I remember the first time I pronounced a patient dead—that’s something they make sure you learn well in medical training, as nobody wants to get it wrong. They taught us how to apply pressure to the fingernail to ensure the patient does not respond to pain while holding the patient’s hand, watching for breaths, and feeling for a pulse. They taught us to take our time to ensure we got …
Since its inception in the 1960s, traditional CPR has been heralded as a revolutionary life-saving technique. However, the limitations of CPR are becoming increasingly apparent, particularly in cases of out-of-hospital cardiac arrest (OHCA). Currently, the survival rate for OHCA patients with good neurological function at discharge stands at a mere 7.5 percent. This raises important questions about the efficacy …
An excerpt from Facing Suicide: Understanding Why People Kill Themselves and How We Can Stop Them.
Between 2000 and 2007, suicide rates were almost stagnant for young people between the ages of ten and twenty-four. Then they began moving steadily upward. By 2018, suicides in this age group had increased 57.4 percent from 2007 levels. An economic crisis darkened that period, and according to online posts, some seventeen- and eighteen-year-olds …
An excerpt from Krooked Ketamine.
OK, here’s the thing: I had a little problem that needed correcting if I wanted to continue to work as a government surgeon. I had a janky heart, and it had a tendency to fire off at the absolute worst possible moments. I needed a pacemaker to help with the recalcitrant muscular metronome, but I absolutely hated the thought of lying down and feeling, at …
You can’t tell how much someone is suffering by looking at them—one reason I don’t share my journey with anorexia using photos to signify my mental health status. I’ve suffered more when appearing well, and “before and after photos” would spread misconceptions about eating disorders. They don’t magically go away with weight restoration and nourishment.
People assume I no longer live with anorexia. I perceive this is partially due to the …
As a physician who cares about patients’ health and well-being, you have likely experienced the grief of disillusionment. You spent years in college, medical school, and residency, imagining the kind of health care you’d provide. It would be high-quality, patient-first, equity-oriented, and heart-centered. That vision got you through tough moments along the path.
Now, you find yourself pressured to spend as little time with patients as possible. You’re giving precious hours …
Are hospitals crazy?
I suspect many physicians would answer “yes” to that question without much contemplation. I have always assumed that, although hospitals are profit-driven and therefore likely to have very different priorities than physicians who care about patients, the institutions can be relied upon to have some semblance of reasonableness.
Lately, however, I have been forced to reconsider my position. For decades, I have represented physicians in their various interactions with …
Epigenetics has revolutionized our understanding of how lifestyle factors—such as diet, stress, exercise, and environmental exposures—affect fertility. Unlike genetic mutations, which change the DNA sequence, epigenetic changes modify how genes are expressed without altering the DNA itself. These changes occur through mechanisms such as DNA methylation and histone modifications, and they play a critical role in fertility. Even more intriguing, these epigenetic changes can be passed down to future generations …
The fourth major concussion recently suffered by Miami Dolphins quarterback Tua Tagovailoa – his third in 24 months – brings into sharp focus the balance between patient/player autonomy and treatment decisions. The right to self-determination, even in sports, has become as much a moral as a medical issue. If Tagovailoa is not able to pass concussion protocols for a third time in his NFL career, he could be forced to …
An excerpt from The Problem with Men.
Gary could tell something was wrong the moment he saw me. “Come in, friend,” he said, his voice gentle. He guided me into the kitchen, a cozy, older space similar to the one in my apartment across the street, but his was painted a cheerful light yellow. After rummaging through a cabinet, he returned with a joint and lit it without hesitation.
“Here,” he …
The modern IUD has been an option for women for 60 years now.
CDC just updated its 2016 guideline that advises physicians to discuss pain management options. This comes after continued viral TikTok patient stories about IUD insertion pain have garnered increasing attention from the medical community.
For perspective: According to OB/GYN’s Kristyn Brandi and Aliye Runyan, MD, their patients describe the insertion procedure as sometimes feeling like …
As a U.S. health care writer and patient advocate for almost 30 years, I read a lot. Recently, some of that reading is in court transcripts of doctors being persecuted out of medicine or into jail by various prosecutors and their hired “experts.” I use the term “persecuted” intentionally. I believe that “medical experts” in many court or Medical Board proceedings are simply “hired guns” – clinical predators hired for …
As a retired physician, I notice many seniors become skinny and weak due to muscle loss yet have big bellies as fat accumulates. They are less strong, less vibrant, and prone to falls and chronic illnesses like heart disease, diabetes, and cognitive decline. This does not need to happen, but many older people do not appreciate the health and wellness impacts of muscle loss …
Once again, I found myself balled up on the kitchen floor, head between my knees, sobbing. My shoulders shook, and my chest heaved as I gasped for air, but air wouldn’t be enough. What I was truly gasping for was hope, something that had eluded me during this perpetually challenging season of my “neurodivergent” parenting career.
I’m not sure what made that moment any different from the countless dysregulated nights that …
War metaphors in oncology are controversial, to say the least. For some patients with cancer, the idea that they are “cancer warriors” in a “battle” with their disease is inspiring. Using such language gives them a sense of agency in a situation where very little is in their control. Many others loathe such language …
An excerpt from Nephilim.
“Those eggs really hit the spot, right?”
“I’d love some more,” he answered.
“Sure,” Zdenek responded. “One or two?”
“How many do we have?”
Before long, James had wolfed down nine eggs.
“I wonder if it’s the choline,” Zdenek mused as James shoveled. “Eggs have a boatload of choline. Maybe she’s craving it. Orange that is.” James hadn’t touched his toast. “Choline, you know? It might help my baby merge with …
In today’s health care ecosystem, patient retention has become a $3 billion dollar issue for health systems, with patient leakage (also known as patient keepage) at its core. Despite efforts to keep patients within their networks, a significant portion continue to seek care elsewhere, leading to financial losses. Interestingly enough, physical therapy proves to be key in improving patient retention, as recent data shows that rehab-related leakage is the number …
Fred was the cool guy.
Back in the 1950s and 60s, smoking cigarettes was considered movie star quality. That circling of smoke in his parked car with the girl of his dreams.
He started smoking at the tender age of 15.
Fred had it figured out. Cigarettes were glamorous. Cigarettes were cool.
Doctors advertised that smoking was good for you. It helped you keep weight off, and it relieved your anxiety.
In 1965, the Surgeon …
With more than 15 years of experience as a board-certified behavior analyst (BCBA) and clinician working with children and teens with autism spectrum disorder (ASD) and their parents, I have seen first-hand how parent involvement is the key to success in intervention programs. To make an impact on these children’s lives, we need to go beyond simply applied behavior analysis (ABA) therapy sessions. This is where parents come in, reinforcing, …
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