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It was created by enthusiast Josh Kesselman

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And I run through the rolodex of childish explanations people give about smoking, each as pathetic as loving Catcher in the Rye too much past the age of 19

I think we thought it was smoke, not steam

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[30] A summit in 2018 called "Populating the Native Health Care Workforce with American Indian and Alaska Native Physicians: Moving the Needle on Quality of Health Care in Indian Country" gathered tribal leaders, IHS administrators, and medical school leaders to find barriers and come up with solutions to low Native American provider rates