Category: Leisure

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Media Distortion Syndrome: The Baby Boomer Edition

It was 1963, the Yankees were swept by the Dodgers in the World Series, the Kennedy assassination was to be a month later and the Jetsons were on network TV. My upstairs neighbor, a wise old soul, a year ahead of me in 5th grade, casually predicted the future as he was downing his second Twinkie. “By 2000, all of the Jetsons things will be there for us.” The flying cars, the robot maids, the vacuum transport to Europe and the 2 day work week. 

Fast forward to New Years Eve, 2000 as I anxiously turned on the TV to watch the Times Square Ball drop to usher in the new millennium. Car commercials came on, all terrestrial vehicles, United Airlines ads promising low fares to Europe at subsonic speed and no robots in sight in my Southern California home. How could Joel, my upstairs neighbor, be so wrong?  A case of media distortion syndrome, baby boomer edition, no doubt. 

Social media is replete with opinions and conspiracies that pass as truth and shape our world today.  My generation, spared from the early influence of the internet, was a product of broadcast television. The three networks (CBS, ABC and NBC) and local New York City stations, WNEW channel 5 and WPIX, channel 11, raised us through the ‘50s and 60’s and shaped our proclivities, biases and sense of reality. Through the writer’s scripts, we were raised on the magical, the ingenuity of the white male, the geological time slips, bigotry-lite, and anthropomorphisms. Here is a sampling of television education gone wrong:

  1. The Magical
    1. Bewitched: A corporate advertising executive who marries a witch that can twitch her nose and change reality.
    2. I Dream of Jeannie: An astronaut finds a magic lamp and releases an attractive genie who alters reality and discombobulates authority.
    3. The Flying Nun: Self explanatory.
  2. Ingenuity and Family Glue: The White Male
    1. Family Affair: A wealthy, N.Y.  bachelor engineer becomes surrogate father to two prepubescent 6 year olds and a female teenager, assisted by his English valet. No problem!
    2. Bachelor Father: Bachelor attorney adopts his adolescent niece and live happily ever after. 
    3. Sky King: Rancher and aviator raises his niece and extricates her from all sorts of perils.
    4. My Three Sons: Widowed engineer raises three sons with the help of his father-in-law and later invites his daughter-in-law to live with the extended family. No problem!
  1. Geological Mayhem
    1. The Flintstones: Stone age family lives in Bedrock with their pet sauropod dinosaur. Humans: Pleistocene epoch, Dinosaurs: died in Late Cretaceous: 65 million year gap; a rounding error to the networks.
    2. The Jetsons: Flying cars, humanized robots and push button jobs but no physicists consulting on the show..
  2. Anthropomorphisms
    1. Mister Ed: A debonair horse who only talks to his owner and has an egotistical streak.
    2. The People’s Choice: Politician’s basset hound makes wise cracks about the hi jinx experienced by his owner.
    3. My Mother the Car: Self Explanatory.
  3. Bigotry-Lite
    1. The Real McCoys: An Appalachian grandfather moves with his grandson, and his family to cast aspersions on California natives. Starring  Walter Brennan, a John Birch Society member and avowed racist. 
    2. All in the Family: A Queens cabdriver, Archie
      Bunker, spins prejudice at home but his persona softened by his work ethic and his financial and housing support of his liberal son-in-law.
    3. The Beverly Hillbillies: Appalachian family moves to California where rich, wealthy Californians belittle the rural immigrants. A mirror image of The Real McCoys.

What we digested from those 3 networks and local feeds was entertainment to some and truth and dogma to others. Twitch your nose, rub a lamp, consult your single male engineer/attorney about child rearing or converse with your horse or your loquacious canine and prepare for a blissful life.  As to our current world, with each more outrageous conspiracy theory espoused on cable and social media, the Senate ready to discuss disenfranchisement of  millions of voters I can only shake my head and utter the insightful and comforting words of an equine star of yesteryear, “Oh Wilbur.”

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Understanding Oxygen and the Apple Watch 6: A Primer on Oxygen Saturation 101

The tech world has had a hold on the imagination and pocketbook of Americans for decades, improving our day to day communication, entertainment and educational options, all contained in the device we hold in our hands. More recently, tech companies have entered the multi-billion dollar health and wellness market, claiming a roseate outlook on life quality by revealing a wealth of “health” data populated on our iPhone or Android phones for us to peruse. For those that majored in business, art, political science or philosophy in college, watched “Keeping Up with the Kardashians” instead of “Mr. Wizard” reruns and did not take a physiology or human biology course, these numbers may be bewildering. It is time to let some “air into this room” and provide a background for understanding tech and health devices.  After 4 decades around EKG’s and pulse oximeters attached to humans and a user of Apple products for almost as long, I will provide the introductory course on the latest Apple foray into health: oxygen saturation and the pulse oximeter.

Oxygen is a key to human health. Before it’s atmospheric debut, we had bacteria for a billion years with few tech inventions during this period, save for the flagella, a whip like structure that could take you a few inches across a scum filled pond. Queue the plants (algae and other photo-synthesizers) and oxygen enters the atmosphere allowing for multicellular organisms and ultimately us (now is the time to hug your house plant out of gratitude). What did oxygen do for us? It unlocked the ability to generate much more energy from food sources that allowed us to dig a ditch, launch a satellite or use your TV remote. As any biochemistry or medical  student knows, ATP, the powerhouse chemical we use to store and release energy, is manufactured 16 fold in the presence of oxygen (for the curious, see oxidative phosphorylation and electron transport chain for more details).

The engineering dilemma that evolution was faced with for us multicellular beings was a supply and distribution problem. How to get oxygen from the air to each of our cells?  To move a substance, you need a pressure gradient to drive the work and the atmosphere pressurizes oxygen to move from high to low pressure zones. But this does not get the prized element to deeper tissues. For that obstacle, we evolved the lungs, blood vessels, blood and heart to circulate oxygenated blood to tissues to bypass this problem. 

Yes, blood, that substance thicker than water. Oxygen can dissolve in blood but at very low concentrations. To improve on the quantity of oxygen, we inherited the red blood cell and its key constituent, hemoglobin. Hemoglobin is the main oxygen carrier in the blood and allows pick up and delivery of 02 to the tissues. Oxygenated blood is bright red (usually arterial) and less oxygenated blood (usually venous) is blue. We can exploit this light absorbing property to determine how much oxygen is bound to hemoglobin at a particular moment by shining a frequency of light at a blood vessel and checking how much is absorbed and reflected at one time in the heart beat cycle.  The ratio of oxygenated to  de-oxygenated hemoglobin is measured, and reported as  oxygen saturation.

Do you need a device that warns you of oxygen shortage? Shouldn’t you feel short of breath, breathe faster and get yourself into an emergency room in time? Not always, as your brain, highly dependent on oxygen, can go haywire with  confusion, lethargy and poor judgement as a consequence. This is why the flight attendant always directs you to put your oxygen mask on first before your children. What about turning blue (cyanosis) from low oxygen? Unfortunately, this is a late occurring sign which occurs when fully ⅓ of the hemoglobin is devoid of oxygen.

Is there an early warning device to warn us of oxygen deprivation?Cue the pulse oximeter:  oxygen saturation can be measured by a pulse oximeter, or more recently with tech watches that have similar technology. Healthy lungs at sea level usually allow for oxygen saturation over 95%. As with all technologies, certain pitfalls apply. If your hemoglobin is abnormal it may not be measured properly. Carbon monoxide poisoning, for instance, renders hemoglobin incapable of binding to oxygen but is not registered by the pulse oximeter. Yes, you can asphyxiate with a normal pulse oximeter reading. The sensors must be close to the skin and not moving or else a faulty reading could result. Even expensive devices can be subject to error. Many a time in the surgery center, a reading of 60% could appear in an awake, non sedated patient. Repositioning the sensor, recalibrating the device or wheeling a new machine into the OR solved the false reading.

So what can you glean from the result? High altitude can lower oxygen saturation due to lower oxygen pressures. Altitude sickness can result with headaches, shortness of breath and in extreme circumstances, flooding of the lungs with fluid. Severe pneumonia can lower oxygen saturation and in the case of COVID 19, may not result in air hunger which would normally warn you of severe lung infection. Severe asthma could also cause a drop in oxygen saturation. Apple has started a research trial examining the usefulness of the Apple Watch 6 in this circumstance.

 The most important use of this technology may be in screening for obstructive sleep apnea. This condition is quite common in the U.S with a prevalence up to 30% of males and 15% of females).  Celebrities such as Rosie O’Donnell, Shaquille O’Neal,  William Shatner, (aka Captain Kirk of Star Trek fame), Quincy Jones, Randy Jackson (of American Idol fame) are afflicted. Luminaries whose death may have been influenced by sleep apnea include William Howard Taft (former 27th President), Jerry Garcia (of the Greatful Dead), Justice Antonin Scalia, Carrie Fisher (of Star Wars fame) and James Gandolfini (of Sopranos fame). Sleep apnea has severe health consequences and has acceptable, effective therapy. With the increase in risk factors such as adult obesity and sedentary nature of the population, obstructive sleep apnea is becoming epidemic, resulting in upper airway obstruction at night with snoring, interruption of breathing and dangerous reduction in oxygen saturation. This condition often results in headaches, daytime fatigue, hypertension, acceleration of cardiac disease and premature death. A continuous positive pressure mask can ameliorate this condition. A convenient, readily available screening tool such as a reliable pulse oximeter for nighttime use could potentially save multiple lives by directing those into the office of sleep specialists for definitive diagnosis and treatment.

So should you climb on board the day and night pulse oximetry tech train?  With certain caveats (a device that has reproducible results and matched to gold standard testing, FDA approval and  that works for night-time monitoring) this metric may benefit you when hitting the ski slopes and when your significant other has had it with your snoring and asks you to “do something about it.” Take a deep breath and ponder that.

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The Art of the Golf Excuse

With retirement comes the end of one of golf’s most prized excuses: “I don’t have enough time to practice.” Realizing that my golf foundation has been built on the art of the golf excuse, my anxiety level naturally elevated. While there are plenty of golf instructional books and videos, there is a dearth of expert commentary on the golf excuse. I will detail my excuse tree as generated over 50 years to help the struggling golfer with alibis for their own game.

  1. The Physician Golfer: I grew up watching golf on TV. There was Dr. Stone, Donna Reed’s pediatrician husband on “The Donna Reed Show” playing a Wednesday round; Dr. Cary Middlecoff and Dr. Gil Morgan (OK a dentist and optometrist but still in healthcare) were skilled PGA professionals with doctorates. Sitting for the MCAT (Medical College Admission Test) in 1974, the general knowledge section had the question: “Which sport do you take a divot?” Checking off golf, I dreamed of a future of an expanding medical knowledge and a shrinking handicap. Reality ensued over the years with the rise of HMO’s, IPA’s and 80 hour work weeks that left little time for golf. And the realization that pharmaceutical reps are the scratch golfers in healthcare.
  2. Learning the Game at the WRONG COURSE at the WRONG TIME: Few serious golfers seek New York City for their home base for learning and living the game. But that was not the case in the late 19th century when golf was brought over the Pond from Scotland. Willie Tucker was one of the first golfing emigres . Willie was was born in Scotland. His father was a greenskeeper in Wimbledon and his maternal grandfather competed against Old Tom Morris in the British Open. His brother in law, William Dunn, had the happenstance of meeting William Vanderbilt, the grand son of Cornelius, who was in the vanguard of the gilded age tycoons. Vanderbilt met Dunn in Biarritz, France where he was teaching his guilded age cronies the art of the game.Dunn summoned Willie to assist him in France., Willie realized his talents and funding were aligned in NYC where gilded age money was waiting to build golf courses for the privileged few. And build them they did. Willie Dunn designed Shinnecock Hills and their contemporary, Dr. Alister Mackenzie ( yes, of Augusta fame and a trained surgeon) designed the Bayside Links, just steps from my high school.  Willie Tucker got into the act, constructing the less heralded Clearview Golf Course and Yacht Club and Douglaston Golf Course, both in Queens. Golfing nirvana in Queens? Well, in 1920, New York City government took over management of Willie Tucker’s courses, cut down the trees to speed up play and put a goldfish pond near the clubhouse to (?) placate the golfers waiting hours to play a round. The end of World War II brought peace but golfing disharmony to the Queens tract. Robert Moses, the NYC Parks Commissioner, (see Robert Caro, The Power Broker, an in depth view of Moses) built the Clearview Expressway and Cross Island Parkway that further diminished the golf course acreage. New homes for returning veterans led to the closure of several golf tracts. Alister Mackenzie’s Bayside Links was closed and replaced with tract homes but Willie Tucker’s Clearview Golf Course was given a pardon. By the 1960’s, Clearview Golf Course had few trees, few traps, a busy expressway adjacent to the 5th hole, no practice areas and a typical 5 hour wait on the weekends. My first golfing lessons at Clearview were 1) aim is secondary and 2)always have a hammer ready to get your tee in the ground. If you got frustrated there was always meditation near the goldfish pond. 
  3. Golf magazine overdose: My first Golf magazine subscription was mid 1960s:take it back slowly, take it back quickly, stand close, stand far, take a lot of sand, take little sand: 50 years of golf tips was enough to prove the “paralysis by analysis” hypothesis. Luckily, I was spared of the launch monitor and spin rate statistics of the 21st century. 
  4. NYC High School Golf Team: under normal circumstances, competitive golf would be a boost to excellence. Our team played at the infamous Clearview course (vide Supra) and our golf coach was moonlighting from his usual job as the  the High School basketball coach. Not being familiar with the game, the team schooled him in the finer points of golf. We received “let’s press,” and “dig deeper” from his basketball motivational speeches. Bogey golf was the order of the day. 
  5. Getting Older: the only legitimate excuse in retirement. Loss of elasticity, lumbar and cervical discs on the move, degenerative joint disease, forgetfulness. The only benefit of dementia is vaccination against #3 and insures the golfing edict, “stay in the moment.”

The human mind (aka neocortex) is resourceful and resourceful hackers (the golf variety) can contribute to the “golf excuse” online community. I welcome your comments.