Additional audio editing by Matt Largey form Boston’s WBUR radio station.

When FBI Agent Renee Walker attempted to revive a car accident victim on the popular television show 24 last season, the victim had no chance.  Agent Walker only pushed weakly a few times on the victim’s chest before giving up.  Her compressions were shallow, her timing too slow, and her demeanor glamorous—but distracted.  It’s no wonder the patient died.

24 CPR from Meredith Sorensen on Vimeo.

In real life, effective cardiopulmonary resuscitation (CPR) looks brutal—and it should.  In order to keep blood moving and provide oxygen in patients whose hearts stop unexpectedly, chest compressions have to be forceful and fast.  Rescuers must assume a stiff-armed, dominating posture above the victim, who must be lying flat on a hard surface.  Rescuers must push on the patient’s chest hard enough to actually compress the heart, meaning the entire chest wall should be depressed by 2 inches—about the width of an 800-page paperback.  That’s a big distance for bones to move, and ribs often snap.  The compressions must be given at an exhausting pace—ideally 100 per minute—and continued until medical help arrives.  It may sound violent, but, as Agent Walker showed, gentle CPR does not save lives.

In fact, the CPR technique used by actors in television shows and movies rarely would be good enough to save a real patient.  That’s a problem because the entertainment industry reaches far more people than the American Heart Association or local emergency services, the organizations that offer formal training in CPR.  Indeed, 70-92% of the general public reports that they receive most of their information about CPR from television.  If they see it wrong, they will do it wrong.

Unlike most medical interventions that are based on the skill of specially-trained medical professionals, successful CPR depends on knowledgeable members of the public.  After a person’s heart stops, CPR must be started within 4 minutes—preferably sooner—in order to prevent serious damage to the brain, heart, and other vital organs.  Even the fastest emergency medical services rarely arrive that quickly.  So, the burden of initiating timely and effective resuscitation efforts falls to lay people—the same people who admit to learning about CPR primarily from television.

Although doing chest compressions is a kinetic experience, effective CPR also looks different from ineffective CPR.  Proper technique starts with positioning, which is easily observable.  Rescuers should kneel or stand over the victim, place the heel of one hand in the middle of the victim’s chest between the nipples, and overlap the other hand over the first for reinforcement.  With straight arms and locked elbows, rescuers push forcefully on the breastbone using the weight of their entire upper body to depress the chest by two inches—a distance big enough to see.  Any shallower and the compression won’t generate enough pressure in the heart to squeeze blood out to the rest of the body.  After every compression, the chest must be allowed to recoil, or bounce all the way back to its normal position.  This allows the heart to refill.  Uninterrupted compressions given at the rate of 100 per minute promote blood flowing forward.

It would be easy to show these essential components of CPR on film, and yet producers rarely do.  Actors often give weak chest compressions with bent elbows.  On an episode of Baywatch, David Hasselhoff teaches ten other lifeguards to give CPR.  Their arms are tanned and muscular, but none of them are appropriately straight.  In other episodes of Baywatch as well as in episodes of Lost, the actors correctly lock their elbows, but do not push nearly hard enough.  Their shoulders merely twitch or their heads bob rhythmically, but they do not actually use their upper body strength to compress the victims’ chests.  Close-up shots of the patients show no depression or recoil of the chest.  Timing of compressions on television also varies too widely.  In general, they are too slow.  Nowhere is this more pronounced than in Friday the 13^th: Jason Lives, in which the actress playing Megan gives Tommy one weak chest compression every four seconds.  Miraculously, Tommy recovers to sit up and embrace his savior.

On television, CPR often serves as an entrée to sensual scenes.  Rescue breathing frequently morphs into making out when the attractive victims simultaneously regain consciousness and lust for their rescuers.  Interestingly, mouth-to-mouth resuscitation, which figures so prominently in fictional CPR scenes, actually matters much less than chest compressions in terms of physiology.  The official American Heart Association algorithm still teaches rescuers to give two breaths after every 30 chest compressions, but recent studies suggest that survival rates are similar when bystanders give compressions only.  If Hollywood portrayed CPR as mere rib crunching, they may have fewer excuses for unlikely pairings of characters to lock lips, but the survival of these characters would be far more believable.

CPR on television has come under fire before.   TV shows and movies depict survival rates that far exceed even the most optimistic rates in real life. At least 75% of fictional film characters survive CPR, whereas only about 40% of real patients do—and many of them suffer from serious complications.  A 1996 New England Journal of Medicine article criticized television shows for that very reason, claiming that inaccurate depiction of survival after CPR on TV leads to unrealistic expectations by patients and families.  While this may be true, the outcome of CPR on screen matters far less than how well the actors do it.  Perhaps if their technique were perfect, a 75% survival rate would not be quite so far-fetched.

Some producers and directors might think that depicting CPR correctly cramps creativity, but this is simply not the case.  In a scene from Season 5 of The Office, Michael Scott organizes a CPR class for his employees after one of them suffers a heart attack at work.  The roughly four-minute scene delivers plenty of laughs and pokes gentle fun at the American Red Cross and the stereotypically uptight instructor.  However, it also packs in several accurate and memorable facts—such as the initial assessment of unconscious patients (Airway, Breathing, and Circulation) and timing compressions to the tune of the Bee Gees’ song Stayin’ Alive (a recommendation published in a real study from the University of Illinois).  Not to mention, the actors’ techniques are reasonably good.

The Office CPR from Meredith Sorensen on Vimeo.

Despite this model example, there is no real incentive for the entertainment industry to change.  They include CPR in order to heighten drama, not to educate the lay public.  Hollywood has been criticized for other portrayals of behaviors that negatively affect public health, most notably for glamorizing smoking.  Proving the strength of this subliminal message, however, is impossible.  Similarly, proving that modeling effective CPR on film actually saves real lives cannot be done.  Consequently, Hollywood would have to modify their depiction of it based upon an altruistic assumption.

Granted, fictional television shows and movies are not training videos, but a few simple changes would drastically improve the accuracy of CPR on screen.  If actors consistently straightened their arms, locked their elbows, pushed harder, and pushed faster, it would provide a positive model for the public.  Then, in the event of a real emergency, people would be more likely to save lives by doing CPR “as seen on TV.”

If you make it right, it’ll even float.

Each year, the American Society of Civil Engineers (ASCE) puts on the National Concrete Canoe Competition, for which engineering undergraduates formulate, troubleshoot, sift, mix, and cast concrete canoes. Then they race them.

More than 250 ASCE student chapters from the U.S. and Canada compete in the regional competitions. But the competition is as stiff as the stone they race; only a handful of teams make it to nationals. To win, students must not only craft a stone canoe and paddle it speedily down a river–they also need to earn top scores for the canoe design, technical write-up, and oral presentation.

Wentworth Institute of Technology in Boston, MA made their canoe debut in 2005. They started out with a bang—taking regionals, and winning 17^th place in the national competition. Since then though, it’s been a challenge: in 2006, they took third in the regional challenge and won fifth in 2007. But since then, they haven’t placed.

But this time, headed up by sophomore Joe Jazwicz, Wentworth’s canoe club team is starting earlier, running more cement experiments, and busting out the creativity.

It’s a crew race—engineer-style.

For many western fly-fishermen, climate change is hitting too close to the snow-fed trout rivers they call home: trout populations are declining throughout the interior west as water temperatures rise, habitat ranges shift and buckle, and stream ecosystems collapse. In fact, recent studies conducted by federal agencies and trout conservation groups predict that by century’s end climate change will decrease suitable trout habitat in the American west by 50 percent or more. Indeed, the impacts of climate change on trout are as clear and chilling as the water in which the fish have tenaciously survived since the Pleistocene, one million years ago.

Less clear, however, is how waning trout populations will impact the state and local economies that derive millions of dollars from trout-related recreation every year. Local trout shops, guides, and outfitters rely on the health and stability of trout fisheries. However, climate change has increased the frequency and intensity of winter flooding, summer drought, and forest fires. And it is unclear if these businesses will be able to adjust quickly enough to compensate.

Climate change for trout begins high above their river residences. Mountain snow pack, a frozen, natural reservoir of the cold, clear water that nourishes trout streams and their piscine populace is decreasing. The chief cause is a rapid rise in western air temperatures. According to the Rocky Mountain Climate Organization, a non-profit coalition of businesses and environmental groups, the five-year average temperature for Montana, Wyoming, Idaho, and Colorado is two degrees higher today than it was in those states a century ago.

As the air warms, precipitation patterns change. More snow now falls as rain in the winter, which leads to smaller mountain snow packs. Normally, snow pack melts incrementally during the spring and summer, providing rivers a constant supply of cold, clear water. But smaller average snow packs mean that western states are not getting the mountain water storage they need to maintain stream flows during the year. Bruce Farling, Executive Director of Montana Trout Unlimited, says that for eight of the last ten years Montana has seen below average stream flows. On top of that, he says, severe droughts, which plague nearly every western state, are preventing beleaguered streams from being naturally replenished by spring and summer rains.

Decreased stream flows directly affect trout, which depend on cold water to survive. Less water means less suitable habitat for fish because shallow water heats up faster. “All salmonids (a family that includes trout, salmon, and whitefish) have pretty limited temperature ranges,” somewhere between 50 and 65 degrees Fahrenheit, says Jeffrey Kershner, Director of the United States Geological Survey’s (USGS) Northern Rocky Mountain Science Center in Bozeman, Montana. At these temperatures, water contains enough dissolved oxygen for adult trout to respire or “breathe” and for young trout to develop. Beyond 60 degrees, however, dissolved oxygen decreases, and trout begin to suffocate.

Ominously, climate models indicate that surface water temperature in many western rivers and streams will increase if air temperatures rise beyond 5.4 degrees Fahrenheit. In fact, scientists predict a rise in average air temperatures anywhere from 5-10 degrees by the end of the century, according to the NRDC.

Dwindling snow packs indirectly influence trout populations as well. Consistent supplies of snow pack runoff helps reduce the frequency and intensity of forest fires. “When forests dry out, wildfire activity picks up,” says Jack Williams, Senior Scientist for Trout Unlimited. “This can have some serious ramifications for trout fisheries.” Intense forest fires burn away the vegetation that anchors soil and sediment in place. This liberated sediment can enter streams in large quantities and muddy up the clear, oxygenated water that trout eggs require for development.  Streams containing more than 15 to 20 percent of fine sediments like silt or clay, Williams says, threaten trout eggs. “The sediment gets into spaces between gravel and the eggs die from lack of oxygen.”

As diminished snow packs melt earlier and faster, many western states now experience more frequent and powerful spring and winter flooding. These floods are the combined result of rapidly melting snow pack and increased winter rains when there should be snow. They can devastate fall-spawning species like brown and bull trout, which lay their eggs in river gravel during the fall to over-winter for a few months before hatching in the spring. Frequent and intense winter and spring flooding effectively scours the eggs from the river bottom, killing the un-hatched fish in a roil of sediment and stones.

As trout populations suffer, however, so too will the trout angler’s experience and all of the businesses inspired and supported by that experience.   According to the American Sport Fishing Association, the country’s 40 million anglers produce nearly $50 billion in retail sales a year. In 2002, Colorado sport fishing supported more than 10,000 jobs and generated nearly $800 million for the state. And in Montana, angling produces nearly $300 million dollars for the state, annually.

Most of this money is generated during the summer when vacationing tourists seek refuge from their sweltering cities and flock to the cool, trout-filled rivers of the Rocky Mountains. But as the West warms, peak trout fishing season shifts to months when people can’t take vacation. “Most out-of-state anglers are geared to fishing June through September,” says Dave Kumlien, outfitter and owner of Troutfitters fly shop in Bozeman, Montana. “You might have a handful of hard core guys who can come and fish earlier but most people just can’t do that.”

This seasonal shift is largely the result of prolonged and widespread summer fishing closures on western rivers. These closures are instituted by the Department of Fish, Wildlife, and Parks (FWP) when water temperatures exceed the thermal limits of a river’s trout population. From 2001 to 2007, the FWP ordered161 fishing closures in Montana alone.

In July of 2007, for instance, hundreds of rainbow and brown trout died when temperatures in Yellowstone National Park’s Firehole River reached 82 degrees Fahrenheit. The event prompted a highly publicized river closure that many guides say deterred potential clients. That’s because river closures, which generally begin in the afternoon, force anglers to begin their day well before the sun comes up. This is a problem for guides whose clients would rather cancel their trips than get up at 5:00 a.m. to accommodate closures.

Other fishermen will cut their trips in half.  But “Half days equal less tackle and less equipment which means less money coming in,” Kumlien says.  In addition, the quality of fishing in rivers warm enough to warrant closures is generally poor since the thermally stressed trout are sluggish and weak. Consequently, summer tourists cancel their trips and truck their rods to cooler, Canadian waters where trout are in better shape. This adversely impacts western fly-fishing businesses that depend on the summer tourism to keep them financially healthy during the off-season.

Changes in insect hatches also promote a seasonal shift. The emergence of mayflies, a primary trout food, coincides with the tail end of peak runoff and, Williams says, the insects have been shown to emerge earlier in warmer water. So, as rivers warm and runoff peaks sooner, mayflies that normally hatch in June and July are now emerging in March and April. “When popular hatches shift to these earlier months”, says Kumlien, “people don’t come in the same numbers they used to and you have fewer guides and outfitters running around.”

Ultimately, climate related changes restrict trout habitat, and less habitat means fewer fish. Over time, trout will retreat to higher, cooler tributaries to escape the starving flows of the West’s progressively tepid main stems. As a result, easily accessible and heavily-fished rivers like the Madison in Montana and the North Platte in Wyoming may empty of fish and, hence, fishermen. Over time, guides and their clients may have to travel farther to find fish. And because the higher elevation streams to which trout populations will move are narrow, steep, and more difficult to access, outfitters may be pushed out of the float-fishing business.  Similarly, prolonged drought, violent runoff and flooding will make boat access to floatable rivers more challenging.

Scientists are only just beginning to quantify the economic impacts associated with climate change; so much is left to speculation.  But the trout that swim beneath the West’s imperiled rivers and the anglers who cast feathered trickery upon them can’t wait for calculation. “If we wait for hard and fast numbers to act it’s going to be too late,” says Farling.

Williams believes the best way to mitigate climate change impacts on trout and their associated economies is to manage river systems responsibly; to ensure that trout are not forgotten in our rush to seize water for irrigation, recreation, and cities.  “One of the most important things we can do,” he says, “is to make sure river systems are in good quality. Because those that are in good shape can withstand the disturbances associated with climate change and they will be able to bounce back.”

After all, fly-fishing is not simply a past time. For many western states, it is a way of life, a western heritage built on blue-ribbon trout streams and supported by family-owned fly-shops and outfitters. Protecting these businesses and the millions of dollars that trout angling generates begins by protecting the resource: the beautiful and boisterous beasts caught in the swift current of a changing climate.

To learn more about western fisheries and trout conservation click here!

Scrubs used to be the best medical show on television by far.  Past tense.  Season 9 premiered with two episodes that aired December 1 on ABC, and I want to sue the producers for malpractice.  The show has made too many changes to maintain its integrity, but too few changes to give it an entirely new identity.  Instead, this bastardized mish-mash demotes Scrubs to a mediocre medical drama on par with all the others.

I knew many original cast members had left.  I knew that the premise of this new season was to create a show about medical students based at Sacred Heart Hospital.  I still thought it had potential.  After all, Frasier was a pretty successful spin-off from Cheers.  And, in real life, medical school is a recipe for funny:  take a bunch of smart people, mix in a lot of stress and a little competition, and throw them into some awfully awkward situations.  Unfortunately, this new iteration of Scrubs completely misses the mark.

Not surprisingly, the best part about the new Scrubs is the old cast.  Dr. Cox is still hilarious.  As he has for the past eight years, John C. McGinley thrives in his role as a ranting, lovable jerk.  Kelso, played by Ken Jenkins, is still an amusingly cantankerous old man.  The bromance between J.D. (Zach Braff) and Turk (Donald Faison) continues to flourish.  However, even these familiar elements feel a bit empty without the supporting cast.  Brief cameos by Sarah Chalke (Elliot) and Neil Flynn (the Janitor) weren’t enough to infuse their personalities into the show, and without Judy Reyes (Carla), Turk’s character seems a little flat.

Still, my disappointment goes much deeper than a sentimental yearning for an original cast reunion.  I was willing to give this version of the show a chance to make it on its own merit.  It’s just that the new characters simply don’t cut it.  Whereas the old crew featured complex characters, each with annoying traits balanced by endearing ones, this group is a bunch of irritating caricatures.  The writers have gotten several of the med student stereotypes right: the overeager but insecure Lucy, the entitled Cole, and the slacker Drew.  (Even if they are going for one-dimensional generalizations, though, they’ve missed a few.  What about the bookworm who spends every second of her spare time in the library or the guy who is so socially awkward you wonder how he’ll ever interact with his classmates, let alone his patients, or the gunner who asks everyone else about their MCAT scores on the first day?)  The point is, every medical school class has its “types,” but as a Scrubs viewer, it’s no fun being able to categorize them already.  Undoubtedly, the characters will evolve on the show, but there’s nothing surprising about any of them at the start, and that’s just plain boring.

Photo Larry at http://www.photolarry.com/

Ironically, even though the show now has a female narrator in Kerry Bishe’s Lucy Bennett, the Scrubs women have taken a fall.  For the first eight seasons of Scrubs, Chalke’s Elliot (while admittedly insecure at times) showed that women do not have to give up their femininity to succeed in a professional career.  Reyes’ Carla was a strong positive role model—an intelligent advocate for her patients, a loyal girlfriend to Elliot, and a supportive wife, all while maintaining her own independence.  Lucy, at least so far, is a simpering sycophant.  Even in her attempts to stand up to Dr. Cox in the climax of the first episode, she appeared weak and annoying.  I was secretly rooting for Dr. Cox to crush her.  The other two developing female leads fall short as well.  The Australian medical student may eventually show some spunk, but for now she is simply a vapid butt of Dr. Cox’s jokes.  And, Denise, a holdover from Season 8, is occasionally funny, but generally an unlikable crude mannish hussy.

Speaking of which, the show’s degeneration into Gray’s Anatomy-like debauchery is also irksome.  Of course, the characters’ love lives were important sub-plots in the first eight seasons (and real-life hospital romances are common gossip fodder), but now undeveloped flings seem to be taking center stage on Scrubs.  Lucy sleeps with Cole before we really know either character.  Denise and Drew’s affair comes out of nowhere (and therefore Denise’s emotional attachment is unconvincing).  And, whereas “The Todd’s” sexual innuendo has been consistently funny for eight years, Cole’s sleaziness takes it a step too far.   Sex sells, and Scrubs has sold out.

The saddest thing about the new Scrubs is its divorce from the truth.  Once widely recognized among medical professionals as the most accurate medical show on television, the writers seem to have stopped doing the research for Season 9.  Especially for the first four seasons as the main characters progressed through residency, the show was spot-on in terms of the tasks they did, the types of patients they saw, and the fears they had.  Only two episodes in, Season 9’s script has lost that completely.  Granted the feeding frenzy over the “crappy pizza” during orientation and the juvenile “do-we-have-to-take-notes” scene are universal medical school experiences, but it’s pretty sad when those were the most truthful parts.

For one thing, residents never serve as teaching assistants or RAs, like Denise is doing in the show.  Residents take care of patients, and while they are expected to teach medical students during their clinical rotations, they absolutely do not help out in the classroom.  And, most medical schools don’t even have conventional dorms, so the idea of a resident acting as a dorm counselor is absurd.  If the writers felt compelled to create a college scene, maybe this should be a show about pre-meds.

Infinitely more disappointing is the lack of accuracy within the hospital itself.  Medical students do not see patients right away.  At most medical schools, students spend the first two years in the classroom and the anatomy lab.  When they do go on rounds or see people in clinics, the patient encounters are generally awkward contrivances rather than actual contributions to care.  They practice on “fake patients” (i.e. actors who are paid by medical schools to pose as patients at scheduled sessions) and shadow “real” doctors, but they do not actually participate in patient care until the third year of medical school.  Consequently, it is exceedingly unlikely that Dr. Cox would even see these students in a hospital-setting, and it is downright impossible that Lucy could have recognized her group’s cadaver as one of “her” former patients.  Not only is this frustrating for viewers who once admired the show for its authenticity, the writers have stupidly stolen their own built-in narrative.  These do-it-all med students have no room to grow.  If they’re already fully functioning members of the team in their first days of medical school, what on earth will they do for the next four years?

We can only hope this lame version of Scrubs won’t last that long. In the Season 9 premiere, Denise rounds on a comatose patient and says, “Man, I wish his family would just let him die.”  I wish producer Bill Lawrence had been graceful enough to do the same for his show.

Viruses are mindlessly competent, ruthlessly efficient, and so simple they blur the line between life and non-life. Yet we humans, despite our elaborate nervous systems and thousands of genes, can barely keep pace.

Modern technology has allowed us to begin combating viral infections, but many still afflict our daily lives. These are not necessarily the diseases that overwhelm our news headlines—rather, they’re the chicken pox, the seasonal flu, and the common cold. Sometimes, they’re the viruses we didn’t even know we carried. So how about a moment of respect for these tiny, beautiful plagues of daily life?

The Flu

We’re bigger, brainier, and have technology on our side—but we still can’t stamp out influenza. Every year, those microscopic sacs of 11 genes manage to evade and elude us.

The inner workings of the influenza virus. Photo credit: CDC/Dan Higgins/Douglas Jordan. http://phil.cdc.gov/phil/details.asp

The key to influenza’s repeated success stems from two proteins studding the outside surface of the viral particles: hemagglutinin (H) and neuraminidase (N). When the body mounts a defense against the virus, it remembers those proteins so that the next time, it can catch the virus before it wreaks havoc. Unfortunately for us, influenza has a few tricks up its membranous sleeves. It is advantageously sloppy as it copies and proofreads its genetic material. Sometimes, it sticks adenine where there ought to be a cytosine, or a guanine where there ought to have been a thymine. These little changes add up. By the time the next flu season rolls around, the face of the virus has morphed into something a little less recognizable.

But influenza’s most stunning shapeshifting comes about through a process called antigenic shift. When this happens, the virus shuffles its genetic deck to create a new incarnation of itself, unknown to vaccine-makers and immune systems alike. Shift happens for two reasons: First, influenza viruses store their genetic information not in one long strand, but in eight separate segments. When it infects a cell, those segments are dumped out for replication. Second, some animals—like pigs—can be infected by multiple versions of flu simultaneously, like swine, avian and human. If that happens, and if those viruses all happen to go after the same cell, then they can swap out genetic information and recombine into a whole new strain.

Our T cells never had a chance.

Respiratory viruses have little difficulty getting around, despite their lack of limbs. A sneeze is worth a few million virions.Photo credit: Tim Vickers/CDC, via Wikicommons. http://commons.wikimedia.org/wiki/File:Sneeze.JPG

The Common Cold

Almost everyone in their lifetime will contract some form of the common cold—hence the descriptive common.  Technically though, the ‘cold’ covers a spectrum of minor pathogens. Some people might contract the rhinovirus or maybe the coronavirus. But five to ten percent will get the adenovirus: a misery-inducing, fever-producing virus that just happens to be one of the most studied viral vectors in biomedical research.

Viral vectors provide scientists a chance to turn the table on our microscopic invaders, making them work for us.  In essence, parts of another less manipulable or more dangerous virus like Ebola are inserted into the genetic code of the vector virus. The Ebola-flavored vector enters the body and revs up the host defense system. The end result: immunity not only to those cold proteins, but to those key pieces of Ebola.

There are many faces to the beautifully geometric adenovirus particle--twenty, to be precise. The viral shell is arranged as a twenty-sided icosahedron, made up of an elaborate latticework of about 252 different subunit. Photo credit: CDC/Dr. G. William Gary Jr. http://phil.cdc.gov/phil/details.asp

Lots of viruses can serve as vectors, but the adenovirus holds a special place in the heart of many a geneticist. Of all the vectors out there, the adenovirus genome has been so well picked apart that tweaking its code has become old hat. By now, it has appeared in more human clinical trials than any other vector so far. It’s a small virus, so it doesn’t have as many proteins to compete with the added antigens, unlike the pox or herpes virus vectors. But it’s still large enough to comfortably fit two to three antigens without becoming unstable. The adenovirus also stays in the body for a long time—up to ten days—without necessarily killing all the cells it enters. That means the immune system can take a long, hard look at the foreign antigens.

The Viruses in our Genes

Most diseases make themselves known as they set up shop in a person’s cells. But there’s a class of viruses so indelibly everyday that few people ever realize they’re infected. From conception to death, human endogenous retroviruses (HERV) make up eight percent of our genomes.

Retroviruses act opposite the typical genetic cycle. Instead of transcribing from DNA to RNA to protein, they reverse transcribe their RNA into DNA, and then integrate it into our DNA. In a generic cell, that integration only goes so far. But if the retrovirus happens to infect an egg or sperm cell (and doesn’t kill or cripple the fetus that results from that cell), then its legacy can continue indefinitely. But that said, millions of years spent traveling down our ancestry has rendered most of these now-endogenous retroviruses defunct. It’s as though someone jammed an image into a Xerox machine and let it mash around for a few million years. After a while, the image gets a little screwy. Still, just because they’re defective doesn’t necessarily mean they’re out of the picture. Some retroviruses have been key to our evolution. They’re critical to the existence of the placenta and they maximize how well we digest our starches. But some, like the HERV-K family still produce virus-like particles and proteins. HERV-K members have been found in various cancers, but it’s not clear why yet. In fact, over the years, retroviral genes have been tied to all sorts of problems, including cancers, diabetes and lupus. But again, no one knows for sure whether and how much they cause or exacerbate these conditions.

The Chicken Pox

Up until the 1995 vaccine program went into effect, chickenpox was about as common as puberty. Except that, unlike puberty, it sometimes came back. The virus, varicella zoster, belongs to the same family as genital and oral herpes, but with less stigma. It usually makes a single (spotty) appearance during its host’s childhood, then goes dormant for decades–waiting for an encore. Same virus, different diagnosis: shingles.

How it does this is a bit of a mystery. However, the varicella zoster community has pieced together a tale to the best of their ability, and it goes something like this: As a patient scratches through the throes of chickenpox, th­e virus sneaks through an open sore and hitches a ride back to the heart of a spinal cell. There, instead of going into its usual hijack-replicate routine, it allows the cell’s defense mechanism to kick in. The cell coats the invader with little proteins called histones, which wrap the DNA around themselves so tightly that transcription grinds to a halt. The virus goes dormant.

Nearly a lifetime later though, the virus suddenly revs up the protein-making machinery, hijacks its host, and kicks off a new breakout. The only difference is that this time, the pox only shows up in the one span of skin that the infected nerve covers. Just what sets off this revival remains unclear—it could be old age, or a weakened immune system from disease, or something else. But one thing’s for sure:  it’s the perfect strategy. The virus runs through one generation and then lays low for a few decades. By the time it reactivates, a whole new generation of children await, just yearning to hug their be-shingled grandparents.

St. Valentine’s Day as we know it is largely the brainchild of greeting card companies and Geoffrey Chaucer. In his “Parliament of Fowls”, the English poet details the events of the 14^th of February, when the beasts of the air gather to choose their mates. Birds, it turns out, have been perfecting the art of courtship long before Valentine’s Day was a twinkle in Hallmark’s eye.

A male Indian peafowl (Pavo cristatus) displays his brilliant plumage.

Love often inspires demonstrations that appear quite mad. Case in point: the peacock’s tail. Darwin himself was vexed by this appendage, which appears to be the result of temporary evolutionary insanity. Blazing colors advertise the peacock’s location to his predators as well to his paramour. Its weight hinders escape. Why would nature produce such a beautiful death sentence?

The answer, as Darwin found, lies in a special corollary to “survival of the fittest”: sexual selection. In retaining his splendid tail, the peacock gains more by attracting females than he loses by decreasing his own chances of survival. The opportunity to pass on his genes motivates him more than ensuring his own safety.

Female (left) and male (right) satin bowerbirds (Ptilonorhynchus violaceus) in a courtship ritual.

But success involves more than length of your feathers. Sometimes, the most ostentatious display isn’t the smartest strategy. During courtship rituals the male satin bowerbird builds little bowers, shaped like huts, out of twigs.   Females make a round of visiting all the males, squatting in each hut in turn. Meanwhile, the male then runs back and forth, fanning his feathers  and emitting a pulsing cry. The display is aggressive, though, and if the male overdoes it, the female will flee.  Not unlike their human counterparts, male bowerbirds walk a fine line between advertising their wares and killing the mood.

Dr. Gail Patricelli of the University of California at Davis, who studies the birds, used a novel mechanism to gauge a male’s social sensitivity- a robotic female bowerbird.  She placed the “fembot”in a bower and manipulated the controls to make the robot crouch higher or lower. Real females will adopt a lower stance when they are more receptive to mating.  A higher one signals that she is nervous.  Some males scaled back their displays when the fembot showed reluctance, while some plunged on regardless.  Dr. Patricelli compared the behavior of the male bowerbirds towards the robot to the number of successful courtships with real females.  The results, published in a supplement to the Journal of Ornithology, suggested that males who best tuned the intensity of their displays to match the fembot’s mood would later have the greatest mating success with non-robotic partners.

Sometimes, courtship becomes too complicated for one bird, and he needs a little help from his friends. Taking a cue from Facebook, David McDonald from the University of Wyoming mapped the social network of a subpopulation of long-tailed manakins. In this species of songbird, the males have a unique arrangement. A pair of unrelated manakins will team up to perform a kind of backwards leapfrogging dance for curious females. However, the pas de deux only pays off for one of the partners. The younger male never mates. He’ll only have the opportunity for romance once his older partner dies.

Long-tailed manakins (Chiroxiphia linearis) performing a courtship dance.

The dance of the manakins seems to defy evolutionary sense. Actively assisting a genetic competitor isn’t exactly Darwinian. Manakins, however, gain an advantage by playing wingman. In the biological journal of the Royal Society, Dr McDonald reports that those males who had the largest number of connections to other males eventually had the greatest mating success when they became alphas themselves. McDonald suggests that in pair courtship, females are rating the overall performance rather than paying attention to the individual. “It’s the restaurant,” he says, that garners a good reputation, “not the chef”. Sexual selection might appear to make fools of birds and men, but it’s a foolishness that’s finely tuned for romantic success.

Although people perpetuate the urban legend every year around this time, the tryptophan in turkey is not responsible for the Thanksgiving food coma.  (In fact, you get tired because your stomach steals blood flow from your brain to help digest the huge meal.)  Still, there are plenty of other ways in which your tasty Thanksgiving feast is out to get you.

WISHBONES: NOT ALWAYS SO LUCKY

People swallow weird stuff all the time.  The most common unintentionally consumed objects include dentures, toothpicks, cocktail sticks, and bones—all of which make regular appearances at gatherings revolving around family and food.  And, when people eat too much, too fast…or when they talk so much, they don’t chew properly…or when their dentures don’t fit right, they often don’t even know they’ve swallowed anything unusual.

In 99% of cases, these ingested “foreign bodies” pass right on through.  But, in the unfortunate 1%, these objects can punch a hole in the intestines along the way.  This depends on the length and the sharpness of the object—but toothpicks and bones tend to be pretty long and pretty sharp.  As they journey through the intestines, they tend to do their damage in places where the tube gets narrow or takes a turn, like where the small intestine meets the large one or where the large intestine meets the rectum.

A hole in the intestine, called a perforation, requires immediate surgery.  Patients complain of severe abdominal pain and often have a fever.  The tricky part is that these symptoms often show up about two weeks after the ingestion—so even if someone knows they swallowed the wishbone, they often won’t relate it to the pain.

It’s better to avoid this problem altogether.  So slow down, chew your food, and make sure whoever carves the turkey does a good job.

DOES A “CEREUS” PROBLEM LURK IN YOUR MASHED POTATOES?

Raw potatoes almost certainly contain some Bacillus cereus—a ubiquitous bacterium that is usually killed when food is cooked.  However, B. cereus can form heat-resistant spores that lie dormant until the right conditions trigger them to germinate.  These spores are particularly resistant to dry heat, making them well-suited to survive the manufacturing process of dehydrated potato flakes.

The spores themselves are harmless, but when you add heat and moisture (i.e. when you cook the potato flakes), they transform into normal bacteria, able to grow and reproduce.  Strains of B. cereus that flourish in starchy foods produce an emetic toxin—i.e. a poisonous substance that makes you vomit.

At least 100,000 viable B. cereus cells per gram of food must get together to produce enough toxin to make you sick.  Levels of B. cereus spores in American boxed potato flakes have been measured between 100 and 4000 cells per gram.  They can still wreak havoc.  It only takes 2.5 hours from the time the flakes get rehydrated until the bacteria starts to grow, so boxed mashed potatoes that are not served right away can cause problems.

If you opt for the convenience of dehydrated potato flakes to make your mashed potatoes this Thanksgiving, make sure you don’t let them sit out on the counter for too long.  The vomiting associated with B. cereus toxin can hit within one hour of consuming contaminated food.  That sure would ruin the pumpkin pie.

GRAVY-TRIGGERED REVENGE OF THE LITTLE GREEN STONES

The average Thanksgiving meal contains 229 grams of fat—more than three and a half times the recommended daily allowance.  That often means pain for the more than 20 million Americans with gallstones.

A normal gallbladder is a robin’s-egg blue pouch plastered to the underside of the liver.  It stores bile, a greenish watery substance that the liver produces for fat digestion.  Gallstones, which are most common in women over the age of 40, form when too much cholesterol gets into the bile.  The cholesterol then crystallizes into greenish pebbles that reside in the gallbladder.  Thirty-five percent of people with gallstones never even know they are there.

The other 65% know it all too well.  After a fatty meal, the small intestine produces a hormone called cholecystokinin (CCK) that tells the gallbladder to contract and release bile.  The problem comes when a gallstone finds its way into the duct and prevents bile from coming out.  The gallbladder keeps squeezing against the obstruction—which can cause excruciating pain, nausea, and vomiting.

The symptoms usually resolve within minutes to hours: the stone either drops back into the gallbladder or slips through the duct and into the intestine.  If attacks occur frequently, the gallbladder can be removed.  Sometimes, the offending stone gets hopelessly stuck, leading to a swollen and inflamed gallbladder.  These patients don’t get better and usually require surgery sooner rather than later.

So, especially if you know you have gallstones, lighten up on the gravy—if you have to go to the emergency room, you’ll miss all the football games!

NO TURKEY TROT FOR A SORE TOE

Many people associate gout with Henry VIII and lavish Renaissance banquets, but our traditional Thanksgiving spread has much in common with those lavish feasts.  Indeed, many elements of our Western diet put us at risk for problems associated with dietary extravagance.  There are 3-5 million people with gout in the United States, and the number is growing.

Lots of stuff on the Thanksgiving table–organ meat (i.e. giblets in gravy), white meat (i.e. turkey), and fatty, cholesterol-laden foods–contain high levels of a chemical called purine.  Usually, the kidneys break purine down into uric acid, which simply gets peed out.  But, some people either can’t get rid of uric acid or make too much of it.  The excess uric acid in the blood forms sharp, spiky crystals that collect between the joints and cause a very painful type of inflammatory arthritis.

These acute gouty attacks usually involve a single joint, most frequently where the big toe meets the foot.  The joint gets red and swollen and is so painful that people describe not even wanting the bed sheet to touch it at night.   The attack peaks about 12-24 hours after symptoms start, and (even without treatment) goes away by itself within a few days to several weeks.  In the meantime, anti-inflammatory drugs, like ibuprofen and its stronger cousins, can help treat the symptoms.  Some people, who have chronic problems with gout, must take medications every day to try to prevent it.

Almost everything served at the Thanksgiving meal can cause problems for someone with gout.  Even peas and asparagus are high in purines, and the yeast in beer also commonly triggers flare-ups.  So, be careful—you don’t have to run in a turkey trot to get sore joints from Thanksgiving.

LOADING UP OUR PLATES

One third of Americans are overweight, more than one third are obese, and Thanksgiving isn’t helping.  What American hasn’t chuckled about holiday weight gain?

It’s easy to overlook packing on a few extra pounds over the holidays.  A study published in the New England Journal of Medicine almost 10 years ago suggested that people only gain about one pound over the holidays, but that the extra weight never comes off.  Over the years, that adds up.

Another study, more specific to Thanksgiving, measured the weights of 94 college students before and after their Thanksgiving breaks.  Participants also gained a little over one pound on average.  More concerning, students who were already overweight or obese gained more than two pounds, suggesting that a group already at risk may only add to their problem at holiday time.

So enjoy Mom’s candied sweet potatoes in moderation—or else you might regret it 50 years and 50 pounds later.

Link to Google Map of Turbidity on the University of Cincinnati's website

Dozens of molecules with scary-sounding names, but nearly always in quantities so small that they’re deemed safe by the Environment Protection Agency.

For some molecules, the name may indeed be more scary than the molecule itself, and for some we don’t really know yet–there are no restricted levels on all possible contaminants. In any case, there is one relatively cheap way to improve your drinking water even further, by buying an NSF-approved home filter.

Tip-Top tap waters

I turns out you should worry more about the water from a hand-pump in the National Park campground than about the one flowing out of the tap in a big city. Smaller utilities and water from wells sometimes come closer to the allowed limit for some contaminants, because they may not afford to invest in expensive equipment.

Link to Google Map on the University of Cincinnati's website

Still, a study by the University of Cincinnati and Procter & Gamble researchers found all tested waters to be within federal health limits, and therefore safe to drink: “I believe the overall picture for US drinking water quality in the US is good,” says lead author Scott Dyer of Procter & Gamble. (Note: Procter & Gamble markets the “PUR” line of home water filters, one of the main brands on the market with “BRITA.”)

The authors of the study started looking at many utilities around Cincinnati, including some supplying water to only a hundred homes. They then enlarged the study, but to be make it relevant to more people, they focused on 77 urban areas in the US.

Find out if your city is one of these 77.

Note that the concentrations used are reported by the utilities themselves–as required by federal regulation–and date back to 2004-2006. The report took into account 392 water utilities that serve 62% of the population.

Costs and benefits

You wouldn’t fill your bathtub with spring water. Yet you flush drinking water down your toilets, use it for washing clothes, dishes and your skin. It would be even more irresponsible to ask for all that water to be absolutely pure. All drinking waters are exposed to contaminants, whether from pipes, bottles or contact with the environment. Purifying beyond a certain point is counterproductive: both useless and prohibitively expensive.

A more cheaper solution is to use a filter at home, and treat only that water which you are going to drink. A filter containing what is called “activated carbon” and “ion-exchange resins” is the easiest, most affordable solution to raise your drinking water quality above federal standards.

Link to the results for Boston on the University of Cincinnati's webpage

If you find out that your tap water (on the right is a diagram of the results for Boston) contains high levels of some unwanted contaminants, you may consider getting a filter that removes the incriminated contaminants. Just make sure it is NSF-certified and doesn’t rob your water of its healthy minerals (most filters won’t).

What’s good for you is not good for your dishwasher

You should drink water that is free from microbes and various organic molecules seeping from farms and factories. Yet you do want some of the minerals–not lead or arsenic, but at least calcium and magnesium.

When spring water contains lots of minerals it’s called mineral water. With minerals such as calcium and magnesium, water is beneficial to your heart. Even companies that bottle tap water after purifying it also often add some of these minerals back–check the labels to see how much. Don’t get too crazy about this, though: with a balanced diet, you should get a lot of these minerals from food rather than from water.

The simpler and cheaper way is to drink tap water: when tap water contains lots of calcium and magnesium, it is called hard. So if you live in an area with hard tap water, by all means, drink it! A proper filter shouldn’t remove these healthy minerals.

On the other hand, if the water in your area is hard, you may want to install a water softener on the pipes that feed your dishwasher and other appliances, because the calcium and magnesium in hard water clogs these.

“I can see clearly now the rain is gone”

“One cannot tell if water is safe just because it appears clear or tastes good,” says Rick Andrew from the National Science Foundation.

#1 Bubbles: Your water may appear cloudy, but colorless. Most likely, the pressure in the mains has increased so that minuscule bubbles form when the waters exits your tap and reaches normal pressure.

Bottom Line: Leave your glass aside for a minute or two and see if the bubbles coalesce and finally clear up. If that’s the case, you’re fine, but if the cloudiness remains and is accompanied with color, go to step #2.

#2 Soil: Heavy rains may have caused soil runoff, or maybe there’s repair work being done on the water mains: the little submarines floating in your glass are soil particles, and they may have brought microbes along for a ride.

Bottom Line: You may see soil particles, but you can’t see germs, so check item #7. You may also want to get a filter.

#3 Iron: Iron oxide can seep into some wells and color the water a rusty brown-orange and give it a metallic taste. To avoid this nuisance, federal standards recommend an upper limit on the iron content of water.

Bottom Line: Utilities have no obligation to follow the federal standards for taste, only those for health. There is no clear associated risk with iron–which is why water in some rural areas can taste funny–but if iron is leaching from a mine, there may be other metals around (see #8).

#4 Algae: Algae present in lakes and stream can give an unpleasant flavor to drinking water, if your water comes from reservoirs as opposed to wells.

Bottom Line: The presence of algae mostly causes an unpleasant odor, but it can also be accompanied by bacteria (see #7).

Not just a matter of taste

#5 Chlorine: Chlorine is added to disinfect tap water: water leaving the treatment plant without chlorine wouldn’t be so safe during its trip through the water mains. But chlorine brings an unpleasant taste and can produce unwanted byproducts that affect the nervous system, irritate the eyes or nose and increase the chances of cancer and anemia.

Bottom Line: You can use a home filter to remove chlorine and its byproducts right before you drink–just don’t leave the water standing for days, and pay attention to seasonal variations in waterborne germs (see #7).

#6 Copper: Corrosion attacks pipes, and copper may slowly dissolve into the water. This gives a metallic taste and even a blue-green color to your water. It can also upset your digestion, or even damage your liver and kidneys in the longer term.

Bottom Line: More recent pipes made out of PVC avoid the problem with copper, older ones containing lead may be worse (see #8).

Tasteless

#7 Microbes: Germs in human or animal excrement can trigger gastro-intestinal illnesses. Spikes in bacteria concentration may also stem from the seasonal blooming of algae on which some bacteria feed in lakes and streams. In areas that rely on surface water as opposed to groundwater, these bacteria can end up in tap water.

Bottom Line: In general, utilities will solve the safety issue, but make the flavor one worse–by adding chlorine to get rid of germs (see #5).

#8 Lead: If the pipes in your area are old and contain lead, this metal can find its way into your water–even if it was removed properly at the plant. Lead can delay a child’s development and affect an adult’s kidneys and blood pressure. Even though old water systems are more likely to have lead pipes, the tests reported by utilities may not reflect that since they’re often performed upstream at the plant.

Bottom Line: Pipe quality varies, and it is impossible to test the water in every single house. This may be a good reason to install a filter, unless you can convince someone to replace the pipes in your area (see #6).

Link to Google Map for Nitrate on the University of Cincinnati's website

#9 Residue from fertilizer and septic tanks: These produce nitrites and nitrates which can affect infants, leading to shortness of breath and blue-baby syndrome and possibly death. On the map drawn by the University of Cincinnati – Procter & Gamble team, these concentrations are clearly high in a teardrop-shaped region from Nebraska to Ohio, says team researcher Scott Dyer from Procter & Gamble, who explains this by fertilizers seeping into the cornbelt’s water table.

Bottom Line: As for many other contaminants, you can use a filter to remove most of it.

Everything you ever wanted to know about tap water

There are many other compounds to pay attention to. For instance, perchlorate, which is used in explosive and rocket fuel to provide extra oxygen, has been found in some tap waters. The Environmental Working Group’s Nneka Leiba is hoping that the EPA will enforce an upper limit on perchlorate concentrations in drinking water. She mentions 141 unregulated compounds found in tap water for which she would like to see standards enacted–yet for most of these, it is unclear what effect they have on our health, if any.

The Environmental Working Group’s report is a few years older than that of the University of Cincinnati, but it lists many more communities, and separates them according to 39,751 utilities, so you can find yours instead of reading about a city average. It also lists a broader range of compounds, including unregulated ones.

If you still cannot locate your utility, try via the EPA’s website.