“I only need the pain med at night”; “I just take one a day, at night when I’m trying to sleep”; “I need something to help me at night”; I hear words like these over and over from patients. Something happens at night, lying in the dark waiting for the escape of sleep to overtake us. The pain of recent surgery often intrudes and seems more intense at these moments. The distractions of the daytime; other people, the humdrum light and noise of the daytime are gone and all the pain that has been buried during waking hours rises to the surface.
Our brain is amazing, the way it filters out wave after wave of unwanted stimuli, selecting only what’s important to capture our attention. But all this stimulation fades away in the night and we are left with only ourselves, our thoughts, dreams and pains. My patients fill out a history questionnaire as part of their initial evaluation; one of the symptoms they can check is difficulty sleeping. I think almost half my patients check this box.
Little children cry out in fear and their parents rush to comfort them; the darkness and solitude are fertile ground for the young imagination, calling up horrible monsters that prey on the innocent, but are frightened away by even the tiniest bit of light and a few sharp words from a loving parent.
The monsters of childhood give way to the demons of our later years. The worries of these supposedly enlightened progressive times creep out during the dark hours, robbing us of the tranquility that sleep promises. Perhaps the monsters are real; a prodigal child, a wayward spouse, financial burdens or disappointment over perceived failure, concerns that well up into our consciousness at a time when we yearn for the serenity and peace of sleep.
Charlie Brown of “Peanuts” fame would lie awake at night and ask questions out loud addressed to no one in particular or, perhaps, to God. The answers were never particularly comforting:
“Sometimes I lie awake at night and ask ‘where did I go wrong?’ And a voice answers ‘This is going to take more than one night.”-Charlie Brown in ‘Peanuts’
“Sometimes I lie awake at night and ask ‘Why me?’ And a voice answers, ‘Nothing personal, your number just came up’-Charlie Brown in ‘Peanuts’
Is God so arbitrary? I doubt it.
But, the night isn’t always bad. Triumphs and successes of the day bring a sense of joy and excitement that can keep us from the peace of sleep. It is far more likely that elation leads to celebration and sleep is banished for a while; our day to day struggles pushed back into the recesses of our brain, quietly waiting for the moment to emerge and send our joyful feelings crashing into the abyss.
The Bible speaks of rest as a reward, something given by God for work well done.
"Come to Me, all you who labor and are heavy laden, and I will give you rest. Take My yoke upon you and learn from Me, for I am gentle and lowly in heart, and you will find rest for your souls. For My yoke is easy and My burden is light." -Matthew 11:28-30
At the end of a long day or a long life God rewards us with His rest. Scripture presents rest as the ultimate gift from God. Over a six day period God created the universe and our world and on the seventh day He rested. Number four of the ten commandments is to remember the Sabbath day and keep it holy, which means set apart as something special, a time for rest.
So night is the time for rest, to be alone with God and with our thoughts; a time of reflection on the day’s events and a time to anticipate the days to come. So many times at night I think about the day that has just past, surgery’s that have been done, family concerns and any troubles. It’s a time to offer prayers of thanks and supplication. Personally, I think God listens best at such moments or, more likely, I can focus better at these times; the quiet darkness shielding my thoughts from unwanted intrusion.
And then there’s sleep. We drift away from consciousness, but remain alive. While we sleep amazing things happen. Although it has never been proven I think that sleep provides a time for repair: physical, mental and emotional. Body temperature falls, heart rate decreases, blood pressure decreases and vascular resistance falls. Our organs are bathed in blood that seems to circulate more slowly during sleep, allowing built up toxins to be released and disposed, focusing our immune system on potential invaders, repairing damages done and probably a multitude of other functions that remain a mystery.
Sleep is the time for dreams, our pent up thoughts and feelings released into a private theater that may be cryptic, vivid, heart-warming or terrifying. Sometimes in color, sometimes in black and white, Freud wrote a whole book on the interpretation of dreams. The Bible gave special credence to those that could interpret dreams and treated our dreams as messages from God. Daniel and Joseph were the premier dream interpreters of the Bible; they both suffered because of this skill, but were also rewarded. Most often our dreams leave us confused and often we forget them as soon as we awaken; leaving us with a vague recollection that something of importance may have transpired, but little more.
We may never remember a dream and remain oblivious to our environment, but we still yearn for sleep, for this time of physical, mental, emotional and spiritual repair. We cannot live without its benefits and yet it can prove to be so elusive. Lying awake, tossing and turning, counting sheep by the millions, downing pills and elixirs; searching for the elusive rest. Our world has become so complicated that moments to relax, do nothing and dream become fleeting until they seem lost forever.
Where can we find peace? As children the comforting word or touch of a parent was all that was needed. So, we come back to our parent, to God, our Heavenly Father. His word, His grace, His promise are all that we need to find rest. It is promised throughout the Bible and night is the time when we can feel His soothing touch and receive His peace.
Sunday, December 12, 2010
Monday, November 29, 2010
Aliens Among Us
I just read an article which discussed how the teenage brain is wired differently than the brains of other normal people. Apparently, there was a study done that proved this difference; a fact that has been obvious to parents for ages, probably since the days of Cain and Abel.
That teenagers function on a different level when compared to younger children or adults is more than the result of “different wiring”. No, it is the consequence of a much more sinister plot; a plan that could eventually lead to the end of civilization as we know it. Recent observations out of Roswell, NM have clearly demonstrated that during a child’s thirteenth year aliens visit and our sweet innocent children are replaced.
Every parent has had the experience. That sweet child that loved to be with Mom and Dad, be it a simple walk or a game of catch, suddenly can’t be seen with parents. But it’s more than this. There is no question that teenagers are not human.
For example, years ago I had a simple surgery scheduled on a fifteen year old girl, excising a cyst from her scalp. It was too big to do under strictly local anesthesia in the office, so I scheduled the surgery to be done in the OR utilizing local anesthesia along with intravenous sedation. The procedure started uneventfully; the area on her scalp numbed adequately and her peaceful snores indicating an appropriate level of sedation.
As I made my incision she became agitated and started to scream that someone was trying to cut off her head. I have to comment at this point that local anesthesia will eliminate most sensation, but pressure feelings and awareness that something is being done still are maintained. As she became more agitated the anesthesiologist gave her more sedation, actually enough to stop a charging elephant. My patient tried to jump off the table.
Needless to say the surgery was stopped, she was given general anesthesia and we finished the procedure without incident. At that time I chalked it up to a single paradoxical reaction. But, about six months later I had another similar occurrence. A minor procedure on a sixteen year old boy, once again under local anesthesia with IV sedation yielded the exact same outcome. This time we were better prepared and as soon as it was apparent that the sedation was not effective, general anesthesia was induced and we finished the operation without further mishap. After these two episodes I decided that teenagers were not like normal people and since then all operations on this subspecies of humanity have been done either with straight local anesthesia, that is, sans sedation, or with full general anesthesia. I have to add that, at the time, my own kids were all sweet, innocent toddlers and young children. They’ve since grown and I am older and wiser.
But, what is the underlying mechanism for this devious transformation? Prevailing theories are that rapid hormonal changes coupled with the growing social pressures of the teen years lead to the instability of the teenage specimen. This explanation is at best inadequate. No, there is much more to the phenomenon and the answer, undoubtedly, is alien invasion.
During the seventh grade, usually a few months after the start of the school year the exchanges begin. Our teenage children are snatched away as they sleep and transported to alien space ships hovering just outside the Earth’s atmosphere, shielded from any prying military probes. Exact physical copies of our precious children are created and, unlike Stepford, where the wives were replaced by docile, compliant androids, the replicants are programmed to disrupt the lives of all the sane adults and younger children they encounter.
Because they are artificial they have no fear of driving too fast, or drinking excessively and, being perfectly engineered machinery, they believe it is beneath them to fraternize with imperfect biologically based beings like parents or younger siblings. Instead they prefer their own kind, congregating at malls, particularly around the Apple Store or in arcades where other machines can be found.
Oh, they are devious, that’s for sure; pretending to be sweet and innocent for a moment, filling their forlorn parents with hope that their baby has been returned, but it’s all a trick. Once rewarded with spending money and car keys, they revert to their real selves, congregating together to prowl the streets in packs and wreaking havoc at every turn. Of course it isn’t all bad. These alien creations have remarkable central processors that can soak up Shakespeare or trigonometry like a dry sponge. When properly motivated they are capable of performing a Vivaldi Violin Concerto or winning Olympic Gold in gymnastics. Through all this we cheer them on, pray for them and hope, deluding ourselves into believing that these ‘replacements’ are truly ours.
Is there hope for humanity; will we ever be released from these thorns in our sides? I don’t know what happens to the real children as they are held prisoner on these alien ships, but most of them manage to escape shortly after they enter adulthood. The vicious, unpredictable beasts are dismantled and our children, now responsible adults, return.
So, if your teenager is getting you down, acting in bizarre ways and causing you to reach for the Ativan two or three times a day, relax. Just say to yourself: “They’re not human, they’re not human, just be patient, just be patient”.
In a few years it will all be over. But, until that time, keep a stiff upper lip, hide the car keys and keep the Ativan close at hand.
That teenagers function on a different level when compared to younger children or adults is more than the result of “different wiring”. No, it is the consequence of a much more sinister plot; a plan that could eventually lead to the end of civilization as we know it. Recent observations out of Roswell, NM have clearly demonstrated that during a child’s thirteenth year aliens visit and our sweet innocent children are replaced.
Every parent has had the experience. That sweet child that loved to be with Mom and Dad, be it a simple walk or a game of catch, suddenly can’t be seen with parents. But it’s more than this. There is no question that teenagers are not human.
For example, years ago I had a simple surgery scheduled on a fifteen year old girl, excising a cyst from her scalp. It was too big to do under strictly local anesthesia in the office, so I scheduled the surgery to be done in the OR utilizing local anesthesia along with intravenous sedation. The procedure started uneventfully; the area on her scalp numbed adequately and her peaceful snores indicating an appropriate level of sedation.
As I made my incision she became agitated and started to scream that someone was trying to cut off her head. I have to comment at this point that local anesthesia will eliminate most sensation, but pressure feelings and awareness that something is being done still are maintained. As she became more agitated the anesthesiologist gave her more sedation, actually enough to stop a charging elephant. My patient tried to jump off the table.
Needless to say the surgery was stopped, she was given general anesthesia and we finished the procedure without incident. At that time I chalked it up to a single paradoxical reaction. But, about six months later I had another similar occurrence. A minor procedure on a sixteen year old boy, once again under local anesthesia with IV sedation yielded the exact same outcome. This time we were better prepared and as soon as it was apparent that the sedation was not effective, general anesthesia was induced and we finished the operation without further mishap. After these two episodes I decided that teenagers were not like normal people and since then all operations on this subspecies of humanity have been done either with straight local anesthesia, that is, sans sedation, or with full general anesthesia. I have to add that, at the time, my own kids were all sweet, innocent toddlers and young children. They’ve since grown and I am older and wiser.
But, what is the underlying mechanism for this devious transformation? Prevailing theories are that rapid hormonal changes coupled with the growing social pressures of the teen years lead to the instability of the teenage specimen. This explanation is at best inadequate. No, there is much more to the phenomenon and the answer, undoubtedly, is alien invasion.
During the seventh grade, usually a few months after the start of the school year the exchanges begin. Our teenage children are snatched away as they sleep and transported to alien space ships hovering just outside the Earth’s atmosphere, shielded from any prying military probes. Exact physical copies of our precious children are created and, unlike Stepford, where the wives were replaced by docile, compliant androids, the replicants are programmed to disrupt the lives of all the sane adults and younger children they encounter.
Because they are artificial they have no fear of driving too fast, or drinking excessively and, being perfectly engineered machinery, they believe it is beneath them to fraternize with imperfect biologically based beings like parents or younger siblings. Instead they prefer their own kind, congregating at malls, particularly around the Apple Store or in arcades where other machines can be found.
Oh, they are devious, that’s for sure; pretending to be sweet and innocent for a moment, filling their forlorn parents with hope that their baby has been returned, but it’s all a trick. Once rewarded with spending money and car keys, they revert to their real selves, congregating together to prowl the streets in packs and wreaking havoc at every turn. Of course it isn’t all bad. These alien creations have remarkable central processors that can soak up Shakespeare or trigonometry like a dry sponge. When properly motivated they are capable of performing a Vivaldi Violin Concerto or winning Olympic Gold in gymnastics. Through all this we cheer them on, pray for them and hope, deluding ourselves into believing that these ‘replacements’ are truly ours.
Is there hope for humanity; will we ever be released from these thorns in our sides? I don’t know what happens to the real children as they are held prisoner on these alien ships, but most of them manage to escape shortly after they enter adulthood. The vicious, unpredictable beasts are dismantled and our children, now responsible adults, return.
So, if your teenager is getting you down, acting in bizarre ways and causing you to reach for the Ativan two or three times a day, relax. Just say to yourself: “They’re not human, they’re not human, just be patient, just be patient”.
In a few years it will all be over. But, until that time, keep a stiff upper lip, hide the car keys and keep the Ativan close at hand.
Saturday, November 20, 2010
Jesus was a Wino...Like Me
A few weeks ago, in the midst of some heated discussion in the OR, my assistant made an interesting, perhaps profound comment. I don’t remember the topic, but the conversation must have wandered into religion and somehow the person of Jesus came up. Sometimes we actually have deep and profound discussions while slaving over hot gallbladders; this must have been one of those times. Anyway, as the conversation heated up, she blurted out:
“Jesus was a wino…like me”.
It sounded funny at the time, and I don’t think anyone in the room really believed it. First of all, although my assistant enjoys a fine glass of Chardonnay on a regular basis, in moderate amounts only (except on the rare occasion when she is celebrating something, when she allows herself a bit more), she does not fit the definition of a wino. There are various definitions of “wino”, but an amalgamation of them all would probably be: “an indigent person, usually homeless, who drinks alcoholic beverages, usually to excess”.
But what she said in the heat of discussion actually contains a great deal of theology and, if examined closely, one can find the gospel. So, let’s deconstruct this simple phrase and uncover its truth.
Jesus refers to Jesus Christ, the remarkable figure on whom the various Christian religions are built. Over two thousand years ago he was an itinerant rabbi hiking around ancient Palestine, trailed by twelve disciples, whose purpose was to deliver the “good news”, a message of God’s love, hope and salvation for all His people; the Gospel. During his three year mission He had no home and it is well documented that he drank wine, although never to excess. He performed many miracles; the first was changing of water into wine at the wedding feast in Cana. But, whereas his disciples may have become drunk on at least one occasion, (they seemed to have a hard time staying awake at Jesus greatest time of need in the Garden of Gethsemane), Jesus never drank inappropriately. Drunkenness would be considered a sin and he lived a perfect, obedient, sinless life, which uniquely qualified him as the perfect sacrifice to satisfy God’s wrath and to take our sins upon himself at the Cross.
So, he does not meet all parts of the definition of wino. Homeless, yes, indigent, yes, drank wine, yes, excessively, no. But, what about the Gospel? At the Cross, the sins of the world were heaped upon Him and by this act of love we are saved. When the believer stands before God for judgment,
God will see the righteousness of Jesus instead of a wretched sinner. This is the heart of the Gospel. At the Cross Jesus takes all the sins of the world upon himself and we, the sinful winos, are cleansed. Jesus becomes the wino in our place.
“He made Him who knew no sin to be sin on our behalf, that we might become the righteousness of God in Him.” -2 Corinthians 5:21
In this sense one could say that it’s true; Jesus was a wino. Perhaps it’s better said, “Jesus became a wino…for me”.
But, what about “…like me”. Can anyone say that Jesus is “like me”? Jesus left heaven; separating from all his glory, and became human, assuming all the frailties and weaknesses of humanity. He suffered all the temptations that we suffer and more. He was offered bread when he was starving, but rejected it, preferring God’s word. He was offered all the world, but chose the promise of God and Heaven and, finally, He refused to put God to the test, holding on to His faith and rejecting Satan. These temptations make Jesus “like me”, except he succeeded where we all fail miserably.
“Jesus was a wino..like me”. The Gospel shouts from these words and, as a result, hope and truth are offered to all of us.
“Jesus was a wino…like me”.
It sounded funny at the time, and I don’t think anyone in the room really believed it. First of all, although my assistant enjoys a fine glass of Chardonnay on a regular basis, in moderate amounts only (except on the rare occasion when she is celebrating something, when she allows herself a bit more), she does not fit the definition of a wino. There are various definitions of “wino”, but an amalgamation of them all would probably be: “an indigent person, usually homeless, who drinks alcoholic beverages, usually to excess”.
But what she said in the heat of discussion actually contains a great deal of theology and, if examined closely, one can find the gospel. So, let’s deconstruct this simple phrase and uncover its truth.
Jesus refers to Jesus Christ, the remarkable figure on whom the various Christian religions are built. Over two thousand years ago he was an itinerant rabbi hiking around ancient Palestine, trailed by twelve disciples, whose purpose was to deliver the “good news”, a message of God’s love, hope and salvation for all His people; the Gospel. During his three year mission He had no home and it is well documented that he drank wine, although never to excess. He performed many miracles; the first was changing of water into wine at the wedding feast in Cana. But, whereas his disciples may have become drunk on at least one occasion, (they seemed to have a hard time staying awake at Jesus greatest time of need in the Garden of Gethsemane), Jesus never drank inappropriately. Drunkenness would be considered a sin and he lived a perfect, obedient, sinless life, which uniquely qualified him as the perfect sacrifice to satisfy God’s wrath and to take our sins upon himself at the Cross.
So, he does not meet all parts of the definition of wino. Homeless, yes, indigent, yes, drank wine, yes, excessively, no. But, what about the Gospel? At the Cross, the sins of the world were heaped upon Him and by this act of love we are saved. When the believer stands before God for judgment,
God will see the righteousness of Jesus instead of a wretched sinner. This is the heart of the Gospel. At the Cross Jesus takes all the sins of the world upon himself and we, the sinful winos, are cleansed. Jesus becomes the wino in our place.
“He made Him who knew no sin to be sin on our behalf, that we might become the righteousness of God in Him.” -2 Corinthians 5:21
In this sense one could say that it’s true; Jesus was a wino. Perhaps it’s better said, “Jesus became a wino…for me”.
But, what about “…like me”. Can anyone say that Jesus is “like me”? Jesus left heaven; separating from all his glory, and became human, assuming all the frailties and weaknesses of humanity. He suffered all the temptations that we suffer and more. He was offered bread when he was starving, but rejected it, preferring God’s word. He was offered all the world, but chose the promise of God and Heaven and, finally, He refused to put God to the test, holding on to His faith and rejecting Satan. These temptations make Jesus “like me”, except he succeeded where we all fail miserably.
“Jesus was a wino..like me”. The Gospel shouts from these words and, as a result, hope and truth are offered to all of us.
Sunday, November 7, 2010
Grown Up
This post talks about "Toy Story 3 and contains spoilers, in case you haven't seen that movie
Last night I watched “Toy Story 3” with my wife and daughters. I thought the story was very touching and I found my eyes filling with tears at the end. Since then I’ve been wondering: what is it about this story that I found to be so moving? The ending was a bittersweet, but it was the best of all possibilities for the motley crew of toys. And, yet I felt far more sadness than anything.
As I reflected on everything the wonderful story contained I realized that “Toy Story 3” wasn’t about the toys at all. Just as “Ben Hur” was really about Jesus (the complete title is “Ben Hur, a Story of the Christ”), “Toy Story 3” is about Andy. Sure, the majority of the time the focus is on the plight of the toys, but at almost every moment it is the plight of Andy that is in the background.
We start with video of Andy playing with his beloved toys, games of make believe that demonstrate the unashamed imagination that is special to young children. But, the screen cuts to Andy preparing to leave for college. What will become of the toys; trash or attic or worse? At this point the viewer gets only a glimpse at Andy’s thoughts. He cares enough to put them away in the attic and he plans to bring Woody to college where he would likely end up as an ornament on a desk, seen, but not to be played with. It is a better fate than the attic.
If you’ve seen the movie you know about the plight of the toys, but one of the most revealing scenes is that of Andy searching for the toys he wanted to save and learning that they were accidently put out with the trash. Andy is visibly upset and then we don’t see him for a while. At that point perhaps he realizes that the childhood memory that he thought he was shuffling off to storage has been lostforever and we feel his loss.
The toys go through a number of misadventures until they find themselves, in a Jonathan Edwards moment, on the brink of annihilation, only to be grasped from the fire by the giant, divine “Claw”. They all make their way back to Andy who gets a second chance at redemption. Through the intervention of Woody he decides to give his toys, except for Woody, to Bonnie, a girl who we know will truly appreciate them and play with them just as Andy had done.
At the point when Andy stops at Bonnie’s home to give her the toys he demonstrates that he has not forgotten what the toys are, what they meant to him and what they still mean to him. He could have just handed the box to Bonnie or her Mother and drove off to college, but that wouldn’t have been right. He takes each toy, one at a time and lovingly hands it to Bonnie, making sure that she knows the true story of each one. And in the end he is left with Woody, who still plans to bring to college. But, Bonnie already loves Woody, just as Andy loved Woody when he was that young age. And Andy sees her love and gives Woody to Bonnie.
At this moment Andy finds redemption, just as Judah Ben Hur found his redemption through his three encounters with Jesus. Because, it is expected that Andy, having been true to his toys, would have left, gone on to the more important task of moving into college. After all he’s seventeen and playing with toys just wouldn’t be proper for someone moving on in this world. But, he stays and for the rest of the day he plays with his beloved toys and with Bonnie, recapturing the childhood he thought he had lost forever. And, it is at this moment that the tears start to flow, because for all of us we realize what we have lost. The childlike innocence that we used to have, imagination that can turn a piggybank into evil Dr. Porkchop, is lost; buried beneath the day to day routine that we call growing up and adulthood.
One of my favorite songs, since I was about eight or so, is “Puff, the Magic Dragon”. Years ago someone wrote that this song is about drugs, but if you read the lyrics it is clear that this song is about the losses we suffer when we grow up. Jackie Paper plays with Puff and the two go on the greatest adventures together, until Jackie grows up, Puff is replaced by other toys and forgotten. Without a little boy to bring the imagination there may be a toy dragon, but that is all there is, a lifeless stuffed animal. The imagination of a child brings toys and us to life.
Puff, the magic dragon lived by the sea
And frolicked in the autumn mist in a land called Honah Lee
Little Jackie Paper loved that rascal Puff,
and brought him strings and sealing wax and other fancy stuff. Oh
Puff, the magic dragon lived by the sea
And frolicked in the autumn mist in a land called Honah Lee
Puff, the magic dragon lived by the sea
And frolicked in the autumn mist in a land called Honah Lee
Together they would travel on a boat with billowed sail
Jackie kept a lookout perched on Puff's gigantic tail,
Noble kings and princes would bow whene'er they came,
Pirate ships would lower their flags when Puff roared out his name. Oh
Puff, the magic dragon lived by the sea
And frolicked in the autumn mist in a land called Honah Lee
Puff, the magic dragon lived by the sea
And frolicked in the autumn mist in a land called Honah Lee
A dragon lives forever but not so little boys
Painted wings and giant rings make way for other toys.
One grey night it happened, Jackie Paper came no more
And Puff that mighty dragon, he ceased his fearless roar.
His head was bent in sorrow, green scales fell like rain,
Puff no longer went to play along the cherry lane.
Without his life-long friend, Puff could not be brave,
So Puff that mighty dragon sadly slipped into his cave. Oh
Puff, the magic dragon lived by the sea
And frolicked in the autumn mist in a land called Honah Lee
Puff, the magic dragon lived by the sea
And frolicked in the autumn mist in a land called Honah Lee
Last night I watched “Toy Story 3” with my wife and daughters. I thought the story was very touching and I found my eyes filling with tears at the end. Since then I’ve been wondering: what is it about this story that I found to be so moving? The ending was a bittersweet, but it was the best of all possibilities for the motley crew of toys. And, yet I felt far more sadness than anything.
As I reflected on everything the wonderful story contained I realized that “Toy Story 3” wasn’t about the toys at all. Just as “Ben Hur” was really about Jesus (the complete title is “Ben Hur, a Story of the Christ”), “Toy Story 3” is about Andy. Sure, the majority of the time the focus is on the plight of the toys, but at almost every moment it is the plight of Andy that is in the background.
We start with video of Andy playing with his beloved toys, games of make believe that demonstrate the unashamed imagination that is special to young children. But, the screen cuts to Andy preparing to leave for college. What will become of the toys; trash or attic or worse? At this point the viewer gets only a glimpse at Andy’s thoughts. He cares enough to put them away in the attic and he plans to bring Woody to college where he would likely end up as an ornament on a desk, seen, but not to be played with. It is a better fate than the attic.
If you’ve seen the movie you know about the plight of the toys, but one of the most revealing scenes is that of Andy searching for the toys he wanted to save and learning that they were accidently put out with the trash. Andy is visibly upset and then we don’t see him for a while. At that point perhaps he realizes that the childhood memory that he thought he was shuffling off to storage has been lostforever and we feel his loss.
The toys go through a number of misadventures until they find themselves, in a Jonathan Edwards moment, on the brink of annihilation, only to be grasped from the fire by the giant, divine “Claw”. They all make their way back to Andy who gets a second chance at redemption. Through the intervention of Woody he decides to give his toys, except for Woody, to Bonnie, a girl who we know will truly appreciate them and play with them just as Andy had done.
At the point when Andy stops at Bonnie’s home to give her the toys he demonstrates that he has not forgotten what the toys are, what they meant to him and what they still mean to him. He could have just handed the box to Bonnie or her Mother and drove off to college, but that wouldn’t have been right. He takes each toy, one at a time and lovingly hands it to Bonnie, making sure that she knows the true story of each one. And in the end he is left with Woody, who still plans to bring to college. But, Bonnie already loves Woody, just as Andy loved Woody when he was that young age. And Andy sees her love and gives Woody to Bonnie.
At this moment Andy finds redemption, just as Judah Ben Hur found his redemption through his three encounters with Jesus. Because, it is expected that Andy, having been true to his toys, would have left, gone on to the more important task of moving into college. After all he’s seventeen and playing with toys just wouldn’t be proper for someone moving on in this world. But, he stays and for the rest of the day he plays with his beloved toys and with Bonnie, recapturing the childhood he thought he had lost forever. And, it is at this moment that the tears start to flow, because for all of us we realize what we have lost. The childlike innocence that we used to have, imagination that can turn a piggybank into evil Dr. Porkchop, is lost; buried beneath the day to day routine that we call growing up and adulthood.
One of my favorite songs, since I was about eight or so, is “Puff, the Magic Dragon”. Years ago someone wrote that this song is about drugs, but if you read the lyrics it is clear that this song is about the losses we suffer when we grow up. Jackie Paper plays with Puff and the two go on the greatest adventures together, until Jackie grows up, Puff is replaced by other toys and forgotten. Without a little boy to bring the imagination there may be a toy dragon, but that is all there is, a lifeless stuffed animal. The imagination of a child brings toys and us to life.
Puff, the magic dragon lived by the sea
And frolicked in the autumn mist in a land called Honah Lee
Little Jackie Paper loved that rascal Puff,
and brought him strings and sealing wax and other fancy stuff. Oh
Puff, the magic dragon lived by the sea
And frolicked in the autumn mist in a land called Honah Lee
Puff, the magic dragon lived by the sea
And frolicked in the autumn mist in a land called Honah Lee
Together they would travel on a boat with billowed sail
Jackie kept a lookout perched on Puff's gigantic tail,
Noble kings and princes would bow whene'er they came,
Pirate ships would lower their flags when Puff roared out his name. Oh
Puff, the magic dragon lived by the sea
And frolicked in the autumn mist in a land called Honah Lee
Puff, the magic dragon lived by the sea
And frolicked in the autumn mist in a land called Honah Lee
A dragon lives forever but not so little boys
Painted wings and giant rings make way for other toys.
One grey night it happened, Jackie Paper came no more
And Puff that mighty dragon, he ceased his fearless roar.
His head was bent in sorrow, green scales fell like rain,
Puff no longer went to play along the cherry lane.
Without his life-long friend, Puff could not be brave,
So Puff that mighty dragon sadly slipped into his cave. Oh
Puff, the magic dragon lived by the sea
And frolicked in the autumn mist in a land called Honah Lee
Puff, the magic dragon lived by the sea
And frolicked in the autumn mist in a land called Honah Lee
Saturday, October 30, 2010
Project Run-Off
Elections come and go and every year it’s the same thing: a dozen or so men and women overwhelmed with their own sense of self importance vie for a spot on the ballot and then two or three square off in the election, hurling mud, false accusations and touting their own spurious virtues as they attempt to win our votes and “earn” a trip to Washington DC (or Austin, Albany or any of the other state capitols).
It’s time for a change. The election process in its present form is cumbersome, expensive and extremely annoying. It’s time to take a page from those people who know what the American people want and who know how to deliver it. It’s time for “Project Run-Off”.
Anyone who’s anyone knows that Gretchen recently stole the prize that Mondo deserved on “Project Runway”. Such are the vagaries of reality TV. But, the processes utilized by TV shows such as American Idol, Project Runway, Dancing with the Stars, among others lend themselves very well to our electoral system. After all, on most such programs a group of 10-15 contestants, most of which have had to demonstrate some prior qualification, compete week after week hoping to win the grand prize, some sort of fortune and fame. The process and result is similar to an election campaign, only a bit more entertaining and far more civilized.
So, starting with the 2012 Presidential campaign, which I’m sure will kick off the moment all the returns are in from the November 2nd election, all presidential wannabees will have to go through a grueling audition process, be selected by our panel of judges to go to the Elimination Round, scheduled to be held in Branson, MO in January 2011 and then be selected as one of the final fourteen candidates to compete each week on national television, starting during the sweeps month of May, with the finale in November 2012. In order to be truly fair and balanced, all networks will be given the option of picking up the broadcast.
Each week, the panel of judges will provide commentary and give their score for each contestant, but viewers also will vote, with eliminations based on a combined score, a la “Dancing with the Stars”. The panel of judges will consist of former president Bill Clinton, certainly qualified based on his past experience, former Hollywood Madame Heidi Fleiss, a woman well versed in intimate interaction with the rich and powerful, Iranian President Mahmoud Ahmadinejad, a man averse to everything American, but one that will surely provide even handed commentary and, finally, George, a bank teller from Piscatawy, New Jersey, selected to keep the panel connected to the common man.
Producer James Calhoun comments, “We want to flesh out the contestants. One week they may be asked to create a lavish state dinner for powerful heads of state, but with a budget of only $200, shopping limited to what’s on the shelves at the Pennsylvania Avenue Convenience Mart and preparation limited to two hours, utilizing only a single medium sized sauce pan and a hot plate. The next week they may be required to plan and carry out a military operation in Somalia, with a budget of only $1000, weapons limited to an arsenal of water pistols. The competition will test not only the resourcefulness, but also the character of the contestant.”
Director Clint Westwood added, “My favorite week will be ‘temptation week; each of our contestants will face some form of temptation, one that would not be uncommon to our president, but also selected based on the precompetition questionnaire each contestant will have filled out. It could be a White House intern offering sexual favors, a Russian spy with a sack full of money, a guest role on CSI or any of several others, some more unsavory than others. The goal is to demonstrate any character flaws before the contestant assumes the responsibilities of Commander in Chief, with his finger on that proverbial button.”
The competition will continue until there are only two contestants remaining. The final pair will live together in a one bedroom apartment for six weeks, cook for each other and have to perform a variety of tasks, sometimes working together, sometimes competing, all under the watchful eye of our judges and the our viewing audience. At the end of this period each will address the combined Senate and House of Representatives, laying out a program designed to face the challenges our nation faces today. They will then receive scores from our judges on creativity, originality and probable effectiveness. Viewers will then have twenty four hours to cast their votes, either by phone, texting or online, with each individual allowed one vote through each channel. The votes will be tallied by the accounting firm of Hood, Wink and Swindle and the results announced on the results show the following night.
We truly believe that “Project Run-Off” will make the election process more civilized, fairer and provide a far clearer image of our future leader. And, we will all be spared those boring, patronizing, insulting political ads that are a blight on our airways, stealing valuable airtime from truly important programs, such as “The Jerry Springer Show” and “Oprah”.
It’s time for a change. The election process in its present form is cumbersome, expensive and extremely annoying. It’s time to take a page from those people who know what the American people want and who know how to deliver it. It’s time for “Project Run-Off”.
Anyone who’s anyone knows that Gretchen recently stole the prize that Mondo deserved on “Project Runway”. Such are the vagaries of reality TV. But, the processes utilized by TV shows such as American Idol, Project Runway, Dancing with the Stars, among others lend themselves very well to our electoral system. After all, on most such programs a group of 10-15 contestants, most of which have had to demonstrate some prior qualification, compete week after week hoping to win the grand prize, some sort of fortune and fame. The process and result is similar to an election campaign, only a bit more entertaining and far more civilized.
So, starting with the 2012 Presidential campaign, which I’m sure will kick off the moment all the returns are in from the November 2nd election, all presidential wannabees will have to go through a grueling audition process, be selected by our panel of judges to go to the Elimination Round, scheduled to be held in Branson, MO in January 2011 and then be selected as one of the final fourteen candidates to compete each week on national television, starting during the sweeps month of May, with the finale in November 2012. In order to be truly fair and balanced, all networks will be given the option of picking up the broadcast.
Each week, the panel of judges will provide commentary and give their score for each contestant, but viewers also will vote, with eliminations based on a combined score, a la “Dancing with the Stars”. The panel of judges will consist of former president Bill Clinton, certainly qualified based on his past experience, former Hollywood Madame Heidi Fleiss, a woman well versed in intimate interaction with the rich and powerful, Iranian President Mahmoud Ahmadinejad, a man averse to everything American, but one that will surely provide even handed commentary and, finally, George, a bank teller from Piscatawy, New Jersey, selected to keep the panel connected to the common man.
Producer James Calhoun comments, “We want to flesh out the contestants. One week they may be asked to create a lavish state dinner for powerful heads of state, but with a budget of only $200, shopping limited to what’s on the shelves at the Pennsylvania Avenue Convenience Mart and preparation limited to two hours, utilizing only a single medium sized sauce pan and a hot plate. The next week they may be required to plan and carry out a military operation in Somalia, with a budget of only $1000, weapons limited to an arsenal of water pistols. The competition will test not only the resourcefulness, but also the character of the contestant.”
Director Clint Westwood added, “My favorite week will be ‘temptation week; each of our contestants will face some form of temptation, one that would not be uncommon to our president, but also selected based on the precompetition questionnaire each contestant will have filled out. It could be a White House intern offering sexual favors, a Russian spy with a sack full of money, a guest role on CSI or any of several others, some more unsavory than others. The goal is to demonstrate any character flaws before the contestant assumes the responsibilities of Commander in Chief, with his finger on that proverbial button.”
The competition will continue until there are only two contestants remaining. The final pair will live together in a one bedroom apartment for six weeks, cook for each other and have to perform a variety of tasks, sometimes working together, sometimes competing, all under the watchful eye of our judges and the our viewing audience. At the end of this period each will address the combined Senate and House of Representatives, laying out a program designed to face the challenges our nation faces today. They will then receive scores from our judges on creativity, originality and probable effectiveness. Viewers will then have twenty four hours to cast their votes, either by phone, texting or online, with each individual allowed one vote through each channel. The votes will be tallied by the accounting firm of Hood, Wink and Swindle and the results announced on the results show the following night.
We truly believe that “Project Run-Off” will make the election process more civilized, fairer and provide a far clearer image of our future leader. And, we will all be spared those boring, patronizing, insulting political ads that are a blight on our airways, stealing valuable airtime from truly important programs, such as “The Jerry Springer Show” and “Oprah”.
Saturday, October 16, 2010
Anti-Gravity
With election day right around the corner it’s time to start thinking about the 2012 campaign year. The usual run-up to the presidential election will feature the usual mundane ramblings by interchangeable Republicans and Democrats about taxes, jobs and the weaknesses and corruption of the opposing candidate. It’s time for a new party, one with a bold vision that looks to the future with imagination and a plan that will lift the people to previously unknown heights.
In this spirit the formation of the Anti-Gravity Party is now official. It’s time to look at some of the antiquated laws that hold all the world hostage to ideas that have grown old and stale. The Law of Gravity has been on the books for over three hundred years, ever since it was penned by Sir Isaac Newton. This law, brought into existence by only one man and never voted upon by a proper representative government, holds us down and limits the potential for growth by its very restrictive nature.
If the Law of Gravity were repealed just think of the endless possibilities. Currently, almost all our activities are limited to those areas close to our planet’s surface. Most construction is merely on the ground or just beneath. If gravity were eliminated, however, all the sky above us would be opened for the expansion of the human population. Food shortages would disappear as the burgeoning population moved to the sky, opening up precious land to agriculture. Energy shortages would become a not so fond memory as a world without gravity would allow for unrestricted mobility.
Of course, the elderly among us would be grateful for the potential health benefits. Bodies would no longer be subject to years of pummeling by the unrelenting force of gravity. The “settling” of so many of our body parts that accompanies the aging process, all mediated by gravity’s undiscriminating brutality, would be eliminated. It’s true that some Plastic Surgeons would see a loss of revenue as many of their procedures that were geared towards counteracting gravity’s long term effects would become mere footnotes in history of surgery textbooks.
So, it’s time to say “Down with Gravity, Up with True Freedom”, the Anti-Gravity campaign slogan. In the coming weeks more details about the Anti-Gravity Party will become available. Support is needed from everyone that is unhappy with the status quo. Donations as small as 25 cents will go a long way towards freeing humanity from the shackles imposed by the antiquated Law of Gravity. And, if this campaign proves a success other outdated precepts can be addressed. In particular, the Laws of Friction should bear some scrutiny, because it is clear that there is far too much friction in our world.
In this spirit the formation of the Anti-Gravity Party is now official. It’s time to look at some of the antiquated laws that hold all the world hostage to ideas that have grown old and stale. The Law of Gravity has been on the books for over three hundred years, ever since it was penned by Sir Isaac Newton. This law, brought into existence by only one man and never voted upon by a proper representative government, holds us down and limits the potential for growth by its very restrictive nature.
If the Law of Gravity were repealed just think of the endless possibilities. Currently, almost all our activities are limited to those areas close to our planet’s surface. Most construction is merely on the ground or just beneath. If gravity were eliminated, however, all the sky above us would be opened for the expansion of the human population. Food shortages would disappear as the burgeoning population moved to the sky, opening up precious land to agriculture. Energy shortages would become a not so fond memory as a world without gravity would allow for unrestricted mobility.
Of course, the elderly among us would be grateful for the potential health benefits. Bodies would no longer be subject to years of pummeling by the unrelenting force of gravity. The “settling” of so many of our body parts that accompanies the aging process, all mediated by gravity’s undiscriminating brutality, would be eliminated. It’s true that some Plastic Surgeons would see a loss of revenue as many of their procedures that were geared towards counteracting gravity’s long term effects would become mere footnotes in history of surgery textbooks.
So, it’s time to say “Down with Gravity, Up with True Freedom”, the Anti-Gravity campaign slogan. In the coming weeks more details about the Anti-Gravity Party will become available. Support is needed from everyone that is unhappy with the status quo. Donations as small as 25 cents will go a long way towards freeing humanity from the shackles imposed by the antiquated Law of Gravity. And, if this campaign proves a success other outdated precepts can be addressed. In particular, the Laws of Friction should bear some scrutiny, because it is clear that there is far too much friction in our world.
Thursday, October 7, 2010
Fearfully and Wonderfully
Psalm 139 declares that we are fearfully and wonderfully made. Over more than twenty five years spent caring for a wide variety of sick and injured bodies I have come to agree with the profound truth of this statement. The human body is constructed in a remarkable way that keeps it running during the most trying situations.
From the top of our heads to the soles of our feet our bodies are constructed to withstand extremes of temperature, assaults by invading organisms, physical and mental challenges and to perform with uncanny accuracy under the most arduous and taxing conditions.
So, let us start with the bottom of our feet. The plantar aspect or soles of our feet are a thick layer of skin and fascia perfectly suited for the stress and strain of upright walking. All the trumpeting of modern technological advances in athletic shoe design has not yielded any product that can claim to be superior to our feet. Indeed, recent research suggests that running barefoot or with a flat shoe with minimal padding is far superior to the thick soled, complicated athletic shoes that probably create more stressors for our feet than they prevent. It seems that Hobbits had it right.
Our bodies are maintained at a near constant temperature, 98.6 F or 37.5 C. We are equipped with very efficient heaters and coolers to keep us in the appropriated narrow range. If our body temperature starts to rise, be it secondary to a hot environment, physical exertion or some other factor we will sweat (or perspire if you are a lady). The moisture can cool directly, but the greatest cooling is a result of evaporation from our skin. External adjuncts, such as fans speed the process. Rapid breathing also can contribute to elimination of heat via the lungs. Of course this is carried to an extreme in dogs, who pant to cool themselves.
Conversely, our body is constantly producing heat. Routine, but essential metabolic processes all generate heat. In a cold environment this metabolism speeds up and more heat is generated, often manifested by shivering. Similarly, in the course of many illnesses a patient develops a fever. In the most extreme circumstances an ill patient will develop uncontrollable shaking called “rigors”. Such shaking is the result of rapid muscle contractions designed to generate heat and rapidly raise body temperature. In such situations the “thermostat” is turned up. Body temperature rises from the normal 98.6 to 101 or 103 or even higher. During the rising phase the patient complains that he feels cold and will attempt to cover himself to conserve body heat until the new temperature set point is reached. Although such high fever is a cause for concern and does carry its own set of risks, there seems to be some benefit, aiding our body’s fight against invading pathogens.
The fever may persist or it may dissipate, at which time the patient will usually have profuse sweating that lowers body temperature, the fever “breaks”. The fever must play a role in repelling an invasion by micro-organisms. The higher body temperature seems to have an inhibitory effect on certain viruses and bacteria. In the post operative patient fever is very common. Low grade fever, below 101.5 is probably secondary to a systemic inflammatory response unrelated to infection. Above this level, there is more concern that an infection might be present.
In any scenario, the fever has a purpose, be it fighting infection or assisting with the healing process and is one example of the amazing intricacies of human physiology.
Fever, of course, is a very common occurrence, be it a simple cold or life threatening sepsis. There is an aspect of human physiology and anatomy that is very important to our well being. Our bodies are built with long tunnels passing into and through us. The aerodigestive tract allows us to exchange a variety of elements with the outside world. The tracheobronchial tree starts at a shared entrance with the digestive tract. In the pharynx the two systems divide, with the respiratory limb ending in the lungs, two balloon-like structures that constantly inflate and deflate, exchanging inhaled oxygen for carbon dioxide, a byproduct of cellular metabolism. This essential mechanism keeps us alive. In fact, the first two letters of the ABC’s of trauma resuscitation are Airway and Breathing, (the third is Circulation), the jobs performed by the lungs.
But, it is the efficiency of our lungs and airway in light of constant bombardment by potential pathogens from the world around us that is truly remarkable. Our upper airway is equipped with mucus membranes that secrete mucopolysaccaride chemicals that trap invaders so they can be expelled or killed. Our upper airways are also outfitted with cilia, tiny hair-like structures that rhythmically beat and carry foreign particles away from the lower bronchial tree. We have the ability to cough, an extremely efficient mechanism that clears uninvited strangers from our lungs and trachea. Finally, our alveoli, the tiny balloons where gas exchange occurs, have all the components of our immune system standing at readiness to attack any invaders that make it to that level. Should this final line of defense be overwhelmed by bacteria, viruses or merely large particles, infection and/or impairment of gas exchange occurs. Pneumonia results from micro-organism infection of the lungs. Smoking damages cilia and allows particulate matter to reach the ends of our airways, eventually causing damage that is irreversible, the common condition called Chronic Obstructive Pulmonary Disease (COPD).
The other fork of the aerodigestive tract leads to the esophagus, stomach and the small and large bowel. While the lungs are efficiently scavenging wayward invaders, the gastrointestinal tract has learned to live in harmony with such organisms. Technically, the GI tract lumen is outside our bodies. It is a long, tortuous tunnel that snakes its way from our mouth to our anus. Inside this tunnel trillions of bacteria reside in a symbiotic relationship; welcome, as long as they stay in their place.
The numerous types of bacteria play a crucial role in maintaining normal physiology and immune function. It is likely that the resident bacteria stimulate a variety of immune functions, particularly during the early developmental years. The bacteria help with digestion of certain nutrients, breaking down complex polysaccharides into more digestible forms and also play a key role in the enterohepatic circulation of bile salts. In addition, the GI flora help with the absorption of certain vitamins and play a protective role for their human host by preventing the overgrowth of harmful bacteria within the gut lumen. As long as these tiny helpers stay inside the tunnel of the GI tract they are our friend. If they escape and invade surrounding organs or spaces, then they are most unwelcome. But, the normal GI tract physiology is a wonderful example of symbiosis between vary disparate organisms.
It is easy to see that the human body is an amazing creation that is well suited to living and flourishing in a hostile world. But what is it that sets the human apart from other animals. Other animals may run fever and are also bombarded by microscopic invaders. Is there anything that sets the human apart; an attribute that screams: “I am unique to the Homo sapien; you won’t find me in a dog or a chimpanzee”?
GK Chesterton said it was art that separates humanity from all the rest of creation. The ability to paint, write, sculpt, play or write music is the sole province of mankind. The ability to appreciate such endeavors is an even greater exclusive human attribute.
But what is it that allows a Bach to write music that soars, a Picasso to create unique, expressive paintings or a Charles Dickens to string together a series of words that actually make sense and have the power to entertain and inform? There are two components of the human body necessary for such creation. The first and most obvious is a brain, an organ that is incredibly complex, with mechanisms that are poorly understood, but capable of the most astounding achievement. Every original thought, every idea that became a concept and then a commodity started in the recesses of someone’s brain.
A mass of neurons, synapses, electrical impulses and chemical transmitters work in harmony to produce a thought. This thought may be the next logical conclusion from a series of previous thoughts or it can materialize from nowhere, an inspiration from an unseen Muse. Thoughts may be fleeting or they may coalesce into ideas. Eventually the idea comes to fruition and a new creation emerges. Humanity lurches forward into new realms with every thought and idea. Unfortunately, some ideas seem to cause us to step back.
The passage of idea to commodity requires that some form of work be performed and the principle agent of such work, particularly in the arts, but also in most other endeavors is the hand.
A complex organ made up of skin, bones, nerves, blood vessels and muscle, the hand is capable of turning black and white notes on a page into the sweet sound of Rachmininoff’s Piano Concerto Number Three; it can mold and shape a lump of stone into Michelangelo’s David. This incredibly versatile organ allows us to surpass all the rest of creation, to create the art that we all appreciate.
It is possible to provide substitutes for our hands; amazing creations have come from people who have lost the use of their hands. But, as we marvel at the human capacity to adapt to such disability, consider what these talented individuals could have done. Substitutes for our hands can be fashioned or trained, but they remain substitutes, at best performing nearly as well as a normally functioning hand, but never surpassing the hand.
A whole book could be written on the amazing design of the human body. Many of the intricacies are still being discovered, but it is this remarkable design, this body so perfectly suited to thrive in the world that surrounds us, that allows someone like me to slice a patient open from stem to stern, root around inside for a while, stitch the wound closed and then see that patient walk into my office a month later entirely well. Truly amazing.
From the top of our heads to the soles of our feet our bodies are constructed to withstand extremes of temperature, assaults by invading organisms, physical and mental challenges and to perform with uncanny accuracy under the most arduous and taxing conditions.
So, let us start with the bottom of our feet. The plantar aspect or soles of our feet are a thick layer of skin and fascia perfectly suited for the stress and strain of upright walking. All the trumpeting of modern technological advances in athletic shoe design has not yielded any product that can claim to be superior to our feet. Indeed, recent research suggests that running barefoot or with a flat shoe with minimal padding is far superior to the thick soled, complicated athletic shoes that probably create more stressors for our feet than they prevent. It seems that Hobbits had it right.
Our bodies are maintained at a near constant temperature, 98.6 F or 37.5 C. We are equipped with very efficient heaters and coolers to keep us in the appropriated narrow range. If our body temperature starts to rise, be it secondary to a hot environment, physical exertion or some other factor we will sweat (or perspire if you are a lady). The moisture can cool directly, but the greatest cooling is a result of evaporation from our skin. External adjuncts, such as fans speed the process. Rapid breathing also can contribute to elimination of heat via the lungs. Of course this is carried to an extreme in dogs, who pant to cool themselves.
Conversely, our body is constantly producing heat. Routine, but essential metabolic processes all generate heat. In a cold environment this metabolism speeds up and more heat is generated, often manifested by shivering. Similarly, in the course of many illnesses a patient develops a fever. In the most extreme circumstances an ill patient will develop uncontrollable shaking called “rigors”. Such shaking is the result of rapid muscle contractions designed to generate heat and rapidly raise body temperature. In such situations the “thermostat” is turned up. Body temperature rises from the normal 98.6 to 101 or 103 or even higher. During the rising phase the patient complains that he feels cold and will attempt to cover himself to conserve body heat until the new temperature set point is reached. Although such high fever is a cause for concern and does carry its own set of risks, there seems to be some benefit, aiding our body’s fight against invading pathogens.
The fever may persist or it may dissipate, at which time the patient will usually have profuse sweating that lowers body temperature, the fever “breaks”. The fever must play a role in repelling an invasion by micro-organisms. The higher body temperature seems to have an inhibitory effect on certain viruses and bacteria. In the post operative patient fever is very common. Low grade fever, below 101.5 is probably secondary to a systemic inflammatory response unrelated to infection. Above this level, there is more concern that an infection might be present.
In any scenario, the fever has a purpose, be it fighting infection or assisting with the healing process and is one example of the amazing intricacies of human physiology.
Fever, of course, is a very common occurrence, be it a simple cold or life threatening sepsis. There is an aspect of human physiology and anatomy that is very important to our well being. Our bodies are built with long tunnels passing into and through us. The aerodigestive tract allows us to exchange a variety of elements with the outside world. The tracheobronchial tree starts at a shared entrance with the digestive tract. In the pharynx the two systems divide, with the respiratory limb ending in the lungs, two balloon-like structures that constantly inflate and deflate, exchanging inhaled oxygen for carbon dioxide, a byproduct of cellular metabolism. This essential mechanism keeps us alive. In fact, the first two letters of the ABC’s of trauma resuscitation are Airway and Breathing, (the third is Circulation), the jobs performed by the lungs.
But, it is the efficiency of our lungs and airway in light of constant bombardment by potential pathogens from the world around us that is truly remarkable. Our upper airway is equipped with mucus membranes that secrete mucopolysaccaride chemicals that trap invaders so they can be expelled or killed. Our upper airways are also outfitted with cilia, tiny hair-like structures that rhythmically beat and carry foreign particles away from the lower bronchial tree. We have the ability to cough, an extremely efficient mechanism that clears uninvited strangers from our lungs and trachea. Finally, our alveoli, the tiny balloons where gas exchange occurs, have all the components of our immune system standing at readiness to attack any invaders that make it to that level. Should this final line of defense be overwhelmed by bacteria, viruses or merely large particles, infection and/or impairment of gas exchange occurs. Pneumonia results from micro-organism infection of the lungs. Smoking damages cilia and allows particulate matter to reach the ends of our airways, eventually causing damage that is irreversible, the common condition called Chronic Obstructive Pulmonary Disease (COPD).
The other fork of the aerodigestive tract leads to the esophagus, stomach and the small and large bowel. While the lungs are efficiently scavenging wayward invaders, the gastrointestinal tract has learned to live in harmony with such organisms. Technically, the GI tract lumen is outside our bodies. It is a long, tortuous tunnel that snakes its way from our mouth to our anus. Inside this tunnel trillions of bacteria reside in a symbiotic relationship; welcome, as long as they stay in their place.
The numerous types of bacteria play a crucial role in maintaining normal physiology and immune function. It is likely that the resident bacteria stimulate a variety of immune functions, particularly during the early developmental years. The bacteria help with digestion of certain nutrients, breaking down complex polysaccharides into more digestible forms and also play a key role in the enterohepatic circulation of bile salts. In addition, the GI flora help with the absorption of certain vitamins and play a protective role for their human host by preventing the overgrowth of harmful bacteria within the gut lumen. As long as these tiny helpers stay inside the tunnel of the GI tract they are our friend. If they escape and invade surrounding organs or spaces, then they are most unwelcome. But, the normal GI tract physiology is a wonderful example of symbiosis between vary disparate organisms.
It is easy to see that the human body is an amazing creation that is well suited to living and flourishing in a hostile world. But what is it that sets the human apart from other animals. Other animals may run fever and are also bombarded by microscopic invaders. Is there anything that sets the human apart; an attribute that screams: “I am unique to the Homo sapien; you won’t find me in a dog or a chimpanzee”?
GK Chesterton said it was art that separates humanity from all the rest of creation. The ability to paint, write, sculpt, play or write music is the sole province of mankind. The ability to appreciate such endeavors is an even greater exclusive human attribute.
But what is it that allows a Bach to write music that soars, a Picasso to create unique, expressive paintings or a Charles Dickens to string together a series of words that actually make sense and have the power to entertain and inform? There are two components of the human body necessary for such creation. The first and most obvious is a brain, an organ that is incredibly complex, with mechanisms that are poorly understood, but capable of the most astounding achievement. Every original thought, every idea that became a concept and then a commodity started in the recesses of someone’s brain.
A mass of neurons, synapses, electrical impulses and chemical transmitters work in harmony to produce a thought. This thought may be the next logical conclusion from a series of previous thoughts or it can materialize from nowhere, an inspiration from an unseen Muse. Thoughts may be fleeting or they may coalesce into ideas. Eventually the idea comes to fruition and a new creation emerges. Humanity lurches forward into new realms with every thought and idea. Unfortunately, some ideas seem to cause us to step back.
The passage of idea to commodity requires that some form of work be performed and the principle agent of such work, particularly in the arts, but also in most other endeavors is the hand.
A complex organ made up of skin, bones, nerves, blood vessels and muscle, the hand is capable of turning black and white notes on a page into the sweet sound of Rachmininoff’s Piano Concerto Number Three; it can mold and shape a lump of stone into Michelangelo’s David. This incredibly versatile organ allows us to surpass all the rest of creation, to create the art that we all appreciate.
It is possible to provide substitutes for our hands; amazing creations have come from people who have lost the use of their hands. But, as we marvel at the human capacity to adapt to such disability, consider what these talented individuals could have done. Substitutes for our hands can be fashioned or trained, but they remain substitutes, at best performing nearly as well as a normally functioning hand, but never surpassing the hand.
A whole book could be written on the amazing design of the human body. Many of the intricacies are still being discovered, but it is this remarkable design, this body so perfectly suited to thrive in the world that surrounds us, that allows someone like me to slice a patient open from stem to stern, root around inside for a while, stitch the wound closed and then see that patient walk into my office a month later entirely well. Truly amazing.
Subscribe to:
Comments (Atom)