I never thought much about my kidneys. I felt fine, I stayed active, and at 74 years old, I figured I was in pretty good shape. But kidney disease has a way of sneaking up on you. By the time most people find out they have it, they’re already in trouble. That could have been me—but thanks to the right care at the right time, I got a transplant before …
How early care saved my life from silent kidney disease
When I turned 50, I weighed 265 pounds. Over the next 12 years, through walking, yoga, and strength training, I lost 60 pounds and kept it off. But despite the discipline, I remained plagued by inflammation, pain, and sleep apnea.
Then last year, my doctor suggested tirzepatide (Zepbound), not just for weight loss but to treat my sleep apnea as well. That alternative diagnosis unlocked insurance coverage and led to a …
Why GLP‑1 drugs should be covered beyond weight loss
As a urologist, I see recurrent UTI patients nearly every day, and most cases are routine: nasty bacterial infections that appear in the bladder every few months. However, a recent patient turned out to be the zebra rather than the horse. This particularly lovely woman was 91, an Italian immigrant, and was accompanied by her adult son, who helped provide history and translate as needed. She sat calmly on the …
When recurrent UTIs might actually be bladder cancer
As a cardiologist in New York City who treats a sizable Bangladeshi‑American community, I have witnessed otherwise healthy individuals exhibit concerning cardiovascular events, frequently in the absence of conventional risk markers. What unites them? Severe, protracted psychological stress brought on by prejudice, family court disputes, immigration problems, or financial instability.
The mechanisms of prolonged stress
Prolonged stress raises cortisol, adrenaline, and inflammatory cytokines via activating the sympathetic nervous system and hypothalamic‑pituitary‑adrenal (HPA) …
How chronic stress harms the heart in minority communities
Coronary artery disease is still the world’s number-one killer.
That’s despite statins, PCSK9 inhibitors, stents, bypasses, and decades of lifestyle messaging.
We’ve gotten better at managing heart attacks, but we haven’t cured heart disease. Or prevented it. Or even figured out exactly what causes it.
As an internist and lipidologist (in recovery), I spent years chasing cholesterol numbers, especially HDL. I gave talks for Abbott. I pushed niacin like it was salvation. Then …
Could antibiotics beat heart disease where statins failed?
American medical schools and universities once led the world in biomedical discovery, in large part due to federal funding. Public investment in science helped eradicate polio, unlock the human genome, and develop life-saving treatments for diseases once considered death sentences. But that era of reliable federal funding is ending under the current White House administration – and America’s research enterprise is at risk of going with it.
Over the past decade, …
Universities must tap endowments to sustain biomedical research
I’ve worn many hats in my medical career—lab technician, Physician Assistant, Army Captain, and teacher. But no matter where I’ve served, one truth has followed me like a shadow: The most effective medical learning doesn’t happen in a classroom. It happens beside a patient, with blood pressure cuff in hand, chart under arm, and a mentor who knows when to step back and let you try.
The most powerful educational model …
Apprenticeship reshapes medical training for confident clinicians
As doctors, we often tend to focus on solving the problem at hand. We identify the issue, make a diagnosis, and try to treat the condition to the best of our capabilities. And in this pursuit to achieve our textbook level of homeostasis, we often forget that it is the patient who requires us. As rightfully pointed out in the posters outside the palliative care center, sometimes we may encounter …
Why palliative care is more than just end-of-life support
I have always despised the trope of the patient who pulls through against all odds, despite all evidence to the contrary. Yes, diagnoses can shift and treatment plans evolve, but the ultimate trajectory rarely strays far from the original suspicion. Still, I understand why those stories resonate.
As a resident, I cared for a teen who got a night off from treatment to get married, and another who went to prom …
My improbable survival of stage 4 cancer
Sunlight is essential to life. It stimulates the production of Vitamin D, a hormone that plays a crucial role in bone health, immune function, and possibly the prevention of several chronic diseases. Sun exposure also influences our circadian rhythm, improves mood through serotonin regulation, and has been linked to better mental health outcomes, including reduced risk of Seasonal Affective Disorder (SAD).
In moderation, sunlight can be deeply beneficial, especially in populations …
The truth about sun exposure: What dermatologists want you to know
“Are you going to be wearing a white skirt and a hat from now?”
That was one of the first things I heard when I told relatives I had been accepted into nursing school. It was a joke — at least that’s how it was delivered. But the meaning behind it wasn’t funny.
In my South Asian community, nursing is seen as women’s work — important, but low-status. For a man to …
How a South Asian nurse challenged stereotypes in health care
The question is not where one is born, because birthplace—whether a country or continent—is never chosen by oneself, but always determined by others and the surrounding environment.
Nor is the question where one lives, because even though the place, country, or continent may seem self-chosen, it is often influenced or guided by others and external circumstances.
The real question is where one belongs, because the feeling of belonging—to a place, country, or …
Could ECMO change where we die and how our organs are donated?
We are informed by the Spanish-American philosopher, essayist, and poet George Santayana, that “those who cannot remember the past are condemned to repeat it.”
That has never been my problem.
I grew up immersed in family stories from both parents — some of them true, and some not so accurately remembered. Starting at about age three with Little Golden Books that my mom bought for a nickel each at local thrift stores, …
From Civil War tales to iPhones: a family history in contrast
In July 2017, 24-year-old mother Lucero Garza sought a natural diet pill to aid in her journey to lose weight gained after pregnancy. Without consulting a doctor, Garza bought the supplement’ Avitia Cobrax’ via Facebook. While the supplement was marketed as a natural remedy, its effects were anything but remedial. After consuming the product, Garza began experiencing severe headaches and ultimately fell into a coma. Tragically, she passed six …
The hidden dangers of over-the-counter weight-loss supplements
“Doctor, it’s not my portion. I don’t have hypertension,” she said confidently, shifting her wrapper and returning my gaze like I had just accused her of something terrible.
The blood pressure monitor read 170/120 mmHg. I had just measured it myself twice, yet here I was, facing a patient who flat-out refused to believe her numbers.
She was a middle-aged woman who came in complaining of a headache and body weakness. She …
How denial of hypertension endangers lives and what doctors can do
Imagine a family physician who works 12-hour days packed with complex cases and endless paperwork. They may skip meals, miss their child’s recital, and stay late to finish charting. Patient care feels rushed, and the physician begins to feel emotionally numb and irritable. Driving home exhausted, the doctor wonders if medicine was the right career choice! A physician’s role is considered a calling, and when it starts to feel like …
How physicians can reclaim resilience through better sleep, nutrition, and exercise
It is a question that has stopped more than a few of my physician clients in their tracks: Who are you outside of the white coat?
I do not mean your hobbies, though yes, of course those matter. I mean your identity. Your core sense of self when you strip away the pager, the patient lists, the provider ID, and even the deeply ingrained instincts to care, to fix, to achieve. …
Who are you outside of the white coat?
Medical errors happen every day, and patients are being harmed in hospitals. Despite years of tracking and reporting outcome-based quality measures, preventable harm remains widespread, prompting the Centers for Medicare & Medicaid Services (CMS) to launch the Patient Safety Structural Measure (PSSM). This measure, released in August 2024, focuses on structural and cultural root causes of harm rather than just retrospective results of quality improvement initiatives.
In our consultancy practice, we’re …
How hospitals can prepare for CMS’s new patient safety rule
For decades, you were told that whole milk was the devil in a glass. Doctors (including me), dietitians, and public health agencies told you to toss the red cap and grab the blue — skim, 1 percent, or 2 percent milk. Why? Because whole milk had fat. And fat, particularly saturated fat, was supposed to clog your arteries like grease in a kitchen drain.
Except we were wrong.
The fat in whole …
The truth about fat in whole milk and your health
About a month ago, I developed a very sudden and alarming skin condition—clusters of painful, itchy bumps that quickly spread across my arms, legs, and chest. At first, I was not overly worried. I made an appointment with my primary care physician, expecting answers. But the exam was brief—she took a cursory glance and speculated it was an allergic reaction. To her credit, she didn’t jump to conclusions. She snapped …
Why primary care needs better dermatology training
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