healthcare

Dentistry, tooth meat and oral health: Your pain is nothing to me

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Lately I have had a number of conversations about dentistry and the whole fun tooth-and-gums thing. Maybe I think about this more than many thanks to my childhood spent in dentist chairs and the mouthful of problems I have always had. Probably for these reasons I am not scared of dentists or the frightening-sounding procedures they want to do. Everyone I know seems terrified of the ominous “root canal”, but for me, the root canals I’ve had have provided nothing but relief, even if getting one is not the most comfortable thing ever.

One of the free online courses I signed up for and never actually participated in was something called Intro to Dentistry. Why would I sign up for this? To practice DIY dentistry in my barn? Still, I can’t explain why these things are so fascinating to me. I don’t literally want to dig around in people’s mouths, but I love the idea of knowing about the various teeth and teeth ailments that afflict people.

Always want to know too many different things – ever the dilettante. After talking with someone about his mouth/gum problem and how much pain he was in, I came back to the question of whether men and women feel pain differently. I contemplate often how little pain men seem to be able to withstand comparatively speaking – and I don’t know if it is physiological (they feel pain differently, they feel different kinds of pain differently) or psychological (they feel more compelled to complain about it – and that is not always true but usually is – or what?). Just when I think maybe they can’t handle pain, they volunteer themselves to participate in a boxing match – which must be painful in its own way. But then adrenaline kicks in and they must not feel it – or feel it in the same way as they feel a toothache. A toothache is a singular misery, but the rush, excitement, testosterone, adrenaline,

But if this is true that men are just reporting such agony and pain, how can it also be true that women report feeling more intense pain than men? Not that any of this is definitive – the science of it is pretty much non-existent and can be influenced by so many factors – also the science in the cited article is based a lot on self-reported perceptions of pain.

Hard to say for sure, but the science seems to say that women are more sensitive to pain – but not necessarily doing anything about it or being vocal about it. I suppose it depends – but in my experience, the women who complain most about pain are usually hypochondriacs (or seem to be).

“…male and female bodies don’t process pain the same way. If a man and a woman each place their hands on a hot stove, different parts of their brains will activate. In 2003, researchers at UCLA discovered that the cognitive, or analytic, region of the male brain lights up, while the female limbic system, the brain’s emotional headquarters, springs into action

So does that emotionally charged limbic response mean that women are merely making a louder fuss than men over the same amount of pain? Not quite.”

I just have trouble matching up how most women I know behave when in pain against how much pain they report being in and how men behave when in what seems like minor pain. Not only are women perhaps in more intense pain, they are certainly reticent and stoic about it. It seems. I know I am making generalizations and have no qualifications for saying a word about any of these matters, really.

What I am a bit more qualified to throw my irritation around about, though, is words. And one word that has haunted me since I first arrived in Norway is the word tannkjøtt – literally “tooth meat”. Yes, this refers to the gums. But come on – tooth meat?! I remember just having arrived in Norway, feeling completely upside-down and out of place, staying at a friend’s house, turning on the tv and understanding barely a word of Norwegian, and hearing this one improbable word I did pick out immediately. A commercial for toothpaste or something, a confident dentist coming on the screen blabbing away about “tannkjøtt” health.

PhD in dilettantism: Everything is an ecosystem

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If I could get a PhD in being a dilettante (a nice way for saying that I can’t focus and want to know and learn a lot about everything without really becoming an expert), I’d sign up now.

Today I dabbled and dealt in so many different disciplines, tackled so many things in so many languages, worked on hands-on fix-it things but also read poetry, marketing theory papers and some clinical research (in healthcare), that it could never be said that I do the same thing all the time. What I do with my time would probably bore the majority of people, but that’s what makes the world tick. Some of us want to drive trucks; some of us know how to mix drinks; some of us want to drill teeth (hopefully as dentists); some of us want to write about destination weddings in Italy while baking coconut macaroon tarts and filling them with dark chocolate ganache (recipe and pictures to come). I also saw a record number of cats prowling around the immediate vicinity, answered a lot of overdue email and told someone what a “croque monsieur” is (even if I have never made nor eaten one myself).

I write all of this, though, as a preface to a debate I often have running in my head about the value of focus versus multidisciplinary meanderings. I conclude that there should be no “versus” in that statement because it is not really something about which one can make a value judgment – both ways of doing things have their own value. They accomplish different ends.

What prompted this was the recent death of activist Billy Frank Jr. One of the articles I read after his passing pointed out that Frank’s life work, dealing almost exclusively with fishing rights, restoring salmon habitat and the ecosystem was sometimes criticized by Native American groups that felt Frank should use his voice and platform to fight for or pursue broader Native American issues in his agitation and political work. Frank was direct as always: he worked with what he knew. He wanted lawmakers, when they saw him coming, to know exactly what he wanted from them and would talk about.

“I know there are other problems, but the one I know about is the salmon, and when these politicians see me coming I want them to know that’s what I am here to talk about.”

While this singular focus served Frank, does a singular focus on an important issue sometimes prevent us from seeing a bigger picture or looking outside a given discipline to find a solution to a big problem? This might not have crossed my mind except that around the same time Frank died, and I had salmon populations and the whole “ecosystem” idea on my mind, I had seen a program (multiple times), Lifelines, on Al Jazeera English about how an overabundance of a parasite in Senegal led to epidemic levels of schistosomiasis. The disease is one of the world’s neglected tropical diseases (have you ever heard of it? I hadn’t) and can have very severe consequences.

In the story presented on Al Jazeera, the freshwater snail that carries this parasite basically overpopulated the river once the river had been dammed. The population using the river water would then become infected. Even though the infection is treatable, reinfection occurs when the person uses infected water, of course, making it a neverending cycle unless something could be done about the overpopulation of snails.

Doctors and specialists working in Senegal on this public health issue decided to look outside their own sphere of expertise. They knew, according to the documentary, that damming was responsible for the outbreak but were not sure how or why.

“…until a development specialist linked the explosion of schistosomiasis to the extinction of river prawns in the river system caused by the dam.

River prawns prey on the snails that carry the schistosomiasis parasite. Without prawns, the snail population increased, and so did the risk of schisto infection for everyone who entered the river”

It took some different thinking to look outside, for example, the immediate problem of a dammed river or outside the medical problems at hand to see the entire ecosystem and discover what had changed (the prawn population) that could have caused this. In this case, a focus on one thing (suddenly 90% of the population was infected with schisto) led to expanding the focus to consider different disciplines that could explain the problem and come up with a solution (repopulating with prawns).

One could argue, of course, that all of this makes sense because regardless of whether you are a specialist or a generalist, so much of what gets done is well-integrated with everything else. It’s an interdisciplinary world, and much like the natural ecosystem, the manmade ecosystem relies on this interdependence and the different types of skills and expertise its parts and people have. (More reason to cheer for my unorthodox but totally interdisciplinary higher education at The Evergreen State College, eh?)

Misused Words | J = Y | Don’t Double Down Until You Double Check

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Misuse = Abuse = You Are a Boob

Everyone is brutalizing my beautiful husband, the English language!

How is it that something reads “collegiate” when “collegial” is meant? I know how it happens. You think you heard it or saw it that way and eventually start using it with confidence. And next thing you know you’re throwing your misheard/misused word around all over town. But it’s wrong and could be fixed by just checking and confirming it in a dictionary first. Just to be sure, even if you are sure you’re sure.

I am almost always sure, but I like to double check. (Or, to jump in and use a phrase I hate – and discuss below – Don’t double down until you double check.)

I saw a job ad today that put itself out there as a high-end, exclusive luxury branding manager kind of role. But then in the bulleted highlights, it read: “collegiate environment”. I dunno about you, but if I were going to take on a luxury-goods senior brand management role, I don’t want to feel like I’m back in college – kegger anyone? Which is what “collegiate” means.

In a similar vein, my mom did some work for a writer who wrote the line, “She reached into her brazier” when he actually meant “brassiere”. He was offended when she corrected it. But, pardon the pun, would you rather look like a boob… or actually use the right word for what is essentially… a boob holder?

The Swedish J to Y

It isn’t that Swedes cannot say “J” as in “just” or “judge” or “jet lag”. In some constructions, depending on where the “j” comes in the word they want to say, they say the “dj” sound. In many others they pronounce it “y”. Many Swedes pronounce it “y” always. So it’s “yet lag”, “yust”, “yudge”, “yoy” or “enyoy yourself” – or, as I heard today, “yam” when “jam” was meant. There was some discussion that employed the word “jam” – and it was all I could do not to laugh when people quite earnestly said “yam”. Candied yams all around. I should be used to this now, and for the most part I am. I never so much as flinch when I hear the common words from the mouths of Swenglish speakers every day. But this may well have been the first time I heard “jam” as “yam”.

Doubling Down on Dumb – Vernacular Abuse

I was none too pleased quite some time ago when KFC launched a sandwich called the “Double Down” – it is basically two fried chicken patties in place of the bread that would normally house a sandwich. The media has enjoyed the launch and limited-time relaunch of this “sandwich”, with The New York Daily News going so far as to question what constitutes a sandwich, and The Guardian calling it “controversial”, almost as much as the eating, feasting public likes the (as described) “bunless, protein-rich, fat-filled” concoction.

Double Down on coronary artery disease

Double Down on coronary artery disease

All that aside, and my point for even bringing it up, I am not at all a fan of the term “double down”. I noticed it creeping into everyday language a few years ago (and wrote about it) – especially from the babbling mouths of political pundits, usually criticizing other politicians who had a bad idea and then “doubled down” on the same bad idea. (“Double down” is a gambling term – doubling the bet on whatever one was wagering on.)

“Double Down Under” – The Crystal Method

Now, this build up of “doubling down” has finally reached its peak (or given how poorly I think of it, its nadir). I sat in a corporate meeting today and TWO executives mentioned that we will “double down” on some part of the strategy. Can we get a collective Nancy “My life really began when I married my husband” Reagan (that is, “just say no”) here? Once its in the corporate jargon lexicon, it’s past annoying. It’s vomit-worthy.

African Ramblings: Putting a Human Face on Distant Lands of News Stories

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That “Africa”, nebulous netherworld and neverland that it is in my imagination, is comprised of little, uninformed portraits, characters and blurbs on the news (usually about something horrible), is little wonder. I have written before about how Africa is something massive, which – even if trying to absorb the idea and place systematically – would take time and only be possible in increments.

Africa is an idea more than a reality to me. Not just because I have not been anywhere on this vast and ridiculously diverse continent but also because “Africa” as a concept is kind of an idea. One giant landmass it may be but this very vastness and diversity makes it impossible to categorize or talk about as one giant entity. People may refer to themselves as “African” but can there be an “African” identity in the same way there is an American one? It strikes me as more like trying to convince Europeans to identify as “Europeans” before their nationalities. It is not that one never identifies as “African” or “European” but neither label tells an observer much of anything.

As usual I am consuming Africa-related matters in small bites, like geographical, cultural, historical amuse-bouche. Not always a tasty sampling.

Today’s thoughts inevitably turn to the most newsworthy of Africa’s countries.

Rwanda

The 20-year mark since the genocide in Rwanda has sparked a virtually endless flow of news and related content, ranging from reconciliation (and photography projects chronicling that complex and painful process) to the “miracle” of modern Rwanda, from the firm and perhaps dictatorial hand of President Paul Kagame, to the growing power of women (who are the majority of Rwanda’s population once the massacre ended), from restoration, reconciliation and commemoration in societies torn apart by this kind of catastrophic human damage as well as individual stories about personal conscience, reminiscent of World War II-era stories of people who took in and hid Jews at considerable personal risk to themselves (and how those stories often came to late quite a long while after the war).

“It’s now 20 years after genocide,” Kamuronsi says. “And in every commemoration, every movie, we see stories of survivors, we see stories of perpetrators. We see less stories of rescuers.”

Those stories are particularly important, he says, for the more than half of the country’s population born after the genocide, to see that not every Rwandan played their ethnically assigned role of killer or victim.

Yet most of Rwanda’s rescuers are not officially recognized. A government program to give rescuers an official “thank you” was put on hold after canvassing just 20 percent of the country and identifying fewer than 300 of them. In comparison, Yad Vashem — the Holocaust memorial and research center — was seeking out the stories of German rescuers, the “righteous among nations,” by the 1950s — less than 10 years after the war.” (From NPR)

Before the genocide (and the film, Hotel Rwanda, which chronicled the 100 days of horror that ensued – and of which the first ten minutes were ruined when I saw it at a cinema in Iceland because the idiot projectionist let some horrible George Michael music play right over the top of the film and its soundtrack. Iceland: home of the world’s worst film projectionists – you heard it here first), all Rwanda was to me was mountain gorillas at Karisoke Research Center, Dian Fossey and a brief story an election-monitor colleague, Randall, had told me about being in Rwanda and how the air there – and in every African city – always smelled like diesel fuel.

After the genocide, unfortunately, genocide is almost all Rwanda is in the collective public memory. But it should and could be so much more. How does a country referred to as “nonviable” become a “success story” (despite the dark side of that success)?

“During Kagame’s two-decade rule, Rwanda has made spectacular progress. A country famously deemed “nonviable” in the mid-1990s has become one of Africa’s best-run, most orderly, least corrupt, and safest states, with a booming economy (Rwanda’s GDP has grown by an average of eight percent in recent years). But Rwanda’s success has come with a darker side: opposition politicians have been jailed or killed under mysterious circumstances, journalists complain of harassment, and Kigali has been regularly criticized for meddling in neighboring Congo’s long-running civil war.” (From Foreign Affairs)

“Kagame is said to admire the limited democratic models of Singapore and South Korea, where economic competence is valued over political liberty. As the world observes and judges Rwanda, they will find a country tenuously balancing its need for stability and growth against the virtues of open democracy.” (From Harvard Politics)

Maybe this autocracy is good enough for the population for now – certainly craving stability, growth, opportunity and tranquility over “personal freedom”.

UGANDA

Uganda often comes up – whether because of its own problems with dictatorship (a story also told in the film The Last King of Scotland), conflict and disease (both positive and negative – Uganda had considerable success in controlling the spread of HIV but this appears to be moving backwards now; it is one of the countries in Africa to have had an Ebola outbreak as front-page news; or because of issues like Uganda’s notables (such as Joseph Kony) or issues (homosexuality is illegal and can carry a maximum life sentence in prison).

I sometimes joked that I would, if given the chance, exile people to Uganda. And that was (apart from a few of the aforementioned highlights) the sum total of my Uganda-related knowledge.

Recently, though, I saw a report on Al Jazeera about pain management and the world shortage of morphine – and what role Uganda plays in this. It is not really an issue I would have considered – I had no idea that there was any shortage of morphine or that this is in large part due to the ill-conceived and long-running “war on drugs” waged mostly by the United States. Likewise, I had no idea that there was some kind of stigma attached to its use.

“Red tape and misinformation are to blame for the world’s unequal distribution of medical morphine, and it is patients in the developing world who are losing out.

But Uganda has become the first country in Africa to allow nurses to prescribe morphine to patients.” From AJE)

It is hard to imagine that palliative care, particularly in Africa, where the disease burden is so high, in the form of pain management would be such a difficult matter. The Pain Project has documented this struggle.

“The International Reporting Program traveled to Ukraine, Uganda and India to find out, and to document the human toll of this hidden human rights crisis. It turns out a combination of bureaucratic hurdles and the chilling effect of the global war on drugs are largely to blame, leaving humanitarians scrambling to work outside the law — or change the law — to bring relief to suffering patients all over the world.

The Pain Project has produced documentaries on this issue for CBS Sunday Morning, Al Jazeera People & Power, and Global 16×9, reaching millions of people and gaining international media attention.” (From The International Reporting Program)

GUINEA

Finally, there’s Guinea – frankly not a country I thought about at all (other than an occasional mention of it, and a follow-up question in the form of, “Are you sure you don’t mean Guyana?” Not even the same continent! Even Wikipedia has to caution the reader not to confuse Guinea with Guinea-Bissau, Equatorial Guinea or – seriously! – Papua New Guinea!) until it appeared in recent news reports about its Ebola outbreak and attacks on treatment centers and universal airport screening for Ebola upon departure from Guinea. In Guinea, the death toll has topped 100, and worries about its spread are on the rise.

As the disease has traveled, neighboring Liberia has reported 21 cases, Mali reported a few, and bordering Senegal closed access to and from Guinea, citing outbreak fears.

Incidentally it is through these kinds of stories that I learn other things about these countries – under the siege of an infectious disease outbreak or a civil war or a massacre/genocide, the human face of these countries comes to light.

And while the human face is exactly what I want to strive to see, I did come across this map that should help with rethinking Africa in some ways – I have seen it before but came across it again just as I was writing and decided to share it again.