Sunday, May 22, 2016

A Whiff of Memory

He was diagnosed with dementia several years ago. His high intelligence beforehand, supportive family and set routines allowed him to live alone in his house in the country until recently. He came into hospital with an infection and delirium and is now waiting for a long term care bed. His body is strong and he is accustomed to walking outdoors. The locked unit is confining and frustrating so I try to take him outside for a walk a couple of times a day. He picks up sticks on the lawns and checks the downspouts and drains of the outbuildings. We sit at the lookout over the river and watch the Turkey Vultures circling above. Like many people with dementia, he has lost his nouns, including the names of his children and his deceased wife. I talk about our surroundings and he responds politely with normal conversational cadence and tone but the words he strings together make no sense at all. 

As we walk along a ridge at the back of the property we come upon a sweet, strong smell. I ask him if he knows what it is. 

“Lily-of-the-valley,” he responds without hesitation.

I pick one stalk of fragrant white bells and put it in his buttonhole as we walk back to the locked unit.

Monday, May 16, 2016

Logos and Mythos

Trent Evans was a Canadian involved in making the ice for the hockey tournament at the 2002 Salt Lake City Winter Olympics. He secretly placed a “loonie”- our dollar coin- under the surface at centre ice. He did tell the players of the Canadian men and women’s hockey teams about the talisman and both teams went on to win gold medals. The “lucky loonie" was retrieved and is now in the Hockey Hall of Fame in Toronto. Similar coins have been placed beneath the ice at subsequent international hockey tournaments and the Royal Canadian Mint has released a commemorative edition "lucky loonie" for each Olympic Games since 2004. 

Logic would tell us that the teams won gold medals because of skill and hard work. But adding Mythos to the formula added confidence and initiative which may have contributed to the victory. Having a ritual or physical lucky charm can decrease stress and anxiety, give a more positive focus and an illusion of control. Superstitions can provide meaningful psychological benefit, giving a sense of power thus diminishing negative emotions such as helplessness. 

My best friend from childhood is a tenured professor at a Toronto university who has published several books and is one of the most intelligent people I have ever met. We had brunch together this past weekend and she shared how the number “5” or better still, “55” had significant meaning for her. Both of us were born in 1955. When applying for her doctorate program her application form had her special number on it. She sets her alarm for x:55 AM and goes to bed and x:55 PM. When she bought her current home, she knew it was the right place because the street address was “55”.  And of course her vanity license plate includes the number 55. I have known her for over 50 years and was not aware of her private idiosyncrasy. 

Medicine is an interesting field where Logos and Mythos go hand in hand. Medical practitioners are well educated scientifically but patients are emotionally vulnerable and need more than facts. When we visit a doctor we expect a diagnosis, adding great pressure to quickly provide a name for our ailment and a prescription for an appropriate remedy. Imagine going to a doctor and coming out without a diagnosis and a concrete treatment plan! Misdiagnosis is a huge problem and the overprescription of antibiotics and pain medication is at crisis levels. Using inert formulas as medication can bring about real physiological cures in what is known as the placebo effect. Placebos were used frequently when I first worked at a hospital but they are now only given with patient consent, which erases their value in my opinion. Brian Goldman is a Canadian doctor who has an interesting show and podcast on CBC Radio One called “White Coat, Black Art”. He explores the “art” of medicine which has not changed all that much over the millennia. 

Most of us have some interest in mystical and supernatural phenomena. I wrote a post a few years ago about the ghost, Francine, who supposedly haunts our hospital. We blame all unexplained events on her, from call bells that go off in empty rooms to consistently similar visions reported by patients at night. I do not have Logos to accept or refute the presence of ghosts so Mythos prevails.

Is faith different than superstition? Many times religion becomes “religistition” - a mix of faith and superstitious belief and ritual. There are people who seek indulgences, works, or a trail of “signs and wonders” rather than focusing on a faith that quietly sustains the soul in good times and bad. I see God at work around me and use prayer as preparation for my day. But it is easy to slip into rote prayers, expectations of blessings, and pronouncements of finding "God's will".

The human mind is very susceptible to suggestion. Superstitions change the way people behave either by increasing fear and anxiety or by boosting confidence, performance and positive outcomes. Knowledge is a combination of logic and intuitive insight which is not always present in balance. Mythos varies culturally and from person to person and helps explain the gaps in Logos which we all experience. How boring would life be with nothing but logic?

Saturday, May 07, 2016

About Birds, Nests and Caretaking

Male Bobolink in the meadow

One of my favourite places to go birding is a large field in the country that contains five large communication towers. The meadow is fenced and no public access is allowed. It is the only regional place I have found that is home to nesting Bobolinks, Horned Larks, Meadowlarks, Grasshopper Sparrows as well as more commonly found birds like Bluebirds, Savannah Sparrows, Killdeer and Goldfinches. Bobolinks are very hard to find and their overall numbers have decreased 74% since the 1960s mainly because of loss of meadow land. They build their nests on the ground and raise one or two broods a season. I took this picture of a male last May when they returned from wintering in South America.

I visited the area one evening in June and was horrified to see that the field had been mowed. The land had not been touched in the several years I had been coming here. Large round bales of meadow grasses and flowers were scattered about and the lack of bird song created an eerie silence. I took one picture and left quickly, very upset that bird habitat was destroyed during nesting season, just for cattle feed. 

Bobolink meadow mowed and baled

We have a lot of farmland surrounding our city. The main crops are corn and soybeans and mixed farms are scarce except among the Old Order Mennonite community. Corn and soybean fields line the roadways kilometer after kilometer.  Corn crops are mainly used for animal feed, ethanol, and processed corn products. Soybeans are also used for animal feed and processed foods. With all the soybeans grown in the area, I cannot buy a single fresh pod of  fresh edamame anywhere because the entire crop is sold through a marketing board before it is planted.

Corn, corn and more corn across the road from the Bobolink meadow

More than half of the grain crop in North America is used for livestock feed, in other words, for meat and dairy production. Factory farming methods have contributed to ecological destruction in other ways. Single commodity crops require large amounts of fertilizer and pesticides which in turn contaminate water supplies and likely contribute to recent declines in pollinator insects. Animals raised in factory farms are given antibiotics routinely and this adds in part to increasing antibiotic resistance. Cattle produce significant amounts of green house gases (methane) and factory farmed animals produce huge amounts of untreated fecal waste.

In 2006 the United Nations produced a report called Livestock's Long Shadow: Environmental Issues and Options. It claimed, among other things, that livestock create 18% of green house gases which is more than all types of motor vehicles combined. The report is available online or you can read the Wikipedia summary at the link above.

Seven years ago I decided to stop eating meat, mainly for health reasons. I also decreased my dairy intake significantly and the benefits to my well-being were significant. Over time, I continued to abstain from animal products for the good of the environment and for the welfare of the animals themselves. My husband is a meat eater and the dog will not eat vegetables so we have animal products on our grocery list. But our meals are mostly plant based and we try to buy meat and cheese locally, using it sparingly. It is unrealistic to think that the whole world will become vegan but even modest reductions in processed foods and animal products can make a big difference to the environment.

Local Old Order Mennonite farmer harvesting corn on his small mixed farm

I realize our household carbon footprint is still too large. We continue to look for ways to contribute to better environmental and social practices that will make a difference to earth and its inhabitants in future generations. The issues are complex and are different in third world nations than in first world nations. Our demand for inexpensive food, clothing, and other "throw-away" possessions is detrimental to the earth and to the workers in developing nations.

This documentary contains much of the information contained in the 2006 United Nations report on livestock. The first ten minutes or so outline the basic concepts that are discussed.

“Only within the moment of time represented by the present century has one species -- man -- 
acquired significant power to alter the nature of the world. ” 
Rachel Carson, Silent Spring

Monday, May 02, 2016

Spring Horse Auction

We have the most interesting year-round markets in our region, the largest being the St Jacobs Farmers Market which is north of the city. On Friday and Saturday, a large horse auction was held on the grounds of the market. This is a significant event for the region's Old Order Mennonite population and they came in large numbers. The horses I saw auctioned were sold in the three to four thousand dollar range. It is not unusual for a larger buggy to be pulled by two horses making their transportation costs similar to the purchase of a used car. 

I find it interesting to watch the Old Order Mennonite children. They are well behaved and participate in adult activities without complaint or special attention. I also had to smile when I heard the descriptions of the horses before they were led into the ring. Some were featured as "buggy broke" "church broke" and "traffic broke" along with their age, parentage and current owner. 

I didn't have much time to linger on Saturday after we did our market shopping but managed to take enough photos to put this short movie/slide show together.

Sunday, May 01, 2016

Falling, Fear and Fortitude

Trail companions- Raven and nordic poles

I have been afraid of heights as long as I can remember. Very afraid. I am uncomfortable on a balcony higher than the third floor or climbing more than three rungs up a ladder. Seeing someone stand on the edge of cliff makes me feel physically ill. For many years I could not look at a photograph of a waterfall without my stomach doing a loop. Sky diving, bungee jumping, zip lining, and rock climbing have never been on my bucket list. 

As a physiotherapist working in geriatrics, fall prevention is an important part of my job. I see many people who are admitted to hospital as a result of falling and sustaining a significant injury. In taking a good history, it is very important to determine the reason for a fall. Was it due to a medical condition or the physical environment? Does the patient need a gait aid? Our goal is to prevent further falls in hospital and after discharge. 

Whatever the cause, falling aways does one thing. It creates an increased fear of falling. And that fear keeps people at home, decreasing their participation in activities in the community and can even create walking disorders. Canadians endure long winters with lots of snow. We have a few ice storms each season which are far more treacherous than snow storms. Inclement weather is one reason people here can become increasingly isolated as they get older. This increases their risk of depression, physical and cognitive decline, placing them in a downward spiral functionally. 

I am surprised at the resistance I frequently get when trying to get someone with a history of falling to use a cane or wheeled walker. They don’t buy my argument that a gait aid will help them get more exercise, making them more independent and less likely to fall. I tried to get a family member to use a walker after she fell and broke her shoulder because of poor balance. A year later she fell and broke her hip and had no choice but to use one. (Family members are often most resistant to advice!)

Tackling my fear of ice and waterfalls at Niagara Falls
I had two bad falls on ice resulting in a broken wrist and a broken elbow. They happened over 20 years ago and when I see ice, I still feel some panic. Initially I was inclined to want to call in sick at work rather than walk across an icy parking lot after a storm. Instead, I bought ice grips for my boots and a pair of nordic poles which stay in my car at all times. Every time I succeed in walking across a slippery surface, my confidence increases. Nordic poles are also my constant companion when walking on trails and prevent stumbles on tree roots and uneven ground. 

Over the years I have come to understand the source of my fear of heights and my panic is under more control. Fear protects us but is debilitating in excess. Depending on our experiences, added years bring new anxieties which alter or replace childhood fears. We can fall down physically, professionally, socially, or in close relationships, but in each case it is important to learn from the fall, to put aside fear, get up and try again. Other people may have insight into the reason for our fall and may we never be too proud to ask for guidance and advice on our journey. 

Two people are better off than one, for they can help each other succeed. 
If one person falls, the other can reach out and help. 
But someone who falls alone is in real trouble.

Ecclesiastes 4:9-10 NLT