When Steve Jobs died, I mourned the passing of a great innovator. He took objects other companies made and elevated them to conversation pieces. No cell phone, laptop, or pad-like objects were as popular or as talked about as the ones made by Apple. That got me thinking. What makes a great innovator? Can I be one? Where do I start? Let’s face it. Only a handful of people will ever invent something useful. The one place we can innovate is in our personal lives.

At the start of this new year, many people make resolutions. 83 % of people make the same resolutions every year! Maybe we should not be engaged in the same unsuccessful endeavor annually. This year, instead of making resolutions, maybe we should make plans to innovate our lives.

To innovate your life, you have to not just think outside  the box, but live outside the box. Wouldn’t it be great to face and conquer some fears and grow as a result? People make resolutions because they are hopeful for change. Most resolutions are not a good road map to get where you are going. What is the difference between a resolution and an innovation? A resolution says “I’ll work out more”. An innovation is saying “I’ll run a marathon this year”.  A resolution states “I’ll spend more time with my family”.  An innovation states “I’m taking my family to the Grand Canyon for a week”.

In 2012, I hope we can tap into the Steve Jobs in each of us and finish the year a better version of ourselves.

One of the most common questions I get asked as a surgeon is whether “stress” contributed to one’s cancer diagnosis. First of all, what is stress? A good scientific definition is that it is the “emotional and physical strain caused by our response to pressure from the outside world”. Every animal knows stress from moths to man. To be alive is to have stress in some fashion.

The effect of stress on decreasing immunity is well documented. However, the National Cancer Institute reports, “Although studies have shown that stress factors, such as death of a spouse, social isolation, and medical school examinations, alter the way the immune system functions, they have not provided scientific evidence of a direct cause-and-effect relationship between these immune system changes and the development of cancer.” Holocaust survivors have been shown to have a 2-4 times higher rate of cancer. This is primarily believed to be from the severe calorie restrictions and starvation they underwent. Even this 2-4 times higher risk is quite minimal for most cancer. For example, the average woman’s risk of breast cancer (with no family history of the disease) is 0.8%. A 2 time higher risk is 1.6%. This is lower than the risk for a woman who has more than 2 first degree relatives with breast cancer. Genetics trumps stress very quickly.

Our more colloquial definition of stress is a packed day. When we are overextended, we define it as stress. Chances are, if you ask any of your friends if they have stress, the answer will be “yes”. Stress is also very subjective. I had a young woman with cancer who was dismayed with the diagnosis. She was happily married with no children. She worked because she wanted to and not because she needed the income. When she told me she thought stress was the cause of her cancer, I couldn’t help but be amused. She was telling a surgeon with two kids married to another surgeon that her life with no kids and a 9-5 job was more stressful. Has stress become a competition?

Isn’t it nice that we as a society have time to think about stress? I wonder if women in Africa who have to walk with their babies on their backs for two miles just to get marginally clean water think it’s stressful. I suspect they just consider it life. Is our life more stressful now than 200 years ago when we had no refrigeration, dishwasher, or other modern conveniences?

Maybe the real issue here is that we need to blame something for cancer and control it. The media constantly bombards us with information that the plastics in our water bottle cause cancer or that eating broccoli will prevent it. This makes us think that all the bad health issues that happen to us are within our power to prevent and control. While some things are – like smoking or obesity – most are not. The people who feel the most gypped are the ones who do eat right and exercise. They somehow feel that this is a guarantee to good health. When they get cancer, they are angry and shocked. It must just be the stress. In reality, we can limit our risk but cannot control it. It’s just life.

It seems like I have had a lot of conversations with friends about the dangers of fast food. I hear the usual argument of corporate America feeding the public fattening meals and making money off poor, ignorant people. I am, quite frankly, tired of McDonald’s bashing.  Criticism of the fast food industry has been around a long time but worsened when “Supersize Me” came out in 2004. It was the documentary of a man who ate at McDonald’s three times a day for a month and gained weight. How can you eat 5000 calories a day and not gain weight – if it’s McDonald’s or Dunkin Donuts, or some fancy French New York City restaurant like Le Cirque? I’m amazed to find people quoting that movie like it proves anything other than the well known fact that overeating makes you fat. School children know this.

Here are some interesting facts. McDonalds and most other fast food restaurants publish the calorie and nutritional content of every single item on their menu. When was the last time you went to your favorite upscale restaurant and got the same information? Why is the food at a French restaurant smothered in butter better for you? The number of calories in a dinner at such a restaurant probably far exceeds a Big Mac and fries – no matter how you supersize it. For example, a marinated salmon carpaccio with green apple and dill appetizer once served at Le Cirque had 361 calories and 26 grams of fat. Yes, I said appetizer. That’s before the bread basket, pre-dinner drinks, bottle of wine, entree, and dessert. Most sit down restaurants have more calories than fast food places. Can you gain weight eating at “finer” establishments? Absolutely. The author of “Julie and Julia” (the now famous tome and movie of a woman who cooked her way through Julia Child’s cookbook every day) gained 20 pounds that year! Also, upscale restaurants have fought legislation to publish the calorie content of their menu (this has happened repeatedly in New York City). All of a sudden, the fast food industry is looking more transparent and honest to me.

Fast food restaurants have tried to bend to the focus groups that said they wanted a healthy alternative.  This has resulted in failed products because regardless of what people say, they do not want healthy burgers when they pull up to the window (remember the unpopular McLean Delux?).  Published calorie counts only changed menu choices in 1 out of 6 people. The other 5 didn’t read it or didn’t care. That’s not the fast food industry’s fault. We are an obese nation because we make poor food choices – even when the information is readily available.

Just something to think about the next time you are at your favorite bistro and a friend mentions how bad fast food is for you.

When I first moved to Grand Junction, I was concerned about prejudice.  Our town is small and not ethnically diverse.  Would people want to come see a female, Indian surgeon?

Because Grand Junction does not have a large minority population, friends visiting from “culturally diverse” metropolitan areas assume there is more ignorance and prejudice.   I think it’s just the opposite.  You need to have a big group of a minority population to start disliking them.  In “melting pot” cities, people may live next to each other but may not always mingle.  Sometimes, this is because minority groups prefer to congregate together.   They are trying to maintain their culture in a foreign country.  This can, however, lead to misunderstanding and resentment with other groups.  The roots of people disliking each start not on an individual level but disliking a people as a whole.    Those are the places where people say ” The Jamaicans always….” or ” The Indians never…..”.  When you don’t have a large enough population of any minority group, you don’t have enough interactions to make broad sweeping generalizations about the whole.

My experience in Grand Junction has been that I am judged as an individual and not as a member of a minority group.  I recently spoke to a friend who is Caucasian and married to an African-American.  She reports getting more negative comments about her inter-racial marriage in other metropolitan places than here. I’m not naive.  I know racism exists here;  I just think it’s surprisingly lower than any other place where I have lived.

There is one drawback to our lack of diversity.  I miss Ethiopian food.

When I was young, I remember the  crayon color called “flesh”.  It was controversial because it was considered racist – that naming a light color “flesh” only represented a portion of the population.  It was an ugly color and it didn’t look like any of my Caucasian friends!   I never understood what the fuss was about back then.

This summer, the color “nude” is in.  When I open various catalogs, there are shoes in “nude” and once again, they don’t look “nude” on me!  In fact, there is not a bronze option that would look like my flesh tone.  Thirty years later, my toys are still misnamed!

If there’s anything mob movies have taught us is that if someone is shot, you must dig that bullet out.  Usually the recipient of this torture grits his teeth, sweats a little, curses a lot, and toughs it out.  In real life, most bullets do not have to be removed.  They are harmless left in place.  The body walls the bullet off.  Since I hang around people who are shot a lot, I have come up with a handy list of the times when a bullet needs to be removed:

1.  A bullet in a joint space or the globe of the eye ( this usually comes out with the eye!).

2.  A bullet IN or near a large blood vessel (risk of traveling in the vessel to the heart and lungs or compromising blood flow to surrounding tissues).

3.  Pressing on a nerve and causing pain.

4.  In an abscess ( pus collection).

5.  Bullet that has gone through the colon and is resting in muscle or bone ( it’s contaminated with poop)

Some bullets can work their way out slowly to the skin and then they can be removed easily.

So, the next time you watch a bullet being dug out of an appendage in a movie, snort condescendingly and roll your eyes in disgust.  I do.