Conditions

Why your health is a portfolio to manage

Conditions
October 16, 2025

I’m not a financial advisor. But after 35 years in internal medicine and lipidology, I’ve realized that physicians are essentially wellth managers, stewards of human energy, rhythm, and resilience.

We help people diversify their time, protect their emotional capital, and build habits that generate compound interest in the form of years, vitality, and peace. In a way, our patients are portfolios: living, breathing balance sheets of choices and consequences.

It’s not money …

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Pain control failures in fertility clinics

Conditions
October 16, 2025

“The Retrievals” is a podcast series hosted and written by Susan Burton and presented in cooperation with the New York Times that focuses on the failure of a Yale fertility clinic to address uncontrolled pain during procedures. As it turns out this was the result of a nurse surreptitiously replacing the pain medication fentanyl with saline to support her addiction. This apparently unfolded over the course of a year or …

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Why what you do in midlife matters most

Conditions
October 16, 2025

Aging well is not solely a matter of luck or genes, in my experience as a gerontologist. The choices we make, the connections we nurture, and the support systems we build shape it. There is no better time than now to start—the latest research from 2024 and 2025 supports this.

Let us begin with a crucial insight: midlife is more important than we once imagined. In new studies, it has been …

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Was Viagra the best heart drug we never had?

Conditions
October 15, 2025

Prologue: the lost opportunity

Everyone knows Viagra as the “little blue pill” that revolutionized the bedroom. But what if its greatest potential was never about sex, but about saving lives?

A long-term study from Manchester followed men with both diabetes and a prior heart attack, about as high-risk a group as you can imagine. The results were astonishing: those who used sildenafil (Viagra) had a thirty-eight percent lower risk of another …

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How to stay safe from back-to-school illnesses

Conditions
October 15, 2025

From daycare to college, the back-to-school season almost always correlates to one thing: a rise in respiratory illnesses. In late summer, when children are returning to their classrooms, outbreaks of illnesses like strep throat, influenza, COVID-19 and respiratory syncytial virus (RSV) become more common, and schools can quickly become amplifiers of community transmission. These infections can spread rapidly through contact with surfaces where the virus or bacteria is present, like …

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The infectious hypothesis of heart disease revisited

Conditions
October 14, 2025

I have written here before about my growing conviction that coronary artery disease is not just about LDL, inflammation, or bad luck. It is time to talk about what might be the elephant in the cath lab: infection.

A recent pathology study out of Japan looked at coronary plaque samples from patients with symptomatic CAD. Using both immunohistochemistry and PCR, they found Chlamydia pneumoniae in every single sample. All fifty plaques …

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How timing affects chemical exposure risks

Conditions
October 13, 2025

As physicians, we’re used to thinking about dose (how much medication, how often, and for how long). But there’s another dimension that’s often overlooked: time. For decades, we’ve known that the body processes medicines differently depending on the time of day. A blood pressure pill or chemotherapy drug can have markedly different effects depending on when it’s taken. This field, known as chronopharmacology, has transformed how we think about drug …

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A physician’s tribute to respiratory therapists

Conditions
October 13, 2025

Larry is a friend. We are not besties. He is a neighbor, a few miles down the road from our forty-eight-acre hobby farm in our quaint little town, surrounded by farmland, generational farmers, rusted old tractors, cornfields, livestock, and a few homes interspersed in between. He is a neighbor, nonetheless. And a friend.

I first met Larry when we were building our country home, where my wife dreamt of raising a …

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How to protect your voice like a professional

Conditions
October 13, 2025

California Governor Gavin Newsom recently made headlines for his marathon public appearances, speeches, and press briefings. Watching him, I could not help but wonder what his voice coach or speech-language pathologist might say. As a clinician who specializes in voice therapy, I see teachers, pastors, lawyers, and health care providers (people who depend on their voices every day). Politicians are no different.

Our voices are often our most valuable tool, yet …

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Is Alzheimer’s an infectious disease?

Conditions
October 12, 2025

For decades, neurology has told us that Alzheimer’s disease is caused by toxic proteins (amyloid plaques and tau tangles) that clog the brain. Pharmaceutical companies have poured billions into anti-amyloid drugs designed to wash them away. The results? Repeated failures, high-profile disappointments, and a handful of marginal approvals with no meaningful improvement in patients’ lives. Sound familiar? In cardiology, we’ve built an entire industry on lowering LDL cholesterol. Statins move …

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Life after GLP-1s: How to sustain weight loss

Conditions
October 12, 2025

It should come as no surprise that GLP-1 receptor agonists have revolutionized the management of obesity and metabolic syndrome. These drugs have shown extraordinary promise in regulating appetite, promoting weight loss, and improving blood sugar control. Nearly one in eight adults (twelve percent) have taken a GLP-1 agonist, and forty-three percent of adults diagnosed with diabetes have used these therapies, numbers likely to have increased further in the last year …

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A new framework for depression recovery

Conditions
October 12, 2025

What if recovery from depression was not only about reducing symptoms, but about rekindling a person’s inner spark?

During my years as a Navy nurse in mental health, I witnessed countless people navigating the heavy fog of depression. Many were offered medication, therapy, or structured activity schedules. These approaches saved lives and improved outcomes. Yet sometimes, despite best efforts, patients still felt like they were going through the motions, managing symptoms …

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Why health self-advocacy is an essential life skill

Conditions
October 11, 2025

Money management and career planning are considered life skills (but the skill that shapes health self-advocacy) deserves the same status. Without it, care suffers. My family member was recovering from surgery, facing medication safety concerns, severe anxiety, and the need for constant care. At the same time, I was managing my own records and preventive health. Like so many women, I had become the family’s chief health executive, carrying responsibilities …

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Are doctors’ emotions fueling the opioid crisis?

Conditions
October 10, 2025

It should be obvious by now, but somehow it is not: Physicians are not immune to the same emotions that govern human behavior everywhere else. We like to imagine that our white coats and years of training somehow grant us a protective immunity to fear, to shame, to the raw surge of emotion that can stop us in our tracks. The truth is, physicians and other medical professionals are just …

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Focal therapy for prostate cancer: a new option

Conditions
October 9, 2025

Prostate cancer treatment is evolving, and focal therapy is gaining relevance as part of that change.

For decades, patients and their physicians have had limited options: whole-gland treatments like radical prostatectomy or radiation, or active surveillance. But what about the men who fall somewhere in between? What about those who need more than monitoring, yet want to avoid the significant side effects associated with whole-gland therapy?

That is where focal therapy enters …

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Why a 500-calorie meal isn’t always fit

Conditions
October 8, 2025

I was watching Michigan take on Nebraska the other Saturday when a popular sandwich chain dropped its latest ad: “Our new 500-calorie Fit Sandwich!” Catchy. Marketable. But let’s be honest, it’s mostly bread, a little processed meat, and not much else. Yes, it comes in under 500 calories, but so does half a sleeve of Oreos. Does that make Oreos “fit”? This is the oldest trick in nutrition marketing. We …

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How physician obesity affects patient care

Conditions
October 8, 2025

Obesity affects one-third of the adult U.S. population, including physicians, and is estimated to cost $147 billion annually. How does the Body Mass Index (BMI) of the physician affect the relationship with patients and the care provided? According to a study in Obesity magazine, “Understanding physician body weight as a possible barrier to obesity care is critical given the important role physicians can play in helping patients manage or lose …

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When culture has the final word in cancer care

Conditions
October 8, 2025

Oncology has long been described as a discipline ruled by biology. Tumor pathways, mutational signatures, margins, and survival curves dominate how we measure, categorize, and predict outcomes. We are taught early in training that tumor biology is king, and much of our decision-making revolves around this truth. Yet, after years of practicing surgical oncology in India, I have learned that biology alone rarely determines the fate of my patients. Culture …

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A nurse practitioner on leaving the medical machine

Conditions
October 7, 2025

I began my career as a nurse practitioner in primary care, where patient visits are often limited to 15 or 20 minutes to manage complex conditions like hypertension, diabetes, and COPD. What struck me was how often these medical issues came with a psychological overlay like depression, anxiety, panic attacks, and trauma. That shaped the course of treatment as much as lab results or medications. The pace of primary care …

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The mental health workforce is collapsing

Conditions
October 7, 2025

A system hemorrhaging talent: the scale of the crisis

The global health care system is teetering on the edge of a catastrophic workforce deficit, with the World Health Organization projecting a shortfall of 11 million health workers by 2030. Nowhere is this crisis more acute than in the behavioral health sector, which is not merely losing talent but hemorrhaging it. The time for action is not just now, it’s yesterday.

Community …

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