October 8, 2010

The Breast Cancer Conspiracy

Cancer is bad.  I get that.  Each of my parents has survived two distinct kinds of cancer.  My grandmother died of multiple myeloma.  I'm going to say that the genetics aren't exactly in my favor here.  Now none of them were breast cancer, but I surely understand the urge to do something about it.  But this Facebook purse crap?  Uh, no.  Last year it was your bra color, this year it's purses.  We're raising awareness by being obtuse and dropping double entendre?  And what the heck do purses have to do with breast cancer anyway?  Women have purses?  And breasts?

Somehow these Facebook status updates are supposed to titillate and get so much attention that we'll all have our awareness raised about breast cancer.  Great!  But even if it works... so what?  What does awareness do in the face of a huge problem like cancer?  Awareness without action or a response is meaningless.  If we are aware of a great  truth but don't share it we haven't done anyone any favors.  As a doctor, if I'm aware of a problem but don't do anything it's called negligence.  We have vigorous conspiracy theories about politicians supposedly being aware of Pearl Harbor or 9/11 and taking no action.  Is breast cancer a conspiracy?  One where we have all manner of awareness but don't do anything about it?  Talking about it via Facebook statuses is the best we can do?

This purse wannabe-meme is ridiculous to me on another level.  It does nothing, and yet is all about  something that can effect real change.  Inside all those purses that women are innuendoing across Facebook lie wallets.  In those wallets lie money.  In money, there lies research and healthcare.  So I say we turn this silly thing on itself.  How much did that purse cost?  Give that much to cancer research.

I replace plenty of functional gadgets and gizmos with newer versions all the time, so I'm no better.  But I'm guessing that the purse replaced one that was still totally functional but out of style.  If we can afford that, we can afford cancer research for better treatment and more cures.  What if everyone gave to the American Cancer Society or some similar organization what their (or their significant other's) last purse cost?  Then you can update your Facebook status with that instead. Heck, you can be as salacious as you want about it.  "I pay $100 to get it." "I charged my husband $75 for it." Whee! We're having innuendo-laden fun now.  Or you could say what I'm about to, no innuendo required:

I donated $160 to the American Cancer Society's breast cancer efforts today.  How about you?

August 29, 2010

Neo goes running

I love the differences in how each foot will strike the ground.
From: http://goo.gl/Wpqn
Back in med school I started training for a marathon.  It seemed a good and ambitious goal.  I was excited about the prospect of saying I had done it.  What I wasn't so excited about was the part whre I have to run a whole lot to get ready for it.   Running is, generally speaking, miserable... especially in Dallas.  You have your ludicriously hot, combined with a good chance of pain.  I soldiered through, making it to about 12-15 miles at a (rather slow) time.

Then my shins started hurting.  Soon it was interview season for residency, and I was travelling a good bit.  The two combined were enough to throw me off my training regimen and I gave up.

Fast forward 5 years and I haven't really run since.  When we moved to Salt Lake City my new job afforded me the time to do some regular exercise.  So back to the running I came.  But it still wasn't much fun.  The odd thing is that part of me wants to enjoy running.  I like being outside.  I like not being a pudgy slob.  I don't really like running.

Recently Julia and I heard Christopher McDougall on NPR discussing his increasingly well-known book Born to Run.  The basic gist is this: mankind is designed to run.  We probably hunted millenia ago by running animals to death over the course of many hours. (Humans can sweat and therefore cool ourselves while exercising, our early prey couldn't, so they eventually drop from heat exhaustion... there's a pleasant thought for you.)  We didn't have big cushioned shoes when we were doing this, so why is it that we think this is how we need to dress our feet for running now?

The common wisdom is that you need the right shoes for your particular shape of foot, and that you need shoes that correct for the deficiencies in your stride etc.  But there's no real research to support this, and most of what does was paid for by shoe companies.  The military did an experiment where they assigned recruits to get running shoes specific for their foot shape or a style of shoe regardless of their foot shape.   Their results showed no difference between the groups, and possibly an increased risk of injury in those assigned shoes based on their arches.  A study in 1989 by Bernard Marti found that in his sample of over 4000 runners the most common factor in who was injured and who wasn't was the cost of their shoes.  If your shoes cost over $95 you were 2x as likely to be hurt than those who had shoes under $40.  A 1999 study out of McGill university in Montreal showed that thicker soles doubled the risk of injury.  The same authors did another interesting study where volunteers were asked to step off a slightly raised platform onto a platform covered in shoe sole material.  They were told that one material offered superior absorption, one was neutral and one had a warning that it offered poor absorption.  When stepping off onto the superior material subjects landed with significantly greater force.  The kicker is that all three materials were identical.  What varied was the advertising associated with each material.  A similar study showed that gymnasts will land harder when there is more padding beneath them.  The speculation is that they are instinctively trying to do what it takes to feel stability under them.  Or maybe it's just compensatory behavior.

So while the issue isn't fully proven, I was intrigued enough to give it a shot.  I bought some Vibram Fivefingers and set out for a quick one mile jaunt to see how my body naturally wanted to run and all that.  Well my body may be made to run, but it's gotten stupid over time.  I thought one mile would be a very conservative distance to go for my first time at this ("go slow" being the most ubiquitous advice anyone will give you about barefoot or minimalist shoe running).  The fiery pain in my calves attested to the fact that one mile is in fact not slow enough.  I was used to running a few miles at a time without it being insanely difficult.  But that was not using the same muscles as this.  I felt like the running version of Neo from The Matrix.

Runner Neo: Why do my calves hurt?
Morpheus: Because you've never used them before.  Now weep quietly.  Answers are coming.

After recovering from that I was motivated to do the homework I should have done first.  Something along the lines of 1/8th of a mile would have been a better place to start.  I've built up to about 2/3rds of a mile without a problem.  I've also started running barefoot more and in the Vibrams less.  That may well change as it gets cold here.  But the whole thing is a lot more fun, which was kind of the point.  I mean look at those dudes in the picture up top... which one looks like he's having more fun?

March 16, 2010

Why can't I choose my battery?

Mr. McGuire: I want to say one word to you. Just one word.
Benjamin: Yes, sir.
Mr. McGuire: Are you listening?
Benjamin: Yes, I am.
Mr. McGuire: Batteries.

OK, that's not how it goes. But if it were made today, that's how it should go. Allow me to descend into wanton nerdery for a minute. My wife is thinking of joining the 21st century (or perhaps the 20th) and getting a cell phone she will carry around with her and actually use on a daily basis. As anyone who has tried to call her cell # can attest, it's rarely with her, and if it is the battery is probably dead. I have been a happy iPhone user for a couple of years now. If it weren't for Twitter I don't think she'd have much motivation to get with the times, but the idea of updating on the go (as was the original intent) appeals to her.

So we're looking at our options. The iPhone is nice and all, but depending on where we move to there may not be very good coverage with AT&T. Verizon seems much more likely to work out, so we're looking at Android based phones. But regardless of what we end up getting her, I am struck by our lack of choices. Oh sure, there are a number of good phones. And with something like the iPhone you can even pick how much storage space you want on it. But increasingly that's irrelevant.

I carry only a portion of my music on my phone. The rest I can stream from my home computer, or listen to internet radio like Pandora or Last.fm. Google documents abound, our email is all web based... on mobile devices cloud computing isn't some emerging thing, it's already here. I also drain my battery to near death over the course of every single day. So what matters isn't how much storage space you can give me, it's how long my battery will last while I access all that decentralized information. And that's where I run out of choices. I can choose the storage space, or color, or calling plan, etc of my phone, but I can't do a thing about the battery. Increasingly this is what matters. Batteries are the new storage space for mobile devices. Why doesn't anyone offer the option of paying extra for a more robust battery?

Perhaps it is that we lack choices in general when it comes to batteries. It seems like they are the bottleneck to electric cars, and that by and large we haven't seen a breakthrough battery technology in a long while. But I have to believe that there will be a market for battery choice. I also wonder how long it will take before we're as fluent in battery terminology (NiCd, Li-ion, cell number, energy density, etc) as we are in horsepower, CPU clock speed or other more traditional metrics of speed or power. In the near future I think the battery is going to be the key thing we care about in a lot of devices.  Now if they can just let me care about it in the next couple of months, that would be great.

February 17, 2010

If You're Going to Salt Lake City

I recently visited Salt Lake City to interview for a position with an allergist there.  Once I found out I was going to go out there I could not stop thinking about Scott McKenzie's San Francisco.  But in my head it's something along the lines of:

If you're going to Salt Lake City
Be sure to wear a three button suit with care.
If you're going to Salt Lake City
You're going to meet some business people there.

It's a work in progress.

At any rate, the trip was very good, and we'll see what comes of it.  The opportunity seems like a really good one for a lot of reasons.  Professionally it's very good: a solo practice that is growing, with people that seem like they would be very good to work with.  The timing is right, as the doctor wants to make a decision in the next few weeks.  The area is stunningly beautiful.  Maybe for people who grew up in the mountains it's no big deal, but I sort of feel like a landlocked person visiting the ocean for the first time.  "Look!  Snow!  Mountains!  Seasons!"  The city itself is an interesting issue.

The SLC area seems to be growing, and from a professional standpoint that's of course a good thing.  We initially were looking at Portland, Seattle, etc.  While those are great places, it turns out that we're not the only ones who think so, and the market for allergists is pretty saturated.  There are a couple of advertised jobs in SLC, which says something right off the bat.  Some people speculate that Salt Lake of today is Portland or Denver from a decade or so ago.  Soon maybe it too will be a hip destination where all the cool kids will want to live.  We had some concerns about the LDS influence there, but I think we've become much more comfortable about that.  For starters the city is very kid friendly as a result of their influence, and in many ways they are fantastic neighbors.  But in SLC itself the population is only 30-40% LDS.  It goes up as you get out into the suburbs and other parts of Utah, but Salt Lake itself turns out to be a fairly liberal college town.

The LDS issue made me think on a number of levels though.  The biggest one is what it will be like for our kids.  Will they be socially isolated for not being Mormon?  If so I think it's probably our fault in large measure, for not finding some of the few thousand kids who also aren't Mormon for them to relate with if need be.  It would also be very interesting to live in a place where orthodox Christianity is undeniably the minority opinion.  If we're being honest with ourselves pretty much every place in the country fits this bill.  But we're not honest, and still hold to the notion that this is a Christian culture and a Christian country.  Perhaps in name it is, but in many respects that name has been co-opted by politics and agendas and a great many non-spiritual driving factors.  I have to imagine that living in a place where the dominant religion is not your own will help you to understand the first century church better.  It will force you to decide what it really means to live what you believe.  Plus I don't think the Mormons are going to be burning any evangelicals on the stake.

In fact, I find it interesting to ponder the very systematic and organized way that relationships are built between the LDS and their neighbors.  I was told that each house on a street is assigned to an LDS-member who lives nearby.  They are responsible for that house, regardless of what type of people live in it.  Should a natural disaster or a power outage or whatever occur, it is their job to make sure everyone in that house is OK.  Say what you will about the structure and the expansion efforts and such of the LDS church, and you could argue that being told to do these things by your leadership is merely legalism and not true spirituality, but how much of that has mainstream Christianity lost?  Maybe you're being a good samaritan because you were told to, but for the person you help the impact is the same.  I am forced to wonder what the country would think of evangelicals if each one had to look out for their neighbors and do good deeds in the name of the church.  To my discredit I don't even know most of my neighbors.  We drive all over the city to go to work, shop miles from where we live, and go to churches that have little to do with location and much to do with finding the people and the beliefs most similar to our own.  Not that these things are all bad, and some of that is a natural result of how we build our cities and organize our lives.  But I have to wonder if a little forced neighborliness would really be a bad thing.