I have spent over two decades treating bariatric patients, and one of the most frustrating clinical situations I encounter is this: A patient sitting across from me who has done everything right. They are hitting 75 grams of protein a…
I have spent over two decades treating bariatric patients, and one of the most frustrating clinical situations I encounter is this: A patient sitting across from me who has done everything right. They are hitting 75 grams of protein a day. They are tracking every gram. They are bringing their food logs to every appointment. And they are still losing hair, losing muscle, and showing up with low labs.
Something is happening in women's health care. Perimenopause is finally being discussed openly. Vaginal estradiol has entered mainstream conversation. Testosterone therapy for women is no longer confined to niche clinics or whispered discussions. Across medicine and social media alike, women…
Something is happening in women’s health care. Perimenopause is finally being discussed openly. Vaginal estradiol has entered mainstream conversation. Testosterone therapy for women is no longer confined to niche clinics or whispered discussions. Across medicine and social media alike, women are asking new questions about tissue health, sexual function, intimacy, discomfort, sensation, and quality of life. And perhaps more importantly, they are no longer accepting silence as an answer.
Recently, a California jury found the tech giants Meta and Google guilty for the depression and anxiety which ensued in a young woman following her compulsive use of social media. The court found the corporations liable for features that cause…
Recently, a California jury found the tech giants Meta and Google guilty for the depression and anxiety which ensued in a young woman following her compulsive use of social media. The court found the corporations liable for features that cause children to become addicted to the platforms and that it results in the aforementioned mental health distress. Many are calling this ruling social media’s tobacco moment, citing parallels …
Health care-associated infections (HAIs), including Clostridioides difficile infection (CDI), Candida auris, and multidrug-resistant organisms (MDROs), persist as significant challenges for U.S. hospitals despite advancements in infection management, environmental cleaning, and isolation protocols. These infections pose a huge threat to patients…
Health care-associated infections (HAIs), including Clostridioides difficile infection (CDI), Candida auris, and multidrug-resistant organisms (MDROs), persist as significant challenges for U.S. hospitals despite advancements in infection management, environmental cleaning, and isolation protocols. These infections pose a huge threat to patients and health care staff. But at the bedside, there is one persistent issue that seems more overwhelming and messier than other protocols dealing with fecal incontinence in critically ill patients …
I sometimes find myself reflecting when my well-cited journal articles begin to show a decline, whether gradual or sudden. In academic medicine, citations have become a form of currency, used not only to trace ideas but also to measure worth.…
I sometimes find myself reflecting when my well-cited journal articles begin to show a decline, whether gradual or sudden. In academic medicine, citations have become a form of currency, used not only to trace ideas but also to measure worth. Yet what gets cited is not always what matters most. In biomedical research, citations support arguments and help measure impact. In principle, they show how knowledge develops over time. In …
Whether parent coaching is getting delivered formally, through parent behavior training programs, or informally, through evidence-based parenting advice and recommendations shared in clinic with the family, parent coaching has become an essential part of clinical care today, both in general…
Whether parent coaching is getting delivered formally, through parent behavior training programs, or informally, through evidence-based parenting advice and recommendations shared in clinic with the family, parent coaching has become an essential part of clinical care today, both in general and in subspecialized pediatric clinics. The American Academy of Pediatrics (AAP) recommends anticipatory parenting guidance to be provided starting at the first visit. The AAP also recommends that pediatric health …
10 years ago, I met a local news health reporter at my cousin's house. By then, I had been a general surgery attending for almost a decade and was shocked by the lack of public health education about anal health…
10 years ago, I met a local news health reporter at my cousin’s house. By then, I had been a general surgery attending for almost a decade and was shocked by the lack of public health education about anal health care issues. I had also amassed a particularly busy proctology clinic over the years, seeing patient after patient who had suffered for extended periods, afraid to see a doctor and …
Randy McNeely: We are never more vulnerable than in the moments when life delivers news we did not expect, and are not prepared to hear. That moment came for my wife and me in early August 2023. A few weeks…
Randy McNeely: We are never more vulnerable than in the moments when life delivers news we did not expect, and are not prepared to hear. That moment came for my wife and me in early August 2023.
A few weeks earlier, Kimberly was helping our daughter move a small chest freezer when she felt a sharp twinge in her right thigh. It seemed like a pulled muscle, so she treated it …
A little-known and misunderstood disease affecting as many as 12 million Americans, putting them at risk of potentially deadly complications, is often missed or misdiagnosed. Primary aldosteronism (PA) is a serious condition that affects as many as 5 to 10…
A little-known and misunderstood disease affecting as many as 12 million Americans, putting them at risk of potentially deadly complications, is often missed or misdiagnosed.
Primary aldosteronism (PA) is a serious condition that affects as many as 5 to 10 percent of adults with high blood pressure (BP). High BP is widely prevalent in the U.S., nearly half of all adults (almost 120 million individuals) have it. Yet, for many years, …
Thirty years ago, I ran a cardiac arrest in the operating room. The patient survived. The room eventually quieted down. The nurses began cleaning up. People moved on to the next case. But I remember standing there afterward feeling exhausted…
Thirty years ago, I ran a cardiac arrest in the operating room. The patient survived. The room eventually quieted down. The nurses began cleaning up. People moved on to the next case.
But I remember standing there afterward feeling exhausted and unsettled. It had been several months since my ACLS recertification, and during the code I caught myself mentally reaching for details of the algorithm that had once felt automatic. I …
"Can we fit just a few more?" This was the question I was asked one snowy evening. Pretty soon, I found myself surrounded by no less than 20 people. They had all convened here to see the man lying in…
“Can we fit just a few more?” This was the question I was asked one snowy evening. Pretty soon, I found myself surrounded by no less than 20 people. They had all convened here to see the man lying in bed at the center of the room. He had struggled with cancer, which had progressed through numerous treatments, leading to his current intubated and sedated state. As an internal medicine …
"I wish I could get a free boob job." It is a comment I heard more than once after sharing I was undergoing a double mastectomy. I understand the impulse, people do not know what to say. But the joke…
“I wish I could get a free boob job.”
It is a comment I heard more than once after sharing I was undergoing a double mastectomy. I understand the impulse, people do not know what to say. But the joke reveals something worth examining: how little most people understand about what this surgery actually costs you.
At 28, I found out I carried the breast cancer gene 1 (BRCA1) mutation. At 34, …
A high school basketball player lands awkwardly after a fast break. For one second, the gym goes silent. He grabs his ankle. His coach runs toward him. His teammates stop moving. His parents, sitting near the sideline, do not know…
A high school basketball player lands awkwardly after a fast break. For one second, the gym goes silent. He grabs his ankle. His coach runs toward him. His teammates stop moving. His parents, sitting near the sideline, do not know whether to hope he can stand up or pray that he will not try.
In that first minute, no one is thinking about professional titles. The question is painfully simple: Who …
The recent outbreak of hantavirus infection on the Dutch cruise ship MV Hondius raises several questions and concerns. Dutch ornithologist Leo Schilperoord was the first person to die of hantavirus infection on the ship on April 11, 2026. He and…
The recent outbreak of hantavirus infection on the Dutch cruise ship MV Hondius raises several questions and concerns. Dutch ornithologist Leo Schilperoord was the first person to die of hantavirus infection on the ship on April 11, 2026. He and his wife, Mirjam, 69, had recently visited northern Patagonia in Argentina, 1,500 miles north and before boarding the ship at a southern Argentine port. So far there have been eight …
In medicine, patients are often seen as recipients of care rather than contributors to it. But their lived experiences bring something data alone cannot: context, meaning, and truth. Early in my exposure to clinical research, I understood it primarily through…
In medicine, patients are often seen as recipients of care rather than contributors to it. But their lived experiences bring something data alone cannot: context, meaning, and truth. Early in my exposure to clinical research, I understood it primarily through a quantitative lens. Outcomes were measured in numbers: complication rates, recovery times, and statistical significance. These metrics are essential, but they do not always capture what matters most to patients. …
There are few rituals in medicine as aspirational as the 24-hour urine collection. On paper we see an elegant examination. A direct measurement of renal function, grounded in physiology and liberated from the assumptions that plague our estimating equations. In…
There are few rituals in medicine as aspirational as the 24-hour urine collection. On paper we see an elegant examination. A direct measurement of renal function, grounded in physiology and liberated from the assumptions that plague our estimating equations. In practice, however, what we see is a plastic jug and a set of instructions that compete poorly with daily life. What we are left with is a quiet understanding, shared …
In New Orleans, shoppers often request "lagniappe," pronounced lan-yap, to express their desire for something extra, the baker's dozen, a 13th donut. Added benefit was a major topic of interest for the 500 participants in the combined International Early Lung…
In New Orleans, shoppers often request “lagniappe,” pronounced lan-yap, to express their desire for something extra, the baker’s dozen, a 13th donut. Added benefit was a major topic of interest for the 500 participants in the combined International Early Lung Cancer Action Program (IELCAP), International Early Lung Cancer and Respiratory Tract (IELCART), and AGILE 3 conferences held March 19 to 21, 2026, in Gdansk, Poland. Although this topic ranged freely …
Last year, I saw a teenager in the emergency department (ED). He was 15, and his mother brought him in after finding a vape in his backpack. She wanted him screened for substance use, but he wanted no part of…
Last year, I saw a teenager in the emergency department (ED). He was 15, and his mother brought him in after finding a vape in his backpack. She wanted him screened for substance use, but he wanted no part of it.
I asked him a few questions anyway. He gave short answers and stared at the ceiling while his mother watched from the doorway. No one in the room felt comfortable. …
Scent beads and laundry additives are innocuous If you are online or on broadcast you cannot miss it: personal care corporations telling you that you stink. Even if you are using deodorant on "those places," your body smells all over,…
Scent beads and laundry additives are innocuous
If you are online or on broadcast you cannot miss it: personal care corporations telling you that you stink. Even if you are using deodorant on “those places,” your body smells all over, say a disturbing number of ads, and the odor “transfers” all over your house. Just saying.
The manic ads for dryer sheets, detergents, fabric softeners, and scent “love stories” do not mention …
There is a danger in being good at holding everything together. People start to believe you do not need holding. Competence becomes camouflage. Reliability becomes a cage. And one day you wake up realizing you have become the infrastructure of…
There is a danger in being good at holding everything together. People start to believe you do not need holding. Competence becomes camouflage. Reliability becomes a cage. And one day you wake up realizing you have become the infrastructure of a life that no one is helping you carry. For those who thought they could carry everything alone, I have realized there comes a time when a “foreclosure notice” may …
