Coastal Direct Primary Care

02/23/2026

Waking up to a winter wonderland! It looks beautiful, so stay home and enjoy the view!

We are in a State of Emergency and a Level 3 Driving Ban has been issued. You must stay off the roads and let the road crews do their job. Please don't put others at risk, including First Responders, by trying to drive before the roads are cleared.

Obviously, the office is closed today. In between shoveling (using my legs, not my back, and only in short periods of time), I will be available for virtual visits.

(SMYRNA, Del.) – Governor Matthew Meyer has issued a Level 3 Driving Ban for Kent and Sussex counties and Level 2 Driving Restriction for New Castle County beginning at 10 p.m. This state-mandated Driving Ban will remain in place to keep emergency responders and other essential motorists safe by m...

02/23/2026

Do you know what the measles rash looks like? I don't. I've never seen it. I've been a physician for over 20 years and this just isn't something I've seen. Why? Because measles was eliminated in the US 25 years ago. Before I went to medical school. It was something taught about in historical context. A lesson on the victory of vaccines.

This week I did a house call on a very ill patient. They had a fever of 104.1F and looked (and felt) miserable. And I know measles is now in Delaware, so I wondered if this was it? I hope not, and I don't think so, but I really don't know. 🫣 Picture of patient's rash in the comments, shared with permission.

Measles is extremely contagious and the viral particles can remain in the air for hours.😷 So, if I had seen this patient in the office, the next patient in the room could be infected if they did have measles. We now have to come up with new protocols for patient safety when we see anyone with a rash in the office. 😥

Infectious disease experts say the latest outbreak is still in its infancy and could get a lot worse – here’s what to know

02/22/2026

Medical Mysteries Doctors Still Haven’t Solved ( #2 of 5)

The Mysterious 19th-Century Exploding Teeth

In the early 19th century, modern dentistry was basically in its infancy, which may be why nobody knows what caused several cases of exploding teeth. In 1817, a Pennsylvania reverend had a toothache so bad that he was, according to his dentist, “boring his head on the ground.” The next morning, his tooth burst apart with a sharp cracking sound and the pain was gone.

One exploding tooth is strange, but this wasn’t an isolated incident. Three more cases popped up in America in 1830, 1855, and 1871, and a few were recorded in England as late as the 1920s.

In 1860, one dentist theorized that gas from tooth decay was building up and causing the teeth to explode. Modern dentists have suggested that it was an issue with the varieties of metals used for fillings at the time. Both are pretty unlikely scenarios, and the cause remains a mystery.

https://interestingfacts.com/medical-mysteries

02/22/2026

Black History Month, Day #22

Jane Cooke Wright, MD was a pioneer in clinical cancer chemotherapy for almost 60 years, and she became the highest ranking Black woman at a nationally recognized medical institution in 1967. During this time, there were only a few hundred Black, female physicians in the United States.

Born on Nov. 30, 1919, Wright grew up in Harlem in New York, N.Y. Her father, Louis Wright, one of the first Black graduates of Harvard University Medical School, established the Cancer Research Center at Harlem Hospital. Wright would eventually do some of her most important research at the center. She began to study art at Smith College in Northampton, Massachusetts, before changing her major to pre-med. She received a full academic scholarship from New York Medical College, where she was one of few Black students. There, Wright was elected vice president of her class and president of the Honor Society; she graduated with honors in 1945.

Wright eventually joined her father at the Cancer Research Foundation at Harlem Hospital, where they began experimenting together with chemical agents on leukemia in mice. They eventually began treating patients with anticancer drugs and saw them experience some form of remission. Wright continued her research in anticancer agents throughout her career by exploring the relationship between patient and tissue culture response and developing new techniques for chemotherapy administration.

Wright became director of the Cancer Research Center following her father’s death in 1952. In 1955, she became an associate professor of surgical research at New York University Medical Center and was appointed to the President ‘s Commission on Heart Disease, Cancer and Stroke by President Lyndon B. Johnson in 1964. The commission ‘s report led to the establishment of a national network of treatment centers for the three diseases. Wright became the highest ranking Black woman at an American medical institution when she was named professor of surgery, head of the cancer chemotherapy department and associate dean at New York Medical College in 1967. She became the first woman elected president of the New York Cancer Society.






https://www.aacr.org/professionals/membership/aacr-academy/fellows/jane-cooke-wright-md/

02/21/2026

Medical Mysteries Doctors Still Haven’t Solved ( #1 of 5)

The Dancing Plague of 1518

In July of 1518, a woman in Strasbourg — now part of France, then part of the Holy Roman Empire — stepped into the street and started to dance. She kept going until she collapsed from exhaustion, then started up again. More people started to join her, and a week later, there were more than 30 dancers, unable to stop even when overexertion set in and they started hurting themselves. Local leadership thought the solution might be more dancing, so they brought in dance halls, musicians, and even professional dancers. The issue, predictably, got worse, and eventually hundreds of people were afflicted. Some died of heart attacks and strokes. Strangely, this isn’t even the only time this happened — just the best-known case.

At the time, doctors and clergy thought the culprit was demonic possession or “hot blood.” Modern theories include stress-induced mass hysteria or a psychoactive mold called ergot that grows on rye (and which some have also blamed for contributing to the Salem witch trials).

https://interestingfacts.com/medical-mysteries

02/21/2026

Black History Month, Day #21

Louis W. Sullivan, MD

Federal cabinet appointee and college president Dr. Louis Wade Sullivan was born on November 3, 1933, in Atlanta, Georgia. After graduating from Booker T. Washington High School, Sullivan received his B.S. degree in biology from Morehouse College and his M.D. degree from Boston University School of Medicine. He completed his residency two years later at New York Hospital-Cornell Medical Center.

In 1960, Sullivan began a one-year pathology fellowship at Massachusetts General Hospital, in Boston, before working at Boston City Hospital and studying hematology at Harvard Medical School’s Thorndike Memorial Laboratory until 1963. He was hired as co-director of hematology at Boston University Medical Center in 1966 and he founded the Boston University Hematology Service in 1967.

In 1975, the Morehouse College Medical Education Program was founded and Sullivan returned to Atlanta to serve as its first dean and director. The Program became The School of Medicine at Morehouse College in 1978. In 1981, the School became independent and was re-named Morehouse School of Medicine (MSM)—the only predominantly black medical school in the United States established in the twentieth century—with Sullivan serving as its founding president and dean. In 1989, Sullivan left MSM to accept an appointment from President George H. W. Bush to serve as Secretary of the United States Department of Health and Human Services. Sullivan returned to MSM in 1993 as president, becoming president emeritus in 2002.

In 1976, Sullivan became founding president of the Association of Minority Health Professions Schools and, in 1985, he became one of the founders of Medical Education for South African Blacks, serving as chairman from 1994 to 2007. From 2001 until 2006, he served as co-chair of the White House Commission on HIV and AIDS. In 2003, he was appointed chair of the advisory committee of the White House Initiative on Historically Black Colleges and Universities. Sullivan also has served as co-chairman of the Henry Schein Cares Foundation, chairman of the Washington, D.C.-based Sullivan Alliance to Transform the Health Professions, now a central program of the Association of Academic Health Centers (AAHC), and on the boards of 3M, United Therapeutics, Emergent BioSolutions, General Motors, Cigna, Bristol Myers Squibb, and Equifax.

Sullivan has received more than seventy honorary degrees, including an honorary M.D. degree from the University of Pretoria in South Africa. He was the 2008 recipient of the Jimmy and Rosalynn Carter Award for Humanitarian Contributions to the Health of Humankind from the National Foundation for Infectious Disease.

Sullivan is the author of The Morehouse Mystique: Becoming a Doctor at the Nation’s Newest African American Medical School, with MaryBeth Gasman (2012). His autobiography, Breaking Ground: My Life in Medicine, with David Chanoff (2014), won the NAACP Image Award for Literature in 2015.






https://www.thehistorymakers.org/biography/dr-louis-wade-sullivan

02/21/2026

***RECALL ALERT*** for Moringa Powder

Salmonella is no fun!

Outbreak Investigation of Extensively Drug-Resistant Salmonella: Moringa Powder

Do not eat or sell certain lots of recalled Rosabella-brand moringa powder capsules. FDA’s investigation is ongoing.

Symptoms of Salmonella Infection:
Illness usually occurs within 12 to 72 hours after eating food that is contaminated with Salmonella, and the symptoms usually last four to seven days. Symptoms include diarrhea, fever, and abdominal cramps. Children younger than five, the elderly, and people with weakened immune systems are more likely to have severe infections.

https://www.fda.gov/food/outbreaks-foodborne-illness/outbreak-investigation-extensively-drug-resistant-salmonella-moringa-powder-february-2026

02/20/2026

Black History Month, Day #20

Rebecca J. Cole, MD

In 1867, Rebecca J. Cole became the second African American woman to receive an M.D. degree in the United States (Rebecca Crumpler, M.D., graduated from the New England Female Medical College three years earlier, in 1864). Dr. Cole was able to overcome racial and gender barriers to medical education by training in all-female institutions run by women who had been part of the first generation of female physicians graduating mid-century. Dr. Cole graduated from the Woman's Medical College of Pennsylvania in 1867, under the supervision of Ann Preston, the first woman dean of the school, and went to work at Elizabeth Blackwell's New York Infirmary for Women and Children to gain clinical experience.

Although Rebecca Cole practiced medicine for fifty years, few records survive to tell her story, and no images of her remain. Cole was born in Philadelphia, Pennsylvania, where she attended the Institute for Colored Youth, graduating in 1863. Her medical thesis at the Woman's Medical College of Pennsylvania was titled "The Eye and Its Appendages."

In her autobiography, Blackwell commented on Rebecca Cole's valuable clinical skills: "In addition to the usual departments of hospital and dispensary practice, which included the visiting of poor patients at their own homes, we established a sanitary visitor. This post was filled by one of our assistant physicians, whose special duty it was to give simple, practical instruction to poor mothers on the management of infants and the preservation of the health of their families. An intelligent young colored physician, Dr. Cole, who was one of our resident assistants, carried on this work with tact and care. Experience of its results serve to show that the establishment of such a department would be a valuable addition to every hospital."

Cole went on to practice in South Carolina, then returned to Philadelphia, and in 1873 opened a Women's Directory Center to provide medical and legal services to destitute women and children. In January 1899, she was appointed superintendent of a home run by the Association for the Relief of Destitute Colored Women and Children in Washington, D.C. The annual report for that year reported that she possessed "all the qualities essential to such a position — ability, energy, experience, tact." A subsequent report noted that: "Dr. Cole herself has more than fulfilled the expectations of her friends. With a clear and comprehensive view of her whole field of action, she has carried out her plans with the good sense and vigor which are a part of her character, while her cheerful optimism, her determination to see the best in every situation and in every individual, have created around her an atmosphere of sunshine that adds to the happiness and well being of every member of the large family."






https://cfmedicine.nlm.nih.gov/physicians/biography_66.html

02/20/2026

Friday Funny. Have a great weekend!

02/19/2026

Black History Month, Day #19

Leonidas Harris Berry, MD was known for his groundbreaking work in gastroenterology and endoscopy. After earning several bachelor of science degrees, he entered residency at Cook County Hospital in Chicago, IL in 1931. He completed both is residency and gastroenterology fellowship as the first Black intern in the facility. Berry joined the staff at Michael Reese Hospital in 1946.

Even as a renowned gastroenterologist, Dr. Berry faced racism in the workplace. Berry was the first Black doctor on staff at the Michael Reese Hospital in Chicago, Illinois, in 1946, but he had to fight for an attending position there for years. “I have spent many years of crushing disappointment at the threshold of opportunity,” he wrote to the hospital’s trustee board committee in his final plea, “keeping my lamps trimmed and bright for a bride that never came.” He was finally named to the attending staff in 1963 and remained a senior attending physician for the rest of his medical career.

In the 1950s, Berry chaired a Chicago commission that worked to make hospitals more inclusive for Black physicians and to increase facilities in underserved parts of the city. But his dedication to equity reached far beyond the clinical setting: He was active in a civil rights group called the United Front that provided protection, monetary support, and other assistance to Black residents of Cairo, Illinois, who had been victims of racist attacks. In 1970, he helped organize the Flying Black Medics, a group of practitioners who flew from Chicago to Cairo to bring medical care and health education to members of the remote community.

He was also actively involved in community service. He was a founding member of the Chicago Council for Biomedical Careers. The council provided education and resources to encourage and prepare African American youth for careers in medicine.






https://facultyadvancement.med.jax.ufl.edu/2023/02/13/in-celebration-of-black-history-month-2/
https://www.aamc.org/news/celebrating-10-african-american-medical-pioneers

02/19/2026

Lachanophobia: Fear of Vegetables

It’s not uncommon to dislike certain vegetables — especially for kids — but to people with lachanophobia, the sight, smell, or texture of the foods triggers a distinct sense of disgust and dread.

For some, the fear is tied to where vegetables come from: They’re grown in soil and therefore exposed to insects or contamination. In other cases, the reaction is to specific types of vegetables. Mycophobia, for example, is the fear of mushrooms, which is most often linked to concerns about their potential toxicity.

One documented case of lachanophobia involved a 22-year-old university student from Portsmouth, England, whose fear of vegetables caused her to have panic attacks. Like other specific phobias, lachanophobia is often treated through gradual exposure or anxiety management.

https://interestingfacts.com/rare-phobias/?lctg=a2490f1b-0e35-4702-9be2-a4d7fadca1c4

02/18/2026

Black History Month, Day #18

Dr. Dorothy Lavinia Brown spent her childhood in an orphanage and grew up to become the first African American woman surgeon in the South, eventually being made chief of surgery at Nashville's Riverside Hospital. She was also the first African American woman to be made a fellow of the American College of Surgeons.

Dorothy Lavinia Brown was born in Philadelphia in 1919. Soon after her birth, her mother, Edna Brown, moved to upstate New York and placed her in an orphanage there. The predominantly white Troy Orphanage (later renamed Vanderhyden Hall) was her home from age five months until her thirteenth birthday, when her mother reclaimed her. By that time, however, the orphanage seemed a safer home than the one her estranged mother could provide, so Dorothy ran away five times, returning each time to the orphanage. As a teen, she worked as a maid and at the Wing Sing Chinese Laundry. Determined to get an education, she finally ran away at age 15 to enroll in Troy High School. When the principal realized that she did not have anywhere to stay, he arranged for a foster home with Lola and Samuel Wesley Redmon. They became a major influence throughout Dorothy Brown's life, as a source of security, support, and enduring values.

In 1937, when Brown graduated from Troy High School at the top of her class, the Troy Conference Methodist Women awarded her a four-year scholarship to Bennett College in Greensboro, North Carolina. She received her B. A. in 1941, graduating second in her class, and became an inspector in the Rochester (New York) Army Ordinance Department as part of the war effort. Dorothy had wanted to become a physician since she had her tonsils removed as a child, and in 1944 she enrolled at Meharry Medical College, in Nashville, Tennessee. She graduated in 1948.

After a year's internship at Harlem Hospital, the next challenge was her choice of residency: surgery. There were no other black women in general surgery in the South and she had to forge through almost universal resistance. She said that "Dr. Matthew Walker was a brave man" because he accepted her into the program despite advice from his staff that a woman couldn't withstand the rigors of surgery.

Brown worked through a five-year residency at Meharry and George W. Hubbard Hospital to become Assistant Professor of Surgery in 1955 and the first African American woman to be made a Fellow of the American College of Surgeons. Describing her drive to persevere, Dr. Brown has said "I tried to be...not hard, but durable."

From 1957 to 1983 Brown was chief of surgery at Nashville's Riverside Hospital, clinical professor of surgery at Meharry Medical College, and educational director for the Riverside-Meharry Clinical Rotation Program. She also served as a consultant on health, education, and welfare for the National Institutes of Health (National Advisory Council Heart, Lung, and Blood) in 1982.

Brown's determination, beliefs, and values helped her to break through barriers in other aspects of her life too. When a young, unmarried patient implored the orphanage-raised physician to adopt her newborn daughter, Brown became the first single adoptive mother in Tennessee, in 1956. Then, in 1966, when redistricting opened the door for a black candidate, Brown was asked to run for a seat in the state legislature. She ran, and she won, becoming the first black woman representative to the state legislature in Tennessee. Brown would later resign after the bitter defeat of an expanded abortion rights bill she sponsored, frustrated in her belief that it had the potential to save the lives of many women in Tennessee.

Among Dr. Brown's many honors are the naming of the Dorothy L. Brown Women's Residence at Meharry College in 1970. She also received the humanitarian award from the Carnegie Foundation in 1993 and the prestigious Horatio Alger Award in 1994. As she often said, she was proud to be a role model, "not because I have done so much, but to say to young people that it can be done."






https://cfmedicine.nlm.nih.gov/physicians/biography_46.html