Author Archives: susanjustwrites

A Day Without a Drug Commercial

Last night I dreamed there was a day without a drug commercial….

When I woke up, reality stared me in the face.  It couldn’t be true.  Not right now.  Not without revolutionary changes in the drug industry.

Here are some numbers that may surprise you.  Or maybe not.

Six out of ten adults in the U.S. take a prescription medication.  That’s up from five out of ten a decade ago.  (These numbers appeared in a recent study published in the Journal of the American Medical Association.)

Further, nine out of ten people over 65 take at least one drug, and four out of ten take five or more—nearly twice as many as a decade ago.

One more statistic:  insured adults under 65 are twice as likely to take medication as the uninsured.

Are you surprised by any of these numbers?  I’m not.

Until the 1990s, drug companies largely relied on physicians to promote their prescription drugs. But in 1997, the Food and Drug Administration revised its earlier rules on direct-to-consumer (DTC) advertising, putting fewer restrictions on the advertising of pharmaceuticals on TV and radio, as well as in print and other media.  We’re one of only two countries–New Zealand is the other one–that permit this kind of advertising.

The Food and Drug Administration is responsible for regulating it and is supposed to take into account ethical and other concerns to prevent the undue influence of DTC advertising on consumer demand.  The fear was that advertising would lead to a demand for medically unnecessary prescription meds.

It’s pretty clear to me that it has.  Do you agree?

Just look at the statistics.  The number of people taking prescription drugs increases every year.  In my view, advertising has encouraged them to seek drugs that may be medically unnecessary.

Of course, many meds are essential to preserve a patient’s life and health.  But have you heard the TV commercials?  Some of them highlight obscure illnesses that affect a small number of TV viewers.  But whether we suffer from these ailments or not, we’re all constantly assaulted by these ads.  And think about it:  If you feel a little under the weather one day, or a bit down in the dumps because of something that happened at work, or just feeling stressed because the neighbor’s dog keeps barking every night, might those ads induce you to call your doc and demand a new drug to deal with it?

The drug commercials appear to target those who watch daytime TV—mostly older folks and the unemployed.  Because I work at home, I sometimes watch TV news while I munch on my peanut butter sandwich.  But if I don’t hit the mute button fast enough, I’m bombarded by annoying ads describing all sorts of horrible diseases.  And the side effects of the drugs?  Hearing them recited (as rapidly as possible) is enough to make me lose my appetite.  One commercial stated some possible side effects:  suicidal thoughts or actions; new or worsening depression; blurry vision; swelling of face, mouth, hands or feet; and trouble breathing.  Good grief!  The side effects sounded worse than the disease.

I’m not the only one annoyed by drug commercials.  In November 2015, the American Medical Association called for a ban on DTC ads of prescription drugs. Physicians cited genuine concerns that a growing proliferation of ads was driving the demand for expensive treatments despite the effectiveness of less costly alternatives.  They also cited concerns that marketing costs were fueling escalating drug prices, noting that advertising dollars spent by drug makers had increased by 30 percent in the previous two years, totaling $4.5 billion.

The World Health Organization has also concluded that DTC ads promote expensive brand-name drugs.  WHO has recommended against allowing DTC ads, noting surveys in the US and New Zealand showing that when patients ask for a specific drug by name, they receive it more often than not.

Senator Bernie Sanders has repeatedly stated that Americans pay the highest prices in the world for prescription drugs.  He and other Senators introduced a bill in 2015 aimed at skyrocketing drug prices, and Sanders went on to rail against them during his 2016 presidential campaign.

Another member of Congress, Representative Rosa DeLauro (D-Conn.), has introduced a bill specifically focused on DTC ads.  Calling for a three-year moratorium on advertising new prescription drugs directly to consumers, the bill would freeze these ads, with the aim of holding down health-care costs.

DeLauro has argued, much like the AMA, that DTC ads can inflate health-care costs if they prompt consumers to seek newer, higher-priced meds.  The Responsibility in Drug Advertising Act would amend the current Food, Drug, and Cosmetic Act and is the latest effort to squelch DTC advertising of prescription meds.

The fact that insured adults under 65 are twice as likely to take prescription meds as those who are not insured highlights a couple of things:  That these ads are pretty much about making more and more money for the drug manufacturers.  And that most of the people who can afford them are either insured or in an over-65 program covering many of their medical expenses.  So it’s easy to see that manufacturers can charge inflated prices because these consumers are reimbursed by their insurance companies.  No wonder health insurance costs so much!  And those who are uninsured must struggle to pay the escalating prices or go without the drugs they genuinely need.

Not surprisingly, the drug industry trade group, the Pharmaceutical Research and Manufacturers of America, has disputed the argument that DTC ads play “a direct role in the cost of new medicines.”  It claims that most people find these ads useful because they “tell people about new treatments.”  It’s probably true that a few ads may have a public-health benefit.  But I doubt that very many fall into that category.

Hey, Big Pharma:  If I need to learn about a new treatment for a health problem, I’ll consult my physician.  I certainly don’t plan to rely on your irritating TV ads.

But…I fear that less skeptical TV viewers may do just that.

So please, take those ads off the air.  Now.

If you do, you know what?  There just might be a day without a drug commercial….

 

[The Wellness Letter published by the University of California, Berkeley, provided the statistics noted at the beginning of this post.]

 

Feeling Lazy? Blame Evolution

I’m kind of lazy.  I admit it. I like to walk, ride a bike, and splash around in a pool, but I don’t indulge in a lot of exercise beyond that.

Now a Harvard professor named Daniel Lieberman says I can blame human evolution.  In a recent paper, “Is Exercise Really Medicine? An Evolutionary Perspective,” he explains his ideas.

First, he says (and this is the sentence I really like), “It is natural and normal to be physically lazy.”  Why?  Because human evolution has led us to exercise only as much as we must to survive.

We all know that our ancestors lived as hunter-gatherers and that food was often scarce.  Lieberman adds this idea:  Resting was key to conserving energy for survival and reproduction.  “In other words, humans were born to run—but as little as possible.”

As he points out, “No hunter-gatherer goes out for a jog, just for the sake of it….”  Thus, we evolved “to require stimuli from physical activity.”  For example, muscles become bigger and more powerful with use, and they atrophy when they’re not used.  In the human circulatory system, “vigorous activity stimulates expansion of …circulation,” improves the heart’s ability to pump blood, and increases the elasticity of arteries.  But with less exercise, arteries stiffen, the heart pumps less blood, and metabolism slows.

Lieberman emphasizes that this entire process evolved to conserve energy whenever possible.  Muscles use a lot of calories, making them costly to maintain.  Muscle wasting thus evolved as a way to lower energy consumption when physical activity wasn’t required.

What about now?  Until recently, it was never possible in human history to lead an existence devoid of activity.  The result:  According to Lieberman, the mechanisms humans have always used to reduce energy expenditures in the absence of physical activity now manifest as diseases.

So maladies like heart disease, diabetes, and osteoporosis are now the consequences of adaptations that evolved to trim energy demand, and modern medicine is now stuck with treating the symptoms.

In the past, hunter-gatherers had to exercise because if they didn’t, they had nothing to eat.  Securing food was an enormous incentive.  But today, for most humans there are very few incentives to exercise.

How do we change that?  Although there’s “no silver bullet,” Lieberman thinks we can try to make activity “more fun for more people.”  Maybe making exercise more “social” would help.  Community sports like soccer teams and fun-runs might encourage more people to get active.

Lieberman has another suggestion.  At his own university, students are no longer required to take physical education as part of the curriculum.  Harvard voted its physical-education requirement out of existence in the 1970s, and he thinks it’s time to reinstate it.  He notes surveys that show that very few students who are not athletes on a team get sufficient exercise.  A quarter of Harvard undergraduates have reported being sedentary.

Because “study after study shows that…people who get more physical activity have better concentration, their memories are better, they focus better,” Lieberman argues that the time spent exercising is “returned in spades…not only in the short term, but also in the long term.  Shouldn’t we care about the long-term mental and physical health of our students?”

Lieberman makes a powerful argument for reinstating phys-ed in those colleges and universities that have dropped it.  His argument also makes sense for those of us no longer in school.

Let’s foil what the millennia of evolution have done to our bodies and boost our own level of exercise as much as we can.

Tennis, anyone?

 

[Daniel Lieberman’s paper was the focus of an article in the September-October 2016 issue of Harvard Magazine.  He’s the Lerner professor of biological sciences at Harvard.]

 

Link

Looking Back…The Election of 1984 (Part II)

I wrote Part I of this blog post in late 1984.  In Part I, I commented on the campaign for president and vice president that had occurred that fall.

Part II, also written in 1984, offered my thoughts at the time about what might take place post-1984.

During the past 32 years, we’ve seen another major political party nominate a woman to be vice president.  In my view, the selection of Sarah Palin as that candidate in 2008 was John McCain’s replication of Walter Mondale’s unhappy selection of Geraldine Ferraro.  It was perhaps even more detrimental to McCain because he probably had a better chance of being elected president than Mondale had in 1984. Palin was even more untested as a political figure than Ferraro, having served only as a suburban mayor and a recently elected governor of a small state.  She soon demonstrated her lack of experience and knowledge of national issues, making her a genuine liability for McCain, who lost the support of many voters who might have otherwise been inclined to vote for him.

In 2016, American voters finally have the opportunity to select a woman as their president.  This time she’s a woman with a great deal of experience in public life and vast knowledge of the issues confronting our nation.  Although, as a candidate, Hillary Clinton hasn’t inspired unbridled enthusiasm, she’s as close to a “woman candidate of national stature” (to use my own words) as we’ve ever had.  In 1984, I predicted that a “woman candidate of national stature” whose position “represents the majority thinking in this country” would be “a realistic candidate,…and she will win.”

Was I right?

Here’s exactly what I wrote in 1984:

 

PART II

How does this leave things for the future?  Putting aside the personal future of Geraldine Ferraro, which is probably bright, what about other women candidates?  And what about the possibility of any woman being nominated and elected to the presidency or vice presidency of this country?  The Mondale-Ferraro defeat should not and must not be read as a defeat for women candidates in general.  Ferraro’s assets, both as a candidate and as a human being, are considerable, but, to be honest, she joined the campaign largely unknown and untested.
Another woman candidate might well fare otherwise.

Twenty-five years ago [i.e., in 1959], Margaret Chase Smith, a well-known and respected Republican U.S. Senator from Maine, announced her candidacy for the presidency.  She never had a realistic shot at it in that benighted era, but she might have had one in the 1980s.  She had established herself through a number of terms in the House of Representatives and the Senate, had climbed up the ladder in the Senate to committee chairmanships, and had become a recognized and admired figure on the national political scene.  A woman presenting similar credentials in the 1980s would bring a credibility to a national ticket that Ferraro, as a relative newcomer to the political arena, could not.  For this reason it’s important that women continue to run for political office on the state and local level, building political careers that will lead to the White House after they have achieved national stature—not before.

In all of the fuss made over Ferraro’s candidacy, something important was forgotten.  It’s not desirable for any political party to nominate a candidate solely or even primarily because that candidate is a woman or a black or a Hispanic—or a white Anglo male, for that matter.  The selection process must be based on the totality of what any given candidate will bring to the office.  The Democrats were wrong to select a woman candidate largely because she was a woman (those who said that a man with Ferraro’s credentials would never have been considered were—however painful it is to admit—correct).  They were wrong because Americans do not, and should not, vote for “symbols.”  When it became clear that Jesse Jackson wasn’t a candidate with a broad-based constituency but had become a “black” candidate and nothing more, that was the death knell for any realistic chance he had of winning the nomination.  But saying that is not saying that no black candidate can ever win.

Women candidates and candidates who are members of minority groups have run for office and won broad-based electoral support where they have been viewed as representing the best interests of a majority of the electorate.  But women and others who are viewed as “symbols,” representing only that segment of the electorate from which they came, will never win that sort of broad-based support.  On the contrary, their candidacies may serve only to polarize voters, leading to strife and bitterness among the electorate, and probable if not certain defeat at the ballot box.

When Mondale chose Ferraro, he already had the votes of the politically aware women for whom Ferraro became a symbol by virtue of his position on such issues as the ERA [the Equal Rights Amendment] and [the issue of] comparable worth.  He would not have lost the votes of those women no matter what else he did.  Likewise, Reagan didn’t have the votes of those women and wouldn’t have had them no matter what he did.  Even in the unimaginable event that Reagan had selected a woman running-mate, she would have had to be a woman whose thinking was compatible with his, and if she had endorsed Reagan’s views on the ERA (á la Phyllis Schlafly), feminists wouldn’t have been any more likely to vote for Reagan-Schlafly than Reagan-Bush.  It shouldn’t therefore be terribly difficult to understand why women who were otherwise happy with Reagan weren’t inclined to switch to Mondale simply because of Ferraro.

In sum, women voters are really not very different from men voters, and Democratic strategists who thought otherwise were proved wrong in 1984.  Women vote their interests, and these do not necessarily coincide with what is popularly perceived as “women’s” interests.  Women, like men, are concerned about the economy, our country’s status in the world, and a host of other matters along with the particular concerns they may have as women.

When a woman candidate of national stature emerges whose position on these interests represents the majority thinking in the country, she will be a realistic candidate for the vice presidency or the presidency, and she will win.

Looking Back…The Election of 1984

If you’ve followed politics for as long as I have, you probably remember the election of 1984.  In the race for U.S. president, Ronald Reagan was the Republican incumbent, first elected in 1980, and seeking to be re-elected in 1984.  Most observers predicted that he would succeed.

Opposing him was the Democratic nominee, Walter Mondale.

I found the campaign for president so absorbing that shortly after Mondale lost, I wrote a piece of commentary on the election.  Somewhat astoundingly, I recently came across that long-lost piece of writing.

Regrettably, I never submitted it for publication.  Why?  In 1984 I was active in local politics (the New Trier Democratic Organization, to be specific), and I was apprehensive about the reaction my comments might inspire in my fellow Democrats.

Reviewing it now, I wish I’d submitted it for publication.

On June 11th of this year, after Hillary Clinton appeared to be the Democratic nominee for president, The New York Times published a front-page story by Alison Mitchell, “To Understand Clinton’s Moment, Consider That It Came 32 Years After Ferraro’s.”  Mitchell’s article is a brilliant review of what happened in 1984 and during the 32 years since.  My commentary is different because it was actually written in 1984, and it presents the thinking of a longstanding political observer and a lifelong Democrat at that point in time.

Here’s the commentary I wrote just after the election in November 1984.  It was typed on an Apple IIe computer (thanks, Steve Wozniak) and printed on a flimsy dot-matrix printer.  It’s almost exactly what I wrote back then, minimally edited, mostly to use contractions and omit completely unnecessary words.  I’ve divided it into two parts because of its length.

 

PART I

Although Walter Mondale conducted a vigorous and courageous campaign, perhaps nothing he did or did not do would have altered the ultimate result.  But his fate was probably sealed last July when he made two costly political mistakes.  He chose to tell the American people that he’d increase taxes, and he chose Geraldine Ferraro as his running mate.

Savvy political observers have always known that talk of increased taxes is the kiss of death for any candidate.  One wonders what made Walter Mondale forget this truism and instead decide to impress the electorate with his honesty by telling them what they had to know (or, rather, what he thought they had to know) about the deficit.  By making the deficit—a highly intangible concept to the average American voter—a cornerstone of his campaign, Mondale committed the political gaffe of the decade.  One can imagine the glee in the White House the night Mondale gave his acceptance speech and tipped his hand.  The most popular theme of the Reagan campaign became identifying Mondale with the idea of “tax, tax, tax; spend, spend, spend,” a theme that had spelled doom for Jimmy Carter and came to do the same for his Vice President.

Mondale’s choice of Geraldine Ferraro as his running mate was surely not a gaffe of the magnitude of his promise to increase taxes, but as a political judgment it was almost equally unwise.  Mondale faced a popular incumbent president.  All the signposts, even back in July, indicated that the American people were largely satisfied with Reagan and willing to give him another term.  To unseat a popular sitting president, Mondale—who’d been through a bloody primary campaign and emerged considerably damaged—had to strengthen his ticket by choosing a running mate with virtually no liabilities.  He simply couldn’t afford them.

Some of the best advice Mondale got all year was George McGovern’s suggestion that he choose Gary Hart for his vice president.  In one stroke, Mondale could have won the support of those backing his most formidable opponent, many of whom had threatened to go over to Reagan if their candidate wasn’t nominated.  Like Reagan in 1980, Mondale could have solidified much of the divided loyalty of his party behind him by choosing the opponent who’d come closest in arousing voters’ enthusiasm.  Instead he chose to pass over Hart and several other likely candidates and to select a largely unknown three-term congresswoman from New York City.

It pains me, as a feminist and an ardent supporter of women’s rights, to say this, but it must be said:  Mondale’s choice of Ferraro, however admirable, was a political mistake.  When the pressure from NOW and others to choose a woman candidate arose and gradually began to build, I felt uneasy.  When Congresswoman Patricia Schroeder (for whom I have otherwise unlimited respect) announced that if Mondale didn’t choose Hart, he had to choose a woman, my uneasiness increased.  And when Mondale at last announced his choice of Ferraro, my heart sank.  I was personally thrilled that a woman was at last on a national ticket, but I knew immediately that the election was lost, and that everything a Mondale administration might have accomplished in terms of real gains for women had been wiped out by his choice of a woman running-mate.

There was no flaw in Ferraro herself that ensured the defeat of the Mondale-Ferraro ticket.  She’s an extremely bright, attractive, competent congresswoman and proved herself to be a gifted and inspiring V.P. candidate.  She has, by accepting the nomination, carved out a secure place for herself in the history books and maybe a significant role in national politics for decades to come.  She deserves all this and perhaps more.  But one must wonder whether even Ferraro in her own secret thoughts pondered the political wisdom of her choice as Mondale’s running mate.  If she is as good a politician as I think she is, I can’t help thinking that she herself must have wondered, “Why me, when he could have anyone else?  Will I really help the ticket? Well, what the hell, I’ll give it a shot!  It just might work.”

And it just might—someday.  But in 1984, up against a “Teflon President,” Mondale needed much more.  Reagan was playing it safe, and Mondale wasn’t.  Some observers applauded his choice of Ferraro as the kind of bold, courageous act he needed to bring excitement to a dull, plodding campaign.  But American voters weren’t looking for bold and courageous acts.  They wanted a President who didn’t rock the boat–a boat with which they were largely satisfied.  They might have been willing to throw out the current occupant of the White House if Mondale had been able to seize upon some popular themes and use them to his advantage.  Instead, the Reagan administration seized upon the tax-and-spend issue and the relatively good status of the economy to ride to victory while Mondale was still groping for a theme that might do the same for him.  And all the while he had a running mate with a liability:  a woman who had no national political stature and who turned out to have considerable problems of her own (notably, a messy financial situation).

Mondale’s choice of Ferraro was compared by Reagan to his appointment of Sandra Day O’Connor to the U.S. Supreme Court.  In the sense that both men selected highly capable but little-known women and in one stroke catapulted them to the top of their professions, Reagan was right.  But Reagan’s choice was very different and politically much smarter.  A V.P. candidate must be judged by the entire American electorate; a Supreme Court nominee is judged only by the U.S. Senate.  A vice president must stand alone, the metaphorical heartbeat away from the presidency; a Supreme Court justice is only one of nine judges on a court where most issues are not decided 5 to 4.  [We all recognize that this description of the Court in 1984 no longer fits in 2016.  But a single justice on the Court is still only one of nine.]

Let’s face it:  the notion of a woman V.P. (and the concomitant possibility of a woman president) is one that some Americans are clearly not yet comfortable with.  Although 16 percent of the voters polled by one organization said that they were more inclined to vote for Mondale because of Ferraro, 26 percent said they were less likely to.  It doesn’t take a mathematical whiz to grasp that 26 is more than 16.  These statistics also assume that the 55 percent who said that Ferraro’s sex was not a factor either way were being absolutely candid, which is doubtful.  Many men and women who are subconsciously uncomfortable with the idea of a woman president are understandably reluctant to admit it, to themselves perhaps as much as to others.

 

 

 

The Charm of San Miguel de Allende

 

Light rain was falling when I arrived at the airport in Leon, Mexico, searching for the shuttle that would take me to San Miguel de Allende.  A sign listing all the passengers on my shuttle made clear it would be crowded.

I jumped on board, taking a seat near the door. Not a great choice.  Passengers departing before me carelessly left the door open too long, and raindrops pelted me every time.  Even more annoying was the man behind me who talked incessantly, telling another passenger everything to do and see in San Miguel.  I wished he’d shut up.  I wanted to discover all of it for myself.

The shuttle driver finally located the house on Calle del Castillo belonging to Merrily and Paul, my great friends since college, and they welcomed me warmly, ushering me inside.  The house was a wonderful surprise, modern and comfortable, and I felt very lucky to be in their sheltering arms.

For the next few days, the three of us set out together every day, covering a host of sites in and around this charming city set in Mexico’s central highlands.

Why go to San Miguel?  First, it’s a UNESCO World Heritage site, an extremely beautiful city filled with historic and architecturally-astounding buildings.  Next, although parts of Mexico have sadly seen a measure of violent crime in recent years, San Miguel is still a peaceful sanctuary where one feels totally safe.  And although it’s perhaps best known in the U.S. as a city inundated with American ex-pats, the overwhelming majority of the population is made up of warm and friendly mexicanos.  Unlike the Mexican resort cities like Puerto Vallarta (my favorite) and Acapulco, San Miguel is a much more authentically Mexican city.  You may want to spend a vacation of a few days there, or linger much, much longer.  Or, like Merrily and Paul, you may even want to move there, joining the five thousand or so ex-pats who have made San Miguel their home.

In case you’re wondering how the lengthy name of the city came about, here’s a brief history lesson:  When the Spaniards arrived in this part of Mexico during the 16th century and established a colony, many of the indigenous inhabitants fled.  A Franciscan friar took advantage of their departure and founded a Spanish settlement that evolved in the 17th century into a beautiful town called San Miguel el Grande.

During the next hundred years, when many people who by now considered themselves Mexicans rose up against Spanish rule, Ignacio Allende was a prominent local leader.  He was executed by the Spanish, but he was not forgotten.  After the Mexican army defeated the Spanish in their War of Independence, the city was renamed San Miguel de Allende to honor him.

Today’s city has the Spanish to thank for many of its striking buildings, constructed during the colonial period.  The most magnificent is the Parroquia de San Miguel Arcángel, a pink-hued Neo-Gothic cathedral dominating the Centro Histórico, the historic center of town, directly across from the leafy park, El Jardin.  Originally built in the 16th century, a local architect did a smashing renovation about 300 years later.  Its pink sandstone towers present a facade unlike that of any other church I’ve ever seen, resembling a set right out of a Disney fairytale, and when it’s illuminated at night, it has a truly magical vibe.

The city contains a host of other remarkable sights.  Instead of listing all of them, I’ll highlight just a few.  One of the must-sees is El Jardin (pronounced har-deen), the leafy green park in the center of the city.  It’s a vibrant gathering place, filled with both locals and tourists.  Groups of mariachi musicians play there every evening, and all around its perimeter are vendors featuring kids’ toys, balloons, and lots of food, including some pretty wild varieties of ice cream (helado), including elote (corn), queso (cheese), and guayaba (guava).

El Jardin is also the place where tours of the city center begin.  These tours, organized by a local children’s charity called Patronato de Ninos, are offered at 9:45 a.m. three times a week.   They’re led by a diverse group of cheerful and knowledgeable guides (mine was an American ex-pat wearing an exquisite locally-embroidered dress).

Another highlight is the Fábrica de Aurora, a former textile factory whose machinery has been preserved and can be viewed through large glass windows.  It’s been totally renovated and now houses a wide range of art galleries, craft studios, and delightful places to eat and drink.  A bit north of the city, it’s well worth the trip.

Farther outside the city (about eight miles from downtown San Miguel) is the town of Atontonilco.  Its centerpiece is another World Heritage Site, an astonishing church called the Santuario de Jesus Nazareno de Atononilco.  The church’s walls and ceilings are covered with paintings of religious stories and figures, a remarkable achievement by an artist who spent 30 years of his life creating this result.

We arrived on a Saturday and encountered not just one but two weddings being held in the church.  While the first wedding was being celebrated, the second wedding party lined up outside, awaiting its turn.  On the city streets outside the church, friendly locals offered items for sale, most notably whips of various sizes.  Whips?  Yes, whips–mainly of the “cat-o’-nine-tails” variety.  Why?  Because the sanctuary has a long history as a Catholic-pilgrimage destination, and that history includes self-flagellation by some of the pilgrims.  For kicks, you might want to buy a souvenir whip while you’re there.

Speaking of shopping:  If that pursuit interests you, San Miguel offers a wide range of possibilities.  Merrily and Paul first guided me to a largely low-rent and authentic option (my choice).  Descending to a small alleyway, we found the Mercado de Artesanía, a distinctly non-posh assortment of stands tended by local artisans and their families.  There I purchased trivets and other items made of pewter, earrings made of silver and abalone shell, and colorful embroidered blouses and pillow covers.  Besides admiring their wares, I relished meeting the artisans and speaking with them in my high-school-level Spanish (Merrily helped).

We then went on to some actual shops, like Martha’s shoe store, where she sells the famous “San Miguel” shoes in many different colors; delightful candy shops; and the highly unusual “oil cloth” store, where the brawny young proprietor makes useful items—like tote bags and luggage tags—out of a variety of bright oil cloth patterns.  (I hadn’t seen so much oil cloth since I was a kid in Mom’s postwar kitchen!)  I later sought out stores offering artisanal products like ceramics and jewelry.  My favorite purchases were the ceramic trees-of-life I bought for both of my daughters.

If the art scene is your thing, be sure to check out Bellas Artes, an art school and cultural center in downtown San Miguel.  Stroll through the arcades surrounding its beautiful courtyard and view exhibits by local artists.  As for art galleries, they’re everywhere you look.  Many of the ex-pats living in San Miguel are part of a well-established artists’ colony, and anyone interested in art will have no problem finding the kind of artwork he or she prefers.

And then there are the fiestas.  Mexico has a huge number of outdoor fiestas and religious celebrations, all observed with great exuberance.  I was extremely lucky to be in San Miguel during one of its notable events, the celebration called the Fiesta del Seňor de la Conquista.  I won’t elaborate on its history and religious connotations.  But I was blown away by what I saw and heard.

When we entered the area surrounding El Jardin, we saw crowds gathered in and around it to watch a multitude of dancers garbed in wild costumes, many with brightly colored feathers, masks, and most notably, shells artfully attached to their legs.  As they danced, the shells vibrated, making a wonderful and raucous noise.  The dancing, accompanied by music, went on all day Friday and continued on Saturday.

Combining indigenous traditions with Catholic ones, this fiesta struck me as extraordinary.  But it’s just one in a long list of festivals like it.  In fact, if you happen to be in San Miguel around Easter, you’ll witness an even more spectacular celebration—two full weeks of processions and pageantry.

Here’s one more thing about San Miguel:  Great food and drink are available everywhere.  (Just avoid local tap water.)  For recommendations, check a recent guidebook or ask locals like Merrily and Paul.  The food is delicious and prices are remarkably low.

And just in case you long for familiar surroundings, there’s a busy Starbucks in the center of town and, believe it or not, a place called the Bagel Café!

Punting on the Cam

The keys to my front door reside on a key ring I bought in Cambridge, England, on a magical day in September 1986.  It’s one of the souvenir key rings you used to find in Britain (and maybe still can, though I didn’t see any during a visit in 2012).  They were fashioned in leather and emblazoned in gold leaf with the name and design of a notable site.

During trips to London and elsewhere in Britain during the 1980s and ‘90s, I acquired a host of these key rings. One of my favorites was a bright red one purchased at Cardiff Castle in Wales in 1995.  I would carry one of them in my purse until the gold design wore off and the leather became so worn that it began to fall apart.

Until recently, I thought I had used every one of these leather key rings.  But recently, in a bag filled with souvenir key rings, I came across the one I bought in Cambridge in 1986.  There it was, in all of its splendor:  Black leather emblazoned with the gold-leaf crest of King’s College, Cambridge.

I began using it right away, and the gold design is already fading.  But my memories of that day in Cambridge will never fade.

My husband Herb had gone off to Germany to attend a math conference while I remained at home with our two young daughters.  But we excitedly planned to rendezvous in London, one of our favorite cities, when his conference was over.

Happily for us, Grandma agreed to stay with our daughters while I traveled to meet Herb, and on a rainy September morning I arrived in London and checked into our Bloomsbury hotel.  Soon I set off in the rain to find theater tickets for that evening, and in Leicester Square I bought half-price tickets for a comedy I knew nothing about, “Lend Me a Tenor.”  Stopping afterwards for tea at Fortnum and Mason’s eased the pain of trekking through the rain.

When Herb and I finally met up, we dined at an Italian restaurant and headed for the theater. “Lend Me a Tenor” was hilarious and set the tone for a wonderful week together.

We covered a lot of ground in London that week, including a visit to Carlyle’s house in Chelsea, a sunny boat trip to Greenwich, viewing notable Brits on the walls of the National Portrait Gallery, tramping around Bloomsbury and Hampstead, and lunching with a British lawyer (a law-school friend) at The Temple, an Inn of Court made famous by our favorite TV barrister, Rumpole (of the Bailey), whose chambers were allegedly in The Temple.

Other highlights were our evenings at the theater. Thanks to advice from my sister, who’d just been in London, we ordered tickets before leaving home for the new smash musical, “Les Miserables” (which hadn’t yet hit Broadway). It was worth every penny of the $75 we paid per ticket (a pricey sum in 1986) to see Colm Wilkinson portray Jean Valjean on the stage of the Palace Theatre.  We also loved seeing a fresh interpretation of “The Merry Wives of Windsor” at the Barbican and Alan Ayckbourn’s poignant comedy “A Chorus of Disapproval” at the Lyric.  Although “Mutiny!”–a musical based on “Mutiny on the Bounty”–was disappointing, we relished a concert at South Bank’s Royal Festival Hall, where I kept expecting the Queen to enter and unceremoniously plop herself down in one of the hall’s many boxes.

But it was our day trip to Cambridge that was the centerpiece of our week.  On Friday, September 19th, we set out by train from King’s Cross Station and arrived at Cambridge in just over an hour.  We immediately reveled in the array of beautiful sites leaping out at us on the university campus nestled along the Cam River.  Our first stop was Queens’ College and its remarkable Mathematical Bridge.  The college spans both sides of the river (students jokingly refer to the newer half as the “light side” and the older half as the “dark side”), and the world-famous bridge connects the two.  The legend goes that the bridge was designed and built by Cambridge scholar Sir Isaac Newton without the use of nuts or bolts. But in fact it was built with nuts and bolts in 1749, 22 years after Newton died, and rebuilt in 1905.

Our next must-see site was King’s College.  During my college years at Washington University in St. Louis, I learned that Graham Chapel, our strikingly beautiful chapel–built in 1909 and the site of many exhilarating lectures and concerts (in which I often sang)–shared its design with that of King’s College, Cambridge.  So we headed right for it.  (Graham Chapel’s architect never maintained that it was an exact copy but was only partly modeled after King’s College Chapel, which is far larger.)

Entering the huge and impressive Cambridge version, we were suitably awed by its magnificence.  Begun by King Henry VI in 1446, it features the largest “fan vault” in the world and astonishingly beautiful medieval stained glass.  (A fan vault? It’s a Gothic vault in which the ribs are all curved the same and spaced evenly, resembling a fan.)

As we left the chapel, still reeling from all the stunning places we’d just seen, we noticed signs pointing us in the direction of punts available for a ride on the Cam.  The idea of “punting on the Cam”—riding down the river on one of the flat-bottomed boats that have been around since 1902–sounded wonderful.  We didn’t hesitate to pay the fare and immediately seated ourselves in one of the boats.

The river was serene, with only a few other boats floating nearby, and our punter, a charming young man in a straw boater hat, provided intelligent narration as we floated past the campus buildings stretched out along the river.  He propelled the boat by pushing against the river bed with a long pole.  His charm and good looks enhanced our ride enormously.

The boat wasn’t crowded.  An older British couple sat directly across from us, and we chatted amiably about Britain and the United States, finding commonality where we could.

The sun was shining, and the 70-degree temperature was perfect.  Beautiful old trees dotted the riverbanks, providing shade as we floated by, admiring the exquisite college buildings.

What’s punting like?  Ideally, it’s a calm, soothing boat ride on a river like the Cam.  Something like riding in a gondola in Venice, except that gondolas are propelled by oars instead of poles. (I rush to add that the gondola I rode in Venice had a much less attractive and charming oarsman.)

An article in the Wall Street Journal in November described recent problems caused by punting’s growing popularity.  Increased congestion in the Cam has led to safety rules and regulations never needed in the past.  According to the Journal, “punt wars” have divided the city of Cambridge, with traditional boats required to follow the new rules while upstart self-hire boats, which have created most of the problems, are not.

But luckily for Herb and me, problems like those didn’t exist in 1986.  Not at all.  Back then, floating along the river with my adored husband by my side was an idyllic experience that has a special place in my memory.

I don’t recall where I bought my leather key ring.  Perhaps in a small shop somewhere in Cambridge.  But no matter where I bought it, it remains a happy reminder of a truly extraordinary day.

 

Hamilton, Hamilton…Who Was He Anyway?

Broadway megahit “Hamilton” has brought the Founding Parent (okay, Founding Father) into a spotlight unknown since his own era.

Let’s face it.  The Ron Chernow biography, turned into a smash Broadway musical by Lin-Manuel Miranda, has made Alexander Hamilton into the icon he hasn’t been–or maybe never was–in a century or two. Just this week, the hip-hop musical “Hamilton” received a record-breaking 16 Tony Award nominations.

His new-found celebrity has even influenced his modern-day successor, current Treasury Secretary Jack Lew, leading Lew to reverse his earlier plan to remove Hamilton from the $10 bill and replace him with the image of an American woman.

Instead, Hamilton will remain on the front of that bill, with a group representing suffragette leaders in 1913 appearing on the back, while Harriet Tubman will replace no-longer-revered and now-reviled President Andrew Jackson on the front of the $20 bill.  We’ll see other changes to our paper currency during the next five years.

But an intriguing question remains:  How many Americans—putting aside those caught up in the frenzy on Broadway, where theatergoers are forking over $300 and $400 to see “Hamilton” on stage—know who Hamilton really was?

A recent study done by memory researchers at Washington University in St. Louis has confirmed that most Americans are confident that Hamilton was once president of the United States.

According to Henry L. Roediger III, a human memory expert at Wash U, “Our findings from a recent survey suggest that about 71 percent of Americans are fairly certain that [Hamilton] is among our nation’s past presidents.  I had predicted that Benjamin Franklin would be the person most falsely recognized as a president, but Hamilton beat him by a mile.”

Roediger (whose official academic title is the James S. McDonnell Distinguished University Professor in Arts & Sciences) has been testing undergrad college students since 1973, when he first administered a test while he was himself a psychology grad student at Yale. His 2014 study, published in the journal Science, suggested that we as a nation do fairly well at naming the first few and the last few presidents.  But less than 20 percent can remember more than the last 8 or 9 presidents in order.

Roediger’s more recent study is a bit different because its goal was to gauge how well Americans simply recognize the names of past presidents.  Name-recognition should be much less difficult than recalling names from memory and listing them on a blank sheet of paper, which was the challenge in 2014.

The 2016 study, published in February in the journal Psychological Science, asked participants to identify past presidents, using a list of names that included actual presidents as well as famous non-presidents like Hamilton and Franklin.  Other familiar names from U.S. history, and non-famous but common names, were also included.

Participants were asked to indicate their level of certainty on a scale from zero to 100, where 100 was absolutely certain.

What happened?  The rate for correctly recognizing the names of past presidents was 88 percent overall, although laggards Franklin Pierce and Chester Arthur rated less than 60 percent.

Hamilton was more frequently identified as president (with 71 percent thinking that he was) than several actual presidents, and people were very confident (83 on the 100-point scale) that he had been president.

More than a quarter of the participants incorrectly recognized others, notably Franklin, Hubert Humphrey, and John Calhoun, as past presidents.  Roediger thinks that probably happened because people are aware that these were important figures in American history without really knowing what their actual roles were.

Roediger and his co-author, K. Andrew DeSoto, suggest that our ability to recognize the names of famous people hinges on their names appearing in a context related to the source of their fame.  “Elvis Presley was famous, but he would never be recognized as a past president,” Roediger says.   It’s not enough to have a familiar name.  It must be “a familiar name in the right context.”

This study is part of an emerging line of research focusing on how people remember history.  The recent studies reveal that the ability to remember the names of presidents follows consistent and reliable patterns.  “No matter how we test it—in the same experiment, with different people, across generations, in the laboratory, with online studies, with different types of tests—there are clear patterns in how the presidents are remembered and how they are forgotten,” DeSoto says.

While decades-old theories about memory can explain the results to some extent, these findings are sparking new ideas about fame and just how human memory-function treats those who achieve it.

As Roediger notes, “knowledge of American presidents is imperfect….”  False fame can arise from “contextual familiarity.”  And “even the most famous person in America may be forgotten in as short a time as 50 years.”

So…how will Alexander Hamilton’s new-found celebrity hold up?  Judging from the astounding success of the hip-hop musical focusing on him and his cohorts, one can predict with some confidence that his memory will endure far longer than it otherwise might have.

This time, he may even be remembered as our first Secretary of the Treasury, not as the president he never was.

Crawling Through Literature in the Pubs of Dublin, Ireland

We gathered on a chilly October evening in the venerable Duke pub at 9 Duke Street in the heart of Dublin, not quite certain what to expect.  We’d come across praise for the Dublin Literary Pub Crawl in at least two of our guidebooks, Lonely Planet’s (which called it “excellent and highly recommended…great fun and…a fine introduction to Dublin pubs and Irish literary history”), as well as the Ireland guide by the always-dependable travel writer Rick Steves.

The night before, we’d relished the wonderful Dublin Musical Pub Crawl that began at Oliver St. John Gogarty’s Pub on Temple Bar.

How could we pass up this one?   As fans of literary fiction, including that of the great Irish writers, we simply couldn’t.

To ensure that we wouldn’t be turned away, we walked from Grafton Street to Duke Street early enough to have a pleasant dinner at The Duke pub before positioning ourselves at the front of the ticket line.  We had no regrets about arriving early:  a large group assembled, eager to begin the crawl at 7:30 pm, and latecomers may indeed have been turned away.

To begin, two actors (both probably fifty-plus) stood in front of the group and launched into a scene from “Waiting for Godot.” They very clearly pronounced the name as “God-oh,” with emphasis on “God.”

Ever since my first encounter with the Samuel Beckett play when I was 22, I’d heard it pronounced “Gah-doh,” with emphasis on “doh.”  But here we were in Ireland, where Beckett began his writing career.  Which pronunciation was right?  According to one source, the name is pronounced with emphasis on the first syllable in Britain and Ireland, while the norm in North America is to emphasize the second syllable.  But what about Beckett himself?  He settled in Paris in 1938 and wrote the play there in 1948-49.  And apparently both he and his French literary agent always pronounced it in “the French manner,” with equal emphasis on both syllables.

Pronunciations aside, the scene the actors chose from “Waiting for Godot” was brilliant and performed with the precise amount of irony and absurdist humor it demanded.

The actors then led us to three other notable pubs, where they spoke/performed either inside the pub or outside on a street near the pub.  I later learned the actors’ names:  Colm Quilligan (could it be more Irish?) and his colleague Derek (whose last name I failed to catch).

The first of the three pubs was O’Neill’s, on a corner at 2 Suffolk Street, with a remarkably pretty exterior featuring four tall windows that rise above its name.  Near the campus of Trinity College, it’s famous for a diverse set of patrons, including many writers.

At one of the pubs, maybe O’Neill’s, we entered a good-sized “snug,” a quiet area in the pub set apart from the usual pub revelry.  On the snug’s walls were framed photographs of the four Irish writers who’d won the Nobel Prize in Literature.  (Do you remember who those four prizewinners were?)  The photos were helpful reminders of Ireland’s literary history as we continued our crawl, listening to excerpts from a variety of Irish poets and playwrights.

At one stop, Colm and Derek read a hilarious passage from Oscar Wilde’s reminiscence of his lecture tour in America, in particular his encounter with the miners of Leadville, Colorado.  Here’s a bit of it:  “I read them passages from…that great Florentine genius…Cellini, and he proved so popular that they asked…’why the hell I hadn’t brought him with me’. I explained that [he] had been dead for some years, which elicited the immediate demand: ’who shot him?’”

We moved on to The Old Stand, located at the corner of Exchequer Street and St. Andrew Street.  Its most famous patron was Michael Collins, whose efforts led to the creation of the Irish Free State.  He reportedly visited this pub to gather information about members of the British Secret Service.

The crawl ended in front of Davy Byrne’s, a pub back on Duke Street, near where the crawl began.  The actors pointed out a significant literary reference–a scene in James Joyce’s Ulysses is set there–and read an excerpt from it.  The pub is just one site that honors Joyce’s book during the Bloomsday celebration held in Dublin every year.  We learned that both Dubliners and literary tourists don “boaters” and read from the novel at Davy Byrne’s each Bloomsday.

As we stood in front of Davy Byrne’s (where the name reminded me of the beleaguered first—and so far only—woman mayor of Chicago, Jane Byrne), Colm and Derek asked our group a batch of questions based on things we’d heard and seen during the crawl.  One key question:  the names of the four Irish Nobel Prize winners.

When my daughter Leslie got all of them right, and also answered more of the other literary questions than anyone else in our group, she was awarded with a t-shirt!  The dark green shirt, emblazoned with “Dublin Literary Pub Crawl,” along with an image of stained glass at The Duke pub, will forever be a tangible reminder of our delightful evening crawling through Irish literature in Dublin’s pubs.

PS  The Nobel laureates (in case you don’t remember):  George Bernard Shaw, William Butler Yeats, Samuel Beckett, and poet Seamus Heaney.  Heaney, probably the least known of the four, is the most recent winner (in 1985).  For a long while he was a poet-in-residence at Harvard, and during her college years there, my daughter Meredith was fortunate to hear him recite his stunning poetry—from memory—several times.  She also helped entice him to give a memorable speech to students, like her, who wrote for its literary journal, The Advocate.

 

Curl Up With a Good Book

If you have a penchant for reading fiction, guess what. You may have better social skills as a result.

A recent Harvard study asked 26 young people to undergo MRI brain scans while reading brief excerpts from novels, magazines, and other sources. The study found that reading fictional excerpts about people heightened activity in a brain system called the default network.

The study suggested that those who read a lot of fiction turn out to have stronger social skills than non-readers or people who read nonfiction. Why? Well, according to the researchers, reading fiction can improve social skills (also called social cognition) because a reader’s attention is drawn into other people’s mental states.

When the study’s participants read passages about people, there was significantly greater activity in the default network. (Reading about physical places didn’t evoke the same response.) The researchers noted that the enhanced activity stemming from reading about people linked to higher scores on social-cognition assessments.

In other words, stories with compelling emotional, social, and psychological content seem to trigger neural changes in the brain. And this apparently translates into enhanced social skills in real life.

The take-away? Reading fiction, especially stories that take readers inside other people’s lives and minds, may improve social skills by exercising the part of the brain related to empathy and imagination.

As someone who occasionally writes fiction, I’m delighted to learn the results of this study. They validate the feedback from those of my readers who’ve praised the characters I’ve created and the harrowing situations they’ve found themselves in.

As a reader, I love plunging into an absorbing story that’s focused on people with fascinating lives. Now I can envision my brain lighting up as I read an exciting passage.

I’ll bet you can, too.

So curl up with a good book—especially a story about other people’s lives. Then take a break and spend some time with your family or friends. As someone with enhanced social skills, you’re sure to have a great time.

The study, published online in Social Cognitive and Affective Neuroscience, was reported in the Wall Street Journal on March 8, 2016.

The Pink Lady

When I was growing up, my mother’s cocktail of choice was a “pink lady.” Whenever our family went out for dinner (and those dinners-out didn’t happen often), she’d order a frothy and very rosy-hued “pink lady” while Daddy chose an “old-fashioned.”

My parents weren’t everyday drinkers. Au contraire. My mother would sometimes speak disparagingly of those who indulged overmuch in alcoholic beverages, referring to them as “shikkers.” Although Daddy may have had an occasional drink at home after a difficult day at work (probably bourbon or another kind of whiskey), Mom never did. She reserved her pursuit of alcohol for our occasional dinners-out.

One dinner spot we favored was the Fireside Restaurant in Lincolnwood, Illinois, not far from our apartment on the Far North Side of Chicago. (Ironically, the restaurant was itself destroyed by fire–reputedly by mob-related arson–a few years later.) Another place we patronized was Phil Smidt’s (which everyone pronounced like “Schmidt’s”), located just over the Indiana border.

Why did we travel to Indiana for dinner when good food was undoubtedly available to us much closer to home? And long before an interstate highway connected Chicago to Northern Indiana? I remember a prolonged and very slow trip on surface streets and maybe a small highway or two whenever we headed to Phil Smidt’s.

Perhaps we wound up there because the restaurant was a perennial favorite among the people my parents knew. Or perhaps because my father actually enjoyed driving. Yes, Daddy liked getting behind the wheel in those long-ago days before everyone had a car and the roads weren’t jam-packed with other drivers. Daddy got a kick out of driving us in every direction from our home on Sunday afternoons, when traffic was especially light. But I also remember his frustration with drivers who didn’t seem to know where they were going. He referred to them as “farmers,” implying that they were wide-eyed rural types unaccustomed to city driving.

Perhaps we headed to Indiana because my parents were overly enthusiastic about the fare offered at Phil Smidt’s. As I recall, the place was famous for fried perch and fried chicken. I usually opted for the fried chicken. (At the Fireside Restaurant, my first choice was French-fried shrimp. Dinners-out seemed to involve a lot of fried food back then, and oh, my poor arteries.)

If we were celebrating a special event, like my mother’s birthday or Mother’s Day, Mom would wear a corsage. I’ve never been especially fond of corsages, which were de rigueur during my high school prom-going days. Boys would bring their dates a corsage, and girls were expected to ooh and aah over them. But I always thought corsages were a highly artificial way to display fresh flowers, and I rejected them whenever I had a choice. I’m glad social norms have evolved to diminish the wearing of corsages like those women and girls formerly felt compelled to wear.

Mom, however, always seemed pleased to wear the corsage Daddy gave her. Her favorite flower was the gardenia, and its strong scent undoubtedly wafted its way toward her elegantly shaped nose whenever he pinned one on her dress.

The “pink lady” cocktail, which incorporates gin as its basic ingredient, first appeared early in the 20th century. Some speculate that its name was inspired by a 1911 Broadway musical whose name and whose star were both called “The Pink Lady.”   It may have become popular during Prohibition, when the gin available was so dreadful that people added flavors like grenadine to obscure its bad taste.

The cocktail evolved into a number of different varieties over the years. Mom’s frothy version, around since the 1920s, adds sweet cream to the usual recipe of gin, grenadine (which provides flavoring and the pink color), and egg white.

Apparently (and not surprisingly), the drink eventually acquired a “feminine” image, both because of its name and because its sweet and creamy content wasn’t viewed as “masculine” enough in the eyes of male critics. One bartender also speculated that the non-threatening appearance of the “pink lady” probably was a major reason why it appealed to women who had limited experience with alcohol.

No doubt Mom was one of those women.

The very name of the cocktail, the “pink lady,” fit Mom to a T. She was absolutely determined to be a “lady” in every way and to instill “lady-like” behavior in her two daughters. I was frequently admonished to repress my most rambunctious ways by being told I wasn’t being lady-like. And when I had two daughters of my own, decades later, despite my strong opposition she still repeated the same admonition. She found it hard to shift gears and approve of her granddaughters’ behaving in what she viewed as a non-lady-like way. Although her basic sweetness, like that of her favorite drink, predominated in our relationship, we did differ on issues like that one.

The appellation of “pink lady” fit Mom in another way as well. She was a redhead whose fair skin would easily flush, lending a pink hue to her appearance. Whenever she was agitated (sometimes because my sister or I provoked her)…or whenever she excitedly took pride in one of our accomplishments…and assuredly whenever she was out in the sun too long, she literally turned pink.

So here’s to you, Pink Lady. In my memory, you’ll always resemble the very pink and very sweet cocktail you preferred.