The Coast Range, British Columbia


The Bulkley River, British Columbia


This has been a busy summer! I spent a week in Brooklyn with my son as he underwent and initially recuperated from a total hip replacement. During my stay, I had the opportunity to read Goldilocks and the Three Bears not just once, but several times. Probably about 11 times.

My grandson, Walker, (think Walker Percy, the writer or Walker Evans, the photographer) obviously thinks highly of the story and so do I.

Actually, my interest in Goldilocks began some years ago when I was managing immunosuppressive medications. The trick with immunosuppression is, of course, not too little and not too much! Abstracted a bit more, the story tells us that in many of our activities, the relationship between a given parameter (temperature of soup) and a desired outcome (good taste of soup) is not linear. These relationships often take a U-shape or a J-shape, depending on how one draws the graph.

Walker lost interest when I tried to explain how to graph his story (increasing soup temperature on the X-axis, increasing tastes good on the Y-axis = upside down U.) You shouldn’t. This is how a lot of things work in life. Now we’re going to talk about one of them.

The August 22 issue of JACC (the Journal of the American College of Cardiology) has now completed preliminary seasoning. It has rested quietly in a stack of printed material on the breakfast counter, slowly making its way to the surface.

In it are some interesting data, along with a thoughtful editorial. (data, Xi et al, J Am Col Cardiol 2017; 70:913-922 and editorial Gaetano and Costanzo, pgs 923-925.)  The data are a re-confirmation of the J-shaped relationship between alcohol consumption (gm/day) and the relative risk of total mortality.

If one sets the baseline relative risk of dying at 1.0 for “never consumed alcohol” abstainers (this excludes problem drinkers who are abstaining for health reasons), the relative risk of dying from any cause actually decreases to about 0.85 for those who take a drink or two a day. Then it heads right on up, so that when you get to a half-dozen or more pops a day, your risk is well above 1.0.

What does this mean? However the Goldilocks story began, it means that the concept of getting something “just right,” whether it’s the dose of cyclosporine or the temperature of the soup, is something that humans have been working on for a long, long time. Probably almost as long as they have been fermenting stuff…

Note: 20170827-DSC02182.JPGThe two landscape photos are panoramas of multiple shots with my Nikon D7100, put together in Adobe Lightroom. Enjoy!