Hacking

By Dr. Jim Ferguson
The flu continues to rage, and the spittle keeps flying. You may find this a  disgusting statement, but I assure you it is a valid observation. Years ago I watched two friends talking in front of a window as the morning sun streamed in. Just as dust, suspended in the air, reflects light, my friends’ animated conversation spewed micro droplets easily seen floating in the sunlight.

Understandably, coughing and sneezing produces more flying droplets than even impassioned dialogue. You would think people would have gotten the word that you’re supposed to hack and sneeze into your sleeve. Thankfully, no one uses a handkerchief anymore, but too many are otherwise oblivious or just don’t care to protect others from their flying secretions. Recently, I read that during the 1918-19 Spanish Flu pandemic, you could be arrested in Knoxville for indiscriminately casting your fomites (infected spittle) to the wind or on the ground.

My mother was the victim of a Typhoid Mary bridge partner who hacked and sneezed into tissue paper, callously casting soiled tissue on the table as he then dealt the cards with contaminated hands. It took two weeks, two rounds of antibiotics, inhalers and steroids to fix my Mom; and her cold wasn’t the deadly influenza virus variety.

Cough is one of the most common reasons a patient sees a doctor. And during the flu season, ERs and doctors’ offices are full of hacking and masked people. Masks may lesson sprayed fomites from the sick, but otherwise offer little prevention to the well. Staying out of crowds and at arms length even from friends is wise during an epidemic. During a flu outbreak several years ago, our minister recommended that we omit handshakes or hugs and instead extend greetings by crossing our forearms with our neighbors in the pattern of a cross.

Though influenza and other viral infections are in the news, we live surrounded by bacteria. In fact, deaths from influenza often occur from viral induced bacterial complications. Humans have evolved to live in a symbiotic relationship with the hordes of bacteria in, for instance, our intestinal tracts. Science is now discovering a relationship between the gut bacterial biome and a healthy immune system.

I recently read a study on the internet – so it must be true – of germ concentrations associated with air travel. Obviously, you should be concerned if the person sitting next to you in coach is sick with a cold or the flu. And for years concerns have been raised about recirculating air in a closed airplane cabin. It’s difficult to culture viruses from the air or environmental surfaces because drying quickly kills viruses. Bacteria are more readily cultured, and in the recent study high concentrations were found in airplane bathrooms and perhaps not surprisingly on check in kiosks. Even restaurants are moving toward computer screens for ordering dessert, bagels or coffee. The teaching points are your hands are easily contaminated, and you should carry a bottle of hand sanitizer with you when you’re out and about.

The most frequent cause of cough is a cold from viral syndromes and usually resolves in one to three weeks. Even persistent coughing is usually due to a transient respiratory syndrome. Hacking (cough) for more than three weeks may just be due to post nasal drip, but persistent cough may be a harbinger of asthma or even gastroesophageal reflux. And a chronic cough is a different animal all together, and raises the issue of cancer or chronic lung diseases. This is not a disclaimer, but my essay should not to be used for what doctors call a differential diagnostic list. If a cough persists, see your doctor.

Learning should never stop, and while researching this essay I learned that women have a more sensitive cough reflex than men. Men will certainly agree that women have a keener sense of smell. And anyone trapped in a room filling up with smoke will eventually cough. This is especially true of people with asthma who have hypersensitive airways and react to lower ambient levels of dust, irritants or pollen.

I write this paper with dust on my forehead because it is Ash Wednesday. How interesting that this year Lent begins on Valentine’s Day, February 14, and ends on April 1, April Fool’s Day. Growing up, I was never focused on the Lenten season. As a boy, Christmas was a bigger event than Easter. Hey, there were gifts under the Christmas tree! However, time changes us all. Once “I thought like a child” but “when I became a man, I put the ways of childhood behind me.”

The usual Lenten admonition is to give up something for the forty days before Easter. The philosophy is giving up something will help you focus on the more important spiritual aspects of Easter. An example is fasting, a traditional spiritual discipline of denial. I tried fasting once, but it didn’t help me focus on the reason for the season.

My minister advised us to give up what “keeps you from God” and instead choose something that “brings you closer to God.” For me, these recommendations seem better than fasting. Circulating on the internet is the advice of Pope Francis, though I didn’t research the quote because the admonitions are nonetheless worthy. The Pope recommends “fasting” from hurtful words, anger, bitterness and selfishness. Instead, he advises us to choose kind words, patience, joyfulness and compassion. These perspectives seem to be good pathways for Lent and for spiritual as well as physical health.

Carl Sagan once said “We are star stuff.” What he meant was that humans, the earth and the sun itself are made from the atoms of the creation. As an example, the water of your body is made of oxygen and the same hydrogen which fuels stellar fusion. The very iron in your red blood cells is a remnant (ashes) of nuclear fusion reactions in some primordial sun. When that sun’s life was over the ashes were cast to the cosmos and ultimately recycled in our blood.

The Biblical patriarchs did not understand solar fusion or the cosmos as we moderns do. However, their account in Genesis 3:19 is nonetheless poetic and profound. “Out of the earth [humans] were taken; for dust you are and to dust you will return.” Jesus Christ changed that.

While it is true that the ashes and atoms of our bodies will be recycled after we die, our essence, our soul will continue. That is the Lenten lesson.

 

 

 

 

 

 

 

 

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