by Douwe Rienstra, M.D.

Dear Friends,

Let’s try something different. Each newsletter will include various topics. Click on those you find interesting. Skip those you don’t. You can always read them later at MedicineForPeople.com.  Your feedback is welcome!

OK, nobody dies of fungus on their toenails. But don’t you want to look at all your various parts and be happy about them?

About a quarter of adults eventually end up with some degree toenail fungus. Even with expensive treatments, the condition often returns within a year.

Image from https://brisbanefootclinic.com.au/conditions/ dated 15 Aug 2026 and used under Creative Commons license 4.0 .

Good shoe and foot care habits can prevent this. Here are simple measures you can take.

Raising a little human? Here are tips to reduce shopping friction and make a game out of cleaning up.  Plus a look at what worked for my parents.

In an earlier newsletter, you read about Medicine from India and Ailments of the Elderly. Click here to learn more about what specific foods will help, as well as self-massage with sesame seed oil as another means to reduce dryness in older folks and anxiety at any age.

Everything in this recent posting was correct, but not as clear as it could have been. This rewrite is easier to understand.

A couple of weeks ago I was at dinner with some friends who are quite depressed about the current national situation. I expressed my view that we, individually and as a community, do have power to make things better. One friend, a well-educated academic physician, protested. “People have tried to have utopian communities. It doesn’t work!”

Of course it doesn’t work. Let’s not aim at something impossible we can never achieve. Let’s simply aim at “better.”

We have strengths we often lose sight of, not just within ourselves but also in people unlike ourselves. Take this story from 1977 in Brookfield, Wisconsin, a suburb of Milwaukee.

In addition to my primary care practice, I helped cover an alcoholism treatment ward inside a larger hospital. We cared for patients, mostly men, referred by their employers. Treatment was required, not voluntary.

Today, many people might think that the HR departments in these workplaces were unacceptably paternalistic. I might agree if I hadn’t toured one of these workplaces, the P & H plant. That company makes huge machines for coal mining, interstate highways, and other major construction. Men fed material to thirty-foot-tall hydraulic presses, or controlled room-sized tools cutting inch-thick slabs of steel ten and twenty feet on a side with computer-driven oxy-fuel cutting machines. Gantry cranes carried multi-ton pieces above our heads. We were issued hard hats but in that environment the hats seemed about as protective as a rabbit’s foot.

You could see in a moment that an impaired worker was immediately dangerous.

When identified as impaired, he was promptly taken off the factory floor and ushered to HR. There he was offered the choice of treatment or termination of employment. The carrot was that he would have his job back when treatment staff said he was ready. The stick was that sobriety and continued follow-up were not optional.

These were sick guys. In most cases we shepherded them through serious withdrawal symptoms. Once that was over, usually in a week or so, we and our AA-based treatment team worked with them to get them back to work. As patients still do, many groused about AA. As doctors still do, we looked around, could find nothing else to rely on, worked with what we had, and were grateful for that program.

After about a month in the hospital, most of our patients returned to their own doctors.

Of those men who switched care to our office, one developed cancer two years after discharge. He was still sober and working, but it was too late for effective treatment. Eventually he couldn’t work. The last time I saw him he was near the end and too weak to travel. The directions his wife gave me to get there were odd, but she radiated confidence. I drove out a county road, turned left onto a dirt track underneath high-tension electric wires, and followed them a couple of miles to a house tucked back under big trees in the woods. I provided the comfort measures he needed, and as I said goodbye, he hesitantly asked “Do you think it’d be OK if I had a beer?” His wife looked at me straight and quietly nodded her approval. I didn’t need convincing. He was a good man and deserved whatever beer his body could accept. The next day he let go of life.

Thinking back to the utopia comment we started with, no one in those days was aiming for it.  The movers and shakers of those days had grown up in the Great Depression and were not the idealists we like to think we are.  Yet they had built the system I worked in and we all benefited from. 

And as those folks did then, we must build something better. It won’t be easy.  It never was and probably never will be. We’ll need to modify and improve as we go.  

We owe it to our own hearts and to our children and grandchildren to get started.