25 years ago today, my wife Lisa and I had our first date. Months earlier, we met each other the old fashioned way, at one of Baltimore’s landmark watering holes…the “Cat’s Eye Pub”. But as they say, life got in the way. It wasn’t until the Saturday evening in late October, as I was heading into my elevator for a night on the town. Sparks flew as I came face-to-face with the same strikingly good-looking woman (shown above) that I had met earlier that winter. As it turns out, she was exiting the elevator to attend a party for two of her friends who just happened to live on my floor! Several days later, we met for sushi. Minutes of easy conversation flowed seamlessly into hours; the rest is history. Over the years, I’ve learned more than a few lessons that has enhanced our relationship in good times and in times of stress. That said, here are five simple things that guys can do to enrich their love in the time of COVID-19 (and beyond).
Start the day on the right foot: Whether it is unloading the dishwasher, feeding the dog, making coffee, etc.-whatever eases her burden will go a long way toward contentment.
Touch base midday: Check in each day with a simple text to see how her day is progressing.
Do something together each day: The after-dinner walk is always a great activity weather permitting, but even doing puzzles/word games together are fun. Our favorite these days is NYTs “Spelling Bee”.
Express gratitude: This might seem obvious, but expressing gratitude for the time you spend and things you enjoy doing together, never grows old…even as we all do.
Laugh together: Take the 4 things mentioned above, add up their significance and you arrive here. Laughing together helps to sustain and nourish relationships. While it might be more difficult to easily engage in laughter during this time of crisis, it is also a powerful de-stressor that may improve your overall health and spirits (more to come).
Michael Miller, MD is Professor of Cardiovascular Medicine at the University of Maryland School of Medicine in Baltimore, Maryland USA. His latest book is “Heal Your Heart: The Positive Emotions Prescription...” published by Penguin Random House.
My father-in-law Paul, was born on this date (October 17) in 1916, two years before the dreaded Spanish Flu Pandemic and more than a decade before the Great Depression. His father was born in Lithuania and was an indentured servant until he was able to escape to America, the “Land of the Free”. Paul was born in Baltimore, the 3rd of 5 sons. A great storyteller, he would regale us with amazing memories. For example, his favorite teacher growing up in the 1920s was “Miss Booth”, a matronly spinster rumored to be a cousin of John Wilkes Booth, whose family had lived outside of Baltimore.
As I got to know Paul, it became apparent that he was a most remarkable man. He was born to teach and math was his forte. One night at the dinner table about 15 years ago, I asked Paul out of curiosity, whether he knew how many years he had been teaching. Ironically, despite being a math wizard, he had never done that calculation! As it turns out, he started teaching in 1934 (after graduating college at the age of 18) and to that point had been teaching well over 70 consecutive years. We wondered whether he might qualify for the Guinness Book of Records. They requested detailed information – we contacted the Social Security Administration and received Paul’s records dating to the late 1930s (Social Security did not exist when Paul began teaching)! Amazingly, Baltimore City had Paul’s earliest teaching records. Nonetheless, the Guinness Book of Records rejected our application, stating that the record holder was Medarda de Jesus Leon de Uzcategui who began teaching at age 12!
As it turns out, reviewing Paul’s teaching records turned out to be a treasure trove because we learned that he taught at 20 different schools. They ranged from elementary level math through college calculus, spanning secular and religious domains and Universities that were public (University of Maryland), prestigious (Johns Hopkins) and historically of color (Coppin State). Paul also taught at Fort Meade and worked on military cartography during World War II.
To Paul, math was a universal language to be shared selflessly and tirelessly with others.
When Paul celebrated his 75th consecutive year of teaching, he received a congratulatory letter from one of our current Presidential candidates. The following year, he was elected to the National Teacher’s Hall of Fame. To see their special tribute posted today, click here.
Paul taught math for 80 consecutive years, finally retiring at age 98. Having taught thousands of students (including families of 3 generations), he will tell you that his greatest achievement is his family (7 children plus grandkids/great-grandkids). He taught all of us that “if you love what you do, you will never work a day in your life“. For Paul, it has been alife well lived and words to live well by…Wishing you a Very Happy Birthday!!
Michael Miller, MD is Professor of Cardiovascular Medicine at the University of Maryland School of Medicine in Baltimore, Maryland.
Last week, My daughter started medical school in her quest to help others. But the road she took was less traveled compared to many of us, including yours truly, who took the more traditional/direct route of entry. As an undergraduate at the institution that Benjamin Franklin founded, she was drawn to architecture and after receiving a Masters degree from the home of the Trojans, she settled in Los Angeles. She began work at a firm whose mission was a bit different than hers. To put the word “green” in perspective, Avery’s vision was to construct environmentally-friendly buildings that could serve as community hubs. While the firm worked on large commercial projects, she discovered that the sustainability of the buildings was driven by the developer, not the firm. And so, she moved on.
I was delighted when she was hired to work at one of the premier architecture firms for designing health care related facilities, including medical schools. During this time, the American Heart Association was interested in collaborating with architectural groups to create “healthy spaces” in medical facilities. My colleague Dr. Francine Welty and I, volunteers for the AHA, arranged with Avery to set up a meeting between her CEO and AHA to initiate discussions toward this goal. One idea, for example would be to create more attractive stairwells, that might include piping in lively music (NOT “muzac”) to encourage and energize us to use the stairs daily. Heck, wouldn’t it be cool to have an internal Spotify player (or “Jukebox” to us older folks) inside the stairwell, where you can choose the song you would love to hear as you climb up to your designated floor?
Needless to say, I was caught off guard several years ago when upon visiting Avery and her fiancé, Andrés, she said “Dad, I’m thinking of applying to Medical School”. It wasn’t so much that she didn’t enjoy her job. Rather, she had a deeper passion to help others and a career in medicine certainly provided the perfect vehicle to accomplish this long-term goal. Over the years, Avery has certainly walked the talk. Not only did she donate peripheral blood stem cells (PBSC) for a stranger requiring a life-saving bone marrow transplant, but she has also been a strong advocate for the homeless (often giving away her lunch/buying a sandwich for someone in need) and spent countless hours after work as a volunteer tutor for disadvantaged youth.
As Avery embarks in this new and exciting phase in her life, I have no doubt that she will be an extremely empathetic and devoted physician. I recall that my classmates who took time off between college and medical school were at the top of the class. This stemmed in large part because of their deep appreciation and passion for medicine that grew after college. While Avery may be the only accredited architect in her class, there are undoubtedly other classmates who took time off to have successful ventures prior to committing to medicine. This is supremely encouraging because with medical school applications rising to new heights in the middle of the COVID pandemic, we need the best and brightest to drive the future of healthcare and medicine.
While I may have been a bit squeamish at the prospect of her desire to become a physician in 2017, based upon the many years of study/training that lie ahead, my viewpoint in 2020 is: “Avery, I couldn’t be prouder!”
Michael Miller, MD is Professor of Cardiovascular Medicine at the University of Maryland School of Medicine in Baltimore, Maryland.
Two of the many things I vividly remember about my grandfather, a product of the Greatest Generation and a 25 year veteran of the U.S. postal service, was to 1) constantly correct me when I said “you know, you know” (his retort: “…you know, you know…I DON’T KNOW”) and to teach me about common sense when I would do something stupid (not a rare occurrence) using his favorite expression…”why don’t you use a little common sense?”. There is no doubt that the Greatest Generation had a great deal of common sense to continue to build and lead this country.
I was reminded about “common sense” recently following a conversation I had with one of Baltimore’s most beloved pastors, Bishop Marcus Johnson, Sr. As we discussed the continued spike of COVID-19 in many states across the country, I asked “Isn’t it just simple common sense to wear a facemask and keep social distance?” His tongue in cheek response was “maybe common sense isn’t so common anymore!”
What has happened to common sense in our society? My grandfather was a great storyteller and had a lot of common sense. If he and many others of the Greatest Generation were alive today, they would have taught us the importance of using common sense to combat this pandemic. Since they are not, I will at least try to represent how I believe my grandfather would have responded to some ludicrous comments and continued disregard by some to use proper precautions in order to slow the spread of this potentially lethal virus.
First, the Greatest Generation would have had no problems wearing a face mask and socially distance, especially after many had experienced the 1917-1918 Influenza pandemic, a time when common sense prevailed. Yet, a Sheriff of Marion County, Florida recently ordered his Deputies NOT TO WEAR MASKS! His reasoning was: “it would be better if officers’ voices were not muffled behind masksand that citizens’ faces were not obscured.” I can hear my grandfather state the obvious: “Sheriff, if you are so worried about watching the words come out of the mouth of the Deputy or citizen, why don’t you provide them with clear face masks?”
But how would my grandfather have responded to large gatherings that disregard social distancing or face coverings, including “COVID parties“? Well, he loved to sell his stories through pictures, and it would not have been surprising if he had asked my brothers and me to think of COVID as “leprosy inside our body”. When many of us think of leprosy, we think of skin disfigurement, loss of digits, etc. But if we now visualize COVID as “leprosy inside our body” this virus would be viewed through a very different lens….after all, would anyone ever consider attending a party where they might catch leprosy? I could also envision his pinball analogy for why the virus loves to invade humans the closer we are to each other; just like more points are obtained as pinballs bounce off bumpers, the virus can more easily “bounce off” and invade people who are close to each other. The farther away (greater than 6 feet) the less likely that the virus sustain its reach and energy level.
My grandfather also taught me that listening to and heeding the advice of experts is common sense. In fact, my colleague, Dr. Robert Redfield, whom I had the pleasure of interacting with when he was Professor at the University of Maryland School of Medicine prior to becoming Director of the CDC, has repeatedly emphasized the importance of social distancing and face protection. Why would you not listen to experts such as Redfield, Fauci, and Birx who have made significant contributions and have devoted their careers to this field?
To continue not to take this virus seriously is hard to understand as we continue to lose friends, colleagues, loved ones and heroes on the front line. This was the case of Jeff S., a paramedic who was passionate about helping others. Several weeks ago, Jeff was called in to resuscitate a Police Office who was suffering from COVID. Jeff knew that the officer had COVID and despite wearing protective gear, contracted the virus and passed away earlier this week. Even first responder heroes need to ensure that their protective equipment, including N95 masks remain tightly sealed at all times, including active resuscitation efforts.
Perhaps, Pete Seeger’s classic song “Where Have All the Flowers Gone” says it best in its final lines…”when will they ever learn, when will they ever learn“?
Michael Miller, MD is Professor of Medicine, Epidemiology & Public Health at the University of Maryland School of Medicine in Baltimore, Maryland USA. He is the author of more than 200 original scientific publications and 3 books. His most recent book is “Heal Your Heart“ published by Penguin Random House.
I was very saddened to learn of the passing of my friend and colleague, Dr. Mickey Foxwell. He was the Associate Dean of Admissions at the University of Maryland School of Medicine for nearly 3 decades, during which time more than 4000 medical students were accepted, enrolled and eventually earned their M.D. degrees. As the face of the medical school admissions committee, he cared very much about each student’s welfare and their progress over the 4-year program. He knew every student in the medical school, and he even made himself available to meet with candidates who did not gain admission on the first go-around in order to make their application more competitive for subsequent tries. He was also a kind and caring physician whom his patients adored- I knew this first hand because we shared a number of patients and I was always humbled by their gratitude and admiration for him.
But it was his love of the game of baseball that connected so many of us, including myself. Mickey was a walking baseball encyclopedia and when it came to the Eastern Shore of Maryland, where he was raised, no one knew more about the national pastime. He would regale stories about some of baseball’s greatest players including, John “Home Run” Baker, Walter “The Big Train” Johnson and Jimmy Foxx (“there’s no crying in baseball”) who were raised or have family currently living on the Eastern Shore. When I begged him to write a book on Eastern Shore’s impact on Major League Baseball, he smiled and said, maybe someday…
Of course, Maryland’s most renowned ball player is Babe Ruth, whose birthplace (and museum) is directly across the street from our medical center. In fact, two of my fondest memories of Mickey involved the Babe. The first occurred when we both attended the 100th Anniversary of Babe Ruth’s birth on a cold February day when the U.S. postal service issued commemorative collectibles. The 2nd was also in the mid-90s when he beamed with delight as he showed me the autographed Babe Ruth baseball he had just purchased in pristine condition, similar to the ball pictured above, but this one was signed in green, a true collector’s rarity!
Mickey was well loved and respected throughout our medical community. But I was lucky to share a special friendship not only based on the love of medicine but also for the love of the game. Mickey, rest peacefully… in your field of dreams…
Michael Miller, MD is Professor of Cardiovascular Medicine at the University of Maryland School of Medicine in Baltimore, Maryland.
Advanced age is a well-established risk factor for heart disease and its complications. This occurs in large part because 3 out of every 4 men and women aged 65 years and older have at least 1 major risk factor for heart disease. They are as follows: a history of cigarette smoking, diabetes mellitus, hypertension and elevated LDL cholesterol levels. And while death rates from heart disease have been significantly reduced since the 1960s, the one age group where less progress has been made are in men and women 65 years and older. In fact, rates of cardiovascular disease (heart attacks and strokes) with advanced age is expected to double over the next 2-3 decades, unless risk factors are better controlled. The good news is that older hearts can age gracefully as demonstrated in societies such as in Okinawa, Japan where rates of heart attack and stroke have traditionally been low due to healthy lifestyle and excellent social engagement.
This blog will explore ways that older men and women can protect their aging hearts by taking better control of their risk factors. Even if you have multiple risk factors or have experienced a cardiovascular event, it is never too late to intervene in this process and improve your cardiovascular health. You can also check out the recent interviews that my colleagues and I did for Medscape where this topic is discussed in greater detail.
Cigarette Smoking: Because a history of cigarette smoking can shave 10 years off of your life, efforts directed at complete smoking cessation (without switching to vaping) may help to offset risk. Some useful non-pharmacologic tools include hypnotherapy, acupuncture and behavioral counseling. The Nicotrol® inhaler has been the most successful tool in my practice as it most closely simulates the act of cigarette smoking (as compared to nicotine gum or nicotine patches). Other smoking cessation aids that have been effective in my practice are Zyban® and Chantix.®. Always check with your physician to determine what smoking cessation strategies might work best for you.
Diabetes Mellitus: A normal fasting glucose is less than 100 mg/dL with “prediabetes” defined by fasting glucose levels between 100-125 mg/dL and diabetes defined as at least 2 fasting levels exceeding 125 mg/dL. If you have prediabetes, you may be able to reduce conversion to diabetes by losing 5-10% of your body weight. Similarly, if you have early stage diabetes, you may also be able to move your metabolic clock back to the prediabetes stage when a similar proportion of weight reduction has been achieved. This can be accomplished through reducing caloric intake and increasing physical activity. A simple rule of thumb is that if you just remove the equivalent of 1 bagel (300 calories) and add 2 miles of walking (200 calories) each day, you are on your way to losing 10 pounds over a 2-3 month period!
High Blood Pressure: Hypertension is defined as a systolic blood pressure (top number) of 140 mmHg and diastolic blood pressure (lower number) of 90 mmHg. The goal is to gradually lower blood pressure in older men and women. While an ideal blood pressure is less than 120/80, older men and women with long-standing hypertension typically have stiff blood vessels (arteries) and therefore lowering blood pressure too drastically and quickly (e.g., reducing systolic blood pressure from 160 mmHg down to 120 mmHg) may compromise blood flow to the brain and cause a stroke. Therefore the goal in older men and women is to more gradually lower blood pressure. This can be accomplished safely through dietary measures (less than the equivalent of 1/2 teaspoon of salt daily) and medication that is titrated over weeks to months (rather than hours to days).
High LDL Cholesterol: Lowering LDL (bad cholesterol) levels is an important component to reducing cardiovascular risk with benefits persisting well beyond age 65. A healthy LDL level is less than 100 mg/dL but if you have cardiovascular disease, your LDL target goal should be less than 70 mg/dL. Natural ways to lower LDL include foods that are high in soluble fiber (such as oats, beans and psyllium- see “Heal Your Heart” for a list of the Top 50 Foods) as well as safe and effective cholesterol lowering medications that are proven to reduce the risk of a heart attack and stroke.
While vacationing a number of years ago, I heard an older gentleman grimace when he heard a younger father say to his boy, “come here buddy”. “A father should not call his son his buddy” he remarked angrily. Soon after, when I made a similar pronouncement to my son, the old man got up from the pool and left in disappointment and dismay. While I understood his belief that a father calling his son “buddy” might signal development of a collegial relationship and contradict the “older-school”, authoritarian parenting style, I didn’t quite grasp why the former could not be incorporated if parents instilled a solid value system. That is, why can’t a parent also be a friend to their age appropriate child(ren)?
In fact, over the years, our parental-son relationship has been built on a solid foundation of empathy, kindness to strangers and respect for all. And yes, my son and I enjoy each other’s company and friendship. These days his common interchange is “watch it fella”, when he’s sinking basketball 3-pointers behind the top of the key or reminding me not to challenge his 6’3″ frame when driving down the lane for a layup. Recently, I’ve been able to provide the satisfactory retort “gotcha fella” at the billiard table after he gifted me a cool pool cue stick on my b-day that has indeed vastly improved my game.
All told, our family is very fortunate to have such a thoughtful, kind, appreciative and considerate young man in our lives. We hope that his lucky number “17”, will ring true throughout his 17th year-
It’s been 20 years since I led a study evaluating gender disparities at leading medical institutions in the U.S. and Canada. Our research was among the first to show that women were vastly undertreated than their male counterparts despite having a similar degree of coronary disease. Over the past decade, I’ve also had the privilege of serving as a Trustee for The AstraZeneca Foundation’s Connections in Cardiovascular Care, where we’ve funded more than $20 million in innovative, non-pharmaceutical based community projects to marginalized communities. However, systemic discrimination continues to pervade our country’s healthcare system and should be classified as a health risk. Upon medical school graduation, reciting the Hippocratic Oath is a rite of passage. One of its core tenets reads that a physician is “to treat the ill to the best of one’s ability”. This statement is meant to encompass ALL people: of all races, religions, genders and sexual orientations. Unfortunately, research has shown that this important oath has not been upheld properly. It’s time for the medical community to recognize this and make systemic changes.
It takes activists and community leaders working together alongside dedicated professionals to help reduce health care disparities. Progress can be achieved through greater awareness in the medical community, and educational initiatives in the patient population. Such an initiative might include a series of educational messages featuring BIPOC (actors or medical professionals or patients) on media-based platforms that are promoted by prestigious organizations such as the American Heart Association. The goal of these messages would be to increase knowledge and relevance of heart disease risk factors, such as hypertension in underserved communities. Another goal would be to ensure that heart healthy foods are readily available in all communities, focusing on those with food insecurity. One such successful program is the Sankofa Community Development Corporation in New Orleans, LA which educates high-school age youth and their families about heart healthy lifestyles, nutrition and techniques for growing fruits and vegetables.
A third goal would be to integrate healthy nutrition with measures to increasing physical activity to help reduce the high rates of obesity in underserved communities. An example of one such successful program is the “Partnering for Youth Cardio-Fit Project,” which provides free-after school programs to enhance physical fitness and overall well-being. The fourth goal would be to offer programs that help to reduce chronic stress that in itself, remains a significant health issue in these communities. This might include yoga, meditation, tai chi, dance instruction and spirituality exercises. For example, in my Baltimore community, there are a number of local wellness advocates who provide free access to yoga and meditation.
Right now, there is considerable unconscious (and conscious) bias that arises when medical professionals see a patient that is part of the BIPOC community. For example, when a Black patient discusses their health concerns, medical professionals (on average) are less likely to take their concerns as seriously as they might a White patient. This shows that these problems must be solved NOT ONLY with community outreach, but also with a revised curriculum for medical professionals. Physicians, nurses, PAs, etc. must all be trained in unconscious bias and learn how to recognize how these biases affect patients in real time. In addition, medical schools need to revise their curriculum to include case studies that showcase conditions in multiple races (since diseases may manifest themselves differently depending on the racial makeup of a patient). For example, @brownskinmatters is an awesome instagram account that does this for dermatological conditions.
The bottom line is that as health care professionals, we need to do better and treat all of our patients as if they were our family members, regardless of race, religion, gender or sexual orientation.
In celebration of the Juneteenth holiday, I would like to pay homage to Dr. Elijah Saunders, a world renowned cardiologist who was one of my heroes and a hero to countless medical students, physicians and patients alike. Dr. Saunders was the first BIPOC cardiologist in the state of Maryland who practiced for nearly 50 years until his passing in 2015 at the age of 80. He was the consummate physician who gave patients his all, all of the time. His area of expertise was hypertension for which he was not only a stalwart who took care of thousands in the black community, but he was also a Doctor’s Doctor because we constantly sought his advise and looked up to him as a leader in the medical field.
I met Dr. Saunders 30 years ago where he was a professor at the University of Maryland School of Medicine and head of the Hypertension Division. Soon after, his pioneering work found that black patients responded better to certain blood pressure medications, helping to pave the way for identifying more effective blood pressure treatments in underserved and marginalized communities throughout the world.
He was a brilliant physician and had the innate ability to inspire curiosity in others, regardless of their background. He always made himself accessible — from patients to junior residents to senior staff members.
Medicine today as we know it was shaped by his enormous contributions.
Michael Miller, MD is Professor of Cardiovascular Medicine at the University of Maryland School of Medicine in Baltimore, Maryland.
In celebrating our wedding anniversary on August 25th, I’ve reflected upon some commonsense strategies that have worked for us over 20+ years. Here are 6 meaningful ways to strengthen your bond because healthy marriages= healthy hearts!
Always Show Gratitude: My wife Lisa, has always expressed appreciation for even the most mundane tasks and I’ve learned over the years that being grateful never grows old even as we do.On the other hand, not being appreciative on a regular basis (or supportive, for that matter) will erode a relationship.
Be United: Just like there is no I in TEAM, working together a united front strengthens bonds. For example, don’t fall for your kids manipulative games such as “well Mom (or Dad) said it was okay”. When one of us is not readily available, our mantra has consistently been “…your mother (father) and I will discuss it and get back to you”.
Compromise is Key: Because life in a 24/7 environment can be super busy, we sometimes forget things/tasks/priorities. Not to worry…when this happens, we make it a point to compromise… “I don’t have time to take George (our dog) out today or tomorrow, can you please take care of him and I will make it up next week?…”
Divvy up Duties: Even though this may seem intuitive, it’s not uncommon for relationship imbalances to occur as it relates to household chores, spending and other shared responsibilities that can lead to bad will and resentment. Just like financial portfolios tend to be readjusted on a regular basis, rebalancing shared responsibilities (if needed), will solidify the relationship.
Embarrassment is never an option: Embarrassing your partner in public (intentional or otherwise) is disrespectful and destructive to relationships. Air out grievances behind closed doors and in a civilized tone that cannot be heard by others.
Find time to celebrate your relationship: You may need to add it to your (mental) calendar but carving out time specifically designated for the 2 of you only (such as a weekly date night) is precious time that is well spent.
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