This is my October contribution to the NWTC Newsletter, What’s Cooking. Since it is October, I saw no harm in a little morbidity.
We’re all gonna die! Someday. That’s an obvious given, a constant, the elemental fact of life with which we will be confronted. One day. That momentous day, in which the age-old question that has plagued mankind subsequent to the onset of sentience is answered—is there a God; is there a spiritual realm in which I will have an awareness of; will I find St. Augustine’s Eternity? The problem is; you won’t be able to tell anyone else the answer. No, that glorious answer belongs to you alone, and all the antecedent arrivals to the hereafter.
The Mayan “Long Count” calendar wraps up a 5,126 year era on 21 December, this year, in a few months, and is supposed by some to mark the end of the world as we know it. How the end comes is anyone’s guess; perhaps it’s a collision with a planet called Nibiru en route from the star V838 Monoceros;
Monocerotis, from where Nibiru is coming (courtesy of NASA)
or, perhaps it’s a collision with one of a thousand (that we know of) Near Earth Objects (NEO) that are already in the neighborhood. Well, 5000 years doesn’t seem all that significant against the backdrop of a 4.5 billion year-old earth, and the chance of a planetary collision is less likely than me winning the Powerball, and what do a bunch of extinct old Mayan’s know anyway. Therefore, before sinking into the Paranoia of these end-of-the-world scenarios, perhaps we should focus on the more common causes of our material end.
I knew a neurosurgeon where I trained who never drank out of an aluminum can because he thought he’d get Alzheimer’s despite the lack of medical evidence for a causal relationship—but, he is a neurosurgeon, which makes one go…hmmm. After all, Alzheimer’s is the eighth most common cause of death in the U.S., which makes that frosty can of MGD on a blistering summer day behind a fishing pole on a stone beach radiating shimmering waves of heat look less appealing…okay, not really—but then, I’m not a neurosurgeon either. Alright, let’s consider causes of death one, two and three; heart disease, cancer, and cerebrovascular disease (stroke), which accounted for 60% of all deaths in 2000. Let’s further consider some of the most common causes of cancer; breast, colorectal, endometrial, kidney, ovary, lymphoma, and pancreatic, the first three for which a link to obesity has been firmly established, and the remainder for which there at least seems to be an association.
The sixth most common cause of death is diabetes mellitus of which type II is also strongly associated with obesity. The fifth most common cause of death are unintentional accidents, an example being like going for an innocent bike ride on a beautiful day and suddenly finding yourself launched head-first into space with the overwhelming thought…is this my day? (Ahem…true story—last Memorial Day)
So, it is clear that there’s plenty to be paranoid about, if not fearful, unless you face the thought of death with the equanimity of a saint, unless you are a saint. Not being a saint, I admit to finding myself a few degrees to either side of fearful, depending on the day, my mood, and whether or not I’ve attended church lately. But, if you want to exert a force towards longevity and delay of that momentous day, it is clear where your efforts should be focused—not on avoiding beverages in aluminum cans, but on defeating obesity, given the well-documented link between it and heart disease, diabetes, cancer and stroke; and by only riding your bike on flat grassy fields.
Now all those things seem rather mundane and common (maybe because they are), and much less dramatic than a planet called Nibiru colliding with the earth; but at least they are things we have some control over. Still…I’ve noticed that my exposure to aluminum cans has fallen, and I did notice a particularly bright star in the sky the other night, and I do have a Mossberg 12 gauge leaning in the corner with four shells in the tube, and a pile of nonperishable food in the basement next to my beer-fermenting carboyl for December 21st when the world goes crazy because I’m no saint, and don’t plan on going gentle into that good night.
Although brilliant, he was not known as a tidy researcher, and so, when leaving for an August holiday with his family it seemed of no particular significance that he should leave a stack of petri dishes in a dusty corner of his laboratory, an irregular glass pillar of staphylococcus bacterium subject only to the barely perceptible currents of air in a closed room, and neglect. The month of August in London is a warm month; had it been January, perhaps the dust blown through a loose pane would not have been so heavy with fecundity; as it was, the month was August, and the warm particles of dust were heavy with a fecund ripeness of portent as they wafted lazily towards the pile of glass in a forgotten corner.
One month later, he approached the pile of culture plates, much as he would a stack of dirty dishes, with reluctance and a pang of mild regret for having not done them before he left on vacation. As he reached for the plate on the top, most exposed to the air, he noticed three dark purplish spots, scattered amongst the coalescing colonies of staphylococci, around which there was a ring of…nothing. The day was September 3rd, 1928.
Alexander Fleming recognized the antibacterial nature of the purple spots, and published his findings in the British Journal of Experimental Pathology in 1929, where the discovery languished for the next decade, a few sheets of printed paper buried amongst shelves and shelves of those dusty periodicals found only in a smattering of academic institutions of industrialized countries across the world. By 1939, Sir Alexander abandoned his research of the Penicillium mold after failing to find a chemist skilled enough to refine the active agent.
On a Saturday, May 25th of 1940, another researcher, Dr. Howard Florey, a subscriber to the Journal of Experimental Pathology, tested eight mice that were injected with a lethal dose of streptococci bacteria. The four mice that received the penicillin his team had extracted from the Penicillium mold lived. The four controls that didn’t receive penicillin did not. In 1941, the first human received penicillin after suffering an infection from a rose thorn, and in 1943 Dr. Florey traveled to North Africa to test penicillin on wounded soldiers. His results were hailed as a miracle.
The popular antibiotic, Augmentin, was developed by SmithKline Beecham in the seventies, a US patent filed in 1979, a patent granted in 1984, and the drug first sold in the nineties, nearly twenty years later. Although the FDA was created in 1936, it wasn’t until the 1960’s that its role was expanded in the premarket approval process, driven by the thalidomide tragedy in which thousands of European babies were born with deformed limbs after their mothers ingested the drug for the treatment of nausea.
In 1940, Penicillin went from the lab bench to practical use in the battlefields of Northern Africa three years later. In 1977, Augmentin began the FDA premarket approval process to achieve practical use some twenty years later.
It is now 2011, and modern medicine is running out of antibiotics. There are few new drugs in the pipeline, and invisible bacilli and cocci are multiplying and dividing in a most fecund and Darwinian fashion, developing resistance to the antibiotics developed since the first serendipitous sticking of a penicillium mold spore to one of Dr. Fleming’s culture plates while he was away on vacation.
There are strains of the common skin bacterium, Staph aureus, now resistance to Vancomycin, which had been used to treat the S. aureus that was resistant to Methicillin, which had been used to treat the S. aureus that was resistant to Penicillin. One strain of the innocuous gut organism, E. coli, is resistant to at least 14 antibiotics—the same strain that killed dozens of people in Europe this past spring, and caused the hospitalization of hundreds more. Some of these virulent strains of E. coli release a Shiga toxin that causes bloody diarrhea and kidney failure; and the common antibiotic, Cipro, can make it worse because it triggers a massive release of the toxin as the bacteria dies; fortunately, there is another antibiotic that does not cause a release of the toxin, and that the antibiotic is not resistant to…yet.
So, as we swim through the omnipresent microbial soup in our own Darwinian pursuit of longevity and procreativity, it is important that you minimize your risk by practicing good hygiene; washing your hands, doing your dishes in a dishwasher or fresh hot water with detergent, cleansing your produce, and growing your own if so inclined. You can avoid needless exposure to antibiotics, and if you suffer a bad case of bloody diarrhea while on a trip overseas, don’t take the Cipro you’ve brought with for just such an occasion on the outside chance it might trigger the release of a lethal dose of Shiga toxin.
To complement the post, I ran around my yard and shot some photos and video and put them together in a montage.
For food, for exercise, to add beauty, to learn, to make money, to meet people, to be creative, to win gardening contests, for emotional needs and a spiritual connection, for lasting memories; at least, those are the top ten reasons listed by the National Garden Bureau at ngb.org. No mention was made of the reason because I have to or else the hill on which my house stands will wash away with the rain if I uproot the wild grape vines, milkweed, and other invasive species spinning a cocoon of weeds around my house, as though spun by evil caterpillars that drink Round Up for breakfast, lunch and dinner.
It may be that my initial impetus for gardening was something less honorable then the NGB’s top ten. It may be that my initial efforts were driven more by my wife’s joy of gardening than my own. It may be that my early labors at gardening were the product of a thoughtless physical reaction to a wife, who, like a female Ben Hur, drove me mercilessly to pull the chariot that was our garden—not with a whip made of leather, but with hurled implements; rakes, spades, hoes, pick-axes, trowels; driving me harder, further, deeper into the ground until I’d rear up at end of day lathered in a thick foam of muddy sweat like Sea biscuit after the Preakness. “Is that all, honey?” I’d whimper, “Can I be done now, puh-leeze?”
However, that is the case no longer. I now garden for some of my own reasons. My son gardens for food, beauty, creativity, and to learn. My daughter gardens for food, beauty, and spirituality. Anyone who has any plant, indoors or out, requiring attention, is a gardener for some reason. I grew up in a family of gardeners, spending summers at my grandparents where the only grass existing was on the boulevard where my grandpa would put the garbage cans on Sunday nights, and which he would mow with a rotary push mower, the revolving horizontal blades whirring, throwing a gentle arc of fresh clippings behind it, covering his black oxfords with a damp green hair. The land behind the seventy-five feet of sidewalk, too precious for grass, was managed for peak vegetable production, and an apple tree—for food.
I couldn’t understand why my grandparents and my uncle Don would spend every waking moment in the garden, digging, pulling, planting, harvesting, watering. To what end, I wondered–isn’t that what grocery stores were for? For what reason would one spend all day under a hot sun, toiling, when one could be fishing or playing kick ball; and later, as an adult, when one could be reading a book in the shade under a tree or bike riding down a quiet country road.
From what I could tell, Uncle Leo, a retired pharmacist, had it figured out. If he was outside, it was usually in a chair, with a magazine, the radio, sunflower seeds, and a can of Budweiser making a wet ring on the pavement next to him. The only thing I remembered enjoying about gardening those many years ago was digging for potatoes, possibly a genetic sequence from an Irish heritage; nonetheless, a penchant for digging that persists to modern day such that if I have to plant something, I’d just as soon as it be big so I’d have to dig a bigger hole. Despite this curious fondness of digging, I’ve regarded gardening for most of my life as an odious labor best avoided, I think, because of the time spent during my formative years, surrounded by gardens whose sole inanimate task seemed to be in keeping my uncles from taking me fishing.
I ask again…Why garden?
Because it brings me joy. Because I can create a special place, a sanctuary, where I might rest at close of day, surrounded by colors and beauty that wouldn’t be otherwise but for my attention (and my wife’s). And for every one of the top ten reasons, except, of course, for “to make money,” and “to win contests” which is decidedly not the case—more aptly I’d say would be, “to spend money,” and “honorable mention for ‘most improved’ (in my own mind).”
Gardening does not have to be restricted to landowners solely. Many communities have a “Community Garden” where small plots of land can be cultivated by community members. Door County’s newest garden, The Community’s Garden, is coming to fruition at The Garden on 16th Place, between Michigan Street & Rhode Island. So, there is no excuse, should there exist a desire.
To garden or not to garden, that is the question before you. I choose to garden.
The telomere test for approximation of your biological age has been getting some press lately, so I thought I’d research it a bit and make it the topic for June’s NWTC “What’s Cooking” newsletter.
I’ve been interested in telomeres for a few years because of their relationship to aging.
Have you checked your telomeres lately? Do you need to? What the heck are telomeres?
There is a new test that you will soon encounter in the mass market media. The advertisement will read something like, “How much longer will you live,” or maybe, “Find out when you’re supposed to die.” Or, perhaps it will be more positively framed as something like, “Find out your biological age, and how to prolong it.” The test will require a blood sample (possibly saliva) and a payment of about $300, give or take. I’m guessing that the additional information, regarding the prolongation part, will be extra, likely having to do with daily supplements, specialty foods or other allegedly crucial interventions.
The telomere test is a provocative melding of actual science and the various human emotions in orbit around the all-too-real planet of our individual mortality. You have to admit that each of us has, at least to some extent, a morbid curiosity of if not the actual end-of-days, at least our own end-of-day; and, the desire to somehow impact it. This is what some selling the telomere test will promise—a calculation of your biological age, and how to prolong it…by taking vitamins, increasing physical activity, avoiding weight gain or obesity, and correcting insulin resistance (diabetes).
Telomeres are like protective caps on the end of chromosomes, and when the wear out, cells stop dividing and eventually die; so, long telomeres are good and short ones are less good, unless you’re 120 years-old, in which case short ones are expected; or so the argument goes. Of course, it’s not that simple, or predictable for a host of reasons. Let me explain.
You have 23 pairs of chromosomes (46 total) in each cell in your body. Each chromosome is made of your DNA that is specific to you alone in all the universe, unless you’re an identical twin. DeoxyRiboNucleic Acid is kind of like a zipper in that it is made of two matching molecular strands that can unzip and divide into two so that proteins in the cell can assemble new, matching strands so that where there was one, there now are two. This works because each zipper strand has four different kinds of teeth (nucleotide base pairs) call them A, C, G, and T. Each tooth will match up with only one other: G with C, and A with T. And it is the specific sequence of the base pairs that encodes specific genes, like blond hair and blue eyes, or risk of colon and breast cancer. Some genes might have only a few base-pairs, and others, thousands.
23 pairs, 4 different kinds of nucleotides, only two matching pairs—doesn’t sound like big numbers; but, each chromosome can contain up to 10 billion base pairs in a twisted tangled chain. 46 invisible threads in an invisible nucleus in an invisible cell that tell us what we are, if not who. Pretty amazing stuff; and all supposedly arising from a lightning bolt striking a primordial soup long ago; or God—it’s your choice.
The problem with cell division is every time the DNA unzips you lose 30-150 base-pairs off the ends. It’s called “the end replication problem.” Since the telomeres serve as the protective caps, losing a hundred pairs is no big deal—the gene sequences remain safe on the inside as the telomere sacrifices a little bit of itself. The telomeres have about 10,000 base pairs, which comes to 66.6 (10,000/150) cell divisions before they wear out and die.
The age-related diseases; cancer, diabetes, atherosclerosis and heart failure have all been associated with shorter telomere length; as are also obesity and smoking. The question is, do short telomeres cause all this bad stuff; or, does all this bad stuff cause shorter telomeres?
In these studies of associations, and the telomere test itself, it is the White Blood Cell (WBC) whose telomere is being measured. All of our other cells (brain, heart, etc.) have telomeres too, which are widely variable at birth and across population groups; but, they are much harder to sample for obvious reasons, as opposed to a finger stick for a tiny drop of blood. Perhaps the WBC telomeres are more a marker of inflammation, which is the root cause of the metabolic syndrome, diabetes, heart disease, and many types of cancer. Perhaps the telomere test is more a marker of lifestyle choices, the results of which should be no surprise, than it is of longevity.
I don’t think the telomere test is ready for prime time. There are too many variables and too many assumptions; and more importantly, what will it tell you that you don’t already know: that you should stop smoking, lose weight, and control your blood sugars if diabetic? Well, let me say it then. Stop smoking, lose weight, and control your blood sugar. That will be $300 please, and you didn’t even have to give me a blood sample.
Additional Online Only Edition:
The nucleotides in DNA are; Adenine, Cytosine, Guanine, and Thymine; A, C, G, and T; and in humans, the telomere is made of repeating sequences of TTAGGG repeats for a total telomere length of 8-15 kilobase (kb) pairs, or 8-15,000 base pairs. This sequence is shared with mice, rats, and birds; and slime mold has an extra “T” (TTTAGGG). Hmmm…I wonder if there’s slime mold in primordial soup.
The cells in our bodies are called somatic cells; they have differentiated from stem cells into specific cell types; and as such, suffer from mortality, being good for about 50-70 divisions before cell senescence or apoptosis, which basically means cell death or disintegration. In contrast, embryonic stem cells are as immortal as a cell can be in that it has high levels of a protein complex, called telomerase, which can rebuild telomeres; so, in the stem cell, the telomeres don’t wear out. Some cancer cells also have high levels of telomerase, which is a factor in a tumors relentless growth.
Most of the studies drawing age-related associations have been with the telomere length of WBCs, which may be a more accurate measurement of the inflammatory state. The telomere lengths of various organs are widely variable from person to person, and from organ to organ within an individual. Do those individuals with shorter telomeres at birth of the heart cellshave a shorter life span than those of an individual with longer ones? Do people that die at a young age from illness have shorter telomeres than age-matched controls?
I think the telomere is a factor in aging, and potentially, eventually, subject to interpretation and intervention for longevity; but at this time the test result is, I think, nothing more than a curious novelty, no more accurate than having your palm read at a carnival.
My June contribution to the NWTC “What’s Cooking?” Newsletter. There. All caught up with my site migration. If not perfect, it is, at least, serviceable. I will be adding further video content in the weeks ahead. Anyway…the newsletter.
If you have not read part I, it is the immediately previous post.
Hungry in Hawi II
So I’m sitting on the covered-porch of the Zest restaurant in Hawi staring through the water in my glass to the street beyond. I feel trapped in an optical illusion with a wildly canted water level seemingly out of proportion to the table it was sitting on and I wonder if the inside of the restaurant is like one of those houses at the carnival where you can walk up walls. Cutting the first of my four ravioli into tiny pieces only made Jim, my brother-in-law, laugh harder, so I ate the last three whole, which didn’t take very long since I didn’t have to open my mouth any wider than if pronouncing a vowel, and I’m not even sure there was much mastication involved. Honestly, I couldn’t remember, the whole lunch being so opaque, ephemeral, like a dream.
Did I just eat lunch? Oh, silly me; of course I did, here’s the $110 tab by the water glass.
I can’t look at my brother-in-law sitting on the other side of the porch. His constant snickering, peppered with guffaws, grates on my nerves like a wire brush against fresh sunburn. “Hey. Shaun,” he says, managing to squeeze out, “maybe you should ask for a box,” before collapsing back in his chair in a paroxysm of laughter. It’s all I can do to keep from leaping across the narrow space that separates us and throttling the evil cackle from his throat. I imagine his eyes bulging, face turning purple… no…not in front of the children. It is they who save me, my nephew and niece; Gabe with one of his bread sticks, and Morgan with half of her BLT.
There…that’s better; I feel the carbs crossing the blood mucosal barrier into in the bloodstream. My serum glucose surges and the amygdala of my hypothalamus registers a modicum of satiety. I’m going to be okay. At least I’ll have enough energy to perambulate to the custard stand I see across the street.
As a physician, finely tuned to the metabolic processes of his body, I sense the ebbing of my rage, and trust myself to speak. “Say, Jen,” I ask, “what time’s that luau you signed us up for?”
“Um…” She’s thinking, lips pursed in a silent whistle, mentally ticking off the activities she’s planned for the next two weeks. It must be a tight schedule because her eyes are unfocused and moving back and forth like she’s watching the Williams sisters at Wimbledon as she mentally sorts through dolphin encounters, volcano excursions, snorkeling trips, and beach days at various locales. Finally, she says “…we have to be there at six for the open bar; and dinner and the program start at seven.”
Wow. I’m impressed. No notes or anything—it’s like a recording: a three hour period in a schedule probably as congested as the week before a shuttle launch at Cape Canaveral. I ask, “I wonder if it’s all-you-can-eat.”
“Well, I’m not sure about that,” she says, not as bothered by her ravioli dish as I, having the benefit of a prefatory bread stick and blended drink in a tall glass; “but,” she adds helpfully, “it is served buffet-style.”
Hmmm…buffet-style…that’s better. I know that even if the plates are on the smallish side I can always go vertical. I could even sneak in with a later table if necessary—I mean, what could they do? Arrest me? Humiliate me? Well, not likely; and, I don’t care. That’s one of the things I liked about being half-way around the world–anonymity.
The next five hours fly by. I try drowning Jim in violent surf at Hapuna Beach, but he gets away from me. At 1800, I’m standing behind Jen in a line at the open bar, wearing a see-through plastic poncho that the lady handed out, because of the rain. I put a bottle of beer in my cargo pocket and ask for two Mai Tais, but the bartender says, “Two drinks at a time.” I take the Mai Tais.
We found a table closer to the stage. Maybe that’s why it was the last table called– no later table for me.
Lunch a distant memory, chewed up orange-rinds from spent Mai Tais littering the ground around me, the maître de finally gives our table a tired wave. I leap to my feet like a Navy Seal on a mission. In the thick line ahead of me, the large bowl of kalua pork is half-full. I see that the serving spoon has fallen into it. A thin hairy arm reaches into the bowl to pick it up. The arm looks vaguely familiar. Then I see the lightly bearded face of the waiter that looked like the artist formerly known as Prince. He looks back at me, and smiles.
(I should add that the food at Zest was superb, if scant; hence, my general avoidance of fancy restaurants, not that Zest was all that fancy, other than the food, which was decidedly so.)
We’re driving north on 270 as it turns eastward at the extreme northern end of the big island. We just passed through Hawi on our way to the Pololu Valley overlook and as we passed the Bamboo restaurant Sue asked, “What’s that?”
“That’s my stomach growling,” I told her. “I’m starving. It feels like my belly button and backbone are touching.”
“Yeah, well, we’ll stop on the way back.” She didn’t sound very sympathetic. It was early on in our vacation, and I always start my vacations aggressively—with exercise, I mean. That morning, I had run three miles towards Mount Kea, and three miles back, towards the Kona coast, the ocean a glittering blue, suspended before me, like I was the only one in the world, down-hill—I almost ran fast. Later that morning we spent a couple of hours body-surfing in the waves with my brother-in-law and his family—I didn’t leave the water once. Now, we’re all dry and on our way to a late lunch, eventually, somewhere, and the way I had it figured, I was 6,000 calories in the hole, and that wasn’t counting the two thin waffles and left-over, pinkish-tinged, warm milk in the bottom of my six-year-old nephew’s cereal bowl. It was the last of the milk. I didn’t care. I drank it.
Pololu Valley is beautiful. I had seen it two years ago, but had forgotten where it was on the island. I just remembered a gorgeous view and a killer trail down a mountain to a black sand beach. I think it’s prettier than the Cliffs of Mohr. I stood at the top of the Awini Trail, looking down the zigzagging, dirt path, and swayed. I actually became light-headed at the thought of the caloric expenditure required for the descent and subsequent ascent. I barely made it back to the car, having to stop half-way to lean on a boulder, so weak with hunger was I.
Twenty minutes later, I’m standing behind my sister-in-law as she’s reading the menu in front of this place called, “Zest.”
“Mmm,” she purrs. I didn’t know if I should rub her belly or scratch her behind the ears. “Crab Ravioli with lemongrass and kefir lime infused coconut brodo,” she says, rubbing her hands together like she just squirted a tablespoon of lotion into her palm. “We’re definitely eating here.”
“Huhn? What’s that? Crab legs? Sounds good. Let’s eat.” I can’t wait. I hope they have a big basket of bread before the meal.
The waiter/cook/maître de, who looks like the artist formerly known as Prince, only with a light beard, and a faded ironman tee-shirt instead of a velvet purple jacket, seats us on the front porch, facing the street; Sue, I, and Morgan to the left of the main entrance; and Jim, Jen, and Gabe to the right of the door; but we’re all close enough that we can talk and pass things back and forth. Six-year-old Gabe orders bread sticks; ten-year-old Morgan orders a BLT; Jim orders the catch of the day; Sue, a salad; and Jen and I, the crab ravioli. It’s an entrée, it’s lunch, and it costs $18.95, so, I figured it’d do me just fine, especially with the side dishes and bread.
I suppose I should have known from my pasta experience the previous night at Merriman’s. It was a late supper. Of course, I was ravenous, but in a fit of fiscal sanity I passed on the $35 steak dinner, opting for the $17 pasta something or other. Unfortunately, my meager savings were quickly offset by the pre-dinner drinks and $10 deserts after supper; however, the six loaves of bread did allow me to push myself away from the table only slightly hungry, happy that I had hid the leftover Donkey Balls (chocolate-covered macadamia nuts) behind the toaster, back at the condo.
I hear the door slam and I smile. Hear it comes, I think. Let the feast of coconut brodo and lemon grass, or whatever, begin. Oh. It’s only Gabe’s bread sticks. They’re huge, almost like mini-French loafs. A few door slams later, Sue’s salad and Morgan’s BLT come out, then Jim’s fish, and with that, I experience my first tinge of concern—the dish is a huge white bowl with straight sides, and I can’t see the entrée all that well.
I don’t get any bread. There’s no side dish either. Set before me is a small, porcelain bowl with four ravioli in it the size of walnuts. I’m not even sure they’re touching. There’s some green vegetation that I take to be either lemon grass or a kefir lime leaf, maybe both.
Jim and Jen look over at me and start to laugh. I grimace, pick up my knife and fork and cut one of my four ravioli in half, hoping that the guy looking like the artist formerly known as Prince didn’t come out because I wasn’t sure I could stop myself from doing something I knew I’d regret later.