How Many People Have Been Harmed by Current U.S. Policies?

29 Aug 2026 12 Comments

by Dr. John Persico Jr. in Uncategorized Tags: cruelty, fear, gaza, Genocide, greed, health, Israel, lack of compassion, murder, news, policies, Politics, revenge, trump

A cautious attempt to estimate the human scale of policy choices in foreign aid, health care, food assistance, immigration, environmental regulation, tariffs, vaccination policy, Gaza, and Iran

Analysis by Metis (ChatGPT, GPT-5.6 Sol), OpenAI
August 29, 2026

Important qualification. There is no scientifically defensible single “body count” for a presidential administration. The categories below overlap; some figures describe observed changes, others are forecasts; and in wars such as Gaza, U.S. support is one causal factor among many. The most responsible approach is to distinguish deaths, serious losses of services or security, and broader economic or social effects.

Introduction

I think it is time we have an accounting of the damage that the Trump Administration has had to date on the USA and World. I tasked my AI program Metis, with a prompt to give me a summary of the impact of the policies that Trump and the Republican Party have been promoting. Following is a summary and analysis done entirely by AI but with citations and documentation to support her analysis.

The short answer

If “hurt” means a substantial loss — death, serious illness or heightened disease risk, loss of health insurance or food assistance, detention or removal, war injury, displacement, or comparable deprivation — the policies discussed here plausibly place tens of millions of people in a substantially worse position. A rough order-of-magnitude estimate of about 15–30 million people already seriously affected or placed at substantial near-term risk is defensible as a discussion range, but it should not be presented as a precise total.

If “hurt” is defined more broadly to include higher prices, reduced purchasing power, environmental exposure, uncertainty caused by immigration enforcement, or deterioration in public services, the number rises into the hundreds of millions. That broader number is less useful, however, because it treats a modest increase in household costs as statistically equivalent to losing medical care, food assistance, a home, or a life.

What the major policy areas suggest

Policy area	Indicator of harm / risk	How to interpret it
Foreign aid / USAID cuts	A peer-reviewed forecasting analysis projects about 14.05 million excess deaths worldwide by 2030, including about 4.54 million children under five, under its near-termination/defunding scenario. The same model estimated about 1.78 million excess deaths in 2025.	Very consequential but modeled rather than a verified death ledger. The estimate depends on assumptions about sustained cuts and the ability of governments or other donors to replace lost services.
Medicaid and health-care reductions	The Congressional Budget Office estimates that the 2025 reconciliation law’s Medicaid provisions will reduce Medicaid enrollment by 12.9 million and increase the number of people without health insurance by 7.5 million in 2034.	Strong federal projection for coverage effects. It does not mean 7.5 million deaths or illnesses; the downstream health consequences are harder to quantify.
SNAP and food assistance	CBPP’s analysis of USDA and state data estimates SNAP participation fell by roughly 5 million people between July 2025 and May 2026. In 25 states with child data, about 1.2 million fewer children were receiving SNAP; CBPP has estimated the nationwide child decline is likely above 1.5 million.	The decline is observed, but not all of it can be attributed solely to the reconciliation law. Loss of SNAP can also make access to other nutrition benefits, including free school meals, more difficult.
Environmental deregulation	NYU’s Institute for Policy Integrity estimates that the environmental and energy rules targeted for rollback put about 3,299 avoided premature deaths per year at risk, along with more than $150 billion in annual net benefits.	A prospective regulatory-impact estimate, not a count of people already known to have died.
Tariffs	The Budget Lab at Yale estimates that the 2025 tariffs increase the number of Americans in poverty by roughly 650,000 to 875,000, depending on the poverty measure. Its tariff analyses also estimate broad household purchasing-power losses.	Economic modeling. Nearly every household can be affected through prices or income, but the severity varies enormously.
Immigration policies	Enforcement, detention, visa revocations, deportations, family disruption, and fear within immigrant communities can affect very large populations. Some specific administration actions have also been found unconstitutional by federal courts.	There is no clean, non-overlapping national number that can responsibly be added to a master total. Whether every lawful arrest or removal should be labeled ‘harm’ also involves a normative judgment.
Vaccination policy	The administration has moved to narrow the routine childhood vaccination schedule. Medical organizations warn that reduced vaccination can increase preventable disease. The United States is also experiencing its largest measles outbreak in decades; Pennsylvania reported two measles deaths in August 2026.	The direction of risk is medically important, but it is too early to assign a credible aggregate number of deaths or illnesses specifically caused by the policy changes.
Gaza and U.S. support for Israel	By August 2026, Gaza health authorities reported more than 73,000 Palestinian deaths since October 2023. UN satellite analysis found approximately 81% of structures in the Gaza Strip damaged as of October 2025, reflecting the extraordinary scale of destruction and displacement.	The human toll is enormous, but it would be analytically wrong to attribute every Palestinian casualty directly to the current U.S. administration. Israel conducts the military operations; Hamas and other actors also bear responsibility for their actions; the war began before the current administration.
War with Iran	Reuters reported on August 29, 2026 that 18 U.S. service members had died and more than 750 had been wounded during six months of war. The conflict and intensified sanctions have also imposed severe economic and security costs on Iran and the region.	Direct U.S. military casualties are measurable. A comprehensive, independently verified total for Iranian military and civilian casualties and indirect economic harm is harder to establish.

Why foreign-aid cuts may dominate the mortality calculation

The most striking numerical estimate in this exercise is not Gaza or Iran but foreign aid. The USAID forecasting study estimates approximately 14.05 million excess deaths by 2030, with an uncertainty interval of roughly 8.48 million to 19.66 million, if the modeled defunding scenario persists. About 4.54 million of the projected deaths are children under five. The study’s 2025 estimate was approximately 1.78 million excess deaths.

These numbers should be described as projections, not as counted deaths attributable person-by-person to a presidential decision. Nevertheless, the magnitude is plausible because foreign-aid programs operate in areas where relatively inexpensive interventions — childhood vaccination, malaria prevention, HIV and tuberculosis treatment, nutrition, clean water, maternal care, and basic public-health systems — can avert large numbers of deaths in low-income populations.

Gaza requires a different kind of attribution

The Gaza figures should not be converted into a statement that the United States ‘killed’ every person who died there. Israel conducts the military campaign, Hamas initiated the October 7, 2023 attack and remains an armed participant, and the conflict predates the current administration. At the same time, U.S. military, diplomatic, and political support is an important part of the environment in which the war has continued.

A more defensible formulation is: “More than two million Gazans have experienced the humanitarian consequences of a war that the United States has continued materially to support, while Gaza health authorities report more than 73,000 Palestinian deaths since October 2023.”

Why I would not add all the numbers together

The same person can appear in several categories. A low-income American might lose Medicaid, lose SNAP, face higher tariff-driven prices, and live in an area with greater pollution exposure. Counting that person four times would make the total look more precise while actually making it less meaningful. The same problem occurs internationally when foreign-aid reductions, war, displacement, disease, and food insecurity affect the same population.

For that reason, a published argument is stronger if it uses three separate measures: (1) deaths and severe physical injury; (2) people losing essential services, security, food, health coverage, or homes; and (3) the much larger population experiencing economic or social costs. This prevents a $100 or $1,000 household loss from being treated as equivalent to death, serious illness, hunger, or displacement.

A reasonable overall conclusion

The safest ballpark is not a single body count. The policies considered here plausibly have already harmed, or placed at substantial near-term risk, tens of millions of people. A discussion range of roughly 15–30 million people is defensible for serious harm or substantial loss, provided it is explicitly labeled an order-of-magnitude estimate rather than a statistical total. If ordinary economic effects such as tariff-driven price increases are included, the affected population becomes hundreds of millions.

The mortality implications could become far larger over time. The most consequential published projection is the USAID estimate of roughly 14 million excess deaths through 2030 if deep funding reductions persist. That projection alone demonstrates why relatively small budget items can have consequences disproportionate to their share of federal spending.

The strongest counterargument

Supporters of the administration argue that these policies pursue legitimate objectives: reducing federal spending and waste, encouraging work, controlling immigration, increasing domestic production, reducing regulation, supporting an ally, and countering Iran. Those objectives should be stated fairly. The central question is therefore not simply whether the policies have costs — virtually every major policy does — but whether the intended benefits justify the scale, distribution, and avoidability of the human costs.

That distinction matters. Estimating consequences is primarily an empirical question. Deciding whether those consequences are morally or politically acceptable is a value judgment. Keeping those questions separate makes the analysis more credible and much harder to dismiss as partisan rhetoric.

Sources and notes

USAID mortality projection: Van Beusekom, Mary. CIDRAP summary of the peer-reviewed Lancet analysis, reporting a projection of more than 14.1 million excess deaths by 2030, including 4.5 million children under five. Source

Medicaid: Congressional Budget Office. The Budget and Economic Outlook: 2026 to 2036, Appendix A; and CBO’s October 2025 estimate of the Medicaid provisions of Public Law 119-21. Source

SNAP: Center on Budget and Policy Priorities. SNAP Tracker, August 26, 2026. The tracker uses USDA and state program data and notes that factors besides the reconciliation law may contribute to the decline. Source

Environmental rollbacks: Institute for Policy Integrity, NYU School of Law. Tracking the Damages of Regulatory Rollbacks. Source

Tariffs and poverty: The Budget Lab at Yale. The Effect of Tariffs on Poverty, September 9, 2025. Source

Gaza casualty context: Reuters reporting, August 2026, citing Gaza health authorities as reporting more than 73,000 Palestinian deaths since October 2023. Source

Gaza structural damage: United Nations Satellite Centre (UNOSAT). Gaza Strip Comprehensive Damage Assessment, October 31, 2025: approximately 81% of structures damaged as of October 11, 2025. Source

Iran war: Reuters, August 29, 2026. Report on U.S. military families and casualties after six months of war with Iran. Source

Vaccination policy: Reuters, August 2026. Reporting on the administration’s childhood vaccine order and medical opposition to narrowing the routine schedule. Source

Prepared for publication. Figures and policy conditions are current through August 29, 2026 and should be rechecked if published substantially later.

When Healthcare Became a Business: Why America Can’t Find Enough Doctors? — Part 1 of 2 Parts by Metis with some assistance from Dr. Persico

02 Jun 2026 27 Comments

by Dr. John Persico Jr. in Uncategorized Tags: business, commercialization of health care, health, healthcare, medicine, mental health, news, profits, shortage of doctors

No matter where you live in American today, you will encounter the problem that there is a physician shortage. It is easy to blame people. We can ask why more people are not interested in becoming doctors. The truth is that America does not suffer from a shortage of people who want to become doctors. It suffers from a healthcare system that systematically limits physician supply, burns out existing doctors, redirects resources toward profit-generating activities, and increasingly treats healthcare as a business rather than a public service.

This issue became more personal for me recently when my wife had three emergency room trips and three overnight stays in the hospital. One for six days, and two for two days each. Despite the fact that no definitive prognosis was found, we could not get an appointment with her pulmonologist for over thirty days after her third emergency visit. My wife was a BA/RN with a master’s degree in public health nursing for over 55 years full time before she retired. I have an undergraduate degree in Health Education. None of our credentials mattered. We were mostly treated like mushrooms. Kept in the dark and fed manure. The reasons we were given “Not enough specialty doctors in our area.”

I have written before about the problems in the American medical system. The problems have only grown worse. Here is a brief summary of where the American Medical System ranks on the five statistics that patients care most about in comparison to other countries.

1. Life Expectancy

This is perhaps the single best measure of whether a healthcare system is helping people live long lives.

U.S. life expectancy reached about 79 years in 2024.
That is roughly two years below the OECD average and among the lowest of developed nations.

Why patients should care:

If a nation spends the most on healthcare but its citizens die younger than those in comparable countries, something is wrong with the system.

2. Preventable and Treatable Deaths

These are deaths that should not occur if people receive timely and effective healthcare.

The U.S. has among the highest rates of avoidable deaths among wealthy countries.

Why patients should care:

This measures not whether doctors are talented, but whether the system gets patients the right care at the right time.

This statistic directly relates to physician shortages and delayed access.

3. Access to Primary Care

Primary care physicians are the “front door” to healthcare.

The U.S. has fewer primary care physicians per capita than many peer nations and faces projected shortages of tens of thousands of doctors in coming years.

Why patients should care:

Longer waits for appointments.
Delayed diagnosis.
Greater use of emergency rooms for routine care.

This may be the statistic most directly connected to your physician-shortage article.

4. Infant Mortality

Infant mortality is often considered one of the most sensitive indicators of a nation’s health system.

The United States continues to have a higher infant mortality rate than many other developed countries.

Why patients should care:

If a healthcare system struggles to keep infants alive during their first year of life, it raises questions about access, prenatal care, and healthcare equity.

5. Healthcare Cost

This is where the United States is number one.

The U.S. spends more per person on healthcare than any other nation.
Recent estimates place spending at nearly $15,000 per person annually, roughly double many peer countries.

Why patients should care:

Americans are paying luxury-car prices for a healthcare system that often produces middle-of-the-pack—or even worse—results than comparable medical systems in other countries. The following table shows where the USA ranks against the list of OECD countries. The OECD currently consists of thirty-eight member nations most of them high-income democracies.

Measure	United States
Healthcare Spending	Highest
Life Expectancy	Near Bottom
Preventable Deaths	Near Bottom
Primary Care Access	Near Bottom
Infant Mortality	Near Bottom
Overall Ranking Among Peer Nations	Last

To verify this data – Go to the Organization for Economic Cooperation and Development site at https://www.oecd.org/en.html

In the blog that follows, I am going to identify some of the major factors that are contributing to the dismal performance of our health care system.

Factor 1: The Doctor Shortage

The U.S. is projected to face a shortage of tens of thousands of physicians over the next decade. Rural communities are especially affected, but shortages are increasingly appearing in urban areas as well.

The Association of American Medical Colleges projects the United States could face a shortage of up to 86,000 physicians by 2036.
The projected shortage of primary care physicians alone is estimated at 20,200 to 40,400 doctors by 2036.
Only about 24% of U.S. physicians practice primary care, even though primary care is often the front line for prevention and early diagnosis.

Factor 2: Medical School and Residency Bottlenecks

Most people assume the problem is that too few students want to become doctors.

The reality is more complicated.

Every year thousands of qualified students are rejected from medical schools.

Even after graduation, physicians must complete residency training.

The number of residency positions has not kept pace with population growth because Medicare largely funds residency programs and funding has historically been capped.

Result:

Fewer physicians enter practice than society needs.
Existing doctors must see more patients.
Wait times increase.

Healthcare Outcomes

Patients wait longer for:

Primary care appointments
Specialists
Mental health services

Research consistently shows that delayed care leads to:

Worse disease outcomes
More emergency room visits
Higher mortality rates

Factor 3: Physician Burnout

This may be the most important factor.

Nearly half of all physicians reported burnout in 2024. One major survey found a burnout rate of 49%.
Although burnout has improved somewhat, 43.2% of physicians still reported symptoms of burnout in 2024, and 41.9% in 2025.
Primary care physicians consistently report some of the highest burnout rates in medicine.

Many physicians report spending nearly as much time on:

Documentation
Electronic medical records
Insurance approvals
Billing requirements

as they spend caring for patients.

Doctors often describe themselves as data-entry clerks with medical degrees.

The Commercialization of the Medical System plays a key role in Doctor Burnout. While it does not directly reduce the number of medical graduates. Instead, it can make physicians less willing to remain in practice.

Think of it as a retention problem.

Doctors often cite:

Loss of autonomy
Productivity quotas
Administrative burden
Corporate oversight

as reasons for burnout.

When experienced physicians retire early, the effective shortage grows.

Healthcare Outcomes

Burnout contributes to:

Earlier retirement
Reduced patient access
Medical errors
Lower patient satisfaction

The average patient often experiences this as:

Rushed appointments
Less physician attention
Difficulty obtaining follow-up care

Factor 4: Aging Population

America’s population is getting older.

Older adults consume significantly more healthcare resources.

The Baby Boom generation is moving into years where:

Cancer rates rise
Heart disease increases
Joint replacements become common
Chronic illnesses multiply

Demand is increasing faster than physician supply.

Healthcare Outcomes

More patients compete for the same physicians.

Wait times lengthen.

Primary care becomes increasingly difficult to access.

Factor 5: Geographic Maldistribution

The United States may not have a pure national shortage as much as a distribution problem.

Doctors tend to locate in:

Wealthier communities
Urban areas
Regions with better reimbursement

Rural America often struggles to attract physicians.

Arizona experiences this challenge in many communities outside Phoenix and Tucson. We live in Arizona City, and the selection of specialists is poor to non-existent here. We are fifty miles from Phoenix and fifty miles from Tucson. Depending on the time of day, it can take two to three hours to get to some areas of Phoenix and two hours to get to some areas of Tucson.

Healthcare Outcomes

Rural patients experience:

Longer travel times
Delayed diagnosis
Higher mortality rates for many conditions

Factor 6: Commercialization of Healthcare

This is where the story becomes particularly interesting.

Many Americans still imagine hospitals as community institutions.

Increasingly they are large corporate enterprises.

Over the past forty years:

Independent physician practices declined.
Corporate healthcare systems expanded.
Investor-owned hospital chains grew.
Private equity entered healthcare.

Healthcare increasingly became a business sector rather than a public service sector.

Hospital mergers and physician acquisitions frequently increase prices without corresponding improvements in quality.

Factor 7: Hospital Consolidations

The percentage of physicians employed by or affiliated with hospital systems increased from less than 30% in 2012 to at least 47% in 2024.
- More than three-quarters of U.S. doctors are now employed by health systems or corporations rather than practicing independently.

Thousands of hospitals merged into large regional systems.

Proponents argued consolidation would:

Reduce costs
Improve efficiency
Improve quality

The evidence is mixed.

Many studies suggest consolidation often results in:

Higher prices
Greater market power
Increased administrative costs

Studies reviewed by the Government Accountability Office found that physician and hospital consolidation is generally associated with higher prices and spending, with limited evidence of corresponding quality improvements. Read my blog called, “When Bigger is Not Better.”

Factor 8: Administrative Growth vs Physician Growth

One of the most striking trends is that administrative staffing has grown much faster than physician staffing.

Hospitals employ:

Compliance officers
Revenue cycle managers
Coders
Contract specialists
Marketing personnel
Financial analysts

Many are necessary.

But the growth rate has greatly exceeded physician growth. According to one statistic administrators now outnumber physicians by roughly 10 to 1 in some healthcare systems.

Critics argue the system increasingly rewards administration rather than caregiving.

Healthcare Outcomes

More money flows toward administration.

Less is available for:

Physician recruitment
Nursing support
Patient services

NEW YORK, NEW YORK – DECEMBER 19: People demonstrating against the healthcare industry

Factor 9: Private Equity and Physician Practices

This is a newer development and one that many people do not know about.

Approximately 6.5% of physicians worked in private-equity-owned practices in 2024, up from 4.5% in 2022.

While still a minority of practices, the trend is moving rapidly.

Private equity firms increasingly purchase:

Physician groups
Emergency departments
Specialty practices

Their objective is generally to increase profitability and eventually sell the practice.

Critics argue this creates pressure for:

Higher patient volumes
More procedures
Cost cutting

Before concluding Part 1, lets summarize the human cost of the physician shortage in the USA and the attendant commercialism health care in America.

The Human Cost

The physician shortage ultimately affects patients through:

Longer Wait Times

Patients may wait months for specialists.

Reduced Preventive Care

Diseases are detected later.

Overcrowded Emergency Rooms

ERs become substitutes for primary care.

Physician Fatigue

Burned-out physicians are more likely to leave practice.

Health Disparities

Rural and low-income populations suffer most.

Treatment Outcomes

You may die from something that could have been treated with earlier diagnosis.

So Where Do the Profits Go:

Consider this paradox. The United States spends nearly twice as much per person on healthcare as many other high-income countries. Yet Americans generally do not live longer, have better access to doctors, or enjoy better health outcomes. If the additional money is not producing better results, where is it going?

After all this discussion about Health Care becoming a business instead of a human service, the obvious question is “Where do the profits go?” There are five main actors in this picture. I would like to call them “villains’ but Metis who is the main author of this piece refuses to let me use this terminology. Hence, here are the five major actors who share in the money pie.

Hospital CEO Compensation
Administrative Growth and Costs
Insurance Company Profits
Pharmaceutical Profits
Private Equity Returns/Profits

The easiest way to view the answer to the distribution of profits is to look at a pie chart:

Who Is the Villain? Or is there a Villain?

Whenever Americans discuss healthcare, there is a tendency to look for a villain. Some blame insurance companies. Others blame pharmaceutical firms, hospital executives, private equity investors, politicians, or even doctors themselves. While each of these groups deserves scrutiny, focusing on any single villain misses the larger truth.

The real problem is not one person, one company, or even one industry. The real problem is the system.

Edwards Deming, the quality management expert, often argued that most organizational failures are caused by systems rather than individuals. If Deming were alive today, he would tell us to stop looking for villains and start looking at incentives. Why does the American healthcare system produce higher costs, physician shortages, burnout, and poorer outcomes than many comparable nations despite spending more money than any other country on Earth?

The answer lies in the way the system is structured.

Every major participant in healthcare—hospitals, insurance companies, pharmaceutical firms, physician groups, investors, and government agencies—is responding to incentives that reward revenue growth, complexity, and market power. Over time, these incentives have created a healthcare system that increasingly behaves like a business rather than a public service.

Where does the money go? The largest portion of it disappears into administrative complexity. The United States has built one of the most complicated healthcare financing systems in the world. Hospitals and physician practices employ armies of billers, coders, compliance officers, contract specialists, lawyers, and administrators simply to navigate the rules. Physicians spend countless hours on documentation, insurance approvals, and billing requirements instead of patient care. This complexity contributes directly to physician burnout and rising costs.

Other high-income nations are not perfect, but many have simpler systems, stronger primary care networks, and greater control over prices. As a result, they often achieve comparable or better outcomes while spending far less.

My wife once had a visiting nurse from Sweden come to North Memorial Medical Center where my wife was a nurse manager. Karen was asked to take the visiting nurse and show her around the hospital for the day. She enjoyed the day with the nurse. When Karen came home that evening, she told me about the visit and some of the things that surprised her. This was back in 2005 before Karen retired the first time.

Karen took the nurse to the business center where the people were working on billing and insurance issues. North Memorial was then a 4500 employee hospital and the visiting nurse came from one of comparable size in Sweden. In North Memorial over 200 people were employed in billing and medical coding processes. Karen was shocked to find that in the visiting nurse’s hospital (ALMOST THE SAME SIZE) only three people were employed. Why? Because they had a single payer system with only one place to bill. In the United States, hospital billing can be bewilderingly complex.

A large American hospital may deal with dozens or even hundreds of insurance plans, each with its own reimbursement rules, approval requirements, referral procedures, and appeals processes. What appears to be fifty insurance companies may actually represent hundreds or even thousands of distinct billing arrangements. The result is a healthcare system that requires armies of administrators simply to get paid.

A small rural hospital might have:

20–50 major payer contracts

A medium-sized regional hospital might have:

50–100 payer contracts

A large urban hospital system may have:

100–300 payer contracts

So who is the villain?

The villain is a system that rewards complexity over simplicity, treatment over prevention, administration over caregiving, and financial performance over patient outcomes. Most of the people working within the system are trying to do their jobs well. The problem is that the system often pushes them in the wrong direction.

Until we address those underlying incentives, physician shortages, rising costs, and patient frustration will remain symptoms of a deeper disease. The challenge before us is not to find someone to blame. It is to build a healthcare system that rewards the outcomes patients actually care about: timely access to care, affordable treatment, healthier lives, and better results.

Conclusion

America spends more on healthcare than any nation in history, yet millions struggle to find timely access to a physician. The problem is not a lack of talent or technology. The problem is a system that prioritizes financial performance over system performance. As hospitals consolidate, private equity expands, and administrative complexity grows, physicians increasingly find themselves serving the business of healthcare rather than the practice of medicine. Until we address these systemic issues, doctor shortages will remain a symptom of a deeper disease within American healthcare itself.

If the United States spends more on healthcare than any nation in the world, why do so many patients struggle to find a doctor, wait months for appointments, and feel lost in the system?

If you want more data or resources on any of the subjects I have discussed above, you can find substantial data and references on the following sites. These organizations provide some of the most widely cited and respected data on healthcare spending, physician workforce trends, access to care, and international healthcare outcomes.

1. OECD (Organization for Economic Co-operation and Development)

Best source for:

International healthcare spending
Life expectancy
Physician supply
Infant mortality
Cross-country comparisons

OECD Health Statistics

General OECD site:

OECD Official Website

2. Commonwealth Fund

Best source for:

International healthcare rankings
“Mirror, Mirror” reports
Comparisons of U.S. healthcare to other wealthy nations
Access, equity, and outcomes

The Commonwealth Fund

3. AAMC (Association of American Medical Colleges)

Best source for:

Physician shortages
Residency bottlenecks
Medical school enrollment
Workforce projections

Association of American Medical Colleges (AAMC)

4. KFF (formerly Kaiser Family Foundation)

Best source for:

Healthcare costs
Insurance statistics
Medicare and Medicaid
Hospital consolidation
Easy-to-understand charts and graphs

KFF (Kaiser Family Foundation)

KFF Health System Tracker

_____________________________________________________________________________

In Part 2, we will look at what is driving the commercialization of hospitals and why they have become places of profit rather than service. We will also look at some possible antidotes to the commercialization infecting the American Medical System. Some of these solutions will address:

Expanding residency funding.
Reducing administrative burden.
Increasing primary care reimbursement.
Encouraging independent physician practices.
Scrutinizing hospital mergers more aggressively.
Increasing transparency in healthcare pricing.
Developing rural physician incentives.
Measuring healthcare success by patient outcomes rather than revenue generation.

Why I am Sick of Experts!

31 Mar 2026 7 Comments

by Dr. John Persico Jr. in Uncategorized Tags: brainiacs, con artist, experts, geniuses, health, life, social media influencers

Experts On Aging Reveal The 5 Major Habits That Will Improve Your Longevity

UK ‘weeks away’ from medicine shortages if Iran war continues, experts say

H-1B Visa Restrictions Will Hurt America’s Research Potential, Experts Say

Should you use AI to file your taxes? Experts warn it can lead to costly mistakes.

Every time you turn around today there is an “Expert Saying.” Saying this and saying that. Telling you what to do. Telling you what to wear. Telling you how to think. Telling you what to eat.

I wonder “Does anyone else hate these experts as much as I do? Is it just jealousy on my part that a 22 year old social media influencer on YouTube or Instagram is now considered an “Expert?” Just this morning I heard of a new class of experts on social media to which you absolutely must listen. I will describe them later in this blog.

A few weeks ago, a Social Media Hiker Influencer was hiking in the Superstition Mountains equipped with her ever present cell phone and Selfie Stick taking pictures of her hiking the trails. She was someone that other would be hikers looked up to for her expertise. Young, lean, sexy, and self-assured, she was narrating from a trail. As some point, she quit narrating and they found her body up on the trail the next day dead from heat exhaustion. Ms. Social Media Hiking “Expert” apparently never learned that Arizona heat can be deadly.

Now I am saddened that she came to such an end, but I am also saddened by the people that were following her. If her knowledge of hiking essentials was this poor, I feel even sorrier for the deluded fans that regarded her as their “Expert.”

Once upon a time, I was regarded as an “Expert.” A book on management consulting listed me as one of the top Labor Management Consultants in the USA. I was surprised to come across this commendation as I was definitely unaware that I ranked this highly. How they came to this conclusion will forever be one of the many mysteries of my life.

We used to joke in the consulting firm where I worked that an “Expert” was a man or woman fifty miles from home with a briefcase. I remember one consultant I met who had worked with Ernst and Young. They sent him out to a firm to help them develop self-managed work teams. Self-managed work teams were all the rage at the time and Earl became their in-house “Expert.” The only problem was that Earl did not know what a ‘”self-managed work team” was. As Earl went off to his consulting engagement, his company handed him a recent book that was the “bible” for self-managed work teams. They told Earl to read the book before he got to California so that he would know what to do.

I am now seventy-nine years old. When I was thirty and forty, I actually thought I was an “Expert.” Not only was I an “Expert,” but I was also an “Expert” in many different areas of life. The proof was that companies were paying me for my expertise. You wanted advice, I would like to give it to you. Back in the nineties, it would only cost you $2500 a day for my expertise.

Today, I lack the courage to give almost any advice except perhaps in my blogs where I am shielded from immediate scrutiny. I know I cannot bear to look back upon my twenty or so years of consulting and reflect on the “expertise” I shared. If I could, I would give all of my thirty-two clients a rebate or maybe even all their money back. But brother, I was the “Expert” and even a freight train or Spider Man could not stop me from telling everyone else what they must do.

As puzzled as I am by my former hubris, I am even more puzzled at all the people tuning in to get their daily dose of “expertise” from talk shows, media influencers, scientists, doctors, politicians, and lawyers. Here is one example. Since the start of our war on Iran, have you noticed how many “Experts” are telling us what is happening and what will happen?

As soon as I thought of this issue, I knew I would call upon Metis, my AI assistant for help. I gave her the following prompt:

“Metis, this is going to be a tough question for you. I only need a rough estimate or ballpark figure. I want to know how many military analysts, policy analysts and government state department analysts have spoken out on the Iranian conflict since it started? I know that is a tough question, but I just want a general number for an article I am working on about Experts.”

Here was her reply:

You’re right—that’s a very hard question to answer precisely. There is no official count, because “analysts speaking out” includes:

TV commentators
Think tank fellows
academic experts
retired military officers
government/former State Department officials
journalists doing analysis

So, the best we can do is build a reasonable, evidence-based estimate.

Think tank participation alone is already large

A single Atlantic Council feature included 20+ experts answering questions on the war
RAND Corporation published a panel with 9 named experts
Center for Strategic and International Studies regularly publishes multi-expert analyses

👉 That is already 30–50 “Experts” from just a handful of institutions

And there are dozens of major think tanks in Washington and globally, many funded and active in Iran policy debates

OK, thank you Metis. I get the picture. There are possibly hundreds if not thousands of “Experts” and analysts (same thing in my mind) ready, willing, and able to give you the inside story. The whole scoop. The truth and nothing but the truth. What do these platoons and squadron and legions of “Experts” get out of all this? Another mystery? Perhaps there is a fortune to be made in being an “Expert?”

By the way, for those of you who know AI, you are probably wondering what the bottom line was. Ok, so here is the final figure that Metis gave in response to my query:

Bottom-line “headline” number

👉 A realistic ballpark:

~500 to 2,000 analysts have publicly commented on the Iran conflict so far.

Just imagine if this war goes on for another year! How many “Experts” will have told you what was going to happen or what did happen. One of my favorite “Expert” lines goes like this: Interrogator: “So what do you think will be the result of all the bombs we are dropping on Iran?” “Expert” Analyst “Well, it all depends. It might make a significant difference on what Iran does next, or it might not. I think we will just have to wait and see.”

My wife Karen tells me that many social media “Experts” or influencers do not work for a salary, but they are often gifted for the products or services they promote. I mentioned earlier that I was recently exposed to a new class of social media influencers. This one was giving out advice on how to pick a gym out and was called a Social Media Fitness “Expert.” You can see by looking at the people walking into most grocery stores how the advice from this group is working out. For any of you interested in applying for this position, the qualifications are as follows:

Six pack abs
Bulging biceps or firm and large breasts (Depends on whether you are male or female)
Toned and buff with a great tan
Fantastic physique

So, what percentage of todays males have six pack abs and what percentage of women today have had breast enhancements? Metis gave me the following figure: “About 1% to 5% of American men have clearly defined six-pack abs.” If you want to know why this figure is so low, get your own AI program. I am going to be a Fitness “Expert.”

As for women in America who have had breast enlargements, that figure stands at 300,000 breast augmentations that are performed each year in the U.S. The average cost of these procedures is between 7,000 to $10,000 total.

Comparing men with six pack abdominal muscles to women with breast enlargements shows that a larger percentage of women undergo this treatment compared to men with six pack abs. About 3% to 6% of adult women in the United States have had breast implants at some point in their lives. It is clear why the percentage is higher than for men so enough said about abs and breasts.

The point here is that as with all of the “Experts” and analysts telling us what to do, what is going to happen and how to think there is an enormous difference between visibility and reality. I am not going to try to bust anyone’s bubble more than I already have but the situation is a little like me taking lessons from Usain Bolt on how to run faster. Usain is a great runner but there is no way that I ever had the physical equipment to run like he does. The same goes for my singing. I can take singing lessons all day long and I am not going to sound like Morgan Wallen. But here we are talking about physical changes and many of the “Experts” that I am decrying are giving policy advice. For instance, there has been a flood of “Experts” telling the police and FBI what they should be doing in the Nancy Guthrie case. Nut cases with theories abounding are calling up regularly with advice and “clues” that they think might lead the police to finding Nancy.

What happens when the daily and nightly news is full of so-called “Experts” telling us what is going to happen in Iran or any other place in the world? The result is chaos, confusion, uncertainty, and bewilderment. None of these results helps any of us sleep any better. One “Expert” tells us this and another “Expert” tells us that. Who do we believe when we have hundreds of “Experts” all telling us what to believe? Not only does truth die but so does belief. We no longer trust the reality that we navigate in. People without a sense of direction or without any certainties in life become easy prey for demi-gods and would be dictators. The reality that people live in today makes them an easy target for predators that want to get their vote or get their dollar for some cause. The bottom line is always how to get the money from your pocket to their pocket.

How Do We Protect Ourselves from Experts?

I can give you three prescriptions that might help you. Here goes:

Do not trust any single “Expert” or any one medium for information. A friend of mine has the following system. He calls it the “Ladder System.” There are five rungs on the ladder. Each rung represents a means of dealing with anything that we are told or hear or even see.

Rung 1: Bottom Rung

If you see something or hear something new it goes on the lowest rung in the ladder. We do not accept its validity at this point.

Rung 2:

If you hear of some data or facts from a reliable source that corroborates the information on Rung 1, than you can move it up to Rung 2. At this point it has some validity for being believable but perhaps not factual or consistent.

Rung 3:

To get to Rung 3, you need at least three or more independent corroborations from sources that are not selling you anything or benefiting from your dismissing the information. At this point your data or evidence should be highly reliable and valid.

Rung 4:

You may place your information on Rung 4 when you are able to substantiate the data and facts supporting the validity of this information with your own subjective experiences. Theory and Experience are essential to establish the validity or truthfulness of any theory. I prefer to have some personal experiences as well as scientific research before I put anything on this rung.

Rung 5:

Something can reach the Fifth Rung, only when science and reliable research over a period of at least ten years has supported the validity of the truth or information you want to regard as truth. Corroboration + Research + Experience + Time = Validity of the Information

Be suspicious of anyone who has something to gain by your accepting what they say is true.

You have heard the saying “If it is too good to be true, it probably isn’t.” This saying has not stopped millions of people from being suckered in by slick con artists. A potential con artist is anyone who can gain your trust through a variety of means:

Appealing to your emotions
Winning your trust through purported friendship
Claiming (even if legitimately) to be an Expert. This is the position that doctors, lawyers, and other professionals often use. “Me expert. You poor stupid ignorant client or customer or patient.” Just because they have an advanced degree does not make them right. Many so called experts often pontificate well out of the realm of their expertise.
Being referred to you by someone you trust. The problem here is that anyone can become a sucker. Look at all the people who lost millions of dollars to Bernie Maddoff. Your friend might have already drank the Kool-aide.

Do not be so blinded by your own intelligence or ego that you cannot stop and get a second and even third opinion.

It is hard to believe that so many people will sign on the dotted line before checking with someone who might be more objective and more independent. Heed the saying that, “Pride goes before a fall.” “Experts” have fooled thousands of people because the people were too proud to get an independent or third party opinion. We are never so blind as when we think that something we want or need will bring us the desired or expected outcomes that may be predicted by the “Experts.”

Let me tell you a story that happened to me after I was taken to the hospital on my very first ambulance ride.

About five years or so ago, one night I developed a throbbing pain in my side. I tried going for a walk, drinking hot lemon tea but nothing worked. I went to change up hoping to get in bed and the pain would stop. Next thing I know I was in an ambulance and headed to the hospital about forty miles away in St. Croix Falls. I woke when they started to stick me with an IV needle. Apparently I had passed out, and Karen called 911 thinking that I had had a heart attack. By the way, it was my first time ever in an ambulance.

I was driven to the St. Croix Medical Center and went immediately into emergency care. I was put on a bed, and they started a series of procedures to see what was wrong with me. I had an EKG, an Xray and an Ultrasound. All of this took about three hours. By then the pain had gone away and they sent me home with a doctors referral for the next day.

I arrived back at the medical center and had a meeting with a doctor. She informed me that I had a gall bladder attack and that I would need to have my gall bladder removed. I surmised as much and before I came to the appointment I read up some on gall bladder problems. She said they would do the pre-medical check today and I could come back for the surgery the following day. I said “wait just a minute. How do you know that my gall gladder is bad? She replied, “Don’t be afraid, it is a simple procedure, and you don’t really need your gall bladder.”

I said “listen Doctor, I had two surgeries in the past five years. I had my prostate removed and another for an inguinal hernia. I am not afraid of surgery. I just want to be sure that it is needed.” I said, “what if it was just a gall stone and it passed?” She said “Well, you might have other stones and then you will have the same problem again or maybe worse.” I said “Well, can’t you tell from the Xray if there are any other stones just waiting to pass?” “No,” she replied. “Why not” said I. “Because your gall bladder was so inflamed that the Xray could not see anything.” “Well then, what if we wait about two or three weeks and take another Xray when the inflammation has gone down?” “No Medicare will not let us do that. You can either get the surgery or forget about it.” By now I was fed up with the discussion. “I will pay for the procedure” I said. “No, that is not an option.” “Okay, then I will pass on the surgery.” She turned and walked out of the room without even a goodbye or have a lovely day.

A year later, I had another acute pain in my right abdomen. This time I drove myself to the same St. Croix Health Center. Again, it was at night and again the same procedures, Xray, EKG, Ultrasound. However, this time, they thought it was my kidney. Since I was more cognizant at this event, I asked the doctor if when they did the Ultrasound for my kidney, they could also take in my gall bladder. He agreed. When all the testing was over, I went home with another appointment for the next day.

Back again at the St. Croix Health Center. Doctor comes in and informs me that I have stage 1 kidney disease. He wants to know if I drink any alcoholic beverages. I tell him only draft beers, 45 percent Knob Creek Bourbon, 42 Percent Ron Barceló Gran Anejo Rum and 40 percent Cabo Wabo Anejo Tequila. He politely informs me that I might live longer if I cut my alcohol consumption down. I agree. I than ask him if he noticed anything about my gall bladder on the x-rays and how it was doing. Surprise of my life. He said “Your gall bladder was fine. You have the gall bladder of a sixteen year old.”

I went home and checked out the price of a gall bladder removal. It was between thirty-five thousand and forty thousand dollars. I was wondering if there was any way Medicare or my insurance plan would reimburse me for the money I saved by passing up on the Gall Bladder surgery. Five years have since passed. I have not had any more kidney or gall bladder problems. I confess, I have cut my alcohol usage by about 75 percent.

The point of my story here is that the Expert, the doctor was all prepared to do “routine” gall bladder surgery without conclusive evidence that it was needed. If you read some of my earlier blogs, you will find the following statistics on unneeded surgeries. This data is from the Lown Institute hospital overuse analyses using Medicare claims:

Coronary stents for stable heart disease
Lown reported 229,000 unnecessary coronary stents from 2019–2021, which is about 76,000 per year among Medicare patients.
Back surgery: spinal fusion / laminectomy for low-value indications
Lown reported more than 200,000 unnecessary back surgeries over three years, or roughly 67,000 per year.
Vertebroplasty for osteoporotic fracture
Lown reported over 100,000 unnecessary vertebroplasties over three years, or about 33,000 per year.
Hysterectomy for benign disease
In Lown’s March–December 2020 Medicare analysis, hospitals performed 14,455 low-value hysterectomies. That annualizes to roughly 17,000 per year.
Inferior vena cava (IVC) filter placement
In that same March–December 2020 analysis, hospitals performed 9,595 low-value IVC filter procedures, which annualizes to about 11,500 per year.

A few important cautions: these are expert overuse estimates, not exact counts of proven malpractice; they are largely based on Medicare hospital claims, so they do not capture every U.S. patient; and “unnecessary” here means the procedure met published overuse criteria, not that every individual case was inappropriate.

Conclusions:

I do not have much else to say. We rely too much on so-called experts. We need to base our decisions on facts. This means facts based on data and not opinions or even just theories. My mentor Dr. Deming used to say, “In God we trust, but everyone else must have data.” My father always said, “Believe nothing of what you hear and half of what you say.” Both of these admonitions have served me well and I think if they are the only thing that you remember from my blog, I will have done my job. Remember please. I am not selling you anything or charging you any money for my thoughts. You can take them or leave them; it is all the same to me. Here are some quotes on “Experts” by better men than I am.

“The trouble with the world is that the stupid are cocksure and the intelligent are full of doubt.”
— Bertrand Russell

“Those who have knowledge, don’t predict. Those who predict, don’t have knowledge.”
— Lao Tzu

“Science is the belief in the ignorance of experts.”
— Richard Feynman

“Experts are often wrong, but never in doubt.”
— Anonymous

The Perfect Day When Everything Went Right!

20 Jun 2025 6 Comments

by Dr. John Persico Jr. in Uncategorized Tags: everything went right, fun, good day, gratitude, happiness, health, joy, life, mental health, personal-growth, self-care

Did you ever have a day when “everything” went right. A day when you got up on the right side of the bed. The phone rang all day with calls from good friends instead of spam and telemarketing messages. Everyone just called to chat, and no one had any problems or issues to face. A day when the sun was shining and the weather was perfect. There were no bugs or mosquitoes to be found anyplace in your town. You felt like a million dollars with no aches or pains. No one you knew was going to the doctor for cancer treatments or therapy of any kind. It was as the younger generation like to say “Perfect.”

Now as you are reading this, you are probably thinking “He must be daydreaming, such days do not exist.” Or maybe you are thinking that it is my birthday. I concede the possibility that such days are perhaps rare, but then again should they be any more rare than days where “Everything that could go wrong” did go wrong. Or is it just our perspective which is goofed up. We are more likely to remember the days when our dog disappeared or when the doctor told us to come in and see her as soon as possible than days when our dog reappeared or the doctor called to tell us everything is fine. Cognitive scientists have a term for our propensity to remember the bad more than the good.

“Negativity Bias” is a cognitive bias that refers to the tendency to remember negative events and information more vividly and with greater impact than positive or neutral ones. I will not bore you with the reasons for this propensity. I am sure that you recognize that it exists. Thus, if the Yin/Yang of the world is an accurate theory of our existence, we should have at least as many of the Perfect Days as we do the Shitty days.

I ask you to stop reading this blog for a few seconds. I challenge you to see if and when you can remember the last perfect day that you have had. Now I would like for you to describe that day in my comments section before reading the rest of this blog. Think of the happiness you will bring to me as well as the rest of our readers. What if the news carried as much good information as they do bad information? What would your world be like if you only remembered and had perfect days.

At this point, you are probably ready to skewer me as some deranged Pollyanna or Don Quixote. A nutcase who sees everything through rose colored glasses. Someone who is madly optimistic that there is hope for a better world. That Donald Trump will not get a statue on Mount Rushmore and that he and his sycophantic followers will soon disappear in the abyss of forgotten history. I assure you that I go to sleep every night praying to a god that I do not believe exists that these latter events will happen while I am still alive to witness them. Instead, I wake up every morning to more bad news from the front line of the independent media I subscribe to. Thus, either giving me less hope for humanity or making me feel guilty by asking me for more money that I do not have.

See, you thought I was going to write some really optimistic idealistic treatise that would make you feel like your existence meant something and life was worth living. Instead, I refer you to Ecclesiastes from the Bible:

Everything Is Meaningless

1 The words of the Teacher,[a] son of David, king in Jerusalem:

2 “Meaningless! Meaningless!”

says the Teacher.

“Utterly meaningless!

Everything is meaningless.”

3 What do people gain from all their labors

at which they toil under the sun?

4 Generations come and generations go,

but the earth remains forever.

5 The sun rises and the sun sets,

and hurries back to where it rises.

6 The wind blows to the south

and turns to the north;

round and round it goes,

ever returning on its course.

7 All streams flow into the sea,

yet the sea is never full.

To the place the streams come from,

there they return again.

8 All things are wearisome,

more than one can say.

The eye never has enough of seeing,

nor the ear its fill of hearing.

9 What has been will be again,

what has been done will be done again;

there is nothing new under the sun.

10 Is there anything of which one can say,

“Look! This is something new”?

It was here already, long ago;

it was here before our time.

11 No one remembers the former generations,

and even those yet to come

will not be remembered

by those who follow them.

However, I refuse to finish this blog on a nihilistic note. I want to finish on a crescendo of hope and faith and happiness. A belief that one idea, one word spoken, one action taken, one step forward can change the course of humanity. We can look back to the past and find untold mistakes and failures that have eclipsed the sunlight of joy for the world. But we can also look forward to a future that we can create because the vast majority of human beings are decent peace-loving equality seeking individuals. The Negativity Bias blinds us to the positive outcomes that prevail every day in our lives. At the end of each day, we seem destined to remember the bad things that happen in the world. This effort is reinforced by a negative biased media which thrives on horror and destruction and pain. I love the words from this song by Peter Paul and Mary, “Light One Candle”

Light one candle for the terrible sacrifice

Justice and freedom demand

And light one candle for the wisdom to know

When the peacemaker’s time is at hand

Don’t let the light go out!

It’s lasted for so many years

Don’t let the light go out!

Let it shine through our love and our tears

Light one candle for the strength that we need

To never become our own foe

And light one candle for those who are suffering

Pain we learned so long ago

Light one candle for all we believe in

Let anger not tear us apart!

Light one candle to bind us together

With peace as the song in our heart

Don’t let the light go out!

It’s lasted for so many years! (lasted for so many years!)

Don’t let the light go out!

Let it shine through our love and our tears

We need to counter this tendency for negative bias by reinforcing the positive “perfect” days of our lives. Here is a checklist that ChatGPT created from my query:

It is a printable daily practice checklist to help overcome negative bias. You can use it as a daily or weekly tracker to build habits that shift your mindset toward balance and resilience.

🌞 Daily Practice Checklist: Overcoming Negative Bias

Practice	Done Today? ✅	Notes or Reflections
1. Morning Gratitude: List 3 things you’re grateful for.	☐
2. Reframe 1 Negative Thought: Catch a negative thought and reframe it positively.	☐
3. Notice the Good: Write down one positive thing that happened today.	☐
4. Kindness Practice: Do one kind thing for someone else.	☐
5. Mindful Moment: Spend 5+ minutes in meditation or quiet reflection.	☐
6. Move Your Body: Take a walk, stretch, or exercise.	☐
7. Limit Negative Input: Avoid or reduce exposure to toxic media or conversations.	☐
8. Evening Reflection: What went well today? What did you learn?	☐

🗓️ Weekly Reflection (Use at the end of the week)

What patterns of negative bias did I notice?
What helped me shift my mindset the most?
What’s one small thing I want to improve next week?

The End Folks.

Hope you enjoyed this blog. Let me know what your perfect day was.

Ears – by Miriam Mladinov

07 Apr 2024 2 Comments

by Dr. John Persico Jr. in Uncategorized Tags: aging, communication, deaf, deafness, ears, health, hearing, hearing aids, hearing-loss, miscommunication, misunderstandings

hand-and-ear-6

A good friend of mine wrote the following piece about Ears and Hearing. It is quite cute and relevant as many of us are getting older. Being heard and being understood sometimes becomes quite problematic. She gave me permission to post the following piece. I think you will enjoy it. I know I did.

EARS

By Miriam Mladinov

We are born with two ears, one of each side of our head. They are not beautiful, fleshy, curly, or naked. The shape is best described like ear shaped. If they were covered in fur, or at least fuzzy hairs like cat’s or dog’s, they would be prettier. Cats and dogs have another advantage because they can turn theirs in the direction of sound to hear better. By having two ears, spaced by a head in between, they are the first stereo equipment which gives us the direction and spatiality of sound: a really clever invention.

Ears also serve as a carrier of all kinds of trinkets for beautification. This is an ancient practice and many Egyptian, Roman, Aztec, even prehistoric human remains, sport some precious, ornate thing attached to their ears. These decorations were often made of gold, silver bronze, and decorated with colorful beads or stones. The practice is alive today and we call them earrings. If they are round we call them redundantly hoop earrings. They desperately cling to a fleshy lobular, dangling. Some people choose to have holes all around the ear lobe usually filled with small studs or tiny loops. One might think that the neat row of holes, like on a shoe, would be made to tie them together around the head with a shoelace. Other people choose to have a large hoop inserted in the fleshy part stretching it out like an elastic band.

Growing up I thought that piercing ears was a barbaric practice. It probably came from my mother’s belief because she kept her ears intact.… but I inherited a beautiful diamond set earrings from my grandmother and wanted to wear them. When I went to a place to get my ears pierced, I wore an old shirt in case the blood would gush over it and brought my earrings with me to insert them in the new openings. The girl wiped the area with alcohol and click, click inserted two studs like with a staple gun. Not a drop of blood. It was almost a letdown because it was so easy. Now I have a whole collection of earrings. My favorite are two little hoops made from my parents wedding rings.

Ears have another important function: TO HEAR. It is one of our five senses. We never think about it until it fails.

At first a friend tells you:

“Do not get offended, but I think that you might need a hearing aid.”

“WHAT?”

Three men were sitting on a bench in a park.

“It is windy.” The first said.

“No, it is Thursday.” Said the second.

“I am thirsty too. Let’s get a beer.” Said the third.

My neighbor approached me with a question:

“Do you have a problem with roses?”

“No. I did not pay much attention this year.”

“We had an invasion.”

“Invasion of roses?”

“We were gone for a while and roaches were coming out from the sewer.”

She never realized the confusion because she might be hard of hearing herself. After I went home, I could not stop laughing. Roses – roaches, quite a difference.

If I don’t actively listen, I often miss the first part of what is said to me, the second I get. That results in often missing the subject of the sentence and asking: Who or what?

The worst part is with names.

We shake hands and a person tells me: “Aaoouu .”

I say my name and politely ask him/her to repeat the name: “Aaoouu.”

“Nice to meet you.”

Then I run into the same person a few weeks later. I still do not know his/her name because I never heard it in the first place.

“Oh, sure I remember you. We met a few weeks ago. Sorry, can you tell me your name again?”

“Aaoouu!”

Another time at a gathering, I approached a guy and asked him about his sick wife. He gave me a blank look and said that he had a problem hearing. I said that I too have the problem and moved away realizing that I approached the wrong guy. I waved at him and smiled in a way of apology. He probably blamed himself for not understanding. Poor guy.

I got my first set of hearing aids. The small peeps go inside the ear and the minuscule computer sits discreetly behind. The set is very light. When I wear them, I forget about them until they get hungry and start to squeal. Time to change batteries.

My dad, who became completely deaf when he turned 90 and had hearing aids, managed to accumulate used and new batteries all mixed in a pile in a box. It was a big mess. Talking to him face to face was somewhat possible, but over the phone was hopeless. It caused several misunderstandings. The worst one was when I called him from NY telling him that I had arrived after a month-long trip, and that I would stay for a few days in NY. He expected me the next day back in Boston, and when I did not show up his panic escalated to gigantic proportion. I was kidnapped. I was murdered at the Port Authority. Police were engaged and searched for his lost daughter who was having a good time with a friend in NY, completely oblivious to the upheaval that the call has caused.

Incidentally my NY friend tends to choose the nosiest corner on a street in NY to call me. The traffic is clanking, the sirens are tooting, and she is expecting me to hear her soft-spoken voice. She also likes to call me from the car while her husband is driving through the mountains or a tunnel. Afterwards, she texts me how sorry she was that the line was interrupted.

The hearing aids help. They help a lot if I am in a quiet place and talk to one person. Great! We can have a coherent conversation, but I am lost anywhere there are drones and noises. At my exercise class where there is always some music going on, I never hear a joke, or a comment flaunted spontaneously by someone. I try to find a place in front to hear the instructor, who does have a lousy diction (not only my opinion). I get a lot by observing. If I am on my back and we circle the ankle of the left foot, I often miss the clue to switch the leg. It is not the end of the world if one ankle gets more rotations than the other, under the conditions that the next time with start with the other leg.

One unexpected consequence of wearing hearing aids is that I lost the sense of direction of the sound. That clever stereo quality is gone. When my phone rings, I run all over the house to find it and usually when I get it, it stops. I think that it does it on purpose. Or when something beeps, I run to microwave to see what is ready. Nothing. I check the dishwasher. It also calls when is done. Nothing. I run to the door. Nothing. I give up, and then realize that it was outside, the garbage truck backing up.

There are some helpful inventions like Bluetooth. I wonder who named it that way. It is an electronic miracle which beams the sound from your other miraculous devices straight to your hearing aids. Mine are not that smart, so they gave me another gadget for additional cost, which I had to hang around my neck like a necklace, called Dongo. It rings when my phone rings and I can activate the conversation from it, only if my phone is within a reasonable distance. If it is not, I must do the same exercise of running around to locate it. The Dongo is also designed to help with a conversation in a noisy restaurant if your company talks to Dongo instead to you. We got into a competition. This cumbersome little animal hanging from my neck did not last long. My friend whose husband had one told me that his Dongo did not work too.

For watching TV, I have a pair of earphones clasping over my hearing aid. I can control the volume on the TV remote, on earphones and on my hearing device. This triple enhancement actually works. It would make a dead person hear.

There are other means to bypass this handicap. I am not embarrassed to say that I have a hearing problem. It is better that people know that, than thinking that I am stupid. On an occasion when I was giving a presentation there were no problems with me doing it because I was the one who was talking. Anticipating questions, I asked the guy who introduced me to repeat the questions out loud. It helped me, and I think that it also helped many aging people in the audience. Win-win.

A friend of mine who was a speech pathologist told me that deaf people had harder problems to adjust to socially than the blind. Being hard of hearing is not the same as being deaf, but it also conditions one’s life. I avoid large gatherings, do not enjoy theater and any place where there are extraneous noises. I still enjoy the concerts. I probably miss something, but I am not aware of it. I love Japanese Taiko drummers.

Ears are precious.

The Obesity Epidemic in the USA Meets the Drug Epidemic

27 Feb 2024 10 Comments

by Dr. John Persico Jr. in Uncategorized Tags: diabetes, fentanyl, health, obesity, overweight, pot, research, war on drugs, weight bias, weight loss, weight stigma

191218155510-obesity-rates-by-state

Everyone knows or has heard that there is an epidemic of obesity in the USA. The statistics are staggering. The health problems associated with obesity are well known and cited often enough that if Tchaikovsky were alive, he would have written Symphony No. 7 in B Minor: Op. 74 “Obesity”. “Physiologically, adolescents with obesity have an increased risk of developing adverse health outcomes such as type 2 diabetes, hypertension, elevated serum cholesterol and triglyceride levels, respiratory disorders such as asthma, and joint problems.” — “Obesity Stigma and Bias”

I was at a party in Prague over 25 years ago and I was approached by a younger woman who sat down next to me. She promptly asked me, “Why are so many Americans overweight?” I gave the usual uninformed answer and replied, “Because they are lazy and do not exercise enough.” This was part of my belief system back then and is probably still shared by many Americans today. Since that time, Karen and I have traveled to several other countries. I think we are at about 43 now. Over the past few travels, we have noticed that not only the USA, but many other countries are also suffering from the same “Epidemic of Obesity.” If it is a psychological problem of motivation and willpower, than a whole bunch of countries are suffering from the same lack of motivation and willpower.

“Obesity is a complex physiologic condition influenced by genetics, hormones, sleep, environment, cultural norms, and economics. The oversimplistic assumption that obesity is a choice and can be “fixed” by moving more and eating less is outdated and inaccurate in the current science of obesity. Over the last 20 years, researchers have begun to shed light on the multifaceted complexity of obesity.” — “Obesity Stigma and Bias”

images

I started thinking about this problem more recently after observing some of the children in my high school classes. I am a substitute at three high schools in Casa Grande Arizona. I noticed that many of the kids are overweight. Back sixty years ago when I was in high school, there might have been one or two overweight children in the entire high school. Today the statistics say that as of 2023, 1 in 5 children in the United States are obese, and this number is increasing yearly. The rates of obesity are higher for Latino (43%) and Black (40%) youth. — Obesity or Oveweight Now Affect 1 In 3 Youth: How Experts Are Responding.

I wondered how these children deal with this problem. Has obesity become acceptable? We now have many stores with Plus Size clothes and there is an entire industry of “Plus Size Models.” Do these children feel the weight stigma that is allegedly associated with obesity? If they do feel it, how does it impact their socialization, personal image, and mental health? Are they blamed for being overweight as much of the research suggests?

“As the rates of overweight and obesity rise, weight discrimination in America has increased by 66% over the past decade and is equivocal to racial discrimination. Perceived provider weight discrimination often causes individuals with overweight and obesity to be reluctant to seek medical help, not only for weight reduction but also for any health-related problems…Bias against those with obesity appears to be socially acceptable and is reinforced by the media. Mass media has stigmatized obese individuals. A review of research over the past 15 years related to weight bias in media has reported that many media sources such as animated cartoons, movies, situational comedies, books, weight loss programming, news coverage, and YouTube videos have represented individuals who are overweight and obese in a stigmatizing manner.” — Obesity Stigma and Bias

How Can We Help People with an Obesity Problem?

Someone once told me that we are either part of the solution or we are part of the problem. I have noticed that I am part of the Obesity Problem. I have looked many times at obese people and thought “They need to get out and exercise more.” I have been less than empathetic to their problems and less than supportive of their physical and mental state. I have not been helpful.

“Obesity stigma is characterized by prejudiced, stereotyped, and discriminatory views and actions towards people with obesity, often fueled by inaccurate ideas about the causes of obesity. Despite decades of research supporting the dominant influence of genetic and environmental factors in the development of obesity, in the public consciousness, obesity continues to be viewed as a result of individual-level decision-making.” — Obesity Stigma: Causes, Consequences, and Potential Solutions

In my opinion, the health experts have not been very helpful nor have our politicians. We allow many of the sources of the problem to continue to add fuel to the fire. These include inappropriate media images, stereotypes of obese people, purveyors of low-quality high-fat junk foods, poverty conditions, lack of health education in poor and rural areas and overall a political system that almost totally ignores the “Epidemic of Poverty” but is more than happy to spend billions of dollars on any war against drugs. Starting with the war on heroin, then the war on alcohol, the war on pot, the war on cocaine, the war on crack, the war on methamphetamine, the war on oxycodone and now the war on fentanyl, we spend billions of dollars on drug enforcement and drug incarceration for those convicted of selling the drugs. How much do we spend on health education in our schools?

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“This summer, the war turned 52 years old. It was June 1971 when President Richard Nixon declared drug abuse to be “public enemy No. 1” that required a “new all-out offensive” and additional government funding.

Since then, the country has spent more than a trillion dollars fighting drug use, according to some estimates. That includes more than $39 billion the federal government spent last year alone, according to the Government Accountability Office.

And, of course, illegal drugs and drug abuse are still very much with us. In 2021, a Gallup Poll found 64% of Americans said the nation’s drug problem was “extremely serious” or “very serious,” though the primary scourge changes. In the 1980s, cocaine and crack cocaine were the dominant stories. In 1989, President George H.W. Bush held up a bag of crack cocaine during his first White House address and announced the war on drugs would be a primary focus of his time in office.” — Costs in the war on drugs continue to soar, NBC News

This article does not say anything about the costs spent fighting heroin or pot or alcohol long before some of these other drugs became “epidemic.” I wonder what “prohibition” would have cost in today’s dollars? As for health education, who has ever heard of a “War on Obesity.” The obesity problem kills more people than drugs, but it would not benefit our economy to wage such a war. “According to the National Institutes of Health, the obesity epidemic is responsible for an estimated 300,000 deaths per year. The World Health Organization (WHO) estimates that at least 2.8 million people die from being overweight or obese each year.” As for the comparison figures for the “Fentanyl Epidemic” the overdose death rate topped 112,000 in a 12-month period ending in December 2023 according to the Centers for Disease Control and Prevention.

download (2) You may wonder where I am going. From obesity to drugs and back to obesity. Well, what if the two epidemics are related? What if there is not really two epidemics but one huge epidemic? What if one is correlated with the other or what if one even causes the other? Could the stigma of obesity lead to more drug use or could more drug use lead to more obesity? What if all the money we spend on arresting drug users adversely impacts the health of poorer communities where most drug abusers seem to come from? Is there any possibility that the two epidemics are related? Consider the following:

“Since the declaration of the U.S. drug war, billions of dollars each year have been spent on drug enforcement and punishment because it was made a local, state, and federal priority. For the past half century, the war on drugs has subjected millions to criminalization, incarceration, and lifelong criminal records, disrupting or altogether eliminating access to adequate resources and supports to live healthy lives.

Drug offences remain the leading cause of arrest in the nation; over 1.1 million drug-related arrests were made in 2020, and the majority were for personal possession alone. Black people – who are 13% of the U.S. population – made up 24% of all drug arrests in 2020.” — How the war on drugs impacts social determinants of health beyond the criminal legal system, published online 2022 Jul 19.

Do you think it is a coincidence that Black people suffer the highest rates of obesity in the USA and are also targeted the most for drug related offences? It is much sexier to arrest, try and convict a person for a drug related offence than to work to change a system that systematically poisons people with unhealthy foods. Our drug enforcement system keeps lawyers, police, and judges employed. Our nutrition system if you can call it that employs millions of people to sell junk foods in fast food restaurants and grocery stores. Obese people are part of a system that promotes obesity and drug use. Make no mistake at that. As my mentor Dr. Deming used to say, “Put a good person in a bad system and the system will win every time.”

download We need more than a drug war and more than health education to fix the ONE large epidemic in America. We need to have a war on a callous system that condemns millions of people to prison and death all in the name of selling things. Our purveyors of unhealthy foods are just as guilty of being “Drug Pushers” as anyone selling fentanyl in a back alley. The only difference is that “Fruit Loop” cereal is legal and legally spends millions of dollars on advertising each year while fentanyl is illegal and unadvertised.

How to Lose Weight Without Even Trying!

04 Jan 2023 4 Comments

by Dr. John Persico Jr. in Uncategorized Tags: beauty, diet, exercise, fat, fitness, handsome, health, healthy, lifestyle, looks, nutrition, obesity, physical fitness, slim, sports, weight loss

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I wrote this blog five years ago. It seems a good one to help you start the New Year off right. I know lots of us will want to shed those pounds that we put on during the holiday season. This NEED and DESIRE makes us easy pickings for all of the “diet programs” that promise us how little effort it will be too lose weight if we only buy their book and follow their rules. I start off this blog with two rules of my own. I have updated most of the health data in this blog for 2023 but I have no doubt that the data would be the same or even more depressing if you looked it up today and compared it to ten years ago. So lets get to it so you can find out how to “How to Lose Weight Without Even Trying!”

There are two rules of wisdom that I think most of us believe in. They are:

If it is too good to be true, it probably isn’t
There are no free lunches

I have found the above precepts to be good guideposts for my life. They are so often noted that we begin to take them for granted. It could be argued that perhaps they are not true in every situation, but I believe that they are more often true than not true. This brings us to the issue of diet programs. Consider the following statistics:

An estimated 45 million Americans go on a diet each year. (BMC)
Americans spend $33 billion each year on weight-loss products. (BMC)
A higher percentage of women (56.4%) than men (41.7%) have tried to lose weight. (CDC, 2018)
Nearly half of adults (49.1%) attempted to lose weight within the last year. (CDC, 2018)
Obesity is more common among lower-income individuals, those with less education, and some ethnic/racial minorities. (Wiley, 2009)
82% of respondents considered that weight loss was completely their own responsibility, while only 5% did not agree. (Wiley, 2017( Fitness for Weight Loss)

(Statistics are from Weight Loss Statistics and Health Benefits for 2023)

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If I go to Amazon.com and type in “diet books”, I find that there are 184,291 books available to sell me on a strategy for losing weight. There were 424 “Diet Best Sellers” in 2016 and 209 “Best Sellers” published already in 2017. These are only the “Best Sellers.” There were a total of 39,673 diet books listed as published in 2016. Many if not most diet books do not make the “Best Seller” lists. In terms of magazines dealing with diets and weight loss, there are over a dozen magazines that you can buy each week at your local grocery store (that you will find stocked right next to the chocolates) that will tell you how to lose weight “without even trying.”

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However, the above statistics are only the tip of the proverbial iceberg. If I go to Google and type in the words “diet strategies”, I find that there are over 75,000 listings concerning various diets, stratagems, plans, tips, secrets, etc., that will show you how to lose weight “without even trying.”

Here are some typical headlines that you will find as you peruse any of the above information that is offered for those of us that need to lose weight “without even trying”:

The Harcombe Diet 3-Step Plan: Lose 7 lbs. in 5 days and end food cravings forever
1200 Calorie Diet Menu – 7 Day Lose 20 Pounds Weight Loss Meal Plan
Win at Slim: New Secrets to Lasting Weight Loss
Outsmart Your Cravings: Sweet, Salty, Crunchy
How I Lost 42 lbs.
Eat, Drink, Shrink: No Diet Ways to Fight Holiday Gain
No More Guilt: Stop Dwelling, Start Enjoying

no exercise or dieting

The beauty of all these weight loss schemes is that you can lose weight “without (you guessed it) even trying.” Any half-way intelligent person would regard these titles and by applying either of the two rules noted earlier decide that they were pure bunko. Lose weight without trying! End food cravings forever! Lose 7 lbs. in 5 days! No sane person would believe any of this BS. Nevertheless, the diet magazines, diet plans and diet books sell like crazy. Every year a plethora of new diet strategies replace last year’s models. Why do people continue taking the bait when they know that it is a sucker’s game? The simple answer is that when it comes to looking like Margot Robbie, Jessica Alba, Dwayne Johnson or any of the Kardashians, all brain power and rational thinking goes down the drains. Everyone in America wants to be thin and beautiful or have six pack abs “without even trying.”

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Every new diet strategy renews hope for the downtrodden and overweight oppressed masses. Every new diet plan offers the possibility that beauty and slimness might be had before Christmas or at least before our next birthday. Every new weight loss scheme provides the potential to become the person that we dream of being. Hope springs not just eternal in the human breast, but perpetually, irrationally and beyond all measures of logic or intellect: To hell with “no free lunches!” To hell with “it probably is not true!”

If even the remotest opportunity exists that I can lose weight “without even trying”, I will take the bait like a mouse eats peanut butter or a cat eats catnip or a bear eats donuts. “Dam the torpedoes, full speed ahead.” Who cares about logic? Who cares that no evidence exists to back many of these claims up?

before and after male So now we come to the real issue. You wanted to know if there actually might be a method for losing weight “without even trying.” My answer is YES! But there is even better news. I will send you the secret strategy for my quick weight loss “Without Even Trying” plan that I have developed for only $9.95 plus postage and handling. I will give you a money back guarantee that in six weeks or less, you will lose twenty pounds “without even trying” or I will send you a full refund. This offer is good for only thirty days after you read this blog and it will then expire. The following stipulations also apply:

You must reside on a lake
You must be over 99 years of age
You must have been born in Last Chance, New Mexico
You must be at least 100 lbs. overweight at the start of this offer
You must believe everything you read or hear

Time for Questions:

Do you need to lose weight? Have you been trying to lose weight? How successful have your efforts been? What has worked for you? What did not work for you? What would you like to change in your diet?

Life is just beginning.

“I believe that parents need to make nutrition education a priority in their home environment. It’s crucial for good health and longevity to instill in your children sound eating habits from an early age.” — Cat Cora

Que Sera, Sera

18 Apr 2021 8 Comments

by Dr. John Persico Jr. in Uncategorized Tags: death, dying, family, friends, happiness, health, love, lovers, old, pain, sorrow, trailblazers concert, true concord singers

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I think that I am a coward. I don’t want to grow old. They say that growing old is not for the faint of heart. Every day, I understand that aphorism more and more. In the last thirty days, four friends have passed away. Mickey, Glen, Bill, and Dick. I could write a blog about each of them. They were all just nearing 80 years of age. Not one of them died of Covid. Had you known any of them, you would have been truly fortunate. Perhaps, one of my greatest blessings in life has been to have people like this for friends. People who lived life to the fullest and cared about other people. Men who went out of their way to help not just family but strangers.

Two weeks ago, we found out that Karen’s oldest daughter Julie had five brain tumors. For the past year or so, she had been acting very strange. She had frequent bouts of forgetfulness along with severe headaches and neck pain. Doctors had been treating her for an enzyme imbalance for several months, but she kept getting worse. Her husband thought it might be the onset of early dementia.

Finally, someone decided to do an MRI for her. At first, it looked like one large brain tumor but a neurosurgeon looking more closely at the scan found four other tumors. Julie had been diagnosed with leukemia when she was six years old and for ten years had undergone frequent trips to the hospital for chemo and radiation treatment. They believed that the tumors were related to the radiation treatments.

Julie is now fifty-three years old. She went in for surgery on Tuesday of this past week. She was in surgery for nearly seven hours. They chose to remove the largest tumor but indicated that they would need to go in for another one at a later date. They were not able to remove the entire tumor since it was awfully close to the optic nerve and they were afraid of damaging it and causing blindness. Ironically, they want to use radiation therapy to try and remove the rest of the tumor.

Karen flew out Friday night thinking that she could try and help Julie when she returned from the hospital to her home. Only one person could be in the hospital each day with Julie and her husband was the obvious choice. Karen worried all week as complications arose each day and Julie did not seem any closer to coming home. As I write this, it is now five days past surgery and Julie is still in the hospital. She has been in and out of intensive care since the surgery. Karen and Rob (Julie’s husband) have agreed to alternate days spent with Julie at the hospital. So Karen is in Minnesota now and I am watching the home front here in Arizona.

I am growing old, but I am growing more tired of seeing people I care about either get sick or dying. I went to a concert last night with two friends Evelia and Angie. Karen originally was going to go but being with her daughter was the greater priority. The concert was put on by the True Concord Singers and Orchestra in Tucson. It was held outside on a patio at what appeared to be an old mansion that had become a private men’s club. It was called the Mountain Oyster Club. Since it was members only, they would not let us dine there. I had originally thought that after the concert we could dine at this exclusive club but that was not to be. We ended up going to a resort called the El Conquistador. My two companions are both Latina and I wondered what they thought about dining at a place called El Conquistador.

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The concert was called “The Trailblazers” and consisted of songs arranged by women composers and based on the works of noted women writers and artists. Some of the composers included Judith Weir, Hildegard von Bingen, Emma Lou Diemer, Ysaye Barnwell and Alice Parker. The writers and poets included Emily Dickinson, Maya Angelou, and Edith Franklin Wyatt.

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The fifteen songs performed were arranged along a series of themes. One set of the songs was called “Remembering Those We’ve Lost.” Thinking back to my lost friends while these songs were performed brought tears to my eyes. Reflecting on what it might mean to me if Karen should pass away before I do, I could not bear the thought. Coward that I am, I am hoping to pass from this world without too many more losses of those I love. Here are a few of the lyrics from the songs in the concert. It is of course quite different and much more moving hearing these sung but the lyrics themselves are quite compelling.

From: “My Companion” by Edith Franklin Wyatt (1873-1958)

Let the roadside fade:

Morning on the mountain top,

Hours along the valley,

Days of walking on and on,

Pulse away in silence,

Let the world all fade,

Break and pass away,

Yet, will this remain,

Deep beyond all singing,

Beautiful past singing.

We are here together,

You and I together,

Wonderful past singing.

From: “Wanting Memories” by Ysaye Barnwell (1946- Present)

I am sitting here wanting memories to teach me,
To see the beauty in the world through my own eyes.
I am sitting here wanting memories to teach me,
To see the beauty in the world through my own eyes.

You used to rock me in the cradle of your arms,
You said you’d hold me till the pains of life were gone.
You said you’d comfort me in times like these and now I need you,
Now I need you, and you are gone.

I am sitting here wanting memories to teach me,
To see the beauty in the world through my own eyes.
Since you’ve gone and left me, there’s been so little beauty,
But I know I saw it clearly through your eyes.

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I finished a run this morning in the mountains. Saw a large coyote on the trail and thought at first it was a deer. You are not likely to see a deer in the desert, but the coyote was large and brown and from a distance it did look like a small deer. As I ran, I could not help but thinking of the song by Doris Day “Que Sera, Sera.” The lyrics that go “Whatever will be, will be. The futures not ours to see, Que Sera, Sera.”

We scheme, we plan, we strategize, we organize, we bribe, we cajole, we blackmail so that we can control the future. We pray to whatever god or gods we believe in to keep our loved ones safe from harm or pain. I am sure that every one of you reading this would rather suffer death or pain before seeing your family, friends or children suffering. Jesus said, “Greater love hath no man than this, that a man lay down his life for his friends.” John 15:13

But as written in Ecclesiastes, it is all vanity. Nothing but vanity. I can’t stop a single person I know from dying or suffering pain. The best that I can do is to be there for them during their suffering. This is the role that my spouse has chosen to take with her oldest daughter. It is a role that I would gladly have pass by me since coward that I am, I find it harder to watch my family, friends and others suffer then to deal with my own suffering.

I once loved the poem that admonished us to: “Grow old along with me, the best is yet to be.” Now I wonder, what could Robert Browning have been thinking? I am waiting for “the best that is yet to be.” I must be missing something. As each day goes by and as yet another friend leaves this earth, I am more and more wondering what I will have left when they are all gone, and I am the only one here.

Nothing I have ever worked for, saved for, bought, owned, or possess will have any meaning without the ability to share it with those I love. I think about walking through the house where I am now sitting without my spouse or friends or family and it is by far a fate worse than death and dying. I won’t rage into the night. I am reflecting upon death as a comforting blanket than I can pull over my head and use to hide from the sorrows of the world. I will not rush it, but as many have realized that have gone before me, at some point, we all know that our time has passed, and that we must leave this world. As for what will come after, I can only say “Que Sera, Sera.”

I think you will enjoy this song: https://youtu.be/xZbKHDPPrrc

Que Sera, Sera

When I grew up and fell in love
I asked my sweetheart, what lies ahead
Will we have rainbows
Day after day
Here’s what my sweetheart said

Que sera, sera
Whatever will be, will be
The future’s not ours to see
Que sera, sera
What will be, will be

The Seven Greatest Appreciations of Life: Physical Health and Fitness

24 Mar 2021 30 Comments

by Dr. John Persico Jr. in Uncategorized Tags: cardio, diet, endurance, exercise, fitness, health, nutrition, stamina, strenght, weight, weights, Yoga

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There is a lot to be appreciative for in this category. Sadly, too many people ignore or take these elements of life for granted. Many people confuse good health with the health that they are born with. Nature gives us a health plan when we are born. Some of us get a better plan than others. Fortunately, happiness and success are not totally dependent on the plan we are born with. There is a large category of mental health which I am not going to talk about. It is important to recognize though that mental health and physical health while no doubt correlate to some degree are not perfectly correlated. There are many instances of people with major disabilities who are quite happy and quite successful. The element of mental health and mental fitness are essential to overall happiness regardless of your physical conditioning.

Physical fitness or PHY ED classes are remembered by most former students as either something they tolerated or something they hated when they are were in high school. The lessons if any that they learned in GYM classes were promptly forgotten when they left high school. Those that excelled in sports and loved the extracurricular sports confuse sports with fitness. I have met many former athletes who played football, soccer, baseball, or basketball and thought that was enough to be fit.

There is a great deal more to being fit than simply exercising or playing sports. If you look at the people around you today, you will see a nation of unfit people. Years ago, the obese person in your high school was a minority. Today, they are a majority. Walk down most any street in America and you will see a nation of fat and overweight people.

When I taught college, I would see entering freshmen coming in many of whom would have met health guidelines for weight. Four years later, these same students had joined the ranks of obese Americans. All too many had no fitness plan. High school never gave them a fitness plan and neither did college.

But I want this blog to be about appreciation and not about how to do a health program. If you need a fitness plan, you can search my blogs and find a great deal of information about starting such a plan. Today, lets look at the fun and value in each of the six major elements of physical health.

I have put together a model based on my experience that includes six elements I think are essential to overall physical fitness. These include: Stamina, Strength, Balance, Flexibility, Nutrition and Weight Control. Each of these elements are interdependent with the other five elements but each are unique in many ways. I think there is great joy and fun in all six of them and I want to share some of my appreciation of each with you. Let’s start with stamina.

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Stamina

Instead of talking about Cardio or Cardiovascular activities, I chose to call this group Stamina. Stamina activities build endurance and also build a strong heart and vascular system. People can be overweight and still have good stamina. I was in a bike race and I looked over my competition. It was my first race, and I selected a few guys with muscles on their legs that looked like basketballs. I was sure one of them would take first place. Two hours later, the winner was this skinny kid from the University of Connecticut who looked like he could not punch his way out of a paper bag.

Activities like running, swimming, biking, skiing, roller blading, ice skating, all build stamina. Experts call them aerobic activities as opposed to anaerobic activities. I have met many overweight men who see me running and say, “I wish I could run but I blew my knee out playing football in high school.” I want to say “Bullshit. There are many other stamina activities that put less stress on the knees, and you could use to get in shape.” The truth of the matter is that most of these guys would rather sit on the couch and watch football than get out and exercise. Walking is a great stamina activity, and you can walk with extra knee support and it will improve your conditioning without doing more damage to your knees.

You can and should appreciate the range and variety of stamina activities that have been developed and that are available today. They offer variety and fun and surely beat sitting on your couch remembering the “good old days.”

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Flexibility

Can you touch your toes? Can you manage a day without your back aching? Do you get aches and pains whenever you do any physical activity? Over the years, I have noticed when going to the gym or involved in some sports that men gravitate towards weights while women gravitate towards flexibility exercises. Karen and I started doing Yoga about 25 years ago and we do it together about 2 or three times per week. Most of the Yoga instructors are women. We use Yoga tapes that are on DVD or now on Amazon Prime. It is rather sad that many men think flexibility training is something for women and that “real” men lift weights. The two are not mutually exclusive and in fact, the two are essential. They have a Yin and Yang relationship.

I can’t say that I ever liked stretching. After thirty years of doing Yoga, I am still not much more flexible than I was when I was forty. I would rather lift weights and I can see more progress when I do. I have been running for nearly 45 years now. About 25 years ago, I started developing back problems. Back aches, back pain and back spasms would hit me at the oddest times. I did not see the relationship between tight hamstrings and low back pain. I finally made the connection and started doing Yoga.

For the past ten years of so, I have seldom had any back problems. I can’t do many of the Yoga postures like the instructors. I often wonder if my muscles could ever be that flexible. I don’t know the answers to these questions, but both Karen and I will swear that Yoga has helped us over the years to avoid back, hip, knee, and shoulder surgery. If you look at the list of surgeries, these are epidemic today. The medical profession makes more money doing surgery than referring people to Yoga classes.

I appreciate Yoga and I am thankful that there are so many great teachers who will put their classes out on Amazon, YouTube, or other media. Yoga is actually fun if you don’t try to imitate your instructor or compete with your spouse.

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Strength

Lift that bag! Tote that bale! Pick up that grandkid! Strength looks like big muscles to many people. Everyone wants a six pack abs, bulging biceps and great triceps. The funny thing is that I have seen many really strong people who don’t fit the stereotype. There are different types of strength training. Years ago I would focus on power training to build large muscles and lift large weights. Now Karen and I use small dumbbells and focus on endurance training by doing higher reps with lower weights. I don’t need to pick up a 100 lb. bag of cement. I will leave that to the people that are twenty or thirty years old. But there are days when I will need to do some yard or garden work and the ability to shovel a ton of dirt, or more is very much appreciated.

20210324_143136 Just a few weeks ago, I put a new rock river in our home here. I had a yard or about 1600 lbs. of river rock loaded into my pickup truck. I got home with it and used a large Home Depot red bucket to scoop the rock up and put the river rock down. It took me about two hours of steady work, but I had no aches or pains the next day. I was quite surprised, and I give credit to one of our strength trainers that we use a lot. Her name is Cindy, and we purchased her DVD on Amazon.

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Balance

Balance is probably not something that you think about or much appreciate when you are young. You take your balance for granted. As you age, balance becomes more salient in your life. More and more experts are telling elderly people that balance is essential to preventing falls and broken bones. Karen and I added some balance DVDs to our exercise regimen a few years ago. I thought at first that these “silly” exercises would be easy. I run four or five times a week on rugged mountain trails, “What do I need balance exercises for?” Then the instructor said, “If this is too easy, try doing it with your eyes closed.” I closed my eyes and fell into my wife. I still have not been able to do many of these exercises with my eyes closed.

I have noticed that some of our friends have had bad falls resulting in broken bones. The older you get, the longer it takes for anything to heal. I have had three falls so far this year since returning to Arizona and running the mountain trails. I thank both my flexibility training and balance training with preventing any serious injuries when I fell. The most I have received has been some scrapes and minor bruising. As the years go by, we will focus more on balance training. It may look silly, but it is another one of those elements that have improved our lives and that we can be appreciative for.

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Weight Control

Do you like McDonald’s fries, fish sandwiches, or biscuit with sausage, egg, and cheese? Do you enjoy Olive Garden’s Lasagna? Do you go to the Golden Corrals’ breakfast buffet or do you prefer the Saturday night fish buffet at your local casino? Do you expect me to tell you that these are all high fat options and that you should eliminate them from your diet? Are you waiting for me to tell you that a garden salad full of greens and tomatoes is a much better option? If so, you will have a long wait. I love all of the aforementioned.

20210324_150814 I now weigh 139 lbs. and am 5’ 7” inches tall. You might think that my running and exercise is what keeps me thin. OF course, exercise helps but let me tell you a secret. If I run for 60 minutes, which is an exceptionally long run for me, I will burn up maybe 600 calories. A McDonald’s Sausage, Egg and Cheese McGriddle is equal to 550 calories. A large fries at McDonalds is 490 calories. I can go through a buffet at Ak-Chin’s Casino and on my third trip to the buffet will easily have eaten enough calories for three runs in the mountains. I can get an apple fritter at the Circle K after my run, and it will give me back 450 to 600 of the calories that I have just spent an hour or so losing. I can eat a McDonald’s sandwich in about ten minutes and the apple fritter in less than five. Here is John’s Law: “You cannot exercise off more calories than you can eat.”

Weight control is essential to good health. A host of health problems are associated with obesity and being overweight. We live in a society of food abundance and higher than ever before calories per item in the supermarket. The supermarket should be called “The fat Market” because of the high calories food you will find there. A standard box of Pringles holds 900 calories. If I wash that down with a Modelo beer, I will have just consumed 1100 of my daily allotment of 1800 calories. You want to know another secret? In two hours I will be hungry again. My wife made me a Mexican cheesecake the other day. Ninety grams for a standard size piece of this cheesecake gives me almost 450 calories but “Oh, is it delicious.”

20210324_131838 Weight control is not about good nutrition. It is about balancing the calories that you get in with the calories that you put out. You can get 2000 calories of good food or you can get 2000 calories a day of bad food. You can drink yourself to death by consuming a bottle of alcohol a day. You can eat fatty foods that will give you high blood pressure and high cholesterol and increase your chances of a heart attack. Foods that they say are “bad for you” are also foods that we enjoy eating.

I started off by saying that I would not tell you to avoid certain foods. That is still true. What I will tell you is that you will enjoy these foods even more if you eat them in moderation. Rosie Greer the famous football player had to watch his weight. He loved ice cream sundaes. He did not give them up, but he would make a mini-ice cream sundae with a fifth of the calories of a full ice-cream sundae. I often use the “Rosie Greer” strategy in my eating. Instead of eating a large amount of something, I will dish out a smaller plate and put the rest away and out of temptation.

Two items are excellent for weight control. One is a health scale. This is more than just a scale that tells you your weight. Mine tells me such things as muscle percentage, bone density, body fat and BMI. I put these down in a log and every few months or so, I add the updated information to my log. This way I can track how I am doing over time. You can purchase a good scale for about fifty dollars.

The second essential item is a food scale. Karen and I keep one on our counter and use it at dinner to weigh out our portions. It is easy to eat a sixteen-ounce steak. Instead after weighing it out, we might only eat six ounces and save the rest for a second dinner. Looking at how much we are putting on our plate helps us deal with the number of calories we are putting in. We lose it when we go for third helpings at the casino, but our casino trips are much less frequent than our dinners at home. If it were the other way around, I would probably weigh 1000 lbs. Last Sunday we went to the Angry Crab Shack in Phoenix for lunch. We had a two hour wait and missed lunch but had dinner. When I came home, I calculated that my one meal there with two beers, fried oysters and soft-shelled crabs on a po’boy sandwich was over 1700 calories and I took ½ of my sandwich home. Nevertheless, it tasted mighty good.

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Nutrition

Nutrition and weight control are another balancing act or Yin Yang relationship. I mentioned above that all things in moderation is a good strategy for eating but good nutrition should also be on your scheme of things. It is important to eat food that provides a balanced diet with the right amount of fats, carbs, protein, vitamins, and minerals. It is much easier to do this with fresh foods. The world is full of “diet” plans and most of them seem designed to sell you some book or program. There is plenty of good information freely available on what constitutes healthy nutrition.

You do not have to be a nutritionist or doctor to form a plan for good nutrition. I have heard it said that being poor leads to lower nutrition and higher fat and sugar intakes. I have also heard it said that a mobile society has no time to prepare healthy foods from scratch. I do not believe that either of these two constraints cannot be overcome. Both Karen and I have worked all of our married lives with two full-time jobs and now two part-time jobs. Both of us are very frugal and look for bargains at the grocery store. We minimize the number of high-priced cuts of meat or fish that we purchase and do the same with vegetables. If I can get Mexican squash for ninety-nine cents a pound, I will purchase that over asparagus that sells for 4.99 a bunch. We will purchase chicken at 1.39 a pound with bone in rather than 3.99 chicken filets. We will seldom buy frozen pre-cooked foods.

Here are some of my simple principles for good nutrition.

Learn the difference between healthy and unhealthy foods.
Look for healthy foods in the grocery store that are bargains.
Some grocery stores are more expensive for some things than others, explore your local stores to find the best deals.
Measure your portions to your desired weight.
Don’t buy “junk” food except in moderation. Think of it as a special treat.
Always eat leftovers. Use first in first out to eat leftovers before they spoil.
Cook meals that will last a few days in the refrigerator. Such meals as
- Crock pot pork roast
- Chicken soup
- Turkey stew
- Chili
- Fried rice
Freeze any leftovers before they go bad. Use a marker to put title and date on the container.

I love eating. It is one of my greatest appreciations of life. I love eating exotic or interesting foods. I love trying new restaurants. Food is more than just a way to live. Food brings us companionship and adventure. New places to visit and new tastes to acquire. Eating a balanced healthy diet should be thought of as a challenge. Life seldom offers us as many challenges that are as important to living as eating.

“Eating is not merely a material pleasure. Eating well gives a spectacular joy to life and contributes immensely to goodwill and happy companionship. It is of great importance to the morale.” — Elsa Schiaparelli

Reflections on the Corvid 19 Virus by a Prime Target

16 Mar 2020 4 Comments

by Dr. John Persico Jr. in Uncategorized Tags: coronavirus, corvid 19, epidemic, flu, health, illness, overcoming, pandemic, sickness, surviving, virus

corona virus

Someday I am sure we will look back on this time with wonder and amazement. Each of us no doubt has strong feelings about what is happening now and how it is happening. For some it is fear and dread while for others it is a time for retreat and reflection. Millions buy out every roll of toilet paper, face masks, gloves, hand sanitizers, white flour, bottled water and handy wipes. Scalpers take advantage of a dire situation and a dearth of moral inhibitions to make a profit while health care officials try to “flatten the curve” so that the worst cases can get the medical treatment they need.

The media and other “experts” regale us alternately with paradoxical entreaties. “Don’t panic, it won’t be that bad!” “It will be the worst epidemic in history since the Spanish Flu or maybe even the Black Plague.” “The death rate is 20 or thirty times that of a regular flu.” “We don’t really know much about this flu.” “It may take years to develop an effective vaccine.” “We may have a vaccine very soon.”

the corona virus

Wash your hands! Wash your hands! Wash your hands!

I have many conflicting feelings myself. I am seventy-three years of age and have lived a good life. I can hear John the Baptist saying “Repent, Repent. The end is near.” Am I ready for the end? Is my immortal soul as important as my physical body? I see people hoarding food and I think people are more afraid of starving to death than dying of the flu. Everything seems to be closing. Schools, churches, sporting events, concerts, libraries, meetings and much more. We are exhorted to continue spending but to keep going to work by politicians worried about the economy crashing while health care officials tell us to practice “social distancing” and stay home. We are repeatedly told that we must flatten the curve. The unknown is what this will mean for each of us personally in terms of combating this hidden menace. Who will get the virus in a flatter curve and who will die in a flatter curve are unanswered questions.

Stay home! Stay home! Stay Home! Stay Home! Stay Home!

Yet, I cannot help but think how amazing viruses are! Can you imagine something that is barely visible under a microscope and that has no brain or ability to reproduce on its own, but it can reduce a human being to death and dust. The pain and misery that this little thing can create is beyond belief. The greatest science fiction writers in history could not come up with anything as insidious and menacing to the human race as a virus. The movies are full of superheroes defeating the likes of mega villains like: Galactus, Thanos, Ultron and the Dark Phoenix. Yet, we have yet to come up with a superhero who can destroy a single lowly virus. What is more exciting, watching Spider Man beat the Green Goblin or watching a nerdy scientist working in a laboratory trying to find a vaccine that will paralyze a virus?

Virus: An infective agent that typically consists of a nucleic acid molecule in a protein coat that is too small to be seen by light microscopy and is able to multiply only within the living cells of a host.

Corona-deaths-March-9_170bdd867f4_original-ratio

On the political scene, everyone is trying to blame everyone else for the state of affairs that exists. Paranoia seems to reign in Congress particularly with an election fast approaching. The Commander in Chief of the largest most powerful military force in the world is powerless to stop the Corvid 19 virus from spreading. Yet he has the temerity or stupidity to suggest that his “Border Wall” might help staunch the spread of Corvid 19. His stooge in waiting Mitch McConnell can block every bill in the Senate, but he can’t block the virus. Other Trumpists like Representative Gaetz of Florida vote against a bill to provide paid sick leave but then take paid sick leave himself. It has been noted by the opposition that President Trump did not do much to help our medical research capabilities during his reign of horror:

“President Trump’s third budget request, released Monday, again seeks cuts to a number of scientific and medical research enterprises, including a 13% cut to the National Science Foundation, a 12% cut at the National Institutes of Health and the termination of an Energy Department program that funds speculative technologies deemed too risky for private investors.” — March 12, 2019 – Washington Post

A friend of mine likes to remind me that we catch more flies with sugar than vinegar. People want to hear positive things during a time of crisis. We need to have hope and inspiration. Yet to put out shmaltzy homilies when the reality does not support such optimism may simply be a case of too rosy colored glasses. I wonder if I am an optimist or a pessimist? I like to think that I am a realist. Whether the glass is half empty or half full depends to me on whether the glass is filling up or going down.

Total-Death-Toll-Over-Time-of-COVID-19-12

I look at some statistics that say perhaps 40 to 70 percent of Americans will get this virus. The statistics are based on estimates from the Center for Disease Control. Their estimates are based on some modeling methods. For instance, if the population of the US is approximately 330 million people and the death rate of this virus is estimated at 2 percent it will mean that between 200,000 and 1.7 million people will die from this virus. Calculations based on the C.D.C.’s scenarios suggest an additional 2.4 million to 21 million people in the United States could require hospitalization, potentially crushing the nation’s medical system, which has only about 925,000 staffed hospital beds.

On the other hand, current data from China shows the rate of viral infection declining in China and the total number of deaths to be 3,199. This suggests a death rate per capita that is considerably lower than estimates given by many experts. If you figure that there are 1.4 billion people in China and that there were 3,200 deaths to date, this is a death rate of 1 per 438,000 people. Extrapolating to the USA, this would mean a total of 750 deaths. This is a death rate that is considerably lower than most pundits are predicting. Keep in mind that China is where the disease started and where it took some time to identify the virus. On the other hand, China also reacted very rapidly to containing and isolating cases of the virus.

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The figures I present are incredible. The range of deaths vary between 750 and 1.7 million. Who is right? Why are the ranges so great? Are we seeing a battle between optimists and pessimists or is it simply another case of the media hyping worst case scenarios to sell advertising? Very large gaps between 1. 7 million deaths and 750 deaths suggest a lack of accurate facts and evidence. Which will prove to be true? What should the average citizen do? As a wise person once said, “Pray to the lord but row for the shore.” This means that we should hope for the best but prepare for the worst.

Say your prayers for others and wash your hands as frequently as you can. I think this is the best than anyone can do. I wish I had better advice.

Aging Capriciously

How Many People Have Been Harmed by Current U.S. Policies?

Introduction

The short answer

What the major policy areas suggest

Why foreign-aid cuts may dominate the mortality calculation

Gaza requires a different kind of attribution

Why I would not add all the numbers together

A reasonable overall conclusion

The strongest counterargument

Sources and notes

When Healthcare Became a Business: Why America Can’t Find Enough Doctors? — Part 1 of 2 Parts by Metis with some assistance from Dr. Persico

The Perfect Day When Everything Went Right!

Ears – by Miriam Mladinov

The Obesity Epidemic in the USA Meets the Drug Epidemic

How to Lose Weight Without Even Trying!

Que Sera, Sera

The Seven Greatest Appreciations of Life: Physical Health and Fitness

Reflections on the Corvid 19 Virus by a Prime Target

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Dr. John Persico Jr.

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Introduction

The short answer

What the major policy areas suggest

Why foreign-aid cuts may dominate the mortality calculation

Gaza requires a different kind of attribution

Why I would not add all the numbers together

A reasonable overall conclusion

The strongest counterargument

Sources and notes

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Dr. John Persico Jr.

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