Recently, I had been invited to address a selective group of  Deans and Directors from a local university and independent hospital. My presentation was centered on, “The Role of Integrative Health and Medicine in Rural Hospitals,” and it was  based on my work in wellness and prevention. I defined our efforts at both Windber Medical Center (now the Chan Soon-Shiong Medical Center Windber) and then nationally with the Academy of Integrative Health and Medicine.

            Because my goal was to help build a stronger commitment to preventative health and wellness at both organizations, I addressed how a combined effort between these two strong neighboring not-for-profits could foster improved health in their workplace for their employees, for their patients and university students, for the citizens in the communities they served, and finally, for the students in their local school districts.

In the book “Why Zebra’s Don’t Get Ulcers” Robert Sapolsky exposes us to the concepts of stress management and biology. When addressing diet and stress management, he gives the example of a young lawyer who decides that “red meat, fried foods, and a couple of beers per dinner constitute a desirable diet, and the consequences are anything but clear. Half a century later, maybe that attorney is crippled with cardiovascular disease, or maybe he’s taking bike trips with his grandkids.”

As Sapolsky stated in Zebra’s, “We are certainly aware of the extraordinary amount of physiological, biochemical, and molecular information available as to how all sorts of intangibles in our lives can affect very real bodily events.” My presentation was directed toward the steps we, as education and healthcare professionals, can take to assist our stakeholders in their life-journey.

Because “sustained psychological stress is a relatively recent invention mostly limited to humans and other social primates, we can experience wildly strong emotions linked to mere thoughts.” These fight-or-flight emotions were originally intended to assist all mammals during their lives but especially when being chased by saber tooth tigers. (That doesn’t happen much anymore.)

            The purpose of my presentation was to provide them with the tools needed to help deal with our daily ongoing stressors. It’s all about diet, moderate exercise, non-judgmental social support, and stress management via mindfulness activities. In many cases, we can decide every day in every way what should be worth dying over and, for the most part, determine what types of things knock us out of our homeostatic balance?

            Inactivity can be as harmful as smoking a pack of cigarettes a day. Obesity kills as many people as smoking which is life-ending annually for over 450,000 people in the United States alone, but stress? There’s no limit to the amount of people who are harming their health and limiting their futures by not learning any type of mind-calming, stress management techniques. It doesn’t matter if it’s yoga, the rosary, worry beads, meditation, or calmly nurturing a pet.

            Sapolsky goes on to explain the various “nuts-and-bolts factors” that will help determine which of these outcomes will occur. He explores the liver’s role in the making of cholesterol, the enzymes in fat cells, and potential congenital weaknesses. Then he hits the motherload, which is personality and how we individually deal with the stress generating problems between the mind and body.

            We know that the predominant diseases we deal with today are those resulting from, as the author explains “a slow accumulation of damage—heart, cancer, and cerebral vascular disorders.” We’ve also come to learn the fact that these inflammatory diseases are fed by a “complex intertwining of our biology and our emotions.” And there is zero doubt that “extreme emotional disturbances can adversely affect us.” In other words, “stress can make us sick.”

            Bottom line? Find what stops your amygdalae from pushing your emotional buttons to stop making you think that a tiger is chasing you.

            My former Chief Operating Officer, a former emergency room physician, used to look at me when I was stressed and say, “Everything’s okay. No one died.”  And, indeed, it was, and even I’m still here.

In the 1988 film, Who Framed Roger Rabbit, a down-on-his-luck private eye, Eddie Valiant gets hired by cartoon producer R.K. Maroon to investigate a scandal involving Jessica Rabbit, the wife of Maroon’s biggest star, Roger Rabbit. But when Marvin Acme, the owner of Toontown, is found murdered, Judge Doom vows to catch and destroy Roger. If you haven’t seen this movie, it’s time because the country is currently going through a similar experience with the Former President, Donald Trump. Our country may be Marvin Acme, and the January 6th committee Judge Doom, but who is the real villain?
Trump has had some horrific luck during his lifetime where, even though he questionably inherited, many millions of dollars from his real estate-mogul father’s estate, there are those who have analyzed how those funds were used and claim his life would have been better, he would have been wealthier, and even more positively perceived by everyone if he had just invested that inheritance and lived comfortably from the interest generated.
If you look at his history of failed businesses, it’s a lot longer than even his history of failed marriages. I’m sure just paying off his ex-wives, his other misadventures with the ladies, and his myriad lawsuits from not paying contractors and craftsmen for the work done on his various bankrupt buildings, he could have lived luxuriously forever. Stack on top of that the failed Trump Airlines, Casinos, University, Steaks, the Trump Game, Trump Mortgage Company, Trump’s Corporate Communications Company, Trump Travel Site, Trump Tower Tampa, Trump mattresses, Trump Vodka, and even Trump Cologne. Per Forbes, “Trump claimed that his brand and brand-related deals were worth some $3.3 billion. Forbes valued his brand at less than .04% of that amount.” And went on to say, “Trump has repeatedly stood for half-baked schemes, shoddy work, and sketchy characters.” The poor guy just can’t catch a break.
Unlike Eddie Valiant, however, the former twice-impeached, disgraced president had been exposed to a philosophy of living from, among others, his famous Pastor, Reverend Norman Vincent Peale and other mentors and influencers such as his attorneys, Rudy Giuliani and Roy Cohn, chief counsel to the infamous U.S. Representative Joseph McCarthy. Philosophically, he believes whatever the outcome is, never admit defeat. Not unlike Joseph Goebbels, Hitler’s chief propogandist who succeeded Adolf as Chancellor of Germany for one day before he and his wife committed suicide, after poisoning their six children with cyanide, Trump discovered you can win over the masses by using provocation to bring attention. There was a link between all of these men that seemed to inhabit our former president’s psyche. If you do fail, never admit you failed, which was Rev. Peale’s “Power of positive thinking” on steroids, Then, make sure there are people upon whom you can place blame even if you have to fictitiously create them, and Goebbels’ if you tell a lie often enough, people will believe it no matter how ridiculous it is.
Well, the January 6th Committee is carefully unpeeling the Trump onion by using not only his closest advisors, appointed leaders, and former allies, but also his oldest daughter and her husband to demonstrate what he knew, when he knew it, and how he selectively chose to ignore them. He did this to perpetrate the greatest scheme in American History by refusing to secede power and step down as President through igniting the ire of the masses via his “big lie” about a stolen election. According to the witnesses, he skillfully used his accusations and provocations to generate a quarter of a billion dollars designated to defend his presidency but instead spent it on his hotels, and to elect and buy candidates who would be loyal to him.
We don’t know how this real-life movie will end. Will Judge Doom or Merritt Garland press charges? Will autocracy replace democracy? In this case, it’s up to you.

As I sort through my thoughts, I look down at my hands and remember how small they once were,

When my Mom would hold on to each one of them tightly and happily swing me around.

Just like every young kid, my whole world was still new, filled with laughter, with love and with her.

She would hug me and hold me, and sometimes she’d scold me, but then kiss away every frown.

As a small child I knew that my mother would love me and always would help my light shine.

And when I got scared, or felt bad, or was angry, her love like a blanket was there.

It was great to be wanted, to feel that deep comfort, to have such an innocent time,

To be swaddled in light and be filled with contentment with not even one tiny care.

When I saw yesterday that nine shots had been fired just a block from my last Pittsburgh home,

I thought first of Uvalde, the Tops store in New York, then my mind went geography bound

To the 213 mass shootings we’ve witnessed that happened just this year alone,

And I feared for the lives of my neighbors and friends, When I saw a young mom on the ground

Holding Baby De’Avry and crying for help as she cradled her son to her chest.

Her small child was the victim of a gang drive-by shooting, a repetitive story too long.

And like so many others whose names we all know, he was taken, his soul put to rest.

Yes, her baby was just one more senseless victim, collateral damage, so wrong.
So now we must do everything that we can do to stop all this carnage and pain.

Like thinking and praying, and loving and caring, but most of all taking strong stands,

To work with our towns and our government leaders because this is really insane.

Our country must find every possible way to stop wiping this blood from our hands.De”Avery

Think before you speak or just ‘Statazit’

Nick Jacobs

Columnist

As a kid, we were never allowed to say ‘shut up.’ My Italian grandmother would, however, sometimes playfully say statazit (Sta ta zeet) to my grandfather. Yeah, in Italian slang that meant ‘shut up,’ or her English translation, ‘Shut up-a u face.’ But if I ever said that in public, my Presbyterian-Quaker mother would literally end that expression with a swift kick to the pants.

Depending on who or why you say it, ‘Shut up’ can be fighting words, but gosh knows there are several times a week where it is a suppressed response. Statazit, however, is sometimes a fun way to get around being punched.

When you hear a young childless person say something like ‘I believe all kids should always eat whatever they want like gummy worms, chocolate cookies, and soda pop.’ The correct response from anyone anywhere who has any understanding of diet essentials would be, ‘Statazit.’

There was a time when we, as human beings, understood there were areas of experience and expertise about which we had little or no knowledge. That lack of knowledge rendered us as unqualified to express our opinion about the subject.

For example, I don’t know how one goes about preparing a meal that includes beef bourguignon. In fact, I’m not even sure what’s in that recipe except beef and whatever bourguignon is. Consequently, I’m not willing to consider stating my opinion about how to prepare that dish. That, however, is no longer a problem. People now continuously loudly shout out their ideas about things about which they have no knowledge. It’s like some type of arrogant ignorance.

Short of a replacement for the named devices below, I’m not an expert on what it takes to fix the garbage disposal, garage door opener, or for that matter, the front door. Therefore, you will never hear me criticizing or belittling someone who has fixed or replaced any of those things correctly multiple times.

Here’s my point. If we can agree that individual human beings are capable of developing skills from training, repetition, guidance and education that are not skills we have had the opportunity to develop in our lifetimes, we should also be willing to admit they have some deeper understanding of certain subject areas that we don’t have.

That is not a serious idea to comprehend.Do you, for example, know what complex mathematical formulas it takes for an engineer to design and build a skyscraper? No? Then, ‘Statazit.’

Why is it we are being consistently inundated with people on both sides expressing their usually baseless opinions about things they don’t understand, or about things that require knowledge they don’t have? The majority of those topics are not only complex, they are also figuratively and sometimes literally brain-busters.Yes, of course we have the right to free speech, but we shouldn’t expect society to pay for the consequences of our incorrect decisions, decisions that can both harm us and others around us for life. If you’re not sure about something, just ‘Statazit.’

Here’s the bottom line. Go to a hardware store and look at their large selection of filters. We have filters for a good reason. They protect us from dirt, germs, dust, polluted water, and other potentially harmful elements. Unfortunately, they don’t have filters for our words or our thoughts and therein is where the problem lies. Take one second and think before you speak. It’s an amazing way to appear sane, to keep from getting punched, or from having your car keyed. Sure, you can have opinions, but do some serious homework before you choose to die on any particular hill.

Just take a step back once in a while and consider what you’re passionately screaming about. It could be that you should just ‘Statazit.’ Of better still, carefully say it under your breath because someone might understand Italian and give you a Will Smith whack across the mouth.

When I was a little boy, I remember hearing a loud explosion, looking out our kitchen window and seeing a cross burning in front of the Catholic church. My mom, a daughter of the American Revolution whose relatives had been in the U.S. Congress, attorneys, and military officers, and my dad, a first- generation Italian born to immigrant parents, told me not to be afraid. They told me it was just people who liked to celebrate on Friday nights. (By setting off dynamite and burning crosses?)
By the time I was a teenager, this home-grown terrorism toward Catholics had reached a new peak as the first Catholic was elected president, and the United States traditionalists said that the pope would take over running Washington. Obviously, that didn’t happen, and John F. Kennedy became one of the most beloved presi- dents to serve our country.
As an adult, I once asked my mother if she ever knew anyone who was in the Ku Klux Klan, and she very ca- sually said, “Only my dad when he was very young.”
Growing up it was not unusual to hear derogatory
from some of the teachers toward the students. Consequently, I began to treat my non-white students from the Philippines and China, or the African American, or LGBT very special.
I was their guy because, as a musician, I didn’t see differentiators and didn’t care. All I wanted to know was how they played their instrument.
My liberal approach to these minority kids became so obvious to them that one of my gifted African American students came into my office one day and said, “Mr. Jacobs, I need to tell you something.” She went on to say that her friends desig- nated her to be the one to tell me to stop treating the Black kids so differently. She said, “Mr. Jacobs, we just want to be treated the same as everyone else.” That girl was 13 years old, but she taught me a lesson that has lasted for my entire life.
As the president of a re- search institute with brilliant scientists from all over the world, and as a student at one of the most diverse schools in America, Carnegie Mellon, I saw first-hand that intelligence, ability, and more importantly work ethic, drive,
and ambition was not limited to only one race.
The only thing one has to do is watch some of the reality TV shows to see messed-up people, and that’s not race- based. There are gifted, kind, and not-so-kind people of all races.
That statement “of all races” is really where the problem begins. There truly is only one race, the human race, and liking people be- cause of skin pigmentation, hair texture, eye shapes, or any other differentiator should be a nonstarter for any of us, but hatred is definitely taught.
Some of the absolutely most beautiful people in this world are amalgams of all races, colors, and creeds. So, if you’re a hater, look in the mirror and try to determine what it is you hate. It may be looking back at you. Oh, and do 23andMe genetic testing. You may be a part of one of the races you hate.
As Albert Einstein said, “What a sad era when it’s easier to smash an atom than a prejudice.”

One of my favorite songs is titled “Come in From the Rain,” and I’ve been thinking a lot about it lately.
Having evolved from a humble home with humble relatives and goals, I must say with complete sincerity that I am grateful for the things I have both experienced and accomplished over the past nearly 525 dog-years. In fact, when I review the history of that journey, I sometimes marvel at that completely unpredictable somewhat off-the-wall list.
If anyone had ever told me I would have ended up running hospitals and a few research institutes after having been a school band and orchestra director, leading an arts center and being a tourism CEO, not even I would have believed it.
It’s been quite a journey, and thankfully, however restricted it has been recently, it’s still going on today, and that is more than I can say for dozens of my friends and relatives. So, there’s definitely that. When it all boils down though, I can honestly say I wish everyone could experience the peace of mind and contentment that comes from a look back at a life fully lived.
I do continue to have dreams and wishes for the future. The most important wish I have for 2022, however, is for you, your loved ones, family and friends. In my case, my two kids and their mates plus our six grandkids, and my wife who all need special attention as we try to dodge round five of this virus-filled, chaotic time in American history.
I’m praying for order. That’s it, plain and simple. If I had to describe my premier New Year’s wish it would just be for order, free from the chaos that enveloped us these past several years. All I’m proposing is that we embrace that order over chaos. Let the plague end. Let the fighting end. Let the misunderstandings and hatred end. Let there be peace on earth, and let it begin with you.
Oh, wait, those were also lyrics from a song.

New Year from a Boomer

2-O 2-1 is now fading away, and so are the memories some happy, some not.
With the new year approaching and daylight extending, let’s celebrate the good things we’ve got,
Like our family, our friends, like our pets and our homes, and our health and that favorite chair.
If you’re older like me, love the fact that you’re free and you still have some small clumps of hair.
Love the sunshine, cool breezes, the snow-covered mountains, the Sheetz stores wherever you turn.
Love the fish fries in Lent, and a clean dryer vent, and the fact that you’re not in an urn.
The economy’s booming and jobs are rebounding while normal life makes its way back.
We continue to learn the full value of sleep, and what time we should hit the ole sack.
If you’re reading this, it’s ’cause you’ve made it through Christmas, in my case that’s 74–
Right, 74 times I’ve hung out with Santa, and snuck him in through the front door.
Set your goals now for 2-0 2-2 if you can, drop five pounds and drink some red wine.
Eat some dark chocolate, and don’t get the COVID and make sure your blood pressure’s fine.
Turn off cable news, and wear comfortable shoes, and make sure that you go for a walk.
Live your life with ambition and make sure permission is not part of anyone’s talk.
’Cause we’re finite on earth, and we know that’s a rule that even the rich can’t escape,
So we might as well do all the good that we can, while we can, that would be no mistake.

Now stand tall and straight with your shoulders flung back and cry out with the most gleeful strain:
Happy New Year my friends, have a wonderful year and for gosh sake come in from the rain.

The song writer, Frank Loesser wrote the now politically incorrect song titled “Adelaide’s Lament” for the Broadway Musical, “Guys and Dolls” which first came out in 1950.  In the song he refers to the stress a woman faced “back in the day” who had not yet found a husband. So much stress in those days that, “A person could develop a cold. La grippe. La post nasal drip. With the wheezes. And the sneezes. And a sinus that’s really a pip!”  It also said, “You can spray her wherever you figure there’s streptococci lurk. You can give her a shot for whatever’s she’s got, but it just won’t work.”

So, my seven-year-old Petri dish grandson developed a cold. He passed it on to pretty much everyone he knew including his first grade significant other. That cold ran through his house like California brush fire until it landed safely in his grandfather’s nose. Unlike 1950 however, a cold is no longer a cold. You see, I had two important meetings coming up and I was supposed to teach a three-hour leadership class on Friday, and I surely didn’t want to infect anyone with whatever is going around.

I drove to the local Rite Aid and bought a quick COVID test which came up negative, but how dependable are the quick tests? My son had had two negative tests and when the PCR came back, it was positive. Consequently, I masked up for the meetings and kept my distance. It was not until the night before the leadership class that things got tense. You see, after having had a slightly sore throat, and sneezing my way to oblivion, I developed a fever. That’s when I decided to go all out and find out what the heck was going on with my body. 

Now three years ago that would have meant, take it easy, blow my nose, drink plenty of fluids, take Tylenol as needed, get plenty of rest, and chew on some Vitamin C tablets. But today we have to be concerned about COVID, Flu, Strep throat, a Strep blood infection, and even Lyme. Having had a strep infection from a 32-year-old root canal earlier this year, the possibility of a reoccurrence and 42 days of IV antibiotics was still on the table.

The other thing that is different now is the hospitals are full, and they usually can’t let you in if they’re testing for COVID or you think you might have COVID. So, all of these tests that I described for all of those potential ailments had to take place in a 30 degree parking lot with dainty snowflakes drifting slowly from the sky. Let me be clear, I was in my running, heated car, but the laboratory technologists and nurse had to stand outside my car in their light-weight scrubs while they swabbed my nose, drew my blood five different ways from Sunday, and did all the things they had to do to rule out these numerous potential invasive bugs.

During my first year of teaching, I had nearly 150 students in my marching band. I alone would load them into five school buses with only me and the bus drivers as chaperones. My last year of teaching I had 120 students, an RN on every bus, parents on every bus, a brief case filled with the prescription drug permission slips for each student, and parental permission to allow a student to be treated at any emergency room. Oh, and did I tell you?  That was 1979. 

Now that 80% of the deer in Iowa have been diagnosed with COVID, and it may be cross-over COVID. That could mean that for the first time, deer would be thinning the human herd rather than humans thinning the deer herd. What a complicated world we live in because “A person, could STILL just develop a cold.” 

The 10 minute drive to work was routine. It was one of those amazing September mornings where, no matter your age, your work responsibilities, or your lifestyle, you had to be in awe over the beauty and brilliance of the nearly cloudless, luminescent blue sky. It was warm, sunny, and what could only be described as a perfect morning. In fact, every time I experience those same stunning atmospheric conditions of that Western Pennsylvania morning, a tinge of telltale PTSD chemistry runs through both my connecting neurons and my bloodstream because what unfolded not two hours later  evolved into an emotional catastrophe for our country.

The very nature of my position as the CEO of a hospital often revolves around one’s ability to cope with tragedy, heartbreak, and trauma.In fact, having spent the previous five years at the Level 1 Trauma center, communicating and dealing with tragedy had somehow become, at a certain level, just part of the job. That morning, however, was different. It was a virtual body blow to the soul on every level.

My 8AM meeting with a former Mossad agent and a U.S. Ranger was a discussion of the possibility of utilizing our sophisticated proteomics and genomic analytical equipment from the DoD funded research institute that was a part of our health system in detecting the presence of anthrax.  It was a topic that I had hoped would never need to be broached in little Windber, Pennsylvania, but world matters, terrorism, and various political miss-steps had gotten us to this point in our international relationships.

In the middle of this meeting, my assistant politely interrupted our meeting to suggest I step into the administrative conference room to watch the television that had been tuned into the Today Show. As I stood to walk there, my cell phone rang.

It was my wife who said, “Are you watching this?”

My response was, “What?”

To which she replied, “A plane just hit the twin towers.”

“I’m on my way to the TV right now,” I replied.

And as I entered the small conference room, plane number 2 hit the second building. No one was really sure what was happening at that time, but that second plane did not seem like the first hit was a fluke. We watched for a few minutes more and then returned to the meeting where we continued our previous anthrax discussion.

Several minutes later, I received a call from the Trauma Center that they had just been notified that a plane with 157 passengers on board had reported a bomb on board and were headed toward the Johnstown airport. The caller suggested that I put our hospital on full trauma alert. My mind immediately sorted through those numbers and realized that at least 100 of those potential patients could not be cared for immediately in the three local hospitals due to staffing and capacity issues. I called an immediate full-alert which meant getting extra gurneys, calling in off-duty emergency room physicians, and preparing for a full disaster response.

A few minutes later when people described my complexion as a dull shade of gray, I received another call, and that call was more stark. Cancel the trauma alert, the plane has crashed near Shanksville, your paramedics will be needed onsite. By then, the word of the attack on the Pentagon, the World Trade Center and what some referred to as Fort Murtha because there were so many DoD funded plants operating in this area had painted a picture of warfare, and we were told there were approximately 1200 unaccounted for airplanes in the sky of the United States and we should be on the lookout for stolen ambulances and other emergency vehicles potentially containing terrorists.

Our paramedics were deployed and spent the day at the site of the crash. When they returned, they told me the following, “We have bad news and worse news. Everyone on that plane was killed, and no one there took precautions in the event there was anthrax or any other potentially lethal substance on board that flight. We could all be dead by the end of this week.”

Ironically, by the end of the week, the hospital was filled with sneezing, coughing employees who had either psychologically manifested an anthrax infection or had not taken proper precautions against a common cold.  And that was the beginning.

A few weeks later I received the call from then County Coroner, Wallace Miller, asking about out capacity to house the remains of the victims found at the site in our minus 180C freezers at the research institute. Obviously, we were ready and willing to accommodate his request, but those remains were sent to the Bethesda area where all other victims remains were being held and genetically analyzed.

Our involvement with those first responders continued with the help of our in-house psychologist who was made available to them over the next several months. Since then, life has not been nor will it ever be the same for the United States of America. Our perceived impermeable status would forever be history.

Hey Rox,