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Retired emergency department nurse Amy Dinaburg discusses her article “Lowercase PTSD: Why emergency staff are still hypervigilant.” Amy reflects on the relentless pressure of the COVID-19 pandemic where nurses were forced to …
Emergency nurses struggle to turn off survival mode after the pandemic [PODCAST]
In the hallowed halls of medical school, we are often screened for traits that make the “ideal doctor”: high empathy, meticulous perfectionism, and a profound sense of duty. We are the fixers, the ones who find deep meaning in the intersubjective space between healer and patient. Yet, there is a shadow side to this personality architecture that no one talks about, an underlying proclivity toward rejection sensitivity.
The very traits that …
Why perfectionism in medicine leads to moral injury
“Let’s Fly.” Captain Burnham’s words on the USS Discovery were more than a command. They were a declaration of trust, of forward motion, of refusing paralysis.
That is the question before us now: What happens when children with disabilities grow up?
For decades, pediatrics treated disability as a childhood condition. The grant language, the fellowship training, the systems of care, all built on the assumption that disability ends at eighteen. But children …
Adult disability care transition: Why medicine must grow up
For decades physicians have dreamed of a simple technological solution to one of modern medicine’s most corrosive burdens: documentation. The electronic health record promised efficiency but delivered something quite different: extra burden. Physicians now spend hours each evening completing notes, clicking boxes, and reconciling fields, what has become known as “pajama time.” The keyboard has often replaced eye contact. The screen has displaced the patient. Ambient AI scribes arrived with …
The hidden risks and rewards of AI scribes in medicine
For years we have searched for the causes of aging inside the cell. Researchers study mitochondrial dysfunction, DNA damage, and the accumulation of senescent cells. But the real bottleneck in aging may not lie inside the cell at all. It may lie in the system that keeps those cells alive. During my years working in emergency medicine, I often saw patients whose blocked coronary arteries had been successfully opened during …
How the microvasculature drives the human aging process
Anyone that has suffered a herniated disc knows that the road to recovery can feel like a spiritual journey. The searing pain can be so extreme that it leads us to prayer. We may even question the very design of the human body. Why would an all-powerful, wholly good Creator of the Universe endow man with the capacity to experience so much agony? To fear the electric jolt caused by …
Herniated disc recovery: a physician’s personal journey
In medical school, we only learn a fraction of what we need to know to succeed as doctors. The rest, we learn serendipitously through role modeling, trial and error, and other venues. Without luck, however, we may not learn these factors at all. It turns out that unspoken forces, the so-called “hidden curriculum,” may have a greater impact on our personal and professional outcomes than most people realize. As educators …
The hidden curriculum: What medical school does not teach you
Since 2023, while volunteering at an amputee sports competition in Los Angeles, I encountered athletes whose amputations resulted from complications of diabetes. In many cases, limb loss did not begin with a catastrophic injury, but with gaps in preventive care that allowed small, manageable wounds to progress into irreversible outcomes.
Participants traveled long distances to attend the competition, seeking peer support and health information that was often unavailable in their home …
Diabetic foot complications prevention: Stopping amputation before it starts
As a nutritional scientist and educator, I spend a lot of time thinking about the heart through a lens of physiology, metabolism, and medicine. I aim to reduce risk for cardiovascular disease by sharing evidence-based nutritional strategies. As a human, I realize an equally dangerous health risk can begin in one’s emotional heart. We are hardwired for connection. In this regard, the heart seems simultaneously the strongest and most fragile …
The physiology of heartbreak: hormones, ischemia, and healing
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Internal medicine and functional medicine physician Shiv K. Goel discusses his article “Agentic AI in medicine: the danger of automating the doctor.” Shiv analyzes the new ARPA-H “ADVOCATE” program which aims to …
Autonomous AI agents could strip the soul from medicine [PODCAST]
Modern health care works tirelessly to treat illness and save lives, yet it often intervenes after disease has already taken hold. The system prioritizes acute treatment over prevention, despite overwhelming evidence that early intervention and public health strategies save more lives, earlier, and at far lower cost. While dramatic rescues capture attention, the quieter work that could prevent disease is often underappreciated, leaving patients and communities to face preventable health …
The hidden cost of ignoring public health infrastructure
Patients ask me about supplements every week. They bring bottles from Amazon, health food stores, podcasts, and social media. They want something natural. They want something gentler. They want something they can buy without asking permission. I understand the instinct. Psychiatric medications have side effects, cost, stigma, and disappointment. But the supplement aisle is not a sanctuary. It is a marketplace that could turn dangerous.
That matters because supplements in the …
The truth about psychiatric supplements and mental health
Every year on March 14, mathematicians celebrate Pi Day. The constant π (approximately 3.14) describes the ratio between a circle’s circumference and its diameter. It represents perfection in geometry. But in clinical life, health rarely looks like a perfect circle. I was reminded of this while speaking with Mrs. Chen at a community health program. She was 78 years old. By most medical standards, she was doing well. Her blood …
Rethinking health care for older adults beyond lab results
A false accusation or unfair allegation can destroy a doctor long before any court delivers a verdict. That is the part the public rarely sees. A charge alone can shatter a medical career. It can trigger suspension, isolation, gossip, media exposure, loss of referrals, financial collapse, and permanent reputational injury. In many cases, the accusation becomes the punishment. The acquittal verdict arrives later. By then, the damage is already carved …
Why false accusations against doctors destroy careers
Despite an ongoing shift in medical training across the country to enhance physician communication skills, there remains limited formal training communicating with patients who have tracheostomies. With over 100,000 tracheostomies performed every year in the United States, clinicians in every field will encounter patients who have individualized communication needs. These patients often experience isolation, depression, and anxiety due to an inability to interact and communicate with others. Clinicians can and …
Tracheostomy communication barriers: a gap in medical training
Dental anxiety remains one of the most common yet overlooked barriers to oral health care. Despite advances in modern dentistry (painless techniques, improved anesthetics, and patient-centered care), millions of people continue to delay or completely avoid dental visits because of fear. The consequences extend far beyond oral health; untreated dental disease can significantly affect overall health, confidence, and quality of life. For many patients, dental anxiety begins early in life. …
Overcoming dental anxiety for better oral health care
“Oh, poor thing!” exclaimed Dr. S, shaking her head in empathy.
“It is very sad,” I chimed in.
Lalita lay on the operating table. A sterile green cloth hung perpendicularly, separating her, the patient, from Dr. S and me, the operating surgeons.
She was undergoing her first cesarean section in view of fetal distress.
It was indeed very sad. Not the cesarean part, but the fact that her husband had passed away when she …
Tubal ligation and widowhood: Navigating toxic requests
An excerpt from Lessons Learned: Stories from Dual Physician Marriages, published by the American Association for Physician Leadership (AAPL), is available in print and eBook at Amazon and the AAPL bookstore.
How do two people build a strong marriage while both are practicing physicians? Medicine is demanding, and marriage can be too. Plenty has been written about how those pressures can strain relationships, but far less …
Dual physician marriage: stories of love and partnership in medicine
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Pediatrician and certified coach Jessie Mahoney discusses her article “Why physician wellness programs must evolve beyond institutions.” Jessie reflects on her seventeen years leading in-house wellness initiatives and argues that while institutional …
Wellness requires safe spaces outside the medical system [PODCAST]
I just signed my first attending contract.
It should feel like pure celebration. Mostly, it does. But it is also a moment that forces reflection. For first-generation physicians, the hardest part of the journey often is not medical school or residency. It is learning how to navigate what comes after, inside systems we were never born into.
You are just as capable, compassionate, and prepared as anyone else. You have worked harder …
First-generation physician: Navigating the first attending contract
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