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“Terrain theory” advocates use an image of two goldfish bowls, one in which the water is green, and in the other the water is clear. It always comes with a slogan: “Don’t medicate the fish, clean the tank!” I’ve been staring at that image for a few days now because I knew there’s something wrong with it, but I couldn’t quite figure out what that something was or how to put it into words.

“Terrain Theory” is an “alternative model of health” promoted by the US Secretary of Health and Human Services, Robert F. Kennedy Jr. The idea behind it is short, easy to understand, simple to the point of childishness, and utterly, fatally wrong: if you lived in a healthy world, you wouldn’t need vaccines and antibiotics.

But goddamn is that fish lonely.

Terrain Theory is presented as an alternative to germ theory; the essential idea is that human body is a “terrain” that hosts lots of other micro-organisms, and that illness isn’t the introduction of inimical organisms, it’s when the terrain becomes “unbalanced” in some way, making one exhibit symptoms.

Like all zombie ideas, this one has a clear grain of truth. A healthy gut is undistracted and can handle small incursions of foodborne illness without making you ill. A healthy immune system can fight off a lot of familiar diseases. (The word “familiar” there is doing a lot of work!) Strong muscles and bones make a healthy old age more likely. We take great pains to keep our food fresh, our water clean, and we’re slowly learning the necessity of keeping our air decontaminated.

But goddamn is that fish lonely.

The reason we do things like keep our food fresh and our water clean is because they can harbor dangerous bacteria and other germs. Infections are a matter of numbers and statistics: a small incursion of viri can be handled by your immune system, but if enough get into you, some will sneak past the guards and give you fever and chills and worse. A small amount of hostile bacteria in a dish too-long among the leftovers will die in your stomach acid, but if enough get into you, you’ll be spending tomorrow on the porcelain throne. That threshold is different for everyone, depending on a host of factors that depend on front-line defenses in your respiratory and digestive systems as well as the entire layered defense system of your bloodstream and tissues. (For example, I almost never seem to get foodborne illness, but my wife is much more sensitive; on the other hand, I seem to catch every virus my nose encounters, but she never catches the flu or a cold.)

Terrain Theory is the bizarre idea that at the microbial level, predator/prey dynamics don’t exist. That no invasive species would cause a boom/bust cycle inside your body, turning it into a battlefield as it seeks out its prey and the body fights back.

What makes the image so wrong is that the fish is lonely. It never sees other fish. It’s nowhere near its niche of evolutionary adaptation. They evolved to live in slow-moving streams in the mountainous regions of China, not pristine clean goldfish bowls.

You and I don’t live in a perfectly clean world. We’re not Howard Hughes, holed up in our air-filtered bunkers. We live among other human beings, some of whom will encounter other human beings that have diseases, and they may transmit those to us, via air, via touch, via intimacy. There’s only so much cleaning we can do in a day, and unlike RFK Jr. we can’t hire other people to do it.

What Terrain Theory advocates don’t understand is that there is no perfectly immune human being, not even close. At the microbial level all of nature is trying to figure out how to live within us or eat us, and they evolve one Hell of a lot faster than we do; we produce new offspring about three times in our lifespans, and each of those three has some shatteringly small chance to develop a novel immunity they might pass on to their children. Inside you, an average of thirty-five trillion bacteria are reproducing every three days, and every one of those has its own shatteringly small chance to develop into something deadly inimical… but you get 3 chances in 70 years and they get 70,000,000,000,000 chances every week.

What’s worse is that you can’t live without them. Some of those bacteria are actually as essential to your well-being, speaking of “terrain,” as mammals and birds are to the health of a forest. Microbiome gut bacteria help regulate blood sugar and bowel health, and I’m sure we’ll find even more functions they and we have evolved together to provide them with a mobile survival platform and us with a better immune system.

Besides, I’ve known several monks in my life. They’re not holed up in their monasteries. They go out into the world to do their ministry and integrate their monastic orders with the surrounding communities.

Terrain theory takes a single idea how we live healthier lives, “we should live with a reasonable amount of cleanliness,” and tries to claim that it’s the only idea. That somehow the microscope was not only unnecessary but an evil addition to our arsenal of tools with which we defend ourselves from sickness and death. Throwing out medication and vaccination as “dispensable modern inventions humanity never needed before” ignores the centuries of pain and suffering disease inflicted even on those warlords who kept for themselves the lion’s share of clean water and fresh food.

I’m not a monk. And, quite likely, neither are you. We eat, drink, breath, kiss, and even have sex with other human beings, and every contact gives the microbial world in which we live and of which we are hosts another chance at moving from one body to another. Terrain Theorists can avoid good food, good friendship, and good messy sex all they want, but they’re sadder– and sicker– people for doing so.
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While out Christmas shopping, I ran into my orthopedist while waiting in line. I usually thought doctors hated being asked about patient stuff out of the office, but he actually asked, “How’s the shoulder?”

It was a fair question. Despite being two years out from surgery and being mostly healed, I had gone to see him back in early November because I had been suffering from incredible upper-back pain radiating from the right shoulder. I told him, “The next a patient comes in with that sort of shoulder pain I reported, tell him to buy a new office chair.”

Omaha and my kids had gone in for a gorgeous gaming chair, the sort you’re supposed to be able to sit in for hours on end and just game. And it was just as comfortable as I could have possibly imagined. The chair had a tall back with these wings that seemed to bucket and embrace the whole upper body.

But I tend to slouch forward anyway, so over the two year I’d had that chair my shoulders had started to pull forward, straining the muscles and tendons that connect the shoulder to the ribcage in the back. My current job involves a lot of transitions between mouse and keyboard, and that small motion, constrained by the wings of the chair, had started to set up RSI in the unnaturally extended connective tissue. The pain had started to grow, and I was worried something was wrong with the shoulder again. After seeing the orthopedist, I did a small meditation on the nature of my pain and where it was most obvious, and the answer came to me fairly quickly: at the end of the workday, after being in that chair for several hours. And I also realized that as I approached the chair I was starting to dread sitting in it.

I pulled my old Herman Miller out of the storage room and swapped it with the gaming chair. Fighting with the chair. I became a little more diligent about doing my shoulder stretches and strengthening exercises, and after about two weeks the pain started to disappear.

No real lessons here other than what seemed like a great solution to my sitting forever turned out not to be. Worrying about real ergonomics, getting up regularly, and doing the exercise we’ve all been told to do, turns out to be the real solution.
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Today has been a small disappointment, a modest success, and a huge disappointment, in that order.

Yesterday one of the nurses saw that on the list of assignments I was supposed to be getting zinc, so she took two zinc tablets, put them in warm water, and tried to crush them as well as she could before putting them into the narrow feeding tube. She failed so the tube ended up blocked by the tablet. By the end of the evening I was back on intravenous feeding: saline, glucose, potassium, andh electrolytes, with daily additions of micronutrients. My insides are now completely deprived of food.

I was scheduled for a return to Interventionist Radiology to try and unblock the tube. At 1:30pm today they came and wheeled my down there and we went through the same procedure as the time before. Unfortunately, this there was no success. Lacking additional time or consent to sedate, we had to reschedule, again, for the procedure be attempted once more later that afternoon by a more experienced physician and with my consent to sedate me and replace the tube if necessary.

When I get back from the procedure, I ask the nurse if I can take a walk before she hooks me back up again. She agrees, so today I did eight laps around the floor (about 1600 steps, total), plus two sets of 6 high-angled push-ups (just enough to wake up the muscles in my arms), two sets of 12 calf-raises each, and one set of 12 squats. Still hard to find ways to do hinge or pull exercises. My nurse says “You weren’t kidding, were you?”

“Nope,” I said. “And it’s nice to remind my body that I’m coming to put it back into shape once I break out of this place.”

So at 3:30 a “transport assistant” comes and wheels me down to surgical prep, where I wait in a very cold room while we go through what will be different this time. I sign the consent form for a big dose of anti-anxiety medication to handle how I’ll feel if they have to replace the tube.

The new doc goes through the same process as the previous one and with the same results. After three or four tries with different kinds of, basically, drain snakes, he gives up and says, “Okay, we’re gonna replace the tube.” Since I’m not technically going to be “sedated,” just relaxed, a nurse anesthesiolgist administers a big dose of anti-anxiety medication which, to my surprise, works quite well. I can feel everything going on but I just kinda sorta don’t care that much. He pulls the entire old tube out, the most traumatic part of which was disconnecting the “sinus bridle,” a silicone thing that’s actually wrapped all the way up and around the nasal bone to come out both nostrils and provide a secure mount point for the hose.

And then he puts the new one in. It’s uncomfortable, but as I said the medication makes it so that I don’t really care. I make the appropriate noises, reminding him that “If I feel something is really wrong I’ll let you know in clear English.” I’m clear-headed and communicative but I’m able to handle this disgusting, sinus-and-palate-beating experience without too much concern.

All seems well and they wheel me into recovery. I have only the TV for company and it seems like every channel is half advertising. I’m sick of having my attention span shattered by shit like that.

Everything seems fine for about half and hour and then, suddenly, I start to feel nauseous. I sit up hard in the bed and bend over and begin dry heaving. Nothing is coming up– I haven’t had food in days, the bile pump had been hooked up during the procedure, I was as empty as Liz Truss’s economic plans.

Then suddenly, I cough hard, gag, and the entire feeding tube comes out of my mouth. I hit the panic button and the nurse comes running. They immediately grasp what’s happening and call the gastrointestinal surgeon who put it in. Realizing the problem instantly, he agrees to cut the tube where it exits my mouth, frees it from the bridle, and we pull the last 20cms back through my sinuses.

The procedure is a failure. My body rejected the implant.

Because the “procedures” were so widely scheduled, I didn’t have any visitors today. No sense since nobody could know when I was going to be available. The bridle is left in place in case we try again tomorrow. I’m back on the intravenous nutrition thing again.

Today has been a real thrice-damned disappointment, let me tell you.
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Today has been a mixed day. I woke up this morning to the disappointing news that the apparent reduction in bile reflux had been an illusion. The blocked feeding tube had reduced the amount of processing my GI tract was doing, and my liver had backed off on the production of digestive fluids; that had created the illusion that I was actually processing the bile rather than having it drained by the stomach pump. With the resumption of inter-intestinal feeding, my bile output went back to approximately two liters per day. So the duodenum, the first few centimeters of my intestine, had not opened up as we had hoped.

On the other paw, the surgeon today confirmed firmly, and to Omaha’s satisfaction, that the CT scans indicated that the blood mass from the hemorrhaging had retreated signifcantly, and that the fluid buildup around the duodenum that was crushing it and causing the blockage had likewise reduced quite a bit.

The question of whether or not the duodenum is irrevocably damaged– scarred or necrotic or just incapable of the hydraulic pressure needed to stay open– has not been established. So the course of action remains the current course of action. I’m still here, stuck in the hospital, barely able to stay awake for three or four hours before I run out of brain and must nap. They’re gonna wait until next Saturday for the next CT scan, and if there are no behavioral changes in my digestion by then, we’re gonna talk about sending me home with a cart for the stomach pump and feeding tube, and a in-home nurse who’ll visit three times a day to change out my filters and feeding and watering and such. Dunno if I’ll be able to work under those conditions; I’ll be unable to even leave the first floor of the house, and I’ll be tethered to these stupid pumps until… well…

They’re talking about waiting another two weeks after that to see if there’s any resolution. After that, we’re discussing endoscopic procedures, either a straight-up stent or maybe just a balloon to inflate the duodenum back to its natural geometry, then remove the ballon to see if it holds. If any of this works, I get to start a bland diet, slowly adding more mass and more solids over weeks and months.

If not, we move on to the question of laproscopic resectioning. But they’re saying they won’t even consider that until three months after my initial intake on October 9th.

Something has to give, and I hope it’s in a good way. This is so dreary, and I feel so useless just lying here.

Omaha did come by today, and she helped me walk around the floor twice, and I felt very good doing that, and then she chaperoned my shower, so I’m clean again. She’s been wonderful. I love her so much.
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A couple of months ago I discussed having idiopathic dysgeusia, a benign condition associated with middle age in which everything tastes bad and funny. One of the hypotheses floated originally was posioning, that somehow I had encountered something that damaged the inside of my mouth.

But then it got worse, and I saw another doctor who sent me to my dentist. He was able to say, "It look like desquamative gingivitis, which happens at your age. I'm sending you to a specialist."

So I saw the specialist today. By now, the condition has almost completely cleared up. Everything tastes normal, I can enjoy spicy foods again, I'm no longer suffering "mechanical damage" (i.e. chapping from constantly probing at the weirdness in my mouth). There's a slight hesitancy at the tip of my tounge, but that's about it. The specialist is back to thinking it was poisoning, but we can't pinpoint what.

He basically said if it comes back, take pictures, document the hell out of everything I ate, drank or tasted that week, and make another appointment.
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Let's talk about my mouth.

For the past couple of weeks, everything has been tasting... off. Funny. Sometimes it's a semi-metallic taste, like there was a penny in there. Most of the time it's a dry, caustic sensation, as if I had accidentally breathed in a bit of alum.

So I went to the doctor. She looked. She poked. She prodded. She swabbed and tested. And we can't find anything wrong. There's no infection, no pathogens found, no swelling, no other signs of dysfunction. Nothing else is wrong with me. There hadn't been any significant changes in medication or diet up until the first symptoms. The diagnosis is idiopathic dysgeusia, which is as sad as it sounds: "We don't know what it is, it happens to some people as they get older, it usually goes away after a few months."

Months‽‽‽

Usually‽‽‽

I've lived with it for five weeks now. As "crippling syndromes associated with getting older," this is one of those nobody ever told me about. Bad knees, bad eyesight, poor weight management sure. "Everything will taste funny and probably bad" was not on the list. And I can think of two things that may have gotten me here. The first is possibly my own damn fault. The other was that I was exposed to a slow, long-burning electrical fire that may have put tons of volatile metallics and burned insulation into the air. Both of those happened shortly before the symptoms manifested so... who knows?

It's distressing. It makes kissing less fun, much less other activities one does with his mouth. I'm eating less, so that's a win, I guess. I've lost three pounds. I don't recommend it as a weight loss program.
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I can't breathe.

This season, my allergies have been especially hideous. Which is odd because my most common allergy is to dust mites, which are a non-seasonal problem dealt with best by changing the sheets regularly and a decent vacuum cleaner.

I do have a mild reaction to oak. The pin oak in the front yard retains its leaves all winter, then drops them in spring as new buds grow behind them. The past two days of beautiful, 70F (32C) weather has inspired it and all its brethren to claw deep into the earth and begin signalling to their peers that reproduction has commenced. The spew of oak bukakke everywhere threatened to keep me up last night.

But there is a solution, of a sort. Normally, I just use ceterizine and a steroid inhalant, but the steroid takes three days to kick in. If I want to breathe, I need a solution. For that, I use probably the most painful drug in my current arsenal, azelastine. Azelastine turns off the mucous-producing mechanisms in your nose. It makes delivering the steroids to the right receptors possible. It lets me breathe.

Not being able to breathe or sleep is better than the alternative, but the alternative is a burning, constant but completely unsatisfiable wish to sneeze. It feels like gnomes are pickaxing up in the space behind my eyeballs. Worse, I can't really smell anything. I almost ate a bowl of scrambled eggs and salsa for breakfast this morning before my tongue informed me that the salsa had gone bad-- my nose couldn't tell.

I can't wait for the steroids to take hold.
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We discovered this weekend that my mild color-blind status has a very curious side-effect: under blacklight, I can identify the colors I can see with more accuracy than normally color-capable folks.
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Well, I had my annual ophthalmology trip today. According to the doc, I'm exceptionally healthy, with very good eyesight for my age. She gave me a prescription for driving glasses she stressed I did not need, "but since you're used to having 20/10, these will give you that."

But they did the glaucoma test, this time without that damned "puff" in the eyeball. Instead, she used something with a big ball at the end, like a giant ball-point pen, and rolled it across the eyeball. It felt very peculiar.

She said it would be three to six hours before the drugs wore off. Well, it's been seven hours now, and while I can finally read again, every bright light still has a damn halo and my eyes are still burning.

I guess I'll geek tomorrow.
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I went to the dentist today. Since we have insurance until the end of the month and I needed a crown, we decided to go forward with it. I was booked for a 90 minute procedure. It took almost twice that long. By the time it was over, much of the anaesthetic had worn off, although then it was just pushing and shoving rather than grinding or drilling, so it wasn't terrifically painful, just annoying.

As it turned out, the tooth– or what was left of it– is tightly wedged into a pocket between two others and the normal temporary crown wouldn't do. So the doc used a solid gold temporary, which is apparently quite rare these days. My mouth has bling. Fortunately it's not terribly visible bling, it doesn't show clearly when I smile, so I can still do job interviews without looking like an idiot.

Omaha says I have a file in my head, just one, under "I" for "I might need this someday." At one point, the doc and the tech were talking about the patient after me, discussing which teeth were going to be removed and replaced and so on. I said, "But those are his two front teeth."

"You know that?" the doc said.

I shrugged. "I pay attention to what you say. Like, the difference between a lingual and a facial, or the mesial versus distal."

"And earlier, you were asking about my using the same needle for multiple passes of anaesthetic. You should give up software and take up dentistry."

"I don't think I have the patience for it."

I'm home now. Exhausted from all that time in the chair, the body tension, and the imminent threat of pain. There's only some soreness in my mouth, along with the lingering numbing that always seems to last longer in the lips than the jaw. I'll be okay, I guess. I have an interview appointment to set up for Monday, and then I'll have lunch and maybe go lie down. I owe Omaha about six hours of art and programming, but I don't know if I'm up for it right about now.
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I took Omaha and Kouryou-chan out to the Cheesecake Factory. As we were there, I started to feel more and more exhausted, at a much faster rate than the approach of bedtime would suggest, and when I got into the car I had a fit of the shivers so bad it was damn near a seizure.

When I got home, I took my temperature. 100.2°F (37.9C).

I do not have time for this.
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Well, I saw the doctor today. He hemmed and hawed, and finally said, "Well, you have uniform strength on both sides of your body, your eyes are clear and responsive, your reflexes are fine. I didn't hear anything unusual in your heart, lungs, or carotids. Your worst problem appears to be a buildup of ear wax.

"So, I'm going to tell you right now that, while they'll probably all come back negative, I'm going to order a whole bunch of tests-- cholesterol, blood sugar and AC3, a thorasic doppler, cardiac ultrasound, and a brain MRI.

"You're actually very healthy for a man your age. You have none of the usual indicators-- you don't smoke, you don't drink often, you're not overweight, and your worst drug habit is too much coffee. You're not in any of the risk categories. Your tests from six months ago show good blood sugar and cholesterol levels. I would say it was something else, and not a stroke or TIA. But I'm still ordering all those tests."

Joy.

Needless to say, last night was sleepless with "What if it happens again?" and "What if it happens again and it's worse?" thoughts. So I'm a bit of a zombie this morning.

Zzzzzz....
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I had one of those frightening scares this morning that make me worry too much about my health. I'm sure that on some level I'm quite healthy for a man my age, not spectacularly so but still. The alarm went off and I tried to stand up-- and immediately fell down. I caught myself on the edge of the bed, straightened up, and took two steps-- and found that I couldn't walk. I was too dizzy. My body wanted to pull to the right. My right leg was askew, the toes turned out in a way that's not normal for me.

It felt as if half my body were taking longer to wake up than the other half, and I've never had that happen before. I felt fine until I tried to move and then my body defied me. I am not happy about that. Just another reminder of the thousands of different things that can go wrong with the brain and body.

It took nearly five minutes for whatever it was to pass. I managed to get Yamaraashi-chan up and moving, and by the time I'd gotten dressed I was able to walk confidently. Hell, I had to make a quick run to the grocer as we were out of milk-- 11 minutes, not my best time, but tolerable.

Anyway, I made it out to the bus on time, and am all right now. It took a while for the fingers to wake up for typing, too, so maybe it was just a fluke of some kind.

[Edit: My doc agrees, and will see me tomorrow morning. She said if it happens again I should get myself to an ER immediately.]
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Well, it looks like I'm going to be going in for endoscopic surgery in the second week of June. My doctor is fed up with my complaints about my insides and sent me to a specialist who, naturally, wanted to take a look. So it looks like I'll at least be getting some answers.

The doc seemed like a nice guy, early 30s, used to dealing with lots of middle-aged whiners like me. During the medical history, since he needs to know everything about my GI tract, I listed off all the relevant particulars, you know, no food allergies, glass of wine now and then, no smoking, lots of coffee, and then I said, "How do I put this? I was joking with my wife the other day that I didn't have this much problem with my insides when I was dating boys."

He didn't even blink. Just casually noted it down, asked the obvious questions, yes I've been tested recently, yes, I'm negative for everything.

Anyway, we talked about anaesthetics and reactions to them, and the usual possible risks of surgery, and that'll be that. More as time goes on.

Don't worry about me. It's just an endoscope and biopsy. If you want to really see something to worry about, well, you could always take a look at Jay Lake's blog and worry that he's going in for bowel resectioning surgery today to cut out a tumor this afternoon.

Between now and then you'll still have to read through my jury duty. That's in just ten days! Eek.
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The girls are old enough now that I feel safe leaving them alone in the house for short periods-- while I walk up the street to get the mail, or two blocks to get milk from the corner grocery. I trust Kouryou-chan to be more knowledgeable and reactive to crises than Yamaraashi-chan, which is an odd thing to say; then again, I also expect Kouryou-chan to get into more crises than Yamaraashi-chan. Still, if they're stunned with Guitar Hero for a few minutes, they're fine on their own.

Last night, though, I ran out of Prilosec. I had forgotten to buy more and had lost track of how much I had left. I proposed to Kouryou-chan that I go get some, and she said she didn't want to be all alone in the house after dark. Thinking about it, I decided she was right, that the nighttime was different somehow from daytime, and it wouldn't be fair. So I skipped a dose.

Bad move. Although I slept well, in the morning my throat burned again. I may have to be on this stuff for the rest of my life. After getting Kouryou-chan out the door to school, I went down to the grocery and bought more, so I'll be okay.

Oh, and file under stupid warnings for stupid people: "Do not take this medicine if you are allergic to it." Well, uh... "Duh!"
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For the past six weeks I've been having chest pains. This past week, they've been pretty bad ones, at times flaring up to take my breath away. Yeah, you're all panicking now, aren't ya? Go re-read the subject before you do.

So I went to the doctor and had a whole bunch of tests done. I take five flights of stairs every day regularly, I walk a mile uphill from the parking lot to work on those days when I do drive, and I've otherwise been in great physical shape. I don't exercise enough otherwise, but that's just life.

I remember when having an EKG done meant being hooked up to a big cart and having all this nasty gel on your body. Nowadays, they put a whole bunch of what look like 3M skin-friendly PostItNotes on your anatomy, connect a lead to each tab, and then stick the other end of the wire into a USB port on the same desktop computer where they do data entry, and call up the program "EKG". Cool! I was biologically hooked up to teh intarweb! "Yeah, we'll email the results to a cardiologist to be sure," said the doc, "but these results look fine." She calls up another screen. "You blood pressure is very good, And your cholesterol level is great."

I celebrated that last piece of news by having a bleu cheese and onion burger, medium-rare, for lunch. Work bought.

I have something called persistent costochondritis, a nasty arthritis-like inflammation of the cartilage lining my sternum. It's not dangerous or life-threatening, and it (thankfully!) doesn't indicate that I have a tendency toward other forms of arthritis. It could mask a heart attack someday, so I'll be doing annual EKGs from now on.

And the advice? "Take two aspirin when it bothers you."

Bleah.
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If you own a Sonicare and are familiar with the compact head, don't buy the full-size head by accident. I did that recently and was really unhappy with the result. The magnets that drive the full-size heads are the same size as the compacts, but they have more mass to move and the overall effect is that the Sonicare just doesn't do the job nearly as well. I finally went and bought a pack of the compacts and the difference is quite noticeable. They really do a significantly more powerful job.
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Lovely. It turns out that the Bush Administration has appointed a doctor whose former job was medical advisor to Focus On The Family to the FDA Advisory Committee on Immunization Practices. This is the committee that will be assessing the "public need" for the vaccine that prevents the HPV viri that cause cervical cancer.

I'm pleased to note that the president of the Christian Medical and Dental Association, Gene Rudd, has said publicly that he would give his kids the vaccine, although he says that other parents should have the right to "protect" their children in other ways such as "to teach them abstinence."

What does he think those parents are? Stupid?
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I did not know this. You know that HPV vaccine I mentioned yesterday? Bill and Melinda Gates have donated $7 million dollars to assist the World Health Organization in distributing the HPV vaccine to third-world nations. Coolness.
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Honor Killing is the term used by the Human Right Watch, and by the perpetrators themselves, describing the practice of murdering a woman who has brought dishonor onto the family, usually through unsanctioned sexual activity. Although this National Geographic article is careful to point out that "honor killing" is not in the Koran, it cannot escape the fact that the vast majority of honor killings occur in Islamic countries, is regarded as a family matter and not a criminal matter, and even in countries where the leadership has condemned it punishment remains light and ineffective.

This week, an announcement went out that a vaccine against HPV (human papilloma virus) that had been in review for two years is 100% effective with minimal side effects. This is considered excellent news because HPV is the principal cause of cervical cancer, which kills a quarter-million women a year. It's such a powerful indicator that if a doctor suspects cervical cancer he'll order an HPV test and if the woman doesn't have it he can be confident she doesn't have cervical cancer, either. The vaccine is so effective that many Western governments are looking forward to putting it onto their "required" or "recommended list."

The Family Research Council, a Christian lobby group, has released a statement calling the recommendation "potentially harmful," saying that "abstinence is the best way to prevent HPV" and that young women should not be given the vaccine because "they may see it as a license to engage in premarital sex." (Okay, ignore the fantasy world the FRC is living in: if the vaccine is 100% effective then abstinence becomes only one way equally effective, not "the best way.")

A quarter-million women a year die of cervical cancer. The FRC, seeking to protect their message, has decreed that those deaths should continue rather than let one more woman be less fearful with her sexuality. In saying so, the FRC betrays both the worst instincts of the monotheistic traditions that came out of Judea and the worst instincts of American culture: It wants to continue the honor killings of women who defy the FRC's sexual mores, but it doesn't want to have to look them in the eye while doing so.

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Elf Sternberg

March 2026

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