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Tag: good way

  • Commentary: Doctor who walked L.A.’s perimeter has a prescription for everyone: Escape your own neighborhood

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    Dr. Roy Meals, a longtime hand surgeon, likes to move his feet. He has climbed mountains and he has run three marathons.

    But when he shared his latest scheme with his wife a couple of years ago, she had a quick take.

    “You’re nuts,” she said.

    Maybe so. He was closing in on 80, and his plan was to grab his trekking poles and take a solo hike along the 342-mile perimeter of Los Angeles. His wife found the idea less insane, somewhat, after Meals agreed to hook up with hiking companions here and there.

    Dr. Roy Meals with his book, “Walking the Line: Discoveries Along the Los Angeles City Limits.”

    But you may be wondering the obvious:

    Why would someone hike around a massive, car-choked, pedestrian-unfriendly metropolis of roughly 500 square miles?

    Meals had his reasons. Curiosity and restlessness, for starters. Also, a belief that you can’t really get to know a city through a windshield, and a conviction that staying fit, physically and mentally, is the best way to stall the work of Father Time.

    One more thing: Meals’ patients over the years have come from every corner of the city, and the Kansas City native considered it a personal shortcoming that he was unfamiliar with much of L.A. despite having called it home for half his life.

    To plot his course, Meals unfolded an accordion style map for an overview, then went to navigatela.lacity.org to chart the precise outline of the city limits. The border frames an oddly shaped expanse that resembles a shredded kite, with San Pedro and Wilmington dangling from a string at the southern extremities.

    Dr. Roy Meals takes a break from his walk to talk with Louis Lee, owner of JD Hobbies Store in downtown San Pedro.

    Dr. Roy Meals takes a break from his walk to talk with Louis Lee, owner of JD Hobbies Store, along West 6th Street in downtown San Pedro.

    Meals divided his trek into 10-mile segments, 34 in all, and set out to walk two segments each week for four months, traveling counterclockwise from the 5,075-foot summit of Mt. Lukens in the city’s northern reaches.

    Day One began with a bang, in a manner of speaking.

    Meals slipped on loose rocks near the summit of Mt. Lukens and tumbled, scuffing elbows and knees, and snapping the aluminum shaft of one of his walking sticks.

    But Meals is not one to wave a white flag or call for a helicopter evacuation.

    “Later, at home, I employed my orthopedic skills to repair the broken pole,” Meals writes in “Walking the Line: Discoveries Along the Los Angeles City Limits,” his just-published book about his travels.

    Dr. Roy Meals walks along West 6th Street in San Pedro.

    Dr. Roy Meals walks along West 6th Street in San Pedro.

    Meals, now 80 and still seeing patients once weekly at a UCLA clinic, remained upright most of the rest of the way, adhering to his self-imposed rule of venturing no farther than one mile in from the city limits. To get back to his starting point each day, he often took buses and found that although it was slow going, riders often exited with a thanks to the driver, which struck him as “wonderful grace notes of acknowledgment.”

    The doctor ambled about with the two trekking poles, a cross-country skier on a vast sea of pavement. He carried a small backpack, wore a “Los Angeles” ballcap and a shirt with the city limits outline on the front, and handed out business cards with a link to his book project.

    Those who clicked on the link were advised to escape their own neighborhoods and follow Meals’ prescription for life: “Venture forth on foot, and make interesting, life-enriching discoveries. Wherever you live, be neighborly, curious, fit, and engaged!”

    Meals was all those things, and as his surname suggests, he was never shy about sampling L.A.’s abundant offerings.

    He tried skewered pig intestines at Big Mouth Pinoy in Wilmington, went for tongue and lips offerings at the Tacos y Birria taco truck in Boyle Heights, thoroughly enjoyed a cheeseburger and peach cobbler at Hawkins House of Burgers in Watts, and ventured into Ranch Side Cafe in Sylmar, curious about the sign advertising American, Mexican and Ethiopian food.

    Meals tried hang-gliding at Dockweiler Beach, fencing on the Santa Monica border, rock climbing in Chatsworth, boxing and go-kart racing in Sylmar, weightlifting at Muscle Beach in Venice.

    Dr. Roy Meals stops to take in the American Merchant Marine Veterans Memorial Wall of Honor in San Pedro.

    Dr. Roy Meals stops to take in the American Merchant Marine Veterans Memorial Wall of Honor while walking one of many paths he wrote about in his book.

    In each sector, Meals sought out statues and plaques and explored points of history dating back to the Gabrielinos and Chumash, and to the days of Mexican and Spanish rule. He also examined the history of those peculiar twists and turns on the city perimeter, mucking through L.A.’s long-simmering stew of real estate grabs, water politics and annexation schemes.

    What remains of the foundation of Campo de Cahuenga in Studio City was one of several locations that “stirred my emotions,” Meals writes in “Walking the Line.” There, in 1847, Andres Pico and John C. Frémont signed the treaty that ceded part of Mexico to the U.S., altering the shape of both countries.

    In Venice, Meals was equally moved when he accidentally came upon an obelisk marking the spot where, in April 1942, more than a thousand Japanese Americans boarded buses for Manzanar.

    “May this monument … remind us to be forever vigilant about defending our constitutional rights,” it read. “The powers of government must never again perpetrate an injustice against any group based solely on ethnicity, gender, sexual orientation, race or religion.”

    At firehouse museums, Meals learned of times when “Black firefighters were met with extreme hostility in the mixed-race firehouses, including being forced to eat separately. … Little did I know that visiting fire museums would be a lesson in the history of racism in Los Angeles,” he writes.

    Dr. Roy Meals walks past a display of an armor-piercing projectile in San Pedro.

    Dr. Roy Meals walks past a display of an armor-piercing projectile in San Pedro.

    Although Meals visited well-known destinations such as the Watts Towers and Getty Villa, some of his most enjoyable experiences were what he called “by the way” discoveries that were not on his initial list of points of interest, such as the obelisk in Venice.

    “Among those that I stumbled across,” Meals writes, “were the Platinum Prop House, Sims House of Poetry, and warehouses stuffed with spices, buttons, candy, Christmas decorations, or caskets. These proprietors, along with museum docents and those caring for disadvantaged children, bees, rescued guinea pigs, and injured marine mammals genuinely love what they do; and their level of commitment is inspiring and infectious.”

    His book is infectious, too. In a city with miles of crumbling sidewalks and countless tent villages, among other obvious failings, we can all find a thousand things to complain about. But Meals put his stethoscope to the heartbeat of Los Angeles and found a thousand things to cheer.

    When I asked the good doctor if he’d be willing to revisit part of his trek with me, he suggested we meet in the area to which he awarded his gold medal for its many points of interest — San Pedro and Wilmington. There, he had visited the Banning Mansion, the Drum Barracks, the Point Fermin Lighthouse, the Friendship Bell gifted to L.A. by Korea, the varied architecture of Vinegar Hill, the World War II bunker, the sunken city, the Maritime Museum, etc., etc., etc.

    Meals was in his full get-up when we met at 6th and Gaffey in San Pedro. The trekking sticks, the T-shirt with the jigsaw map of L.A., the modest “Los Angeles” hat.

    “Let’s go,” he said, and we headed toward the waterfront, but didn’t get far.

    Dr. Roy Meals takes a break from his walk to visit with famed San Pedro resident John Papadakis.

    Dr. Roy Meals takes a break from his walk to visit with famed San Pedro resident John Papadakis, 75, former owner of the now-closed Greek Taverna in the neighborhood.

    A gentleman was exiting an office and we traded rounds of “good morning.” He identified himself as John Papadakis, owner of the now-closed Greek Taverna restaurant, a longtime local institution. He invited us back into his office, a museum of photos, Greek statues and sports memorabilia (he and son Petros, the popular radio talk show host, were gridiron grinders at USC).

    San Pedro “is the city’s seaside soul,” Papadakis proclaimed.

    And we were on our way, eyes wide open to the wonders of a limitless city that reveals more of itself each time you turn a corner, say hello, and hear the first line of a never-ending story.

    Down the street, we peeked in on renovations at the art deco Warner Grand Theater, which is approaching its 100th birthday. We checked out vintage copies of Life magazine at Louis Lee’s JD Hobbies, talked to Adrian Garcia about the “specializing in senior dogs” aspect of his “Dog Groomer” shop, and got the lowdown on 50 private schools whose uniforms come from Norman’s Clothing, circa 1937.

    At the post office, we checked out the 1938 Fletcher Martin mural of mail delivery. Back outside, with a view of the port and the sunlit open sea, we met a merchant seaman, relaxing on a bench, who told us his son worked for the New York Times. I later found a moving story by that reporter on his long search for the man we’d just met.

    “Traveling on foot allowed me to reflect on and grow to respect LA as never before,” Meals wrote in his book.

    On our walk, while discussing what next, Meals said he’s thinking of exploring San Francisco in the same manner.

    We were approaching Point Fermin, where Meals pointed out the serene magnificence of a Moreton Bay fig tree that threw an acre of shade and cooled a refreshing salt-air breeze.

    Dr. Roy Meals walks along the L.A. Harbor West Path, one of many paths he wrote about in his book, in San Pedro.

    Dr. Roy Meals walks along the L.A. Harbor West Path, one of many paths he wrote about in his book, in San Pedro.

    “If anything,” Meals told me, “I’m quicker to look at small things. You know, stop and appreciate a flower, or even just an interesting pattern of shadows on the street.”

    The message of his book, he said, is a simple one.

    “Basically, just slow down and look.”

    steve.lopez@latimes.com

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    Steve Lopez

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  • Achieve Tahoe continues to provide for those with disabilities

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    As summer comes to a close, one of the best ways to cool off was at Roseville’s Wake Island, but just beyond the inflatable floats and right past the wake boarders, there are those who have an unimpaired chance at creating a splash of their own. “Everyone is out here to have a good time,” said Michael Hunter with Achieve Tahoe. Achieve Tahoe is a nonprofit organization that started in the 1960s. Its goal is to make sure people with disabilities have the opportunity to enjoy outdoor sports. The organization began as a way to get wounded veterans on the ski slopes, but has expanded to providing programs year-round.“It just feels good to get out and be part of your environment,” Hunter added. “It feels good to feel the wind in your hair.”That includes 34-year-old Brigit Maloney, who has this water skiing date circled on her calendar. “I like water skiing,” she said. “I like doing all my sports.” Fifty miles away in Grass Valley, it would be hard to find a more blessed household than the Maloney family. “The good lord gives you what he wants you to have,” said mother, Cati Maloney. But like most families, they aren’t blessed with a ton of free time, trying to balance the schedule for their adult children. Cati is an occupational therapist who made a very big decision a little more than three decades ago, when she adopted two children with disabilities. The first was Brigit. Cati got her when she was just 1 1/2 years old. She knew her daughter would face obstacles. Brigit is legally blind in one eye and partially in the other. It’s a disability she wasn’t born with. It’s one that happened at the hands of someone she loved. “Brigit was born normal, and she was abused from zero to three months,” Cati said. “She has what they call shaken baby syndrome. When she arrived at the hospital, her retinas were detached, and she had a brain injury.” Life hasn’t been as easy for Brigit as others, but she isn’t about to let you know that. “They probably think that I can’t do stuff as well as they can, but I can still manage on the activity,” Brigit added. She’s done better than manage. Her room is filled with medals hanging on the walls from her time competing in the Special Olympics. In the winter, Brigit skis, and in summer, she skis even more. Brigit is just one of 120 disabled athletes who have a chance to water ski over the summer, through Achieve Tahoe. “When I got Brigit, people said she won’t amount to much,” Cati said. “It’s a simple goal,” Hunter added. “Achievement is universal. We all want to do something more and feel good about ourselves.”See more coverage of top California stories here | Download our app | Subscribe to our morning newsletter | Find us on YouTube here and subscribe to our channel

    As summer comes to a close, one of the best ways to cool off was at Roseville’s Wake Island, but just beyond the inflatable floats and right past the wake boarders, there are those who have an unimpaired chance at creating a splash of their own.

    “Everyone is out here to have a good time,” said Michael Hunter with Achieve Tahoe.

    Achieve Tahoe
    is a nonprofit organization that started in the 1960s. Its goal is to make sure people with disabilities have the opportunity to enjoy outdoor sports. The organization began as a way to get wounded veterans on the ski slopes, but has expanded to providing programs year-round.

    “It just feels good to get out and be part of your environment,” Hunter added. “It feels good to feel the wind in your hair.”

    That includes 34-year-old Brigit Maloney, who has this water skiing date circled on her calendar.

    “I like water skiing,” she said. “I like doing all my sports.”

    Fifty miles away in Grass Valley, it would be hard to find a more blessed household than the Maloney family.

    “The good lord gives you what he wants you to have,” said mother, Cati Maloney.

    But like most families, they aren’t blessed with a ton of free time, trying to balance the schedule for their adult children.

    Cati is an occupational therapist who made a very big decision a little more than three decades ago, when she adopted two children with disabilities.

    The first was Brigit. Cati got her when she was just 1 1/2 years old. She knew her daughter would face obstacles.

    Brigit is legally blind in one eye and partially in the other. It’s a disability she wasn’t born with. It’s one that happened at the hands of someone she loved.

    “Brigit was born normal, and she was abused from zero to three months,” Cati said. “She has what they call shaken baby syndrome. When she arrived at the hospital, her retinas were detached, and she had a brain injury.”

    Life hasn’t been as easy for Brigit as others, but she isn’t about to let you know that.

    “They probably think that I can’t do stuff as well as they can, but I can still manage on the activity,” Brigit added.

    She’s done better than manage. Her room is filled with medals hanging on the walls from her time competing in the Special Olympics.

    In the winter, Brigit skis, and in summer, she skis even more. Brigit is just one of 120 disabled athletes who have a chance to water ski over the summer, through Achieve Tahoe.

    “When I got Brigit, people said she won’t amount to much,” Cati said.

    “It’s a simple goal,” Hunter added. “Achievement is universal. We all want to do something more and feel good about ourselves.”

    See more coverage of top California stories here | Download our app | Subscribe to our morning newsletter | Find us on YouTube here and subscribe to our channel

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  • A Genetic Snapshot Could Predict Preterm Birth

    A Genetic Snapshot Could Predict Preterm Birth

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    This article was originally published by Knowable Magazine.

    For expectant parents, pregnancy can be a time filled with joyful anticipation: hearing the beating of a tiny heart, watching the fetus wiggling through the black-and-white blur of an ultrasound, feeling the jostling of a little being in the belly as it swells.

    But for many, pregnancy also comes with serious health issues that can endanger both parent and child. In May, for example, the U.S. Olympic sprinter Tori Bowie died while in labor in her eighth month of pregnancy. Potential factors contributing to her death included complications of preeclampsia, a pregnancy-specific disorder associated with high blood pressure. Preeclampsia occurs in an estimated 4.6 percent of pregnancies globally. Left untreated, it can lead to serious problems such as seizures, coma, and organ damage.

    Preeclampsia and preterm birth are relatively common conditions that can put both the mother and her baby at risk of health issues before and after birth. But doctors don’t have a good way to determine whether an individual will develop one of these complications, says Thomas McElrath, an ob-gyn at Brigham and Women’s Hospital, in Boston. Currently, physicians primarily look to a woman’s prior pregnancies, medical history, and factors such as age and ethnicity to determine her risk. These measures are useful but limited, and may fail to identify problems early enough to enable effective treatment, McElrath says. “They’re not as precise as I think most of us, as clinicians, would really want.”

    That may soon change. Scientists are learning that free-floating bits of genetic material found in a pregnant person’s blood may offer a way to detect complications such as preeclampsia and preterm birth—although some experts caution that it’s too early to determine how useful these tests will be in the clinic. In the meantime, the tests are providing researchers with a new way to unravel the underlying biology of these inscrutable ailments.


    All of us carry bits of our own genetic material—both DNA and its more evanescent cousin, RNA—around in our bloodstreams. During pregnancy, these free-floating fragments, known as cell-free DNA and RNA, are also released from the developing fetus into the mother’s blood, primarily via the placenta. For more than a decade, clinicians have used cell-free DNA from blood to screen the fetus for genetic abnormalities.

    But DNA provides a largely static view of the genetic content within our cells. RNA gives a snapshot of which genes are turned on or off at a specific point in time. Because gene activity varies across cells and over time, researchers realized that they could use RNA to glean a more dynamic view of the changes that occur within the mother’s body during pregnancy. RNA enables scientists to look beyond the fixed genotype to factors that change over the course of pregnancy such as prenatal complications, says Mira Moufarrej, a postdoctoral researcher at Stanford University who co-authored a paper in the 2023 Annual Review of Biomedical Data Science on noninvasive prenatal testing with circulating RNA and DNA.

    To screen for possible complications, scientists have been looking at cell-free RNA in pregnant women’s blood that originates from both mother and child. Some of the earliest studies of this kind emerged in the early 2000s. In 2003, for example, Dennis Lo, a chemical pathologist at the Chinese University of Hong Kong, and his colleagues reported that in a study of 22 pregnant women, a specific RNA released from the placenta was much more abundant during the third trimester in those who had preeclampsia than in those who did not. Over the years, Lo’s group and others have looked at broader changes in RNA during pregnancy in larger groups of people.

    In a 2018 study, Moufarrej, who was then a doctoral student; her adviser Stephen Quake, a biophysicist at Stanford University; and colleagues reported that cell-free RNA could help determine when labor would occur. The researchers recruited 38 pregnant women in the United States known to be at risk of preterm birth, and then drew a blood sample from each. By comparing cell-free RNA in those who eventually delivered prematurely with that in those who gave birth at full term, they were able to identify a set of RNAs that appeared up to two months prior to labor that could pinpoint about 80 percent of premature births.

    That proof-of-concept investigation spurred the researchers to look further and examine whether cell-free RNA could also predict preeclampsia. Other groups had previously reported RNA-based signatures of preeclampsia—in 2020, for instance, scientists working with the California-based biotech company Illumina reported dozens of RNA transcripts that were unique to a small cohort of pregnant women with the condition. But Moufarrej, Quake, and their colleagues wanted to track RNA changes throughout pregnancy to see whether it might be possible to identify people at risk of preeclampsia during early pregnancy, before symptoms began.

    In a study published in 2022, the researchers recruited several dozen mothers at heightened risk of preeclampsia and drew blood from them four times: at or before 12 weeks, in weeks 13 to 20, at or after 23 weeks, and after birth. Afterward, the researchers compared cell-free RNA for women who indeed developed preeclampsia against that of those who did not. The team identified RNAs corresponding to 544 genes whose activity differed in those who developed preeclampsia and those who did not. (The study did not differentiate between maternal and fetal RNA, but because the majority of cell-free RNA in a pregnant person’s blood is their own, Moufarrej says that most of these RNAs are likely maternal in origin.)

    Then, using a computer algorithm, the researchers developed a test based on 18 genes measured prior to 16 weeks of pregnancy that could be used to predict a woman’s risk of developing preeclampsia months later. The test correctly identified all of the women who would later develop preeclampsia—and, equally important, all of the women who the test predicted wouldn’t develop preeclampsia did in fact escape the disease. (About a quarter of the women who were predicted to develop preeclampsia did not get the disease.) The same 18-gene panel also correctly predicted most cases of preeclampsia in two other groups totaling 118 women.

    The team also took a closer look at which tissues the RNA of interest originated from. This included the usual suspects, such as the lining of the blood vessels (also known as the endothelium), which scientists already know is associated with preeclampsia, as well as other, more unexpected sources, such as the nervous and muscular systems. The authors note that, in the future, this information could be used both to understand how preeclampsia affects different parts of the body and to assess which organs are at highest risk of damage in a particular patient.

    According to Quake, studies like these from both his team and others are starting to reveal the diversity of changes throughout the body that contribute to pregnancy complications—and providing evidence for something that clinicians and researchers have long suspected: that both preeclampsia and preterm birth are conditions with a range of underlying causes and outcomes. “There are now strong indications that you should be defining multiple subtypes of preeclampsia and preterm birth with molecular signatures,” says Quake. “That could really transform the way physicians approach the disease.”

    Research teams elsewhere are also looking at other pregnancy complications such as reduced fetal growth, which can cause infants to be at higher risk of problems such as low blood sugar and a reduced ability to fight infections. Some of these tests are now being validated in large studies, while others are still in the early days of development.


    RNA-based tests for both preeclampsia and preterm-birth risk are inching their way toward the clinic. Mirvie, a company co-founded by Quake in South San Francisco, is focused on developing both. Last year, the company published a study of a preterm-birth test with hundreds of pregnant individuals as well as one on a preeclampsia test with samples from more than 1,000 women. Both studies had promising results. The company is now in the middle of an even larger study of the preeclampsia test that will include 10,000 pregnancies, Quake says. (Quake and Moufarrej are both shareholders of Mirvie.)

    Cell-free RNA-based tests for preeclampsia are leading the way, says McElrath, likely because preterm birth has more subtypes and more potential causes—including carrying multiples, chronic health conditions such as diabetes, and preeclampsia—which make it a more complicated issue to address. (McElrath is involved in validating Mirvie’s tests; he serves as a scientific adviser to the company and has a financial stake in it.)

    Still, questions about these tests remain. An important next step, says Moufarrej, is determining what’s behind the RNA changes associated with a heightened risk for these pregnancy complications. All of the studies conducted to date have been correlative—linking patterns in RNA with risk—but to provide effective treatment, it will be important to determine the cause of these changes, she adds. Another open question is how important maternal versus fetal RNAs are to determining the risk of pregnancy complications. To date, most studies have not distinguished between these two sources. “This remains an active area of investigation,” McElrath says.

    Erik Sistermans, a human geneticist at Amsterdam UMC, says that although  researchers can learn a lot from cell-free RNA, it’s still too early to judge what the power of these RNA-based tests will be in clinical practice. He notes that he and other researchers are also investigating the possibility of using cell-free DNA to determine the risk of pregnancy complications such as preeclampsia. For example, some groups are looking at chemical modifications to DNA known as epigenetic changes, which occur in response to age, environment, and other factors.

    Yalda Afshar, a maternal- and fetal-medicine physician at UCLA, agrees that it’s still unclear whether these tests will provide benefits not available from existing screening methods such as looking for the presence of risk factors. For these screening tests to truly benefit patients, clinicians will first need to understand the underlying biology of these complications—and have effective treatments to offer patients found to be at risk, she adds. (Afshar is an unpaid consultant for Mirvie.)

    There are also ethical questions to consider. Screening tests provide only an estimate of risk, not a definitive diagnosis, Sistermans notes. Before these tests are rolled out to the public, it will be crucial to consider how best to communicate test results, and what next steps to take for individuals who are identified as being in a high-risk category, he says. For preeclampsia, low-dose aspirin can help prevent or delay its onset, while the hormone progesterone may help prevent some cases of preterm birth. But every additional test added to a prenatal screen makes decisions more complicated and potentially stressful for pregnant women. “You shouldn’t underestimate the amount of anxiety these kinds of tests may cause,” Sistermans says.

    Still, researchers are optimistic about the future of cell-free RNA-based tests. The tests for preeclampsia are already more accurate than currently available tests for the condition, according to McElrath. And if researchers succeed in predicting other complications, he adds, future patients will benefit not just from additional information about their pregnancies, but also from the opportunity to receive more personalized care. “Once we start to see success in early preeclampsia prediction,” McElrath says, “it will quickly spread out from there.”

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    Diana Kwon

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  • The Glory of Feeling Fine

    The Glory of Feeling Fine

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    A few months ago, I got food poisoning. The sequence of events that led to my downfall began with a carton of discounted grocery-store sushi purchased and consumed on a Thursday, which led to me waking up a little queasy on a Friday, which devolved into a 12-hour stretch of me vomiting and holding myself in a fetal position, until my legs ached from dehydration. On Saturday the smell of my partner cooking breakfast still made me gag; I sipped water, napped fitfully, and nibbled little golf balls of white rice.

    But Sunday, glorious Sunday, I awoke to a marvelous lack of pain and fatigue. The brain fog was gone. My skin felt plump with fluids. Enthralled by recovery, I found myself behaving with uncharacteristic serenity. When I dropped and broke a ceramic bowl while unloading the dishwasher, I didn’t curse and freak out. Instead, I swept up the shards with cheer. I wouldn’t sweat the small stuff. I was my normal self again, and it felt sublime.

    Yet as I relished in my newfound bliss, a foreboding thought gnawed at me: I knew that as the hours passed and the specter of illness retreated, my fresh perspective, too, would fade. So much of my exuberance was defined by absence, the lifting of the burden of aches and puking. It would only be a matter of time until normal felt normal again, and I’d be back to worrying about all the petty minutiae I always worry about.

    People have different baselines of health, and some might be more or less appreciative of whatever condition they’re in. Even so, humans have long lamented the ephemeral joy of relief. The feeling manifests in all kinds of circumstances: meeting a deadline, passing a test, finishing a marathon. And it can be especially acute in matters of wellness. “Health is not valued, till sickness comes,” wrote the 17th-century British scholar Thomas Fuller. Or as the 19th-century German philosopher Arthur Schopenhauer bemoaned: “Just as we do not feel the health of our entire body but only the small place where the shoe pinches, so too we do not think of the totality of our well-functioning affairs, but of some insignificant trifle that annoys us.”

    So many of us, in other words, are very bad at appreciating good health when we’re fortunate enough to have it. And anyone experiencing this transcendent gratitude is unlikely to hold on to it for long. Indeed, by Monday morning, the afterglow of recovery had worn off; I was engrossed in emails and work again, unaware that just 60 hours prior I could barely sit upright in bed, let alone at my desk. This troubled me. Am I cursed to be like this forever? Or is there anything I can do to change?

    To some extent, I’m sad to report, the answer might well be no. While certainly some people can have experiences of major illness or injury that change their entire outlook on life, the tendency to revert to forgetfulness seems to run pretty deep in the human psyche. We have limited attentional resources, the UC Davis psychology professor Robert Emmons told me, so in the interest of survival, our brain tends not to waste them focusing on systems that are working well. Instead, our mind evolved to identify threats and problems. Psychologists call this negativity bias: We direct our attention more to what’s wrong than what’s right. If your body’s in check, your brain seems to reason, better to stress about the project that’s overdue or the conflict with your friend than sit around feeling like everything’s fine.

    A second psychological phenomenon that might work against any enduring joy in recovery from illness is hedonic adaptation, the notion that after positive or negative life events we, basically, get used to our new circumstances and return to a baseline level of subjective well-being. Hedonic adaptation has been used to explain why, in the long term, people who won the lottery were no happier than those who didn’t; and why romantic partners lose passion, excitement, and appreciation for each other over time.

    Arguably, adaptation need not be seen as any great tragedy. For health, in particular, there’s an element of practicality in the human capacity to exist without fussy attentiveness. This is how we’re supposed to operate. “If our body isn’t causing us problems, it doesn’t actually pay to walk around being grateful all the time. You should be using your mental energy on other things,” Amie Gordon, an assistant professor of psychology at the University of Michigan, told me. If we had to sense our clothes on our bodies all day, for example, we’d constantly be distracted, she said. (This is actually a symptom of certain chronic disorders, like fibromyalgia—Lauren Zalewski, a writer who was diagnosed with both fibromyalgia and lupus 22 years ago, told me that it makes her skin sensitive to the touch, as if she constantly has the flu.)

    All that said, there are real costs to taking health for granted. For one, it can make you less healthy, if as a result you don’t take care of yourself. For another, maintaining some level of appreciation is a good way to avoid becoming an entitled jerk. Throughout the pandemic, for instance, there has been “this language around how the ‘only’ people dying are ‘old people’ or people with pre-existing conditions,” as if these deaths were more acceptable, Emily Taylor, a vice president for the Long-COVID Alliance, a group that advocates for research into post-viral illnesses, told me. Acknowledging that our own health is tenuous—and that certainly, many of us are going to get old—could counter this kind of callousness and encourage people to treat the elderly and those with chronic conditions or disabilities with more respect and kindness, Taylor argued.

    In my view, there’s something to be gained on an individual level, too. In recent years I’ve seen friends and loved ones deal with life-altering injuries and diagnoses. I know that one’s circumstances can turn on a phone call or a moment of inattention. To be healthy, to have basic needs met—to have life be so “normal” that it’s even a little boring—is a luxury. While I am living in those blessedly unremarkable times, I don’t want my fortune to escape my notice. When things are good, I want to know how good I’ve got it.

    What I want, really, is to hold on to a sense of gratitude. In the field of psychology, gratitude can be something of a loaded term. Over the past decade or so, articles, podcast episodes, self-help books, research papers, celebrities, and wellness influencers alike have all extolled the benefits of being thankful. (Oprah famously kept a gratitude journal for more than a decade.) At times, gratitude’s popularity has been to its own detriment: The modern-day gratitude movement has been criticized for overstating its potential benefits and pushing a Western, wealthy, and privileged perspective that can seem to ignore the realities of extreme suffering or systemic injustices. It’s also annoying to constantly be told that you should really be more thankful for stuff.

    But part of the reason gratitude has become such a popular concept is due to bountiful research that does point to genuine emotional upsides. Feeling grateful has been associated with better life satisfaction, an increased sense of well-being, and a greater ability to form and maintain relationships, among other benefits. (The research on gratitude’s effects on physical health is inconclusive.) For me, though, the pull is less scientific and more commonsense anyway: Learning to genuinely appreciate day-to-day boons like having good health, or food in the fridge, seems like being able to tap into a renewable source of contentment. It’s always so easy to find stress in life. Let me remember the things to smile about, too.

    One way to make the most of gratitude may be to reframe how people tend to think of it. A popular misconception, Emmons told me over email, is that gratitude is a positive emotion that results from something good happening to us. (This might also be part of the reason it can be hard to appreciate conditions like health that for many people remain stable day after day.) Gratitude is an emotion, but it can also be a disposition, something researchers call “trait gratitude.” Some people are more predisposed to feeling thankful than others, by virtue of factors like genetics and personality. But Emmons says this kind of “undentable thankfulness” can also be learned, by developing habits that contribute to more of a persistent, ambient awareness, rather than a conditional reaction to ever-changing circumstances.

    What does this look like, practically speaking? “I don’t know that we can, with every breath we have every moment, feel grateful that we’re breathing. That’s a pretty tall order,” says Gordon. “But that’s not to say that you don’t build in a moment for it at some point in your day.” If you’re recovering from a cold, for example, you can practice pausing whenever you’re walking out the door to appreciate that your nose isn’t stuffy before just barreling on with life. Another tactic, from Emmons, is to reflect upon your worst moments, such as times you’ve been ill. “Our minds think in terms of counterfactuals,” he said, which are comparisons between the way things are and how they might have been. “When we remember how difficult life used to be and how far we have come, we set up an explicit contrast in our mind, and this contrast is fertile ground for gratefulness.”

    You can also think of gratitude as an action, Emmons has written. This hews closer to the historical notion of gratitude, which as far back as the Roman days was associated with ideas like duty and reciprocity—when someone does something kind for us, we’re expected to return the favor, whether that’s thanking them, paying them back, or paying it forward. In that sense, being grateful for your body probably means doing your best to care for it (and, probably, refraining from risky behaviors like rolling the dice on discounted grocery-store sushi).

    In 2015, Lauren Zalewski, the writer with fibromyalgia, founded an online community that supports people living with chronic pain by helping them to cultivate a grateful mindset. She tells me that before her diagnosis, she took her health for granted and “beat her body up.” Now, she eats vegan, takes supplements, does yoga, stretches, sleeps more, and gets sun regularly—these are the small things she has personally found helpful for managing her constant pain. “So while I am a chronically ill person,” she muses, “I consider myself pretty healthy.”

    Looking back on my food-poisoning incident, I think I was primed to ruminate more deeply than usual on the topics of sickness and health. In the past two and a half years, I’ve watched COVID-19 show that anyone can get ill, perhaps seriously so. Now, as the head of the World Health Organization tells us that “the end is in sight” for the pandemic  (and President Joe Biden controversially declares the pandemic over), it’s tempting to imagine that humanity is on the brink of waking up the morning after a hellish sickness.

    It’s probably delusional to hope that even a global pandemic could prompt some kind of long-term collective mental shift about the impermanence of health, and of life. I didn’t become a radically different person after recovering from puking my guts out a few months ago either. But maybe the simple act of remembering the health we still have in the pandemic’s wake can make a small difference in how we go forward—if not as a society, then at least as individuals. I’m sure I’ll never fully override my tendency to take my body for granted until it’s too late. But for now, each day, I still get the golden opportunity to try. And I’d like to take it.

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    Gloria Liu

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