Pots and Plants has become a neighborhood staple in Ohio City, a place to get foliage to brighten your day and complete the decor in a room. It recently welcomed new owners, but not because former owner Lori Switaj wanted out. Turns out, she needed to get out.

Being around plants reminded Lori of her mother, who passed on her affection for greenery. When she started Pots and Plants, Lori was looking to invest her time and money into work she could enjoy on a deeper level than just another job.

“My entire business plan is one sentence: Don’t lose more than $500 a month,” she said. She achieved that easily and more. “I wanted a fun store,” she said. And it was fun for her, until she felt like she couldn’t breathe. Now, she can’t look at plants the same way.

“I probably should have gone to the doctors years before,” said Lori.  She had become too comfortable with getting recurrent pneumonia and having it treated with antibiotics. “I’ve had pneumonia so many times I can tell you like what lobe it’s in. I used to just go to the urgent care and say I’ve got pneumonia and they’d take an x-ray and they’d give me some [antibiotics].”

People can have underlying lung conditions which make them more prone to pneumonia. Or someone without a lung condition can be unlucky and get a bout of pneumonia, but the disease should not strike again and again. Lori only had very mild asthma, which never limited her from running or playing ice hockey for years. Something else was going on with her recurring infections. Her lungs were changing since she started the store. This past winter, Lori’s cough seemed the worst yet, making her short of breath, and lasted way too long. 

After consulting with her doctor, enough red flags were raised to pursue a consultation with a lung specialist. At the pulmonologist, with blood tests showing a spike in a specific antibody called IgE, her lung doctor and Lori looked at each other and almost in unison thought, “ABPA.” Maybe Lori wasn’t thinking ‘ABPA’ specifically, but they were both suspicious that the plants might be involved.

ABPA stands for allergic bronchopulmonary aspergillosis — a condition where the body overreacts to doses of aspergillosis (a type of mold) spores found in the air. Those spores are ubiquitous in our environment, found in soil and dust and are unavoidable. Certainly the ‘dose’ that Lori inhaled on a daily basis in her store was higher than the average person. But, this doesn’t mean we are under constant threat from soil. Lori developed an allergy to it, and it wreaked havoc on her lungs. With all allergies, you can develop one at any time even if you’ve been exposed to the allergen many times before.

When she received the diagnosis, Lori said, “it was kind of devastating. You’re just like, what am I supposed to do now?”

Lori’s story has other unique corollaries in medicine, where a person in certain trades or hobbies is constantly exposed to a trigger and are unlucky enough to develop a reaction. It’s called hypersensitivity pneumonitis, with nicknames like coffee maker lung, pigeon breeders lung, farmer’s lung, or malt worker’s lung. There are nuances to these treatments, but without a doubt, eliminating the exposure in all cases is the first measure that has to be taken. 

Lori confirmed this ABPA diagnosis by getting a bronchoscopy, where a camera is advanced into the trachea and deeper into the branches of the lung tree. A small amount of water is squirted and then sucked up so the contents can be studied. It confirmed she had aspergillosis mold in her lungs, coating the lining in her bronchi (branches of air tubes). Lori had to stay at a local hospital after that procedure. In a twisted moment of fate, she realized she was on the same floor she gave birth to her son and jokingly sent him a text that read: “I think I’m going to die on the floor that you were born on.” 

When she got discharged from the hospital, she needed a plan for the store. To start, she wasn’t even allowed to go inside of it. Lori recalled her first course of action.

 “I just put up a post saying 40% off all the plants. And it was like a riot… I passed by later. People were just like, we’re grabbing plants. It kind of felt like, oh, she’s dead. Let’s go take her stuff.”

There was a line around the corner of the block that day, and her employees came to the rescue by staffing the store. Despite the flash sale, and confusion of what to do after, Lori came to terms with her realization. “It has to be a plant store,” she said. It just wouldn’t be hers from now on. 

As her breathing is restored, Lori misses her plant store. In the boredom of her recovery, she asked herself, “How many times a day can I take the dog on a walk?” While on high doses of steroids, and not sleeping well, she made an impulse decision to buy 60,000 pieces of jewelry, thinking some niche retail like she had done before could be a good fit. 

Expected to make a very good recovery, her only limitation moving forward is not being trapped in a room with a plant. She’s embarking on some serious soul searching for her next long-term endeavor, jewelry or not. 

“I’ve been around the block enough to know that at some point I’m going to have some kind of idea or going to see something and I’m just going to do it,” she said, biding her time. Part of what she is grappling with is seeing the world of greenery in a completely new light. Never would she have thought that looking at a plant could spark fear. In the meantime, she cleared out the many plants she had at her house. Actually, she still keeps a couple small ones.

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The post She Owned a Plant Store. It Was Slowly Killing Her appeared first on Cleveland Scene.

If it weren’t obvious enough, he’s basically always talking (or yelling). When Dr. Nelson first met him, he was losing his voice by the end of the school day, making basketball practice and home life a practice of patience for him. The first thing he said to her with his weak and raspy voice was, “I have basketball playoffs in a couple months, and I’m going to need my voice back by then.”

The vocal cords consist of two vibrating ligaments —  suspended in the windpipe — so special in their composition that no prosthetic to date can mimic them. Dr. Nelson explains this material as “like the silver skin of a tenderloin,” atop which sits a jelly-like material that vibrates, generating the quality of someone’s voice. Surrounding these cords is a piece of cartilage called the larynx. (The Adam’s apple, and yes, women also have Adam’s apples.)

It is here, through the nose and down the throat, where Dr. Nelson, using her laryngoscope, looked right at Mark’s vocal cords and found a polyp sitting on the left chord. It could have been many things causing his waning voice, like damage to the nerve that supplies the vocal chord muscles, inflammation and swelling of the chords, nodules, or cancer. Instead, this polyp was weakening Mark’s voice.

Dr. Nelson is accustomed to bizarre pathologies in the larynx. Just this year she performed a surgery to repair a voice box that split in half…because the guy sneezed. Now he has a metal plate for an Adam’s apple. Even still, Dr. Nelson holds her sneezes in but jokes, “maybe I won’t anymore.”

Dr. Nelson also reconstructs tracheas in people who have a tracheostomy (the hole created in the neck going directly into the lungs), which steals someone’s voice from them. The air that usually would travel past the vocal cords instead is redirected in and out of that hole. And when Dr. Nelson reconstructs the trachea, the air is sent where it naturally ought to go, over the vocal cords, returning people’s voices in oftentimes emotional moments in clinic. Other injections that she performs can return a voice back to someone in the office immediately. “These are very satisfying,” she says.

While Mark may not have had the sneeze of death, or complications from an intubation necessitating a tracheostomy, Dr. Nelson helped quell Mark and his wife’s concerns. He will get his voice back. In fact, she’s never not given someone their voice back who lost it and came to see her.

But what caused the polyp? Dr. Nelson works with voice therapists, akin to physical therapists working on sports injuries. These therapists are specialists on the sophisticated coordination and complications of producing the voice. Oftentimes, voice rest and voice therapy is what the doctor orders. Like the concerned actors she sees from Playhouse Square, or the local musicians trying to optimize their voice care, her multidisciplinary team provides what most people with weakened voices need. “I couldn’t do my job without them,” Dr. Nelson said reflecting on importance of voice therapy.

For Mark’s floppy polyp, she planned to snip it and inject a steroid to decrease inflammation in the chord. It all went well, and when the polyp was analyzed under a microscope, the culprit was clear, “He got it from all of the voice strain he was doing,” said Dr. Nelson.

After the surgery, she met Mark and his wife in her office. She sent him to voice therapy, and gave a quick orientation of what was to follow: a period of silence for him. The directions were clear: “No whispering, no humming, nothing comes out of your mouth for four days. It’s very difficult for parents with young children,” noted Dr. Nelson. Of course, plenty of patient’s partners are tempted to seize this opportunity and slip Dr. Nelson some cash in exchange for longer periods of mandated voice rest, always making for a good laugh.

After his bout of silence, breaking directions only once to reprimand one of his kids, he spoke for the first time after surgery in the doctor’s office.

“He was really happy [with the result],” said Dr. Nelson. He had a newfound respect for being quieter and he was given a voice amplifier (a small microphone and speaker attached to his hip) to use in class for the following weeks. He also invested in a megaphone for basketball practice and is well on his way to coaching his team in the upcoming tournament.

The randomness in medicine and disease means that people who don’t seem to depend on their voice as much as Adele do in fact need a local voice doctor. The way Dr. Nelson sees it, everyone’s voice matters.

Dr. Corey Meador is a practicing family medicine physician in Cleveland who has written for PBS NewsHour and The Washington Post. He obtained degrees from Loyola Marymount University School of Film & Television in Los Angeles and Drexel University College of Medicine.

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But Dr. CJ Nock, a lung cancer doctor, treats veterans with the newest treatment called immunotherapy. He thinks it is a game changer. “My guess it has already been tested in every [type of cancer] researchers can think of,” he said.

Without immunotherapy, Rick, a 73-year-old former Marine exposed to agent orange, would be dead. Instead, in 2016 after Rick’s metastasized tumor in his brain was removed but the cancer continued to spread, he met Dr. Nock who offered him experimental immunotherapy.

Dr. Nock remembers Rick’s response: “If it’s going to help someone else, let’s do it.”

Dr. Nock had to remind him that it may actually work on his cancer.

Rick still sees Dr. Nock for what is called surveillance, continuously monitoring for cancer should it reemerge. Rick, one of the nearly 200,000 veterans living the Cleveland/Akron area, is just one example of many lung cancer patients who now live cancer-free after immunotherapy,  which has become standard treatment for some patients in the short time it has existed, alongside traditional chemotherapy.

What is Immunotherapy?

Immunotherapy is like a drone strike in its precision as compared to the “dropping of the bomb that chemo is,” said Dr. Nock. Chemo targets biochemical processes during a cell’s division and throws a wrench in the system, wreaking havoc in the body.

Whereas immunotherapy disables cancer cell’s ability to evade detection by our immune system. It’s as if immunotherapy susses out cancer’s fake ID badge, so that the immune system can identify it as foreign. Everyone always has pre-cancerous cells growing in the body, but these are constantly destroyed by the security system of our immune system, including our natural killer cells.

If you can block the trickery of cancer cells, you can “take the breaks off the breaks [of the immune system,]” said Dr. Nock. Immunotherapy targets just one of these signals (PD-L1) at this point, but Dr. Nock doesn’t think PD-L1 is a great marker.

“There’s got to be something better out there,” he said. He predicts that immunotherapy will become even more diverse, targeting other signals yet to be identified. The advent of genomics — huge amounts of genetic sequencing of cancer cells — and the collaborative efforts happening in Cleveland hospitals, it’s possible to imagine your tumor getting genetically sequenced, and you getting a specialized immunotherapy which blocks signals that your unique cancer expresses.

Big Goals

President Biden asked congress for $2.8 billion in March of 2023 for his ‘Cancer Moonshot’ program. Much of this money will be injected into experimental trials through the country’s largest medical system, the VA.

Dr. Nock, the director of clinical trials program at the VA in Cleveland, administers these trials. He has studies testing out immunotherapy given earlier, and without the adjunctive chemo that ravages patients bodies.

The Biden plan relies heavily on immunotherapy’s success, hoping to reduce cancer deaths by 50% within 25 years. This means the grants used for research in the labs (termed basic research) must entice pharmaceutical companies to take the leap of faith for the theoretical drugs that emerge and pursue clinical trials. Neither can succeed without the other.

“I think were all on the same team,” said Dr. Nock, quieting the skeptics concerned about the for-profit model. “My experience with industry is they are just as engaged and interested in getting rid of cancer as I am.”

He works closely with friends in the industry’s private sector, and thinks that multiple medical systems in Cleveland melding basic research and clinical trials is the perfect breeding ground for leaps forward in treatments.

“I don’t think there could be a better medical city to be in,” Dr. Nock said, noting that the moonshot effort needs not only oncologists, but all types of doctors to help detect and prevent cancer and see the mission through. “The less chemo I give in life, the better I’m going to be.”

Knowing When to Quit

Immunotherapy seems all that it is cracked up to be, but it’s not a cure.

“[Cancer] is a biological event…I don’t think its going to go away for ever,” said Dr. Nock. Knowing when to stop treatment is something doctors and patients struggle with alike. The cost of treating nearly all types of cancer has risen. Certainly the search for more tolerable and effective treatments such as immunotherapy carries a big price tag. And the cost of end-of-life care in the last year of life is known to eat up well over 10% of the Medicare budget, with some estimates putting it over 20%. But it remains difficult to know who will do well and who will not at the time of diagnosing cancer.

When discussing life expectancy with patients, Dr. Nock is much more optimistic.

“I use bigger ranges than I ever used to,” he said, owing much of this optimism to immunotherapy. He still toils with the fledgling patients who die while in treatment or within a month of stopping a therapy. It’s human nature to fight to live. Few other cohorts of people know how to fight like veterans. But cancer remains a valiant foe.

Dr. Nock reminded us that, “Cancer is so smart, it eventually mutates to avoid whatever we’re throwing at it.”

Dr. Corey Meador is a practicing family medicine physician in Cleveland who has written for PBS NewsHour and The Washington Post. He obtained degrees from Loyola Marymount University School of Film & Television in Los Angeles and Drexel University College of Medicine.

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It houses vestiges of horrific Cleveland stories past, like the boxer who died at the hands of Sugar Ray Robinson, the notorious torso killer murder mystery, and a slew of car bombing cases (yes, Danny Greene included).

The first autopsy report done in Cleveland from 1833 rests in a glass case and describes the cause of death as drowning in the lake. There are reports from massive Cleveland fires that led to nationwide safety standards changes, like emergency doors opening outwards and fuel stores not being located within a certain distance of residences.

Dr. Gilson has a soft spot for the history of the office. He is just one of four who has held the position in the last 85 years, afer all, and he looks to his predecessors for inspiration.

Asked about his greatest contribution during his 12-year tenure, he points to chaperoning the office into the 21st century with a newfound sense of professionalism.

It is no coincidence, then, that coroner offices across the country often change their title to “medical examiner,” just as Cuyahoga County did. Historically, “coroner” alludes to the task of housing the body for the interest of the King/Crown while the deceased’s outstanding bills are resolved. It’s a far cry from how Dr. Gilson views the office today, which is as the primary care doctor for the city.

What is Cleveland’s primary care doctor seeing now? There’s still Covid, and the opioid overdoses continue, but Dr. Gilson is these days thinking about a treacherous upward trend — teen suicide.

This year, a 16-year-old Black teen took his own life with a gun, and Dr. Gilson was in the lab to observe the autopsy. Combined with the police report and the evidence of the tip of the gun touching the teen’s skin, there was not much mystery in the autopsy. But the how is not the question people, especially family members ask in these situations.

A common question Dr. Gilson gets from the parents of teens who commit suicide is the more agonizing query to answer: “Did my child suffer?”

What does the the chief medical examiner do?

Medical examiners are medical doctors with a specialty in forensic pathology — the study of the investigation of death. It’s an exclusive group: there are only 500 practicing forensic pathologists in the country.

And while Cleveland should count its blessings in having seven of them, they’re still looking to hire two more (tell your friends). Dr. Gilson was extremely busy in 2022, short-staffed and juggling his various roles.

The chief examiner’s position is very public facing, often testifying before governing bodies and educating the public through the news on death trends. He meets with health departments to bridge the living with the data gathered from the dead. And while many municipalities have their crime forensic lab under the jurisdiction of the police force, Cuyahoga’s falls under the control of Dr. Gilson. He maintains an open-door policy and has a knack for knowing all of his 120+ employees by name.

Despite it all, he still performs autopsies, especially at the end of 2022 when the work was piling up, in the form of bodies. He beckoned an old friend to come help. They worked scalpel-in-hand next to each other, contemplating the work like they used to when they trained in New York City.

Since then, he’s glad to have come up for air with new pathologists doing the brunt of the approximate 2,000 autopsies a year. It has given him time to digest the details of the reports, a daunting task that requires a trained eye to see what information matters. This analyzing is foundational to his work and requires delivering to the public correlations and data, things that can inform the living.

In the 2020 report, Dr. Gilson could not ignore one statistic jumping off the page: the rise in cannabinoids in the bodies of the dead. There has been a three-fold increase of marijuana metabolites in the dead processed by the office since 2016, reaching nearly 30%, and over 50% in homicide victims (25% of them with alcohol in their system as well). There has been a rise in the presence of marijuana metabolites in the teens who commit suicide too. But what does any of it mean?

Interpreting the writing on the wall

Dr. Gilson is the first to tell you it is not the job of his office to make final inferences from the data he collects.

For example, a medical examiner in Chicago might see more deaths during a time of extreme heat, and more deaths might then be attributed to heat exhaustion despite the body on the autopsy table being, ehem, dead cold. Dr. Gilson’s purist philosophy restricts his ability to make such a tempting deduction, and he is not quick to say that stresses of daily living on a vulnerable person is the root cause of a death, unless clear evidence is before him.

If a car backfires, and a person is startled and subsequently has a heart attack, did the car backfiring cause them to die? What if the endorphins of intercourse precede a stroke? How would people react if suddenly there was a spike in deaths by car backfiring (worse yet, intercourse) reported from Gilson’s office?

One of the reasons he is heading a new nationwide organization seeking to foster relationships between medical examiners and public health officials is because the ever-complicated data from the dead requires recruitment of other professionals to make meaningful messages to disseminate to the public. Only then can the conversations within society begin about how we die. Lower rates of cancer deaths, a plateau in heart disease, continued overdoses… what does it all mean? The medical examiner’s office doesn’t bring the train to the end of the station so to say, but they’re providing fuel to get us there.

Each of the cohorts of data require different levels of urgency. Certainly, a rise in youth suicide rates demands swift attention. 2021 saw a rate of teen suicides nearly triple the amount in 2018, and this follows a trend that Dr. Gilson can’t ignore.

Another mysterious trail Dr. Gilson sees is a rise in the number of bullet wounds in victims. Meaning, over the last couple of years, a jump in the the number of murder victims with more than seven bullet wounds. What correlations can be drawn from this? A subset of more violent murderers, ammunition capabilities changing?

To link a trend to the cause remains a scientist’s or investigator’s greatest challenge, and often their greatest pitfall. To say that marijuana causes death, or that humans are becoming more violent would be premature, ill-advised and reductionist. Worst of all, it could be a wrong.

But one thing is indisputable, young Black males are killing themselves at higher rates. Dr. Gilson knows well that middle-aged white men make up the majority of suicide cases and that the stats there are still steady. But to ignore a new group would be negligent.

Did they suffer?

Dr. Gilson has seen some bad things, and his interest in discussing the grotesque that enthralls the public is all but extinct. However, when he speaks with family members, he applies his intimate knowledge of anatomy and death to assist people in the grieving process.

The trajectory of a bullet is always something noted in his autopsy reports, with reference to neuroanatomy, especially as it pertains to how quickly someone perishes. If a bullet reaches the brain stem, he will note this, which certainly means that the moment a bullet is fired the life is lost.

But for some bullets crashing through the skull, they may travel through parts of the brain like the frontal cortex and spare imminent death. There’s often a second bullet in those people who miss the first time.

The truth of the matter is that in the moment when someone takes their own life, it is unlikely that they suffered in their last seconds more than they suffered in the preceding days, months or years. It is with confidence that Dr. Gilson can assure family members that their loved one did not suffer long at the time of death.

But what is of greater interest to the office is how they did suffer in their time of life.
From the ranks of forensic pathologists in Cleveland come credits of defining SIDS (sudden infant death syndrome), identifying signs of child abuse, and standardizing the use of sexual assault kits. And from the greater group comes countless discoveries such as 2nd impact syndrome and chronic traumatic encephalopathy (CTE).

Cuyahoga County’s Medical Examiner Office ethos necessitates the pursuit of knowledge. Whether it is a breakthrough discovery or the sounding of an alarm, we look to Dr. Gilson and his team to tell us where to look. Someday, his contributions will be among the very ranks of the artifacts he holds so dear in his museum.

x988 Is the Suicide Crisis Hotline. If you are having suicidal thoughts please seek help.

The museum at the Medical Examiner’s Office is open to the public by appointment.

Dr. Corey Meador is a practicing family medicine physician in Cleveland who has written for PBS NewsHour and The Washington Post. He obtained degrees from Loyola Marymount University School of Film & Television in Los Angeles and Drexel University College of Medicine.

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In Cleveland, Dr. Khendi White-Solaru has worked hard in a non-traditional way to educate those people most at risk for this disease, called peripheral arterial disease (PAD), by setting up makeshift clinics in local barbershops.

It was in one of those that she met Darron, a 60-year-old guy always hanging out in the shop. He agreed to meet with Dr. White-Solaru and she quickly diagnosed him with PAD. Darron was shocked. He had never heard of this disease and wondered why his doctor that he sees yearly never checked for it. Once Darron learned more, he had good reason to change some of his habits.

Dr. Khendi White-Solaru is a cardiologist, but she chooses to focus much of her research on the arteries outside of the heart. Coronary artery disease, colloquially called heart disease, overshadows PAD despite their similarities in that they both involve clogging of arteries.

The three arteries that feed the heart are named after the Latin word for ‘crown,’ for the shape they take on the the heart. Any other vessels affected by plaque fall under the category of PAD. PAD commonly affects arteries in the legs, neck, and abdomen. As a plaque enlarges, less blood flows to its destination, whether it be the brain, heart muscle or other body parts like the calves. This can cause symptoms like cramping in the legs or be silent, part of the reason Dr. White-Solaru thinks it goes unrecognized.

While in medical school, Dr. White-Solaru read an article that blew her mind. A doctor went into a barbershop to check the customers for high blood pressure. Many Black Americans have had bad experiences with the medical field, and so going to where people are comfortable, like a barbershop,  made sense to Dr. White-Solaru.

Years later, Dr. White-Solaru, in her pursuit for equitable medical care, reached out to the author of the article to ask for help implementing her own study in Cleveland that would seek to educate Black males on PAD. Did they know that PAD was more common in them than in their white counterparts? Did they know PAD could be deadly and even portend worse heart disease?

Her study in the barbershop was working. Dr. White-Solaru noticed the conversations happening around the shop. One participant said, “If y’all out in the community, that might show somebody else that they shouldn’t be afraid to get themselves checked out, because a lot of people don’t come to the doctor. They’re scared.”

Customers were open to being evaluated for PAD after the owner of the shop or people they knew vouched for Dr. White-Solaru. And people who talked with the ever present Darron started to think more intently about what could be lurking in their own bodies.

Darron had disease in his legs that explained the heaviness he experienced when walking. Just as in a heart attack, plaque in any artery can split open, causing a clot to quickly form with dire consequences, starving whatever is downstream of the blockage. Dr. White-Solaru put Darron on aspirin to make sure the platelets in the blood didn’t initiate the clot forming a cascade and  subsequent “leg attack,” as Dr. White-Solaru puts it, which could ultimately lead to amputation. But there was still more that could be done to prevent progression of the disease.

Obesity, diabetes and blood pressure all contribute to PAD. These conditions can often be prevented by changing lifestyle. Dr. White-Solaru had participants watch educational videos explaining these relationships, including Darron, who has hypertension and diabetes. Afterwards, he felt empowered, understanding that for many Black men, the higher rates of diabetes and hypertension exacerbate a host of other health problems.

Perhaps Dr. White-Solaru’s research will inspire more healthcare to be integrated into barbershops or other gathering spaces. The current model fails to reach many people who deserve to have access to the same information about their health that others do. As for Darron, it was exactly this understanding about his body that encouraged him to eat healthier, take medicine regularly, and exercise more.

Dr. White-Solaru continues to work with these local barbershops, hoping that the power of information can be harnessed, aiding in closing the racial gaps that persist in medicine.

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The post In Barbershop Clinics, a Cleveland Doctor is Diagnosing Arterial Disease in Black People Who Don’t Seek Routine Health Screenings appeared first on Cleveland Scene.

That and other topics were discussed earlier this month as more than 100 people gathered at the Happy Dog to learn more about the process.

Cleveland Mayor Juistin Bibb has expressed support and worked with PB CLE to develop the plan, proposing that $5 million in ARPA money be set aside for participatory budgeting.

While advocates hoped for $30 million or more, PB CLE is optimistic that the smaller number would still be plenty to demonstrate the benefits of a pilot program that could be approved by city council in 2023 and launched in 2024.

Jonathan Welle, co-founder of the local non-profit Cleveland Owns and part of the PB CLE coordinating committee, says that while this tool is useful for local municipalities when democracy is failing residents, it’s also a best practice when things are working well.

The basic premise presumes that residents are experts in their own community, at least when it comes to those issues most visible to them and that representatives struggle to address.

The most enticing aspect of participatory budgeting is that it historically engages more residents in voting than do general elections. On the heels of disappointing voter turnout in the midterm elections in Cuyahoga County and the city itself, PB represents a chance to connect with those who might not otherwise engage.

The reason for that, Welle feels, is that choosing to fix a playground, or addressing dangerously hectic traffic areas, are much more tangible projects to which residents feel connected as opposed to voting for a politician. The voter may feel they are exerting their influence more directly in their community.

The ask of proponents is not to have oversight over the entire budget, but rather to harness the expertise residents have in their own community for very specific needs.

Among the participants at the Happy Dog event were panelists Kenny Medrano, the Former Director of Participatory Budgeting in District 2 of NYC; Councilwoman Stephanie Howse; and Michelle Jackson of PB CLE.

They fielded questions in a Q&A session on how the structure would work, such as using a steering committee to help assemble proposed ideas from different wards that could be eligible for funding. They also described general tenets of participatory budgeting to make it successful, such as engaging residents who have had difficulty being heard by their local government.

“Our system is set up to be reactionary. If you don’t ask for anything you don’t get anything. You have to participate,” said Councilwoman Howse. “Help educate us.” 

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The post As Bibb Shows Support for Allocating $5 Million to Participatory Budgeting in Cleveland, Advocates Prepare Final Proposal appeared first on Cleveland Scene.

Hoping the Feds missed a few stacks of cash but naturally discovering the opposite, Hales took the 127 microwaves he found inside, many of had never been opened, and  all of which were never used for their intended purpose, and gave them all away for free last Friday on Lorain Ave near Cents.

Some passersby peered into the the few that were locked shut, hoping to spot a bundle of illicit cash, while others simply scooped up a freebie, all of which were gone in under 30 minutes.

Patricia Williams, a local resident, said she was happy to replace her rusted microwave with a new one.

Hales and his friends call the effort “Restoraging Love,” and it was a success, as lucky residents snagged former mule microwaves that will surely become the appliance with the most interesting backstory in their house.

The post Last Year, 127 Microwaves Hid $2.4 Million in Drug Money. Last Weekend, They Were Given Out for Free to Needy Clevelanders appeared first on Cleveland Scene.

Rosie, the girlfriend of a former patient, stood beside a casket and smiled at Dr. Murphy. She pointed out Matthew’s hand, now with makeup on it, lacking the bruising and swelling that Dr. Murphy remembered in the ICU. Seeing Rosie, admiring her courage, reinforced to the doctor what she always knew, that people are not defined by their illness or their demise, but rather by the love created in their life, young as it may be.

Matthew was grumbling at his mom in the oncology office a few years before, typical 15 year old stuff. He had recovered from a surgery where a bone tumor was removed from his leg. He was back to baseball practices and dreams of college ball. He didn’t have much to say to Dr. Murphy, who reviewed the genetic mutation he had with his mother. While he had achieved remission (no cancer detectable,) the genetic condition he had meant that for the rest of his life cells growing abnormally that would usually be shut off by internal signaling could potentially evade detection and mutate into cancer. But what bothered him most in this moment was Dr. Murphy’s pen, which referenced breast milk, sending Matthew on a disgusted rant, “Now I’m going to be thinking about babies and breast milk all day- Ugh!”

Years later, Dr. Murphy saw this once surly teen, now a grown-up college student, walk past her in the hospital. She remembered the face, but not in time to say hi. The next time she saw him, two weeks later, Matthew was in a coma needing the most sophisticated of medical technology to keep his blood circulating for a fighting chance. How had he taken such a drastic turn?

The body, especially a young one, can mask life threatening conditions in a remarkable way. Hapless Matthew, after enjoying years of remission, was diagnosed with leukemia that was not responding to traditional treatments. The reason he was in the hospital the day Dr. Murphy saw him was to be one of the first patients to receive an ingenious new treatment for cancer. The treatment, called CAR T cell therapy, involves removing a patient’s immune attack cells that monitor out of line cells. Outside of the body, in a lab, the immune cells are trained to recognize a specific cancer. They are infused back into the patient to go weed out and destroy the outlaws.

As with many novel technologies that marvel society, CAR T cell therapy (part of the research awarded the Nobel Prize in 2018), can come at a cost. It was the last effort to treat Matthew’s leukemia and the infused cells were wreaking havoc. In essence, the war in his body was underway and the fallout was causing such intense inflammation that his heart couldn’t circulate or oxygenate the blood quickly enough to the leaky battle sites.

Because patients can often spend weeks in intensive care units, doctors commonly hand off patients in a hyper organized transition of care. Dr. Murphy stood in Matthew’s room, hearing how his therapy wasn’t working. She offered recognition to the family of the difficulty of the situation.

Miracles in the ICU are not always medical. Sometimes, families previously torn apart come together for a sick child and transcend any issues to be present for the patient. Dr. Murphy and staff must set aside their beliefs and personal baggage to ensure that they play a key role in giving the patient the best chance of survival. The team acts as a stabilizing force for distraught families. For Matthew’s family, they knew that the machine that he was hooked up to, called ‘ECMO’, which literally bypasses the heart to pump the blood and the lungs to oxygenate it, only bought some time. It wouldn’t solve the primary issue of the inflammatory storm in his body. When on ECMO, survival rates often drop below 50%.

Dr. Murphy bears a heavy burden. She’s no stranger to pediatric patients coding — their heart stopping and a team of pros crowding into the room each with a specific role trying to clutch a patient from imminent death. But doing this over 100 times has not made this experience any more monotonous for Dr. Murphy. Her determination to give those who have been unlucky so early in life a chance to survive only deepens her calling, not hardening her as it can for some.

At one point, Dr. Murphy’s team allowed Matthew to wake up to see if he was strong enough to breath on his own. He opened his eyes, offering a false glimmer of hope.

A week later, Matthew passed. Dr. Murphy was not on call that day. But she came to know the family at one of the hardest times of their lives. She hopes that her presence at patients’ funerals does not bring back negative memories to families, but rather communicates to them that people care deeply about their young loved ones. Sometimes when medicine can not save us, it is the life that was lived that makes death tolerable.

Dr. Corey Meador is a practicing family medicine physician in Cleveland who has written for PBS NewsHour and The Washington Post. He obtained degrees from Loyola Marymount University School of Film & Television in Los Angeles and Drexel University College of Medicine.

The post Cleveland’s Most Fascinating Medical Stories: When Care Continues After Death appeared first on Cleveland Scene.

Fifty years later in Cleveland, Dr. E. Byron Marsolais had risen as an international leader in the field of spinal cord injuries. He was invited by the Mayor of Paris to cut the ribbon at a hospital opening. At the ceremony, a man who couldn’t walk before he met Dr. Marsolais stepped across the stage placing the final brick. Dr. Marsolais’ tireless work with nerve stimulators, blending his engineering PhD with surgery, kept his boyhood aspirations alive. In 1993, a movie was being made that depicted the story of Marsolais’ paraplegic patient, a former marine who was shot, learning to walk again. That same year, in October, PBS’s Scientific American featured Marsolais’ technology. It was shown in Cleveland schools, celebrating the local hero.

Days later, when it seemed no dream of Dr. Marsolais’ was unobtainable, his nightmare would begin. On the eve of Halloween, a man wearing a “Jason” hockey mask and a doctor’s white coat walked through a Cleveland hospital and up to Dr. Marsolais, a .38 caliber pointed from the hip.

“I’m going to kill you because you killed my mother,” said the masked former patient of Dr. Marsolais. Seconds later, after Marsolais felt the gravity of the words and refused to enter into an exam room that would have further isolated the two, the assailant shot Dr. Marsolais. He stumbled backwards, a pain in his abdomen blunted by the surge of focus on survival. Dr. Marsolais had never before been in a fight —  athletics not a trajectory in his life due to his prosthetic leg. But now, blood pooled under the two men as they found themselves in a tangle, punches and lunges leading them to the ground. The mask had fallen off the assailant as he fought to get free from under the doctor. Marsolais didn’t recognize the man, but there he was, pointing a gun up at Marsolais’ head. Only a split second was the difference between life and death, Marsolais hitting the man’s arm as the second bullet grazed the doctor’s scalp.

Dr. Marsolais woke up in an ICU room to a representative of his department informing him that they were worried about the optics of the situation: a doctor fighting a patient. His friend, a surgeon, had just operated on him, removing the remnants of his gallbladder and sewing up his guts. The exit wound was so severe it would remain open for days, too gaping to stitch together.

What Dr. Marsolais remembered last was the most excruciating pain he had ever experienced. A breathing tube inserted into his trachea when he was fully awake caused him to cough uncontrollably. This cough increased the pressure in his abdomen, which had minutes earlier been ravaged by the bullet, obliterating his gallbladder and ripping through his liver and intestines. He remembered the hospital security rounding the corner as he sat alone on the ground. He was clutching the assailant’s pistol he secured after their fight. Finally, someone had come. Then the security guard kicked the gun out of his hand, unsure if he was the doctor or the intruder. Marsolais tried to piece together the traumatic night, his wife now at his bedside.

Flowers were in his room from the film production company. Reporters wanting a chance to talk to the doctor ringed the room while a police chief disseminated the information he knew to the press. His wife reeled at the fact that bail had been set for the attacker at a mere $25,000. Her husband remained quiet, advised not to talk to the press. The work of rehabilitation had begun.

He was used to seven days a week in the hospital, but not as the patient. He required more surgeries, including one on his thumb for a tendon damaged during the struggle. But the worst injury of all was Dr. Marsolais’ spirit. Confused, he thought people hated him and wanted him dead. Following this blast of trauma, unable to process it all, his wife had brought just the right treatment. She sat at his side, wanting her husband to know just how good a man he was and to dismiss this haunting doubt that was creeping in his mind. And so, she read the letters of school children who sent support for the wounded doctor. They had just seen him on TV at school, and they hoped their new hero would heal quickly. He did.

One month later Dr. Marsolais was working back in clinic. For some time after the incident he did wear a kevlar vest under his white coat when walking the halls of the hospital, but this was a temporary crutch. Paradoxically, the best therapy was his patients who loved him dearly. They spent much of their consultations asking how he was doing.

He would operate again for many years, sometimes on patients who also suffered gunshot wounds, but to their spinal cords. Him and his wife continue their work present day with spine surgery national organizations. They still retreat to Iowa regularly where they farm the land. Just like his patients, Marsolais would not let his wounds dictate the terms of his life.

He still thinks about that late October day. He can’t explain why the assailant referred to his mother, who at the time was alive and never before seen by Dr. Marsolais. Thinking back on their rather generic back pain consultation, the motives behind the attempted murder will never be known. He often remembers the moment sitting over the man he had just put in a choke hold, about to wake at any moment. The doctor needed time to escape, and had the gun pointed at the imposter. Marsolais grabbed the barrel of the gun and whipped the man on the head with the handle. Crawling to the nearest phone to call security, Dr. Marsolais left a trail of blood in the hallway.

With trauma, there is often no profound discovery in years of contemplation. Instead, there can be peace. Sitting in his sunroom some 30 years later, his wife and dog at his side, the Doctor speaks quietly. He says, after much thought, that he is lucky.

Dr. Corey Meador is a practicing family medicine physician in Cleveland who has written for PBS NewsHour and The Washington Post. He obtained degrees from Loyola Marymount University School of Film & Television in Los Angeles and Drexel University College of Medicine.

The post Cleveland’s Most Fascinating Medical Stories: The Doctor Who Became the Patient After Being Shot appeared first on Cleveland Scene.

Unlike most doctors, psychiatrists don’t have the luxury of blood tests, scans, or microscopic clues to help establish a diagnosis. Dr. Rodio must rely on observation. After treating Jamie over many years for opioid addiction and depression, both in remission, he discerned a new quiet yet restless affect in her, a lot going on beneath the surface. This was his first clue, which psychiatrists describe as ‘guarded’. Next, she had fixed delusions. For example, she was certain people at work were talking about her behind her back: on the phones, in emails, and in the subtle whispers of the office. Worst of all, she thought her husband was spying on her with the video surveillance system he was installing at their new house. Sure, they had a security system at their old house. But now she could tell he was looking at her differently.

Beyond treating patients, Dr. Rodio is also a forensic psychiatrist, testifying before courts on defendants’ mental statuses. He knows well that people who are psychotic can act on irrational thoughts or they can retreat deeper into their own world. Reaching people with psychosis for treatment can sometimes be very difficult. Thankfully, Jamie kept her appointments. Never before did she display signs of psychosis and it would have been unusual at her age to develop schizophrenia.

People can have isolated psychotic episodes for reasons other than schizophrenia, such as drugs, depression, and trauma. With the information gained from the husband, Dr. Rodio knew she wasn’t using drugs. She did however complain of feeling more stressed and anxious at work. It was prudent to ask, what has changed recently? People don’t like change.

What was painfully obvious to Dr. Rodio was that Jamie was exhausted. Now, three months after their move, Jamie thought the new suburb was less safe. She was seeing shadows at night, hearing weird noises outside, and was sure the furniture was being moved around the house. Hallucinations? With further prodding, Jamie admitted she hadn’t been sleeping well since the move — maybe three hours a night.

A major component of Dr. Rodio’s satisfaction from his work is helping people achieve stability. The opportunity to live a happy life is too often stolen by addiction and mental illness. And so, Dr. Rodio has relationships with patients that can last years, patient and doctor steadfast in this pursuit of health. With time, Dr. Rodio better understood what was afflicting Jamie.

Jamie was psychotic due to the fact that she hadn’t been sleeping well in her new house. Such a change at first glance, familiar bed in a new house that made creepy noises in a neighborhood Jamie didn’t love, seemed trivial. Yet, this wreaked havoc on her sleep, and, in an insidious fashion, led to psychosis and a fear of the world around her. Given the worry of erratic behavior that can accompany this mental state, Dr. Rodio nearly pursued admitting her into a psychiatric ward. They hoped that treatment would act quickly. In the meantime, he urged her husband to lock and hide their gun.

Antipsychotics work on specific dopamine neural pathways in the brain responsible for psychosis, regardless of what’s causing the aberration. Jamie was started on an antipsychotic. To treat the underlying problem, she was given a medicine used for sleep and depression. This would help her adjust to her new situation.

Call it a miscalculation, weighing the financial benefits of the sale with the unforeseen destabilizing effects of a move. But now, Jamie was no longer psychotic. She had doubted her marriage, struggled to perform at work, and became suspicious of the people closest to her. Dr. Rodio validated that her lack of sleep for months on end, and nothing more, was enough to spark this nightmare.

Jamie is sleeping better. She’s reflecting on the value of stability and happiness, amazed at this chunk of time in her life where everything seemed a blur. She’s taking time off work, considering what is next. And they’re asking a new question: Should they sell their new house?

Dr. Corey Meador is a practicing family medicine physician in Cleveland who has written for PBS NewsHour and The Washington Post. He obtained degrees from Loyola Marymount University School of Film & Television in Los Angeles and Drexel University College of Medicine.

The post Cleveland’s Most Fascinating Medical Stories: The New House and Sudden Psychosis appeared first on Cleveland Scene.