Last winter, a senior nurse in our psychiatric unit told me, “The dashboard says we’re low-risk. But during night shifts, I don’t even feel safe walking to the bathroom.”
The monthly quality report on her desk said the same thing it had said for nearly a year: “Violence incidents: no significant difference among the three wards (p > .05).”
On paper, her ward looked normal. At the bedside, it was anything but.
Her …
The recent Atlantic article by Olga Khazan, “Avoiding Ultraprocessed Foods is Completely Unrealistic. Especially if you have kids,” brought a concern that I’ve carried for a long time into full clarity: Our worries about family weight and eating habits aren’t actually about the physical body. They’re about perfection. And they are a call to approach health completely differently.
I am a pediatrician working at the intersection of family stress, emotional …
A recent Wall Street Journal graphic traces the rise in autism prevalence among eight-year-olds from 2000 to 2020. The slope is unmistakable, upward, steady, and steep. But it’s not a crisis. It’s a reckoning.
Each inflection point on that chart marks a milestone in institutional clarity:
Take a look in your medicine cabinet. What you see isn’t a sign of weakness; it’s a testament to one of the greatest partnerships in modern life: the one between your body and medical science. From the vaccine you got as a kid to the pill that keeps your blood pressure in check, these interventions aren’t just treating sickness. They are part of who you are. In a world still …
Primary care innovation has always been framed around access, autonomy, burnout, and patient experience. Direct primary care (DPC) in particular is often positioned as a solution for physicians exhausted by fee-for-service complexity and for patients who want a more personal relationship with their doctor.
This article focuses on how the broader economic landscape has shifted in ways that directly affect DPC, especially in light of the rapidly evolving national discussion around …
Most people exercise to improve cardiovascular fitness, metabolic health, or mood, but regular physical activity also plays a significant role in sexual and urinary function. As a urologist, I routinely see how movement influences two intimate yet essential systems: the reproductive system and the lower urinary tract.
When patients present with urinary leakage, erectile changes, or reduced libido, they often expect a prescription or procedure. Yet for many, measurable improvement begins …
Adapted from The Care of Foreigners: How Immigrant Physicians Changed US Healthcare. Copyright 2025. Published with permission of Johns Hopkins University Press.
In the decades following the passage of the Hart-Celler Immigration and Nationality Act of 1965, the face of American medicine irrevocably changed. This bill expedited the rapid entry of physicians from post-colonial Asian nations into the U.S. in significant numbers. In this migratory flow, South Asian physicians, in …
“The FDA has issued a nationwide recall of lisdexamfetamine capsules.”
That sentence in Newsweek magazine should have triggered alerts, guidance, and coordinated response. Instead, the silence from pediatric leadership has been deafening. Newsweek turned to the FDA and the American Academy of Family Physicians. Where are the leadership of the American Academy of Pediatrics (AAP) and the Society for Developmental and Behavioral Pediatrics? Silent. Why?
The recall that should have sparked action
In …
Some cases linger in our memory because of the humanity at their center. The case of Charlie Gard, which unfolded in England in 2017, is one of those. It took place within the National Health Service and under a legal framework in which courts decide a child’s treatment when parents and clinicians cannot agree. Before it became a global controversy, before it drew international headlines, it began as something far …
Introduction
Tay-Sachs disease is a devastating genetic disorder that primarily affects individuals of Ashkenazi Jewish descent, though it is also found among Cajuns in Louisiana and French-Canadians. This fatal condition typically manifests within the first six months of life and leads to progressive neurological deterioration, often resulting in death by age five. As medical science advances, the question arises: Should genetic testing for Tay-Sachs be mandatory for all individuals of reproductive …
Children often surprise us with the seriousness they bring to a clinic visit. Every so often, when the room feels tense, I turn to a simple question and ask what their favorite toy is. Caregivers smile, and children lean forward with the kind of excitement that only play can spark. In a moment, the atmosphere changes. The room feels lighter, the conversation easier, and the visit begins to unfold with …
All clinical trials are fueled, in part, by optimism. A trial currently underway in California is fueled by the optimism of one patient in particular, Kayvon Goodarzy.
Despite decades of effort, there has been an abject lack of new approved therapies for glioblastoma (GBM). The standard of care for this deadly brain tumor has been chemotherapy and radiation, to less-than-ideal results. But that might be changing, and it’s all thanks …
When the American Academy of Child and Adolescent Psychiatry released its October 2025 policy statement expanding what counts as valid, evidence-supported autism treatment, it marked a turning point that has been needed for years. For more than a decade, insurance companies pushed a narrow, outdated narrative that applied behavior analysis was the only evidence-based intervention for autism. That narrative was not accurate. It shaped policy, and it left families with …
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It happens almost every clinic day. A patient walks in, sits down for their vital signs, and their blood pressure reads higher than expected. Sometimes much higher. Moments later, when I retake it myself after we’ve talked for a few minutes, it’s 20 or 30 points lower.
“But, doctor, I check it at home and it’s never this high!”
They are right. This is the phenomenon of white coat hypertension, blood pressure …
Halfway through a teletherapy session, you notice your therapist pause mid-sentence. They’ve just heard the soft clatter of your keyboard, or seen your eyes flick sideways to a second screen. You’re technically “there” on video, but a work email just popped up, laundry is buzzing, someone’s messaging you, and suddenly the session is sharing space with three other tabs in your brain.
On the therapist’s end, it can feel like talking …
I found a lump at age 32, just four months after a clear clinical breast exam. No family history. No genetic markers. I noticed the golf-ball-sized mass one day while putting on my bra.
It turned out to be stage 3C, with spread to 14 lymph nodes, as advanced as it gets without being terminal. I went through a year of aggressive treatments: bilateral mastectomy, chemo, radiation, reconstruction, and hormone therapy.
My …
Where a person lives far too often determines the quality of cancer care they receive and, ultimately, their chances of survival. Despite decades of progress in precision oncology, stark disparities persist between patients treated in urban academic centers and those in rural or underserved communities. A JAMA Network Open study of nearly 37,000 patients found that when rural and urban patients receive the same, protocol-driven care, their outcomes …
As a psychiatrist, I’m often asked by family or friends to “help,” to intervene in the mental struggles of a loved one, a friend, or even a distant acquaintance. It usually begins with kindness and concern: “Could you just talk to them?” or “Maybe you can prescribe something, you’d know what’s best.” What follows is always a difficult conversation, because I have to explain something that sounds incomprehensible to most …
Thanksgiving is my favorite holiday. I love the cooking, the noise, the parade, the extra side dishes no one really has room for. Every year I tell my parents I want to “go bigger”: more food, more people, more traditions. And every year, my mother looks at me with a mix of love and exasperation and says some version of, “Can we please do a little less this year? My …
A few days ago, I was speaking with a high-achieving, articulate, brilliant friend, someone always up and doing, super-expressive. During our conversation, I noticed her stumbling over her words, which was quite unusual, and her fidgety hands. She was narrating a traumatic incident that had occurred to her and how it tore her apart and made her simply give up on everything, in her words, “she was done.” Throughout the …
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