Dear Ann Landers,
woman I've known for years told me she couldn't attend my dinner party next week because she's going to the hospi-tal. When I asked what for she replied, "A little surgery." I asked what kind of surgery and she answered curtly "minor," and changed the subject. This brusholf over my deep concern for her welfare made me so mad I called her doctor, who happens to be a social friend also. I asked him what was wrong with Mrs. So and So. The doctor insulted me by saying it was none of my business and that it was pretty nosey of me to call him. This cut me deeply, as we are all good friends. I'd like you to tell me, Ann Landers,

DEAR ANN,
Love you. Love your column. Heard you speak in Hunting-ton, Long Island, and can attest to the fact that you are a Dynamite Lady. Let there be no mistake about it. I'm on your side. But I wonder if you have a clear picture of what your column is all about? Your response to "Tell Someone Else" raises some serious questions in my mind. why in the world should a person be ashamed of having an operation? FRIENDSHIP UNRETURNED DEAR UNRETURNED: Some people take pleasure in regaling one and all with details of their poor health. They are happy to give an organ recital to anyone who will listen. People of taste and judgment, how-ever, consider such conversation bru-tally boring. They spare their friends. You were rude to press for details of the type of operation when your friend volunteered none. And phoning the doctor to pump him for information was indefensible gall. You earned whatever sharp criticism he ladled out. You said, "Superior people talk about ideas. Mediocre people talk about things. Little people talk about other people." Surely you must realize that each and every one of us enjoys a little gossip. In fact, your column is the most widely read gossip column in the world. People can't wait to see what their neighbors, friends, relatives, col-leagues and fellow workers are up to. The saving grace is that all who write in are protected by the merciful cloak of anonymity. At least nobody is hurt. Just sign me. A LITTLE PERSON WHO LIKES TO TALK ABOUT OTHER PEOPLE DEAR PERSON: If one considers other people's problems "gossip" then I am guilty as charged. But I view this column in quite a different light. To me, it represents an opportunity for anyone and everyone to unload anger, fear, hostility, guilt, frustration -the full gamut of human emotions. I try to print letters that deal with every aspect of life. Although some of them may seem bizarre, let me assure you nothing is so outrageous or crazy that somebody won't do it. The service aspect of this column is the most important. We have on file in Chicago the names and addresses of the agencies and self-help groups in every one of the cities that print this column. We offer guidance to thou-sands of people every month so they can get the continuing help they need. Of course there are those who read Ann Landers for laughs, and I have no objection to this. (It may be their only laugh for the day.) Humor can take the sting out of misery. Anyone who reads this column regu-larly cannot help but recognize himself -or his son, or his wife, or his daugh-ter or his boss-eventually. Trouble is the common denominator of living. It is also a great equalizer. When we share the same kind of trouble we be-come brothers and sisters under the skin. That, to me, is what this column is all about. Gout Gout is a disease with an impressive history. Its earliest account appears to be in the scriptures (II Chronicles 16:12), where Asa is described as "dis-eased of foot." Years before the birth of Christ, Hippocrates termed the mal-ady "the unwalkable disease." The list of gout sufferers is long and illus-trious. Alexander the Great, Lord Chesterfield, Charles Darwin, Benjamin Franklin, Oliver Cromwell, Dryden, Lord Beaverbrook, Cardinal Wolsey, Isaac Newton and Alexander Hamilton. What is gout? Gout was originally called "podagra" from the Greek words "pous" meaning foot and "agra" meaning attack. The name now in use is from the Latin "gutta" which is a broad reference to an abnormal amount of uric acid in the bloodstream. Gout is caused by defective purine metabolism, in the body. Purines are the end products of nucleoprotein digestion. They break down to form uric acid. Everyone has uric acid in his bloodstream. The disease called gout re-sults when the body produces an excessive amount of uric acid or when there is a decreased excretion of the uric acid by the kidneys. It is then that gout manifests itself by attacks of acute joint pain. Chalky deposits may form in the cartilages of the joints, or a buildup of uric acid crystals which are not excreted by the kidneys can produce kidney stones and/or damaged kidneys. For many centuries, gout was considered a disease of the upper class. Art-ists of the day delighted in drawing cartoons portraying a paunchy nobleman slumped before tables overladen with food, his bandaged feet propped on a "gout stool." (Such severe cases are seldom seen today because gout is preventable.) Nineteenth-century physicians believed that gout was caused by the use of alcoholic beverages, especially port wine and sherry. Modem physicians know that gout can also be precipitated by foods high in purines, which the body converts to uric acid. Certain blood conditions and some medications (including many diuretics) may cause an acute attack. Purine-rich foods include beer, wine, liver, kidney, heart, sardines, ancho-vies, fowl, gravies, and other meats and seafood. Consider what Samuel Pepys' diary tells us he ate for dinner on a typical day in March 1660: "Home from my office where my wife had got ready a very fine dinner, viz. a dish of marrow bones, a leg of mutton, a loin of veal, a dish of fowl, three pullets and two dozen of larks all in a dish, a great tart, a neat's tongue, a dish of anchovies, a dish of prawns and cheese." A full service at the table of the well-to-do might consist of thirty-two dishes, including sixteen different kinds of meat. The poor, meanwhile, dined mainly on low-purine foods: cheese, dairy products, vegetables, bread, tea and very little meat except, perhaps, beef at Christmas. Thus a typical menu for the affluent was laden with purines, which explains why gout became associated with rich food, high living and wealth. Gout is most common in males by a ratio of 20:1 and particularly in the over-forty age group. In women, it usually occurs in the post-menopausal age group. What are the symptoms of gout? An attack of gout usually occurs in the middle of the night, most often starts as an acute joint pain in the large toe. However, it may affect other joints in the body, the instep of the foot, the ankle, knee, wrist, or elbow. The skin is hot, red-purple, swollen and exqui-sitely tender. The area cannot tolerate any pressure and the pain becomes in-creasingly unbearable. The patient with gout may feel ill with chills, head-ache, mild fever, weakness and loss of appetite. There is no cure for gout; but this disease is not serious if treated promptly by a physician and kept under control. The problems occur when it is not kept under control, and complications result in severe kidney and joint dam-age. It is important to treat elevated uric even without the acute symptoms of gout. It is also known that an elevated uric acid may be a factor in the later production of heart attacks since elevated uric acid also seems to occur in in-dividuals and people who are very aggressive. Your physician can easily check the uric acid level in your body by a simple blood test. Gout can be effectively controlled by medication and acute attacks of this disease can be relieved within twenty-four to forty-eight hours. credit: Daniel M. Miller, M.D., F.A.C.S., Omaha, Nebraska, Associate Profes- sor of Surgery, University of Nebraska College of Medicine, Omaha, Nebraska. Grandchildren How to Get Along with Them Love them. Love them a lot. Wholeheartedly, without reservation. Let them know you care. Treat them with respect and tenderness. Grandparenthood has got to be the best of all possible times. Loving someone without reservation means doing the best for that individ-ual's growth and happiness. It means full acceptance of that person as an in-dividual, with his own personality and feelings. It means not trying to change Danny into someone he isn't, just because you wish it. It means looking at Susan when she's seven, with her front teeth missing, and not laughing. It means suffering in silence when fourteen-year- old Jimmy's face is a mass of acne. It means accepting Janie's changing hair styles, long, short, or falling over the eyes. She's sixteen. It means enjoying the funny and often ridiculous clothes-Marc's T-shirts that say "Bullshirt" or "Dangerous Curves Ahead," or "I'm with Stupid," with an arrow pointing to whoever is standing nearby. It could be you. Loving a grandchild means understanding the long silences when he can't think of a thing to say except "yep" and "nope." That happens around thir-teen. And at sixteen, when your grandson gets up from your dinner table and says, "Excuse me, but I have plans with some of the guys," you shouldn't feel hurt. He's trying to tell you something. You're not in his world any more. Swallow hard. Understand. Loving that child means you know he still cares for you whether or not your letters to him at camp or college are answered. It means not taking sides or interfering when he's in a head-on collision with his parents, even when you know the parents are wrong. You can speak your piece later, when you're alone with them and the heat's off. Getting along with your grandchildren means not playing favorites with the one who appeals to you most. It means not giving gifts to one and not the others; not talking about Jack's athletic ability to friends while his brother, Bill, stands there, listening. "She never talks about what I can do," Bill is thinking. What he really feels is, "She doesn't really love me." The parents of your grandchildren set the tone and influence their attitudes about you. You are fortunate if your son and daughter teach your grand-children courtesy and consideration towards the older generation. It's not done by scolding and haranguing after you've left, but by family discussions beforehand. "Grandma and Grandpa are coming for dinner tonight. Re-member, Grandma is hard of hearing. Sit close to her and talk slowly and loudly. It will make the evening more pleasant for her." "Grandfather falls asleep after dinner. Sometimes he snores. I know it's funny, but try not to laugh. Old people get tired early." These are suggestions that will help chil-dren learn kindness and consideration. What if grandchildren don't write or call to say thank you for a gift? Should you remind them? Scold them? Tell on them or feel hurt? If your grandchild lives out of town, drop him a note, asking him if he got your gift and if he did, did he like it. That's all. If he lives nearby, call and ask the same question. Mention it to his parents privately. They need to learn how to help their child show appreciation by saying thank you. The next birthday or holiday, send a card-not a gift. You might write, "I wanted to send you a gift because I love you, but it's no fun when you don't write back to let me know whether or not you received it." See what happens. When grandchildren are little, it's easy to get along with them. Their games, music and toys are fun to share. One grandchild, curled up in your lap while you read his favorite story, is worth more than the Shah of Iran's fortune. A surprise treat, like an ice-cream cone, can light up the whole after-noon. A trip to the zoo or playground is a joyful, shared experience. It's when grandchildren grow older that the communication breaks down. Then the challenge is yours. Read some of their books, watch some of their favorite TV programs. Listen to their music, whether you can stand it or not. Go to some of their school football or basketball games. Invite them to a movie. You'll find you have something to talk about together. Help your grandchildren know something of their heritage. Show them photographs from your old family albums. Read them letters if you've saved any. Talk to them about their forebears' struggles and challenges. Bring your parents and grandparents into your grandchildren's world so they can feel re-lated. The important thing is not that they were rich or famous, but that they once lived and represent your "roots." Be proud of the word "family." Help your grandchildren realize that the world doesn't begin and end with them-that all those relatives who lived be-fore them were links in the family chain-and in their own lifetime they have a link to forge. credit: Ellen May Goldberg, columnist for the Chicago Sun-Times. Grandparents Our Greatest Unused Resource When my grandmother died in 1928 at the age of eighty-two, she had seen the development of the horseless carriage, the flying machine, the telegraph and Atlantic cables, telephone, radio and silent films. In my lifetime, I have lived through driving a horse and buggy, making butter, going to bed with a kerosene lamp and the appearance of great air-ships. Because I have been able to go back and forth to the world of peoples still in the stone age, I have also been a participant in their leap into the modem world. Grandparents-and great-grandparents-have now become the living repositories of change, evidence that humans can adjust-witness the enor-mous changes that separate the pre-1945 generation from those who were reared after the war. Under simpler conditions, it was the child who was more likely to accept change. Today the reverse is true. Parents of young children were born into the world of TV, computers, space exploration and the bomb. They have seen much less change than their parents and their grandparents. Many of them learned in school that the only safe way to keep from being over-whelmed by the knowledge of their teachers was to refuse to deal with his-tory. If all the adults in the community are in the same age group, have the same ethnic background and approximately the same income, their children grow up to accept the small world in which they live as the only version of reality. When the Peace Corps began sending suburban-reared middle-class young people to remote parts of the world, a great deal was made of "culture shock," a term invented by anthropologists to describe the impact of a for-eign culture. Actually, what was called "culture shock" was more accurately described as "life shock" to overprotected, middle-class youngsters who had never seen an open sore or a completely disoriented person, or a birth or a death. The children of the slums see more of the seamy side of life, but their experience too is confined and limited. Often one of the barriers to employment is the lack of experience in travel-ing more than a few blocks from home. Consequently, the last decades have given us an increasingly present-bound generation, a generation who assume that the world is somehow finished, although possibly finished wrong. Somehow we have to get the older people, grandparents, widows and wid-owers, spinsters and bachelors, close to growing children if we are to restore a sense of community, a knowledge of the past and a sense of the future to today's children. While better-proportioned communities are being built, there are many things a school system itself can do. Older people, even if they have been segregated in some distant housing, can be brought into nurs-ery schools, day-care centers and kindergartens, if only to watch the children play and be ready to answer their questions. In this way, children learn to relate to older people, to make allowances for their deafness and poor eye-sight and failing memories. They will then be able to learn from them and not recoil in horror when they meet old people for the first time later in life. A second important way in which the two-generational gap can be bridged is by developing ways in which both parents and teachers, after graduating or retiring from their earlier responsibilities, can resume contact with the next generation of schoolchildren. At present, active workers in the PTA retire when their youngest child graduates from the local school system. Most of them are initially very glad to do so. They rejoice that there will be no more frantic calls just as dinner is ready to go on the table, no more frustrating committee meetings, no more scrambling about for the last few dollars needed for a project. But after that wonderful respite, many of those once-ac- tive members will miss the organization that occupied so much of their time and effort. Retired teachers may be asked back to lunch once a year or for a single so-cial evening. A boys' club may give a lunch for the retired teachers. In some places retired teachers are participating actively in day-care programs for children of working mothers. But for the most part there is no continuity. The retired teacher may be smiled at and greeted wherever she goes, and her heart may be wrung when three of her former students yield to temptation and become thieves. But students rarely keep in touch with their former teachers. The older, retired teachers avoid former students because they feel that young people don't like older people. The young people, in turn, feel that older people don't like them. Each act of hesitation increases the mutual shyness. One of the greatest challenges to contemporary education is how to impart a knowledge of the immediate past-ten years, twenty years, thirty years. The lament of the parents who find it hard to explain the Depression to their children separates old and young who have not talked enough together through the years. Many of us, particularly my age, when we heard that Pres-ident Kennedy was shot, thought of the assassination of Lincoln. The reac-tion of the younger generation was, "Who would have believed that this would happen in America?" The gap between generations is wide. In the schools there are beginning to be many young teachers who are on the same side as their high school students. But if they make common cause against the older teachers, there will be no real communication across the gap. Older teachers, younger teachers and students alike will all lose. Long conversations in small groups, looking at old movies and new movies to-gether can start up communication again and keep our social system and our own minds from cracking under the strain of rapid change. credit: Margaret Mead, Curator Emeritus of Ethnology at the American Mu- seum of Natural History and Adjunct Professor of Anthropology at Columbia University, author, among other volumes, of Culture and Commitment: A Study of the Generation Gap, Garden City, New York: Doubleday, 1970. Grief is a catchall word for the feelings and altered behavior that one experi-ences from a significant loss. The grief process is the movement through which one lives as one experi-ences the loss day by day. Hopefully it is a healing process as one goes from one stage to another. It must be emphasized that grief is not pathological but a healthy response to the ebb and flow of life. Bereavement is often viewed narrowly as the state of the survivor after the death of a person who is loved, highly prized or held very dear. When we see a boy suffering from acne after his steady has deserted him, or a young adult has a puffy face and is red-eyed from nights of crying over the breaking of an engagement, we do not refer to them as bereaved, but the sorrow is physi-cally visible. Physically and emotionally they are in real pain. Some of the physical symptoms of acute grief are: sensations of distress occurring in waves lasting from twenty minutes to an hour at a time, a feeling of tightness in the throat, choking with shortness of breath, need for sighing, an empty feeling in the abdomen, lack of muscular power and an intense subjective distress described as tension of mental pain. This discomfort can be caused by visitors who mention the deceased. There is a tendency to refuse to see people lest they bring up old memories. The grieving person may try to keep away deliberately from all thoughts and references to the deceased. Some fear they are going insane. For example, the young navy pilot who lost a close friend with whom he had eaten, slept and discussed all his personal problems-for six months after his death, he would not admit that his friend was no longer with him. One of the major obstacles is that many grievers try to avoid both the in-tense distress connected with grief and the necessary expression of emotion. The male victims bereaved by the Cocoanut Grove fire in Boston in 1942 ap-peared in the psychiatric interviews to be in a state of tension, with tightened facial muscles, unable to relax for fear they might "break down." They required considerable persuasion to yield to the grief process which would enable them to accept the discomfort of bereavement, to accept the grief process and embark on a program of dealing in memory with the deceased person. As soon as this change was accomplished there was a rapid relief of tension, and the subsequent interviews were animated conversations in which the deceased was idolized and in which misgivings about the future adjust-ment were worked through. The most disastrous symptom of unresolved grief is "agitated depression" with tension, insomnia, feelings of worthlessness, bitter self-accusation and obvious need for punishment. Such patients may be dangerously suicidal. While the intensity of interaction with the deceased before his death seems to be significant, the interaction need not have been one of affection. It may be the person who died invited hostility which could not be expressed be-cause of his status or a feeling of family loyalty on the part of those who hated him. Thus two middle-aged men were overheard in a hospital corridor discussing the rapidly approaching hour of death of their elderly father, a person they regarded as a self-centered, hateful old tyrant. They had in-structed the medical staff to spare no cost in prolonging their father's life-a procedure carried out with the usual oxygen masks, blood transfusions, drugs, intravenous feedings and succession of operations. As death drew near, one said to the other: "They really gave it to the old blank, blank, blank, didn't they." They did not like their father, they despised him and used the hospital pro-cedures to spit out their poison. Acting out one's hate is not an appropriate way to resolve grief. Hate pro-duces guilt, which calls for forgiveness and reconciliation. We say we grieve over the loss of another, but we really grieve for our-selves. It helps to see life as the flow of a river which is always moving, never the same. Life is a process in which death and rebirth are natural and normal. The pain of loss does not make the process less human. Good grief is good health, or more simply, being human. credit: Dennis J. Geaney, author of Living with Sorrow, Chicago, Illinois. Thomas More Press. The Grieving Spouse* Mourning is an inevitable part of the human condition. To quote one psychi-atrist, who dealt extensively with widows, "You really don't get over it, you just get used to it." SIGNIFICANCE OF THE LOSS A rough estimate of the size of the problem by a worker in Canada is that 10 percent of Canadian women of adult years are widowed at any one time and that the ratio of widows to widowers is four to one. Bereavement may occur at any age, and many losses of a spouse occur in young age groups; for example, one fifth of all widows created in any one year are under forty-five years of age. Mourning for a spouse, then, is a problem that affects mainly women be-cause of their greater longevity. Moreover, they are usually younger than their husbands and their marriage rate after bereavement is lower than that of widowers. Bereavement is, of course, a tragedy of major proportions. A widow is not only faced with loneliness, loss of companionship and unmet sex needs, but she now lacks the comfort, information and support of a partner of many years. If her income is reduced, as is often the case, the widow may have to move to a smaller place. This introduces the'trauma of relocation on top of the trauma of loss. Her grown children often have moved away. Family attention tends to fade after the first few weeks or months. The widow may be regarded as a threat to her married women friends or looked upon as a "fifth wheel." Some friends may expect the widow to move through her grieving process too rapidly. At times, in order to avoid their own painful memories of the de-ceased, they may withdraw from her at the very time when her need for emo-tional support is most acute. * Milton Greenblatt, M.D., Professor of Psychiatry, University of California at Los Angeles. (American Journal of Psychiatry, Vol. 135, pp. 43-47, 1978), Copyright 1978, the American Psychiatric Association. Reprinted by permission. RISKS TO HEALTH Apart from psychological and social distress, bereavement may pose a serious risk to physical health and even to survival. In many studies of the stresses, the loss of a spouse rates the highest of all stresses. Widows under sixty-five, during the first year of widowhood, consulted physicians at three times the expected rate. Physical symptoms were prominent. Sedation was used sevenfold more than normal. Widows spent more time in bed and in hospitals. It is estimated that at least one bereaved person in five will suffer substan-tial health deterioration during the first year of bereavement. In one series, at thirteen-month follow-up, 32 percent showed deterioration of health. (Health deterioration was more prominent in widowers than in widows.) Widows tend to drink too much. They lose weight and often take more drugs than are good for them. The risk of mortality is greater. The death of widows is mainly due to heart disease. Their illnesses often mirror the illnesses of the spouses they lost. Even in the second year, mortality is higher when compared with married women. Although the mechanism responsible for producing serious illness is not known, it is assumed that physiological stresses related to loss of a life part-ner are very great. One study of parents mourning the acute loss of their chil-dren by leukemia revealed highly significant physical deterioration. GRIEF AS A PROCESS AND THE PHASES OF MOURNING Grieving is not a steady state. It is a process . . . one phase fading gradu-ally into another. Manifestations may vary greatly according to level of edu-cation, personality, rituals and culture. The time it takes to move from one phase to another also varies greatly. In adult mourning the situation is somewhat different. The following phases can be noted: Shock, numbness, denial, disbelief. The most distressing manifestations of shock and numbness last only for a short period, perhaps a few days, but the process of struggling with denial and disbelief runs through many days and even months. The next phase, that of pining, yearning and depression, is most charac-teristic of the grief process. This starts within a few days of the loss and reaches its height in about five to fourteen days but may continue. This is the phase of learning to live with the loss. Weeping, sighing, hopeless feelings, feelings of emptiness, of distance from people, lack of interest and preoccu-pation with the image of the deceased are common during this period. Physical symptoms of distress may come in waves. Many symptoms of this period may be interpreted as an alarm reaction due to a heightened stimula-tion of the sympathetic nervous system and accompanying feelings of danger. The major symptoms that may be attributable to sympathetic stimulation include anger, irritability, fear, sleeplessness and loss of weight. Another group of manifestations may be related to the conscious and unconscious search for the dead object-crying and calling out for him or her, vivid dreams of the departed one, even hallucinations during which the deceased is "seen and spoken with." Sometimes there is a compulsion to visit the graveside day after day . . . with the mourner spending many hours "talk-ing" to the departed one. A process of emancipation from the loved one and readjustment to the new environment is the next phase. In this stage, calling upon one's inner re-sources and the help of all possible supports of family and friends are impor-tant. This period may take several months. The final stage may be called identity reconstruction when the formation of new relationships and the development of a new role in life without the part-ner become crystallized. But even many months after the acute loss has oc-curred, studies show that a significant percentage of people remain depressed. Although many continue to mourn, few of the bereaved are suicidal. This is an important finding in relation to the diagnosis of pathological grief. Several authorities claim that intense grief lasts longer in those who have had a sudden loss. This is particularly true for young widows, who, as we have noted, are also more prone to suffer greater deterioration of health fol-lowing bereavement. On the other hand, others observed that those who anticipated the loss, and therefore grieved before the loss, were less acutely distressed after the loss. However, the literature is not altogether clear at this point and at least some individuals who suffered anticipatory grief felt worse after the death had occurred. Aged persons who suffer losses after living through a chronic, fatal illness of their spouses often show a poor adjustment, probably because during the illness they felt "useful"-they had a function. After the spouse died they were no longer able to do anything meaningful. Family members and friends can help a great deal to relieve the pain of grief. This is especially true where there has been a close-knit family and communication has been good. Under these circumstances, outside help seems to be less necessary. Unfortunately, however, families often do break up rather early and many friends and relatives move away. Under these conditions, emotional support is not even present at the funeral, let alone after the funeral. Delayed or suppressed grief. There is much evidence that delayed or suppressed grief means serious trouble later. Some of the factors that operate to delay or suppress grief are: The loss may be socially stigmatized, as in abortion or suicide. Mortality may be due to a drug overdose. There may be uncertainty as to whether or not there is an actual loss, as in the case of soldiers missing in action. The awakening of old losses that have been unresolved. Multiple losses suffered in the past make normal grieving difficult. Trivial factors such as an unappealing or overcrowded cemetery may inhibit grief. A grieving widow's great concern about the health and welfare of her young children may make it difficult for her to express her own feelings. Other factors that may be operative are lack of finances, lack of religious support, difficult relationship between the widow and mother and/or other family members. Again, when bereavement strikes, as indicated above, wid-owers are at greater risk than widows. RECOGNITION OF PATHOLOGICAL (ABNORMAL) GRIEF It has been estimated that 98 percent of the bereaved do not seek outside help and 81 percent begin to improve in six to ten weeks. However, at any one time in a thirty-eight-bed psychiatric unit this author finds one or two in-dividuals locked in his or her grief process. It is difficult to arrive at figures for incidence of pathological grief; however, in a study of 109 randomly selected widows and widowers, it was found that 67 percent had mild or se-vere anniversary reactions, which is often regarded as one clue to excessive stress. Failure to grieve and delayed grieving are also regarded as clues towards pathological (abnormal) mourning. Signs of pathological grief are excessive sorrow which goes on and on; irra-tional despair, severe feelings of hopelessness and loss of identity, impaired self-esteem; blaming oneself for the death; loss of interest and planning for the future; development of symptoms similar to those of the deceased; apa-thy, irritability or hyperactivity. RESOLUTION OF GRIEF Shakespeare proclaimed, "Give sorrow words. The grief that does not speak whispers the o'erfraught heart and bids it break." Modem writers and clinicians agree with this statement. Unfortunately, well-meaning friends or relatives may have their own ideas of how grieving should be done and become irritated when it goes slowly. Participation by the bereaved in funeral arrangements can help. Faith in God and church or synagogue attendance may be supportive. Often pastoral counseling is the appropriate support, and trusted religious advisers may be more helpful in situations of bereavement than physicians. Some physicians recommend tranquilizers if anxiety, restlessness and in-somnia become severe. Some physicians recommend electrotherapy if the mourner presents significant suicidal trends. Fortunately, both suicidal trends and psychoses are rare. More grief therapists warn that the final adjustment, even in normal griev-ing, requires about two years. This is longer than we have been led to believe through the researches of earlier pioneers. Identity reconstruction takes a long time. The scars of the loss heal slowly or may remain throughout life. The field literally cries out for further research. One of the most painful, self-mutilating, time- and energy-consuming exer-cises in the human experience is guilt. There are two varieties. Both bad. First: Earned guilt. It can ruin your day-or your week or your life-if you let it. It turns up like a bad penny when you do something dishonest, hurtful, tacky, selfish or rotten. Any act, ill-conceived, can make you feel un-worthy, ashamed and then, heaven help you, the guilt moves in like an un-welcome house guest. Every one of us has, at some time or another, behaved badly and suffered the consequences. Never mind that it was the result of ignorance, stupidity, laziness, thoughtlessness, weak flesh, or clay feet. You did wrong and the guilt is killing you. Too bad. But be assured the agony you feel is normal. What's more it may even be a sign of nobility. It proves you have a con-science. But-and here's the clincher-know when to stop suffering. (I'd say two hours is plenty.) Tell yourself, "Enough of this hairshirt already. I did some-thing I'm not very proud of, but I learned from it." You can't relive the past so put it out of your mind. It takes energy to beat yourself over the head. What a waste of life's most precious commodity! So much for earned guilt. Now comes the variety from which nothing can be learned. Unearned guilt. This is the stuff other people lay on us. It's a bad trip and should be avoided at all costs. But first we must learn to recognize it. One of the funniest books I ever read was, How to Be a Jewish Mother by Dan Greenburg. His chapter which describes a fail-safe technique for in-stilling guilt in a child is hilarious. Greenburg suggests the following: Give your son, Marvin, two sport shirts as a present. The first time he wears one, look at him sadly and say in your Basic Tone of Voice, "The other one you didn't like?" Borrow a tape recorder and practice the following key phrases until you can deliver them with eye-watering perfection: "Go ahead and enjoy yourself." "Don't worry about me." "I don't mind staying home alone." "I'm glad it happened to me and not to you." Remember, the child is an emotionally unstable, ignorant creature. To make him feel secure, you must continually remind him of the things you are denying yourself on his account. It is best to do this when others are present, if possible. Greenburg lists four basic sacrifices to make for your child: Stay up all night to cook him a big breakfast. Don't let him know you fainted twice in the supermarket from fatigue. (But make sure he knows you aren't letting him know.) When he comes home from the dentist take over his toothache. Open his bedroom window wider so he can have more fresh air. Then close your own so you don't use up the supply. And while we are discussing guilt in the family, let's not forget that chil-dren can give their parents a bad case of it. These days especially. Working mothers are particularly vulnerable. Often they are loaded with guilt because they are not at home taking care of the little ones. The same goes for fathers who put in long hours at the office or the store -or travel for business. Frequently guilt-ridden parents try to make it up to their kids by buying them expensive gifts or giving them extra privileges. The result: spoiled brats. Gimmee pigs. They grow up unmotivated and shiftless, having learned early if they laid on the guilt they could get whatever they wanted. The most insidious form of unearned guilt (and the most difficult to get rid of) is the brand instilled during childhood. It is the twisted legacy left over from the mid-Victorian era-that anything connected with sex is bad. This notion is often put into the head of a child by a parent who says, "You mustn't touch yourself there. It's nasty." (Or "It's a sin.") Of course, the warning does no good. We continue "to touch ourselves there" because it feels good. But once the seed of guilt has been planted, it's hard to get over feeling that sex is dirty or wrong-something nice people don't do. I have encountered just about every sexual hang-up you can imagine in my daily mail. One I run across quite often is the madonna-whore syndrome. These males cannot enjoy sex with a respectable woman (a wife). The wife is the Madonna. With her there are strong inhibitions and very little satisfac-tion. In order for this male to give full vent to his sexual feelings, he needs a whore. What some people do with guilt is fascinating. They drive it underground (where it festers and surfaces on demand). It can be expiated through suffer-ing and self-flagellation ("I'm rotten. I'm no good. I deserve this.") Or it can be passed on to others. Example: While hurrying toward a crowded theater exit, you accidentally dig your heel into an elderly woman's instep. You look straight ahead as if nothing happened-hoping she doesn't know it was you. A moment later a gentleman steps on your foot-just barely. You let out a bloodcurdling yell. He turns around and says, "I'm so sorry." You bite your lip, manage a weak smile and reply, "Oh, that's all right. It's been two weeks since I had the cast taken off." You limp slowly up the aisle-steadying yourself against the rows of seats. Got the picture? Good. (This is what is known as projecting your guilt onto the next guy.) It's a nifty trick if you can find a sucker. The major drawback is that you can pull it only a few times and then the smart ones get your number. One of the most effective guilt producers is illness. A bad back is the best because the "victim" just lies there-helpless. The unspoken message is, "You did this to me, you S.O.B. You know when I get tense my back goes out -and it's all your fault for upsetting me." Asthma attacks, high blood pressure and headaches are also wonderful aids to keep a parent, a grown child, a husband or a wife "in line." Sample sentences when an argument is lost or expectations not met: "I think I'm get-ting a heart attack." Or, "Will you please bring me my migraine medicine? I can't make it to the other room." An undefined illness can be even deadlier. Nothing much is said. She lan-guishes on the sofa, hair askew, pale as a ghost (no makeup), and sighs, "Go without me, dear, and have a good time. I feel a little dizzy-can't keep my balance. I'm sure it's nothing serious. I didn't get much sleep last night wor-rying about you. Next time please phone when you're going to be late." Resolve-when you finish reading this piece-that: You are not going to spend more than two hours feeling guilty even though what you did was dumb, foolish, mean, petty-whatever. Admit you were wrong, that you behaved badly and vow you aren't going to let it hap-pen again. Then lock the incident out of your mind and never let it creep back in. Refuse to let anyone send you on a guilt trip by making you believe you made him sick. Nobody makes anyone sick. People make themselves sick. Let the characters in your life who try to manipulate you by pouring on the guilt know you are capable of handling their wrath, their anger and their disappointment. When you louse up their guilt-producing equipment you free yourself from a treacherous form of tyranny and create a far healthier climate for growth toward maturity. Remember-guilt is a pollutant and we don't need any more of it in the world. credit: Ann Landers. Guns ( A Serious Problem) 90 MILLION GUNS DEAR ANN: Tonight at 9:55 p.m. our phone rang. Dad answered. We could tell from his responses that it was bad news. It was the mother of a dear friend who had just died. The week before, HER phone had rung. It was the sheriff asking her to come to the hospi-tal. Her son had been shot in the head while driving down one of the main streets in Omaha. He was only 33-a wonderful per-son, no enemies, no reason why any-one would wish him dead. But some-one took a shot at him-and now he is gone forever. The agony of this man's parents is unbearable. He was their only child. There are no clues as to who com-mitted this senseless murder. They will probably never find the killer. It makes me sick to know that whoever did this awful thing is out there somewhere- walking around with that gun. God knows who will be next. AMERICA, WHAT'S HAPPENING TO YOU? DEAR AMERICA: That's a good question. One of the answers is this: There are at least 90 million guns out there and many are in the hands of crazy, irresponsible people. Again I am asking all concerned citizens to urge their congressmen and senators to pass a strong federal gun law. Every poll taken shows that the vast majority of Americans want it. Are the gun manu-facturers and lobbies in Washington stronger than the voice of the people? Let us make ourselves heard. Do you have a handgun in your home or in the glove compartment of your car to protect yourself against assault or robbery? If the answer is yes, here are a few facts that deserve your consideration. In 1976 approximately 25,000 Americans were murdered by guns. To put that figure in its proper context, here's another way to look at it. During our ten-year involvement in the Vietnam war, over twice as many Americans were murdered by guns at home than were killed in that war. So much for the heartbreak that goes hand in hand with loss of life. Here are some financial facts: Gun killings and wounds cost the United States taxpayer at least $4 billion a year, according to the U. S. Department of Justice. Crimes committed with guns account for a large share of the cost of law enforcement, justice, prison upkeep, welfare to dependents, insurance premiums, medical expenses, recu-peration time, losses in talent and experience, permanent disability, work-men's compensation and property losses. How do we compare with other countries in this regard? I don't want to burden you with statistics, but this one will give you a fairly good idea. From 1946 through 1967, 19 policemen were killed by guns in England, as com-pared with 1,014 policemen killed in the United States. No country in the world approaches us when it comes to shooting one another to death. We are the gun-happiest people in the world. Why? Because guns are available almost anywhere, to anyone who wants them. This means minors, idiots and people with criminal records. Anybody who wants a gun can walk into a store and buy one (or ten). In fact, you don't even have to go out of your own home. Guns are available through mail-order house catalogues. (The gun that killed John F. Kennedy was purchased from a Chicago mail-order house.) In Japan the private ownership of pistols is forbidden to everyone except the police, military and a few competitive marksmen. In France all guns must be registered and their owners licensed. In Sweden applicants for gun owner-ship licenses must prove their need for a gun and their knowledge of the weapon. Guns are big business in the United States. Many powerful interests would hate to see them go. Those who are fighting gun control legislation have for years been bankrolling a powerful lobby in Washington. Their motto is, "Guns don't kill people-people kill people." Whenever I print a letter urg-ing gun control laws, that motto pops up in my mail at least 25,000 times. My response to these people is, "Yes, of course people kill people, but it's a lot easier if a person has a gun." Part of the gun problem exists because we are afraid-and we have a right to be. Man can now walk on the craters of the moon, but he cannot walk safely after dark two blocks from his own home. Many people insist they need a gun for protection. They say if guns are outlawed, only the criminals will have them. The response to that statement is "Yes, the criminals-and the police." The war against crime would then be waged by those best equipped to do the job. And the police would win. Citizens who keep guns in their homes to protect themselves against in-traders would do well to keep these facts in mind: 98 percent of burglaries are committed when no one is at home. The burglar often adds insult to in-jury by making off with the handgun-along with the silverware. A Chicago study showed that citizens who resisted being robbed by bran-dishing a weapon were eight times as likely to be killed. The average person is not adept at handling a gun. He is slower on the draw and more easily rat-tled than an experienced thug (U. S. Mayors' Conference, 1976). If you wish to protect your home there are several things you can do: Install a security system. Get a dog. It doesn't have to be a large dog. If he barks and calls neighborhood attention to the fact that something is "wrong," he'll serve a very useful purpose. Ordinary, everyday citizens like you and me must keep in mind this impor-tant fact. Almost 70 percent of the people who are shot to death in the United States year after year are not killed by robbers or rapists. The murders are committed by husbands, wives, in-laws, brothers, sisters, lovers, neighbors, friends, employees and other acquaintances. They are crimes of passion resulting from old grudges, new arguments, lost tempers. Often booze or drags are involved. If there were no gun handy, the victim would have been clobbered by a fist, a club, a piece of pipe or stabbed by a kitchen knife. His chances for sur-vival would have been infinitely better. In addition to crimes of passion, approximately fourteen thousand Ameri-cans shoot themselves to death intentionally. Some psychiatrists argue that if a person wants to commit suicide he will do it-somehow. This may be true, but when a deeply depressed individual has a gun in his bedside table, it is easy to pull the trigger while in a state of anxiety. Often a suicide attempt is a cry for help. If pills are taken, the stomach can be pumped and the person may be saved, but when a bullet blows off a head or pierces the heart, no sec-ond chance is possible. Accidental gun deaths are another tragedy. Last year nearly four thousand people lost their lives in the United States because they "didn't know it was loaded." Can you imagine the excruciating guilt of a parent whose pre-school youngster found a loaded gun on a shelf and accidentally killed his four-year- old playmate? This occurred in Chicago recently. Every poll taken in the United States has shown that the American people are strongly in favor of handgun registration or an outright ban against their sale or possession. It's up to us to let our representatives and senators in Washington know how we feel about this vital issue. credit: Checked for accuracy by Nelson Shields, Executive Director, National Council to Control Handguns, Inc. James Sullivan, National Committee for a Re-sponsible Firearms Policy. Hair Care for Men When the crew cut of the fifties went out and the long hair of the middle six-ties came in it created a revolution in men's hair styles. At first the older gen-eration despised it. Then they imitated it. Full heads of hair, long sideburns, moustaches and beards cropped up everywhere. Hair was definitely "in." At this writing, it is still "in," although the trend is toward shorter hair than in the early seventies. Just as a male would seek a qualified doctor for help with a medical prob-lem he should find a good professional hair stylist if he feels he needs advice on what to do with his hair. If you are one of this group, make an appoint-ment for a consultation and go on from there. Don't be afraid to ask ques-tions. Today hair stylists with professional expertise are not hard to find. The best way to select a hair stylist is to ask someone whose hair styling you ad-mire. Ask, "Who is your barber?" Then make an appointment. A good stylist takes into consideration: hair type-straight, wavy or curly; density of hair-the number of hairs per square inch; hair texture-fine, me-dium or coarse; the growth directions of the hair. The stylist will study the shape of your face and head, your ears (size and degree of protrusion) and the set of the mouth and type of chin. Perhaps he'll suggest a beard, mous-tache ... or perhaps both to enhance your appearance. He will consider your height, girth and general physical posture. He will inquire about your daily grooming habits, your needs relating to recreational and business life-style. What would be appropriate for an introverted man could be all wrong for an active "macho" personality. A competent hair stylist has knowledge of the chemistry and physiology of the body and of the many new products that are available. Don't back off if he recommends a permanent or a straightener to achieve a certain style that would be good for you-or color. If you aren't ready for silver threads among the gold, he can do something about it. Many men today don't realize that their hair is subject to damage by wind, sun, blow-drying and sprays. A hair-conditioning agent is as important for men as for women. If hair is left in a dry state of abuse it can lead to severe hair and/or scalp problems. Weather is a big factor in playing havoc with hair and scalp. Conditioners are plentiful. Your stylist will be happy to sug-gest the type best suited for your needs. BASIC PROBLEMS AND POSSIBLE SOLUTIONS: Dull, lifeless, fine and flyaway hair: Keep it short. Use conditioners, grooming aids, or perhaps a series of herbal henna treatments (neutral or colored). Matting hair, fine or coarse: If the hair is too oily, check your sham-poo. If high in alkaline it will cause the body to produce more oil to regain acid balance. Hair should be cut shorter, in layers, to lift off the scalp, away from the oil, for easier management. Coarse hair: Keep it conditioned regularly and use a creme rinse along with your acid-balanced shampoo. A longer style is advisable because of the additional weight to keep hair smartly in place. Dandruff: Whether it is flaking and itching (known as dry dandruff) or redness and inflammation plus flaking and itching (called wet/oily dandruff), the problems are the same. There is no known cause and it can appear on other parts of the body. No one has proven that germs are the pri-mary villains. If daily cleansing with a good acid-balanced shampoo doesn't alleviate the problem consult a dermatologist. Dandruff can easily be con-fused with psoriasis or eczema. A word of caution: dandruff shampoos (commercial or professional) can be damaging to the scalp and should be used as instructed by a knowledgeable stylist or doctor. Baldness and receding hairlines: On Yul Brynner, baldness looks good, but most men are distressed when they discover their hair is going. What causes it? Mainly it's an inherited tendency but there are other factors as well. Often illnesses, nervous conditions and bacteria can cause the loss of hair. We also know that the buildup of androgen, the male sex hormone in the body, causes the follicle to become dormant. In many cases the hair can be restored to its original glory by the injection of estrogen, the female sex hormone, but this may cause the body to develop breasts and other female symptoms. The loss of hair need not mean the loss of manly pride. There are many al-ternatives, but investigate before you invest. Full wigs, partial hairpieces, implantations, weavings and transplants are available. Decide with your hair stylist which is best for you. Generally when the hair begins to go it is best to keep it cut short. Remember, when you try to conceal a receding hairline or a balding area you merely draw attention to it. "Less is definitely more!" credit: Robert R. Brady, Obelisk Studios for Men, Chicago, Illinois. Hair Care for Women* Man's first miracle fiber was hair. It survives washing, drying, cutting, curling, burning, teasing, stripping, dyeing and straightening. What man-made material can tolerate such torture? While hair may survive, it does not always thrive. The abuse suffered by the average head of hair is incredible. Before thinning begins and split ends appear, something should be done lest woman lose her crowning glory. Beautiful hair begins with good health. It needs loving care and protection. What you don't know about hair care can hurt you. What you do know can mean the difference between having a magnificent mane and a dull, straggly mop that you'll want to cover with a scarf or a turban when you desire to look your best. ABOUT SHAMPOO How often? Often as you like, but the more you do it, the milder your sham-poo should be; if you're a frequent shampooer, it might be wise to dilute the shampoo with water before applying. To forestall as much tangling as possi-ble comb or brush your hair before you wash it, smoothing it in the appro-priate direction-forward if you dunk your head into a washbowl, back if you're shampooed in a salon, down if you shampoo in a shower. Many shampoos offer extras now, in the form of lemon, balsam, herbs or protein. These contribute their own natural benefits-the first three offer fragrance, and protein seems to join forces with the protein hair is made of. The water should be anything but hot-lukewarm to cool is best for hair, and most shampoos work just as well in cooler water. Most, also, do their job in hard or soft water. ABOUT CONDITIONERS Conditioners make hair easier to manage and reduce static "flyaway" elec-tricity. Some conditioners are rinsed off right away; some are rinsed off after a little longer time; some stay on and become setting lotions. Labels will tell you which does what. Most conditioners, now, also have the extra benefits of * Grace Mirabella, Vogue Beauty &. Health Guide, Copyright, 1973, 1974 The Conde Nast Publications, Inc. lemon, herbs, balsam or protein. Conditioners should be applied two inches from the scalp, then down to the ends of the hair-it's hair, not scalp, that needs this therapy. As you work in the conditioner, separate strands of hair with your fingers then comb through them with a wide-toothed comb to dis-tribute the conditioner evenly. After this, loads of rinsing, in fresh-flowing water. Wet hair should look shiny before it dries-if it's dull while wet, there's still too much conditioner left. This can weigh down hair (especially fine hair) and make it limp. One solution: use all the conditioner you need- but no more-to get your comb through without damage; after combing, use a little vinegar in the near-to-last rinse water to counteract the conditioner's limping effects. Final rinse should be as cold as you can stand it-this firms up hair. ABOUT CUTTING A skillful cut makes thin hair appear thicker, limp hair bouncier, thick hair more manageable. For stronger, healthier hair, the blunt cut is your answer. Here's why: The weakest area of hair is the ends, the portion of hair not covered by protective outer cuticle and the only area where the hair shaft is completely exposed. When hair is cut at an angle, even more of the inner hair shaft is exposed, so more protein and moisture can escape (same principle as cutting rose stems on a slant to take up more water; but with hair, nourish-ment goes out instead of in). A good haircut has other advantages. The hair can be washed and blown dry, worn loosely avoiding the torture treatment of teasing, tight clips and rollers and overspraying-all things that could damage hair. Speaking of hair spray-no need for hair to be drenched in it right down to the skull-it's only the top layer that needs it. And if you use spray, be sure to comb it out before going to bed so hair will be unbrittle and unbreakable overnight. ABOUT BRUSHING Forget that hundred strokes. Do it just enough to loosen hair, start it bouncing, but don't overdo. Brushing hair promotes oiliness, so well-oiled hair can do with even less. Before you buy a brush, feel its bristles; if they hurt your fingers, they'll hurt your hair. Same applies to combs. Make sure the teeth won't bite. TWO MODERN PROBLEMS FOR HAIR One is pollution-bad air promotes bad hair. City hair needs washing and conditioning frequently to rid it of fumes and soot. Country hair is luckier, gets cleaner air, is probably attached to a healthier scalp. Another problem is tension. According to one hair expert, tightened-up shoulder and neck mus-cles restrict the flow of blood (and its accompanying oxygen) to the scalp, where it's needed for hair growth and health. The moral: When it comes to hair, relax and enjoy it-more. DIET Your general health will be reflected in your hair. Plenty of protein is good for all of you, hair included. Too many fats and oils, if your skin and hair are oily, will make your hair greasy. It matters what you eat-so eat sensibly. WEATHER Hair grows faster in warm weather than in cold and is more apt to get oily, since oil glands and blood circulation are more active then. Cold weather is harder on hair, makes it less lively; also, in winter, heads are more often covered so hair is squashed and less air gets to the scalp. Excesses of wind and sun are drying to hair just as to skin. Very hot hair dryers are as harm-ful as strong sun and wind, so if the hairdresser, in an effort to get you out in a hurry, puts you under a very hot dryer, move the dial to medium or cool. At home hold your hand dryer a foot away from your head-and keep it moving around. There is a natural tendency for hair to become thinner as the years pass, but with good tender, loving care your hair can remain your crowning glory. Hair Transplants Unless you're the Telly Savalas type, losing hair on the head can be trau-matic. We live in a society where hair loss is often associated with loss of youth, power and self-esteem. In fact, hair loss and its roots (pardon!) reach back into mythological times. When Delilah cut Samson's hair he could have put on a curly wig, but to-day's Samsons have much more going for them. They can have a hair trans-plant. More than a hundred thousand men have had transplants. They are not only our most visible politicians and entertainers, but more often the neigh-bor down the street. Medical authorities agree that hair transplantation is the most effective, safe and permanent method for replacing lost hair. Although it won't look exactly like the hair one had at eighteen, it's the next best thing. Male pattern baldness looks much like a monk's haircut; hair growth at the sides and back of the head, but not at the top. It can begin in a young man just out of his teens or occur ever so gradually over the years. Causative factors point to a combination of hormonal and hereditary influences. Some men have more of the male hormone androgen than others. Add this to a hereditary disposition for baldness, and you are dealing against the odds. Hair loss can also be caused by bums, radiation treatments, accidents or surgery. Other reasons can be glandular disorders such as diabetes, system infections, medications and chronic, physical scalp abuse. Women especially should vary their hair style every few years. Ponytails should not be a habit because continued tension or pulling on the hair impairs the blood circulation at the hair roots. This could cause the root to die and the hair would then fall out. Many of the above conditions can be cured or corrected, but medical sci-ence still cannot prevent the hair follicle from dying. Once the root dies, no hair will grow naturally on that spot and there are no medications or com-mercial products that will grow hair. The one way hair will grow, oddly enough, is if hair plugs are transplanted from the area of the scalp where hair is seldom lost. That location for most men is at the sides and the back of the head. Some doctors bypass the plug technique at the hairline, and place a strip graft there. Too often this type of graft doesn't take. It frequently becomes infected and leaves visible scarring. It's not worth the trouble. Women, too, can be helped by hair transplants as long as they have an ad-equate amount of healthy donor hair. A consultation with a qualified doctor can provide the best answer. Those physicians performing hair transplants are cosmetic surgery specialists in ear, nose and throat, plastic surgery and dermatology. Recommendations from your family physician or the County Medical Society are most helpful in selecting a doctor. Most doctors who do this type of work are kept busy through referrals-people who have been sent by grateful patients. Hair transplants are most always done in the doctor's office. There the doc-tor evaluates his patient's health. A blood test for bleeding tendencies is per-formed, another for the blood sugar level. The doctor makes sure his patient understands what is to be done. The number of total plugs and transplant sessions is discussed. With a pencil, the doctor then draws the future hairline in and takes photographs. Placement of the hairline is important. Some unfortunate individuals have had their hairlines put in straight across their foreheads or too near the eye-brows. Most of the botched jobs occur because people patronize unqualified practitioners, some not even in the medical field. If you admire someone's hair transplant, find out who did it! If you see a botched job, it might be use-ful to find out who did that one-and stay away from him. Once the surgery date has been arranged, the patient is cautioned not to take any aspirin (or its derivatives) ten days prior to that time. He should have no alcohol twenty-four hours before and after the procedure. The patient shampoos his hair the night before and can eat a light meal on the day of surgery. A pre-operative medication is given before the transplant begins; this minimizes the anxiety. The hair at the donor site (usually the back or side of the head) is cut to a 3-mm. length and cleansed with an antiseptic solution. At the recipient site, the scalp is cleansed again and the hairline is penciled in. The next step is about as painful as having a tooth frozen at the dentist's. A local anesthetic is injected into the scalp which minimizes bleeding and dulls sensation. Once done, the patient feels only slight pressure. Then by means of a 5-mm. circular punch, the doctor removes the donor plugs at the proper angle so as to include the hair follicle. Each plug, contain-ing from eight to fourteen hairs, is cleansed, trimmed and put into a "wait-ing" solution. The recipient site at the top of the hair is prepared with a 4.5-mm. punch. This assures a good fit; and as the hair plugs are inserted, the doctor must carefully note in what direction he deposits them. Hair at the hairline grows forward so it must be placed that way. Otherwise, the hair will grow in the wrong direction and tangle badly. The plugs are spaced one plug diameter apart in order to assure a good blood supply. Fifty to sixty plugs are grafted in one session which takes one half hour to one hour. A mild pressure bandage is then applied on the head and changed the following day. A mild analgesic or sedative can be prescribed if needed. It is advisable to avoid alcoholic beverages for twenty- four hours after transplantation and to avoid severe or strenuous physical ac-tivities for seven days after the procedure. The patient is told not to disturb the plugs for two weeks although he can shampoo in five days. A few days later, the patient can wear a loose-fitting cap or toupee, but when new hair growth begins, a toupee should not be worn. Crusts will form on the affected areas, but will fall off in about two weeks. Because the hair follicles go through a shock period, the transplanted hair falls out. No cause for alarm because in about three months, hair begins to sprout. This transplanted hair lasts a lifetime or as long as the unaffected hair remains in the donor region, which, as mentioned earlier, most men never lose. The next tr