In 1983, The Outsiders featured Robert Frost’s “Nothing Gold Can Stay” and, augmented by Francis Ford Coppola’s cinematic genius, it planted a seed, one I was unaware of at the time.
Nature’s first green is gold,
Her hardest hue to hold.
Her early leaf’s a flower;
But only so an hour.
Then leaf subsides to leaf.
So Eden sank to grief,
So dawn goes down to day.
Nothing gold can …
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Fertility specialist and founder of Montgomery Fertility Center Oluyemisi (Yemi) Famuyiwa discusses her article “Infertility public health: the WHO’s new global guideline.” Oluyemisi examines the historic release of global guidelines that reframe …
World Health Organization reframes fertility care as a fundamental right [PODCAST]
Many OB-GYNs find their views on perimenopause and menopause change once they experience these transitions themselves. Even with medical training, the symptoms can be surprising and harder to recognize than expected.
As women’s health clinicians, we understand the common challenges of this stage of life. Hot flashes, sleep problems, vaginal dryness, mood changes, weight gain, and trouble concentrating can affect daily routines in ways that many women do not expect. When …
How personal experience shapes perimenopause and menopause care
For the past few weeks, I’ve been rotating through pediatrics. In the emergency room, I met a little boy I’ll call Ian.
Ian was wary of everyone who came close to him, especially anyone holding a stethoscope or thermometer. Sometimes all it took was the way you raised your hand, or a glance toward his neck, for him to retreat behind invisible walls. He was only about a year and a …
Pediatric care barriers in West Africa: a clinician’s perspective
When Anne-Sophie Mutter appeared under the lights in Taipei to play John Williams, the audience was already aging with her. That is not a tragedy; it is a form of wisdom. In a super-aged society, an evening at the concert hall is not only entertainment; it is an anatomy lesson in movement, meaning, and care.
Tempo and governance
The program opened with “Sound the Bells!” The brass did not summon cinematic sentiment; …
Anne-Sophie Mutter, John Williams, and the art of aging
You know the real flex in life is to be able to stretch out like a cat on a random Tuesday and not worry about bills or appointments or being anywhere.
I think there’s something truly to be said about time freedom (and not only time freedom, but freedom of self) where we can let go of the guilt and shame and all these things that hustle culture has ingrained in …
Why the real flex in life is freedom of time and self
House lawmakers recently passed a health care bill that grabbed headlines for what it excluded: a solution to the looming expiration of enhanced Affordable Care Act tax credits. But largely overlooked inside the bill was a provision that did make it through, a long-requested provision toward creating stronger federal legislation directly targeting pharmacy benefit managers (PBMs), the middlemen who increasingly determine what Americans pay for their medications. These rules …
Why PBM transparency rules aren’t enough to lower drug prices
You don’t learn this in medical school: Clinical familiarity creates attachment.
Not the kind we mean in romance. Not even the kind we mean in psychotherapy. Something quieter and more automatic, built through repetition and stakes.
You don’t have to say anything deeply personal for it to happen.
You just have to show up again. And again. And again.
Same hallway turns. Same waiting room chairs. Same voice calling your name. Same pace in …
Clinical attachment in medicine: How familiarity creates safety
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Internal medicine physician Earl Stewart, Jr. discusses his article “Pancreatic cancer racial disparities.” Earl examines the devastating pattern of pancreatic cancer claiming Black cultural icons like John Lewis and Aretha Franklin while …
Racial disparities in pancreatic cancer screening cost Black lives [PODCAST]
Once a year,
I return to two quiet organs
I once carried without thought,
working faithfully in the dark,
asking for nothing,
until one day they asked to be seen.
Cysts.
Small moons of fluid,
bubbles scattered like careless stars
throughout the geography of me.
Harmless, they said.
Mostly.
Until one was not.
That year,
a word entered my body:
cancer.
A word that knows how to make itself at home
in every corner of thought.
A specialist explained
how light and force could be aimed,
how the invader could …
A poem on kidney cancer survivorship and the annual scan
I’ve spent more than 30 years in nursing, and in recent years my work has shifted to something most people never think about: clinical data abstraction. My job is to review the medical record and extract the pieces of information that clinical registries rely on for research, quality reporting, regulatory requirements, and everyday decision-making. It’s specialized work that depends on clinical judgment, a deep understanding of clinical documentation in the …
AI-enabled clinical data abstraction: a nurse’s perspective
Most physicians begin their careers with a deeply held belief: If treatment is good, patients will come. It feels intuitively correct, and early in practice it often appears to be true. Clinical outcomes build trust, trust brings patients, and for a time the system seems to sustain itself. Yet after years of working inside physician-owned hospitals, group practices, and large corporate health systems, I have learned an uncomfortable truth. Good …
Why clinical excellence isn’t enough to sustain a physician-owned hospital
The emergency department didn’t suddenly get worse.
The numbers did.
Every shift, emergency clinicians are measured by dashboards that insist on telling a familiar story: Door-to-provider times are too long, length of stay is unacceptable, left-without-being-seen rates are creeping up. The implication is clear. We’re slow. We’re inefficient. We’re failing.
But those numbers are no longer describing clinical performance. They’re describing system saturation.
Emergency departments today operate in conditions that were once considered temporary …
Emergency department metrics vs. reality: Why the numbers lie
Hashimoto’s disease is the most common cause of hypothyroidism in children and adolescents, yet it remains frequently overlooked, particularly in adolescent girls. Fatigue, mood changes, weight gain, and cognitive slowing are often attributed to mental health conditions or dismissed as normal features of puberty, delaying diagnosis and treatment. This pattern reflects a broader failure to recognize how autoimmune thyroid disease presents during adolescence, and how gendered assumptions shape clinical interpretation …
Hashimoto’s disease in adolescent girls: Why it’s often overlooked
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Health care attorney Dennis Hursh discusses his article “wRVU threshold risks in physician contracts.” Dennis explains the critical distinction between a guaranteed salary and a draw against future earnings where failure to …
Hidden financial dangers of wRVU thresholds in medical employment agreements [PODCAST]
In medicine, we are trained to lead with logic. To analyze, evaluate, and act. We are praised for decisive thinking, efficiency, and evidence-based decisions. In the hardest moments of my life, career, and leadership, none of those tools brought me clarity.
Ten years ago, as a practicing pediatrician and physician leader, my personal life began to fall apart. My husband, who had always been steady and supportive, began to slide into …
Leading with love: a physician’s guide to clarity and compassion
“I’m surprised I haven’t had a kidney stone.”
It’s a running joke among my co-residents, when it’s 3 o’clock in the morning, with over 20 patients in the waiting room, and nobody can remember the last time they had water. Most days, my fluid intake is limited to the sips needed to swallow my antidepressants (to quote my parents, “you can’t just take them whenever you feel sad,” and “it’s not …
Why doctors ignore their own advice on hydration and health
A man in his late 40s sits down in my office and says, “Doctor, I think my testosterone is low.”
Sometimes he is already holding lab results. Sometimes he is coming from a gym forum, a friend’s recommendation, or a late-night Google search. But almost always, the story sounds familiar: lower sex drive, fewer morning erections, weaker erections, fatigue, brain fog, mood changes, and that stubborn belly fat that seems to …
Low testosterone in men: a doctor’s guide to TRT safety
“Can AI scale in medicine?” is the wrong question.
The real question is: Can AI protect the soul of medicine while people who have never sat with our patients decide their fate?
The ADVOCATE program: an overview
The Trump administration recently launched the ADVOCATE program: Agentic AI-Enabled Cardiovascular Care Transformation. Run by ARPA-H, this initiative aims to build and deploy autonomous “clinical AI agents” for cardiovascular disease, with an FDA authorization pathway of …
Agentic AI in medicine: the danger of automating the doctor
Most clinicians know that eggs age. Fewer acknowledge that the uterus ages too.
In reproductive medicine, we often rely on the seed-and-soil analogy. The seed is the embryo. The soil is the endometrium, the inner lining of the uterus where implantation occurs.
Here is the part that deserves more explicit counseling and strategic planning: Even when embryo quality is controlled, uterine age can independently influence implantation, miscarriage risk, and live birth rates. …
Uterine aging in IVF: Why the “soil” matters as much as the seed
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