At last week’s meeting, our esteemed member, Dr. Harold Elner, MD, called upon his career as a specialist in urology to give us the basic structure, functions, diseases and remedies for the genito-urinary system. All in the space of 25 minutes or so. And he kept it “clean,” PG-rated at most. President Ryan Hamilton expressed appreciation for Dr. Hal’s educational talk and for his discretely avoiding the really graphic stuff. Here is a sample:

• Regarding prostatic cancer, there is the eponymous “three-legged stool” required for diagnosis, to wit, PSA, digital examination, and biopsy. When it occurs in relatively younger men (40s or 50s) a radical approach is often chosen. At times this can result in incontinence and, frequently, impotence.
• Benign enlargement of the prostate, when it reaches a point wherein one experiences frequency of urination, getting up at night three or more times, and a slow/weak output, surgery had mainly been the treatment. This surgery has most often been through an instrument. More recently, drugs that relax the bladder outlet have come into vogue. Use of these has allowed the deferment or avoidance of surgery.
• Any blood in the urine, in even microscopic amounts, and particularly painless, must be investigated. A physician who does not do this is remiss. There are instances in which patients have been treated for assumed infection when there has lurked a malignancy or an enlarging stone.
• As stated, the treatment for kidney or ureteral stones too large to pass had been open surgery. Enter then the Dornier Company in Germany, those fine folks who gave us the long-range WWII bombers. They were experimenting with shock waves to de-ice the wings of the planes. At times these waves shattered the glass on the instrument panels. It was then thought to use this principle to shatter things that needed shattering. Thus arose the lithotripter, in which shocks generated by a condenser were focused on the stones (aka calculi), pulverizing them. Since then, refinements have made the process less cumbersome. A preferred method is to pass a probe into the ureter and blasting the stone with the laser. Ergo, open surgery for urinary calculi is now only rarely done. Anyone who has experienced the agony of a stone can appreciate the relief afforded by these treatment modalities.
  Generally speaking, a patient in such a situation moves about looking for a comfortable position (there isn’t one). This contrasts with someone who has an event within the abdomen (i.e. acute appendicitis) and who lies very still.

Conclusion and Comment: Sooner or later, everyone meets the urologist.

*The drawings used in this presentation were by the celebrated medical artist, Frank Netter, M.D. Dr. Netter was a graduate of DeWitt Clinton High School, Bronx (preceding the speaker there by about a generation). His artistic talent was such that he left his medical practice to devote full time to these drawings that are known worldwide.

Having pitched effectively in classification mode, Michael Bronsdon went into extra innings to explain Digital Marketing. It was quite apparent that this has revolutionized the advertising/selling arena. Traditional marketing messages via radio, direct mail, newspaper, and magazines yielded slow (if any) response times and were costly. By the e-mail route, the process is cheaper, has a quicker response time, and can be tailored to a smaller, more select group of potential customers or even individuals. Digital Marketing entails knowing something about a targeted person and catering to that person. As any business, this modality has its own jargon, to wit:

•  Search Engine Optimization. In this, a marketer may pay for an ad popping up on google. Also, a web page may be tailored, with an ad likely to be captured on the searcher.
• Behavior Analysis. An advertiser ascertains where individuals may spend their time on the web. Their interests can thus be catered to.
• Buyers’ behavior. The vendor can tell when people are abandoning a search avenue and can learn from it. This gives rise to A/B Testing. In this, two offerings are made. Such information can show which works better. 

All of this leads to offers being tailored to an individual. 

• Big Data. Large amounts of stored data provided by companies to advertisers trying to understand customers.
• Machine learning. This is a technique in identifying and tracing fraud, particularly in credit cards. Knowing the patterns of both the cardholder and the aberrant patters of the illegal user, a company (i.e., bank) can pinpoint this in a much shorter time than previously and can put a hold on the credit card.

During this presentation, a murmured “Orwellian” was heard. The implication was, perhaps, that this may be the beginning of further delving, beyond buying habits, into private lives.

Comment: “He who knows, and knows he knows, he is wise. Follow him.”

Can you think of two more diversified interests than coexistence with carnivores and education of the young?

Carol Bogezi is perhaps the only person this side of the dateline (both directions) to carry both credentials. A native of Uganda, Carol has academic degrees both there and in the US. In her slide on human/carnivore interaction, she as an adolescent is seen with a young, trussed up crocodile on her shoulder.

Her work here entails studies on the movements of western WA cougars as well as better acquaintance with wolves.  This must, of needs, take into consideration the economic needs of ranchers. Tolerance for wildlife is the overriding concept of her work.

In her native Uganda, one of her targets is the plight of widows and orphans. She works toward livelihoods for them through the acronymized Community Action Plan and Women Enhancement Progress. This has allowed women to develop their own small businesses through crafts and sweater production, among other creativities.                        

 Then came we to the Child Education Program.  Beginning with universal primary education, the concept is to get as many as possible through at least secondary studies. The impediments to be overcome include HIV, few employment opportunities, lack of resources, driving poverty, and exploitation by sugar companies. Moreover, many regard the country as a forgotten region. 

Additionally, there is school overcrowding and few teachers. But—-once one can make it through secondary school, there may lie ahead good jobs, less HIV, and fewer teenage pregnancies.  It is a teenage pregnancy that so often stops short a girl’s chance for a career (not only there.) A vocational training center for dropouts is now in place.