Joseph F. Clark, Ph.D.

I have been looking for a good, portable food for camping and disaster kits recently. I’m well aware of the US military’s famous MRE’s. I’ve tried them and they are marginally palatable, last for years and are easy to carry while camping or storing for an emergency. My problem with them is that they are so heavily processed that I’m concerned with them as a nutrition source for more than one meal on any given trek. Hence my search for a tasty, healthy food item that could cover both camping and disaster contingencies.

I was doing some soft searches on the internet and came across Pemmican. Pemmican is a truly North American food used and discovered by Native Americans. It was used as a winter food source of meat that could be stored without refrigeration or excessive salt. I read multiple articles on pemmican and discovered that Europeans had largely ignored it as a source of nutrition for travelers. Except that is, for Arctic and Antarctic explorers, such as Robert Falcon Scott and Roald Amundsen who used it as a source of calories, with 16 oz per day supplying all the nutrition needed a hardworking explorer. While I’ve come across many variants for making pemmican it can best be described as 60% dried beef (jerky) and 40% tallow. Commercial jerky is too salty so I use home made with 1/4 to 1/5th the seasoning called for in the recipe and make sure the beef is dry and brittle. Some recipes call for no salt or seasoning, but I like having some seasoning.

The recipe for the aforementioned pemmican is simple. Pulverize dried meat into a coarse powder and add warm (<60C) tallow and mix well. The meat needs to be very dry. A way to check dryness is if you have a strip of dried meat, it should break when you bend it. You do not need to homogenize the mixture in a blender, it just needs to be well mixed. Spread on a cookie sheet about ½ inch thick and chill. Cut into bars and bring on your next expedition with confidence it will satisfy on the trail. The taste and texture reminds me of pepperoni. Some factoids I’ve learned about pemmican: There are a lot of stories explaining that the meat needs to be as dry as possible and not salted at all to taste good and preserve well. Definately keep the Pemmican dry. The tallow can be rendered suet or lard, but rendering the fat source is important. Also whatever fat source you use it should be a solid at room temperature. Using a liquid fat source like cooking oil would change the consistency of the Pemmican. Also adding dried fruit and dried flavorings and spices such as cinnamon or pepper can help mix up the flavors.

When I’ve made it my best results have been with beef and rendered beef suet. I have the dry meat shredded and ready to go when the tallow is done. Once the tallow is cool enough to handle I mix with the meat. Some reading on pemmican can be found at http://www.natureskills.com/pemmican_recipe.html.

After learning about and feeling productive by making several batches of Pemmican in preparation for my next camping trip I got a bit cocky and adventurous and decided to try to make something sweet that would compliment pepperoni-esque Pemmican. I did not want a dessert, but something like a peanut butter and jelly sandwich. So I played around with some simple ingredients that I had in the kitchen.

Believe me when I say I made multiple versions of what I am calling my peanut butter and jelly bars; but I came up with something that tastes great and nutritionally is compatible with the Pemmican bars and will also keep for extended periods. I am still trying to see how long they will last as a disaster food, but they will be a great source of nutrition and energy on the trail.

All I use is;
1 part peanut butter,
1 part dried unflavored breadcrumbs, and
2 parts raisons.

Blend the dry ingredients until they are a coarse meal consistency. Then add the peanut butter and blend until it rolls like a light dough. Caution if you have a blender with < 500 Watts of power you may wish to use a meat grinder or food processor. This mixture can overload a weaker blender – I fried one of my blenders. Layer the “dough” on a baking sheet like the Pemmican and chill; once chilled cut into bars.

I have noticed that some peanut butters seem to be excessively oily for the recipe. So if the bars feel tacky, I roll the freshly cut bars in a 1 to 1 mixture of breadcrumbs and cinnamon. This makes them easier to handle and adds a pleasant flavor. With the nutritional value of the peanut butter bars partnered with the Pemmican, it is a nice balance to meals on the trail and I will be letting some bars age to see how they keep.

Post script. I really want to emphasize a few things about the concept of eating an energy bar that is 40% fat. While many people have much too much fat in their diet, if you are hiking you want to carry as little weight as possible and get maximum energy from what you can fit in your bag. Also, if you are on an extended trek a lack of fat in the diet can lead to protein toxicity; sometimes called rabbit starvation. I am not advocating this as a permanent diet at all. However, it will be on the trail for me the next time I’m in the mountains of Kentucky.

I fully believe that the science suggesting that humans are killing the earth’s environment is right on. Even if all humanity suddenly started behaving in ways to protect the environment it would be many generations before real benefits would be seen. Some things, however, are changing. The water purity of many of the US’s lakes and rivers are substantially better than they were in the 1960s.

I also fully support the education of the masses to try to behave in a cogent and environmentally conscious way. But please let me emphasize the cogent part. There are several examples where some ill informed planner comes up will an unvalidated ‘green’ plan that completely backfires. Let me give a couple of examples, there is fantastic evidence that grass and green lawns are not a benefit to the environment. They often require fertilizer and mechanical maintenance to maintain that has a huge boost to their carbon footprint. Low maintenance trees or a rock garden is often better than a bright green, nicely trimmed lawn.

The so called green buildings where the lights and heat goes on and off based on the presence of people. That is a nightmare because I can supply the reader with numerous examples of times where the temperature in such buildings have produced frost on winders leading to cracking and structural failure. Also, where workers are at work stations and suddenly lights go out, sometimes disturbing power to computers and work is lost or heat goes off so frequently staff bring in portable heaters. Such heaters are fire hazard and have caused fires. So where is the green benefit?

Most workers that I know prefer to not work in a signature green building because it has been designed for form and press releases, and not function. Thus I can assure you there are green buildings where space and services need to be duplicated in functional space. Thus the green benefit is not only gone, but it is worse because traditional resources need to be duplicated. The administrators say the building is a success because it costs so little to run. Yes, if you have a big building with no one working in it, that is a cheap building to maintain. It may never wear out because there is no one producing ware.

Our government at the city, state and federal government has one method for tackling a problem. That is throw money at a problem and brag about all the money spent and or saved.

That is just sad.

What is needed is to throw smart people at a problem and to use resources smart and effectively. It has been less than one year since the big stimulus package has been launched and hundreds of billions of dollars has been documented as wasted. It will be touted as a success however, no matter what the real result because some of that huge pot of money will do some good. A 6 million dollar bonus to a bank executive will help that exec, but that same amount of money might also go to someone doing research to treat a disease that causes mental retardation and cure thousands of people. Why politicians with law degrees from Harvard cannot seem to see which choice for those millions are the smarter choices is beyond me. But history will always tell how the problem was solved by whoever was lucky enough to be in office when the job is done.

Everybody knows that the airline industry is an abomination of American enterprise. It is laughable when the airline representatives say that safety is their concern because they treat people like cattle. Evidence of cattle herding by the industry can be seen anytime you look into the coach section of a jumbo jet. The philosophy is cram as much cargo; people, into the plane and move it from place to place. If the industry was concerned with the people than the ability of the coach passenger to straighten their legs would be a priority because that would prevent deaths by deep vein thrombosis. In the USA approximately 1 million people suffer DVT with 100,000 annually dying from it post flying (Lancet Sept 8, page 838; 2001). That is more people who die annually in the USA from hemorrhagic stroke, but the airlines call it a rare event. All they would need to do is supply passengers with leg room and plenty of water and soft drinks. Instead they provide less leg room and are charging for everything they can including soft drinks.

If 100,000 deaths annually was not enough what about the economic costs of an airline industry? It seems to have forgotten that flying is a service industry. Well, as a scientist I need to travel to communicate with collaborators and researchers to be able to do the work that I do. University and federal regulations require that I try to find the cheapest way to travel, can only travel coach, any frequent flyer miles accrued with my work can only be used for work and minimize the nights away for travel. I was planning to do a day trip to have a couple hours of face to face meetings with some colleagues a few hundred miles away. The airlines have discontinued the earliest and latest flights that they used to fly and made it impossible to do a one day trip. Then we had to schedule an overnight and this caused the costs of the trip to increase. The increase was not only because of the hotel accommodations needed, but the costs of the flight increased.

When traveling on business I try very hard to not check bags. This is because the airlines are notorious at losing bags. The funny thing is that when they lose passengers’ bags they refer to those bags as, “unclaimed.” Who has gone flying and did not try to claim a bag they checked? Those bags should not be referred to as “unclaimed” because that implies that someone did not try to claim the bag. They should be called, “Stupid and Incompetent Airline Lost Bags.” So now the airline sells those bags and pockets the profits. The airlines lose 7000 items DAILY and sell those items (http://www.unclaimedbaggage.com). So they are actually incentivized to lose your bag. They just don’t care and are rewarded for that lack of caring. What other industry is rewarded for incompetence? Someone, if you have an answer, please tell me.

Part of the problem with air travel now is that the rules are changing faster than anyone can keep up with and no effort to phase in changes. There is also a capricious level of inconsistencies on all fronts against the flying public. For example I had 6 flights in one week and had a carry-on bag and my computer bag with me. on the first four flights I carried these on with no problem. But on the fifth flight I was told only “one bag.” While the sign that was less than two feet from the woman telling me this read one bag with the exception of a personal bag, purse or computer bag. Remember, I had a personal bag and computer bag. I did not argue for fear of missing my flight. I checked one bag with numb resignation that I had no choice as cattle going to slaughter. I kept my computer bag – of course. On the plane I saw several people with two bags that matched or were larger than what I had checked. Still there is and was no recourse. Once on the flight we were delayed for 30 minutes because of traffic at the destination, when I had a 55 minute layover between flights. On the flight the stewards insisted that all electronic devices be turned off 22 minutes before landing. This is frustrating because I use my computer for work and this cuts into the time I would use for important blog writing as well as science writing. The 22 minutes of electronic silence does not improve navigation, so I’m at a loss as to why this is needed on a 1 hr and 10 minute flight.

By the way, when the plane landed we were forced to wait for 10 minutes again on the tarmac because of congestion at the terminal. We disembarked with less than 15 minutes to catch the next flight and of course, I was at the back of the plane and one of the last people off the flight. Believe it or not, the congestion at the airport had delayed the next flight from pulling away from the gate and even though boarding had closed I made the connection. Maybe it was a blessing that I was not carrying that extra bag because it might have slowed my jog between terminals.

I fly about once per month in the USA and annually one international flight and have done so for about 20 years. Twenty years ago, flying was comfortable and somewhat luxurious. Now flying sucks. It is stressing the law abiding citizen and killing business. People say that these “changes” are for our safety. If you believe that talk to the passengers who have been stuck on a plane on the tarmac for 6 hours. How is that safe? If you want safety it is achievable through fair and balanced approaches that need not drive honest paying customers away.

My threshold for driving versus flying used to be a 4 hour drive. That threshold is now up to 6 hours and I will be refusing trips because it is not productive and the stress of the demeaning experience does nothing for my work productivity. I’ve got access to skype and several virtual communication options, which will be my preference over flying.

The bottom line for me is that flying is getting too expensive, too time consuming and all and all an abysmal experience. I try to drive if I can, and do virtual meetings when possible. I also combine trips when I have to travel but I do whatever I can to avoid flying.

My Ambulance Education continues to sell at a brisk pace. In the past year I’ve been privileged to make connections with people in the trenches, reconnect with comrades from those days and work every day to do research that may benefit patients in the ambulance. I have said many times; working on the ambulance has been an education for me in many ways and still has that affect on me. I’m also working with local educators to participate in educating the next generation of EMS practitioners. So those years on the ambulance have been an important personal growth time in my life.

There is another important period in my life that was educationally significant and that was my graduate education. I spent six years in Lansing Michigan attending Michigan State University to obtain a Masters and Ph.D. The time spent there was a lot of hard work, but as enjoyable as it was successful. I experienced multiple things that I had never experienced before including; getting fired, moving in with a girl friend and matured as a scientist. Yes, getting fired, which I will not talk about now. While much of graduate school in the sciences is parochial it is a distinctly unique rite of passage required for burgeoning scientists.

In the USA there are about 16 million people in college at any given time and a substantial percentage of those will consider going to graduate school. There are, however, relatively few memoirs about scientists going through graduate school. Those few that exist tend to be from Nobel Prize winners who write on their recollections as to how graduate education participated in them getting the most famous scientific prize in the world. I think my book on graduate school will make nice reading to talk about how an active scientist managed graduate school and overcame the relatively typical adversities that occur to many of us along the long road that becomes one’s life.

So if you have not guessed, I’ve written the follow on to My Ambulance Education. It is called, How I Survived My Graduate Education and covers the years of finding a graduate school through the Ph.D. and finding a postdoctoral position. Concerning my postdoctoral position, I worked as a postdoc in Paris France after leaving Michigan and that is an interesting story as to how I got a job in Paris and prepared for the next stage of my life.

By the way, the story about getting fired and bouncing back from that is discussed in detail in How I Survived My Graduate Education.

To tell the truth Book 2, as it is called, is complete. I’m trying to find a publisher for it, and unfortunately the publishing business is suffering from the economic down turn just as fiercely as everyone else. So How I Survived My Graduate Education is having a difficult time finding a home. I’ve resolved to work hard in getting it published for the next eight months and if it is not picked up by a publisher by that time, I will be posting it as part of my blog starting September 1 2010. Do not worry I’ll blog as normal, which is once or twice a week, but will intersperse book chapters in between my regular blogs.

The book has been proofed by several beta readers including educators and graduate students and universally they have said it is entertaining as well as informative. The feedback about how useful the graduate education information is has been extremely positive such that I think it is important to get that information out there. While Book 2 is a memoir it is informative and useful for people, contemplating graduate school or in graduate school. But, it will be a pleasant read at the same time.

So if you are a publisher or have links to a publisher (literary agents included) feel free to make contact with me and perhaps my education series can continue. Or if you have no publishing connections just wait to see what the book looks like, it might be free on line starting in September.

It has been one year since I started my blog. During that year My Ambulance Education has been released. The book and blog have facilitated my reconnection with numerous friends from my past. I’ve also continued my research into diagnosis and treatment of neurologic disorders has made tremendous strides towards success. I have been invited and accepted several invitations to write about and participate in panel discussions concerning EMS and acute care issues associated with stroke and neurologic disorders. So the career is moving in a productive direction. Although it is a constant battle I still have fun being a college professor.

The blog has been enjoying reasonable success too. A couple of sites now link to the blog and it sees a regular flow of hits and traffic to the site in general. There have been quite a few occasions where people have made contact through the web site but all too few comments or feedback on the blog. I also tweet and put a note up on Facebook when a blog is posted, so it gets some exposure. It has been a lot of fun launching a web site and blog. For those of you who follow the blog, you should already know that I try to blog at least once per week and twice a week when I can. My plan is continue blogging regularly. If you have any subjects you want me to blog on, feel free to make a suggestion by either commenting on an existing blog or use the contact page on my site.

Thanks for following my blog in year one and I hope to have a successful year two.

In stroke rehabilitation circles the sick joke is, Speaking, Writing or Walking; pick one. What that means is that our health care system for rehabilitating patients post stroke is so poor (being both broken and insufficient) that if you have a stroke you can only get enough rehab paid for to re-learn one life skill; talking, writing or walking.

Please try to imagine for one minute that you are a care giver (spouse or other family member) and your loved one’s life has been devastated by a stroke. You may be somewhat relieved that he or she survived this lethal event. Your love for that person allows you to be blind to their current inability to talk to you, but you understand them nonetheless. Although, no one else understands them and you become a translator. Still, you are encouraged because every day they seem a little better.

After about 10 days in the hospital they are transferred to a rehabilitation institute. This raises your hopes because you are sure that the rehab will bring them back to normal. At the rehab hospital, every day you see improvements in balance and communication. The occupational and physical therapists are firm with the regimen but fair and compassionate in the care they provide. After about three weeks there are still many difficulties with simple skills like walking and communication, but it is announced that the rehab is over and you’re given some literature on how to care for a disabled stroke patient at home.

Now at home without the skill and training the therapists had you are unable to motivate your loved one as well and the status quos that results is they depend upon you for everyday tasks; getting dressed, preparing food etc. You are now the main caregiver of a physically dependent adult, which is a full time job. You may need to quit your job or hire home health care workers to give you time to make some money. Insurance often falls well short of this. They are depressed because their lifestyle is shattered. Sadly, many stroke patients only receive about 30% of the physical rehabilitation they need or would benefit from. This leaves patients disabled and family devastated by trying to figure out what to do after being given a bunch of literature with lots of information but few answers.

These post stroke victims are largely unable to care for themselves and less able to fight to get the help they need. That is because they are ‘disabled’ and society tends to not want to see them. But please take a close look at this deserving segment of society estimated to be growing by 300,000 people per year in the USA. A productive member of society has a stroke and not only is their income lost to the family, but often a second income is lost caring for that person. Families are hit with a financially catastrophic double-whammy. Every family in the USA is one stroke short of bankruptcy.

That is just sad.

The current health care plan being bantered around in Washington DC will not fix this. What is needed to fix this is an understanding that rehabilitation is not finished when the insurance runs out. More and better rehab will return insurance premium paying people to the insurance companies and work force. So the simple policy that is needed is that if a patient’s improvement is continuing post stroke and the feasible goal is return to work / normal, keep up with the rehab. I believe that three extra weeks of physical therapy will be paid for by the years of extra life we can get from those people after successful rehabilitation.

Oh yeah, and one more thing. Lets support more rehabilitation research to get even more people back to work post stroke.

Well there is no “but,” I said “but” to get your attention. I was inundated with requests from numerous people and agencies to support and donate to the Haitian relief funds. I have chosen to not donate in any way to the Haitian charities. This is not at all because I do not care or in any protest, but rather because my entire career is dedicated to the relief of others. That is what EMTs do and that is what my medical research does. So, while the well meaning advocates pushing for donations to relief agencies will do this for a few weeks, I will go on thinking and working on ways to save sick and injured every day for the next several years. The truth is, being prepared for a disaster is a full time job and all of us need donations and relief continuously, not just for the weeks surrounding an earthquake.

Did you ever think about the people with the rescue dogs in Haiti? Those people, and dogs, train year round to be ready to help rescue trapped Haitians. The medical personnel train for years to be ready to treat Haitians after being rescued. The logisticians and administrators put in place numerous technologies and equipment ready to be distributed to the Haitians. Do you think those pallets of boxes labeled, “Emergency Relief USA”, were made on demand? Those are made continuously, ready to be used for dealing with a disaster.

I do not disagree that what the Haitians need now is relief. That is paramount. But when the commotion from Haiti dies down, think for a second about those of us who work on such things and if you are so moved, donate your time or money to a charity that supports rescue operations like those that you are seeing in Haiti. Those agencies need the funds year round. Remember the cash you donate today could be used to serve you in the event of some future tragedy.

A student came to my office to enquire about becoming a graduate student in my lab. She was extremely bright, energetic and had done some homework about my work as evidenced by the insightful questions she was asking. I put a lot of weight on the questions and dialogue that occurs when I interview, and she was a top notch inquisitor.

I’m actually a big fan of trying to read information behind the question. It is something I’ve tried to teach students to read the question and understand why it is being asked. With this student I could tell that her interests were in clinical science and medicine and that she has an interest in pursuing an MD or an MD/Ph.D. degree. This is fine because that is the type of research my lab does. Also based on her questions I could tell that she was interested in neuroscience and brain disease. While I do stroke research and am a professor of neurology my expertise is NOT brain but how the blood vessels affect the brain during diseases and injury. I gently pointed that out to her and she was unfazed and continued with her barrage of questions.

What I was trying to do was to answer her questions directly but also provide information to her that I hoped would be helpful in the career decisions she was facing. I could do this based on the motivation I surmised being behind her questions. There is every possibility that my interpretations were wrong, but in the end she asked to be put on my mailing list of news, events and plans so she could keep track of my research.

But the episode did remind me of the tools I’ve tried to teach students and colleagues about the information behind the questions people ask. As an example I was involved in a discussion of research being conducted that a company was interested in pursuing to develop a commercial project. We were updating the company bosses on the latest research and told them that some additional funds were obtained to do some new experiments. One of the “bean counters” also known as an accountant, from the company asked where the funding came from. I answered it came from a student grant award, which was the correct and truthful answer. The quizzical expression on the accountant’s face surprised me, but my boss, who understood the reason for the question, added to my answer. He informed them that the funding was a non-dilutable government grant. He of course knew and I learned that the reason for the question was to determine if they needed to pay someone back or had competition for taking over the technology. Everyone was happy and we went on.

The greatest skill in providing information in a question, or a series of questions, I witnessed was with a college professor of mine and a fellow graduate student. The professor asked a question of the student and the student said he did not know. Undaunted the professor asked a simpler question on the topic that the student answered quickly. Nodding the professor asked a series of questions all of which the student answered correctly and were related to the initial question. The final question was, “based on what we’ve been discussing, can you answer the original question?”.

The student was able to effectively answer the first, harder, question. The lesson I learned and I think the class learned is that we have to think about the answer to a question based on what we know as well as there being information in the questions asked of us. The professor was pointing out relevant facts pertinent to the initial question by asking other questions.

I’ve tried to employ those skills when teaching and have several times said to a student who claimed to not know the answer to a question to hang on so we can get back to the subject. I then try to do what my professor did in graduate school without torturing students. Inadvertently embarrassing students is sometimes a risk depending upon the students’ sensitivities and personalities. I’ve not mastered that skill yet, but it is rewarding when I see the lights go on as I quiz a student. The little victories keep me going.

For anyone who wants to know what it is like to write a memoir it is easy to give a brief philosophy that partially addresses that question. That is if you do not get yourself emotionally involved and in tears, you are not honest enough with what you are writing.

What brings people to read about tragedy is because it is like watching or looking at a car accident and not being able to look away. It is emotional and we want to see it. We are drawn to our emotions by our emotions.

The link between writing a memoir and bringing back those emotions is a lot like that car accident we want to gawk at. If you have not brought your personal car accident back to life in the writing it won’t be emotive enough for anyone else to want to gawk at.

When I wrote My Ambulance Education, it brought back horrible memories. There were calls I refused to talk about and did not want to write about. But after lots of soul searching and prompting from friends and colleagues I went to the dark memories I had and put them down in black and white. After writing some of those stories I was thoroughly emotionally drained, drenched in sweat with burning eyes. Maybe those emotions came across in the book and maybe not. But they came back when I was writing them.

Reliving those events also reemphasized to me why I am where I am now. My Ambulance Education helped me become a college professor and I am still trying every day to help people as well as help the EMTs and paramedics on the ambulances. My sincerest hope is that the paramedical practitioners who grace our emergency medical services will benefit from my current work as much as I have gained from working amongst them.

There are two types (maybe three) of difficult classes: Classes with a lot of material making the class difficulty due to the volume, Classes with difficult concepts and the third is when these two factors are combined.

Anatomy is an example of a difficult class because of the sheer volume of material that needs to be memorized. Calculus is an example of a class being difficult because the concepts are hard for most people to grasp. Biochemistry is an example of a class with a tremendous volume and contains relatively complicated math. So biochemistry is difficult because it is a combination of volume and subject matter.

While I have never taught calculus or anatomy I have taught multiple levels of biochemistry. It is difficult to teach because for the classes I was teaching it was required by the students and less than a favorite. My goal for the students was to make the class as relevant as possible and to try to keep them engaged.

When I was teaching biochemistry to medical students I would make references to clinical maladies and relate biochemical changes to clinical manifestations. Quite simply every chemical reaction in the human body is needed for normal bodily function. If defective or absent medical problems often occur and bringing in such examples make the class and lecture more interesting for the students.

Teaching with real life examples or case studies is a common teaching method, but the down side is that it can take up a lot of time. So the choices for such examples need to be chosen carefully. This is especially poignant because of the large volume of material that must be covered. As discussed earlier this is a classic example of combining volume of material with complicated subject matter makes the class hard for the students and difficult to teach.

Without being overly formulaic I would either introduce the clinical study at the beginning of the class and let the students ponder it as I go through the lecture and close the lecture with the conclusion of the clinical example. Alternately I would go through the lecture and give a clinical case study from the days lecture as I close. After multiple years of giving the lectures coming up with examples was not a problem and there are multiple texts available for cross referencing as well. Either way it is a lot of effort to get information across and keep it interesting and it is still a very hard class and unpopular with students.