CHART: Compulsion to Complain When the Waitress Brings You Ketchup Instead of Hot Sauce

CHART: Things That Annoy Me About NGOs Working In Malawi

Can't afford healthcare? Rob a bank for $1 and reap the rewards in jail.

You've got chronic back pain, and nowhere to turn for relief. Thousands of American work their butts off day in and day out are turned down for insurance coverage despite paying their taxes and living civilly obedient. There are only two demographics in our country that are guaranteed health care, active military personnel and inmates (and even the lines for these groups is blurred at times). So you can either continue to suffer without health insurance or you can achieve coverage by joining the military or going to jail. That's what this guy did.  His plan was flawed, as you'll discover in the article, but the care he's receiving in jail is better than nothing.  The important point to take from this article is that a system that leads a guy to do this is clearly broken.  He's not lazy or worthless; he's sick. 

 Read the full article HERE (1).  and HERE (2)

Video:

TIA, bambo

I trust that you’ll

allow me the space

to share my thoughts

for a moment regarding

the uninhibited grace

of your tempt, Love.

The olfaction of

the trip has quartered

me in your arms.  The

sweet aroma of red dusted

roads runs miles through

my mind of memories past.

The sound of your straw

bristles across my stoop,

linens flapping in the breeze.

The warmth of your

beating bossom has grabbed hold

again with the site of your

barren landscapes.  I accept

your embrace, as in years past.

The smoky drip of your

charred flesh, the

gritty swig of your social circle,

a part of which I somehow belong.

With the wave of your hand

hesitation fades

revealing wholesome

sunrises burning like fires

speckling the horizon.

TIA, bamboo.  Welcome home,

my wayward friend.

Jeffrey Brenner's brilliant idea.

The majority of health care reform critics cited the assumed impossibility of reducing health care costs while improving care as reason to abandon efforts.  But what if we could have our cake and eat it, too?

Jeffrey Brenner is a physician in Camden, NJ.  He had a brilliant idea after analyzing crime data from the city, which revealed "hot spots" of crime in various parts of the city.  The presence of such a trend suggested that the deployment of police around the city to model these patterns of crime found in the data would both reduce costs and increase the effectiveness of the police force.  Naturally, he then considered applying the model to health care.

He crunched through some data and found that there were hot spots of sick people in Camden that were not only the sickest but also receiving the worst care.  If we took this population out of the hospitals and brought them into specialized clinics that would help them improve their health through lifestyle changes, could we save money systematically while indeed improving the the quality of care that they receive?

Thus far, Brenner's program - and similar programs that have popped up around the country - seems to be achieving what the critics thought was impossible.  Granted, they've only been in operation for a year or so, but, down the line, if the results are positive, Brenner may have uncovered a part of the solution to our nation's healthcare crisis.

A few points about his program that stand out to me:
-24-hour emergency hotline (would reduce costs by limiting calls to 911 in non-medical emergencies such as falling over and not being able to get back up)
-health coaches, recruited from backgrounds outside of healthcare
-morning meetings to get all of the staff on the same page about scheduled patients' recurring health problems and the barriers to their well-being
-constant nagging from clinical staff about patients' unhealthy habit: smoking, diet, exercise, etc.

Read the whole article ("The Hot Spotters" by Atul Gawande) HERE.

Petrichor-doux

After a long drought, I'm ready to rain down some sweet rain in the form of some blogging.

I’m finished with my first year of med school, which makes me 25% MD. At this point, we've adjusted to the idea of accumulating $250k in debt. There's no turning back now. We're all going to be doctors. What isn't clear is what the hell that actually means in the grand scheme of things.

The waters have been muddied by the biomedical scientific flurry of information that has been forced into our brains. Many fresh MDs admit that, during your preparation for board exams at the end of your second year, you will have the ability to recall greater fundamental medical details than you will for the duration of your practicing years.

But one thing that can't be instilled in us is a sense of purpose. Since my time on Semester at Sea, I've felt some calling to the world, though I still don't know where I'm heading. Other friends that pursued medicine have described how the process has beaten the altruism out of them. My friend at Harvard Dental - who also happens to have been on the Semester at Sea voyage with me - told me that he held an altruistic view of dentistry until very recently. Now, he merely hopes to achieve a comfortable life for himself while performing his job as best possible. This is coming from a guy that has devoted a great deal of his time over the past years to servicing the poor.

I'm on a path to change the way that we think about health. The current stream of thinking in society is that our bodies either work well or they don't, which, in my opinion, isn't really a terrible way to simplify things. On the other hand, take, for example, the study of epigenetics. A great deal of research is now focused on how factors in our environment – including pollution, diet, and exercise – affects the expression of our genome. All of these things can influence the way that we feel and perform.

Cancer is a dysfunction that arises from within the body itself. It deals with the uninhibited division of cells, a process that is highly regulated in a normal cell. This dysfunction is usually the result of damage to genes that regulate cell division. Free radicals or some DNA-damaging agent such as radiation causes this damage. While inheritance of certain cancers must be mitigated by our role as physicians, providing the tools for people to minimize this damage by reducing the stresses on our bodies that cause them. Epigenetics research has shown that these agents range dramatically…from the food we eat to the amount of time that we spend on our cell phones.

This isn't about money, politics, economics, or health care policy. This is a throw back to what makes life possible. We must do our best to preserve our bodies. It’s the only way to optimize our wellness in spite of a poor genetic hand. The food, sleep levels, stress levels, and activity that we constantly expose our bodies to can and will affect gene transcription, and thus alter our mood, energy levels, focus, and general well-being.

A recent lecturer suggested we decide now where our interest lies in medicine: taking care of sick apples or preventing apples from getting sick in the first place. While care for already sick patients is critical, I think that we as medical professionals owe it to society to begin taking prevention more seriously. Considering the potential of epigenetics, this battle is not solely against obesity. It’s a battle to preserve our wellness and morbidity by devoting more resources and energy to mapping out an optimal way of life most appropriate for maintaining the integrity of our genome.

What is Crossfit?

For the past five months, I've aimed to do four or five Crossfit workouts per week.  Crossfit is a very unusual fitness program that I would highly suggest to anybody who is easily bored with their normal gym routine and who likes to see results in everything from flexibility to strength to cardiovascular fitness.  But it's a little bit hard to explain...

First of all, let me give you an example of one of my mornings while attending Crossfit South Hills.  I would wake up at 6:30, mix up a protein shake, grab an Accel gel, and race over to the gym. The warm-up consists of the following:

3 rounds of ten reps each of the following exercises:
-dislocates (PVC pipe raise above head and rotated down to the lower back then back up and in front, etc.)
-overhead squats (again using PVC)
-dislocate + lunges (PVC)
-back extensions
-sit-ups
-push-ups
-pull-ups

Then, we were required to do a "Buy In", which is usually to practice a skill-based movement. But it could also be a sprint (400m, 800m, or mile), max rep body weight exercise, or a mini-workout.  You never know!

After the buy-in, there's a Workout-of-the-Day (WOD), which is normally a nightmare.  After that, you complete a "Cash Out", which follows the same formula as a Buy In, only it normally works the same muscles focused on in the WOD, so it's extra hard.

Here's is an example of a typical workout routine at Crossfit South Hills:

-Buy In-
Max Effort Burpees For A Minute

WOD
21 Renegade Rows
Row 250M
12 Knees To Elbows
15 Renegade Rows
Row 500M
12 Knees To Elbows
9 Renegade Rows
Row 750M
12 Knees To Elbows

-Cash Out-
25 Strict Chin Ups

 The idea here is to complete the workout as fast as possible.  The beauty of most of these WODS is that they don't take very long.  Sometimes, the WOD only lasts for 6 minutes.  Other times, you might be grinding through it for a half hour.  Every session is an hour or less, though.  So if you switch to Crossfit, those constant, drawn-out sessions at your local Bally's will be history.  Crossfit four or five times per week, and your body will thank you.

Another great part of Crossfit - and probably the key to its incredible results-producing regimen - is that when you walk into your Crossfit gym, you are totally surprised by the workout.  Indeed, their slogan is "unknown, unknowable". While those who program the WODs do have a formula in mind to keep their athletes balanced over the long haul, you  have to be prepared for anything when you walk into the gym.  You might work the same muscles multiple days in a row (this is body-building, it's general athletic preparedness!); likewise, you may go a week without doing any ab-concentrated movement, for example.  Some WODs include tire-flipping, rope-climbing, or pushing a weighted sled across a parking lot.  We use jump ropes, kettle bells, medicine balls, and sand bags.  Like I said, Crossfit WODs are murder, but you see results quickly in all areas of fitness.

Here's another example of a WOD:

"Fran"

21 Thrusters (95 lbs.)
21 Pull-ups
15 Thrusters
15 Pull-ups
9 Thrusters
9 Pull-ups

This one takes more elite athletes less than three minutes to complete, but it's a full body workout.  

Olympic lifting and virtually any exercise that uses a long barbell will engage your core whether you like it or not (you like it, trust me).  Because most Crossfit WODs include a barbell movement, every workout does something for your core.  

A lot of people are critical of Crossfit because they see it simply as a strong man competition because of its frequent resort to Olympic lifting.  Here's a WOD that displays the type of cardiovascular workout that you can get from Crossfit:

2 power cleans on the minute (205 lbs.) for 15 minutes

For the remainder of the minute, do as many double unders as possible.  

Keep a running total of double unders.

This workout requires both strength and cardiovascular fitness to finish with a good time.

The only way to experience the benefits of Crossfit is to try it out for yourself.  Affiliate gyms are located virtually everywhere nowadays.  Despite all of the perks to your health and body, the community fostered in these gyms is unbeatable.  You would be hard-pressed to find a group of Crossfitters that wouldn't welcome you whole-heartedly into their gym and cheer you on while you improve your fitness.  I consider my coach and colleagues at Crossfit South Hills some of my dearest friends.

I can also testify to Crossfit's effects on my performance as a triathlete.  In July, I competed in the Steelhead 70.3 half ironman.  I broke my personal records in the swim, bike, and run distances (1.2 miles, 56, and 13.1 respectively).  My times: 32:57, 2:48:55, and 1:33:11.  My training reached about 15 hours per week, but five of those hours were dedicated to Crossfit training, meaning only 10 hours per week of swimming, biking, and running.  Most triathletes at this level are training anywhere from 15-20 hours in swim, bike, and run.  At the race, I was particularly strong in my transition from bike to run, which is normally considered the hardest part of the race. I also required virtually no recovery time.  In fact, I had to jump in the car and drive straight back to Pittsburgh after the race in order to be in Philadelphia for classes less than 48 hours afterwards!  After having crushed the triathlon and then driving for 7 hours back to Pittsburgh and NOT having any stiffness or sore muscles, I can only attribute my great experience and times to Crossfit South Hills (and my adherence to the Paleo Diet, but more on that in the next post...)

Try out Crossfit.  Most gyms will allow you to work out a few times for free!  And all you have to do is show up ready to sweat.  I suggest Crossfit South Hills if you live in Pittsburgh.

Have fun getting the body you have always wanted, sleeping better, buying new clothes, making new friends, and freeing up some time in your schedule due to the brevity of Crossfit sessions!