Physicians writing on KevinMD about the diseases they treat and the people who have them: cancer and its screening arguments, pain and the drugs that treat it, diabetes and the obesity argument, mental illness and who gets treated for it, and the decisions at the end of a life. Five maintained records draw on this archive: Cancer: what physicians say, in their own words, Opioids: what physicians and pain patients say, in their own words, End of life: what physicians say, in their own words, Diabetes and obesity: what physicians say, in their own words, and Mental health: what psychiatrists and physicians say, in their own words.
In 2024, centralized cryptocurrency exchanges recorded approximately USD 18.4 trillion in trading volume, with Binance alone accounting for forty percent (~USD 7.7 trillion). While the total number of cryptocurrency holders exceeded 600 million globally, active traders (those engaging in high-frequency or large-scale trading) appear limited to thirty to sixty million monthly users. Epidemiological data indicate these traders skew male (≈sixty-one percent), primarily aged 25 to 34 (thirty-four percent of owners), …
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Crypto trading’s impact on mental and physical health
I see it every week in my practice: Patients obsessed with their cholesterol numbers. LDL, HDL, triglycerides, the full alphabet soup. They have been trained to believe these numbers hold the keys to life and death.
But here is something I cannot stop thinking about: When you look under the microscope, an atherosclerotic plaque (the thing that clogs arteries and leads to heart attacks) looks an awful lot like a tuberculosis …
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Why we may be fighting the wrong enemy in heart disease
Most of us have done it: a new symptom pops up, and instead of calling a doctor, we type it into Google. In that moment, the internet feels like the fastest way to get answers. But when it comes to urology, a field where stigma, fear, and embarrassment often hold people back, the flood of conflicting or misleading information online can do more harm than good. That’s where digital health …
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How digital health is changing urology
Back-to-school season is one of the busiest times of the year for health care providers (HCPs). Doctors’ offices are full of young patients and families preparing for the year ahead, checking off physical exams, immunization forms, and age-based screenings. These visits are more than just routine; they are critical opportunities to talk about risk factors and catch early signs of health issues. Yet too often, one disease slips through the …
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Why type 1 diabetes screening should be part of back-to-school
I am an internist and, once upon a time, a card-carrying lipidologist. I have spent years watching medicine’s “standards of care” quietly stretch like elastic waistbands. What begins as a targeted therapy for a small group of high-risk patients slowly expands until everyone and their grandmother is expected to be on it. That phenomenon has a name: guideline creep.
How it works
The cycle is simple:
What is guideline creep in medicine?
As a physician provider in my State Physicians Health Program, I have watched brilliant colleagues flicker out. Not because they lacked skill or grit, but because the system treated their humanity like an optional feature. We train physicians to master physiology, not how to metabolize grief. We celebrate heroics, not healing. Then September arrives, Suicide Prevention Month, and we draft statements. The statements are sincere. They are not sufficient. It …
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It’s time to operationalize physician wellness
I have spent decades learning about how bodies and brains work, but nothing has taught me more about complexity than raising my autistic son. He is nine, curious, brilliant, and completely captivated by chemistry. He can explain the structure of an atom with more clarity than most high school students.
But when we step into the real world (classrooms, stores, even family gatherings), sometimes his brain does not get to shine. …
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The science behind my son’s sensory overload
I never expected that iron deficiency anemia would change the course of my life. I felt off. Tired in a way that sleep could not fix. Foggy, weak, emotionally distant. At first, I thought I was just worn down from work and the daily grind. I was not myself, physically, mentally, or emotionally.
Eventually, I was diagnosed with iron deficiency anemia, a condition many associate with mild fatigue or simply “not …
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My invisible illness destroyed my marriage
Kidney stones are not only about what you eat or the genes you inherit. They are also about where you live and how hot it gets. Every summer, urologists notice the same pattern: as the temperature climbs, so do the visits for kidney stones. Because heat and humidity do not just make us sweat, they change how our bodies handle water and minerals. Dehydration concentrates the urine, crystals form more …
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How summer heat increases your kidney stone risk
As physicians, we are trained to prescribe, to fix, to optimize. Our patients expect it, and frankly, so do we. I built a career around lipid panels, trial data, and prescriptions meant to shave percentage points off cardiovascular risk. But lately, I find myself offering something far less high-tech and far more radical: a walk.
Walking is slow. Impractical. Rarely the efficient choice. Which is exactly why it matters.
Everywhere around us, …
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Your nervous system does not need another hack. It needs a walk.
In the hierarchy of health care professionals, I supposedly stand on one of the lowest steps of that ladder. Some say I am just a CNA. Some say I am the backbone of nurses and physicians. I say: I am a strategic part of this ladder. I do not have the medical knowledge or skills of a physician nor of a nurse. But what I do have is a heart …
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He begged for mercy and his family refused
As a practicing internist and lipidologist, I have long been trained to believe in the cholesterol hypothesis. Statins were not just recommended; they were the gospel. Lower LDL, save lives. That mantra was repeated at every lecture, every conference, every guideline committee.
But like many dogmas in medicine, the cracks are there if you dare to look. And some of the most damning cracks are found in a set of randomized …
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The ignored clinical trials on statins and mortality
The door closes with a soft click, sealing me inside a room that smells of alcohol and cotton swabs. The light is too bright, pouring down from overhead panels that have withstood the test of time. The entire room is bathed in a white-wash of light, leaving no shadows, except those that lie within me. A token landscape or two adorn the antiseptic walls, attempting to distract me from the …
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Inside the exam room: anxiety, trust, and medicine
Varicocele is one of the most common findings in men being evaluated for infertility. Roughly 15 percent of all men have one, and the number climbs to about 40 percent among men with fertility problems. Yet despite how common it is, a varicocele remains a confusing diagnosis. Some men are told they need surgery right away, while others are advised to do nothing at all.
The truth is somewhere in between. …
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What is a varicocele and how does it affect fertility?
Gasping for breath, Michael (name changed) pushed back in his chair. His legs felt like lead weights. He could not delay the rescue call any longer. The oxygen in his blood had dipped into the 80s.
An X-ray showed a shadow over the lower part of Michael’s right lung, and the hospital admitted him to treat a pneumonia. A smoker for decades, he was relieved a few days later to be …
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How profit-driven hospitals fail long-term patient care
Across the world’s earliest civilizations, healers turned to nature as their pharmacy. Ancient systems like Ayurveda in India, Unani (Hikmat) medicine in the Middle East, and early European herbalism developed sophisticated therapeutic practices rooted in plants and natural compounds, many of which are still clinically relevant today.
Take turmeric, for example. Traditionally simmered in milk or prepared as a paste, it was used for its healing and anti-inflammatory properties. Today, biomedical …
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How nature is inspiring the future of pain medicine
When I was in my studies as a psychiatry resident, I learned about an interesting field called metabolic psychiatry, which focuses specifically on ketogenic therapies to treat psychiatric conditions. This is a nascent field at this time, with no extensive clinical trials like we have for medications, though some small trials exist. I even have some patients who have been on ketogenic diets (not prescribed by me) …
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Psychiatrist tests ketogenic diet for mental health benefits
In my practice, I care for many patients obsessed with longevity. They fast, they microdose, they meditate, they cold plunge, they gulp down supplements by the handful. They optimize their labs with the fervor of a hedge fund manager optimizing a portfolio. They read Peter Attia and Andrew Huberman like scripture.
And yet, they still die.
This is not cynicism; it is reality. Over the years, I have watched patients do everything …
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The myth of biohacking your way past death
For twenty years I have been the mother of a child with a life-threatening food allergy. I know what it is to watch my son’s throat close, to see terror in his eyes, to hear him beg not to die. It felt like time slowed down as we waited for epinephrine to work. Those moments are seared into me. They are not, and never will be, a joke.
That is why …
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Why Hollywood’s allergy jokes are dangerous
