Rural Suicide and Mental Health; my column today at Politico.com.

Here’s a column of mine, published today at Politico.com.  Everyone wants to make these issues into right/left battles.  I was asked to write this, and it concerns mental health, which is a topic very important to anyone in emergency medicine.  I have written for publications of various political orientation and I’ve tried not to let the liberal/conservative division limit me too much.

http://www.politico.com/agenda/story/2017/04/suicide-er-rural-hospitals-000398

Thanks!

Edwin

 

Can we Change our Minds?

It’s easy to be excited about facts when they support our own opinions. It’s nice to believe that uncomfortable facts are fake. Likewise, it’s comforting to believe that everyone who disagrees with us is ignorant. When the truth is so obvious, we say, how could anyone but an uneducated bumpkin deny it? And yet, it seems that much of our knowledge is incomplete and that our deeply held beliefs may be more fragile than we imagine.
I was thinking about this recently when I listened to a podcast about evolution. It was a discussion about some events that happened last November at the venerable Royal Society in London. It turns out that some well-respected scientists think that perhaps evolution isn’t just due to ‘random mutation and natural selection over time.’
According to some researchers at the meeting, our DNA is even more amazing than previously believed. It appears that external stressors change the way plant and animal DNA works so that creatures adapt much more rapidly than we thought. This doesn’t necessarily mean evolution is wrong; but certainly our understanding of it is probably incomplete.
This poses a challenge to some beliefs that have been held in exactly the same way by scientists, and the lay public, for a very, very long time. Can we handle the change in paradigm? Could we ‘adapt’ if we suddenly found out that evolution is a bit off? After saying for years that it was a not a theory but a hard fact?
The science of medicine changes all the time. For the past 20 years, physicians in training were taught that they should never hesitate to boldly give narcotic pain medication to patients who asked for them. Because after all, ‘why would anyone mislead their doctor?’ And who were physicians to judge? We were told, ‘you can’t create an addict in the ER.’
Except, according to some pesky researchers, it appears you can. Some people can become addicted after a very short course of pain medication. They’re just wired that way. And now pain pills and heroin are killing people in staggering numbers. Our venerable, white-coat clad instructors were wrong. (What? Physicians and professors wrong? Perish the thought…) And now we have to face the facts and change our behaviors as doctors.
New, intriguing information presents itself all the time in many areas of study. The bacteria in our guts may have to do with obesity and mental health. Litter boxes may contribute to human mental illness due to a parasite cats sometimes carry. Socialism in Venezuela is a disaster. Foreign aid sometimes worsens international crises. Who knows what’s next?
But what if we discovered a slam-dunk gene for religious faith that was so powerful that those who had it couldn’t help but believe? Could their detractors still regard them as simpletons or haters? What if we learned that the absence of that gene made for equally solid atheists? How would we believers treat them? What if some transgender people really have a body dysmorphic problem like anorexia? Or that there is a genetic marker that indeed makes them identify with another gender? What if discussing it isn’t hatred, bigotry or compromise, but compassion? What if we find, someday, that the science of climate change isn’t settled?
Obviously science advances. We love that idea until it bumps into us. What do would do when science, or new historical information, or some other new finding puts our personal beliefs in question? Can we let go of our political correctness? Or religious rigidity? Can we stop calling our opponents rude names? Are we OK with new facts when they contradict ideas dear to us?
It’s hard to let go. But just as we look back on our ancestors and smile about their quaint beliefs, someone will eventually do the same to ours. It will likely be the case that we were wrong about many things in ways we could never have imagined.
As times change and knowledge grows, we should all be a lot kinder in the way we view the opinions of others and cautious in the way we view ours own. Today’s unassailable fact could become tomorrow’s flat earth. A little humility, a little willingness to open our eyes and the courage change our minds, are probably in order all around.

A Simple, Cheap, Health Fix.

This is my latet column in the Greenville News.  Healthcare is expensive, so it’s much cheaper not to need it in the first place.

http://www.greenvilleonline.com/story/opinion/contributors/2017/03/02/commentary-simple-health-fix/98636916/

I have never wanted to be the medical advice columnist. ‘Dear Dr. Leap, my feet sweat all the time. I’ve tried everything! What should I do?’ Nope, I’m not your guy. Neither do I want to opine on study after study about statin drugs for cholesterol or discuss whether women should take estrogen. There are physicians who love those questions! And I think they’re fantastic. But I’m an emergency medicine physician. Which means I have an attention span only somewhat longer than a Jack Russell Terrier. So as long as no squirrel runs across the room, I’ll finish my thought.
I think a lot about what brings people to the hospital. And I have come to some conclusions. If people want to live healthier, longer and better, then the solutions are not especially complex. But they involve pretty hard decisions. They don’t, however, involve pills.
Obviously some people have terrible diseases and medical events and simply can’t help the medications they need to take. I’m not talking about them. I’m talking about the vast number of Americans who, with a few lifestyle changes, could take no medications and be just peachy.
So here goes. Stop smoking. No, don’t even start smoking. It does nothing but bad things. It makes your teeth decay, gives you mouth, throat and lung cancer, causes emphysema, worsens asthma and costs way too much money. Money you could spend on important medicine, or no medicine, on your kids, or could save for a trip to someplace cool. Seek out help from a physician or support group and put down the coffin nails.
Next, eat less. Being overweight is bad. I’m not ‘fat shaming,’ I’m trying to save lives. Being overweight is unsafe, since you can’t rescue yourself from danger as easily. Being overweight makes you sluggish, strains your heart and causes your hips and knees to wear out, resulting in joint replacements. It makes it harder to exercise. It contributes to diabetes. Obese patients are harder to care for when they’re ill; they don’t always fit in CT scanners and their surgeries are more difficult and take longer to heal. How do you lose weight, you ask? There are lots of plans and lots of people to help. But it starts with the decision to sometimes look at yummy food and say ‘nope, I’d rather be a little hungry but healthy.’
Now this is radical: stop sitting around. Do things. Be busy. Walk, hike, have an active hobby. Stop binge watching shows for hours (in fact, a study not long ago suggested that binge watching increases your risk of dangerous blood clots in the lung). Step away from the tablet, the television, the gaming system and go outside. You needn’t run marathons or Iron Man races to just keep moving. Humans stayed fit for millions of years before there were gyms or exercise equipment. Of course, they were busy trying not to starve or get eaten, so they had an edge on us. But they died by 30 or 40, so we have it a little better.
Also, don’t take drugs of abuse. And if a doctor offers you a narcotic, unless you have cancer or a badly broken bone, say ‘no thanks.’ You’ll be better off in the end. Drugs are killing people in staggering numbers; so is alcohol. Therefore, while you aren’t doing drugs, don’t abuse alcohol. Don’t drink and drive, drink and boat, drink and hike, drink and shoot, drink and fight; you get it. Alcohol is dangerous. Also, wear your seat belt. Or helmet if you ride a bike or motorcycle. Additionally, don’t text and drive!
For simple illnesses like colds, don’t take antibiotics. Don’t ask for them and decline them unless absolutely necessary. In fact, for simple illnesses and injuries avoid doctors, X-rays, CT scans and all of it.
I could go on. But these things alone, if taken seriously, would change the face of medicine and the financial makeup of the entire healthcare system. And the best part? They don’t involve a prescription, an X-ray or even a visit to a doctor. They’re low-tech, low-cost interventions.
Some of my favorite patients are the 90-year-olds who show up for something simple; a bruise or a cut, fresh from yard work.

‘Sir,’ I ask, ‘what medicines do you take?’
‘None.’
‘Who’s you’re doctor?’ ‘Son, I don’t have one. Can I go home now? I have beans to pick!’
‘Well there you go. That’s why you’re 90.’

Life and Limb: the Rural ER

Welcome, readers, to my new column in the Daily Yonder!  It will concern rural emergency medicine and things I see through that particular lens.  Have a great day and feel free to share liberally!  I’m honored by the Daily Yonder to be included on their team, dedicated to all things rural.

Life & Limb: In Rural E.R., Exams Include the Obvious Questions, Like ‘Did You Get a Turkey?’

What Jesus would do, and say, today…

My most recent Greenville News column.

http://www.greenvilleonline.com/story/opinion/contributors/2017/02/10/commentary-some-thoughts-what-jesus-would-do/97743538/

Some thoughts on what Jesus would do today 

(As we all grow more and more divided and arrogant in our views.)
Given the current political climate, a lot of our citizens are reasonably sure they know exactly what Jesus would do if he were here now. I happen to have a few thoughts on that topic myself.
It seems to me that first and foremost he’d disappoint us all by not debating the way we do. He’d actually love the people he was talking with, and want the best for everyone. Screaming matches and endless point-counterpoint were never his thing, or so it appears in the scriptures.
I think that while everyone was trying to convince everyone else about their opinion (and not changing anybody’s mind), he’d be on some street-corner healing sick people. And he’d be doing it in a way that was so dramatic people would think he was a charlatan. ‘There’s no way that paralyzed kid can walk now! It’s just a trick to convince simple-minded, unscientific people!’ That’s what some would say. And Jesus would keep right on healing cancer, HIV, gunshot wounds, schizophrenia and other awful problems.
And those people who were so full of inner pain that they wanted to die, and kept thinking that they had no worth? He’d heal their pain, and cast out demons from them. That’s what the Bible says he did, anyway. He said he was God and he taught about things like demons. People probably wouldn’t like that much; neither atheist skeptics or solid, staid, educated Christians. But the people he healed would love it.
Of course, he’d talk to people at the marches, the rallies, in the halls of legislatures and in the churches. Unlike our milquetoast, pale-faced images of gentle Jesus from Bible story-books, he would sometimes look (and be) angry. Angry about injustice and cruelty, angry about the neglect of the needy. He would also be angry about false teachers and others who robbed men and women of faith in God and left them nothing to comfort them. As before he would be angry at anyone who led others to sin. Occasionally, he would be sarcastic and insulting. He’d have harsh words for lots of pastors and sanctimonious believers. Read the Bible; it’s how he was.
Our many-flavored hatreds would give him plenty of fuel for parables, in order to guide us to the truth. But he would also be unhappy about the division and ideas heaped on people that leave them feeling worthless. Like the idea that humans are a scourge, a virus on earth. Or the obsession with hungry, sick animals while children face the same. And the way men and women are weighed down with one of two burdens, endless victimhood and its chiral image, the belief that some people’s ‘privilege’ causes all the world’s problems. He came to liberate everyone from beliefs that imprisoned them. He condemned religious leaders in his day for giving people burdens but not helping carry them; he would do the same for modern politicians and educators, ministers and mullahs who create anger, tension and violence in order to control and manipulate others.
Obviously, would talk about ‘sin,’ from greed to sexual immorality to idolatry and all the rest. He talked about those things a lot. He’d preach about the coming Kingdom of God and eternal life and redemption and judgment. He was serious about sin, but kind to all sinners, right, left and moderate. Conquering sin and death was his main mission, after all.
That would be just about enough for lots of folks. Because they didn’t come to be pressured about morals or lectured about their personal lives or told stupid fairy tales; they came for justice! For revolution! And they’d ask him to leave. Or maybe scream at him, because it’s what we do when we’re angry and sure we are right.
Ever the gentleman he would leave if asked. But before Jesus left, he might remind all of the passionate, angry people of what he said before:
“You have heard that it was said, ‘love your neighbor and hate your enemy.’ But I tell you, love your enemies and pray for those who persecute you, that you may be children of your Father in heaven. He causes the sun to rise on the evil and the good, and sends rain on the righteous and the unrighteous.’
It seems to me that in his absence he remains present, and his teachings still condemn our hatred 2000 years down the road. If only we’ll listen.

Sanitized Human Experience in a Reality Challenged Culture

 

My column in today’s Greenville News.

http://www.greenvilleonline.com/story/opinion/contributors/2017/01/27/commentary-hollywood-sanitizing-human-experience-reality-challenged-culture/97136066/

I love a good action movie. I tend to prefer the Marvel franchise over DC. I think Superman is too perfect and Batman just too moody. I mean, which rich guy would you rather party with? Bruce Wayne or Tony Stark? Exactly.
But I have always been amazed at the amount of destruction wrought by my beloved X-men and Avengers when battling monsters, aliens, gods and other ne’er do wells. Buildings and freeways and bridges destroyed, untold cars exploding, earthquakes and giant holes in the ground. It’s apocalyptic! In fact, if that were really happening, the toll of human dead would be staggering. Tony Stark could probably make a fortune selling coffins, and ER docs like me would be overwhelmed.
Movies like that are obviously meant to be outlandish; and to take your hard-earned vacation money. But I fear that television and movies sanitize too much of our bitter human experience, making misery somehow palatable.
Take regular action films for instance. Whatever the underlying story, it seems that gun-fights are everywhere! Bullets fly in all directions. Then, at the end of it all, bystanders aren’t injured. Nobody lies moaning or screaming for help. We don’t see the pools of blood spreading across the ground, the skin becoming more clammy, more pale as police call for an ambulance, as the paramedics or surgeons try frantically to stop the flow. We don’t see, or hear, the family member of the dead when they’re told what happened. I’ve done that a bunch and it’s something you never, ever forget. Scenes like that don’t make for fun entertainment.
In our movies nobody sees survivors, good and bad, condemned to paralysis, or with colostomies or amputations from those exciting gun-fights. What about characters punched and kicked to a pulp, their faces bloodied until they can’t breathe? They get chronic headaches, brain damage, vision problems, inability to chew or smell. I have seen them die too.
But we’re oblivious to more than real violence. When we watch trials and cheer for justice, when we want this or that person to go to prison for their crime, we sometimes forget that the imprisoned don’t see their families much, and their families miss them for years, or for life. And let’s not forget that prison, real prison, is a place where violence, rape and drug addiction are far too common.
I hate it when someone says, ‘guess he’ll get it good in prison; I hope he enjoys his cell-mate,’ or some other bit of cruelty. It’s never OK to wish for someone to be raped, male or female. Ever. Although prison has a necessary role, maybe we need to revisit the boundary between punishment and torture. We should want better for even the worst; especially if we call ourselves Christian.
There are others disconnects, of course. When characters in movies have multiple sexual partners, it looks like nothing but fun to modern, sexually liberated viewers. But we seldom see the misery of loneliness that comes from all of those connections, made and broken. Films and television do a poor job of showing us the pain and terror of HIV or hepatitis, the anxiety of unplanned pregnancy and the reality of abortion. They fail to reveal the suffering brought by cervical cancer associated with HPV. The don’t show the tears shed over infertility caused by chlamydia or gonorrhea infections; the danger to newborns caused by herpes. It’s also hard to fathom the fact that many who work in pornography are miserable in heart, mind and body, and some around the world are compelled to do it against their will, working as sex slaves.
On screen, getting drunk is just what you do. We have all laughed at intoxicated characters, for as long as actors have played them. But we seldom consider the mortality and disability from car crashes. We rarely think about the way men and women die from head injuries or asphyxiation due to alcohol or drug abuse. We don’t get to witness the abuse and neglect of children, the cruelty to spouses, the lost hope, lost productivity and broken families from both.
We have to remember that what we see in movies and television is seldom the whole story. Sometimes, the truth is better. And sometimes, unfortunately, the reality is a lot worse, and far darker than the screenwriter, producer or director can ever, or would ever, convey to our entertainment soaked, reality challenged culture.

My column in the Winter 2017 Gray Matters, Newsletter of the Osher Lifelong Learning Institute at Furman University.

 

THE NEWSLETTER OF THE OSHER LIFELONG LEARNING INSTITUTE @ FURMAN

http://www.furman.edu/sites/OLLI/member-resources/Documents/GMJan2017-PDF_reduced.pdf

PAIN MANAGEMENT AND THE TIE TO ADDICTION – PART 2

Sometimes medicine offers us wonderful, almost unimaginable gifts. Heart attacks that were devastating, life-altering events a few short decades ago are now treated with an expediency and skill that our grandparents couldn’t imagine. A couple days pass, and the victim is home with stents in occluded arteries and directions to modify activity and diet. Pneumonia, once the ‘old person’s
friend’ (so called because it took the aged to eternity), is far less terrifying, thanks to both antibiotics and the pneumonia vaccine.

However, some of the things we do give benefits that are less clear. Although it could be an entire column in itself, the ‘stroke center’ movement, with the promise of miracles from ‘clot-busting drugs’, is a thing full of as many questions as answers. And what about depression and anti-depressants? When I looked up the side-effect profile of an anti-depressant a friend was taking, I was reminded that all of them have the potential side effect of increasing suicidal behavior.

But what about pain management? Thanks to improved understanding of the physiology of pain, the persistence of medical providers, and the investment and research of pharmaceutical companies, we have a wide array of pharmaceuticals available for the treatment of pain. Some are over-the-counter, like acetaminophen and ibuprofen. And others, those we refer to as narcotics or opioids (because in previous times they were derived from opium), are useful, potent, and (as is increasingly evident) fraught with danger unless used very cautiously.

Of course, for a very long time, physicians were taught to be judicious in prescribing narcotics. Our venerable teachers warned young doctors in training to be frightened of the side effects. We were especially aware of the very immediate danger that patients would stop breathing and die due to excess sedation. We were also aware that over time, patients on narcotics might develop problems with addiction.

About 20 to 25 years ago, that whole paradigm shifted and physicians were suddenly accused of callous disregard of suffering for prescribing too few narcotics. I remember this because I was in my emergency medicine residency at that time. We were constantly reminded to give more narcotics and be sensitive to pain. We were taught to use the ‘pain scale,’ in which a patient-reported score of zero meant no pain and a score of ten meant ‘the worst pain of your life.’ Never mind that it was entirely subjective and that there was no objective standard, no ‘painometer’ against which to measure it. We were instructed to see pain as the ‘fifth vital sign’ after blood pressure, pulse, respiratory rate and temperature. Of concern to many, these initiatives coincided with the development and aggressive marketing of ever more powerful, addictive medications like Oxycontin tablets and Fentanyl patches and lozenges.

Patient satisfaction surveys included the question ‘was your pain adequately treated?’ Physicians were castigated when those satisfaction survey scores fell. Physicians were instructed, by non-clinician

15

administrators, to give more pain medication to make patients more satisfied. (A satisfied customer/ patient is one that may come back!) Physicians who resisted, in the name of science or safety, were too often met with threats of reduced income or job loss if patient satisfaction scores fell. In some instances, physicians were (and still are) reported to state medical boards for alleged inadequate treatment of pain.

I sincerely believe that most of those encouraging us to write more narcotics prescriptions did so out of genuine concern and compassion. People are in pain, so why not treat the pain? In medicine, where science meets suffering humanity, it’s so easy for us to say, ‘Well, it just makes sense, doesn’t it?’ We assume that our compassion will be supported by our science. It happens with infections; sure it’s probably a head cold, but what’s the harm in an antibiotic to keep the patient happy? The child bumped her head pretty hard, so what’s the problem with a CT scan, even though she looks good? The parents are customers, after all, and want a scan!

With tragic consequences, our compassion sometimes causes harm as the Law of Unintended Consequences rears its ugly head. For instance, those antibiotics for colds? They can cause dangerous allergic reactions and life-changing intestinal infections requiring hospitalization or surgery, and resulting in death. Those CT scans everyone wants? Physicians are trying to reduce the number of scans, as many of us are concerned that they may induce malignant tumors later. And those pain medications? The evidence looks pretty damning.

Addiction to prescription narcotics is growing at a terrifying rate in the U.S. Likewise, death rates from narcotic overdoses have soared. The U.S. has seen 165,000 deaths from opioid overdose between 1999 and 2014. http://www.cdc.gov/drugoverdose/data/overdose.html. In fact, opioid-related deaths have now surpassed deaths from firearms in the United States. http://www.cbsnews.com/news/drug- overdose-deaths-heroin-opioid-prescription-painkillers-more-than-guns/ Admittedly, some of those deaths are not due to prescription opioids but rather to injected heroin. However, many heroin addicts began their addiction issues when taking legitimately prescribed pain medication.

Sadly, seniors are not immune. Physicians don’t want to see seniors suffer, so they often give narcotics even for pain that in decades past would not have been treated with those drugs. We give them for back pain, headache, arthritis, or other less serious conditions. And we use them extensively in treatment of chronic, intractable pain. In fact, in 2015, one-third of Medicare recipients received a prescription for an opioid analgesic; some 40 million prescriptions. https://www.statnews.com/ 2016/06/22/many-opioid-prescriptions-seniors/

Furthermore, seniors not only develop addiction, not only die from accidental overdoses, their narcotic analgesics have a host of side-effects, including (but not limited to) the following: excessive sleep, impaired thinking, increased pain sensitivity, nausea, constipation, and cardiac arrhythmia. In addition, opioid drugs contribute to weakness and loss of balance and thus to falls, resulting in head and spine injury, various fractures, and other trauma. Their already impaired reflexes are dampened by their medication so that for those who still drive, it becomes an even more dangerous activity than before.

No one is immune from this devastating epidemic, not rich nor poor, not young nor old. The medical profession, the mental health community, law-enforcement, social services, churches, families, and friends all have to come together and find ways to roll back the rising tide of death and addiction, which came as an unforeseen outcome of attempting to ease suffering with compassion and science.

This problem will be highlighted this spring at an OLLI bonus event, March 31, 2017: Seniors and Opioids: Unexpected Origins of a Greenville Epidemic. I will be speaking in conjunction with James Campell of the Phoenix Center addiction and rehabilitation facility. We really hope you join us to learn more about this pressing public health crisis.

Sports Impairment and My Southern Man-Card

 

This is my column in today’s Herald-Dispatch.  My hometown newspaper in Huntington, WV!

http://www.herald-dispatch.com/opinion/edwin-leap-don-t-worry-you-won-t-lose-your/article_3706dd19-3472-520d-856d-09e3580d3886.html

It’s a terrible confession to make as a Southern male, but here it goes. I don’t care a lick about sports; not leagues, not high school, not college not pro. It feels liberating to say so. I figured I might as well be honest about it, because I’m forever confronting the reality of my sports-impairment in various and sundry ways.
One way my dilemma arises is I’m standing in the check-out line at a store, wearing my WVU t-shirt when another customer asks what I think of the Mountaineer’s chances this year. I usually make some sort of generally non-committal remark about how ‘I sure HOPE they do better this year!’ Which means that at some point in the distant future, if they manage to win a championship, I’ll have to be more careful and say ‘well, if LAST year was any indication this should be a good one!’ I try not to make eye-contact. It’s too uncomfortable.
What I usually want to explain, but never bother, is that I wear the shirt because I grew up and went to school there. And it was awesome and I have wonderful memories (same reason I wear my Marshall shirt). But it’s hard to stop a die-hard sports fan and say, ‘well, the truth is I really didn’t have time for sports because I was studying a great deal, but I’m proud I graduated!’ That makes people go to the next checkout line and shake their heads.
I’ve noticed the same thing at church. I remember finding myself in deacon’s meetings with little to contribute to the discussion at zero dark thirty Sunday morning. As everyone made the rounds of the previous day’s games, it was ‘Ed, Marshall did well yesterday didn’t they!’ ‘Sure did…(I guess).’ I put my head down, ate my biscuits and gravy and (since I live in South Carolina) I just let the orange or garnet wave pass over.


I’m not trying to be a snob, please understand. In my childhood I just wasn’t formally taught anything about athletics. Admittedly, my dad built a basketball court for me in the back yard. All the neighborhood kids and I had a great time there at all hours of the day and evening. But the rules were not exactly formally enforced. It was as much social time as athleticism. I also learned a little about football in the front yard. Specifically, I learned that ‘touch’ can be widely interpreted. I realized that lying on my back gasping for air one day, looking up at the fading blue sky.
I remember once around sixth or seventh grade that I went to the mother of one of my more athletically inclined friends and asked about joining a basketball league. She was kind, in a ‘bless your heart’ sort of way, and said we might be able to cram on the rules but it wasn’t looking good. Age 12 and I was already too old to start. I got the message and moved on without looking back.
Instead I filled my days with walks in the woods, turning over rocks in the creek for crawdads, seining for minnows, riding horses with my grandfather, shooting arrows into bales of straw, carrying my BB gun everywhere, shooting bigger guns whenever the opportunity afforded itself and generally acting like a joyous junior barbarian. Those became my preferred activities, until I discovered martial arts, then girlfriend, in high school.
My wife Jan grew up with brothers playing football. If I don’t understand a game that’s on, I just ask her and she guides me through. Two of my children attend Clemson University, and the other two are also fans, which is great. But they didn’t get it from me. Just recently they were all talking about the season and daughter Elysa said, with surprise, ‘why look at us, talking about sports like a normal family!’
I have great respect for all those devoted to their teams, who can quote stats like chapter and verse of scripture. May your team get all of the touchdowns, field-goals, runs and everything else it needs. But to all those who never got it, who never fell in love with sports, it’s alright. You aren’t alone.
Do your thing. You aren’t less of a Southerner or less of a man. And when the discussion turns to yesterday’s contest, learn to smile, nod and just say this: ‘that was some game!’

Election Related Illness…

Now that the presidential election is past, national emergency departments are seeing an increase in election-related health problems. While anxiety, depression and homicidal rage are what one might expect, it turns out, according to emergency physician Dr. Chuck McShortridge, the bigger issues seem to stem from people sitting at computers all day long and linking to political posts on Facebook, Twitter, Reddit and assorted other online outlets.
“Just last week we had three patients with massive pulmonary emboli. I asked their spouses about surgery, cancer, fractures, trips overseas, and the common thread was this: ‘No, but he (or she) spent the last six months linking to articles about how Hillary is a crook or Donald is a liar, or something like that.’”
Other physicians have noticed the same. Dr. Maggie McFarris reported another issue: “I keep seeing patients who complain of a constellation of symptoms: blurred vision, sleeplessness, carpal tunnel syndrome and in some cases, acute renal failure. I call it Donald-Clinton Syndrome. They never get off the (expletive deleted) couch. All day long it’s ‘that Hillary is a crook who can’t be trusted’ or ‘he hates women’ and links to dozens of articles a day. They don’t eat, they don’t drink, they don’t exercise, they don’t even have sex.”
One spouse we interviewed in the waiting room of a large ER said, “My wife has lost a lot of weight because she won’t eat! Just the other day I made this great vegetarian dish she loves and all she said was ‘I don’t have time, I just found this incredible piece on Trump at Politico and I have to share it!’ I ate dinner alone. Thank God the election is over say she can finally get the Xanax and IV fluids she needs.”
On a related note, some politically active physicians we met in the course of this article are lobbying to have advocacy counted as CME. Dr. Joseph Mooring, known for his bumper-sticker-laden Subaru, political buttons and frequent presence at online forums, stated: “CME? Who has time for that? I’m trying to save America, and in the process American healthcare! I should totally get credit for the hours I’ve logged trying to save the nation!” American Board of Emergency Medicine representatives said the board might be able to work political advocacy into the new Lifelong education modules.
Practitioners are urged to continue to be diligent in looking for election related illness and injury.

Idols All Around

http://www.greenvilleonline.com/story/opinion/contributors/2016/11/14/commentary-humans-easily-deceived-idols-every-sort/93588762/

One of the consistent themes that runs all through the Bible is the theme of idolatry. And if we can learn anything from its writers down the thousands of years and hundreds of generations since they lived, it’s that humans are easily deceived by idols of every sort.
It’s arrogant for us to laugh off the idea of stone and wooden deities, and shake our heads at the fish or dragons, serpents or elephants that they represented to our ancestors. (That’s right, all of our ancestors!) Because we’re no less susceptible despite our assertions that we are modern and rational. Twenty-first century man remains a remarkably idolatrous creature.
This is rarely as evident as it is during a presidential election cycle, when we believe that vast power, and all our destinies, rest with the office and person we are electing. If only we elect him, or her, all our problems will be solved and our enemies smitten! We elevate candidates and politicians to places they were never meant to be, not by God, nor indeed by the founders of our republic, who doubtless had a much more suspicious view of human character than we do; else they would never have built in so many checks and balances.
In fact, during elections we also make idols of government in general, constitutions, courts and legislative bodies. We worship commentators and media outlets and anyone and everything connected with the process. We idolize our own opinions and spend far more time in our own personal echo-chambers than we do either worshipping God or (for the non-religious) simply pursuing secular knowledge or simple joy. Pity, as our self-adulating tirades and tantrums change few minds.
But it isn’t only politics. We all have our idols. Thanks to social media, young people take constant photos of themselves in a kind of self-worship. Social media have also allowed Americans to make an idol of the approval of others, whether in likes for one’s selfie, or agreement with one’s views. The disapproval of others is a bitter pill whose side effects include exclusion from friendly society; a kind of excommunication for heresy. How many opinions would be shared more honestly if not for the fear of being shunned or attacked en masse online?
Conservatives often idolize guns or military prowess, as if they could save us from all danger. And yet the Bible says ‘Some trust in chariots and some trust in horses, but we trust in the Lord our God.’ (Psalm 20:7) (The chariot being the main battle tank of antiquity, by the way.) And liberals make an idol of choice, as if replacing the word ‘killing’ with a euphemism makes it less like the reality of killing an unborn child, less like a modern adoration of the dark god Molech.
We idolize the freedom of sexual expression and sexual orientation, as if all that mattered in this life were who could have sex with whom. And on the other side, we idolize morality, as if our sanctimonious attitudes about sexual sin were anywhere as important as the forgivingness and redemption offered in the Bible to those who sin sexually, gay or straight. Grace matters more than moralism.
America idolizes the idea of compassion and charity without understanding the moral and spiritual underpinnings that make it reasonable and possible. And yet, we also idolize the American concept that everyone can simply succeed if they try, which is simply untrue. The deck is sometimes stacked and there are those who need our assistance, personally and through state programs. Some idolize capitalism, some idolize socialism, but both can become monstrous deities when not applied with Godly wisdom and caution.
The Decalogue begins with ‘I am the Lord your God who brought you out of slavery, out of the land of Egypt.’ And follows it immediately with ‘you shall have no other gods before me.’ And of course, after receiving the Ten Commandments, the people promptly made a Golden Calf and ignored God, the source of all their good things. You can be an atheist and still see the truth in this tale. This is the story of all mankind. The worship of those things we shouldn’t, and the rejection of those things that are truly, ultimately good.
Whether a citizen is religious or not, we can surely agree that we all have idols we should take from their altars. Maybe it’s a good time to start.