The Big Five By Dr. David Hepburn

Nestled in a bungalow on the Serengeti, deep in the Serengeti-ish part of Tanzania, we were warned not to leave the confines of our bungalow, even to venture the 75 yards to the main lodge, without first contacting security to escort us.

Thinking this a bit overkill, I nonetheless reluctantly called. Nanomoments later, a young man with an old gun appeared on our doorstep, just the ambience you want en route to dinner in the Serengeti. “Sorry to have to bother you.” I commented as we took the first couple of steps out the door. “You must hate doing this.” Suddenly, he swung his flashlight to the left and to my amazement, a few feet way away from where I was wishing I’d brought my Depends, were the intimidating tusks of a friggin’ elephant! Right there!! (African elephants and similar beasts are often officially described as “friggin’” given that they are the size of a friggin’ house or at least a friggin’ condo, and tend to make you sputter out words similar to friggin’, if not “friggin’!” itself, often expressed when you discover one 20 feet from your doorstep.) “Friggin’ thing!” I gasped.

Turns out that elephants, cape buffalo, lions and even leopards often made their way past our front door to get to the swimming pool for a chlorinated drink. And you thought clearing shad flies and ants out of your pool was a hassle. “Thaminiki, can you go grab the elephant net, oh and make sure to clean out any king-of-the-beasts clogging up the filter.”

We literally could’ve sat in our bungalow and witnessed 80% of the sought after African Big 5, the rhino being the only one of the Big 5 not in the vicinity. Why they are referred to as the Big 5 was not always clear to me. It isn’t the “biggest” 5 as the hippo isn’t included. It isn’t the tallest as the giraffe doesn’t make the grade. It isn’t the most dangerous given that hippo attacks are the most deadly in Africa, perhaps due to the fact they got left off the list in the first place. The Big 5 are the Big 5 because they are the most sought after and valuable animals in Africa.

The Big 5 of Africa - Dr. David Hepburn
The Big 5 of Africa – Dr. David Hepburn

Twice a week, I, like Lindsay Lohan, enjoy a drug lunch. This is when well-coiffed and well informed pharmaceutical reps with great teeth and tusks come by the office to provide lunch and chat about what is new in the world of pharmaceuticals. It is a welcome and needed opportunity to discuss the drugs we prescribe you.

“So what’s new Kevin?” I asked one of the reps whose name was Kevin as suggested on his name tag.

“Really Dave, not much. Drug companies continue to focus most of their resources on the Big 5.” Once again, the Big 5 refers to the most sought after and valuable. The Big 5 diseases that pervade our society. Diseases at which Big Pharma aims it’s elephant guns. Big bins of sample drugs addressing the Big 5 fill our big shelves. Listing these diseases tempts me to compare them to the African Big 5, as that is just the way my mind works or perhaps doesn’t work depending on if you’re me or my wife.

Diabetes, often due to diabesity and requiring a trunk full of medications, is the elephant of the group.

Depression. I don’t personally recall ever seeing an overly happy Cape Buffalo. They always look like they’ve woken up on the wrong side of the savannah. They are the grumpiest beast in all of Africa and are constantly complaining to those who would listen, which really would only be other Cape Buffalo and the occasional ox pecker on their backs.

Osteoporosis. Rhino horns are all too often turned into dust and powders in the name of medications, just as the eggshell skeleton of osteoporotics turns into chalk dust… requiring medications.

Asthma/COPD. When lions grab a Zebra, wildebeest or wild tourist, they simply clamp down on the windpipe and slowly wait for the victim to expire. This is exactly the sensation of obstructive lung diseases, though usually without the claws sunk deep into your cranium.

Hypertension. Leopards, due to their stealth, are not easily noticed in the Serengeti, until one suddenly rips you apart. Blood pressure, the silent killer, may not be seen coming until one morning you wake up dead. Leopards tend to go up trees to eat and stroke their fur. As our blood pressure goes up, we tend to stroke too.

Big 5 of Diseases -Dr. David Hepburn
Big 5 of Diseases -Dr. David Hepburn

And so as not to irk the irksome hippo, I would like to give the hippopotamus honorable mention as I would also like to do for cholesterol. Both are chomping at the bit to be part of a Big 6. Both are all about dangerous fat floating around, either in our blood stream or the Zambezi as the case may be. So keep your serum hippos down….friggin’ things.


Problem on the rise…..for men only – Dr. David Hepburn

Dr. David Hepburn:

As a lion, if you’ve decided to name yourself King of the Beasts you had better back it up with a little action. Roaring is cheap. It’s usually a rather short-lived glory for the lion king as there are others constantly wanting his job. And who wouldn’t! Successful applicants will:

  • Sleep 20 hours a day
  • Be served fresh wildebeest by a coterie of naked lionesses
  • Copulate 70 times a day for five days
  • Participate in an occasional fight to the death

Wait! Go back to c. for a second.

Yup. Seen it with my own eyes. On safari, we happened upon a beastly king, busily engaged in c. who happened upon his Mrs three times in less than an hour, not that any of these times involved a lot of champagne or petunias. Was more of a Wham Bam thank you ma’am, roar, nip on nape, roll over, nap, repeat. Feeling a little like peeping panthers, we left, but returned the next morning to find the same couple. This time, however, she was sitting with a bit of a snarl on her face waiting for more King of the Beast action but he was completely laid out flat! Am sure I could hear him muttering something like “You have got to be kidding me woman. Why don’t we just smoke a few jackals and call it a day.” I may have lost something in the translation.

“Oh doc, there’s just more thing…”

“You have ED, right Bloggins?”

“Well no, but… well… yes. I ain’t exactly King of the Beasts around the back 40 these days.

“No lyin’ there king. Your sugars, cholesterol and blood pressure are sky high which is why the rest of you is rather low and slow. ”

Erectile dysfunction (ED) affects 40% of men over age 40 and 65% over age 65. Extrapolating, should you make it to 100, you apparently aren’t going to make it.

Erectile dysfunction- Dr David Hepburn
Erectile Dysfunction- Dr David Hepburn

-Over half of men with diabetes have erectile dysfunction. I have actually seen women in tears, having discovered that the fella they were dating was just too sweet.

-Men who smoke more than one pack per day have a 50% higher chance of impotency than nonsmokers the same age, unless apparently you are 100. So if you’re smokin’… you ain’t really smokin’.

-Got blood pressure issues? Chances are you have other pressure issues too. In fact, having erectile dysfunction is so intimately involved with the overall state of the lining of your blood vessels that ED is now considered a potential marker for cardiovascular disease. And to make matter worse one of the drugs that can cause ED is a common blood pressure pill.

-Most men under 40 years of age can achieve an erection in 10 seconds, while most men over 40 years of age can find an excuse in 10 seconds.

-Men in their 40’s with ED have a higher risk of having a stroke or heart attack in the future. Toss a little depression on top (and what man in his 40’s wouldn’t be a little depressed if the rooster don’t crow, the lion don’t roar, the hedgehog….) and the risk is even higher.

ED is a problem on the rise, as now every seven seconds a brand new baby boomer turns 50, hence the recent run on lawn flamingoes. With the plethora of treatment options, no longer are men afraid to bring it, er, up, in the doctor’s office. (This is getting increasingly… harder to write about without you perverts and Mrs. Horsblaggin reading unintentional double entendres into this.) Viagra,Cialis and Levitra are the number one option for treating ED. For those who cannot tolerate these pills, don’t give up hope as there are pumps and even injections that are quite successful, though to some men the thought of a needle in the nether regions could well cause their testicles to disappear forever.

Erectile Dysfunction-Dr David Hepburn
Erectile Dysfunction pills-Dr David Hepburn

So don’t ignore ED because remarkably, almost a third of all women over 80 years of age still have sex.
It’s the truth, trust me I’m a doctor… not lion.

Ten ways to give yourself cancer – Dr. David Hepburn

A recent article I wrote recommending the top ten things you could do to acquire a heart attack generated a plethora of mail, and I do enjoy an occasional plethora. For example:

An interesting article, as in the Chinese curse “may your life be interesting.”” Wing Chow

Shing hoa chou bein mein wong shang sweet and sour.”  Sean McElgunn

We are upset that you have given the heart attack prime time as we think people would really prefer to know the best ways to get cancer.” Canadian Cancer Society

You are an idiot!” Rosemary Hepburn   “But you’re still my only son.”

Dr. David Hepburn
Dr. David Hepburn

And so, in order to give cancer equal time, here are my top ten recommended ways to get cancer. I include modifiable risks only as, though genetics plays a significant role in many cancers, it is a little awkward to go to the stork station and request a new set of parents because they usually say “Sorry Dave but this is the 62nd time you’ve asked us this month.” But as more than 30% of all cancers are self-induced, there is plenty you can do by yourself. Cancer is a growth industry, with 8 million deaths each year globally, projected to increase to 12 million by 2030.  If you don’t want miss out on the trend here’s what you can do.

  1. Tobacco: be it ingested by smoking, snorting, the attractive chewing or in an enema, be it 1st, 2nd or even 3rd hand, be it mild, moderate or severe, be it in a pipe, a puff, a paper or a pinch, tobacco is far and away your single best bet for getting a tumour or two or twenty.
  2. Alcohol: Fire back two drinks of alcohol or more per day. Alcohol not only boosts your serum boorish levels, but it can boost your chances for melanoma, stomach, breast, colorectal, liver, mouth and throat and oddly even lung cancer.
  3. HPV: This contagious virus is not only responsible for those sweet genital warts but HPV, particularly when combined with smoking really enhances your cancer chances. The combination of the two not only increases your likelihood of developing cervical cancer by a whopping 15 times, but also causes fatal squamous cell cancers of the head and neck. And if you don’t have a cervix and are currently lacking a head or neck, you can enhance your risk of getting liver and lymphoma cancers by getting the Hepatitis C or even B virus.
  4. Obesity: Yes, that is a lot of a lot of us. So crank that spare tire up to say a spare walrus and increase your chances of getting: breast, colon, kidney, uterine, esophageal and prostate cancers.
  5. Sedentariness: Couch potato-itis not only helps your walrus develop, but if you’re skinny and just can’t get fat, then being a happy slug might help you snag pancreatic, breast, colon or uterine cancers. Exercising not only scares away tumours but it gets your clothes sweaty.
  6. PAHs and HCAs: Do not ignore the effects of burnt barbequed beef giving us those crunchy carcinogenic PAH’s and HCAs. And while you’re sweating over the barbie, light up a cigar. Bulls Eye.
  7. Ditch the D: Indications are that colorectal and breast cancer may be associated with low Vitamin D levels. No more Vitamin Dave.
  8. Diabetes (primarily type 2): is associated with an increased risk of some cancers (liver, pancreas, endometrium, colon/rectum, breast, and bladder). Oddly diabetes is associated with a reduced risk of prostate cancer. Sweet!
  9. Quit vegetables:  Stop eating your vegetables and fruit and dig right into those saturated fats. Wrap your hotdog up with salami and bacon. Barbeque them until extra crispy for added potential.
  10. Expose yourself: Get a job that exposes you to difficult to spell chemicals or even radiation. Inhale copious amounts of asbestos, benzene, pesticides or solvents. This can be done alone or with the rest of the band.

And should all of that fail then try these: avoid your pap smears, load up on the sun, practice unsafe sex, demand X-rays and CT scans for every sniffle. And if you need more ideas, heck, I have a plethora.

Venom for medicine – Dr. David Frederick Hepburn

While New Mexicoing it recently in New Mexico I narrowly missed running over and squashing a monster sunning itself on the road, a Gila monster. Had I hit this loathsome leathery lizard and created this monster mash I could have once again destroyed one of the secrets that could save mankind. “Gila” pronounced “heela” as in healing, is a less than sexy reptile that, like the less than sexy Olson twins, eats only three meals a year.

Gila Monster - Dr. Hepburn
Gila Monster – Dr. Hepburn

I have some patients that eat three meals before breakfast. Most are now diabetic, a disease that is the product of how and how much we eat in this country. Yet Gila monsters not only don’t get diabetes but they don’t even get hungry. They have a chemical in their saliva, no doubt discovered by a lonely southwest lad with way too much time in the desert, called exenatide. Like insulin this chemical stimulates cells to take sugar out of the bloodstream but stops working when the sugar is normal! Thus it only works when it is actually needed, an advantage it gives diabetics who don’t want to have their blood sugar drop too low at the wrong time such as in the middle of the night or when dancing with Marie Osmond or her teeth.

As a result an exciting class of drugs called incretins have been spawned thanks to the lovely lizard of Laredo. It is known as exenatide, a much more palatable name than monster mucous, and is amongst the fastest expanding medications in waist expanding North America, diabetic capital of the expanding universe, which apparently, is expanding as it should. It is also an appetite suppressant and induces weight loss.

For those gumbooters who believe that only “natural” stuff can cure your lazy blood yeasts blahblahyawn, you can take rasta hair huggin’ joy in knowing that this medication is tantamount to swapping spit with a lizard. But hold your Gilas, lizard lovers. You are not to have all the glucose glory. Turns out that the skin of a South American frog secretes a compound that stimulates insulin release from the human pancreas with no side effects, unless warts bother you.

Now IT is about to be made into a medication, (Fernando flakes?). Soon it may benefit diabetics to camp out at the reptile and amphibian exhibit at the local zoo just to keep their sugars in check. Snuggle down at night with a monster and a frog (gotta kiss a few to find the guy formerly known as a prince anyway) and you could have normal blood sugars, a dream that only diabetics could appreciate.

Not to be outdone by his disgusting cousins, a scorpion named Sid decided to get in on the action. Finding that the diabetic field was getting crowded with do-gooder lizards and Amazonian frogs, Sid focused on brain tumours. He is no ordinary run of the mill, sleep in your slippers scorpion, he is the African Death Stalker (emit low evil cackle). What a cool friggin’ nickname. “Hey look out guys! Here comes Dave the African Death Stalker!” But Sid comes by his moniker honestly as his venom can kill a human or even Kim Il Jong.

His venom is remarkable as it has an affinity for the very nasty death stalking brain tumour known as a glioma. Injected directly into the brain the venom bypasses normal brain tissue and heads right to the tumour and with the help of a little radioactive package that the doctor has attached to it, kills the deadly glioma cells! Incredible! The cure for cancer possibly lies in the tail of a scorpion? Who knows? But wait there are even more venom cures.

Scorpion - Dr. Dave Hepburn
Scorpion – Dr. Dave Hepburn

There are fish loaded with pain killers, cone shells with anesthetics, ant juice that may lower blood pressure, tick stuff that may stuff heart disease and awkward looking toads that simply tickle our funny bone. Venom, designed by nature to kill us may in fact keep us alive. So scorpio/spidey/snake lovers, fill your boots. Just take a glance in them before you put them on.