Conditions

Methamphetamine-induced lung injury: the hidden diagnosis in South Texas

Conditions
January 21, 2026

Methamphetamine has become an unavoidable presence in South Texas medicine. It shows up in our EDs, clinics, and ICUs, usually framed as a cardiotoxic, neurotoxic, or psychiatric problem. But over the past few years, a different pattern has kept surfacing in my practice: “pneumonia” cases that don’t behave like pneumonia, young lungs that look like ARDS, and hypoxic patients whose imaging and labs do not match the story, until someone …

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The cost of ignoring pharmacist clinical judgment in health care

Conditions
January 21, 2026

A patient walks into the pharmacy with a prescription. The pharmacist reviews it, recognizes a serious problem, and contacts the prescriber. The prescriber dismisses the concern. The pharmacist has two choices: dispense a medication they know is wrong, or refuse and risk professional consequences. This happens daily. And health care pretends it doesn’t.

The power imbalance nobody discusses

Pharmacists are trained to be medication experts. They study pharmacokinetics, drug interactions, disease-specific dosing, …

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10,000 steps before lunch: How a retired doctor models prevention

Conditions
January 21, 2026

On a recent morning, my mentor, a retired breast cancer surgeon in his 70s, sent me a screenshot from his Apple Watch.

10,208 steps.
7.25 kilometers.
One flight of stairs.
Before lunch.

For him, it was just another day. For me, a younger volunteer and PhD student watching Taiwan age into a super-aged society, it was a quiet masterclass in what prevention really means.

This surgeon, Dr. Lin, is not just any retiree. For more than …

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How a pregnancy test on a male patient revealed health care flaws

Conditions
January 20, 2026

My father’s last medical bill suggested he might be expecting a child. He was 88 years old. Somewhere in the hospital’s system, common sense had vanished. We found the pregnancy test charge only after paying the bill in full. My mother and I wrote to the hospital. The first reply was warm and procedural: Thank you for contacting us. We will submit this to Revenue Integrity. You should expect a …

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Beyond burnout: the rise of the optimized, dissociated executive

Conditions
January 20, 2026

The man sitting across from me is a Titan.

In the taxonomy of the 2026 economy, he is the apex predator: an MD, a CEO, and the chair of multiple boards. He has navigated the post-pandemic attrition and the algorithmic market corrections that swallowed lesser firms. He is wildly, empirically successful.

But recently, he sat across from me, sharing a shade of rage I hadn’t seen before. He had just navigated a …

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How fNIRS and light therapy are shaping precision psychiatry

Conditions
January 19, 2026

Light drives human biology. Morning light sets the daily clock. Daylight supports attention, energy, and mood. Evening darkness supports sleep. Modern routines disrupt that rhythm through indoor lighting, screens, night shifts, and rapid travel. Psychiatry sees the costs. Sleep disruption feeds anxiety. Circadian drift worsens depression. Cognitive speed and motivation fall when sleep timing slips. Most recently, screen time has joined circadian disruptors.

Light as a diagnostic tool

Light already powers diagnosis …

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The emotional labor of volunteering in an aging society

Conditions
January 19, 2026

Hospitals are not the only ones who rely on volunteers.

Nonprofits rely on them for aging programs. Faith communities rely on them for spiritual formation. Philanthropy relies on them for legitimacy. Even emerging “wellness” and “compassion training” industries rely on them for content and credibility.

But no one ever asks: Who sustains the sustainers?

For more than 20 years, I have watched hospital volunteers become the invisible infrastructure of modern care. We are …

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Understanding the evolutionary mismatch in health and modern disease

Conditions
January 19, 2026

As a family medicine resident physician who practices primary care, it is my responsibility to be the first doctor a patient, their family, and their community may visit for any undifferentiated issue. No other field of medicine increases the life expectancy and the quality of life in a community as much as primary care, which provides more meaning to me than can be qualified. My objective is for people to …

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Why Brooklyn’s aging population needs more vascular health specialists

Conditions
January 17, 2026

When I began my surgical training in the 1990s, vascular surgery looked very different than what it does today. At that time, only a small number of physicians specialized in treating blood vessel diseases, and even fewer practiced in Brooklyn. I chose to complete my education and surgical training here in New York so I could stay rooted in the community I care most about. As the second board-certified vascular …

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Why pediatricians are key to postpartum depression screening

Conditions
January 16, 2026

When asked what I wanted to be when I grew up, the answer changed from ballerina to teacher to everything in between. One thing remained constant: I wanted to be a mother. I have narrowed my career aspirations to becoming a physician, but my desire to be a mom has been unwavering. In a climate where maternal mental health is so misunderstood, I constantly wonder what support I will have …

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Prostate cancer genomic testing: a physician-patient’s perspective

Conditions
January 16, 2026

I’ve spent my entire professional life practicing medicine, guiding patients through uncertainty, and translating complex science into actionable information that could be clearly understood. I thought I had a solid grasp on what it meant to face illness. I thought I knew how to navigate the medical maze and interpret all the jargon.

Nothing prepared me for the moment when I became a patient.

The diagnosis was prostate cancer.

Suddenly, I wasn’t the …

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Taiwan’s “Yi-Dong-Yang”: a preventive aging model for super-aged societies

Conditions
January 16, 2026

In Taiwan, the year 2026 marks our transition into a “super-aged society,” where more than 20 percent of the population is over 65. Yet what strikes me most is not the demographic milestone itself, but what it does to the dinner table.

During Lunar New Year gatherings, I often observe a tense choreography among middle-aged children. Who will take father to his cardiology appointment? Who will accompany mother during the day? …

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What is palliative medicine and why is it so misunderstood?

Conditions
January 16, 2026

After years of leading palliative medicine departments, as a Fellow of the American Academy of Hospice and Palliative Medicine, I’ve had countless conversations that start the same way. A colleague in the hallway says, “Oh, palliative care—that’s so important. You all are so nice.” Or a hospital administrator tells me, “We wish we could give you more, but resources are tight right now.” Or my personal favorite: “Palliative care is …

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Physician suicide: a daughter-in-law’s story of loss and grief

Conditions
January 14, 2026

When my father-in-law died by suicide, our family did not just lose a person. We lost the gravitational center of a small universe.

He was a giant in my eyes. Not because of his curriculum vitae, though his was extraordinary, but because of the way he moved through the world: steady, modest, and relentlessly devoted to the people who needed him.

He had survived what should have broken a human being. As …

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The “patient carryover crisis”: Why hospital readmissions persist

Conditions
January 13, 2026

In hospital boardrooms across America, the “30-day readmission rate” is treated as a financial vital sign. It determines reimbursement levels under the Hospital Readmissions Reduction Program (HRRP); it influences star ratings; and increasingly, under new Department of Justice scrutiny, it serves as a barometer for potential “substandard care” investigations.

Yet, despite decades of regulation and millions spent on discharge planning software, the needle on preventable readmissions barely moves.

The industry is failing …

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How flight surgeon training mirrors medical residency stress

Conditions
January 13, 2026

The room went quiet the way rooms do before something consequential, when conversation thins and all you can hear is the pulse in your ears.

“Captain Kumar,” the instructor said, “you have an in-flight engine failure. What do you do?”

I stood at attention, spine locked, as my classmates turned toward me with the focused expectation of a clinical team evaluating a tenuous presentation. A bead of sweat slid down my temple. …

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A school nurse’s story of trauma and nurse burnout

Conditions
January 11, 2026

School had just started for the new school year. It was hot and humid. I had just retired from ICU nursing and behavioral health, a 46-year career and never skipping a beat. After several months of retirement, I couldn’t sit still. I was bored and had that nagging feeling that I wasn’t done yet with my career. Maybe that nagging feeling was guilt. Like you can’t quit. You can’t stop. …

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SNF discharge planning: Why documentation is no longer enough

Conditions
January 11, 2026

There is a dangerous assumption circulating in skilled nursing facility (SNF) boardrooms: “If it’s documented in the EMR, we are protected.”

For years, this logic held up. Compliance was a game of checkboxes. Did the nurse educate the patient? Check. Did the patient verbalize understanding? Check. Is the care plan signed? Check.

But the regulatory landscape has shifted beneath our feet. The Department of Justice (DOJ) and CMS are no longer just …

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How honoring patient autonomy prevents medical trauma

Conditions
January 11, 2026

Holding my mother in my arms as she took her last breath changed the way I understand care. That moment, Easter Monday in Canada, was heartbreaking and transformative. Her unwavering faith and peaceful passing contrasted sharply with the confusion that followed when CPR began despite her do-not-resuscitate (DNR) order. I felt helpless.

The experience became the catalyst for my commitment to advocacy and ethical clarity. It taught me that even well-intentioned …

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Why fear-based approaches fail in chronic illness care

Conditions
January 9, 2026

In caring for patients with chronic illness, we often assume that if people truly understood the consequences of poor disease management, they would change. We explain complications, cite lab values, outline risks, and sometimes lean into fear in hopes that it will motivate action. When patients do not follow recommendations, we label them as noncompliant or unmotivated. Yet chronic illness is not managed in exam rooms or hospital beds. It …

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