Since a diagnosis of colon and rectal cancer in 1993, I have had a number of serious complications and a recurrence. Some, if not most of what occurred could have been avoided. My experience points to some gaps in my health care that providers and patients might want to consider.
I was given the option to choose a cancer treatment and made the wrong choice. As a busy university administrator, I …
A story of gaps in cancer care
For the past century, physicians have practiced within the framework of materialism: the belief that everything real can be measured, and everything measurable is real. But that worldview has been quietly eroded by physics itself. In the double-slit experiment, particles behave as waves of probability until observed, at which point they collapse into definite form. Later variations (such as Wheeler’s delayed-choice experiments) demonstrated that observation seems to determine not only …
The role of meaning in modern medicine
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Diagnostic radiologist Rakesh A. Shah discusses his article “A critique of medicine’s response to RFK Jr.” Rakesh argues that major physician organizations have failed in their duty to protect public health by …
Medicine’s silence on RFK Jr. [PODCAST]
This is an invitation to clinicians and health leaders to shape the next decade of care: more precise, more connected, more human. The tools are here. The leadership is you.
The quiet nudge
If you’ve felt that steady tug that health care could be so much better, you’re not alone, and you’re not wrong. We’re investing more than ever, but patients still meet friction at the exact moment they need ease. That …
A new vision for modern, humane clinics
On July 6, 2025, in Nanjing, China, a construction worker plunged onto a steel rod that pierced him from pelvis to chest. That night, doctors fought millimeter by millimeter through a five-hour battle against death.
The call at midnight
The phone’s shriek tore through the heavy summer silence just after midnight.
Professor Ji Zhenling, president of Nanjing Jiangbei Hospital, surfaced from sleep, the warmth of his pillowcase still pressed against his cheek. His …
The night of an impalement injury surgery
The question “What’s strong with me?” startled me the first time I heard it. Because we direct so many of our day-to-day thoughts to what’s wrong, it can feel odd to ask what’s strong. But this simple question has the power to release the tight hold that problems have on our thoughts and open a new way of thinking. We’ve all had moments when problems seem so big that it’s …
Finding your child’s strengths: a new mindset
Patients once traveled on foot from Afghanistan to see my father, a Cleveland Clinic-trained doctor who practiced in Peshawar, Pakistan. It is easy to attribute such health care to a developing country. But California’s economy outperforms whole nations, and patients in the Central Valley still drive for hours to get life-saving treatment. I have lived and studied in both of these “doctor deserts,” one arid and one fertile. Both are …
The crisis of physician shortages globally
An important paper, “How to communicate medical numbers,” was published in a recent edition of the Journal of the American Medical Association (JAMA). This is so important, for the doctor-patient relationship, for what journalists write for the public, and for individual decision-making. One of the authors, Angie Fagerlin, PhD, of the University of Utah medical school and Salt Lake City Veterans Affairs Medical Center, was interviewed for a …
How to better communicate medical numbers
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Health attorney Dennis Hursh discusses his article “First physician employment agreement mistakes.” Dennis shares his amazement after 30 years in health law at the timidity of new attending physicians during contract negotiations. …
An attorney’s guide to your first physician contract [PODCAST]
There’s a quiet heaviness that has settled over medicine, not always visible, but deeply felt. It lingers in hospital corridors and hovers over clinic desks cluttered with charts and cold coffee cups. You can see it in the nurse scrolling through yet another new policy update, her shoulders sagging under invisible weight. You can hear it in the tired sigh of a physician glancing at the clock at 9 p.m., …
Why do doctors lose their why?
The creed of compliance
In every hospital, a grotesque comedy unfolds: Poor Sod, our hapless patient, lies gut-shot, aorta spewing like a B-movie fountain. Clinicians, faces blank as overcooked porridge, scurry in a choreographed panic, clutching flowcharts like sacred scrolls. Monitors bleep like a chorus of lobotomised parrots. A registrar, mad enough to trust his gut, tries a life-saving stunt not in the Holy Manual. A nurse, eyes glinting with the …
Bureaucratic evil in modern health care
The day before the attack, a senior physician at a Catholic university hospital in Taiwan sat with young medical students at noon, talking not about lawsuits or hospital finances, but about Brahms. He loved four-hand piano pieces, especially Brahms’s Hungarian Dances, and he would explain how two players must breathe together, listen to one another, and balance passion with discipline. For him, this was also a lesson about medicine: You …
Protecting elder clinicians from violence
I just read the new Cleveland Clinic Journal of Medicine introduction by its editor-in-chief, and it’s laying out the usual playbook: demonize lipoprotein(a) (Lp(a)), list all the terrible things it does, and hint that salvation is around the corner, pending results of a major pharmaceutical trial, of course.
It’s a neat narrative arc.
But it’s incomplete.
What’s missing is the one question almost no cardiology article seems willing to ask:
Why does Lp(a) exist …
Why does lipoprotein(a) exist?
For years, I believed that the best clinicians were the ones who never stopped. We covered extra shifts, skipped meals, charted past midnight, and proudly wore exhaustion as a badge of honor. My patients were happy, my colleagues admired my work ethic, and I was quietly unraveling.
The slow slide into burnout
Burnout didn’t arrive like a crisis; it crept in as a constant background hum. I began to dread the pager’s …
The myth of endless availability in medicine
Medicine is more than biology; it is organization. Every country builds its system of care according to its culture, economy, and priorities. In Japan, where I have spent the past few years, health care feels like an extension of social rhythm: precise, deliberate, quietly humane. In the United States, where I trained, the emphasis is on innovation and specialization, but often at the cost of coordination. Now, as I prepare …
China’s health care model of scale and speed
Idaho has become the first state to end Medicaid funding for Applied Behavior Analysis (ABA) therapy. This marks a shift away from concerns about inflated billing and variable outcome metrics toward a model focused on measurable and inclusive care. As a pediatrician who participated in NIMH-RUPP trials and has observed the clinical evolution of ABA, I recognize the significance of Idaho’s decision. The state acted proactively rather than awaiting federal …
A new autism care model in Idaho
He came to my office holding the results of his coronary CT scan. His eyes went immediately to the numbers, his voice tense: “Doctor, my FFR is 0.86. Do I need a stent?”
This is not an unusual question anymore. Coronary CT angiography with fractional flow reserve (FFR-CT) is rapidly becoming a common tool in cardiology. It gives us noninvasive insight into whether a coronary lesion is functionally significant. In plain …
What an FFR-CT score means for your heart
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Health care executive Kimberly Smith discusses her article “Why clinicians must lead health care tech innovation.” Kimberly explains why clinicians, who are on the front lines of patient care, are in the …
Why clinicians must lead the health care tech revolution [PODCAST]
For nearly a decade, almost every time my husband, Teddy, went into the hospital, they asked if he had an advance directive. And he did: It was notarized and given to any doctor he saw and any hospital he visited, including the one he died in.
But on the last day of Teddy’s life, the interventions he received were explicitly against his wishes as documented in his advance directive: no resuscitation, …
Advance directives not honored: a wife’s story
You notice them wherever they go. The new titans of industry dressed like college kids on their way to class. Recently, I saw a picture of Jack Dorsey, the founder of Twitter, in a plain cotton T-shirt and nerdy trousers. With his overgrown beard completing the look, he resembled a man emerging from months deep in the jungle after a survivalist contest. Then there is Mark Zuckerberg, perpetually clad in …
Why billionaires dress like college students
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