Conditions

A patient’s resilience and the challenge of dialysis

Conditions
October 14, 2023

After she developed a serious complication, she wanted to know the facts plainly stated. I told her the treatment would change her quality of life; it would be hard but doable. To this, she replied, “Now, don’t bullsh*t me, I don’t like bullsh*tters.”

These words were uttered by my resilient, 75-year-old patient undergoing peritoneal dialysis. She had recently developed one of the most dreaded complications of this treatment: calciphylaxis.

Her strong will …

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Fruit and sugar: Debunking the myths

Conditions
October 13, 2023

On many occasions, patients have asked me whether it’s OK to eat fruit. They’re worried about whether they should be eating foods high in sugar. Is fruit in that category? No, it is not. Does anyone really believe that fruit is what’s causing the paired epidemics of diabetes and obesity? This scourge is not being caused by fruit.

Let’s think about this. As long as the sugar in the food you …

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COVID vaccines and weight loss medications: a tale of 2 needles

Conditions
October 12, 2023

I am perplexed by two different needles which, when viewed together, illustrate the irrational themes which dominate our shared humanity. They inform me that, despite being a doctor for more than twenty years, I honestly feel dumber each day about human behavior. If, unlike me, you have somehow figured out more along the way, good for you.

The first needle which vexes me was the one stuck in my arm on …

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I’m a neurosurgeon. Social media may change your kid’s brain.

Conditions
October 11, 2023

A 2023 study of middle school-aged children laid out some alarming findings. Scientists recruited more than one hundred and fifty children, all aged twelve, from rural North Carolina public schools. The children were surveyed regarding their social media usage, including Facebook, Instagram, and Snapchat. Some of the kids rarely checked social media (one time or less per day), while others were glued to their screens, checking social media more than …

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Will Kaiser Permanente see a spike in medical malpractice from the strike?

Conditions
October 9, 2023

The Kaiser Permanente strike, with over 75,000 impacted employees, is the largest health care strike in the history of the United States. CNN reported that the affected workers are represented by a coalition of unions across California, Colorado, Oregon, and Washington and Oregon.

The strike, which is intended to last four days and involves 40 percent of Kaiser Permanente’s staff, could deeply impact patient care. The reality …

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Don’t put off medical care: X-ray for minor knee pain finds tumor

Conditions
October 6, 2023

My fiancée had been complaining on and off about minor knee pain and swelling for months. She kept putting off doing anything about it, because she’s a former college basketball player who had already had two surgeries on that knee, and she assumed it was residual effects from those injuries. But I was having a slow day in clinic, so I told her to come in for an X-ray.

And then …

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The role of institutions in medical misconduct

Conditions
October 6, 2023

There are no words more devastating than, “Our hands are tied” to a survivor reporting abuse and seeking some semblance of accountability from a larger institution. “The institution admitted no fault” is a close second.

Picture this sequence: a trusted physician at a renowned academic medical center sees a patient at a vulnerable stage in her life for a regular appointment. As she is exposed for a standard physical exam, he …

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What is the physician’s role in the food is medicine movement?

Conditions
October 4, 2023

In the early 1990s, complementary and alternative medicine (CAM) began its rise with the development of the National Institutes of Health’s CAM center. However, scientists and clinicians struggled with the decision of whether or not to allow individuals access to information on these CAM approaches. I was part of that discourse as I was invited to speak at a congressional hearing on that very issue. Thankfully for everyone, the right …

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America’s young men are facing a mental health crisis. Can we help them before it’s too late?

Conditions
October 4, 2023

September was National Suicide Prevention Month. In a short while, we also approach the 41st birthday of the late Stephen “tWitch” Boss, a widely beloved dancer and executive producer of The Ellen DeGeneres Show whose death by suicide is still hard to grapple with

tWitch, who initially rose to prominence from the dance competition So You Think You Can Dance, captured the hearts of millions by running social media …

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Communication, power dynamics, and organizational culture in health care

Conditions
October 2, 2023

In a recent podcast conversation with Kevin Pho, MD, we talked about the importance of assertiveness in health care, including the ability to say “No” and the significance of culture in supporting it.

One of the topics we touched on was the influence of both top-down and bottom-up factors, which I want to elaborate on here.

Organizational culture refers to how and why things are done at work and the rules …

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Everyday dangers unknowingly impacting our health

Conditions
October 1, 2023

When we think of symptoms or ailments, they are often a signal to us that there’s something off with our health. Yet, many of us, as well as doctors, often don’t think so much outside the traditional box when it comes to what may be influencing or causing these health issues. I have even experienced this personally in my life.

Some people may even experience ongoing frustrations with concerns failing to …

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A shop teacher’s daughter on transforming patient safety

Conditions
October 1, 2023

Just a few weeks ago, the President’s Council of Advisors on Science and Technology (PCAST) issued a report, “A Transformational Effort on Patient Safety.” This was both a “surprise” and “not a surprise” to me because I’m a nurse, a subject matter expert in patient safety, and a shop teacher’s daughter.

PCAST’s call for action was not a surprise because in 2023, care intended to help patients harms them at an …

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What happened to the chemical pathologist?

Conditions
October 1, 2023

During my early years as a pediatric hospitalist in the U.K. during the ’80s, a figure that loomed large was the chemical pathologist (CP).
The CP was the guardian of the laboratory, and every hospital had one. This fearsome beast was approached with trepidation, as the outcome was likely to be a unique but bruising “educational experience.”

Interaction was common because almost every lab test apart from the CBC, ESR, chem 20, …

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A teenager’s perspective: the pressing need for mental health days in schools

Conditions
September 29, 2023

Mental health in children and teens is worsening, and there are not enough providers to support them. This is a cause for significant concern.

As a teenager who has experienced firsthand the challenges of maintaining positive mental health amidst a demanding school environment, I strongly advocate for the inclusion of mental health days as a means to support the well-being of students nationwide. May has been observed as …

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The art of pediatrics: Connecting through observation

Conditions
September 29, 2023

On my first day of inpatient rounds during intern year, I was taken aback when the attending stated, “Let’s stop outside the room and just spend a few moments watching the child and mom.” I started my residency on my community rotation site in Chester, PA, where several of the Philadelphia training programs at that time were sending residents. It was a nice introduction to pediatrics with a smaller inpatient …

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CME Spotlights