As I recounted in a previous post, I apparently have cured my plantar fasciitis by going against medical advice and walking barefoot whenever possible. In this post, I would like to review the medically prescribed treatments that didn’t work. I tried quite a few approaches over several years, and I eschewed only the final, most draconian alternative. Some of these treatments border on quackery.

Tried and worked

Stretching has helped to alleviate my symptoms and perhaps has contributed to my eventual cure. However, by itself or in combination with any other medical advice or intervention, it was insufficient. Now I feel fine without stretching regularly.

Tried and didn’t work

• I underwent physical therapy, consisting mostly of ultrasound, stretching, and massages. This actually increased my pain on a day-to-day basis. Usually, it became excruciating about an hour after I left the therapy center, even if I was sitting down.
• I had a very expensive shockwave operation, under general anesthetic, as a next-to-last resort. I had developed doubts about the treatment’s efficacy after agreeing to it. The brochure explaining the procedure noted that something like 60 percent of patients experienced a successful recovery from plantar fasciitis, but in a footnote it said that a slightly lower percentage of patients recovered fully if they simply skipped the operation and followed the post-op instructions to rest for a month. That is, the main benefit of the shockwave therapy was to get patients to rest! Sadly, it didn’t work for me.
• I received cortisone injections at least twice. In neither case did I receive any perceptible, lasting benefit. Amazingly, the doctor suggested a third attempt, just in case. Perhaps equally distressing, one time he applied local anesthetic to the wrong foot and started aiming the very long needle at it. When I reminded him that my left foot was the right foot, he decided to make up for lost time by not waiting for the local anesthetic to take effect. I remember very clearly having that  long needle pushed slowly into the bottom of my foot.
• I was prescribed and fitted for expensive orthotic inserts for my shoes. These kept my feet from having to adjust to support my weight as I walked. That is, they weakened my feet while protecting them from injury. However, wearing them did not cure my condition. Several times, I became pain-free for a significant period. So I would begin to ease out of using the orthotic all the time. The pain recrudesced every time.
• A orthopedic specialist practically prescribed particular athletic shoes for me to wear.  Apparently, they were designed to structure my footfall to make it as different from walking barefoot as possible – lots of cushioning and support. My problem began to diminish only when I chose to junk the shoes and walk barefoot. I now happily wear the least-coddling shoes possible. Also, doctors told me that dress shoes, with heels, would be the best kind of shoe and would not need an orthotic insert. My experience has been that wearing them results in the most pain.
• Doctors cavalierly told me – a reasonably fit man then about 40 years old – that I might have to stop running for the rest of my life. Gullible, I took them at their word, but I believe that this inactivity only prolonged and exacerbated my problem by weakening my feet.

Not tried

Finally, the orthopedic surgeon who had helped to perform the shockwave operation told me that the only remaining treatment had the highest success rate. He would open up the bottom of my foot and indiscriminately cut half of my fasciae. He told me that he had no idea why this procedure worked, he could not even see which fasciae were damaged. I feared that this operation would permanently weaken my foot, reducing my capacity for high-intensity athletic endeavors. I suspect that much of his success rate with this operation was due to: 1) disgusted former patients refusing to continue contact with him, which is how I reacted to the shockwave operation, and 2) as with shockwave, the benefits of forced, post-operative rest.

For several years, I suffered from plantar fasciitis. A series of medical treatments and advice did nothing to ease my pain and sometimes even increased it. Nonetheless, I seem to have solved this problem, and my experience directly controverts much of the medical advice that I received. So I offer this testimonial in case others find it instructive.

What worked

In a separate post, I’ll cover what didn’t work. But here is what I have done to ‘cure’ my plantar fasciitis:

• I walk barefoot whenever possible, to strengthen my feet as they have evolved to operate. When my feet are cold, I walk around the house in socks.
• I use shoes that allow me to walk in a manner as similar to walking barefoot as possible. My first choice are highly flexible sandals from Mexico, aka huaraches, that have no heel. Otherwise, I usually wear Nike Frees. Finding this model actually took my problem from ‘manageable’ to ’solved.’ Wearing them, I could painlessly hike around a college campus carrying a heavy backpack, which I could not do while wearing, for example, trail-running shoes from New Balance. Wearing huaraches or Nike Frees, I trudged through several South American cities for a month this summer – often carrying a very heavy backpack – without plantar fasciitis recurring.
• I devotedly performed the stretches that doctors and physical therapists had shown me, even on days when I felt no pain. I have since reduced my stretching without symptoms recurring.
• I carefully eased back into exercising. I started by walking briskly (sometimes barefoot). I would walk one minute longer each time that I exercised. Then I graduated to running by mixing in running one minute at a time, up to a half hour of running. I limited the time to avoid re-injuring myself, and I would not run two days in a row. Finally, I graduated to playing tennis, which I can now do for three hours at a time without hurting my foot. (My back and ego are another story.) I can play full matches on successive days.
• I used my $200, custom-fit orthotic inserts on rare occasions, just for safety’s sake. Such occasions included moving very heavy furniture and wearing dress shoes. However, I have eschewed their use in recent months without untoward effect.

Why it worked

The medical doctors told me that I should avoid any activity that would stress my feet. Two of them told me, to paraphrase: ”You may just have to give up running for the rest of your life.” The orthotic that they had prescribed encased my foot into the ‘proper’ shape, relieving my foot of the need to adjust to my gait. It seemed to me that the doctors were telling me, in essence, to give up, to stay weak but protected. At the same time, they admitted that they didn’t really know why some treatments worked more often than others or in some patients instead of others. (I’ll detail my many unsuccessful treatments later.)

I’m not a medical doctor, but I am one of anthropology. And I just couldn’t believe that, for 200,000 years, Homo sapiens had been suffering chronically from plantar fasciitis because they lacked orthotics and expensive shoes. It seemed much more likely that the condition that had made this injury possible was weak feet and an unfortunate running motion, especially since I’m severely flatfooted and a little pigeon-toed. Moreover, I developed plantar fasciitis by running in shoes. (I probably worsened it by running through the pain.) I eventually decided to mimic the walking and running of our shoeless ancestors, since our feet are much more likely to have evolved to facilitate a shoeless stride than to have evolved in response to shoe -wearing – the latter being, in evolutionary terms, a recent innovation.

In short

So, after years of following medical medical advice to the letter, I decided to ‘go rogue.’ I simultaneously strengthened my feet and changed my gait by going shoeless. And it worked!

Rhetoric in the United States regarding our military opponents has descended to the point where childish name-calling has become the default. Calling others ‘evil’ and ‘bad guys,’ without explanation, should be the stuff of children’s entertainment. Instead, the widespread use of these terms is anti-democratic as it hinders citizens’ understanding of our opponents and selves, and it impedes peace-making through compromise.

‘Evil’ fosters war

In his speech accepting the Nobel Peace Prize, President Obama asserted that “evil” exists. Then he predictably trotted out the Nazis and al Qaeda as self-evident exemplars, without actually explaining what constitutes evil. Since he was arguing in favor of wars against evil, this seems like a considerable omission. Perhaps he would be hard-pressed to find a definition that would not encompass some actions in recent years by the United States or its allies.

But his use of this term – popularized especially during the Bush years – creates deeper problems. The first is the easiest to convey: who decides what is evil? Indeed, al Qaeda and the United States government have portrayed each other as consistently engaging in evil actions. Which is made of rubber, and which of glue?

The second problem is actually more practical. ‘Evil’ is such an absolute term that its use makes it easier to fight wars but hard to compromise to end them. George Orwell demonstrates this problem, perhaps unwittingly, in 1984 and Animal Farm, as the reader feels frustration at the rulers’ blatant (albeit successful) redefinition of allies and enemies. While I believe that the United States was less likely to make a deal with Saddam Hussein after depicting him as another Hitler during the Gulf War, we did in fact reach a compromise that lasted for years. I suspect that the Taliban can expect similar treatment soon.

I am most concerned that public figures use the term ‘evil’ to trick people into supporting or participating in military actions without serious contemplation. How can we not fight evil with everything we have? If Nazis were evil and so are al Qaeda, North Korea, and Iran, shouldn’t we fight World War II against them all? Won’t that make us heroes?

A major change must have occurred since 1983, when President Reagan described the Soviet Union as an ‘evil empire.’ This phrase received widespread ridicule for being cartoonish and engendered criticism for making coexistence less imaginable. Today, I hear even anthropologists saying ‘evil’ as if it had a self-evident referent. How have so many Americans, of so many political persuasions, become so simplistic? So fundamentalist? It frightens me.

I understand the attraction of the concept: It makes it easier to stop thinking. What we are doing is ‘good,’ even if it entails killing the people that the ‘evil’ ones are primarily victimizing. And demagogues have the Nazis as a handy resource in making evil seem self-evident. How can we describe such systematic murder as if it were committed by ordinary humans? And yet clearly it was, as evidenced by the ability of murderous concentration-camp personnel to lead quiet, inconspicuous lives after WWII.

It may be difficult to understand our opponents, but peace-making (and democracy) depend on relative estimations of our peers – not absolute ones. As Obama said in his acceptance speech, “no Holy War can ever be a just war. For if you truly believe that you are carrying out divine will, then there is no need for restraint …” Perhaps, then, he should eschew the absolutist rhetoric of ‘evil’ and work to promote a more relative assessment of our actions among our erstwhile enemies and vice versa. This might create the conditions for a less belligerent coexistence in which dialogue replaces epithets.

A cartoon world with ‘bad guys’

At least Obama seems to shy away from the term “bad guys” to refer to the United States’ momentary targets. The nearly ubiquitous use of this phrase shares all of ‘evil’s’ problems. Mostly, though, it appears to be part of an attempt to reduce our analytical sophistication to the level of a seven-year-old. Perhaps I’m being generous, but I believe that adults should be using this phrase with tongue in cheek, as exemplified by a list of “Top Ten Evil Bad Guys Ever” and an “Evil League of Bad Guys” t-shirt.

Aside from the question of who gets to decide who is “bad,” this phrase masks the complexity that we, as citizens in a democracy, should understand as we guide our representatives in making decisions regarding war. If someone is ‘bad’ or ‘evil,’ why bother trying to understand their motivations? They are what they are … until they support us, at which point they become selfless forces of ‘good.’ Indeed, some of yesterday’s ‘bad guys’ in Iraq are now being called ‘good guys’ because they are cooperating with U.S. forces. It seems unlikely that their moral or ethical standing has changed en masse.

We might also ask whether such automatic and partisan moralizing of positions impedes self-reflection. Could it be reasonable for Iraqis (or Panamanians or Dominicans, etc.) to oppose an invading foreign army that their country had never attacked or even threatened to attack? Might the so-called ‘bad guys’ reasonably see themselves as ‘patriots’?

A question of democracy

Finally, I want to give our public figures’ sophistication the benefit of the doubt. I believe that the childlike use of these simplistic, absolute terms started as part of a cynical, Nixon-like attempt to frame the debate regarding our country’s military operations. This is part of politics in a democracy.

But if military figures use this loaded language to conjure support for war, then they are propagandizing the populace. This is not their role in a democracy, in which influence should flow from the people through the elected officials to the military. It is anathema to the military’s status as a nonpartisan institution that implements political leaders’ decisions. So, General Petraeus, please stop.

College dropouts – and the majority of students in the U.S. will drop out – say that more-immediate financial and scheduling commitments outweighed the investment that attending college represents. The solutions appear obvious but require a financial investment in equal opportunity.

A group called Public Agenda has recently released a study of former students. (The New York Times has an article here.) The researchers found that dropouts’ main obstacles were insufficient money and time. To wit, many students were working full-time or nearly full-time to support themselves and perhaps family members, including their children.

So what is the solution? When given a list of twelve potential changes, the dropouts preferred those that directly addressed these issues. Their top five changes included three related to finances: lowering tuition and fees and increasing aid. The remaining two addressed scheduling: daycare on campus and classes at night and on weekends. This makes sense to me.

Yet Hilary Pennington, from the Gates Foundation, commented in the Times article, “We need a system where, if someone is struggling, if professors notice that somebody is missing a lot of classes, … they immediately go to student-life services, and someone reaches out.”

Until recently I taught at a college where this was the expectation, which I tried to fulfill. Unfortunately, my experience was that it rarely, if ever, worked. Most students did not answer my messages. Those who did respond might come to class another time or two. But the only successes that I can remember resulted from students receiving additional grants (not loans) or a job on campus. That crisis-management approach cannot work for the sixty percent or more who drop out.

If we, as a country, are committed to equal opportunity through education, the answer seems apparent: Make college easy to attend aside from academic expectations. That is, gaining admission and mastering academic outcomes should be the main challenges that a student confronts. Drastically reducing tuition and fees, providing inexpensive childcare and healthcare on campus, and scheduling classes at times that students find convenient might significantly boost the chances of deserving students who do not currently have the advantages that many of us enjoyed as we struggled to graduate.

I just saw Purton Hupp down in New Orleans, and he gave me the inside scoop on the rules regarding busking there. Apparently, he learned them the hard way, as usual. In short, you can busk just about anywhere  in the French Quarter – except Jackson Square – until something like 11 pm. You can busk along the Moonwalk by the mighty Mississip, too. Buskers do not need a permit.

But the rules are different around Jackson Square. Apparently, you have to stop by 8 pm there, lest you disturb the residents’ slumbers. And here’s the real drawback: unlike buskers, the ‘artists’ (aka painters) have to pay for permits, so they have protected their investment by getting rules passed that restrict buskers in that area. Buskers have to set up at least twenty feet from the fence and cannot block any entrance.

Recent research has suggested that driving while conversing on a cell phone is more dangerous than doing so while speaking with passengers. The researchers suggest that passengers, by paying attention to conditions on the road, help drivers to pay attention at critical moments, thus mitigating the distractions that conversations cause. This seems reasonable. I would like to suggest an additional reason that phone conversations are distracting: humans’ ability and tendency to imagine the world through others’ eyes.

Another line of recent research has focused on “mirror neurons” in humans and other primates. These neurons, or networks thereof, fire similarly whether an individual performs a particular action or observes someone else performing it. That is, were I to observe you opening a jar, the same subset of these neurons would activate as if I were opening the jar. However, researchers are beginning to delve into an obvious complication: we identify with some things and types of actions more than with others. This makes our mirror neurons more likely to “mirror” some people’s actions more than others’.

The third piece of the puzzle is that imagining a scene triggers neurological processes similar to observing it with our eyes. Particularly vivid fantasies can result in significant changes throughout our bodies. For example, I used to drift off to sleep thinking about playing basketball; many nights, on the border of sleep, I would unwittingly hit my partner as I moved my arms to make a pass, and I would awaken with a pounding heart.

So, back to driving: drivers talking on cell phones, handless or not, will imagine themselves to be in the presence of their conversational partner. The closer they feel to their partner, the more deeply they will imagine this displaced scene. Perhaps they see their partner’s face, but perhaps, their mirror neurons firing, they also imagine what the conversant is seeing and doing. For example, imagining my mother’s experience in her house will certainly distract me from driving. Conversely, drivers speaking with passengers are more likely to imagine what the passenger sees – the road ahead. (Passengers watching movies are another story.)

The obvious moral is to avoid speaking on the cell phone while driving. If you insist on doing so, at least monitor your attention so that you do not displace your mind’s eye into someone else’s head.

Scientific American has recently published a provocative article explaining humans’ seemingly universal inability to imagine a lack of consciousness and, thus, an end to consciousness at death. In short, the conscious imagination never experiences non-consciousness. When we’re not conscious, we’re not aware and thus can’t remember what it was like. At most, we can remember regaining consciousness. This inherent quality may be a key part of the explanation for the widespread belief in some sort of afterlife.

But the article does not address at least one important dimension of this issue: imagining that other beings – human or otherwise – have the same kind of consciousness. It is a categorical leap to apply insights about one’s own experience to that of others. The ability to do so – empathy – is also a nearly universal capacity among humans and, at least, many other primates.

However, humans do not employ this capacity in universal ways. Historically, some people have imagined that only some other peoples had immortal consciousness, categorizing the remaining humans as wholly mortal animals. Conversely, quite a few people around the world have held that other animals, plants, and/or geological formations have immortal consciousnesses equivalent to that of humans. Ancient Greek myths provide a handy compendium of examples.

In short, I cannot imagine being dead, but I can imagine the death of your consciousness – or, for that matter, its non-existence – without much strain. I can imagine its immortality, too. Given this flexibility, the historical paths by which humans have developed such a wide variety of beliefs about others’ immortality awaits a fuller explanation.

Have you ever wondered why women’s breasts are so fascinating? If so, here’s your answer: they’re like buttocks with eyes.

Now here’s your explanation. The first part basically recapitulates a common hypothesis:

• Much of evolution results from random genetic mutations that help individuals within a species to reproduce more than other individuals. Survival doesn’t matter unless it helps an individual to procreate. Human breasts are considerably larger than those of other apes, and this size does not seem to improve women’s health (i.e., survival). If anything, large breasts stress the rest of the body. So some researchers have looked for reasons that large breasts would increase reproduction.
• Other apes favor rear-entry sex (although not exclusively) so our common ancestor probably did, too. As a result, things that look like buttocks might trigger a genetically inherited association with sex. A genetic mutation that made breasts fuller would trigger this desire, too.
• This mutation would have more effect among human ancestors than among other apes, because human ancestors spent more time upright, with chests fully exposed. Also, as the only ape with exposed “whites” of the eyes, humans are particularly oriented to others’ eyes. So, being near the face, buttock-like breasts would be particularly noticeable to us.

Here is where my Nobel-laureate-level insight takes place:

• Most human breasts have pronounced differences in darkness between the areola/nipple and the rest of the breast. This is especially visible among humans because of our relative hairlessness, compared to other apes.
• Excluding the occasional pimple, buttocks don’t share this feature, so why would breasts? Watch enough videos of breastfeeding apes, and you’ll know that it’s not to help an infant find the nipple. The answer: the areola/nipple complex mimics eyes, much as breasts mimic buttocks. Ta da! What could be more fascinating?

If this sort of specualtion strikes you as hooey, I suggest that you not dedicate your life to evolutionary psychology or sociobiology. Otherwise, the next time you see breasts, think, “buttocks with eyes.”

P.S. Actually, we could jettison the whole buttocks bullocks and retain my MacArthur Fellowship-deserving insight. After all, many women have quite flat chests.

Our correspondent claims to have scored a highest-possible 800 on two sections of the GRE and over 700 on the third, without studying. S/he shares tips for doing one’s best while taking a test. Preparing is a separate and more important step.

IFS Guide to Test-Taking

Attitude is key:

• Your only goal and focus is to maximize your score for each section.

  • Ignore the consequences – it doesn’t help to remind yourself that the test matters little or greatly.
  • Like sports champions, good test-takers learn this: narrow your focus to the task immediately at hand; nothing outside the test exists.
    • You can’t change your preparation or travel to the future to experience the results.
    • Clear your mind of thoughts about how you did on previous sections, too; it’s now irrelevant.
  • Relax! You don’t know how a test will be scored. Will there be a curve? Will everyone miss that question? Is it possible to miss a lot and still get a great grade? You don’t know, so just focus on the question you’re on.
    • For example, I missed a few questions and still got an 800 out of 800 on the GRE Verbal section.
    • Besides, you’ll do better if you continue to feel confident. You won’t get smarter through despair.
  • As ‘background music,’ recall the feeling you had while you achieved something noteworthy, such as a sports victory or a musical performance or a test.
•  All tests are opportunities and never represent a danger. They are an opportunity to show what you can do.
• Tests are fun. They’re puzzles to solve. This includes essay tests.

 Some entailments of this attitude:

• Work the test until you know that you’re done. You must choose fight over flight.

  • Understand the question clearly, even if you feel rushed.
  • Answer every question if you have time.
    • If guessing is not punished, answer randomly if need be.
      • Consider: You have a 20-25% chance of guessing correctly. The odds are better if you can eliminate one or more answers.
    • If guessing is punished, consider the odds: if you’ve narrowed the answer to two or even three possibilities, it’s probably a good bet to guess.
  • Answer the ones that you’re sure about first, then return to the middling areas, and then to the hardest questions.
    • Some of the later questions might give you a clue or at least let you identify patterns in the test.
  • ALWAYS double-check (and triple-check) everything if you have the chance. In an essay, did you say what you mean? Is your writing or bubbling legible? Did you put the answer in the right spot? Did you understand the question?
    • I mark questions that I’m unsure about and return to them. If I’m still unsure, I return again.
    • I also re-check my math on ALL problems, if I have time
• Trust that the test doesn’t and shouldn’t have any tricks in it.
  • Always choose the best, most obvious answer.
    • If you find yourself trying to determine whether there’s a trick, stop! Sometimes tests have answers that are partially right, but choose the one that’s completely correct.
  • In essays, never make up an answer in the hope that it’s right. It’s better to give greater detail about what you do know is applicable.
• Learn to work the test.
  • For example: Standardized, fill-in-the-bubble tests almost always have a fairly even distribution of answers. When you’re unsure about an answer, consider whether there’s a shortage of one of your possibilities.
    • I create a tally after answering the questions that I’m sure about, and I update it as I go on after that.
    • Focus on how the essay will be graded. For example, if it’s mostly a test of writing skills, rather than content, spend your time polishing the writing rather than  trying to pile on evidence. (And vice versa.)

These tactics can change from test to test. The key is your attitude: confidently focus on maximizing your score on each section of the test. Enjoy the opportunity to work this puzzle and to show what you can do.

Purton Hupp doesn’t like to talk much, and even less about himself. Now, singing is another thing altogether. I’ve spent enough time with the man to know that his music is like waves noisily crashing against the shore. It’s easy to forget there’s a whole ocean behind it.

Still, I’ve learned a bit from the man. I hope he doesn’t mind my sharing some of it here:

• Crickets don’t tweak their songs. The leaves don’t tweak their rustling.
• If it weren’t for bosses, no one would sing about trains.
• Love is like a hurricane in the desert.
• If you’re proud of feeling zen, then you might be ashamed of feeling pain.
• Jokers are wild by nature. Most people prefer to play without them and don’t miss them when they aren’t in the deck.

Now you can listen to Purton break – sometimes against a cliff, sometimes on the rocks, and too seldom across the sand: http://phupp.wordpress.com.