Living the Admirable Life

How do you lead a good and admirable life, even if you are never going to be famous? Perhaps a good idea would be to search for and identify people who are widely admired and to try to follow their example.

With this in mind I went to the Wikipedia list of the 18 most widely admired people of the 20^th Century. The full list includes: Mother Teresa, Martin Luther King, Jr., John F. Kennedy, Albert Einstein, Helen Keller, Franklin D. Roosevelt, Billy Graham, Pope John Paul II, Eleanor Roosevelt, Winston Churchill, Dwight D. Eisenhower, Jacqueline Kennedy Onassis, Mohandas Gandhi, Nelson Mandela, Ronald Reagan, Henry Ford, Bill Clinton, Margaret Thatcher.

Indeed these are all admirable people, but immediately I run into a problem. Most of these people don’t look like me. Five are women, and three definitely have darker skin. Three have far more hair, Eisenhower has less, and Einstein’s hair – well. That certainly narrows down my options.

Maybe instead of being admired it would be better to be significant. Again there’s a list for that, this time from the Smithsonian. They have several different categories. As a Rebel or Resistor I have slim chances when I see names like Martin Luther King Jr., Robert E. Lee, Thomas Paine, John Brown, Frederick Douglass, Susan B. Anthony, W.E.B. Du Bois, Tecumseh, Sitting Bull, Elizabeth Cady Stanton, and Malcolm X. How many of these people look like me?

The rest of the categories were equally discouraging, George Washington or Abraham Lincoln (?) and especially where, listed under the athletes category I found Secretariat!

Not to be deterred, I look for a role model under “25 Most Influential People In History By Attribute.” Bruce Lee, I don’t think so. Washington (again) was followed by Walt Disney, Louis Pasteur and Marilyn Monroe. I stopped reading. I can see this will be another dead end. Few if any of them look like me!

Yes, this essay has gotten a little silly, but it’s only to point out how silly people are to handicap themselves by believing their role models must be someone who “looks like me” to be valid. None of the originals had any role models at all. They just had to behave their way to success. We could learn a lot from them just by looking at their words and actions, yet we hear the looks-like-me mantra all the time on the news and in sports. The absence of a role model who looked like me is a favorite complaint. It seems like another excuse to portray oneself as victim, often by people who have been successful enough to be given a platform in the first place. That a role model must look like me is a limiting, negative and discouraging message to give to any child. It’s a shame that it has become such a common theme.

On a related note, one of the most influential and admired people in my life is having a birthday today. Happy birthday, Marilyn. Cheers!

Responsibility - It’s Never My Fault

The tragic news originally came out on July 8. Yahoo reported it with the headline: “Young girl falls to death from cruise ship ‘after being accidentally dropped by grandfather.’” Everyone was shocked and saddened. A little 18-month-old girl from Indiana fell “about 150ft after slipping through her grandfather’s arms as he held her by an open window, according to local media reports.” The family was vacationing on a cruise ship. The incident happened while the ship was docked at San Juan, Puerto Rico.

This sad story might have ended there. But at the time I predicted that lawyers were probably tripping over each other trying to get to the family to convince them that it was not their fault; the cruise line was probably to blame. The family is understandably suffering, and shifting the blame and collecting some compensation would provide some level of closure and relief. The child will not have died in vain if they can use this lesson to make cruise ships safer.

The case would move into the American legal system where they can achieve some sense of relief at no cost to them. Attorneys will take thirty to forty percent of the award or settlement amount, charging nothing if they don’t win. The cruise line need not be shown to be totally at fault; only a small amount of blame will make them legally liable for damages.

Originally, the reports held that the grandfather was holding the toddler on a ledge next to an open window when she wriggled free, he lost his grip and she fell. By the next day the story is changing. They were in an area designed for kids with a wall of windows, which passengers can open. Their attorney says, “She fell because an open glass pane should have been closed securely” and describes the open window as a “hidden hole” in that wall of windows. The grandfather unknowingly placed the child on “the wood railing before the wall of windows, believing Chloe will bang on the glass just like she does at her brother's hockey games, ‘and the next thing he knows, she's gone.’”

The following day an Australian news outlet reports that the family “denied reports the little girl’s grandfather lost his grip on her.” Judging from the pictures accompanying that story, the wall of windows consists of upper and lower panels, each about three feet high with only the upper ones able to be opened. Despite the fact that it is highly unlikely that an 18-month-old could get out of such a window unassisted and that it is strange that a grandfather would be unable to distinguish between an open window and a pane of glass, they insist on placing “significant blame” on the cruise ship. (Are we to believe children commonly plummet out of these hidden holes?)  

In the later reports, see how quickly the baby has a name with cute pictures posted along with pictures of grief stricken parents. This benefits the news media by further sensationalizing the story and benefits the lawyers in the same way.

What will happen next is clear, and this headline tells it all: “Lawsuit likely to be filed by end of month in toddler's cruise ship death.” Would many companies take the risk that a jury, looking at those cute pictures and seeing such pain in the faces of the parents, would decide that the grandfather was careless and there was no reasonable action the cruise line could have taken? No, they will use the “did they do everything possible” argument, a condition no one could live up to. I predict a settlement for an undisclosed amount: happy lawyers, parents somewhat comforted and jurors feeling good about being able to bring about some level of comfort.

It’s happened so many times before. People die of lung cancer after a lifetime of smoking; relatives sue. People get sick from improperly using pesticides; relatives sue. Bartenders don’t take responsibility for their customers. The list goes on, facts don’t matter, no one is responsible and we are no longer surprised.

Latest (?) Alzheimer’s News

Isn’t it interesting how the number of Alzheimer’s stories and articles picks up every July? Actually, it’s not a coincidence at all. The annual meeting of the Alzheimer’s Association International Conference® is scheduled for the middle of July. This year it ran from the 14^th to the 18^th in Los Angeles. Naturally, the news media eagerly awaits the latest studies coming out of the conference because the subject of Alzheimer’s Disease or dementia is an emotional draw for so much of their audience.

Since there is still no drug treatment to prevent or cure dementia, the emphasis lately has been on other prevention practices. Is there anything we can do? Yes, there is, and it’s announced as a new breakthrough regularly. But in reality, it differs from year to year by only a few minor tweaks and looks very much like other familiar health advice.

In 2017 a new study, “published in The Lancet and conducted by the first Lancet Commission on Dementia Prevention and Care, brought together 24 international experts to review existing dementia research and provide recommendations for treating and preventing the devastating condition.” They concluded that a third of dementia cases “worldwide could potentially be prevented through better management of lifestyle factors such as smoking, hypertension, depression, and hearing loss over the course of a lifetime.” It was presented as a new report. Although the report was new, these recommendations look very familiar. 

For example, in 2015 World Dementia Council (WDC) asked the Alzheimer's Association to evaluate and report on modifiable risk factors, that is, possible prevention steps for cognitive decline and dementia. They concluded that there was “sufficiently strong evidence” that “regular physical activity and management of cardiovascular risk factors (diabetes, obesity, smoking, and hypertension)” along with “a healthy diet and lifelong learning/cognitive training" could have a positive effect.

 And last July similar news came out of their annual meeting, which was held in Chicago. One of the experts announced the results of a large multi-year study: “Lowering blood pressure more than usually recommended not only helps prevent heart problems, it also cuts the risk of mental decline that often leads to Alzheimer's disease.” Getting the top number down to around 120 was shown to lower risk of mild cognitive impairment by 19 percent. (That’s three references to hypertension in four years.)

At that time they reminded readers that the American Heart Association recommends the following lifestyle changes to help manage high blood pressure: balanced diet, alcohol in moderation, regular exercise, weight and stress management, no smoking and taking medications as directed. (It all sounds familiar.)

Not to be deterred by the fact that this is getting a bit repetitious, last week the BBC (and many others) reported on the latest findings revealed at this year's conference with the headline: “Dementia: Lifestyle changes that could lower your risk.” The report outlined the factors associated with a healthy lifestyle: no smoking, eating a healthy diet, getting regular exercise and drinking only in moderation.

I didn’t investigate these studies to mock the findings. I agree with the findings. In fact, it is totally aligned with something I published over 5 years ago, pointing out that there are really no secrets to good health, just the same old advice.

 Rather my intention was to show how the media repeat news stories, rarely questioning whether or not it’s really new. I also discovered, without a hint of surprise, that they will adjust any news story to fit their agenda. In this case as reported by Kaiser Health News (KHN), the Washington Post reported that the study advised, “Ditch the red meat,” and KHN wrote, “Give up red meat.” When I looked at the study details and dug into the (footnote) source they used to define a healthy diet, the wording was “fewer red meats,” not to ditch it or give it up.

That leaves us again with a need for discipline to stick to that common-sense healthy lifestyle and critical thinking to take the news with a large helping of skepticism.

Pets and Perspective

At its core perspective is about having a healthy and realistic system of values. Values are what help each of us separate the important from the trivial to set appropriate priorities, to know what to work for and to know what is worth fighting for. Values determine how we spend our energy and our money. 

One area where this idea of healthy and realistic values seems to be breaking down is the automatic responses of pet owners.

I’ve written before about the family in Oklahoma who wanted to bar their neighbors from a public tornado shelter because the capacity limits would not allow their dog to stay. 

The same story tells of a woman who chose to stay outside with her small dog in the storm when another shelter would not allow it to come in. Although I think it’s foolish, I wouldn’t deny someone the right to risk her own life to comfort her pet. But they have no right to deny a safe haven to other humans for the sake of a pet. It’s no different from the people we read about every winter who risk their lives to save dogs (or other animals) stranded on the ice. The foolish choice rests with them, but their families may be the ones to live with the consequences.

Along those lines, when I hear news reports of a firefighter saving family pets, I wonder if the young family of a firefighter who died in an attempt to save another family’s pet would think it was a justifiable decision. 

I’ve written elsewhere about the thought experiment where people must choose whether to reroute a trolley, where one choice would kill one person while the other would kill five. Among the variations of this experiment is a case where people could save a stranger or their dog. Over one quarter chose to save their dog over another human.

The question arises; do many people really value the life of an animal over the life of a fellow human being? This is apparently the case. Even when it is not a life-and-death decision, more people are choosing the dog.

The headline from earlier this month tells it all. “Survey Finds Over Half of Dog Owners Kiss Their Pooches More Than Their Partners.” Not only that, but the survey conducted by Riley Organics, an organic dog treat company, goes on to say that “over half of dog owners surveyed preferred to sleep with their pet, not their partner, in the bed.” The outcome was 52% in each case, and 61% report kissing their dog on the mouth – I hope we’re not talking about French poodles!

According to another source reporting on the same survey, 94% “said they would rather stay at home with a dog than spend a night out with a human friend.”

I found no indication of the number taking the survey. It may be a small sample size. Also, self-reporting is a less reliable indicator of reality. The participants may also have been their customers, and people who buy organic treats for their dogs are already a little off-center. If that is the case, the accusation about skewed values may not apply to a large part of the population, however, it is suspicious and the behavior seems to be spreading.

If dogs are becoming more popular companions than other people, I guess an addiction to cell phones and texting is not the only reason for the growing interpersonal isolation.

Keeping an Eye on the Doctors

Over the past few weeks a number of shady healthcare situations have come up. There is often not a lot patients can do about doctors with bad intentions or to recognize their illegal behavior, but there are usually clues.

The first case involves medical fraud. A cardiologist was convicted on two counts of fraud for double billing insurance companies and using a procedure to treat problems it was not designed for.

The doctor administered an outpatient treatment known as External Counter Pulsation (ECP). “ECP involves the use of a specialized bed equipped with pressure cuffs, which exert pressure upon patients’ lower extremities as a means to increase blood flow to the heart.” Insurers only reimbursed doctors when this treatment is given to patients with angina and only when a physician is present.

The doctor operated 25 beds at numerous locations in three states where, in many instances, no doctor was supervising. Even for his patients who never experienced chest pain, he “instructed his employees to indicate that every patient had disabling angina on billing sheets that were used to support false insurance claims.”

Although they couldn’t do anything about the billing, the patients should have been very suspicious. It came out at the trial that in order to acquire new patients he advertised the procedure “as ‘the Fountain of Youth,’ claimed that it made patients ‘younger and smarter,’ and offered the treatment for a range of ailments other than disabling angina, including obesity, migraines, high blood pressure, low blood pressure, diabetes, and erectile dysfunction.” When a single medicine or procedure is advertised as curing so many unrelated ailments and uses come-ons like Fountain of Youth, patients should smell fraud miles away – not insurance fraud, but someone definitely trying to sell them snake oil.

In another case at the behest of the FDA, a judge issued a permanent injunction against a stem cell company “to stop...illegal behavior after several attempts to provide the clinic and the individual defendants the opportunity to work with the agency to come into compliance with FDA regulations and protect patients from harm.” In an inspection the government  found “significant deviations from current good manufacturing practice requirements” including failure to establish and follow procedures to prevent microbiological contamination. “The FDA has not approved any biological products manufactured by [the company] for any use.”

Again the patients cannot know all the details, but the products were being administered “to treat a variety of serious diseases or conditions, including Parkinson’s disease, amyotrophic lateral sclerosis (ALS), chronic obstructive pulmonary disease (COPD), heart disease and pulmonary fibrosis.” [Emphasis added.] 

These too-good-to-be-true qualifications should be a warning signal to everyone seeking medical help, even the most desperate. For every two that the authorities catch up with and go through the long, legal process of shutting down, there are probably two hundred still operating and advertising. As long as this kind of outrageous advertising continues to attract patients, the practice will continue.

It is not surprising that insurance companies cause frustration by being as careful/fussy as they are even about reasonable practices. Some healthy skepticism and critical thinking on the part of patients are our best, and sometimes only defense against fraud.

You Can’t Judge a Beer by Its Cover

The alternative title could be Beauty and the Beer. 

In either case, I am not awfully qualified to talk about beer. I drink it rarely, at the infrequent cookout or gathering, primarily when that’s what everyone else is having. I let someone else choose the brand because they all taste about the same to me. I would always prefer a moderately priced wine.

That being the case, on some of those occasions I’m puzzled to hear someone defending his choice of beer as the best tasting. Television ads have also for years touted the taste of their beers, especially stressing how they can remove the calories without negatively affecting the great taste, presumably allowing imbibers to get drunk without getting fat.

That’s why I was so surprise to see, first on the TV news and later on the CBS website, the headline: “ ‘They want more than just a great beer’: How craft breweries are embracing cover art.” That’s right, craft breweries – considered by some to be the best of the best, small batches, meticulously brewed, old-world recipes, etc. – are trying to differentiate themselves with artistic labels. Or as CBS puts it, “Craft beermakers go to extraordinary lengths to brew up the perfect pint – and lately, that attention to detail has shifted to what's on the outside as well.”

They go on to explain how one particular brand was rated Best Beer Label in a recent USA Today poll. “For years, the can has been one of the most sought after in the world.” 

Their competitors are following their lead, teaming up with artists and designers to create new and captivating labels. Some examples of their efforts are listed here in a piece called, “The 20 Best Beer Label Designs of 2018.” Although these are fun to look at, the first question that comes to mind is, who is judging which is the best? As subjective as the rest of the art world is these days, it’s likely one person’s opinion vs. another. Are they going to develop “schools” of beer can art?

While the beer brands are trying to win business with artsier labels, this is one of the companies trying to win business as a label designer by convincing them of the importance of such a decision. “With the sheer variety of beer labels on store shelves, making a buying decision can be challenging. As a result, many shoppers gravitate toward the brightest, boldest, most unusual designs.” 

Although judging a beer by it’s label may seem like a silly premise, Nielsen studies have shown that the design of the container or box can carry almost as much weight with the beer buying public as the style and brand name.

The whole situation reinforces the observation of how superficial Americans can be. No matter how adamant some are about their favorite brand, marketing departments of large and small brewers are willing to shell out more money for designers to come up with innovative labels to sway the public, increase market share and even turn their customers into beer can collectors. It’s the perfect marriage of two purely subjective judgements, taste and beauty. Will the beer drinkers of today be trading beer cans like their grandparents used to trade baseball cards? Will they march like lemmings to buy the prettiest beer can as determined by the annual beer can judging contest, just as teenagers are influenced by the number of likes on social media content?

Perhaps this means that I have been right all along and that one beer tastes about the same as another, forcing them to turn to a new gimmick to try to stand out.

Walk Faster, Live Longer?

A very interesting article in JAMA a number of years ago requires the application of critical thinking to avoid making a misinterpretation.

 A team of scientists put together a summary of nine studies over the years totaling almost 35,000 subjects over the age of 65, residents of various nursing facilities . Each study was trying to find out whether measuring a person’s walking speed could help predict how much longer they would live.

The data came from the various researchers measuring how fast people walked over a short measured course, between 8 and 20 feet long, using a stopwatch and converting the speed to feet or meters per second. They then followed up years later to see how well the measured speed at the time of the test correlated with how much longer the individuals lived. (The authors refer to it as “gait speed.”)

The published conclusion, when they put the information from all the studies together: “In this pooled analysis of individual data from 9 selected cohorts, gait speed was associated with survival in older adults.” The graphs accompanying the article show this quite clearly, and the findings held true for both men and women and for people of different races. The top group walked the course at 1.6 meters per second, which converts to about 3.6 miles per hour. (For a longer distance this would mean a pace at which someone could walk a mile in about 17 minutes.)

How is this useful? “First, gait speed might help identify older adults with a high probability of living for 5 or 10 more years, who may be appropriate targets for preventive interventions that require years for benefit.” It could help assess whether a particular medical procedure would be worth the risk – there is always a risk, especially for older people. “Second, gait speed might be used to identify older adults with increased risk of early mortality, perhaps those with gait speeds slower than 0.6 m/s.” It is a simple and informative way for “assessing expected survival to contribute to tailoring goals of care in older adults.” Furthermore, it is a simple measurement that can be easily done in a nursing home corridor by non-professionals.

How is this not useful? Correlation is not causation. Someone seeing this article and not using critical thinking might conclude that beginning to walk faster was a way to guarantee longer life. After all, the graphs on the page clearly show that those who walked faster lived longer. Except for the fact that exercise is good for anyone, this conclusion is not necessarily so; it’s not what the analysis shows.

The authors theorize that the correlation exists because, walking “requires energy, movement control, and support and places demands on multiple organ systems, including the heart, lungs, circulatory, nervous, and musculoskeletal systems.” A slower walking speed could indicate some damage or a larger than normal energy requirement for other reasons. Both could be a general indicator of lessened vitality. It makes sense that those who were going to live longer were just capable of walking faster, and did so.

Unfortunately, scientists did not prove that increasing our walking speed will increase our life expectancy. (In fact, people walking faster while texting could easily decrease their life expectancies.) Getting more exercise, including walking, and generally taking care of ourselves will. There is rarely one easy answer. The real secret to good health appeared in this space over five years ago and, unfortunately requires some degree of discipline.

Gas Price Self-Deception

Here we are in the middle of the Independence Day weekend. AAA expects a record number to spend time away from home, an estimated 49 million people traveling in total. “That’s up 4.1 percent – 1.9 million people – compared to last year. This will mark the sixth consecutive year of travel growth for the holiday.” This source says “you’re better off staying home,” but that’s unlikely to change anyone’s mind.

Of all those travelers, more than 41 million will be driving, “likely thanks in part to lower gas prices,” which AAA expected to be 19 cents lower than last year.

The estimate of 19 cents was posted on June 27. A week later the new number was lower. “U.S. gas prices are creeping higher this week, owing to an extended rally in global oil markets and a weaker dollar, but drivers are still set to pay some 15 cents less per gallon over the July Fourth holiday and the weekend that follows, adding more than $100 million in extra spending power to the consumer economy.”

This is something I can never make sense of. A few pennies per gallon and people are ready to adjust vacation plans. Consider first the estimate cited above of $100 million available for other spending. That’s a lot of money. But wait! That amount divided by the 41 million people filling up their cars (or riding in them) is $2.44 per person. That is not a lot of money. Even if the difference had stayed at 19 cents and the savings jumped to $3.10 per person, that is still not a lot of money. Yet people make these kinds of decisions all the time without doing the math.

(Also, if an AAA estimate can be off by over 20% in less than a week, consider how little faith to put in other, similar estimates, even when they are made by people who study the subject all the time.)

But back to the subject of gas prices and on a related note, we find that Illinois residents who live near the border are going out of state to refill their gas tanks after the state doubled the gas tax, raising it (coincidentally) by 19 cents per gallon.

The July 1 issue of the Chicago Sun-Times leads with: “Illinois Drivers Head Over The Border To Find Cheaper Gas On First Day Of New State Gas Tax.” Gas stations just across the border are seeing a surge in business as “some Illinois drivers are frustrated, fed up and willing to make the trip to save some money.” They are almost in the same boat as the vacationers except the decisions they are making are long-term, so calculations are even more important.

The newspaper interviewed various residents traveling to Hammond, IN for gas. In one example a man said, “Takes me 20 minutes to come over here” to fill the tank. That could easily burn half a tank of gas. Burn half a gallon of gas each way at $2.75 per gallon to save on 19 cents for 12 or 15 gallons? (19 x 15 = $2.85) After the round trip the savings comes to about one dime!

Another case looks more favorable. “He makes the trek from Pilsen,” near Chicago, which is also about 20 miles away, but he buys more than gas. “We go to the big box store” and “are able to get more groceries for the family.” Now it becomes a destination for other shopping, not just a round trip, and the Indiana sales tax is 3% lower than the tax in Chicago. This makes a little more sense.

One other consideration, though, is the value of your time. Some insist it should be worth a minimum of $15 per hour to any employer. Should it be worth less to you? Is spending an extra 20 minutes an investment of another $5 or do people consider it free time? 

Critical thinking leads to some interesting questions and often some different conclusions.

Crazy Cat Lady – A Critical Thinking Parable

Mayor Rescot was just getting settled at her desk, when she heard a knock on the doorframe and looked up to see Sheriff Blanding standing in the doorway.

“Come on in, Sid. What can I do for you?”

“It’s that Maude Romans, the crazy cat lady.”

“What now?”

“Things are getting worse. Those cats of hers are in the yard, in the street, and yesterday she called the fire department to get a kitten out of a tree.”

“Sid, I thought we had that all taken care of. Didn’t you send someone to have a nice talk with her and try to persuade her to give up a few of those cats? Isn’t animal control looking into it?”

“Yea, but she wouldn’t listen to anyone. And she went to the local shelter last week to try to adopt another one. They shooed her away, but they suspect she has also been sending her teenage grandson on similar missions. He and his friends think it’s a hoot to try to get more inventory for the crazy cat lady. The problem is we don’t have an ordinance limiting the number of pets per household like most other towns do. Without that my hands are tied, and the complaints from the neighbors are getting louder and more frequent, taking resources away from real problems.”

“OK. Good point.  As you know there’s a town board meeting tonight. I’ll bring it up and it wouldn’t hurt if you were there too.”

The next morning saw two glum town officials sitting in the mayor’s office sipping coffee.

The mayor broke the silence, “Well, that didn’t go as expected. I thought the debate might be about whether two or three was the right limit on the number of pets per household. Instead it turned into a screaming match. Are there that many cat lovers on the council, or are they just trying to make our jobs impossible?”

“Yeah, and when I pointed out that the place smelled and we’ve gotten reports of some supposedly underfed cats, Councilor Johnson went ballistic! She suggested that if it’s such a problem we should stop harassing the poor old lady and use tax funds to send extra cat food and hire a cleaner for her house. She said they're not cats and kittens. They're Mrs. Roman’s furry children, and she loves them. Does it get any crazier than that?”

“As a matter of fact it does. This morning my daughter told me a petition was already going on Facebook making us look like the bad guys. I wouldn’t be surprised if there were protesters gathering on the lawn with ‘Save the Cats’ signs and ‘We Don’t Limit Families.’ Johnson had some of citizens whipped into a frenzy.”

The sheriff shook his head. “Why does it seem that all the crazies turn out for these meetings and the sane, sensible, cool-headed ones stay home?”

“Well, I’ll just have to wait until things settle down, try to talk to the other board members individually and hope common sense will prevail. As long as people think acting nobly to make themselves feel better is the same as solving a problem, we will face opposition. It’s too many cats in one place, not how happy Maude Romans and her cats are.”

The sheriff headed for the door. “Well, good luck on that, Madam Mayor. You’ll need it.”