The first time I watched One Flew Over the Cuckoo’s Nest, it stayed with me for days. As an internist who has had the opportunity to care for psychiatric patients, I could not watch it as just a movie. I saw the familiar faces, the emotional extremes, the silent battles between care and control. And I felt the weight of questions the film still asks us today: Are we truly …
Modern medicine is failing in three critical areas: mental health, chronic disease, and prevention at the cost of trillions of wasted dollars and untold suffering.
The problem runs deep. In my earlier KevinMD post, “Medicine’s mental health crisis: why the system is failing us,” I described the “mind-body split” theory of the 16th and 17th-century Scientific Revolution as guiding medicine and medical education since that time. It …
Bridgett Brown, a resident of California, developed breast cancer from using brand-name and generic versions of the antipsychotics Risperdal (risperidone) and Zyprexa (olanzapine) says a new lawsuit from the Wisner Baum law firm.
Neither Brown or her two prescribing physicians knew or “had reason to know” that the drugs could cause breast cancer since the drug manufacturers “obfuscated and disclaimed such risks while promoting these dangerous, expensive drugs over safer, …
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Licensed counselor and certified coach Mary Remón discusses her article “How doctors can turn criticism into collaboration.” Mary explains why physicians often react defensively to suggestions from colleagues, citing hierarchy, malpractice fears, …
As a practicing internist and lipidologist, I have long been trained to believe in the cholesterol hypothesis. Statins were not just recommended; they were the gospel. Lower LDL, save lives. That mantra was repeated at every lecture, every conference, every guideline committee.
But like many dogmas in medicine, the cracks are there if you dare to look. And some of the most damning cracks are found in a set of randomized …
Lifestyle medicine is now a known, respected and utilized aspect of medical care to help patients live healthier lives and ward off chronic disease. Clinicians often counsel their patients on the pillars of LM: movement, nutrition, sleep, stress management, connection, and avoiding risky substances. These pillars are powerful and proven to be effective. But after integrating my training as a physician and health coach to lead group wellness travel adventures …
Remember the “before times” pre-pandemic, when most doctors had a single job that they went to every day, saw patients, did surgeries, took call for the same employer or practice?
Then in March 2020, the unthinkable happened. There was a worldwide shutdown of almost everything, including physicians’ offices, except for emergency rooms, ICUs, and other essential health care functions.
Once the realization set in that medicine was going to have to change …
The door closes with a soft click, sealing me inside a room that smells of alcohol and cotton swabs. The light is too bright, pouring down from overhead panels that have withstood the test of time. The entire room is bathed in a white-wash of light, leaving no shadows, except those that lie within me. A token landscape or two adorn the antiseptic walls, attempting to distract me from the …
An excerpt from Taking Care of Your Future: Your Simple System for a Big Retirement.
Whose plan? Is it yours or someone else’s?
Your financial plan is too important to be someone else’s. It must be yours. This book will help make it so.
It all starts with your vision.
Ever notice that when you get a new car, you suddenly see the same model all over the road and in about every …
Dara closes one eye, then the other. “What the hell?” she thinks. The vision in one eye is noticeably darker and worse than in the other eye. She exits the dark room, where she had been coding a new website for a client, and heads to the bathroom. She looks at herself in the mirror. Nothing seemed wrong with her eyes. Nothing hurts, well, maybe a slight headache, but she …
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Clinical psychologist Faust Ruggiero discusses his article “How to rewire your brain with positive language.” Faust explains how the words we use internally shape our thoughts, emotions, and behaviors, and why negative …
Varicocele is one of the most common findings in men being evaluated for infertility. Roughly 15 percent of all men have one, and the number climbs to about 40 percent among men with fertility problems. Yet despite how common it is, a varicocele remains a confusing diagnosis. Some men are told they need surgery right away, while others are advised to do nothing at all.
The truth is somewhere in between. …
Gasping for breath, Michael (name changed) pushed back in his chair. His legs felt like lead weights. He could not delay the rescue call any longer. The oxygen in his blood had dipped into the 80s.
An X-ray showed a shadow over the lower part of Michael’s right lung, and the hospital admitted him to treat a pneumonia. A smoker for decades, he was relieved a few days later to be …
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We are trained to move quickly. To respond before thinking. To act before doubting. To rise at three in the morning because someone’s life might depend on it. That is how we learn ethics, not in seminar rooms, but in corridors that smell of antiseptic and coffee, under fluorescent light, beside stretchers with failing hearts.
And so, somewhere along the way, we begin to believe that morality lives in the moment. …
As a young pediatric anesthesia attending, I would often roll my eyes at resident trainees who prioritized their personal needs and required mental health days. I may have even looked down upon them as lazy, weak, and lacking grit. I prided myself on my work ethic, sacrificing time with my two children and aging parents for the sake of my patients. Medicine is a calling, not just a job, I …
Across the world’s earliest civilizations, healers turned to nature as their pharmacy. Ancient systems like Ayurveda in India, Unani (Hikmat) medicine in the Middle East, and early European herbalism developed sophisticated therapeutic practices rooted in plants and natural compounds, many of which are still clinically relevant today.
Take turmeric, for example. Traditionally simmered in milk or prepared as a paste, it was used for its healing and anti-inflammatory properties. Today, biomedical …
“We do not have the money! You took it all!”
Startled, I moved the phone away from my ear to dampen the screaming voice on the other end. I had just explained to my patient’s son that his 95-year-old mother could walk again; she just needed surgery to repair her hip fracture. This was good news, or so I thought. His mother had insurance, “good” insurance, and needed a fairly routine …
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Maternal-fetal medicine fellow Frank I. Jackson discusses his article “Affordable postpartum hemorrhage solutions every OB/GYN should know.” Frank explains how postpartum hemorrhage remains a leading cause of maternal mortality, especially in low-resource …
Cancer care has long been associated with physical, emotional, and psychological hardship. But for many patients, a quieter burden (the financial strain of treatment) shapes their experience in equally profound ways. Increasingly referred to as financial toxicity, this form of distress is emerging as a key determinant of cancer outcomes. Yet it remains under-recognized in day-to-day clinical care.
The high price of staying alive
Financial toxicity describes the economic hardship caused by …
When I was in my studies as a psychiatry resident, I learned about an interesting field called metabolic psychiatry, which focuses specifically on ketogenic therapies to treat psychiatric conditions. This is a nascent field at this time, with no extensive clinical trials like we have for medications, though some small trials exist. I even have some patients who have been on ketogenic diets (not prescribed by me) …
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