Thoughts about Muhammad Ali

• What an athlete: 6-3, 215. Imagine him at middle linebacker.
• One of the first mainstream celebrities to embrace Islam. Today it's common, and we've come to understand that Islam plays a major role in our world.
• Out front of most of the nation in opposing the Vietnam War. In retrospect, of course, he was right.
• A pioneer in athletic celebrity for the television age. He was the first athlete to engage in what we now call "trash talk", but he was clever about it. His relationship with Howard Cosell forced TV sports in a different direction.
• His record was 56-5. Hung around too long at the end; a lesson for us all.
• What the late Teófilo Stevenson might have become.
• A model of humility and responsibility in retirement.
• A reminder that being a professional athlete in contact sports is a hazardous profession.

The Chief Justice says what he really thinks

When I hear or read a particularly sharp or sarcastic comment, I often say "Don't sugar-coat it; tell us how you really feel". And today, I say that to Chief Justice John Roberts.

Yesterday the Supreme Court released its opinion, written by Roberts, in Foster v. Chatman, a heartbreaking case about an African-American man in Georgia convicted of murder after prosecutors systematically removed all African-Americans from the jury pool. Quotes from Roberts' opinion:

• "Despite questions about the background of particular notes, we cannot accept the State’s invitation to blind ourselves to their existence."
• "On their face, [the prosecutor's] justifications for the strike seem reasonable enough. Our independent examination of the record, however, reveals that much of the reasoning provided by [him] has no grounding in fact. [His] misrepresentations to the trial court began with an elaborate explanation of how he ultimately came to strike Garrett."
• "[The prosecutor] had described [a potential juror's] conviction to the trial court as being for 'basically the same thing that this defendant is charged with.' Nonsense."
• "'If a prosecutor's proffered reason for striking a black panelist applies just as well to an otherwise-similar nonblack [panelist] who is permitted to serve, that is evidence tending to prove purposeful discrimination.' With respect to both [prospective jurors], such evidence is compelling. But that is not all. There are also the shifting explanations, the misrepresentations of the record, and the persistent focus on race in the prosecution's file."
• "The contents of the prosecution’s file, however, plainly belie the State's claim that it exercised its strikes in a 'color-blind' manner."
• "This argument falls flat. To begin, it 'reeks of afterthought'."
• "Two peremptory strikes on the basis of race are two more than the Constitution allows."

That's as blunt as an appellate judge gets. I guess the Chief Justice won't be getting a Christmas card from the prosecutor in this case, who has been implicated in other misconduct. Folks, please be careful when you vote in local elections like the DA. The mess that an incompetent or malicious DA makes will inflict pain on many people and can take years to remedy. I've written about this before.

The Court voted 7-1 to overturn the conviction. The outlier is Justice Clarence Thomas, the only African-American on the Court. His written dissent provoked direct criticism from the Chief Justice in the Court's opinion. This is the type of situation that leads even a political centrist to conclude that putting Justice Thomas on the Court was a big mistake.

One more thing: the original trial was held in 1987, and it has been bouncing around appellate courts since. Why did it take so long for justice to be attained? During the first round of appeals, the defendant's lawyers did not have access to the prosecutor's notes. In 2002 Georgia adopted its Open Records Act. Only then could the defendant's lawyers, still striving for a fair trial, discover the "smoking guns" in the prosecutor's notes. These smoking guns eventually attracted the attention of the Supreme Court. And folks, this is just another reason why open records laws are so important.

Did the defendant, Timothy Foster, actually commit murder? Maybe, but that's not the point. He deserves a fair trial. And if a representative jury finds him guilty, he deserves to be incarcerated for the rest of his life.

The end of frequent flyer programs

For 35 years, airlines have offered their most loyal customers a deal: fly with us as often as possible, and we will reward you with perks and free tickets. While conforming to the travel policies of my employers, I have received numerous benefits from this deal. It has made tolerable what would otherwise have been a very arduous aspect of my career. But the deal is being revoked, not just from me personally but from all road warriors in the U.S.

At the outset of frequent flyer programs, airlines typically operated their flights half full and therefore had many seats to give away. These days the average load factor has risen to 70-80%. Naturally the airlines have less inventory to give away. The net effect is that airlines have raised, and keep raising, the number of miles necessary to get a free ticket. Meanwhile they have restricted, and keep restricting, the accrual of miles in their programs. Furthermore they have added, and keep adding, fees to use free tickets. The consequence is that truly free tickets are far less plentiful to obtain and less convenient to use. Strike one.

As for in-flight perks, some of them cost the airline nothing — such as the right to "pre-board" (what a term!) the aircraft while the overhead bins are still empty. But the most valued perks have been upgrades to a higher class of service and selection of the best seats in economy when you cannot get an upgrade. Alas, these perks are gradually ending. The best seats in economy are being individually priced, and access to those seats at no charge by frequent flyers is being cut back. Likewise, airlines have re-learned a lesson from the advent of deregulation: if they simply price first-class domestic seats at an affordable premium above economy seats, they'll be able to sell those seats for real dollars instead of giving them away. Strike two.

Airlines and hotels experimented with affinity credit cards and discovered that they could make a handsome profit without actually having to sell a ticket or a hotel room. It's easy money for the airlines, and consequently they are granting perks to card holders that were formerly reserved for frequent flyers. The more people who receive those perks, the less valuable they become. Strike three.

I will play the game as long as possible, and I have an accrual of miles and points to consume even though they are depreciating rapidly and using them requires ever-increasing flexibility and creativity. But let's be clear: for someone starting a business career that will require frequent travel, the gravy train has ended. Either spend your personal money to travel comfortably or be satisfied in cattle class. I dislike the phrase "race to the bottom", but we clearly are moving into an era when you don't get what you don't directly pay for.

Prankster at large

During my sophomore year in high school, I caught a ride to and from school with the juniors in my neighborhood. I wasn't old enough to have a driver's license, but they were. Four days a week they ran a carpool, one guy assigned to each weekday. On Fridays my mom drove us.

There was mischief, naturally.

Somebody came into possession of a condom. I don't remember who or how. The driver that morning —  let's call him Herb (not his real name, not even his first initial) —  had taken out his wallet for some reason and left it on the car seat while he drove. I distracted him and slipped the rubber into his wallet. My hope was, his parents would see it later and ask all kinds of embarrassing questions. Good fun, right?

It gets much better.

That afternoon on the way home, things got a little crazy in the car. Herb flew past an elementary school at a high rate of speed. The school zone limit of 15 mph was still in effect. Unfortunately for Herb, a State Trooper happened to be in the vicinity.

He chases us, pulls us over, and accuses Herb of going 62 in a 15. Catastrophe! Herb freaks out. The trooper sternly commands Herb to get out of the car and then demands his driver's license. Herb reaches into his back pocket, fumbles around nervously with the wallet… and the condom falls out onto the pavement.

I don't believe even Truman Capote could describe the look on Herb's face. The trooper breaks out laughing and lets Herb go with just a warning. I'm still laughing about it.

True story from 1970. Herb, wherever you are, you can't get mad at me because my practical joke saved your ass.

One of my favorite episodes of M*A*S*H was the revelation that placid B.J. Hunnicutt was the camp's secret practical joker, with a string of marvelous successes.

Yes, I still try to pull a good practical joke every few years. They require careful planning because I strive for quality, not quantity. Ask around, you'll hear. At work, ask Steve about the Frontline restaurant. At church, ask Becky about the fake newsletter. And watch out; you could be next.

Prince's Percocet

At this time it's difficult to tell what role Percocet played in the death of Prince, but there's an aspect of Percocet that is worth considering even if it wasn't a factor for Prince.

Percocet is a combination of oxycodone and acetaminophen. We hear a lot about the addictive dangers of oxycodone, an opioid. We don't hear so much about the dangers of acetaminophen, the over-the-counter drug used in Tylenol. The truth is, acetaminophen can be dangerous — or, as the FDA puts it, "Acetaminophen has a narrow safety margin".

Percocet tablets come in different strengths of oxycodone, from 2.5 to 10 mg per tablet. The prescribing physician selects the dosage of oxycodone based on how severe the pain is, how much risk of addiction there is, how large the patient is and what the patient's experience with opiods has been, and so forth. But every Percocet tablet, regardless of much oxycodone it has, also contains 325 mg of acetaminophen. The same is true of Vicodin, which uses hydrocodone instead of oxycodone.

Why does this matter? Because an overdose of acetaminophen can kill you by wrecking your liver. Acetaminophen overdose has replaced viral hepatitis as the #1 cause of acute liver failure in the U.S. About 50,000 Americans go to an emergency room each year because of acetaminophen overdose, and about 1% of them die. Even when they survive, it's a very unpleasant and expensive recovery that is only partial in many cases. It's an ugly way to go, and it's an ugly condition if it becomes chronic.

The FDA knows all about this problem, but it also recognizes the usefulness of acetaminophen when used in accordance with guidelines. The limit for acetaminophen consumption is 4000 mg a day for a healthy adult. (For someone whose liver is already compromised, it's lower.) Because of the prevalance of acetaminophen overdose, some have argued that the limit should be reduced to 3000 mg a day. Either way, if you stay within the guidelines for acetaminophen dosage, you will not exceed the limit:

• Two tablets of 325 mg each, four times a day, is 2600 mg per day.
• If you take two of the larger 500 mg tablets, three times a day, that's 3000 mg per day.

But people who exceed 4000 mg are putting themselves at grave risk. For that matter, even 2600 or 3000 mg per day every day over a long time could be troublesome. If you use that much acetaminophen, discuss it with your doctor who may recommend blood tests of liver enzymes.

Back to Prince. People who get Percocet tablets with low doses of oxycodone — the 2.5 or 5 mg doses that, some say, are easier to get a physician to prescribe — may be tempted to double up or triple up on their consumption of Percocet in order to get the amount of oxycodone that they crave. Problem is, in the process they unwittingly exceed the daily limit on acetaminophen. Did this happen to Prince? I don't know. But it has happened to other people.

By the way, acetaminophen is not the only over-the-counter pain relief medication with a narrow safety margin. Aspirin, ibuprofen (the active ingredient in Advil, Motrin, etc), and naproxen (the active ingredient in Aleve, Accord, etc) are in the same category. And combining the maximum daily dose of several of these NSAIDs can also be dangerous.

Aching Achilles?

A photograph of my right heel:

Maybe yours looks like this. My left heel looks basically the same. The bump in the blue oval is caused by a bone spur underneath the Achilles tendon, and it has the effect of stretching the tendon in a manner similar to the bridge of a violin:

Well, not so dramatically, but you get the idea. Problem is, Achilles tendons don't like to be stretched like that. Inflammation of the Achilles tendon, called Achilles tendinopathy, can be quite painful. And this is a problem that I've fought for seven years. I've learned a few things about the problem and how to manage it, so I'll offer these in case you might find something useful.

But first, the inevitable disclaimer: I am not a physician, and I do not practice medicine. My story may not be applicable to you. All your medical conditions should be evaluated by a physician or other qualified and licensed provider of medical care.

My initial reaction was to see an orthopedics MD, who x-rayed the ankle and diagnosed the condition. He said that surgery to remove the spur is a last resort because the rate of failure or complication is significant, recovery is lengthy and difficult, and the spur might grow back. He was reluctant to recommend an injection of steroids because of potential complications also. Instead he prescribed oral steroids, which helped immediately to reduce the inflammation. But long-term oral steroids are to be avoided whenever possible. Next he recommended physical therapy, which I tried for four months and consisted of two treatments: stretching exercises and additional steroids infused via iontophoresis. I found that the stretching exercises made things worse, and the iontophoresis was less powerful than the oral steroids. Besides, PT was expensive, time-consuming, and inconvenient.

During and after PT, I figured out a few things on my own:

• Shoes matter a lot. Thick-heeled shoes help because they elevate your heel and relieve tension in the Achilles tendon. Flat-soled shoes are your enemy. Don't bother to fix flat-soled shoes with inexpensive inserts that you can buy at a drug store; the fix won't work. Just get new shoes.
• When your tendinopathy is acute, minimize the amount of time you're on your feet for a few days. It's not the time to visit an art museum or walk on the beach. Postpone those until you're better.
• Don't go barefoot, even inside the house.
• Pain relief cremes are helpful. The one that works best for me, Movelat, is available only in Europe. But Aspercreme and its equivalents work too.

My next visit was to a podiatrist that my family has had very good experiences with. In hindsight, I should have gone to him first. He agreed with the diagnosis and said it's not uncommon for stretching exercises to be unproductive or even counterproductive. He agreed with my other observations and suggested two more measures. One, he provided custom inserts for my dress shoes to elevate my heel further. (I suppose I wear high-heeled shoes now.) Two, he prescribed splints to wear at night.

These look formidable, but I came to appreciate them. They stretched the Achilles tendon very gently while I slept. After six months of wearing splints, I found that I didn't need them anymore.

Obviously my condition has not been "cured" because the bone spur underneath the Achilles tendon is still present and possibly still growing. I can say, however, that for the time being these measures have reduced the condition from a substantial constraint on my activity to a mere annoyance. If you have Achilles tendinopathy, good luck and let me know what works and what doesn't for you.

Holiday no more

Last month I drove 400 miles on I-95 from North Carolina to the Georgia/Florida line. I lost count of the derelict or decrepit motels along the way.

By 1970 Holiday Inn alone had opened over 1,000 hotels, most of which were along the then-new Interstate highway system and many of which faced a Ramada, HoJo, Best Western, Travelodge, Econo Lodge, Days Inn, Super 8, Knight, Red Roof, or Motel 6. All these hotels were built to the same pattern: rooms opening to an outdoor walkway, thin walls, one or two floors, an onsite restaurant and an outdoor swimming pool — a regrettable combination of cookie-cutter architecture and inexpensive construction.

Almost nobody wants to stay in a roadside hotel like that anymore; our tastes have moved upward to Hamptons, LaQuintas, and Fairfields. Problem is, the pre-1980 properties that the modern brands replaced linger on. Some have been wiped clean to their slab foundations, never redeveloped. Weeds and even small trees grow through cracks in the asphalt and concrete, surrounded by rusting chain-link fences. Others are operated as deep-discount hotels catering to transients by the week, lovers by the hour, and operators of meth labs. The remainder simply sit there, eyesores that instantiate the recent TV show Life After People. Nationwide the number of empty hotels surely numbers in the thousands.

When a commercial building is erected, I'd like to see a requirement for the owners to place an amount of money on deposit with a trust fund and sign a covenant that if the property sits idle continuously for ten years, the trust fund can take over the property, demolish every building, replant it with natural vegetation, and deed the property to a nearby town. I doubt such a policy will ever be implemented, but instead more cities could act to acquire and remediate these properties.