Friday, August 22, 2014

The Need for Zzzzz

It happened again last night. I’m sleeping like a baby when all of a sudden, my brain stirs to life and shouts, “WAKE UP AND START WORRYING!!” It happens all the time. My internal alarm strikes 3 a.m. and that little worrywart inside my head jumps aboard the stress treadmill and starts ticking off the miles. Lately, he’s been training for a marathon.

After recently resigning from my job and selling my house, I’m facing an impending move and a new direction in life. This provides a veritable smorgasbord of concerns on which my anal retentive mind can feast. To make matters worse, I can never seem to sleep past dawn. In fact, I’m lucky to make it to 6 a.m.. Usually I’m tossing and turning by four, checking and rechecking the clock, until boredom sets in, I throw back the covers, and get on with my day. Even when I aim to sleep late, my brain usually betrays me by whispering, “Time’s a’ wasting!

All this insomnia got me thinking about the need for sleep. Sometimes I imagine how much I could get done if sleep weren’t a necessity. I could write or work out or study till dawn. Unfortunately, my early rising usually means I’m comatose by ten. Sleep comes quickly, even if it's short lived.

So let’s take a peek at the necessity of sleep and remind ourselves of the critical role it plays in a healthy body.

We are not alone in our need for Zs. Sleep is a necessity akin to eating and breathing, and all mammals share the same fundamental sleep patterns; which, in humans, are broken down into five stages, culminating in REM, or “rapid eye movement” sleep.

Stage one is the light sleep we experience as we drift off. This is also the time when sudden muscle contractions, known as hypnic myoclonia, can jolt us awake, since they are usually preceded by the sensation of falling. Stage two eases us into Stages three and four, known as “deep sleep,” during which our brain downshifts, producing the slow delta waves that accompany these stages. It’s during deep sleep that it’s most difficult to be awakened. And then comes the REM sleep.

Rapid eye movement sleep is the crème de la crème of snoozing and begins with signals sent from the base of the brain, or pons. The signals are whisked to the thalamus and then relayed to the cerebral cortex, that vital outer layer of the brain responsible for higher thought. As the cerebral cortex is stimulated, the pons sends other signals to neurons in our spinal cord, shutting them down so we don’t act out in our sleep - a dangerous but I’m guessing, potentially hilarious condition called REM Sleep Behavior Disorder. Can you imagine the carnage associated with an afflicted competitive eater??

REM sleep is when our dreams take flight. Each of us spends about two hours a night in the dream stage, which scientists have discovered is critical to a healthy brain. Protein production increases during REM sleep and those deprived of it have greater difficulty learning and retaining information. REM may also be fundamental to brain development, since infants spend much of their downtime in this stage. (I wonder what fills their dreams… giant nipples, perhaps?).

In fact, sleep is crucial to good overall health. Sleep gives our cells time to repair and produce proteins, and promotes a healthy nervous system. Sleep deprivation leads to lack of concentration, memory impairment, and, possibly, early death. Studies among rats show that well-rested rats typically live two to three years, while their sleep deprived buddies usually croak after only five weeks.

Scientists are still trying to sort out why we dream. Some believe dreams are the brain’s attempt to organize and interpret random signals given off during REM. Freud believed dreaming provided a safety valve for our unconscious desires and that through our dreams, we could fulfill our innermost wishes. However, they are constructed, dreams provide a momentary escape from reality. They can exhilarate, stimulate, or terrorize, depending on their content. But they can also provide a window to the past.

Sometimes, I dream of my parents. And in those dreams they are young and smiling and alive.

Perhaps Freud was right.

See you next week.

Friday, August 15, 2014

Up in Smoke: A Brief History of Cremation

Around forty thousand years ago, along the shores of Lake Mungo in southeastern Australia, a small group of aborigines took time out from wallaby hunting and emu egg gathering to cremate the remains of a woman. Mungo Woman, as she is affectionately known today, was cremated and her bones crushed, then cremated again, before being buried along the shores of this ancient lake. Discovered in 1968 by a young geologist scouting for fossils, Mungo Woman would achieve fame not only as one of the most ancient skeletons from the land down under, but also the oldest human cremation yet discovered.

It took a while for cremation to catch on. The tried and true method of earthly interment began around one hundred thousand years ago and, although our friends in the Outback may have gotten a jump start on cremating, it wasn’t until around five thousand years ago that it took hold as a custom. So let’s trace its origins and see how it’s become one of the most common methods of disposing of the dead.

Cremation on a regular basis first crops up in northern Europe and the Near East. Stone Age Slavs were producing decorative urns in which to house their loved ones' remains and the practice soon spread into the British Isles and southern Europe. By three thousand years ago, the Greeks had jumped aboard the cremation train and it quickly became their primary means of disposal. Cremation was quick and clean, and proved a handy means of disposing of the dead, especially during times of war (aka, most of Greek history).

By the rise of the Roman Empire, around two thousand years ago, cremation had taken hold in Italy (an excellent means of dispensing with dead gladiators). Urns had become so elaborate that they required special repositories; they were simply too pretty to stick in the ground.

But with the rise of Christianity, cremation found itself in a death spiral. Christians shunned the practice since it smacked of paganism, and it soon fell by the wayside, except during the rare instances of plague and war. From this point on, the dead were placed in the ground and it would take another fifteen hundred years for cremation to emerge from the ashes (couldn’t help myself…).

And emerge it certainly did. But it didn’t just slink back onto the stage. Modern cremation sprang to life at the opening of the Vienna Exposition in 1873, when an Italian by the name of Brunetti displayed his cutting-edge oven, guaranteed to reduce your loved one to a fine, ashy powder! A year later in England, Sir Henry Thompson, surgeon to the Queen and enamored of the thrift of cremation, founded the Cremation Society of England, and crematoriums began cropping up in England and Germany.

Never to be outdone by our friends across the pond, Americans began experimenting with cremation - which is ironic, since Native Americans had been cremating their dead for thousands of years before the palefaces came ashore. The first American crematorium was built by Dr. Francis LeMoyne in 1876 on a small parcel of his land, aptly named Gallows Hill, within the quaint community of Washington, Pennsylvania. Fearing the town’s crowded cemetery was leeching into local water sources, Dr. LeMoyne deemed cremation a more sanitary alternative, so he spent fifteen hundred dollars of his own money to have the small brick building erected.

He designed the oven to prevent direct flame contact with the bodies, and the first cremation was lit off on December 6th. Sadly, of the forty-two cremations that took place at Dr. LeMoyne’s crematorium, his would be number three. He was slid into the oven in 1879 and his ashes were placed in a small urn in front of the building, which still stands today and is run by the Washington County Historical Society. (Call ahead for private tours.) 

Today, cremation is all the rage. It is a world-wide custom practiced in most societies and integral to many religions. From Buddhists to Christians, from Hare Krishna to Quakers, burying ashes has become an accepted method of interment, although many have specific guidelines. Yes, there are religions that shun the practice - Islam, Orthodox Judaism, and even the Presbyterians, who don’t forbid cremation, but simply prefer the ground - but cremation provides an economical alternative to the rising (and ridiculous) cost of traditional burial.

In fact, a quick Google search in my area not only turned up a plethora of crematoriums, they also sport catchy names. According to their website, Island Cremations, located on Merritt Island, provides an all-inclusive deal for the bargain price of $695. (“Don’t overpay on your most difficult day!”) There are even crematoriums for your pets! Pet Passages, which claims to be the “Leading Authority in Pet Loss,” has a website where you can choose the type of service, pick from a beautiful collection of stylistic urns which start at seventy dollars, and peruse a list of books to help get you through your loss (such as Cold Noses at the Pearly Gates, by Gary Kurz).

So if you haven’t done so already, give cremation some consideration. According to the fun folks at the National Funeral Directors Association, the number of those preferring the oven to the ground have skyrocketed, from a paltry three percent in 1960 to a whopping forty-three percent in 2012! It’s an affordable, space-saving means of disposal without all the fuss and muss of a casket and hearse (urns fit comfortably in the trunk). Besides, I’d rather be perched on the mantle than stuck in the cold, hard ground any day.

On a personal note:
Two of my books recently won silver medals in the Florida Authors and Publishers Association President's Book Awards. Check them out!

Friday, August 8, 2014

Unintelligent Design

Last month, doctors removed an astounding 232 teeth from the jaw of a young boy in India. The teeth, which ranged in size from small flecks to marbles, were the result of a rare disorder called “complex composite odontoma” and were removed using a hammer and chisel, since the size of the growth precluded simple extraction. When all the fragments were removed (along with a normal molar affected by the tumor), the boy’s jaw was sewn up and he went happily on his way.

By normal standards, this is a strange case, but these peculiar tales crop up on a fairly regular basis. It seems the human body is always devising bizarre ways of expressing itself, like the eighty-seven-year-old woman from Switzerland whose esophagus would twist into a corkscrew every time she ate, or the nineteen-year-old Iranian boy who had a tumor removed from his eye when it started sprouting hair - an apparently normal response for limbal dermoid tumors, which have also been known to grow cartilage and sweat glands.

These stories represent odd conditions in which the normal structures of the body have gone awry. But you don’t have to search far and wide for biological oddities. Our bodies contain a number of strange and nonsensical structures that no intelligent designer would include when drafting the model Homo sapiens, and I have spent considerable time imagining alternative arrangements, some of which I’ll share with you today. So let’s take a look at a few of these anatomical anomalies.

Let’s start with our eyes. There are numerous problems with the design of the eye, which is ironic, since many creationists use the intricate construction of the eye as proof of a creator. If that were the case, why would our retinas be inside out? Why would our photoreceptor cells (the rods and cones) be displaced by the optic nerve and vessels, resulting in a “blind spot”? And why the hell do so many of us have to wear glasses?? If only we had the eyes of a gecko… Nocturnal geckos sport zig-zagged pupils that make for excellent night vision and their little wandering orbs are about 350 times stronger than ours.

And what about our throats? It’s a sad state of affairs that our esophagus and trachea originate in our mouths. That small flap of cartilage known as the epiglottis, whose sole purpose is to slam shut to prevent food and drink from “going down the wrong pipe,” fails on a regular basis, resulting in many a fatal choking. A better design would be two separate openings: one for air and one for food. If only we had a blowhole, we could breathe and swallow in unison. No wonder dolphins are always smiling.

Since we started our story with teeth, let’s address the problem of dental crowding. The majority of humans can no longer accommodate the full set of thirty-two, forcing many of us to have our wisdom teeth yanked. We’d be better off if we simply did away with the third molars. We can obviously survive just fine without them. Despite having mine removed, I’ve gone on to lead a full and healthy life, yet was relegated to two torturous years of braces to correct the crowding they left behind.

And how about our nipples? How did they end up so high on the chest? They would be far more practical at waist level, allowing mothers to simply nurse their infants from their laps. And why do men even have them? Aside from a tickle during foreplay, they really serve no purpose on you boys.

And speaking of sex… vaginas are another issue, especially when it comes to childbirth. Because of the route the vagina takes through the base of the pelvis, our bigheaded infants must pass through the tight confines of the pelvic outlet. This arrangement can make childbirth a dangerous venture. We’d all be much safer if the newborn was simply expelled via the umbilicus. Or better yet, if we could transform ourselves into marsupials and carry the little bugger around in a pouch. When it was ready to emerge, it could simply scuttle up to the nipple (and if they were waist high, our little joey wouldn’t have to scuttle nearly as far!).

The human body is full of idiosyncrasies, proof that we did not arrive fully formed. Nor are we models of perfection constructed by an omniscient designer. Our bodies are the result of millions of years’ worth of evolutionary tinkering. Natural selection has tweaked our structures to provide greater adaptability and an evolutionary edge, yet our flaws are numerous, our quirks abundant.

So embrace your oddities and keep in mind they are part of our complex evolutionary legacy. Besides, perfection is overrated. See you next week!

Here's an awesome read on the subject!

Friday, August 1, 2014

Resuscitating the Dead

How many of you have ever seen CPR performed on a victim? Better yet, how many of you have performed it yourself? If you’ve never seen or done it in person, I’m sure you’ve witnessed the hokey representations on TV, where the medical crews pump on the victim’s chest for a few minutes and are rewarded when the patient sits up and says “howdy.” Unfortunately, it doesn’t really work that way.

This week, as part of my paramedic renewal, I completed my recertification in Advanced Cardiac Life Support (ACLS). ACLS provides guidelines for cardiac emergencies, including CPR, drugs, and advanced techniques, such as airway procedures and defibrillation. The certification must be renewed every two years, so that providers remain proficient in their skills and informed of guideline changes.

I’ve been cramming for the past week, studying EKG strips, calculating drug dosages, and memorizing the latest protocol changes in an effort to avoid embarrassing myself during my exams. All that studying got me thinking about the history of cardiopulmonary resuscitation (CPR) and how far we’ve come in our attempts to revive the dead. So let’s take a peek at this convoluted history.

First, for those unfamiliar with the basics of CPR, let me give you a brief overview. If someone goes into cardiac arrest, CPR, when performed properly, provides breathing and circulation for the downed victim. Compressions to the chest circulate the blood, thereby oxygenating the tissues, and ventilations done mouth-to-mouth (or better yet, mouth-to-mask) provide the necessary oxygen. These measures, performed as soon as the victim collapses, greatly improve his chance of being revived, since the longer one goes without circulation, the less likely one is to respond to advanced treatments.

Early medical practitioners understood the basics, even though it took them a while to put the pieces together in a coherent strategy. As far back as the 1500s, the physician and anatomist, Andreas Vesalius, realized that animals could be kept alive by forcing air into their lungs. The alchemist, Paracelsus, tried resuscitating a corpse using bellows, a technique he lifted from ancient Arabic medical scripts. And there are even references to mouth-to-mouth in the Bible. Elisha is reported to have breathed into a child in order to revive him, so apparently people have been dabbling in artificial respirations for quite some time.

It wasn’t until the 1740s that the Paris Academy of Sciences publicly recommended mouth-to-mouth for drowning victims. But following the discovery of oxygen in the 1770s, practitioners decided the exhaled air delivered via mouth-to-mouth was too deoxygenated to be of much use. Mechanical methods had also fallen out of favor after a few mishaps with the bellows (apparently it’s pretty easy to blow out someone’s lungs if you’re not sufficiently trained), so the idea of artificial respirations fell by the wayside and the focus shifted to chest compressions.

It was well understood by this time that blood circulated throughout the body and that circulation was fundamental to life (battlefield injuries probably provided the obvious link between bleeding and rapid death). A Mr. Moritz Schiff, in 1874, noted that pumping the chest of a dead dog produced a carotid pulse, and word of his canine cardiology quickly spread. It was soon tried out on felines when Rudolph Boehm and Louis Mickwitz successfully resuscitated a kitty by squeezing its chest and ribs. But it wasn’t until the 1890s that Friedrich Maass actually applied it to a human.

Unfortunately, the concept of cardiac massage would also fall by the wayside for the next seventy years, until 1958, when William Kouwenhoven reintroduced chest compressions in treating the pulseless.

Despite the evolving science, misconceptions about reviving the dead persisted. Folks believed the stricken merely required the proper stimulation. Bodies were placed in rolling barrels or strapped to horses in order to jostle them back to life. A naïve but industrious sector even devised crazy contraptions on which the dead could be resurrected, and these methods hung on well into modern times.

Through trial and error, it was finally established that a combination of ventilations and chest compressions could provide adequate respirations and circulation for victims of cardiac arrest. Lifesaving took another giant leap forward with the discovery of electricity and its effect on the heart. Since the heart relies on electrical impulses to generate a pulse, and certain types of cardiac arrest are due to erratic electrical impulses (known as fibrillation), researchers devised a method of delivering a shock to the heart that could correct the dysrhythmia. Thus the tried and true technique of cardiac defibrillation was born.

Today, millions are trained in CPR, professionals and laypeople alike. And it’s a good thing, for immediate CPR is an essential link in the “Chain of Survival.” By recognizing an unresponsive person, activating emergency medical services, and quickly initiating CPR, you too might help save a life. So get trained and stay current. The next victim could be someone you love.

Here's a great how-to video about CPR!