Friday, February 12, 2010

Horse Paths

By Jacob Schor ND FABNO

Cherry creek state park
Photo by MetroDenver via Flickr, used under the Creative Commons License.

This winter my dog Poppy and I started following the horse trails that lead off from the off-leash dog area at Cherry Creek State Park. With the snow, the hard freezes, and the lack of horse traffic, these paths have opened up a new world for the both of us. This is because hardly anyone knows they are there, just a few enterprising souls, enough to pack down narrow trails in the snow. Some of the trails we follow are not actual horse trails but narrow tracks made by deer. I get to see the white flashes of their tails between the trees and luckily, Poppy rarely sees them as she has her nose to the snow, schnuffeling along in her world of smells. It’s the white of these tails and also the red flash of tail feathers as our approach moves the hawks from their tree perches that highlight my memories of these solitary walks through woods and meadow.

There is a problem with horse trails though. Horses don’t mind trampling through muck, mud, wetland and swamp. They do not complain about wet feet. The hard cold spells we have had this winter have allowed me to forget these details about the ground underfoot. That is until yesterday. We’re in the midst of a thaw, the temperature reaching 60 degrees F for the last few days. Yesterday when we started our morning jaunt, the mud of the main dog walk area was still frozen but as the sun rose, we found ourselves in situations that might be described as, ‘up a creek without a paddle’ or better, without a boat; the sun and warmeth thawed the ice bridges that had allowed us to wander freely through wetlands and swamp.

This longer than usual walk gave me room to sort out some thoughts I’ve been having. In the practice of medicine, or at least naturopathic medicine, we are not following the main roads, the ‘medical standard of care.’ For various reasons our patients have either, out of necessity or personal habit chosen a ‘road less traveled.’ Some of our patients are in the habit of always choosing roads less traveled in all areas of their lives, to the point it almost seems pathological. Others will wander off onto horse trails only occasionally when the route offers advantage.

We have to remember that these alternative, less-used paths are just that. They may not be as dependable as the main roads, they may be subject to changes, with the weather, the time, or the season. These past summers walking this same area, Poppy and I have seen water levels rise by several feet when a thunderstorm adds water upstream.

These thoughts reminded me of a recent paper on macular degeneration. For years the science has suggested we use a complex of antioxidant vitamins and plant extracts to treat this condition. Almost every supplement supplier we do business with makes an, ‘eye formula’ containing almost the same ingredients. According to a review written by Elizabeth Johnson at Tufts University and published last week, we need to change our prescriptions. Both beta-carotene and vitamin E, ingredients found in every one of these formulas, not only don’t help, but may increase risk of macular degeneration. Whoops.

Reading this information creates about the same sensation as having an ice bridge give way and finding yourself knee deep in water and mud. Cold water.

If we are going to choose the less traveled paths in medicine we need to keep alert and watch our steps more carefully than those following the well worn standards of care. We cannot just follow the crowd. No one is going to post a big sign telling when we need to change course.

These thoughts remind me of the book, Mount Analogue. I read this book at a young and impressionable age. It was written, though never finished, by Rene Daumal who died in 1944 and then published posthumously in 1952. Daumal was one of a group of European intellectuals who were mountain climbers, writers and apparently drug users. Daumal and his peers apparently had a habit of utilizing unusual substances, the most notable being carbon tetrachloride, to generate transcendent experiences. Regular exposure to this substance that will not lead to a long life. This book used mountain climbing as an analogy to describe his mystical views. Leaving the details aside, there is one particular passage that has stuck with me for four decades. In it Daumal tells climbers of the importance of marking new routes with cairns, or what we in this country call ducks. In the high mountains two or three rocks piled atop one another stand out and say, ‘I’ve gone this way.’ He then tells climbers that it is their responsibility if the, ‘route proves to go nowhere,’ to trace back their steps and remove the cairns they have left.

I think of this image sometimes when I’m reading research. There are many of us exploring new routes, new ideas and new techniques. It is our responsibility to tell others what route we have taken. It is also our responsibility to come back and tell others if a route is a dead end.

In the meantime, though closed out from parts of our walk by these unseasonable temperatures, I look forward to the summer where the gravelly stream bed provides a new path to explore. The dog and I have a summer route through the park, wading knee deep in the stream, using it as a route through the woods. The only problem is remembering to bring a waterproof container for my phone as sometimes the water gets deep, suddenly. I want to be able to call someone if I get lost.

A post script:
The most well known quotations from Daumal’s book, one that was printed on the cover of a Sierra Designs catalog in the 1960’s is:

"You cannot stay on the summit forever; you have to come down again. So why
bother in the first place? Just this: What is above knows what is below, but
what is below does not know what is above. One climbs, one sees. One descends,
one sees no longer, but one has seen. There is an art of conducting oneself in
the lower regions by the memory of what one saw higher up. When one can no
longer see, one can at least still know."

— Rene Daumal

Curr Opin Clin Nutr Metab Care. 2010 Jan;13(1):28-33.
Age-related macular degeneration and antioxidant vitamins: recent findings.

Johnson EJ.

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