Spotlight on Houston Museum District

There is always something new and different to experience when you visit Houston’s  Museum District. In fact some of the sights are so close to Dr Brewton’s office you can’t help but check them out before or after a visit to your favorite Houston doctor.

New Museum District Gem: McGovern Centennial Gardens

First on our list is the new McGovern Centennial Gardens which is kitty-corner from Dr. Brewton’s office on Hermann Park Drive at Caroline Street. It officially opened in October but inclement weather slowed down the planting schedule so you’ll see a few finishing touches being put in place now in time for December. Within the garden is the new Cherie Flores Garden Pavilion, which was designed by architect Peter Bohlin of Bohlin Cywinski Jackson. Bohlin is world-famous as the designer of the iconic Apple Stores.


Houston Museum District’s Bosta Wine and Coffee Bar

Before or after a brisk walk through the McGovern Centennial Gardens, you can check out the new Bosta Wine and Coffee Bar on 1801 Binz Street (at Chenevert) in Houston’s Museum District. It has a very spare, modern loft vibe with bare white walls, like something you might see in Montréal. Warm up with a cappuccino or hot chocolate. Also recommended are their lunch plates, with a rotating selection of soup and half sandwich combinations. We loved the kale salad they had on offer the day we visited. And we’ve saved the best for last: Bosta offers free covered parking! Drive into their main garage directly from Binz and park on the ground floor at no charge.

View our Houston Museum District Neighborhood Activity Map for Fall and Winter 2014. (PDF File opens in new window.)

View our Houston Museum District Neighborhood Activity Map for Fall and Winter 2014. (PDF File opens in new window.)

Hidden Houston Museum District: Russian Cultural Center “Our Texas”

Given the recent spell of cold weather in Houston, some of us have been grousing that we are actually living in Moscow on the Brazos, which brings us to the next stop on our Museum District tour. Somehow we didn’t know about the Russian Cultural Center, located on 2337 Bissonnet Street (one block west of Greenbriar/Shepherd).

The RCC has stepped up their program schedule as they try to fundraise for a new location. Between now and the end of 2014, you can:

Know Your Houston District Architectural Landmarks and the Architects Who Designed Them

Bundle up this coming December 27th at 10:00 am for the fourth Museum District Walking Tour hosted by the Houston chapter of the American Institute of Architects (AIA). During this two hour tour you’ll learn about four major landmarks:

  • Museum of Fine Arts Houston’s Cullinan Hall (1958) and the Brown Pavilion (1974) by Mies van der Rohe (1886-1969)
  • Contemporary Arts Museum – Houston (1972) by Gunnar Birkerts (b1925)
  • The Lillie and Hugh Roy Cullen Sculpture Garden (1986) at the MFAH by Isamu Noguchi (1904-1988)
  • Asia Society Texas Center (2012) by Yoshio Taniguchi (1937)


Meet at 10 a.m. December 27 at the Miro sculpture in front of the Glassell School at 5101 Montrose Boulevard, Houston.

Houston Museum District: Home of Asia Society Texas

If you’d like a more in-depth tour of the new Asia Society Texas Center by Yoshio Taniguchi, you are invited to take a guided tour on December 6, 2014 at 2 p.m.  The hour-long tour will include:

  • The Brown Foundation Performing Arts Theater
  • Edward Rudge Allen III Education Center
  • Elkins Foundation Water Garden
  • Fayez Sarofim Grand Hall
  • The Water Garden Terrace

Immediately following the architecture tour, is docent-guided viewing of photographer/artist Kirk Pedersen’s exhibition of urban Asia images at 3 p.m.

Crash Course in Chinese at Asia Society Texas Center

The Asia Society Texas is now offering a ‘Crash Course‘ in Chinese (Mandarin) in cooperation with the Chinese Community Center. You can sign up now for the 10 week course starting in the first week of January 2014.

These 10 week courses include all the learning materials. Tip: Join the Asia Society Texas before you sign up for the $400 course and you can get a $50 discount.


We hope you enjoyed this update on the sites and happenings in the Houston Museum District.


Houston Heights Winter Gardening

As you may know, many of Dr. Brewton’s patients live in the Houston Heights. This is a great neighborhood to walk around in or explore by bicycle (see our related article on an upcoming Houston Heights bicycle tour on November 22).

One of the reasons the Houston Heights is such a popular neighborhood destination is all the beautiful cottage-style gardens. And now that the weather’s cooled off, it’s a great time to get out and get some healthy exercise by working in the garden.

What should we plant now? We asked landscape designer Matt Hannon.

But many of us are unclear about what kinds of plants we should be planting now to enjoy in throughout the winter and into the spring. To get some guidance, we turned to landscape designer Matt Hannon, of B. Matt Hannon Designs (telephone 409-599-5337), to find out what we should be planting now.

According to Matt, as a gardener you tried it to your best to guess what the weather will bring in the Houston area during the winter. The Houston Heights and I-10 is often the dividing line between heavy freezes in the northern suburbs — like Spring and The Woodlands – and milder winters to the south of Houston, in Galveston County, in places like League City or on Galveston Island.

Be prepared to protect your Houston area garden from frost

Matt says the key for planting at this time of year is to be prepared with a frost blankets or some old cloth bed sheets to drop over your garden beds if there is a risk of frost. Just don’t use plastic bags or plastic sheeting as this actually transmits the cold, providing less protection to the plants than cloth material.

Suggestions for Winter Planting in the Houston Heights and other area neighborhoods

In the following gallery, you can see Matt’s suggestions for what to plant now to bring color to your garden. The way things are looking, according to Matt, it will be a colder winter this year, and so he believes that pansies and violas would be an especially good choice.

What about vegetable gardens in the Houston Heights and surrounding regions?

As all Dr. Brewton’s patients know, he wants us to eat more fruits and vegetables. So what could be better than growing winter vegetables at home in your own garden?

Matt has eight suggestions for planting a vegetable garden at this time of year. All of them except one are resistant to cold, the exception is tomatoes. If the winners frost free, you may end up with the earliest homegrown tomatoes on the block, but if we have a cold spell, the tomatoes will really suffer. You may consider planting them in containers that could come inside as needed.


Healthy Recipes for All Kinds of Rice and Beans

A lot of us don’t cook much any more. Yet it’s one of the best ways to control your calorie intake and know what’s going into your body. If you are one of these inexperienced or out of practice cooks you are in luck. We are planning to start offering some tips on how to make some easy, healthy recipes.

First up in this series are tips on cooking Rice and Beans, which are not only very nutritious and satisfying but also very economical. We’ve compiled some strategies to make sure you get the most nutritional value out of cooking Rice and Beans while  avoiding high fat levels in many traditional recipes.

For good health, vegetarian beans and rice is the way to go

Forget about cooking with ham hocks or even with chicken stock. There’s too much sodium and saturated fat in those traditional recipes. You can also forget about cooking refried beans!

Instead, focus on getting some good quality ingredients together.

We’ll start with the beans

It’s good to have some of these things on hand when making beans (see list below). You don’t have to have all of them but these are good things to select from when cooking:


Food Ingredients You Can Add to Bean Recipes

  • whole ginger root
  • greens, like collards, mustard greens, kale (can be frozen)
  • raw fresh organic spinach
  • leeks
  • celery
  • white onions, spring onions or scallions
  • raw, uncooked asparagus (Cut the stalks into 1 to 1 1/2 in. lengths on the bias)
  • baby bok choy
  • broccoli
  • garlic
  • carrots
  • diced peppers
  • diced tomatoes
  • okra

Spices and Other Items Which Are Good For Bean Recipes

  • ground tumeric
  • curry powder
  • chili pepper
  • ground dried mustard
  • ground black pepper
  • dried bay leaves or dried avocado leaves
  • (optional) frozen bean mixture from last recipe
  • olive oil or grapeseed oil
  • apple cider vinegar or rice wine vinegar

Cooking Utensils and Gadgets

  • stockpot or French oven (pot) with a heavy bottom that will not burn when you sauté onions
  • optional pressure cooker (an advanced topic we covered in a recipe for Caramelized Carrot Soup.)
  • slotted spoon (useful to serve beans and for tasting them as you cook)
  • Ziplock type bags (for storing leftovers in the freezer)
  • electric rice cooker

Think about the Life-Cycle of your Cooking

If you are somewhat new to cooking, one of the things that might not occur to you right away is how to plan to cook, reheat and freeze your meals. For example, you generally won’t cook beans for just one meal (unless you expect to feed a huge group). You will cook enough to have leftovers, which you will eat in the coming days or, if you freeze your beans, you’ll enjoy eating a second or third time at some point in the future.

Soaking is Beneficial

Just about all beans cook quicker and taste better if you soak them the night before. Eight hours is plenty of time. But don’t forget about them in the morning. If you leave them on the counter in a hot kitchen they will start to ferment. If you notice this happening, drain off the liquid and put them in the fridge until you have time to start cooking them— but try to do it later in the same day or next morning.

Soaking not only speeds up the bean cooking process, it can also reduce the amount of annoying gas that gives beans their reputation for causing flatulence!

Tip: Neither Split Peas nor Lentils (nor the variation of Lentils known as Dall which are used in Indian cooking) need to be soaked beforehand; you can just start cooking them right away.

How Many Beans Should You Cook at One Time?

Two cups is actually a lot of beans. But that’s good amount to start with, because you’ll have leftovers. When you get beans out of the bag, pour them into your stock pot and fill with enough water to cover the beans. Anything that floats might be dirt or leaves or dead insects — which is something to discard at this step. Wash the beans again in fresh water and then drain. Then refill the water (consider using filtered water when cooking) to so there is at least 2 inches of water above the level of the beans. As you gain experience, you might see the need to add more water when soaking certain types of beans.

Choosing Which Beans to Cook

Stock up on a variety of beans and experiment. We recommend three types of beans for beginning cooks:

You can cook low-fat Black Beans using our recipe.

Black Beans

Black Beans: These have have a rich taste, great for cooler weather. (Forget the sour creme topping by trying yogurt instead or skipping entirely)

Mayocopa Beans: These are mild and won’t overpower the rest of the food on your plate. A good choice for a side dish.

Mayocopa Beans

Mayocopa Beans: These are mild and won’t overpower the rest of the food on your plate. A good choice for a side dish.

Butterbeans, plain or speckled: These large beans (also known as lima beans if you are a Yankee) are seasonal. They can be very filling.

Speckled Butterbeans (also known as Lima beans)

Butterbeans, plain or speckled: These large beans (also known as lima beans if you are a Yankee) are seasonal. They can be very filling.

 Here is our general recipe for cooking all types of beans:


Basic Cooking Technique for Low Calorie Beans
Heat a tablespoon or two of grapeseed oil (cheapest from Costco) in your heavy duty stockpot. When it shimmers, add diced or thin sliced rings of onions and sauté for about five minutes. Don’t burn it. Add some chopped garlic at the last minute, which will tend to make it burn on the bottom so stir quickly.Get ready with some water.
Once the garlic starts to get too brown too fast, douse it with a cup of water before it burns.Turn the heat down to medium low.Now add your beans.Add enough water to just cover the beans. (As we add more ingredients, you may need to top up the water)Now cut off a portion of raw ginger root (about the size of your thumb) and remove the skin. Slicing the skin off with a knife may be more efficient than using a peeler. It doesn’t have to be exact. Add to the pot.Add 8 to 12 dried twelve bay leaves or avocado leaves.Optional: Add some previously cooked beans. If you made a batch of beans earlier and saved a small portion with the liquid in the freezer, get that out now and drop it into the pot. It will defrost as you cook your beans and it will add richness to your sauce.Add a quarter teaspoon (more if you like it) of ground dried mustard.Do you want an Indian style curry taste? This would be good option with mayacopa beans, yellow lentils (dall) or butterbeans. If so, add a 1/2 teaspoon of ground tumeric and 1/2 teaspoon of curry powder.

Tip: recipes made with curry powder can stain some dishware if you don’t wash promptly after eating.

If you don’t want to go in the curry flavor direction, add a tablespoon of apple cider vinegar and some ground pepper. You can add a tiny pinch of ground chili pepper as well.

Now make sure there is enough water to just cover the beans and the heat is just high enough for it to simmer. Your beans should be done in 35 to 90 minutes.

As you experiment with each type of bean you can write down how long they took to cook so you’ll know what works for you next time.

Tip: Be careful to not overcook split peas and lentils as their cooking time can be much shorter, sometimes well under a half an hour if you like them chewy. If you cook them too long, they will turn into pure soup.


But wait! We’re not done adding ingredients… Here is where the fun begins!

You can mix and match different vegetables to add to your beans as they are cooking on the stove. Often you can just take a look at what you already have in the kitchen. It’s a good way to use leftovers.

Here are some good combinations:

  • spinach and kale leaves and asparagus
  • diced tomatoes and okra plus onions, green bell peppers and celery (aka the cajun trinity)
  • onions, leeks and scallions
  • onions and baby bok choy and leeks

Just add these items into the stock pot about halfway through the cooking process. For more delicate items that cook quickly, you can add them closer to the end. Don’t forget to top up the water if you add a lot of new things to the stockpot. You can partially cover the stockpot as you cook.

Tips for cleaning the Leeks

Washing leeks is important. As they grow they will naturally capture a little bit of dirt in the layers. Here’s how to clean them properly. Cut off the bottom edge off of the root off (the part with the little root hairs). Then cut your leek at the other end as well where the leaves start to grow away from the central stalk. Now you have just the central stalk remaining. Cut this stalk in half lengthwise. Use a sharp knife and be careful! Now carefully chop off the stalk every inch or to make sections of leeks. Drop all the leek pieces into a bowl of water and let the dirt that’s accumulated as the leek was growing settle to the bottom. You can grab the floating leek slices with your hands to remove them. Try not to disturb the dirt gathering at the bottom of the bowl. You might want to rinse them once more in a different pot then drain. Now add them to your beans on the stove.

What about the Rice?

White rice Is the classic processed food that you want to avoid. Without getting too technical or exact, we can think of white rice as being the polished inside of the rice grain. It lacks the natural outer portion, which is very nutritious. Without this outer layer of rice grain, white rice will be converted into energy by your digestive system far too quickly, giving you a ‘sugar high’ spike.

So stick to brown rice.

But which kind?

Be adventurous. Try different kinds of mixed wild rice and brown rice. Learn what you like. Just try to avoid rice packaged in a box with other seasonings included. These will be too salty and unnecessarily expensive.

You can also try more exotic imported rices from Asia, including ‘black rice’. Ranch 99 in the Spring Branch neighborhood has many varieties to choose from. That’s also an excellent place to pick up a high-quality electric rice cooker at a reasonable price.

Cooking the Rice

Once you’ve tried using an electric rice cooker, you may not want to go back to cooking in a pan. It generally comes out perfect each time.

Once you have the beans simmering, you’ll have time to measure the rice and water combination according to the instructions that came with the rice cooker.

Keep in mind that cooking brown rice can sometimes take nearly twice as long as white rice. And generally you’ll find the cooking instructions ask you to add a wee bit more water when cooking brown rice.

Tip: Don’t lose the little measuring cup that comes with the rice cooker unit! You’ll need to use that to measure your rice. It’s not equivalent to a standard measuring cup.

Enjoy your Rice and Beans

As you cook the beans, you can taste test to determine when they are done. Use a slotted spoon to fish out some beans and try them.

After you get some experience, you can make rice and beans without looking at a recipe at all. It’s a nice relaxing routine that allows you to try different variations.

After serving the beans and rice, you can let the stockpot cool off and put it into the fridge. Or transfer it to a smaller container. Since this is a vegetarian meal, you don’t have to worry as much about food safety issues, which would be a greater concern with chicken soup, for example. Just avoid putting hot food into plastic containers, which can cause the plastic material to break down and possibly leach into your food. That could be risky. Use glass storage containers or wait for it to cool to room temperature.

If you have more beans left over than you need, wait til they are completely cool and ladle them into some plastic freezer bags or containers than can go in the freezer. (Again wait for them to cool to room temperature. Hot food in plastic bags is not a good combination.) Don’t forget to label the type of beans and the date. Keep one small bag reserved for adding to your next batch of beans if you like.

Rice can be kept in the rice cooker for up to about 10 or 12 hours as long as there is no meat protein added. Be sure to store it in a sealed container in the fridge to avoid it drying out.

Enjoy and be sure to let us know what you think!


Dr Gary Brewton Earns National Recognition for Patient-Centered Care


I’ve got some breaking news for you… We’ve just been awarded the top quality award (Level 3) from the National Committee for Quality Assurance (NCQA), based in Washington, D.C. This Patient-Centered Medical Home award measures the quality of our evidence-based medicine and patient-centered care.

I’d like to thank our staff, our colleagues at Memorial Hermann Hospital and most of all — our patients — for your support over the years.  This award goes to each of you! 

It represents well-deserved recognition for all of your efforts, and it’s a testament as to how we’ve been able to work together as a team in pursuit of better health.

Read the press release about Dr Gary Brewton’s NCQA award.


How Houstonians Can Prevent Getting Mosquito Diseases Like West Nile, Chikungunya and Dengue Fever

Female Aedes aegypti mosquito hard at work feeding off a human host. This daytime biting mosquito is the primary vector for transmitting Flavivirus Dengue (DF) and Dengue hemorrhagic fever (DHF). Image courtesy CDC / James Gathany

Female Aedes aegypti mosquito hard at work feeding off a human host. This daytime biting mosquito is the primary vector for transmitting Flavivirus Dengue (DF) and Dengue hemorrhagic fever (DHF). Image courtesy CDC / James Gathany

Which Mosquito Diseases Do We Need to Worry About in Houston?

We want to scare you, just a little bit. At least just enough to take mosquito-borne diseases and mosquito control seriously.

That’s because we are now have three different mosquito-borne diseases that are of concern in Houston: West Nile virus, Chickungunya virus and Dengue virus.

Mosquito Diseases: West Nile Virus Activity in Houston and Harris County

Since first arriving in the U.S. in 1999, West Nile virus has established itself in many areas of the country, including Texas. The Center for Disease Control (CDC) has created an online mapping tool, called ArbotNET, which tracks areas where West Nile is active. We’ve made a screen shot using the mapping tool to show the total number of West Nile cases in our region.


The West Nile Virus Can Cause Two Different Human Diseases

The first is called West Nile neuroinvasive disease (WNND). It’s the more severe form of the illness; it can cause headache, high fever, neck stiffness, stupor, disorientation, coma, tremors, convulsions, muscle weakness and paralysis.

The second disease caused by West Nile virus is West Nile fever (WN fever). Symptoms of WN fever include (obviously!) fever as well as headache, body aches, and occasionally a skin rash on the trunk of the body and swollen lymph glands. According to the Texas Department of State Health Services,

The Texas Department of State Health Services released its own update on September 16 with a detailed breakdown on West Nile virus activity in Houston. To date, they report that Harris County has had twenty confirmed cases of WNND and five confirmed cases of WN fever so far in calendar 2014.

We will look at West Nile in more detail in a future update.

Mosquito Diseases: Dengue Virus Activity in Houston and Harris County

Dengue virus is a huge problem world-wide. The CDC estimates as many as 400 million people contract the virus each year, primarily in the tropics. Below we have another screen capture taken from the CDC Disease Mapping tool showing where Dengue virus (DENV) has been detected.


If you look closely, you will see the active selection on the mapping software is set to DENV(imp). This selection show cases believed to be “imported” by visitors or tourists who contracted the virus elsewhere (generally in the tropics) and brought it with them to the Houston area (rather than having contracted it by local mosquito infection).

Visitors to Puerto Rico, Latin America, Southeast Asia and the Pacific islands need to be especially alert for these areas are high risk for the disease.

The CDC has not yet identified any locally acquired Dengue virus infections in Texas during 2014. There is in fact some debate among area health officials whether Dengue virus may now be sufficiently established in the Houston region to enable transmission via local mosquitoes. Most agree that if it’s not the case today then it’s only a matter of time.


Both the Dengue virus and the Chikungunya virus (discussed below) are transmitted by Aedes mosquitoes (as shown in the photograph at the top of this article). These type of mosquitoes are active during the day, so you shouldn’t drop your guard and only worry about mosquito protection during the early morning and dusk hours.



Like West Nile Virus, the Dengue Virus Can Cause Two Different Diseases in Humans

The most common disease is Dengue Fever, also commonly called breakbone fever. This disease can bring on symptoms like fever, headache, muscle and joint pain, as well as a skin rash that looks similar to measles. To date there is no vaccination to prevent or medication to treat Dengue virus diseases.

Less common is a more severe, life-threatening disease called Dengue Hemorrhagic Fever. Patients who contract it can bleed and lose blood plasma as the skin and organs develop hemorrhages.

We will investigate Dengue in more detail in a future article.

Mosquito Diseases: Chikungunya Virus Activity in Houston and Harris County

Like the Dengue virus, Chikungunya virus can cause fever and debilitating joint pain. The virus — once limited to Southeast Asia and Africa — reached the Caribbean islands toward the end of 2013, where it has since infected thousands of people.

Chikungunya virus has also reached Texas this year for the first time. However public health officials contend that all cases of Chikungunya virus infection in our area have been imported from elsewhere, e.g. those who contracted the virus did so outside of the continental United States.

To date, the CDC disease mapping tool hasn’t been updated to include Chikungunya virus infections. But the Texas Department of State Health Services announced on September 9th that they had identified 19 cases of Chikungunya across Texas, with 4 cases confirmed in Harris County and one each in Brazoria County and Montgomery County.

Indicative of the heightened level of concern about this new disease, the U.S. Defense Advanced Research Projects Agency (DARPA) is conducting a contest with a $150,000 award for the best epidemiological / mathematical model predicting how this mosquito-borne Chikungunya virus will spread across the Americas.

Checklist on How to Avoid Getting Infected by Mosquito-Borne Diseases

1. Avoid Bites from Mosquitoes in Daylight Hours too, Not Just at Dusk

Back before West Nile virus arrived in Houston, you may have learned that mosquito bites at dawn and dusk were the ones to really worry about, because the mosquito species active in the evening and early morning were considered the most likely to transmit encephalitis and malaria. This is true. But since the arrival of West Nile virus we have to worry about daytime mosquito activity too. Many types of mosquitoes can harbor West Nile virus, including Aedes aegypti, which is active in the day. Now that we are at risk for Dengue and Chikungunya, both of which are transmitted by Aedes aegypti, it’s even more important to avoid mosquito bites during daylight hours.

2. When Outside Use Mosquito Repellent and Wear Protective Clothing

The CDC has a guide for effective mosquito repellent use. They recommend choosing products with one of the following ingredients: DEET, picaridin, IR3535, certain varieties oil of lemon eucalyptus or para-menthane-diol.


Caution: Do not use permethrin products (not on the list) on your skin.


Wear socks, long pants and long-sleeved shirts when possible. This will help prevent mosquito bites. If some of these are made of thin fabrics, the mosquito may bite anyway, so apply mosquito repellent to thin fabrics.

3. Analyze Your Environment and Think Like a Mosquito

While the shorter-lived male mosquitoes are feeding on flower nectar and sweet juices, the female mosquitoes are searching for blood to nourish the eggs they develop. They use chemical sensors to detect carbon dioxide and lactic acid (and sometimes sweat) up to 30 yards away.

They are on the lookout for movement — this indicates you are alive! And, if you wear clothing that contrasts with your surroundings, you’ll be a more noticeable target to mosquitoes as well.

Finally mosquitoes can detect heat sources from a distance — they can sense warm-blooded animals, like us humans.


So if you have been working in the yard, you are a prime target due to exhaling Co2 and sweating! If you plan on working for a long time, it would be ideal if you could take a break partway to rinse off in the shower, change clothes and re-apply mosquito repellent before going out to work again.

The female mosquito needs to find still standing water to lay her eggs, which can total up to as many as 500 during her lifetime. The water needs to be still for about a week for the mosquito larvae to develop into young adults.

If You Were a Mosquito, Where Would You Look for Still Water?

You’d look for still water in the alley — discarded car tires are the best mosquito hatchery ever devised. Or maybe you’d find still water in mud puddles, stopped up drains or gutters, flower pot drip plates or even large upturned magnolia leaves lying on the ground. All are ideal locations for mosquito reproduction. Think like a mosquito and drain the water from these areas at least once a week.

If you can’t drain the water for some reason (like a rain-barrel collecting water from your gutters example), consider some other options:

  • Buy a couple of goldfish who will gladly eat the larvae that hatch
  • Add a pump and fountain to make the water flow
  • Use non-toxic mosquito ‘dunks’ in the water
  • Add a little vegetable oil to the the surface of the water to prevent mosquito larvae from hatching

Concerned About a Mosquito Bite? Give Dr Brewton a Call for an Appointment

It’s hard to avoid getting bitten by mosquitoes even with these tips from the CDC. So if you have a concern about a mosquito bite, call us at (713) 529-9224 and schedule a same day doctor appointment. We are open Monday through Friday from 8:30 a.m. to 5 p.m.

As always, if you are having an urgent medical emergency, call 911 immediately.