Today is my due date.
But the hours are ticking down and the likelihood of a punctual baby is just about zero at this point.
I realized this might happen as soon as I found out I was pregnant. My mom had three of us. We were all late. Very late. I was three weeks late, my older sister was as well, and my little brother was induced after two weeks post date.
My husband likes to remind me that he was four weeks early, so maybe we will just cancel each other out and this baby will come right on time. But I am convinced that it has nothing to do with him and that I am doomed to follow in my mother’s footsteps and carry this baby around for another three weeks (or until the doctor induces me).
So what is a “due date” and does our genetic make up have anything to do with it?
An article that was published this summer in Human Reproduction entitled “Length of human pregnancy and contributors to its natural variation” by Jukic and colleagues highlighted the importance of not putting too much weight on set due dates. By analyzing 125 pregnancies and calculating gestation age based on ovulation date rather than the less reliable date of last menstrual period, the researchers found that gestation length can vary quite a bit. Over a 37 day span, to be more specific. That puts the due date range for normal gestation length at five weeks! The median gestation length was 38 weeks and 2 days (keep in mind that due dates calculated by the last menstrual period would tack on about 14 days – so this would be around 40 weeks for those with true 28 day cycles). Basically, it wouldn’t be crazy if this baby came in two weeks, rather than, say, tomorrow. UGH.
They also tried to figure out what exactly was leading to shortened or lengthened gestation time. Although they were quite limited with their sample size, from the data they were able to mine, they did find that events in the first two weeks affected timing of delivery. This related to the time it takes for the little ball of cells to implant itself into the uterine wall and also how fast the hormone progesterone increases in the circulation after conception.
Again, this study was quite limited with its sampling. Of the 125 pregnant women included, 95% were high school educated white women. There were very few smokers and the average age was 29. So, someone like me, a 32 year old, educated white non-smoker might be able to glean information from this study, but it is hard to predict what other factors could contribute to gestation length unless you fit this profile.
With that said, in this study, the mother’s own birth weight did show some correlation with the gestation length. Since this was not true of the mother’s adult weight, it can be inferred that there is something going on with inheritance from the mother – whether it be on the fetal side (e.g. growth rate) or maternal side (e.g. uterus size, pelvic size).
What about the father? Will the hubs’ jump-the-womb-ship-early genes cancel out my late bloomer genes?
A 2006 paper “Maternal and Paternal Influences on Length of Pregnancy” published in Obstetrics and Gynecology by Lie, Wilcox and Skjeorven considered the input from both parents. Here the researchers combed the Medical Birth Registry in Norway to gather birth data for two generations. From this massive data set, they found that several aspects of delivery date could be correlated with heritable traits from both the mother and the father. For fathers, a higher birth weight correlated with a decreased gestation length for their babies but this did not hold true for the mother’s birth weight (in contrast with the Jukic et al. study). The authors suggest that fathers may pass down their fast growing baby genes and thus influence the timing of birth. However, comparing parental birth weight with baby birth weight, both parents showed a positive correlation. In addition, the gestation length for both mothers and fathers correlated with the gestation length of their babies.
Although these two correlating factors, parental birth weight vs. offspring birth weight and parental gestation length vs. offspring gestation length, were evident for both parents, the effect was twice as strong for the mothers. Therefore, the mother’s genes appear to have twice the influence over birth weight and gestation length than the father’s. The authors predict this uneven influence from the maternal side suggests that the delivery decision is split between the baby’s input and the baby maker’s input. Here is their logic – the baby is half dad genes, half mom genes. If it was solely fetal input setting the date, that baby would follow exactly in the parents footsteps with no maternal leaning. But this is not the case, the maternal side is more predictive of the outcome (nearly two-fold), therefore, there must be some additional input from the maternal side. And similar to what was suggested by Jukic et al., this could have to do with the inner workings of the maternal body as it carries and grows a tiny human.
So, can we predict when this baby is going to make her debut?
Here is the basic baby prediction math –
1/3 = super early baby genes from the hubs (4 weeks early)
1/3 = super late baby genes come from me (3 weeks late)
1/3 = super late baby maker machine (again, 3 weeks late)
While this might seem like I should expect this baby to arrive a little more than a week past my due date, to complicate this math even more, the correlations between mother/father/baby gestation length and birth weight are not one to one. According to the Norwegian study, an extra week in parental time is not the equivalent of an extra week in baby time. Rather an extra week for mother’s gestation length = 1.22 days; for the fathers, one extra week = 0.58 days.
Revised baby prediction math – (keeping in mind that maternal input and baby input from mom’s genes are indistinguishable for the week:day ratio)
super early baby genes – 4 (weeks) x 0.58 (days) = -2.32 days
super late baby/baby maker genes 3 (weeks) x 1.22 (days) = 3.66 days
average = 0.67 days
Ok, so even if I give myself a bit more credit, this math suggests that the baby should arrive… tomorrow.
But, then again, these are averages, based on correlations, and I am not Norwegian.
And, really, this baby will probably just come out whenever she damn well feels like it.
Fellow American preggos, we are being deprived and we didn’t even know it!
In that inevitable conversation of whether or not we are going to want pain medication during our labor and delivery, the only option that really comes to mind is the epidural.
But for most women across the world, the epidural is not the only analgesic pain relief option. WHAT!?
Our fun times Saturday activity a few weeks ago was an all-day birth class. Pretty typical stuff, lots of vaginas and babies trying to fit through spaces that seem impossible to navigate. But one issue that came up, almost in passing, really stood out to me. A fellow student asked the instructor about the “gas option” for pain relief. Pretty sure every woman in the room leaned in with a very confused look on her face – thinking, what the hell is “the gas option”?
As explained by our instructor, the question referred to nitrous oxide. And, no, the gas option was not available at our hospital nor was it available at >99.99% of the hospitals in this country. Fortunately for us, here in the Bay Area, if this is something we really wanted, we could just go across the bridge to UCSF, one of the FIVE hospitals in the US that offers this option to laboring mothers. Going across the Bay Bridge while in labor is not my idea of fun so I’ll forgo this opportunity, but I was intrigued.
Apparently, nitrous oxide (N2O, also known as “laughing gas”) is the most commonly used labor analgesic in the world – used by more than 60% of laboring women in the UK, 70% in Sweden!
First, how does it work? It seems that the best “dose” of N2O is a 50:50 mix of nitrogen and oxygen, mixed immediately prior to inhalation. It is self-administered – the woman holds up the mask and takes a puff any time she wants. How it works, physiologically, is a bit murkier but the overall gist is that it effects the way pain is perceived in the brain. It is very temporary – it takes about 30 seconds to have an effect and it is cleared from the system within minutes. It does not accumulate, it only goes through the lungs and never involves the liver so there are no bits left over from metabolism.
So how good is nitrous oxide for pain relief during labor and why is it not available to most of us here in the US?
A 2002 review by Dr. Mark Rosen, an obstetrician at UCSF, pointed out the basics of the benefits and the absurdity of the concerns . In the review, he evaluated every scrap of scientific and clinical evidence he could find about the use and the study of nitrous oxide in labor pain management. Overall, what he found was that the literature was lacking.
(A more recent review demonstrates that this lack of information and sound, well-controlled studies is still a problem . But I can imagine it is pretty difficult to ethically give a woman in labor a placebo pain medication, so designing that perfectly controlled experiment can be a bit tricky.)
With that said, there were some key points that Rosen could assert. First, the concerns are stupid (my words, not his). For the actual labor component, there is far less to worry about than pretty much any other medical option – N2O does not affect uterine contractions and it does not affect the newborn. It can cause drowsiness – but the beauty of the self-administered system is that if the woman gets drowsy or starts to pass out, she drops the masks, inhales fresh air and, voila! drowsiness from the N2O is gone. The main concerns really center around the gas getting out into the room and into the world. Escape into the room exposes the health care workers BUT most of our hospitals these days have pretty damn good ventilation systems and the units for administering the N2O have scavenging systems in place to grab the escaped gas before it accumulates. Plus, the mask only releases N2O when the patient takes a pull. The second escape concern is that N2O is a potent greenhouse gas. But as Judith Rooks points out in her 2007 article in the Journal of Midwifery & Women’s Health  “…it is clear that medical uses of N2O are a very small part of the problem. In summary, the global warming risks are valid but low relative to many less vital uses of N2O, including NASCAR races, the followers of which, however, have a more effective political voice than pregnant women in the United States, who might want to use N2O but who don’t even know about it as an option”. Sing it, Judith!
Second, for the pain, well, let’s just say it’s no epidural. According to Rosen, it has not been shown to be a potent labor analgesic, it does not eliminate pain, but it can provide “a sense of relief”. And there are ways to improve the effectiveness of the pain relief; for example, learning how to time inhalation with contractions since it can take up to 30 seconds to kick in and does not last long after the mask is removed. But, it is safe and it is adequate and most women who labor with access to N2O do not end up going for the stronger stuff.
As someone who studies stress, I am reminded of a classic stress experiment involving two rats, two tethered cages, two electrified floors, and one off lever to push. The electrified floor switches on unexpectedly, give both rats a little shock, and one of the rats has the ability to stop this pain by hitting the lever in its cage. Same shock, same timing, same pain, but one rat has a sense of control over this pain and the other does not. It is this sense of control that appears to be what saves this rat from the stress of the situation while the other rat turns into a stressed out mess (non-scientific terminology, of course).
By giving a laboring woman the option, the mask to hold in her hand to self-administer a little hit of possible pain relief, we are giving her control. We are lowering the stress of the situation. Why? WHY? Is this option not widely available or even known about in the US? The birth class instructor seems to think that it has something to do with money – no one makes money from an off-patent, inexpensive, old school gas option so who is going to promote it? If this is actually the case, it would be another incredibly sad and f-ed up thing about the American Health Care System.
Personally, I am going to try to get through as much of labor as physically possible without medication. I’m honestly curious about what it all feels like (all the mamas out there have one eyebrow raised with deep insight and skepticism). But, man, I do wish I had the option of hitting some laughing gas rather than only having the option that involves a tube feeding nerve knockout juice past my spinal column.
2. Likis FE, Andrews JA, Collins MR, et al. (2012) Nitrous oxide for the management of labor pain. Comparative effectiveness review no. 67. AHRQ publication no. 12- EHC071-EF. Rockville (MD): Agency for Healthcare Research and Quality.
Did I mention that I am currently part of a science experiment?
Sure, there is a sample size of one so I can’t promise a powerful data set coming out that would revolutionize how we think about pregnancy but maybe…
Anyway, as soon as I announced my pregnancy to the world last spring, a fellow postdoc, who is interested in biological rhythms in humans and other furry creatures, immediately jumped at the chance to make me a lab rat. “Can I wire you up?”, he asked.
My first thought was that I was going to have electrodes attached all over my body for the next six months. So, of course, I responded “Hell yeah!”
How could I resist?
Luckily, I do not have to wear multiple electrodes on my increasingly uncomfortable body, but I have been wearing an armband with a little data collector attached to it. It is actually marketed for the much more lucrative fitness and weight loss industry (technically an “on-body monitoring system”) and it monitors aspects of everyday life from steps taken (your standard pedometer) to calories burned (changes in body temperature) to sleep patterns (are you laying still or moving around a lot).
So far, we have only peeked at the output with plans to really get into the data once the womb baby has joined the world. My predictions – my sleep will get progressively crappier (I can see that 3am wake up, toss and turn, and every additional midnight trip to the bathroom), the number of steps I will take will decrease and calories burned will …. well, that one will be interesting (Can we see if I’m actually “eating for two”?)
While I’m quite interested to see what information my friend can actually mine from this data set, I don’t have my hopes up too high. It feels very limited.
But is there a way to glean even more information from our pregnant bodies? A way to glean more information about this tiny stranger that we are building and carrying around inside our body for 9+ months?
Looking around for this kind of technology it appears that there are quite a few things out there for understanding our own bodies… to some degree. For example, fitness buffs and not-so-buffs looking to get into shape are using things like BodyMedia (what I currently have strapped to my arm), FitBit, and Jawbone UP. Again, think fitness, these guys are really out for quantifying your physical output and come with handy apps to also keep track of your eating patterns, weight, etc. They also claim to measure sleep “efficiency” but really they just rely on an accelerometer to say “ooh, movement! fitful sleep!” or “no movement, must be cruisin’ in deep sleep”. Interesting, but not completely insightful (and maybe not even that accurate!)
In addition, there has been a burst of technology coming out to monitor babies’ bodies as well. Mimo, comes with a cute little “turtle” that attaches to a special electrode equipped onesie and tracks sleep trends and development and can also alert the parents about changes in breathing, sleep position, temperature, and waking patterns. Owlet, is a little foot cuff thing that tracks baby heart rate and oxygen levels. Sproutling is another wearable for the baby’s ankle that monitors heart rate and breathing along with a base station that measure temperature and humidity in the room. Teddy the Guardian by iDerma is a special teddy bear that will take the kid’s temperature and oxygen saturation. This one requires the kid to actually grab onto the bear’s paw for a reading. With a name like Teddy the Guardian, I would actually be a little frightened that the thing might grab back, Poltergeist-style, so I don’t know about this one.
It is hard to escape the fact that we live in a world revolving around technology. Through our keyboard, we literally have information at our fingertips (although, I must say, I am not impressed with much of the pregnancy “advice” coming up on Google). Is monitoring our own bodies and our babies’ bodies the next step in the fully informed patient generation?
Is having access to this level of knowledge about your baby empowering or neuroses enabling?
What do we need to know? What do we want to know? Where is the line?
What can we learn about pregnancy if devices are available or adapted for pregnant women to track biological rhythms, changes in womb baby’s movement, heart rate, sleep cycles?
What can we learn about babies when more parents opt to go beyond the baby monitor and keep track of biological details of daily and nightly patterns?
Is this a pediatrician’s worst nightmare or previously unattainable dream?
As I prepare to make this transition from pregnant scientist to mommy scientist, I have just a few more questions for those of you who have gone through all of these stages already. From what is available and what might become available, what is one thing you wish you could have monitored at any point during pregnancy or infancy? What kept you up at night, checking on the baby (besides the screaming, feeding, changing part)? Would a little bit of tech have brought you peace of mind? Or made you crazy?
And what the hell is the point of TweetPee?
Please leave comments below!
WELCOMING ANOTHER NEW CONTRIBUTOR!
Fellow scientist and good friend, Dr. C, has already made her way through this whole pregnancy thing and has been my sounding board for all things bump related. I must admit, I am extremely jealous of those pregnancy superpowers – super smell, super taste – bestowed upon many a pregnant lady that seem to have missed my expanding body. But then again, if this oversight also provided that sweet bypass from the cookie-tossing gods, I will take it.
Dr. C., however, was lucky… or not so lucky… to have experienced the full on rewire –
It’s a bird! It’s a plane! No, it’s a heightened rhinological olfactory manifestation!
Or, in plain English, a heightened sense of smell…
Honestly, I think my nose knew I was pregnant before I did.
It was a beautiful, San Diego Saturday. I was relaxing on the couch working on my computer (a.k.a. guiltily watching the latest reality show…), when my husband decided to make himself a tuna fish sandwich.
Within moments of opening the tuna can, the fishy aroma hit me like a Mack truck. I ran for the bathroom and promptly threw up in the toilet. And a little around it.
“Whoa. It must have been something I ate,” I said to a very surprised husband…
It wasn’t until weeks later I figured out that I was pregnant. By then, I could, from our apartment, smell what our neighbors three doors down were having for dinner.
Was I imagining it?
Much like a spider bite gave spiderman his spidey sense, did a German shepherd bite me?
Target knew I was pregnant before I did, too. I started to get all these coupons for diapers and nursery furniture. I have no idea what changed in my buying habits to tip them off, but one secret experts posit is that expectant moms tend to opt for the scent-free lotions! 
So, what is it about smell that changes for pregnant women?
In a study by the National Geographic Smell Survey , a whole bunch of women (290,838 women to be exact, of whom 13,610 were pregnant) reported on their sense of smell. The pregnant women claimed they couldn’t smell as well as those that were not pregnant, yet they performed better on one of the smell tests they took. More recent studies showed that women did self-report to have a better sense of smell while pregnant  , or at least experienced a change in smell .
But what yours truly says to all of those studies is: brave be the soul that can endure the smell of pungent fish while pregnant.
So, how and why do we get these super smell powers when we’re expecting?
During pregnancy, the hormone estrogen increases to help with a whole host of events that occur. It’s been shown that it is this increase in estrogen that activates that crazy smell superpower.
Why? Back when we were all running away from the dinosaurs (ok, that never really happened, but a looong time ago), a heightened sense of smell may have been beneficial to the health of mama and baby. Those that ate the stinky, spoiled foods or other such toxic agents got very sick, couldn’t maintain pregnancy, or even died. Those that could smell out bad food and avoid it lived, passed on this beneficial smell trait to their daughters, who had daughters that could smell, who had daughters that could smell, and so on.
Because of this, women in general, as compared to men who maintain lower levels of estrogen, are supposed to have a better sense of smell and of taste. After all, taste is very much linked with smell . Think about it – your nasal passageways and your mouth are connected – which you most likely tested unknowingly as a child when you drank chocolate milk, laughed, and it came out of your nose.
With that appetizing thought…
Have you ever watched the Food Channel? Whenever they have those awesome cooking competitions, sometimes the women judges disagree with the guy judges about which competitors’ pistachio-encrusted crème brulee tasted better. The women judges will proclaim themselves, because they are women, as having the more sensitive palate (and thus are right about their choice of most delectable brulee).
Gentlemen, I’m afraid the ladies have you on this one. Ten points for estrogen!
So, in this sense, when women get pregnant and have what an old science teacher of mine called “oodles and gobs” of estrogen, their smelling and tasting powers cannot be rivaled.
In fact, my pregnant ladies, you make the best wine tasters! Now, stay with me here – wine connoisseurs from Tesco’s HQ in Hertfordshire claim pregnant women make the best tasters . They even put out a nationwide call for pregnant women to help them with in-store tasting and called it, Operation: Cot du Rhone!
Of course, some doctors came out of the woodwork shouting, “Alcohol BAD!” ;
But back to the big picture: whether a pregnant woman’s heightened estrogen and associated sense of smell leads her to puke at a whiff of tuna or become the greatest wine connoisseur in the land, I think we all can genuflect in awe and wonder for these newly (and temporarily) acquired superpowers of the Nose.
Well, the internet knows I’m pregnant.
Maybe it’s my lazy way of shopping for maternity clothes. Maybe it’s all those searches for silly pregnancy advice. Whatever it is, the internet knows I’m pregnant and now pregnancy related ads follow me everywhere.
The latest – Umbilical Cord Blood Banking.
I didn’t even realize this was an industry!
With tags like “Could One Day Be a Lifeline of Hope for Your Child” and “Saving More Cells-Saving More Hope”, how can one pregnant lady resist?
Yes, promising to save my unborn child from leukemia AND save me $300 if I sign up now is very enticing. Apparently, there are 80+ diseases that I could rescue this baby from by simply bagging up the umbilical cord and paying a company to safeguard until later use. Still not convinced, until I saw a point about it being used as a cure for Type 1 Diabetes. Really? This disease has the best likelihood of actually affecting my family, I paused and thought about it – should I bank my cord blood?
Although perfect in nearly every way, my husband is defective (love you, honey).
If not for the wonders of modern medicine, nature would have killed him off around 14 years of age when Type 1 Diabetes caused him to become completely dependent on insulin injections. Because this disease is genetic, there is a good chance our little bundle will be carrying this defect and either developing Type 1 Diabetes or passing it along.
A brief overview of the disease – Type 1 Diabetes occurs when certain cells in the immune system (white blood cells called T lymphocytes) decide to gang up on little groups of cells in the pancreas called islet β cells. What triggers these T cells, normally defenders of the realm, to turn into maniacal bullies targeting their own kind is still a bit of a mystery But what we do know is that these crazed T cells are very effective in their islet β cells annihilation. Type 1 Diabetes is no longer fatal if treated but it is chronic – all patients have to pick up the slack for their islet cell lacking pancreases and provide their bodies with every drop of insulin their body will need to deal with sugar appropriately throughout the day, every day for the rest of their lives.
Where does umbilical cord blood come in? Well, cord blood is rich with stem cells. And stem cells, especially the unique ones found in cord blood, have yet to be programmed, they don’t have a strict plan for their cellular destiny. This makes them naive enough to be tricked into becoming any number of cell types across the body – perhaps even…. insulin-producing cells! So, could stem cell rich cord blood actually be the answer to treating this baby’s possible Type 1 Diabetes? Could my husband be treated with this magic blood and be cured?
Back to reality – the problem with stem cell therapy for Type 1 Diabetes is that even if you get those islet cells regenerated, the T cell bullies are still hanging around, waiting to beat them down. How could stem cells from cord blood be any different?
This is where I found some really freaking cool science.
As pointed out in a paper in Autoimmunity Reviews by Zhao and Mazzone in 2010, there are three main things that cord blood stem cells will have to accomplish to cure a Type 1 diabetic: 1) bulk up the stock of insulin-producing cells, 2) protect any introduced/re-grown islet β cells and 3) get the patient’s T cells back in line so they won’t attack and destroy. And this research team may have found a way to tackle all of these points using cord blood stem cells using a very unexpected approach.
Zhao’s team followed up this tease of a review with a study published in BMC Medicine in 2012. Rather than trying to introduce or re-grow insulin-producing cells, the team used the cord blood stem cells to educate the bad T lymphocytes.
That’s right! The baby cells are basically sitting this old guys down and saying “Listen up, its time to shape up and stop bullying the islet cells!”
How? Well, this is a bit more complicated that I can even fully wrap my head around, but the gist of it is this: lymphocytes are isolated from the patient’s blood and cycled through a column of petri dishes that are coated with the cord blood stem cells. These stem cells have an added bonus property of sticking really well to the petri dish such that the lymphocytes feeding through the petri dish stacks simply bounce along the top of the stem cells, which are attached tightly to the dish. As they bounce along, the lymphocytes hang out in the presence of the stem cells long enough for the stem cells to bestow their baby wisdom upon them. What is this baby wisdom you may ask? A micro environment created by different secreted molecules and molecules on the surface of the stem cells that alters how the patient’s lymphocytes respond to immune challenge. Let’s just call this the “happy place”.
Once the patient’s lymphocytes visit the “happy place”, they are returned into the patients blood stream. These lymphocytes have been schooled, educated, seen the light and turned away from the dark side.
As tested on a small number of patients (12 receiving treatment, 3 placebo), either showing a degree of islet β cells activity (group A = 6 patients) or absolutely no activity (group B = 6 patients), this Stem Cell Educator therapy was able to return insulin regulation capabilities. Group A patients, who went in with subpar insulin responses, regained normal levels of insulin activity within 4 weeks of treatment. Group B patients, who went in with no insulin activity whatsoever, were already progressing to normal insulin activity within 12 weeks and nearly matching normal levels at the end of the study (40 weeks).
To reiterate: Group B patients went into the clinic with no insulin activity suggesting they had absolutely not a single working insulin-secreting cell in their bodies. After one treatment with the cord blood stem cells educating the patient’s lymphocytes, insulin activity was nearly regained. This suggests that either even these patients have a population of islet β cells struggling to survive or have other unidentified insulin-producing cells waiting in the wings, but the crazy T lymphocytes are constantly playing whack-a-mole to keep the numbers down. Educate the lymphocytes, let these cells bounce back, BAM, Type 1 Diabetes cured? Maybe someday.
To get back to why this relates to me and my pregnancy – I have decided that I am going to try my damndest to donate my cord blood. I am sure this is only one of many amazing scientific pursuits cord blood stem cells are currently being used for and it seems a shame to let those precious precious cells get incinerated in a sad medical waste facility.
I’m still weighing my options, but I did find a helpful list of cord blood banks (public and private).
Maybe those cells will go on to save someone’s life.
Maybe a researcher will use them to cure Type 1 Diabetes.
Maybe this is just my way of making this baby a little scientist in utero.
“What are you up to, baby?”
“You know, just culturing some miracle cells inside the womb”.
Fast approaching the second trimester which means, I am in “the clear”. At least that is the marker by which we decide when to spread the news far and wide.
So, here we are, internet, I am pregnant.
I am a pregnant scientist.
Field of research, generally? – Physiology.
Specifically? Stress and reproduction.
How appropriate, right? The stress of doing research, looking for a new job, moving, buying a house, LIFE, nearly got in the way of my own reproduction (more on this later?). And, unfortunately, I know all too well why. Ok, so I know, potentially why. If I knew why, I wouldn’t have funding to ask the questions I am asking.
As a physiologist, my first instinct whenever I have all those nagging pregnancy questions is to ignore those pregnancy sites that treat you like a human who has no idea how the human body works and dive right into the scientific literature.
Really? I would ask. But what does the actual research show!?
Hopefully I’ll find some answers, clues, interesting factoids. And I plan to share them here. In no way do I intend this site to be a place to look for advice, so take my “findings” with a grain of salt. I am not a medical doctor, just a curious PhD.
And in the end, I will probably realize that there might be a reason we don’t go off exploring on our own.