An excerpt from Real Medicine, Unreal Stories: Lessons and Insights from Clinical Practice (Volume 2).
The dinner plates had been cleared and a lazy instrumental playlist drifted through the background. Thad Brigham leaned back in his chair, a satisfied smile crossing his face as he looked at his daughters across the table.
“You two always manage to bring the energy back into this old house,” he …
8:00 a.m.: The start of a not-so-perfect morning
I wake up, already running a bit behind. I toss last night’s leftovers into a lunchbox while thinking, Will this meet my nutrition for the day? Maybe tomorrow I’ll pack something better. Morning routine kicks in: shower, brush, poop, pack bag, grab tea. No time to sit and sip, I carry it with me.
8:45 a.m.: Wheels on the ground
I hop into my WHO-assigned …
It was early morning—likely the first appointment of the day. The music in the waiting room had not even been turned on yet, and the smell of coffee was just beginning to meet the air. After a few minutes, I was called back to a room and sat in the exam chair, already in scrubs and mentally preparing to scurry off to work right after. In fact, I was already …
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Physician executive Sreeram Mullankandy discusses his article, “Bridging the digital divide: Addressing health inequities through home-based AI solutions.” The conversation highlights that while the future of health care delivery is moving into …
I’ve felt an overwhelming need to write for about a month now. I struggled to find the right words as recent events in medicine and society have created a constant state of confusion and distress. Most notably, I have found it increasingly difficult to understand or process how some medical professionals can remain silent or indifferent in the face of ethical crises. At times, the anger this evokes leads me …
They left quietly. Logged their last note. Disconnected their badge. Maybe cleared out a drawer, maybe not. And just like that, another clinician walked away from medicine. No exit interview. No debrief. No conversation about what led up to that final decision. Just silence.
In most professions, when someone resigns, leadership wants to know why. What worked? What didn’t? What could we do better next time? But in medicine? We barely …
Imagine assembling an IKEA bookshelf with instructions in 12 languages, missing pages, and screws that cost vastly different amounts depending on which store you went to, unbeknownst to you. Then, after assembling it, you discover you’ll be charged even more because you used an Allen wrench.
That’s a standard experience for Americans navigating the health care ecosystem—one that feels deliberately designed to create confusion and drain bank accounts.
The numbers speak for …
I’ve lived a full life. A hard one. A beautiful one. A complicated one. And now, at 61, I’m finally beginning to live an honest one.
I was built in survival mode. Growing up as a Korean American boy in Central Texas—often the only Asian face in the room—my earliest years taught me that difference could either be celebrated… or punished. At first, it was celebrated. I flourished. But a move …
An older woman with osteoporosis fell at home, developed back pain, then went to urgent care and was diagnosed with a “muscle strain.” During a follow-up visit in my office, she told me she’d had transient urinary incontinence after her fall, and on exam she had midline back tenderness, hip flexor weakness, and hyper-reflexive knee jerks. This woman had suffered a vertebral fracture, not a pulled muscle.
One of my patients …
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Pediatrician Sarah Webber discusses her article, “Why it’s so hard to admit when we don’t like our jobs.” The conversation is a vulnerable look into her personal experience with burnout just nine …
Professional coaching can contribute to personal growth and development by providing encouragement and support using a handful of simple techniques designed for deepening exploration in a co-created working relationship. Focuses can be wide ranging and include development and clarification of goals, refining communication, boundary setting, and conflict management skills. A coaching stance typically seeks improved performance, for example increased efficiencies at work or navigating executive function more effectively. It can …
A nation that can map the human genome, transplant a face, and land rovers on Mars somehow cannot guarantee its citizens a timely doctor’s appointment. The official story blames “complex market forces,” “geographic maldistribution,” or the ever-handy “burnout.” But beneath the diagnostic babble lies a simpler, more uncomfortable truth: A powerful medical guild has learned that scarcity pays—and it intends to keep the spigot only half-open.
A cloister in white
Walk the …
The first rule of being a doctor is not “do no harm.” It’s “mind your own business.”
You won’t find it in the ethics textbooks. It’s not part of any formal curriculum. But ask around—quietly, privately—and most seasoned clinicians will tell you the same thing: the people who ask too many questions don’t last long.
You learn this not from lectures, but from observation. A colleague flags a safety concern. A note …
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The vast majority of my physician colleagues understand the value of interoperability for their patients and their ability to deliver high-quality care.
In the rare cases that I encounter a clinician who is unsure of interoperability’s benefits, I simply tell them that it creates a situation where everyone wins: Providers deliver better, safer, less expensive care, and patients get more coordinated experiences.
Interoperability makes a strong, positive difference in the care I …
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LGBTQ+ journalist BJ Ferguson discusses the article, “Why physician voices matter in the fight against anti-LGBTQ+ laws.” The conversation serves as a call to action for medical professionals, arguing that their duty …
On June 12, 2025, Air India flight crashed minutes after takeoff from Ahmedabad in India. Among the 242 people on board, only one survived: a man seated in 11A.
That image has stayed with me—not just because of the miraculous survival, but because of what it reveals about systems. Seat 11A was located near the plane’s wing box, the structurally strongest part of the aircraft, and beside an emergency exit. Experts …
The next major health epidemic in the U.S. will not come from a pathogen. This plague has a potential patient population in the tens of millions, limited effective treatments, and is not widely studied in the medical community.
I’m referring to sports gambling, an activity that deeply alarms me as a physician who specializes in addiction. Problem gambling can increase the incidence of depression and anxiety and can lead to bankruptcy, …
When I was working full time in emergency medicine, I didn’t think much about the systems in my personal life. I had just enough clarity to show up for the next shift, keep my kid fed, work out, stay married, and try to remember where I parked the car. I wasn’t stupid. I wasn’t lazy. I was underwater. So I did what a lot of physicians do when they’re trying …
Medicine has always evolved through a blend of scientific rigor and bold innovation. Over the last century, surgical practice has progressed from risky open procedures to highly controlled, minimally invasive interventions. Laparoscopic surgery marked one such revolution, dramatically enhancing patient outcomes by enabling precision through small incisions. By the 1990s, it had become an essential part of modern surgery.
A similar, albeit slower, evolution has taken place in endovascular care. …
The solution to the physician burnout crisis isn’t more diagnoses or interventions. The antidote isn’t more modules, surveys, screenings, or questionnaires. What’s needed is cultural healing: One that we have so far been unwilling and/or too depleted to attempt.
Over the past decade, physician wellness has been medicalized. We’ve absorbed it into the very system that made us unwell. We’ve labeled it as pathology—when in fact, it’s a predictable outcome of …
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