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A New York-based artist-slash-engineer is taking a typical visit to the doctor’s office and turning it on its head.  According to the New York Times:

“Dr. [Natalie] Jeremijenko, an Australian artist, designer and engineer, invites members of the public to the clinic to discuss personal environmental concerns like air and water quality. Sitting at the consultation desk, she also offers them concrete remedies or ‘prescriptions’ for change, much as a medical clinic might offer prescriptions for drugs.”

Until profound legislative and social changes occur, Dr. Jeremijenko’s clinic serves as a place for people to act now to improve their local environment, from installing “butterfly gardens” in no-parking zones to halt storm-water runoff, to using solar energy to power LED lights.  This kind of prescription for change is an idea well worth emulating.

Sometimes, the sheer enormity of the problems in the world can make you feel that your efforts to help out are a bit trifling.  How can small changes on an individual level possibly make a dent?  Michael Pollan, journalist, author, and localvore, takes this mindset to task in a recent article that argues that little steps, individual actions and yes, even changing your light bulbs, really can save the world.  Pollan maintains that one of the “most powerful things an individual can do” is plant a garden.  He admits that it sounds pretty trivial, but says that it’s actually the key to “reduce your carbon footprint, sure, but more important, to reduce your sense of dependence and dividedness: to change the cheap-energy mind.”

I can vouch for this: container gardening changed the entire way I look at food, food production and my part in the whole system.  It didn’t happen overnight of course.  Just like my tomato plants, my concept of gardening took a while to flower.  I started out small – just a few herbs, like basil, parsley and cilantro.  I felt like an abject failure for a while because my coriander plants yielded nothing but a few spindly stems and then promptly bolted in about a month.  Why did my plant look nothing like the lavish bunches of cilantro I see at the grocery store?  It was maddening. Undeterred, I went bigger and gave lettuce, onions, tomatoes and jalapeno peppers a go. 

Little by little, my “separateness” from the food I eat became smaller.  I witnessed the entire process – seed to plant to flower to food to table – right there in front of me. Embarrassingly enough, until I actually grew veggies, I didn’t realize how different they actually look compared to the more processed versions available in stores.  I had a vague idea of how peppers come to fruition, but now, I get to check in on the whole process as I leave my apartment each morning for work.  And I still can’t quite believe how much lettuce six small plants can produce.  “I don’t think we have to buy any lettuce until October,” Chris, my significant other, said to me last week, almost giddily.   

 I recently went to a free container gardening workshop put on by a Portland organization called Growing Gardens.  There, I learned how to fertilize the soil, what times of the year are best to plant different veggies, and just how much food one can yield from very small spaces.  During the workshop, the teacher mentioned that a local restaurant called Rocket grows the majority of their veggies on the roof of their space using a range of containers, including kiddie pools.  That absolutely threw me for a loop.  If a container garden system can provide a restaurant with enough food to feed hundreds of stomachs each week, then surely I can feed my two-person household with some dirt, a few planters, and a little bit of know-how.

While I’m not quite at the level where I can forgo trips to the grocery store, I envision a summer when all the veggies I eat come from my backyard.  Container gardening definitely increased my sense of self-sufficiency and, at the same time, my concept of integration with the natural rhythms of life.  None of this is groundbreaking, and it certainly won’t be responsible for saving the world.  I can tell you though that my little corner of the world is different.  There are thousands of container gardens just like mine dotting the city of Portland and millions across the country.  All of those gardeners’ little corners of the world are better for it.  Pollan says, “The Big Problem is nothing more or less than the sum total of countless little everyday choices.”  Like a virus, or just a really good pop song, making better “little everyday choices” can stick with you and spread, transforming “The Big Problem” into a “Large But Not Intimidating Issue That Can Be Fixed.”

Should US citizens be concerned about pharmaceutical drugs and personal safety? Aside form the litany of side-effects that accompany pharmaceutical drugs, the US’s FDA might be putting patients in harm’s way. Here are the facts, you decide:

An article in the NY Times today announced that 80% of the components comprising the US’s pharmaceutical drugs are made in foreign countries. Foreign drug suppliers do not have to meet the minimum regulatory standards set here in the US, which may result in counterfeit products. When you take a moment to consider all the recent news from China concerning toothpaste ingredients such as diethylene glycol (a poison found in antifreeze) and the lead-based paint used on toys, we may want to reexamine our health care options.

The FDA announced that it is unable to keep regulatory records for the safety of these foreign manufacturers, citing poor data management systems. The result is that the FDA relies on foreign inspectors and volunteers, oftentimes where the manufacturer gets a “heads up” before an inspection or translators are used. Are we receiving an honest picture of what is going on?

Following that same line of thought, recently the FDA recommended NOT to import/buy pharmaceutical drugs from international sources, such as Canada and Mexico, citing caution about unknown ingredients and ineffective doses of active ingredients:

“For public health reasons, FDA remains concerned about the importation of prescription drugs into the U.S. In our experience, many drugs obtained from foreign sources that either purport to be or appear to be the same as U.S.-approved prescription drugs are, in fact, of unknown quality. FDA cannot assure the American public that drugs imported from foreign countries are the same as products approved by FDA.” (Source)

Does the new information highlighted today in the New York Times conflict with these precautionary measures? Perhaps so. Clarification from the FDA and US policies for the origins of its pharmaceutical drugs should be reexamined and implemented in a way that protects consumer safety.

Why are the costs for pharmaceutical drug higher in the US than any where else on the globe? 60 Minutes attempted to get to the bottom of this powerful lobbying action with their expose` entitled: “Under the Influence“. You’d be surprised how this got through Congress.

And if that’s not enough questionable karma:

When it comes to pharmaceutical advertisement, the specifics are presented with a slight of hand technique, leading scientists say at the Poynter Institute. An example of a recent NPR interview looks at the drug, Lunesta, a sleep-aid, where the consumer is given the particulars in a manipulative manner. To name a few techniques: benefits are read at a sixth-grade reading level, side effects read at a ninth-grade level; visual imagery was used to detract from a cautionary list of complications; and the only difference between the treatment group (those that received Lunestra) and the control group (those that did not), according to the fine print, was a mere 40 minutes of sleep! Is this a reasonable antidote for sleep considering the list of side effects?

Not convinced of Big Pharma’s karmic debt? Well, unfortunately, you ain’t seen nuthin’ yet: http://www.newstarget.com/Big_Pharma.html

Stay informed, protect your most valuable asset: your health because you’re worth it.

It was a rather dull day within the confines of my inspiratory (the name I prefer to call my cubical), and I was itching for some action. My beloved boss, Heather Zwickey, who always has had the ability to recognize my state of affairs, observed my fidgeting mind and instructed me to take in a matinee.

This presented an opportunity to leave work early and to go and see Sicko so that I could understand more clearly the commentary about health care from the outsider’s point of view. This was not exactly my idea of taking the afternoon off. In order to avoid the sickness and nausea that comes with this sort of experience for me (I know the subject matter all too well), I knowingly disobeyed a direct order from my favorite boss of all time. Instead, I went to see the latest Harry Potter picture film. What I discovered was a two-minute preview piece by Geena Davis that I found equally as sick as the infamous Sicko flick.

I caught the number 19 bus downtown, feeling lucky that I did not have to wait too long out along the busy traffic’s edge. Now don’t get me wrong: I love the bus. If you ever go to Portland, ride the bus. It is an inexpensive experience that allows you to act as a passenger in life, absorbing the scenes flitting past windows edge, as well as opportunity to interact with the population in intimate encounters. For today’s venture, a clinically obese individual sat next to me, the weight of his presence occluding most of my point of view. I began to systematically create a diagnosis of his condition, acting as detective, recording visual and non-visual clues, attempting to sum a life’s experiences into a densely neat paragraph. This is a common exercise that I use to keep my medical and writer’s skills up to par. The richness that I lap up during this short span of time, moments between bus stops, satiates my appetite, my innate curiosity of soul. For this stout individual: I noticed cellutitis, a thickened purply patchwork of dead skin tissue, creeping up his leg, as he laboriously inhaled and exhaled recovering from his exercise of climbing onto the bus. Quietly I debated my position as a medical practitioner or as a fellow bus passenger and whether or not I should dispense any health related advice. I have learned that being a Good Samaritan is not always appreciated; sometimes this approach goes well, other times it does not. Knowing that my bus stop was approaching, I continued to keep my thoughts quiet, but the internal struggle would remain with me long after our encounter. We did not exchange words, but in our brief unsaid conversations of body language and sensory exchanges, the event was pleasant enough that we traded smiles as I exited for my stop.

Arriving at the theater with time to spare, I decided to observe some more, being a spectator of spectators yet again. In today’s day and age, you no longer have the opportunity to sit and stare blankly ahead, organizing thoughts and enjoying the stillness of silence. Now, instead of muted monolith to look upon, advertisements, insidiously capture its captive audience proclaiming youth and happiness with dancing candy bars and teddy bears. As we all sat before the previews, before the movie, Geena Davis flashed in giant stature, standing stiffly along the right-hand side of screen, appearing plastic in form and facial expressions. Her unnatural movement mechanically and methodically took our eyes from right to left, explaining to her audience her support of a leukemia charity. We, as an audience, also could join in her mission to eradicate cancer. To do this, we simply need to purchase a package of large popcorn and large coca-cola beverage. A snack of unhealthy combinations, greasy kernels and corn-syruped, ice-cubed concoctions; essentially the most unnatural dietary snack one could imagine.

My mind screeched to a halt, snagging on the idea that this was how a health-related charity decided to generate money for cancer research?

My thoughts slipped back to my fleeting friendship on the bus. My internal Jiminy Cricket Conscience, went into over-drive and I began to question the morals of those that chose to make this decision, and sought to comprehend how Geena Davis, a card-holding MENSA member, missed this rather obvious detail. I could feel my body recoiling from this poorly planned marketing approach, one that seemed to take advantage of the ill-savvy nutritional eater in an opportune moment in order to plea for a worthy cause through irrational methodology….

Then the blame-game on my end ceased.

Perhaps this was one of the most lucrative ways to make money for the charity. Perhaps Geena Davis has a family member affected by this devastating aliment, and she is doing her part to save a loved one. My skin relaxed as my mental venom uncoiled. Reality settled in: this extends far beyond this monetary movie madness, reaching fingers into relationships beyond a bag of popcorn, and into the interconnected lives and routines of billions of people. Searching for any sort of health related cure must be thoughtful, on all fronts, not simply focused on how to gain funds.

Perhaps this was a lesson for me as well, as I begin to create conduits of change for personal health and well-being for the individual, maybe this is a great way to add insight into how to revolutionize the way health care is managed. Finding funds is only part of the answer, as the overlooked details like greasy popcorn leads to gallbladder overloading and soft drinks lead to insulin surging… and on down the line, promoting unhealthy diets, regardless of the initial health “cause” does not ultimately support what was intended: a healthy community of people. Leukemia is only part of a wider cry of health concerns.

Shouldn’t those involved in health care, in all areas, try to see the big picture and choose ways to support both the individual and our worthy cause? Shouldn’t our goal be to create a healthy and robust society, thereby using common sense like balanced eating and lifestyle thus eliminating chronic aliments such as cancer and diabetes? Am I the only one that sees the enormous impact this will have?

Here’s a rather novel idea, as a society, let’s begin taking the whole picture into account when making personal business decisions.

This form of approach that will not only be sustainable in the long run, but will also prove worthy no matter the kind of business: start seeing the infrastructure of how funds are generated. What systems are involved, how do these systems relate to the health of an individual involved and moreover, the health of the community at large, and then eventually how and where those funds are allocated. And the ultimate test as to whether a decision was made appropriately or not: Would this choice create consequences that would harm your mother?

~ Kimberly Ann

Research Coordinator for the Helfgott Research Institute

In the great irony of the coming political season (i.e. the upcoming presidential campaign) will be involved in perhaps the most meaningful national discussion on health care we have yet witnessed. Already each candidate has a plan, each is attempting to use the language of universal coverage without actually meaning universal coverage. Each is trying to dance the tricky step of appeasing the public’s growing anger over our health care system and the tremendous power of the insurance companies, pharmaceuticals and the AMA. I don’t envy these politicians; the music is discordant, the beat hard to follow, the crowd raucous and unsympathetic.

In the end, health care reform will most likely be more about economics then medicine. On August 8th in the New York Times there was an article discussing this point. The article questions whether preventative medicine will in the end be cheaper then treating people after they have developed a disease. It is a good question, it is always good to question assumptions and it has been assumed that prevention is cheaper then treatment. However, the question leaves out the also important question, what is the cost of suffering?

However, Mr. Leonhardt, the article’s author, falls prey to the main pitfall in the current health care discussion - a failure of imagination. He attempts to answer his good question within the same model, the same mode of thinking that currently exists, and that is itself the source of the problem.Anything that happens within the current model will be expensive and benefit the industries’ that created the model. He uses the example of diabetes and says that for every one person potentially cured five will have to be “treated,” treatment here being some sort of prevention program. Mr. Leonhardt clearly imagines this all happening within the current model of patient visits to a clinic, the doctor as God, disseminating a 15-minute sermon on whatever, filling a script and see ya later. Next.

Research conducted in communities where diabetes is on the rise indicates that people don’t like these models (See researchers: Dr. Lynn Shinto ND, MPH and Dr. Kimberly Tippens ND, LAc ). They do not feel respected by their doctor and are thus less likely to listen to anything they have to say. They do not want drugs; they understand that lifestyle is essential to managing their health and potentially curing their disease. Lifestyle change is complex and requires a completely different approach. It requires doctors to meet people where they are, meet them for example in the grocery store where lifestyle change starts. It goes back to Michael Pollan’s most excellent question; “What should I eat?” For more information, see his NYT article “Unhappy Meals.”

Imagine treating diabetes in the grocery store where people buy food. The patient is looking to change their diet, armed with the American Diabetes recommended diet pamphlet (which may well be a fairly incomplete approach in and of itself) and wondering what to buy and how to make it. Now here is an opportunity for education. In our current system this is beneath the God-like doctor, removed in his or her pulpit of an office, well insulated by the bevy of receptionists, clerks and nurses. Of course, in this model education would be expensive and cumbersome.

The beginnings of this approach can be seen at a health food store chain in Portland, OR – New Seasons Market. There they hire nutritionists or Naturopathic Doctors to be on staff specifically to answer the “now what?” moment that occurs after a doctors visit when someone realizes they must make a change. This model has potential to revolutionize how we conceptualize health care.

Health care will become more cost effective through a tremendous imaginative effort and it is here where Mr. Leonhardt’s answer falls short, but a good question is a good beginning.