Adventures in Research Administration.
I get annoyed with administrative processes. I can be an entitled, spoiled jerk. And so I often feel like people should bend the rules for me. This has in part been exacerbated by the fact that people in authority have been bending the rules for me my whole life. Parents, teachers, administrators. I’ve always been able to convince people to bend the rules when I wanted to, and even more frequently, people have bent the rules without my even asking. I remain somewhat flummoxed as to why.
But here at MECMC, I’m simply trying to go about things the right way, according to the rules. I don’t want rules bent. I want to appear as someone who does things carefully, the right way, and asks for no special treatment. But the processes are baffling to me. There’s training to be completed on at least three different computer systems. I have to submit a request to be labeled a PI, because my title isn’t one that automatically confers PI status on its holders. So I need to get special permission in order to be a PI and then to submit to the IRB.
But it’ll all happen. Because I’ll just keep at it until it’s done. That’s how things get done, right? For regular people who know how to live and work within administrative systems? I just want to be one of those people. One of the ordinary people who understand how to negotiate the regular processes of life. Who doesn’t get in trouble because they didn’t do the things that they were told how to do. It’s very easy for me to ignore things, or let them slide. Procrastinate. but being a grown-up means paying attention to those details.
I like the way my life works when I behave according to the rules of the systems. I’ve gotten better and better at it as time goes on. And I’ve gotten to be a person who appreciates it as I advance in sobriety.
Life in ECC.
Well, at the end of the week, I will have been here for two months. I’m in the middle of my 4th week of work. I’m just starting to get my mind around how this place works. I’m finding myself having two types of adjustments to go through. First is that the institution, MECMC, is very different from my institution back in St. Louis. It’s bigger, faster, sleeker, and full of really dynamic, effective people who care a lot about getting shit done. That’s great. I’m excited by that. The other is that my role in the institution is different from my role in St. Louis. I’m not a PI, and my research activity is going to be minimal for a while. I’m considered support staff, and that’s a tiny bit difficult to swallow, because I can be egotistical.
But it is good to work with humility. I like to think that when I am in charge, when I’m the PI, I’m magnanimous and humble. I’ve certainly never had anyone tell me otherwise. But it’s easy to act that way when I’m in charge. Then I’m being generous. It’s harder for me to be humble when I’m not the PI. When my role requires me to consider someone else to be the top of the pyramid. I don’t mind having a boss. Hell, PIs have bosses too. Everyone does. But I don’t like being at the beck and call of someone who clearly thinks I’m not terribly important, the way so many surgeons seem to look at others. But my work group clearly respects me, and I’m happy for that. I need to learn how to fit in. I’m doing that slowly.
And I’ve found a couple of great meetings. I go to a Men’s Meeting on Wednesday nights, which is about 2 miles from my apartment, and 2.6 from work. I walk when I can. I’m not sure what the weather is like outside right now (I work in a windowless cellar), but I think it’s walkable tonight. At least it will be home from the meeting. If it’s as hot as my phone thinks it is, I’ll take the bus from my job to the meeting, probably. We’ll see what time I make it out. And on Sundays there’s a meeting at the local Ethical Society (Which surprises me a bit; the Ethical Society is known for being a little prickly toward anything that invokes God, and AA does, of course. Though AA certainly doesn’t require you accept any particular faith or spirituality. Our only requirement for membership is a desire to stop drinking.).
So I’ve found a couple of places where I fit in. And I’m hopeful that I will find more. It will be nice to have friends, when I have some. So far, I mostly just have a few people I work with, and a few people I go to meetings with. But I’ve hung out with a couple of twitter people. I think other friends are on the horizon. Maybe. It’s been a long time since I needed to make friends. I don’t really know how. But I’ll be meeting some more twitter people in a couple of weeks, including a couple who went to the Great Chicago Tweetup. I’m really looking forward to that.
Loneliness is insidious. And isolation and depression lead me to those old places I used to drink to avoid. But I know now that I have better ways of dealing with those impulses and fears. So, in an hour, I’ll head to my Men’s Meeting. And It’ll be good.
Baby Steps.
Today feels a tiny bit better. I found out yesterday that that R03eq I worked on last year and submitted in January will indeed be funded, which is exciting. Hopefully I’ll have something like an academically credible CV in the event that I ever need one again. And I had a conversation with my boss who seems to think that I’m doing reasonably well for the beginning. She’s charitable and enthusiastic. I’m just feeling stupid and lonely and isolated and ugly. Which is pretty standard territory for me. I know it well enough to know it passes. Things pass. And life moves forward.
Bruised Ego.
I’m sure this is cyclical, in terms of my emotional state. But this morning, I am not particularly looking forward to my new job. Not this week. Last week I made my first real faux pas where I wasted a surgeon’s time in a meeting and had to be told afterwards to “stifle my curiosity” so that the meeting could proceed on pace. I was asking too many questions. I was told they were perfectly fine questions, but to write them down and ask after the meeting, don’t just bring up new stuff during the meeting.
That’s fair, sure. What’s hard to accept is, I’m not the PI anymore. It’s abundantly clear that people are tired of me talking about publishing. I’m going to stop, for a month at least. I just need to quietly go about doing the things I need to do to have publishable projects, and then publish them when that happens. This is an environment that has never cared about that, and while it’s something that I think people will be excited about when it does happen, no one sees it as valuable right now. And to them, it’s not. Papers won’t advance their careers. And maybe not mine either. I’m doing it for ego.
And it bruises my ego that I’m seen as wasting the surgeon’s time. I want to say, “No, he was rude for presuming I’d cater to his agenda.” But that’s not the case either. There was a published agenda that my office put together. I was going off books. And, objectively, that surgeon has more to do than I do. And my institution, a hospital, values his work more than it values mine. Probably by a factor of five. Maybe seven.
I want to be the person in the room that everyone respects the most. The one with the ideas and the one whose time is the most important. But that’s just not true here. It’s true for very few people in life, and I’m not one of them. I spent about three years as a PI where I got to be a sort of head-honcho. I’m not that anymore. I traded it for a good stable career doing what I was trained to do without having to submit grants. I’m part of a team, and I’m not at the top of it.
I’m feeling small. I’m feeling jealous of medical doctors who are no smarter and no better trained who get vastly more money and vastly more respect. I’m feeling rejected that the woman I went out with that I thought I liked didn’t return my email or my text, so she probably isn’t in to me. I’m simply feeling a tiny bit alone. In a strange new place. In a different culture.
Summary Statements Galore!
So I got back two summary statements yesterday. The first was for my own big R01eq. Actually, I thought that I had trimmed it considerably, writing it for only $500,000 and 3 years. I thought that keeping it slim like that would make funding more likely. In fact, it just led reviewers to complain that it was too long and expensive, and that I should: (1) make it shorter, (2) add an implementation aim, and (3) reduce my effort. You can have any two. Not all three, idiots.
OK, enough of calling them idiots. They were actually very complimentary. I think I wrote that I got a pretty good score. My impact score was 221, and the funding line (lower is better) has traditionally been about 190. This funding agency doesn’t use percentiles, but it does publish them. I was in the 37th. A strong first submission, as everyone seemed to agree. Some relevant quotes:
“Very innovative study and a very good first submission.”
“The proposed research addresses an important issue using state-of the-art tools. The aims are particularly significant because they combine [Proprietary Grant Ideas].”
“This is a promising proposal in the area of management science/operations research, and should have substantial relevance to … operations.”
“This is really important work.”
“This is a very feasible project with an excellent jump from a [R03eq] to an [R01eq].”
“The scientific approach is well supported by the literature and their prior work.”
So, clearly, they liked it a lot. However, there were also some issues:
“The one limitation that I can identify is relatively poor description of their pilot findings.”
“What is lacking is an explanation of the next phase.”
“The three full years for the project are not justified.”
“The implementation plan for the findings is essentially absent.”
But overall, I think that the issues are all addressable and that this review is clearly a leading review to funding. I even got pretty good investigator scores (1.8, 1.9, 2.0), though they continue to note that I’m junior. Well, how do you expect junior investigators to become senior if you don’t give then an R01 when they write a grant worthy of one? I feel pretty confident that I could get this funded on A1.
So I’m pleased with that work. I wrote my own idea, and it was very well received. With a constructive review that I believe would lead to funding if I were to pursue it. But I have a new position now, where grant funding is not expected. And my new institution cannot receive funds from the agency to which I submitted that grant anyway. So it’ll almost certainly wither on the vine. Which is sad, because a grant like that could’ve really launched me to a professorship somewhere. Instead, on my CV all I have are a few R03-sized grants and a couple of smaller foundation grants. And while people don’t actively spit at those, they’re not tenure-track material.
The other summary statement I received was for an R03eq that, even though I wrote the first draft of the grant that was well scored but not funded when submitted to one agency, I was not the PI for this submission. I gave it to a friend who rewrote it and submitted it to the same agency as the above grant, with me as a CI. And it appears to be getting funded. Our score was 181, well below the historical funding lines for this mechanism. By comparison, my own R03eq that was funded was scored 202, which was the 11th percentile. Percentiles weren’t announced for this grant, but I think it’s safe to assume we’re in the low single digits.
Relevant comments:
“Novel systems engineering approaches in health care need to be encouraged and tested and this proposal is an example of how that can be done.”
“This is a novel proposal that focuses on an understudied topic in health care.”
“The PI targets a very interesting but important topic.”
“The approach here is one that holds considerable promise in that it addresses both [Proprietary Grant Ideas].”
“This is a sound pilot proposal that proposed to study an interesting, important, and neglected population.”
They had a few negatives, too, but they were superficial and perfunctory. So I feel good about this too. It’s almost certainly going to be funded, and we’re still working out how to accept the funding, considering that I’ve left and my institution let the PI go despite having this grant with this score out there. Now they’re scrambling to get him back so that they can accept the funding. I don’t know if it’ll happen. If it does, I’ll work on it from here. If it doesn’t, the institution will be throwing away about $125,000.
My old institution deserves to lose this for their stupidity and short-sightedness. But I actually want to do the work. Because it’s good work. It’ll make a difference in some people’s lives, and it’ll be good for my career. Especially because this PI really knows how to drive a project. So, here’s hoping.
And my A0 of the R01eq will keep for a few years. I may yet get the opportunity to revise. We’ll see. The future is a big place.
Defensiveness Kills.
I’m not so much afraid of screwing things up as I am of being found out about having screwed things up. Having it exposed to everyone. It’s humiliating. I feel naked and exposed and very, very small when it happens. And I’m not sure which is worse, when people are angry that I’ve made a mistake, or when people laugh at me for not being good enough. The worst, the absolute worst, is when people call me stupid. That was the weapon of choice of my mother’s. I cannot count the number of times she hissed at me: “How could you be so stupid?” when I’d done something foolish that children do. All the times she called me a “concrete idiot” when I didn’t understand a simile or couldn’t parse a metaphor. I learned rapidly to pick things up the first time. To hide my misunderstandings.
I was, as an adolescent and as a younger man, very defensive. Because I felt I had to protect myself so carefully, I would lash out at people who accused me of not doing things correctly. Because the consequences of being wrong felt so dire. As a result, it became very difficult for me to admit when I was wrong. Being wrong was heaped with shame and horror. Admitting that I didn’t understand something was blankly terrifying. Confronted by something I felt I couldn’t understand made me angry, sick.
Being defensive is one reason I kept drinking so long. Because I couldn’t admit to being overwhelmed, I couldn’t address the problem. It was absurd that I would have any trouble with alcohol. I wasn’t a drunk, I was a “professional”. And drinking assuaged the constant terror inside, the fear of not knowing, of not measuring up. Of not fulfilling promise. Of being exposed as a fraud and a liar. Because I didn’t really understand the difference between being wrong, and telling lies. It was no worse to simply be wrong than to tell lies. And so soon, lies covered for being wrong. Lies propped me up when the truth wasn’t good enough.
Any liar will tell you that it becomes difficult to protect all their lies, as time goes on. A drunken liar has the additional wrinkle of not remembering which lies they might’ve told in a blackout, to whom and for what. I lied for the sport of lying. And my defensiveness, the hedgerow that defends a tender ego, that shelters that yolk within me that was ashamed to tell lies, allowed me not to confront what I had become. Someone who wasn’t merely “screwing things up”, but was actively sabotaging himself, and those around him.
I couldn’t see what I was, because I couldn’t look at it. And once I saw it, finally, I couldn’t bear it. I lashed out at myself, too. Cutting myself, bleeding in the bathtub, fantasizing that the black bile of my lies and shame could drain out of me in that way. It doesn’t work. I’d have run out of blood long before I ran out of shame.
When I finally had no more options, when I was finally abandoned to death or recovery, I somehow chose recovery. It isn’t an easy choice. I wish I knew a way to explain that to people who don’t have addictions. I think we’d all be a little better off if there were some way to allow non-addicts to empathize with the difficulty of that choice. To this day, drinking myself to death doesn’t really sound all that bad. At that time, it was a real, viable option. Attractive and nearly compelling. And a lot of people make that choice. And I don’t know how to help them make a different one.
I’d like to say that I’ve succeeded at being 100% honest with everyone, all the time. I haven’t. The program of AA is called a “program of rigorous honesty”, but I don’t know anyone who has succeeded at that, not even those who have many decades of sobriety. In my five-plus years, I’ve told lies. Especially by omission. But I’m making progress.
We claim progress rather than perfection, says the book. And I can gladly claim that. I have made great progress. And I am happy to continue that work. I am happy in my recovery. Happy in my new job. My new city. My new life. I’m still ashamed when I make mistakes. But I’m not stupid. I think I know that now. I would really like to be certain that I’m not stupid.
My life is moving up. A far cry from the chasms I used to long after. That a small, sick part of me will always want to call home. I can relinquish my defensiveness by remembering: I don’t always have to know. Because I’m allowed to learn.
Admitting What We Are.
I went to a very powerful meeting on Sunday. One difference I’ve noticed between meetings in ECC and in St. Louis is that the meetings here are much less frequently speaker meetings. Back in St. Louis, most of my regular meetings involved one person speaking for 10-20 minutes, and then discussion of the talk or whatever else was relevant to our sobriety that day. Here, the meeting chair (still a rotating position), introduces a topic, or we read from some literature, and then discuss it, or whatever else is relevant to our sobriety that day. It’s not a big difference, but speaker meetings let me get to know people a little faster, and in greater depth, I think. At least, if the speaker is a regular at the meeting.
My Sunday meeting is a topic/discussion meeting except for the last week of the month, when it’s a speaker meeting. So, yesterday, I heard a talk. The speaker was an older black man, in his 70s and perhaps just beginning to loosen his grip on presence and awareness. His talk was a bit disjointed, and jumped around in time. But it wasn’t hard to follow. In fact, it was riveting. Because of the gruesome honesty it contained, and the pain he still feels about what he spoke about.
The man was a batterer. He talked about having been abused, horrifically, as a child, beaten by a parade of step-fathers. He alluded to other abuses very obliquely. And how he grew up with no concept of where to put his rage. And so, when he was an adult, and women didn’t behave the way he’d like them to behave, he lashed out. Even, and this was the hardest part for me to hear, in sobriety. Even into his beginning years as a sober man, he continued to beat his succession wives.
Eventually, he went to a program for batterers, and stayed there for two years. He talked about learning to control his anger, not to lash out.
I don’t know where to put these kinds of talks. One woman in the meeting said: “Your talk was hard to listen to. But let’s face it, this isn’t called We Made Great Decisions Anonymous.” Everyone laughed. But it isn’t funny, of course. I go, a couple of times a week, and sit in rooms full of killers and thieves, reprobates and villains. And I belong among them.
I have no standing to judge anyone. Everything that another drunk did, I might yet do if I return to alcohol. I am vodka’s marionette. We recover, slowly, emerging from pits of slime and degradation, by admitting what we are, and confronting what we do. Honesty is the first step towards change. We tell our stories so that we can recover, and so that we can carry the message to others, that recovery is possible. It is a work of progress. There remain things I have not addressed. Things I cannot confront head on yet.
But I’m making progress. Step by step. Pain by shame. I stand upright in the wan light and do not blink. But I’m not yet ready for the whole full light of day.
Health and Wellness and Fear.
Today I had my employee health screen. I’m always terrified about these things. Blood work numbers are absolutely terrifying. I’m not sure it is, maybe the old sense that what I don’t know can’t hurt me. Except I’m very, very aware that that isn’t true. But I avoid learning about my health because I’m so afraid of what I might see. I used to have the same problem with my bank account. I couldn’t look, and as a result, I would get overdraft charges. Even though I had enough money, I just wasn’t managing it correctly. But the fear of looking was overwhelming.
I got over that by forcing myself to look at my account balance every single day. I had to in order to conquer the fear. Now, I have a financial plan that keeps me on target. I need to do the same thing with health, especially now that I’m in my late 30s, and I am approaching the age where, in the words of a dear physician friend of mine, we “begin to see events.” Events are things like your heart suddenly rage-quitting. But MECMC offers about a $500 incentive to get an employee health screen annually. And I really, really need to get over my fear of learning about my health status.
So, I went and got my screen. And there, in bold letters, was the terror-question: “Do you have diabetes?” Now, my answer is no. I don’t. At least, I hoped I don’t. Type II diabetes runs in my family. It marauds in my family. It led to my father having a debilitating stroke in his early 60s. My father never took care of his health. As a result, he’s suffered his whole life from treatable illnesses. I want one of his gifts to me to be the knowledge of what will happen to me if I do not manage my own health carefully.
And yet, I still fear. It’s easier for me not to know than to confront my health issues. In the short term. So I do the things I know I need to do to take care of my health without actually looking at numbers, like exercise a lot and eat well. Four years ago, I was teetering on the edge of diabetes. My fasting glucose was 117 (repeated measure of 126+ is diagnostic). I was 50 pounds overweight. I smoked. I was sedentary. My A1c was over 6. Everything suggested that I was going straight down the path my father had gone.
Except one thing. I had a program that I had used to confront my alcoholism. And I’d been through the psychological analysis that allowed me to understand my self-destructive tendencies. And because of that, I knew how to address complex and difficult issues in my life. I started applying the program to exercise and diet. Do today what I can do today. Small, incremental improvements. Consistency. I lost weight. I quit smoking. I started exercising. I confronted my fear and my laziness as character defects that had become objectionable to me.
Today, my fasting glucose was 100. My A1c was 5.4. My total cholesterol was 198 (though the components could be better: HDL 47, LDL 139). My blood pressure is routinely around 115/75.
All of this was achieved without medication. Without medical interventions. I eat well, most of the time. I exercise regularly. I recognize that my fear is not useful to me in this context. I believe in the utility of emotions, anger and fear exist in part because they motivate me to make useful choices that help me flourish. That is, if I understand them carefully and employ them productively. It does me no good to allow my fear of knowledge of my health status to blind me to my condition.
These are the things that my alcoholism has given me. The gifts of my addiction. The treatment for my chronic mental illness is in fact a program for living a life of health and happiness. It is baffling in the beginning when people say, “I’m a grateful alcoholic”, and we come to understand that they are saying that they are grateful to be afflicted with alcoholism. But it’s no mystery to me now. This disease, bent on death and misery, has launched me into a useful, satisfying life. I am grateful for affliction, because its harvest is recovery.
Asking for Help.
You know, all things considered, I feel like I’ve handled this enormous change reasonably well. I planned as carefully as I know how. Which is to say, I did a little bit of planning and occasionally wrote things down. Mostly, I asked for a lot of help. I cannot stress enough how much, when facing a major life change, asking for help helps. I needed all kinds of help to get this move accomplished, and I asked for help from at least a dozen people to do it. Prior to that, I needed help to find a job. I asked for help from at least 300 people about that, casting a wide net on twitter and among my other science and engineering friends.
And in fact, it was one of my requests that led to my position at MECMC. A man with whom I’d done some business, and with whom I will now do more business, put me in touch with the woman who was to become my boss here, and things rolled forward from there. Then, I had help from the scientific community on twitter to prepare my CV and my job talk for my interview. I had help from friends and relatives in planning how to negotiate for my compensation package (Though that turned out to be essentially fixed. They just wanted to know how much money I wanted, and their first offer was more than my first ask was going to be. Our most difficult negotiation was over my start date.).
And so finally, after all of that, I’m here, I’m ready, and I’ve started. And now, I’m asking for help again. I’m in a new job. I suck at office politics. I know it. I’ve asked my co-workers to help me keep from missteps. I’ve asked dozens of stupid questions. And I’ll continue to do so. I’ve decided that I’m simply not going to be ashamed about not knowing something. It’s far, far better to get help than to realize later that I really needed it, but now it’s too late.
The same goes in the program, and in other life upheavals. When I got divorced, I got help from friends who’d been through divorce. When I needed to get sober, I got help from people who’d gotten sober. When I am faced with these daunting challenges, I find the people who’ve been successful at it and ask them. I find it’s especially helpful to find people who have the experience of doing things badly at first, learning, and then doing them well. I have all kinds of experience like that. I’ve done a lot of things badly in my life, and later figured it out.
Asking for help can be humiliating. We all want to present ourselves as having all of our shit together. I want people to look at me and think: “There’s a hoopy frood who really knows where his towel is.” But the truth is, sometimes I’m totally lost. Afraid. Bewildered. And other people, people in my immediate community, have usually faced what I’m facing. So, these days, I ask. Because it works.
We also tend to think that we’d be a burden on others as well. But I think that’s generally not true. After all, if a friend came to me, and told me that they needed help quitting drinking, or going through a divorce, or applying for a job or moving to a new city, I’d be happy to help them. So why should I presume otherwise when focusing outward? If I’m willing to help, and if I think well of my friends, why should I think they wouldn’t be willing to help? In the words of a new friend that I am realizing more and more is a very, very wise man, “We get through this together, or not at all.”
Abstract
In this article, we lay out a set of best practices for the use and distribution of consumable breath-freshening aids (CBFAs). We adopt the vernacular “breath mint” interchangeably despite stipulating that many such CBFAs may not be mint-flavored, and we do not distinguish between peppermint and spearmint (despite the less-frequent latter’s clear superiority). We address both the receipt of offered breath mints and the offering of one’s own breath mints to others. It is our hope that by promulgating the following set of best practices we may simultaneously improve the overall odoriferous quality of society’s aggregate exhalations, and mitigate any social awkwardness associated with receiving an offer of a breath mint.
Background
In today’s society, we are all expected to have fresh – or, failing that, unnoticeable – breath. It’s simple courtesy, and it’s highly associated with good dental hygiene, which is a social proxy for hygiene in general. There are many historical and traditional means of freshening the breath, ranging from caraway in ancient Egypt[1] to fennel in India[2]. It is universally acknowledged that fresh breath is a desirable quality in a potential mate. However, it is also inevitable that the freshness of one’s breath deteriorates (leading to halitosis) over time unless countermeasures are deployed. The standard weapon in the battle against halitosis is the toothbrush, but chewing gum, rinsing with mouthwash or water, and even eating are common substitutes[3]. In this article, we concern ourselves with the consumable breath-freshening aid (CBFA) or “breath mint”, and attempt to lay out best practices for both the distribution and receipt of same.
Definition:
Breath Mint: n. A mint is a candy characterized by the presence of mint flavoring or real mint oil, whether it be peppermint oil, spearmint oil, or another natural or artificial source; the sweets are often referred to as “peppermints”.[4]
Figure 1. Peppermint CBFA. Source
Discussion
It can be a socially delicate interaction to offer a breath mint to a person in dire need of fresher breath. The mint bearer (MB) wants, in general, to improve the potential mint receiver’s (MR) breath while avoiding the possible social shaming of the MR. It is therefore desirable to construct a scenario wherein the CBFA may be proffered without the MR becoming aware that the MB has discerned a condition of malodorous exhalation.
Best Practices for the Distribution of CBFAs:
1. Prior to offering a CBFA, the MB should always, without comment, take one themselves first.
2. The MB should then feign a motion to return the breath mints to their pocket, drawer, or other bag.
3. When the package of CBFAs is nearly returned to its original location, the MB should ‘suddenly remember’ to politely offer a breath mint to the MR. For example: “I’m sorry, would you like one too?” Or, if in a group of people: “Silly me! Who else would like one?”
4. Open the container, or peel back the wrapping, without touching the breath mint and extend the CBFA towards the MR.
5. If the MR does not accept the CBFA, suck it up. You’re just going to have to deal.
Best Practices for the Receipt of CBFAs:
1. Always, under all circumstances, accept a proffered breath mint. This is non-negotiable.
2. Gum too.
3. The MR should not make a stupid comment like: “Oh, do I need one?” This risks derailing the polite attempt to spare the MR’s feelings with a flat “Yes.”
Conclusions
The previous set of best practices are designed to reduce overall halitosis and associated unpleasantness while ensuring that social standings and general comfort are respected. Nothing in this article should be construed to dissuade any person from adhering to and practicing good oral hygiene, as CBFAs are not a substitute for appropriate dental and oral care. They counteract halitosis only transiently. Halitosis may be a serious medical condition. Chronic sufferers should seek medical care.
References
[1] Aboelsoud NH, “Herbal medicine in ancient Egypt” Journal of Medicinal Plants Research Vol. 4(2), pp. 082-086, 18 January, 2010
[2] Türkyılmaz Z, Karabulut R, Sönmez K, Başaklar AC “A striking and frequent cause of premature thelarche in children: Foeniculum vulgare” Journal of Pediatric Surgery Volume 43, Issue 11 , Pages 2109-2111, November 2008
[3] Nachnani S, Clark GT, “Halitosis: A Breath of Fresh Air.” Clinical Infectious Diseases 1997;25(Suppl 2):S218–9
[4] Wikipedia page: Mint (candy). Accessed 23 March, 2013 http://en.wikipedia.org/wiki/Mint_(candy)
Infactorium 
