Immune system

[Aaron researched the immune system, wrote this report, and created a model illustrating key players in the immune system. He did this very independently; it was completed entirely at school, and his teachers report that he hardly used their assistance. Here is the report verbatim.]

THE IMMUNE SYSTEM
by Aaron

The lymph nodes, the bone marrow and the white blood cells, combined with some other components: These magnificent body parts make up the immune system. The immune system is a very important system to the body. It protects your body from diseases such as colds, flu, and AIDS (Acquired ImmunoDeficiency Syndrome). Doctors who work on it are called immunologists. Some parts of this wonderful system are the monocytes, the macrophages, the erythrocytes, and the lymphocytes.

Here is some information about the lymphocytes. There are three main types of lymphocytes. They are the T cells, the B cells, and natural killer cells. Here is how the first two work: the nerves give the T cells and B cells a "heads up" and they get on the move. Once they get to the diseased cell or place, the B cells build an antibody to stop the virus from multiplying. Then, the T cells go in and fight off/eat the virus. There are not a lot of lymphocytes. There are only around 500-700 in the body. Another cool thing about them is that they can change their size without much cause. Also, they are mostly created by blood.

Monocytes are interesting too. The monocytes' main function is to help out other cells fighting the disease, kind of like an army doctor except 900 billion times smaller. Since I am sure that an army doctor is not 12-18 micrometers in length and formed by blood, I am sure there are some differences. The monocytes, even though tiny, are the largest white blood cells. In addition, if they are not needed, they can change to another type of cell.

Please do not stop reading yet because I still have to tell you about neutrophils. Neutrophils take up 45-75% of the white blood cell population. They are also the fastest cell, therefore they get to the infection first. So, around 55% of white blood cells get to the disease first. Also, they are formed by bone marrow. So those who eat bone marrow are sucking around 60% of an animal's immune system out.

One disease that affects this immune system is rheumatoid arthritis. Arthritis is a disease that hurts people's bones or joints. The death rate from this disease is not very high, but it can be extremely painful. It is a disease that makes your joints and small amounts of tissue around it hurt. When someone has arthritis, their immune system is attacking the joints instead of helping.

Some ways to protect yourself from autoimmune diseases are: 1: Do not smoke 2: eat lots of fruit and vegetables 3: exercise 4: avoid stress 5: control your blood pressure 6: avoid alcohol and 7: get enough sleep. All of these should be things that come naturally, especially 6 and 7. I am not kidding about #4. Not getting stressed is the key to a lot of things.

Astronaut

When Dale got the cast on his ankle removed, his surgeon told him that now he was like an astronaut. Astronauts, whose bodies don't bear weight for months at a time, return to earth with their bones so fragile that they "lean over to sip their their soup and their spine breaks in three places," according to the surgeon. I was hoping that was an exaggeration, but apparently some returning astronauts have to be carried away from their landing craft in stretchers; it is rare that they are able to walk, and the rule of thumb is that they need one day of recovery in Earth's gravity for every day they spend in space. It turns out that when bones are unused, the body just starts taking the calcium out of them, resulting in "disuse osteoporosis." Isn't that fascinating? I forget that bones are dynamic living tissue, constantly being depleted and renewed according to the body's inner logic.

What this meant for Dale is that he had to be very gradual and intentional about putting weight on his leg. Much of the time he still used his peg leg or scooter, but his day also included sessions of careful "practice walking" with the boot and crutches. At first he placed only the lightest pressure on his foot (supposedly measured by him stepping on a bathroom scale to see what 20 lbs felt like, though in practice he found this difficult to gauge). He increased the pressure a little bit every few days. He also did exercises designed to stretch his tight muscles, increase the range of motion in his ankle, and strengthen his disused calf and foot. (For example, he would draw the alphabet with his toes.)

After about three weeks of that, he got the go-ahead to walk with just the boot. Walk! For the first time in months! He felt like an astronaut all over again ... because he was over the moon. Ba-dum bum. But really it was an incredible feeling. He took the crutches to work with him for a while just in case his foot got tired, but soon he stopped needing to do that.

That was a couple weeks ago. Now he has shed the boot and walks in sneakers. Barefoot still feels painful and unstable, and the thought of any kind of jumping, running, etc gives him the shivers. But he is well along the road to recovery!

Knitting

The same weekend that Dale broke his ankle, I learned to knit. I'm more of a curl-up-by-the-fire person than a go-trekking-through-the-snow person (plus, there's less risk of a broken ankle), and several of the other people in the cabin were knitters so I knew I would have mentors around. One of these knitter friends took me to a yarn store for supplies, and I was ready to go.

Perhaps 40 years ago, my aunt Linda had taught me the basic stitch on some family trip, and I got as far as knitting a scarf for a stuffed animal - it was probably five stitches wide and 25 long. She did the casting on and binding off for me that time. This time I did it all myself! :) The first thing I made, under my friend's guidance, was a hat. For a hat you learn more skills than you do for a simple scarf, and also you finish faster. That weekend I learned the skills of casting on, knitting, knitting a gauge swatch, calculating how many stiches my hat would need to be, purling, and ribbing. And I practiced, and I kept making mistakes like yarn-overs without realizing I had done it until alas there was a hole, and so what, it was my first hat. It took me longer than the weekend to finish it (I also had a good book, after all), so after I got home I had to learn the skill of decreasing. This is when I had my first disaster: decreasing involves double-pointed needles, and a bunch of stitches slipped off the other end needle and began to unravel. I tried to fix it but kept just making it worse. Thank goodness my sister-in-law stopped by (to entertain Dale during his ankle recovery) and fixed it for me. Eventually, I got it done, and it was so exciting! I turned a long piece of string into a hat! This is the plain green one in the photo below. You can see that it is a little scruffy, but it is dear to me.

My next project was going to be another hat, one with fewer mistakes in it. I had my heart set on a nice yarn that a different friend had unloaded on me (she has switched from knitting to painting). Sadly I ran out of yarn partway through... so I made it a headband (bottom of photo). I actually like this headband a lot, partly because I am a sucker for variegated yarn. For this project I learned to bind off, and learned that the simplest way to bind off has zero stretch in it...potentially awkward for a headband, but this one turned out okay.

Next up, I made the striped hat pictured above, meaning I learned how to do stripes and also just continued to get better. I made fewer mistakes, and learned how to correct more of the ones I made. You can see in the photo how much smoother it is than the plain one. I was fairly terrified of the decreasing part, but I learned the trick of wrapping the ends of my double-pointed needles with rubber bands so the stitches can't fall off the back, and nothing bad happened.

I think my favorite thing about knitting is that it gives me something to do with my hands and still interact with people. It's great at a meeting, or listening to a lecture, or supervising piano practice. When I went off in April to a two-day symposium with a dozen hourlong lectures, I just had to have something to knit. I made a cowl out of some yarn from my painter friend's basket. I love that variegated yarn and I am happy enough with the quality of my knitting, but it's way too big. I might just unravel it and use the autumnal colors for something else.

At that symposium, I told another knitting friend that I wasn't sure what to make next, and she introduced me to Ravelry. Whoa! what fun! I decided that next I want to learn to make something lacy, so I am working on a shawl. This is teaching me how to read a pattern, knit with very thin yarn, and make holes on purpose. :) I'm about halfway through.

Cooking

Jordan asked for a cookbook for Hanukkah and I was more than happy to oblige. Since then, he makes dinner every Thursday night. It's awesome. Here he is with his first dinner ever, savory meat pies (yes he made the crust!) and a salad with cranberries, almonds, and optional blue cheese.

A few months later: pigs in a blanket (the blanket is puff pastry, and no he did not make the pastry from scratch); roasted beets with cilantro-orange dressing; and his favorite kale salad, which he makes just about every week, massaged with parmesan and a fresh lemon dressing. He has named this Snicket Salad, because it is so lemony. We all love it.

In the kitchen zesting the lemon. He is a zesting master by now.

After several weeks he stopped consulting the cookbook and started just suggesting things he wanted to make. I find him a recipe or just give him directions. Here he is with tortellini with homemade basil-walnut pesto, crispy paprika-roasted cauliflower, and Snicket Salad.

There is so much to learn in the kitchen! Cracking eggs, peeling beets, operating the food processor, chopping onions (always the onions), rolling out dough, seasoning things, it just goes on and on. He is more and more confident, though he still dislikes getting things in and out of the oven. It's worth it, though, especially when you have a friend over to make chocolate chip cookies.

Tazria-Metzora

Aaron's teacher invited me to give another d'var Torah to their class. I chose to speak during the week of Tazria-Metzora (Leviticus 12-15). This is a notoriously undesirable Torah portion, but I am a big believer that nothing is wasted in the Torah, and also I like a challenge. As it turned out, the kids were very engaged, and it was fun! Here's what I shared with them.

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This week’s Torah portion, Tazria-Metzora, might be the yuckiest Torah portion. It has instructions about what to do when various disturbances happen with your body (like swellings, or rashes, or bleeding, or pus), or when something weird shows up on your clothes, or on the walls of your house. For example:

When a person has on the skin of his body a swelling, a rash, or a discoloration, and it develops into a scaly affection on the skin of his body, it shall be reported to Aharon the priest or to one of his sons, the priests. 

The priest shall examine the affection on the skin of his body: if hair in the affected patch has turned white and the affection appears to be deeper than the skin of his body, it is tzara’at; when the priest sees it, he shall pronounce him unclean. (Leviticus 13:2-3)

Ew, right? Gross. And I am not even reading you the grossest parts. You can go read those yourself.

So what we learn is that there is this disease, tzara’at, which shows up as weird scaly patches on your skin, and it is apparently very important, because a priest has to come and examine you to see if it is really tzara’at. [1] And if it is, the priest says you are tamei, which gets translated as “unclean,” though it is a bit of a mystery word. [2] If the priest says someone is tamei, they have to call out “Tamei, tamei!” wherever they go, so that people know. And then, it says – Help me translate. [Here I had the kids work with me to translate the Hebrew, especially the easier lines. This is Leviticus 13:46.]

Kal y’mei -- All the days
asher hanega bo -- the scaly patch is on him
yi-tamah tamei hu -- he shall be tamei, he is tamei
badad yoshev -- Alone sits.
michutz lamachaneh moshavo -- Outside the camp his seat.

This says that if the priest says that someone is tamei, they have to go outside the camp, far away from any of the tents, away from their family, away from their friends, by themselves in the wilderness. Badad yoshev. [3]

• What do you think that would be like??

[The kids thought it would be lonely, and sad, and embarrassing. I proposed that it might even be dangerous, out there in the wilderness alone.]

Sometimes we send someone away from other people for health reasons. When you get a bad cold you can’t come to school; you have to be “outside the camp” for a little while while you recover, to keep everyone else from getting sick. When you get better, you are welcomed back and all is well. Some people think the tzara’at situation sounds like this. You get a skin disease, and you have to go away on your own until you are healed, and then you can come back. This Torah portion also describes how the priest should inspect you to make sure everything is okay before you return, which makes the priest sound like a doctor.

[The kids had a lot of questions about tzara'at, like whether it is contagious (yes) or deadly (no) or curable (yes).]

But actually there are good reasons to think that being sent outside the camp wasn’t for medical reasons; it was for spiritual reasons. There were plenty of diseases that the Israelites suffered from at that time, and they didn’t send you out of the camp for those other diseases. The rabbis say that tzara’at happened not because you had a virus or whatever, but because you did something wrong. In particular, they say that tzara’at happened when you said mean things about people. One reason they said this is that there was a time when Miriam said something rude about Moses’s wife – in fact, she said something racist about her – and G-d punished Miriam by giving her tzara’at temporarily. [4]

So if tzara’at was not a contagious medical condition, why were people suffering from tzara’at sent alone outside the camp? I think one answer is that they were being punished, and I do not like that. But I think another answer is that the Israelites knew that saying mean things about people is, in a way, a contagious disease. For example, I know a bunch of kids at another school who have gotten into saying racist things; it started with just one or two people but unfortunately now it has spread, so that a lot of kids are doing it, and it’s a bad situation. I wonder if maybe those first few kids could have been kept from talking to the other kids for a while, it might not have spread.

These days if we see someone who is sick, we don’t think that means they are being punished. At least I hope we don’t! We know from science that this is not true, and it could be cruel to think that. Even the rabbis knew this was not how things are in our world – they say the punishment of tzara’at was a special thing that only happened in ancient times, like G-d appearing in a pillar of fire.

But what would that be like?

• What do you think it would be like if, when you said something mean about someone else, you got scaly patches on your skin? How would you feel?

[The kids were predictably distressed by this idea. They said it would be gross and embarrassing, and that it would be a very nasty punishment.]

• Would there be anything good about it? Any benefit to it?

[It was not easy for the kids to think of anything good about it, and I don't blame them. Some kids suggested that visible affliction provides a better opportunity for quarantine. Others felt that visible affliction would be an effective deterrent. These both seem legitimate to me, if a little depressing. I also shared with them my own idea, which is that sometimes I say hurtful things about another person without realizing it, and getting tzara'at would make me aware of the hurt I had caused. Kids responded to this with stories about times they had said something unintentionally hurtful, which I thought was great.]

Thank you for sharing your ideas with me!

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[1] Tzara'at has historically been translated as "leprosy," but it isn't leprosy as we know it. For example the real disease, now called Hansen's disease, is a progressive and disfiguring disease if it's untreated, whereas tzara'at supposedly went away on its own.

[2] I spent some time learning about tamei (and its opposite, tahor) and wow, what a rabbit hole, or PhD thesis if you prefer. Things that convey "uncleanness" include dead human bodies, dead bodies of nonkosher animals, women who just gave birth, men having abnormal discharge from the penis, and women normally menstruating. It takes a lot of effort to construct a concept unifying all these things, especially if you are not going to claim that normal female reproductive activity is abhorrent. I decided not to go there with ten-year-olds.

[3] This is actually the line that strikes at my heart. Badad yoshev; michutz lamachaneh moshavo. Do we not all have a primal fear of this kind of exile? The times that I have perceived myself to be forced to sit "outside the camp," when loved ones seem to refuse to connect with me, are some of the worst times I can remember. When and why do we do this to each other? And what about as a society - who do we force to sit alone, outside the protection and favor of our community? Obviously many people and in many cases for the wrong reasons. I originally thought the d'var would be all about this but I got overwhelmed.

[4] "Miriam and Aaron spoke against Moses because of the Cushite woman he had married: 'He married a Cushite woman!'" (Numbers 12:1) Cushites - approximately, Ethiopians - were distinguished by dark skin. Both Miriam and Aaron made the rude remark but only Miriam was stricken with tzara'at. Harumph.

Peg leg

Dale is healing well from his ankle surgery as far as we know, though to be fair we don't know much. He is reasonably comfortable in his sleek black cast, which the children have signed in silver sharpie. He works normal hours, drives, parents, and somehow manages to sleep in the limited positions that his cast allows. He is amused by not needing to match his socks when he's folding laundry.

At work he uses a rolling knee scooter, which is a great thing. How did it take humanity so long to come up with this? It is stable and comfortable and well suited to his workplace, with its long wide halls and frequent transitions from sitting to standing to sitting again. However, there are still major limitations. The scooter can't go on gravel or grass or even rough sidewalk, and it certainly can't go upstairs. It also doesn't put itself in the trunk of the car; Dale can do it solo, but then needs crutches to get around to the driver's seat. And neither crutches nor the scooter leave your hands free. Dale is very capable, but when he took himself to the grocery store, there was just no good option. He couldn't push a cart, so he hung a basket from the scooter handle, but he needed more than the basket could hold, and then what about when they bagged his groceries? The whole thing was very awkward, and irritating.

Enter the iWalk, which was recommended by Dale's surgeon. This is basically a peg leg, with support for the calf of the injured leg.

Strange as it looks, this thing totally works! It takes a few minutes to learn how to walk, but within half an hour it feels surprisingly natural, and within a day it pretty much feels like part of your leg. Pirate jokes are welcome, Dale makes them himself.

With the iWalk, Dale's hands are free, which is huge. And he can go up and down stairs safely, which is also huge. It's compact and light so it's easy to tote around as needed, and he's using an almost-normal walking motion, which is probably good for his recovery. Look at him go!

(Okay, this may have been a tiny bit staged. But he was actually playing badminton with Aaron, in a limited way.)

The iWalk is not as convenient as having two working legs. For example, when you stand up (or sit down) you need to strap yourself in (or unstrap yourself), which is a bit of a process. But overall it is the best mobility device Dale has used; if he had to pick just one, it would definitely be this one. More people should know about this. It's really very good.

10 days until his next appointment! If everything goes according to plan, he will get his cast off then, and begin walking on two feet. Not to mention putting on a matching pair of socks for the first time in two months. We are very hopeful.

Seedlings

At school Aaron created a picture book in Hebrew, about a seedling that was all alone until a little boy planted it in a garden with seedling friends. Then he read his book to a first grader, and helped the first grader plant kale seedlings, which will later go in the garden. To add to the sweetness, the first grade class is named Seedlings (shtilim), and the fourth grade class is Trees (ilanot).