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Photo from Pixels

By Daniel Dunaief

Daniel Dunaief

Picture a cup.

Better yet, picture 100 drinking vessels, all of different sizes, lined up next to each across a long table.

Now, on a cold day, when you’re not that thirsty but could use something to warm your hands, you might choose a mug that allows heat to bring comfort against a cold wind and frigid temperatures.

On a hot day, when you’re running, gardening or watching your child play yet another sporting event, you might choose an insulated cup that has plenty of ice cold water. That container also might have condensation on the outside, which could give your palms a respite from the pools of sweat clinging to them.

When you’re handing your two-year-old a cup filled with milk, soy milk, water or juice, the container likely has a lid and a drinking attachment.

These cups can all be different sizes and shapes, can serve various purposes and can hold different amounts of liquid.

Even before you touch one of them or take a sip, no matter how eager you are for the liquid inside, you can imagine the feel of the cup in your hand, and you can gauge just how much your mouth and body can expect. You’re likely to take small sips of a scalding cup of hot chocolate, while you might down eight ounces of iced cold water in a matter of seconds.

What would you do if you had a cup mismatch?

Let’s say you were incredibly thirsty after a long run on a mid-July day when you pushed yourself to go further or faster than you had in months. Instead of a tall glass filled with water or a water bottle, you take out a shot glass. The water might be just as cold, but the amount could leave you wanting more and disappointed, even before you lift that small glass to your lips.

At various points in life, the size of the glass (OK, now I’m speaking figuratively) from which we drink doesn’t align with our expectations or hopes.

We want a day, an interaction, or an outing that fills a large cup, and, yet, the lived experience falls short of our hopes.

As a barometer of our expectations, the cup, like the small shot glass filled with barely enough water to wet our parched lips, can feel like it’s too small, leaving us disappointed and thirsty.

As we go through life, we, our friends, and our family members experience times – after a storm, amid a physical or mental health crisis, after leaving a satisfying job, to name a few – when the size of the cup, as a measure of the expected dose of happiness, coherence, joy, or meaning, falls short.

Those tough times become disheartening. We might lose faith or feel slighted or cheated. We need more to fill our cup.

While we can seek to fill the largest cup around with successes, accomplishments, support, and affection, we can also rethink the container.

A small child pouring water into a Dixie cup, for example, might be incredibly successful if a few drops make it.

As adults, the juxtaposition of our daily expectations against our experiences can dictate our mood and reflect our evaluation of the quality of the day. When something happens that reduces the likelihood of our achieving or enjoying our lives, we can feel like we’re holding a frustratingly empty cup that we have little prospect of filling.

Instead of being disappointed, we might consider reaching for a different container. I’m not suggesting that we aim low or that we stop striving for personal achievement and growth.

A smaller cup, however, breaks the iconic model of the optimistic half-full cup or the pessimistic half-empty container. Instead, we can choose to fill a smaller cup.

Over time, we can increase the size of the cup, filling it each time until it runs over.

This process might restore our sense of accomplishment and help us appreciate what we have and not lament what’s missing.

As life changes, we can redefine what we need to feel fulfilled.

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Alexander Hamilton's statue in Central Park. Photo from Wikipedia

By Leah S. Dunaief

Leah Dunaief

“What if,” is always a tempting game to play with history. This week in July, thanks to what we learned from the play “Hamilton,” makes us wonder. 

What if Alexander Hamilton had not been fatally wounded on July 11, 1804? He died of his stomach wound the next day, yesterday, all those years ago.

He is reputed to have tossed away his shot, but Aaron Burr didn’t.

What if the two men, bitterly at odds over The Jefferson-Burr election for President in 1800, had never had a duel? Even though Hamilton was a member of the Federalist Party along with Burr, still Hamilton campaigned for Jefferson, a member of the Republican-Democratic Party, as having the better character.

What if Burr and Hamilton’s father-in-law, Philip Schuyler, had not opposed each other in the election for New York State Senate? Subsequently, would Hamilton still have said such derogatory things about Burr’s character that prompted Burr to challenge him to a duel?

Hamilton’s oldest son, Philip, was killed in a duel not long before, reportedly defending his father’s honor. Instead, he brought unimaginable grief to his parents. Hamilton is said to have thrown away his shot in turn because of the anguish caused by that killing. What if that great loss hadn’t happened? Would Hamilton have accepted Burr’s challenge, then deliberately missed? After all, Hamilton had been a highly decorated Major General, proficient in battle. He surely knew how to use a gun.

What if Hamilton had lived? After all, he was only in his 40s at the time of his death. Hamilton had been of enormous influence, first as an aide-to Camp for George Washington, then in writing most of the Federalist Papers and helping to get the Constitution passed, again as the United States first Secretary of the Treasury and setting up the national banking system that still exists today during Washington’s administration. (Perhaps less known, to get the Southern members of the Congress to vote “aye,” he agreed to their demand to move the Capital from Philadelphia to Washington, DC, a far easier destination for them.)

Hamilton is regarded today as a brilliant visionary and one of the most outstanding men of his century, at least according to the French diplomat Talleyrand in 1794. His life and thoughts have spanned three centuries. What more might he have given us had he lived?

What if?

His wife, Elizabeth, known as “Eliza,” lived to age 97 and is saluted for her remarkable contributions to the young nation.

Initially left with young children, a mortgage and bills, she was to additionally suffer the loss of her father, who had at the time of his death lost his fortune. 

With the help of friends, she was able to hold on to her home but eventually was forced to move her family to lower Manhattan from her 35-acre estate in Harlem. Her children were well-educated and went on to impressive careers.

Eliza became co-founder and director of New York City’s first private orphanage in the area now just south of Columbia Presbyterian Hospital. She remained in that role for 27 years, during which time she oversaw 700 children. She also was a founder of the Orphan Asylum Society. Throughout her life, she remained sensitive to the plight and the needs of orphaned children, reflecting the world her husband had grown up in.

Eliza also was dedicated to preserving her husband’s writings and legacy, including the purchase of his work by Congress. This is how we know so much today about his life and thoughts. His writings are in the Library of Congress.

We might play, “What if,” at any turn in history, some of which could send shivers down our spines. This week, though, it seemed clearly Alexander Hamilton’s turn. He did much to create the world we live in today.

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Sam Kleeman. Photo by Caryn Koza/CSHL
From left, Sam Kleeman, Assistant Professor Tobias Janowitz, Miriam Ferrer Gonzalez and Emma Davidson. Photo by Caryn Koza/CSHL
Sam Kleeman at Lake Tahoe
Sam Kleeman in front of a sequoia grove at Yosemite.

By Daniel Dunaief

This is part 2 of a two-part series.

Cancers not only compromise human health, but they can also suppress the body’s immune response. A little studied small protein called cystatin C, which is secreted by numerous cells, may render the immune system less effective in its response to tumors.

Sam Kleeman, a PhD student in Cold Spring Harbor Laboratory Assistant Professor Tobias Janowitz’s lab, recently published results in the journal Cell Genomics that demonstrate a link between elevated levels of this protease inhibitor, the suppression of the immune system, and the development of cancer.

Kleeman was able to demonstrate a potential role “Cystatin C might play in damping down the immune response to tumors,” he said.

Cystatin C is a known cysteine protease inhibitor, but the biological and organ-level relevance of this has not been characterized in detail. This protein could be one of many mechanisms by which glucocorticoids can reduce the effectiveness of the immune system.

Cystatin C could drive the progression of the disease, which could explain why Kleeman has found evidence that higher levels coordinate with worse outcomes.

Starting with the data

Pursuing an interest in data- driven research, Kleeman, who has a Bachelor of Medicine and Surgery from New College at the University of Oxford, searched the UK Biobank, which provides health data for numerous people in the United Kingdom. 

In this Biobank, Kleeman, who joined Cold Spring Harbor Laboratory in August of 2020, found that cystatin C was the best prognostic indicator of cancer deaths.

“I was a little surprised by this,” Kleeman said as he had heard of cystatin C as a marker of kidney function, but was not aware of any association with cancer mortality. Some studies had found evidence for this previously, but those were in small cohorts and were poorly understood, he explained.

A healthy kidney clears most proteins quickly, pumping it out into urine. A kidney that’s not functioning optimally, however, allows it to accumulate.

In his research, Kleeman removed cystatin C selectively in cancer cells, causing the tumors to grow more slowly. The main changes in the architecture of the tumor was that it reduced the frequency of macrophages with expression of a protein called Trem2. While the exact mechanism is not known, it’s likely that immune control of the tumor increases without cystatin C.

Kleeman also demonstrated a similar effect on the connection between levels of Covid-19 and mortality in a paper published in iScience.

The biological mechanism explaining the correlation is nuanced. Patients with higher levels of glucocorticoids can be associated with poor outcomes. It is not a simple relationship, he said, which makes causality difficult to assess.

Kleeman believes cystatin C secretion in response to glucocorticoids has context dependency. Not all cells posses inducible cystatin C secretion.

The research primarily found that only macrophages and cancer cells can secrete cystatin C in response to glucocorticoids.

He describes a “two hit” model, by which glucocorticoids plus an inflammatory stimulus recruit macrophages. The model applies to all inflammatory stores, but is co-opted in the case of cancer.

At this point, drugs aren’t available to inhibit or reduce cystatin C. Instead, Kleeman suggested that a viable research target route might involve creating a specific antibody.

Some researchers have created so-called knockout mice, which don’t have this protein. These mice can survive without it, although eliminating all cystatin C creates other problems.

Kleeman speculated that the protein could play a role in preventing significant immune reaction against sperm.

Indeed, this protein is secreted at high levels in the testes. Males without it have lower sperm function and production.

Kleeman hopes this work acts as a starting point to understand the mechanism better by which glucocorticoids modify immune response to cancer, and to investigate cystatin C as a possible therapeutic target.

Long standing partnership

As an undergraduate, Kleeman took a class with Janowitz, which kicked off a mentorship that now spans two continents.

Kleeman appreciates the comfort level Janowitz has in working on higher-risk, higher-reward topics or on ideas that haven’t already attracted considerable attention from other scientists.

“There’s a tendency in science towards group think,” Kleeman said. In the history of medicine and science, many widely accepted theories turn out to be wrong. “Patients undoubtedly benefit from a diversity of thought in science and medicine,” he explained.

When he completes his PhD, Kleeman said it would be a “dream to have a dual appointment” in which he could conduct research and work in the clinic with patients. To get there, he knows he needs to establish his research profile that includes a genuine track record of achievement while demonstrating that he can function as a reliable and effective clinician.

Kleeman’s thesis research lies outside the field of cystatin C, which started out as a curiosity and developed into the recent publication. He wanted to “understand what UK Biobank could teach us about cancer patients.” With Janowitz and Cold Spring Harbor Laboratory Professor Hiro Furukawa, Kleeman is working to understand how a specific type of cancer could cause an auto-immune disease.

A resident of Forest Hills, Kleeman lives about 45 minutes from the lab. Outside of work, he enjoys visiting national parks. He has visited 10 so far, including Yosemite National Park, Zion and Rocky Mountain National Park. 

Professionally, Kleeman feels it is a privilege to be a PhD student. He appreciates that he can explore his interests without too many restrictions and is eager to make the most of the opportunity.

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Spiced Pecan Grilled Peach Salad

By Heidi Sutton

From an enjoyable crunch to comforting creaminess and a satisfying chew, pecans deliver a perfect bite and texture. This Spiced Pecan Grilled Peach Salad and Grilled Pork Chops with Peach Pecan Salsa are loaded with fresh flavors for an easy, nutritious warm-weather meal.

Spiced Pecan Grilled Peach Salad

Spiced Pecan Grilled Peach Salad

YIELD: Makes 4 servings

INGREDIENTS:

Spiced Pecans:

1 large egg white

3 tablespoons dark brown sugar

1 teaspoon cinnamon

1/4 teaspoon cayenne pepper

1/4 teaspoon kosher salt

2 cups pecan halves

Salad:

1/4 cup, plus 2 teaspoons, extra-virgin olive oil or pecan oil, divided

1/4 cup white wine vinegar

1 teaspoon Dijon mustard

1/4 teaspoon garlic powder

salt and pepper, to taste

2 large peaches, halved and pits removed

6 cups mixed baby greens (such as arugula, spring mix and spinach)

4 ounces soft goat cheese

DIRECTIONS: 

To make spiced pecans: Preheat oven to 275 F. Line rimmed baking sheet with parchment paper and set aside. In medium bowl, whisk egg white, brown sugar, cinnamon, cayenne pepper and salt until well combined. Fold in pecans and mix until evenly coated in mixture. Spread in single layer on prepared baking sheet. Bake 45-50 minutes, stirring occasionally until pecans are fragrant and golden brown. Allow to cool completely.

To make salad: Heat grill to medium-high heat. In small bowl, whisk 1/4 cup olive oil, white wine vinegar, Dijon mustard, garlic powder, salt and pepper, to taste. Set aside. Brush cut sides of peach halves with remaining olive oil and grill until grill lines appear and peaches become tender, 3-5 minutes. Remove peaches and cut into slices. Divide greens among four plates. Top with grilled peach slices and goat cheese. Divide 1 cup spiced pecans evenly among salads and reserve remaining cup for snacking. Drizzle each salad with vinaigrette. 

Grilled Pork Chops with Peach Pecan Salsa

Grilled Pork Chops with Peach Pecan Salad

 

YIELD: Makes 4 servings

INGREDIENTS:

4 boneless pork loin chops (each 1-inch thick)

3/4 teaspoon, plus 1/8 teaspoon, kosher salt, divided

 freshly-ground black pepper, to taste

2 medium peaches, diced

2/3 cup raw pecan pieces

2 tablespoons red onion, diced

2 tablespoons chopped fresh basil

1 teaspoon minced jalapeno pepper

2 teaspoons lime juice

DIRECTIONS: 

Season pork chops with 3/4 teaspoon salt and black pepper, to taste. Heat grill or grill pan to medium-high heat. Grill pork chops until browned, about 5 minutes. Flip and cook 5-6 minutes until food thermometer inserted in center registers 135 F. Transfer to plate and rest at least 5 minutes until internal temperature rises to 145-160 F. Gently stir peaches, pecans, onion, basil, jalapeno, lime juice and remaining salt. Add salsa on top of each pork chop with remaining salsa on side.

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By A. Craig Purcell, Esq.

A. Craig Purcell, Esq.

After an automobile accident, you should always stop and notify the police. Indeed, under New York State (NYS) law, anyone involved in an accident must stop at the scene, and if the accident caused injuries or significant property damage, it is very important for you to notify your insurance company right away.  

A car accident can have far-reaching consequences on everyday life for you and any other driver or passenger involved. Although an accident may occur within the blink of an eye, the subsequent negative impacts on an injured person’s ability to work and perform daily activities may continue well into the future. This may potentially jeopardize the health and financial security of all parties involved in the accident (driver, passenger, etc.). The property loss that may be sustained may pale when compared to the severe bodily harm from a crash.

As we have discussed previously, New York imposes the following minimum amounts for liability coverage:

• $10,000 for property damage coverage (PDL) from a single accident

• Bodily injury coverage (BIL) of $25,000 per person and $50,000 for all persons injured

• Death coverage of $50,000 per person killed in an accident and $100,000 for all persons killed in an accident

• No-Fault coverage of $50,000

Types of Automobile Liability Insurance

Liability insurance covers damages if someone makes a claim against you for loss or harm as a result of your negligence. Your insurance provider protects you and reimburses the individual who made a claim against you up to the extent of your coverage. In addition to being required by law, liability insurance is crucial to avoid out-of-pocket losses.

If you cause a car accident, your liability insurance, specifically your bodily injury liability policy, will pay for the injured parties’ pain and suffering or permanent injuries after a settlement is reached or a personal injury verdict is rendered. Remember, NYS only mandates that you hold accident coverage of $25,000 per individual. This amount should be increased to protect you and your assets, so paying for a policy that at least provides $100,000 per individual and $300,000 per accident in coverage for all injured persons is essential, and more is strongly recommended 

So how much liability coverage is enough?

As much as you can reasonably afford. Don’t scrimp on liability coverage when deciding how much auto insurance you need. Doubling liability coverage does not mean you will pay twice as much for the additional protection. Low liability limits place your savings and assets at risk should you cause an accident, making it imperative that you purchase as much liability insurance as you can. This is especially so because medical expenses are constantly increasing. 

High liability limits protect you if you cause an accident and prevent you from possibly having to sell your home to cover accident costs caused by a severe injury to the other party. Therefore, it is crucial that you assess whether your liability limits accurately reflect the assets at risk should an accident occur due to your negligence.

A. Craig Purcell, Esq. is a partner at the law firm of Glynn Mercep Purcell and Morrison LLP in Setauket and is a former President of the Suffolk County Bar Association and Vice President of the New York State Bar Association.

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Fireworks in the Village of Asharoken on July 4. Photo by Steve Zaitz

Each year, we have the pleasure of covering the patriotism and camaraderie of our North Shore community.

While we love featuring fireworks and celebrations, it’s easy to get discouraged about the state of our nation. Yet, we are reminded each year to put it all in perspective. 

On a rainy Fourth of July, as families gathered for barbecues and the fireworks shot into the sky, it’s safe to say most of us could recognize that we are among the luckiest of people in history to have the freedoms and opportunities we have.

To love our country, and our community, is to fight for them both. The Founding Fathers envisioned an active, informed and passionate electorate. We encourage everyone who took Independence Day to reflect on their patriotism and gratitude for our service members, and to think about how we got this wonderful freedom born out of a grand experiment.

The Founders were passionate citizens, many of whom risked their lives to design a government they thought would bring freedom and prosperity to all. This bit of history, which we all shared this week on July Fourth, is one we should remember each day.

We, too, should think of ways to improve our government. In these divided times, most of us have plenty of opinions on this already, but maybe not in terms of realistic expectations and compromise.

We must think about issues and consider ways we can move the needle. Writing to our elected officials and contributing letters to the editor are ways to do that.

The Founders wanted us to participate in the political process. We should follow their example and speak up, while being civil and compromising as we work toward mutually agreeable solutions for all.

The spirit of freedom we celebrated this week can live on throughout the year. It’s up to all of us to continue to pursue efforts to maintain equity and justice for all Americans and all members of our communities. It’s up to us to ensure that all of us feel free.

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Increase fruits, vegetables and whole grains and eliminate processed meats

By David Dunaief, M.D.

Dr. David Dunaief

For many of us, Independence Day launches a long string of summer barbecues. What if you could use these to kick-start your path to better health?

In the past, I have written about the dangers of processed meats in terms of causing chronic diseases, such as cancer, diabetes, heart disease and stroke. These are barbecue and picnic staples. But there are healthier alternatives. If we lean into alternatives, like those found in a Mediterranean-style diet, we can improve our health while enjoying mouth-watering dishes.

The Mediterranean-style diet includes green leafy vegetables, fruit, nuts and seeds, beans and legumes, whole grains and small amounts of fish and olive oil. The options are far from tasteless.

At a memorable family barbecue, we had an array of succulent choices. These included a three-bean salad, mandarin orange salad with mixed greens and a light raspberry vinaigrette, ratatouille with eggplant and zucchini, salmon fillets baked with mustard and slivered almonds, roasted corn on the cob, roasted vegetable shish kebobs, and a large bowl of melons and berries. I am drooling at the memory of this buffet. Let’s look at the scientific evidence that explains why these foods help us.

Cancer prevention

A systematic review initially published in 2016 and updated in 2017 provides a comprehensive look at the results of studies focused on weighing the effects of adherence to a Mediterranean-type diet on cancer risk and progression (1, 2). When the authors pooled and analyzed cohort studies and randomized control trials, they found an inverse relationship between cancer mortality risk and high adherence to the diet. This means that the more compliant participants were, the lower their risk of cancer mortality.

When making the same comparison between high adherence and low adherence from studies of specific cancers, they identified risk reductions for colorectal (17 percent), prostate (four percent), gastric (27 percent), and liver cancers (42 percent) (1). Further study also found high adherence reduced the risks of breast, head and neck, gallbladder, and biliary tract cancer (2).

The authors note that, while it’s improbable that any single component of the diet resulted in these effects, they were able to demonstrate significant inverse correlations between specific food groups and overall cancer risk. For example, the higher the regular consumption of fruits, vegetables, and whole grains, the lower the risk. All three of these fit right in at an outdoor feast!

Looking more closely at specific cancers, another study found that increased consumption of fruits and vegetables may help prevent pancreatic cancer. This is critical, since by the time there are symptoms, often the cancer has spread to other organs (3). In a case control (epidemiological observational) study, cooked vegetables showed a 43 percent reduction and non-citrus fruits showed an even more impressive 59 percent reduction in risk of pancreatic cancer (4). Interestingly, cooked vegetables, not just raw ones, had a substantial effect.

Diabetes treatment and prevention

Fish might play an important role in reducing the risk of diabetes. In a large prospective study that followed Japanese men for five years, those in the highest quartile of fish and seafood intake had a substantial decrease in risk of type 2 diabetes (5). Smaller fish, such as mackerel and sardines, had a slightly greater effect than large fish and seafood. Therefore, there is nothing wrong with some grilled fish on the “barbie” to help protect you from developing diabetes.

Nuts are beneficial in the treatment of diabetes. In a randomized clinical trial, mixed nuts led to a substantial reduction of hemoglobin A1C, a very important biomarker for sugar levels for the previous three months (6). As an added benefit, there was also a significant reduction in LDL, bad cholesterol, which reduced the risk of cardiovascular disease.

The nuts used in the study were raw almonds, pistachios, pecans, peanuts, cashews, hazelnuts, walnuts and macadamias. How easy is it to grab a small handful of unsalted raw nuts, about 2 ounces, on a daily basis to help treat diabetes?

Stroke prevention

Olive oil appears to have a substantial effect in preventing strokes. The Three City study showed that olive oil may have a protective effect against stroke. There was a 41 percent reduction in stroke events in those who used olive oil (7). Study participants, who were followed for a mean of 5.2 years, did not have a history of stroke at the start of the trial.

Though these are promising results, I caution you to use no more than one tablespoon of olive oil per day, since it’s calorically dense. 

It is not difficult to substitute the beneficial Mediterranean-style diet for processed meats, or at least add them to the selection. This plant-based diet can help you prevent many chronic diseases. So, this Independence Day and beyond, plan to include some delicious, healthy choices.

References:

(1) Curr Nutr Rep. 2016; 5: 9–17. (2) Nutrients. 2017 Oct; 9(10): 1063. (3) Nature. 2010;467:1114-1117. (4) Cancer Causes Control. 2010;21:493-500. (5) Am J Clin Nutr. 2011 Sep;94(3):884-891. (6) Diabetes Care. 2011 Aug;34(8):1706-11. (7) Neurology. 2011 Aug 2;77(5):418-25.

Dr. David Dunaief is a speaker, author and local lifestyle medicine physician focusing on the integration of medicine, nutrition, fitness and stress management. For further information, visit www.medicalcompassmd.com or consult your personal physician.

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Poor air quality can be dangerous for pets too. Pixabay photo

By Matthew Kearns, DVM

Dr. Matthew Kearns

The Canadian Forest fires are still burning and there are recommendations to stay inside. The good news is that the smoke associated with forest fires do not contain harmful gases and compounds in high concentrations as compared to a housefire. This does not mean that the smoke is not harmful, just less harmful. How does smoke and poor air quality affect our pets? Let’s use this article to explore this.

Fine particulates associated with forest fires can damage the airway starting at the larynx (voicebox) all the way down to the lungs. These particles (especially if they contained chemicals like plastics, etc) can cause inflammation that will decrease clearance, cause tissue sloughing, promote small clot formation, and lead to edema. Edema is a diffuse accumulation of fluid within the tissue itself. This edema can narrow the diameter of trachea, or windpipe, as well as cause fluid to settle in the lung tissue itself. 

A secondary complication to this tissue damage and edema is the risk of secondary infections. Bacteria will take advantage of this temporary breakdown in the immune system and cause bacterial bronchitis and pneumonia.

 The first gas to consider in any fire is carbon monoxide. Carbon monoxide is in higher concentration in any fire. Carbon monoxide is such a dangerous compound because it competes with oxygen to bind with hemoglobin on red blood cells. As a matter of fact, hemoglobin has an affinity of 200-300 times more for carbon monoxide than oxygen. This means red blood cells can carry less oxygen and, when red blood cells can carry less oxygen, less oxygen gets to vital tissues. At the cellular level low oxygen levels leads to cell death and the release of all sorts of cytokines, or inflammatory chemicals. This leads to more cell death and entire organ systems shut down. This happens very, very quickly.

The treatment of choice with any airway injury secondary to smoke inhalation is to move our pets out of contact with the smoke. If breathing is labored then oxygen is either just as important, or a close second. Other treatments are what are called symptomatic, or based on symptoms if they present themselves. If there is coughing, cough suppressants are used. If there is wheezing, anti-inflammatories and antibiotics are used.

Once again, the good news is the poor air quality secondary to these fires presents less dangerous symptoms. However, try to keep your pets inside during these poor air quality days and bring your pet immediately to your veterinarian if any symptoms of respiratory distress occur.

Dr. Kearns practices veterinary medicine from his Port Jefferson office and is pictured with his son Matthew and his dog Jasmine. 

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Image from Pixabay

By Daniel Dunaief

Daniel Dunaief

Okay, I’ll admit it: I’m a morning person.

Yes, sometimes, I’m an annoying morning person, ready to poke my wife in the arm, kiss her cheek, or play peek-a-boo with a son who can barely open his heavy lids to notice me.

No, my son is not two, and yet, I still have the urge to smile at him and play games in the morning.

I’m the lone morning wolf in my family. Even my dog, who is as far from a wolf as a dog could be, sometimes closes his eyes tightly when I get up too early for him, hoping I’ll go away or, maybe, I won’t see him. No matter how much his fur blends in with the carpet, it’s impossible not to notice a 95-pound dog.

On the other end of the circadian spectrum, I start to fade early each day. Surrounded by family and friends, much of the time, who enjoy late-night snacks, conversations, giggle fests, and games, I can barely keep my head up and my eyes open.

“You look so tired,” someone will say at about 10 p.m.

“Huh?” I’ll respond, trying to figure out if they’re talking to me. “Oh, yeah, well, I got up early today.”

I get up early almost every day. Getting up late for me means climbing out of bed after 8 am.

I’d like to alter my circadian clock sometimes, but I can’t.

Sensing my imminent departure into dreamland, my wife sometimes asks me a question or two at the utterly reasonable hour of 10:30 pm. I do my best to pick up my head and offer a coherent answer, knowing that the top few floors of my cognitive team have packed up, turned off the lights and tucked themselves in for the night.

The balance between the morning and night person in our marriage means that one of us can handle whatever time-sensitive needs or responsibilities might arise throughout the day. We have shifts.

When we go out on dates, which we can do on any given night as empty nesters, we typically lean towards the earlier side for our outings. The other diners at the early bird special are often decades older than we, although we also sometimes eat with families who have young children.

Our circadian differences extend to the seasons as well. I love the winter, when the sun isn’t too bright, and the air is cooler. Skiing is one of my favorite sports.

My wife, naturally, revels in the summer sun, basking in the extra sunlight each day and soaking up the warmth of the midday sun.

These seasonal differences also mean that one of us often feels energized and inspired by the season. With my wife dressed in numerous layers, we can take a stroll in cooler weather.

During those days when the sun bakes the sidewalk, and the humid air weighs on my shoulders, I can carry ice water or my wife can obligingly dump a welcome ice cube down my back.

Apart from the bookends of each day, we find times when we can give each other our best, reveling in the accomplishments of our children, observing the absurdities of life, and laughing at the differences in approaches to play between our dog and cats.

Even as we are in the middle of my wife’s favorite season, I enjoy the summer more than I otherwise would, knowing that she’s fulfilled and, when I need it, ready to search for a comforting ice cube sometime around mid-afternoon, when I prepare to pass the baton towards her favorite time of day. 

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By Leah S. Dunaief

Leah Dunaief

When I make my way downstairs in the morning, I am often singing, usually some show tune. This never occurred to me as being something special until now. But I recently read an article by Alexandra Moe in The Washington Post that “singing is good for you.” Since it’s always nice to learn that something you do is actually good for you, I am sharing this result of significant research with you. Perhaps now you will feel emboldened to sing beyond the shower.

In a study called, “Sing With Us,” conducted on members of a choir in a London suburb, tests performed before and after they sang indicated an increase in their physical and mental health. This was no ordinary choir, but rather one made up of cancer patients, and their singing “reduced stress hormones and increased cytokines, proteins that can boost the body’s ability to fight serious illness.” Ultimately the study involved 192 patients. 

Other studies have found singing “lessened anxiety, stimulated memory for those with dementia, increased lung capacity and an easing of postpartum depression.” While singing in a group offers additional benefits, like social bonding and community, just singing because you feel like, if you are alone or with someone else, is calming and promotes a sense of well-being.

My mother would sing often when she was in the kitchen preparing meals. So did my dad, who would break into song at no particular time. I never thought about it then, but they did have nice voices, and they did sing on key. They didn’t sing together, just spontaneously. And they really were singing, not just humming along while they worked. No one thought it was strange, as far as I knew. It was in this way that I learned the lyrics to any number of World War I songs, which were popular when my dad was a teen. When, as a child, I would start to sing one of them, older people who might be sitting on a park bench, for example, would look surprised and ask where I had learned them.

And that is how my children learned Broadway show tunes. When we went on long car trips, in particular, we would spend much of the time singing together. I grew up amidst the Rogers and Hammerstein, then Rogers and Hart musicals of the 1940s and 1950s, the “golden age of musical theater,”and my children know those lyrics as if they had seen those magical shows, which were well before their births.

Some of our favorites were: “Oklahoma!” from the show of the same name, “Getting to Know You,” from “The King and I,” “Somewhere Over the Rainbow,” from “The Wizard of Oz,” “Some Enchanted Evening,” from “South Pacific,” and “Anything You Can Do, I Can Do Better,”  (a natural for our three boys) from “Annie Get Your Gun.”

All I had to do was start with, “Chicks and ducks and geese better scurry, When I take you out in the Surrey,” and they would all start singing from the back seat of the car. 

While I loved all the melodies, my particular favorites were from “My Fair Lady,” including “The Rain in Spain,” “Wouldn’t It Be Loverly,” “Just You Wait, Henry Higgins,” “I Could Have Danced All Night,” “You Did It,” “Get Me to the Church On Time,” and “I’ve Grown Accustomed to Her Face.”

I share this with you so you will know what I am singing when I begin. It is, I’m afraid, not always apparent. On the other hand, I would encourage anyone to sing, even if you think you can’t carry a tune or have a terrible voice. A friend was asked to try out for a play when she was in junior high, and when she began to sing the required song, the teacher interrupted her with, “No, really.” He thought she was kidding. But it was “really,” and for many years, she never again sang until she met me.

Everyone should sing, softly if you must, but do it. And if anyone asks, it’s for your health.

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