Tuesday, August 31, 2010

The War and Us

Because my son, Nick, is in The Basic School of the USMarines in Quantico Virginia, I have found myself reading books about the war that I would not even have stopped to look at until recently.

First, I read War by Sebastian Junger who is the wonderful writer many of us admire from his book The Perfect Storm.  In War,  Junger chronicles a storm of a different sort as he shows us what it is like to be stationed for months at a forlorn outpost in Afghanistan with a small platoon of  bored, lonely and confused soldiers.  This is a story of the agony of waiting, of sitting out their tour of duty in a devastated and uncertain area.  

The next book I read is The Good Soldiers by David Finkel that recounts his eight months in Iraq while embedded with soldiers during the surge.  A reviewer on Amazon.com summed it up this way, better than I ever could:

It's not easy to read. It's not fun. It always seems like the audience wants these types of books to be either blatantly anti-any-war polemics, or rah-rah, wave-the-flag screeds. Iraq was neither of those places. It wasn't anything other than the worst place on earth, with a lot of bad things happening, and everybody telling a lot of funny stories while they were hoping to get home okay. Nobody really remembers or considers the soldiers who had to go out there, into that fight. They think they do, but they don't. This book will help you understand; oh, will it ever.


I can only tell you that my personal reaction to these Up-Close-And-Personal accounts went deeper than just the read.  Yesterday when I boarded a plane to fly home after vacation, I saw a very young soldier in army camouflage seated in the bulkhead seat in first class.  Some spirit possessed me to lean over to him as I passed and say "thank you for whatever you do." As he smiled at me and thanked me in return,  I recognized some person in myself that I was not familiar with until this summer.  That's a person who used to think there was some pathological weakness about a US soldier, especially someone who would have been to Vietnam.  As the soldiers in these two books show, these warriors are our very own boys and girls-- brave, adventurous, fit, idealistic, damaged, funny, talented, and scared.  

I wish I could believe that the current drawdown and return of our troops meant the end of something.  I fear it will be just a new phase, maybe even more removed from our daily lives, even more inaccessible to our understanding.  Bravo to Junger and Finkel for exposing the harrowing, disconcerting and unsettling inner workings of this war in writing that is gripping and has the ability to change us.  

Monday, August 23, 2010

Lessons from the Garden for Parents

Back in the Spring I bought those familiar little spindly plants in a four-pack at the local nursery imagining that I would enjoy a few meals of sophisticated sauteed zucchini blossoms stuffed with goat cheese.
But now three months later, my plants are almost waist high, the leaves as big as a t-shirt and the blossoms usually forgotten under a jungle.   What lies beneath is a zoo of zucchini that are proliferating out of control.  Just when I think I have corralled them and harvested them and sent them on their way to be pickles, fritters, frittattas, parmesans, breads, grilled side dishes, and ultimately compost, I take one more gander and there hiding below me is one more.  Bigger than the last ones, or more deformed, or even in the shape of conjoined twins, or slightly orange, or completely rotten and falling apart.  How come I missed this one or that?  How did it grow to be this way right under my watchful eye?  All I did was plant and wait.  And here is a gaggle of ZOOKS! 

Had I pruned more, harvested more blossoms, pinched back the foliage, been more watchful, applied more discipline, would it have made a difference?  Would it have produced a different crop of perfectly shaped, predictable, tasteless, uniform and dullard veggies for me? 

You get the idea, anyway.  We plant, we sow, we harvest, we marvel.  At the uniqueness, the humor, the variety, the troubles, the stealth, the versatility, and the inexplicable offspring that result from our love and labor.

Saturday, August 21, 2010

On Your Marks, Get Breakfast, Go!

Looking for a great way to start the day once school begins?  Everyone knows that breakfast is key.  Nonetheless, when I see students in the mornings for sports physicals, or when I talk with patients in my office, I am struck by how frequently they confess to never eating breakfast.

I am seldom accused of being a helicopter parent and strongly believe in kids' independence and self reliance, but I think parents can and should go a long way to making breakfast happen in the morning.  It can be as simple as a bowl of cereal, but there are many other quick, fun, delicious ways to start the day.  Since I drive my kids to school, I frequently pack a small picnic basket (it's literally a small basket) with foil-wrapped warm goodies, a water bottle of milk or hot chocolate, and napkins.

Although it does require a bit of extra time on mom's part, the rewards are huge, and the effort is well worth it.   Here I share with you my recipe for breakfast bread which comes to mind right now because I have some monster zucchini in my garden that need a destination.  Breakfast bread can be made on the weekend and can last the whole week  (in theory anyway--you'll see, it's a real hit.) It is highly nutritious, easy to slice and can be supplemented with butter, jam, nut butter or cheese.  My group tends to like it just plain.
Breakfast Bread Recipe
Makes two 8-inch or three 6-inch loaves
Ingredients:
  • 5 eggs
  • 1 cup oil (safflower or canola)
  • 1 TB fresh lemon juice
  • 2 tsp vanilla
  • 3 cups flour (half whole wheat, half white)
  • 1 ½ cups sugar
  • 2 TB cinnamon
  • 2 tsp baking powder
  • 2 tsp baking soda
  • 1 tsp salt
  • 2 ½ cups grated veggies (zucchini, carrot, squash, apple, in any combinations)
  • ½ cup chopped walnuts (better if roasted before adding)
  • ¼ cup raisins (better if soaked in OJ or even water)
Method:
Prepare loaf pans: spray with oil and coat with demerara (coarse) sugar. Pat to empty. (This gives the breads a sweet, crunchy crust that also acts to keep the bread moist.)
Preheat oven to 350.
In large mixing bowl, beat eggs, oil, lemon and vanilla until foamy.
In separate bowl, sift flour, sugar, cinnamon, baking powder, soda and salt. Mix in veggies, nuts and raisins. Gradually add egg mixture, beating until smooth, but not over-beating. Pour batter into pans. Sprinkle cinnamon and coarse sugar on top of batter.
Bake about one hour until tester just comes out clean. Cool a bit, then invert carefully, and continue cooling.
May be wrapped in foil and kept in refrigerator or sliced and frozen.

Watch here for more breakfast options.  Soon it will be a happy habit!
image credit

Thursday, August 19, 2010

Guys Get a Turn at STD Prevention Too

HPV or Gardisil is now approved for boys and men.  Over the past 6 years we have been vaccinating girls and women, and now boys and men can be on an equal footing with this virus. It is now recommended for boys and men ages 9-26.

HPV, or human papilloma virus is a ubiquitous virus, easily contracted through intimate contact or touching that does not necessarily involve intercourse.  "Outercourse" and oral sex are easy ways to pass HPV among partners, friends, friends with benefits, etc. You get the picture.

We know that over three quarters of people have been exposed to HPV by the time they are sexually active for a short period of time.  We also know that most types of HPV in most people can be disposed of by our amazing immune systems.  However, there are certain sub types of HPV which we know can wreak havoc and are not so easily gotten rid of.  The most frightening consequences of these infections are genital warts and cervical cancer.

Genital warts are not pretty.  I chose not to display images of them but you can see some pretty nasty pictures of them here.  People might remember from health class that genital warts can be contracted by skin to skin contact outside of the areas protected by condoms.  Hence the advantage of the HPV vaccine. 

Downsides to this vaccine?  It is expensive as these things go;but my brief investigation has taught me that most insurance companies are covering it.  They know how much treating one case of genital warts can cost and they are only measuring the financial costs, not the emotional and psychological ones ("You gave me WHAT?").  In addition to cost, immunization involves three shots over a six month period and truth is they hurt a bit.  But hey, nothing compared to having a wart burned off the private parts.

Ask your doctor about HPV vaccine.  Or contact my office.

Thursday, August 12, 2010

Money and Mental Illness: how much does it matter?

Today Lisa Belkin published an article in the New York Times which profiles some of the life of Millicent Monks, the grand niece of Andrew Carnegie.  Monks has just written a book called "Songs of Three Islands, a Story of Mental Illness in an Iconic American Family" and Belkin's interview with Monks is a poignant story of a woman's attempt to explain her history and her legacy to herself. 

As interesting as the interview (and probably as interesting as the book itself) is the conversation on Ms Belkin's blog, where readers (including myself) are weighing in with personal anecdotes and reactions to this story.   Many, of course, are noting that the disabled Monks/Carnegie clan can hole up on beautiful, remote and private islands and have round the clock caregivers if they need and want them.   Such options  for daily care are not available to many and in our current dysfunctional health care system, it is difficult for many even to get the therapy or medications that they need for proper diagnosis or to keep their illness in check.  

However, it is worth noting that much of the misery of family members in this situation arises from the reluctance to seek treatment, the aggression, the hostility, and the loss of motivation that is inherent to some mental illness itself, particularly borderline personality disorder which appears to have afflicted some of Monks' family.  No amount of mothering, management or even money will dissolve these enduring difficulties.  No amount of self-flagellation or questioning will really help the strong, healthy survivors in the family to carry on. 

But understanding mental illness and genetics can sometimes help create the cushion that is necessary to protect oneself.  The efforts of Monks and Belkin might serve to encourage more of us to explore the family tree and grow in our knowledge and compassion.

Tuesday, August 10, 2010

Puberty Hits the News!

First graders with breasts? Third graders just mastering their multiplication tables also managing menstruation? Anecdotal reports from school nurses and my experience as a district physician have been calling attention for a while to what appears to be the earlier onset of puberty in early elementary years, especially among overweight girls.



So what is going on? A study reviewed all over the news yesterday but published in the American Academy of Pediatrics journal Pediatrics, showed that in fact the onset of puberty for Hispanic and black girls is not much earlier than reported in 1997 but that for white girls the onset does appear to be dropping to age 7 or 8. The reasons for earlier development are not clear. Pudgy girls appear to develop signs of breast development earlier, but in a 2009 Danish study girls were developing earlier whether overweight (measured as BMI) was a factor or not.


Researchers are postulating and concerned that some other factor in our environment, such as the chemicals in many of the ubiquitous plastics, may be disrupting the natural endocrine systems of our young girls. Further studies will need to be done to determine how this might actually happen and whether it is true in early bloomers.


In the mean time, what should we do?


As the lead author of the Pediatrics study, Dr. Frank Biro, suggested in an interview with the Los Angeles Times "...for younger children and the tweens, they should probably live a little bit greener. People could eat together as families — not avoiding fast food, but minimizing it to once a week — and families could engage in regular physical activity." Managing weight, living "green" and keeping the family meal might all serve to protect us from the risks of overweight, bad chemicals, and stress.


It's amazing how frequently it comes down to this simple bit of advice, best encapsulated by Michael Polan: "Eat real food, not too much, mostly plants."  And I think I would add that we should avoid drinking, eating, and microwaving out of plastic containers until we have more information.  

image credit: Google images

Wednesday, August 4, 2010

Workshop for Middle School Girls on Relationships


Queen Bees, Wannabees, Bullies, Friends, Best Friends Forever!
As our youngest teens and tweens head to middle school, some of them need tips, advice and coaching on handling the new and strong social relationship challenges that will meet them.

To help with the transition we are announcing a three part series of workshops for middle school girls, grades 6-8. The groups will be led by Jenifer McLaughlin,a social worker with vast experience leading groups in schools who is now sharing my new office in White Plains.

The series looks like this:

Tuesday August 31, 5:30pm:
Transitioning (fitting-in versus being yourself)

Tuesday, September 14, 5:30pm

Understanding peer relationships(why do kids act that way sometimes?)

Tuesday, September 21, 5:30pm

Navigating Social Media (Getting the most out of Facebook and the Internet)
Girls may choose to attend one or all three sessions. Each session will cost $10, last one hour, and be held at the office in White Plains. Small healthy snacks will be available.
Please RSVP to 698-5544 or email engellandoffice@aol.com

image from www.wondercomments.com