"There is a man with a boil on his back in the suture room." The nurse at the urgent care, where I worked, informed me, one day, long ago.
The patient was a man in his forties with a large abscess on his upper back. On exam, it did not seem fluctuant and had an atypical and unusual characteristic to it. On further questioning, the patient stated that he had just returned from a hunting trip to Africa and on his last night there, had felt a bite like sting on his back and thinks that it might have been a spider bite.
I consulted a colleague, and we felt that an I & D was in order. After prepping and anesthetizing the area, we made a small incision. Seeing no discharge, we extended the opening and, to our surprise and horror, witnessed many tiny spider like insects crawl out of the wound. We managed to stop them from spreading, irrigated the wound and dressed it.
Apparently, an African spider or insect, laid her eggs under the patient's skin, and he unknowingly aided their immigration to New Mexico. Our great hunter brought back more than one trophy from his African Safari.
Diagnosis: Immigrating insects from Africa.

The recent Covid 19 epidemic, and the speed in which it moved across the entire planet, reminded me of that incident. Which is a testament to the extent of the spread of contagions of all kind. Something to which we all need to be alarmed about, and rather than blaming a group, or individual, seriously think of the ramification of our travels around the world. That brings to mind still, another historical incident so similar and comparable to the paralyzing atmosphere of our views of today's pandemic.

Back in 1721, a smallpox epidemic in Boston, Massachusetts, raged uncontrollably. A man by the name of Cotton Mather learned from one of his slaves that, back in Africa, they used a very effective method of inoculation to combat smallpox. Mather convinced a physician named Boylston to try the radical procedure. Upon learning, where the idea originated, the public was enraged, so much so that they chased Boylston out of town and firebombed Mather's house. Today too, our incredulous people would rather believe in conspiracy theories that have nothing to do with science, and put themselves, their families, and society at risk by playing the blame game than seek treatment. It is noteworthy that it is our own self-serving actions that are increasing the spread of contagions. So if we are not willing to change our wandering behavior, we should at least heed to the ways of controlling what we inadvertently allow to migrate with us.

Far north of the American continent, lies our largest, most majestic and unspoiled state: Alaska. Unpopulated, wild, and full of splendor, it crowns our country to the envy of the world. Whales, foxes, seals, moose and bears are just a few of nature's living things that call it home. Eagles are everywhere, as are salmon, crabs and fish of all kind.

The volcanic heritage of the landscape reminds the visitors of its turbulent past, like the Valley of Ten Thousand Smokes, in Katmai National Park. In this land of snow and ice, one is surprised to find beaches with sand at 140o F, due to volcanic hot springs.
Man's presence, outside the native dwellings, is limited to a handful of towns, and fishing processing settlements along the Gulf of Alaska and the Aleutian Islands. The population density is about one person per square mile. At that rate, there would be only 22 people on the Island of Manhattan (Vs 1.7 Million.) Such adverse conditions demand neighborliness and sociability for, services and help of any kind are sparse and very late in coming. That goes for daily needs that most of us take for granted, as well. Such as education and healthcare.
The geographic demand of such a vast area dictates that the only viable option of providing healthcare and education is through Telehealth, Telemedicine, and Tele-education. Such is true for many places in the lower 48 as well. States like Wyoming, New Mexico, Alabama, and Mississippi that, by order of their economy, terrain, people, and politics, are at a disadvantage and can also benefit from such programs. If this pandemic has taught us anything, it is the true resiliency of our people. For despite the many challenges, we are still moving forward and learning that we have the means to care for each other and educate ourselves with the help of the wonderful tools at our disposal. Let's use them to heal and educate our nation for the betterment of our children and their children. 

"When you look at the sun, and its light - after traveling through space and time - comes to rest in the back of your eyes, and you feel its heat, and its essence, it becomes a part of you! And you a part of the sun." Grand-Lady used to say. "That is the oneness of all life, here (touching her heart), out there, in the universe, everywhere." Though she did not know the scientific doctrine or terminology of it, she fully understood the existential principle of nature and life.
 
It is interesting that Stephen Hawking, whose birthday was January 8, 1942, spent his life pursuing the Theory of Everything. He said, "My goal is a complete understanding of the universe; why it is as it is and why it exists at all." His lifetime of study of the universe and our place in it was to understand the ONENESS of all life. Something philosophers and thinkers have grappled with throughout history. And that may be understood as the existential principle of oneness of nature and life.
 
It is further interesting, how our western civilization assesses existence. For as philosophers Jean-Paul Sartre and Simone de Beauvoir whose birthday was January 9, 1908, formulated the philosophy of existentialism which is the idea that human beings should define their own existence, without regard to culture, society or religion - and I might add; science.
 
The problem is, the farther one dwells on such thinking, the more one disconnects himself from the oneness that binds all life together. And that is when the separation of cultures, races, nationalities, and even genders develop. But none of that is natural. It is self-taught and assumed. For, as Beauvoir wrote in her book The Second Sex, "One is not born a woman, one becomes one." That the difference between the sexes was the result of culture, not nature. It was this thinking that founded the modern feminist movement. Such beliefs and others like Black Lives Matter, White Nationalism, Latino Power, etc. divide us even more. The existential principle of life is the unique oneness of all living things. Once we truly understand that we are all a part of one another, caring for all humanity and life becomes easier and natural.
 
This is what medicine in its core teaches us as well: CARING FOR ALL, BENEFITS ALL!

We woke up on the morning of the New Year
Full of good wishes for all
Spreading our hopes like the tail feathers of Sultan's peacock
With a thousand colorful eyes, displaying our desire
For a peaceful world, oblivious to the stormy weather outside.
 
It's been a long time since we've been face to face
Dancing cheek to cheek, being closer than six feet
Still we wash our hair in a fragrance from far distant lands
In the hope of it catching attention even from afar
But it's hard, flirting through masked lips.
 
God knows the world is full of tired faces
Still, we fill our bird feeders and watch the birds
Cheeringly circle it like worshipers around a saint's shrine
In the hope that others too are called to it
And some day soon, we may watch the birds together.
 
If history has taught us anything
Is that we've been here before and
Man's genius always finds a way out
But this time, there seems to be
More deniers of the truth.
 
Wishful we are though, that despite it all
This storm too will pass, skies clear, and
Our children will play together again
Lovers get to flirt and kiss again, and
We get to take our masks off and say hello.
 
Here is to the coming days of the New Year!
May they be happy ones.
 
Reza Ghadimi
January 2022