Conditions

New autism treatment guidelines expand options for families

Conditions
November 22, 2025

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 For more than a decade, insurance companies pushed a narrow, outdated narrative that applied behavior analysis was the only evidence-based intervention for autism.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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Is white coat hypertension harmless?

Conditions
November 22, 2025

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 …

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Gen Z, ADHD, and divided attention in therapy

Conditions
November 21, 2025

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 …

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Early-onset breast cancer: a survivor’s story

Conditions
November 21, 2025

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 …

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Remote second opinions for equitable cancer care

Conditions
November 20, 2025

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 …

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Why psychiatrists can’t treat family members

Conditions
November 19, 2025

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 …

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Aging parents and Thanksgiving: a gentle check-in

Conditions
November 19, 2025

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 …

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Trauma in high-functioning adults

Conditions
November 19, 2025

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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Female athlete urine leakage: A urologist explains

Conditions
November 18, 2025

Female athletes have redefined strength and endurance, but one common issue still hides in silence: urine leakage during training or competition.

It’s more common than most realize. In certain sports like gymnastics, trampolining, and CrossFit, the rates are particularly high. Still, many women keep silent, assuming it’s a normal side effect of being active or that nothing can be done.

As a urologist, I often meet women who are in top physical …

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Funding autism treatments that actually work

Conditions
November 18, 2025

Applied Behavior Analysis (ABA) has become the default therapy for autism in the U.S., not because it’s the most effective, but because it’s the most entrenched. Mandated by insurers, funded by Medicaid, and marketed as “medically necessary,” ABA now consumes hundreds of millions of dollars annually. But here’s the truth: ABA is unproven, ethically fraught, and fiscally unsustainable.

As a developmental-behavioral pediatrician and lead investigator for the NIH-funded RUPP trials, I …

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Why patients delay seeking care

Conditions
November 17, 2025

Every clinic has moments that stick with you. They aren’t always dramatic, but they show why some people end up suffering longer than they should. During my time working as a medical office assistant, I observed a recurring pattern that spanned across various age groups, backgrounds, and diagnoses. Patients didn’t delay care because they were careless. They delayed because the system had quietly taught them to.

One afternoon, a middle-aged woman …

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The burnout crisis in long-term care

Conditions
November 17, 2025

Canada’s primary health care crisis has garnered news headlines and political attention, but an equally alarming crisis is ongoing in long-term care (LTC). More than five years after COVID-19’s deadly sweep through LTC homes, exposing long-standing deficiencies in funding, infrastructure, infection control, staffing and working conditions, many problems remain, driving a critical staffing shortage, burning out workers and impacting resident care. With the need for LTC …

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A story of gaps in cancer care

Conditions
November 17, 2025

Since a diagnosis of colon and rectal cancer in 1993, I have had a number of serious complications and a recurrence. Some, if not most of what occurred could have been avoided. My experience points to some gaps in my health care that providers and patients might want to consider.

I was given the option to choose a cancer treatment and made the wrong choice. As a busy university administrator, I …

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The night of an impalement injury surgery

Conditions
November 16, 2025

On July 6, 2025, in Nanjing, China, a construction worker plunged onto a steel rod that pierced him from pelvis to chest. That night, doctors fought millimeter by millimeter through a five-hour battle against death.

The call at midnight

The phone’s shriek tore through the heavy summer silence just after midnight.

Professor Ji Zhenling, president of Nanjing Jiangbei Hospital, surfaced from sleep, the warmth of his pillowcase still pressed against his cheek. His …

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Finding your child’s strengths: a new mindset

Conditions
November 16, 2025

The question “What’s strong with me?” startled me the first time I heard it. Because we direct so many of our day-to-day thoughts to what’s wrong, it can feel odd to ask what’s strong. But this simple question has the power to release the tight hold that problems have on our thoughts and open a new way of thinking. We’ve all had moments when problems seem so big that it’s …

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How to better communicate medical numbers

Conditions
November 16, 2025

An important paper, “How to communicate medical numbers,” was published in a recent edition of the Journal of the American Medical Association (JAMA). This is so important, for the doctor-patient relationship, for what journalists write for the public, and for individual decision-making. One of the authors, Angie Fagerlin, PhD, of the University of Utah medical school and Salt Lake City Veterans Affairs Medical Center, was interviewed for a …

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Bureaucratic evil in modern health care

Conditions
November 15, 2025

The creed of compliance

In every hospital, a grotesque comedy unfolds: Poor Sod, our hapless patient, lies gut-shot, aorta spewing like a B-movie fountain. Clinicians, faces blank as overcooked porridge, scurry in a choreographed panic, clutching flowcharts like sacred scrolls. Monitors bleep like a chorus of lobotomised parrots. A registrar, mad enough to trust his gut, tries a life-saving stunt not in the Holy Manual. A nurse, eyes glinting with the …

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Protecting elder clinicians from violence

Conditions
November 15, 2025

The day before the attack, a senior physician at a Catholic university hospital in Taiwan sat with young medical students at noon, talking not about lawsuits or hospital finances, but about Brahms. He loved four-hand piano pieces, especially Brahms’s Hungarian Dances, and he would explain how two players must breathe together, listen to one another, and balance passion with discipline. For him, this was also a lesson about medicine: You …

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Why does lipoprotein(a) exist?

Conditions
November 15, 2025

I just read the new Cleveland Clinic Journal of Medicine introduction by its editor-in-chief, and it’s laying out the usual playbook: demonize lipoprotein(a) (Lp(a)), list all the terrible things it does, and hint that salvation is around the corner, pending results of a major pharmaceutical trial, of course.

It’s a neat narrative arc.

But it’s incomplete.

What’s missing is the one question almost no cardiology article seems willing to ask:

Why does Lp(a) exist …

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The myth of endless availability in medicine

Conditions
November 15, 2025

For years, I believed that the best clinicians were the ones who never stopped. We covered extra shifts, skipped meals, charted past midnight, and proudly wore exhaustion as a badge of honor. My patients were happy, my colleagues admired my work ethic, and I was quietly unraveling.

The slow slide into burnout

Burnout didn’t arrive like a crisis; it crept in as a constant background hum. I began to dread the pager’s …

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