.  I did not have, nor did I express, disdain for his decision not to cast a ballot.  I only hoped life’s daily doings would encourage him to go to the polls.  As he shared his personal narrative, I inquired.  “Will you vote in hopes that coverage, costs, and the circumstances for practitioners and patients are improved?”  “No,” was the immediate response.

He laughed.  John Rubens was not joyous or jovial.  The physician was pensive.  He pondered aloud.  No amount of money, and neither of the Presidential candidate’s plans will do anything to improve what John just experienced.  John Michael Rubens recently returned from an extended hospital visit.  He was the patient, not the physician.  

While in the hospital, it became increasingly obvious to the man I love, hospital staffs are underpaid.  Personnel are scant.  Each day more and more positions are cut.  The economic downturn has had a direct effect on employee benefits, on whether ill or injured persons seek care, and on the ratio of attendants to individuals admitted to the hospital.

J.M. Rubens, M.D. observed nurses, physical therapists, and specialists in surgical procedures are asked to stretch them selves beyond what any person could physically, or emotionally endure.  He recounts his own medical history, as a Doctor, and in treatment.  John marvels.  Surgeons, who may stand for as long as seven hours in the course of a single operation such as his, make less per hour than he earned decades earlier.  The number of people medical practitioners in every field serve has increased.

Among specialists, invasive cardiologists’ compensation declined (0.18 percent loss) even before inflation.  Conversely, noninvasive cardiologists’ compensation increased 11.72 percent.  Compensation for emergency medicine physicians and hematology/oncology also failed to keep up with inflation.  Specialists who fared better included anesthesiologists (6.43 percent increase above inflation) and urologists, posting a gain of 5.5 percent above inflation – compounding a similar gain in 2006.

“Although primary care physicians posted modest gains in compensation as a result of increased productivity and re-weighting of evaluation and management codes, overall practice costs continue to rise at staggering rates,” said William F. Jessee, MD, FACMPE, president and CEO, MGMA.  “The continued uncertainty of the reimbursement environment creates an untenable situation for physician groups.”

Compensation, when it comes, is inadequate.  In truth, the doubtful delivery of reparation is, in part, why John retired early.  If the patient is “covered” by Medicare, reimbursement is less.  The time needed to evaluate is not considered in the repayment.    Little is.

Doctors have complained for years that Medicare rates haven’t kept pace with costs, such as new technology and the added paperwork required by insurance companies.  The formula for determining reimbursement rates has basically been unchanged since Medicare was created in the 1960s, said Gondo.

Medicare reimburses doctors for about 46 percent of their fees while private insurance pays from 60 to 65 percent, said Dr. Timothy Melhorn, medical director at Cornerstone Medical Clinic, which is owned by Yakima Valley Memorial Hospital.

Medical practices incurred a 7 percent increase in operating costs in 2005, but Medicare reimbursed doctors less than half that amount, according to the Medical Group Management Association, which advocates for medical practice managers.

Doctor Rubens reminds me of what he received when I was a Medicare patient.  The payment was very low by today’s standards.  Even then, before he saw me, he told me he would not take on another patient who did not have private insurance.  His office maintained a waiting list. Quality referrals were my entrance into his office for one visit.  All those decades ago, John agreed to see me for a single appointment.  Fortunately, for me, during our first encounter, he realized we had so much in common.  John Michael Rubens, thankfully, decided to add me to his workload. Rarely, do the millions on Medicare list have this opportunity.

Today, in territories such as Texas, more than forty percent [40%] of physicians will not accept new Medicare patients.  Before 1990, ninety percent [90%] of medical professionals were willing to take on the persons now turned away.

At the time, Doctor Rubens saw me, he felt he could afford one more “charity” case.  Today, he observes medical professionals do not have the time to be so benevolent.  They work more hours than is healthy.  Money does not motivate them.  Indeed, the profession is no longer a fruitful pursuit.

The physical condition of the health care system is not what it was a score ago when John saw me as a patient.  On many occasions, Doctor Rubens has said, “Physicians’ income fell 7 percent between 1995 and 2003 after adjustments for inflation.”  I have heard the many stories.  I recall what he shared of his last years in practice.

When John Michael Rubens was eight years out of Medical School, he was able to purchase a house in an exclusive enclave.  That property is now worth millions.  The lot looks over the Pacific Ocean.  From what was once his window years ago, he had a panoramic, breathtaking view of the surf and shore.  Today’s Doctors, John declared with a deep sense of distress, even after many years in practice, cannot begin to pay for what he had after less than a  decade.

In 2006, in what feels like an eternity ago when we consider today’s economic crisis, the greater number of jobs lost, and a reduction in employer provided benefits, it was reported that Doctors’ income falls over eight years.   Primary care physicians are impacted more than specialists; although at the time of this survey, surgical specialists’ revenue dropped 8.2%.  Young persons who, in the past, thought a future in medicine would be wondrous, are affected by reduced returns on an ample investment.  Fewer wish to enter the medical profession.  

Earnings are but one consideration.  Malpractice premiums, technology for an office and personnel are large expenses.  Then, there is the paperwork, and telephone calls not paid for.

“Every day, I spend at least an hour after my workday to call patients back, to discuss lab results, to discuss test results,” Ryan Mire said.  “That’s not compensated.” . . .

“Just in the last three weeks, I have actually noticed three medication errors from specialists who prescribed medications for my patients because they did not have the full history,” Mire said. “I received those consultation notes, saw what the specialist prescribed, and said, ‘Absolutely not, do not take that medicine.'”

Yul Ejnes, a Rhode Island internist also on the panel [part of an internal medicine conference in DC] added a couple other typical primary care tasks that aren’t reimbursable: “talking with family members,” and “just sitting down and thinking” about a case.

“Sometimes I wonder whether I want to keep doing this,” Ejnes said.

These doctors are not alone.  John Michael Rubens wrestled with the question for quite some time before he decided emotionally, physically, economically, the career he once loved was not worth the toll it took on his personal and professional life.

Recently, for two long weeks, Doctor Rubens laid in a hospital bed, listened to the tales of sickroom staff, and observed what occurred before and after his operation.  John took time to reflect on his earlier evaluations, his money, his health, and his life.  When circumstances were not as bad as they were today, John chose the retirement that has provided him greater perspective.  Frequently, he has mused, ‘There is so much I missed, or just did not understand in the way I do now.’

Time with family, friends was perhaps less than he had hoped it might have been, although he was sincerely committed to his relationships at home, and in the office.  John, the Medical Doctor, in private practice, was more often than not, on call.  Doctor Rubens loved his work.  He chose his profession for the love of people.  Physician Rubens entered a consultation room with a desire to heal.  He yearned to lend a hand to the patient who wished to help him or her self return to good health.  

John took the time to talk and more importantly to listen to his patients.  John Michael Rubens was invested in the Doctor Patient Relationship.  As he speaks with younger Practitioners, who drop in and then quickly out of his hospital room, John grasps, for them, the Hippocratic oath is a luxury they cannot afford.  The current Health Care culture dictates, money matters are the vital sign to be considered.  Empathy for a patient has been eliminated from the profession.  In the latter years of his practice, Doctor Rubens prescribed as practitioners have, “The changes in medicine are at odds with many of the values that defined the profession I joined”

The physician realized there was a transformation when  health insurance companies identified him as a “provider.  He was assigned a number.  His name was as meaningless as his diagnosis.  He spent hours on the telephone in an attempt to advocate for patients.  The ill and injured were denied treatment.  Payment for prescriptions could not be secured.   John recalls when he worked with a particular hospital, months passed and he received no pay.  His children, now attorneys argued he should sue.  Doctor Rubens preferred to just walk away.  Today, he expresses with trepidation, litigation is more prevalent than quality licensed health care.

As the Doctor reminisces, he reflects on the education young interns receive.  He hears tales of woe from his daughter-in-law, who is enrolled in a teaching hospital.  He reads of how these premier institutions are in crisis.  Some experts are anxious.  While no one believes the refuge for research, development, and the place in which a patient can receive better medical care will disappear permanently, the money needed to maintain such stellar institutions is no longer a priority in a managed care culture,

As a physician in practice, John knew times were tough.  However, he did not fully imagine what it must be like for those who are captive to coverage plans that do not consider the wellness of a patient.  Life as one who is in dire need of medical treatment has also opened his eyes.  Only days ago, John was in critical condition.  He had been rushed to the hospital.  Repairs made in a crucial operation years earlier ruptured. Toxins spread throughout his body. The medical professional needed to place his faith, his life in the hands of those who he trusted had stresses of their own.  The surgical procedure was deemed a success.  Physical pain nearly paralyzed John.  His ability to toss or turn was trivial.

Every movement required great effort.  When he rang for a nurse, often, no one came, or they arrived long after he alerted them.  Ultimately, Doctor Rubens realized if he was to receive adequate care and attention, he would need to hire his own personal nurse to perform tasks that hospital employees could not get to.  John Michael Rubens, who is an avid reader, knows the research.

[H]igher patient-to-nurse staffing ratios are associated with higher mortality rates and greater incidence of medical complications and errors, lower job satisfaction, and more burnout among nurses.  The findings that follow in this report provide additional insight into the effects of nurse staffing levels from the perspective of the nurses directly providing patient care in hospitals today.

The survey data demonstrate that nurses view understaffing as a serious problem when it comes both to the quality of care that patients receive and to nurse burnout.  For example, three in five (59%) hospital nurses say that the staffing level at their hospital is having a negative impact on the quality of care patients receive . . .

The study’s data on patient-to-nurse ratios explain why nurses are so concerned about staffing levels today. Med-Surg nurses report that on average they are caring for 8.0 patients per shift

There are so many people to care for.  Yet, circumstances, realities in the Health Care system make this career choice less desirable.  The once sought after benefits, and a superior sense of service have virtually been eliminated from the medical profession.  

As Doctor Rubens may have heard amongst paid health care specialists, the occupation has been reduced to rituals.  Physicians push papers and pills.  Nurses administer shots and sponge up urine. Blood is spilled and no one has the time or resources to repair a medical system in distress.  The condition is critical.  

John feels the pain in the profession he loves.  I too worry and wonder.  Since we spoke of the dire crisis on the day before this decisive election, I inquired as I had so many time in the past, “Will you vote tomorrow?”  Doctor Rubens quickly replied “No.”  John sad with apparent sorrow; he assessed John McCain’s Health Care agenda.  John saw the Republican leader did not put his country or the citizenry first.  Barack Obama, the Physician proclaimed, offers no change that he, personally, could believe in.  John Michael Rubens laments today as he did before there was a President-elect, ‘Yes we can; yet, we do not provide adequate care for Americans.’

Sources for a dire situation; Health Care and Medical Coverage in America . . .

Sunscreens; Little Protection – Much Harm

Everybody’s Free to Wear Sunscreen! (Original Version)

copyright © 2008 Betsy L. Angert

For years, Sarah felt safe as she traveled about.  She shielded herself from harm.  She placed her faith in science.  She  listened to the  advice of experts.  She thought she had been careful with chemicals and creams.  This wise woman knew not to trust recommendations without doing a thorough examination of evidence.  After an avid assessment, Sarah avowed, “Sunscreens are good.”  Then one day, as she entered her home after being out and about, she saw what she had never imagined.  Sarah was beyond surprised; she was shocked.  Her mouth agape,  Sarah shrieked;  “I have been burned.”  Not only had the solar rays she worked to avoid scorched her skin in ways she had not thought possible.  The lotion may have seared parts of her body not easily seen.

What Sarah had not considered was her sunscreen may have debilitated people, plants, and aquatic animals throughout the planet.  She was not sensitive to the symbiosis that governs the globe.  Sarah was as most individuals are, she was consumed with what affected her directly.  Her skin, her health, the salves she slathered on, these were her priorities.

On a bright afternoon in June, Sarah, a person whose complexion is pinkish in hue, first realized reason for alarm.  She turned the television on, and was greeted with the headline, “Study: Some sunscreens overpromise on protection.”  Extremely disturbed by the possibility cosmetic creams might have an effect on her personal health, Sarah pursed her lips and rushed to the computer.  She needed to read the research for herself.  After all, her life and wellbeing were threatened.  She decided to take control and more closely scrutinize her choices.  She perused the survey.

In a new investigation of 952 name-brand sunscreens, the Environmental Working Group (EWG) found that 4 out of 5 sunscreen products offer inadequate protection from the sun, or contain ingredients with significant safety concerns.  Leading brands were the worst offenders: None of market leader Coppertone’s 41 sunscreen products met EWG’s criteria for safety and effectiveness, and only 1 of 103 products from Banana Boat and Neutrogena, the second- and third-largest manufacturers, are recommended by EWG.

Sarah sighed.  She had likely tried every brand imaginable before she chose what she thought best for her.  This studied soul, whose skin is sensitive, discovered she reacted poorly to most creams, ointments, and sprays.  Rashes raged on her skin after most any application.  For her, hypoallergenic was an oxymoron.  She believed the government had the best intentions when they coined this term; nonetheless, for her it was meaningless.  Sarah suspected perhaps, in the past, her trust in public officials and manufacturers was misplaced.  

(The Food and Drug Administration) FDA now stands in direct violation of a Congressional mandate requiring the agency to finalize sunscreen safety standards by May 2006, flouting not only Congress but also consumers, who are reliant on sunscreen to protect their health . . .

FDA has spent the past 30 years drafting sunscreen standards (FDA 2007a), which it urges manufacturers to follow voluntarily.  FDA issued its latest draft standards in August 2007, which include a proposal for first-ever UVA standards, but still has failed to finalize the standards to make them mandatory.  In lieu of enforceable standards, each sunscreen manufacturer decides on test methods, marketing claims, and the level of protection they are willing and able to provide consumers.  Health authorities recommend sunscreen, but people are left wondering which of the hundreds of sunscreens on store shelves will best protect their and their families’ skin from the sun.

Sarah now reluctantly realized her government, in all its glory, fried her sense of pride.  She thought herself careful.  This woman had faith; she could trust those in charge of the Food and Drug Administration to protect her.  Certainly, Congress would check the claims of sunscreen producers.  They would be the balance if policymakers engaged in questionable behaviors.  Such was the wisdom of Sarah.  

This lovely lady believed as she was taught.  The forefathers understood; equilibrium is essential.  This vital notion was built into the Constitution.  Government agencies work for the common good. In America, public officials, and civil servants, are employed by the people and labor in their interest.  Now she wonders.  All she is certain of is she is free to wear a sunscreen.  The question is, which one will she choose, and what are the hazards of such a decision.  Sarah reads on.

Many products on the market present obvious safety and effectiveness concerns, including one of every seven that does not protect from UVA radiation This problem is aggravated by the fact that FDA has not finalized comprehensive sunscreen safety standards they began drafting 30 years ago.  Overall, we (Environmental Working Group – EWG) identified 143 products that offer very good sun protection with ingredients that present minimal health risks to users. Find out which in our best and worst lists.

Once the records are retrieved, Sarah saw that one of the two products that did not cause her to weep in reaction to the chemicals was deemed a “high hazard.”  The other that did not irritate or inflame her flesh was rated “moderately hazardous.”  She was uncertain whether she should be relieved or grieve further.  Could it be that a “moderate” rating was fine.  Frustrated with her choices Sarah read on.

The U.S. lags behind other countries when it comes to products that work and are safe. FDA has approved just 17 sunscreen chemicals for use in the U.S.  At least 29 are approved for use in the E.U. FDA has approved only 4 chemicals effective in the UVA range for use in the U.S., and has failed to approve new, more effective UVA filters available in the E.U. and Asia.

So many illusions were destroyed as Sarah reviewed the literature.  She wished she could go back in time when life was carefree, and ignorance seemed blissful.  She wanted to trust in her government, in the free market system, in anything again.

Sarah recalled the words of friends and family.  “A day in the sun, would that not be fun.”  So was the gleeful cry of every school child for decades, perhaps for centuries.  For eons, babies bathed in the light.  Parents would watch in delight as they watched the progeny play.  Long ago, she knew, some Moms and Dads were cautious; they feared exposure to such intense beams would not wear well over the years However, even those who expressed alarm, knew certainly, the sun could do no harm to internal organs, (or to organisms outside our body.)  However, today, we learn sunscreens can cause serious problems.  What we slather on with abandon apparently may do more to age us and cause illness than sun exposure ever did.

Some sunscreens absorb into the blood and raise safety concerns.  Our review of the technical literature shows that some sunscreen ingredients absorb into the blood, and some are linked to toxic effects . . .

Most sunscreen chemicals are far from innocuous.  In sunlight, some release free radicals that can damage DNA and cells, promote skin aging, and possibly raise risks for skin cancer.  Some act like estrogen and may disrupt normal hormone signaling in the body.  Others may build up in the body and the environment.

Oh my gosh, she exclaimed.  These supposedly innocuous sunscreens seep into the bloodstream and place the planet in peril.  Sarah understood that a chemical on the skin might cause residual effects.  However, she was challenged to comprehend how a unguent could bother Mother Nature?  

Yet, her interest was peaked.  How could a balm she rubs on her body possibly do damage to the flora and fauna?  She searched for more information, an explanation, and some elucidation.

The scientists said ultra-violet filters found in sunscreens and commonly used fireproofing materials were to blame for the presence of these dangerous (hormonally active chemicals known as endocrine disruptors) . . .

Even at low dosages, these chemicals have an effect, according to the national research programme into endocrine disruptors.

Endocrine disruptors of this type are fairly common in the environment, in household dust or office spaces. Researchers consider that people absorb these airborne chemicals at least as much this way as they do through nutrition.

Small children who are still crawling as well as aircraft crew are considered to be among those most under threat.

Traces of bromide fireproofing agents have also been found in fish, in sludge at sewage treatment plants and even in foxes living in urban zones.

Sarah sighs and in the moment thinks herself  relieved. Perhaps, chemicals found in fish and foxes are not critical.  After all, humans are filled with toxins and we still survive.  Most of us thrive.  The thoughtful person that she is, Sarah is fascinated by the realization she is in a relationship.  Her actions are a cause.  What she does has an effect the other being, some of whom she has never seen or touched.  She could not imagine what this might mean.  Little sweet spirit Sarah never thought she might have the power to  injure cuddly babies.  As she read and reflected, tears fell from her eyes.   She knew not whether the salty solution that drifted down her cheeks spoke to her sorrow or rage.

Sunscreens are the tip of the iceberg when it comes to ways that the chemical industry and the government are failing to protect public health.  An extensive body of scientific literature demonstrates that everyone in the world carries in their body hundreds if not thousands of industrial chemicals at any given moment, the result of exposures to contaminants in air, water, and food, and to ingredients in everyday consumer products.

No one understands the health implications of our exposures to complex mixtures of industrial compounds and pollutants: remarkably, federal health standards do not require companies to test most products for safety before they are sold, including nearly all chemicals in sunscreen and other personal care products.  Little is known about the safety of most industrial chemicals.  In the absence of data the federal government approves new chemicals for the market using computer models to predict if they are toxic to humans.

Sarah wondered; how can she trust what she thought to be true?  She had relied on the strength of her government.  She placed her faith in an industry who she now accepts profits from her pain.  Sarah, too often experiences a reliance on technology reaps results that harm humans.  Her faith in all that is familiar is dashed.

Article after article, reveals a truth she had not realized.  Sarah is related to every entity on the Earth and she is somewhat responsible for realities beyond her belief.  Sarah concludes, ignorance is not an excuse; arrogance is injurious.  She bemoans her own failure to know what each essay reminds her of.  The invisible connection every individual has with all other life forms cannot be disputed or ignored.  

Sarah’s heightened stress prompted more reading and greater concern.  One treatise was perhaps more persuasive than the next.  “Chemicals in sunscreen may be harmful to aquatic life.” Injurious indeed; what might that mean?  She scanned further. “If your suntan oil can change the sex of fish, what can it do to you?” The tome stated, “The stuff is not only on our skin: it’s in our tap water and lunches too.”  Sarah gasped.  Then, she looked back at the page.  Sarah hoped to learn more.

“Almost 80 percent of our water in the U.S. shows trace amounts of chemicals from personal care products, which could be sunscreens, lotions, colognes or medications,” said Sejal Choksi, the program director for Baykeeper, an environmental watchdog group. . .

A recent study authorized by the European Commission found that the chemical compounds that filter ultraviolet radiation in cream-based sunscreens caused bleaching in coral reefs.

The study, published in the U.S. journal Environmental Health Perspectives, showed that even small amounts of the chemicals made the algae on coral susceptible to viral infection.  The killing, or bleaching, of the algae — which have a symbiotic relationship with the coral — is a death knell for the whole structure . . .

Some 60 percent of the world’s reef systems are now being threatened by a combination of global warming, industrial pollution, and excess UV radiation, which is why the sunscreen threat is being taken seriously by scientists.

“As with anything that happens in the environment, there is a confluence that joins together in weakening an ecosystem.

The union of man and beast, flora and fauna when in balance give birth to a thriving bionetwork.  When destabilized even the strong cannot survive.  Life, as we know it, ultimately dies, when impurities are the source of imbalance.  

Sarah had never considered the importance of marine life before.  Nor did she suspect the depth of synergy.  Coral for her, just seemed to sit on the bottom of the ocean floor.  She did not fully consider collectivism.  The statement, “Man is not an island” does not begin to explain a fellowship that exists beyond humans.  As she investigated, she gained greater insights into synchronicity.

Sea life supports plants and animals.  Fish are dependent on a healthy coral reef.  Humans are perhaps more reliant on the vigor of aragonite structures.  Sarah marveled; her choices and those of every person on the planet affect the well-being of life forms beneath the sea.

Why are healthy reefs important?

Healthy coral reef ecosystems play several important roles by:
  • Maintaining ecosystem structure and function
  • Supporting ecosystem and community services
  • Protecting shorelines and preventing erosion

Unhealthy systems have been linked to:

  • Human illnesses or diseases linked to ecological imbalance
  • Decline in economic profits due to loss of natural resources
  • Loss of cultural traditions due to changing use of natural resources
  • Decline in tourism
  • Increased vulnerability to hurricanes due to altered/decline of reefs and coastal areas.

What are the primary threats to reef health?

The primary disturbances in the Mesoamerican Reef Ecosystem have been:

  • Unsustainable coastal development
  • Overfishing
  • Pollution (including agrochemicals, sedimentation and nutrients/sewage)
  • Global Climate Change (which may increase the impact of coral bleaching and hurricanes)
  • Lack of protection or lack of enforcement of existing regulations

Sarah surmised what she read and heard of sunscreens was more significant than reported.  Pollution, even from a lotion, gives way to global warming.  A planet heated is beset with hurricanes.  Certainly, recent weather conditions illustrate there is reason for concern.  Sarah, just as citizens throughout the globe, has witnessed odd occurrences.  Historic cyclones, floods, tornadoes, hail, winds, and rains have become our daily truth.  People everywhere speak of unprecedented, unpredictable weather conditions.  No matter the season or the region, men, women, and children do not know what the weather will be.  Sarah marvels, might the effect of sunscreens partially explain these mysteries.  Yikes!

Sarah said aloud, “What else do I not know of the layers and layers of lotion, lathered high above the epidermis?”  As she settles into her routine, she reflects.  

Where can she go to hide from the rays that put her at risk?  Can she sneak away from the government that she thought cradled her soul and secured her safety.  Must she accept, in a society built on entrepreneurial enterprises, manufacturers create a market and no matter where she travels, she will not escape the woes that a want for more money advance.  Hours later, tucked into the darkness of night, Sarah, now ready for bed decides, she is free to choose, and only she can be her best shield from entities that could cause her to suffer.  She sleeps and dreams of daylight.  What will she do come morning. Might she slather on the sunscreen and live with the guilt.  Sarah never thought the cream she applied to her face, arms, and legs could cause such a crisis worldwide.

Sources and Sunscreens . . .

Americans Have No Choice; A Diet of Fats, Salts, Sugars

copyright © 2007 Betsy L. Angert

‘Tis the season to be jolly.  From Thanksgiving Day to the dawn of the New Year, Americans are encouraged to eat.  He, she, you, and I are expected to fritter our fears away.  We will worry not of weight gain, heart attacks, coronary artery disease, strokes, or diabetes.  Citizens in celebration will gorge on and gulp down millions of morsels.  Americans will eat, drink, and be merry with reckless abandon.  There are some expressed concerns for food safety, especially after a year of scares; however, for the most part we will dine with delight.  

Then, come the First of January we will do as we did last year and the year before, we work to munch more wisely.  Most of us will make a conscious effort to decrease the fats, salts, and sugars in our daily diet.  Individuals throughout the country will convince themselves it is only a matter of self-control.  We can eat well if we decide to.  Citizens in the USA believe what they ingest, how, and when is a choice.  In the land of the free, and home of the brave, we boldly do, as we desire.  Here, in America, there are food choices galore, or so we are led to believe.

However, since the late twentieth century Americans have actually had a very limited selection.  They, we, are not free to dine as we might.  Our menu is extremely restricted.  We can chew on Acidulants, enriched Baking Aids and Mixes, luscious Cocoa and Chocolate, chemical Emulsifiers, Texturants, and Stabilizers, refined Flours, “organic” Nutrition Ingredients, [meager when available], processed Oils and Fats, palatable Protein Products, and “naturally” Sweeteners.  If we wish to ingest more wisely, we can; that is, if we are up to the challenge.  In the States, the Recommended Daily Allowance is wrought with ruse.  

The public professes they want no government in their lives, or more importantly, on our dinner plates.  Yet, Americans accept that administrative authorities must regulate to ensure that what we eat is truly safe.  Federal Officials are necessary and tolerated in moderation.  Indeed, Americans actually appreciate the Food and Drug Administration.

According to a survey of 30 federal agencies being released today, consumers asked about the FDA’s performance believe that food labeling is useful, clear and understandable, that consumer alerts of food safety issues are useful, and that customers trust FDA to ensure food safety in the future . . .

The survey asked about the usefulness and clarity of food labeling; customer awareness and the effectiveness of inspecting, testing, and labeling efforts; and the usefulness of consumer alerts; meats and poultry are regulated by USDA.

In addition to consumers’ positive views of the food label and FDA’s ability to ensure that food is safe, the survey also indicated that the FDA should increase public awareness of actions to ensure food safety and focus on awareness efforts during consumer alerts.

Despite the claims of contentment, for the most part Americans resent government influence in their daily lives.  Americans are independent minded mavericks.  Granted, we are grateful for the small favors the Food and Drug Administration affords us; however, we want no more assistance than we deem suitable.  Citizens in this country are selectively scrupulous.

Americans prize and advocate a free enterprise system.  We want the freedom to decide for ourselves what is best.  Where food is concerned, citizens of this civilized nation want to preserve their right to choose.  We welcome the rise of an innovative industrialist who might introduce an ingredient into the mix.  A crunchier cookie, a sweeter soda, tastier tenderloins, a savory sauce, and a flavorful fondue, all are appreciated in abundance.

Cakes, cookies, crackers, pies, bread, potato chips, corn chips, popcorn, salad dressing, breakfast cereal, margarine, and animal products all taste good to the average American..  Regardless of the warnings, that each of these manufactured or mechanically prepared foods contain trans-fatty acids, are high in sodium, and are filled with high fructose corn syrup, those in the Western World continue to consume these tidbits with fervor.

Intellectually, we may know trans-fatty acids, salts, and sugars are hazardous to our health.  We sacrifice some.  Nonetheless, we do so slightly or on occasion.  Mostly we gorge, gulp, guzzle and stuff our gullet with these gems and then die.  

Clogged arteries might cause our demise.  A heart attack could end our life.  Obesity may do us in.  Still we say, we rather eat fats and be happy.

Scientific evidence shows that consumption of saturated fat, trans fat, and dietary cholesterol raises low-density lipoprotein (LDL), or “bad cholesterol,” levels, which increases the risk of coronary heart disease (CHD).  According to the National Heart, Lung, and Blood Institute of the National Institutes of Health, more than 12.5 million Americans have CHD, and more than 500,000 die each year.  That makes CHD one of the leading causes of death in the United States.

People say they might as well enjoy now.  After all, we will all pass eventually.  An additional year or two will not make a difference.  The quality of our life is what matters.  Besides, any true danger is moderated by the system.  

In this agri-industrialist nation, we trust that if a corporation wishes to make a profit, they must  and will keep the consumer in mind.  That construct alone will guarantee quality.  When it does not, then, the government will step in to preserve safety . . . well sort of.

Years ago, Josh joyfully ingested his early morning Egg McMuffin ™ in a Fifth Avenue McDonalds.  As he ate, he read the news.  An article in The New York Times, screamed for his attention.  Hold That Fat, New York Asks Its Restaurants.  He thought of how much he loves his partially hydrogenated oil filled foods.  Joshua would not wish to be deprived of the greasy flavors that warm his belly.  The young gent contemplated what might this announcement mean to him.  Then, Joshua concluded, he need not worry.  At least Gotham City officials give restaurateurs a choice.  Proprietors will cater to what the their customers crave; thus, the world will continue to turn as it has.

Months later, a content Joshua sat in his overstuffed chair and snacked on a bag of Doritios®.  He could not imagine a life more complete.  Suddenly, that tranquil sense of calm disappeared.  A radio announcer declared our democratic right to choose would be constrained.  The broadcaster bellowed,  New York City Plans Limits on Restaurants’ Use of Trans Fats.  The earlier “request” had done nothing to reduce usage of the hazardous oils.

The Board of Health vote comes a year after it conducted an unsuccessful campaign to persuade restaurants to eliminate trans fats from their recipes voluntarily.  It said yesterday that despite mass mailings about the hazards of trans fats and training programs for 7,800 restaurant operators, about half the city’s restaurants continued to serve trans fats, about the same as before the campaign.

Trans fats, derived from partially hydrogenated oils, became popular in the 1950’s as an alternative to the saturated fats in butter.  They allow fast-food restaurants to use frying oil for longer periods and make crunchier cookies and flakier piecrust.  They also have a longer shelf life than butter, olive oil, corn oil or other alternatives.

Joshua became extremely concerned.  He exclaimed aloud, “What is this a Police State?”  Eatery entrepreneurs have a right to serve what they believe is best.  Customers can digest what they think delicious, or at least they could in some municipalities.  In time, concern for the health of a crowded community increased.  Last year, during the holiday season, a peaceful Josh took in the decorations in his favorite restaurant.  He dined with delight.  After he ate, Joshua released his belt buckle.  A friend seated across from a full and sleepy Josh inquired, had he heard, New York Bans Most Trans Fats in Restaurants.

The usually quiet chap was aghast.  Now officials in this cosmopolitan metropolis had gone too far.  How and why would a municipality choose to restrict what the people consume?  Josh began to ponder how all this change might affect him personally.  He thought of the mashed potatoes and gravy, he consumed only moments ago.  Would he be deprived of such tasty fare in the future?  

Certainly, the potatoes would not taste as sumptuous if they were prepared differently.  Joshua reveled in the delicacy just as he had been for decades.  The recipe as is, is wonderful, this fit fellow thought.  Joshua belched.  Then he pondered; the dozen or so doughy delights he digested moments earlier.  These goodies would never be the same.  Joshua dreamt of the cookies, cakes, and creams he just ordered for desert.  The word “Ridiculous!” rolled trippingly off his tongue,

“No one has the right to tell me what I can consume.  It is my life, my body, and I will take care of it as I see fit.”  In a huff he continued,  “I eat a little bit of everything; it is called a well-balanced diet.”  “No matter what we gulp down or scarf up, it all turns into sugar once in our blood stream.”  “All food is natural.”  This news is preposterous.”  “Who has the authority to tell us what to eat or drink?”  The government is already too involved in our lives.  “Let them eat what they like and I will munch on what brings me pleasure.”  Does the Constitution not grant us  liberty and the pursuit of happiness?  “I want to be left alone, to be free to be me.”

Joshua grappled with what seemed inevitable change in his diet.  He wondered, “What is all the fuss about trans-fatty acids?  Are there not more important issues of concern?”  Almost immediately, he received an answer.  Another blow brought Joshua to his knees.  A condiment that he was certain could cause no harm was listed as injurious to his health.

It was not an e coli spinach scare that altered his awareness.  Salt shocked his sensibilities.  What could be more safe than salt?  For goodness sake, this savory substance sits on his dinner table.

A hulk of a man, Josh knew, to spill salt is an ominous sign.  He understood, since the beginning of time, people believed if they were to waste the commodity considered as valuable as gold, certain misfortune would follow them into the future.  Still, this gent never thought there was anything to fear from the sodium substance.  Such mythical legends have lived long.  As Joshua mulled over the latest revelation, he laughed, he acted as though he believed if he were to carry salt, or throw the small white crystals over his shoulder, he would be assured the best of luck.

A jovial Josh has long assumed the want of good will was the reason we poured the crystalline element on every entrée.  Good flavor or good fortune; both together might be wondrous.  This healthy man was aware the traditional use of this prized substance is in question.  However, he never imagined, the Food and Drug Administration would contemplate a serious and severe crackdown on the zesty zinger of a spice.  Yet, as Joshua perused the paper and listened to radio and television reports he learned . . .

Putting the Pinch on Salt, Medical Groups at Odds Over Proper Solution to Sodium Problems

By Carla Williams?

ABC News Medical Unit

Nov. 29, 2007

The U.S. Food and Drug Administration is holding a public hearing today to determine whether to place federal limits on the salt content of processed foods, such as canned soups and breakfast cereals.

The hearing comes at a time when medical experts are becoming increasingly concerned over the amount of salt contained in many foods on grocery store shelves, including products not normally associated with salt.

For example, said Dr. Randall Zusman, associate professor of medicine at the Harvard Medical School, a bowl of one popular cereal brand may pack more of a sodium punch than many consumers realize.

“One cup of Cheerios — frequently advertised as heart healthy — has 300 milligrams of salt,” he explained.

“No one eats only one cup, so two to three cups each morning would be nearly 50 percent of your daily allotment.  Yet, the FDA allows Cheerios to be advertised as a healthy alternative.”

But while most agree that the excess salt in the diets of many Americans poses significant health risks, experts in the medical community remain divided over what should actually be done to address the problem.

Some agree with advocacy groups and believe that the FDA should require stricter labeling for manufactured foods.  Such labeling could take the form of warnings placed prominently on the packaging of high-sodium foods.

But others think the focus on salt regulation is misdirected and say that the FDA should address more harmful elements of the American diet and lifestyle, such as obesity.

The American Dietetic Association, for one, has spoken out in favor of stricter product labeling to tackle the problem.

My goodness; Cheerios, a food that Americans such as Josh ate to protect themselves from a coronary crisis may actually place them at risk for a heart attack.  What, and whom, can we trust.  Do we do as we are told or as the specialists do?

Physicians often gobble just as regular folk do.  We have seen stout surgeons, rotund nurses, hefty dieticians, and even a lean doctor dine on junk.  Our spouse may insist we eat healthy; yet, he or she does not.  Acquaintances swig and swallow whatever they wish.  No one seems to suffer serious repercussions at less not while in our range of vision.  Thus, we conclude there is little reason to change.  People are just overly cautious.  Certainly, federal, state, and city officials are wary without cause.

A mild mannered Joshua was familiar with the cautionary tone of doctors.  He heard his wife whisper her concerns.  For years, medical professionals and his Mom expressed their angst when they discussed his fervent application of this sour, yet sharp, condiment.  Josh reduced his use; although admittedly he wondered whether there was reason to do so.  Oh, sure, Joshua saw the advice columns.  Caveats called him, or at least those who love him suggested he read the literature.

University of Maryland Medical Center, expert on hypertension, Dr. Stephen Havas, states, high-salt diets cause 150,000 premature deaths in the United States each year. Heart attacks, coronary artery disease, and strokes are the frequently result from obesity, high blood pressure, and the perilous pre-hypertension.  Each of these afflictions can be traced to the intake of salt.  Havas declared there is an imperative need for the Federal Health authorities to reduce sodium consumption.  

However, contrary to what this and other physicians think wise, most persons in this civilized country retain the attitudes of their ancestors.  Americans are as the rugged individualists, or at least, Joshua was and is.  Our countrymen can take whatever is dished out.  Salty, sweet, or saturated in oils, citizens of this wild and western nation have the stomach for it.

Americans are independent and we like it that way.  No government agency, guy, or gal in a white lab coat will tell US what to eat.  They certainly will not dictate to Joshua what he eats.  In truth, the Food and Drug Administration does not tell us what is best to consume.  Nor do they closely monitor corporate claims; although they would wish us to believe they do.  Joshua trusted that his food was safe with thanks to this industry watchdog.

Fake Food Fight

by Paula Kurtzweil

“It is true that you may fool all the people some of the time; you can even fool some of the people all the time; but you can’t fool all of the people all of the time.”

–Abraham Lincoln

When it comes to fraudulent food in the marketplace, Lincoln’s sage observation has certainly rung true. In the Food and Drug Administration’s experience, when hucksters try to cheat Americans out of millions of dollars of genuine foods, their schemes are ultimately exposed by a sharp-eyed consumer, a competitive industry, or FDA itself.

Known as economic adulteration of food, this practice involves using inferior, cheaper ingredients to cheat consumers and undercut the competition.  And even though the 1938 Federal Food, Drug, and Cosmetic Act specifically bans it, economic adulteration persists, challenging FDA’s resourcefulness to remain vigilant against it.

In recent years, FDA has sought and won convictions against companies and individuals engaged in making and selling bogus orange juice, apple juice, maple syrup, honey, cream, olive oil, and seafood.

According to Martin Stutsman, a consumer safety officer in FDA’s Center for Food Safety and Applied Nutrition, FDA relies heavily on industry and consumers to help identify instances of economic fraud.

What businesses will not do for money.  Artificial adulterants put much dough in many a breadbox.  The Food and Drug Administration discovered some producers sold, what they said was pure orange juice; however, the beverage was loaded with corn syrup or beet sugar.  Dairy cream was, in fact, corn oil.   Corn syrup passed for honey.  Bottles of horseradish were actually containers of potato starch.  Salt mixed into water was advertised as milk.  Scallops, an expensive delicacy on occasion was found to be water worked into sodium tripolyphosphate (STP).

The fake foods, [mixtures of trans fatty acids, salts, and sugars] may yield temporary financial benefits.  However, what qualifies for natural, and approved, fodder feeds fills more pockets than the illegal imitations ever did.  Corn syrup found in a product labeled pure orange juice is considered an adulterant.  However, when the same sweetener is listed on a can of orange flavored juice the Food and Drug administration thinks that fine.  

There is a delicate balance between healthy and harmful sustenance.  Equilibrium is difficult to maintain when the scales are tipped in favor of corporate influences.  For many in the Food and Drug Administration dough is more flavorful than moral fiber might be.

Former FDA Investigator Exposes Aspartame As Deadly Neurotoxin That Never Should Have Been Approved

Can Republish, Namaste, Vol 6, Issue 1,UK

Many policies, I found out, were not made to protect the public health, but rather, to provide leverage at appropriation time before Congress, and to protect the industry and their political government.  This is especially true when they were paid for their ‘services’ by the pharmaceutical or chemical industries.  This is what I call ‘social cancer’.

Many systems for protecting the public health are (were) less than effective . . . making very little difference on public health issues.  Much of it was for ‘show’ and for funding.  It was the folks in Rockville and Washington who made the final decisions on how to play most of these issues out.  Unfortunately for us, it was not to favor the public health processes.  The entire process reeks of political and corporate influence.

If Americans had the time or energy to do more than eat what is easily available they might notice how ubiquitous industry is in our diets.  Advertisers have captured our attention.  

“Shouldn’t your baby be a Gerber baby?” “Trix are for kids.” “Keebler. Uncommonly Made, Uncommonly Good.” “Mmm Mmm good. That’s what Campbell’s Soup is; Mmm good.”  “Subway. Eat fresh.”  “Taco Bell. Think Outside the Bun.”  “McDonalds.  I’m lovin’ it,” and you do, we do.  We are trained to eat prepared foods from birth.  At Burger King, we can have it our way.  At Kentucky Fried Chicken, we can trust it is finger lickin’ good.  At Subway, we can “Eat fresh.”  If only we knew what that was.

Manufacturers and marketers choose what we consume.  High fructose corn syrup is an ingredient is most  American food.  Many Americans, sadly, a vast majority, do not even know what unprocessed fruits and vegetables truly taste like.  Apples?  That is the crisp, wet fare under the caramel.  Tomatoes top pizza.  Strawberries and cherries await your bite when you sink your teeth into that piece of bittersweet chocolate.  Squash and pumpkins grace the doorstep during the Fall holidays.  Spinach is for cartoon characters.  Potatoes, yum-yum.  This starchy crop, when deep-fried is absolutely ambrosia.  

Even when we think we are ingesting only wholesome fare, surprise, we discover, there is more to the meal than meets the eye.  The local bakery still creates healthy doughy fare.  The smell of fresh baked flour and yeast reminds us that quality food does exist.  Have you read the ingredients on baked goods?  Let us consider the plainest of plain preparations, a bagel.  The elements that go into this not so enticing ring of dough are numerous. Unbleached flour (wheat flour, malted barley flour), water, dough conditioner (sugar, salt, malted barley flour, molasses, mono & diglycerides, ascorbic acid, L-cysteine, azodicarbonamide, enzyme, ammonium chloride, DATEM, potassium iodate, brown sugar, yeast.

As we study the marketplace we realize, what satisfies our senses is not so sensible.

In the 1980s, manufacturing methods improved, prompting a boost in production of high-fructose corn syrup and a drop in price to just pennies below that of refined sugar. “While that may not sound like much to the average consumer, when you consider how many pounds [the soft drink industry buys], it was millions of dollars if not hundreds of millions of dollars in savings,” says Drew Davis, NSDA’s vice president for federal affairs.

The switch made economic sense and, as Davis notes, “back then, there was no suggestion that high-fructose corn syrup was metabolized differently” than other sugars. More recent research suggests, however, that there may be some unexpected nutritional consequences of using the syrup. “Fructose is absorbed differently” than other sugars, says Bray. “It doesn’t register in the body metabolically the same way that glucose does.”

For example, consumption of glucose kicks off a cascade of biochemical reactions. It increases production of insulin by the pancreas, which enables sugar in the blood to be transported into cells, where it can be used for energy. It increases production of leptin, a hormone that helps regulate appetite and fat storage, and it suppresses production of another hormone made by the stomach, ghrelin, that helps regulate food intake. It has been theorized that when ghrelin levels drop, as they do after eating carbohydrates composed of glucose, hunger declines.

Fructose is a different story. It “appears to behave more like fat with respect to the hormones involved in body weight regulation,” explains Peter Havel, associate professor of nutrition at the University of California, Davis. “Fructose doesn’t stimulate insulin secretion. It doesn’t increase leptin production or suppress production of ghrelin. That suggests that consuming a lot of fructose, like consuming too much fat, could contribute to weight gain.” Whether it actually does do this is not known “because the studies have not been conducted,” said Havel.

Another concern is the action of fructose in the liver, where it is converted into the chemical backbone of trigylcerides more efficiently than glucose. Like low-density lipoprotein — the most damaging form of cholesterol — elevated levels of trigylcerides are linked to an increased risk of heart disease. A University of Minnesota study published in the American Journal of Clinical Nutrition in 2000 found that in men, but not in women, fructose “produced significantly higher [blood] levels” than did glucose. The researchers, led by J.P Bantle, concluded that “diets high in added fructose may be undesirable, particularly for men.”

Other recent research suggests that fructose may alter the magnesium balance in the body. That could, in turn, accelerate bone loss, according to a USDA study published in 2000 in the Journal of the American College of Nutrition.

We can thank the Food and Drug Administration for our fodder, and we can express our gratitude to Archers Daniel Midland, the mother or father of invention.  A financial crisis in the parent company led the this corporation to merge and grow beyond their wildest dreams and ours.

In 1971 [Archer Daniels Midland] purchased Corn Sweeteners, Inc., producer of high-fructose syrups, glutens, oil, and caramel color. Corn Sweeteners brought good returns for Archer Daniels Midland and increased the company’s finished-food capabilities.

Currently we can find Archer Daniels in most every “finished-food” option.  Bread and brews are loaded with high fructose corn syrup.  Cereals, before the flakes are frosted, are filled with the fluid.  Spaghetti sauce is supplemented.  The sugary additive makes up a substantial portion of this tomato-based product.  Sodas are essentially high fructose corn syrup, as is . . . [name your food of choice.]  While high fructose corn syrup is good for earnings, it endangers human health.

Loading high fructose corn syrup into increasingly larger portions of soda and processed food has packed more calories into us and more money into food processing companies, say nutritionists and food activists. But some health experts argue that the issue is bigger than mere calories. The theory goes like this: The body processes the fructose in high fructose corn syrup differently than it does old-fashioned cane or beet sugar, which in turn alters the way metabolic-regulating hormones function.  It also forces the liver to kick more fat out into the bloodstream.

The end result is that our bodies are essentially tricked into wanting to eat more and at the same time, we are storing more fat.

Sheer will power must be our guide, for certainly the Food and Drug Administration does not point us in the direction of good health.  Nor do the conglomerates have our best interests at heart.  Most Americans believe given a choice, people buy what they sense their body craves.  Unfortunately, few acknowledge that certain foods create a chemical reaction that fools the physiology and the psyche.

No mysterious ingredient. The Cadbury’s secret is out. Chocolate is drug-like in its effect. Artificial taste explodes in the mouth with crunchy, smooth, sweet flavors, supplying intense pleasure. Every texture and nuance of taste contrived to stimulate your 9,000 taste buds into sending pleasure signals to the brain.  The intensified pleasure effect is addictive.  We don’t care about the additives or empty calories.  Chocolate junkies crave a fix, driven by the desire for that chocolate pleasure.  Pleasure for which we will pay any price, even our health.

Chocolate bars are loaded with salt, sugar, caffeine and fat, up to 300 calories per bar.  Like a body demanding heroin for its balance, the body will crave sugar, salt and fat.  Take candy from a sugar junkie, and look out! Quitting causes withdrawals.  Remove sugar, processed fat or salt from your diet, and you will crave them.  You will go through the discomfort of facing withdrawal similar to the withdrawal from drugs.

Humans hunger for sweets.  We are extremely fond of fats.  Salt is savory.  Eons ago, our bodies learned to love what would help us survive in the wild.  We needed the weight and the energy.  The habits of our ancient ancestors now seem innate.  Food and chemical industry leaders know this.  They exploit our obsession for the flavors that excites the palette and satisfy the electrical impulses within our gray matter; thus, expanding their profits.

Physiologically we cannot resist.  Psychologically, we are easily swayed.  Financially, we turn our fate over, and fortunes are made.  Most of us forget what we once knew before our brains and bellies were filled with trans-fats, salts, and sugars.

The story of how the most basic questions about what to eat ever got so complicated reveals a great deal about the institutional imperatives of the food industry, nutritional science and – ahem – journalism, three parties that stand to gain much from widespread confusion surrounding what is, after all, the most elemental question an omnivore confronts.

Humans deciding what to eat without expert help – something they have been doing with notable success since coming down out of the trees – is seriously unprofitable if you’re a food company, distinctly risky if you’re a nutritionist and just plain boring if you’re a newspaper editor or journalist.  (Or, for that matter, an eater.  Who wants to hear, yet again, “Eat more fruits and vegetables”?)  And so, like a large gray fog, a great Conspiracy of Confusion has gathered around the simplest questions of nutrition – much to the advantage of everybody involved.  Except perhaps the ostensible beneficiary of all this nutritional expertise and advice: us, and our health and happiness as eaters.

Hence, dear Josh, if you do not wish to be controlled by the government or the corporate kings and queens, if you wish to eat well, remember, to look beyond what seems to be your freedom to choose.  Do not travel to the eateries that serve only what they know will leave you yearning for more.  Do not frequent food pantries that prefer you be fat.  Venture not into the aisles of processed ambrosia.  If you wish to be free from the thought police and those that place temptation on the plate, carefully consider foods that are not fake. You can enjoy real foods, unprocessed provisions, and your health if you truly peruse the labels, make meals from scratch, and ask for more than just the menu when you dine out.

Bon appetite Josh.  A happy and healthy holiday, every day to all, and to all a good night.

Satiated, Satisfied, and Sources . . .

Obesity: Friendship Fills a Heart, Mind, Body, and Soul

Please view How Obesity Spreads Through Social Networks

copyright © 2007 Betsy L. Angert

I awoke to the question; Are Your Friends Making You Fat?  Apparently, according to a longitudinal study involving 12,000 people, if your best friend is obese you are more likely to gain weight.  Researchers say obesity is growing as an epidemic would.  The results did not surprise me; the reaction to such a speculation did.  People postured; “I make my own choices.”  “My friends and family do not influence my decision to take good care of myself.”  The research is flawed.  The findings are faulty.  It is not possible.  Friends cannot make friends fat.

Yet, according to this well-respected study, Obesity Spreads In Social Circles As Trends Do.  All around us we see overweight people.  There are more hefty individuals than there were in years past.  The chubby, chunky, and corpulent fill the streets.  These persons find it difficult to sit comfortably in a chair.  On airlines, the flabby stuff themselves into small seats.  These individuals are stigmatized and suffer physically.  There are many health risks when one’s weight is high.

As the researchers’ note, obesity is virtually epidemic.  Scientists wanted to know why this is and what might be done.  They explored.

The study, involving more than 12,000 people tracked over 32 years, found that social networks play a surprisingly powerful role in determining an individual’s chances of gaining weight, transmitting an increased risk of becoming obese from wives to husbands, from brothers to brothers and from friends to friends.

The researchers found that when one spouse became obese, the other was 37 percent more likely to do so in the next two to four years, compared with other couples.  If a man became obese, his brother’s risk rose by 40 percent.

The risk climbed even more sharply among friends — between 57 and 171 percent, depending on whether they considered each other mutual friends.  Moreover, friends affected friends’ risk even when they lived far apart, and the influence cascaded through three degrees of separation before petering out, the researchers found.

Several state, the theory is thoughtless.  It is obvious, ‘Birds of a feather flock together.’  Even the esteemed doubt the veracity of the study.

Some researchers, however, questioned whether the study had fully accounted for other factors.

“People pick friends because they are similar in the way they eat or the way they move,” said Barry M. Popkin, who studies obesity at the University of North Carolina, Chapel Hill.  “It’s a nice piece of work but still stops short of being able to deal with causality.”

I understand this statement.  Look around you.  It seems the rotund rally round the obese.  The plump find pleasure in spending time with others that will understand their plight.  Often we see a heavy miss or missus with a portly mister. 

Some say the truer cause of obesity is in the genes.  Many a chubby child has a corpulent parent, or two.  However, recent trends, a population growing large by leaps and bounds may disprove that theory

Any physician, dietician, or athlete might tell you there are other matters to consider.  We must take cause and effect into account.  Each of these experts has evidence.  They can demonstrate numbers make a difference.  Calories count.  Exercise is important.  If you want to lose weight, get off the couch.

Certainly, friends cannot make us eat what we choose not to.  Most individuals think themselves freethinking, independent, separate from all others.  Numerous persons interviewed on the topic declared, ‘Friends and family cannot and do not influence my food intake, or much else.’

Considering one ‘close’ association, I could make that argument.  I was never a victim to peer pressure.  I was, am, can be very independent.  I revel in my autonomy.  Acknowledging that I do care about every aspect of life, what others think, say, or do has an emotional effect on me.  However, I do not recall a time that I let the desires of another affect my decisions.  I did not, and do not, follow the crowd.  Dawn’s eating did not direct mine.

Dawn and I have been friends since Middle School.  We attended the same High School.  We hung out together.  Up until little more than a year ago, we lived only fifteen miles apart.  At times, our weight was similar, on other occasions it was not.

I recall during our freshman and sophomore years in secondary school, Dawn and I spent hours doing whatever it was we did.  We lunched; did dinner, and yes, of course, there was snack-time.

I often felt as though my friend was encouraging me to eat.  ‘Here, have this.’  ”Try that.’  It is delicious.  I recall contemplating, did Dawn want me to be fat?  If I gained weight, would she think it fine for her to add a few pounds?  It seemed to me, she wanted to be the thin one.  If I lost weight, I sensed that she thought she too would have to reduce the tonnage.  I cannot be certain; nonetheless, I experienced a subterranean competition. 

Since childhood, I shied away from competition.  Rivalries feel antagonistic to me then and now.  Perhaps that is why I never fully related to Dawn.  There was an air, an aura that I found disturbing.  When we were young, some thought we looked alike.  Each of us said aloud, we do not see it.  Possibly, she too knew we were not close.  We have known each other for decades, and no matter the miles between us, remain [barely] in touch.  However, our weight gains and losses do not support the findings.  Therefore, one might think that I would consider this study lacking; yet, I do not. 

Appearances are deceiving.  Often companionship is an illusion.  People may seem close and still independent; However, I experience if an individual authentically admires their chum, they are influenced by that person, In my estimation, truth be told, Dawn and I are not good friends.

For me, observations corroborate the conclusion of this study.  I think the results of this report are valid.  Ample investigation reveals that the influence of friends reaches far beyond the superficial.  Individuals do not merely imitate those they spend time with.  Nor do people choose to engage with others that do as they do.

I believe this comprehensive report considers the cause and effect of obesity beyond calories and exercise.  We all wonder why do the pounds not peel away when we diet and deliberately do our calisthenics.  Many muse; why do I often slip back into old habits, or how might I adopt new, more productive, patterns of behavior. 

Some seek social environments that promote weight loss.  For a few, this works.  However, consciously or not, for most, a little help from their friends does more than assistance from strangers might.  Those we are fond of ignite a fire that fills the heart, mind, body, and soul.  Miles do not lessen the effect of a strong association.

This research compares and contrasts the power of our connections.  For centuries Social Scientist have acknowledged, people learn from those they most admire.  Friends speak a language that cannot be replicated.  Reciprocal reverence helps us to realize what we would never dare imagine on our own.

As emotional resources, friendships furnish children with the security to strike out into new territory, meet new people, and tackle new problems.  Friends set the emotional stage for exploring one’s surroundings, not unlike the manner in which caretakers serve as secure bases for the young child.

I recall the influence of a true friend, two, three, four, or more had on me.  My experiences replicate and validate the portion of the study that addresses the benefits of letting another human into your life.  As the experts explain, much of this examination relates to weight gain, for currently, worldwide, and particularly in the United States, people are expanding their girth.  However, not everyone engages in unhealthy practices.  Numerous individuals lose weight with thanks to their friends.  Others not feeling the need to transform their appearance chose healthier habits, just as those closest to them do. 

The same effect seemed to occur for weight loss, the investigators say.  But since most people were gaining, not losing, over the 32 years, the result was, on average, that people grew fatter.

Dr. Nicholas A. Christakis, a physician and professor of medical sociology at Harvard Medical School and a principal investigator in the new study, said one explanation was that friends affected each others’ perception of fatness.  When a close friend becomes obese, obesity may not look so bad.
“You change your idea of what is an acceptable body type by looking at the people around you,” Dr. Christakis said.

Those we admire often look good to us; we see the beauty within.  As we share, we have an opportunity to experience the wisdom that makes them as special as they are to us.  In my own life, those physically near and far have the most amazing, beneficial effect on my decisions and me.  Proximity, in an emotional sense enhances and enlightens my life.  My bodily health is improved as is my psyche, all with a little help from my friends.

I met the person I often title my closest and deepest friend when we worked together.  Danae does not enjoy disruptions.  For her, chatting while at the office is a distraction.  She is focused.  I understand this.  I too prefer being productive.  Stopping to converse, for me, takes me away from the task I wish to complete.

While we worked, Danae and I walked and talked.  We each apologized in advance for the possible lack of eye contact.  We were only willing to split our attention slightly; however, not completely.  Over time, we grew very close; however, I left that job.  I lived almost thirty miles away and took a position close to home.  Danae does not like to drive; nor do I.  For years, Danae and I rarely, if ever saw each other.  Nonetheless, we spoke on the telephone for hours at a time, almost daily.  We discussed everything, and then some.

I recall sharing that my skin was dry.  Every ointment and lotion I tried did little to relieve the itch.  I was scratching myself until I broke the skin.  I stopped using conventional soap.  I switched to Cetaphil® recommended by dermatologist for babies.  While this helped greatly, I never forgot the words Danae uttered as I searched for a solution.  She said, “It is not what you put on your body; it is what you put in it.”  Danae went on to explain much about diet, not in terms of losing weight, but in respect to good health.

I never forgot this statement.  Slowly I began to consider what I put into my mouth.  I studied the effects each food had on my health.  The transition was measured; however, deliberate.

My friend Heather was also a huge influence on my eating.  Heather is a nurse.  Health is her main concern.  Studying the body, chemistry, and physiology are her hobbies as well as her profession.  Heather observed my poor eating habits and said so.  Most of the calories I consumed were in the form of fluids.  Heather spoke of the nutritional value of fruits and how juices cannot compare.  I read much and realized she was right.  I already understood the damage soda does.  I lived it.

You may recall, dear reader, for decades I struggled with bulimia. The idea of putting solid food into my stomach and keeping it down was both a psychological problem and a physical peril.  My body was no longer accustomed to digesting fodder.

Nevertheless, my conversations with Heather helped.  Again, I progressed at a snails pace.  Still, I did not forget all that Heather taught me.  Ultimately, with much effort I was able to eat normally.  To this day, I chomp on whole foods.  I swallow my meals.  The only fluid I consume, excluding a great soup, is water.

Friends or those we are fond of can truly influence our food choices.  I know of mother and son that are not biologically connected.  Circumstances help to create a unique and friendly bond.  They spend much time together.  They snack, eat supper, and raid the refrigerator together.  Each is obese, and each has health problems.  Nonetheless, emotionally they support the other.

Often, one human does provide reason, a rational for the actions of another.  Interestingly enough, though the adage is “Monkey See; monkey do,” indeed, it man is the species that emulates the behavior of others.  People wish to please their compatriots.  In an experiment conducted by Yale University, graduate student, Derek Lyons scientists discovered, as Victoria Horner and Andrew Whiten, two psychologists at the University of St. Andrews in Scotland did.  Three to four year old children imitate the behavior of their ‘teachers’ even if better options are obvious.  Chimpanzees will only do as taught if they are unable to see other, superior opportunities.

Mr. Lyons sees his results as evidence that humans are hard-wired to learn by imitation, even when that is clearly not the best way to learn.

While researchers in the chimpanzee studies conclude imitation may be glorious, emulating another may also at times be hurtful.  Other experiments tell us that at any age we engage in behaviors in order to accommodate or please others.  Scientists in this novel study realize, we are likely to do as those we love do, even if they live far from us, or if they have habits that hurt their health.

Christakis and James H. Fowler of the University of California at San Diego took advantage of detailed records collected between 1971 and 2003 on 12,067 adults who participated in the well-known Framingham Heart Study. The researchers were able to construct intricate maps of the social connections among the participants, identifying spouses, siblings, neighbors, and both casual and close friends.

Sophisticated statistical analyses revealed distinct groupings of thin and heavy individuals, and found that siblings and spouses had less influence than friends, supporting the idea that the study’s findings were not the result of people eating the same food, engaging in the same activities or sharing genes.

And though environmental factors such as living in neighborhoods with lots of fast-food restaurants and no good grocery stores or sidewalks probably play a role, the researchers found no effect among neighbors unless they were friends, and being friends had an effect, regardless of whether they lived nearby. That ruled out common surroundings as explanations for the findings, the team said.

Fowler, speculating that friends could influence one another just by getting together once or twice a year, said, “We were stunned to find that people who were hundreds of miles away had just as much impact on a person’s weight status as friends who are next door.  This is not due to people eating or exercising together.”

The researchers also found that one person’s weight gain increased another’s risk only if the second person considered the first to be a friend.  If not, there was no effect. If each considered the other a friend, the effect was magnified.

“This shows that this is a social process that goes on here,” Christakis said.  “If it was because you had two people exposed to the same fast-food joint or there was something in the air, then the direction of the friendship should be irrelevant. The fact that it is relevant helps us to exclude spurious or confounding effects.”

That was reinforced by the fact that people of the same sex influenced one another the most.  In same-sex friendships, an individual was 71 percent more likely to become obese if a friend did.  But friends and siblings of opposite sexes had no increased risk.

“People are more likely to copy the actions of people they resemble,” Christakis said.  “What we think is going on here is emulation.”

Imitation, emulation, whatever we wish to call it, doing as those we love do may not be wise.  It could be wonderful.  Perhaps, if we are aware of the human tendency to mirror our mentors we will learn to choose wisely.  We may wish to assess not only what our gurus gravitate to, but also what we make available.  If we know that fast food is not healthy, might we consider not placing it in the path of one person, or his pal.  If we are aware of our unhealthy habits and discuss these with those that care astounding change occurs, at least it did for the person I consider my soul mate.

I often find this tale hard to accept.  However, I have heard it repeated often enough, perhaps I must believe it to be true.  As I stated, I was anorexic, then bulimic for many years.  Although I thought surely everyone knew, indeed, only a very few say they did.  The person I call the yin to my yang, the one that I relate to in a manner I cannot describe definitely was aware of what I was doing. 

Regrettably or perhaps fortuitously, she interrupted my deed one day.  I was “caught in the act.”  Yet, I trusted, she would not judge.  Summer understood my pain, as I did hers.  During a bad bout, Summer considered bingeing and purging.  I am unsure how I knew this with certainty, for deciding to regurgitate food is not something either of us felt a need to discuss.  Nonetheless, I had a feeling.

As with most of my friends in Southern California, we lived very far apart.  We met while working together years earlier.  One night, I telephoned.  Summer did not answer.  I had a feeling, I know not why.  I left a message on her answering machine.  The voice-activated recorder accepted my lengthy monologue.  I believe I went on and on for near forty-five minutes. 

I shared all the trauma I lived as a bulimic.  I pleaded, asking Summer not to begin.  I stated that, while I did not understand the physiology, neurology; nevertheless, I knew that this affliction was far more than a psychological choice.  Once the path was taken, turning back was not possible.  As Robert Frost offered, “The only way out is through.”

Later I learned, Summer was seriously contemplating the possibility.  She was definitely disheartened and thought inhaling and exhaling food would numb the feelings.  My speech took her by surprise.  For whatever reason, perhaps because our friendship is as meaningful as it is, she was able to hear my words.  Summer internalized the sentiment.  She trusted my affection was authentic, as was my fear.  Before she traveled too far, Summer decided to save herself.

I personally believe I did little; yet, in her mind I did much.  If nothing else, Summer and I can give credence to this report.  Friends are a phenomenal influence.  We need not blame them for what we do.  Let us embrace them.  I do not think it dreadful that another can influence my choices.  I consider the possibility glorious.  Friends are forever; with thanks to them we are wiser.  I can only speak for myself; nonetheless, may I say, I am grateful that those I love have the power to teach me.

The Thin, Fat, Fit, and Friendship . . .

  • The Spread of Obesity in a Large Social Network over 32 Years, By Nicholas A. Christakis, M.D., Ph.D., M.P.H., and James H. Fowler, Ph.D.
  • Are Your Friends Making You Fat?  By Allison Aubrey.  National Public Radio. July 26, 2007
  • Obesity Spreads In Social Circles As Trends Do, Study Indicates, By Rob Stein.  Washington Post. Thursday, July 26, 2007; Page A01
  • pdf Obesity Spreads In Social Circles As Trends Do, Study Indicates, By Rob Stein.  Washington Post. Thursday, July 26, 2007; Page A01
  • Barry M. Popkin. University of North Carolina, Chapel Hill.
  • Dr. Nicholas A. Christakis., Harvard Medical School.
  • James H. Fowler.  University of California at San Diego.
  • Find Yourself Packing It On? Blame Friends, By Gina Kolata.  The New York Times. July 26, 2007
  • pdf Find Yourself Packing It On? Blame Friends, By Gina Kolata.  The New York Times. July 26, 2007
  • Children Learn by Monkey See, Monkey Do.  Chimps Don’t. By Carl Zimmer. The New York Times. December 13, 2005
  • pdf Children Learn by Monkey See, Monkey Do. Chimps Don’t. By Carl Zimmer. The New York Times. December 13, 2005
  • Bulimia. Anorexia. By Betsy L. Angert.
  • EPA Proposes Lower Toxic Reporting Standards

    copyright © 2007 Possum Ponders.  Sedalia Tales

    A recent report issued for the Colorado Public Interest Group, Toxic Pollution and Health, PDF analyses the release of toxic chemicals into air and water in America.  Current standards of reporting require industries to monitor more than 600 toxic chemicals.  Under new rules promulgated by the Bush admininistration, these strictures will be reduced.  That may mean we will see few or no more reports like the one just released.

    The Environmental Protection Agency has a mission statement which states the following is their responsibility:

    to protect human health and the environment.

    To accomplish their stated purpose the EPA employs more than 17,000 people across the nation.  The agency sponsors research and publishes information necessary to the public interest.  Sorting through the current body of laws and regulations is a daunting task, but the information is available for those so inclined.

    Now we hear the EPA wishes to stop the oversight of

    waste that companies say is destined for recycling and reuse in the manufacturing process

    This will leave the public and American consumers without the protections we previously enjoyed. 

    Critics say the rule change could lead to mismanagement of hazardous materials, creating new toxic dumps and increased risks to public health.

    The proposed rule allows companies to provide a one time reporting which states the name of the company and the address.  No requirement for quantity or disposal means is required to be reported.  And since this is a program of exclusion, the EPA, according to director of hazardous waste in the Identification Division Bob Dellinger, will not

    be doing an environmental risk assessment because it was not an “appropriate analysis for these kinds of exclusions.”

    The Bush administration once again demonstrates its opposition to fair and responsible treatment of the American public and the environment in response to industry pressure.  The new regulations will more than likely be cheaper than the old ones.  And maybe there will be a savings in overall paperwork, but the question remains, will this be better for our world?  I submit the damage is predictable only in that it will occur.  The magnitude of the damage will not be known since we can get no information under these rules.

    This writing is based on an article in The New Standard which may be read here. and from RH Reality Check.

    Overweight Children – Adults Face Widespread Stigma and Strain

    copyright © 2007 Betsy L. Angert

    In America and the European Union Overweight Kids Face [a] Widespread Stigma.  Only days ago, I contemplated this truth.  As I watched a family shop, I was struck.  She was young, perhaps ten years old.  She was very heavy.  I wondered how could one little girl carry so much weight on such a small frame. 

    The lass was sweet, quite petite, although clearly troubled.  She had been shopping with her Mom, her grandmother, and her younger brother.  From appearances, it seemed this family was in Target gathering wares for Grandmamma.  They did not give the impression of being poor; nor did they look to be wealthy.  They were average folks; they could have been you or me. 

    This family did not dress well.  Their clothes were clean, just not stylish.  Were this group more fashion conscious pants, shirts, and shoes would have been color-coordinated.  Patterns might have blended in a manner that was more appealing.  However, I guess they were comfortable in casual apparel.  After all, making purchases in a discount department store does not require a person to dress with finesse.  Simply covering your body is sufficient for such a chore.

    The family of four entered the checkout line.  I was standing behind them.  Their exchanges were pleasant.  The children each chose to purchase an item for themselves.  Grandmother and Mom paid for their goods, as did the boy.  Then the young woman did her transaction.  The cashier rang up the sale.  Dollars passed from one hand to another.  There was change.  The school age girl went to place her pennies, nickels, quarters, and dimes into her tiny purse.  A single nickel fell to the ground.  The coin made a sound as it plunked to the floor.  The girl heard the noise and saw the shiny nickel.

    She looked at the currency longingly.  Then, this lass turned and glanced at her family.  They were walking away.  Her brother, mother, and grandmother had not noticed what occurred.  The group was not far and yet, not near to the girl.  It would only take a moment to pick up the coin and move towards the others.  Pensively, the female child considered the nickel.  She looked down and then up and down again.  Finally, she fled in haste, leaving the lonely coin behind.  She never bothered to pick it up, although she did think too.

    It did not seem to me that this little lady thought a five-cent piece was not worth much.  From appearances, or perhaps I am projecting, recalling my own struggle with excessive weight, her greater concern was the effort involved in bending over to retrieve a small piece of anything.  I remember the days, and not too fondly.  My heart went out to this child.  There, but for the grace of G-d, go I.

    I am reminded of the time when I was obese, not pleasing plump, chubby, or fat; I was corpulent.  I grew into a size that was twice that of normal quickly.  I did not consume gross quantities of food.  The portions on my plate, or in hand were not large.  It was actually quite startling to see the weight pile on.  Pound after pound was added to my body mass.  There was no index to guide me.  Indeed, I was eating less than I had for years before this gain.

    However, my weight gain was not an anomaly.  For me, fighting with my body mass was normal.  My family was substantial mentally and physically.  Many of my relatives are big people, not tall, just wide.  The little girl and I seem to share a family shaping, or might I say out of shape.  Her mother and Grandmother were large.  Her brother was not as rotund; however, he seemed to be ready to tip the scale.

    In my family, some were fit.  My Grandpop walked for miles, each and every day.  He was active and agile; a  few relatives are.  However, it seems on average, the propensity toward plump was prominent in my world.  The younger generations in my own family might have mirrored their elders, or perhaps more accurately did as their parents had.  This is true in most families, even the thin ones.  However, patterns change.  In recent years, Americans are shorter and more stout.  For generations, Americans were taller than those in other nations; however, this is changing.

    [H]eight has been stagnating in the US for a decade, and Americans are now shorter on average than many Europeans, including not only the very tall Dutch and Scandinavians, but even the citizens of the former East Germany, see John Komlos and Marieluise Baur (2004).

    While Americans are not expanding upwards, they continue to expand outwards, and the average American, like the average Briton, is now heavier than the weight that would minimize mortality risk given average height.

    This is troubling for many reasons.  Not only is our health and life expectancy effected, so too is our income.  For years, Economists told us tall persons earn more money than the diminutive do.  An inch can increase your net worth by at least a thousand dollars per year.  However, recent research reveals the height you achieve in adulthood may not determine your income.  Stature may not be the key to financial success.

    Tall men who were short in high school earn like short men, while short men who were tall in high school earn like tall men.

    That pretty much rules out discrimination.  It’s hard to imagine how or why employers could discriminate in favor of past height.  If tall adolescents?even those who stop growing prematurely?grow up to be highly paid workers, it’s got to be because they’ve got some other trait that employers value.  [Nicola Persico, Andy Postlewaite, and Dan Silverman of the University of Pennsylvania] believe that trait is self-esteem.  Tall high-school kids learn to think of themselves as leaders, and that habit of thought persists even when the kids stop growing.

    If, during our younger years we do not think we are worthy, excellent, brilliant, or outstanding than likely we will not believe we are the best later in life.  Often, we trust we are admirable when others act as if we are. 

    For the fatter child, the need for approval weighs on their minds.  Much embarrassment is felt, and experienced early on.

    Overweight children are stigmatized by their peers as early as age 3 and even face bias from their parents and teachers, giving them a quality of life comparable to people with cancer, a new analysis concludes.

    At the age of two, nearly three, I recall sitting in the den with a ballpoint pen in hand.  I drew lines on my thighs designating exactly where I wanted the excess meat removed.  I do not recall being ridiculed at home; nor do I remember peers speaking of my weight. 

    I did attend summer camp at that age.  At two and one half years, I was the youngest camper.  Perhaps, being four years younger than all other campers had an effect on me.  Indeed, I was left out of much.  The counselors were not willing to teach me to swim.  My bunkmates did not wish to include me in games.  Being a person that loathes and avoids competition, and always did, I had no desire to participate.  I was somewhat sedentary. 

    Possibly the situation demanded it.  I could not go off and play on my own.  I needed to stay with the group.  Yet, I was separate.  I sat still for hours while my bunkmates engaged in recreational activities.  My situation, although different, mirrors much of what occurs today.

    Lack of exercise is a major factor in the growing problem of obesity, both for children and adults, according to Dennis Styne, a UC Davis Medical Center pediatric endocrinologist who is a recognized authority on issues of childhood obesity.  “Obesity has become a serious health risk in America, and it is reaching epidemic proportions, even in the pediatric population,” Styne says. “Close to 25 percent of America’s children and adolescents are now considered overweight, and the numbers are increasing.”

    I developed habits that hurt my already hurting heart.  The children ran, jumped, laughed, and enjoyed each other’s company.  I could not join in.  They thought me too young.  At an early age, my less active life took its toll.  The pounds piled on.  Later, as the years passed, I was just lethargic.

    They say obese children are victim to teasing, rejection, bullying, and other types of abuse because of their weight.  I was fortunate, I did not experience much, if any of this in my youth.  However, when I reached the age of sixteen, and added a few more pounds, a phrase was used by a loved one to describe me, “butterball.”  To this day, every year from Thanksgiving to Easter when the company with the same name advertises their turkeys, I cringe.

    “The stigmatization directed at obese children by their peers, parents, educators and others is pervasive and often unrelenting,” researchers with Yale University and the University of Hawaii at Manatoa wrote in the July issue of Psychological Bulletin.

    The paper was based on a review of all research on youth weight bias over the past 40 years, said lead author Rebecca M. Puhl of Yale’s Rudd Center for Food Policy and Obesity.

    Research determined the heavier child exposed to such pressure is two to three times more likely to report suicidal thoughts.  Frequently, the young and hefty suffer from other health issues.  High blood pressure and eating disorders are not uncommon.  Yikes, there I am.  I was anorexic, then bulimic.  My eating was out of order.

    I have long been certain that my bingeing and purging was not related to my weight.  Indeed, doing as I did, did not help me maintain a stable mass.  The process stressed my body and my mind.  Anorexia and bulimia are burdensome.  They are as obesity in many ways.  There is great shame associated with starving oneself.  Over-eating and puking do not leave one feeling proud.  People judge those that do not appear perfect or act in a manner that pleases others.  We all criticize ourselves.

    “The quality of life for kids who are obese is comparable to the quality of life of kids who have cancer,” Puhl said, citing one study.  “These kids are facing stigma from everywhere they look in society, whether it’s media, school or at home.”

    Even with a growing percentage of overweight people, the stigma shows no signs of subsiding, according to Puhl.  She said television and other media continue to reinforce negative stereotypes.

    “This is a form of bias that is very socially acceptable,” Puhl said.  “It is rarely challenged; it’s often ignored.”

    In a time when children are growing fatter, we can no longer avoid an issue that is pervasive.  We must consider that they way people treat us when we are young has an effect throughout our lives.  Height and weight evoke a response.  That reaction stays with us.  At a time when childhood obesity overwhelms the planet, we must consider the effect of this epidemic.

    By 2010, almost 50 percent of children in North America and 38 percent of children in the European Union will be overweight, the researchers said.

    While programs to prevent childhood obesity are growing, more efforts are needed to protect overweight children from abuse, Puhl said.

    At times, we as a society must shield children from those that love them most, us.  Sadly, parents, teachers, and friends do not realize how they hurt a fragile heart and soul.  Teasing is thought to be just in fun.  Expecting less of a fat child is considered realistic.  Reacting to personal guilt for not caring for a child as you thought best, in a moment, might seem reasonable.  However, the harm we do is immeasurable.  Children internalize their pain.

    A growing body of research shows that parents and educators are also biased against heavy children.  In a 1999 study of 115 middle and high school teachers, 20 percent said they believed obese people are untidy, less likely to succeed and more emotional.

    “Perhaps the most surprising source of weight stigma toward youths is parents,” the report says.

    Several studies showed that overweight girls got less college financial support from their parents than average weight girls.  Other studies showed teasing by parents was common.

    “It is possible that parents may take out their frustration, anger and guilt on their overweight child by adopting stigmatizing attitudes and behavior, such as making critical and negative comments toward their child,” the authors wrote, suggesting further research is needed.

    Lynn McAfee, 58, of Stowe, Pa., said that as an overweight child she faced troubles on all fronts.

    “It was constantly impressed upon me that I wasn’t going to get anywhere in the world if I was fat,” McAfee said. “You hear it so often, it becomes the truth.”

    Her mother, who also was overweight, offered to buy her a mink coat when she was 8 to try to get her to lose weight even though her family was poor.

    “I felt I was letting everybody down,” she said.

    Other children would try to run her down on bikes to see if she would bounce. She had a hard time getting on teams in the playground.

    “Teachers did not stand up for me when I was teased,” McAfee said.

    A study in 2003 found that obese children had much lower quality of life scores on issues such as health, emotional and social well-being, and school functioning.

    “An alarming finding of this research was that obese children had (quality of life) scores comparable with those of children with cancer,” the researchers reported.

    Sylvia Rimm, author of “Rescuing the Emotional Lives of Overweight Children,” said her surveys of more than 5,000 middle school children reached similar conclusions.

    “The overweight children felt less intelligent,” Rimm said.  “They felt less popular. They struggled from early on.  They feel they are a different species.”

    Fat children are distinct.  They stand out in a crowd.  Actually, in their own mind they are often larger than life.  I know I was.  I was so surprised years later when I saw photographs of myself as a camper.  I was not obese then.  I only thought I was.  For me, it was as Lynn McAfee stated, “You hear it so often; it becomes the truth.”  Even if the words were heard only in my head, they were repeated routinely.  The belief that I was fat became my reality.  In my teens I grew into the person I long thought I was.  I became obese.

    Anyone that has ever struggled with their weight knows, trying to take off a few pounds can be a challenge.  Eliminating the weight of years of mistreatment takes more effort than most can imagine.

    Heavy children are insulted, ignored, rejected, and ultimately resent themselves.  They misuse food.  The weighty wonders may not appear malnourished; however, they are.  The obese do not eat well.

    [P]oor nutrition remains an impediment to health in much of the world today, Much less obvious is the idea that nutritional deficits are an important part of the health story in the rich world today.  Yet there is a good deal of evidence, even?and in some cases particularly?in populations whose most obvious nutrition-related problem is obesity and over nutrition.

    Such mass consumption does not serve our children well.  Nor do our eating patterns benefit us as we age.

    “Obesity rates are increasing fastest among children, and they will carry obesity-related health risks throughout their lives,” Ludwig says.  “An adult who gains a pound or 2 a year through middle age will be at increased risk.  But that is much less dire than the overweight 4- to 6-year-old who gets diabetes at age 14 or 16 and has a heart attack before age 30.”

    Ludwig — director of the obesity program at Children’s Hospital, Boston — says the childhood obesity epidemic has three phases. The first came in the last decade, when child obesity became common but the public health effects weren’t yet felt. Phase two is right now, as we begin to see serious complications such as type 2 diabetes in very young people.  Phase three, Ludwig predicts, is coming soon.

    “But we still have a little time before these children become young adults with diabetes and start to have heart attacks, stroke, kidney failure, and increased mortality,” he says. “It is a massive tsunami headed for the United States. One can know it is coming. But if we wait until we see the ocean level rising over the shore, it will be too late to take action.”

    Sadly, some of those that were heavy as children are already adults.  Older persons, for the most part, do as they did in their childhood.  Even if individuals lose the “baby fat,” the feelings and ill effects associated with obesity often linger.  Lifestyle, habits, health problems are more difficult and daunting than poundage.  There are infinite influences on our body and mind.  The marketplace matters. 

    The advent of processed foods altered the physique and psyche.  Motor vehicles and machines have an effect,  A commuter and computer culture counts.  The number of calories we consume and do not burn off as earlier generations did effects our overall well-being.  There is ample cause for concern.

  • Poor nutrition and lack of physical activity are responsible for an estimated 300,000 to 600,000 preventable deaths each year.

  • An estimated one third of all cancers are attributable to poor nutrition, physical inactivity, and being overweight.
  • Today, we stunt our growth upward and expand our girth outward.  Perhaps, we need to advance our awareness for what motivates us.  Why do we torment the portly?  How easy it is to ridicule and judge.  Frequently, the tall, the thin, those that appear healthy blame the obviously wounded one.  These saintly souls think obesity is a choice.  People are not born fat.  Perchance that is, in part, true.

    It was once thought diabetes or the tendency for this illness was inherited; however, there is ample to reason to believe that is not always true.  Might we imagine that nothing occurs in isolation.  If we are to cure what ails us, we must be open to options that are not easily observed.

    Might we assess why those that gain so easily gravitate to food.  I believe for too long we have presumed the answers are simple.  It is often claimed obesity runs in families.  The genes prime the pump.  Numerous researchers prefer placing the blame on parents.  Habits are learned.  Mothers and fathers are our primary teachers.  Schools receive their fair share of culpability.  Surely if educational institutions supplied more nutritious fodder children would not eat as they do.  Restaurants, food manufacturers all can claim an ounce of responsibility. 

    We too bear a burden; each of us decides what we will eat and enjoy.  We believe we can easily forego exercise.  We all are as the little girl.  Bending down to pick up the nickel is not a simple task.  Our mind may wish to do what we think wise; yet our body says we cannot.  The two work in unison.

    I believe, too often we do not honor the mind body connection.  Possibly, we all are vulnerable to whatever affliction inhabits our bodies.  In recent years, we are realizing that many ailments, once thought to be the result of natural causes are related to diet.  What we eat has power; it effects the brain and bulk.  Might we consider victuals feed us in ways we rarely explore.

    To learn how to work with your appetite center, you must first understand it.  It’s time for you and your brain to become better acquainted.

    As soon as you bite into any food, sensory stimulation of nerve endings on the tongue leads to the release of a number of chemicals, including opioids, into the bloodstream.  You release more opioids — the body’s natural versions of drugs like morphine — when you consume foods high in sugar and fat, creating a powerful, neurochemical drive to overeat those foods. 

    These opioids and other chemicals enter the bloodstream and carry their messages to the hypothalamus, which sends out yet another set of chemicals to regulate appetite.  The more flavors your taste buds register, the more stimulated the hypothalamus becomes, releasing the hunger-promoting hormone neuropeptide Y.  When you taste a lot of flavors at once, the brain releases a lot of neuropeptide Y.

    Meanwhile, in response to the smell and taste of food, your stomach produces the hormone ghrelin, which also stimulates appetite.  It continues to produce this hormone until you eat enough food to literally fill your stomach and stretch the stomach wall.  Farther down the line, in your intestines, levels of several hormones rise to varying degrees — depending on the nature of your meal — either inducing more hunger or turning off hunger..

    Perchance, we might empathize with the chunky little lass.  She is you and me.  Might we consider that our culture provides us with foodfare that harms us.  Society teaches us habits that hurt us.  Some lessons are learned subliminally.  Others are fashioned at the dinner table.  Possibly, we all would be wise to teach and treat the children well.  If we do not attend to the biological, physiological, intellectual, and emotional needs of our progeny, they will suffer as will we all.  If one man, woman, or child is diminished, we all are.  Little girl, may I help you reach for more than a nickel.

    The thick of it . . .

  • Why We Overeat, By David L. Katz, MD, MPH, with Catherine S. Katz, PhD., Authors of The Flavor Point Diet: The Delicious, Breakthrough Plan to Turn Off Your Hunger and Lose the Weight for Good
  • Overweight Kids Face Widespread Stigma By John Christoffersen.  The Associated Press.  The Washington Post. Thursday, July 12, 2007; 3:54 AM
  • pdf Overweight Kids Face Widespread Stigma By John Christoffersen. The Associated Press.  The Washington Post. Thursday, July 12, 2007; 3:54 AM
  • Poor Nutrition and a Sedentary Lifestyle. The 21st Century Plague. 2001 Community Health Needs Assessment
  • The Great Escape: A Review Essay on Fogel’s The Escape from Hunger and Premature Death, 1700?2100.  By Angus Deaton. Princeton University. April 2005
  • Hey, Gorgeous, Here’s a Raise! As For You Fatties, We’re Cutting Your Salaries. By Steven E. Landsburg.  Slate. Monday, July 9, 2001, at 9:00 PM ET
  • Sedentary children Less active kids a weighty problem, UC Davis Health System. October 2000
  • Will Obesity Shorten the American Life Span? Study: without action on child obesity, U.S. life span to get shorter.  By Daniel J. DeNoon. WebMD Medical New. March 16, 2005
  • Hate Abortion. Love Planned Parenthood!

    Our Bodies, Our Choice

    © copyright 2007 Betsy L. Angert.

    I never thought I might share a conviction with the former Mayor of New York, Rudy Giuliani.  All week we have heard the news, “Conservatives Step Up Attacks On Giuliani’s Abortion Stance.”  When asked to discuss the question of abortion, during the Republican debate, the “Right” says Giuliani flinched.  He shrugged his shoulders.  His words were “I hate abortion”; yet, his body said he was fine with the “gross” practice.

    Later in the week when it was revealed Mayor Giuliani donated to Planned Parenthood on numerous occasions, there was ample outrage.  The “Right” loudly proclaimed, ‘How could a Conservative, a Republican, and a Presidential candidate no less, be so bold as to contribute to an organization that is well-known as abortion clinic.’

    The consensus was, or is, a person cannot be pro-life and pro-choice.  Yet, I believe many are, me among them.

    I am not writing in support of candidate Rudy Giuliani. I do not endorse him or his campaign. The reasons are many.

    I consider myself a bleeding heart Liberal. I am a Progressive.  More often than not, Democrats are too moderate for me. I purposely did not use the term “conservative,” for I think a person can be defined as an open-minded radical and still choose to conserve.  Environmentally, too may Liberals do not wish to eliminate what makes their lives easy. Socially and economically, I think Democrats are frequently shortsighted.  They, as their counterparts, often prefer simple solutions. I rather live for the Seventh Generation.  Nevertheless; forgive me, I digress.

    I have been a patient of Planned Parenthood since I was sixteen. I entered the clinic with my parents’ knowledge and permission.  Yes, I am a person that believes wholeheartedly in complete communication and comprehensive understanding.  I did discuss my choice with my Mom and Dad.  In fact, the dialogue began when I was first able to speak.

    Before my birth, I know not when; although I trust that my older siblings experienced similar, volumes of written material were placed in every bathroom. My Mom made certain we had ample access to biology books.  Some of the resources were meant for adults; others helped young children learn.  Tomes addressed reproduction.  A few of the volumes were humorous. ; These too taught lessons; however, the approach was amusing.

    Often, too frequently for a young child that had little interest in “sex,” my Mom would discuss what I read. She asked questions, wanting to affirm my knowledge was accurate.  When I reached the age of five, my Mom was confident, I understood.  Reproductive organs and the act of procreation were not mysteries to me.

    The issue was integrated into my life early on.  As a family, we did not dwell on the topic, nor was it avoided.

    I was fascinated when children at school and in my neighborhood broached the discussion with winks, nods, and laughter. They smirked, sneered, and said the silliest things. There was so much misinformation. They thought their childish jokes funny; I found them folly.

    I often wondered whether these children understood conception.  Could they conceive of how they came to be?

    I strongly suspect many of these young persons were not wanted. It seemed evident if only they bothered to assess the quality of their lives.  Perhaps, some were scheduled to be aborted.  I was.

    Although, when I was an embryo the procedure was illegal, if a couple, or an individual could raise the cash there was always someone willing to do the deed.  If finding funds was impossible, there were other ways to terminate an unwanted pregnancy.

    Believe as you might, my Mom thinks she changed her mind; however, I am certain the decision was mine. Nonetheless, my own birth history has less influence on my reasoning, my belief in the need for legal and safe abortions than other factors might.

    We all have choices and we invoke our right to choose in every moment.  Whether my Mom was influenced by my fetal feelings or not need not matter when we consider the topic.

    When I was twelve my parents said to me, ‘When you think you are ready to engage in physical intimacies, please tell us so that we might make arrangements.’ Contraception was an option they thought vital.  I agreed.  As an adolescent, I did not wish to give birth to a baby.

    A few years later, Mommy and Daddy handed me a periodical.  The type was printed on newsprint.  I believe the National Organization for Women produced this publication.  I believe, somewhere in my house I still have this magazine.  I spent hours reading it.  It was interesting. In many ways, it spoke of the mechanics as did the books in the bathrooms. However, it also provided references and resources for a pubescent mind.

    Throughout my life, my Mom and Dad spoke of the differences between sex and love, lust, longing, and an affection born out of knowledge, sharing, and caring.  They helped me to understand that “sex” is “sex.”  Bodies bending, bumping, and grinding together is not necessarily a loving act.  It can just as easily be gratifying a physical need, as much as it might be satisfying an emotional deficit.  

    In the case of “rape,” violence and control are the motive.  A baby produced through such an encounter may suffer emotional repercussions.  He or she may not. Only we can choose for ourselves what is.  Mothers, fathers, and babies may never agree when considering what was, what will be, or why our birth and life is as it is.

    At the time of my reading, I knew that for me, pregnancy was not my preferred path.  At the age of sixteen, I imagined I was the only virgin left on the face of the planet.  A close friend was experimenting.  While she told herself she was in love, I wondered.  I am not a romantic.

    Years earlier I thought another acquaintance had engaged in intimate entanglements.  Her home life was not as it might have been, it was perhaps, not as she believed was best.  There were so many secrets.  She never knew who her biological father was.  This bothered her.  Granted, the man that acted as her Dad was great and Mom was wonderful in many ways.  Still, something was missing.  She was often looking for love.

    Given these two girls, who I thought had experienced as I never had, I concluded I was ready.  However, months before I embarked, while walking through the kitchen, the telephone rang.  I picked up the receiver and said “Angert residence,” or did I just say hello.  I think had I known that this call would alter my life forever, I would recall my exact words in that moment more precisely.

    The voice was unfamiliar.  The caller was a man; he asked to speak with my Mom.  I cried out “Mommy . . .”  She was in the basement intensely involved in doing laundry.  She requested I take a message.  The baritone breathed deeply and then stated with a sigh, “Anna is fine.  We found out later the doctor is a butcher.  However, everything is going to be all right.”  I thanked the stranger for the message and went to talk with my Mom.

    Anna is a loved one, someone I knew since birth.  I had not seen her or spoken with her in years.  What happened?  Did Mommy comprehend what seemed so cryptic to me.

    Berenice Barbara understood what was meant.  Mommy shared that Anna had an abortion; she discovered she was pregnant.  Anna was scared.  What was she to do?  The young and lovely woman reached out, asking my Mom for assistance, guidance.  Anna needed a shoulder to cry on.  Sweet and scholarly Anna was in college, she had plans.  She never thought . . . I believe she had taken precautions.  I am uncertain; however, I know many that did and still the unexpected occurred.

    Whatever the reasons, Anna felt it best to abort.  I understand.  Women have and will likely continue to release themselves from what may be a medical, psychological, or emotional  emergency.  Females, and males, will save one soul and without wanting to, sacrifice another.  We can never fully comprehend what people believe is their only choice.  We, as a society, can only establish a safe and sane means for whatever a person feels they must do.

    I am well aware that my Mom instilled a desire in me to never hurt another.  She also helped me to understand that I need to be happy.  These two truisms must work in concert or chaos will ensue.

    I personally, do not believe I would be able to ever have an abortion.  Killing any being hurts my heart.  Even accidental deaths cause me great pain.  When I witness an animal in the road, bloody, and belly up I cry.

    I cannot bear to think of initiating pain on any organism.  I love life forms.  That is why I have supported Planned Parenthood for as long as I can remember.  

    I was aware of the good this organization does before I first entered one of the numerous centers.  Since becoming a  patient, I lived in three states and many cities.  I regularly received services at four offices over the years.  Now, in a new home, a fifth location meets my needs.

    This organization is extremely conservative and careful.  After decades of regular appointments, I know. On only a few occasions, I have entered a personal physician’s office for gynecological needs.  Each time I was astounded.  Medical professionals outside of Planned Parenthood do not interview a patient, or at least they did not consult with me, in depth.  Doctors do not require the details I must deliver each time I enter the doors of a Planned Parenthood center.

    Planned Parenthood does as their name states, they assist people in parenting decisions.  Initially, I sat through a four-hour seminar.  Questions and answers came at the end.  The clinicians insisted that each individual understood their bodies, their choices, the reason for conception, the hazards, and the best methods for ensuring problems would not arise.

    Medical examinations are mandatory.  Consultations are continuous.  In my own life, it was Planned Parenthood that “forced” me to go to a doctor for further diagnosis.  My blood pressure is low.  My heart on occasion murmurs.  Were it not for this wonderful community I would not necessarily know the simple statistics, cholesterol, triglycerides, glucose count, and other facts about my body.  Examinations required by Planned Parenthood are often not suggested by the private physicians’ friends of mine see.

    It is with thanks to Planned Parenthood and the Roe versus Wade Supreme Court decision, that I trust no woman will be told after ending a pregnancy,  “The doctor is a butcher.”  Do not worry everything is going to be all right.

    Citations and Situations  . . .