Neurology

Post-stroke cognitive impairment: the hidden challenge of recovery

Conditions
February 1, 2026

When clinicians think about stroke recovery, attention often focuses on motor deficits, speech impairment, and the risk of recurrent cerebrovascular events. Cognitive outcomes, however, are frequently treated as secondary or inevitable consequences rather than primary targets of intervention. This oversight carries consequences. Post-stroke cognitive impairment (PSCI) is common, persistent, and one of the strongest predictors of long-term disability, institutionalization, and caregiver burden, yet it remains under-recognized in routine care.

As acute …

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Genetic mutations and racial disparities in leukemia survival

Conditions
January 30, 2026

Throughout contemporary medical discourse, health disparities among racial and ethnic groups are often attributed to systemic and structural racism. Furthermore, organizations such as the American Medical Association assert that race itself is a social construct and urge a shift away from viewing race as a “biological risk factor” toward a “deeper understanding of racism as a determinant of health.” Unfortunately, this framing rings hollow and obscures an important …

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Psychiatrists are physicians: a key distinction

Physician
December 17, 2025

A new patient recently told me, “I’ve already seen two doctors about this.” She meant a life coach with an online certificate and a therapist with a doctorate in education. Neither was a physician. Neither had examined her, ordered labs, or considered medical causes for her rapid cognitive decline.

When I evaluated her, it was immediately clear she needed urgent neurological workup. She wasn’t suffering from “stress.” She had an early …

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Valuing non-procedural physician skills

Physician
December 14, 2025

No matter the specialty, the best doctors make it look effortless and “easy.” Whether it’s suturing a jagged laceration, reading an MRI spine with multi-level degeneration, or delivering a ten-pound baby with shoulder dystocia, the most skilled physicians can handle it without breaking a sweat. But we know it took many years of training, proficiency, feedback, and improvement to master their craft.

I’m not going to argue that surgical procedures are …

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Alzheimer’s link with insulin resistance [PODCAST]

Podcast
December 11, 2025
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Psychiatrist, internist, and addiction medicine specialist Muhamad Aly Rifai discusses his article, “How insulin resistance may cause Alzheimer’s disease.” Muhamad introduces the paradigm-shifting concept of Alzheimer’s as “Type 3 diabetes,” arguing that …

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Why police need Parkinson’s disease training

Conditions
December 11, 2025

As innovations and changes develop in the police field, new areas and populations, including PwP, must be included. More than 1 million cases of Parkinson’s disease are predicted in the U.S. by 2030. PD is the fastest-growing neurological disorder in the world. According to the World Health Organization, “globally, disability due to PD is rapidly increasing,” which can precipitate more encounters between law enforcement and PwP worldwide. The current article …

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Why not all ADHD generics are created equal

Conditions
November 29, 2025

A 2022 KevinMD article raised concerns about generic formulations of ADHD medications. The author described what many patients and families had already discovered: Not all generics are created equal. For those of us who lived through the substitutions, the difference was not abstract. It was a roller coaster that intruded on daily life, even on vacation.

The generic in question was manufactured by Mallinckrodt. Unlike Concerta, which uses an osmotic-controlled …

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How medical gaslighting almost cost a neurologist her life [PODCAST]

Podcast
November 28, 2025
YouTube video

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Neurologist Carolyn Larkin Taylor discusses her article, “How medical gaslighting almost cost me my life.” Carolyn shares her terrifying personal story of being dismissed by her long-time gynecologist, who labeled her cancer …

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Finding your child’s strengths: a new mindset

Conditions
November 16, 2025

The question “What’s strong with me?” startled me the first time I heard it. Because we direct so many of our day-to-day thoughts to what’s wrong, it can feel odd to ask what’s strong. But this simple question has the power to release the tight hold that problems have on our thoughts and open a new way of thinking. We’ve all had moments when problems seem so big that it’s …

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China’s health care model of scale and speed

Physician
November 15, 2025

Medicine is more than biology; it is organization. Every country builds its system of care according to its culture, economy, and priorities. In Japan, where I have spent the past few years, health care feels like an extension of social rhythm: precise, deliberate, quietly humane. In the United States, where I trained, the emphasis is on innovation and specialization, but often at the cost of coordination. Now, as I prepare …

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A new autism care model in Idaho

Conditions
November 15, 2025

Idaho has become the first state to end Medicaid funding for Applied Behavior Analysis (ABA) therapy. This marks a shift away from concerns about inflated billing and variable outcome metrics toward a model focused on measurable and inclusive care. As a pediatrician who participated in NIMH-RUPP trials and has observed the clinical evolution of ABA, I recognize the significance of Idaho’s decision. The state acted proactively rather than awaiting federal …

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A question about maternal health and the rise in autism [PODCAST]

Podcast
November 13, 2025
YouTube video

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Patient advocate and author Irene Tanzman discusses her article “A mother’s question about PCOS and her son’s autism.” Irene shares her personal journey as a mother to a son with severe autism …

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Why early diagnosis of memory loss is crucial

Conditions
November 13, 2025

Memory loss is one of the most common and anxiety-provoking complaints in medicine. Over the past five years, the evaluation of cognitive decline has become remarkably refined. No longer is memory loss assessed solely to “rule out dementia.” Today, clinicians have tools to detect the beginnings of Alzheimer’s disease or other neurodegenerative conditions before major symptoms appear, allowing patients to make informed decisions about their work, life, and health.

The first …

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Many seizures don’t look like the movies

Conditions
November 8, 2025

When most people think of seizures, they picture someone falling to the ground with violent shaking, the dramatic scenes we’ve seen in movies and television. While these tonic-clonic seizures (previously known as grand mal seizures) do occur, the reality is that many seizures look nothing like what Hollywood portrays. They are often subtle, easily missed, and can be mistaken for daydreaming or unusual behavior.

More than 3 million Americans have active …

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The crisis in modern autism diagnosis

Conditions
November 2, 2025

Autism was never meant to be diagnosed in 15 minutes.

The original vision, born in war-torn Vienna and postwar Baltimore, called for deep observation, multidisciplinary insight, and time. But somewhere between the ideal and the insurance code, we lost the standard.

Today, families navigate a system built for speed, not truth. And children pay the price.

The ideal vs. reality

In theory, pediatricians perform routine developmental surveillance. Screenings like the M-CHAT happen at 18 …

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Expanding Parkinson’s care: a new universe for patients, caregivers, and clinicians [PODCAST]

Podcast
October 27, 2025
YouTube video

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Neurologist Ray Dorsey discusses the article “Expanding the Parkinson’s universe of care for patients, caregivers, clinicians, and communities.” In this episode, Ray reimagines Parkinson’s care through a cosmic analogy, with patients as …

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Why our health system fails chronic disease patients

Conditions
October 20, 2025

John, a man in his early sixties, waited nine months to see me about memory problems. When he finally arrived, I had twenty minutes. Eighteen went to detective work, extracting fragments of history from conflicting accounts, piecing together months of decline from unreliable memories, and completing a paper-based subjective memory test. What should have been a full consultation of patient-focused care, was reduced to only a few hurried minutes at …

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The danger of calling medicine a “calling”

Physician
October 19, 2025

The idea that medicine is a “calling” has been entwined deeply within our profession. From white coat ceremonies to recruitment posters featuring smiling doctors holding stethoscopes, we are told that to enter medicine is to answer a higher purpose. This framing is powerful. It inspires loyalty, fuels commitment, and builds identity. That is how the brainwashing begins as it also hides a dangerous truth: Labeling medicine as a calling has …

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The weight of genetic testing in a family

Physician
October 17, 2025

An excerpt from Held Together: A Shared Memoir of Motherhood, Medicine, and Imperfect Love.

Scott and I held hands as the last few minutes of waiting expanded to rival the anticipation of the days that had already passed. Two weeks ago at this same medical center, our perinatologist had performed a chorionic villus sampling, the procedure to collect the fragment of placenta that would determine our course. I had been …

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