Conditions and Diseases

Physicians writing on KevinMD about the diseases they treat and the people who have them: cancer and its screening arguments, pain and the drugs that treat it, diabetes and the obesity argument, mental illness and who gets treated for it, and the decisions at the end of a life. Five maintained records draw on this archive: Cancer: what physicians say, in their own words, Opioids: what physicians and pain patients say, in their own words, End of life: what physicians say, in their own words, Diabetes and obesity: what physicians say, in their own words, and Mental health: what psychiatrists and physicians say, in their own words.

High-functioning codependency is quietly draining doctors

Sarah Bergakker, CRNA

July 20, 2026

A colleague recently recommended licensed clinical social worker Terri Cole’s book Too Much after seeing a quote I shared on social media about no longer accommodating people who refuse to take responsibility for their own emotional work. Her timing was remarkable.

As I read, I felt as though Cole had somehow studied the way I lived for much of my life. I recognized the constant monitoring of other people’s emotions, …

Why the digital rectal exam fails prostate cancer screening

Paul Dranichnikov, MD, PhD

Conditions and Diseases

July 20, 2026

For decades, the digital rectal exam (DRE), the traditional “finger test,” has been a routine component of prostate screening. It is quick, inexpensive, and engrained in medical culture. But the question is no longer whether we can do it. It is whether we should. With PSA testing, advanced imaging, and refined risk stratification, routine DRE in asymptomatic men is increasingly indefensible.

Low sensitivity and limited value

Recent studies show that DRE has …

The harm reduction debate isn’t exchange or nothing

Del Carter, MD

Conditions and Diseases

July 19, 2026

Needle exchange programs are one of the most well-known, and subsequently most controversial, forms of harm reduction in addiction medicine. These programs provide clean needles and/or syringes for drug users, often in exchange for used needles, in efforts to curb the unsanitary reuse of needles and subsequently decrease the spread of infectious diseases such as hepatitis and HIV. Needle exchange programs, on their own, have been shown to decrease …

The PCOS diagnosis gap medical schools must close

Aislinn Jones

Conditions and Diseases

July 19, 2026

“Guess what? I have PCOS,” was not what I expected to hear over the phone when catching up with a college friend the summer before my second year of medical school. Even more puzzling to me was the story of how she got her diagnosis. She relayed the saga of an intrauterine device placement gone wrong, infection-induced psychosis, and severe menstrual bleeding and pain. Following an extensive workup, she was …

Why medication access fails even the best-case patient

Alexandro Vasquez, DNP, APRN, PMHNP-BC

Conditions and Diseases

July 19, 2026

A medication was recommended to me a week ago. It still has not reached me. I prescribe medications for a living. I know where an order can stall: awaiting a signature, sent but never received, delayed by an authorization, or routed to a pharmacy without stock. I know whom to call and what to ask.

None of that has moved my prescription. There is no one covering the service, so it …

When fragmented care misses pancreatic enzyme insufficiency

Sheila Crow, PhD

Conditions and Diseases

July 19, 2026

I spent thirty years in academic medicine as a dean for faculty affairs and development, training physicians to be not just clinically competent but genuinely patient-centered and thorough. I believed in the system I helped build. I still do, mostly. But I am also a patient. And as a patient, the system failed me for fifteen years, not through negligence, but through something quieter and harder to fix.

Fragmentation.

The history

In 2005 …

What bull riding taught me about sports medicine gaps

Ann Lebeck, MD

Conditions and Diseases

July 19, 2026

It was our first night at a bull riding event, Shoot Out Arena in Tombstone, Arizona, an August night, and I had no idea yet what any of this actually looked like up close.

We were sitting beside the chutes in the VIP section. The rider gave the nod, the gate swung open, and the clock started. Bull and rider came out together …

Smile confidence is a real mental health concern

Kambiz Kamangar, DDS

Conditions and Diseases

July 18, 2026

A patient once sat in my chair with her hand covering her mouth mid-conversation. She wasn’t cold. She wasn’t shy. She was ashamed of her smile, and that shame had quietly shaped nearly every social interaction she’d had for years.

In over eighteen years of dental practice, I’ve seen this pattern more times than I can count. Patients come in for a clinical procedure, but what they’re really carrying through the …

Oral health literacy is the barrier we rarely name

Daria Buinevich, DDS

Conditions and Diseases

July 17, 2026

During my years in dentistry, I often noticed something that extended far beyond clinical care. Many people were not ignoring their oral health because they did not care. They were making decisions based on incomplete, confusing, or inaccurate information.

Some believed that bleeding gums were normal. Others assumed that dental visits were only necessary when pain appeared. Many did not realize that everyday habits, such as frequent consumption of sugary drinks …

The ceramic tree that got me through residency

Loretta Cody, MD

Conditions and Diseases

July 17, 2026

Being a doctor is hard.
Becoming a doctor is hard.
The hours are tough.
The days are tiring,
and the nights are tiring.
Missed holidays with family are difficult.
The exhaustion is palpable.
The insecurity in your ability is real.
The sadness about sick patients is human.
It seems obvious that it might become overwhelming.
What happens when you are faced with this?
Reach out.
Reach out to anyone and everyone.

Years ago, as an intern in pediatrics, the hours, fatigue, and on-call …

When doctors don’t believe you, you’re on your own

Rachel Weaver

Conditions and Diseases

July 17, 2026

An excerpt from Dizzy: A Memoir.

Two days later, in the nurse practitioner’s office, she said, “Here, take a look at the X-ray.” On the backlit screen, she hung up the butterfly image of my torso and I wanted to yank it down immediately. I had always been so strong, so independent, and here was proof that I was nothing but whispery, small bones, the rest of my body fading …

It isn’t physician burnout. It’s erosion.

Cynthia McPherson, DSc, PA-C

Conditions and Diseases

July 16, 2026

I understand why clinicians kill themselves.

That’s not a dramatic opening. It’s a fact I’ve carried for years, one that most people in medicine understand but rarely say out loud, because saying it feels like an indictment of something we gave everything to.

And yet here we are. Still losing people. Still calling it something it isn’t.

The word everyone reaches for is “burnout.” It’s on hospital posters, in wellness newsletters, in keynote …

Lead apron management is a logistics problem ignored

Adwait Chafale

Conditions and Diseases

July 16, 2026

Every day, thousands of health care workers put on lead aprons before stepping into imaging suites, fluoroscopy rooms, and interventional radiology labs. These garments, unglamorous, heavy, and easy to overlook, are the last line of defense between clinical staff and the cumulative effects of ionizing radiation. According to the World Health Organization, repeated exposure to radiation can lead to skin and blood damage, cataracts, infertility, congenital disabilities, and cancer. …

What Lindsey Graham’s death reveals about aortic dissection

Laurel A. Coons, PhD

Conditions and Diseases

July 16, 2026

Senator Lindsey Graham died on Saturday, July 11, at his home in Washington, D.C., at 71. Emergency responders had been called to his home for a cardiac arrest. His office initially described only a “brief and sudden illness”; the next day it released preliminary findings from the District’s chief medical examiner: aortic dissection due to arteriosclerotic cardiovascular disease.

Nothing in the public reporting suggests Graham’s care was delayed or that anyone …

Needle exchange programs treat the symptom, not the disease

Del Carter, MD

Conditions and Diseases

July 15, 2026

We can rewrite DNA but not deliver it in time

Shaan R. Mody

Conditions and Diseases

July 15, 2026

She was seven months old when her parents first noticed it. Not the peaceful stillness of sleep, but something heavier. Her arms, which had once reached for hanging toys, had grown quiet. Her head, once held with the wobbly determination of a healthy infant, began to drift. The milestones that seemed to be arriving suddenly began moving in reverse.

Weeks later, a child neurologist delivered the diagnosis: spinal muscular atrophy type …

When a DNR order becomes a legal liability

Teddy A. Teddy, MD

Conditions and Diseases

July 14, 2026

A 78-year-old Black woman with advanced heart failure is admitted with shortness of breath. Her admission order set: full code. The next day, after a brief family conversation, a resident changes the order to DNR/DNI. No note explains the discussion. Two days later, she goes into cardiac arrest. The code team hesitates, then proceeds based on an outdated full code order still visible in the chart. The family later sues, …

When a hit medical drama glorifies physician burnout

Farid Sabet-Sharghi, MD

Conditions and Diseases

July 14, 2026

I have spent the last few weeks watching a popular television drama set in a chaotic urban emergency department. After more than three decades of practicing psychiatry, I did not expect a network drama to affect me this way. It has felt like a strange form of therapy, vividly resurrecting the ghosts of my formative years and bringing back the exhausting, exhilarating days of medical school and my time as …

How doctors die differently than the rest of us

Mindy Leake, DNP, PMHNP-BC

Conditions and Diseases

July 13, 2026

When my father was diagnosed with terminal brain cancer, I made him a promise. I told him I would not let him die in a hospital.

I had been an ICU nurse for years by then. I knew what dying in a hospital looked like. The fluorescent lights. The strangers in scrubs. The machines making noise at 3 a.m. The family members standing in hallways being asked to make decisions they …

How to stop fighting with the people you love

Kayvan Haddadan, MD

Conditions and Diseases

July 13, 2026

We all bump into conflicts, whether at home with our partner or kids, or at work with colleagues. Many of these fights feel necessary in the moment but turn out to be exhausting and pointless. The good news? A few ideas from Immanuel Kant, mixed with a dash of Stoic wisdom and a clear-eyed look at how humans actually work, can help dial them down.

Kant pointed out something fundamental in …