Blooming Wildflowers: As I set foot on the trail, my eyes widened with delight. The recent snows and rains had cast a spell, and the wildflowers responded by bursting into bloom with such enthusiasm that even the most seasoned botanists would be envious. Golden Columbine, Woods’ rose, Common Pacific Pea, Sticky Geranium, Wasatch Penstemon, and Pacific Ninebark paraded their colors, turning the trail into a living tapestry. Thankfully, I had my trusty sidekick, the Picture This app, to help me identify each flower. With a snap and a click, I became a botanist extraordinaire. Move over, Fremont and Ogden!

Symphony of Bird Calls: As I ventured deeper into the trail, a delightful cacophony of bird songs enveloped me. The Yellow Warbler, Chipping Sparrow, Western Tanager, and Black-Headed Grosbeak took center stage, performing their avian concert with gusto. How did I know who was who? Well, I whipped out my virtual maestro, the Merlin Bird ID app, which analyzed their melodious tunes and provided me with front-row seats to the avian symphony. I couldn’t help but imagine President Theodore Roosevelt himself tapping his foot to the beat, although I doubt he had access to such technology back then.

Tech Guides the Way: Amidst the lush scenery and melodious serenade, I realized that staying on track was crucial. Enter AllTrails, my digital hiking guru. With its comprehensive maps, trail descriptions, and weather updates, it kept me from getting lost and even warned me about the occasional lightning risks. AllTrails had my back, ensuring I wouldn’t end up as a character in a survival reality show. So, armed with my smartphone and a good sense of humor, I embraced the harmony of nature and tech.

Conclusion: The Dawn to Armstrong Trail is a testament to the beauty of nature, but it’s also a shining example of how technology can enhance our experiences. As I strolled along, Picture This transformed me into a wildflower expert, Merlin Bird ID made me a bird whisperer, and AllTrails guided me with the wisdom of a seasoned explorer. Who knew that 19th-century explorers and President Roosevelt could be upstaged by the likes of an app?

So, dear hiker, don’t hesitate to embrace the wonders of technology while immersing yourself in the wonders of the Dawn to Armstrong Trail. Let modern-day explorers like you use apps to become botanists, ornithologists, and expert navigators. Laugh, learn, and indulge in the perfect harmony between nature and tech as you create your own unforgettable adventure on this enchanting trail. Happy hiking!

I took my canine blog piece this week to ChatGPT and asked to convert it into Shakespearean sonnet and then write it in the New Yorker magazine style. All of four seconds passed when I received this output. It did not “red line” my original nor summon me to the English office after school hours. After a few minutes of sadness about the state of human creativity, I realized that we are doomed to the only job in the future: pushing a button like George Jetson working for Spacely Space Sprockets. Comments welcome.

Oh, how quaint and retro I may seem,

A lover of dogs from a bygone dream.

Gravy train and kibble, an old soup bone,

A shag rug for my faux dog throne.

Lassie, dear Lassie, my model of canine grace,

Saving grandpa from that mine shaft, what a race!

Rin Tin and Airbud, oh how they shone,

Snoopy, that smug dog, his charm never gone.

But now, in the 21st century, a grandpuppy has come,

A blend of beagle, pug, and a touch of Old Yeller’s gumption.

Watching stress-reducing videos on YouTube,

Meeting rodents in the forest, the views reaching 13 million, oh how true!

His bones, oh what a vast array,

No longer just bovine, they come in every flavor and day.

Rawhide, nylon, rubber, antler, oh what a delight,

Calcium phosphate, magnesium, salt-poor, salt-rich, what a sight!

Improved mouth health, jaw strength, tartar removal, all for the taking,

Supplemental vitamins and minerals, turning a dog into a Kennel Club sensation.

A Frisbee, an old treasure, the grandpup found,

But a new one from Amazon, a Kong, we quickly found.

Durability and universal love of dogs, oh what a claim,

Over the desiccated Portuguese Man o Wars, our pup was not the least bit tame.

Doggie health insurance, oh how grand,

Medicare coverage at 65/7, that’s a plan!

But what of fame and fortune, oh what can a pup do,

Hollywood is not the only path, I never knew.

Dog entrepreneurs, with their grooming and accessories galore,

Supporting animal shelters and having patents and trademarks to adore.

Manny The Frenchie, with a non-profit and a net worth of a million,

Walter Geoffrey, with his clothing line and sass, and a rap album in the making, how thrilling!

Loki The Wolfdog, co-founder of a travel app and a movie deal with Netflix,

Tuna, the Instagram celebrity, with an overbite that always smiles, and a book deal with Penguin Random House to fix.

Opportunities are endless, for the new century pup,

With improved nutrition, emotional adjustment, and love, they can really strut.

If only our grandpup would watch that instructional video on Frisbee catching,

The next Super Bowl halftime show, he’ll be ready, dispatching.

The New Yorker Style

As a proud retro dog lover, I was content with the basics: gravy train, kibble, an old soup bone, and a shag rug for a faux dog bed. My 20th century pup had it made. Lassie was the epitome of canine responsibility (Timmy: “Lassie, grandpa fell into the abandoned mine shaft again, go get help) and Rin Tin Tin and Airbud oozed star power. And let’s not forget Snoopy, with his smug confidence radiating from the daily comics.

But my recent encounter with a 21st-century pup shattered my nostalgic bubble. Baby-sitting my grandpuppy, a 9-month-old Orlando Rescue pup, I watched in amazement as he relaxed while watching a stress-reducing YouTube video of a Labrador retriever strolling through a verdant forest meeting a variety of rodents. This channel had 13 million views, although it wasn’t clear if they were the human or canine type.

And then there was the bone aisle at Petco – a cornucopia of choices that made choosing a variant of Pinot Noirs from multiple continental terroirs seem easy. Rawhide, nylon, rubber, antler versus bovine, calcium phosphate, magnesium, salt poor and rich and anti-oxidants. Bacon and cheese flavors could be added for those picky “chewers.” The packaging touted improved mouth health, jaw strengthening, tartar removal, improved oral microbiome, fresh breath, and supplemental vitamins and minerals that could turn your dog into an American Kennel Club icon.

Our grandpup discovered an old Frisbee in the closet which he immediately bonded with. But thanks to the mass of dog owners and capitalist ingenuity, I found Kong – a natural rubberized Frisbee that had nearly 27 thousand 4 1/2/5 star reviews touting its durability and universal love of dogs for this flying disc. I ordered it on Amazon and it arrived seemingly a few hours later. Our pup was bouncing after it on the sand and over the desiccated, beached Portuguese Man o’ Wars on the South Florida shores. And with top-notch “doggie” health insurance, he had no worries about jellyfish envenomation. I couldn’t help but wonder – at what age would he be converted to Medicare coverage? 65 years? 7? The thought amused me.

But wait, there’s more. Who knew that dogs have become entrepreneurs and started their own businesses? Grooming, training, accessories, food, and treats are just a few of the products and services offered. And some dogs even have patents or trademarks for their inventions or innovations. Manny The Frenchie (@manny_the_frenchie) not only runs a non-profit organization that supports animal shelters but also has a net worth of $1 million. Walter Geoffrey (@waltergeoffreythefrenchie) sells his own line of clothing and accessories that feature his signature sass and has a rap album coming out soon. And Loki The Wolfdog (@loki) co-founded a travel app called Loki The Wolfdog that lets you explore the world with your furry friend and has a movie deal with Netflix. Dog influencers populate the internet and often have more subscribers than humans. Tuna (@tunameltsmyheart), an Instagram celebrity, has a distinctive overbite that makes him look like he’s always smiling and also has a book deal with Penguin Random House.

So the opportunities are endless for the modern-day pooch. With improved nutrition, better emotional adjustment, and plenty of love, our grandpup can be the best dog he can be. If only I can get him to watch the YouTube instructional video on Frisbee.

Twenty years later, my hitchhiking days behind me, I drove with a friend to San Francisco. With the passenger seat littered with AAA and Rand McNally maps, my navigator advised staying on I-80 as the Embarcadero came into view.  “On no!”, I muttered, as I realized I was going the wrong way on the LONG Oakland Bay Bridge toward Oakland and was doomed to pay a double toll. 

Undeterred by my past travel mistakes, my family embarked on a European vacation at the turn of the century. My spouse, a capable cartographer and blessed with a directional sense like a passenger pigeon,  assured me that we were not going to get lost. We rented a Renault in Paris, buckled up our two boys,  and set out to discover the continent.  A few miles out  I failed to translate the “sens unique” (one-way sign, not covered in High School French). Sweating profusely, I made an instantaneous U turn and avoided a vacation ending collision. We arrived in Aachen, Germany and entered a museum devoted to Charlemagne. The exhibit explanations were in German with no translation. Ich bin ein Berliner and aufedasein were the extent of our German vocabulary. We detoured to the snack bar to complete the museum experience. That evening we arrived in Strasbourg with a thimble full of gas in the tank. The next morning, I pulled into the gas station, opened the gas tank door and noticed French instruction on the inside door (words, again not covered in High School French). I filled the tank and set off to Switzerland. A few miles onto the highway, the car started to lurch and emit a high pitched moan as I was shifting my manual transmission into 2nd gear. I got off the highway into rush hour Strasbourg traffic when the car led out a cringe worthy groan and stalled. Behind our Renault were at least 50 angry French commuters yelling French words (that again were not covered in High School French class). Later that day, a mechanic, with a cigarette dangling from the corner of his lip, informed me of my error of filling up a diesel engine with regular gas. He muttered some unintelligible French sentences but my rudimentary French picked up some words (stupide: stupid, guignol: clown).

After the ordeal, we decided to recharge with French cuisine. The bill came and I calculated the tip by mentally converting dollars into Francs. I mistakenly used the wrong currency in the calculation and was off by a factor of ten. The waiter was elated by his generous tip and my wallet was a good deal lighter.  I had finished the day with a trifecta of vacation gaffes.

I am now millions of neurons lighter in the 21st century compared with my youthful self but have gained “vacation bonus IQ points” with the advent of smartphone technology. Currency converters keep tabs on the foreign exchange markets by the nanosecond.  Apple and Google Maps keep me on track and down the right one way streets. I was cruising in the Mojave Desert on I-15 last week and the app warned of an accident (truck on fire) halting all traffic for 2 hours. As the temperatures soared in the desert, I placed a  call to the California Highway Patrol.   The California Highway Patrol representative asked, “ What lane are you in?”  “The far left lane,” I answered. “Stay in that lane. We just opened up that lane 60 seconds ago and you should be good.” Seconds later, the cars started to inch forward and we made our way past the accident. It was highway nirvana. 

Language barriers have fallen. Despite English ubiquity, Google Translate helped convert German menus, German museum placards and German signs into understandable jargon.  Impractical high school French classes devoid of real life vocabulary are no longer  dangerously impactful. Choosing a restaurant no longer requires a recommendation from a fellow bus passenger.  Today, Yelp, Google and TripAdvisor have us covered wherever we go in the world. 

 In May of this year, we took a trip through Eastern Europe for almost a month without a hitch.  I relied heavily on my technology loaded Iphone, T-Mobile cell towers and an occasional friendly recommendation from an equally tech savvy European citizen.  But travels would not be travels without mishaps that many times end up being memorable happy accidents.  The proof:  many years later these are the stories my family and I speak of and write about.

I am still recovering from my Diesel Mishap but encouraged to know that fossil fuels are in the rear view mirror and electric vehicles in the future will have only one plug to choose from. 

I

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.

The fates of Dr. Li Wenliang and Dr. Anthony Fauci will be irrevocably linked in our current times. Both physicians were muted by their respective political overlords:  Dr Wenliang sacrificed his life in the pursuit of warning the world of a deadly airborne virus originating in Wuhan, China and Dr Fauci, by the Trump Administration in thwarting his public health efforts in limiting morbidity and mortality. In these unsettling times, the assault on medicine and public health is not only lethal, but tolerated by industry, public opinion and political factions. 

When capitalism and profit intersect with human health, the American experience has often been in the favor of the former. American medicine in the 19th century was profit driven, fueled by several hundred medical schools that had no legitimate science curricula, no formal training programs and no criteria for competent professors. US medical students, desiring a top flight education, would journey to Paris to get state of the art instruction. Snake oil salesmen who peddled dangerous potions for multiple ailments thrived in the 19th century. 

The 20th Century provided some sanity and sanctity in the pursuit of science and healthcare. Abraham Flexner, an American educator, at the request of the Carnegie Foundation, reported in 1910 on quack medical training that resulted in the closure of multiple schools and began the scientific basis of medical education in the U.S. The Food and Drug Administration, established in 1906,  provided an oversight of drug therapy and provided a safety net to the general public.

Greed and the pursuit of profit in healthcare today still cannot be denied.  Popular entertainment reinforces the profit motive. Mr. Wonderful, on Shark Tank, when reviewing a vitamin and herbal supplement, gleefully queried the proprietor, “I don’t care if it works, what are your yearly sales?” Gordon Gecko, in the 1980’s movie “Wall Street”, uttered “Greed is good.”  Even in the 1950’s, Jim Anderson,  the iconic principled father in “Father Knows Best” sitcom during  the Eisenhower era, readily endorsed the Springfield snake oil salesman’s request for a business license because he was good to his dog and family. 

Congress got into the act of greed and greenbacks in response to a potential flood of pharmaceutical lobbyist money, further sacrificing the principles of science and public safety. Utah Senator Orin Hatch orchestrated potential legislative medical malpractice with The Dietary Supplement and Health Education Act of 1994 (DSHEA) which decreed that over the counter supplements and herbal products did not need to prove safety data prior to their release to the public and any complications would only need to be voluntarily reported. The supplement companies could not claim to treat a “disease” but misleading euphemistic claims such as “supporting health, “wellness,” or supporting a biologic system could be used in advertising without any scientific data to confirm the claim. What was the result? The OTC industry money profits increased from $9 billion to $50 billion,  Salt Lake City, Utah became a destination for the supplement companies. Hatch’s family became lobbyists for the industry and he and other members of Congress had a reliable flow of campaign donations.  What did the consumer get? The answer is clear: A flood of products that resulted in liver injury, life threatening drug interactions and occasional cardiovascular deaths. Product labeling was often misleading or wrong. Probiotics, living bacteria that can contribute to health, were often non viable or absent when analyzed by microbiologist/scientist scrutiny (R. Knight, UC San Diego). Families put themselves into financial jeopardy by spending hundreds of dollars per month on bogus supplements hawked by salesmen and health providers. This was a legislative fiat that legally supported medical quackery.

Now the technology industry is attempting to expand their profits by tapping into our health obsession and circumventing health law. Products that evaluate sleep hygiene, pulse and heart rhythm and oxygenation are entering watches, phones and bracelets. When developing a new technology, the rational response is to compare your experimental device to a gold standard that accurately measures the outcome you are looking at. For sleep analysis this is polysomnography, a medical test that looks at EEG, respiratory rates, eye movements among other data; oxygenation gold standard is the transmission pulse oximeter. Tech companies, such as Fit Bit and Apple, for instance, bypass the gold standard test and support their device results with an opaque “secret artificial algorithm.”  In the few studies that compare products to their gold standard, they are often shown to be inaccurate. The companies, unable to get FDA approval, then take guidance from the supplement industry by using “wellness” as the reason for the biometric. With no reproducibility and no public direction on the meaning and actionable explanation for the results, we are left with tech company advertising babble to encourage their purchase. 

It has been the pandemic of 2020 that has shown the stark reality of science deniers. Trump’s effort to undermine science and mask wearing and the infiltration and destruction of our beloved NIH, CDC and FDA autonomy has been an armageddon moment in healthcare. Pushing hydroxychlorquine, megavitamins and experimental medications that have not been fully vetted in randomized controlled studies as effective cures is unacceptable to the medical community and cannot be recommended as treatments to the public at large. Furthermore,  anti-vaxers, and proponents of the deadly “Herd Immunity” strategy are further evidence of our dilemma.

I am reminded of Dr. John Snow, a British obstetrician in the mid 19th century, who observed his London patient washing her infant’s diapers in a common water pump in town that spread cholera throughout the community. Snow’s work established the water-borne source of cholera and his urging of removing water pump handles. His pleas went unheeded by the public and scientists of his time leading to the death of thousands of additional victims in the cities around the globe. Accepting well designed investigations and their conclusions are our only way to avoid a “Dark Ages” outcome of health goals.

Our hope for the future lies in the investment of science teachers, high quality training of physicians and allied health providers, debunking and removing dangerous healthcare products on our social networks and providing the public with political leaders who want to move away from the past and into the evidenced based medical world of the present.