More Tucson Thoughts

-A few Saturdays ago I rode home from the hospital and passed 9 yard sales, in 4 miles. It's an exercise in discipline for me not to brake, spin my bike around, and hit the pedal back to the tables of possible treasures. This makes me feel adolescent because I stand up to pedal faster, leaving my backpack flapping from shoulder to shoulder, rapid-fire. But I didn't stop...I think because my mind caught hold of a thought and held onto it like angel food cake.

How many other countries have yard sales embedded as a social norm? I can strike off Israel, Brasil, Ghana, France, Mexico, and Egypt because I've been there over weekends, never seeing yard sales.

-Over the past couple years a few physicians disclosed their salaries to me. They also disclose offers they've received to relocate. One physician was offered seven figures to pick up and move from Phoenix to a practice in New York. But the physicians don't move for money. And they all commonly say the same thing: "Enough is enough. You get to a point where you are comfortable and you don't need more." Just seeing how much Peyton Manning signed for ($96 million for five years) made me wonder why you rarely hear athletes say, "enough is enough." They are always bartering for more.

-I finish my neurology clerkship today. In one lecture we learned about treatment for Alzheimer's. The current treatments do not cure, but prolong the inevitable--a form of mental life support. If it were me being treated, would I want to prolong the inevitable? My knee-jerk reaction is to answer, "no." This probably has to do with imagining the strain I would put on loved ones. However, rarely do I see loved ones less angelic than when they are caring for their Alzheimer's loved one. No judgements here, just observations.

-I read this in my textbook: "Essential tremor often responds briefly but dramatically to ethanol consumption, which may be a useful diagnostic feature." I always find it interesting when medicine and The Word of Wisdom intersect in a most perpendicular way.

-Racism. If someone criticizes the church for withholding Priesthood from those of African descent, and it's a criticism based purely on race--with no subjective bias against the church--then they should always be willing to discuss, at the same time, how America withheld the right to vote from those of African descent until the 15th Amendment. And if they truly have no church bias, they won't object to the comparison, for sake of discussion.

Eat Your Spinach

Mom always told us to eat our spinach. It will make us strong. We believed. We ate. And we walked away from the dinner table to gather our capes and plastic swords to battle the bad guys down the hallway. Good thing only my sisters lived at the end of the hallway because I ate a lot of spinach. Dad always said I would grow hair on my chest if I ate sardines.

"Now these will put hair on your chest," he said. I can still remember his smile as he bit the heads off at the dinner table, making my sisters run back down to the end of their hallways where I would later confront them with my spinach-bolstered bravery...er...knavery--with no hair on my chest.

Okay, so this blog entry has a point. Spinach. I love you Mom, but maybe moms have been known to be wrong about a few things--propagating healthy rumors that are nothing more substantial than rumor.

Knuckle cracking. Known as "KC" in the literature. Has Mom ever told you it will give you arthritis? Well I finally came across an elegant (elegant in every sense of the word) study by a physician who found KC does not cause arthritis.

For fifty years he diligently knuckle cracked his left hand at least twice a day. Yes, 50. He refrained from cracking his right hand during this time, and any crack on the right was unintentional. How he did this for fifty years amazes me because I always feel unbalanced if I crack only one side of any part of my body. But he cracked unilaterally, and diligently. And then he imaged his hands and compared the two, finding no evidence of arthritis in either hand, in fact, both hands showed similar joint space findings.

You can check out his paper here:

1. Unger DL

. Does knuckle cracking lead to arthritis of the fingers? Arthritis Rheum 1998;41:949–50.

I finally learned the physiology of knuckle cracking this week. We have ligaments over our joints to provide stability. In between the ligaments is a synovial film, or fluid layer. When we apply pressure to the joint we separate the ligament layers and create a negative pressure within the synovial film layer where air quickly rushes in. The air rushing in is the "pop" we hear. And we can't pop it again right away because it's already full of air. The air must be reabsorbed out of the synovial film space before we can pop it again.

So thanks to Unger at least I can stop worrying about arthritis in my neck, back, knees, fingers, and toes, because the best thing at the end of the day is a little KC!