The Big Chill

The human body possesses an amazing ability to maintain thermoregulation at a temperature not too hot or not too cold. It’s almost like there’s a thermostat that balances heat production and heat loss. Hypothermia occurs when extreme cold sends the body’s temperature below 95° F. However, hypothermia can occur at any temperature lower than normal body temperature. Factors including body fat, age, alcohol consumption and, especially, wetness can affect how long hypothermia takes to strike. So you don’t always see hypothermia coming—which is why we often use the term accidental hypothermia.    

What are some of the early warning signs of accidental hypothermia?    

Warning signs include uncontrolled shivering, memory loss, disorientation, incoherence, slurred speech, drowsiness and obvious exhaustion. 

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Who’s most at-risk?

The elderly and the very young. The next time you visit your parents or grandparents, notice how thin their skin appears. As we age, we lose the insulating protection of muscle, soft tissue and fat under our skin. Children, on the other hand, have a higher metabolic demand, requiring more heat production. 

Besides freezing cold, do other elements come into play?

Yes. Wind and water also play a pivotal role in temperature control. Both elements can precipitously cool the body to perilous temperatures in rapid order.

How is it that some people—like the ones on reality television shows set in Alaska—can tolerate extremely frigid temperatures?

It’s called the “hunting response.” In most of us, cold leads to vasoconstriction, which is narrowing of the blood vessels.  Repeated exposure to the cold, however, causes an adaptive physiology to occur. Those in Arctic climates possess the ability to vasodilate blood vessels in a cyclical pattern. When the extremities and skin begin to lose heat, the body shunts warmed blood to the skin, effectively warming the extremities. This occurs in a repetitive pattern to maintain thermoregulation.

Is shivering a bad thing?

On the contrary, shivering is essential to thermoregulation. In colder temperatures, you shiver to produce heat in your muscles. Small children will shiver after a bath in an attempt to raise their temperature immediately. Shivering is a very effective way to produce heat. It’s nature’s way of keeping our temperature from falling below 98.6° F.

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What can you do to treat accidental hypothermia?

Passive re-warming methods should be carried out for most mild hypothermia patients. A person should be removed from the cold environment. Moist, wet clothing should be removed. The body should be examined for signs of cold-related injuries. Warm clothing in layers should be applied. Passive re-warming methods typically raise the temperature by 0.5° C to 2° C per hour.

What about using warm water to raise body temperature?

I have my reservations. Immersing a foot or a hand is very effective at warming an extremity. However, my trepidation resides with the possibility of incurring a thermal burn during the process. Even simple heating packs or pads can lead to burns.

Does alcohol warm the blood?

No. Alcohol dilates blood vessels, leading to heat loss. Also, alcohol impairs judgment, which could potentiate cold-related injuries.  

How Do I Know if I Have Frostbite?

Warning signs of frostbite include numbness and lack of color. Fingers, toes, ear lobes, and the tip of the nose are the areas most susceptible to cold-related injuries. At or below 0° C, blood vessels close to the skin constrict and shunt blood away from the extremities.

This “life vs. limb” response is designed to protect vital organs such as the brain and the heart.
Typically, in our region, we see frostnip and chilblains. These are less severe cold-related extremity injuries in which the tissue never completely freezes. Burning and itching occur, followed by red and yellow patches. Transient numbness can occur but the damage is not permanent.

Is It True You Should Hold Your Breath in an Avalanche?

Avalanche victims typically die either through direct trauma or asphyxia. The snow becomes packed in the mouth, leading to suffocation. Avalanche survivors have better outcomes when they are recovered with their mouth closed. Assuming you survive the trauma of an avalanche, then hopefully you’ll find an air pocket to breathe. 

Of course, you’re not out of the woods at that point. Hypothermia sets in rapidly, slowing the metabolism down until your heart stops beating.  If a rescue team can get to the victim relatively quickly, people have survived at body temperatures as low as 64° F. Thirty-five minutes seems to be the magic number associated with favorable outcomes.

John D’Angelo, DO Chairman/Emergency Medicine Trinitas Regional Medical Center

Editor’s Note: John D’Angelo, DO, is the Chairman of Emergency Medicine at Trinitas Regional Medical Center. He has been instrumental in introducing key emergency medical protocols at Trinitas, including the life-saving Code STemi, which significantly reduces the amount of time it takes for cardiac patients to move from the emergency setting to the cardiac catheterization lab for treatment. 

Two decades in, the Trinitas HIV program has set new standards for success.

By Erik Slagle

A few years ago, Shawn Sullivan was at a barbecue. “No red meat for me,” she told the cook at the grill.  “Can’t have it with my HIV.” Later, a young woman who had overheard the remark approached Shawn and said she, too, was HIV-positive. She didn’t know where to turn, and didn’t have anyone she could talk to about her condition. She asked Shawn for any advice or direction she could provide. “Come to the Trinitas HIV clinic,” Shawn told her. “I gave her my phone number and told her, ‘I’ll bring you. You won’t be alone

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For 20 years, the HIV program at Trinitas Regional Medical Center has served as a beacon of hope for members of the community living with the virus. Without a lot of fanfare—or the publicity that comes with, say, breakthroughs in cancer treatments or heart disease—the program has provided care to thousands of HIV-positive patients…and helped them learn to care for themselves.

“This is a program that goes above and beyond for the population it serves,” says Judith Lacinak, Director of HIV Services. “We don’t only treat the patients who come to us. We seek them out, offer free testing to people who think they might be at risk, and break down the stigma that’s still attached to having HIV

Nearly 3,000 people in Union County are living with HIV or AIDS, Lacinak adds. “And from anywhere in the county, they can come to us for help.”

Dr. Julius Salamera of the hospital’s Infectious Disease Department has worked with the HIV program at Trinitas for more than three years.  He says the program currently serves about 600 patients—providing medical help but also supporting them through counseling with family issues and, when needed, substance-abuse treatment

“One of things we try to do at Trinitas is get to the root of each patient’s particular problem,” he explains. “For example, why have they stopped taking their medication?Some might prioritize narcotics over the meds they need to stay healthy. Others might encounter insurance problems with their prescriptions. We want to help them understand that, if you’re on medication, then you’re under control. People are living as long as 30 years or more with HIV, and the public at large needs to be educated about this.”

These days, Dr. Salamera explains, HIV is viewed in the medical field as a chronic disease – the same as diabetes or hypertension. The right combination of meds and therapy means the outlook for people living with the virus has greatly improved since AIDS first came into the public consciousness more than three decades ago. Shawn Sullivan is an example of how the evolution of HIV treatment, and the emergence of programs like the one at Trinitas, have altered the landscape.

“I’ve lived with HIV for almost 20 years,” she says. “And the clinic at Trinitas has been a big part of that. I wouldn’t be in the position I’m in now if it wasn’t for them. And I wish—everyone at the clinic wishes—more people with HIV would come in for help.”

A combination of obstacles (the stigma of admitting to having HIV, an increasingly complicated insurance field, lack of familial support, and in some cases the problem of substance abuse) keeps many with HIV from getting treated for the disease. In addition, finding those who need help can be one of the most challenging aspects of running an HIV program, but it’s one the Trinitas team is meeting head-on.

“We can meet the demand,” Lacinak says. “But the demand doesn’t always present itself.”

Getting a patient in the door is sometimes just the first step. If a patient stops coming in for his or her scheduled appointments, the team proactively goes out in search of the patient. A substance-abuse counselor will go out into the community, while the staff won’t hesitate to involve the police and paramedics if they sense something is wrong. It’s all part of the HIV clinic’s larger role as a presence in the community, not just a department in the hospital.

The HIV program at Trinitas works with homeless shelters and houses of worship to reach out to people who may need help, and the team takes part in local health fairs to spread the word about the services that are available. They provide mental health assessments, linkage to proper care, literature and educational events in conjunction with pharmaceutical companies, and permanency planning when needed. Lacinak credits the clinic staff for its tireless advocacy on behalf of HIV patients in and around Union County.

“We have a truly amazing team,” she says. “Our case managers are the backbone of the clinic. They work so very hard to make sure people show up for their appointments and are connected to the services and support they need. It’s like being someone’s personal assistant. It’s just an incredible group, and we’ve all got the same goal: helping patients manage their health and have a non-detectable virus

Today, more than 80 percent of patients at the Trinitas clinic are considered non-detectable. The program is helping them remain healthy, while keeping their HIV disease under control. Not everyone, however, succeeds. Patients may drop out, end up in jail, leave the area or, ultimately, lose their battle with the disease.

To people like Sullivan, the impact of these programs is immeasurable. “People need programs like this,” she says. “If they didn’t have this center, they’d have nothing. Look at me, look at the outcomes. Communities need these kinds of services.”

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The Trinitas clinic, she adds, is more than simply a medical center for people with an illness. “The people there become like a second family…your HIV family.”  

Sullivan, whom the Trinitas team has affectionately dubbed “The Mayor,” is always looking for ways to give back for the new life she’s been afforded by the clinic. “When I meet someone who is HIV-positive, I encourage them to come to the clinic and start getting the help they need,” she says. “I tell them, this is what you’re going to do. You’re coming to the clinic—I’m going with you. We’re going to work on living. When you’re ready, I’ll be there with you

When the community needs support and a partner in the fight against HIV, the Trinitas HIV clinic is there with those affected by the virus. For Shawn Sullivan, and thousands of others throughout the last two decades, it has been a lifeline. For a patient group still stigmatized by a three-letter diagnosis, it’s a haven. And it’s another example of how Trinitas Regional Medical Center is going above and beyond for the community at large

Editor’s Note: The Trinitas HIV Clinic is located at 655 Livingston Street in Elizabeth—about a mile east of TRMC’s main campus on Williamson Street. For more information, call (908) 994-7600. 

The top medical breakthroughs of 2015…and 2016…and beyond.

By Christine Gibbs

In the field of medicine, today’s science fact can sound a lot like yesterday’s science fiction. In 2015, we read about back-to-front face transplants, mind-controlled bionic hands and smart antibiotics—all of which are here and happening. We also heard about cancer-killing nano-robots and head transplants, which are, as they say, “still in the works.” In addition to these headline-grabbing advances, researchers are building on earlier breakthroughs to improve the length and quality of human life

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Consider, for instance, the Human Genome Project, which was completed in 2003 and which was covered in these pages in the spring of 2013. In the three years since, there have been a number of important advances in the treatment and cure of chronic and life-threatening diseases and disabilities. In the 2015 calendar year alone, scientists created the first roadmap of the epigenome (which consists of chemical compounds that modify the genome and tell it what to do), discovered genomic information on how skin changes with aging and sun exposure, and learned how to use known genetic associations to improve the development success rates of new drugs. Scientists also reverse-engineered the complex genetics of infertility, which in turn triggered research that holds promise for up to half the people who experience reproductive difficulty. 

Other recent breakthroughs that have a profound and ongoing impact on our lives range from targeted cancer therapies to stem cell research to laparoscopic surgical techniques. According to the National Cancer Institute, radiation and chemo may soon be replaced by treatments developed to hit molecular targets produced by the patient’s tumor itself. Cloned human stem cells, meanwhile, hold special promise for treating diseases of the heart and eye. And more than 2 million minimally invasive surgeries are done laparascopically in the U.S. each year, saving patients a lot of discomfort and saving the healthcare system countless billions. Recent advances in the treatment of migraines and Hepatitis C, as well as the development of a smarter pregnancy test, have also changed our lives for the better.

THE BIG THREE

My picks for the top three breakthroughs of 2015, as mentioned in the opening paragraph, are (in no particular order) the face transplant, bionic limb and antibiotic stories. Back in 2001, volunteer firefighter Pat Hardison lost almost all of his facial features—including his hair and ears—battling a mobile home blaze. In 2015, he received the most comprehensive face transplant ever attempted, from a BMX biker who was killed in an accident. The 26-hour procedure was performed by a team of more than 100 doctors, nurses and technicians, led by Dr. Eduardo Rodriguez of NYU Medical Center. They grafted both the front and back of the donor’s head to Hardison’s. 

In Austria, three patients received robotic hands that can be manipulated directly by the brain. The bionic hands have sensors that respond to electrical impulses from muscles that were transplanted from their legs to their arms. A few years ago, people who lost hands in traumatic accidents had to make do with mechanical prosthetics. The three Austrian men are able to button their shirts and pour water—tasks that were all but impossible with the old technology.

Perhaps the most important breakthrough of 2015 emerged from the battleground with drug-resistant super bugs—with emphasis on ground. Bacteriologists at Northwestern University discovered teixobactin while studying soil bacteria. The drug safely killed even the toughest infections it encountered in trials with mice, and human trials may not be far away.

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NEW YEAR, NEW BREAKTHROUGHS

What kinds of breakthroughs will we be writing about a year from now? That’s impossible to say. So much work is being done outside what we consider the mainstream that one never knows where the next big story will come from. However, we do know what’s in the pipeline. According to the Cleveland Clinic, the Top 10 medical innovations for 2016 are likely to be:

• A seriously promising Ebola vaccine may be licensed for use on humans this year.
• CRISPR, a genome-editing tool, is presenting a possible way to eliminate genetic diseases by identifying and removing bad genes from a DNA strand—and it could cost as little as $30.
• Cell-free fetal DNA testing for Down’s and Edwards syndrome that is far more accurate than standard blood or ultrasound tests may soon be available.
• In 2016, a new biomarker technology that focuses on changes in the structure of certain blood proteins will offer more accurate cancer screenings and earlier detection. Advances in the technology of breath analysis are also offering promise for even earlier non-invasive detection.
• Swedish scientists have developed the first mind-controlled prosthetic arm.
• Cleveland researchers have developed an under-the-skin system of wires and electrodes that recently restored the sense of touch to two amputees.
• Biosensors are being developed to monitor glucose and other vital statistics. Another remote device is a bandage that can diagnose pregnancy, hypertension or hydration from sweat molecules.
• A tiny device called a neurovascular stent retriever can entrap and remove deadly clots. It will be available in many hospitals this year.
• A study found that resveratrol—a compound found in red grapes, red wine and dark chocolate—may help treat Alzheimer’s disease.
• An “artificial pancreas” is under development that provides a sensor and insulin pump to automatically check blood sugar levels in Type 1 diabetics.

All of this potential in the various fields of medicine is exciting and exhilarating, Yet at the same time, it raises some crucial questions. Where will medical technology and advances in treatment take us as a society with regard to certain moral and ethical issues—such as unbridled longevity, genetic manipulation, and enhanced intelligence? And how will all these medical miracles impact us economically, politically and socially?  Big questions for big breakthroughs.  

BREAKTHROUGH: FEMALE INCONTINENCE

Trinitas OB/GYN Chairman Dr. Labib E. Riachi, is dedicated to neutralizing the taboo regarding female urinary incontinence. Recent advances in technology have reduced a previous 2–3 day post-surgery stay in hospital to a 5–10 minute, same-day outpatient visit. In lay terms, he summarizes the operation as employing a piece of polypropylene mesh, which he calls “Scotch tape,” that works 90% of the time to reduce 90% of any incontinence issue. “The tape is getting smaller and the surgery even shorter,” says Dr. Riachi, whose subspecialty is female pelvic and reconstructive surgery. He is committed to educating physicians and their female patients to eliminate any embarrassment about a problem that can now be corrected quickly, safely and easily, “yet can change a woman’s life 180 degrees.”

BREAKTHROUGH: PACS

In the field of Radiology, says Dr. Eugene Kennedy, Chairman of the Trinitas Radiology Department, significant advances tend to build off of breakthroughs “that happened a while ago, but just continue to expand and develop,” such as:

• Multi-detector Spiral CT, which has revolutionized not only how to perform a CT scan, but also what can be imaged, revolutionizing “how we image the body from head to toe.”
• Positron Emission Tomography (PET-CT), which advanced cancer imaging from solely anatomic to functional physiologic imaging.
• Magnetic Resonance Imaging (MRI), which as a technology has continued to expand in all areas of imaging, including neuroradiology, musculoskeletal radiology, women’s imaging and body imaging.

Pressed to choose one recent breakthrough, Dr. Kennedy says that the Picture Archiving and Communication System (PACS)—which he uses in his private practice—helps him to supply the best possible patient care. One of its sweeping innovations, he explains, is that “PACS images can be viewed simultaneously by numerous different individuals in diverse places.” This makes possible real-time consultations between radiologists and other MDs. 

ON THE HORIZON

A decade from now, we will be celebrating these five medical breakthroughs:

1 Vision Quest: Microchip implants will help the blind to see.

2 Organs to Go: Tissue engineering or regenerative medicine that will let scientists “grow” new organs. 

3 Rewired: Microchip technology, along with a matrix of fiber optic wires, will bridge damaged areas of the brain to cure a multitude of neurological conditions…and possibly even expand human brainpower.

4 Uplifting: Nanotechnology will be applied to a variety of age-reversing procedures.  

5 Heart Beats: Stem cells extracted from bone marrow will help new vessels grow to increase blood flow to the heart.

Wow factor in Westfield

By Mark Stewart

James and Tina Wissel’s single-story, three-bedroom, 4,000-square-foot home is not the only structure in Westfield that fits that general description. However, it is most definitely the only one of its kind. The Wissels designed their modern, single-story structure to take maximum advantage of their wooded, ¾-acre lot—pulling the outside in, and making the interior an open and inviting space for their family, friends and pets. They are living the dream few of us have the courage to pursue: a residence custom-built to accommodate their personal comfort, design sensibilities and family culture. 

The more time one spends in the Wissels’ home, which was completed in 2009, the more apparent it becomes that every detail, from the daring to the mundane, began with an original thought—hardly a shock, as James and Tina make their living as original thinkers. James’ father was a home-builder, and as far back as he can remember he was good at bringing ideas to life with his head and his hands. Tina’s mom and dad were clothing designers; function and form are coded into her DNA. James and Tina designed computer animation and editing systems in the 1990s. Today, they co-own Pure Couture, a thriving ready-to-wear fashion business.  

“We used our expertise and experience in design to create our home on a computer over the course of several months,” James explains. “From those drawings we made 3D scale models, and eventually these were translated into architectural plans.”

Their list of must-haves was extensive, Tina recalls. The majority of the space needed to integrate living areas—the kitchen, living room, dining room and family room—into a long, deep open design. 

“Our goal was to create space we’d use every day,” she says. “We didn’t want to end up with a dining room we use twice a year.”

The Wissels achieved this goal with 11-foot ceilings throughout the home, including three 11’ x 18’ glass walls, floor-to-ceiling mitered corner windows, and a kitchen nook featuring a curved glass window that offers a panoramic view of the oaks, maples and wildlife in their back yard. The kitchen features sleek stainless steel, with a sink and stovetop that can be covered to integrate with the rest of the appliance surfaces. The home’s ambiance is heightened by an interior waterfall that separates the living and bedroom areas, creating a natural sound barrier in the process. An exterior waterfall obscures the massive 42” x 11’ front door and creates a unique little entry alcove.

The home required the extensive use of steel; engineered lumber was used to create a spectacular unsupported 33-foot span.

“From what we first imagined, we achieved 85 to 90 percent of our initial vision,” James estimates, adding that although the goal of a designer is to marry form and function, sometimes one must be sacrificed for the other. “That’s how I come up with 85 to 90. We chose some details that are aesthetically pleasing but not very functional. However, in terms of what we wanted the house to be, we achieved.”

Which choices best met the form and function equation? Tina says the window walls work especially well. 

“They bring you closer to nature,” she explains. “We did a lot of landscaping before we built, and the way the outdoors pours in is breathtaking. I don’t think we fully appreciated the positive effect this would have on our children and pets when we were designing the house. The sunset, the moon, the hummingbirds—they’re out there free for everyone, but in other homes, you don’t always notice them. Here, they are at our fingertips.

Different smokes for different folks

By Mike Cohen

Most New Jerseyans live in “smoke-free” homes. That may change soon, but probably not the way you’d think. While the typical backyard cooking set-up includes a grill and possibly a barbecue, relatively few have incorporated a smoker. Smoked meats are nothing new, of course, but recently they are showing up on the menus of some of the region’s top restaurants. Chefs are paying top dollar for artisanal smoked meat, fish and poultry (and passing that cost along to their patrons); some have even assembled their own smoking operations on-site or nearby.

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So how hard can it be for an average homeowner to add a smoker to the mix? Unlike grills and barbecues, which are fairly simple to operate, smokers can be somewhat counterintuitive. Before burning rubber to Home Depot or Lowe’s to get your new gear, it’s important to understand and respect the process. Unlike grilling (which involves direct, high heat from start to finish) and barbecuing (lower temperature and longer cook time), smoking is essentially the process of “preserving” food with a low temperature while adding salt and smoke. The smoke infuses flavor, while the salt pulls water out of the meat.

HOT VS. COLD

Most of the smokers on the market are “hot” smokers. They operate at a temperature of 160° or higher and are aimed at backyard chefs who want their food done relatively quickly. This type of smoking doesn’t really preserve the meat, as there isn’t enough time for the moisture to be removed. The pros tend to go for “cold” smokers, which involve a little more pre-planning and patience. The results are well worth it.  

Cold smoking typically is a two-step process. Salt is added to remove excess moisture and then the food is subjected to a long, slow smoking process. It involves cooking below 86°F for up to 32 hours. The heat source is kept away from the product and the smoke is pipped in. Some of the newer smokers can be dialed down to work this way. Both methods of smoking brown the meat, as amino acids in the food interact with some reduced sugars to produce the desired color. To create that “smoke ring,” nitric oxide from burning wood combines with the myoglobin in the meat to penetrate a centimeter or so in from the surface. You won’t see a smoke ring if meat is cooked in an oven.

Smoking is more than just heat and smoke. There are essentials to consider, such as sugar and salt for curing and brining, which add just the right combinations of sweet, sour and bitter flavors to your meal.

Curing your protein before smoking helps remove moisture and stop the formation of harmful bacteria (that’s a good thing) and will also enhance the flavor (that’s a better thing).

Brining meat in a mixture of water, salt and perhaps spices and herbs, dramatically impacts the flavor profile. There are many rules about brining, but a simplistic rule is 1 hour of brining for every 2 pounds of product.

For those who have medical concerns about sodium, there is another option. You can salt your meat prior to smoking. A mix of salt and pepper, herbs, sugar and honey can be rubbed over your food anywhere from 2 to 24 hours beforehand (which needs to be removed before it goes in the smoker). The idea is to draw out the moisture without the BP bump. Whichever method you prefer, the purpose of salting is the same: less moisture actually allows for a better absorption of the smoky flavor.

Not to be excluded from the conversation is marinating. Mixing spices, oils, vinegars and even citrus to meals both flavors and tenderizes your final product. Some marinades work best before smoking, while others work best after smoking and right before eating. Meats do particularly well with marinades, which can be as simple as applying Worcestershire sauce just before smoking. Technically, dry rub is a type of marinade. This spice and salt mixture, worked into the food prior to cooking, seals in flavor and softens the texture. This is a tad more subtle and delicate than salting, so get a feel for your particular taste-bud tantalizers before rubbing this all over your Whole Foods purchase. Finally, just for the record, air-drying your meat is another option. This will surely impress your guests, but your neighbors may wonder what the heck you’re up to when they peek over the fence the day before.

KNOW YOUR SMOKER

Not everyone is ready to do battle on a basic-cable barbecue throwdown, so it’s good to know which smoker best suits your lifestyle and circumstance before handing over your credit card or clicking the BUY button. Compact, stainless steel electric smokers, for example, tend to be economical and fairly mobile. Two popular brands are Southern Country Smokers and Masterbuilt (immediate right). They can cook food fairly quickly if that’s a priority—say, if your Thanksgiving guests are waiting for that smoked turkey to hit the table.

Kettle smokers (aka hinged-lid cookers) are the ones you often encounter at home improvement and hardware stores. Weber makes a popular model I see everywhere. This type of smoker (far right) also can double as an oven for larger pieces of meat or poultry. This is your basic charcoal- or gas- fired smoker that uses wood chips to create the smoke. Soaking your chips, or a portion of your chips, prior to burning will produce a longer, slower burn time—a critical component to backyard smoking success. In this variety of smoker, consider placing a water tray alongside your meal to prevent your food from drying out.

One caveat is that kettle smokers are not good for guys I call “Larry the Lifter”—who can’t resist taking periodic peeks at the meat. Every time you open the lid, all the smoke that’s supposed to go into the food goes into the air. It adds about 10 minutes per lift to your cook time.

Cold smokers make up a wide-open category that includes everything from purchased products to funky homemade devices. Their advantage is that it enables you to smoke a large variety of meats at the same time, or accommodate large cuts, and food can be smoked subtly and over a long period of time, which allows the smoke to penetrate without overpowering. The ProQ from Mac’s BBQ (left) is a good model, as it allows you to set up a heat source that can be monitored by way of a built-in temperature gauge. It also doubles as a water smoker. Water smokers are ideal for lean products, such as rabbit or quail, as well as soft and delicate fish.

For those who need to get their smoke on 12 months a year, gas smokers are the way to go. They offer hot and cold smoking with racking and hanging capacity. Easy to move and carry, they can be placed anywhere in the backyard, as long as they are far enough away from objects that you don’t want to sacrifice to the barbecue gods. Make sure there is plenty of ventilation around all sides of the smoker. The propane unit from Camp Chef (above) is a popular example of a gas smoker. Its temperature gauge enables you to switch between hot or cold smoking by dialing in the right temperature. Another benefit is not having to worry about overcooking or drying out the food, as you can control this like an oven.

TOASTING THE CHEF

In the prophetic words of Eagles guitarist Joe Walsh, “The smoker you drink, the player you get.” I’m still not sure what he meant, but I can say with some authority that what you pair with smoked meats can dramatically enhance the experience. Chardonnays are quite the standard around backyard get-togethers, which is fine, but consider taking things a little farther. Get some advice on a barrel-aged gem from Napa or Sonoma that will match with the woody undertones of your meal—one that has a little malolactic fermentation will also add some buttery notes to soften the bitters of the smoke. Look for Far Niente, Cakebread, Frank Family and Neyers. Champagne-wise, the Blanc de Blancs are all chardonnay with the best coming from Cote des Blancs.

If you favor reds, resist the temptation to bring out the monster cab; with all the smoke in the air, the rich fruits may clash with your meal. Syrah from the Rhone Valley in France, with its characteristic pepper aroma leading you into the spice corridor is absolutely stunning with smoked meats. Think of JL Chave, Paul Jaboulet or Chapoutier for your selections. Washington State makes killer syrahs, even better than their cabernets, but don’t tell anyone— it’s the sommelier’s secret. Dunham Cellars, Gramercy Cellars, and Reininger come to mind as superb syrahs for your feast.

Zinfandel usually makes an appearance at most barbecue events and for good reason. Sweet raspberry with some spice hits the spot when taking down some smoke. Napa offers some real value, believe it or not. Consider Elyse, Summers and Chase as brands to trust without breaking the bank. Russian River and it’s cool climate seems to me to be the perfect spot for zin. Check out Williams Selyem or Joseph Swan.

Finally, if you have doctored up your smoky creation with a fiery rub and added some chilis to the wood, the great fill here is one of those fabulous sweet German Rieslings. Sugar puts out the fire, alcohol does not—it makes it worse—so do not grab that high alcohol content wine you think will pair power with power. Grab the good stuff from St. Urbans Hof or JJ Prum. 

INTO THE WOOD

Wood chips for the accomplished smoker are available just about everywhere. So too are wood pellets, but do your research as some pellets use binders, which is not good because binders can influence the food in a bad way. A safe way to ensure you are getting the good stuff?Go to your local lumber yard and ask for some sawdust. It’s cheap and effective. If you want to get adventurous:

Alder Wood Delicate and good for smoking fish—pork, poultry and game birds, too

Almond Sweet and nutty taste that goes with all meats

Apple Wood Sweet and fruity taste that works best with poultry, ham, beef and game

Cherry Wood Mild, sweet and very fruity—ideal for poultry, fish and ham

Grape Vines Aromatic and excellent with all meats

Hickory Best known and most widely distributed—very pungent and good for bacon and other dense meat products

Maple Wood Light and sweet taste, best for poultry and ham

Mesquite Expensive and also quite intense, as it burns very hot—best to mix with lighter woods as it can be a little bitter

Oak Strong flavor that’s good for longer smoking times, including brisket and thick cuts of meat

Walnut Heavy smoking wood that can often be mixed with other lighter woods—perfect with stronger red meats and game

SPICE, GIRL

Prepping your meat for smoking almost never requires a special trip to the grocery store. Most of these spices are already in your kitchen cabinet…

Allspice That nutmeg, cinnamon and clove aroma is perfect for brining and also for rubs

Aniseed Sublime with seafood and game meats

Basil Pungent and sweet—reserved for lamb, tomatoes and chicken

Bay Leaf Can be added to your smoking woods Caraway Peppery and perfect when making sausages

Cardamom Lemony and slightly bitter—perfect with salmon and brines

Chervil Fragrant and delicate, so use it with seafood and white meats only

Chili Add to your smoking chips—sparingly

Cilantro Sweet with some sandalwood notes and perfect with brines and rubs

Cumin Strong, so best in marinades

Dill Sharp, fragrant and sweet—where would our salmon be without it?

Fennel Anise flavor that is perfect with chicken and vegetables

Ginger Hot and pungent—works best with chicken and fish

Juniper Sweet and aromatic, ideal for brining veal

Lemongrass Mix it with your wood for seafood and white meats

Mint Refreshing when rubbed or brined with lamb and vegetables

Mustard Seed Use it whole in brines and rubs Oregano Spicy and sweet for seafood and light meats Paprika Sweet and peppery—produces a smoky taste

Rosemary Great to place atop the smoking wood or into brines

Sage Pungent and best with chicken, venison and mushrooms

Tarragon Very flavorful and palate-cleansing to mix with game and strong seafood

Thyme Perfect with lamb, beef, pork and sausage

BEER ME

Sometimes, that big slab of smoking beef deserves nothing less (or more) than a great beer. The rule of thumb is drink what you like, but if you are interested in tracking down some special suds, try Full Sail Session Black beer. Dark but deceptively light, with flavors of chocolate and roasted malts, it cuts through the fat like a hot knife through butter. With Texas-style brisket it is a jammer!

Got a leg of lamb going? Try Ommegang Abbey Ale from across the river in NYC. It’s high in alcohol but you won’t taste it, as the richness of the lamb will dumb it down. For all those fowl folks, a lighter quaff such as Saison Dupont from Belgium works. Its lively citrus and light carbonation with some pepper will clean your palate quite nicely, thank you.

Last but not least is pork, the stock in trade of all smokers and backyard grillers. Go with a smoky porter. Stone Brewery makes Stone Smoked Porter (right). A peat-smoked malt with the backbone you are looking for…along with a little coffee and chocolate!

By Christine Gibbs

Bright Ideas for the Kitchen

LOOKING SHARP
Edge of Belgravia’s architecturally inspired Precision Metal Knives were designed by artist Christian Bird. Available at designthis.com.

SQUARED AWAY
The Rice Cube creates perfect sushi without tricky mats or sticky rice, and also works to create healthy, bite-sized snacks and desserts. Available at thebigpitchtv.com.

CUTTING EDGE
The Brod & Taylor Knife Sharpener uses adjustable Austrian tungsten carbide steel to keep knives sharp without removing metal. Available at thebigpitchtv.com.

THREE FOR THE MONEY

PAN TASTIC
The dual-setting valve on the
handle of Kuhn Rikon Smart Lids traps steam or lets it escape for perfect pan-frying, steaming, braising, simmering and sautéing. Available at surlatable.com.

Intelligent Designs

SECOND THOUGHT
Electrodes inside the Wave Clock extract energy from the compound particles that reside in water to power this ingenious timepiece. Available at aliexpress.com.

I CUBELET
Cubelets are magnetic blocks that you snap together to make an endless variety of interactive robots, with no programming and no wires. Available at robotshop.com.

TWISTS & TURNS
The Perplexus Epic Ball Maze offers up
125 obstacles as you maneuver a steel ball along a narrow track for hours of 3D frustration and fun. Available at thingsisecretlywant.com.

LEAVE IT TO BEAVER
Rodrigo Torres designed Kastor’s chrome-plated zamak Pencil Sharpener in the shape of the ultimate wood-gnawing animal. Available at cheeseandwinestore.com.

IF YOU BUILD IT
EverBlock life-sized Modular Building Blocks can be used to create furniture, divide rooms and design unique shelving configurations. Available at everblocksystems.com.

Smart Apparel & Accessories

SHIRT OFF YOUR BACK
Whirlpool and Proctor & Gamble joined forces to create the Swash at-home cleaning device, which saves time, money and trips to the dry cleaner. Available at swash.com.

WHAT’S COOKING
Netatmo’s JUNE Sun Monitoring Bracelet measures sun exposure throughout the day and offers real-time sun-protection
advice on your smartphone. Available at blinq.com.

NO BRAINER
Yes, you need a high IQ to join Mensa…but at the end of the day, rocking a Mensa Logo T-Shirt may be the real genius move. Available at shirtmandude.com.

DULY NOTED
The Fiendish Beanie is outfitted with a powerful BE-LINK Bluetooth sound system that creates a personal surround-sound system. Available at touchofmodern.com.

ENERGY SOURCE
SOLZbags’ Solar-Powered Backpack functions as a personal portable power station for smartphones, tablets,
and anything rechargeable by USB. Available at solzshoes.com.

Cool & Clever

MOVIE NIGHT
Luckies of London’s build-it-yourself Smartphone Projector turns your small screen into a private screening. Available at amazon.com.

LET THERE BE LIGHT
BeOn Burglar Deterrent Lightbulbs “listen” for potential break-ins and turn themselves on to scare away intruders. Available at beonhome.com.

THERE’S A RUB
Breo’s easy-to-store-and-carry
iSEE 310 Eye Massager uses air pressure and infrared heat to
provide the ultimate eye massage experience. Available at aliexpress.com.

DASHBOARD PAL
The Mojio is a 3G+GPS automotive monitor that plugs into a car’s onboard diagnostic port and uses a suite of apps to empower and inform the driver. Available at moj.io.

EASY RIDER
The Rockochet rock and debris deflector works with any skateboard and is spring-loaded to move out of the way when performing tricks. Available at thebigpitchtv.com.

“Bulgogi jeongol, marinated beef cooked with a tangle of sweet potato noodles that mingle with mushrooms, tofu and vegetables, is a party in a pot.”

By Andy Clurfeld

Seoulville

45 West Main St., Somerville. Phone: 908.854.4100
Open Tuesday through Thursday from 11:30 a.m. to 9:30 p.m., Friday and Saturday from 11:30 a.m. to 10:30 p.m., and Sunday from noon to 9:30 p.m. Note: Seoulville takes a late afternoon break Tuesdays through Fridays and closes from 3 to 5 p.m. Closed Mondays. Major credit cards and reservations accepted. Prices: Appetizers: $6 to $15. Barbecue dishes: $23 to $29. Dolsot (rice bowls): $15 to $17. Soups: $13 to$17. Casseroles (jeongol): $35 to $38. Entrees: $14 to $32. BYOB.

Kimchi jjigae is the Statue of Liberty of soups, beckoning for generations to the tired, the poor of health, those huddled under quilts struggling to breathe free of wintertime colds and flus. It is potent of broth, fired as it is by spices seeping from fermented vegetables and long-simmered pork belly, and soothing of texture, with slices of tofu and slivers of tenderized cabbage, radishes and other roots turning up in every bite. Kimchi jjigae fortifies the ailing body as it restores the flailing soul. It’s a wonder of a dish, and Seoulville, a relative newcomer to Somerville’s ever-diversifying restaurant scene, nails it.

Seoulville is the result of a natural progression: In before-culinary-enlightenment times in Somerville (and many county-seat centers of New Jersey suburbia), you had your red-sauce Italian joints, your chow mein Chinese joints, your continental masquerading as classy (dress up and take out Aunt Gert for her birthday) or slumming (diners didn’t serve moussaka in those days), and little else. Then came the white sauce known as alfredo, Szechuan and something called “cuisine minceur,” or a lighter side of French cuisine that blew the lid off the butter-and-cream classics and made us feel virtuous and oh-so-nouvelle.

Photos courtesy of Brian Kim/Seoulville

Was it sushi that helped us shake off the shackles of the 1950s Germanic meat-and-potatoes diet? The advent of olive oil? The Eurail pass that allowed post-grads to travel and travel and eat and eat? All of that, for sure. During the course of a decade or two, Japanese, Mexican, Indian, Greek, Spanish, Portuguese, Mediterranean from many ports, island fare and, critically, strains of America’s own regional specialties, came to star on menus at everyday-style strip-mall restaurants throughout the Garden State.

Why it has taken more than a decade of the 21st century for Jerseyites to welcome Korea’s comfort foods to their backyards puzzles me. But after years of trekking to Fort Lee, Palisades Park and Edison, I’m grateful that Brian Kim and his parents Helen and Kenny were brave enough to bring Seoulville to at least one corner of New Jersey that lacked real-deal bibimbap.

Is there a food more comforting than this stew of a salad that flips crusty-topped baked mac-and-cheese on its fanny and actually weighs in as nutritious? Seoulville’s casserole of rice, beef (or chicken or tofu), slivers of mushrooms, carrots, spinach, daikon, a runny fried egg, a scattering of sprouts and, on the side, a cup of gochujang (a Korean chili paste embraced by millennials who spoon it on everything they eat while curled up on Klippan sofas) is filled with ingredients we know. Here, they’re re-assembled, cooked in a stone bowl that crisps some of the rice, and brightened by that smoky-hot-sweet-mysterious sauce it doesn’t take a prophet to forecast as the successor to salsa.

Brian Kim, the front-of-the-house man at Seoulville and the guy who truly wants to teach gochujang, kimchi jjigae and bibimbap to the uninitiated, is happy to guide you through the menu of classics tailored, in varying degrees, to American ways. Give a listen, give a try. You can eat your same-old any time.

For here, the chicken wings come glazed sweet and spicy—and that do-si-do of dolce and daring isn’t sticky and cloying, but invigorating to the meat. Which is the point. The seafood and scallion pajeon, a pancake that tilts in texture to an omelet crossed with a crepe, isn’t even a tad oily, allowing the shreds of shrimp and squid to take charge. My favorite starter is the fried tofu, batter-dipped cubes with taut, crisp crusts that squirt with milkiness. Eat a cube, with or without a brush of sweet soy glaze, then check out the banchan–small bowls of vegetables and condiments, including cubed radish, sliced cucumbers, pepper-licked potatoes, marinated mungbean sprouts–and enjoy the interplay.

Made for sharing, and worth the investment, is the Korean hot pot. Bulgogi jeongol, marinated beef cooked with a tangle of sweet potato noodles that mingle with mushrooms, tofu and vegetables in a broth that tastes meaty but is all about slow-cooking with shiitake mushrooms, is a party in a pot. Stir in a spoonful of gochujang; snag a leaf of lettuce from your bossam platter and pile some of the beef and vegetables inside, wrap and eat; mix some of your banchan with your bulgogi on a side plate. This food is all about customizing to your own tastes. Your own expanding tastes, I hope.

Speaking of bossam, Seoulville’s pork belly boiled in water scented (I suspect) with ginger and garlic, peppercorns and onion till super-tender—then seared and served with leeks and onions—is minimalist compared to some contemporary takes. But comforting it is, and if you ply it with the sauces and banchan, you’ll be well on your way to understanding not only how to eat Korean, but what you can do to charge up your own dining regime at home.

Grilled beef short ribs are a no-brainer to eat and love. Served on a hot plate, meant to be speared and fired and consumed without judgment, they’re one of Seoulville’s relatively shy dishes. So is the cod braised in a soy-based sauce and served with a splay of mild vegetables. It reminds me of a tame version of miso-glazed black cod, a dish made famous at Nobu—a dish that once seemed as foreign as, well, kimchi jjigae.

For weeks after that dinner, I thought of Seoulville. Its mission to serve as a bridge between mother country authentic and suburban Jersey educational did make me a little sad, however. I kept wishing the Kims didn’t feel that need to cotton to Western palates at all. But they are in it for the long haul, definitely wanting to take locals on a culinary trip. I stopped back with a friend, ostensibly for bowls of a couple of soups I’d missed, but really to see how the little place with the big heart was doing.

The room was nearly full at an early-dinner hour. I looked at the menu and chuckled. How could I not have ordered the famous “Hangover Soup,” arguably the most loved of Korean standards, my first time there? Its beefy broth, fortified with both soybean paste and red pepper paste and strewn with cabbage, sprouts and vegetables, might not have the infusion of jellied oxblood that the original must possess, but it scares my friend’s cold into submission. A seafood broth bolstered by that same spicy pepper seeps into soft tofu and infuses it with hints of shellfish, riffs of chilies; it makes for a soup I find magical.

Seoulville, a modest but pleasant storefront with subdued décor and the most welcoming of service, could be part of the natural progression of things culinary. It might just be what the good denizens of New Jersey had to work up to. But it’s also about a carefully orchestrated menu by the Kim family and a style of cooking that’s at once educational and experimental, yet purposefully easy to digest. We’re getting there.

BYOB

It’s possible my love for Korean food is fueled by its compatibility with wine. Specifically, gewurztraminer, the fruit-forward, spicy personality white wine that adores intensely seasoned foods—particularly ones plied with chilies. Bring to Seoulville your best gewurz, be it from Meyer-Fonne or Albert Boxler. In reds, consider an un-shy number from Spain, perhaps something from Rioja or the Ribera del Duero. Or a Priorat. You want something that allows its fruits and heft to be balanced by spice and a little earthiness; a high-alcohol, amped-up, resolutely “big” wine will be discordant with the nuances of seasoning in Seouville’s signature dishes.

The more summer camps change, the more one critical thing stays the same.

By Rachel Rutledge

No industry is recession-proof. However, through good times and bad, summer camps have proved to be one of the country’s most enduring businesses. More than 10 million children in the United States will attend some kind of camp this summer, a number that includes both day-campers and sleep-away campers. The majority of camps are actually run by non-profit organizations. Roughly one-fifth of the nation’s 12,000 camps are for-profit businesses. More than half of U.S. camps are overnight camps. When every last penny is counted, the summer camp industry is estimated to generate more than $15 billion a year. Someone’s doing something right.

That “something” hasn’t changed in a long, long time. For the vast majority of kids, summer camp represents the first real step toward self-reliance and independence. One could argue that this step is more important than ever, given that we now find ourselves in an age of unprecedented over-parenting. 

The job of a summer camp is to provide a safe and stimulating environment for children. In the old days, that often meant a squeaky bed, a leaky cabin, pimple-faced counselors, hiking, paddling, toasting marshmallows and providing a meal for mosquitos. In other words, the greatest time ever. Today, the goal is the same but the offerings are a bit more sophisticated. 

ONE SIZE DOES NOT FIT ALL

If you are the parent of a “veteran” summer camper, then you already know what’s out there in terms of choices. If you have yet to go the summer camp route, prepare yourself to be overwhelmed. While there are many hundreds of long-established, traditional sleep-away camps (both for-profit and by non-profit religious and youth organizations), the most dynamic sector of this market is represented by camps that cater to a child’s talents and interests. Name a focus or specialty, and it’s a stone-cold guarantee that a Google search will turn up pages of possibilities. Is your child a lacrosse prodigy? A budding zoologist? The next Steve Jobs? The next J.J. Abrams?The next Gordon Gecko? Matching a young person with his or her passion has never been easier.

To the old leaky-cabin camper, this might seem like overkill. And perhaps it is. But that’s missing the point of the summer camp experience, which is putting your children in a place where they can be themselves for the first time. 

Read that again and understand it because, whether it’s for a day, a week, a month or more, it is the #1 reason why you send your child to camp. And it always has been. When children are free of parental oversight, the prism through which they experience new things and interact with new people is different and genuine. They become socialized by their peers, not by mom and dad. 

Many camps tout character-development as one of their main selling points. Looking past the marketing pitch, there is a lot of truth to this assertion. Character isn’t based on what you do when your parents are watching; it’s what you do when they’re not watching. Also, part of building character involves teamwork and leadership, which are baked into just about every camp experience.  

www.istockphoto.com

PICKING A CAMP

With so many types, styles, locations and durations to choose from, the best way to find a good fit for your children is to identify camps that offer lots of activities based on their skills and interests. That means their interests, not yours. If you went to a traditional summer camp as a child, be aware that there is a natural tendency to be seduced by camps that you wish had existed 25 years ago. Your child isn’t you. You may be a 007 fanatic, but if your child is a soccer player, two weeks at Secret Agent Camp is probably a horrible idea (and vice versa). 

A couple more rookie mistakes to avoid are sending your child to the exact same camp you attended 30 years ago, and also sending your child to the same camp as an older sibling. Yes, we all know that girls-only poetry camp you went to back in the ’80s changed your life. However, your daughter may want to learn to build virtual reality programs this July. Iambic pentameter may not be her thing. And just because your older son improved his vertical leap by 6 inches at basketball camp, it doesn’t mean his younger brother needs to become Scottie Pippen to his Michael Jordan. 

Whatever experience you choose for your child, make sure to involve them as much as possible in the decision. Day camps can be time-consuming for a family and sleep-away camps financially challenging. Both can be emotionally stressful if you end up second-guessing your decision. But if everyone is on the same page, your first choice is likely to be the correct one.

www.istockphoto.com

SEPARATION ANXIETY

For families that have yet to embrace the sleep-away experience, long-term separation and the anxiety or homesickness that can result should be part of planning an extended summer camp stay. Even if your child loves blowing you off at every opportunity, that may not be the case on drop-off day with the prospect of limited contact for the next 2 or 4 or 6 weeks. Expect some tears; if not theirs, then yours (see KIDSICK? on page 71). Interestingly, separation anxiety actually refers to a disorder where individuals suffer excessive fear or distress when they are removed from people (and sometimes places) with whom they have a strong emotional attachment. Mostly it applies to children under the age of 4, and is part of the development process. But it can occur in older kids, as well as adults.

In camp-age children, some degree of separation anxiety is normal during the first day or two away. Clinically speaking, it must persist for at least 4 weeks before it is considered an actual disorder. Unfortunately, that’s the duration of many camp sessions!  For the small percentage of campers who do have this problem, it’s no fun. They can experience intense anxiety and suffer panic attacks. They might also complain of medical issues, such as persistent stomach pain or headaches. Rarely, however, does true separation anxiety suddenly emerge at camp. Typically, parents of children with separation anxiety are aware of the condition long before summer camps are even discussed, which means sleep-away camps are not a viable option.

Needless to say, all types of camps—from sports camps to military camps to science camps to language camps—are not only good at dealing with mild bouts of separation anxiety, but tend to be experts with the specific type of kids and families that sign up. Truth be told, in the vast majority of cases, the recipe for success is identical: 20 minutes after mixing with the other campers, kids start looking forward, not back, and aside from an occasional pang of homesickness they are good to go for the day, the week, the month or more.

Should you suspect that you are the parent of an anxious camper, the one thing to avoid in the months prior to drop-off day is discussing how worried you are that the child will be lonely or homesick. Sharing your concerns is not making things better, and will almost certainly make things worse. Also, remember that kids aren’t stupid. If you constantly tell them how much fun they are going to have, and how they won’t miss home for a minute, they’ll know something is up. The same goes for constantly saying how much you’ll miss them for the time they are away. 

www.istockphoto.com

TIMING IS EVERYTHING

We’ve all heard the stories about Type-A parents signing their kids up for private Pre-K when they’re still in the womb. Well, securing a spot for your child in your first-choice camp isn’t quite that bad, but if you are reading this story and the first day of spring is approaching, then the clock is ticking. In particular, traditional sleep-away camps tend to fill up quickly, as many families renew year after year. The more specialized sleep-away camps don’t get the same volume of repeat business, but open slots at the ones that market aggressively and are well-reviewed tend to disappear around this time of year.

A significant number of “resident” camps—sleep-away camps that like to make use of boarding school or college dorms—are built around one-week programs in sports, technology or creative and language arts. It is possible to program an entire summer of these short-duration camp stays for your child, usually with alternating weeks home and away. It’s a bit of a Rubik’s Cube to schedule (and not inexpensive) but from an enrichment standpoint it might be just what the doctor ordered, especially if you can’t find a 4- or 6-week camp that works for you.

Finally, don’t ignore day-camp opportunities that may exist close to home. Many of New Jersey’s private schools open their classrooms, gyms and playing fields to specialty camps during the summer as a way of generating extra income. Often, their best teachers (or coaches) either run or teach specific programs, so for the modest price of a day camp your child is exposed to high-powered educators doing what they love. 

KIDSICK?

Kidsickness may not be a real word, but it’s a real thing. Many are the moms who tumble into rudderless melancholy triggered by the temporary absence of their children. Grown men have been known to burst into tears the first time they wave goodbye to their young campers. That’s perfectly fine. Nothing to be embarrassed about. Just keep it to yourself. A hug, a kiss and a quick exit at drop-off make for an ideal send- off. Don’t freak out your kid. 

That being said, a certain percentage of parents really do find themselves suddenly and quite unexpectedly depressed and panicked—while their children are off having the time of their lives. According to the American Psychological Association, if you find yourself worried to the point of distraction while your child is off having fun in the woods somewhere, a session or two with a psychologist is a perfectly appropriate way to navigate your way through this new challenge.  If parental anxiety is a simple matter of not knowing what a child is doing, or fretting obsessively about their safety, or that they’re not having enough fun, then parents should do themselves a favor and pick a camp that posts photos every day.   

Editor’s Note: Each year in its first issue, EDGE writes about a different aspect of the summer camp experience. Log onto edgemagonline.com, click on the FAMILY tab and scroll backwards to find stories such as “Great…Outdoors” and “Extreme Summer.” 

How will Smart Technology change our lives?

By William Mehlman

Edgar Degas was dining at a friend’s home when the telephone—at that time a decided curiosity—rang. As his host finished his conversation and returned to the table, he asked Degas what he thought of the new device “So, that is the miraculous new thing?” the famous painter sneered. “The machine rings, and you run to talk to it?” 

Today’s “smart” technology gets a much warmer reception, although these products are frequently incomprehensible to many of us over the age of 50. My five-year-old solar-powered G-Shock watch, for example, has yet to be maximally programmed, because: (A) all I want to know is the correct Eastern Standard Time, (B) I can’t understand the manual, and (C) those buttons are so small.

amazon.com

Smart technology had its beginnings in products that, by today’s standards, are commonplace, if not actually antiquated. Mechanical adding machines gave way to electric calculators, which yielded to lightning-fast pocket calculators that provided, at their initial appearance, an astonishing array of functions. Today, every smart phone or smart watch can perform all of the standard math operations (ask Siri the square root of 200 or the cosine of 30 and you get your answer without even touching a button), —along with dozens of other functions. Familiar appliances are now performing unfamiliar tasks. For example, electronic ovens—which turned themselves off by means of a timer—are now being replaced by models that will shut themselves down when a probe reaches a predetermined internal temperature. 

Yet the truly remarkable inventions are not merely upgrades of existing technologies so much as purveyors of unimagined services. Laptops, tablets, cell phones?  Old hat. The smart technology that will soon be “everyday” includes quadcopters that are being built to allow same-hour deliveries from online retailers, and drones equipped with Go-Pro cameras, enabling humans to experience the thrill of flight without leaving the ground. Remember how Siri seemed unbelievable when it debuted in 2011? Now many consider Amazon’s Echo to be more versatile and accurate. Well, the next challenger may take us into the realm of social robotics. JIBO, an appealing little critter developed by Dr. Cynthia Breazeal of MIT, is billed as the “world’s first family robot.” JIBO is a member of the family, not just a search engine/database. It will answer questions, independently take photographs, provide audible versions of incoming texts, and act as a good-natured tutor. What it will not do (despite being called a robot) is heavy lifting. Or for that matter, any lifting—JIBO was not designed to do physical work of any kind. The projected sale price is in the $600 neighborhood, the cost of a high-end smartphone, or pair of designer shoes. 

Tesla Motors

SMARTER CARS

If you’ve gone car-shopping recently, you know that automobile manufacturers have been incorporating smart tech features with every new model. Many of these features already come as standard equipment on top-of-the-line models, including the dozens of microprocessors that control individual components and operate unseen by the driver. The Mercedes-Benz C-Class now incorporates Active Blind Spot Assist, which serves to alert the driver to unseen dangers, and will “intervene actively” to prevent an accident. MagneRide is a suspension system controlled by magneto-rheological dampers that adjust stiffness by sending an electric current through iron filings suspended in fluid shocks, and can react to road conditions in a few milliseconds. It is available in vehicles manufactured by Audi, Ferrari and General Motors.

And then, of course, there is the Tesla, an all-electric sedan that has a singular array of smart features, including door handles that open out as the driver approaches, a wildly modifiable seventeen-inch touch-screen video display, gull-wing doors and medical-grade HEPA air filters. These gizmos do not make the Tesla a nerdy, unattractive clunker; the design features are stunning, and the Model S can go from 0-60mph in 3 seconds—more than a second faster than a Porsche 911 Targa 4S.The big automotive project on the horizon is the driverless car, although there are still major bugs to be dealt with. Google’s self-driving vehicle was recently stopped by a California motorcycle officer who wanted to cite the driver for driving too slowly, but couldn’t find anyone to cite for the offense.

BUILDINGS & FOOD

The largest smart technology projects comprise entire buildings. These towers employ systems to reuse “graywater,” which includes all water other than sanitary waste, for use in flushing toilets, irrigation systems, heating and cooling operations and fire protection. These buildings may also have sophisticated security monitors, climate control, renewable energy from solar panels and windmills, and “green” roofs, which capture rainwater for reuse and, due to their heavily planted surfaces, help control the internal climate of the building.

On a smaller scale, many of the advances in smart technology have taken place in the kitchen. Borrowing from methodology employed in profes-sional kitchens, high-tech refrigerators can be programmed with recipes and lists of ingredients. As food is prepared, the software tracks expiration dates, computes the quantity of each ingredient used, and updates shopping lists and analyzes nutritional and caloric values. Further down the road, the smart features on their way to America’s kitchens are truly awe-inspiring. That explains why a past feature in this magazine entitled Kitchen 2020 (available in the HOME section at EdgeMagOnline.com) is one of the most-visited articles we’ve run. 

Advances in technology have made research and development cheaper, faster, and more precise. The result is smart technology popping up in some surprising places. For instance, garage workshop tinkerers can obtain hardware like Raspberry Pi and Arduino—small computers that can be used as plug-in components in new creations. Meanwhile, 3D printers, computer-controlled routers and multiple-axis waterjets (which can cut almost any non-ceramic material) will likely soon be available at your local Lowe’s or Home Depot.

WHIPPER SNAPPERS

The toy industry, for countless decades, has marketed two types of products: cool toys (kids want these) and educational toys (parents want their kids to have these). There have been a handful of crossover hits in recent years, but nothing like what’s in the pipeline. Artificial intelligence, voice recognition and adaptive learning technologies will be coming together soon to fuel a mind-blowing array of cool “smart toys.” CogniToys made a splash this year with its Smart Dinosaur, which is cool (Google the video) to watch. When some Apple-inspired engineer starts paying attention to this market, smart toys will also be cool to own, too. Another area of promise of smart toys is for children with special needs. 

Smart toys may not penetrate the market as quickly as parents want or expect. There will almost certainly be red flags thrown up by education and child-development experts. If a smart toy is doing the teaching, what does that make teachers? If a smart toy is storing all the facts, how are kids supposed to retain and synthesize information?

And if a smart toy becomes a child’s best friend, how will that boy or girl absorb crucial lessons in social interaction and be able to function as adults? 

So what’s the next big thing in smart technology? At this point, the Internet of Things (IOT) looks to be the new territory to be conquered. The IOT is a network connecting machinery, computers, tools, sensors, cloud-based information, rich analytics—in other words, pretty much anything and everything connected to the Internet. Google it. 

Global connectivity is the target for the engineers and scientists working on the Internet of Things. As artificial intelligence (AI) is woven into the mesh of the IOT, the resulting construct hopefully will be a rational solution to many of the world’s problems. Then again, technology sometimes turns out to be a double-edge sword. The combination of IOT and AI could be the beginning of smart technology’s absolute control over the human race, a la The Terminator or, worse, The Matrix.

Degas may have been onto something. 

Forget It

Inevitably, smart technology has a negative side effect, known as digital amnesia or digital obsolescence. This syndrome results from man’s ever-increasing reliance on digital equipment to store information that had always been held in the human memory. In effect, the “muscles” of the brain appear to atrophy as the cranial “hard drive” is employed with less frequency. Remember when you used to know all of the phone numbers of your close friends and family? If you’ve owned a smart phone for more than a year or two, you probably can’t recite half those numbers. Along similar lines, smart contraptions that perform functions traditionally performed by human hands are divorcing man from tactile knowledge and satisfaction. 

ED PROJECT ON SCHEDULE AND ON BUDGET 

The Williamson Street campus is busy with active construction and renovation in and around our Emergency Department. We’re in the middle of an $18 million project that will almost double the depart-ment’s size and capacity, create a dedicated diagnostic imaging suite, and feature areas for pediatric, geriatric and behavioral health patients. The result will be a bigger, better emergency department and improved patient comfort, privacy, and satisfaction. 

Construction is now complete on the imaging suite. Completion of the new ED waiting room and surgical sub-waiting room is expected very soon. Throughout April, ED operations will move from existing areas to these newly-built areas as Phase 1 reaches completion.

Phase 2 will be the construction of the ICU expansion, and creation of geriatric, behavioral health, and fast track/pediatric areas. By December, Phase 3 will begin on the cosmetic renovation to the existing ED. August 2017 is the projected date of completion.

Support of our donors has helped bring the vision of this major project to reality. Thanks to generous individuals, companies, foundations, and Trinitas physicians and staff, we are well past the halfway mark to our multi-million dollar goal. 

Why not join our donor family in supporting our Emergency Department expansion and renovation that will help us continue to bring superior healthcare to our community. Please contact Nadine Brechner at nbrechner@trinitas.org or Rob Eccles at reccles@trinitas.org, or call the Trinitas Health Foundation directly at 908 994-8249. 

GATHER WITH US  FOR OUR ANNUAL GALA! 

You can be part of a night to remember!  Join enthusiastic supporters of Trinitas at the Trinitas Health Foundation’s 2016 Gala on Thursday, May 12. The theme of this year’s event Rising to the Challenge.

Mortimer Gershman, benefactor of the Health Foundation and long-time member of the Foundation Board, will be posthumously honored with the Foundation’s Celebrating Philanthropy Award. His wife, Jacqueline, will accept his award.

The excitement of the Gala returns for a fifth year to The Venetian in Garfield, New Jersey, where the breath-taking ambiance of the venue is rivaled only by the extraordinary food, drink and socializing. The Infernos Band, the area’s premier live performance group, will perform music throughout the evening. The dynamic group boasts Richie Rosato, former lead singer of The Duprees, and Kenny Simmons, former member of The Commodores.  

During a full cocktail hour, guests can meet and mingle as they view a distinctive array of extremely desirable items up for bid at the Silent Auction including trips and one-of-a-kind experiences. Take your chance on a 50/50 raffle, another way you can contribute funds that will benefit Trinitas patients.

For information about attending the Gala or opportunities for sponsorship, contact Laura Ciraco at lciraco@trinitas.org or call 908 994-8249 or go to www.trinitasrmc.org/foundation.htm and click on the Gala invite. 

WINGS OVER TRINITAS 

The United Adventure Bear program, a community outreach program of United Airlines, winged its way to Trinitas and the Trinitas Comprehensive Cancer Center to distribute the plush bears to Trinitas patients.  Complete with their own Passports, the bears brought smiles to patients like Jose Velasco as United employees Estella Ventura and Christopher Bowers presented him with a bear that brightened his day. The Trinitas Health Foundation hosted the visit of United employees and shared information about Trinitas’ strengths as a community hospital boasting 10 Centers of Excellence.   

Schizophrenia Game-Changer? 

A team of researchers from Broad Institute, Harvard Medical School and Boston Children’s Hospital has identified a molecular process in the brain that helps to trigger schizophrenia. It may reveal what goes wrong in a young person diagnosed with the disease. “Research has identified several genes associated with schizophrenia,” says

Mona Ismail, MD
Medical Director Child Partial Hospital Program 908.994.7028

Mona S. Ismail, MD, Medical Director of Trinitas’s Child Partial Hospital Program. “But, until this study, we needed to know their mechanism of action that leads to the manifestation in young adults.” The landmark discovery, published in the February edition of Nature, could be a game-changer, given the emphasis on early detection and new treatments for schizophrenia. Dr. Steven Hyman of MIT, a former director of the National Institute of Mental Health (NIMH) says he is “almost giddy about these findings.” The process identified in the study shows that the risk of schizophrenia is dramatically increased if a young person has inherited variants of a gene important to synaptic pruning, the healthy reduction during adolescence of brain-cell connections that are no longer needed. What neurologists find especially exciting is that this discovery helps makes sense of a lot of other observations about the disease, which affects more than 25 million people around the world. “The question now is, ‘How can we use this information to alter this disease process?’” Dr. Ismail adds. “If we can interrupt it, then we might be looking at a possible cure rather than a lifetime of prescriptions for symptom management, at best. I think with the advancements of genetic and molecular science we are getting there.”

The Health Benefits of Equal Pay 

Researchers across the river at Columbia University recently looked at data on 22,000 working adults between the ages of 30 and 65 hoping to understand why women are more likely to suffer from depression and anxiety than men. What they found was that women who make less than men with similar levels of education and experience were four times more likely to develop an anxiety disorder, and 2.5 times more likely to suffer from depression. Those gaps all but disappeared, however, among women who made the same or more money than their male counterparts. The gender wage gap—when added to the added responsibility for childcare and housework—produces feelings of inequality, unfairness and insecurity that seem to account for the prevalence of anxiety and depression. “Primary care physicians don’t typically discuss wages or income with patients,” says

Vasyl Pidkaminetskiy, MD Trinitas Physicians Practice 732.499.9160

Vasyl Pidkaminetskiy, MD, of Trinitas Physicians Practice in Rahway. “They may touch on general job and family stress, and focus on symptoms and family history as part of making a diagnosis of depression. Since this study points to inequality in pay as it contributes to the rates of depression among women, that is something we as primary care physicians should include in our conversations with patients in the future.”

Screen Strain: It’s a Thing 

Multi-taskers be warned: The Vision Council released a report in January after surveying 10,000 people who spend a large portion of their day in front of a computer screen. The survey revealed that people who use multiple devices (e.g. tablet, e-reader, smart phone, smart watch) at the same time experience eye strain, and neck, back and shoulder pain more than users of one device. People in their 20s are most at risk, as they are the most likely to use multiple devices. More than 70 percent of the people in the survey reported these symptoms. Overall, about 60 percent of us use electronic devices for five or more hours a day. The good news is that digital eye strain is almost always a temporary problem. It is caused by the tiny muscles in the eye being overworked focusing on objects close to the face, or adjusting to differing levels of illumination.

Small Wonder 

One of the major obstacles in treating lung disease has been getting medicine to tough-to-reach parts of the respiratory system. A joint project between Malaysian scientists and Harvard University School of Public Health researchers is seeking a safe and effective way to overcome this obstacle through the development of “smart” nanoparticles that are even smaller than the particles produced by the fine sprays and mists used by lung cancer and COPD patients today. Nanotechnology is the manipulation of matter at a molecular scale, up to 100 nanometers. A nanometer is one billionth of a meter.

Vipin Garg, MD
Director, Trinitas Comprehensive Sleep Disorders Center 908.994.8880

Dr. Vipin Garg, a board-certified physician in pulmonology at Trinitas, is intrigued by this idea. “Those of us who treat patients with obstructive airway diseases like COPD and asthma increasingly realize the important role that smaller airways play in these diseases,” he says. “Our experience shows that newer inhalers with particles reaching the smaller airways have improved management of these diseases.” Currently about 10 percent of deaths are caused by irreversible obstruction of the airway.

What You Don’t Know Can Hurt You 

Urinary Tract Infections (UTIs) account for more than 8 million doctor visits a year in the U.S., generating $1.6 billion in health costs. They are also the second-greatest reason why doctors prescribe antibiotics to women. Yet as two recent studies show, women know surprisingly little about UTIs. For example, only 13 percent of women 18 to 45 knew that sexual activity is a primary cause of bladder infection, and were unaware of the basic precautions that can prevent it. Thirty-nine percent of women assumed that UTIs go away if they do nothing. The fact is that if UTIs are left untreated they can lead to kidney infections, kidney stones or even kidney failure. 

Gene-Editing Breakthrough 

A team of scientists at the University of Texas Southwestern Medical Center has used a new gene-editing technique to halt the progression of Duchenne muscular dystrophy in mice. Duchenne is a rare disorder caused by a mutation in the protein dystrophin. It results in muscle degeneration and premature death. The mutation is carried on the X chromosome. It can be carried by males and females, but strikes boys, usually around age 2 or 3. If the technique is successfully scaled up, it will be the first to eliminate the cause of the disease as opposed to just diminishing its effects. The UT team published its findings in Science.

Mind & Body Connection 

You learn something new every day. For centuries it had been widely accepted in medicine that the brain did not have a direct connection to the immune system. An NIH-funded study completed by University of Virginia researchers in 2015 proved otherwise, as malfunctions in these vessels were shown to contribute to certain neurological diseases, including Alzheimer’s and autism. Abnormal immune activity had been associated with psychiatric conditions in the past, but the UVA study showed evidence of direct links.

No matter the variables, treating patients like family is part of the Trinitas equation. 

By Erik Slagle

When Martin Mintz went into cardiac arrest on September 30th, 2015, he was far from home and the hospitals he was familiar with. A 95-year-old resident of Brooklyn, Martin was visiting family in Elizabeth when the heart attack occurred. The responding paramedics administered the “Code Frosty” protocol—induced hypothermia that preserves brain function in patients following cardiac arrest—and rushed him to Trinitas. There, says his daughter Selena, he experienced a level of care and compassion that met or exceeded that of the most prestigious New York medical centers, making his stay in an unfamiliar hospital a little easier.

Martin, a Holocaust survivor, spent five years in a concentration camp in Poland. The Jewish faith is an indomitable trait of the Mintz family, and at a time of crisis they were able to find some solace in the hospital’s Bikur Cholim Room. Bikur Cholim is the Hebrew phrase for “visiting the sick,” and Martin’s family was impressed that Trinitas, a Catholic hospital, makes this accommodation available for Jewish families in need of support and a place to come together in prayer.

Beyond the spiritual support, Selena says the medical care her father received was equally outstanding.  “The doctors were thorough, attentive and caring,” she says. “The nursing staff was very helpful and calm as they went about their work. They made sure all the patients were comfortable. One of the nurses even offered to work with my father on her day off because she was so concerned about him.  Our family was so very impressed with the whole staff.”

Several of her father’s doctors, adds Selena, stand out for reasons that went beyond just their medical expertise. Dr. Maria Khazai of the Nephrology Department told her, “I’m taking care of him like that is my father in the bed.”  Selena appreciated the candor of cardiovascular specialist Dr. Mehrewan Joshi in assessing Martin’s condition. Along with Drs. Arthur Millman, Clark Scherer, Ying Tao, and Michael Chen—and ICU Director Dr. Michael Brescia—they formed

a team of constant support. Selena also singles out Dr. Leon Pirak for the attention and assistance he provided during Martin’s care.

“Dr. Pirak was simply unbelievable,” she says. “He oversaw everything and ensured that our family always got answers to our questions, and were always fully aware of what was happening.  We were able to discuss everything with him and make sure all aspects of my father’s care were being addressed. Everyone here is an advocate for family members—they constantly check to see how they are doing, if there’s anything they need, down to little details like a cup of coffee to pick someone up. Everyone we came into contact with at Trinitas was simply wonderful.”

Martin passed away later that autumn, but Selena says it was a comfort knowing he was so well cared for in his final days. The doctors, nurses and staff at Trinitas made every effort to give care—“beyond what we had seen when my father was admitted to other hospitals in Brooklyn and New York City.” 

“My father was treated with great dignity and humanity,” she says. “We’re very grateful to Trinitas for the way he was tended to and the care he was given.” 

Spring initiative highlights organ donation.

By Caleb MacLean

On any given day, more than 120,000 people in America are waiting for an organ transplant. On average, 22 people a day die for lack of a donated organ. There are currently more than 5,000 New Jerseyans on various transplant lists. How this precious material gets from donors to recipients is a mystery to most people. That is where groups like NJ Sharing Network come in.   

NJ Sharing Network is a non-profit, federally designated organ procurement organization. It was formed three decades ago at about the same time the government passed legislation that required hospitals to present the option of donation to families of potential donors. Since then, organ donation has quadrupled in New Jersey, saving, extending or restoring countless thousands of lives. NJ Sharing Network coordinates the efforts of hospitals, transplant centers, medical examiners and funeral directors, as well as increasing public awareness through education and media outreach. The organization will be particularly busy this April, during National Donate Life Month. Schools, community groups, businesses, elected officials and, of course, hospitals around the country will be demonstrating their support of organ and tissue donation, and encouraging people to start talking about what they would do if a family member becomes a candidate for donation.

“Everyone needs to have the conversation with their family members about what they would do if they could give the gift of life,” says Jackie Lue Raia, Assistant Director of Resource Development for NJ Sharing Network. “The idea behind National Donate Life Month is to get the community talking about organ and tissue donation.”

In New Jersey, most people are exposed to the concept of donation through the Motor Vehicles donor registry; 34 percent say yes to donation on their driver’s licenses. However, at bedside, that number soars to more than 60 percent, which means there is room for immediate improvement. The need for greater participation is magnified by the fact that less than 1 percent of deaths can actually give the gift of life. A person must be in a hospital, on a ventilator—typically as the result of a stroke, heart attack, aneurysm or auto accident with a traumatic brain injury. 

Last year, NJ Sharing Network facilitated 531 transplants. According to Lue Raia, that made it the “best year ever.”

NJ Sharing Network operates a fully accredited, state-of-the-art transplant lab, which performs compatibility testing between donors and recipients, and also pre- and post-transplant evaluations—a critical component in assuring the success of transplants for hard-to-treat individuals. The lab handles compatibility determination for a number of regional hospitals, including Trinitas. The organization also has a Family Services division for donor families. 

According to Mary McTigue, RN, the VP of Patient Care Services at Trinitas, as well as Chief Nursing Officer, the professional relationship between the hospital and the Sharing Network is very strong. “Both staffs always work in close collaboration to ensure a caring and compassionate approach towards potential donors and their families,” she says. “The skill and expertise of the staff recognizes the sensitive needs of a potential donor family, as well as the drive for a successful outcome for the potential organ recipient.”

The engine that powers NJ Sharing Network is its robust corps of volunteers (above). They handle the outreach initiatives that educate the public about donation and transplantation by participating in events or civic groups, businesses, community centers and houses of worship. 

“If the community is more open to talking and being proactive, we would be able to save more lives,” says Lue Raia. “Particularly in the area of tissue donation, which encompasses procedures including bone grafts, ACL and rotator cuff repairs and breast reconstruction. Volunteers can speak at pubic events, facilitate programs at worksites, or work at hospitals. Each is highly trained and vetted, with a thorough background check. Anywhere we send our ambassadors, you’re getting the best of the best.”

What do NJ Sharing Network volunteers have in common?Most have a personal connection to the organization. Jackie Lue Raia herself was a “donor daughter.” Six years ago, she was driving back from Newark Liberty Airport with her mother and son when a tractor-trailer slammed into their car on the New Jersey Turnpike. Her mother suffered fatal injuries in the crash. Her organs and tissues ended up going to 43 people. Two years later, Lue Raia decided to meet the two kidney recipients (right). One was the same age as she was, the other the same age as her mom. Soon after, she noticed a job opening at NJ Sharing Network. Needless to say, her experience with organ and tissue donation has proved invaluable.

“In part because my mother had not made the decision to be an organ donor,” she explains. “We’d never had that conversation. The clock was running out and the siblings had to make a decision. That was my first encounter with NJ Sharing Network. A volunteer met with us and convinced us that this was something my mother would want to do.”  

Editor’s Note: On June 5 in New Providence, NJ Sharing Network is sponsoring a USATF certified 5K race. For more information on this event call (908) 514–1761. For info on NJ Sharing Network itself, log onto njsharingnetwork.org or call (800) 742–7365. Promotional materials and kits for National Donate Life Month can be downloaded from the web site.

Tales from the front lines of New Jersey’s heroin epidemic.

By Mark Stewart 

Welcome to Heroin Town. That eye-catching headline ran last December on the NJ.com web site. The story posited that, if one were to take all of New Jersey’s heroin addicts and put them in one place, the population would work out to about 128,000 people—making it the fourth-largest city in the state. The scope of the heroin problem in New Jersey has grown over the last decade, claiming 5,000 victims and ruining the lives of countless hundreds of thousands since the mid-2000s. The optics of heroin addiction have changed, as well. It’s now someone you know, someone you work with. Maybe it’s someone teaching your kids. Or maybe it is your kid.  

Or, possibly, it’s you.

Michele Eichorn, Addiction Therapist

According to Michele Eichorn (left), an addiction therapist who runs the Hospitalwide Screening for Substance Use Disorders project for Trinitas Regional Medical Center, the Hollywood version of the zonked-out junkie in an abandoned building or trash-strewn alleyway is not what heroin addiction looks like anymore. 

“The face of addiction has changed,” she says. “Now everybody knows someone with a heroin problem. Chances are, you have a neighbor or a friend or a co-worker or a family member with a drug addiction. It could be that sweet cheerleader who was a friend of your daughter’s 15 years ago. Now she’s hooked on painkillers, or worse. More than ever, this is a problem that’s in people’s backyards.”

Eichorn offers the example of a woman she calls Jane. Jane is a 40-something well-adjusted woman with a college degree, solid work history and a family. Jane was in a motor vehicle accident and had terrible pain. She was put on pain medication, which affected her performance at work. Eventually, she was laid off from her job, lost her insurance and could no longer afford the medication. So she started using heroin because it was the only thing she could afford that made the pain bearable. 

“That’s actually a case that happened here and it was heartbreaking,” Eichorn says.

www.istockphoto.com

IT ALL BEGINS WITH PAIN

Heroin addiction stretches across the full socioeconomic spectrum. It’s a problem in the inner city, to be sure, but its impact is felt in small working-class towns and sprawling suburbs, too. Addiction doesn’t discriminate, it’s not particularly picky and it almost always begins with physical pain. A twist, a tear, a sprain, a strain. An operation. A work accident. A car accident. A prescription for 30 Oxycontin—enough to help manage the discomfort, enough to get a patient over the hump. 

However, when the little orange container runs out and reality sets in, we really miss those pills. Some of us a lot more than others. How one deals with that need can alter the course of a life, a family, a career. 

The first call is typically to the doctor to renew the prescription. Most physicians have become hyper-aware of the addiction risks, and also that they are at the fulcrum of a growing problem. A Los Angeles doctor was recently convicted of murder and sentenced to 30 years after three of her patients overdosed. No physician wants to swap a lab coat for an orange jumpsuit. So they prudently move patients to a less-addictive option. Alas, the warm, fuzzy high isn’t there and sometimes those patients look for pills in other places. On the street, of course, there’s no copay plan. Each pill costs $25 or more. For someone accustomed to gobbling a half-dozen a day, that works out to thousands a month. Some stick with that model until their bank accounts and 401k’s are drained. Or until the shut-off notices start piling up. Others sell their possesions, however and wherever they can. In the end, though, addiction usually boils down to a matter of dollars and cents: How can I achieve my next high for as little as possible? It’s all about today. Tomorrow matters less and less the deeper a person tumbles into addiction.

This is where heroin typically enters the picture. Oxycontin and other prescription opioids are basically pharmaceutical spins on heroin. Heroin may not be as neat or as clean or as “safe” as pills, but with heroin an addict can stay afloat all day for the same cost as a single street-purchased Oxy. And heroin is available everywhere. Take a look at your local police blotter and see where the arrests are taking place. In office buildings. At shopping malls. Outside convenience stores and fast-food joints. The places you already go every day.

A VORACIOUS ANIMAL

Sadly, people overdose and die from painkillers every day. It is a growing problem. Heroin, however, is an entirely different animal, and lately it’s been voracious. According to the Centers for Disease Control and Prevention, since 2010 overdose deaths among heroin users have tripled in the United States. About 1 in 50 addicts will die of an overdose. In New Jersey, the problem is far worse—at least three times worse, in fact. This year, heroin overdoses will kill more New Jerseyans than automobile accidents, homicide, suicide or AIDS. What that number will be—700, 800, 1,000, more—is anyone’s guess. But it will be a big number.

Michele Eichorn, Addiction Therapist

What is being done about this problem? First off, it’s not really a law enforcement issue. Heroin is so widely available in New Jersey that arresting dealers is like playing a carnival Whack-a-Mole game. Smash one down and another pops up immediately. Doctors have become more vigilant about over-prescribing and monitoring their patients’ use/abuse of painkillers, which certainly can stop a problem before it starts. However, there is some thought that closing down pill mills and, in general, being more judicious about refilling prescriptions simply drives more people underground for their drugs, and ultimately into the arms of a heroin dealer. Also, in terms of the overdose epidemic, the availability of the life-saving drug Naloxone may actually embolden heroin users, who regard it as a sort of get-out-of-jail-free card, often with deadly results.

So we are left to deal with addiction in emergency rooms, in rehabilitation facilities, in jails and in the morgue. 

ON THE FRONT LINES

Trinitas has been a leader in the field of treating addiction, initially with its Substance Abuse Services Department and, beginning in 2014, with its Hospitalwide Screening for Substance Use Disorders project. Now every adult patient who is medically admitted to the hospital—regardless of how they present—sits down with a nurse and has a conversation about alcohol and drug use, during which an Alcohol Use Disorders Identification Test (AUDIT) is administered and scored on a scale of 1 to 10. Some of these patients arrive at Trinitas through the ER with drug- or alcohol-related injuries, while others come to the hospital for scheduled procedures, such as removal of a gall bladder or foot surgery. Regardless of what brings them to Trinitas, when patients score an 8, 9 or 10, Michele Eichorn’s team is called in.

“At that point, we do a brief intervention using a technique called motivational interviewing,” she explains. “We have an honest conversation with the patient and really listen. If the person is agreeable, we’ll refer them to treatment and come up with a plan quickly, usually within a matter of hours, or at most a couple of days. It’s a very short window. And in order to ensure that people really are getting to treatment, we have a team of people—an addiction specialist who encourages them, a case manager who conducts outreach and helps people get into programs, and a therapist who is available to work with the individuals.”

Eichorn, who holds a masters degree in Social Work from Columbia University, initially became interested in the field of substance abuse while serving in the Army. She worked with veterans’ drug and alcohol issues and later did an internship at the National Institute of Addiction and Substance Abuse. Eichorn’s research showed that substance abuse as a whole was growing. She saw a challenge and wanted to be on the front lines. When she first arrived at Trinitas, she ran a program for drug-addicted mothers and pregnant women.

During the two short years the Hospitalwide Screening for Substance Use Disorders project has been up and running, between seven and 14 patients a month have been plucked out of the patient population and placed into drug or alcohol treatment. In the years prior, less than two percent of the patients for whom Trinitas counselors recommended treatment actually went. The project has already established itself as a difference-maker, Eichorn believes. 

50–50

On the drug-addiction front, perhaps the most eye-opening number to come out of the Trinitas project is the breakout of alcoholism referrals vs. drug referrals: “What we noticed immediately was that, among the patients our team saw, there was a 50-50 split between chronic alcoholism and serious drug addiction,” Eichorn says. “That includes heroin and other opioids, medications like Xanax, and so-called club drugs. A number of people fell into both groups.”

While the Hospitalwide Screening for Substance Use Disorders project can help heroin users get into the in-patient rehab programs they need, the lack of detox beds available can mean addicts may have to wait two months to start. That delay often has tragic consequences.

“The demand for treatment has increased so much that now folks are literally dying on the waiting list,” Eichorn confirms. “The problem we face is related to the availability of heroin. People are overdosing while they are waiting to get into programs. We know we may only have one shot to engage these people and get them into treatment.”

What stands out the most among the heroin users she sees?

“I’m a therapist so that’s what I can talk about,” Eichorn says. “What I will say is that many patients report that they have trauma in their background. And they have never been part of what we think of as ‘heroin culture’—communities where people are just hanging out and drugs are rampant. A lot of the individuals we see just don’t fit that profile at all. Something unfortunate happened and suddenly they are in this terrible, heartbreaking situation.”  EDGE

Editor’s Note: The Hospitalwide Screening for Substance Use Disorders project is funded by Medicaid’s Delivery System Reform Incentive Payment (DSRIP) program. Michele Eichorn LCSW, LCADC was a recipient of the 2015 Lester Z. Lieberman Award for Humanism in Healthcare from the Healthcare Foundation of New Jersey. She says if she could change two things about the current substance-abuse landscape it would be to make therapy services more readily available to a larger percentage of people, and to reduce the stigma attached to seeking help for substance abuse. “Rather than dealing with people in desperate situations, we could be dealing with them much earlier.”

A look ahead. 

By Christine Gibbs

Over a lifetime, the average person will probably spend close to 20,000 hours in the bathroom. If you bother doing the math it comes out to almost an hour a day. When weighed against the time spent, say, in bed, it pales in comparison. However, what you do in the bathroom you couldn’t (or hopefully wouldn’t) do anywhere else. Which is why the bathroom gets a lot of attention but not always a lot of respect. In recent years—thanks largely to home buying and home improvement “reality” shows—Americans have started looking at their bathrooms with a more critical and creative eye…and wondering what the future might bring to that most intimate room in the house

First a little history. Humankind has made commendable progress when it comes to taking care of our business.

Black Book Archives

Though some would say we still regard the world as our toilet, the truth is that people have been thinking and rethinking the john for thousands of years. Historians have traced commodes to the Indus Valley civilization some 5,000 years ago, while some experts believe primitive toilets date back 7,000 years earlier than that. Leave it to the ever ingenious and pragmatic Romans to install the first pay toilets in Rome, in 74 AD. The first flush toilet was a royal one, installed for Queen Elizabeth I by Sir John (the original “john”) Harrington, in 1596. And, yes, the modern toilet really was designed by Thomas Crapper (left), in the late 19th century

In the 21st century, the trend has been toward transforming the bathroom from a traditionally functional space into an opulent retreat that more closely resembles a high-end spa than a place for personal hygiene. Indeed, the bathroom label itself may be going the way of quaint terms like powder room, water closet and loo. Today’s bathroom is morphing into a sort of sanctuary that could conceivably rival the kitchen as the most expensive room in the house. Above and beyond the soaring cost of fixtures and finishes, bathrooms today overflow with gym-quality treadmills, touch-screen televisions, surround sound equipment, and other high-tech digital paraphernalia.

www.istockphoto.com

The Cost of Fine Bathing

Whether designing a new bathroom or renovating an old standard, cost is always a bottom-line factor, and the typical bathroom project is never cheap. Why? Five-figure invoices often are a result of the fact that renovating or adding a bathroom involves plumbing, electrical and tile work that needs to be done by talented and experienced professionals. The guy who shows up on a Saturday afternoon to unclog your drain is not necessarily someone you want to trust with a more elaborate project. Furthermore, today’s new bathroom will have more equipment, more appliances, and more leisure-time gadgets per square foot than any other room in the house. An ambitious “reno” or a new build can eat up as much as 10% of a home’s estimated value, especially if you do not budget wisely

www.istockphoto.com

Is it worth the time, money and trouble? US News & World Report actually ran a story a year ago that estimated the return on investment for a gold-standard bathroom. First of all, that should tell you something about who can afford such a project. Second of all, the numbers are good but not great: sellers can expect, on average, to recoup about 70% of their investment upon resale. That’s more than 2 percent higher than the average kitchen remodel. Of course, most experts agree that a high-end kitchen and master bedroom with master bath is almost guaranteed to sell a house faster and at a better price (in some markets, the ROI can be as much as 90 to 100 percent), so it’s not an either/or decision. And updating one bathroom may not be enough.

“Homeowners are seeking a balance among all the bathrooms in the house,” says Elisabeth Woomer, Showroom Manager at General Plumbing Supply in Green Brook, NJ. “Everyone looks to economize, whether it’s a renovation or a new build—economizing more on the family bathroom down the hall, while splurging on the private en suite master bathroom

Costs are often dependent on geographical location and can range from as little as $12,000 to $15,000 in hard costs for a standard hall bathroom (not to include labor) to as much as $50, 000 to $80,000 for an all-out luxury master bath, she adds. “We find out what the client is passionate about and then lead them to the best options that satisfy their passions…without breaking their budgets.”

Although New Jersey tends to be a more expensive state in terms of labor and materials, those numbers are right in line with national averages. The National Kitchen and Bath Association annually publishes its Bathroom Planning Guidelines, developed by a committee of experts who analyze statistics, lifestyles, trends and building codes to present recommendations that “promote the health, safety, and welfare of consumers.” In a recent NKBA survey, 50 percent of responding members confirmed the cost for a bathroom ranged between $10,000 and $29,000, while 31 percent said their average price was higher than $30,000

www.istockphoto.com

To Remodel or Not to Remodel…

That is the question. Given the considerable cost of turning an old bathroom into a modern miracle, when should you finally decide to take the proverbial plunge? First, take a look in the mirror. Is it part of a creaky medicine cabinet over a pedestal sink? Now look down. Is that dingy linoleum or, worse, pastel tile that matches the toilet and sink? You may be able to kid yourself into thinking your bathroom is hip and retro, but you won’t be kidding anyone else. It’s old. 

The mistake some homeowners make at this point is to embrace a bathroom trend that’s already on the way out. A little homework is required here and, needless to say, opinions differ from expert to expert. But a quick look at interior design magazines and web sites can give you a sense of what’s in and what’s out. The Coastal Cottage motif? Out. Clean and contemporary with a touch of traditional is in. Bowl-shaped sinks sitting in the vanity? Out. Under-mounted sinks in leggy cabinets are in. Granite tops?Out. Quartz is the current choice for baths (as well as kitchens). Clean, white tile? Boring. Out. Daring, moody designs are in. That being said, with the current emphasis on clean lines, geometric shapes, and minimalist color schemes, a few small touches can make a big statement:

• Skip the “pop” of color and limit even accessories like bath towels to white or gray tones.
• Spring for a freestanding tub that you can strategically place within the bathroom to take full advantage of Feng Shui principles.
• If space is at a premium, consider placing the tub inside a walk-in, no-threshold shower.
• Showcase quartz and wood elements (yes, there are waterproof wood tubs).
• Connect with the great outdoors by bringing in potted plants from your garden and adding a skylight, budget permitting.
• Create an atmosphere with your lighting—it’s as important as the actual light fixtures you select.
• Emphasize that geometric feel by hanging framed prints and personal photos.

Gadget Inspector

With the decision to re-do a bathroom comes a dizzying array of technology options. Brooklyn-based Watermark manufactures a Luxury Shower System ($7,000) complete with a full-color digital touchscreen tablet that lets you select from among nine different shower “scenarios” that program water temperature, pressure, volume, lighting and timing. Kohler makes a $299 shower head with an embedded wireless speaker that delivers music, news and sports. For$750 more, you can purchase Kohler’s Underscore VibrAcoustic Bath, which turns your tub into a Bluetooth-enabled system in which music vibrates through the water when the tub is full and fills the entire bathroom with sound when empty. If you’re into New Age chromotherapy, Tubz Hydrotherapy makes a product that turns bathwater into an array of colors that elevates ordinary bathing to holistic ritual. Light also plays a part in Graff’s Ametis faucet (below), which features an LED display that ranges from blue to red, indicating the temperature of the flowing water ($3,528). Hansa’s Canyon faucet ($1,490) works much the same way over the basin. The Airblade tap, from Dyson ($1,800), doubles as a hand dryer.

And it doesn’t stop there. Showers are now programmable. The RainBrain by Hansgrohe ($4,750) (right) takes total shower jet control to a whole new level, creating the equivalent of a stand-up body massage. How about a laser razor? Skarp makes a slick, minimalistic shaver that emits a powerful light to cut off your facial bristles. Its recent launch on Indiegogo (a crowdfunder for startups), raised almost $500,000 and is targeted to be available this year at $289. FitBit devotees will enjoy the Aria scale, which can be synched to a smartphone to record not only poundage, but also body fat percentage, body mass index (BMI), heart rate, and even let you know about the day’s weather forecast

And then there is the centerpiece that no one likes to talk about: the toilet. I’m not sure how this is calculated, but the average person supposedly spends about five years on (or in front of?) the throne over a lifetime. Not surprisingly, just about every major plumbing manufacturer is rethinking, redesigning, and reengineering it. The Kohler Numi (left) is a case in point. It does just about everything except attend to your most personal hygiene. Its seat senses your approach and raises and closes all by itself. It contains heating elements to warm delicate derrieres and doubles as a self-adjusting bidet with vented airflow. Upgrades include Power-Save mode for energy efficiency and emergency flush for power outages. And if that’s not enough to justify the $6,338 price tag, then there is Numi’s tastefully illuminated panels, its powerful yet pleasant deodorizer, its touch-screen remote, and its wireless speakers

In addition to the various technological bells and whistles they offer, manufacturers are also looking at the safety component of bathroom design. One of Jay Leno’s tried-and-true jokes is about how more people die each year in bathroom falls than in plane crashes (the punch line is, “Yeah, but when you fall off the toilet you’re not falling 30,000 feet!”). Still, it’s no laughing matter. According to the Centers for Disease Control and Prevention, nearly a quarter-million people over age 15 visit the ER annually as a result of a bathroom injury; 14 percent require hospitalization. Two-thirds of bathroom injuries are sustained in or near a bathtub or shower. The injury rate for women is 72 percent higher than for men. And, interestingly, you’re more than four times likelier to get hurt getting out of a tub or shower than getting in. Even if you’re not springing for the big bathroom reno, its worth doing a quick safety assessment. Look for poorly fitting shower curtains, slick tile floors, soapy tub or shower beds, antiquated or improperly installed glass shower doors, area rugs without non-slip backing, and space heaters. These are items worth an immediate upgrade.

Finally, there is the issue of ecological soundness. Most people undertaking a bathroom renovation opt for products and technologies that are environmentally friendly. There’s even a word for it now: Greenovating. The focus is on saving water, using fewer paper products, and avoiding dangerous cleaning agents. There are actually a lot of ways to “green up” our bathrooms. From Moen, we have a shortlist of ideas that don’t require much time or money:

• Install Low-flow Toilets and Showers

Toilets use on average 27 percent of household water consumption; older toilets can use up to about 7 gallons of water per flush. Older model showerhead will use 5 to 8 gallons of water per minute, while a low-flow head can reduce that to 2.5 gallons or less without compromising water pressure.

• Motion-Sensing Faucets

A mind-boggling amount of water is wasted by leaving the faucet running when washing hands or brushing teeth. A faucet with a built-in motion sensor remembers to shut off running water when you don’t.

• Change Light Bulbs

An LED bulb consumes 80 percent less energy and lasts 25 percent longer. That can translate into a cost savings of $160 per bulb on your electricity bill over its lifetime.

• Upgrade Bathroom Fans/Vents

Replace that old bathroom fan with one that is Energy Star-rated; it can provide up to 60 percent in energy savings.

• Shop for Eco-friendly and Sustainable Products Look for the Certified Organic label on everything from bath towels to toilet paper. Any increased cost is more than offset by a lower environmental footprint.

Open or Closed?

Among the many decisions that must be made in advance of a major bathroom renovation, the one that catches many people by surprise is whether the new loo’s design will lean toward privacy or open space. More and more, the line between the master bedroom and master bath is becoming blurred. Did you ever think someone would ask you whether or not you wanted a door on your bathroom? It’s a personal choice, to be sure, and doorless bathrooms don’t yet qualify as a widespread trend. But don’t be surprised if you start seeing homebuyers on one of those reality shows saying, “We love the bathroom, but the door’s gotta go.”

Whether open or closed, large or small, his, hers or available to the entire family, one thing about the bathroom will never change: It is essential to daily living. 

In fact, all this talk of bathrooms has only made me yearn to retire to my own (rather retro) retreat. There I’ll draw a tepid, non-jet-propelled bath and I will relish the downtime despite the fact that there will be no lights and no music. There is nothing masterful about my bathroom, its shortcomings now only too apparent. But one of these days…  

TRENDS FOR 2016 

According to a National Kitchen and Bath Association (NKBA) study, these are some of the top bathroom trends for 2016:

• Neutral Color Palette

Earth tones rule the day, with off-white and beige not far behind.

• Undermount and Trough Sinks

The undermount style continues to be the most popular selection by a wide margin, but the trough type is gaining ground.

• Free-standing Tubs

Selected as a key trend by 67 percent of NKBA members in 2015 and predicted to increase this year.

• Shower Accessories

Special lighting, convenient seating and hand-held showerheads top the list.

• Polished Chrome Finishes

Selected by 80 percent of NKBA members as the most popular finish in 2015. Satin finishes in gunmetal and brass are growing in popularity.

• Pampering Luxuries

Radiant floor heating, steam showers, smart toilets, and even coffee and wet bars were cited as trends by 25 percent of NKBA members.

• Aging in Place Amenities

Seniors are focusing on age-friendly safety and other conveniences, including comfort-height toilets and no-threshold showers, in addition to traditional grab bars, taller vanities and lever door handles for easy opening by arthritic hands.

A LITTLE BUDGET CONSCIOUS 

A year ago, the Huffington Post addressed the issue of how to put your money to best use when renovating a small bathroom. 

With $500… 

• Apply a new coat of paint, preferably in a soothing, neutral earth tone.
• Take down fluorescent or incandescent lights and put up energy-saving LED bulbs.
• Buy some fresh, inexpensive accessories such as towels, plants, and prints.
• Expand storage by installing shelving and hanging racks.
• Rip up that germy old flooring and replace it with light and bright economical new tile.
• Consider investing $20 in a Glow Bowl, the motion-activated mechanism that transforms any toilet into a dazzling nightlight.

With $5,000…

• Reach out to professionals for help in upgrading plumbing and wiring.
• Optimize space by relocating or buying new fixtures that make you feel like you’ve moved into the 21st century.
• Invest in top-drawer ceramic or stone tile, and pay someone who knows what they’re doing to install it.
• Leave enough to get your bathroom repainted.

“The ricotta gnocchi, lavished with black truffles and nibs of wild boar sopressata, was so sensational I did something I’ve rarely done when dining out on the job.”

By Andy Clurfeld

The Frog and The Peach

29 Dennis St., New Brunswick. Phone: (908) 846.3216 

Reservations and all major credit cards accepted. Open for dinner seven nights a week and for lunch Monday through Friday. Prices: Soups and salads: $9 to $14. Appetizers:$16 to $19. Entrees: $21 to $43. Sides: $9. Desserts: $12 to $14.

In the beginning, there was The Frog and The Peach…I wrote that sentence in my mind more than 25 years ago, when I started reviewing restaurants in New Jersey and concocting a sociogram of sorts that linked anyone and anything culinarily worthy in the Garden State. The Frog and The Peach was nerve central, chair of the brain trust, the heart that pumped inspiration and example to everyone else who served forth to the public. The Frog, born in 1983 on a bleak side street in New Brunswick and named for a Dudley Moore-Peter Cook comedy sketch, is where trends and some of the most respected, accomplished culinary and hospitality professionals in the state got their start. Industrial chic? Marquee status to local ingredients? Eclectic, boutique, artisan wine list? Fine-dining at a perfect-pitch bar? Check off a list that goes on and on: It all comes back to The Frog.

FrogAndPeach.com

The Frog today is owned by executive chef Bruce Lefebvre, who purchased the restaurant in 2012 from its birth parents, Betsy Alger and Jim Black. (Rutgers grads, of course.) The married couple had transformed the circa-1876 building at 29 Dennis St. that once housed the printing presses for New Brunswick’s newspaper, The Home News, into a multi-level theater for dining, where various stages could be set nightly for a variety of experiences. Tete-a-tete in an alcove? Communal dinner featuring cult wines in a set-off space? New and novel bites at the bar? Alger and Black’s revolution of continual evolution at The Frog also ignited their neighborhood: Once desolate and stark, with but one other restaurant and a synagogue nearby, the Hiram Square community is now desirable and swank, with brick townhouses that look plucked from Philly’s Old City and luxury condos that house Johnson & Johnson execs.

FrogAndPeach.com

The Frog as design guru/community activist/social conscience, however, is another story.

Lefebvre (facing page), schooled at Wake Forest, the Culinary Institute of America, post-college Frog kitchen and stints at New York City landmarks Aureole, Daniel and Lespinasse, is tag-teamed by general manager/wine director Jim Mullen, an alum of Georgetown, the Corcoran School of Art and restaurants such as the ground-breaking New York wine-and-food mecca Montrachet. There are well-informed front-of-the-house folks no matter where you step and a kitchen crew that seems eternally tuned to Betsy Alger’s famously exacting orchestrations. That’s the way of The Frog, back to the David Drake days, the Stanley Novack era and the Eric Hambrecht reign. Every one of these acclaimed chefs did time as top dog at The Frog.

The current menu under Lefebvre hits on all cylinders. It’s neither silly-obscure nor fearful of challenging diners who come here expecting to learn. There’s Le Quebecois veal tartare, given the sultry counterpoint of winter truffles more potent than the norm and pickled mustard seeds, a one-two punch of earth and warmth that cuts the richness of the veal and encourages a dab at the quail egg and a roll in the lardo. What could be too much luxury, particularly in a starter, is calibrated carefully—an exercise in control.

FrogAndPeach.com

Littleneck clams are partnered with a classic companion, pork sausage. But it’s the infusion of fresh ginger that elevates the dish, intensifying the flavors of both meats with a penetrating heat. Romanesco cauliflower, oh-so hip these days, is romanced by a fancy-schmancy duck Bolognese and a duck egg, then scattered with breadcrumbs. Intriguing, though its texture was off: I wanted to taste something crunchy or crisp to balance the plushness of the double ducks. Loved the concept of the octopus, billed as charred and Portuguese, even though it was served with a world of accents—enoki mushrooms, a chili-miso sauce, treviso, eggplant—but found the execution problematic: The chunks of octopus were alternately tough or mushy and the chili-miso sauce oddly without spirit.

FrogAndPeach.com

But the ricotta gnocchi, lavished with black truffles and nibs of wild boar sopressata, was so sensational I did something I’ve rarely done when dining out on the job:  I hailed a server and asked for another round. I had to taste more—immediately—of those near-weightless mini dumplings I once believed had reached their apex at the restaurant Vetri in Philadelphia, but have a new master hand in Lefebvre. Strewn amid the gnocchi are strands of mildly bitter greens, sweet roasted garlic and squash, deftly inserted accents that, again, serve to balance more forceful ingredients.

Opah, a warm-blooded fish that ranges from pale pink to rosy red when served raw but turns ghostly white when pan-seared as it was here, was brightened by two strong plate partners: a walnut paste much like the Georgian condiment satsivi, which brought a butteriness to the dish, and an olive-spiked brown butter that added a smoky salinity. Pompano took on a world of accents—taro, an avocado-coconut mash, sticky rice and kale soaked in chilies—and might have been more successful streamlined. Duck is done as a duo here these days, Long Island breast and quarter-size meatballs parked on the same plate with pretty cold-weather vegetables: pearl onions, squash and Brussels sprouts. The unifying component here is the duck jus, lush as it is with truffles and parmesan. That’s one delish sipper. Another twosome spotlights Iberico pork,

FrogAndPeach.com

cured ham from Spain and Portugal. The Frog’s Iberico indulgence is splendid, what with a silky-textured skirt steak sliced from the pig and soulful nutty-herby croqueta made from braised rib meat. Maitake mushrooms, an aioli laced with sherry vinegar and blooms of nasturtium complete the plate. 

FrogAndPeach.com

There’s lots of rum firing the flavor of the praline cake, which has an every-day-is-Mardi-Gras appeal. I was thinking the lemon-scented goat cheese tart needed a kick of another stripe to rev up its engine. But a confection that sounded ordinary—milk chocolate ganache isn’t exactly on trend these days—held my attention through the last fine bite. 

FrogAndPeach.com

We don’t seem to want to leave The Frog and The Peach on this night; it’s late and there’s been a huge “Beer vs. Wine” dinner party in the garden room that I wish I’d had the courage to crash, the staff is quietly, discreetly re-setting tables for the next day. We should go home. But we linger. We’re in the bosom of the mother culture of restaurants in New Jersey, and it just feels good.  

Eating my way through ethnic Montclair.

By Helen Lippman 

In the run-up to this year’s presidential election, we’re likely to hear a lot of divisive language about “foreigners” in our midst—so much so that one could easily forget that one of this country’s long-defining qualities has been the way it makes room for new people and cultures. Fortunately, we have places like Montclair to remind us. Craving Cuban black beans or an Indian samosa? You’ll find it here. Love Middle Eastern fare? Sample food from Greece, Israel, Lebanon, Morocco, Syria and Turkey—all within a walkable, small-town mile. As an added bonus, virtually all the restaurants are BYOB To tell you about a few of my go-to places, I’ll start, as my husband and I sometimes do, with the first meal of the day. Simit House Bakery & Co., a casual Turkish eatery on a corner of Church Street, calls its breakfasts “sunrise abundance.” You can order a ”petite” plate of tomatoes, cucumbers, olives and feta or a “hearty” serving with sausage, cured beef, hard-boiled egg and provolone added to the mix. I prefer menemen, a creamy egg dish with a kick from pepper paste, chopped tomatoes and onions. The namesake simit—a sesame seed-covered cross between a bagel and a pretzel that’s been a popular Turkish street food for hundreds of years—surrounds the eggs. Served warm, it needs no butter or jam. 

Owner Ibrahim Yagci, a native of Istanbul, says his aim in opening the bakery was to preserve the simit’s legacy. But the menu has grown steadily in its two-plus years of existence. The sausage-shaped potato roll—onion-flavored mashed potatoes juxtaposed with the crunch of spicy phyllo dough—has become another local favorite, as has the spinach pie. Sweets, salads, soups, sandwiches and Turkish coffee are on tap, too.

Uncle Momo, a French-Lebanese bistro a few blocks away, has a bountiful brunch menu (as well as lunch and dinner). Owner and chef Wissam Elmasri, who is Lebanese and attended culinary school in France, serves a mix of American, French and Middle Eastern fare. The crepes, made from quinoa, are light and airy.  The most unusual is Zeit W Zaatar, made with labne (yogurt cheese), cucumbers and olives, all seasoned with dried thyme. My two favorites—spinach & goat cheese and smoked salmon & spinach—are delicately flavored and topped with greens. Ruby red pomegranate seeds give the salad an unexpected zing.

Individual pitzas, so named because they’re made with fresh-baked pita rather than traditional pizza dough, are also worth a try. I especially like the lamb pitza, seasoned with parsley, onions, and a hint of cinnamon.  I’ve also become attached to the muhalabia, a milk pudding flavored with rosewater, and Wissam’s saffron rice pudding, a colorful twist on an old-fashioned dessert that’s wonderful with mint tea.

Ani Ramen, a trendy Japanese noodle house that opened in 2014, is a good place for lunch, snack or a casual dinner. Its success is not surprising, given that owner Luck Sarabhayavanija and his team tried hundreds of combinations of noodles and broth before settling on a menu. The result: A half-dozen ramens to showcase and about 20 more in the mix. “We have a simple chicken broth, a more complex miso, a brothless ramen with intense flavor, a wonderful vegetarian—our hidden gem—and our signature rich and creamy pork broth,” he says. 

My strategy is to share a bowl of ramen so I have room for other house specialties—the chili-charred, sea-salted edemame, the light and spicy kale salad and particularly, shrimp buns. Made of marinated panko shrimp (a house secret, whispers Sarabhayavanija) pickled cucumber, shredded cabbage and spicy miso mayo on a fresh-steamed bao bun, the taste keeps me coming back for more. 

Right next door is Spice II, a restaurant owned by Sarabhayavanija’s mother, Sheree, and my favorite of the three Thai restaurants on Bloomfield Avenue. Its bright red and gold décor and subtle smell of spice evoke memories of a long-ago trip to Thailand.  I usually start with the fried tofu, served with a piquant plum and peanut dipping sauce. The mango salad—a fruity blend with apple, pineapple and red onions in a chili-lime dressing—is another favorite starter, as is the lemongrass- and lime-infused tom yum soup. Many entrées can be tailored to taste, not just for spiciness or main ingredient, but also with a choice of basil, garlic or ginger sauce and a vegetable mélange. Chicken rama, made with carrots and broccoli in a peanut sauce that’s sweet and spicy, is a house specialty.  Feeling adventurous? Grab a few friends and head to Mesob, where the food cries out for sharing. It arrives on a pizza-sized communal platter, to be eaten not with fork or spoon but with injera, the spongy flatbread that doubles as an eating implement in Ethiopia. Friendly waiters keep replenishing your supply as long as there’s food left to be scooped up. Order carefully here. My husband and I often ask for chicken and lamb tibs—marinated and sautéed with onions, garlic and jalapenos—prepared “between mild and medium,” but which is quite spicy. If you prefer food with little or no heat, select dishes marked “mild.” Each entrée comes with two sides. Misia wat (spicy lentils) and kik aletcha (yellow split peas) are among my favorites. 

Costanera, a Peruvian restaurant whose owner/chef, Juan Placenia, was born in Lima but moved here when he was a tot, is two doors away. He graduated from the Culinary Institute of America, and everything I’ve eaten here—even the humble rotisserie chicken—has been top-notch. That said, fish and seafood take center stage. The restaurant features a raw bar and several ceviches, marinated in leche de tigre, the Peruvian name for the citrus and chili mix that cures the fish. But Placenia has a penchant for unexpected combinations, blending crab, ahi tuna and shrimp, for instance, in a single ceviche. Seafood entrees range from Asian-style shrimp to Peruvian seafood stew. Escabeche de pescado, pan-roasted cod with spiced pickled onions and yams, is my usual choice. Fried yuca, sweet plantains and quinoa salad, perked up with lime vinaigrette, almonds, tomatoes and the tartness of dried cranberries, are favorite sides. Dessert is a main event, too. The tres leches cake won’t disappoint, and the combinado classico blends the tastes of rice pudding and Peruvian purple corn pudding made with apricot, papaya and pineapple in a single parfait. 

If you love Paris—and who doesn’t?—save room for dessert at Le Petit Parisien. Crepes, salads and sandwiches are also served here, but the macarons, pastries and croissants create the biggest buzz. Macarons come in many flavors and hues, including raspberry, pistachio, blood orange and sour cherry. Little cakes and tarts are tempting, too. A strawberry passion fruit mousse cake, covered with tantalizing swirls and topped with a bit of chocolate wrapped in edible gold like a tiny treasure, catches my eye, but I order the flourless chocolate cake instead. 

Owners Limi Maldonado and Baptiste Chigot moved to Montclair directly from Paris, and the atmosphere here is as French as the pastries. “There are a lot of Francophiles in the area,” says Maldonado, “and they tell us they feel like they’re in Paris.” Indeed, anyone who has seen the lights of the Eiffel Tower sparkle at night and watches the blinking lights of the mini Eiffel Tower in Le Petit Parisien’s window can’t help but feel that way. 

BLOOMFIELD & CHURCH

There are dozens of exceptional restaurants in and around Montclair. These are some of my favorites on Bloomfield and Church. Call or check their web sites for days and hours.

on BLOOMFIELD AVE.

Ani Ramen House

401 Bloomfield Avenue 

973-744-3960 aniramen.com

Costanera

511 Bloomfield Avenue

973-337-8289

costaneranj.com

Fusion Empanada  

706 Bloomfield Avenue

973-707-7174

fusionempanada.com

Mediterranea

578 Bloomfield Avenue

973-744-1300

mediterraneanj.com

Mesob

515 Bloomfield Avenue

973-655-9000

mesobrestaurant.com

Spice II 

399 Bloomfield Avenue

973-509-2110

spiceii.net

Uncle Momo 

702 Bloomfield Avenue

973-233-9500

unclemomo.com

on CHURCH STREET

Fresco

15 Church Street 

973-337-8225 frescoonchurch.com

Le Petit Parisien

10 Church Street 

973-746-0288 lepetitparisienmontclair.com

Manny’s Diner

12 Church Street 

973-509-9600

mannysdiner.com

Mundo Vegan

20 Church Street 

973-744-5503 

mundovegannj.com

Raymond’s

28 Church Street 

973-744-9263

Raymondsnj.com

Scala del Nonna Ristorante 

32 Church Street 

973-744-3300

scalinifedeli.com/scaladelnonna

Simit House Bakery & Co.

2 Church Street

973-893-5970

simitlove.com

EDGE takes you inside the area’s most creative kitchens.

Paragon Tap & Table • Pan Seared Mahi Mahi 

77 Central Ave. • CLARK

(732) 931-1776 • paragonnj.com

This rustic dish—Pan Seared Mahi Mahi served on ginger garlic bok choy stir fry, scallion jasmine rice topped with pickled lotus root—is a dish I created to take our guests on a culinary journey. The hearty texture of the fish balanced with the subtleties of the bok choy and jasmine rice make this dish a unique dining experience.

— Eric B. LeVine, Chef/Partner

A Toute Heure/100 Steps Supper Club & Raw Bar

232 Centennial Avenue / 215 Centennial Avenue • CRANFORD

(908) 276-6600 • localrootscranford.com

In the heart of the winter season, the local waters are perhaps the best source of our seasonal favorites…from briny clams and oysters to amazing local catch you simply can’t go wrong.   

— Andrea & Jim Carbine, Owners

BoulevardFive72 • Grilled “Chermoula” Organic Salmon

572 Boulevard • KENILWORTH

(908) 709-1200 • boulevardfive72.com

This Mediterranean-inspired, signature dish is served with fingerling potatoes, roasted golden-beet puree and a whole grain mustard sauce. The Salmon is sourced from the North Atlantic’s Faroese Island Fiords by Boulevard’s own seafood company.

— Scott Snyder, Chef/Owner

Arirang Hibachi Steakhouse • Wasabi Crusted Filet Mignon 

1230 Route 22 West • MOUNTAINSIDE

(908) 518-9733 • partyonthegrill.com

8 oz. filet mignon served with gingered spinach, shitake mushrooms, and tempura onion ring.

Daimatsu • Sushi Pizza

860 Mountain Ave. • MOUNTAINSIDE

(908) 233-7888 • daimatsusushibar.com

This original dish has been our signature appetizer for over 20 years. Crispy seasoned sushi rice topped with homemade spicy mayo, marinated tuna, finely chopped onion, scallion, masago caviar, and ginger. Our customers always come back wanting more.

— Momo, Chef

Publick House • Kobe Short Rib   

899 Mountain Ave. • MOUNTAINSIDE

(908) 233-2355 • publickhousenj.com

Our Kobe short ribs are slow roasted, until the meat is tender enough to literally melt in your mouth. Served with garlic whipped potato purée and sautéed spinach, this dish is the perfect comfort food to escape any cold day.

— Bernie Goncalves, Owner

Luciano’s Ristorante & Lounge • House Made Mafalda Pasta Inverno Style

1579 Main Street • RAHWAY

(732) 815-1200 • lucianosristorante.com

Our goal is to give our guests a pleasurable dining experience, with fresh ingredients and personable service in a beautiful Tuscan décor complete with fireplaces. Our house-made Mafalda pasta features slow-braised artichoke crowns, cipollini onions and oven-dried tomatoes in a saffron cream broth. Luciano’s is available for dining and private parties of all types.

— Joseph Mastrella, Executive Chef/Partner

Morris Tap & Grill • BBQ Braised Pork Shank with Corn Hash

500 Route 10 West • RANDOLPH

(973) 891-1776 • morristapandgrill.com

With the winter here we have created this amazingly deep and rich dish for you to enjoy. This dish embodies the rustic cuisine that I am known for while creating textures.

— Eric B LeVine, Chef/Partner

Thai Amarin • Goong Ma Kham

201 Morris Ave. • SPRINGFIELD

(973) 376-6300, (973) 376-6301 • thaiamarinnj.net

Batter fried jumbo shrimps with a tasty house made tamarind sauce,  topped with roasted almonds and served on a bed of stir-fried spinach.  

— Amy Thana, Owner

Spirit: Social Eatery and Bar • Jersey Breakfast Bar Pie

250 Morris Ave. • SPRINGFIELD

(973) 258-1600 • mclynns.com

Get in the Spirit! Our Jersey Breakfast Bar Pie features potatoes, Taylor ham, cheddar cheese and onions. It doesn’t get more Jersey than that! 

— Mark Houlker, Chef

Arirang Hibachi Steakhouse • Volcano Roll 

23A Nelson Avenue • STATEN ISLAND, NY

(718) 966-9600 • partyonthegrill.com

Hot-out-of-the-oven, crab, avocado and cream cheese rolled up and topped with a mild spicy scallop salad.

The Manor • Petite Filet Mignon & Short Ribs

111 Prospect Avenue • WEST ORANGE

(973) 731-2360 • themanorrestaurant.com

Our hearty petite filet mignon, accompanied by oh-so-rich short ribs that have been braised to tender perfection are ideal for the season. Add to that grilled baby leeks, forage mushrooms scented in bordelaise sauce, caramelized cipollini onions, and a delightfully-presented potato purée in a crisp potato basket and you have a taste of winter well worth the visit.

— Vincent Raith, Executive Chef

POWER PLAYER 

Gary S. Horan, FACHE, President  & CEO, has been named to the prestigious Power 50 Healthcare list published each year by NJBIZ.  This marks the fourth year that he has made the Power 50, during which he improved his standing by moving up 4 notches to #27. Horan is also the 2016 recipient of the New Jersey Hospital Association’s Distinguished Service Award – the highest recognition given by NJHA.

A NAME KNOWN ‘ROUND THE WORLD       

The reputation of the Trinitas School of Nursing stretches across the US and around the world. Nursing educators from the University of Auckland recently visited the school while in the New York metro area. Professor Melanie Birks and Associate Professor Jane Mills, of the University of Auckland, and Dr. Karen Hoare of the Centre for Nursing and Midwifery at James Cook University, shared findings in a study inspired by a previous visit to the school in 2011, when they learned about the patient simulation teaching model used here. 

SHE’S NOTEWORTHY! 

At the 11th Annual Harmabee Breakfast of the Greater Elizabeth Area Section of the National Council of Negro Women, Pamela Glover (second from left), Program Coordinator, Nursing Division, received the Section Award for her dedication and service.  Pam celebrated with Cleadal Waye, Dr. Patricia Bennett, Erica Blount, and Joann Blount. 

NEW NURSING LEADER       

The New Jersey Chapter of the National League for Nursing recently announced that John Lanier, RN, MS, NE-BC, OR Manager, Bloodless Medicine & Surgery Program and Nursing Performance Improvement, has been appointed its president-elect to serve from 2016 – 2019.  

Photo Credit: Grace Photography

Photo Credit: Grace Photography

JUST WHAT THE DOCTOR ORDERED! 

While there are no people in these “People Page” photos, the completion of Phase 1 of Trinitas’ ER construction project will help many people – more than 73,000 per year to be exact.  The new space will include 45 treatment rooms (up from its current 28), and separate treatment areas for families, children and seniors. Coming on line this month are a new reception/waiting/registration area, and a 128-slice CT Scanner.  The overall project will be completed next year.

GARY HORAN INTERVIEWED ON NPR 

Freelance science writer Katie Hiler recently conducted a radio interview with President and CEO Gary S. Horan that was broadcast on WNYC, the local affiliate of National Public Radio. Ms. Hiler sought out Mr. Horan because of his passionate support of the reconfiguration of the Omnia plan of Blue Cross and Blue Shield.   

MILES OF SMILES 

Westfield Smiles was one of the sponsors and participated on Sunday, April 24, 2016, in the 5th Annual NJ Miles with Moms 5k and Fun Run at Oak Ridge Park in Clark.  The event was hosted by the Mothers’ Center of Central NJ  with families and athletes throughout the local community running and walking to support mothers and families.

Raw Milk: Coming Soon to NJ? 

A recent study out of Munich, Germany confirms the fact that children who consume unprocessed cow’s milk are less likely to develop asthma. The research, which was published in The Journal of Allergy and Clinical Immunology concludes that “raw” milk’s higher level of omega-3 fatty acids is a contributing factor. Omega-3 fatty acids are critical to human health, but cannot be created in a lab; they must come from dietary sources. The study’s authors stop short of recommending raw milk, however, because it may contain pathogenic microorganisms. “It is a well known fact that the processing of our foods in this country takes away some vital nutrients, vitamins and minerals,” says

Kevin Lukenda, DO
Chairman, Family Medicine Department 908.925.9309

Dr. Kevin Lukenda, Chairman of the Trinitas Family Medicine Department. “It’s a Catch-22 situation, as the processing of our foods makes them safer from an infectious point of view but takes away many of the health and nutritional benefits.” The sale of raw milk is illegal in New Jersey, however a bill introduced in the legislature this winter may change its status. If so, it will be available to consumers only at the dairies where it is produced, not in stores.

Almond Joy 

A study published in the Journal of Nutrition Research suggests that a handful of almonds a day may be enough to keep the doctor away. A group of 28 child-parent groupings were instructed to consume almonds (or almond butter) each day for three weeks—the adults 1.5 ounces and the kids a half-ounce. University of Florida researchers measured the participants’ Healthy Eating Index—a measure of diet quality based on USDA guidelines—before and after the three-week period. Both parents and children showed exactly the same improvement in their scores (roughly 14 percent), which was attributed in part to decreasing their intake of empty calories. Kids will be kids, however: Researchers noted that many of the children said they didn’t like the taste of almonds or were tired of eating them every day. “This study showed that changing just one component of a diet can have a positive effect,” says

Michelle Ali, RD
Director, Food and Nutrition, Trinitas Regional Medical Center 908.994.5396

Michelle Ali, Director of Food and Nutrition Services for Trinitas. “Eating the same foods each day can becomes monotonous and boring, especially for children. I’d add in a handful of almonds to salads, add almond butter to apple slices, and even to your milkshakes. You’ll improve your nutrition and ease boredom.”   

Big Bang 

While the health risks of e-cigarettes (both to the smoker and others) are still being hotly debated, the overheating dangers of the device itself have been drawing attention of late. Every year, a handful of “vapers” report that their e-cigs have exploded—often causing devastating injuries. The culprit appears to be the lithium batteries that power the devices. The industry has grown to $2 billion-plus annually, with roughly 4 percent of the U.S. population using e-cigarettes regularly. Industry advocates point out that accidents are rare, and that they typically involve extreme conditions or damaged batteries, which can produce shorts. Last December, Daniel Pickett was driving through his hometown in Central Washington when he heard a static-y sound a half-second before his e-cigarette exploded, burning his hand and arm, and leading to skin grafts and five surgeries. Daniel won’t be vaping again. “I just think that if people really knew this could explode in your face, they would consider twice putting a device like this to their mouth,” Pickett says.

Connection Between Autism  and Early Death     

The effort to understand, treat and possibly prevent autism has acquired new urgency after findings by Sweden’s Karolinska Institute published in the March issue of The British Journal of Psychiatry. Individuals on the autism spectrum tend to die significantly younger than other adults—on average 18 years younger. The culprit is not cancer or heart disease, as is the case in a great many premature adult deaths. It’s suicide. “The inequality in outcomes for autistic people shown in this data is shameful,” says Jon Spiers, who heads the British charity Autistica. “We cannot accept a situation where many autistic people will never see their 40th birthday.” The Swedish study tracked 27,000 people with autism and 2.5 million people who were not diagnosed with the social communication disorder. The age at death also changed relative to a person’s cognitive ability. Those considered “high-functioning” with strong language skills lived longer, but still were twice as likely to die young as the general population. “This research really helps characterize the magnitude of health problems faced by people with social communication disorders in Western countries,” says Trinitas psychiatrist

Salvatore Savatta, MD
Deputy Chairman
Dept. of Behavioral Health & Psychiatry
908.994.7281

Dr. Salvatore Savatta. “More research is required on how to engage and retain these at-risk individuals in mental health treatment and related services.”

Zika Update

The Zika scare may come uncomfortably close to home this summer, thanks to the Olympic Games. Although host country Brazil is working to mitigate the Aedis aegypti mosquito—and August is “winter” in Brazil—if the disease comes back to the U.S. through one of the 50,000-plus Americans who reportedly plan to travel to the games, it will arrive during one of our warmest months. That has infectious disease physicians concerned, and has already launched a debate about the best way to attack Zika if it gains a foothold in North America. One plan involves genetically modifying the male mosquito to produce offspring that die in the larval stage. “It is likely that cases will be transmitted here in New Jersey this summer,” says

William Farrer, MD
Chief of Infectious Diseases Trinitas Regional Medical Center

Dr. William Farrer, a member of the Infectious Disease Division of the Trinitas Medicine Department. “It is important that people take steps to reduce mosquito habitats, such as removing standing water from their yards. It is also important to employ methods to reduce your chances of mosquito bites, such as wearing long sleeved clothing and applying insect repellent when outdoors. The CDC website [cdc.gov/zika] has many helpful suggestions and is frequently updated.”

Fish Warning For Mothers-To-Be 

The health benefits of fish have been touted for decades, but because of possible exposure to organic pollutants, most doctors are now suggesting people limit their consumption. According to a recent article in JAMA Pediatrics that advice is especially important for pregnant women. Those pollutants appear to have endocrine-disrupting properties that contribute to rapid growth in infancy and the development of childhood obesity. The study cited looked at more than 28,000 pregnant women in Europe and the U.S. and tracked the progress of their children to age 6. Women who had more than three servings of fish per week gave birth to children with higher body mass indexes at ages 2, 4 and 6. “The latest FDA and EPA recommendations suggest that pregnant women eat 8 to 12 ounces per week, in two or three servings,” says

Yelena Samofalov, MD Trinitas Pediatric Health Center 908.994.5750

Dr. Yelena Samofalov of the Trinitas Pediatric Health Center. “It’s also important to remember that not all types of fish accumulate the same amount of pollutants.” Indeed, while researchers accounted for different fish types, they were unable to drill down on cooking procedures or the quality/type of water fish came from—which may influence the data. Fish associated with higher amount of mercury—which is especially dangerous for the developing brain of neonates—should be avoided during pregnancy and while breastfeeding, Dr. Samofalov adds. Preferences should be given to salmon, pollock, shrimp, tilapia, canned tuna, catfish and cod. 

Going Gray 

Who among us does not rue the day when we go gray?For some, the process is gradual; for others, not. Age and stress are the prime culprits but, according to researchers from University College in London, for about 30 percent of people of European descent, gray hair is a genetic inevitability. The IRF4 gene, which appears to cause people to gray prematurely, is linked to the production of melanin, which regulates eye, skin and hair color. This discovery should be of particular interest to hair care companies which might be able to develop products that delay or reverse graying as hair grows.