Conditions

Is modern medicine losing its soul?

Conditions
November 10, 2025

They tell me the physician’s art lies in the stitching of skin,
the analysis of shadows on X-rays,
and interpreting numbers in a medical chart.
Yes, there is skill involved.
a steady hand, a quick eye,
and a good memory for pathways and procedures.

But I wonder.
where, in the span of 20-25 minutes,
is the art that cannot be quantified
or coded?

It’s found in the stillness of listening,
in the weight of one person’s story
resting in another’s hands.

A doctor …

Read more…

The opioid crisis’s other victims

Conditions
November 9, 2025

Introduction: a crisis of pain

The opioid crisis is one of the most significant public health emergencies of our time, defined by staggering rates of addiction and overdose. Yet, behind the headlines is a story of profound and often overlooked human suffering. In an effort to save lives, public health policies were enacted to aggressively reduce opioid prescriptions. While well-intentioned, these policies have inadvertently precipitated a parallel crisis of iatrogenic harm, …

Read more…

The need for pediatric respite care

Conditions
November 8, 2025

My son Gideon is almost 12 years old. He is funny in that sharp, unexpected way that catches you off-guard. He is deeply expressive and full of life. He gives love and joy more freely than most kids his age. He is curious and social. He is healthy, and I am grateful for it. We are endlessly proud of who he is.

And, our family constantly walks the edge of breaking …

Read more…

A better way to talk about kids’ nutrition

Conditions
November 8, 2025

When parents bring their children to the clinic, they often expect quick advice: “Eat healthy. Exercise more.” But after years in practice, I’ve learned those generic prescriptions rarely work. Families leave feeling uncertain, children feel pressured, and real changes at home are hard to sustain.

That’s why I focus on a family-centered, personalized approach. Nutrition is not just about a child; it’s about routines, traditions, and stresses that affect the whole …

Read more…

Many seizures don’t look like the movies

Conditions
November 8, 2025

When most people think of seizures, they picture someone falling to the ground with violent shaking, the dramatic scenes we’ve seen in movies and television. While these tonic-clonic seizures (previously known as grand mal seizures) do occur, the reality is that many seizures look nothing like what Hollywood portrays. They are often subtle, easily missed, and can be mistaken for daydreaming or unusual behavior.

More than 3 million Americans have active …

Read more…

Breast cancer in teenagers is rare but real

Conditions
November 8, 2025

When people think about breast cancer, they picture middle-aged or older women. The pink ribbons, awareness campaigns, and even clinical guidelines overwhelmingly focus on adults. What’s almost never discussed is that, though rare, breast cancer can occur in teenagers. And when it does, the diagnosis is often delayed, with consequences that change a young life forever.

Breast cancer in adolescents is extremely uncommon, accounting for less than 1 percent …

Read more…

Opioid prescribing guidelines ignore metabolism

Conditions
November 7, 2025

My primary focus is on U.S. and international public health policy for treatment of severe chronic pain. I have been active for over 28 years as a health care writer and educator, with over 300 papers authored or co-authored in a mix of peer-reviewed journals and mass media.

I am a particular critic of what I believe to be the proven misdirection (a.k.a. “fraud“) committed by Federal and State …

Read more…

Is Lp(a) testing the new messiah?

Conditions
November 6, 2025

I just read yet another article praising the new messiah of cardiology (Lipoprotein(a)) and urging every physician in America to start testing for it. The tone was familiar: solemn, scientific, and a little evangelical.

The message? “Measure Lp(a) once in every patient.”

The subtext? “Because we finally found the missing piece.”

If this feels like déjà vu, that’s because it is. We’ve been here before: first with total cholesterol, then LDL, then HDL …

Read more…

My journey to a type 1 diabetes diagnosis

Conditions
November 6, 2025

I was diagnosed with type 1 diabetes mellitus in February 2024. Now it all made sense.

It all started in October 2020 when I passed out cold. I was rushed to the emergency room and 3 days later woke up to find I had a thyroid issue and lost 2 pints of blood. Four days later, after a blood transfusion, I was sent home. At that point, I thought I was …

Read more…

Can flu shots prevent heart attacks?

Conditions
November 4, 2025

As an internist and lipidologist, I’ve spent decades parsing data on statins, ezetimibe, PCSK9 inhibitors, and the endless parade of “LDL-lowering breakthroughs.” Yet the most potent, and perhaps the most underappreciated, intervention to prevent heart attacks each winter doesn’t come from a cardiology journal or a pharmaceutical rep. It comes from your local pharmacy fridge. For years, I’ve told my patients that getting a flu shot may prevent a heart …

Read more…

The hidden cardiovascular cost of alcohol

Conditions
November 4, 2025

A glass of wine with dinner. A cocktail on a Friday evening. A few beers over the weekend. For many of my patients, alcohol is woven seamlessly into daily life: a social lubricant, a way to unwind, even something they’ve been told might be “heart-healthy.”

Yet, in my clinic, I see the other side. A patient who comes in with fluctuating blood pressure, convinced their readings must be wrong. Another who …

Read more…

Lipoprotein(a): the hidden cardiovascular risk factor

Conditions
November 3, 2025

Lipoprotein(a) [Lp(a)] was, until recently, an underrecognized cardiovascular risk factor. However, extensive research over the last 15 years (including vast genome-wide association studies) has confirmed an independent, causal link between elevated lipoprotein(a) levels and atherosclerotic cardiovascular disease (ASCVD). The science has shown that, despite their small size, Lp(a) particles can have a substantial health impact, and as many as one in every five individuals worldwide has elevated levels (defined as …

Read more…

ADVERTISEMENT

What teen girls ask chatbots in secret

Conditions
November 3, 2025

Teen girls are turning to chatbots, not for homework help, but for the questions they’re too afraid to ask anyone else. Not their parents. Not their teachers. Sometimes not even their closest friends. Instead, they whisper their fears into an empty chat box late at night, hoping the words land softly somewhere.

These aren’t silly or shallow questions. They’re small windows into a generation growing up online, trying to feel safe …

Read more…

The problem with laboratory reference ranges

Conditions
November 2, 2025

Tonight, my lab quietly changed what it considers a “normal” ApoB. On Monday, my patient’s ApoB of 98 mg/dL was comfortably green. On Tuesday, that same number was flagged high, a 30-point swing in the normal range overnight. No new evidence. No new trial. No public health crisis. Just a reference-range recalibration. And with that one quiet adjustment, millions of people who went to bed “normal” may wake up “abnormal.”

Reference …

Read more…

Why carrier screening results are complex

Conditions
November 2, 2025

Carrier screening has outgrown the language we still use to explain it. The rapid expansion of genetic testing has uncovered new layers of complexity in how conditions present, how results should be interpreted, and how patients experience and act on genetic information. To practice responsibly in this era of Genetic Carrier Screening 3.0, clinicians must understand not only what we are testing for, but how and why the results look …

Read more…

The crisis in modern autism diagnosis

Conditions
November 2, 2025

Autism was never meant to be diagnosed in 15 minutes.

The original vision, born in war-torn Vienna and postwar Baltimore, called for deep observation, multidisciplinary insight, and time. But somewhere between the ideal and the insurance code, we lost the standard.

Today, families navigate a system built for speed, not truth. And children pay the price.

The ideal vs. reality

In theory, pediatricians perform routine developmental surveillance. Screenings like the M-CHAT happen at 18 …

Read more…

A poem about being seen by your doctor

Conditions
November 2, 2025

I come to you with stories
I cannot name.
They press against my chest
waiting for a moment when
it feels safe
for them to be set free.

Pain is a language
I find difficult to speak aloud,
and the silence between us
feels like a waiting room
that will never empty,
pressing in on me,
catching my breath.

Two strangers,
white walls between us,
your eyes move toward the clock,
while mine look at my folded hands
resting in my lap.

I wonder
am I just a time …

Read more…

The childhood risk we never talk about

Conditions
November 1, 2025

Parents are inundated with advice and guidance on all manner of topics from an array of sources, but as a pediatric emergency medicine physician, I have been astonished to realize that parents hear almost nothing about the risk that actually poses the greatest threat of causing serious harm to their children. Approximately 10 percent of children in the United States experience sexual abuse, with one in four girls and somewhere …

Read more…

Are we scared of the wrong environmental toxins?

Conditions
November 1, 2025

Like you, I receive many emails concerning environmental toxins. Many of their claims are based on conjecture rather than scientific evidence and are delivered in a panicked manner, implying that you or a family member is doomed if you do not act quickly. It is especially annoying that they often target minor issues rather than major ones. For example, they have emphasized the danger of artificial sweeteners. However, if one …

Read more…

124
pages