March 2013

I was at a party last year with a woman who had recently lived in England. Her funniest story was about flossing. She mentioned the use of dental floss to her friends there and found a widespread belief that flossing was bad for you. The punchline was something like, “It makes your gums bleed. It’s bad for you!”

I imagine I was more amused by that story than others at the party, because I pay special attention to what dentists say about dental hygiene. I know, for example, that plaque causes inflammation in your gums, which makes them more likely to bleed. This inflammation also makes your gums more porous, so that bacteria leak into your bloodstream, causing more inflammation throughout your cardiovascular system, resulting in a significantly shorter lifespan. I also know that your body treats plaque as its own tissue, building capillaries inside the plaque, to feed it. This is why plaque can bleed when hygienists scrape it out.


I do what my dentist tells me. Exactly. I am a highly compliant patient.

So far it’s paid off. I’ve had very few cavities and hygienists often fawn over my teeth, both very nice. At the end of a visit I always say, “I want to keep these teeth for 60-70 more years. Am I on track to do that? Is there anything I could be doing better?” The answer has always been “Yes, you are on track to keep your teeth,” and usually, “No, just keep doing what you are doing.”

Every five or six years, though, I get a new set of instructions about how best to brush my teeth. I can remember several off the top of my head: horizontal strokes including the gums, circles including the gums, vertical sweeps including the gums. The last time I got a new set of instructions was in 2011. “Brush along the gum line with a 45 degree angle toward the gums with very small horizontal strokes, using no pressure at all and the softest brush you can find. Move to a new spot every minute or so. Do not brush your gums.”

I was surprised at these changes and a little annoyed. The last time I’d heard horizontal strokes was the 1980s. I’d assumed the move away from that had been an improvement. And don’t brush the gums? I’d never heard that from anyone. I complained that dentistry kept changing things up and that these changes didn’t make sense to me, if the other changes had been real improvements.

My hygienist sympathized and said, “Well, we used to think that brushing the gums toughened them up and kept them from receding. Recently we started noticing that patients who brushed their gums were causing them to recede, so we’ve changed our minds.”

That’s when it hit me. Dentists are performing a very poorly organized and poorly controlled longitudinal experiment on us, without getting our consent, and presenting themselves as having knowledge and authority that they clearly do not yet have. The good dental hygiene of the future could have almost nothing in common with what we have today. We may abandon brushing altogether, in favor of regulation of oral pH and microflora, or who knows what.

To be fair, dentists have an extremely difficult task in this experiment. The number of people who actually follow their recommendations is very small, and even that select group probably fluctuate in their compliance a good deal. And if they told us they were experimenting on us, we’d likely be even less compliant. Plus, they have to put their hands and faces in our stinky mouths all day.

This winter, I worked several weeks with a woman who, during that time, had to get a whole bunch of fillings on the surfaces between her teeth because of flossing. As far as I could tell, this woman (who is an urban legend to you, by definition, but to me is a real person with first and last name, phone number, husband, and child) is one of my high-compliance compatriots. She flossed every day and it wore the enamel off the inner surfaces of her teeth, “because my teeth are close together.” She was pretty upset about it, and I would be too. She was just doing as she was told by the experts. Perhaps she would have been better off in England, where flossing is bad for you.

Still, dentists’ advice is the best we have. Until otherwise notified, I’m sticking with my highly endorsed protocol: brushing as described above twice per day, plus hydrofloss in the morning and dental floss in the evening. I just keep in mind that protocol will inevitably change, and that I may be doing some harm in the meantime.

I just had the pleasure to attend a lecture by Dr. Bruce Perry. It was great, and if his books are as good as his lectures he may be my new hero. The topic was his “neurosequential therapeutics,” which sounds nerdy (and it is) but is much more intuitive and helpful than it is technical. The basic idea is that the developmental stage at which a client was traumatized is an important clue into what kinds of therapeutic activities will be helpful to them, and in what order and priority. Pre-verbal trauma is unlikely to be helped by cognitive therapy, for example.

Anyway, more on that when I get the time to read his books. Another thing I liked about Perry was his attitude towards the DSM, the mental health industry’s diagnostic Bible. Here’s my paraphrase of one of his tangents on the DSM:

The heart is a fairly simple organ. It’s a blood pump. Cardiologists know several hundred ways that the heart can get sick and all of them are diagnosed and named in terms of the physiology of the heart. However, the symptoms that bring the patient in, however, are few–often chest pain and shortness of breath.

The brain, on the other hand, is an extremely complex organ. The DSM lists several hundred psychological symptom clusters which ostensibly represent ways the brain gets sick. But none of them are diagnosed or named based on brain physiology. They are all named based on symptoms: Panic Disorder Without Agoraphobia, Major Depressive Disorder With Postpartum Onset, etc.

If cardiologists followed this protocol, they would have only a few diagnoses, along the lines of Major Chest Pain Disorder With Shortness of Breath, Major Chest Pain Disorder Without Shortness of Breath, etc.


I have been debating with two of my brothers for over a decade about the longevity and importance of 20th century popular music and musical artists. In 100, 200 or 300 years, assuming basic continuity of our civilization, which artists from the last century will be household names, will be known at all outside of music historians, will be considered important in any way?

Our positions have changed a bit over the years, but I tend to argue like this: How many artists can you name from the 19th century? The 18th? The 17th? My music history education is probably better than average, but my lists quickly narrow. I can think of ten or so 19th century composers (and zero musicians) off the top of my head and have put in significant listening time with only Brahms, Chopin, and Beethoven. I can think of about five 18th century composers and have spent significant time with two–Mozart and Bach. I can only think of one composer from the 17th century and have spent no time with his music. By the 16th century, I don’t even recognize any musicians‘ or composers‘ names.

And none of the above wrote in English. If I had needed to understand the words to enjoy the music I would have no use for any of them.

So, I argue, why should we expect more than ten or so musical artists of our era to be generally known and considered important in 100 years, or more than five in 200 years, or two in 300 years? To do so seems to inflate the importance of our music, and to deflate the probable importance of future generations’ music to the generations that produce it and the probability of major shifts in the dominant culture. It’s an easy mistake to make, I think, for the Gen Xers and Millenials in the cultural shadow of the Boomers. After all, who have our generations produced to eclipse The Beatles or James Brown?

And there’s the way language changes. Even assuming English remains dominant, our modern English is quite likely to sound stilted in 100 years and pretty hard to understand in 300. How many people will listen to Bob Dylan purely for the sonic experience, especially once the historical context of 20th century folk music and Dylan’s “going electric” is long gone?

My brothers, on the other hand, tend to argue that digital storage of music and globalization have changed everything and my looking at history to predict the future is not clear thinking. First, there is unprecedented access to fame in modern times: The composers I cite could write down their pieces and try to get others to play them, but couldn’t put them on YouTube with a video to go viral. As far as I know it’s true that even the best known of my list of composers had nowhere near the fame of Michael Jackson. Maybe popes or emperors had a shot at that kind of fame, but not Bach. Second, my composers wrote on paper that can decompose or get thrown away with grandpa’s old junk after he dies. This is way, way less likely to happen with the way we store information now. A recording of music can theoretically live forever in easy access. Third,  the trend seems to be nichification, not extinction. The memory of and enthusiasm for Carl Perkins, for example, lives on in young people who are into neo-rockabilly, psychobilly, gothabilly and who knows what other sub-genres to come.  Finally, my wife, Reanna, points out that language may not drift the way it used to because of globalization and the internet. It seems like standardization (to Californian English) is the trend these days, not drift. Dylan may be only a little harder to understand in a couple centuries than he is today.

For all these reasons, they argue, why should we expect any really great music from the 20th century to lose its place in the popular culture of the future?

We will never know the answer. Still, it makes for an interesting exercise to predict. When or if general knowledge of 20th century music narrows to 10 artists, who will it be? Five artists? Two?

Here are my best guesses. This was very difficult, though a very interesting process to go through. Compelling, even. How can I keep my aesthetics and hopes out of it? How long can a dead musical artist remain in memory based on the force of their charisma or persona or being a major voice of their generation?  I am actually less sure about my guesses now that I’ve thought them through. Perhaps I’ll write another post about the process. 

I’d love to know, what are your versions of these lists?

100 year list: 20th century musical artists still generally known in the year 2100:

  • Aretha Franklin
  • Billy Holiday
  • Bob Dylan
  • Duke Ellington
  • Elvis Presley
  • Frank Sinatra
  • Louis Armstrong
  • Michael Jackson
  • Ray Charles
  • The Beatles

200 year list: 20th century musical artists still generally known in the year 2200:

  • Duke Ellington
  • Louis Armstrong
  • The Beatles

[Note: I gave myself five slots to fill on this list but decided not to.]

300 year list: 20th century musical artists still generally known in the year 2300:

  • Duke Ellington
  • Louis Armstrong