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Pills; Graphic and Living History - Uncle Orson Reviews Everything

Uncle Orson Reviews Everything
February 10, 2011

Every Day Is Special

First appeared in print in The Rhinoceros Times, Greensboro, NC.


Pills; Graphic and Living History

Taking pills is easy for some people -- they can do it dry. Others can hardly gag them down. I used to be in the second group. There is a trick to make it easier.

The older I get, the more pills I take. At first it was supplements, then mild medications like daily aspirin. After my first bout with atrial fibrillation, my doctor upped my dosage of omega fish oil.

My heart doctor put me on a blood thinner that required constant testing, which meant heedless medical people stabbing me in the tips of my fingers, leaving them sore for days -- not a good thing for someone who makes a living by typing. So I resigned from that medication and upped my dosage of aspirin.

As my hospitalist told me after my stroke, "You failed aspirin," so now I'm on Plavix and another tablet to bring down my blood pressure. (There are working bicycle tires with lower pressure than I had in my arteries at the time of my stroke.)

Looking into the future (I need only look at what my parents do now!), I can see that the number of meds I take, and the number of times a day I take them, will only increase. There was a time in my life when this would have horrified me, because the only thing I hated worse than trying to gag down large pills was getting injected.

But there are actually tricks to enduring both. A dentist in Orem, Utah, back in 1980 taught me that the novocaine injection wouldn't bother me much if I simply wiggled my toes as the needle approached.

This works incredibly well. Before, my whole concentration was focused on the spot where the needle would go, and the moment it touched me I tensed up and it was excruciating. But wiggling my toes moved my concentration elsewhere.

I was certainly aware of the needle's entry, but now I felt only the slight pain that was actually there, without any of the magnification that comes from dread and tension.

Toe-wiggling works for putting an IV in the back of my hand and for the endless piercings during hospitalization, where they seem to have missed the memo about how doctors don't cure by blood-letting anymore.

So what about pills and that pesky gag reflex?

You know, we have that gag reflex for a reason -- to keep us from swallowing things that are likely to get stuck and suffocate us because we can't get them down and can't get them back out. The gag reflex makes us eject items before they're close to the getting-stuck region.

But even when tablets or capsules try to go down sideways, they aren't going to choke us (unless we actually inhale them -- which is not advised). Still, the gag reflex can stymie us.

Here's the thing to realize: Not all pills behave the same way when we swallow them with water. That's because some pills are less dense than water, and some are more dense. That means that some of them float and some of them sink in water.

Think about how you take pills. Maybe you tilt your chin up after you have filled your mouth with water. That's great for the denser-than-water tablets and gelcaps, because they sink right to the back of your throat and at the first swallowing action, they're down -- before the gag reflex can kick in.

But the less-dense-than-water powder-filled capsules (and a few very light tablets) rise in water, so if you tilt your chin up, these capsules will rise toward the front of your mouth, and they only get to the gag-reflex region fairly late in the swallow.

By then they're moving slowly; much or most of the water is gone; you can feel them there and you gag.

The trick is to put the floater pills in your mouth, take your mouthful of water, close your lips tightly, and then tilt your head sharply down.

Now the rising action of these lightweight capsules and tablets takes them to the back of your throat, and when you swallow, they are gone instantly, in the first copious rush of water, and you barely feel them.

These days I take three large but less-dense powder-filled capsules at the same time, with a single two-ounce mouthful of water. I hardly notice them. They used to gag me a little when I took them one at a time ... with my head tilted back.

So here's the rule: If it's a powder-filled capsule or a very lightweight tablet, you tilt your head down before you swallow. If it's a gelcap or a heavy-for-its-size tablet, you tilt your chin up (or tilt your head back, whichever way you think of it) before you swallow.

You don't have to test them in water first, wasting an expensive medication. Just put the pill in your mouth, take your mouthful of water, and then, without swallowing, tilt your head down and feel where the pill goes. (Make sure you haven't got it pinned down somewhere with your tongue or cheek.)

If it's not in easy swallowing position, tilt your head the other way; when the pill is in position at the back of your throat, swallow it.

Then remember (or take note of) which pills are sinkers and which are floaters.

As long as you don't try to swallow a sinker at the same time as a floater, you'll know how to tilt your head with each pill or pair of pills.

Maybe I'm the only person who didn't already know this. But in case you've had trouble with pills -- especially the big ones -- this might help.

*

History is the single most important thing we can learn, once we've acquired literacy itself.

In a way, all the other fields of study can be considered as branches of history -- when you study mathematics, you merely recapitulate the history of mathematics; when you study any science, you must first learn all that has already been learned.

Only when you have mastered the previous accomplishments of your branch of history can you begin to make original contributions.

But the most important history as we move forward through time is the history of human societies -- and not just so we can avoid making the same mistakes.

After all, nothing ever happens twice in exactly the same way. So if people are grimly determined to make the same idiotic mistakes as their forebears (and they usually are) they can always find reasons to say, "This time it will be different."

So when someone points out that Barack Obama is being handed everything necessary to repeat Bill Clinton's reelection strategy from 1996, I can hear Republicans saying, "Barack Obama is no Bill Clinton!" Well, that's true -- he's faithful to his wife, he keeps a higher percentage of his promises.

But in vain does one point out to Republicans that they are preparing to do to themselves in 2012 what they did to themselves in 1996 -- hand the nomination to a candidate with no ability to reach out to the independents who are vital to every presidential election victory.

("But we reached out to independents with McCain, and that failed!" cry the rightwing purists. To which the answer is, With the media in lockstep behind Obama, with the appealing milestone of "first black president," with the economy tanking, and with Bush's unpopularity, the miracle of 2008 was that the Republicans weren't crushed into dust. McCain did far better than Dole, than McGovern, than Goldwater -- the three ideologically purist candidates without crossover appeal in my lifetime.)

The point is that even though many people refuse to learn from history, you can't even begin to plan for the future unless you know the past. For instance, in science, it has always been meaningless to talk about "global warming" unless we had some idea of what the cycles of global temperature were in the past.

But the past is often very hard to grasp. Large trends can be talked about but rarely seen. So when someone finds a way to represent history graphically, it can be very helpful.

For instance, I once created a program for the IBM PCjr that showed all the Presidential election results on maps of the United States. You could flip from map to map and see the electoral votes represented clearly at a glance.

Unfortunately, the PCjr was a commercial flop (as it deserved to be), and so my book about how to program its BASIC language died unpublished. For years since then I've waited for someone to do the same job for PC, Mac, or the Web ... and finally I've found one.

http://www.100bestwebsites.org/alt/evmaps/electoral-maps.htm has an array of all the past presidential elections. (I tried to create a shortened version of this address, but SnipURL.com refused because apparently this website has been used to generate spam. But looking at the maps doesn't generate anything except, perhaps, some clarity about the past.)

History is not just about the quadrennial horseraces we call "presidential elections." Swedish medical doctor, researcher, and teacher Hans Rosling has generated an absolutely brilliant animated graphic showing the relative rise of life expectancies in 200 countries since 1800.

This is graphic history at its best. The video takes four minutes, and you will be fascinated the entire time. Not only does Rosling show how all nations have greatly increased their life expectancies, he also shows how their populations have grown.

If all we had were his graphics, that would be enough to recommend the video, but he does more. He himself is present to point things out, clarify, explain. Then he breaks some of the national stats into regions and cities so you can see the internal differences within some nations.

How many videos can you watch and find yourself knowing more at the end than you did at the beginning? Give Hans Rosling's 200 Countries, 200 Years, 4 Minutes, a try.

Most of history cannot be graphically represented, however. We need to have the most complete story possible. But there are so many ways to be "complete."

For instance, Susan Wise Bauer's The History of the Medieval World: from the Conversion of Constantine to the First Crusade attempts to achieve completeness by including the whole world -- including China and India, the Muslim world, American civilizations, and as many "barbarians" as we have records enough to track during that period.

This makes for a wonderful tour, as we are able to see what was going on far beyond the boundaries of the normal eurocentric view.

In another way, though, it is too complete and therefore not complete enough. What was happening in Japan and among the Mayas, for instance, had little impact on the history that led to the rise of Western Europe and the eventual American experiment.

Because she covers everywhere, Bauer can't cover anywhere with thoroughness. She aims for and achieves breadth, but it costs her depth.

Chris Wickham's brilliant achievement with The Inheritance of Rome: Illuminating the Dark Ages 400-1000 is that while he works in a narrower range of time and space, he is guided by a specific question:

How did the institutions and practices that had kept the Roman Empire vibrant for a thousand years continue to influence and shape the successor-states?

The result is a history that manages to be broad and deep as pertains to the relevant matters -- and every page is relevant to our understanding of how governments form, how nations achieve unity, how institutions endure through time.

I have read thick history books on all the major nations and civilizations Wickham covers, and yet none of them achieved his level of understanding, his depth, his completeness.

It helps that Wickham has access to far more evidence, both literary and archaeological, than most of his predecessors.

It helps just as much that Wickham resists any kind of ideological entrapment. I have been aware for most of my life of many different strains of "fall of Rome" theories, including most recently the sadly self-indulgent theory that Rome did not really fall, because the barbarians continued Roman institutions.

That kind of oversimplistic theorizing leads historians into folly -- I remember one recent book in which the author became quite energetic in his condemnation of Justinian the Great and blamed him for actually destroying the Western Empire in his misguided effort to reconquer it and return it to unity with Byzantium.

But Wickham simply presents the evidence and only then reaches conclusions -- which are never sweeping and never moralistic. He picks no "bad guys" or "good guys," he simply reports on what happened, and why certain invasions led to nothing and others created civilizations that spread and lasted.

It's fascinating to see, for instance, how Alfred the Great of England seemed to learn the lessons of Charlemagne's empire better than Charlemagne's own succesors did, so that Anglo-Saxon England actually had the institutional stability and national unity that France and Germany took centuries to recover.

Wickham also takes the time to give us in great detail things that are usually skipped over or summarized. Thus we can trace the development of the Visigothic kingdoms of Iberia into the seeds of the nations that became Spain; we get a pretty clear idea of what the Vikings actually were in relation to the institutions and culture of Medieval Scandinavia.

Along the way, Wickham creates for us a virtual textbook in nation-building. The Muslim conquests succeeded precisely because they made no attempt to proselytize (at first); the first Caliphate preserved the pre-existing governing class and only gradually Islamized the culture. Roman and Persian institutions thus served the new Muslim overlords.

Yet the Muslims also were not swallowed up as so many conquerors of China were, or as the Vikings were absorbed into the languages and cultures of the lands they conquered (in Sicily, Normandy, and, to a slightly lesser degree, the Danelaw of England).

I also could not help but compare (though Wickham never does, as he shouldn't) the Vikings to the Islamist terrorists and Somali pirates of today. Their motives are wildly different, but their effects are similar: All consist of raiders who kill, destroy, steal, and create terror without regard to borders, who are nevertheless sheltered in "home countries" that lack the resources, the will, and the national strength to control them.

Wickham's The Inheritance of Rome is definitely the best medieval history I've ever read; it may be the single best book of history I've read, and it can serve as a model for the thoroughness, rigor, and transparency all historians should strive for.

Bauer and Wickham are both fine, clear writers, but because of the breadth and depth they strive to achieve, they can leave your head spinning if you're not already thoroughly grounded in the major events of the histories of the periods they work with.

So "completeness" can also take another form. The War of 1812 was vitally important in American history, but it ended inconclusively. America lost all its land battles except the last one -- after the peace treaty was signed. And the peace treaty essentially gave in to England on the very points that the war had been fought over -- Britain's insistence on the right to stop American ships and impress, or seize, whatever sailors it pleased them to call "British subjects."

The war was also messy inside the U.S. The regions that suffered most from British practices were most opposed to the war. The party that supported what could only be a naval war (the "Republicans," though it was the party that evolved into today's Democrats) absolutely refused to create a navy to fight it!

And Jefferson -- the most over-rated President in American history, morally, intellectually, and politically -- had just crippled the American economy with an absurdly self-destructive embargo, while leaving us without a fleet.

Yet at the end of the War of 1812 left the United States as a recognized world power, and despite the peace treaty that allowed Britain to continue impressment, the Brits never stopped another American ship to impress sailors.

In short, we won, and big time; yet almost no one realized it at the time, thinking of the war as disastrous and, if not a failure, then certainly not a success.

Thus I doubt most people think they want or need Stephen Budiansky's thorough -- nay, "complete" -- history of the America's naval campaigns in the War of 1812.

And yet I can tell you that you will never read a clearer, more fascinating account of a war than Budiansky's Perilous Fight: America's Intrepid War with Britain on the High Seas, 1812-1815.

Do you like swashbuckling sea stories, like the Horatio Hornblower series? Then you'll love this book -- particularly because everything in it actually happened.

I loved the heroic struggle of the Secretary of the Navy who ended up, for a period of time, as just about the only functioning official in the U.S. government, running not just the Navy but the Treasury. And since the Navy was almost non-existent when the war began, he not only led the Navy, he virtually created it.

The American fleet consisted of a handful of frigates -- but they were first rate, far more maneuverable than any comparable ship in the British fleet, which had hundreds of ships of the line which were capable of blowing any American ship out of the water.

What made the American naval war so successful was the brilliant strategy that the desk jockeys insisted on.

American captains were ordered not to engage in ship-to-ship combat with any British vessel on an equal basis; instead of shooting it out with dangerous British ships, the Americans were ordered to flee (which they could all do, because of superior American ship designs and materials).

Instead, the American strategy was to harass the merchant shipping that Great Britain was absolutely dependent on.

The Brits were spending most of their energy bottling up the French fleet and trying to maintain a blockade that was mostly permeated by British merchants. (One could argue that Britain financed its war with Napoleon on the profits from running its own blockade.)

So when American naval vessels -- joined by hundreds of legal pirates called "privateers" -- attacked British merchant shipping, it was potentially devastating.

The American privateers were not terribly effective -- their goal was to capture British merchant ships and sail them to a friendly port, which meant that many of their captures were captured back again. The privateers themselves were usually caught and imprisoned before doing much damage.

The U.S. Navy, however, soon learned that instead of taking merchant ships captive -- which required putting a skeleton crew on board to sail it home -- they achieved far more by taking the crews captive and sinking the merchant vessels.

A sunken ship can't be taken back by the enemy; an undivided crew remains on board to keep it effective at both fighting and fleeing.

The result is that each American ship did far more damage than their numbers would have suggested. And the British navy, crewed by dispirited, undertrained, and disloyal impressees, was so ineffective in battle (except when fighting the even worse French) that they failed almost entirely in their efforts to blockade American ports.

It was a war that Britain provoked out of sheer arrogance and incompetence, but which -- out of partisan fervor and utter stupidity -- America was hopelessly unprepared to fight.

Yet there were heroic captains who trained their loyal volunteer crews to be the best navy afloat. Most American frigates were defeated only when their captains disobeyed the order not to fight and instead, as a point of foolish honor, fought a British ship of roughly equal gunnage in a duel.

A duel? Exactly. It was an age of dueling, and nobody was quicker to duel than naval officers. Even when a duel meant slaughter and maiming among both crews, they joined in enthusiastically. The American victory at sea would have been far more decisive, the campaigns more effective, except for that insistence that honor required, from time to time, a suicidal duel.

From beginning to end, Perilous Fight is a brilliant history, with all the detail needed to bring the stories to life and make the ebb and flow of the war clear -- and not a speck more.

I read it straight through like a Hornblower novel, but at the end I felt as if I had actually learned something about what makes American military practices so effective -- when they are effective.

In America we're all voters -- but nobody checks to make sure we have any sense at all about how we vote. I urge every American to regard history as the first and most important study of our lives -- the minimum requirement to be a good citizen.

And instead of relying on our castrated and/or politicized textbooks (by Left and Right), which grossly under- and mis-educate our young, we should be reading independent histories every chance we get.

There are some great writers of history and biography, whose work can be read with as much pleasure as good fiction. And the more you read, the more expert you'll become at seeing when someone is grinding an ideological axe. You'll get a sense of which historians you can trust and which you must sift for truth.

It's like watching football or baseball. Both games can be confusing and boring if you truly don't know anything about the game. What are they doing now? This makes no sense!

But the more you watch, and the more people explain it to you, the more you come to understand what the game actually means. Eventually, you are able to recognize good strategies and fine individual achievements for yourself. Things make sense.

Let history be a game you take seriously and watch closely. Because unlike sports, which have nothing riding on them but the salaries of a few athletes and coaches and the bets of fools, every aspect of our lives is affected by history as it unfolds, and if we can get to understand that game as deeply as possible, we might actually cast more intelligent votes.

Instead of most of us vote with "teams" like Republican and Democrat, Left and Right, which are as arbitrary and meaningless as saying the Steelers are "from" Pittsburgh, when almost none of the players have any ties to the city.

The parties are about winning; most of the good historians, however, keep their team loyalties out of their books; and even when they slip in some of their bias, the profession of historian still has high standards of accuracy.

Historians are usually ashamed to be sloppy, biased, or inaccurate, and the result is that with a very little effort you can have far more understanding of history, and make far better judgments about what would be good for America, for our home state and home town, and for the world than any but a handful of the politicians we elect to make decisions for us.

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