Medical Humanity

This Old Constitution Is Falling Down
For Americans, the Constitution is like a national home we all have in common. Its daring new ideas, like freedom from monarchy, and self-determination, poured the foundation for the American adventure.
There was nothing like it, in its day. But it has not stood the test of time.
The beams are warped, pulled slantwise by special favors built in for the slave states, that now benefit small states. The ground under the house grows more uneven, as people gather in large cities in a few populous states. The advantage of small states grows as their relative population shrinks. As states become more unequal in population, the government built from our Constitutional blueprint becomes, paradoxically, less and less representative.
The states, united and not, are locked in unequal embrace. The Constitution is all of a piece – it cannot be fixed part by part. It’s dangerous to live in a crumbling house.

Is Housing Making People Sick?
Worried about air pollution? Don’t go inside.
Indoor air is a LOT more polluted than the air outdoors. Bet you didn’t know that.
How? Because: Two things happened.
First, after the middle of the 20th century we started making houses out of nifty new Space Age stuff: plastics, polymers, coatings, sealants, foams, glues, caulks. And the air was fine, because the small amounts of chemicals, gases, and residues constantly escaping from, and flaking off of, all those synthetic materials were mostly carried outside by the drafts and breezes that passed through chinks and leaks and pores in the walls of houses back then.
But next, 1974. The oil embargo. The energy crisis. Suddenly heat, energy, was precious, and everyone had to stop wasting it. When we sealed our houses, we sealed ourselves in with the chemical residues of what our houses were made of.
People started getting sick. Lots of people. Asthma doubled in the US, quadrupled in Scotland. Took a while, a generation or two, to start figuring out houses were part of the problem.
What to do? Still figuring that out. Read the article.
July 2016.

The Only Town That Beat the Black Plague: Dr. Esther Pohl and Portland
Dr. Esther Pohl knew what had to be done. The problem was, she’d never heard of it being done successfully.
Bubonic plague, the disease that killed a third of Medieval Europe during the 14th century, broke out in San Francisco in the summer of 1907. The City by the Bay had actually suffered a plague epidemic the previous winter, but the mayor, governor, and business tycoons staged a cover-up to avoid a costly quarantine. Now, the germ was back—plague always comes back—and there was no keeping it quiet. Every city on the West Coast was threatened.
(Please ignore the sensationalist and incorrect editorial interjections about ‘killing all the rats.’ That’s not how infection control works.)

How Portland Lives With, Not Against, Its Rats
This is deep science. When the wagon trains rolled in from the Oregon Trail and decided, “This is the spot,” everyone knew that their lives depended on how everyone else took care of their garbage. So Portland has maintained public health discipline about garbage.  Rats can’t multiply without garbage to eat. Over a hundred years later, Portland rats are fewer, less aggressive, and less infectious, than rats in cities that let them eat garbage.

One of the comments on this article is:
“so your grand exposition of how Portland artisanally manages and integrates rodents is nothing more than requiring trash cans?”
Yes. Easy, right? All a city needs to slash its rat population is citizens that are willing to work together over the long haul. Go ahead. Try it. Good luck.
May 30, 2014.

In Portland, even our rats are special
Short, funny, factual science writing.
May 2014. (The “Reasons to Love Portland” issue.)

Pet dental care: Try fluoride, brushing
How would putting fluoride in Portland’s water affect our pets?
Not much, ‘cuz they don’t eat sugar. Pets do have lots of dental problems, especially older animals. But fluoride protects teeth from acid, formed by enzymes in saliva from sugar.
Fluoridated water is perfectly safe for pets, as it is for humans.
November 22, 2012.

Bull Run drinking water would get fluoridated at Gresham treatment plant
Follow the chemicals. Where fluoride comes from, and the several other chemicals Portland already adds to its drinking water. At least one highly-placed Oregonian didn’t know Bull Run water was even chlorinated until he read this article.
May 3, 2013.

Make An Error, Go To Hell: The History Of Admitting Error In Medicine. A Cultural Detective Investigates Her Nation And Her Profession.
May 2010, MFA Thesis in Nonfiction Writing, Portland State University.
The Calvinist – that is, Puritan – roots of American medicine, founded by the Puritan minister-physicians who settled the American colonies.
Unpublished, so far. Not available online. On the shelf in Branford Millar Library on the PSU campus. A gripping page-turner about life and death – yours.

Local initiatives in healthy planning
Portland-area use of Health Impact Assessment, a new technique for recognizing health risks and opportunities before they happen. The later-blooming twin of Environmental Impact Assessment.
In Metroscape, the alumni magazine of Portland State University’s College of Urban and Public Affairs. Goes to regional electeds, and city planners around the world.
Clicking the link opens a longish interview with an HIA expert. My article is pages 5 and 6 in the interview PDF.
Summer 2008.

Plant Life
Short personal essay about how a physician provides end-of-life care in her garden.
First prize in
Bellevue Literary Review’s annual writing competition, listed as a Notable Essay of 2008 by Best American Essays
Spring 2008,
Bellevue Literary Review.

Community Writers
Blog about health, healthcare, and society for The Oregonian.
November 3, 2007 to February 22, 2008.

The Doctor is In: OHSU’s new president, Joseph Robertson, M.D., discusses Pill Hill’s role in the region and the state
Interview with the new top doc in town. Nice guy.
Summer 2007, Metroscape.

Teaser online.
A memoir of being sued for malpractice. I don’t tell the reader how it turned out – that is, whether I won or lost – until almost the end of the piece. My reader has to walk around in my shoes without knowing whether I’m a “bad doctor” or a “good doctor.” Stereotype kablooey!
First prize in CNF’s annual writing competition.
Issue #33, 2007, Creative Nonfiction.

Master of Disaster: Tom Simpson has your back. Your bridges may be another story
Interview with Tom Simpson, Director of Emergency Management for Multnomah County, about how prepared the region is for natural and unnatural disasters. Or not. Learn that when the Big One hits, or even the Medium-Size One, you don’t want to be on or under one of our zillion or so overpasses.
Winter 2006, Metroscape.

Reality Bites: West Nile in the Region
Oh, boy. Infectious disease, my favorite. Plus the suddenly important connection between urban stormwater and mosquito habitat. And how to kill a mosquito without shooting your environment in the foot. Great fun.
Winter 2005, Metroscape.

Why Population is Political
As far back as the ancient Greeks, politicians have urged women to make more babies, to staff armies and fuel economies. My source.
Modern conservatives want the same result — more babies — but they say they just want what’s best for women. Really?
I wrote this paper for the Population and Society course at Portland State.

Mosquitoes Call Stormdrains ‘Home’
West Nile virus was the first mosquito-borne disease in a long time to really threaten North Americans. As a result, public health officials and wastewater engineers had to figure out how to talk to each other.
Spring/Summer 2004, Northwest Public Health.

Killer Mosquitoes: West Nile virus has arrived in the Northwest
I love this disease. That doesn’t mean I ever want to have it, oh, no, no, no. West Nile virus was my training wheels as a newbie journalist. As I set out on this uncertain path, I realized that all my life I’d known a little bit about a great many things. So I decided to pick one thing and learn everything about it. West Nile virus had appeared in New York in 1999, and was dramatically marching farther west every summer toward the West Coast. I knew stories would be needed when it got close.
So I became Little Miss West Nile virus. This story was my first freelance gig, while a grad student in Michael McGregor’s Advanced Journalism class at Portland State. It won my first journalism award — Second Place for Science and Health News/Features, Society of Professional Journalists, Western Washington chapter. The longer the name of an award, the smaller it is — but it was an ‘Attagirl!’ at a time when I needed one.
June 4, 2003, Seattle Weekly.

This little essay just wrote itself when I was a med student.
Years later in Carol Franks’ modestly-titled killer course, Practical Grammar, at Portland State, I anatomized the essay to figure out how it worked. Wow. It’s lucky it wrote itself, because I don’t see how I could have.