In elementary school, my teachers always told us it was important to understand math because “you won’t always have a calculator in your pocket.” That sentiment hasn’t aged well, given that my iPhone and Alexa are always within reach. But no one said, “You better learn this because one day you’ll be teaching your own kids during a plague.” That was where the real value lay. In medical school, I …
When so many children and adults struggle with obesity, it’s easy to see why weight loss is often celebrated. Unfortunately, health care professionals sometimes apply those same social narratives to clinical decision-making, and the consequences can be dangerous.
I’ve developed two distinct clinical niches: metabolic dysfunction and tuberculosis. A colleague once asked me to review the chart of a patient with a history of obesity who had been admitted to an …
Are 10 percent (or 25 percent) of all the physicians in your specialty breaking the law?
Of course not! Who would think such a thing?
Your friendly neighborhood “nonprofit” hospital, that’s who!
I have been reviewing physician employment agreements for almost 40 years, and in the last few years I have noticed a spike in the number of agreements that “cap” physician salary. A shocking number of hospital employment agreements provide that the …
The ED is swamped with new patient arrivals. As a result, the 20-year-old who told the triage nurse he is having difficulty breathing waits an hour before his turn in the triage room. The emergency department technician hands me the ECG—sinus tachycardia—and takes the vitals.
Me: “What brings you to the emergency department today?”
Him: “I feel like I cannot breathe. It started all of a sudden at work.”
As I scroll through …
“My PSA came back at 6.2 — does that mean I have cancer?”
It’s one of the most common and emotionally charged questions I hear in the clinic. The prostate-specific antigen (PSA) test, once celebrated as a breakthrough in early cancer detection, has become a double-edged sword. For many men, a slightly elevated PSA level is enough to trigger panic — and for some physicians, enough to trigger a biopsy.
But here’s …
The Pitt was compelling TV.
As an emergency nurse educator for a Stanford campus in Northern California, there is one thing that is required viewing for my new graduate nurses: The Pitt.
The ambitious series did an admirable job portraying the complex world of the emergency department. The procedures were clinically accurate. The spectrum of patients and social issues was nuanced and believable. They even showcased the incidence of post-COVID PTSD, an …
She was 68. Diabetic. Living alone with chronic osteoarthritis. Like many patients, she carried a story more complex than any preoperative checklist could capture: a long history of opioid dependence, obesity, limited mobility, and no one at home to help her recover.
Her total knee replacement—performed with state-of-the-art robotic precision—was flawless. The surgical plan was executed to perfection. The implant was perfectly aligned. She was discharged on time, per protocol.
But protocol …
What is psychotherapy?
Psychotherapy is a talking process between a patient and a psychotherapist. Psychotherapy makes connections among feelings, thoughts, impulses, and behaviors to understand what works and what gets in the way of meeting life’s goals, reaching one’s fullest potential, feeling successful, and being fulfilled. This is accomplished by self-reflection. By examining life patterns, changing, improving, and unlearning emotional and behavioral habits that get in the way and are no …
The mouth is connected to the body by blood vessels, lymphatic pathways, and the immune system. Ignoring oral health means risking more than a toothache — it could mean risking your life.
When most people think of oral health, they think of teeth, cavities, brushing, flossing, maybe the occasional root canal. But the truth is, what’s happening in your mouth can have a ripple effect throughout your entire body. This is …
In the realm of American politics, discussing the mental fitness of a sitting president – or the performance of a former one – is as delicate as it is critical.
As a psychiatrist, I am profoundly aware of the ethical constraints outlined by the Goldwater Rule, adopted by the American Psychiatric Association (of which I am a Fellow). Psychiatrists’ ethical responsibility is to refrain from making specific clinical diagnoses without Read more…
When people think of Botox and filler, they think of vanity. Frozen foreheads. Pouty lips. Women chasing youth. Injectors chasing cash. They don’t see the woman who finally escaped her husband after 20 years of abuse, coming in not for attention but for control. They don’t see the mother burying her child, hoping that looking “normal” on the outside might steady the chaos inside. They don’t see the cancer survivor …
Menopause is finally having its moment in the spotlight, thanks to high-profile women breaking the long-standing taboo around discussing this life stage. Yet, while discussions around hormone replacement therapy (HRT) have increased, one critical component remains largely overlooked — testosterone.
Traditionally seen as a “male hormone,” testosterone is equally vital for women’s health, playing a key role in mood, energy, libido, muscle mass, bone density, and cognitive function. Yet, …
Veterans deserve the highest-quality health care our nation can offer, but fulfilling this promise often means overcoming major challenges. About 9 million veterans receive care through the VA, with a third living in rural areas far from VA facilities. Meeting their needs requires innovative solutions that combine expertise, technology, and strategic partnerships.
Why VA’s holistic model outpaces traditional care
The VA stands apart with its integrated, long-term approach to care. Unlike the …
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I remember those days well. Long before the era of Beyoncé and Jay-Z, another Hollywood “power couple” captivated the world: Jennifer Lopez and Sean “Diddy” Combs. J.Lo brought the glamour and Latin flair, while Diddy embodied the swagger of hip-hop’s reigning bad boy. Their union was a bold fusion of Latina sass and African American pop culture, a sizzling romance that lit up the entertainment world.
Diddy wasn’t just another rapper …
The Diagnostic and Statistical Manual of Mental Disorders (DSM) defines mental health, including depression, in terms of pathology or a deviation from normal that is reliably exhibited in observable behaviors. It describes genetics and risk factors, differences in gender, and considers cultural perspectives. Limitations of the DSM diagnostic criteria are acknowledged and recognize that human experience, or interaction between genetics and environment, cannot be captured completely. While the underlying neurobiology …
Medicine loves a martyr.
From the first white coat ceremony to the last day of residency, we are told a story: That good doctors are tireless, self-sacrificing, endlessly available. That the more you give up—sleep, family, hobbies, sometimes even health—the more worthy you are to wear the title. The message is rarely said aloud, but it’s everywhere: the ones who leave early to pick up their kids are “lucky to be …
“I look at my baby and I don’t feel a thing,” the patient whispers as she cradles her 3-week-old baby. “I feel so much guilt … sometimes I don’t want to be here at all.” And yet, she is not alone. Her words echo the silent yet growing public health crisis of perinatal mental health.
Approximately 1 in 5 women are affected by mental health conditions during the perinatal period. …
What would a world without vaccines even look like?
Well, it turns out that we do not have to wonder since accurate historical records allow us to distinctly see and learn for ourselves. This is in keeping with our Secretary of Health and Human Services’ (HHS) recent guidance to Do Your Own Research.
What we actually need, individually and as a nation, is clear and consistent science-based advice when it comes …
When reviewing poor maternal health outcomes in the U.S., it is clear we cannot keep doing the same thing and expect to make pregnancy safe and healthy for all. A new approach is needed that harnesses the power of molecular advances to bring precision medicine to pregnancy health. Preeclampsia, one of the most dangerous complications in pregnancy, is a disorder of high blood pressure that has eluded the ability to …
Tucked along the edge of the frigid James Bay, Moosonee stands as one of Northern Ontario’s most remote and storied communities—a place often referred to as the “Gateway to the Arctic.” While towns like Thunder Bay or Rainy River echo similar titles, Moosonee carries its own unique distinctions.
This isolated town of about 3,000 people is shaped by its subarctic climate, deep cultural roots, and resilient spirit. Read more…
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