The Grumpy Doc

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“86” — A Little Number With a Big History

By

On May 2, 2026

In Commentary

Fifty some years ago when I was in the Marines, we used the term “86” to refer to something that should be ignored or discarded—in the colorful vernacular of the Corps, “shit canned”. That’s trashed to you civilians.  The Marines have never been known as a peaceable lot and we had many colorful euphemisms for doing grievous bodily harm, but “86” was never among them.

So why is “86” suddenly everywhere in the news? Blame James Comey. The former FBI Director posted a beach photo on Instagram showing seashells arranged to spell out “86 47” — and the internet promptly exploded. Republicans argued it was a death threat against the 47th president. Comey said it simply meant he wanted Trump removed from office. That dispute has brought a piece of century-old American slang back into the spotlight, so it’s worth taking a look at what the term means and where it came from.

The Short Answer

Eighty-six is slang meaning “to throw out,” “to get rid of,” or “to refuse service to.” It most likely comes from 1930s soda-counter slang meaning that an item was sold out. This was part of a broader diner code that included: 13 “the boss is around,” 81 “glass of water,” and 95 “customer left without paying”.  Over the decades it evolved from a kitchen noun into a verb with broader reach, and today it shows up everywhere from restaurant kitchens to Twitter and now worldwide headlines.

The Longer Answer

Here’s the honest answer: nobody knows for certain. Its etymology is unknown, but it seems to have been coined in the 1920s or 1930s. There are many theories about its origin — one article enumerates 18 possibilities, and another suggests there are “about 86 theories about 86.”

While the leading contender is the mundane diner option, there are several other more or less plausible and frequently more colorful options.

The most linguistically grounded explanation is that “86” is simply rhyming slang. The most common theory is that it is rhyming slang for “nix.” That’s the same “nix” meaning to reject or say no.

One of the more colorful stories involves a Prohibition-era speakeasy. Chumley’s, a bar with multiple entrances including one at 86 Bedford Street in New York. The story goes that the bar was supposedly warned by police before raids. Customers were told to “86 it” — meaning leave through the Bedford Street exit while cops came through the other door. It’s a great story, and if it’s not true it should be.

How It Evolved

First appearing in the early 1930s as a noun, it did not take long for the word to broaden its use beyond the realm of the soda counter. In the 1950s the word underwent some functional shift and began to be used as a verb — initially meaning “to refuse to serve a customer,” and later taking on the slightly extended meaning of “to get rid of; to throw out.”

It was quickly adopted and members of the military services who love slang, shortcuts, and inside terminology.  It may just be a coincidence that Article 86 of the U.S. Uniform Code of Military Justice concerns Absence Without Leave, or AWOL.

By the 1970s it had moved well beyond the restaurant world. In the 1972 film The Candidate, a media adviser says to Robert Redford’s character, “OK, now, for starters, we got to cut your hair and eighty-six the sideburns.”

Where It Stands Today

These days, people use “86” when they cancel plans, dump something, or boot someone from a chat. Social media picked it up — Twitter and TikTok users will “86 a trend” or “86 a person” in a heartbeat.

In professional kitchens and bars, it remains “everyday lingo” — one hospitality industry veteran called it “probably the most overused word in hospitality.”

The Comey controversy also resurrected an older, arcane, and darker shade of the term. According to Cassell’s Dictionary of Slang, “to 86” can alternatively mean “to kill, to murder; to execute judicially.” That said, Merriam-Webster notes this use is infrequent, and they do not include this sense due to its relative recency and sparseness of use.

The bottom line is that “86” is one of those wonderfully slippery pieces of American slang that started in a noisy kitchen, picked up mythology along the way, and is now flexible enough to mean anything from “we’re out of the salmon” to a loaded political statement — depending entirely on who’s using it and who’s listening.

Or, perhaps this entire tempest is just the response of one thin skinned man to his pathologic fear of seashells.

Gluten and Your Gut: Celiac Disease, Sensitivity, and the Gluten-Free Craze.

By

On April 30, 2026

In Medicine, Science

Walk down the aisles at any grocery store today and you’ll find bread, crackers, cereals, and pastas proudly stamped “Gluten-Free” — as if gluten were some kind of dietary villain lurking in your morning toast. For the roughly 1% of Americans with celiac disease, avoiding gluten isn’t a lifestyle choice; it’s a medical necessity. But for the much larger slice of the population without any gluten-related disorder, the science tells a more complicated story.

What Is Celiac Disease, and What Causes It?

Celiac disease is an autoimmune disorder — meaning the immune system turns on the body itself. The trigger is gluten, a protein found in wheat, barley, and rye. Gluten fragments interact with an enzyme called tissue transglutaminase in the gut. The immune system mistakes this complex for a threat and attacks it, but in the process, it damages the body’s own intestinal tissue. This is what makes celiac disease an autoimmune condition, rather than a simple food allergy. The immune system mounts an attack, generating antibodies that damage the villi, the tiny finger-like projections lining the small intestine that are responsible for absorbing nutrients. Over time, that damage leads to malabsorption and a cascade of health problems.

The disease has a strong hereditary component — about 7.5% of close relatives of people with celiac disease also have it. Researchers have identified two specific genetic variants, HLA-DQ2 and HLA-DQ8, that are present in virtually all celiac patients. But here’s the catch: about 40% of the general population carry one of these genes, yet most of them never develop celiac disease. That means genes load the gun, but something else pulls the trigger. Environmental factors — gastrointestinal infections, timing of gluten introduction in infancy, and other autoimmune conditions like type 1 diabetes and thyroid disease, surgery, even pregnancy — all appear to play a role. Researchers continue to study why some genetically susceptible individuals develop the disease while others do not.

Symptoms and Diagnosis: A Tricky Puzzle

If you’re picturing someone doubled over with stomach pain after eating a sandwich, that’s one version of celiac disease — but far from the only one. The disease presents in more than 200 documented ways. Classic gut symptoms include abdominal pain, bloating, diarrhea, and foul-smelling stools. But celiac disease can also show up as iron-deficiency anemia, bone loss, infertility, nerve damage, depression, liver enzyme abnormalities, and even a distinctive itchy skin rash called dermatitis herpetiformis. Children may experience stunted growth and delayed puberty. Some people, especially seniors, may have no obvious symptoms at all.

This symptom diversity is part of why diagnosis is so often delayed. Researchers estimate that somewhere between 60–70% of Americans with celiac disease remain undiagnosed.

The path to diagnosis typically starts with a blood test measuring tissue transglutaminase IgA antibodies — a marker the immune system produces in response to gluten. If that test is positive, a gastroenterologist performs an upper endoscopy and takes small tissue samples from the small intestine to look for the telltale villous damage under a microscope. Both tests need to be done while the patient is still eating gluten; going gluten-free first can produce falsely normal results and delay or prevent an accurate diagnosis.

Treatment: One Answer, Lifelong Commitment

There are no medications, no injections, no surgical fixes for celiac disease. The only effective treatment is a strict, lifelong gluten-free diet. And “strict” really does mean strict — even trace amounts of gluten can damage the intestinal lining, sometimes without producing obvious symptoms. Gluten hides in surprising places: commercial soups, sauces, ice cream, hot dogs, medications, dietary supplements, and even some communion wafers. Working with a registered dietitian is strongly recommended.

The good news is that the intestinal lining is remarkably resilient. Once gluten is eliminated, symptoms typically improve within one to two weeks, and mucosal healing generally follows over one to two years. Nutritional deficiencies — commonly iron, folate, calcium, and B vitamins — are addressed with supplements during recovery. A small subset of patients develop “refractory celiac disease,” where the intestine doesn’t heal despite strict dietary adherence; these cases may require corticosteroids and carry a less favorable prognosis.

Prognosis: Life After Diagnosis

Most people with celiac disease who strictly follow a gluten-free diet do very well over the long term. Intestinal architecture normalizes, antibody levels drop, and many of the downstream complications — anemia, bone loss, neurological symptoms — improve or resolve. The earlier the diagnosis is made and the gluten-free diet is initiated, the better the outcome.

One significant concern on the long-term horizon is cancer risk. People with longstanding, untreated celiac disease face a roughly 6–8% elevated risk of lymphoma of the small intestine. There is also a modestly increased risk of other gastrointestinal cancers. The reassuring part: patients who achieve normal intestinal histology on a gluten-free diet appear to have the same lymphoma risk as the general population. Adherence to the diet is, quite literally, protective.

Non-Celiac Gluten Sensitivity: The Gray Zone

Between full-blown celiac disease and perfectly healthy gluten tolerance lies a murkier territory: non-celiac gluten sensitivity (NCGS). People with NCGS experience symptoms similar to celiac disease — bloating, abdominal pain, fatigue, headaches, brain fog — after eating gluten, but their blood tests for celiac antibodies are negative and intestinal biopsies show no structural damage. The condition is real and increasingly recognized, but its biology remains incompletely understood.

Non‑celiac gluten sensitivity does not have a single definitive test. Instead, it is a diagnosis of exclusion. Once all other causes have been excluded, NCGS is what’s left.

Milder Forms of Gluten Intolerance

Not everyone with gluten‑related complaints fits neatly into the categories above. Some people never undergo formal testing but notice a pattern: when they eat bread, pasta, or pastries, they just don’t feel good. When they cut back on those foods, they feel lighter and more energetic.

These milder forms of gluten intolerance can be tricky to interpret. The symptoms overlap with irritable bowel syndrome, lactose intolerance, stress‑related gut issues, and reactions to FODMAPs (fermentable carbohydrates) found in wheat and many other foods. In some cases, it may not be gluten itself causing problems but the overall carbohydrate profile of a highly processed, wheat‑heavy diet. Some scientists suggest renaming the condition “non-celiac wheat sensitivity” to better capture this complexity. Still, for the individual, what matters most is whether changing their diet in a structured way leads to sustained relief.

Wheat allergy is a classic IgE‑mediated food allergy to wheat proteins that can cause hives, wheezing, or even anaphylaxis, and needs to be distinguished from celiac disease and NCGS.  It is treated like other food allergies and is best managed by an allergist. 

The Gluten-Free Craze: Helpful Trend or Expensive Fad?

Here’s where things get interesting — and a little frustrating for nutritional scientists. Surveys suggest that roughly 30% of American adults are actively trying to reduce or eliminate gluten from their diets. A 2013 poll found that 65% of Americans believed gluten-free foods were simply healthier, and 27% thought going gluten-free would help them lose weight. These numbers vastly outpace the actual prevalence of celiac disease and gluten sensitivity combined.

What does the science actually say? For people without celiac disease, NCGS, or a wheat allergy, there’s no compelling evidence that a gluten-free diet improves health, reduces inflammation, boosts athletic performance, or prevents disease. A large 2017 study of over 100,000 participants without celiac disease found no association between long-term gluten consumption and heart disease risk — and in fact suggested that gluten-avoiders who cut back on whole grains might be inadvertently increasing their cardiovascular risk through lower dietary fiber and an increase in refined starches, sugars and fats in gluten substitutes.

There’s also a nutritional downside worth considering. Gluten-free processed foods — the breads, pastas, crackers, and cookies filling grocery shelves — are often lower in fiber, iron, zinc, B vitamins, and folate than their conventional counterparts. They tend to be higher in sugar and fat to compensate for gluten’s structural role. And they’re almost always more expensive.  

On the other hand, for some people, adopting a gluten‑free pattern coincides with broader healthy changes—more fruits, vegetables, and home‑cooked meals—so perceived benefits may come from overall diet quality rather than gluten removal itself.

The bottom line from Harvard Medical School is clear: if you feel well and have no digestive symptoms, there’s no evidence that a gluten-free diet will help, and some modest evidence it might hurt.

That said, if you’re experiencing real, persistent gut symptoms and haven’t been evaluated, the right move isn’t to quietly go gluten-free and see if you feel better — it’s to see a doctor and get tested first. Eliminating gluten before testing can produce falsely negative results and close the diagnostic door on a condition that, left untreated, carries genuine long-term risks.

The Takeaway

Celiac disease is a serious autoimmune condition affecting about 1% of the population, with the majority still undiagnosed. It requires strict, permanent gluten avoidance and careful medical follow-up. Non-celiac gluten sensitivity occupies a legitimate but scientifically murkier space, affecting a real but incompletely defined group of people for whom reducing gluten makes practical sense. For everyone else — the majority of gluten-free shoppers — the science doesn’t support the hype. Gluten itself isn’t the villain; it’s just a protein. The real story is in the individual biology of those who can’t tolerate it.

Illustration generated by author using ChatGPT.

Sources:

·  WebMD — Celiac Disease: Symptoms, Causes, and Treatment https://www.webmd.com/digestive-disorders/celiac-disease/celiac-disease

·  Merck Manual (Consumer Version) — Celiac Disease https://www.merckmanuals.com/home/digestive-disorders/malabsorption/celiac-disease

·  Merck Manual (Professional Edition) — Celiac Disease https://www.merckmanuals.com/professional/gastrointestinal-disorders/malabsorption-syndromes/celiac-disease

·  American Academy of Family Physicians (AAFP) — Diagnosis and Management of Celiac Disease: Guidelines From the American College of Gastroenterology (2024) https://www.aafp.org/pubs/afp/issues/2024/0100/practice-guidelines-celiac-disease.html

·  Houston Methodist — Celiac Disease: Symptoms, Treatment and What To Know (2024) https://www.houstonmethodist.org/blog/articles/2024/jun/celiac-disease-symptoms-treatment-and-what-to-know/

·  PMC / Nutrients Journal — The Gluten-Free Diet for Celiac Disease and Beyond https://pmc.ncbi.nlm.nih.gov/articles/PMC8625243/

·  PMC / Diabetes Spectrum — The Gluten-Free Diet: Fad or Necessity? https://pmc.ncbi.nlm.nih.gov/articles/PMC5439366/

·  Harvard T.H. Chan School of Public Health — Gluten: A Benefit or Harm to the Body? https://nutritionsource.hsph.harvard.edu/gluten/

·Harvard Health — Ditch the Gluten, Improve Your Health? https://www.health.harvard.edu/staying-healthy/ditch-the-gluten-improve-your-health

Medical Disclaimer

The information provided in this article is intended for general educational and informational purposes only and does not constitute medical advice. It should not be used as a substitute for professional medical advice, diagnosis, or treatment.

Always seek the guidance of a qualified healthcare provider with any questions you may have regarding a medical condition or treatment. Never disregard professional medical advice or delay seeking it because of something you have read here.

If you are experiencing a medical emergency, call 911 or your local emergency number immediately.

The author of this article is a licensed physician, but the views expressed here are solely those of the author and do not represent the official position of any hospital, health system, or medical organization with which the author may be affiliated.

From Minstrel Stage to State Law: The History of Jim Crow

By

On April 27, 2026

In History

Source: Library of Congress via Wikimedia Commons, public domain

Few phrases in American history carry as much weight as Jim Crow. It is shorthand for a century of systematic racial oppression — separate schools, separate water fountains, disenfranchisement and even terror. But the term itself has an origin that is both surprising and telling: it began not in a courthouse or a legislature, but on a minstrel stage in the 1820s, as the punchline of a song-and-dance act performed by a white man in blackface.

Jump Jim Crow: The Birth of a Slur

The story starts with Thomas Dartmouth “Daddy” Rice, a struggling white actor from the Lower East Side of Manhattan who would go on to become one of the most famous entertainers of his era. Around 1828, Rice developed a stage character he called Jim Crow — a singing, dancing, shuffling caricature of a Black man, performed in blackface makeup made from burnt cork and wearing ragged clothes. The precise inspiration for the character is disputed and has, as historians put it, been lost to legend. Rice claimed to have based it on a disabled enslaved stableman he observed singing and dancing to amuse himself, though the time, place, and truth of this claim have never been verified.

What is not disputed is the impact. Rice’s “Jump Jim Crow” routine was a sensation. By 1832 he had turned the character into his signature act, touring from Louisville to Cincinnati to Philadelphia to New York, playing to sold-out houses. He eventually took the show to London and Dublin, where audiences were equally enthralled. Rice became known as “Jim Crow Rice,” the self-proclaimed “Father of American Minstrelsy.”

The character Rice created was deliberately degrading — a dim-witted, lazy, buffoonish caricature built to confirm the worst racial stereotypes white audiences held about Black Americans and to reinforce a racial hierarchy that portrayed Black people as naturally suited to servitude and exclusion from the rights of citizenship. He and his imitators spread these images across the country. By 1838, the term “Jim Crow” had crossed from the stage into everyday speech as a collective racial slur for Black people. The minstrel show had given American racism a catchy name.

It is worth pausing on the cultural mechanics of what minstrelsy did. It was not just entertainment — it was propaganda. Rice and his many imitators, including the wildly popular Christy Minstrels (for whom Stephen Foster wrote songs), systematically presented Black Americans as subhuman, unworthy of social participation, and fundamentally inferior and ridiculous figures. These depictions played to a stereotype that reinforced racial prejudice among white audiences and softened their moral resistance to segregation and violence long before those policies were ever written into law.

Reconstruction and Its Violent Undoing

The Civil War ended in 1865 with the abolition of slavery, and the Reconstruction era that followed was a genuine, if incomplete, experiment in racial equality. The 13th, 14th, and 15th Amendments abolished slavery, granted citizenship, and extended voting rights to Black men. For a brief window, Black Americans served in state legislatures and held federal office across the South.

That window slammed shut in 1877, when President Rutherford B. Hayes withdrew the last federal troops from the South as part of a political compromise. Southern white Democrats — calling themselves “Redeemers” — systematically retook their state legislatures using violence, voter fraud, and paramilitary terror groups like the Ku Klux Klan, the White League, and the Red Shirts. Republican officeholders were run out of town or worse. Black voters were lynched as a warning to others.

Once back in power, Southern legislatures began passing the laws that would become known as Jim Crow — a name borrowed directly from Rice’s minstrel slur. The term had traveled from the stage to common speech and then into the legal codebook and reflected the same racist assumptions embodied in the minstrel character: that Black Americans were inherently inferior and should occupy a subordinate social and legal position.

Beginning with Florida in 1887, states required railroads to maintain separate cars for Black and white passengers. Similar laws quickly spread segregation to schools, restaurants, hospitals, theaters, cemeteries, parks, waiting rooms, and virtually every other point of public contact between the races. Many facilities were marked with signs reading “White” and “Colored” to emphasize the exclusion of Black citizens.  The laws varied by state but shared a common goal—racial separation and political exclusion.

Plessy v. Ferguson: The Supreme Court Blesses Segregation

In 1892, a group of Black and mixed-race citizens in New Orleans organized a deliberate legal challenge to Louisiana’s Separate Car Act. They recruited Homer Plessy — a man who was seven-eighths white but legally classified as Black under Louisiana law — to board a whites-only train car and refuse to move. He was arrested on cue, and his case wound its way through the court system to the United States Supreme Court.

In Plessy v. Ferguson (1896), the Court ruled 7-1 that racial segregation was constitutional as long as the separate facilities were nominally equal. The lone dissenter, Justice John Harlan, stated that the constitution should be color blind and warned prophetically that the decision would prove as pernicious as the Dred Scott ruling. He was right. The “separate but equal” doctrine became the legal foundation for a total apartheid system across the South — and, in many respects, well beyond it.

In practice, of course, the facilities were never equal. Black schools were chronically underfunded, with inferior buildings, used textbooks, and far lower teacher salaries. Black hospitals, where they existed at all, were understaffed and under-equipped. “Separate but equal” was a legal fiction that everyone understood as a polite cover for second-class citizenship.

Between 1890 and 1910, ten of the eleven former Confederate states rewrote constitutions or passed amendments to systematically disenfranchise Black voters through poll taxes, literacy tests administered by white registrars, grandfather clauses, and outright violent intimidation. African Americans who had briefly held political power during Reconstruction effectively disappeared from public life.

The Long Arm of Jim Crow: Life Under the System

For the better part of a century, Jim Crow was not merely a set of legal rules — it was a total social order enforced by custom, economic pressure, and the ever-present threat of violence. A Black man who looked a white man in the eye too long, or failed to step off the sidewalk, or was accused of anything at all, could find himself facing a lynch mob. Between Reconstruction and World War II, thousands of Black Americans — men, women and even children — were lynched, often publicly and festively, with onlookers smiling while posing for pictures with the victim. Law enforcement often did nothing and at times even actively participated.

The Great Migration — the mass movement of Black Americans from the South to Northern and Midwestern cities beginning around 1910 — was driven in large part by Jim Crow. Millions fled to Chicago, Detroit, New York, and Los Angeles in search of something approaching equal treatment. What they often found instead was a northern variant: informal segregation through redlining (systematic denial of mortgages in Black neighborhoods), discriminatory hiring, and residential segregation enforced by real estate covenants and social pressure.

The Legal Dismantling: Brown, the Civil Rights Act, and the Voting Rights Act

The legal edifice of Jim Crow began to crack in 1954, when the Supreme Court issued its unanimous decision in Brown v. Board of Education. Directly overturning Plessy, the Court held that segregated schools were inherently unequal and unconstitutional. The ruling did not end segregation — Southern states resisted fiercely, and desegregation proceeded at a glacial pace well into the 1970s — but Brown pulled the legal rug out from under “separate but equal.”

The civil rights movement of the late 1950s and early 1960s — marked by sit-ins, freedom rides, the Birmingham campaign, the March on Washington, and countless acts of individual courage in the face of brutal repression — built the political pressure that forced legislative action. The Civil Rights Act of 1964 prohibited discrimination in public accommodations and employment. The Voting Rights Act of 1965 dismantled the machinery of Black disenfranchisement in the South, sending federal examiners into states with histories of discrimination to ensure that Black citizens could actually register and vote. By 1965 the majority of the formal Jim Crow laws had been overturned.

The Vestiges: Jim Crow’s Long Shadow

Ending Jim Crow legally is not the same as ending its consequences — or, as some argue, its functional successors. Legal scholar Michelle Alexander, in her landmark 2010 book The New Jim Crow, argues that mass incarceration has emerged as a new system of racialized social control. Black Americans are incarcerated at roughly five times the rate of white Americans. A felony conviction — often stemming from drug offenses prosecuted far more aggressively in Black communities despite similar rates of drug use across races — carries a cascade of legal disabilities: loss of voting rights in most states, exclusion from public housing and many jobs, and ineligibility for certain federal benefits. Nearly 30% of Black men carry felony records.

The racial wealth gap stands as perhaps the most stubborn vestige of a century of legal exclusion. The median Black family holds roughly one-tenth the wealth of the median white family — a gap driven not by individual choices but by generations of legally enforced exclusion from homeownership, inheritance, and wealth-building opportunities. Redlining — the systematic denial of mortgages in Black neighborhoods by federally-backed banks — was official federal policy from the 1930s through the 1960s and left neighborhood segregation patterns that persist visibly today.

Voting rights remain contested territory. The Supreme Court’s 2013 ruling in Shelby County v. Holder gutted the preclearance requirement of the Voting Rights Act, which had required states with histories of discrimination to get federal approval before changing election laws. Since then, a wave of new restrictions — voter ID laws, aggressive voter roll purges, reduced polling locations, and aggressive felony disenfranchisement — has fallen disproportionately on Black, Latino, and Indigenous voters. As of April 2024, 19 states require photo identification to vote, a requirement critics note functions as a modern poll tax for those who lack access to the required documents.

Residential segregation, too, endures. American neighborhoods and, by extension, their schools remain largely segregated by race — a product not of individual choice but of policies like redlining, racially restrictive housing covenants, and “white flight” that were actively promoted by governments at every level. These patterns mean that school quality, which is largely tied to local property tax revenues, continues to diverge sharply by race.

Conclusion

The arc of Jim Crow runs from the absurd to the tragic: from a white comedian in burnt-cork makeup doing a shuffling dance routine, to a legal apparatus that stripped millions of Americans of their dignity, their rights, and their lives for a century. The name itself tells you what the architects of segregation thought of their project — it was always a contemptuous slap in the face of Black Americans.

While the formal system was legally dismantled between 1954 and 1965 — which is rightly understood as a profound achievement — the legal end of Jim Crow is not the same as justice, and it is not the same as equality. The wealth gap, the incarceration gap, the voting access gap, and the education gap all bear the fingerprints of a system that successfully kept Black Americans subordinate for generations.

Understanding Jim Crow fully requires tracing it from its shameful origins in a minstrel song, through its deadly flowering as a legal regime, to its present-day aftereffects. The name may have disappeared from the law books, but the consequences have not and some critics of the current administration see the dismantling of DEI as an indirect form of Jim Crow revival or neo-segregation. They believe that race-neutral language is being used to reproduce racial inequality without openly naming race.  This is sometimes described this as “Jim Crow 2.0” or “colorblind Jim Crow” and should be no more acceptable than its more blatant ancestor.

Sources

1. Wikipedia — Thomas D. Rice: https://en.wikipedia.org/wiki/Thomas_D._Rice

2. Wikipedia — Jim Crow (Character): https://en.wikipedia.org/wiki/Jim_Crow_(character)

3. Wikipedia — Jump Jim Crow: https://en.wikipedia.org/wiki/Jump_Jim_Crow

4. Jim Crow Museum, Ferris State University — Who Was Jim Crow?: https://jimcrowmuseum.ferris.edu/who/index.htm

5. Jim Crow Museum, Ferris State University — The Origins of Jim Crow: https://jimcrowmuseum.ferris.edu/origins.htm

6. Britannica — What Is the Origin of the Term “Jim Crow”?: https://www.britannica.com/story/what-is-the-origin-of-the-term-jim-crow

7. Britannica — Jim Crow Law: https://www.britannica.com/event/Jim-Crow-law

8. National Archives — Plessy v. Ferguson (1896): https://www.archives.gov/milestone-documents/plessy-v-ferguson

9. Wikipedia — Plessy v. Ferguson: https://en.wikipedia.org/wiki/Plessy_v._Ferguson

10. Wikipedia — Jim Crow Laws: https://en.wikipedia.org/wiki/Jim_Crow_laws

11. PBS — Jim Crow & Plessy v. Ferguson: https://www.pbs.org/tpt/slavery-by-another-name/themes/jim-crow/

12. Howard University School of Law — Reconstruction and Jim Crow Eras: https://library.law.howard.edu/civilrightshistory/blackrights/jimcrow

13. American Battlefield Trust — The Jim Crow Era: https://www.battlefields.org/learn/articles/jim-crow-era

14. Michelle Alexander — The New Jim Crow (Introduction Excerpt): https://newjimcrow.com/about/excerpt-from-the-introduction

15. Economic Policy Institute — Voter Suppression Rooted in Racism: https://www.epi.org/publication/rooted-racism-voter-suppression/

16. American Academy of Arts and Sciences — Somewhere Between Jim Crow and Post-Racialism: https://www.amacad.org/publication/daedalus/somewhere-between-jim-crow-post-racialism

17. Yale Macmillan — History of Minstrel Shows and Jim Crow: https://macmillan.yale.edu/glc/history-minstrel-shows-and-jim-crow

Announcing a New Feature

By

On April 23, 2026

In Commentary, Uncategorized

As part of my ongoing efforts to make sure that The Grumpy Doc is no more than 20 years out of date, I’ve added a search function to the site.  If you look to your right, you will see it cleverly labeled as SEARCH.  Just enter any keyword and search away.

The One True Gospel of Wellness

By

On April 23, 2026

In Commentary, Medicine

Why Every Guru Thinks They’ve Found the Only Path to Health

There’s a peculiar affliction that seems to strike fitness influencers, biohackers, homeopathic healers, and wellness gurus with near-universal consistency — the unshakeable conviction that they, and only they, have cracked the code on human health. Whether it’s cold plunges at 4 a.m., microdosing mushrooms, coffee enemas, or whatever supplement stack is trending this week, every one of these prophets arrives at the same conclusion: their method is the path, the others are at best misguided, and mainstream medicine is a corrupt temple worth burning down.

Psychologists have a name for part of what’s happening here. It’s called the Dunning-Kruger effect — the tendency for people with limited knowledge in a domain to overestimate their own competence. But that’s only part of the story. Many of these figures are genuinely smart, sometimes even credentialed. What really drives the zealotry is something closer to what researchers call “belief perseverance” — the tendency to hold tightly to a conclusion even when contradicting evidence rolls in. Once someone has built an identity, a brand, and an income stream around a single idea, the psychological and financial cost of admitting nuance becomes enormous.

Take the biohacking community as a prime example. Some influencers — like the self-proclaimed “father of biohacking” — have built empires on the premise that optimizing the body is a matter of finding the right levers and pulling them correctly. They have championed everything from Bulletproof Coffee to infrared saunas to testosterone replacement, positioning each as a revelation that conventional medicine is too slow or too corrupted to acknowledge. The problem isn’t that all of these interventions lack merit — some have legitimate science behind them. The problem is the rhetorical framework: the idea that skeptics aren’t just wrong, they’re complicit. That’s not science; that’s a revival meeting.

Homeopathy sits at a different extreme but runs on the same engine. Developed in the late 18th century by Samuel Hahnemann, homeopathy is based on the idea that substances that cause symptoms in healthy people can cure those symptoms in the sick — and that extreme dilution actually strengthens a remedy’s potency. The scientific consensus is unambiguous: systematic reviews and meta-analyses have repeatedly found homeopathic remedies perform no better than placebo. And yet its advocates don’t merely disagree with this consensus — they dismiss the entire evidentiary framework, arguing that conventional research methods simply can’t measure what homeopathy does. It’s an airtight position: no evidence can ever count against it.

The fitness world runs its own version of this dogmatism on a perpetual loop. CrossFit devotees insist that anything other than functional high-intensity training is a waste of time. Carnivore diet advocates declare that vegetables are quietly poisoning you with antinutrients. Yoga instructors sometimes slide into the claim that breath control and mindfulness can substitute for actual medical care. Each subculture has its orthodoxy, its apostles, and its convenient explanations for why people who don’t follow the program are sick, lazy, or deceived. The irony is that many of these systems contain genuinely useful elements. Resistance training really does build muscle and bone density. Mindfulness really does reduce cortisol. Dietary quality really does matter enormously. But the insistence on one method to the exclusion of all others transforms useful practices into something closer to religious doctrine.

What’s lost in all the noise is the most important truth in medicine: human bodies are wildly heterogeneous. What works beautifully for one person may be ineffective or even harmful for another. This isn’t a flaw in the science — it is the science. Precision medicine, one of the most promising frontiers in modern healthcare, is built entirely on this recognition. The dream of a single universal protocol for human health isn’t just unrealized — it’s probably unrealizable. Yet that’s precisely what every wellness guru is selling.

There’s also a social dimension worth naming. The wellness industry is, in the most literal sense, an industry. It generated an estimated $5.6 trillion globally in 2022, according to the Global Wellness Institute, and that number continues to climb. When someone’s livelihood depends on their particular system being not just good but uniquely correct, objectivity becomes a luxury they can’t easily afford. Dismissing alternatives isn’t just tribalism — it’s good business.

None of this is to say that skepticism toward mainstream medicine is always misplaced. Conventional healthcare has real blind spots — in chronic disease management, in nutrition research, in the treatment of pain, and in its historical tendency to dismiss patient experience. The gurus often fill genuine gaps that the system has left open. But filling a gap is different from claiming you have the only map to the entire territory. The honest answer in health and fitness, as in most complex domains, is that we know a good deal, we don’t know quite enough, and anyone who tells you they’ve figured it all out probably hasn’t.

The next time someone tells you they’ve discovered the only way — whether it’s a supplement protocol, a spiritual practice, or a morning routine — it might be worth asking the simplest question in science: compared to what? If the answer is a dismissive wave at everything else, you probably have your answer.

Illustration generated by author using ChatGPT.

Sources

Global Wellness Institute — Global Wellness Economy Monitor: https://globalwellnessinstitute.org/industry-research/

Ernst E. — Homeopathy: The Undiluted Facts (Springer, 2016): https://link.springer.com/book/10.1007/978-3-319-43592-3

Dunning D. — The Dunning-Kruger Effect, Advances in Experimental Social Psychology: https://www.sciencedirect.com/science/article/pii/S0065260111440024

National Institutes of Health — Precision Medicine Initiative: https://www.nih.gov/research-training/allofus-research-program

Medical Disclaimer

The information provided in this article is intended for general educational and informational purposes only and does not constitute medical advice. It should not be used as a substitute for professional medical advice, diagnosis, or treatment.

Always seek the guidance of a qualified healthcare provider with any questions you may have regarding a medical condition or treatment. Never disregard professional medical advice or delay seeking it because of something you have read here.

If you are experiencing a medical emergency, call 911 or your local emergency number immediately.

The author of this article is a licensed physician, but the views expressed here are solely those of the author and do not represent the official position of any hospital, health system, or medical organization with which the author may be affiliated.

The Curious Art of Pointing: Late 18th-Century Portraiture and the Language of Gestures

By

On April 20, 2026

In Art

I spend a lot of time studying the period of American history from the late 18th century to the early 19th century, particularly the events and the people surrounding the American Revolution. One of the things I like to do is study portraits of the main characters to try to get a sense of what they may have been like.  When you examine portraits from that period, you’ll notice something peculiar: people are constantly pointing at things. I couldn’t help but wonder: “What’s that all about? “

 English aristocrats extend their fingers toward their estates, American founding fathers gesture toward constitutional documents, and wealthy merchants direct our attention to symbols of their success. This wasn’t accidental theatrical posing—it was a sophisticated visual language where hand gestures functioned as a kind of shorthand, acting as indicators of the subject’s station, qualities and character.

The pointing gesture had become such a convention by the late 18th century that it almost seemed compulsory. But unlike today’s selfie poses, these carefully orchestrated hand positions required subjects to hold them for hours while painters worked. So why would anyone endure such discomfort just to point at seemingly empty space or distant objects?

Where They Were Pointing—And Why It Mattered

The objects of these pointing gestures reveal what late 18th-century society considered worth advertising. In Gainsborough’s painting of Mr. and Mrs. Robert Andrews, the landscape performs a much more important role than mere background—it depicts the Andrews’ estate and is intended to represent their wealth and status. Mr. Andrews doesn’t just stand near his property; he actively directs the viewer’s attention to it, essentially saying “Look at what I own.”

This was particularly important in England, where portraits became public records of status and position during the 18th century, and images of opulently attired figures were a means to affirm the authority of important individuals. Property ownership defined social standing in ways modern Americans might find difficult to fully appreciate. Your land wasn’t just where you lived—it was your identity, your political power, and your legacy rolled into one.

Sometimes the gesture proved unintentionally ironic.  In his 1768 portrait, General Thomas Gage points to imagined military success—an outcome history would later deny him.

American portraiture developed its own flavor of pointing symbolism, though it borrowed heavily from English conventions. After the Revolution, the United States looked for a new identity and history, a capacity for visual communication aimed at all citizens. American subjects often pointed toward documents, books, or symbols of their professional achievements rather than ancestral estates they didn’t possess. A lawyer might gesture toward law books, a scientist toward instruments, a founding father toward constitutional documents. The gesture said, “This is what I’ve accomplished” rather than “This is what I inherited.”

The Multiple Meanings of a Pointed Finger

The act of pointing served several simultaneous purposes in these portraits, which made it remarkably efficient for painters and patrons working within the constraints of canvas and paint. First, it created visual movement and prevented the deadly sin of portrait painting: making your subject look like a corpse propped up in fancy clothes. Long fingers were a sign of elegance and beauty, which signified culture, and hence intelligence, wealth and benevolence in the convention of these pictures.

Second, the gesture connected the subject to their accomplishments and possessions without requiring them all to fit within the frame. A merchant pointing toward a distant ship implied maritime trade; a landowner gesturing toward rolling fields suggested vast holdings beyond what any canvas could contain. The pointed finger became a visual ellipsis, suggesting “and more besides.”

Third, pointing engaged viewers in a way static poses couldn’t. When Thomas Gainsborough’s subjects point at their estates, or when artist Angelica Kauffman depicts herself with art personified pointing the way forward, they’re creating a relationship with anyone looking at the painting. The gesture says, “Let me show you something,” turning passive viewing into a guided tour.

The Curious Case of Pointing at Nothing

Here’s where things get genuinely weird: many portrait subjects from this period appear to be pointing at absolutely nothing of consequence. There’s an abundance of important people pointing at nothing, which most likely has meaning, but it’s impossible to know what. King James II appears in multiple portraits pointing off-canvas at no identifiable object. English courtesans and French aristocrats extend elegant fingers toward empty space. What gives?

Several theories attempt to explain this phenomenon. Some art historians argue these portraits once formed diptychs or larger compositions where the pointing made sense in context. Others suggest the gesture had become so conventionalized that it persisted even without specific referents—it simply meant “I am important enough to be painted pointing at things.” Perhaps the ambiguity was intentional. It invited the viewer to imagine: the future, moral principles, destiny, or duty. This wasn’t symbolism in the modern sense—it was rhetorical suggestion.

Still others propose that the elegant display of hands was itself the point. During the Renaissance and into the 18th century, hands were as important a focus of attention as the face was, because they were the only other visible area of the body, and representation of the position of the hands became a decorative element that was almost as important as the face. Showing refined, aristocratic hands in graceful poses demonstrated genteel breeding regardless of where they pointed.

The Anglo-American Divergence

American portraits, by contrast, celebrated individual achievement in a republic supposedly free from hereditary privilege. In the New World, portraits were created by the people, the ordinary settlers and citizens of the developing countries, and portraits began to make a move from a false pretense to almost exact likeness in the 1730s. John Singleton Copley’s American subjects pointed toward symbols of their professions, their intellectual pursuits, or occasionally toward landscapes that represented American natural abundance rather than private ownership.

This difference wasn’t just aesthetic—it reflected fundamentally different answers to the question “What makes someone worth painting?” In England, the answer remained largely “birth and property.” In America, it was increasingly “accomplishment and character,” even if wealthy Americans proved just as eager to commission portraits displaying their property as any English lord.

The Practical and the Symbolic

There were also wonderfully mundane reasons for the pointing convention. With the invention of photography, the pose continued but may have had an additional purpose in preventing blurring by maintaining the sitter’s hand in a single place. Even in painted portraits, giving subjects something to “do” with their hands solved the age-old problem of what to do with idle limbs during hours of sitting still. The pointing gesture was energetic enough to look dynamic but simple enough to hold for extended periods.

Artists also recognized that pointing could subtly advertise their own skills. German artist Albrecht Dürer’s earliest self-portrait, drawn when he was only thirteen, depicts him pointing with his finger, suggesting that even at that age he knew that a pointing finger was an important symbol. The gesture reminded viewers that what they saw was created by an artist’s hand, a commentary woven into the composition itself.

Those pointing fingers weren’t quirks or affectations. They were a shared visual grammar that told viewers how to understand power, intellect, and legitimacy in an Enlightenment world that cared deeply about appearing rational, purposeful, and morally grounded.

Once you see it, you can’t unsee it—and you’ll start noticing how modern leaders use subtler versions of the same visual cues today.

Image Sources

Gilbert Stuart – George Washington – Google Art Project.jpg Copy, via Wikimedia Commons,  public domain

John Singleton Copley – General Thomas Gage – Google Art Project.jpg Copy, via Wikimedia Commons, public domain

Angelica Kauffmann –  Self Portrait of the Artist Hesitating between the Arts of Music and Painting; National Trust, Nostell Priory, via Wikimedia Commons, public domain

Sir Peter Lely – James II and Anne Hyde, Copy, National Trust, via Wikimedia Commons, public domain

John Trumbull – Alexander Hamilton, full-length portrait, standing, facing left, left hand on hip, right arm extended outward, books and papers beside him LCCN89706847.jpg Copy, via Wikimedia Commons, public domain

Text Sources

·  Baetjer, Katharine. “Portrait Painting in England, 1600–1800.” Metropolitan Museum of Art. https://www.metmuseum.org/toah/hd/bpor/hd_bpor.htm

·  Gustlin, Katherine and Gustlin, Mark. “Portraits (18th Century).” A World Perspective of Art Appreciation. Humanities LibreTexts. https://human.libretexts.org/Courses/Evergreen_Valley_College/A_World_Perspective_of_Art_Appreciation_(Gustlin_and_Gustlin)/10:_The_New_World_Grows_(1700_CE__1800_CE)/10.2:_Portraits_(18th_Century)

·  Lazzeri, D., Nicoli, F., Zhang, Y.X. “Secret hand gestures in paintings.” Acta Biomedica 2019; Vol. 90, N. 4: 526-532. https://www.researchgate.net/publication/338457261_Secret_hand_gestures_in_paintings

·  “Pointing and Touch.” Every Painter Paints Himself. https://www.everypainterpaintshimself.com/theme/pointing_and_touch

·  “Pointing in portraits.” History Forum. https://historum.com/t/pointing-in-portraits.83092/

·  “Portrait painting.” Wikipedia. https://en.wikipedia.org/wiki/Portrait_painting

·  “Portraits in the Landscape.” Photo-graph. https://photo-graph.org/2013/01/09/portraits-in-the-landscape/

The Accidental Footnote: Heel Spurs, the Vietnam Draft, and American Inequality

By

On April 17, 2026

In Commentary, History, Medicine, Politics

If you’ve ever winced taking your first steps out of bed in the morning, you may have already made an involuntary acquaintance with heel spurs — or more precisely, with the condition that often travels with them. The term itself sounds alarming, and for a brief but colorful stretch of American political history, it became something far more charged than a footnote to podiatry. But before we get to the politics, it’s worth understanding what a heel spur actually is, because the medical reality is both more mundane and more complicated than the caricature.


What Exactly Is a Heel Spur?
A heel spur is a small bony outgrowth — technically called a calcaneal spur — that extends from the underside of the heel bone (the calcaneus). It forms at the spot where the plantar fascia — the thick ligament running the length of your foot from heel to toe — attaches to the heel bone. The spur is not, despite what the name implies, a sharp spike. It is typically smooth and rounded, though it can still cause irritation if it presses into surrounding soft tissue.


The image depicts a comparison between a healthy foot and one with a prominent foot ulcer, highlighting the condition's visible effects. AI-generated content may be incorrect.
 
Heel spurs affect about 10% of the population, making them one of the more common foot conditions around, though most people who have one don’t know it. The spur develops gradually — usually over months or even years — as the body deposits calcium in response to chronic stress at that heel attachment point. Think of it less as damage and more as your skeleton’s attempt at reinforcement.

What Causes Them?
The underlying driver is repetitive mechanical stress on the foot. Heel spurs are particularly associated with strains on foot muscles and ligaments, stretching of the plantar fascia, and repeated small tears in the membrane covering the heel bone. Athletes who do a lot of running and jumping are especially prone.

But you don’t need to be an elite runner to develop one. Walking gait problems — particularly overpronation, where the foot rolls inward — place uneven stress on the heel with each step. Worn-out or poorly fitted shoes, which fail to absorb shock or support the arch, compound the problem. Obesity increases the mechanical load on the heel. Occupations that require prolonged standing or walking on hard surfaces put the plantar fascia under constant tension. And as people age, tendons and ligaments lose their elasticity, making the tissues more vulnerable to micro-tears and the subsequent bony repair response.

Heel spurs are also closely connected to a condition most people have heard of: plantar fasciitis. The two are related a but not identical. Plantar fasciitis is inflammation of the plantar fascia itself, usually from overuse. A heel spur can develop as a downstream consequence of that inflammation — the body lays down extra bone in response to the ongoing stress at the fascia’s attachment point.

Symptoms — or the Lack Thereof
Here’s the part that surprises most people: the majority of heel spurs cause no symptoms at all, and many are discovered incidentally on X-rays taken for other reasons. Only about 5% of heel spurs are estimated to be symptomatic.

When a heel spur does produce symptoms, the experience is heavily intertwined with plantar fasciitis. The classic description is a sharp, stabbing pain on the bottom of the foot first thing in the morning, or after any prolonged rest. Many people compare it to stepping on a tack. Paradoxically, this pain often eases somewhat after walking around for a few minutes, only to return after extended time on the feet or after another rest. It’s that “worse in the morning” quality that tends to be the giveaway.

Other symptoms, when present, can include localized swelling, warmth, and tenderness along the front of the heel, as well as increased sensitivity on the underside of the foot. It’s worth noting that the pain associated with a heel spur is not generally thought to come from the bony spur itself, but from the irritation it causes in the surrounding soft tissue — tendons, ligaments, and bursae.

How Is It Diagnosed?
Diagnosis typically begins with a physical exam. Your doctor or podiatrist will ask about when the pain started, what activities preceded it, and what makes it better or worse. They’ll examine your foot for tenderness at specific points, assess your range of motion, and check foot alignment and press on key areas to locate the source of pain.

Imaging confirms the picture. An X-ray can clearly show the bony spur and is the most commonly used test. That said, the size of the spur on an X-ray doesn’t necessarily correspond to how much pain a patient is experiencing — a small spur can be quite painful while a large one may cause no trouble at all. In more complex cases, an MRI may be ordered to assess the soft tissues more closely and evaluate whether plantar fasciitis or another condition is also in play.

Treatment Options
The reassuring news is that the vast majority of cases resolve without surgery. More than 90% of patients improve with nonsurgical treatment. The catch is that conservative management requires patience — improvement typically takes weeks, and more stubborn cases can take months.

The cornerstone of treatment is rest and reducing the activities that provoke pain. This doesn’t necessarily mean completely stopping exercise; low-impact alternatives like swimming, cycling, or rowing allow you to stay active while giving the heel a break from impact. Icing the bottom of the foot after activity helps manage inflammation. Over-the-counter anti-inflammatory medications like ibuprofen or naproxen can provide relief, though they’re intended for short-term use.

Footwear matters enormously. Supportive shoes with good arch support, cushioning, and a slight heel rise reduce the strain on the plantar fascia. Custom orthotics with molded insoles designed to redistribute pressure across the foot are often recommended, particularly for people with gait abnormalities or flat feet. Physical therapy can be part of the treatment plan, focusing on stretching the calf muscles and plantar fascia, strengthening the foot’s intrinsic muscles, and correcting biomechanical issues.

For cases that don’t respond to these initial measures, the next tier of treatment includes corticosteroid injections to reduce inflammation at the spur site, and extracorporeal shockwave therapy — a non-invasive procedure that uses sound waves to stimulate healing in chronically inflamed tissue. Surgery is reserved for the minority of cases where conservative treatment fails after nine to twelve months. Possible complications include nerve pain, infection, scarring, and — with plantar fascia release — the risk of foot instability or stress fracture. Most orthopedic surgeons regard surgery as a last resort.

Are Heel Spurs Debilitating?
For most people, the honest answer is: no.  Heel spurs are a common condition with a favorable prognosis, especially with early diagnosis and appropriate management. Many people live with heel spurs for years without ever knowing it, and even those who develop pain typically find substantial relief with conservative treatment within four to eight weeks.
That said, the pain at its worst — particularly in conjunction with plantar fasciitis — can be genuinely disruptive to daily life. Athletes may find their training significantly limited. People who spend long hours on their feet at work may struggle with sustained discomfort. And a small percentage of patients do end up with prolonged, treatment-resistant pain that affects mobility. So, the more accurate framing might be: heel spurs have the potential to be significantly uncomfortable and functionally limiting during flare-ups, but with proper treatment most people recover well and return to normal activity.

Heel Spurs and the Vietnam-Era Draft
Which brings us to an improbable chapter in heel spur history. During the Vietnam War era, heel spurs became — for at least one famous case — a ticket out of military service. Understanding how that worked requires a brief detour into the draft system of the 1960s and 1970s, and what it meant to receive a medical deferment.
According to the National Archives, of the roughly 27 million American men eligible for military service between 1964 and 1973, about 15 million were granted deferments — mostly for education, and some for mental or physical problems — while only 2,215,000 were actually drafted into service—another eight million volunteered. Some of those who later served had previously had deferments. The system was sprawling, complex, and — as was widely acknowledged even at the time — deeply unequal.
Roughly 60% of draft-eligible American men took some sort of action to avoid military conscription. There were many routes: college deferments, fatherhood, conscientious objector status (170,000 men received those alone), National Guard enlistment, and medical exemptions. Medical deferments covered a wide range of conditions — from serious chronic illness to conditions that, in a different context, most people would consider minor. Flat feet, poor eyesight, asthma, and yes, bone spurs all appeared on the list of potentially disqualifying ailments.
The system was known to favor men with access to money, education, and well-connected physicians. American forces in Vietnam were 55% working-class and 25% poor — reflecting those who didn’t have the means to navigate the deferment labyrinth. A working-class kid from rural West Virginia was far more likely to end up in the Mekong Delta than the son of a New York real estate developer.

The Most Famous Heel Spur in American History
Which leads, inevitably, to Donald Trump. As confirmed by Selective Service records obtained and reported by multiple news outlets, Trump received five Vietnam-era draft deferments — four for college attendance at Fordham and the Wharton School, and a fifth in 1968, recorded as a medical deferment for bone spurs in his heels. The medical classification left him disqualified for military service.

The circumstances surrounding the diagnosis have been contested ever since. Reporting by the New York Times included accounts from the daughters of a Queens podiatrist named Larry Braunstein, who alleged that their father had provided or vouched for the diagnosis as a professional favor to Trump’s father, Fred Trump — a landlord to whom Braunstein reportedly owed a debt of gratitude. Trump’s former lawyer Michael Cohen also testified that Trump had admitted to fabricating the injury. Trump himself has maintained that the diagnosis was legitimate, stating that a doctor “gave me a letter — a very strong letter — on the heels.” The underlying medical records that would resolve the dispute are, conveniently, not publicly available; most individual Selective Service medical records from that era were subsequently destroyed.

It’s worth noting that Trump’s pattern — using legal channels, including a medical deferment of questionable validity, to avoid Vietnam service — was not unique to him. Historians have pointed out that numerous prominent figures on both sides of the political aisle received deferments of various kinds, including Joe Biden (asthma), Dick Cheney (student deferments), Bill Clinton (navigated the ROTC system), and George W. Bush (National Guard). The heel spur episode became politically charged in part because of Trump’s later hawkish rhetoric and his outspokenness in questioning the military service of others — most notably Senator John McCain, who spent years as a prisoner of war in North Vietnam.

How Many People Got Heel Spur Deferments?
This is where the historical record hits a hard wall. No reliable statistics exist specifically for heel spur deferments. The Selective Service tracked broad categories — student deferments, hardship deferments, conscientious objector status, medical disqualifications — but it did not publish a breakdown by specific diagnosis, and most individual medical records from that era no longer exist.

What we can say is that bone spurs were a recognized medical disqualifier under Selective Service regulations, that medical deferments broadly were a commonly used — and commonly abused — avenue for avoiding service, and that the process was heavily influenced by access to sympathetic physicians. A man with means, connections, and a cooperative podiatrist had options that a man without those resources did not.

The honest answer, then, is that we don’t know how many men received deferments citing heel spurs specifically, and we almost certainly never will. The data either wasn’t tracked at that level of granularity or was long since destroyed. What we do know is that the condition became, for a time, a lens through which Americans examined something much larger: who serves, who doesn’t, and whether the systems meant to govern those decisions are applied fairly.

For most people, a heel spur is a manageable, if annoying, footnote in the story of their health. For at least one person, it became a footnote in the history of American politics.
 
Personal Note: I have heel spurs; I wish I’d known about them in 1967.
 
Images generated by author using AI.

Medical Sources
Cleveland Clinic — Heel Spurs overview
https://my.clevelandclinic.org/health/diseases/21965-heel-spurs
WebMD — Heel Spur Causes, Symptoms, Treatments, and Surgery
https://www.webmd.com/pain-management/heel-spurs-pain-causes-symptoms-treatments
Hackensack Meridian Health — Bone Spurs in the Heel: Symptoms and Recovery
https://www.hackensackmeridianhealth.org/en/healthier-you/2024/01/02/bone-spurs-in-the-heel-symptoms-and-recovery
OrthoArkansas — Heel Spurs
https://www.orthoarkansas.com/heel-spurs-orthoarkansas/
EmergeOrtho — Heel Bone Spurs: Causes, Symptoms, Treatment
https://emergeortho.com/news/heel-bone-spurs/
American Academy of Orthopaedic Surgeons — Plantar Fasciitis and Bone Spurs
https://orthoinfo.aaos.org/en/diseases–conditions/plantar-fasciitis-and-bone-spurs/
Vietnam Draft & Military Service Sources
History.com — 7 Ways Americans Avoided the Draft During the Vietnam War
https://www.history.com/articles/vietnam-war-draft-avoiding
Wikipedia — Draft Evasion in the Vietnam War
https://en.wikipedia.org/wiki/Draft_evasion_in_the_Vietnam_War
Wikipedia — Conscription in the United States
https://en.wikipedia.org/wiki/Conscription_in_the_United_States
Students of History — The Draft and the Vietnam War
https://www.studentsofhistory.com/vietnam-war-draft
University of Michigan — The Military Draft During the Vietnam War
https://michiganintheworld.history.lsa.umich.edu/antivietnamwar/exhibits/show/exhibit/draft_protests/the-military-draft-during-the-
Vietnam Veterans of America Chapter 310 — Vietnam War Statistics
https://www.vva310.org/vietnam-war-statistics
Vietnam Veterans of Foreign Wars — Fact vs. Fiction: The Vietnam Veteran
https://www.vvof.org/factsvnv.htm
New York City Vietnam Veterans Plaza — Interesting Facts About Vietnam
https://www.vietnamveteransplaza.com/interesting-facts-about-vietnam/
 
 
Medical Disclaimer
The information provided in this article is intended for general educational and informational purposes only and does not constitute medical advice. It should not be used as a substitute for professional medical advice, diagnosis, or treatment.
Always seek the guidance of a qualified healthcare provider with any questions you may have regarding a medical condition or treatment. Never disregard professional medical advice or delay seeking it because of something you have read here.
If you are experiencing a medical emergency, call 911 or your local emergency number immediately.
The author of this article is a licensed physician, but the views expressed here are solely those of the author and do not represent the official position of any hospital, health system, or medical organization with which the author may be affiliated.
 

Lady Liberty: The Statue We Think We Know

By

On April 14, 2026

In Commentary, History, Politics

Collection of the author

Ask most Americans what the Statue of Liberty means and they’ll say the same thing: she welcomes immigrants. She is the “Mother of Exiles,” keeper of the golden door. That image is so deeply woven into the national identity that it has been quoted, protested, and debated for more than a century. The only problem is that it wasn’t what her creators originally intended.

The story begins in 1865, just weeks after the Civil War ended, at a dinner party near Versailles. The host was Édouard de Laboulaye, a French historian and president of the French Anti-Slavery Society. Laboulaye was one of France’s most passionate admirers of American democracy and was deeply moved by both Lincoln’s assassination and the abolition of slavery. He proposed that France present the United States with a colossal monument — one that would celebrate two things at once: the centennial of American independence and the end of slavery.

Sculptor Frédéric-Auguste Bartholdi was at that dinner and took the idea and ran with it. Early models from around 1870 show Lady Liberty with her right arm raised — familiar enough — but in her left hand she holds broken shackles, not a tablet. The anti-slavery message was unmistakable.

That symbolism didn’t entirely disappear from the final design — it just got moved. According to the National Park Service, Bartholdi placed a broken chain and shackle at the statue’s feet, hidden beneath the copper drapery. Most visitors never notice it. The left hand now holds a tablet inscribed with the date of the Declaration of Independence.

Why the change? NYU historian Edward Berenson points to the political climate of the 1880s. By the time the statue was dedicated in October 1886 — more than 20 years after Laboulaye’s dinner — Reconstruction had collapsed, Jim Crow was spreading, and the country was trying to paper over sectional wounds by quietly forgetting the war’s racial roots. Nobody at the dedication mentioned slavery. The abolitionist origins were simply buried.

The statue was formally named Liberty Enlightening the World and the message broadened toward Franco-American friendship and American liberty in general rather than emancipation specifically.

Then came Emma Lazarus, and the second transformation. In 1883, a fundraiser struggling to pay for the statue’s pedestal asked prominent writers to donate works for an auction. Lazarus, a Jewish-American poet, initially declined as she was then deeply involved in aiding Jewish refugees fleeing wide-spread and organized violence in Russia. A friend persuaded her that the statue, sitting at the entrance to New York Harbor, would inevitably be seen as a beacon by arriving immigrants. She wrote “The New Colossus” — fourteen lines that reimagined Lady Liberty entirely, as a “Mother of Exiles” beckoning the world’s tired and poor to America’s golden door.

Not like the brazen giant of Greek fame,
With conquering limbs astride from land to land;
Here at our sea-washed, sunset gates shall stand
A mighty woman with a torch, whose flame
Is the imprisoned lightning, and her name
Mother of Exiles. From her beacon-hand
Glows world-wide welcome; her mild eyes command
The air-bridged harbor that twin cities frame.
“Keep, ancient lands, your storied pomp!” cries she
With silent lips. “Give me your tired, your poor,
Your huddled masses yearning to breathe free,
The wretched refuse of your teeming shore.
Send these, the homeless, tempest-tost to me,
I lift my lamp beside the golden door!”

Strangely, the poem then vanished. It played no role at the statue’s 1886 dedication. Lazarus died in 1887, before Ellis Island even opened. It wasn’t until 1903 that a friend had the entire poem cast onto a bronze plaque that was mounted inside the pedestal——not engraved on the outside as many believe. By then, millions of immigrants had already sailed past the statue on their way to Ellis Island, and the association with immigration had taken hold in the public imagination.

The immigration meaning deepened through the early 20th century as the government used the statue’s image in campaigns to assimilate immigrant children, many of whom lived in ethnic enclaves in large eastern cities. Meanwhile, the abolitionist symbolism that had inspired the project in the first place faded almost entirely from public memory.

The broken shackles are still there, tucked under her robe, mostly invisible. Lady Liberty has been continuously reinterpreted for 160 years — by abolitionists, by a poet responding to a refugee crisis, by politicians, and by millions of people who looked up at that torch from the deck of a ship. Will Lady Liberty and her words continue to offer welcome and hope and be a source of national pride or is her meaning once again being rewritten as a symbol of American identity, dominance, and, perhaps, exclusion?

The Statue’s shackles and feet. National Park Service, Statue of Liberty NM, Public Domain

Sources

National Park Service – Statue of Liberty history: https://www.nps.gov/stli/learn/historyculture/statue-of-liberty.htm Library of Congress – Dedication and speeches: https://www.loc.gov/item/ihas.200197394/ Cleveland, Grover. Dedication Address (1886): https://www.nps.gov/stli/learn/historyculture/cleveland.htm Smithsonian Magazine – History of the Statue of Liberty: https://www.smithsonianmag.com/history/statue-liberty-180970340/

The Art of Rigging Democracy: A Close Look At Gerrymandering

By

On April 13, 2026

In History, Politics

Wikimedia Commons: Elkanah Tisdale (1771-1835) (often falsely attributed to Gilbert Stuart), public domain


Picture this: It’s 1812 in Massachusetts, and Governor Elbridge Gerry has just approved a redistricting plan that creates such a bizarrely shaped legislative district that when a local newspaper editor saw it on a map, he thought it looked like a salamander. The editor sketched wings and claws onto the district, and someone quipped that it looked more like a “Gerry-mander” than a salamander. The term stuck, and more than two centuries later, we’re still dealing with the same problem that inspired that joke.
What Gerrymandering Actually Means
At its core, gerrymandering is the practice of drawing electoral district boundaries to give one political party or group an unfair advantage over its opponents. It’s a form of political manipulation that allows those in power to essentially choose their voters, rather than letting voters choose their representatives. Think of it as a sophisticated form of gaming the system—perfectly legal in many cases, but profoundly anti-democratic in spirit.
The mechanics are surprisingly straightforward. There are two main techniques: “cracking” and “packing.” Cracking involves splitting up concentrations of opposing voters across multiple districts so they can’t form a majority anywhere. Packing does the opposite—cramming as many opposing voters as possible into a few districts so they waste their votes winning by huge margins in just a couple of places, leaving the rest of the districts safely in your column. These techniques can be deployed together to engineer a decisive partisan advantage.
A History of Creative Mapmaking
The practice didn’t start with Gerry, of course. The Founding Fathers—for all their lofty rhetoric about representative democracy—weren’t above putting their thumbs on the electoral scales. But gerrymandering really came into its own in the 20th century as advances in census data, and statistics combined with the addition of newly available computing power made it possible to draw districts with surgical precision.
The 2010 redistricting cycle marked a watershed moment. Single-party control of the redistricting process gave partisan line drawers free rein to craft some of the most extreme gerrymanders in American history often down to the level of individual city blocks. Republicans, having won control of many state legislatures in the 2010 midterms, used sophisticated computer modeling to create maps that locked in their advantages for a decade. Democrats did the same where they had the power, though Republicans controlled more state legislatures and thus wielded greater gerrymandering capability overall.
The 2024-2025 Gerrymandering Wars
Here’s where things get really interesting—and deeply concerning. The situation has exploded into what some are calling “gerrymandering wars” following the 2020 census and a critical Supreme Court decision in 2019. In Rucho v. Common Cause, the Supreme Court ruled that partisan gerrymandering constitutes a non-justiciable “political question” where federal court intervention is unsuitable. Translation: The federal courts won’t stop partisan gerrymandering because they claim there’s no objective standard to measure it.
This opened the floodgates. The Brennan Center estimates that gerrymandering gave Republicans an advantage of around 16 House seats in the 2024 race to control Congress compared to fair maps. But here’s the kicker: we’re not even done with this decade’s redistricting.
In an unprecedented move, President Donald Trump has pushed Republican state lawmakers to further gerrymander their states’ congressional maps, prompting Democratic state lawmakers to respond in kind. In August 2025, during a special session, Texas’s legislature passed a redistricting plan that weakens electoral opportunities for Black and Hispanic voters.  California has threatened to respond with its own gerrymander, creating a tit-for-tat dynamic that could spiral out of control.
North Carolina provides perhaps the most dramatic example. After the state supreme court reversed its position on policing partisan gerrymandering, the Republican-controlled legislature redrew the map, and after the 2024 election, three Democratic districts flipped to Republicans—enough to give control of the U.S. House to the GOP by a slim margin.
The situation has gotten so extreme that both parties are now openly engaging in mid-decade redistricting—something that traditionally only happened after each ten-year census. California, Missouri, North Carolina, Ohio, Texas and Utah have all adopted new congressional maps in 2025, with new maps also appearing possible in Florida, Maryland and Virginia.
The Racial Dimension
It’s crucial to note that gerrymandering comes in two flavors: partisan and racial. While partisan gerrymandering is currently legal thanks to the Supreme Court, racial gerrymandering—drawing districts specifically to dilute the voting power of racial minorities—violates the Voting Rights Act of 1965. The line between the two can get blurry, though, since partisan voting patterns often correlate with race.
In May 2025, a federal court ruled that Alabama’s 2023 congressional map not only violates Section 2 of the Voting Rights Act but was enacted by the Alabama Legislature with racially discriminatory intent. Similar battles are playing out in Louisiana, Mississippi, and other states. The legal landscape here is complex, with courts sometimes walking a tightrope between ensuring fair representation for communities of color and avoiding the creation of what could be challenged as racial gerrymanders.
What Can Be Done About It?
The most popular reform proposal is the creation of independent redistricting commissions—bodies of citizens (not politicians) who draw district maps according to neutral criteria.  Currently, several states including Colorado, Michigan, Ohio and Virginia use redistricting commissions to draw congressional and state legislative maps, ranging from political commissions with elected officials to completely independent commissions that bar all elected officials from serving as commissioners.
Do they work? The evidence is mixed but generally positive. According to a Redistricting Report Card published with the Princeton Gerrymandering Project, the states that had some form of commission drew “B+” maps on average, while states where partisans controlled the process drew “D+” maps.  California’s independent commission is often held up as the gold standard, though it’s not perfect—even fairly drawn maps can produce lopsided results due to how voters cluster geographically.
Another proposal focuses on clear, enforceable criteria: compactness, contiguity, respect for existing political boundaries, and transparency in the mapping process. Advances in statistical analysis also make it possible to compare proposed maps against thousands of neutral alternatives to detect extreme outliers, a method increasingly discussed in academic and legal circles.
Federal legislation has been proposed repeatedly. The Redistricting Reform Act of 2025 would prohibit states from mid-decade redistricting and would require every state to adopt nonpartisan, independent redistricting commissions. Similar provisions were included in the “For the People Act” that Democrats passed in the House in 2021, but it died in the Senate. Getting such legislation through Congress would require bipartisan cooperation, which seems unlikely given that both parties see gerrymandering as a political weapon and they believe they can’t afford to unilaterally disarm.
Some reformers advocate for more radical solutions. Proportional representation systems, where the share of votes equals the share of seats, would end boundary-drawing battles altogether and make democracy more representative. Under such a system, if Democrats win 60% of the vote in a state, they’d get roughly 60% of that state’s congressional seats. It’s intuitive and fair, but it would require a fundamental restructuring of American electoral systems—something that’s probably not politically feasible in the near term.
State courts have emerged as a potential backstop. At least 10 state supreme courts have found that state courts can decide cases involving allegations of partisan gerrymandering, even though federal courts won’t touch them.  This means that state constitutional provisions against gerrymandering could provide meaningful protection—though as North Carolina demonstrated, state court compositions can change, and with them, their willingness to police gerrymandering.
The Bottom Line
Gerrymandering represents a fundamental tension in American democracy: How do we draw districts fairly when the people drawing them have every incentive to rig the game in their favor? The problem has ancient roots but ultra-modern manifestations, powered by big data and sophisticated computer modeling that would make Elbridge Gerry’s head spin.
The current moment feels particularly precarious. With Republicans’ razor-thin majority in the House and midterm elections traditionally being unfavorable for the party in power, the Republicans’ action amounts to a preemptive move to retain control of Congress. The Democrats threatened response could trigger an escalating cycle of partisan map manipulation that further entrenches our political divisions and makes elections less responsive to actual voter preferences.
Independent commissions offer a promising path forward, but they’re not a silver bullet. They work better than partisan control, but they can’t eliminate all the inherent challenges of translating votes into seats through geographic districts. More ambitious reforms like proportional representation could solve the problem more completely, but they face enormous political and practical obstacles.
For now, gerrymandering remains what that newspaper editor saw in 1812: a monstrous distortion of democratic principles, hiding in plain sight on our electoral maps. The question is whether we have the political will to slay the beast, or whether we’ll keep feeding it for another two centuries.
 
Sources:
Brennan Center for Justice – Gerrymandering Explained
https://www.brennancenter.org/our-work/research-reports/gerrymandering-explained
 
Brennan Center for Justice – How Gerrymandering Tilts the 2024 Race for the House
https://www.brennancenter.org/our-work/research-reports/how-gerrymandering-tilts-2024-race-house
 
American Constitution Society – America’s Gerrymandering Crisis
https://www.acslaw.org/expertforum/americas-gerrymandering-crisis-time-for-a-constructive-redistricting-framework/
 
ACLU – Court Cases on Gerrymandering
https://www.aclu.org/court-cases?issue=gerrymandering
 
Stateline – State Courts and Gerrymandering
https://stateline.org/2025/12/22/as-supreme-court-pulls-back-on-gerrymandering-state-courts-may-decide-fate-of-maps/
 
Campaign Legal Center – Do Independent Redistricting Commissions Work?
https://campaignlegal.org/update/do-independent-redistricting-commissions-really-prevent-gerrymandering-yes-they-do
 
RepresentUs – End Partisan Gerrymandering
https://represent.us/policy-platform/ending-partisan-gerrymandering/
 
Senator Alex Padilla – Redistricting Reform Act of 2025
https://www.padilla.senate.gov/newsroom/press-releases/watch-padilla-lofgren-introduce-legislation-to-establish-independent-redistricting-commissions-end-mid-decade-redistricting-nationwide/
 
Protect Democracy – How to End Gerrymandering
https://protectdemocracy.org/work/how-to-end-gerrymandering/

Ramps: The Pungent Pride of Appalachian Spring

By

On April 11, 2026

In Appalachia, Food and Drink

It’s time for my annual column about ramps.

Every spring, something remarkable happens on the forest floors of the eastern United States. Before most of the world has shaken off its winter coat, before the first wildflowers have dared to show their faces, a small, broad-leafed plant quietly pushes up through the leaf litter and announces that the season has changed. That plant is the ramp — and if you’ve never heard of it, you probably don’t live in Appalachia, where its annual arrival is something close to a religious event.

What Are Ramps?

Ramps (Allium tricoccum) are a wild, perennial plant belonging to the same family as onions, garlic, and leeks — the Amaryllidaceae, or amaryllis family. Botanically speaking, they’re sometimes called wild leeks or wood leeks, and they share the pungent, sulfur-driven flavor profile of their cultivated cousins. But ramps carry something extra: a garlicky wallop layered on top of the onion bite, bold enough to clear a room. The plant produces two or three broad, smooth, bright green leaves in spring, growing 8 to 12 inches long, attached to a slender stalk that narrows into a small white bulb underground. By late spring, the leaves die back and a flower stalk emerges, producing small white blossoms.

From a nutritional standpoint, ramps belong firmly in the vegetable category — specifically among the allium vegetables — and are genuinely impressive in what they deliver. They’re low in calories (around 30 per 4 ounces) but rich in vitamins A, C, and K, along with minerals including selenium, chromium, iron, and folate. A single cup provides about 30% of the daily recommended value of vitamin A and roughly 18% of the daily value of vitamin C. They also contain sulfur compounds like kaempferol and allicin — the same bioactive chemicals found in garlic — that are associated with cardiovascular health, anti-inflammatory effects, and even some cancer-protective properties.

Historically, ramps also carried a reputation as a kind of folk remedy. After months of limited fresh produce, their arrival was thought to “cleanse the blood” and restore vitality—a belief rooted more in tradition than modern science but not entirely disconnected from their nutritional value.

Where and How They Grow

Ramps have an enormous native range, stretching from Nova Scotia down through Georgia and west to Iowa and Minnesota. But they’re most densely concentrated — and most enthusiastically celebrated — in the Appalachian Mountain corridor. They thrive in rich, moist, well-drained soil under the shade of deciduous trees: maple, beech, poplar, and birch are favorite neighbors. You’re most likely to find them carpeting the floor of a hardwood forest near a stream or on a hillside slope that holds moisture.

The timing of their emergence is part of what makes ramps so culturally charged. They’re spring ephemerals — plants that exploit the brief window between winter’s end and the closing of the forest canopy, when sunlight still reaches the ground in quantity. The leaves typically appear in early April and last only through mid-May before yellowing and dying back. That’s it. A few weeks. You either catch them or you wait another year.

Growing ramps from scratch is not a project for the impatient. Seeds can take 6 to 18 months to germinate and require both a warm moist period and then a cold period to break dormancy. The plants themselves take 5 to 7 years to mature. This slow reproductive cycle is one reason that overharvesting has become a serious concern. The Smoky Mountains National Park banned ramp harvesting entirely in 2002, citing studies showing that ramp populations need years to recover from even a single harvest. Some parts of Canada now limit foragers to 50 bulbs per person.

Many enthusiasts now recommend not harvesting the bulb at all and picking only a single leaf from the plant to allow continued growth.

How They’re Prepared

Ramps are famously versatile — every edible part of the plant can be used. The leaves are milder and wilt down beautifully when cooked. The stalks carry more punch. The bulbs are the most potent part, with an intensity that can outlast the meal and the evening— and sometimes days. That lingering quality, by the way, is a significant part of ramp lore. Eating them raw is a commitment. Even cooking them doesn’t fully tame the aftermath.

The classic Appalachian preparation is almost aggressively simple: fry them in butter or bacon fat alongside sliced potatoes and scrambled eggs. That combination — earthy, fatty, pungent, satisfying — is the dish most associated with the tradition. But ramps also appear in soups, pancakes, and hamburgers. Modern chefs have expanded the repertoire considerably, featuring ramp pesto, ramp butter, pickled ramps, ramp-infused oils, and even ramps on pizza. High-end restaurants began showcasing them in the late 1990s and early 2000s, turning a humble Appalachian forage vegetable into a coveted seasonal ingredient.

Pickling is a popular preservation method, extending the ramp season well beyond the brief spring window. Pickled ramps retain a pleasant tang and a gentler bite than raw ones, making them an easy addition to charcuterie boards or grain bowls. Ramps can also be blanched and frozen for up to six months, though freezing softens the texture.

Cultural Significance in Appalachia

To understand what ramps mean to Appalachia, you have to appreciate what they meant historically. For communities in the mountains that went months without access to fresh vegetables, ramps were among the first green things to appear after winter. They weren’t just food — they were a signal that the hard season was ending. Native American groups including the Cherokee, Iroquois, and Chippewa had long used them as both food and medicine—treating colds, earaches, intestinal parasites —and as a springtime tonic. European settlers learned from those traditions and wove ramps into their own seasonal pattern.

The word “ramp” itself has deep roots. Botanist Earl L. Core of West Virginia University traced the term to the Old English word “ramson,” a dialectical variant used across the southern Appalachian region in contrast to the “wild leek” terminology used elsewhere. That linguistic distinction is itself a marker of regional identity — ramps aren’t just what you call the plant, they’re a signal of where you’re from.

In Appalachia, ramps are far more than an ingredient—they are a tradition. For generations, families have ventured into the woods each spring to gather them, often returning to prepare communal meals that celebrate the end of winter. These gatherings, commonly known as ramp feeds or ramp festivals, remain a fixture in many communities.

Ramp festivals have anchored spring calendars in Appalachian communities for a century. The ramp festival in Haywood County, North Carolina has drawn as many as 4,000 participants per year since around 1925. Richwood, West Virginia — whose newspaper editor once famously mixed ramp juice into the printer’s ink as a prank, drawing the wrath of the U.S. Postmaster General — hosts one of the most well-known celebrations. True confession, as teenagers, a friend and I twice visited the Richwood festival because the street vendors would sell us beer without checking to see if we were 18 yet. Flag Pond, Tennessee holds its annual festival on the second Saturday each May. Whitetop, Virginia does the same the third weekend of May, complete with live music from local legends and a ramp-eating contest for children and adults. Huntington, West Virginia hosts what it calls the Stink Fest, organized by an indoor farmers’ market called The Wild Ramp.

These festivals aren’t just excuses to eat pungent vegetables (and drink beer). They’re expressions of place and belonging. Academic researchers who’ve studied ramp culture describe the plant as “an important symbol of Appalachian regional identity, providing rural mountain communities with a sense of place.” The ramp’s reputation for extreme smell — the kind that follows you out of the room and through the next day — has become something worn with pride rather than embarrassment. It’s the badge of someone who knows the land, who grew up digging bulbs out of a hillside with a grandparent, who understands that the best things have seasons.  Their strong odor lingers on the breath and skin, creating a shared experience that borders on communal initiation. In some Appalachian communities, it has long been joked that eating ramps together ensures that no one notices the smell—because everyone smells the same. And, if you were lucky, it might get you sent home from school the next day.

The ramp’s recent rise in fine dining circles has introduced a complicated tension into that identity. National demand has strained wild populations, raised prices (sometimes to $20 per pound or more at specialty markets), and prompted genuine concern about sustainability. There’s a real question about whether the ramp can remain a community food when it becomes a luxury ingredient. For now, those spring festivals still draw crowds who know the difference between a ramp pulled from familiar woods and one that traveled a thousand miles to appear on a white-tablecloth menu.

 The ramp is, in the end, a small plant carrying an outsized story. It’s a vegetable, yes — a nutritious allium with impressive micronutrient credentials. But it’s also a calendar marker, a community ritual, a flavor memory, and a contested symbol of who gets to claim a landscape as their own. If you ever get the chance to try them fresh in April, take it. Just don’t plan anything important for the next 24 hours.

Illustration generated by author using ChatGPT.

Sources

Botany, Natural History & Range

1. Wikipedia. “Allium tricoccum.” Wikimedia Foundation. https://en.wikipedia.org/wiki/Allium_tricoccum     Botanical overview, common names, Appalachian cultural history, ramp festivals.

3. Conzit. “The Allure of Ramps: A Culinary Springtime Delight.” https://conzit.com/post/the-allure-of-ramps-a-culinary-springtime-delight     Seasonal availability, native range, sustainability concerns, and culinary significance.

7. Davis, Jeanine M. and Jacqulyn Greenfield. “Cultivating Ramps: Wild Leeks of Appalachia.” Purdue University New Crops & New Uses, 2002. https://hort.purdue.edu/newcrop/ncnu02/v5-449.html     Definitive agricultural source on ramp cultivation, seed germination, growing conditions, festival traditions, and the Smoky Mountains harvesting ban.

8. WildEdible.com. “Ramps: How to Forage & Eat Wild Leeks.” March 2022. https://www.wildedible.com/blog/foraging-ramps     Foraging identification, historical role as a spring tonic, preparation methods, and seed propagation advice.

11. American Indian Health & Diet Project. “Ramps.” University of Kansas. https://aihd.ku.edu/foods/Ramps.html     Native American uses of ramps (Cherokee, Iroquois, Chippewa), etymology of the word ‘ramp,’ and historical range.

Nutrition & Health

12. SnapCalorie. “Ramps Nutrition.” https://www.snapcalorie.com/nutrition/ramps_nutrition.html     Nutritional overview: vitamins A and C, iron, magnesium, caloric content.

13. Facts.net. “20 Ramps Nutrition Facts.” October 2024. https://facts.net/lifestyle/food/20-ramps-nutrition-facts/     Detailed micronutrient breakdown including vitamins A, C, E, K, folate, potassium, calcium, and anti-inflammatory compounds.

14. Precision Nutrition. “Ramps Recipe & Nutrition.” Encyclopedia of Food. https://www.precisionnutrition.com/encyclopedia/food/ramps     Nutritional analysis, beta-carotene and selenium content, culinary preparation techniques, and storage guidelines.

15. Eat This Much. “Melissa’s Ramps Nutrition Facts.” https://www.eatthismuch.com/food/nutrition/ramps,139795/     Macronutrient breakdown per cup serving; vitamin A as 30% of daily value.

16. Specialty Produce. “Ramps Information and Facts.” https://specialtyproduce.com/produce/Ramps_775.php     Comprehensive botanical and culinary profile; vitamins A, C, K; selenium, chromium, iron, folate content.

17. Instacart. “Ramps – All You Need to Know.” February 2022. https://www.instacart.com/company/ideas/ramps-all-you-need-to-know     Seasonal availability, storage, Canadian foraging limits, and commercial market pricing.

18. Healthline. “10 Health and Nutrition Benefits of Leeks and Wild Ramps.” June 2019. https://www.healthline.com/nutrition/leek-benefits     Peer-reviewed nutritional analysis; kaempferol, allicin, thiosulfinates, vitamin C concentration versus oranges, cardiovascular and cancer-protective properties.

19. HealthierSteps. “Health Benefits Of Wild Ramps And Leeks.” February 2023. https://healthiersteps.com/health-benefits-of-wild-ramps-and-leeks/     Vitamin B6, manganese, folate, potassium and blood pressure; kaempferol and cancer risk reduction.

20. Healthfully. “Nutritional Benefits of Ramps.” January 2021. https://healthfully.com/257269-nutritional-benefits-of-ramps.html     Detailed vitamin A and C daily value percentages; selenium and chromium content; cites Eric Block’s ‘Garlic and Other Alliums: The Lore and the Science.’

Appalachian Culture, Identity & Foraging Tradition

2. Sachdeva, N. et al. “Pungent Provisions: The Ramp and Appalachian Identity.” Academia.edu. https://www.academia.edu/22223522/Pungent_Provisions_The_Ramp_and_Appalachian_Identity     Peer-reviewed qualitative research on ramp culture, identity, and the tension between regional tradition and national culinary demand.

4. Jordan, M. et al. “Ramps (Allium tricoccum Aiton) as a Wild Food in Northern Appalachia.” Society & Natural Resources. Taylor & Francis Online, 2025. https://www.tandfonline.com/doi/full/10.1080/08941920.2025.2512536     Peer-reviewed mixed-methods study on ramp harvesting, commercial trade, conservation, and Appalachian regional identity.

5. Appalachian Memories. “The Love of Wild Ramps in the Appalachian Mountains.” EchoesofAppalachia.org, October 2024. https://appalachianmemories.org/2024/10/25/the-love-of-wild-ramps-in-the-appalachian-mountains/     First-person Appalachian foraging traditions, preparation methods, and sustainable harvesting practices.

6. Serra, Janet. “Discovering Ramps: Spring’s Wild Culinary Treasure.” JanetSerra.com, May 2025. https://janetserra.com/2025/05/16/discovering-ramps-springs-wild-culinary-treasure/     Spring ephemeral lifecycle, leaf emergence timing, sulfur compounds and cardiovascular health benefits.

9. OhMyFacts. “15 Facts About Ramps.” October 2024. https://ohmyfacts.com/food-beverage/vegetables/15-facts-about-ramps/     Cherokee culinary and medicinal traditions, nutritional profile summary, and harvest season.

10. ForageFinds.com. “Appalachian Foraging: Native Edible Plants Guide.” December 2024. https://www.foragefinds.com/foraging-by-region/central-appalachia-native-edible-plants/     Indigenous knowledge of ramps, European settler adoption, and role of ramps in contemporary Appalachian cuisine.

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