Closer To The Ideal

Interesting:

Let me preface this by saying that Killarney isn’t inner-city Baltimore or anything. It’s a beautiful, quaint Irish tourist town, where playing fiddle music in pubs is still a growth industry, and people say “ass” and genuinely mean donkey.

And yet…

Seventy-something woman comes in with some bruises. Her daughter married a guy, the guy turned out to be a crazy abusive husband and tried to kill her, she flees the country. Now the guy keeps attacking the woman to try to beat information about the daughter out of her.

Forty-something woman comes in, asks the doctor if her twenty-year-old son can be committed to a mental institution. He’s been doing all sorts of drugs and attacking people and stealing stuff and now he’s threatening her. He’d been living with his girlfriend until the girlfriend realized he was a good-for-nothing criminal and kicked him out, and now the son is demanding to move back in with the mother, who’s understandably terrified.

Guy comes in for routine blood work, I take a look at his history. He was hospitalized for attempted suicide after he invested all his money into opening his own business just before the big economic crash. Ended up on unemployment, decided to end it, failed, now sits at home wondering what he’s going to do with his life.

Guy comes in, he’s always wanted to be in the army. Went through all his training, got in an accident that lost him the use of both his legs. Told he can’t be in the army and stuck on disability for the rest of his life.

Seventeen year old girl comes in with a headache…that’s a pregnancy. Sixteen year old girl with nausea…that’s a pregnancy. Eighteen year old girl comes in terrified because she got really drunk over the weekend and she knows she had sex with someone but she can’t remember who…wants a pregnancy test. Pregnancy pregnancy pregnancy pregnancy oh and guess which European country doesn’t allow abortion?

Twenty-something woman comes in a few weeks after splitting up with an abusive boyfriend. She’s thrilled that she finally got the courage to tell him to stop destroying her life. Gets some routine blood tests and a routine urine test, and…yeah, she’s pregnant too.

Sixty-something woman comes in with heart palpitations, is asked if she has any family history of disease. There’s the brother with psoriasis, the sister with Addisons, husband who died of a heart attack, both her parents died of cancer, her daughter got another rare syndrome, and then she proceeded to list off practically every disease in the textbook along with the relative of hers who’d had it. As practically the only healthy person in the family, she’s got the responsibility for caring for all these people. And now it looks like she’s got a dangerous cardiac arrhythmia.

Guy comes in, he’s married to a woman with a mental disorder. She had to be committed to the hospital a few times, but they stuck together and managed to save their marriage. Now he’s coming in for the sake of his five year old kid, who’s started having major behavioral problems. Wants to know if the disorder is hereditary. And yeah, it is.

This isn’t even counting all the usual alcoholics, people stuck in unhappy relationships, parents who hate their kids, kids who hate their parents, people who are unemployed and unemployable, people who are literally too stupid to understand that they need to take medication and so who end up getting very sick from easily curable disease, drug users, welfare moms, people with stalkers, old people who spend their entire lives in some tiny lightless apartment drinking tea without any friends or family.

I’m not some sheltered rich kid who was previously unaware of the existence of poor people. I’d already factored the existence of your obvious “living in a ghetto off food stamps” sort of poor people into my calculations. What I didn’t factor in was how many people who were financially pretty well off also have utterly ruined lives, and how invisible they are to anyone who’s not listening to their doctor visits.

…There’s really not a lot of evidence against the idea that a very large subsection even of first world countries is unbearably miserable. We’d never see them, because they’d be off living in poorer areas, or stuck in nursing homes, or too sick to go out much. No one would make movies or TV series about them. And no one would give them jobs as newspaper commentators.

Mark Suster writes about the difficulty of staying in shape when you are an entrepreneur:

I was now 38 and in worse shape than my previous experience. The time zones, the travel, 2 kids, pressure, managing the sales process, speaking at conferences Somehow I had yo-yo’d back to where I was previously.

In early 2007 I focused exclusively on the sale to Salesforce.com. I stopped doing conferences, traveling or pitching to VCs.

As a result I freed up the time to get back into shape. I swam every morning and ran every afternoon. I started “pulling doubles” often doing the swim then run one after the other. I began bike riding and dreamed of become a triathlete again. I lost 22 pounds between January 1st and March 27th through a combination of serious exercise and watching my calorie intake. I was on top of the world again.

Except that after the acquisition, my job at Salesforce.com required that I commute more than an hour each way from Palo Alto to San Francisco. So 2 hours of potential exercise vanished. The work pressure mounted, the food piled in, the sleep disappeared and the exercise was non existent.

I would like to finish this post on a happy note but I can’t. After I left Salesforce.com I moved to LA and became a venture capitalist (no, that’s not the sad part and had a new challenge to prove myself in a new field. My hours picked up, I worked hard to establish myself in a new city and a new industry. My wife said to me, “I thought you weren’t supposed to work entrepreneur hours when you’re a VC?” I still felt like an entrepreneur. I had something to prove.

I lost perspective and my life hasn’t been in balance since then. Exercise hasn’t been enough of a priority in 2008-09. But now I’m nearly 42. This time it’s for real. After a recent international trip with limited sleep I went to the doctor with chest pains again. It’s still acid reflux. But this time it’s combined with high blood pressure. I’m still in the manageable zone of hypertension but the doctor said I’ve got to change my ways. He also ordered me to take medicine to control my blood pressure.

So the yo-yo continues. But with 2 beautiful kids and a lovely wife I have much more to be serious about. It’s easy in your 20’s to imagine you’d never be in my shoes. I thought that, too. But I’ve spoken with many entrepreneurs in their 30’s who are going through some of the yo-yo health issues that I have brought on by work, travel, food choices and stress. And one doesn’t have to look beyond the most prominent technology bloggers, early-stage Silicon Valley angels or even some of the biggest names in tech (Marc Andreessen, Reid Hoffman, Marc Benioff) to find people suffering like I have been.

It’s far more productive to make sure that exercise and healthy eating creeps into your routine. Find something else to cut out – not this. You know what I’m talking about – it’s far easier to stay in shape than it is to get into shape.

The conventional wisdom has been that any exposure to radiation increases your risk of cancer. However, an incident in Taiwan suggests that low levels of radiation may decrease your risk of cancer.

Chronic radiation is defined as the radiation received slowly or in a low-dose-rate from various sources. It is completely different in nature to the acute gamma or neutron radiation generated from the atomic bomb explosions that occurred in Japan at the end of World War II. Tantalizing insights from people living in higher-than-normal background radiation areas in the world and from nuclear energy workers receiving excess radiation over long years have suggested that chronic radiation might paradoxically be beneficial to humans. However, in the absence of an epidemiological study, it has been impossible to conclude whether chronic radiation is harmless or indeed beneficial to human beings. Fortuitously, an incredible Co-60 contamination incident occurred in Taiwan 21 years ago, which provided the data necessary to demonstrate that chronic radiation is beneficial to human beings.

The contamination occurred during the recycling of metal scrap when a Co-60 source was mixed with metal scrap, melted and drawn into steel bars in the mill. Unaware of the contamination, the steel bars were ultimately used in construction of more than 180 buildings in 1982-84. Most buildings were partitioned into about 1,700 apartments for dwelling, and some buildings for other purpose. The first contaminated apartment was discovered in 1992. The residents in the apartments totaled 10,000 individuals who had been exposed to chronic radiation for at least 9 years and as long as 21 years.

…If the linear-no-threshold (LNT) model constructed based upon data from the atomic explosions in Japan is appropriate for evaluating chronic radiation, such excessive doses received by the contaminated apartment residents could induce at least 35 excess leukemia and 35 solid cancer deaths after 21 years. However, actually no increase cancers were observed. On the contrary, the spontaneous cancer deaths of the residents totaled 243 over 21 years based upon the vital statistics provided by the Taiwanese government. The mortality rate from these cancers dropped to only 3% of the general population as shown in the following graph.

I’m assuming that, if this benefit is real, it comes from killing the cancer cells. Doctors use radiation to kill cancer. Perhaps low levels over the long term are similar, or better, than being treated by doctors. When my dad was treated with radiation, I had the impression that doctors were over doing it. Back then, I wondered what would happen if he received a smaller dose.

Once upon a time, psychologists thought that electric shock therapy might help people with mental illness. People were shocked with high voltages. The benefits were few. Then electric shock therapy went out of fashion. Then it came back in a different form. Now electric therapy uses very low doses of electricity, so low that patients barely notice it. And this is, apparently, one of the most effective treatments for depression. Kitty Dukakis has written about this in her book. I wonder if radiation treatment will go a similar route, with doctors realizing that low doses are more beneficial than high doses?