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During our most recent family movie night, we watched one of my favorites: Encanto. At one point in the movie, a character who has been gifted supernatural strength confesses that she fears she will crumble under the weight of all that is expected from her. Although she accomplishes amazing things, it never feels like enough. She never feels like she, herself, is enough. Popular culture suggests she should prioritize "self-care," which is usually represented by manicures or massages and long...
I confess that occasionally even doctors get squeamish. Or perhaps more honestly, this doctor does. My personal list has gotten pretty short, but one of the things that still makes me squirm is something I nevertheless frequently recommend to my patients. So what is this mysterious and rather ominous medical recommendation? Nasal saline irrigation. The practice of rinsing the nose out with liquid probably originated centuries ago in India and it remains part of spiritual ritual as well as...
My son is one of the many Americans with cleft lip and palate. The specifics of each affected individual’s situation vary, but one thing they have in common is that they will be having surgery. Lots of surgery. Although most individuals with orofacial clefts, including my son, are otherwise healthy and lead normal lives, the process of restoring a normal smile, normal speech, normal chewing, involves many steps from birth into adulthood. Most of his surgeries have blurred together in my mind, h...
Recently, while visiting from out of state, my father had a "health hiccup." As we navigated getting this problem investigated and addressed, he was very concerned that we keep his primary care doctor informed. As my dad has said repeatedly, "I give him more grief than any of my other doctors, but I also listen to him more than any of my other doctors. He's the only one looking out for all of me!" Like many Americans, particularly older Americans, my dad has a whole host of specialists he sees...
It’s tempting to blame the pandemic for the dizzying rates of mental health concerns among American teens. We are all familiar with the impact Covid is having on our lives and the disruption it continues to cause in the lives of young people. Kids witnessed vehement disagreements between neighbors, friends and family over the decisions that had to be made in response to the pandemic, and felt the stress at home as parents faced economic and work changes, all without many of their usual s...
The annual wellness exam is one of my favorite things to do as a doctor. It’s a chance to talk about one of my passions: health promotion. As most patients expect, our health-promotion discussion includes smoking cessation, diet and exercise. Perhaps more surprising is our conversation regarding personal safety. We talk about sunscreen, seatbelts, helmets, distracted driving or driving under the influence. And I ask if their guns are locked up. I grew up in Iowa and I live in South Dakota. B...
For the past few months, I’ve been fielding questions about the baby formula crisis. Make no mistake, the shortage of baby formula is indeed a crisis. Babies are delicate. Their immature bodies rely on having just the right intake of water and salts, and just the right composition of proteins, fats, and carbohydrates. Their organs can’t keep that balance independently, the way healthy older children and adults can. Formula is carefully designed for this. Breastmilk is the ideal food for bab...
I don’t know how you feel, but in my opinion, parenting is hard. Someone must have forgotten to hand me the instruction manual when my children came home. I have yet to meet a parent who wouldn’t appreciate one. New parents can count on getting lots of advice from well-meaning friends and relatives and, sometimes, even perfect strangers. Some of that advice is welcome and useful. Some, not so much. And sometimes that advice is downright dangerous. Many grandparents raised their own children at...
Skin is the largest organ in the human body, but it’s easy to take it for granted. Unless we notice pain or itching or funny spots, most people don’t give it much thought. However, the skin is critically important. It helps regulate our body temperature and fluid and electrolyte balance. It provides us critical information about our environment, and it protects us from invasion by the sea of germs we encounter every day. Some of the sickest patients doctors ever treat are those who have had sig...
Lately my teenager has been fascinated by medical dramas. Although my “doctor self” is usually rolling my eyes throughout the program, it’s often a good conversation starter. One recent show featured a pregnant woman who experienced one medical crisis after another. Her kidneys, liver and lungs failed in succession as the team raced to identify the underlying obstetrical problem and find a treatment. At the climax of the episode, her heart stopped. Of course, being television, the correct diagn...
One of my favorite parables describes the difference between heaven and hell. In both places, hungry people sit at tables laden with delicious food. In hell, people suffer and starve because they cannot eat with the long utensils provided. In heaven, people are happy and thrive because they use the utensils to feed each other. Many cultures and religions have some variation of this story. It illustrates a universal truth: we depend on each other. The current pandemic has starkly illustrated...
Obesity affects approximately 40% of American adults and I've been one of them for nearly as long as I can remember. There are innumerable schemes that promise effortless, or nearly effortless, weight loss, and many diets that claim to be the best approach. Most of us recognize that if something seems too good to be true, it probably is. It's much simpler to identify the miracle potion advertised on our social media feed as snake oil, than it is to sort through all the conflicting and seemingly...
In medicine, we routinely ask people about their family health history. Knowing that your mother had diabetes, or that your grandfather battled alcoholism, helps us be alert for health conditions to which you may be predisposed. Sometimes, though, what is revealed by those histories isn't a medical problem, but a family tragedy. Earlier in my career, my older patients commonly told me that their grandmother, or even their mother, died in childbirth. Today, it is all too easy to forget just how p...