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Behind Bars | Behind the Times

When I think of the prison system in America, I think of my high school self. I was grounded so many times that I believe the only thing it taught me was to act out smarter. Luckily, I developed a frontal cortex and realized I shouldn’t be doing the things I was doing, but point is: punishment doesn’t work.

Like being grounded, does time in prison really prevent people from doing what they did to get in there? Let’s look at the numbers.

According to the National Institute of Justice, 68% of prisoners released in 2005 were re-incarcerated within three years. There’s even a term for it: recidivism. This means that going to jail once means, odds are, you’ll go again. If the point of jail is to end the behavior, then doesn’t this number defeat the purpose of going to jail in the first place?

Our penal system doesn’t take into account the bigger picture. More than a matter of right or wrong, we need to examine the circumstances which puts people in jail in the first place. If the situation is the same going in as getting out, not much can change. Consider factors like substance addiction.

Imagine a patient prescribed opioids for pain after an accident. Opioids are highly addictive, and this patient craves more after her prescription is finished. With Florida’s new E-Forsce system, doctor shopping for more pills falls through. She resorts to friends of friends, and eventually winds up not with Vicodin but full blown heroin—and a nasty addiction. She gets caught and goes to jail. Will being behind bars extinguish her addiction? Without proper attention, her post-incarceration chances of relapsing are between 40 and 60%–the greatest risk being within the first three months of her release.

More than 65% of United States prisoners meet criteria for a substance use disorder, yet less than 20% of these people receive treatment of any kind while in prison.

When rehabilitation programs are properly implemented, rates of recidivism have been shown to drop, but less than one-fifth of the prisoners who need these programs receive them–due to overcrowding, lack of resources and poor consensus on methodology.

Our current regimen is inadequate, calling for a re-examination of our approach to substance abuse rehabilitation in prison.

Now consider the fact that in 2015, American taxpayers contributed $51 billion per year towards prison upkeep. Funds are preferentially given to prison maintenance over prevention because, like anything else, that is where money can be made. If our theoretical heroin addict has around a 50% chance of relapsing, has this small fortune accomplished anything? Excuse the conspiracy theorist in me, but could it be possible that our government is suppressing actions which would help these prisoners stay out of jail, all so it can get more money?

Here’s my thought: why not start treating addiction as a health issue, rather than a crime?

What if we took those 65% of addicted prisoners out of jail and put them in intensive rehabilitation programs? What if we devoted just half of the $51 billion per year to actually fixing the problem, rather than investing over and over in what is clearly a sunk cost?

Believe it or not, Mexico is one of the world leaders in prison reform, and experts at MAPS (Multidisciplinary Association for Psychedelic Studies) are attributing it to their incorporation of a naturally occurring indole alkaloid called ibogaine into their rehabilitation programs. Although ibogaine is a Schedule I drug in the United States and most of the European Union, countries like Mexico, New Zealand, South Africa and Brazil have legitimized its use by medical professionals specifically for the purpose of drug rehabilitation. Multiple studies have been conducted worldwide (notably few in the United States) showing that ibogaine may reduce withdrawal symptoms, diminish drug seeking behavior, prolong drug-free intervals following release from prison, and improve post-incarceration employment rates.

Ibogaine plant

My first thought was that ibogaine must be giving some kind of opioid-like high. Au contraire. Although its pharmacokinetics continue to be unraveled, it’s been found that ibogaine does not act on opioid receptors at all. It is an antagonist at the NMDA receptor—a mechanism similar to that of Alzheimers drugs and ketamine.

More clinical trials on humans under controlled environments are needed before anything can be claimed as “fact,” but the initial results are promising. And if it looks and smells like it could be a cure to the prison paradox, shouldn’t we at least be looking into it? Or should we kick back our heels and throw $51 billion each year at a system we know is broken because “drugs are bad”?

The war on drugs is ending thanks to research and awareness. Maybe it’s time we look to the earth to figure out just what kinds of tools were put here for us. I’m no expert, but I have a feeling we may have been given just what we need.

To learn more about ibogaine and its medical uses, visit: https://maps.org/research/ibogaine-therapy

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Mental Health in Medical Providers

So far, two of my medical school classmates have taken their lives, and we still have two years to go—in addition to residency. Mental health is consistently undervalued in the medical field, leading to a rise in suicide and burnout.

The first two years of medical school were undoubtedly intense. We had around 40 hours of lecture each week to master, and at the end of the two years we sat for a cumulative board exam–Step 1–which determines what kind of doctor you can be and thus, how much money you can make. Walking around the hospital with your Step 1 score embroidered on your white coat is not much of an exaggeration.

The deaths were a huge tragedy and wake-up call, and I was soon to realize, now as a third year medical student, that the pressure is only just beginning.

After spending twelve weeks rotating through the surgical specialties, I got a feel for the life of a surgeon. While there are exceptions, I found that overwhelmingly, the surgeons I encountered were curt, dismissive, hard, impatient, and short-tempered. And I was soon to find out why. The surgical residents were overworked and underpaid and under tremendous pressure. They weathered high expectations from their superiors and, perhaps more significantly, from themselves. It comes as no surprise that their interpersonal skills would suffer over time.

I’m not here to complain about a process that has been ironed into medical education since the dawn of Western medicine—whether you want to call it professional hazing or not. I’m here to reflect on the wellbeing of medical workers in America and the vicious cycle into which they are swept due to an innocent desire to help those in need.

Residents run the hospital, a fact which is chalked up to their need to learn and, less publicly, the money their cheap labor saves hospitals. The result is low wages and long hours, which leads to sleep deprivation, resentment and often, burnout. What an odd thing, I think to myself, to take the people whose role in society is among the most important and force them into these working conditions.


It wasn’t until 2003 that residents’ hours were regulated—a development which only occurred after patients started dying on the table from medical error. The regulation? Eighty hours over six-day weeks, averaged over a month. That’s double what the average American works. Further, residents have examinations which require studying after what is often a 14-hour shift. By the end of the week, you’ve got an exhausted doctor craned over an operating table with somebody’s fate in their gloved hands, running on four hours of sleep and a gallon of coffee. After six years of this (ten if you count medical school), it is not hard to imagine a morning where this doctor wakes up to all the aspects of her life which she has neglected and becomes suddenly overwhelmed. It is not hard to imagine why this resident decides to scream at the medical student standing in the corner; or swerves into a tree on her way home because she fell asleep at the wheel; or hangs herself in the closet when she gets home because people are dying all the time and deep down she feels she’s been dead a long time, too. It is these conditions which lead physicians to have among the highest suicide rates.

Two of my classmates have committed suicide, and it never reached the news. Who are the people sitting on the medical boards who continually sweep these deaths under the rug, tucked away from the public eye? Who is to say this number won’t grow as the pressure builds? What will it take for something to be done?

Doctors are expected to be super humans—the white coat their capes. They are not to show weakness, sadness, or fatigue. They are to be there for their patients before they are there for themselves. But doctors are people, too, and in adapting to the demands of medical work already I have seen how it can affect people. I have stood all day in a sterile operating room, demeaned for things over which I had no control, unable to defend myself due to the hierarchy which defines the hospital. I have had days where I had to pull over on my drive home because I couldn’t see through the tears. I have stolen away to find an empty room where I could scream, grieve for the patients I had seen, mourn my own new-fangled fate as some sort of machine. Each day I go in, I am reminded of my classmates who never made it to third year, pushed over a fine line which led them to take the action they did. They started as bright minds with a desire to help; they ended a statistic.

We need to protect our doctors for the sake of our patients—for the sake of all of us. We need to stop treating mental health as a weakness, especially in medical providers where emotional demands run high. We need to stand up when we are mistreated because nothing is worth the trends we are seeing. They say there is a shortage of doctors, so why are we making it so hard to keep the ones we have?

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Horror Stories from Abroad: Huế, Vietnam

 

I should be studying for STEP 1 right now. It’s that time of year for second year medical students, the dreaded “Dedicated”—as in dedicated to studying upwards of eight hours a day for eight weeks in preparation for the biggest standardized exam we’ve taken in our educational careers. NBD.

Instead, I’m writing about a time six months ago when I was on the other side of the world, a time when standardized exams were the last thing on my mind because something much more important was occupying my frontal cortex: my survival. That’s right, this post will be another near-death (or at least catastrophic) experience from abroad, this time in the historic city of Huế, Vietnam, the capital of the country from about 1800 to the end of WWII. The city is best known for its Imperial Palace, so I on my first day there I set off on bicycle to explore it on my own.

The palace was cool, and huge, but I managed to cover the entire grounds in about three hours (did I mention it was approximately 1000 degrees? That’s about 550 Celsius). And because I’d allotted the whole day for the Imperial Palace, I had some time to kill before nightfall. I figured I might as well continue exploring the city. There was a riverside market that was supposed to be big and strange (two of my favorite things!), and from the free map the bike rental guy had given me, it seemed fairly close by. I drank some water, ate a few Lychee berries (free with the room—score!) and set off.

The Imperial Palace

About an hour later, it seemed like I’d been riding too long. I pulled out my map. Unable to recognize any landmarks (there were none) nor street names (all in Vietnamese), I was forced to pull onto a side street to get my bearings. “Follow the river,” the bike rental man had said. But the river was nowhere in sight! The roads snaked in every direction, with neither a grid pattern nor house numbers to guide me. I appeared to be in a neighborhood, perhaps a suburb of the main city, and I was a long way from any tourist sights. Of that much, I was sure. I hadn’t seen a white person in, well, about an hour.

I pulled out my cell phone. Even though I had neither service nor wifi, I had a half-populated Google Maps app which represented frantic me as a glowing blue dot in a sea of nondescript green. It also showed the river. I was far from it, as I’d suspected, and there didn’t appear to be any roads that would lead me straight to it. Rather, it would require a sequence of turns, and this banking on the fact that once I reached the river, there would be a continuous path alongside it to reach the bridge which would then take me back downtown. That was a lot of variables. Still, I had no choice but to turn back, hoping to take the same turns I’d taken, avoid getting struck by the onslaught of disorganized motor bikes, (I’m talking no street signs, no traffic signals, no lanes, no sidewalks. Strictly mahem, with every man and woman for his or her damn self), and stumble across the correct bridge which would lead me back into the center of town.

Big girl that I was, I threw on my Tupac playlist, hopped back in the metaphorical saddle, and turned my ass around. And the first thing that I did was take a wrong turn. Of course, I didn’t know this at the time. I only realized it about thirty minutes later, when my flashing blue portrait on the Maps app showed that I was now farther from the river. How the…?

Okay, I told myself. Let’s give up on the bike thing and get a cab.

Funny, that, because I was in a residential area, and there wasn’t a cab in sight.

The sun was beginning to slip behind the buildings. My stomach was rumbling, and I had just one sip of water left in my bottle.

Yeah, right…

Plan B: stay calm. Plan C: find somewhere with wifi. You can contact the hotel and they can send someone to pick you up.

I looked around. There was no wifi advertised anywhere. I was walking my bike now, Tupac turned down to low, hands slick on handlebars. True, there was no wifi—no apparent business anywhere, in fact. But as I continued to walk the streets, I noticed an open garage with a few tables set up inside and a boy about my age sitting with a laptop. I wheeled up to him, and he started, slamming his computer shut.

This reaction startled me in return, but I laugh now to think what I must have looked like marching up to this kid: a misplaced tourist, sweat soaking my shirt, face fried from the sun, and what must have been a crazed look in my eyes, accosting him in a foreign language about God-knows-what. How’s that for a first impression?

I sat at one of the tables, tried to look totally cool. I ordered a bottle of water, continuing to test my host’s English. The garage was in fact the kitchen of a private home. Why the door had been opened to the public I can’t say, but there was definitely no other patrons coming in, nor was there complimentary wifi.

Turns out the boy spoke zero English, and when I brandished my map under his nose, he frowned and scratched his head for a few minutes before sliding it back to me. Then he had an idea. He opened up his laptop and began furiously typing. “Translate” he muttered to me, then faced the screen towards me to type.

“I’m lost,” I wrote. “Can you help me get back to my hotel?”

An excruciating ten minutes of Google translate later, the boy had the brilliant idea to call me a cab. I gestured to my bike, but he assured me it would be okay.

While waiting in silence for the cab, what I gathered to be the boy’s father entered stage left. He and the boy spoke at length in Vietnamese, obviously about the strange white girl who had landed at their kitchen table. What the hell was that all about?

The boy caught his father up to speed, and about this time the cab driver arrived. He took one look at the bike and turned visibly angry, shouting in Vietnamese at the boy and his father and gesturing wildly to me. Yikes. I continued to sit, drink my water, and suffer my panic attack in silence.

The cabbie left.

The father sat across from me. He pulled out a napkin and began to draw a map. God help me, another freaking map. I really played up the damsel-in-distress role on this one, partly because I couldn’t read the damn map and partly because I knew as soon as I was on my own I would end up lost again, considering my frantic state of mind and ever-failing navigational abilities. The man crumpled the napkin on which he was drawing and stood. “I will take you,” he said.

Wait, what? That was an option this whole time?

He disappeared for a moment and returned with a red motorbike.

Shit.

“But my bike…” I said. What didn’t these people understand?

“I will take you,” he said again, and made to get on his bike. Okay…

I followed him, not knowing what else to do, and sat my ass on the back of his bike.

He laughed. “No, no,” he said. “You bike. I take you.”

This was going to be interesting.

He started up his bike and I hopped on mine, ready to pedal like my life depended on it (which it did) miles back the way I’d come. My consolation was that he probably knew these streets well, meaning he knew shortcuts and backroads so we wouldn’t have to take the highways.

Wrong.

I want to say this man was a Vietnamese Evil Knievel, but looking around as we raced through five lanes of seething, beeping traffic, I realized everyone in Vietnam was off their rocker when it came to driving. I was the only regular bike in the middle of the highway, that was for sure, but no one even batted an eye at the spectacle. They simply beeped and swerved their way around, leaving me tailing my lifeline in the form of red motorbike at ten miles an hour.

My lifeline was doing me a huge favor, but he wasn’t exactly making it easy for me. Not only did I have to constantly fear (appropriately) being struck from any angle at any moment by one of the thousands of motorbikes streaming around us, but he was also taking his turns at breakneck speeds with no notice, leaving me jerking and flailing behind. One such turn (about halfway through this godforsaken journey) he turned so sharply that when I made to emulate him, my tire caught on a ledge and sent me tumbling into the street. I glanced up just fast enough to see my little red lifeline disappear around the corner and out of sight.

I quickly snatched my bike and body out of the street before getting pummeled, but now I was truly out of luck. My back tire had popped! And, I was still in terrifyingly unfamiliar territory, perhaps even more lost than before. I wheeled my limp body/bike to the grassy patch on the side of the highway and sat, palms bleeding.

If there is a god, he appeared to me that day in the form of that Vietnamese dad on a red motorbike, zooming back around the corner to my rescue.

He had come back for me! Vietnamese Dad idled over to where I sat (not to mention that he was stalling in a lane of traffic running in the opposite direction), took one look at my bike, and laughed. It seemed to me like a God-better-thank-me-for-being-such-a-goddamn-saint kind of laugh. And then he told me to get on his motorbike, repeating over and over, “I will help you. I will help you.” His plan was to tow the broken bike alongside us, a prospect even more terrifying than following him on the bike myself. Still, we had no other option, so I hopped on the back of his bike for a second time, noticing instantly that the only way for us both to fit was to flatten my entire frontside up against his backside. Great.

Off we went, idling through the mad dash of motorbikes yet again, this time with a barely-rolling bike careening to one side of us.

Granted, I did see some insane feats on motorbikes in the days following this fiasco (spoiler alert: I survive!), including a full cart of vegetables and someone’s grandma being towed by a single motorbike. But at this point in time I hadn’t seen such feats, so naturally I was convinced we would die.

I don’t know if I took a single breath during the rest of our journey back to my hotel, not only because I felt very near to death the entire time, but now with the added realization that I had no idea where this man was taking me, nor did I know a single thing about him. For all I knew, he could be taking me to his warehouse to be his next sex slave. Or, to his friend’s warehouse to sell me as a sex slave. My attention flicked back and forth between Taken and Crash for what could have been five minutes or fifty. But eventually my panic was rewarded by the sight of the river. The river! We were going in the right direction; I was almost “home.”

In about three more minutes (I can comment on this time frame with confidence, as I was about 70% calm by this time), we arrived at my hotel, the friendly bike rental man, completely oblivious to the tribulations of the day, rushing out to greet us with a massive smile.

I practically fell off the motorbike, entirely drained from sympathetic nervous system overdrive and so overcome with relief that I was. But I did have the wherewithal to reach into my backpack and pull out a wad of Vietnamese Dong (yes, that’s really the name of their currency). I didn’t even look at what I was offering him, as my survival was priceless (right, Mom?).

Vietnamese Dad leaving

My guide refused, even appeared a little heated that I would offer. I stuffed the cash back in my bag and shook my head, unable to express my gratitude. In an impulsive moment I threw my arms around Vietnamese Dad, not stopping to think about customs in Vietnam and whether that was vastly inappropriate, or what I was conveying in such a gesture. He patted my shoulder and repeated, “I help you.” With that, he started up his bike and peeled off down the road. I never even got his name.

“Did you find the palace?”

It was the grinning bike man.

“I found it, all right,” I said, returning the shredded map he had given me that morning and the bike with the busted tire.

And as I walked away, back up to my room, I pondered what exactly it was that I found that day. More than the palace, or Vietnamese suburbia, I had stumbled across something to which no map could have led me—something like hope: a restored sense of faith in the good of people, even complete strangers.

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Horror Stories from Abroad: Mysore, India

This posts kicks off a series I’m calling “Horror Stories from Abroad”—stories of which I’m not proud, but since I happened to survive them all I figured they could at least provide some entertainment. Disclaimer for all these stories: do NOT emulate them (don’t know why you would). Disclaimer #2: I like to think of myself as an intelligent person and an experienced traveler, but no matter who we are we all make mistakes, so if you can manage not to judge me I would appreciate the benefit of the doubt. Without further ado, a near-death experience in Mysore, India.

 

Led Primary at KPJAYI

Mysore is a magical place. It is a haven for truth-seekers and yogis, counter-culturalists and artists. There you can find anything the mystic in you desires: group meditations, manifestation workshops, philosophy talks, yoga shalas (Mysore is the birthplace of Ashtanga yoga), Sanskrit language courses, Vedic studies, massages, Ayurveda, cleanses, vegan food, Kirtans, gong baths…the list is nearly endless. In short, I was Alice and it was Wonderland. I lived in Mysore for a month in 2015 studying yoga with Saraswati Jois at the K. Pattabhi Jois Ashtanga Yoga Institute (for more on this institution, read my post here), and when I wasn’t practicing yoga I was quenching in any manner my thirst for Eastern spirituality.

Mysore is fairly safe compared to many places in India. It sees throngs of Western yogis seeking to practice under the venerated Sharath Jois each year, and still more hoping to escape Westernism for other reasons. However, it is still an Indian city, and there are customs and precautions by which any traveler need abide. These include avoiding going out at night—especially alone. There have been stories of yogis on their way to an early morning practice who were assaulted by men on motorbikes. There have been muggings. Women need wear modest clothing in order to avoid unwanted attention. Women should travel in groups, especially when venturing outside the city center. Women are not commonly seen in chai shops, so it’s best to partake only in the direct sight of the street traffic. All taxi and rickshaw drivers cannot be trusted similarly and extreme caution must be taken if you choose to hitchhike. As a general rule of thumb, it’s best not to walk alone.

While very aware of these unwritten rules now, it took me a while to catch on to them then. You could say I learned the hard way.

Patchouli the Dog

One day during my second week in Mysore, I was returning to my apartment after a particularly moving meditation. It was about noon. I had befriended the stray dog who lived outside my building—a ridiculously playful pup who I’d named Patchouli (and proceeded to adopt, only to be thwarted at the airport all the way in Bangalore…), and he bounded up to me as usual on this day. Patchouli must’ve only been about one, but he’d gotten in a fight with something bigger than him which left one ear with a patch missing. Hence, Patch.

I was in such a good mood, I rolled around with Patch for a while until a rickshaw driver with amber eyes like a tiger and dressed all in white approached me. His name was Hakim, and he was touting Ayurvedic massages for a ridiculously cheap price. “Free sample massage!” He also mentioned pure essential oils and incense, all handmade at his shop. I was feeling so light from my practice, meditation, and from this adorable pup that I decided to give Hakim the benefit of the doubt. He seemed kind enough, and he offered me a free ride in his rickshaw to get to his shop for said services. Not having anything planned for the rest of the day, I went.

Off we drove in his rickshaw, about half an hour out of the city through ramshackle adjoining towns. The further we sped from Mysore, the more anxious I became. “Hakim,” I said. “I’d like to turn back. I didn’t realize your shop was so far away.”

He waved his hand at me, assuring me over and over it was “just up here.”

Keep your cool, I told myself. Panic won’t get you anywhere…

After what felt like an eternity, we arrived at a concrete, two-story structure with no doors and shattered windows. When we stepped inside the noise from the street fell away. It was dark and cool. There was an old Indian woman squatting on the dirt floor, hunched over a pile of hand-rolled incense sticks. So, the tidbit about handmade incense was true. “My worker,” said Hakim, gesturing to her. The woman kept her head bowed over her work.

I shivered to think what “worker” implied. The place seemed more like a sweatshop than anything else. Still, it comforted me that there was a witness in the room. This was the state of my psyche.

Hakim showed me to a ratty couch. I sat gingerly on the edge, afraid of what that couch may have seen. There was graffiti on the walls in a handful of languages, some of which I couldn’t identify.

“No worries,” he said, noting my discomfort. “I have travelers all over the world come to my shop.” He passed me his cell phone—already opened to WhatsApp—for me to read over the conversations he’d had with past visitors.

 

This was the strangest part. All of the exchanges were with foreign women, and all of them involved bold advances from Hakim—“you are so beautiful,” “I love you,” kissing emojis, and such things—while the women, if they replied, would say things like “you are making me very uncomfortable,” and “please stop messaging me.” Why would he show me this? The only purpose it served was to increase my anxiety about a hundred-fold. I quickly passed the phone back, quite disgusted, and demanded he take me home. My palms were slick with sweat.

“You don’t want my massage?”

“I want to go back. You promised.”

“Come upstairs to my massage room. I won’t charge—all for free.”

I rose, ignoring his outstretched hand. I don’t know what I would have done if, you know…

There was no wifi in this part of town, and I had no cell service. Nobody spoke English, either, because we were so far outside of Mysore, and I hadn’t seen any other rickshaws on the streets outside. But it didn’t matter—I just had to get out of that shop before he got any more aggressive.

Hakim saw I was serious. He thrust his hands in front of him as if to pacify me—impossible at this point. “Okay, Mary,” he said (I had given him a false name, of course), “I am sorry you didn’t get to enjoy my services. But I will take you back if you wish, and you can come back tomorrow.”

And he did. On the way back he had the nerve to ask for my number. What didn’t he understand? I snatched his phone from him without a word and typed something which wouldn’t have passed for a phone number in any part of the world. I just wanted to play the part until we got back, avoiding any action that might cause him to turn back around.

I directed him to a building that was on the other side of the city as my actual apartment, just in case.

“I’ll message you. Tomorrow I will show you the oils.”

I gave him a hateful look as I stepped down from the rickshaw and walked away.

I still curse myself for my stupidity that day. I can’t say exactly what went through my head when I hopped into a stranger’s rickshaw to God-knows-where. If I had to guess, I’d say all my uplifting experiences in Mysore up to that point gave me the naïve perspective that only good could come from such a place. My confidence in its security had outgrown reality.

Patch was waiting for me when I got home. I’ve never been happier to see anyone in my life. The moment Hakim whisked me away could have been the last time I ever saw that excited tail and half-eaten ear. I could have disappeared in India without a word. Or I could have come back but with pieces missing—just like Patch.

By nothing but a twist of fate, these things did not happen. I came away unharmed but frightened into a more cynical and shrewd attitude towards travel. Better to keep your guard up and your confidence close at hand. When you travel alone, the only person whose trust you can be certain of is your own. And sometimes not even that. 

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Forgiveness on Christmas: Letters from a Non-Believer

Every year I run from Christmas. 

It terrifies me. The shameless consumerism, the pressure to buy gifts and to spend time with everyone–jumping from party to party to fit everything in. It’s emotionally (and financially) exhausting, and so I run. I run emotionally, distancing myself from the songs, movies, shopping, togetherness–what you might call an all-or-none phenomenon. But this year, instead of running emotionally (although that definitely played a part), I ran physically. As soon as I finished my last exam, I booked the cheapest one-way out of the States, and two days later, I found myself in Montezuma, Costa Rica—a sleepy surf town on the Pacific with as many dreadheads as stray dogs (it’s a lot). And I haven’t left yet.

It was a sigh of relief arriving here, where year-round sand and sun obscure any semblance of season. No Christmas trees, no snow, no crazies pushing their Reason-for-the-Season pamphlets at you outside the bar. And the relief this initially brought gave way to something quite unexpected—a connection with the Christmas Spirit! The Macy’s ads, Bing Crosby croons and Hallmark Originals strangle out any pretense of emotion (aside from irritation) that I could have felt back home, but underneath the black hole of what is Christmas-in-America, there truly is a feeling to this time of year. There must be, if I’m feeling it all the way out here.

From a strictly agnostic standpoint, it is a time of shorter days, colder temperatures, and death. It is a time when we hunker down with the closest people in our lives and are grateful for each other and what we have, for we are reminded by the browning leaves outside that life is fleeting. We reflect on the thoughts, encounters, and experiences of the past year, wondering what could have gone better, what we’d rather not repeat in the year to come. It is a very powerful time, a time to allow death of the aspects of our lives that no longer serve us, to let go of past grievances and screw-ups, and to start the next cycle cleansed. And the only way to do this is to forgive—and forget.

So this year, I am holding a funeral for the grudges and heartbreaks, the fuckups and embarrassments.

I am saying my final goodbyes to the people I hurt and the people who hurt me, the shit which hit the fan, the mistakes I made, the love I missed out on. Readers, hopefully you can find something in these letters to which you can relate. And if not, I urge you to address those special people and situations from your 2017, to forgive yourself and them, and then burn those letters, or set them out to sea, or publish them on the interwebs for the entire world to behold (me). Because if you start a fire in the darkness, you’ll have the light to move forward.

To my family,

I forgive you for misunderstanding me. All you want is to make me part of your world, but you don’t understand that my world is very different from yours—that our most fundamental views on life lie on opposite sides of the seesaw. To me, this is cause for strife, tension, and the desire for distance. You love me so much, but I am afraid to show you who I really am, for I fear you wouldn’t love that person the same way. Every time we’re together, I am relegated to the youngest child, in need guidance from the rest of the family.

Who is lost. Who is naïve.

I have never felt more myself than when we are apart. In fact, I feel strangled when I’m with you, as this identity you attribute to me is nothing like the one I have worked so hard to create for myself—and it’s fragile. I push you away because I reject the identity of the person you knew me as when I was younger. But I know you love me more than I am afraid to consider, and even though you frustrate and sadden me, I know you would be there for me when nobody else is. And for all the arguments, heartache and confusion this has caused me, I owe you forgiveness. Ultimately, all you want is to love me, include me, and be part of my life. So I forgive you for going about it in the wrong ways because these are the only ways you know, and I know that above all else, your intentions are good. And of course, I love you back. Even from afar.

With love,

Becca of 2018

To my Exes of 2017,

I forgive you for the pain you have caused. I forgive you because I know you too are afraid to be vulnerable, and this past year has instilled a similar fear in me. I forgive you for the brick wall you built around yourself and refused to let me enter. I forgive you for kicking me out, even when I thought I was making headway. You were only protecting yourself, your heart. You tried to be kind in the aftermath, but emotions are intoxicating, so for the times that you were less than kind, I forgive you. I forgive you because fear, confusion and past heartbreak make giving yourself to another difficult and scary. They are also what make us human.

I forgive you for being human.

We are all guilty of dragging casualties into our problems, and if I were to fault you for this, I would be a hypocrite. I forgive you for being selfish because even though loyalty to your values occasionally manifested in miscommunication, manipulation, and flat-out ill will, I can forgive you because I see myself in you, and I know you never meant to hurt, only to protect Numero Uno. I must also do this. The emotional rollercoaster you drove me down has taught me many lessons which I continue to learn, foremost of which is the importance of nurturing myself before others and being very careful who I allow in to this sacred space of self. You taught me never to compromise who I am, for if that’s what it takes to attract someone like you, then you aren’t right for me, and we must blossom into something beautiful yet apart from each other. I hope for the best for you. I hope that you may unearth and understand your feelings about relationships, love and loss, and that whatever troubles you may come to pass. I forgive you as I let you go, and I wish you fair seas on your way out of my heart.

With love,

Becca of 2018

To Becca of 2017,

I forgive you. I forgive you for the times you put yourself above the ones you love, and for being callous to the ones who tried to give their love to you. I forgive you for pushing your family away, and for the stress this caused, because you only meant to take care of yourself. I forgive and let go of the embarrassments because you were only trying to be funny, or kind, and most of the time that works out all right. I forgive you for running away when life got too hard, for pushing away when life got too close. I believe that you are kind, and I believe that you want harmony in your relationships and happiness in your life. I forgive you for the times you acted in contradiction to this, knowingly or unknowingly. You care to succeed, and you can, so I forgive you for the times when adventure and excitement got in the way of your vision. I forgive you for the times you were less than kind to your body. I forgive you for the times you tested karma, for more often than not it tested you back. I forgive you for the times you strayed from the path because I know you always find your way back—that’s who you are. I forgive you for allowing how others see you define how you see yourself. I forgive you for anger and regret, for unexplained sadness and intentional cruelty. I forgive you because I love you and want what is best for you, and I know the only way to achieve this is to forgive, and to move on.

With love, 

Becca of 2018 

 

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A Vegetarian Abroad: Gili Trawangan, Indonesia

I’ve been vegetarian for most of my life. And while I can’t speak about the specifics of meat production in other countries, I can speak with a semblance of knowledge about how it goes down in the ole U-S-of-A.* In America, the vast majority of meat comes from factory “farms,” where animals are commodities: means to an end. As such, their lives are spent in space-efficient pens, and they’re fed what’s cheap: byproducts of subsidies like soy and corn, or worse: recycled parts of their fallen comrades. (If you think I’m exaggerating, check out the documentary “Food, Inc.”) They are given antibiotics and hormones to ensure their meat stays juicy despite unnatural diet and unnatural living conditions.

More than this, factory farms contribute about 10% of our carbon emissions, and the number is growing as natural habitats–from rainforest to desert–are converted into pastures.** What’s more, consuming meat from these animals posits dangers to our own health. Of course, large government subsidies to these farms means their affairs are kept largely hush-hush, a whisper drowned in boisterous campaigns advocating Meat! It’s What’s for Dinner, Goddammit! [Emphasis my own.] In fact, compared to every other world nation, American meat consumption ranks highest or second highest across the board (in the categories poultry, pork, veal, and beef).*** That’s more than the [former] European Union combined. Thanks, propaganda!

But I digress. Believe it or not, the purpose of this post is NOT to mount my soap box nor to scold the omnivores in the house. My mission is quite the opposite, actually…

Lombok, Indonesia

 

Strange & tasteless, the snake fruit

A week ago I arrived in Lombok, an island in Indonesia that gets largely overshadowed by its neighbor, Bali. Especially in the coastal towns and offshore islands, the native people have a distinct cuisine based on native crops: coconut, spicy pepper (and I mean spicy), tropical fruits, green beans, rice and, of course, the sea. I visited several markets where fish and seafood is brought in daily and offered to customers, charged per 100 grams and barbecued over a fire pit for you to eat on the spot–often whole. But instead of recoiling from such a display (as I might in America, scurrying past the meat aisle as though the butcher had her wily eye on me, next), I found it inspiring (aside from the Giardia I’m still coping with). Without the ocean, the locals wouldn’t be able to survive, period. They rely on it for food, transport, supplies, diversion and livelihood. Though Muslim, they still show gratitude towards the gods of the sea and the creatures within it. And although they are grateful for the sea, they don’t hesitate to consume its inhabitants. It would be a foreign concept.

Yeah, this just wouldn’t fly in America.

A big disconnect in American culture is lack of appreciation for our food. In Japan, too, (where I was a few weeks ago, and where eating from the sea is like breathing air), food and the ocean and nature at large are shown respect–a bow before and after eating, before and after swimming, climbing a mountain, et cetera. In America, there seems to be a sense of entitlement for food, potentially due to a disconnect from our food sources. Have you ever seen an animal carcass at the grocery store? What about even a picture of the animal on the label of a meat package? Don’t think, just do.

I wouldn’t argue when someone says humans are “designed” to eat meat. Our ability to eat widely is what helped us to the top of the food chain. And, when animals are treated with respect, killed with compassion, and consumed for subsistence rather than desire, it becomes a very natural process. All things in moderation, of course.

Humans, however, are capable of subsisting without meat. We also are endowed with a conscience which allows us to choose what we will and will not eat. Such has been the practice of Buddhists, Jains, Hindus, Jews, and many other religions around the world for centuries. Ultimately this is the choice that I’ve made, too. So no, I did not eat the market meats, but only because years of vegetarianism-for-a-cause has lent me sympathy for the critters who happen to sit below us on the food chain. It was a personal choice more than a boycott-the-man one. Because despite my emotions, the process in these Indonesian markets feels very…natural.

To reiterate, I’m not preaching vegetarianism. Everyone has the right to choose what they eat and how they live. But until America in particular cleans up its act and learns some respect (which I believe will come hand in hand), I can only hope more people will cut back–in any small way–in their support of a tasteless industry. That, or move to Indonesia.

Contemporary Indonesian farming methods?



*Experience gained from extensive book-reading, documentary-watching and lecture-listening on the subject.

**Statistics from EPA 2015 official report.

***Statistics from OCED 2016 official report.

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On Dissecting Humans

Today I held a human brain in my hands. It weighs about four pounds, slightly pink, squishy, and dense—just like you’d expect from the movies. We removed it from our cadaver, who we’d christened Agatha because we were never provided anything but her age and cause of death. Before we reached the pearl, though, we had to crack the oyster. Our professor presented our two grisly choices: bone saw or bone chisel?  We selected the former, which was essentially your everyday chopping device with the word “bone” tacked on the front. And off we went into the bony orb that holds so much, with such nonchalance that I began to question what the hell kind of person I was becoming.

8243262473_29fd1a62e7_o“Whoa,” I’d told my lab group. “Shouldn’t we say a few words or something? I mean, this is her face here. People used to recognize that face. She used to smile with it.”

My comments, of course, went unheeded. Not, as I must point out, because my lab group members are heartless, cold scientists. The field of medicine is like any other: a business. There are procedures you follow to achieve certain ends, and in medicine, emotion is not a part of the procedure. In fact, emotion can get in the way of what is at stake, particularly when it comes to cutting into some body.

So, while my team members were sawing and hammering at Agatha’s skull, I sat back. This body was someone—maybe not anymore, but once. She had lips and hair, fingernails painted dark, dark blue. This brain worked for Agatha her entire life, and here we were in our lives, making use of the parts she no longer needed.

Before long I succumbed to the joking, the poking, casual words exchanged over Agatha’s exposed parts. I made cuts, removed the top of her skull—skin and hair attached—and then her brain. Because what else can you do?  We all have a purpose in life, and each of them has certain rules of the game. To win at anything, you have to play by them.

Different people are cut out for different endeavors. For instance, I don’t have a competitive bone in my body, and things like team sports have never been my friend. Other people are artists, and they might be horrified at the dry science and anatomy of medical school. At first, I felt like I fell into such a category. All my life I’ve been a writer, a wanderer, a yogi. And yet I was keenly aware of the underpinnings of human functioning, the intricate pathways that made our amazing machinery operate, and I was fascinated by the ways it could go wrong. But when I started medical school this year, the two sides of me didn’t want to meet. It felt like I was trying to lead two lives at once: one was scientific, rigorously pursuing logical explanations for phenomena that the other life, the yogi, felt and experienced.

Every person is looking for the same things in life—fulfillment, answers—but in different ways. The yogi seeks transcendence, liberation from the external stimuli to understand the patterns of existence. A doctor pursues scientific explanation for how things work, and understanding on such a minute scale the details of human functioning allows a doctor insights into the bigger picture—why we’re here, why we act the way we do. One is a top-down approach, where the other is bottom-up: two means to the same end.

We can’t fight who we are, and we can’t fight destiny. I come from a legacy of physicians, and for the longest time I resisted falling in line with the rest of the family. I wanted to be an artist, to be different. I scoffed at their reductivist views of life and the world. But after taking the year after graduation to travel the world, write, and teach yoga, I realized there was something more that was calling, another layer to my purpose, and the longer I waited, the harder it was to ignore. I was meant to be a doctor, and I realized that having an art-loving yogi inside my white coat would only add to the potentials afforded by either field alone.

I’m not saying it hasn’t been difficult. Medical school is so busy that I find myself desperate for time to exercise my creative passions, and every day I am surrounded by types who are quite different from those that I am used to surrounding myself with. It is a strong lesson for me to appreciate the nuances of the medical field and the very different sorts of people who are attracted to it, all while maintaining my own distinct identity. But despite the setbacks, being the oddball has proven to be a boon.

In that frigid anatomy lab, with gloved hands trembling and the stench of formaldehyde a thick cloud overhead, I took hold of the scalpel and looked Agatha dead in the face. I made an incision here, one more there, and with a little help from my friends retracted Agatha’s brain from her skull. The artist was there, though, so much so that the whole time I was handling Agatha’s brain my own was shouting reassurances at me, coaching me to breathe deep and slow and not to stop.

Future docs!

Future docs!

Throughout the cool callousness and analysis, the artist in me is able to tap into the bigger picture behind all the parts, pathways, labels, and medical jargon to realize that it’s all part of a greater effort. Day by day, through the collective efforts of different individuals in their different roles, we fill in the picture of what it means to be human, what it means to be alive, and why we’re here in the first place. We play our roles to keep moving forward, toward that light at the end of the tunnel that some call God. When a road block arises—say, a brain—you take a deep breath and remove it. You may be revolted,  but gradually you grow accustomed to the change. Poke it, appreciate it, and learn from it. Give thanks for the path you are on, and keep heading forward. In our own ways, it’s what we are all meant to do.

 

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Why I Don’t Make New Year’s Resolutions

It’s a noble thing to want to be a better version of you. January 1st is the day the Gregorian calendar tells us we are starting the cycle anew: one year gone, another fresh start to come. This naturally causes us to reflect 8282560669_e7e935d3df_q (1)on traits that may not be serving us anymore and inspires us to change that trait.

Perhaps you’ve noticed that January is the busiest time at gyms and, as a current employee of a juice bar, I can tell you it’s by far our busiest time for juice sales and cleanses.

But change is a gradual thing. January is the busiest time for these places because, inevitably, we fall back into our old habits. How many people even remember what their NYRs were last year? Point is, we forget. That’s why I think the craze of resolving to improve is overrated, and that’s why I don’t do it.

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More like learn how to spell…

I strive to be a better person every day I’m alive, and I’m constantly reflecting on myself with this in mind. It shouldn’t take a new year to ask how I could do things differently.  Some common themes in my own life are having more patience, slowing down my life, listening to my body more. And these are things that I struggle with every day of the year.

NYRs don’t last, and that’s my problem with them. They don’t last because you can’t all the sudden decide you want to be a different person and—poof!—you’re a new you. The truth is that it takes a lot of time, effort, and self-reflection to actually let go of old habits and develop new ones. It might even take more than just one year.

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New Year’s Day is a spiritual time because this is when people slow down to consider how to live and be better than they were. But New Year’s Day shouldn’t be the only time this happens. If you’re making a resolution this year, resolve to resolve every day, and then maybe you’ll see those resolutions turn into reality.

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Thinking like a Caveman: The Latest Cure to Cancer!

Cases of cancer are raising some absurd statistics: some 1 in 3 women will have breast cancer, is the latest I’ve heard. But I’m not here to write about cancer statistics; I’m here to write about why the numbers are so high—and rising—in the first place.

The easiest answer is that the population is aging, and granted, some cases of cancer are likely the result of getting older. But some cases are not, and it seems like diagnoses continue to shock us. “But she was so healthy!” “But he was so young!” Sometimes it feels like cancer is striking out arbitrarily, and anyone could be a target—even the strong, the young—even children.

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Sadly, the answer is not a simple one; there is no singular culprit—apart from the very way we lead our lives. Evolutionarily, we’re still quite similar to our Neolithic ancestors in terms of design. Without spoiling anything, we’re meant to wake and sleep according to the sun, to be able to build, hunt, gather, run, and climb all day long, to spend the majority of our time outdoors and be in tune with the cycles of nature. But society has advanced quicker than our evolution so, granted, living like a caveman isn’t exactly practical or feasible. But to completely neglect the natural state of our physiology is to make ourselves targets of self-destruction.

293013492_76ea598e8e_oConsider Mike, a middle-aged manager of some business firm. On a typical morning, Mike’s phone sounds an alarm at seven a.m., and he hits the snooze button two or three times before rising and getting ready for work. For breakfast, he makes three eggs, slices up some fruit, and drinks two cups of coffee with Splenda. He has to be in to work by nine, but he leaves at eight because there’s always dense rush hour traffic. Sometimes that’s still not enough time, and he spends the last few miles gripping the steering wheel and yelling at people who cut him off. At work, he takes his seat in his cubicle and works on his computer, where he sits until five, taking two quick breaks and lunch in between. After work, he goes to the gym where he listens to his iPod and runs on the treadmill while watching TV. He is exhausted on his way home, but there is an accident on the road, and he is again stuck in traffic. Finally, he reaches his house, whereupon he showers and heats up some leftovers. He relaxes on his bed to watch his favorite TV show before plugging in his phone on his nightstand, setting his alarm, and going to sleep to do it again the next day.

This is the familiar story of a day in the life of the average American, perhaps one of even above-average health. But it’s average people who are coming down with cancer. Here’s why.

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First and foremost, I’d like to point out the preponderance of blue light we are exposed to. This is the radiation given off by most of our technology: iPods, televisions, computers, digital clocks, fluorescent lights. In an increasingly digitized world, blue light is constantly surrounding us. It stimulates the “awake” part of our Circadian rhythm (what regulates our wakefulness and sleep), but constant exposure to this is thought to be implicated in rising rates of insomnia, anxiety, cancer, and a host of other ailments (I invite you to read Max Strom’s There is No App for Happiness for more information on this).

Sleeping with a phone next to your head, particularly a smart one, exposes you to hours of radiation every night. Not to mention the teens and pre-teens and yes, even elementary school kids who carry cell phones around 7317967922_b938afbd93_oeverywhere with them like an extra appendage. These things give off signals—GPS, cellular, and more—and it explains why there has been a preponderance of new cases of brain tumors found just above the right or left ear. Hands-free Bluetooth, anyone?

Let’s now turn to Mike’s diet. It sounds pretty healthy, right? It would be if it weren’t for the fact that the most commonly distributed, sold, and consumed food stuffs are all genetically modified, laden with pesticides, enhanced with artificial colors and sweeteners, or injected with antibiotics. Our food isn’t food anymore, unless you take scrupulous time to read the labels. But that’s Food for Thought for another article 😉

Waking up isn’t easy for Mike, which is why he hits snooze so many times. So maybe he’s not a morning person…but does that really exist? Humans are naturally designed to be rise with the sun, as it gives off blue light (this is in addition to ever-growing exposure to blue light in the modern world).130559143_92c20a2021_o If a person gets sufficient hours of quality sleep per night, the daily alarm will cease to be a torture sentence. As for the commute to and from work, sometimes traffic is unavoidable, and while nobody likes sitting in traffic, it seems almost an expectation that we get stressed and angry while in it. If we let it, the stress will cause our bodies to tense, our blood pressure to rise and breath to quicken. Try to consciously relax the body and slow the breath. Listen to books on tape or make playlists with favorite songs. Hell, do some mental math.

After Mike arrives at work, he sits, and for many of us, this is an inevitable aspect of our jobs. Get up often to stretch (especially the front body) and walk around. Step outside for a few minutes. Try replacing the desk chair with a ball so at least some muscles are being used while sitting. During lunch breaks, go for a walk or eat outside. The human body was not designed for a sedentary lifestyle. Envision again the daily life of a cave man.

Back to the story. After work, Mike works out. Super. The only problem is that his workout is yet again indoors, surrounded by the sounds, distractions, and radiation of fluorescent lights, loud music, talking heads on TV. All these different, loud vibrations everywhere can stress us out over time, get us wired up, distract us from what’s going on inside our own bodies. Take the workout outside every once in awhile. Try leaving the iPod at home. Though it may not be easy at first, it’s simply a matter of acknowledging an attachment to it and breaking a habit.

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Look familiar?

The only other thing I’d like to add here is falling asleep in front of the TV. This again goes back to the blue light phenomenon, but it’s especially important before bed. Exposure to blue light and stories or news that may elicit emotional or intellectual responses will keep the brain alert. Not only will falling asleep be harder, but the quality of sleep will not be as sound, either. And please, people, don’t fall asleep with your phone next to your head.

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To recap:

  • Spending too much time indoors, surrounded by bright, loud, distracting technology
  • Attachment to our phones, iPods, televisions, and technology as a whole
  • Quality (and quantity) of our “food”
  • Quality and quantity of sleep and rest
  • Sedentary lifestyles
  • Stress!

It’s no wonder we are a population addicted to coffee! How else would we possibly keep up with such fast-paced living? In developed countries, particularly the United States, there’s an expectation to live this lifestyle, and as such, many jobs make it pretty hard to step away from. Don’t get distracted by it. Open your eyes to these things around you every day, and you can make a conscious effort not to let them dictate the way you live your life. Cancer a result of neglecting the natural design and needs of our bodies from a purely scientific and evolutionary standpoint.  My suggestion? Think like a caveman.

Note: I didn’t mention prescription drugs here, as it’s a complicated issue so I saved it for a different article, Prescribing a Paradox. But I do believe that overuse and over-prescription of drugs (yes, that includes alcohol and caffeine!) is a major contributor to rising cancer rates, as well.

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Prescribing a Paradox

The United States spends more on health care than any country in the world, and yet for documented health, we don’t even make the top 10: a paradox, indeed. In fact, it’s a paradox which has politicians and healthcare workers relentlessly pushing to expand funding for drug research and health coverage—wait, what? Somebody is missing the big picture, here.

 

It is clear that our tremendous health spending is not correlating with increased health. The problem cannot be solved by increased use of pharmaceuticals and increased access to hospitals (and here I’m talking about Western, not infectious diseases. However, in the West, it is no longer infectious diseases which are killing us). The problem is much deeper than this, but it’s rare to come across somebody bothering to wonder what is causing all this disease in the first place. Rather than treating ailments once they have already taken hold of the population, wouldn’t it save a lot of time and money to prevent them from happening in the first place?

3315748907_5445d270cb_bOf course it would, but there are people with money and incredible influence who are benefitting from keeping our current healthcare paradigm centered on treatment. I’m talking about big-time health insurance and pharmaceutical companies who, these days, run the show. They have the money to buy out doctors in private practice to join their army, where they can dictate the nature and number of patients their doctors see. They are wining and dining these physicians to coax them into prescribing their new “products” to patients. Their influence is higher than this, though, permeating governmental policy and funding.

It’s a vicious cycle: increasingly sedentary lifestyles in the West and consumption of processed foods lead to an increase in the diagnoses of Western diseases. Thus, our reliance on these pharm and health insurance companies rises and their influence grows.  Soon every rambunctious toddler will be prescribed sedatives! Oh wait…

The point is, we are struggling to keep afloat in the costs we are incurring to maintain “health,” and for some of us, we’ve already drowned. If it sounds gloomy, fret not! The most important thing you can do is take charge of your own wellbeing. It’s not rocket science: physical exercise, eating fruits and veggies, and taking time to relax will benefit health. If you have the means, go see experts who will help you become the healthiest you can be, such as yoga teachers, personal trainers, dieticians, massage therapists, acupuncturists, psychologists. Taking charge of your health now will not only extend your life but the quality of it, as well.

Don’t wait until it’s too late, or you may be paying the price. –WB