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Winds of Change

"Season of mists and mellow fruitfulness,
Close bosom-friend of the maturing sun;
Conspiring with him how to load and bless
With fruit the vines that round the
thatch-eaves run"
-To Autumn, John Keats

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Ah yes, fall is upon us, and those of us living in the Pacific Northwest know all to well this season of mists (and rain, and darkness, and abandonment of hope that the sun will ever appear). You can already see color bleed into the edges of leaves, pumpkins fill the bins at farmers markets, and there is a nip in the morning air, suffused with the with the smell of decay. Personally, I love this time of year. We call it the beginning of cold and flu season, the Chinese see as a time of change, specifically yang (summer) transforming to yin (winter, once the transformation is complete).


I don't want to go all theoretical on everyone (and by everyone I mean the small handful of folks following this blog), but looking at autumn from the Chinese medical perspective is an interesting way to know what sort of things to look for, and possibly prevent, in both ourselves and our animals. Western medicine has a way of looking down on the Chinese system as quaint and simple, when even MDs will say that you "caught a cold", have "chills" or are "burning up", yet still smirk in half-hidden superiority when an eastern practitioner talks of wind-cold or wind-heat invasions, when both are talking about cases of influenza.

Environmental conditions have always been important predictors of disease in Chinese medicine. In
five element theory, each season is paired with a corresponding organ; winter with the Kidney, spring with the Liver, summer with the Heart, late summer with the Spleen, and autumn with the Lung. That's right, the lung, which in this system of medicine is not only part of the breathing apparatus but also responsible for the health of the skin and the immune system. This immune system, or wei qi, is thought of as circulating between the skin and muscles, acting like a shield to keep the bad bugs out and keep us warm. Damaged, things like "wind" can bring bad qi like "heat" or "cold" into the body. This wind-heat would cause fever, sweating, a deep cough and thick-yellow mucous production. A wind-cold invasion would cause chills, a dry cough, headache, and a clear discharge from the nose. Sound familiar?

Our animals are no different and are affected in similar ways. Horses tend to get the short end of this seasonal stick. With big temperature swings occurring regularly, a horse can be turned out with a blanket in the morning and come in in a full sweat by evening, with little time to dry before temperatures drop. These wild fluctuations can damage the
wei qi and make it easier for a wind-cold or wind-heat to invade, and indeed, this time of year is rife with cases of equine influenza. (the other time being spring, the season of transformation from yin to yang) Another example of cold invasion in horses is spasmodic colic; the sudden onset being an element of wind, the stabbing pain being a sign of cold. Horse people the world over know to be on the lookout for this type of colic whenever a storm front blows in.

Dogs have it a little easier, most having the protection of a house. But as the season comes into itself, we see a syndrome in dogs also common in people: joint pain. People with arthritis in the knee, shoulder, hands, or wherever will often complain that symptoms worsen in bad weather. In Chinese medicine this is called
bi ("bee") syndrome and is an accumulation of wind, damp, and cold in the body (usually at the joints). When the environment has more wind, cold, and damp it aggravates the pre-existing condition, stagnates the flow of qi and blood in the body and causes pain. So, dogs with hip dysplasia, or arthritis in the knees and back will often stiffen up this time of year. In all cases, human or animal, the onset of disease mimics the seasonal change: in autumn, diseases of wind, cold, and damp are more prevalent; in summer, diseases of heat, like skin rashes and allergies, are more common.

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So do we all just get in a funk, throw our hands up and despair? (interestingly, sadness is the emotion associated with the lung and autumn). Of course not. As humans, we listen to our mothers and dress appropriately for the weather. As owners, we protect our animals from the elements as best we can and try not to expose them to drastic temperature swings, both environmental and man-made (don't put your horses away wet and don't lock your dog in a cold, damp garage). Though not used widely in Chinese medicine, an everyday herb that helps the lung is garlic, which stimulates the immune system and eliminates wind, cold, and damp. A clove or two in a horse's grain bucket can go a long way towards preventing the flu, if not doing wonders for their breath. A Chinese formula commonly used for similar purposes is Yu Ping Feng San, or Jade Screen Formula, which uses Astragalus root as its chief herb, and is stronger for immune support than garlic. For bi syndrome, many people find tumeric to be helpful. Called Jiang Huang, or "yellow ginger" in Chinese, this herb is often used as an ingredient in formulas for reducing swelling and relieving pain.

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Fall, like all seasons, is part of the natural cycle of birth, death, and rebirth. It brings with it the bounty of the harvest, respite from the heat, splashes of color, football, and plentiful opportunities for some serious comfort-food consumption. It also heralds shorter days, cooler weather, and plentiful opportunities for some serious lung infections. For ourselves and our animals, the best defense is to keep protected from the elements, keep stress to a minimum, keep the joints warm and wei qi strong. And if you do find yourself in a doctors office and he or she diagnosis you with a cold, make sure to compliment the good doctor on their knowledge of Chinese medicine.

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Story Time: An Aleutian Adventure

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You know those little projects that just never seem to get done? Well, I finally finished one that has languished for twenty years: having the necklace and earrings in the photo to the left framed. They were carved by a Russian craftsman out of mammoth ivory and I picked them up in a small shop in Dutch Harbor. What was I doing in Dutch? Now that's a story...

I think growing up in a military family instilled a bit of wanderlust in my persona. Shortly after graduating vet school this pull took hold pretty hard and I found myself looking for, and accepting, a job outside of Anchorage. The drive up the
Alcan highway in late December, with no four-wheel drive, little food, and even less money is a tale in and of itself, but I digress. At this Alaskan clinic, we did everything from cut colics to orthopedic surgery, a trial by fire for a young vet, but a great way to gain years of valuable experience in a short time. One of the contracts this clinic had was to fly out to the Aleutian Islands a few times a year to vaccinate and neuter as much of the island pet population as we could.

This trip required a lot of packing. We would fill one cooler full of vaccine, syringes, and gloves and another with Spartanly equipped, pre-sterilized spay and neuter packs. These trips were about volume, not luxury.

When you fly into Dutch, about two hours from Anchorage, the plane banks very steeply to make the approach. Steep enough that you begin to wonder just how the seat belt is managing to hold you down and stiff cross winds push the plane sideways like an air-hockey puck. The runway never seems long enough--737s are the biggest thing able to land here and the sight of Bering Sea closing in at the end is enough to make you white-knuckle the armrest every time.

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Many people know Dutch Harbor from the show Deadliest Catch. Bald Eagles thick as seagulls. Craggy volcanoes jutting up from the ocean. Rough men and women bundled up against the weather and just daring someone to pick a fight. To this day, the best Mexican dinner I've ever eaten was in Dutch. It's true, the town is like Tombstone. With fish.

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It certainly felt like the frontier when we set up the makeshift hospital in the community center. Without gas anesthesia, we relied on injectables. I had spent some time my senior year at an emergency clinic where the head veterinarian concocted this great mixture of Rompun, Ketamine, and Acepromazine you could give intramuscularly to both dogs and cats and within a few minutes have a surgical plane anesthesia for about twenty minutes, and we found this mixture to be perfect for our island trips. Twenty minutes is a cake-walk for castrations, but, especially for a new grad, a bit disconcerting for a spay. But you gotta do what you gotta do, and before long I was whipping out spays "skin-to-skin" as we say, meaning from incision to last stitch, in about twelve minutes. And that's how it went: inject, scrub, cut, stitch. Patient after patient. At the end of the day we washed up the instruments at the local human clinic and used their autoclave to sterilize our packs for the next go-round. I was flush with adrenalin and didn't think it could get much wilder. Then we moved on to Akutan.

One island east of Dutch Harbor, Akutan is small, and I mean small. In comparison, Dutch might as well have been New York. Akutan is a lone sashimi plant and a village of about ninety people. We took a float plane in, as the only other option was a long boat ride; an option we would be forced to take if a storm came up. The village, where we were doing more work, had no roads, only plank walkways wide enough for ATVs, which was just as well, because you could walk anywhere you needed to in less than five minutes.

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No high falutin' community center here. At Akutan we neutered animals on the village constable's desk, then moved them to a jail cell to recover like so many Otises in Mayberry. That evening we walked to the fishery and picked up some king crab to take home (for a fraction of what you pay in stores), stopping to throw sashimi scraps to the sea lions, gathered like pigeons waiting for breadcrumbs.

Next morning we spoke to the school kids and neutered a cat in the classroom for a demonstration. (now
that's an education) The class consisted of about a dozen kids ranging from elementary to high school. One of the seniors told me that right after graduation he was moving to L.A. I thought, "Whoa champ, slow down. Akutan to biggest city in the country? Might want to ease into things, maybe try Dayton, or Boise." But I didn't say it. Hope he didn't get eaten alive. I blame television. But then again, I blame television for everything.

While we were on Akutan an accident occurred that served as a reminder of just how isolated these islands are. A worker at the plant injured himself splitting crab. Crab-splitting is done assembly-line fashion, where a crab is taken and split in half over a sharp blade, kind of like you would break kindling over your knee. This unfortunate worker slipped and shoved his hand against the blade at the web between the thumb and forefinger, almost amputating the thumb. The wind was up, so he had to go by boat to Dutch just to get to a nurse who could properly attend to the wound, and then get on a plane to Anchorage for surgery. My hand hurts just thinking about it.

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After this little detour we went back to Dutch, which is when I came across the ivory necklace. There was a small general store (trading post, more like) in town run by a wind-weathered immigrant couple. Apparently they went back to Russia (this was within a year after the collapse of the old Soviet Union) frequently and came back with all sorts of interesting stuff. I love handmade things, especially from craftsmen (or women) of talent, and as soon as I saw the curves and warm browns of the mammoth ivory, I was set on having it, and after a bit of haggling packed it in my suitcase for the trip home, along with a wolf-hair and bead necklace that I just thought was cool. The necklace, the ivory one, is awkward for actual wearing, though Lynne has taken it for a spin or two. Still, I always saw it as a piece for framing, but never got around to it because, to be frank, our farmhouse really didn't have an appropriate wall for it. All the packing and unpacking for our recent move it returned to front of mind and I was determined it would not sit in a box for another two decades. It now hangs in our living room and resonates of Alaska: great memories of wilderness, adventure, and youth. Sometimes I see that necklace and those earrings and feel like wandering, if just for a little while.
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Carnies, Coasters, and Corndogs--Oh My!

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It's fair season all across America and Oregon is no exception. I never experienced fairs growing up, perhaps it was the insulation of military bases, or being in more metropolitan areas, but once Lynne and I moved west we always made an annual pilgrimage to the Evergreen State Fair and this year continued the tradition in the Beaver State.

The Oregon State fair is held in
Salem, the state capital and a shy hour's drive from the house. Our good friend Mark, family-less while his wife and kids are visiting relatives, piled into the back seat with the boys and came along. Hard to tell which of the three enjoy fart humor more.

Is anything more quintessentially American than a state fair? Don't dare say Disneyland--Michigan holds the honor of holding the first state fair in 1849, fifty-two years before Walt was even born and century before Charlotte saved Wilbur with her own writings on the web. The fair showcases everything good and bad about the US--from entrepreneurship to obesity--but most of all it's just a heckuva good time.

First we had to get there. For the last mile or so it was a crawl, bumper-to-bumper traffic to get in the gate and to our parking space at the farthest reaches of the fairgrounds. And no charge for parking. How did the fair miss
that opportunity to make a buck?

Oh, the food! It is impossible, and should probably be illegal, to go to the fair and stick to a reasonable dietary regimen. Look, don't whine at me, you can always bump up your insulin by a couple of units, and God invented cardiovascular surgeons for a purpose.

Ice cream, scones, elephant ears and their super-sized cousin the mammoth ear, corn dogs, popcorn. If it can be put on a stick you can find it at the fair. If it can be deep fried, (never mind if it should) it will be. They were selling fried Pepsi, who even thought of that? And in this great melting pot of ours if you don't want hamburgers, hotdogs or barbeque, you can get Greek, Mexican, Thai, Indian, Chinese, Polish, German, Italian. Really, shouldn't that be the barometer for getting into this country: is your food good? Then come on in! My apologies to the English and Irish--but you had first dibs, and anyway, you get a pass for beer and whiskey.

To truly enjoy this smorgasbord it helps to ignore the migraine-inducing prices. When the kids each got a one-flavor sno-cone for $3.50 apiece I had to suppress the urge to ask someone how anyone could justify three-fiddy for a cup of ice and high fructose corn syrup. I shut up, took pleasure in the smile on my kid's faces, and thought about how much we had saved by not paying five bucks for the ultra-posh three-flavor version.

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The exhibitions were also a blast. I'm not talking about the booths of people hawking Seen-On-TV stuff, though they are fun to watch, little Billy Mayses in the making. I'm talking about the original spirit of the fair: craftsmen and farmers showing off their wares, 4H kids buffing their cow to a fine shine, church-ladies vying for the blue ribbon for best plum preserves. My youngest, Colin, a Legomaniac if ever there was one, loved the display of Lego creations, especially the 1/3 scale model of a Pac-Man arcade game. I liked the cakes, in particular a fondant masterpiece with a Taj Mahal-esque flavor. Seeing this cake next to a less, shall we say "unambitious" creation, Mark pointed to a purple onion dome and said, "wouldn't it suck to see that come in and get plopped down next to yours?" Hey, there's always next year, right?

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The fairgounds in Salem have some great buildings, most especially the Oregon State Fair Stadium and Poultry Building Ensemble, which is on the National Register of Historic Places. Wandering through, we came across a few young 4H-ers showing their lambs--shorn and cleaner than either of my two sons--and learning the finer points of sheep conformation.
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The logger competition was being filmed by ESPN and next door Stihl had an exhibition where you got to try your hand and sawing a simulated round off the end of a log. Think I'll stick to veterinary medicine.




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The fair is fertile ground for people watching as well. I heard Spanish, Russian, and Japanese being spoken and saw more ethnic groups than that. Tattoos abounded as did outfits worn by both women and men that should have know better. I'll give the elderly lady in denim shorts, black panty-hose, and sneakers a pass, but just barely. I have less patience for all the dudes in Ed Hardy tee shirts. Really? I may be middle-aged but I can remember the day when it seemed everybody was wearing a black shirt with the Jack Daniels label. Know what time that was? Time to get a new look. And ladies? The slutty biker-chick look is fine, in fact I heartily endorse it--if you can pull it off. Word to the wise: if your skin has more creases than your leather and that butterfly tattoo is starting to look like a California condor, you are definitely not pulling it off.

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Of course the boys are there for the rides, and ride they did. Colin is finally tall and brave enough to ride what was called the Ring of Fire in Monroe, and Super Loops in Salem. Watching his expression transform from nervous to joy is one of those experiences that makes being a parent fun.

Heading back to the car when you can no longer see the lights, no longer inhale the smells, you can still hear the fair. The clatter of the rides, the chatter of the barker, snippets of foreign tongues, screams, laughter, and music all blending together to form a soundtrack of America.


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Healthy Muscle, Happy Horse

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("Equine Muscle Structure" courtesy of BH Visual Art, target="blank" >www.bhvisualart.com

Recently I have been inundated with requests to consult on cases involving equine muscles: tying up, strains, EPSM (Equine Polysaccharide Storage Myopathy), and other primary muscle conditions. This is likely due to a number of reasons: the show season is coming to an end, miles are adding up and aches and injury are following; snow is finally clearing out of the high mountain regions and allowing horses to be taken on longer and steeper rides; and the summer heat is leading to overexertion and dehydration. Of course, muscles are important for every horse, whether for competition or just getting up that next hill in the North Cascades, and keeping those muscles as healthy as possible should be every horse owner’s goal. Like many things, prevention is a much better option than treating an emergency, so rather than discuss an individual muscle disease it makes more sense to look at what can be done to optimize muscle health.


Diet

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Muscles get their energy by synthesizing ATP from ADP (don’t you wish you had stayed awake in biochemistry now?). One way to do this is called glycolysis, which uses the glygogen stored in muscle. The byproduct of this pathway is lactic acid, responsible for the “burn” we feel while working out. Another process oxidizes fat and results in the byproducts of carbon dioxide and water. Endurance horses become very efficient at using this cycle. The bottom line is that if horses have too much energy stored in the form of glycogen, and are exercised, it can result in a cascade of events that result in severe cramps, impaired blood supply to the muscles, permanent tissue damage and in some cases, severe kidney problems. Some animals are genetically predisposed to these events and have to be fed very carefully, to avoid them. Feeding concentrates (grain) in large amounts, or choosing feeds with high sugar concentrations can worsen the condition in predisposed horses, or set up less than ideal muscle function in horse that aren’t. Diets higher in fat and lower in carbohydrate can help minimize and possibly eliminate the problem in some cases, but this method of feeding is probably optimal for muscle function in all horses. This means feeding carbohydrate at less than 15% of the total weight of a diet and fat at more than 10% (in tough cases even lower carb and higher fat percentages are recommended). There are commercial feeds like Re-Leve, SafeChoice or Strategy that provide these proportions in a complete feed, but these goals can also be achieved by adding high levels of rice bran or corn oil to other diets. In any case, it’s a good place to start.

Supplements

Even with a good diet, and in animals that don’t have a specific muscle dysfunction, there are supplements that can improve muscle health and help with performance.

Selenium is a trace element important for muscle and thyroid function, two tissues vital for performance. Though not a common deficiency because selenium is often added to salt blocks and commercial feeds, horses with recurring muscle problems should have selenium levels checked. This is especially important information to know before arbitrarily starting a selenium supplement, because high levels can be toxic.

Vitamin E is an excellent antioxidant that can scavenge free-radicals and decrease muscle damage from exercise--microscopic tears that result in delayed onset muscle soreness (DOMS). Supplementation reduces the sore-muscle grumpiness of horses and helps that Monday morning ache of weekend-warrior trail horses. Most horses can get by on 1000-2000 IU per day, though horses with specific diseases and those in intense exercise can be given double this amount with no problem.

CoQ10 makes Vitamin E more available and improves its efficiency, so CoQ10 at 100mg per day in conjunction with Vitamin E should be considered for any horse in training.

Herbs

The Chinese have a unique view of muscles and performance. Exercise depletes the essential energies of the body (qi and blood) and if not replaced can lead to atrophy, cramps, and weakness that may lead to injury. There are many herbs that replace these energies. Take for example the formula
Ba Zhen Tang, which uses eight herbs to replenish both qi and blood. In it, ginseng, atractylodes, poria mushroom and honey-fried licorice replenish qi while rhemannia, angelica, white peony root, and lovage root tonify blood. Often ginger and Chinese date are also added to help digestion. From a western perspective, this combination of herbs increases red blood cells, relieves muscle spasm, stimulates the immune system, and counters the effects of adrenal stress.

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For athletes, additional herbs can be added to modify this classic formula. Two of the most famous are cordyceps (see image), which helps stamina and endurance by increasing oxygen utilization and eleuthero root, which is an adaptogen that helps the body deal with stress and fatigue.

Mares and nervous horses are more prone to cramps, likely due to hormonal changes in mares and tension in nervous horses. If cramping is situational, (a mare in heat, a spooky horse in a new environment) herbs can be given for this as well. Raspberry leaf can effectively mitigate some of the hormonal changes of estrus, and valerian root can help with anxiety. Of course, traditional Chinese formulas made up of multiple herbs to address specific imbalances of an individual are also available to treat such cases.

Horses with chronic muscle disease or damage from an injury are going to need a more aggressive approach, which often means combining a strict diet with supplements, massage, herbal formulas, and acupuncture.

Every horse, pasture ornament or FEI star, has muscles, and with sound nutritional and supplement choices, those muscles can be kept as happy and healthy as possible.
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Is Domestication Inherently Unhealthy?

There was a discussion on a radio program the other day I found fascinating. It involved Darwinian evolution and focused on an experiment begun by Dmitri Belyaev and domesticating silver foxes. This has been written about many times, and is highlighted in Richard Dawkins' excellent book on Darwinian theory, The Greatest Show on Earth. The method of this experiment was simple--all foxes were classified in one of three ways: Class I would flee and/or bite a handler that tried to hand-feed and stroke the animal; Class II would accept the handler but show no positive response; and Class III would approach the handler, wag its tail and show other positive behaviors. Only Class III foxes were bred, and within 6 generations Belyaev had tame animals. The truly remarkable part of this experiment were the unexpected changes that took place (seen in the top image to the right): the silver coat changed to black and white piebald, teeth became smaller, bones less robust, faces became rounder, ears flopped over, tails curled up, and females went into heat every six months rather than on
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ce a year like the typical vixen. In effect, the foxes had become more dog-like and development had stopped at a juvenile phase: Belyaev's foxes had become Peter Pans of the canine world.

What really grabbed my attention was the explanation for why these physical changes are tied to behavior. Domestication experiments in both foxes and Norway rats show that structural changes occur in the zona fasciculata of the adrenal cortex, the area responsible for glucocorticoid (think prednisone) release--in a larger sense the flight-or-fight response. Makes sense right? If an animal has a weaker flight response it should be easier to domesticate. Where it really gets interesting is when we look at where these cells come from. The adrenals originate from the neural crest in embryonic development. These cells also differentiate into other tissue like craniofacial bone and cartilage (faces and ears), teeth, bone, heart valves, and some neural tissue.

This correlates very closely with Chinese medical theory. Centuries before we had any understanding of embryonic development the Chinese came up with their system. Within this system, six pairs of organs are said to be responsible for all the physiological processes in the body--one of which is the Kidney. This should not be confused with the (small 'k') kidney; the actual organ. The Chinese concept of Kidney includes the bean-shaped organs but also encompasses many other functions not typically associate with the western definition of the kidney. This Chinese Kidney is responsible for many things--
Jing, or Essence being one, which can be thought of as constitutional or genetic health. In addition to urine production, the Kidney also controls aging, bone growth, teeth, hair, and reproductive function. Interesting, huh?

All of this is important to the health of our animals. If, as the research indicates, domestication leads to a weaker adrenal-pituitary axis, might this explain some of the medical problems that seem rampant in our pets? There are the obvious, like dental issues that might arise from smaller teeth, or ear infections in floppy ears. But what of Cushing's or Addison's disease, both directly related to the adrenal/pituitary axis? How about conditions like inflammatory bowel disease and skin allergies? Both are overreactions of the immune system and commonly treated in Western medicine with steroids like dexamethasone and prednisone. What if in normal/wild systems the adrenal cortex pumps out just enough steroid to keep things in check--a feedback loop grown weaker with domestication? This is very much along the line of the research and treatment protocol of
Dr Alfred J Plechner's Endocrine-Imbalance-Syndrome.

Of course, the horse is out of the barn and we aren't going back to tying a wolf up in the back yard or roping a mustang to ride. But it might give owners and breeders a little pause when choosing an animal: maybe a little attitude is preferable to an animal that rolls on its back every time you look at it sideways.

This radio program ended with a discussion on what might be going on with our own species. Our ancestors had larger teeth and thicker bone as well as coarser facial features. Through the centuries, have social groupings like cities and events like war culled the most aggressive humans from our gene pool? Are human adrenals becoming weaker as we become more "domesticated"? If so, then the choices we make in diet, lifestyle, and medical care might be as important for the health of ourselves as that of our pets.
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A Creation Story

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This being the inaugural blog post and all, it seems fitting to start off with the story of how Hindsight came to be. The decision to start my own practice was not easy; I had been part of a very large clinic for almost eighteen years and in that time developed cherished relationships with people and their animals. But deep down I knew it was time to branch out on my own, and though I felt confident in my ability to succeed in the veterinary side of things, it was vitally important to develop a name and logo that was both meaningful and attractive, and for that I needed help.

I have a middling amount of creativity; I can write and am pretty handy with a camera, but my most valuable skill is the ability to conceptualize and communicate a vision. It’s the execution where everything goes to hell. Smart enough to realize I couldn’t do this in my own, I turned to the net and googled Seattle area designers. After clicking through a bunch of portfolios and following up with interviews, I eventually decided on Akira Morita and Dipika Kohli, the dynamic husband-and-wife team behind
Design Kompany, who had almost dropped off my list when I discovered they had relocated to North Carolina. I had thought distance might hinder communication, but at our first Skype meeting there was an almost audible click of meshing personalities, and I knew this was the right crew for me.

One of the more rewarding aspects of working with Akira and Dipika is their commitment to getting it right and develop a name and design that speak to both clients and me. It was weeks before we even thought about a name, or put pen to paper for a logo. Instead, it began with a lot of talk of what the clinic was about, what it stood for, who my clients are, and, when it comes right down to it, who I am. This conversation produced a group of about a hundred words that defined the new practice and then painstakingly winnowed this list down to seven keywords: integrity, compassionate, confident, talented, attentive, passion, and insightful.

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These words were the seeds for an online mind-map, where for days we would go and free associate. Subjects emerged that one wouldn’t normally associate with the keywords: mountain and river, turtleshell and spiderweb, dancers and samurai, and many, many others found their way onto a map that wound up more like a rabbit warren than a L’Enfant layout. We also constructed a mood board: a collection of images that reflected the sentiment of our seven keywords. Elements of color, texture, and theme emerged from both image and word—building blocks for the naming and design stage.

It was Dipika who had the spark of inspiration. Though we constantly exchanged emails, tossing names back and forth like a game of hot potato, she waited until our next Skype meeting to present it, wanting to see my reaction. “What do you think of…Hindsight?” It took a few seconds for the word to sink in. It made so much sense: one simple word that evoked feelings of vision and clarity, but also the idea of learning from the past. Dipika had hit it out of the park. She knew it too, for she had the same smile on her face that my boys get when they know they’ve just done something really cool, like flip on a trampoline or write a clever story. Over the next few days I’d throw it out to coworkers and clients and every single person thought the same thing: perfect. We had a winner of a name, now we just had to develop a visual representation of it.

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At our next online meeting, Akira and Dipika presented some very simple concept sketches: more about thematic and structural possibilities than any move towards a logo. A lot of these came from repeated elements in the mood board and mind map: curves, patterns, interconnectedness, and figures in nature. This idea of patterns and connectivity was important because it is so representative of both chiropractic and Chinese medicine.

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The team came up with some brilliant, intricate designs that were gorgeous, but a bit too busy to incorporate into a logo. Plus, I liked the lines of the sketches, something crafted by hand, similar to the pencil sketches of the great masters. Dipika sent me a sample: “hindsight” inside a hand drawn circle and we were close, really close. But there was no pattern, no connectedness. She added another circle below and suddenly we had it all: the beginnings of a pattern and feelings of connectedness, motion. The circles are reminiscent of lenses, in line with a sense of vision, or focus. But what colors to use?

Blue came up a lot in the images of the mood board, as did various shades of yellow. Blue though, was my first choice. Looking for inspiration, I had been reading a collection of poems by
Gary Snyder called No Nature, given to me by my good friend Katy. In this collection is a poem called The Blue Sky. Here are two excerpts:

Eastward from here,
beyond Buddha-worlds ten times as
numerous as the sands of the Ganges
there is a world called
PURE AS LAPIS LAZULI
its Buddha is called Master of Healing,
AZURE RADIANCE TATHAGATA

And later:

Horse with lightning feet, a mane like
distant rain, the turquoise horse,
a black star for an eye
white shell teeth
Pony that feeds on the pollen of flowers
may he
make thee whole.

So blue it was.

As the design was tweaked, we searched for a brand statement, something short but meaningful to the practice; a tagline if you will. From our conversations, Dipika put together a collection of thoughts that resonated so well I put it on the homepage. Its original form was this:

Close your eyes, listen with your heart.
Feel the energy of the everywhere
distilled before you.
Be
mindful.
For now, forget the start point, the end point,
and the mechanics of method.
Be
present.
Trace the pattern.
Learn. Heal.

“See” was added to the last line, because it completes the process I go through with every case. To “see” is to take in everything about a patient, searching for that imbalance causing pain, illness or poor performance. From this I try to “learn” what’s going on. I like this word very much because it’s a reminder that every case can teach me something, that I don’t know it all, and will continue to be a student, always. I also want clients to learn from me, and that understanding why we treat a certain way will strengthen their relationship with the animal. “Heal” is of course the goal with any patient, but must come last in the sequence because if you are blind, if you are closed to learning, you will never accomplish this last step.

It is hard to describe how much fun working with both Akira and Dipika has been. We have always been on the same page, but on those occasions when we did differ on details, they always took great pains to explain why one design choice was preferable over another, how subtle changes can speak volumes in the final product.
Edmund Burke said, “Good order is the foundation of all things” and with the help of my new friends in Durham, Hindsight is starting off with a deeper, stronger foundation than I could have ever hoped for.



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