Social Media Is a Very, Very Powerful Tool. It Also Gives Power to Tools

I recently had an interesting experience that raised concerns about the impact of social media platforms on human health. I am particularly concerned about the impact of social networking sites on the mental health of children and young adults.

Throughout my professional career, I have benefited from the writing skills handed down to me by my educator mother (Thanks, Mom.). Beyond this monthly column, I have parlayed my writing prowess into professional manuscripts, textbooks and several successful medical research grants. I have often quipped that the only decent high school skill I have carried throughout my career was learned in typing class.

Fear is contempt, whether the fearful know it or don’t

Dr. Anthony Fauci appeared before the Senate Homeland Security and Governmental Affairs Committee on July 29th, 2026. On the advice of his attorneys, Dr. Fauci invoked his Fifth Amendment right against self-incrimination, refusing to answer leading questions regarding his actions during the COVID-19 pandemic. Senator Rand Paul, who chairs the Committee, has convinced himself, despite a lack of evidence, that Dr Fauci lied to Congress concerning his actions in advising the Federal Government during the pandemic.

‘As Physicians, We Owe Our Patients Two Things—Only Two Things—Our Time and Our Skill.

My wife and I have had the good fortune to spend the United States’ semiquincentennial (July 4, 2026), the 250th anniversary of the Declaration of Independence of the 13 United States of America, with a rare gathering of our entire clan at the Maine family camp. Like many Americans, I have used this landmark July 4 celebration to reflect on myriad positive aspects of being born and raised in this country. Of late, the 24-hour news deluge of graft, corruption, war and disaster that consumes American media can challenge the patriotism of the most ardent United States citizen.

One ‘Aw Sh*t’ Wipes Out 1,000 ‘attaboys’

I must have heard or used variations of this month’s quote several hundred times during my military career. As a resident physician, my existence seemed to be ruled by this postulate, since months of smooth sailing at work could be wiped out in seconds by the smallest error. Good works seemed to fade in the collective memory of my superiors overnight, but mistakes appeared to stain my reputation in perpetuity. I guess whether it is resident relations with staff or international relations between countries, one’s reputation is only as formidable as the magnitude of one’s last mistake.

Should the disorder infect the Army in the natural way, we should have more to dread from it than from the Sword of the Enemy

Gen. George Washington penned this month’s quote in a 1777 letter to Dr. William Shippen Jr., the Continental Army’s medical director, ordering all Philadelphia recruits for the Continental Army to be inoculated for smallpox. Washington had personal experience with the disease, contracting the virus on a visit to Barbados in 1751, marking him with scars but providing him with lifelong immunity to the disease. As a military commander, Washington witnessed how the scourge of smallpox could burn through his army and devastate combat effectiveness. During the ill-fated winter campaign in Canada (1775-1776), more revolutionary soldier casualties were due to smallpox than enemy fire.

A Walking Stick Is a Friend That Steadies You When the World Tilts

During my medical career, I was involved in managing the consequences of falls in my patients. In those days, I was more consumed with providing care in reaction to a patient’s fall, usually in the form of a regional anesthetic to manage perioperative pain. Now that I have a few more decades under my belt, the issue of falls in friends and family has taken on more personal significance. In her 80s, my mother experienced a fall, severely injuring her shoulder; my 80s father-in-law sustained a fall, breaking his neck; my wife fell a few months ago, breaking her patella; and my sister-in-law recently fell, injuring her face. A common thread among these tragic family injuries is older age, universal shock and surprise at the fall. They all said versions of, “I was fine; then I was on the ground.”

Death smiles at us all; all we can do is smile back

The word hospice is derived from the Latin hospitum, meaning “a place of rest and shelter for the ill and weary.” As I have aged, the reality of death and dying has occupied more of my time as aging parents and friends enter the twilight of their lives. At times, as with my father, this process can be excruciatingly sudden and swift. The undisputed reality that we are all in the process of dying from the moment of our birth does not ease the shock of a loved one lost unexpectedly. When my father died suddenly, he had a brand-new car in the driveway and a new suit hanging on the bedroom door for my first daughter’s wedding. The shock of his loss still reverberates in my life today. I do recognize that the sharp edge of my father’s passing spared him the realities of a slow, plodding demise. He would not have been a model citizen within a nursing home (enough said).

Give a man a mask, and he will show you his true face

I have been attempting to process one of our country’s recent tragedies. Pam and I can stay abreast of the news in America while exploring the Bahamas with satellite internet. The cold weather back home in Baltimore makes us grateful to be here, but the rest of the news is challenging to consume, to say the least. As I write this in the clear-water beauty of a tropical harbor, I cannot free myself of the heart-wrenching image of Alex Pretti, a VHA critical care nurse, being brutally beaten, then executed by U.S. Immigration and Customs Enforcement’s (ICE) federal agents.

It’s Not Food. It’s an Industrially Produced Edible Substance

Pam and I are presently island-hopping in the northern Bahamas. Sailing my own boat to the Bahamas has been on my personal “bucket list” for over 40 years. We are on the “hook” at Allans Pensacola Cay (pronounced “key”) and will be adding our boat name to the famous Signing Tree soon. To say we are in an isolated region of the world would be an understatement. The majority of the cays we visit are uninhabited and accessible only by boat. Our mornings begin with coffee and a check-in with world news and family via satellite internet. The news has been as challenging as ever to consume as we start 2026 in another foreign war with Venezuela.

Extraordinary Claims Require Extraordinary Evidence

ECREE was a concept popularized by Carl Sagan to help the public understand the key features of the scientific method. It can be difficult for people to realize that science can never prove anything; instead, scientists develop a hypothesis (an educated guess about the natural world) and design tests to determine whether empirical evidence supports or contradicts the original hypothesis. To be considered science, a hypothesis must be subject to being proven false through observation or experimentation.

We must accept finite disappointment but never lose infinite hope

My wife, two close friends and I have recently completed a three-night passage around Cape Hatteras, North Carolina, on our Lagoon 42, Shavasana, as we move our sailing vessel south for the winter and the end of the 2025 hurricane season. The Cape Hatteras region of the Atlantic is notorious for shipwrecks, as wind, weather and the mighty Gulf Stream often collide there in a dangerous mix that can be perilous for unprepared mariners. The famous Union Civil War ironclad, the Monitor, foundered and sank in a Hatteras storm in 1862; the recently discovered wreck is now a marine park. My son-in-law, Dan, likes to remind me that the region is nicknamed “the graveyard of the Atlantic.” Thank you, Dan, that is helpful.

The point of modern propaganda isn’t only to misinform or push an agenda. It is to exhaust your critical thinking

Garry Kimovich Kasparov (born 1963) is a renowned Russian chess grandmaster and political activist. Kasparov has been a political opponent of Russia’s President Vladimir Putin, so he is likely very familiar with misinformation. A series of events in the past few months has led me to consider the dangers of misinformation and its consequences for those who are misinformed.

I have a higher and grander standard of principle than George Washington. He could not lie; I can, but I won’t

The ongoing political assault on the American medical establishment has been painfully on display this week with the closure of our government. Our Congress is deadlocked over the loss of government Affordable Care Act (ACA) tax credits, which are set to lapse at the end of 2025. The Affordable Care Act, dubbed Obamacare, signed into law in 2010, made health insurance coverage available to more than 20 million Americans and effectively halved the number of citizens living without health insurance. The One Big Beautiful Bill Act (OBBBA—for historians reading this 100 years from now, I did not make this up) was signed into law this year by President Donald Trump. OBBBA has provisions that will end subsidies in 2026 for Americans who rely on them to afford insurance under ACA. Millions of low-income Americans will likely lose their coverage if these OBBBA cuts are not amended.

Blind Idealism Is A Death Sentence.

T.D. Severin is a professor of surgery at the University of California and a writer. The quote comes from his debut novel, Deadly Vision. Beyond this column, in which I have had the good fortune to express my anxieties concerning the American medical profession, I have utilized reading and my own fictional book writing (Terminus – Trip Buck) to cope with the ongoing stressors of modern reality. Through fiction, the myriad shortcomings of the human species can be explored without the stark and morally bankrupt reality of actual human behavior and its consequences of injustice and death revealed on the nightly news. Regardless of your life’s occupation, reading remains the most viable method of understanding yourself and the world in which you live.

Laws, Like Sausages, Cease to Inspire in Proportion as We Know How They Are Made

Purportedly, the American poet John Saxe made his comment regarding laws and sausage-making in the Daily Cleveland Herald on March 29, 1869. Variations of the quote regarding the unsavory nature of the legislative process abound in American literature. Politics in a democracy is, at best, the art of compromise between competing interests, but the slaughterhouse floor reality of most legislation is messy and disgusting to behold by the public.

I don’t want to seem like I’m being evasive, but I don’t think people should be taking medical advice from me.

Health and Human Services (HHS) Secretary Robert F. Kennedy Jr. made the quoted statement during a May 2025 House Appropriations Committee hearing. The secretary’s comment was made in response to a hypothetical question regarding his willingness today to vaccinate his children for the measles. Kennedy responded, “My opinions about vaccines are irrelevant.”

They say the world has become too complex for simple answers. They are wrong.

This month’s quote comes from a speech made by Ronald Reagan (“Ronald Reagan: A Time for Choosing Speech,” 1964). It was essentially a warning against socialism and the expansion of government. He stated, “Public servants say, always with the best of intentions, ‘What greater service we could render if only we had a little more money and a little more power.’ But the truth is that, outside of its legitimate function, government does nothing as well or as economically as the private sector.”

Veterans Know Better Than Anyone Else the Price of Freedom, for They’ve Suffered the Scars of War

Honestly, readers of this column do not need me to tell them that the removal of 80,000 VA employees will seriously degrade veterans’ health services. I am certainly not against the thoughtful application of reason to improve efficiency in any federal organization, including the VA. That said, the ‘loose cannon on a pitching deck’ government firings of the ad hoc DOGE have nothing to do with improving efficiency. Nobody reading this column voted for creating DOGE through their congressional representatives. There are correct ways to downsize government agencies through legislative action as government administration policies and priorities change. DOGE is not one of those processes.

There Is Nothing So Useless as Doing Efficiently That Which Should Not Be Done at All

The ongoing assault on America’s health infrastructure has been brutal to watch. The selection of Robert F. Kennedy Jr. as the 26th secretary of the U.S. Department of Health and Human Services (HHS) marks a low point in the department’s leadership history. That decision is already potentially contributing to increased morbidity and mortality within U.S. borders with the recent resurgence in measles cases.

‘Tip of the Spear’

Throughout my military career, I would hear the phrase ‘tip of the spear’ to describe units or leaders who were first to the fight. The metaphor refers to the business end of one of the oldest weapons of warfare, the spear. As Madeline Miller in “The Song of Achilles” says, “You can use a spear as a walking stick, but that will not change its nature.” Everyone understands what the spear represents and what it is for. As military medical physicians, we often discuss our role as the “soft side of the spear.” We were not at the pointy end, but we certainly supported the effective implementation and application of force embodied by the spear tip.

You can’t have a healthy civilization without healthy soil. You can’t have junk food and have healthy people.

I identify with the label “foodie.” While I am no help in the kitchen (I can burn water) beyond doing the dishes, I am a joy to cook for because I enthusiastically praise anything prepared to pass down my gullet. As expected, managing my weight and body shape has been a lifelong challenge due to my passion for food.

To Care for Him Who Shall Have Borne the Battle and for His Widow, and His Orphan.

During my many career visits to the U.S. Department of Veterans Affairs (VA) building on 810 Vermont Ave. NW, Washington, DC, I have been greeted in the main lobby by Lincoln’s mission statement for the VA. Few governmental agency taskings have been stated more eloquently and succinctly. It would take another 65 years before the modern VA was created, on July 21, 1930, when Hoover signed Executive Order 5398. Lincoln’s call for the American people to pay their debt to those who defend the Constitution remains a primary responsibility of our democracy

The work of epidemiology is related to unanswered questions, but also to unquestioned answers

The work of epidemiology is related to unanswered questions, but also to unquestioned answers

Pam and I have been hanging out in central Maine at an ancestral lake cabin that has been in Pam’s family for over 100 years. We are fortunate to have this haven to retreat to as our lightning-struck boat/home is being repaired. I like hiking for exercise in the Maine woods, which occasionally necessitates moving through dense vegetation. Following one hike, I broke out in an incredibly itchy rash on my back and chest. It felt like I had rolled around in a field of poison ivy (which I decidedly did not), and the rash seemed to spread to new areas of my body as days passed.

Good ride, cowboy! Good ride!

Good ride, cowboy! Good ride!

Pam and I have had our share of hard knocks this summer. From the ongoing personal and financial trauma of our sailboat/home lightning strike to our latest bout of COVID-19, the hits just seem to keep on coming. I also (finally) finished a fictional novel, but was utterly unprepared for the hell that is getting published.

The Report Of My Death Was An Exaggeration

The Report Of My Death Was An Exaggeration

It has been a challenging week for me in my interactions with American institutions. I had a primary care appointment for my annual checkup and to manage my ongoing respiratory issues related to burn pit exposure. I fancy myself savvy in how the healthcare system works (and how it does not), so I used the Johns Hopkins MyChart system to request my routine blood work before my visit. This electronic medical record and communication system performed flawlessly, and my labs were ordered a week before my appointment. I was feeling rather smug concerning my patient prowess after reviewing my results and having the opportunity to inquire about some abnormal values via MyChart. The day arrived for my clinical visit, and I wanted to double-check the appointment time, so I logged on to my trusted electronic medical record. MyChart informed me that my account had been disabled.

I Will Well And Faithfully Discharge The Duties Of The Office On Which I Am About To Enter

I have sworn this oath several times throughout my military career, as did my wife and first daughter. A framed print of the oath of office adorned our living room for years. Often, when asked what I did for a living by a new acquaintance, I will state that I spent a career protecting and defending the United States Constitution. It is an occupation my family has been involved in for generations. Except for my family, nothing has been more fundamentally important to my identity and sense of purpose. Defense of our Constitution is the most important endeavor I have performed to protect my family, posterity and my country.

Change Takes Courage

I am tapping out this editorial on my 60th birthday in May. I prefer the annual and unavoidable nonevent—which is the date of my birth—to go by quietly and without too much hoopla. Family and friends have been asking if I feel any different at 60. I have responded that it seems no different from how I felt yesterday at 59. That is not to suggest I have not noticed the changes to my appearance associated with aging as I gaze in the mirror. I have no idea where all the gray hair is coming from (damned barber) or why less of it seems to be growing on my head but has sprouted with renewed aggressive vigor from my nose and ear canals (God does have a sense of humor).

It is good to have an end to journey toward; but it is the journey that matters, in the end

My wife, Pam, and I have just completed a 413 nautical-mile sail from Key Biscayne, Florida, to Hilton Head, South Carolina, on our Lagoon 42 – Shavasana. It is our most extended passage so far and the furthest out in the Atlantic Ocean we have ventured. We are headed back north towards the Chesapeake Bay and had a weather window that allowed us to sail into the Gulf Stream and ride that fabled ocean river north. The two to three knots of push make for some incredible boat speed over the ground, and we were often logging 8 to 10 knots with stern winds and following seas. From a sailor’s perspective, that is fast. I imagine the powerboat enthusiasts shaking their heads and smiling at such pitiful velocities.