Stories

By Bruce Lindsay, M.D.

From a tick’s perspective the CSA is a target rich environment, and you are one of the targets. The problem is the abundance of deer ticks and the risk of Lyme disease. I contracted Lyme disease at the CSA a few years ago. I recognized it and was treated without any problems. I also saw a few patients at the Cleveland Clinic who had Lyme disease affecting their heart, which is a more difficult problem. There are significant complications that can be avoided if people understand Lyme disease, take measures to avoid it, and know what to do if they are infected. Perhaps my review of this unappetizing topic will help you to avoid a disease that can be debilitating. Be aware that ticks carry other diseases such as Babesiosis (destroys red blood cells), Anaplasmosis (resembles flu symptoms), Alpha-gal Syndrome (triggers severe allergy to red meat and dairy), Powassan Virus (encephalitis), Tick Paralysis, and Rocky Mountain Spotted Fever. Some of these can be very serious or even fatal.

Overview. Lyme disease has spread into the upper Midwest. It is a problem in Benzie County and adjacent counties along the coast of Lake Michigan.¹ Recent CDC data show that visits to emergency departments for tick bites are higher than ever in 2026 and Michigan is among the worst states.² Confirmed reports have nearly tripled in the past 2 years and the CDC estimates that 500,000 people are infected annually in the United States.³ Lyme disease is caused by the bacteria Borrelia burgdorferi, which is transmitted to you by the bloodsucking black legged deer tick Ixodes scapularis, and the risk of Lyme disease increases where deer populations are higher. The deer tick is a “hard tick” with a tough shield on its back. Infected ticks carry the bacteria in their gut and transmit it to you through their saliva when they are feeding. There are several species of ticks, but only the black legged deer tick carries Lyme disease in Michigan. Suffice it to say that we have an abundance of deer and black legged deer ticks at the CSA.  Other species of ticks, including the more common dog tick, do not carry Lyme disease, but they carry other diseases and it is not so easy to tell them apart unless you study the topic.

Life-Cycle. Ticks, which are active in the Spring through Fall, have 3 stages over a life cycle of 2-3 years: larva, nymphs, and adults. Each stage requires a host to provide a single blood meal so they can progress to the next stage. They only feed once at each stage and they are waiting for you.

1. Eggs hatch in leaf litter, then the larvae (6 legs, about the size of a typed period) find their first host. Larvae are not infected with Lyme disease when they hatch, so they cannot transmit it to you. They quest close to the ground and latch onto mice, birds or other hosts that carry the Lyme disease bacteria and the larvae become infected. They become engorged, drop off, and emerge as 8-legged nymphs the following spring.
2. Some nymphs are infected from their first host. They limb onto low lying vegetation and ambush the second host – a deer, a dog, or perhaps you. They can detect their new hosts through exhaled CO_2, body heat, shadows, odor, and vibration. Children or pets may bring them into the house and share them with you. Once aboard the ticks crawl around your body – often meeting a barrier such as a waistband, skinfolds or the hairline. They commonly attach on the back, thighs, shoulder, or around the hairline, ears, waistline, armpit, and groin. The nymphs are most likely to transmit Lyme disease because they are abundant, and they are tiny and may feed on you for days before they grow large enough to be detected. They are about the size of a poppy seed initially, so you may not notice that you have a hitch-hiker, especially if they are lodged on your back or some other area that is out of sight.^4,5 Once engorged with blood the nymphs drop off and will progress to become adults.
3. Adult ticks carry Lyme disease if previously infected. They tend to climb higher on vegetation while awaiting the 3^rd host - primarily deer, which distribute them around the CSA, though you would be a welcome meal too. They eventually become engorged and drop off. Then the females lay about 2,000 eggs in the leaf litter to start the next cycle.

Attachment & Risk. When deer ticks burrow into your skin their secretions have a neurotoxin to prevent pain or itching so you probably won’t feel them, and the saliva forms a biological cement that makes them hard to remove⁶. Their metabolism is so low that they only breath a few times per minute. Swimming will not kill them because they are able to extract oxygen from water and can survive underwater for up to 15 days.⁷. They grow larger as they become engorged with blood. Adult ticks are less likely to bite humans and they are more visible, so they are often removed before transmitting the disease. The left image shown below compares the size of the adult (left) and nymph (right) blacklegged deer ticks.⁸ The right image shows how much larger the nymph becomes as it feeds.

Two important factors determine your risk of infection.

1. First, is the incidence of infected ticks in the area. About 20% of nymphs and 50% of adult ticks are infected in areas that are highly endemic for Lyme disease.⁶ The incidence may be lower in Benzie County, but it is significant and growing.
2. Second, time is of the essence. You won’t be infected by a tick that is crawling around look for a good place to lodge. Once they have attached by burrowing into your skin, it takes about 36-48 hours for the bacteria to move from the tick’s gut into their saliva, so a tick that is detected and removed promptly will not infect you with Lyme disease; however, research shows that 50% of infected nymphs transmit the disease by 68 hours of attachment.^9,10,11

A tick bite is considered to be high-risk only if it meets the following 3 criteria:⁵

1. It was a deer tick
2. It occurred in a highly endemic area
3. The tick was attached for ≥ 36 hours.

The reality is that you might not know what kind of tick it was and may have flushed it down the toilet in disgust before it occurred to you to save it and show it to someone who could identify it accurately. The CSA is in a relatively high endemic area. If you think the tick was attached for ≥ 36 hours you should seek medical attention. 

Recognize Lyme Disease. You may wonder how bad is Lyme disease and how do I know I have it? Early infection is heralded by a distinctive rash called erythema migrans in 80% to 90% of cases.⁵ As shown below, the classic rash is an expanding area of redness about 5-15 cm or more in diameter with a bulls-eye or target pattern: however, there are many variants that look much different.¹² The rash may be accompanied by nonspecific symptoms such as headache, fatigue, aching muscles or joints, or neck stiffness. More disseminated disease that affects the nervous system or the heart may occur days to weeks after exposure. There also is a late form predominantly affecting joints that can occur months to 2 years later. If you have had Lyme disease before, it doesn’t prevent you from getting it again.⁵ The good news is that if Lyme disease is diagnosed and treated promptly most patients do well. 

Prevention & Removal. Now that you are thoroughly repulsed, let’s focus on how to avoid Lyme disease if you are walking or working outside:

1. Wear light-colored clothes so ticks that climb aboard will be more easily seen.
2. If you tuck your pant legs into your socks it helps prevent ticks from gaining access to your skin. You can buy gaiters treated with permethrin that repels or kills ticks on contact. These are not fashion statements, but they are effective.
3. You can spray permethrin on the outside of your clothes to repel or kill ticks, but do not spray it on your skin.
4. DEET, picaridin, and oil of lemon eucalyptus are tick repellants that can be applied to skin, but they don’t kill ticks.
5. Inspect yourself when you come in from the woods or grassy areas. A shower is effective in washing them off before they attach.
6. Wash your clothes in hot water ( ≥150 degrees F) after working in a high-risk tick zone in case the ticks are clinging to the clothes. Cold or warm water is ineffective. However, 6 minutes in a dryer on high heat will kill them.¹³
7. Inspect pets if they have been with you.
8. Don’t worry about ticks that have not attached to your skin. Just get rid of them and wash your hands.
9. If you find a tick that has attached, remove it with a set of fine tweezers inserted between the tick body and the skin. Pull gently upward until it is removed. Twisting or jerking is not recommended. Try not to crush the body of the tick. Wash the bite site and your hands after removal. While it is best to remove all mouth parts, sometimes pieces remain in the skin. If not easily retrieved, don’t worry, they will eventually work their way to the surface and probably don’t increase the risk of infection. The risk of disease transmission is greatly reduced even if the tick is inadvertently crushed or squeezed during removal.¹⁴There are commercial tools designed to make removal easier, but good technique is more important.^11,14,15
10. Do not try burning the tick or applying noxious chemicals. These methods are not effective and may actually cause the agitated tick to regurgitate more bacteria into your skin.^4,14,15

By Bruce Lindsay

               We hope your children will enjoy the new playground equipment that has been installed for the 2026 season.  The Playground Subcommittee of the Waterfront worked assiduously on the design and safety of this project, which was approved by the Board of Trustees, and has been supported entirely through generous donations. We recognize that outdoor play has a vital role in supporting children’s health and development. Playgrounds provide essential opportunities to climb, slide, practice balance, build strength and engage with peers, thereby fostering both physical and social growth. Although playgrounds carry some risk of injury, these risks can be minimized through careful equipment design, strategic placement, proper impact absorbing surfaces, regular inspection, and active adult supervision.

This article reviews data related to playground safety and what we can do to manage those risks. To put this in perspective, the vast majority of children are not injured on playgrounds or only have bumps and bruises that do not require medical attention. The discussion that follows is based on the small number of children with more significant injuries that require medical attention.

Risk of Playground Related Injuries

              The highest risk of injury is in children 5-7 years old and tapers with age. The reason is that younger children have less strength, balance, and experiential judgement.¹ Moreover, as children transition to greater independence they may be supervised less intensively than younger children and try to emulate what the older kids do.

Falls are the leading cause of playground injuries accounting for up to 75% of cases seen in emergency departments. Most fractures involve the upper extremities because of how children hit the ground. Monkey bars have elicited discussion because the risk of fall related fractures from monkey bars is twice that from other climbing surfaces and 7 times that from swings and slides. Fortunately, they are rarely associated with head impact with the ground. ² The problem with monkey bars is not that they are inherently bad; however, they are tempting for children less than eight or nine years old who don’t have the upper body strength to play on them safely. Monkey bars that are not as high would reduce the risk of injury from a fall, but young children don’t have the strength for monkey bars and should not be using them in the first place.

There are of course other types of injuries, but impact with an obstacle (11%) or injury from body parts being cut, pinched or crushed (8%) or entrapped (1%) are less common than falls. Head injuries, which account for 15% of playground injuries seen in emergency departments, are most often related to swings as opposed to slides or climbing structures. ³ The development of swings with impact absorbing seats is an important safety measure, but it doesn’t eliminate this risk.

Fortunately, playground related deaths are very rare. They can be related to falls, but they are most often due to strangulation caused by clothing getting caught on equipment, such as at the top of a slide (2). This risk is greatly reduced by modern slide designs. According to the CDC the death toll of children from accidents in the United States is about 12,000 per year. In comparison the annual number of deaths associated with playgrounds is in the order of 15 per year.⁴

Research identifies fall height and the impact surface beneath equipment as the most important determinants of injury.⁵ Falls from heights > 5 feet quadruple the risk of injury compared with falls from lower heights. If the maximum height of equipment were lowered from about 8 ft to 5 ft the estimated risk of injury would be reduced by 45%, but much depends on how old the children are who use the equipment.  Impact absorbing materials such as sand or other loose materials provide better protection than grassy surfaces. However, even the best absorbing materials probably reduce the risk of injury by only about 10%.⁵ Loose bark or rubber surfaces would be impractical on the CSA beach where it would either be blown away or covered with sand. The CSA replenishes our beach with fresh sand every few years and some of it is intentionally put under the playground equipment to enhance safety.

Another important factor is how kids land when they fall. In one study, children who fell and suffered no significant injuries were compared with those who were injured. As you might expect, they found that children who landed on their legs were much less prone to injury, but when children did not land on their feet injuries most commonly involved the upper extremities because their arms broke the impact.⁵ Perhaps the reasons that children 10 years or older account for fewer injuries is that they are less likely to suffer a fall and more adept at landing on their feet.

We should not underestimate the importance of supervision. Children under the age of 5 are less likely to take harmful risks when a parent or someone else is nearby and supervises. An observational study found that playground injuries are often associated with “using equipment improperly.” They also found that the frequency of injuries decreased when class teachers or other monitors supervised playgrounds.³ However, the reality is that most public playgrounds are not supervised. At the CSA parents need to supervise young children because they are more prone to injury.

Incidence of Playground Injuries

An analysis of the National Electronic Injury Surveillance System (1995-2019) documented 213,000 annual visits to emergency rooms because of playground related injuries.¹ They ranged from minor abrasions to more severe traumas such as fractures, concussions, and rarely death. Over the course of 24 years 9 deaths occurred. This analysis also found that children 5-9 years of age were twice as likely to sustain injuries after falls compared with children 1-4 years old, who generally are less adventurous. The three leading playground equipment categories responsible for injuries included climbing apparatuses (36%), swings (26%), and slides (21%). Most patients were treated and released whereas 4.6% were hospitalized. The most common diagnoses were fractures (36%), contusion/abrasions 18%, lacerations (17%), strains/sprains (11%), internal injuries (7%), and concussions (2%).

There is some evidence that hospitalizations have declined, presumably because of better equipment and regulations.  Yet despite these efforts the annual incidence of significant playground injuries has not changed appreciably since 1995 and hovers around 25-30 per 10,000 children.

Balancing Risk and Safety

Most playgrounds are designed to target children aged 2-12 years old with different equipment for specific age groups. For example, young children should not play on climbing equipment without direct parental supervision because they don’t have sufficient strength and balance; however, other low level balancing challenges are good for them. Our goal is to provide a playground that is fun for children over a range of ages with an acceptable level of risk. In the context of playgrounds and sports we can never eliminate the risk of injury, so it is unrealistic to claim that any playground equipment is entirely “safe,” as some risks persist regardless of design or placement. Even the most cautious safety measures have limited impact if children circumvent these precautions. For example, a child might walk in front of a moving swing even if the swing meets all safety standards.  That is why parental supervision of young children is so important.

Advocates for allowing children to engage in play that carries manageable risk believe that the risk is tolerable if children are allowed to progress at the pace they choose. Research into child behavior highlights the importance of “risky play” for the physical, mental, and emotional development of children. These opportunities help to develop spatial awareness, coordination, tolerance of uncertainty and confidence. It has also been linked to greater resilience, self-confidence and problem solving. Children who are allowed to engage in risky play develop better risk assessment skills. Perhaps one way of looking at this is to say that “children should be as safe as necessary, not as safe as possible.” ⁶

Measures the CSA Can Use to Manage Risk

     We have the responsibility to verify that our playground equipment meets the standards of the Public Playground Safety Handbook that was developed by the U.S. Consumer Product Safety Commission.⁷ To be clear, this document does not advocate against swings, climbing structures or other specific equipment that has some risk, but it does provide safety guidelines related to height, space between the equipment and many other measures. There are three approaches to playground safety that we have emphasized.

1. Remove or repair equipment with rough edges that may cause splinters or lacerations, as well as equipment with peeling paint or other signs of disrepair.
2. Modify or replace equipment posing elevated risks with equipment that meets safety standards. This includes equipment that exceeds recommend fall heights or presents hazards such as entanglement, entrapment, or collisions.
3. Our members should be educated about the risks of playground equipment and the need for direct parental supervision. This is particularly important for monkey bars or other climbing equipment that exceeds 5 feet in height and is not designed for small children.

References

1. Nabavizadeh, B: Hakam N, Holler JT, et al. Epidemiology of child playground equipment-related injuries in the USA: Emergency department visits, 1995-2019. Journal of Paediatrics & Child Health 2022; 58: 69-76.
2. Playgrounds - risks, benefits, and choices. Prepared by Middlesex University for the Health and Safety Executive 2002.
3. Fuselli P, Yanchar NL, Canadian Paediatric Society, Injury Prevention Committee. Preventing playground injuries. Journal of Paediatrics & Child Health 2012; 17:328
4. Norton C, Nixon J, Siber JR. Playground injuries to children. Play value, safety, or both. Archives of Disease in Childhood 2004; 89:103–108.
5. Chalmers DJ, Marshall SW, Langley JD, et al. Height and surfacing as risk factors for injury in falls from playground equipment: a case control study. Injury Prevention 1996; 2:98-104.
6. Nowogrodzki J. Why kids need more chances to take risks. Nature 2025; 637:266-268.
7. Public Playground Safety Handbook. https://www.cpsc.gov/Playground-Handbook

By Ginanne Brownell

“Celebrate the CSA Way” is the slogan for this year’s 125^th anniversary of the Congregational Summer Assembly. That slogan really has two meanings: celebrating in a way that feels personal to members—maybe it’s a bonfire at Michigan beach or an intimate dinner party in your cottage to cheers our quasquicentennial or volunteering to help out during the tennis tournaments or rolling up your sleeves to get stuck in during the Art Fair—but also celebrating what the CSA means and what it stands for. This year, we are taking CSA to also mean Community, Stewardship and Action. What makes CSA so special is the can-do spirit that we all feel towards our community but also the wider Crystal Lake community as well. 

In Rwanda, there is a term called Umuganda, which highlights (mandatory) community service for everyone who is fit and able in the country. It is held on the last Saturday of every month from 8am until 11am, and the idea of coming together for a common purpose is aimed at community development and engagement. Communities must decide each month what their focus will be—from cleaning public spaces to planting trees or helping build infrastructure—and they work together not only to implement the plan but also to also work together for a common goal on that day. It is an example of how community, stewardship and action can come about not only to create change but also build a sense of cohesiveness and belonging for all citizens.  

While volunteerism is obviously not a mandatory part of being a member of the CSA, there is a call to action that many people feel deeply. Maybe it’s being an active part of the many CSA committees that do everything from human resources to waterfront and Pilgrim Fund, or it could be participating in an operetta or chaperoning a teen dance to make sure it is a success.  Whatever it is, as Nate Dennison, who is the head of the Board of Trustee’s ad hoc volunteering working group, said, volunteerism is woven into the DNA of the CSA experience. For 125 years, the stewardship of our community has flourished because Assembly members generously give their time and talents.  This year, the CSA Board examined volunteerism, including its strengths, challenges, and trends, with the goal of developing recommendations and a refreshed strategy to sustain this crucial part of CSA life. “Many people,” Nate said, “find their place in the fabric of our summers through service.” 

Nordic Rocks was built with every kid in mind. Nearly half of participants qualify for free or reduced lunch, and the program deliberately reaches rural schools where winter recreation can feel out of A group works its way through the forest trails - coats ditched, spirits high.reach. It asks very little of families. There are no equipment costs, no special clothing requirements, and coaches keep spare gloves and socks on hand for kids who need them. And while kids are busy having fun, they’re also getting one of the best full-body cardio workouts of their young lives — legs, core, arms, lungs — the kind of workout that feels like play. Healthy bodies, active minds, and a genuine love of being outside in winter: Nordic Rocks delivers all three.

 “I love doing this — it makes me feel so alive inside. I can’t understand why more people don’t do this!” — ZOE, 4TH GRADE, BLAIR ELEMENTARY

After each session, kids pile into the Nordic tent — cheeks red, boots off, skis racked — and wrap cold hands around hot chocolate while popcorn disappears faster than it can be refilled. The tent gets loud. The stories get bigger. Nobody is in any hurry to leave. Teachers report that ski days are favorites all around — and not just for the obvious reasons. The confidence kids carry back onto the bus tends to follow them through the rest of the school day. They’re calmer, more positive, and with notable changes in behavior — fueled by the particular confidence that comes from trying something that scared them — and finding out they were more than up to it.

The Nordic Rocks coaching team brings genuine passion to every session. Program coordinator and coach Liz Negrau is second from right. Not pictured: part-time coach and fellow CSAer Matt Nahnsen.

Thank you, CSA Women’s Association.

This season, the CSA Women’s Association generously funded Nordic Rocks equipment — skis and boots sized specifically for 3rd through 5th graders — making it possible for hundreds of kids to experience the sport on properly fitted gear. That investment shows up in every session, in every kid who pushes off for the first time and discovers they can actually do this. We are deeply grateful. Your generosity is felt by every child who pulls on those boots, pushes off for the first time, and discovers they can do something wonderful.

• How can the Trustees use these values to guide their leadership and decision-making?
• How can Committees and staff use these values as a compass for their work?
• Is there benefit in periodic reflection on our shared values? If so, should the CSA develop a plan to repeat the 2025 community conversations going forward?

• Given our diversity, how can we support the spiritual growth of all of our members as we strengthen our capacity to build genuine affirming relationships across our membership?
• How can we engage younger generations in conversations that both mentor and value their unique experiences and visions to help the CSA innovate and evolve?
• Can we develop and establish a new way of verifying membership that is both consistent and considerate (especially at the beach)?
• How can we build relationships with newcomers and new family members, fostering engagement so they are truly connected to and welcomed in the CSA community