What doctors should ignore

A fascinating op-ed appeared in yesterday’s New York Times: https://www.nytimes.com/2017/12/08/opinion/sunday/should-medicine-discard-race.html?emc=edit_th_20171210&nl=todaysheadlines&nlid=44005038

The author, Moises Velasquez-Manoff, argues that tying the propensity for certain diseases and health care behaviors primarily to racial identity is problematic. An example is sickle cell anemia, long hailed as a “Black person’s disease.” making exceptions to the rule–i.e., “White” patients with the disease–difficult to explain. The reason for the confusion, as suggested in the article, is that there are far too many unknowns and misconceptions in our broad understanding of race.

Several years ago, I listened to a featured speaker at the Cancer Health Disparities Conference sponsored by the American Association for Cancer Research. He made the argument that beneath just about every claim of health disparity tied to race was an insufficiently-explored inequity of another sort–economics, housing or diet, for example. In effect, the speaker (whose name unfortunately escapes me) proposed that researchers think carefully before focusing on race in medical research and health care rather than the socioeconomic factors that might be more influential on the health of a particular individual or population.

I have to wonder where this argument will lead as more of us investigate our genetic histories and discover that we may not be who we think we are.


Small towns

This story on msn.com cracked me up: http://www.msn.com/en-us/lifestyle/smart-living/22-things-you-only-understand-if-youre-from-a-small-town-so-many-parking-lot-hangs/ss-BBs47ph

The authors got it right. Almost everything they listed as “things you only understand if you’re from a small town” was something I could relate to.

One exception, of course:

In my hometown of Clinton, Illinois, our favorite high school pastime/sign of coolness was cruising the town square. In hindsight, it was pretty ridiculous. We’d get together with friends on a weekend night and drive in circles, never actually going anywhere but feeling seen while seeing everyone else from school

No wonder my dad had a fit about the waste of mileage, and time!


This week’s issue of the journal Science features a story on the largest man-made wavemaker just engineered by a Dutch research facility in Delft, a small city which our group visited in April: http://www.sciencemag.org/content/350/6256/21.full?utm_campaign=email-sci-ntw

The Delta Flume, a water-filled trough that will produce waves as high as 4.5 meters, will be used to study threats to coastal areas and to devise new systems for protecting these areas. Since so much of the Netherlands lies below sea level, there’s a real need for innovative approaches to managing all that water.

The Dutch are absolute masters of technology.

New digs

Edwina has moved.

The rent for her old apartment, the only residence she’d ever called her own, went up and she couldn’t make the payments. Plus, once management at the place shifted, Edwina discovered that not much got fixed. As a case in point, she spent much of the summer without a front window after the wind shattered the glass during a particularly forceful storm.

Last week, Edwina and I decided to meet up. She wanted me to see her place and catch up on things since the last time we’d seen each other.

I had an hour or so between a scheduled appointment and the time I hit carpool to pick up the girls from school, so I checked out my Google map directions and headed off towards Edwina’s new digs.

But the closer I got to my destination, the more out of place I felt. Block after block revealed dilapidated buildings, abandoned cars, street dwellers hanging out on corners and propped up against store fronts and benches in the middle of the afternoon. Perhaps my discomfort stemmed from an unclear sense of direction–I’d never been in this particular part of Birmingham before–but whatever the reason, my gut told me to turn around and head back towards my own side of town.

When I got home following carpool, I couldn’t help feeling guilty. My friend had moved to what seemed like a more dangerous area because she had no choice. Shouldn’t I be willing to move outside my comfort zone for an hour to pay her a visit? I’d never turned away from Edwina before, not because of a decision she’d made that I disagreed with or because I didn’t completely understand her perspective on something. What made this situation any different?

I was scared. Driving through Edwina’s new neighborhood, I felt like I stood out. I was dressed up for work, driving a car that looked newer and in better condition than any other means of transport I saw in the area. I hadn’t come across another white person as I drove block to block looking for Edwina’s address. Despite years of knowing Edwina, her family and her friends, I didn’t feel safe in her new surroundings. And I felt terrible for admitting that I felt the way I did because of what I saw when I looked out my car window.

Edwina and I did meet up the next day when she stopped by my office. We chatted for a while and then she headed for home when I told her it was time for me to leave for class.

We are spoiled.

Today, we visited the Fenix Food Factory in Rotterdam, a market-like atmosphere in an old warehouse on the outskirts of the city. At Fenix, visitors discover a bakery, coffee shop, cheese shop, butcher, craft beer pub, a cider shop, fresh produce vendor, and the odd assortment of arts and crafts stands.

A couple of things make the place unique:
* The vendors in the facility rely on one another. So at lunchtime, the baker might head over to the cheese seller to ask for some fresh slices and to the butcher for the smoked meat of the day. As a result, she’s able to offer a sandwich for sale to the passerby.

I thought this strategy was fairly unusual by American standards, since vendors in markets in Seattle or Philly, for instance, often compete for business. There’s rarely anything cooperative about the way they market their goods.

* This warehouse, like many we’ve visited in the Netherlands, is located in a traditionally undesirable neighborhood–a place where folks don’t necessarily want to find themselves after dark. The innovative work of the vendors and the concept of the Fenix Food Market, though, have transformed this space into a hospitable, rather upper-scale destination.

One thing our guide/resident entrepreneur, Wooter, told us was that the place offers something special–yet altogether reminiscent of a more traditional Holland.

“We offer what we have that day,” he said. “Sometimes people come in and they ask for something, and we have to tell them we don’t have what they are looking for on that particular day. Instead of pork, we have beef or lamb.”

Wooter added that customers are occasionally disappointed.

This disappointment, he thinks, has to do with the fact that “we are spoiled” by the modern supermarket. By its promise of convenience, consumers expect that any product will be available at any time.

“It’s not normal,” Wooter told us. I tend to think that’s true.

Uitvaart, or Museum of Exit

Several of the students and I headed to a rather unusual tourist spot in Amsterdam, Tot Zover: The Netherlands Uitvaart Museum, or Museum of Exit. The facility is devoted to death and funeral traditions in Holland and was of interest because of our group’s focus on sustainability practices. The development of more sustainable burials and cremations is one outcome of the green movement, so I wanted a glimpse of how the Dutch have traditionally addressed the passing on of a life.

Unsurprisingly, Uitvaart is located just inside the gates of a cemetery in a quiet neighborhood. The museum is filled with an array, albeit somewhat disconnected, of emblems of the funeral experience. The first room was filled with photographs of hearses from various eras, followed by miniature toy models in the next room (some models being available for purchase in the lobby).

Visitors are then presented with a display of five wooden coffins, each providing details about various funeral traditions: the personal funeral (planned in advance by the deceased), and then rituals of the Surinamese Hindu, Chinese Buddhist, Muslim, and Dutch Roman Catholic traditions. Mortician apparel and tools round out the second room. On special display throughout the hallways was a series of photos called “Images of Death,” which included the photos of famous (for instance, Steve Jobs and Princess Diana) and everyday people taken shortly before their deaths. The idea behind the exhibit was the transience of life, especially revealing in photos of people smiling and laughing without any idea that within seconds (in some instances) their lives would end.

A final room in the museum was perhaps the most eerie. On display were death masks, photographs of the deceased (part of a tradition during the Victorian era known as memorial portraiture or mourning portraits), mourning apparel (black dresses and veils), and trinkets that could be worn or displayed to honor the passing of a loved one.

As we left the museum, the woman who had given us our tickets at the start of the tour (and who, quite frankly, was a tad creepy and dressed head to toe in black with just a hint of red) pulled me aside to tell me about a new feature available in the chapel to the right of the museum.

“If families wish, and for an extra fee,” she told me, “at the end of the service the casket can be raised off the podium and will rise into the ceiling which is opened. That way, they can see their loved one going up there instead of down there.” She pointed her finger up and down for emphasis as she explained.

Placing her hand beside her mouth, she added in a whisper: “Of course, the ovens are up there, but still it is a nice option.”

Um, thanks?