Archive for September, 2009

Our National Parks

Friday, September 25th, 2009

A new film by Ken Burns, “The National Parks: America’s Best Idea“, will be presented by PBS in six episodes starting Sunday, September 27, at 8 pm Eastern Time. Filmed over a course of more than six years, this series will show some of the most beautiful places in our country, at the best time of year, in the best light, along with the history of our national parks, people who made a difference, and park profiles.

“The National Parks: America’s Best Idea” is directed by Ken Burns and written and co-produced by Dayton Duncan.

See a behind the scenes tour of this new Ken Burns series, “The National Parks”, in this PBS Preview.

Ken Burns points out that the concept of a national park is an American idea and ideal, and that Yellowstone National Park, established in 1872, is arguably the world’s first truly national park.  Our national parks are living symbols of democracy, and are special places of discovery and inspiration, building human happiness, and should be preserved for all people to enjoy (not just for royalty or the rich).

Talking about national parks and monuments, President Theodore Roosevelt is quoted in the film as saying, “It is the preservation of the scenery, of the forests and the wilderness game for the people as a whole.  Instead of leaving the enjoyment thereof to be confined to the very rich, it is noteworthy in its essential democracy, one of the best bits of national achievement, which our people have to their credit.  And our people should see to it that they are preserved for their children, and their children’s children forever, with their majestic beauty all unmarred.”

On June 8, 1906, President Theodore Roosevelt signed into law the Antiquities Act of 1906, giving the President of the United States authority to restrict use of particular land owned by the federal government by executive order, bypassing Congressional oversight, and avoiding partisan gridlock.  The Antiquities Act resulted from concerns arising about protecting mostly prehistoric Native American ruins and artifacts.  The intent is to allow the President to set aside and protect certain valuable public natural areas as park and conservation lands, which are given the title of “National Monuments“.

The first declared United States National Monument was Devils Tower, established on September 24, 1906 by President Theodore Roosevelt.  Devils Tower is a monolithic igneous intrusion or volcanic rock in the Black Hills of northeastern Wyoming.  Native American tribes including the Arapaho, Crow, Cheyenne, Kiowa, Lakota, and Shoshone had cultural and geographical ties to the monolith long before European and early American immigrants reached Wyoming.  More than 48% of land in Wyoming is now owned by the United States Government (as noted in Wikipedia’s article, “Wyoming“).

On January 11, 1908, President Theodore Roosevelt (struggling against mining interests) proclaimed more than 800,000 acres of the Grand Canyon as a National Monument (it was declared a National Park on February 26, 1919).  This is an example of an early success of the environmental conservation movement, which may have helped to thwart proposals to dam the Colorado River within its boundaries.

On October 14, 1913, President Woodrow Wilson created Cabrillo National Monument, which is located on the southern tip of the Point Loma Peninsula in San Diego, California, and commemorates the landing of Juan Rodriguez Cabrillo in San Diego Bay on September 28, 1542.

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At the highest point in the park stands the Old Point Loma Lighthouse, which became operational in 1855.

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People come from all over the world to enjoy the views of the region’s mountains, San Diego harbor, Pacific Ocean, Mexico and the Coronado Islands.  Pacific gray whales can be seen migrating from late December to early February.  Cabrillo National Monument contains one of the finest (and protected) rocky intertidal areas (tide pools) on the southern California coast and is one of the last refuges of coastal sage scrub habitat.

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Ken Burns film, “The National Parks: America’s Best Idea”, also highlights other heroes who have made a difference in preserving our natural resources and wilderness areas, such as Stephen Mather (first director of the National Park Service, which was established by the National Park Service Organic Act signed into law by President Woodrow Wilson on August 25, 1916),  John Muir (naturalist, author, early advocate of the preservation of the wilderness, and founder and first president of the Sierra Club), President Franklin D. Roosevelt and his Civilian Conservation Corps, Marjory Stoneman Douglas (friend of the Everglades), William Gladstone Steel (“father of Crater Lake”), and George Melendez Wright (National Park Service naturalist).

George Melendez Wright was noted as saying, “Our national heritage is richer than just scenic features… perhaps our greatest national heritage is nature itself, with all of its complexity and its abundance of life”.  See this wonderful video clip on George Melendez Wright.

The most recent national monument was designated by President George W. Bush on January 6, 2009: The Marianas Trench Marine National Monument.  The Marianas trench reefs and waters (95,216 square miles) are among the most biologically diverse in the Western Pacific and include the greatest diversity of seamount and hydrothermal vent life yet discovered.  The Mariana trench is the deepest point on Earth and five times longer than the Grand Canyon.

Our national parks and monuments are our national treasures that bring us happiness and a sense of well-being…  a sense of comfort, like going home… and like a home, they need to be protected, restored (including restoration of native species), maintained and kept functioning for all to enjoy for all time.

See one more video selection from this new, beautiful mini-series, along with a moving interview of documentary filmmaker, Ken Burns, shown in this clip from The Rachel Maddow Show of September 24, 2009.

Mohs surgery

Sunday, September 20th, 2009

“Nose surgery?” I asked as the secretary was scheduling me for Head & Neck surgery.  “No, Mohs surgery,” she said, and she had to spell it several times before I got it right.  I jotted down the check-in appointment time of 4:30 p.m. for surgery at 5:00 p.m. and without delay I proceeded to Google “Mohs surgery“.  Google presented 162,000 hits (links) and of course, my reliable friend, Wikipedia, was on top.

Mohs Micrographic Surgery (MMS) was developed by Dr. Frederic E. Mohs (1910-2002) in 1936 to precisely remove skin cancer lesions while sparing healthy tissue and is the procedure of choice used by physicians today for anatomically important areas (eyelids, nose, ears, lips, etc.) where tissue sparing and low recurrence is important.

In my case about a year ago I started to notice a small, pin-point tenderness on the left side of the upper bridge of my nose near where the pads of my reading glasses rest and I noticed this most when I slipped on my sunglasses.  I could feel a dry raised tiny spot there that I attributed to wearing reading glasses.  Last spring my dermatologist finally got to see it and he treated it like my other precancerous skin lesions, called solar or actinic keratoses, with cryotherapy.  This initially worked, but after a few weeks I felt the tenderness again and I scheduled a return visit to my dermatologist, which had to be rescheduled after the completion of my summer jury duty on a murder case.  When I finally saw the dermatologist, he offered to freeze it again… or just cut it out.  “Well,” I said, “freezing didn’t work last time… maybe it would be better to just cut it out.”  And he did and sent it to the lab and I got the report back the next week that it was indeed squamous cell carcinoma, the second most common cancer of the skin, with more than 250,000 new cases diagnosed every year in the United States.  (Basal cell carcinoma is the most common.)

The image below shows the healed biopsy spot just before surgery.  The spot is the light circular area on the anatomically left side of the bridge of my nose, horizontally across from my pupils.

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So last Thursday, Larry drove me to the hospital where I checked into the fourth floor Head and Neck Surgery Department for this outpatient procedure, which I was told usually takes one to three hours.  It is performed using local anesthesia and the patient guidebook said it would be okay to listen to an iPod during the procedure, and to bring a companion to drive me home afterward.

Being a “writer”, I thought I ought to avail all of my senses to savor the full experience, so I left my iPod at home.  I felt the smooth coolness of the rectangular cauterizing grounding pad applied by the friendly nurse to my upper left arm.  I was draped and felt the wet coolness of liquid and smelled the chemical odor of antiseptic solution as it was applied over my closed eyes, forehead, nose and upper cheeks.  I felt the sharp skin-prick and brief pain as the surgeon injected anesthetic into the bridge of my nose.  The surgeon and nurse then left me alone with my thoughts for about fifteen minutes while the anesthetic took hold.  I could barely hear questions and answers of the patient having a similar procedure in the next room, which helped me know what to expect.  I also heard the high pitched sound of what sounded like cauterizing equipment.

The surgeon returned and applied a drape with a small opening over my head.  We chatted and I told him that I was a retired RN.  I was pleasantly surprised when he informed me that his wife works as an administrative RN in the medical center where I had worked for 28 years.  As he mentioned names of people whom I had known and worked with, I drifted down memory lane while he scraped, cut, snipped, sliced and cauterized away.

The removed tissue was sent to the pathologist on duty and Larry was invited in to chat with me (he read to me an article in the latest Camping World magazine) while we waited for the surgeon to return with the pathologist’s report.  Meanwhile, the pathologist flattened, dyed, froze and cut thin horizontal sections (see You Tube frozen section technique) of the tissue using a microtome-cryostat.  The sections were placed on microscope slides, fixed, stained and examined to determine if the tissue margins were clear of tumor cells.  After about thirty minutes, the surgeon returned with good news (no more tissue needed to be removed) and closed the wound with ten small sutures and applied steri-strips.  I was given postoperative instructions, prophylactic antibiotic, narcotic pain reliever, a return date for suture removal and an instant cold pack to apply to prevent swelling during the return trip home.

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One year ago in my “Sun safety” post, I documented my actinic keratosis on my left cheek and how it was treated with the antimetabolite Fluoroucil.  Development of actinic keratoses are associated with exposure to the sun.  As noted in this AOCD article on Actinic keratosis, sun damage to the skin accumulates over time and up to 80% of skin damage is thought to occur before the age of 18.  Left untreated, actinic keratoses can progress to squamous cell carcinomas.  Properly treated, the cure rate is 95% to 97%.

Having one squamous cell carcinoma is an indication that others may arise over time and it is important to be watchful and have dermatological examinations at least once a year.  Fortunately, my health care is provided by one of the largest and most respected health maintenance organizations (HMOs) in the United States.  I have affordable health care insurance, but some people are not so fortunate, which is one reason some believe that health care reform is the most important issue of our times.  It is also currently one of the most hotly debated national issues, as evidenced in this New York Times article of Sepember 18, 2009, “The Baucus Plan: A Winner’s Curse for Insurance Companies“, by Uwe E. Reinhardt.

Every day is a gift…

The recent death of Senator Edward M. Kennedy, whose passion in life was noted to be health care reform, has sharpened this debate, as evidenced in the August 26, 2009 New York Times article, “Kennedy Death Adds Volatile Element to Health Fight“, by Carl Hulse and Katharine Q. Seelye.  Mr. Kennedy wrote that health care was the great cause of his life and that he hoped that his words would inspire readers to take up the cause (page 506 of his recently released memoir, True Compass, Edward M. Kennedy, Twelve, Hachette Book Group, September, 2009, which is one of my fall reading books).  “Every day is a gift,” he was quoted as saying in the August 26, 2009 New York Times article, “After Diagnosis, Determined to Make a ‘Good Ending’“, by Mark Leibovich.

Although we are faced with increasing health concerns as we age, we are also determined to make each day count and enjoy celebrating life.  For example, last Friday Larry made (from scratch, his first, and so delicious) honey-raisin round challah and I learned how to blow the shofar to celebrate Rosh Hashanah (see the You Tube videos) , one of three annual new year celebrations that we observe.

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Also seen on our table above are chopped Chinese roast duck and plum sauce, stir-fried Chinese broccoli (Gai lan) with oyster sauce, one fig (freshly picked from our Brown Turkey Fig tree) on a plate with three apples and nearby honey, peanuts, butter and baklava.

We continue to celebrate life and look forward to our fall and winter camping outings to the nearby mountains and desert.  So for us, and the “Snow Birds” beginning their seasonal migration to warmer, sunnier climes, this is a good time to review Sun Safety Action Steps

And contemplate autumn sounds and sights.

About the Author

BILL, along with partner, Larry, were first-time RV'ers when they purchased their custom-ordered 23' 2007 Airstream Safari SE. Bill (a retired RN) and Larry (a retired pediatric Occupational Therapist) enjoy bringing history alive in the area of San Diego, CA.