Archive for May, 2010

DON’T FORGET THE LITTLE GUYS

May 31, 2010

(The Echo, Sierra Club, Grand Canyon Chapter’s quarterly paper).

I’m deep in a channeled wash for at least the sixtieth time, alone, removing buffelgrass along the concrete berms and anywhere else I find it.  It is nasty, difficult and dangerous work, since rattlers are out.  I duck under a mesquite, noting its thick, luxuriant growth, put the shovel into the deep soil, and lever out another plant, a thorn nailing my arm again.  I will remove between 200 and 300 plants today, bag them, tie the bags, and with great difficulty haul them out of the wash, because there is so little traction on the berms.  Dig, bag, tie and haul.  Over and over again.

Buffelgrass is like Kudzu.  It was imported from Africa to Mexico as cattle forage about 70 years ago, and has spread like wildfire.  And that’s the literal truth.  Buffelgrass grows and burns hot–1500 degrees–and uses the heat to spread seeds.  The Sonoran desert is adapted to fire, but not fire that hot, so if buffelgrass crowds a cactus or a mesquite and burns, the native growth dies.  I don’t know if we can eradicate it from the entire American Southwest–Sonora is a lost cause–but many of us think we can, and in addition to my adopted wash, I help monthly on another section with other people.  I’ve taken out at least 11,000 plants, and as a side benefit, I’m getting a good upper body workout.

In one five day stretch, I dug out 1400 plants, using over 120 bags.  I gained maybe 50 yards up the wash.  Probably less.  In the past six months, I’ve worked my way about a quarter mile, slow going, as I hack, bag, tie and haul.  But I’m noticing changes.  First, if there is no buffelgrass around mesquites, there will be no hot fire if lightning strikes.  That will save a tree.

Second, I’m noticing native vegetation moving in where the buffelgrass stands once were.  We finally got average winter rainfall, and it helped.  Third, I am amazed at the deep soil that has washed down from the mountains; there are shade trees, quail, white-crowned sparrows, pyrrhuloxias, and black-tailed gnatcatchers.  Lately, the black throated sparrows have arrived.  They are difficult to see, but I hear many of them.  This wash with its thick growth is a park; an oasis, with condos, roads, and people just above the fence.  The above walkway is frequently used by joggers, cyclists and dog walkers, all enjoying the quiet, the green, and the lack of people below them.  Maybe it isn’t a greenbelt, but it is a green garter.

I could do without the trash; a sign reads a fine of $2500 for littering, but I wonder if anybody has ever been fined for doing it.  Some of the litter ends up in the trash bags with the buffelgrass.

This wash would need a rain we will likely never see again to flow bank to bank.  But it does get some water coming off the berms and from the west end of the nearby Catalina Mountains.  And even in Arizona, it won’t be developed, so if I can remove the invasive buffelgrass, there can be a dense growth of mesquites and palo verdes, good habitat desperately needed; an island of calm in a noisy sea of stucco and steel.

We must preserve the major rivers in this state–the Colorado, the Verde, the Salt and the San Pedro.  But washes abound, and they are part of the riparian network, too.  Visit one some cool morning, before the snakes wake up, and walk where you can.  Dress appropriately, because the mesquites are thick.  You may find you can’t even go far because of the growth.  That’s just great, because the fewer people disturb the area, the more wildlife can live.

Never thought I would adopt a wash, clean it up, and enjoy it so much.  Never realized how much life was in one.  Remember the little guys.

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TIME TO WEIGH IN ON OBESITY

May 26, 2010

We now know the current body mass index (BMI) for all 926 6th graders in 4 different Tucson middle schools: 45% are overweight (BMI above the 85th percentile), 27% obese (above the 95th percentile).  From 926 students we would expect 46 to be obese; the actual number is 250. If these schools are typical, and the four have remarkably similar results, we may have the highest proportion of obese 12 year-olds in the country.  But we don’t know for sure, because we haven’t studied enough middle schools.  National surveys of childhood obesity in 2007 included 44,000 10-17 year-olds; I would expect 9 Tucson 6th graders in those statistics.  Nine.

I find the lack of complete, current local and national data appalling.  We know obesity is a problem; how difficult is it to weigh and measure every 6th grader?   It isn’t, and we can do it here at NO ADDITIONAL COST with current school nurses/health aides, U of A student nurses, volunteers from the Pima County Public Health Department and the Medical Reserve Corps.  All have helped and are willing to continue helping, using a known efficient process to perform health screening in schools.  At no charge, I entered much of the data; I interpreted all of it.

A 12 year-old 5’, 155 pounds, or 5’ 4”, 175 pounds, is obese and will have increased medical problems and costs during a shortened life. Many of the students weigh more than 200 pounds.  More than half, should nothing change, will be unfit for military service, which concerns me as a veteran. We don’t want young people smoking because it is harmful and addicting.  Obesity in young people is harmful, and we know certain foods are addicting.

Here is what we do:

  • Establish a baseline by screening every public school 6th grader (I welcome private schools, too) early in the school year.  Such screening is an excellent math and biology project in its own right, and obesity should be addressed both in the schools and at home.  Each school should know its own and district data; the public should know district and community data.  We don’t want inter-school competition; we want to know the number of overweight students in each school, which determines where and how we act.
  • Perform pilot projects in schools to test efficacy of changing meals or vending machines, mandatory physical education, parental notification and nutritional counseling.  Having a baseline will allow us to evaluate an approach.
  • Recognize this problem will require years to address.  But if we don’t act, it will not vanish; indeed, it will likely worsen, as it has this decade.

We must address child obesity, and we can,  if we have the support of local leaders, superintendents and principals.  Screening all our 6th graders and acting on solid, current data during state penury would put Tucson in the national spotlight and stun the nation–favorably, for a change.



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TIME TO MAKE TRAUMA PHYSICIANS AN ENDANGERED SPECIES

May 16, 2010

In early March, a young woman was thrown from her dressage horse during a routine schooling ride.  She was rendered comatose and two months later in a rehab facility with a mild hemiparesis but finally able to swallow.

The woman was a member of the US Equestrian Olympic Team, one of only two sports where men and women compete equally.  I say “was,” because we both know it is unlikely that she will ever be able to compete again at a high level in dressage, one of the most demanding partnerships between man and animal.  She has recovered remarkably well and hopes to teach riding; unfortunately, even her young age was not young enough for better recovery.  She is at higher risk for epilepsy, personality and emotional residuals as well.  In short, she suffered a catastrophe.  Fortunately, she didn’t end up vegetative, especially since the accident occurred in Florida, where adults with 600 gram brains are felt by cardiac surgeons to be conscious and doing well, because they smile even if they can’t comprehend 15 years after the insult.

Florida and the 109th Congress aside, what is finally occurring is a helmet debate in the equestrian community, similar to the helmet debate seven years ago in the cycling community, where 9 years earlier, almost to the day, Andrei Kivilev, a superb Kazakh rider, collided with two other riders on the Paris-Nice race.  The other two were fine; Kivilev, 29, hit his head and died the next day, leaving behind his widow and six month old daughter.  His death was a catalyst for mandatory helmets in major cycling races, which first did not mandate helmets for mountain top finishes, but now do.  Every cyclist in every major event wears a helmet.  Something good came out of Kivilev’s death; hopefully the equestrian community will do the same.  Already, several equestrian riders have stated publicly that they were saved by a helmet they began wearing.

But there is still no mandate.  Dressage riders must dress formally; indeed, proper riding attire is considered appropriate dress anywhere, something I often kid my wife about.  Helmets are not part of dressage riding.  Well, the judges need to get over it and deduct points should someone not be wearing a helmet.  Better yet, it should be cause for immediate disqualification if any rider on a horse at any time at a horse event is not wearing a helmet.

In 1976, Arizona allowed motorcyclists not to wear helmets.  I remember the demonstrations at the Capitol.  I wonder how many have since died or been permanently maimed as a result of not wearing a helmet.  It is time for a helmet debate in this country.  At what point do an individual’s rights conflict with the rights of his loved ones to have him (usually a him) around and whole, and society’s rights to pay for the extra care that going without a helmet and having an accident causes?  It’s a fair debate.  I know where I am on this issue.  I, like many of my former colleagues, bitterly remember coming into an ED at 2 a.m. to take care of another drunken biker who wasn’t wearing a helmet.  In my case, the lack of payment was a minor annoyance.  The sleep I lost was not so minor.  We live in a republic.  We have a government, and by definition, that government has some control over us, even in the hinterlands of Alaska.  We need an honest, factual debate on regulation, without Rush, Bill, Glenn, Sarah, Keith, Jon, Rachel or Steven.  In my view, failure to regulate almost took down the world’s economy and has given us wireless service that is worse than many third world countries.  There is an imperfect but better middle ground out there that we need to find; otherwise, Zappa’s Law about universality has a third part:   hypocrisy, in addition to hydrogen and stupidity.

Growing up, I didn’t know about seat belts; today, even in Arizona, 75% wear them.  I skied for 40 years without wearing a helmet; I didn’t know better.  Or didn’t want to know better.  I knew that ½mv2 =mgh, and a fall at 25 mph was like falling off the roof.  I would wear a helmet today if I skied.  In my three major bicycling accidents, my helmet was significantly damaged, damage my skull didn’t have.  I was not knocked out, even when I could hear the back of the helmet go WHACK! on Moore Road, the day I broke my clavicle.

Physicians need to frame the helmet issue and lead the debate.  And after we deal with helmets, we will have to deal with a hot, extremely difficult issue:  the long term side effects of playing football as the game is currently played, for the data show that the sport is far more dangerous than anybody ever realized.

For now, the equestrian community must recognize the dangers of being 10 feet off the ground on an unpredictable animal, and where a head might hit if the animal bucks.  It won’t be the only buck in the equation.

We will never drive trauma centers out of existence, but every physician should want to.  I hope most trauma physicians would be among the first to agree.

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