Sharks are found in oceans, tropical rivers and lakes. They range in size from 10 centimeters to over 15 meters (whale sharks). Approximately 30 out of 350 species have been implicated in human attacks. On average, there are fewer than 100 attacks reported each year worldwide, and less than 10% of these attacks are fatal. Sharks are superbly equipped predators, and can detect motion, chemicals, electrical signals, and vibration in the water, with a sensitivity that enables them to easily hone in on prey. The most dangerous sharks from a frequency-of-attack perspective are the white (“great white”, “white pointer”), tiger, bull, blue, dusky, hammerhead, and grey reef sharks. However, it is important to note that any shark, including the seemingly docile nurse shark, will bite a human if sufficiently provoked. Read more »
This week’s CBS Doc Dot Com features 42-year-old Dara Torres, who has been in five Olympics and won every kind of medal a swimmer can win. She juggles motherhood (her 3-year-old daughter, Tessa, is a gold medalist in being cute), a career, and philanthropy. And to top it off, as she proudly displayed during my interview with her, she has serious abs – world class.
But it wasn’t her abs that impressed me the most. Not nearly. It was the pride she took in her work. She understands that there’s no free lunch, that every one of her achievements has been paved by hard work and attention to detail.
I am always moved by a person who rolls up their sleeves, committed to doing a good job – whatever that job is. When I first started dating my wife, Kate, I took her to one of my favorite Italian restaurants. As we sat at our table, I suddenly saw her eyes well up with tears. She explained that she had been observing a bus boy carefully set a large, round table across from us. Seconds from finishing, he had noticed a small stain on the tablecloth. Rather than hide the spot by covering it up, he had painstakingly removed everything, replaced the tablecloth, and begun setting the table again. She was touched by his work ethic and I by her sensitivity and powers of observation.
Ponzi schemers may hog the headlines but I’ll bet most people still believe in the value of an honest day’s work.
Which brings us back to Dara Torres’ abdominal muscles. They didn’t just appear. She swims for two hours every morning and then does about seventy five minutes of core exercises. The take-home lesson from Dara Torres isn’t about her abs; it’s about the work ethic that lies beneath them.
My health club’s outdoor pool’s hot tub has a new sign:
“No children under 12 allowed in the hot tub…this includes dangling feet and dipping toes!”
It’s very large and placed in front of the entrance to the hot tub at the stairs. Not only can you not miss it, you can’t miss reading it – the letters are huge and neatly written.
You only have to be at the club for a few minutes to see why the need for the sign:
1. This week, the high heat: in this weather, kids will dehydrate quickly and put themselves at risk for heat-related illnesses. Just not worth the few minutes in the very hot water. Kids may already be relatively dehydrated if not drinking enough in heat waves so time in hot water will hasten the onset of heat illnesses in that situation.
2. Parents were already ignoring the smaller posted signs.
3. Hot tubs are really grown-up venues and actually have a therapeutic function. They are not toys or meant as recreation so shouldn’t be used or fostered as such.
Adults, too, shouldn’t be in a hot tub for very long when the outside temperature is in the mid 80’s and above with high humidity. We, too, can become dehydrated and put ourselves at risk for heat exhaustion and heat stroke. However, sometimes us adults need the hot tub for therapeutic reasons, such as after exercise, to aid in the healing of injury, arthritis, etc. That’s how I use the hot tub and why I found myself sitting in it for a few minutes on an 85 degree, very humid day. My healing back needed a few minutes of intense heat and those jets after my usual swim. I kept my eye on the time and after 10 minutes got out and downed some cold water.
The sign did keep away most people and most older kids and adults did respect it. But, a few blatantly did not. One mom actually read the sign for a good few minutes and then when her toddler tossed a fit because she wanted to go in she finally relented but said “only your toes…that’s allowed.” Well, actually not. The sign specified no toes specifically so I’m not sure how she made the leap that her daughter’s toes were the exception.
Her daughter didn’t dip for long before a lifeguard came over and shooed her away. The mom looked miffed but hopefully will be wiser next time and not attempt to pull one over on the staff or the rest of the people there to have fun and were willing to follow the rules.
Safety aside, the ultimate issue here, the other important issue is teaching our kids that rules are meant to be followed. If we break the rules and don’t follow them ourselves, our kids will grow up thinking they, too, can break rules, that they are “above the rules”. Those are the kids who tend to get themselves into all sorts of trouble as teens. The seeds of risk taking and bad behavior do start young and are often planted by watching us.
So, have a blast this summer but follow the posted rules. You’ll not only keep your kids safe today…but tomorrow, too.
For more information on heat illness in kids, click here.
*This blog post was originally published at Dr. Gwenn Is In*
Ask almost any surgeon and he will tell you your chances of surviving a catastrophe are inversely proportional to your usefulness to society. This sentiment is expressed in different ways by different surgeons but the basic message is the same. If two people come in with exactly the same injuries and one is a teacher who spends his extra time in community upliftment projects and the other is an armed robber, the armed robber will sail through treatment and be back on the streets in no time, but the teacher will slowly waste away in ICU and finally die. Unfortunately it seems to be true.
There was a super clever cardiologist friend of mine who speculated as to why this was the case. He basically divided people into two groups, those with over active immune systems and those with just the basic immune system. The first group would tend to be allergic to everything and be over protected by their mothers. They would tend to grow up in a protected environment devoting their time to inside activities (safe from the dangers of the outside world, including grass and pollen and dog hairs and the like) reading and bettering themselves. The latter group would be immunologically free to run around like wild things doing whatever they liked.
He then extrapolated this to the likelihood that the first group possibly had a higher chance of developing SIRS (systemic inflammatory response syndrome) after major trauma and it was in fact their own immunity’s overreaction that finally brought them down. Amazingly enough this theory is based on logical scientific thought.
Like all surgeons I too tend to think that the good guy will probably die and the bad guy will survive. I have seen it too often. But unlike my boffin cardiology friend I think it is just some sort of evil cosmic reverse karma that is out to destroy all good people in this world. This makes much more sense to me than actually trying to understand immunology. And that is why I try to do at least one bad thing a day so that if something does befall me I at least have a chance of surviving. But there are always limits.
A few years ago our hospital organised a weekend away for all the doctors and their families. It was at a really nice lodge here in the Lowveld and truth be told, it was great. The days were pretty much spent lounging around the pool. That is of course if you didn’t play golf. I don’t play golf.
Anyway, there I was producing vitamin D for all I was worth when I glanced over at the pool. One of the other doctors had a small boy of about 4 years old that had been running around all day like a mad thing. But at that moment, as I looked at him leaning over the edge of the pool he toppled in. I was about 10 meters away so I first looked to see who was closer that would respond. No one moved. No one had seen him fall in except me.
Then everything went into slow motion. I could see that he could clearly not swim. His eyes were wide open as his arms an legs flayed about helplessly not bringing his head any closer to the surface. He was clearly in trouble. Then a strange thought went through my mind based on my above mentioned philosophy.
“If I leave him, that is bad enough that I will probably live forever.”
In continuing with the theme of getting ready for the beach and water sports this summer, let’s consider what to do about substance abuse. There is no controversy whatsoever about the fact that persons under the influence of alcohol or any other mind-altering substance have a higher incidence of accidents. In fact, ingestion of alcohol figures prominently as a statistic in falls, drownings, motor vehicle accidents and virtually every variety of activity that has ever been studied. The issue, then, is not whether or not alcohol contributes to illness and injury, but to what extent we are able to control its use by reason and, when necessary, prohibition.
Im June of 2008, Solana Beach, California banned alcohol consumption on its beaches for at least a year. This ban continues. Here is what appears on the city’s website:
Alcoholic Beverages – Alcohol is banned at all beach areas in Solana Beach. Alcohol is also prohibited in the parking lot, community center, viewpoint or any other public place adjacent to the beach. Glass is prohibited as well.
There are similar rules at, among others, Torrey Pines State Beach, Cardiff, San Elijo, South Carlsbad and Carlsbad state beaches.
City officials made this move proactively, to avoid the sorts of tragedies and social problems that have intermittently plagued “wet” beaches. Recognizing that judgment is often an irrelevant factor when it comes to drinking alcohol, they made a strong and, in my opinion, laudable move. Like it or not, judgment is impaired by drinking alcohol, so the concept of “responsible drinking” is an oxymoron when water sports and potentially hazardous surf conditions coexist with beer, wine, and liquor. Of course, the same is true for certain prescription drugs and illicit drugs.
Needless to say, civil libertarians and numerous other individuals are opposed to mandated prohibitions. They cite lack of observation of problems, principles of freedom and personal rights, and even the loss of romanticism. The issue obviously has two sides.
From a safety perspective, it’s a no-brainer. There’s no benefit to drinking alcohol and entering the ocean. It can never make you safer, and can only make you less safe. Even if you are able to drink alcohol at the beach and safely dispose of your metal cans and glass bottles, not litter, not be rowdy or obnoxious, and keep your drinking to yourself, the moment you dip a toe, you are a greater risk to yourself and to the lifeguards and other rescuers entrusted to protect you. You may not believe that to be the case, but the stories and statistics don’t support you. Having pulled intoxicated victims from the water, treated them at the scene, stitched their heads and set their broken bones in the emergency department, and having had to tell their families and friends that they are dead (while knowing that none of this would have ever happened had the victims been sober), I am offering well-intentioned advice. Not every city will mandate that you leave your beer cooler at home when you head to the beach. When you need to be the one to decide, choose wisely.
It’s no secret that doctors are disappointed with the way that the U.S. healthcare system is evolving. Most feel helpless about improving their work conditions or solving technical problems in patient care. Fortunately one young medical student was undeterred by the mountain of disappointment carried by his senior clinician mentors…
I am proud to be a part of the American Resident Project an initiative that promotes the writing of medical students residents and new physicians as they explore ideas for transforming American health care delivery. I recently had the opportunity to interview three of the writing fellows about how to…
I m often asked to do book reviews on my blog and I rarely agree to them. This is because it takes me a long time to read a book and then if I don t enjoy it I figure the author would rather me remain silent than publish my…
When I was in medical school I read Samuel Shem s House Of God as a right of passage. At the time I found it to be a cynical yet eerily accurate portrayal of the underbelly of academic medicine. I gained comfort from its gallows humor and it made me…
I am hesitant to review diet books because they are so often a tangled mess of fact and fiction. Teasing out their truth from falsehood is about as exhausting as delousing a long-haired elementary school student. However after being approached by the authors’ PR agency with the promise of a…