This is The Health Show, a presentation of national productions.
It seems like you can't turn on the radio or read a health blog anymore without finding
something else that will eventually kill you.
Sunshine, artificial sweeteners, natural sweeteners, there's no escaping it, they're all gunning
for you.
But according to a new book, it's even worse than we thought.
And today's health show, a conversation with an author of the Encyclopedia, Paranoica.
Then we'll head to the Bronx, where work is being done to help people with asthma in low
income housing.
And we'll hear why making critical healthcare decisions should be a collaborative effort.
I'm Dr. Nina Sac.
I'm Bob Barrett and this is The Health Show.
Cake, fruit, armadillo, Santa Claus, rubber duckies, new smurnda, beach, Florida and gray
goo.
According to the new Encyclopedia Paranoica, these are all things that can and eventually
will kill you.
The book is the brainchild of authors Henry Beard and Chris Surf, two of the founders
of the legendary humor magazine The National Lampoon.
And while the book is certainly tongue in cheek, every entry has been painstakingly fact-checked.
After looking through the book, I was a little afraid to get out of bed in the morning.
Here to talk about the book is co-author Henry Beard.
And Henry, what were you guys trying to do with this book?
Scare the hell out of people or just make them laugh?
Well, primarily to make people laugh.
I mean, I think that as we continue our research, it just becomes apparent what I'm sure you
noticed reading in the newspapers or reporting on the radio.
Today, after day, you get these extraordinarily fundamentally contradictory pieces of information
about health, well-being and all the rest diet.
One day you're told, gosh, leave that hamburger alone, eat soy.
And the next day it turns out soy has some problems.
You're supposed to avoid french fries.
Let's have some bean sprouts.
But it turns out that one of the big, equally, uh, breakouts is called a sprout break, but
the center is for disease control because it is so commonly associated with leafy greens.
This book, I mean, and it is hilarious, is actually a fact-checking masterpiece.
How much research went into this?
Well, a great deal.
And again, we have to give credit where credit is, is due without the internet, this book
would have been virtually impossible.
If it were to spend decades in libraries checking and cross-checking.
But the great thing, and perhaps the troubling thing today about the, about the internet is,
you could right now go on to Google and type the two words, cushion and hazard.
And you'd probably be directed to a website like www.cushionscankillu.com.
You can find every possible interrelated source of information on things, some of them
more reliable than others.
And we were very strict.
The 50 pages of references we have in the back to various websites, all of those websites
have some actual capacity for accuracy.
I will admit that some of them are a little self-interested, but we point that out whenever
we think it occurred.
If anything is taken from this book, the one thing I think that everyone will get that
is anything that has ever been touched by another living being is suspect and could kill
you.
And this is the problem, of course.
We actually put together a lovely little video showing chicken little, the famous bird
who warned the sky was falling.
Being caught in a public restroom because every time she went to wash her hands, she realized
that the faucet she touched were covered with germs.
If she tried to use the air dryer, it turns out the air dryer circulates germs.
Obviously, you go near the bathroom itself.
You're in a world of hurt and you can't leave the bathroom because you'll have to touch
the door handle, which has been handled by everybody else and is covered with germs.
While it turns out in the end, according to your book, chicken can kill you too.
So there's just no winning for it.
There is no winning.
There is absolutely no winning.
Everything can kill you.
And I think one of the lessons, if there's a lesson, then you're right.
This is basically a tongue-in-cheek, not knife in the back book, is don't overreact
to every single thing that's reported.
I mean, just very recently since the publication of the book, we've learned that either aspirin,
which we know in a daily dose, has demonstrated benefits, can either hurt you by causing
macular degeneration or further protect you by keeping you from getting melanoma.
Now, which is it?
Both, neither?
Well, after a certain point, you sort of have to rely on common sense and a general idea
of where the preponderance of established opinion rests.
It's almost impossible to read this book one page at a time because when you read about
one thing, it gives you references to another portion of the book.
One of my favorite references was, as you read through leoporcy, at the end it says,
see armadillos.
I mean, okay.
Yes, I mean, who the fuck it turns out that armadillos, which are a native new world creature,
nevertheless, turned out to be one of the very few creatures that can actually spread the
old world disease of leoporcy because of the curious architecture of its blood.
So I mean, well, I don't think you're going to go out and some people apparently do in
the southwest and pick up road killer armadillos and roast them on the barbecue, but if you
do, think twice.
And of course, rubber duckies, they're deadly.
They're deadly.
Here's this harmless, but of course, like all bath toys.
It's been in the, guess what, bathroom.
So it's capacity to contain and spread germs is almost unlimited.
It's really an enjoyable read.
And for your career, I mean, you've had a long career in writing and it's almost explicitly
been in print.
Is that just something you just never wanted to leave that medium?
Well, I think it's just a bourbon action to history.
I mean, that came along.
I'm 67.
I came along at a time when print was still very much alive.
I mean, it still is both in its normal form and electronic form.
But it just turned out that way.
And because I was lucky enough along with my co-author, Christopher Surf, to have started
the National Anthem, who'd magazine, once you go down that road and start grading enormous
amounts of soil.
It's supposed to be funny stuff.
I guess you're going to get stuck in it.
And you guys, you've done a few books together.
The politically correct dictionary in handbook was a masterpiece.
And we feel a very helpful guide to everybody who doesn't want to say, oh, do you want to
say chronologically challenged?
And it just goes on and on.
We also collaborated on the book of sequels, which provides happy endings to almost all
the sad pieces of literature around like, you know, where I'm actually at, and what
we did.
So yeah, we've been at it for a while.
We won't even get into French for cats right now.
So Santa Claus, New Smirno Beach, and Bolshev Cherries, all deadly.
Forget about them.
All deadly.
I mean, Santa Claus is particular because he's such a bad image for kids.
I mean, the guy is clearly obese.
Never mind the fact that when he goes ho, ho, ho, which is apparently scary to kids who would
prefer, uh, huh, he's spreading germs that were passed onto him by the previous kid who
sat on his lap and gave him his list.
The Bolshev Cherries, of course, cherries contain pets and, you know, what pets can do
that's terrible.
Well, it seems, you know, you get on Santa Claus for being obese so he should eat healthy,
but apparently all fruit is deadly too.
Just about every fruit we encountered, whether it was a problem of pesticides or some inherent
chemical makeup of the fruit itself seems to have some problem.
I mean, it's just crazy making blueberries, strawberries, every berry you can possibly
imagine apples, the skin is a problem.
It just goes on and on.
Of course, we would quickly add that compared to what and how many apples and blueberries
you have to eat.
So it's, you have to keep a sense of proportion though.
We don't do much, frankly, to help you keep that sense of proportion.
Well, with things changing, do you see an update coming in a couple of years?
I must tell you honestly, I have that already been, and Chris Sir have been collecting new
stuff because as I said, even in the very few months since the book has been published,
I mean, we've always a study that seems to suggest that overweight people live longer than
skinny people, hard to believe.
There's a new study that has been, not new, but recently rediscovered from Australia,
that suggests that eating traditional bed for you saturated fats, you know, burgers and
pannet and hot dogs is actually healthier than eating polyon saturated fats like sunflower
seed oil, which seems completely preposterous.
But once again, the statistics are there and you choose to ignore them or actually pay
attention to them at your peril.
Well, as someone who wants owned a monogarilla t-shirt, I wish you the best of luck.
I need it.
Henry Beard along with Christopher Serf is co-author of The Encyclopedia Paranoica.
It's published by Simon and Schuster.
One health problem that is no laughing matter is asthma, and the problem is worse in some
lower income communities.
For example, New York's East Harlem section has the highest rate of asthma in the country.
Many neighborhood and advocacy groups have brought attention to the problem in recent years,
but the problem still persists and there are no easy answers.
Ray Lopez grew up and developed asthma as a child in the Bronx.
Now as an adult, Lopez helps families who are experiencing hazardous housing issues
related to asthma.
Lauren Bonner has more.
Ray Lopez spends most work days outside the office and inside the homes of East Harlem
families.
Equipped with anything from a HEPA filter vacuum cleaner to an air purifier, Lopez decontaminates
the homes of chronic asthma patients.
His work helps relieve their symptoms.
Lopez runs the environmental program at little sisters of the Assumption Family Health
Services.
He handles about 100 asthma cases having to do with indoor environmental problems.
Mold is one of the more frequent complaints he receives.
After seven years on the job, Lopez says he's seen it all.
Just severe mold growth in multiple places in the bathroom and in a hallway.
The leak was just to the point where the ceiling caved in.
This serious problem is in multiple asthmatic Sarah.
One child is so severe that he's been moved to live with an aunt.
Lopez can relate.
He too is asthmatic and must take extra precautions like wearing a mask when going into these homes.
He developed the disease as a child growing up during the 80s in the Bronx.
I don't ever remember as a child being told about the connection between say cockroaches
and mice are mold with asthma.
Since then, a lot has changed.
The medical community has established scientific links between mold and some health problems.
A 2003 study by St. Vincent's Hospital in Manhattan showed a correlation between
spore counts and the likelihood of developing childhood asthma.
As of the toxic nature of some types of mold, exposure can aggravate and even cause asthmatic
symptoms.
But legislation is slow to help renters.
The New York City Housing Department received 21,121 mold complaints in 2006.
Up from about 16,000 in 2004.
The housing department will dispatch an inspector in 24 hours if the problem is severe.
But there's no enforcement in the law that says landlords have to fix mold problems.
So there's no details given to them or procedures that they have to follow to address a mold problem.
So they do the cheapest, easiest thing, which would be to plaster over a problem, paint over the problem.
It's not surprising that the problem persists in low income neighborhoods.
The buildings are old and poorly maintained.
Dr. Hal Strellnick is a professor of family and social medicine at the Einstein School of Medicine.
And the author of several studies on the environment and asthma.
The issues of mold are often related to moisture and to leakage and unrepaird plumbing problems
that landlords are supposed to take care of.
So you have a lot of different problems that have to do with poverty.
Last spring, the public advocate introduced a bill to reduce indoor allergens, specifically mold hazards.
With the bill still in committee, Lopez won't be out of a job anytime soon.
That story comes to us from producer Lauren Bonner.
Still to come, making critical healthcare decisions should be a collaborative effort between you, your doctor, and maybe some other people.
That's next on the health show.
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This is the health show. I'm Bob Barrett.
And I'm Dr. Nina Sachs.
Dealing with illness and disease often forces people to make complex and emotional choices.
While it is natural and sometimes comforting for patients to value and rely on their doctor's advice in such frightening situations,
the jargon that doctors can sometimes use can be confusing.
And the variety of treatment options available doesn't clear up matters either.
In his new book Critical Decisions, How You Win Your Doctor Can Make The Right Medical Choices Together,
Dr. Peter Yubel, a physician, behavioral scientist and bioethicist at Duke University,
takes on this confusing and emotional topic in a way that tries to encourage all parties involved
to redefine the doctor-patient relationship.
Dr. Yubel spoke with a health show's Joe Donahue about the reason for writing this book.
Well, I got interested in this.
Been writing about this topic just because I struggled with it.
I've struggled with it. I'm both ends of the stethoscope.
I've been a physician, but I've been a patient, and I've been a spousive of a patient.
And I've seen how hard it is to get doctors and patients on the same page.
And yet I know that the right medical decision is often not just a medical fact,
but it depends on what a particular patient cares about.
And so if there's not a good dialogue, a good exchange, a good conversation between doctor and patient,
they might not make the right choice.
Do you think that it is often the patient's understanding that they don't have much say in the decision?
I think that's their belief. That's right.
And I think when I go to my auto mechanic, I don't say, oh, I think that way or I'd put it that way
or something, because I don't know anything about current, and then I trust my auto mechanic.
Do that. And I wouldn't tell my surgeon which is scalpel to use.
On the other hand, sometimes when the surgeon says, I think you need surgery,
it might depend on whether you want to take the risks of surgery, and there might be alternative
treatments that aren't so risky, and so archivist to go through. And you are the one who knows what
you care about, and so you have a role to play. So how do you empower the patient?
Well, what I try to do is get people to just understand what it's like to be in these situations.
So if they or their loved ones are facing such choices, it won't be brand new.
They'll seem stories like it before, they'll be able to imagine it better, and that helps prepare.
If you go into the doctor just expecting the doctor to kind of take over and tell you what to do,
you might not be ready for that decision, and that's what I try to prepare people to do.
You also talk about the importance of really creating a team of people, of friends,
and family, and talk about the diagnosis, talk about the decision because that network can then
relay a lot of the stories that they have personally, and which helps in the ultimate decision-making
process. Oh yeah, I even think you should bring loved ones to your visits if you can, and there are
times where you that might be uncomfortable or not what you want, but even going to a routine
checkup could be a lot of information come in your way in that 15 minute, 20 minute visit,
and to have your spouse there listening, asking questions, maybe asking questions to embarrass to ask,
that's a really helpful thing, have another set of ears and eyes.
Do you sense as a physician that when you are using terminology that a patient doesn't understand,
do you can you detect when they don't understand it, or is it really up to them to say,
I don't understand that? Yeah, no, it is, and it's strange to say that you'd think you'd go in,
and with the doctor starts throwing a bunch of words at you, it's a really normal human reaction
to feel overwhelmed, but to not allow, like you understand, if the doctor says, do you have any
questions, the polite thing to say is no doctor, thank you, but it's so important to understand
what your doctor's saying, one of the things I really try to teach people is how to politely ask
questions, or to say, you know, I didn't quest that can you say it again, I even think you can tape
record your visits, so you have a chance to listen to them again. And then as so many people do,
even with tape recording, when you walk out, then you are, then you come up with all the questions
that you wanted to ask when you have that few moments. So then do you ever get that chance again?
How do you then nail the doctor down again to ask the questions, it means something to you?
Yeah, that's a great point. You know, if it's a doctor, you're going to see again, of course,
you can do that. There are some doctors are increasingly accepting emails from patients for just
these kinds of clarification questions. And if I'd say if you're making an important decision,
you don't understand everything going on, you have more questions, and the doctor doesn't have time
to answer those questions, you might want to think about a different doctor.
You read about in the book and I found it interesting that if someone say, for example,
is deathly afraid of surgery, and they may not tell you that going in, but their whole apprehension,
the whole reason that they are putting up roadblocks to things that you are discussing is because
of this fear that they have. At what point is it on them to tell you that, and at what point
should you be able to detect that? All of us physicians need to strive to understand the world
from our patient's perspective to know what our patients are thinking and feeling, but that's a lot
easier to say than to do. Sure. And so while I try to give doctors tips in this book too, and I even
try to push that we change medical education so doctors are better at picking up these signals,
if you are the patient, assume unless you've been, you've set it out loud that your doctor doesn't
know what you're thinking or feeling. Do you have a sense that some of this is generational?
I think there are generational differences. I think my parents' generation might
earn around the late 80s. They really were raised in an era that doctors know best and do what you're
told, and my generation not so much. But I'll tell you, illness can age one pretty quickly, and when
you get sick, you get scared, it's amazing how quickly you start wanting to defer to someone and
just say, tell me what to do. It's a very normal response. I think one of the reasons you were
such a good advocate for your parents isn't just generational. It's because you weren't
the patient. Another reason to bring someone else in the room. Because a lot of that just has to do
with the relationship. You worry, you would worry about, I know when I was sick as a child, my mother
would go through hell on earth to find out what the answers were that question before she was
going to put me on a table, let somebody go after me with a scalpel. Sure. You know when I was buying
a car once, and I'd actually gone to one dealership a couple of times and really liked this one dealer,
and he didn't put a hard sell on me, really, he was my type of sales guy, but I don't want
it the price to be lower. So I bought a friend in, because I felt like, I liked the guy too much,
to be a good negotiator, and my friend came in, no compunction, just saying, hey, let's talk about
this price. You talk about this in the book that if you have time to decide, then take your time,
but of course you don't always have time, but if you have it, use it. Amen. And sometimes when you
feel like you don't have time, you should just ask. So you know, I'd like a little more time,
can I sleep on this? Can I talk to him or with family and friends, and if they say no, you know,
we were there to decide right now, well, okay. How important is the second opinion?
It can be very important, but I think when you have a doctor and a good relationship and you feel
like you understand your situation, you're in good hands. You should be lucky and you're unlikely
to find someone better on a second opinion. I guess this is a question I should have asked you at
the very beginning, but when it comes to critical decisions, what you term critical and what we
term critical may not be the same thing? Yeah, I know. I actually think critical decisions can
be quite mundane ones. Like, should I take that blood pressure pill? Should I make my blood sugar
much lower like my doctors ask me to? Even little things like that. There's pros and cons to them,
there's good and bad things about them that you need to understand, so you can decide whether that
blood pressure pill or cholesterol pill is good for you. It's critical to know that about every
healthcare decision if you can. And of course, then there are the critical decisions that really are
life and death of this surgery versus that surgery or this procedure that have a lot more writing on them.
Yeah, and that just ramps up the difficulty like put it on steroids, right? It makes it that much harder
because the emotions are stronger, the stakes are higher. And going back to an earlier point of
talking about patients bringing in different people and bringing in advocates and bringing in people
a team, if you will, that are interested in the outcome of this decision that you as a physician
like to see that, right? You want to see that team Joe come in and talk about what the issues are
because then there's more ears, there's more information and ultimately more questions that I assume
you're asked. Well, you see, you've kind of put your finger on it there. I like it in theory,
and often it's the best thing, but I'll tell you, there are going to be times where that's going to
be hard for the physician if there's a bunch of people and they all have a bunch of questions and
time is tight. And so that's why the more important and more serious the decision and a major surgery
you're going through, whether it's going to be intensive care unit for advanced illness, whether
to have chemotherapy for cancer that didn't respond to the first chemotherapy. You should have
people to help you and the doctor should be willing to take time. Again, the name of Dr. Peter
Yubel's new book is Critical Decisions, how you and your doctor can make the right medical
choices together. He spoke with the health shows Joe Donahue.
That's all the time we have for this week's health show. If you'd like to listen again,
join us online at healthshow.org. You can explore the archive for any programs you might have
missed or would like to hear again. You can also subscribe to our podcast that's healthshow.org.
Want more? Then follow us on Facebook. Just go to facebook.com slash the health show.
And if you have any questions or comments about the program, send them in.
Our email address is letters at healthshow.org. I'm Bob Barrett and I'm Dr. Nina Sack.
Stay healthy and be sure to join us next time for another edition of the health show.
Dr. Nina Sack is a practicing member of the American College of Gastroenterology.
Bob Barrett is producer of the health show. Dr. Alan Shartock is executive producer.
The health show is a presentation of national productions, which is solely responsible for its content.
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