One of my favorite movies is the very underrated Avalon, from 1990. The film tells the story of an immigrant family in Baltimore, from their arrival around the time of the first world war up through several generations, until around the late 1960s. The family is fictional and from somewhere in eastern europe (I got the sense watching the film that they were probably a Jewish family from Poland, though I don’t recall that their background was ever definitively specified), but their experience could easily stand in for millions of Americans, no matter the ethnic or religious background.
At first the family are poor and work menial jobs as they struggle to acclimate to life in America. But as the years pass and successive generations take over, they climb the ladder, achieving the American Dream of middle class affluence: better jobs, a big home in the suburbs, automobiles and televisions. However, there is a price to pay for this success, as the close family cohesion that they share at the start of the film begins to dissolve. By the film’s end, the members of the family are well assimilated into American life and much more prosperous, but also lonelier and less happy.
It’s a very beautiful film and if you take nothing from this blog post other than that you should see Avalon, then I’ve done something good for the world today. But of course, I didn’t create today’s post just to share my taste in cinema with you.
In the age of media-induced panics over every possible issue, several patients have recently asked my thoughts on the recent Hantavirus outbreak onboard the cruise ship MV Hondius. The quick punchline: I think it’s very unlikely that this will become a major pandemic ala COVID.
Here’s a brief FAQ I’ve prepared that breaks this down a bit more:
Crohn’s disease, in case you aren’t familiar, is a type of “Inflammatory bowel disease,” in which an autoimmune process causes severe inflammation throughout the digestive tract, leading to abdominal pain, bloody stools, malabsorption of nutrients, and other serious and sometimes life-threatening complications. Like many autoimmune diseases, it has become more common over the past few decades, which strongly suggests (since our genetics have not, as a species, changed during that same time period) that environmental triggers such as pollutants, changes to our gut microbiome, stress, and poor diet likely play a role in its development.
This new study, conducted by a group of doctors in Canada, bolsters this idea. After all, if changes in the way we live can cause Crohn’s disease, then it follows that changes in the way we live should also help to alleviate it.
I have previously posted on this topic several times over the past few years – you can read my prior posts by clicking here, here, and here. Having mentioned his film and the screening it will be having in the area (April 13th at the AMC 11 in Dartmouth – click here if you’d like to reserve tickets), I’d like now to come back to this research and discuss my latest thoughts on it.
I’ve discussed in a few prior posts (for example here and here) the potential downsides of doing too much testing in medicine. This is an important topic, and one that can be difficult to discuss. Patients – quite reasonably – want to feel that their doctors are listening to them, and running all reasonable medical tests to prevent, diagnose, and treat disease. Any discussion of how medical testing can sometimes actually be detrimental to your health can therefore risk coming off as being callous and uncaring. “What do you mean I shouldn’t be tested for disease x?,” a patient may think. “Don’t you want me to know if I have it or not?” Unfortunately it’s not so simple.
I’m going to take a holiday break from posting on this blog over the next few weeks. But before doing so, I’d like to share a few parting thoughts as we wrap up the year.
