The Tin Lizard

Funerals, TV-Style

It's often suggested that television, movies, and other visual forms of popular entertainment help keep us au courant about new trends in our society.  To some extent that's true, especially (because of advertisements and product placements) if we want to be up-to-date about the latest styles in furniture, clothes, or other material things.

On the other hand, there's a lot that's false about the mass media's representation of our society.  Seldom do they manage to reflect the real squalor of big-city slums, to offer just one example.

One distortion that I've noticed turns up almost without exception is the reality of funerals and burials in the 21st century.  Dead people on TV invariably get buried in old-fashioned, well-maintained cemeteries with mature trees and big standing granite headstones like this:

  
This kind of tony cemetery (or what one relative of mine used to refer to as a "marble orchard") may be reality for an older generation that still owns a plot, or for the high muckety-mucks with lots of money, but not for most others.  Nevertheless, on television, with few exceptions (and leaving aside military funerals), you'll see all manner of people still getting interred in such peaceful, relaxing spots:  the policeman who died in the line of duty, the poor-but-honest whore who got bumped off because she testified (or almost did) against some bad guy, the kid who was smacked by a bus, the penniless 20-year-old cancer victim.  Yes, on TV, everybody and anybody finds a place worthy of a king ... well, not a king maybe, but worthy of a leading politician or a famous lawyer.

The truth is, though, that cemeteries run in styles like everything else, and this style of "final resting place" is largely extinct.  They're not making them like that any longer, and those that exist are either full or spoken for.  Most folks are more likely to end up in a place like this:

Maybe this will, in 20 years or so, look like some of the older ones.  At least trees may grow, though those flat-to-the-ground headstones, made to permit the big five-gang lawnmowers to trundle easily over them, aren't going to stand up and take on new shapes.  

Far from showing our society as it is, in this case, mass entertainment consistently paints a false picture, showing us what we'd like to see.

Like Your Eggs Fully Cooked? You'd Better.

The whole escalating furor over unsafe eggs being shipped even when they were known to contain salmonella strikes me as a perfect object lesson for those who think government is not worth a dime - until it's needed.

As a Republican President and a Republican majority pretty much let businesses dictate their own terms for most of the decade, one result was a considerable lessening of regulatory controls on a wide variety of American business; businesses would henceforth regulate themselves, obviating government watchdogs.  At the same time, advocates of so-called "small government" pushed tax cuts (but not war spending), hoping to "starve" government à la Reagan; this led to budget cuts in many areas, but especially in those "unnecessary" regulatory commissions and agencies.

We've seen the result in the financial and real estate markets, and in coal mining, and have been dealing with it for some time now.  But we've also begun to see it in food safety - tomatoes, nuts, jalapeno peppers, pet food.  Now eggs.  This latest case stands out because here, the media are working hard to stir outrage that salmonella was detected as early as last spring in the two companies now in the spotlight, but regulators did nothing about it.  Yet regulators at all levels, thanks in large part to budget cuts and staffing reductions, are understaffed and until July, didn't even have the power to shut down a plant producing tainted food. 

The lessons are just plain common sense, if you've ever heard the adage about the fox and the henhouse: (a)  Given the opportunity, some businesses will inevitably cut corners to reduce costs, even where public health is involved; (b) no instituition can be counted on to regulate itself; (c) there is a legitimate role for government regulation; (d) like anything else, government services have to be paid for and (e) the way that's done is through taxes.  The whole conflation of small-government, no-tax, pro-business "concepts" that was so popular with the Bush crowd is nonsense.

There will, of course be compromises.  I doubt that any of us would care to pay the full costs of (say) weekly inspections of the thousands of food companies across the country.  Yet clearly, a budget that allows for only a dozen inspections a year (across the many thousands) is inadequate.  There must be balance, but overall, there's room for a good deal more to be done.

Often, regulation is best when it's preventive.  However, there's constant resistance, in many sectors of business, to any standards that raise costs.  That's why we have power lines strung through the trees, subject to interruption in every rainstorm; and it's why we have food production facilities that aren't built to keep out rats, flies, and other disease carriers.  It's not impossible, as this article regarding practices in Denmark suggests.

Currently, the advice is to avoid many common brands of eggs, or to be sure your eggs are "fully cooked."  Yet the best ways of eating eggs are those that leave the yolk runny:  soft-boiled, poached, or sunny-side up.  Should we just adapt to having our eating practices dictated by the failure of producers to work to prevent problems?   Maybe.  We've done that in many instances.  (Remember when you could eat a steak rare without worrying about dying?) But it's getting tiresome. 

(This post is also being cross-posted on Morning Fog .)

 

Bread: White, Wheat, And Real

Lately "wheat" bread has, for the first time in U.S. food history, outsold "white" bread.  That sounds as if we're all learning to eat better, get more whole grains in our diet, and cut down on overrefined flours.  Certainly that's the slant some writers gave it, for example, Greg Beato, writing in the Washington Post, who made this basic statistic sound like the greatest thing since ... sliced bread!... though he turned it into more of a sociological and lifestyle trend than a nutritional one.

Beato's piece didn't satisfy me, though.  It didn't seem I was getting the whole story. Mainly I think, because he kept using those two terms "white" and "wheat" as though they were clear and separate categories.  They're not.  Even the most insipid, mushy, tasteless, pasty bread manufactured for its child appeal (Wonderbread is the prime example) is made from some small quantity of wheat.  And the health benefit of "wheat" bread, on the other hand, is minimal if it's not whole wheat.

However, I credit Beato with leading me to a much more complete report on the bread war, from which the real facts are more evident.

First the report refers clearly - and exclusively - to sales of packagedbread.  People do buy a lot of that but Beato is way off base suggesting that anything in this category could be a foodie trend.  Foodies wouldn't touch any packaged bread with a ten-foot pole.  I guess I'd have to confess I'm a foodie but luckily I've found a pretty good bakery that makes serious bread, and before I found them, I made my own, rather than eat bread that comes in a plastic sack on the supermarket shelf.  Though some are better than others (when for some reason I do buy bread at a supermarket, I have occasionally bought Arnold's, one of the "wheat" brands mentioned in the study).

Second, I found that for bread factories, the only real distinction between packaged white and packaged wheat bread is the color.  Color can be added in a number of ways - with dyes, with molasses, caramel, or other ingredients.  By this definition "wheat" bread might or might not have any higher nutritional value than "white."  Producers of these products can spot a trend when they see one, and they've been quick to label almost any product "wheat" or "whole grain" but such slogans (surprise, surprise!) may not indicate much.   

So the fact that "wheat" now outsells "white" indicates that people are gradually absorbing the message that whole grains are better, but the shift doesn't say much about whether they're actually getting more food value.  For example, one woman in the Chicago Trib story says that she looks for bread that has grains on top.  That can be attractive and even tasty, but it's not the few seeds and grains scattered on top that add nutritional value, it's how much whole grain is in the flour that the bread is made from.  Whole grain isn't necessarily visibly "whole" to the naked eye.

Meanwhile, let's not allow the big factory bakers to define white bread out of existence for us.  White breads do still exist in the unpackaged world.  Many of them have whole grain and might easily represent a better nutritional value than the packaged variety  -- sourdough, baguettes, and a variety of other breads can be made with whole grain wheat and won't look a bit less white.   

Self-Service Air Travel

My last post ("Life's Annoyances"), and a comment I received on it. got me to thinking about the frustrations of modern air travel, and how we got to where we are now, when most people seem to agree air travel is neither fun nor convenient anymore.

Certainly the handling of our "stuff" is one of those areas that contributes to our inconvenience.  People jam onto planes carrying all manner of huge suitcases, oddly shaped bulky packages, or multiple bags per traveler; they delay loading, whack their fellow passengers with their gear, and the like; and as my commenter pointed out, they're saddled with having to drag their bags around with them through check-in, to the snack bar, to the rest room, etc.  This isn't a new trend that arose after airlines started charging for stowed baggage.  It's been going on (and getting worse) for decades, abetted by the airlines themselves, which do not enforce the few rules they do have (regarding the size of carry-on bags, for example).

Airlines will tell us that their passengers demand this "convenience" but in my view that's double-speak worthy of George Orwell.  If we look back at some of those idyllic advertisements for air travel in the 1950s when companies like PanAm and TWA were trying to build passenger traffic, we'll see those happy besuited passengers filing aboard with nothing but a purse or a briefcase.  They're not dragging entire steamer trunks on rollers!  Nor were airplanes designed for huge amounts of in-cabin luggage.

I suggest that it was the airlines, not the passengers, that encouraged more and more carry-on luggage.  As air travel burgeoned, they found it inconvenient and expensive to handle our baggage.  Why bother with that, when they could subtly incentivize people to carry their own belongings?  As it became standard for the business traveler to carry his/her own luggage onto the plane with him, savings translated into fewer baggage handlers, less interest in making the service work well, and more lost and damaged baggage. Now we're in the era of paying separately for a whole panoply of "services" that ought to be part of the ticket price. 

The whole process is standard teaching in first-year business school courses.  Establish a product or service in the market, and then look for ways to reduce costs while still charging the same or higher prices.  Whether it's self-service gas pumps, ATMs, or a seat on an airplane, the process is the same -- do it cheaper, but sell it as a benefit to your customer. 

We can't deny that in some cases the end result really is more convenient. After all, we can get cash at any time of the day or night now (rather than just the three hours per day that banks used to be open to the public) but on the other hand, who needs cash these days?  But far too often, the benefit to the consumer is illusory, while the advantage to the seller is tangible. 

Will the new fee structures change anything?  Charging for checked luggage will only make matters worse, pushing people toward carrying more and more junk into the cabin with them.   One airline is testing a charge for a carry-on bag.  That seems like effrontery.  It is effrontery, if a fee is assessed for any bag.  But if properly structured -- what about no fee up to a certain basic size and weight, with charges increasing as the piece gets larger and/or heavier? -- it could actually bring improvement.  Unfortunately I don't see any benefit for the airline in that, so it's unlikely to happen.

Finally, it's worth noting that governments also succumb to the lure of short-term savings that leave traveler paying for that "saving" thousands, even millions, of times over in lost time and inconvenience.  In the Washington DC area, the "metro" is being extended for the first time to Dulles International Airport (an airport, incidentally, that has the slowest baggage delivery I've ever encountered anywhere).  But this week there were reports that to cut costs, planners are considering building the airport subway station NOT at/under the terminal, but at one of the satellite parking garages instead. 

Reason? Cost.  Effect?  Travelers for ever afterward will have to schlepp their bags into the subway, then get off for a second trip by bus/rail/whatever to the terminal, adding another 30 minutes to their planning.  How many people will give up entirely and take a cab instead, when faced with this kind of deliberately placed obstacle to convenience and speed?   I will.  Such short-sightedness is endemic; ultimately, it adds needlessly to the frustrations of air travel. 

Life's Annoyances

Have a look at this little list:

-- Difficulty merging into traffic or staying in lane.

-- Abrupt lane changes.

-- Increased aggressiveness or irritation while driving.

-- Speeding or going too slow for road conditions.

These are the first several items in a list of driving behaviors that "may prompt intervention," taken from an article about the problems of older drivers whose skills deteriorate to the point where they are a danger to themselves or others. 

As my wife remarked, reading this, you can hardly take a five-minute drive anymore without seeing all of these behaviors.  They're usually not the actions of oldsters, but of "normal" middle-aged and young people; and they're usually not attributable to dementia or old age, but to cell phones, texting, or just plain blithering. 

Admittedly, the article goes on to list other driving issues that are more clearly the province of the elderly who are losing some cognitive skills, e.g., being unable to find their way home, or difficulty moving their foot from gas pedal to brake. 

Nevertheless, if doctors, police, and just plain folks are going to start recommending "intervention," remedial driver training, and even "taking away the keys" for drivers who exhibit the first four traits listed above, we would quickly find that about half the motorists in the country were affected.  Of course, there's a silver lining:  this could soon solve our traffic problems. 

From here I jump from drivers to other annoying people, like those who might think the rules of air travel just aren't meant for them.   Which brings us to the JetBlue flight attendant Steven Slater, who's made himself famous by berating a passenger over the plane's PA system, then jumping plane via the emergency chute, absconding with a couple of beers.  No doubt the passenger involved belongs in the class of cell-phone-jabberers who clog our highways but I can't share the web's enthusiasm for Mr. Slater as a "hero."  Doesn't the younger crowd these days recognize that unfortunately, earning a living in almost any walk of life involves learning to cope with annoying clients without blowing your cool?  Evidently not.  The backstory (that Slater is dealing with some personal difficulties) isn't germane.

So maybe we need new ways of dealing with those annoying ones.  Possibly some guidelines for intervention:  if they carry on bags double the size of what's nominally permitted; leap from their seats before the plane has stopped taxiing; refuse reasonable requests; crowd in at the boarding gate before their seating tranche has been called -- we should consider these people demented, a possible danger to themselves and others, and ensure that they take training, or in extreme cases, get blacklisted so that no airline will issue them a ticket ever again.  Once again, at least half the air-passenger population would be affected, and the benefits in terms of reduced crowding and more pleasant air travel could be immeasurable.    

How DO You Pick A Doctor, Anyway?

For years, from early childhood up to my retirement, I was the beneficiary (or victim, take your choice) of military and subsequently U.S. State Department medical care.  Whether on a military base, in a combat zone, or in a remote foreign location rife with tropical diseases, the choice of a health care professional was usually not mine; I'd be treated by whomever the government provided. 

After I got past childhood and understood better the economics of health care, I'd often wonder whether physicians who chose to work for a government salary, rather than the distinctly better income they might make in private practice, were necessarily the "best" of their profession.  But surprisingly the system, while producing its share of quacks who clearly couldn't have made it in the private world, coughed up some very good doctors, for a variety of reasons:  surgeons might find that work on combat casualties gave them extensive experience they might not gain in years in a stateside hospital; epidemiologists could benefit from being in a place where weird tropical diseases weren't a rarity; some doctors made a lifestyle choice, trading a high income for more regular hours; and there were always those who just preferred an old-fashioned style of family practice that wasn't any longer the norm in the private world.

Long story short:  It wasn't until late in life that I confronted the problem of how to select a doctor, in particular a primary-care doctor, from the many available.  Ultimately, my choice of primary care physician was made for me by a specialist I consulted on a specific matter, who mentioned a general practitioner who was located right across the corridor.  Of course I wouldn't have stuck with that choice if there were problems, but it turned out the doctor thus "recommended" had an approach I liked and a general theory of treatment similar to my own (minimize the pills, please, and not too many silly tests). 

For specialists needed from time to time, I found that surveys conducted in the local area by magazines or newspapers worked best as a source from which I could select someone who was on my insurance plan.  Generally those surveys combined, in one way or another, polls of medical professionals themselves with patient inputs on matters like bedside manner, waiting times, cost, and the like. 

Unsatisfying and random as that selection process sounds, the situation nowadays, as described in a recent article by Michelle Andrews of Kaiser Health News (published in the Washington Post), seems different and less satisfactory.  I suppose it's not surprising that insurance companies are taking an increasing role in trying to shape the selection process, but as Andrews points out, quality of care is less easily quantified, so for that reason (and other obvious ones), insurance company ratings are likely to be based heavily on cost.  I believe strongly that Americans need to be taught to consider cost in making health choices, but it shouldn't be the only factor.

On the other side of the spectrum are patient ratings such as those being geared up by a number of websites, including "Angie's List."  But most reasonable people will recognize that lists like that are bound to be skewed by responders who have an ax to grind, or who just don't have the same priorities for care that you do.  (E.g., do you want a doctor who's good at listening to your description of your ailment, or one who leaps to the "most likely" conclusion almost before he/she has examined you?)  It's like picking a restaurant from Zagat's -- it can be of some help, but be aware that many responders don't have the same standards you do.  Restaurants are less serious.  Most of us can survive a meal that doesn't meet our expectations, or even a bad repast; so I do offer my reviews of restaurants on Zagat and elsewhere, but I don't review physicians or care facilities online, with one exception. 

Ms. Andrews is correct in surmising that we'll see more and more efforts by insurers and others to "rate" doctors.  It's a trend we can't buck, whether or not it provides us useful information.  I think the best way forward is to be clear what we're seeing, and to use a combination of ratings and other information.  

Overcoming Fears And Dislikes

A recent report by Dana Scarton, "Obsessive-Compulsives Follow Psychologist...," gives an interesting glimpse into some aspects of obsessive-compulsive disorder and its treatment.  Here, specifically, we read about people overcoming their fears of contamination by mustering the courage to touch a public toilet (and lick their hands afterward!), handle nasty garbage, or shake hands with a homeless person; or to conquer their paralyzing uncertainties by passing through a gantlet wielding a knife.

There's always something new and surprising in the world, it seems.  But if these exercises, conducted by a psychiatrist, work to help people overcome irrational fears, no doubt they are worth the apparent eccentricity. 

From time to time during my professional travels to distant corners of the world, I encountered odd foods or sometimes issues of contamination similar to those the OCD victims in the article were dealing with.  These chance collisions with unaccustomed aspects of foreign cultures are far from OCD, but the successful traveler learns to deal with them.  Or some don't, like a visitor to Turkey I observed who, even in an elegant, white-tablecloth restaurant, couldn't face the prospect of eating a fish -- a nicely grilled, fresh fish -- because its head was attached. 

Maybe all world travelers learn to deal with these things in different ways, or maybe in the same way.  I wasn't brought up to be adventurous in diet or experience, but somewhere early in my independent life I somehow decided that if the local people ate it, touched it, breathed it, or lived through it, I could too.  So I can't recall anything I hesitated about:  shaking hands with lepers; having a nibble of singed dog; eating the lamb's eye; buying meat from a butcher outdoors in a market who would lop your chosen section off a carcass exposed to dust and flies; drinking rice beer from a common bowl with Vietnamese Montagnards whose living conditions made tuberculosis prevalent ... all these "tests" and others went by and I'm still here to tell the tale. 

None of them was any worse than having to eat a stick of raw celery.  Ick!  

Sports Figures

I don't watch a lot of sports on TV but when I do, I'm often impressed by the superb physical conditioning of most athletes, male and female, and even in sports where you wouldn't necessarily expect it, like automobile racing.  (Yes, racing!  I remember about 20 years ago that someone set up a sort of modern pentathlon with top names from various sports competing against one another.  The race driver - I don't recall his name - won.)  

But the impression often turns negative when it comes to American football.  Because there, every weekend, on any NFL team's defensive squad, you can see what appear to be giants gone to pot -- beer bellies and balloon butts abound.  They have the physiques of many 60-year-olds, but they're not anywhere near 60; mostly, they're in their 20s.  The only other sport I can think of where you can regularly see specimens of such magnitude but with such clearly unhealthy avoirdupois is sumo wrestling. 

I look at these guys and think, well, they must be able to do something or they wouldn't be on a pro team in the first place...and of course any of them could crush me or rearrange my anatomy with one hand tied behind his back... and I realize they're really selected for that bulk... yet I had to wonder, wouldn't they have a better claim to the title of "athlete" if they could lose some of that loose, floppy heft and just get down to the muscle?   In short: are they really in SHAPE? 

Not to pick on one individual, but the case of Albert Haynesworth, a 29-year-old, six-foot-six, 350-pound defensive lineman for the Washington Redskins, is much in the news in our area and gives at least one answer to that fitness question.  Haynesworth seems to be having a little trouble getting past a conditioning test which is described thusly: 

The conditioning test consists of two 300-yard shuttle runs that must be completed with just a 3½ minute break in between. The player runs 25 yards at a time, back and forth for a total of 12 sprints. Linemen must complete the first shuttle in 70 seconds, the second one in 73 seconds.

Now, we might suppose that Redskins coach Mike Shanahan deserves a lot of credit for recognizing this problem of needless overweight, and doing something about it.  But we'd be wrong.  The conditioning test seems to be available more as a punishment than a fitness tool; nobody on the team is being asked to pass it except Haynesworth, because he played prima donna (oh, the mental picture of that!) by boycotting the team's early off-season workouts amid grumbling about the Redskins' defense strategy. 

The spotlight -- an embarrassing and possibly even unfair one -- may be on Haynesworth but there are many pro footballers out there who I'm sure couldn't pass this same conditioning test.  Maybe Haynesworth will have the last laugh by living a little longer than some of his peers.