Conditions

Anne-Sophie Mutter, John Williams, and the art of aging

Gerald Kuo

Conditions

January 28, 2026

When Anne-Sophie Mutter appeared under the lights in Taipei to play John Williams, the audience was already aging with her. That is not a tragedy; it is a form of wisdom. In a super-aged society, an evening at the concert hall is not only entertainment; it is an anatomy lesson in movement, meaning, and care.

Tempo and governance

The program opened with “Sound the Bells!” The brass did not summon cinematic sentiment; …

A poem on kidney cancer survivorship and the annual scan

Michele Luckenbaugh

Conditions

January 27, 2026

Once a year,
I return to two quiet organs
I once carried without thought,
working faithfully in the dark,
asking for nothing,
until one day they asked to be seen.

Cysts.
Small moons of fluid,
bubbles scattered like careless stars
throughout the geography of me.
Harmless, they said.
Mostly.
Until one was not.

That year,
a word entered my body:
cancer.
A word that knows how to make itself at home
in every corner of thought.

A specialist explained
how light and force could be aimed,
how the invader could …

Hashimoto’s disease in adolescent girls: Why it’s often overlooked

Callia Georgoulis

Conditions

January 27, 2026

Hashimoto’s disease is the most common cause of hypothyroidism in children and adolescents, yet it remains frequently overlooked, particularly in adolescent girls. Fatigue, mood changes, weight gain, and cognitive slowing are often attributed to mental health conditions or dismissed as normal features of puberty, delaying diagnosis and treatment. This pattern reflects a broader failure to recognize how autoimmune thyroid disease presents during adolescence, and how gendered assumptions shape clinical interpretation …

Why doctors ignore their own advice on hydration and health

Amanda Shim, MD

Conditions

January 26, 2026

“I’m surprised I haven’t had a kidney stone.”

It’s a running joke among my co-residents, when it’s 3 o’clock in the morning, with over 20 patients in the waiting room, and nobody can remember the last time they had water. Most days, my fluid intake is limited to the sips needed to swallow my antidepressants (to quote my parents, “you can’t just take them whenever you feel sad,” and “it’s not …

Low testosterone in men: a doctor’s guide to TRT safety

Martina Ambardjieva, MD

Conditions

January 26, 2026

A man in his late 40s sits down in my office and says, “Doctor, I think my testosterone is low.”

Sometimes he is already holding lab results. Sometimes he is coming from a gym forum, a friend’s recommendation, or a late-night Google search. But almost always, the story sounds familiar: lower sex drive, fewer morning erections, weaker erections, fatigue, brain fog, mood changes, and that stubborn belly fat that seems to …

Uterine aging in IVF: Why the “soil” matters as much as the seed

Oluyemisi Famuyiwa, MD

Conditions

January 26, 2026

Most clinicians know that eggs age. Fewer acknowledge that the uterus ages too.

In reproductive medicine, we often rely on the seed-and-soil analogy. The seed is the embryo. The soil is the endometrium, the inner lining of the uterus where implantation occurs.

Here is the part that deserves more explicit counseling and strategic planning: Even when embryo quality is controlled, uterine age can independently influence implantation, miscarriage risk, and live birth rates. …

How modern health care design strains patients and clinicians

Deanna J. Gilmore, RDH

Conditions

January 25, 2026

My great-grandfather was a small-town doctor in the early 1900s.

It was a different time. A different place. A very different pace.

He knew his patients. He knew their families. He understood their lives, not just their symptoms. Care happened in the context of relationship because that was simply how medicine worked.

Today, health care looks very different. The science is better. The technology is stronger. We can do things now that would …

Physician retirement: a cultural shift from system to self

Gerald Kuo

Conditions

January 25, 2026

The number was specific: 18,000 steps.

It came from a retired hospital director in Taipei, a physician-administrator who spent four decades building services, negotiating budgets, and managing crises across a health care system that now treats an aging society as its primary patient.

Most physicians retire into silence. He retired into data.

But the more interesting revelation did not come from his smartwatch. It came from the dinner table.

A shift in governance

In Western …

ADHD and cannabis use: Navigating the diagnostic challenge

Farid Sabet-Sharghi, MD

Conditions

January 25, 2026

As a psychiatrist, I increasingly meet patients who come in convinced they have attention-deficit/hyperactivity disorder (ADHD). They arrive prepared: an online screening test, a list of symptoms (poor concentration, low motivation, distractibility) and often a quiet sense of relief at finally having an explanation. Then I do what physicians are trained to do. I take a careful history. I review medications. I ask about sleep, mood, anxiety, substance use, and …

How the mind-body split in medicine shaped modern clinical care

Robert C. Smith, MD

Conditions

January 24, 2026

In my first and second KevinMD posts, I emphasized how medicine had failed clinicians by not training them in mental health care. All agree, it’s not our fault. Now let’s look at how successfully our teachers did prepare us for patients with medical disorders. There’s an interesting history behind how we developed expertise in physical diseases: Medicine needed to overthrow the four humors theory that guided clinical care …

Is testosterone replacement safe after prostate cancer surgery?

Francisco M. Torres, MD

Conditions

January 23, 2026

It has been six months since my robotic-assisted radical prostatectomy, and I find myself suspended in a strange middle space, grateful to be cancer-free, yet still struggling with a question I cannot fully answer: Is it safe for me to restart testosterone replacement therapy?

Before my diagnosis, testosterone replacement was not just a prescription; it was a restoration. I have lived with hypogonadism for years, and TRT helped me regain the …

The impact of war on the innocence of children

Michele Luckenbaugh

Conditions

January 23, 2026

They are not born into battle.
They arrive with open hands,
with laughter,
with faith that the world will keep them safe.

Yet, men who are not content with peace
clench their fists around power,
mistaking domination for strength
and control for legacy.
They draw borders with bullets
and call it victory.

In their pursuit to prove themselves,
they let the bombs fall.
Roads darken with blood.
Homes become rubble.
The sky learns the language of fire.

And in the wreckage stand the children.

They watch …

Why epistemic trespassing in medicine is a dangerous trend

Farid Sabet-Sharghi, MD

Conditions

January 22, 2026

Somewhere over the last two decades, medicine began to drift into strange territory. Authority (once grounded in evidence, humility, and disciplined expertise) became diluted. Being loud, charismatic, or highly visible somehow became a substitute for scientific credibility.

We’ve long had celebrity doctors, but a new hybrid has emerged: Physicians who are not celebrities in the traditional sense, yet who speak with sweeping certainty far outside their field of training. A neurosurgeon …

Why evidence-based practice in nursing is a strategic imperative

Mark Mahnfeldt, RN, MBA

Conditions

January 22, 2026

Every day, nurses make thousands of clinical decisions that directly shape patient outcomes, safety, and recovery. Yet in many hospitals across the country, these critical choices are still guided by experience-based models rather than current evidence. For a profession that defines itself as patient-centered and science-driven, this approach contradicts the very standard of care we strive to uphold. True excellence in nursing is not defined by technology alone or by …

Why organizational culture eats strategy for breakfast in health care

Jeffry A. Peters, MBA

Conditions

January 22, 2026

Eighteen months ago, I learned something every patient hopes never to hear: that my cancer had returned. Years earlier, I had been treated successfully for prostate cancer. When my PSA began to rise again, I knew something was wrong. It took persistence and more than a few second opinions to confirm what my instincts already told me.

That journey eventually led me to a leading cancer center. I had already seen …

The economics of prevention: Why an ounce is worth a pound

Joshua Mirrer, MD

Conditions

January 21, 2026

We repeat the phrase “an ounce of prevention is worth a pound of cure” as if it were a folksy reminder to eat better or get a flu shot. But taken seriously, it is not a medical cliché. It is an economic law. And it exposes a devastating flaw in how modern societies choose to spend money.

Prevention is not the opposite of cure. Cure is essential, lifesaving, and often extraordinary. …

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

Shiv K. Goel, MD

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 …

The cost of ignoring pharmacist clinical judgment in health care

Muhammad Abdullah Khan

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, …

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

Gerald Kuo

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 …

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

Eric Goldfarb

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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