The highway from western North Carolina to northeast Georgia is dark at five in the morning. One of my long-time patients grips the wheel and drives two hours for a 15-minute visit with the doctor she trusts. She could have met me by video from her kitchen, but the law forbids it. The moment she crosses that state line, I lose the right to care for her. That’s not medicine. …
I wrote last year about physician suicide as a silent epidemic. The silence is not lifting. The losses are getting closer. The grief is heavier. We all feel it. This month, we lost Dr. Nolan R. Williams. He advanced care for severe, refractory depression and pushed neural stimulation science forward. Then he died by suicide. His death landed like a shock wave across medicine and beyond and the …
This morning marked a sad ending to my night shift. It was, or rather, had been, at a small community hospital in a tiny New England town, nestled in the backyards of where I was born and raised. But in just a few days, it will cease to exist as a hospital and morph into a stand-alone ER. Before I wrapped up my final shift, I sat down with a …
In December 2017, a fellowship-trained neuroradiologist in good standing was pulled off his teleradiology shift mid-interpretation by the police, put in handcuffs, and taken to jail. He was accused of reading ultrasound studies too quickly, approximately three to five minutes per interpretation, inconceivable to the district attorney and their hired plaintiff radiologist expert. Because there were Medicaid patients involved, he was said to be defrauding the government. The allegation was …
Extreme longevity
People claim they want to live to be 100, yet is that a good thing? How you get there may make all the difference. Here’s my take on Blue Zones and the prospect of living to 100. “Blue Zone” is a nonscientific term popularized twenty years ago by Dan Buettner, a National Geographic explorer who studied five geographic regions where many people live to be over ninety or 100. …
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Internal medicine physician Rajeev Khanna discusses his article, “I passed my medical boards at 63. And no, I was not having a midlife crisis.” He shares his journey of studying for the …
As a founder developing AI systems for mental health support, I have wrestled with a fundamental question: How do we use AI to expand access while maintaining patient-provider trust? Building an AI Mental Health Copilot has shown me that the ethical challenges are as complex as the technical ones, and far more consequential. The mental health crisis demands innovation. AI copilots offer scalable, always-available support to bridge care gaps caused …
During the pandemic lockdown I felt lonely and cut off from the usual fun and games with friends and family. I spent far too much time inside my own head, reading and thinking, but starving for the simple nourishment of play. When restrictions eased, all I wanted was to wag my tail at other people and invite them to a game of catch. Esoteric intellectual play can be rewarding, but …
I didn’t understand why, especially since I had just spoken with him before his travels. The day my son’s father, Joseph, died, I was sitting in a nail salon. A friend from the military called, offering condolences. I didn’t understand why; until I checked social media and saw the news of an airplane crash. My heart knew before my mind could process it.
Six years later, same month, just five days …
Psychiatrists know what it feels like to practice in a field questioned at every turn. From the earliest days of our specialty, we have faced doubts not only from the public but also from our own colleagues in medicine. The very existence of conditions such as schizophrenia, melancholic depression, bipolar disorder, or attention-deficit disorder has been challenged repeatedly. We have heard the claims: It’s just weakness. It’s a vitamin deficiency. …
Physicians hold one of the most essential and sacred trusts in every society: the care of human life. Yet across many developed nations, this trust is undermined by a growing culture of suspicion, litigation, sensationalism, and retaliation. When unethical malpractice lawyers hunt for profit, unfair regulators overreach with bureaucratic zeal, unprofessional journalists publish half-truths for headlines, or disgruntled patients weaponize complaints, the damage goes far beyond the doctor’s reputation. The …
In a major advance in medicine, a man with type 1 diabetes is making his own insulin again, this time using genetically engineered donor islet cells. Researchers provided the new cells with an invisibility cloak to allow them to escape immune detection. After three months of follow-up, his body had not only accepted the new tissue but was quietly producing insulin. This single-patient proof-of-concept study gives hope to the millions …
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Neurologist Ray Dorsey discusses the article “Expanding the Parkinson’s universe of care for patients, caregivers, clinicians, and communities.” In this episode, Ray reimagines Parkinson’s care through a cosmic analogy, with patients as …
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In 1995, I stood at the edge of a map most policymakers ignored: Appalachian Ohio. The Surgeon General’s 2002 report, “Closing the Gap: A National Blueprint to Improve the Health of Persons with Mental Retardation,” would later cite our work as a model for rural specialty outreach. But long before that recognition, we were ledgering care into counties where children with developmental disabilities had no clear path to diagnosis, let …
A recent Washington Post article called for earlier detection of atherosclerosis and a shift from “ischemia-centric” thinking to an “atheroma-centric” model. That’s progress, but it’s still missing the most important piece: Plaque isn’t the root cause.
For 50 years, we’ve built a trillion-dollar cardiology machine around the cholesterol hypothesis. Statins, PCSK9 inhibitors, ezetimibe, inclisiran, Lp(a) drugs, all circling the same biochemical drain. LDL plays a role, yes. But LDL is …
HBO’s The Pitt collected thirteen Primetime Emmy nominations this year, winning both Outstanding Drama Series and Outstanding Lead Actor in a Drama Series for Noah Wyle. But the recognition was not just for great television. The series struck a cultural nerve because it captured something raw and real: the emotional side of medicine. Viewers saw the chaos of an emergency room after a mass casualty event, the head physician …
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Physician and coach Jessie Mahoney discusses her article “Stepping down in medicine is an evolution.” In this episode, Jessie challenges the cultural belief that stepping down from medical roles is a sign …
Students have been sharing with me their reasons for deciding to pursue a career in internal medicine, a fitting topic for this year’s upcoming Internal Medicine Day. The most moving stories are those describing them seeing the person behind …
As a research scientist who is devoted to ensuring that immigrant nurses have successful U.S. careers, the issue of internationally educated nurses’ (IENs’) cross-culture language competence has recently been both a sensitive and front-and-center issue pervading my work. In my more than 30 years in the health care sphere, the topic is now reaching a fever-pitch as IENs increasingly enter the U.S. health care workforce and play a critical role …
The Federally Qualified Health Center stands as perhaps the most eloquent institutional response to the perennial tension between medicine as market commodity and medicine as moral imperative. In the concrete reality of the FQHC (with its sliding-fee scales, its community governance structures, and its legislative mandate to serve the underserved) we find materialized those aspirations that have animated medical ethics since the Hippocratic tradition: that healing should flow toward need …
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