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Mood swings and bipolar disorder are not the same thing

Nebyou Belay, MD

August 6, 2026Aug 6, 2026

Few psychiatric terms have migrated into everyday language as completely as "bipolar." It is now routinely used to describe irritability, emotional volatility, and rapid shifts in mood. Yet this widespread usage reflects a fundamental misunderstanding of the condition itself. At…

Few psychiatric terms have migrated into everyday language as completely as “bipolar.” It is now routinely used to describe irritability, emotional volatility, and rapid shifts in mood. Yet this widespread usage reflects a fundamental misunderstanding of the condition itself.

At the center of the confusion is a mismatch of scale. The public conception of “mood swings” involves rapid fluctuation, changes occurring over minutes or hours. These shifts may be mild, or …

Elizabeth Agyeman Prempeh, MD

The one-dimensional doctor is going extinct

August 6, 2026Aug 6, 2026

I was recently watching the wedding and honeymoon vlog of one of my favorite content creators. Weddings are fascinating milestones. It is probably the only moment in your entire life where you get absolutely every person you love gathered together in one single room. You are the undisputed center of attention. All eyes are on you, and the atmosphere is pure, concentrated love.

But as I was watching those perfect moments …

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The patient experience question physicians get wrong

Manoj Sreedharan, MD

August 6, 2026Aug 6, 2026

There is a question I have heard countless times throughout my career. "Was the patient happy?" It is usually asked with good intentions, but I have often wondered whether we are asking the wrong question. As physicians, our responsibility has…

There is a question I have heard countless times throughout my career.

“Was the patient happy?”

It is usually asked with good intentions, but I have often wondered whether we are asking the wrong question. As physicians, our responsibility has never been to make every patient happy. We cannot promise antibiotics for viral infections, unnecessary imaging for reassurance, or pain medications simply because they are expected. Good medicine often requires uncomfortable conversations …

Mpox in 2026 no longer looks like 2022

Mpox in 2026 no longer looks like 2022

Melvin Sanicas, MD

August 6, 2026Aug 6, 2026

In medicine, we are trained to react to alarms. A monitor beeps. A CT scan lights up. A lab value crosses a dangerous threshold. We move. Public health is harder. Sometimes the most important signal is not a siren, but…

In medicine, we are trained to react to alarms. A monitor beeps. A CT scan lights up. A lab value crosses a dangerous threshold. We move.

Public health is harder. Sometimes the most important signal is not a siren, but a persistent hum. That is where mpox appears to be now.

The latest World Health Organization situation report should not send clinicians into panic, but it should pull mpox back into …

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Team-based diagnosis is already how modern medicine works

Yaroslav Dokuchaev

August 6, 2026Aug 6, 2026

Walk into any tumor board and you can watch the problem resolve itself for one hour a week. A radiologist, a pathologist, an oncologist, and a surgeon each hold a piece of the same patient. It is one of the most valuable hours a hospital spends, and one of the few moments when the system concedes that a single physician cannot see an entire case.

Outside that room, we still build …

Why evidence alone doesn’t change minds

Why evidence alone doesn’t change minds

Steve Sobel, MD

August 6, 2026Aug 6, 2026

If solid evidence reveals that major, long-held beliefs rest on wobbly pillars of false assumptions, how can we convince others to jettison such beliefs and embrace novel approaches? What can we learn from the tragic case of Ignaz Semmelweis in…

In 1847, one in six mothers perished from childbed (puerperal) fever at the Vienna General Hospital where Dr. Semmelweis worked. In some months up to 30 percent of …

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Nurses are getting assaulted at work and no one listens [PODCAST]

August 5, 2026Aug 5, 2026

A nurse survived a violent assault at work, then watched her hospital treat her like a liability, not a victim. In this episode, June Garen, a retired psychiatric and operating room nurse and author, and Carleigh Beriont, a former union…

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Why using AI to write articles needs an audit trail

Bobby Dubois, MD, PhD

August 5, 2026Aug 5, 2026

Not long ago, I wrote a Sensible Medicine article about AI called "I invented a headache to test AI and here is what I found." I concluded that for diagnosing my headache (and a few other conditions), AI got things…

Not long ago, I wrote a Sensible Medicine article about AI called “I invented a headache to test AI and here is what I found.” I concluded that for diagnosing my headache (and a few other conditions), AI got things wrong quite often. When given full history of my problem, it did well, but a typical patient doesn’t know the pertinent negatives and positives to provide the GPT. False-positive …

Medicine keeps treating oral health as someone else’s job

Daria Buinevich, DDS

August 5, 2026Aug 5, 20263

During my years in clinical dentistry, I repeatedly met patients whose oral disease had been causing symptoms long before they reached a dental office. Some had mentioned bleeding gums to another health care professional but did not understand that the symptom required evaluation. Others had lived with painful chewing, loose teeth, or persistent dry mouth while managing diabetes, cardiovascular disease, or multiple medications. By the time they sought dental care, …

Medical misinformation arrives before the physician does

Arthur Lazarus, MD, MBA

August 5, 2026Aug 5, 2026

An excerpt from Medicine Versus Politics: Three Tales of Patient Survival. Deception has always been a weapon, but in our time it has become a system. In medicine especially, where facts should be the most trusted currency, lies can wound…

An excerpt from Medicine Versus Politics: Three Tales of Patient Survival.

Deception has always been a weapon, but in our time it has become a system. In medicine especially, where facts should be the most trusted currency, lies can wound as surely as disease itself. Repetition, amplification, and manipulation turn rumor into “truth” at a frightening pace. When politics co-opts this process, the consequences are not merely theoretical; they can …

Health technology

Clinical judgment is what turns information into medicine

Dr. Souad Remani

August 5, 2026Aug 5, 2026

Medicine has always evolved Every generation of physicians has witnessed change. New instruments replaced older ones. New imaging techniques revealed what could once only be imagined. Laboratory medicine became increasingly accurate. Minimally invasive procedures reduced recovery times. Digital records replaced…

Medicine has always evolved

Every generation of physicians has witnessed change. New instruments replaced older ones. New imaging techniques revealed what could once only be imagined. Laboratory medicine became increasingly accurate. Minimally invasive procedures reduced recovery times. Digital records replaced paper files. Today, artificial intelligence is beginning to assist physicians in ways that seemed impossible only a few years ago.

For many people, these changes suggest a simple conclusion: Technology will eventually …

Kyoko L. Yoda, DMD, MSPH, MSD

What ethics education owes students when evidence changes

August 5, 2026Aug 5, 2026

Ethics education differs from other disciplines because its main goal is not to transmit information but to encourage moral reasoning. When students leave an ethics course, we hope they will be better equipped to analyze competing values, evaluate evidence, and justify their conclusions, not merely adopt those of the instructor. When you think about it, the teaching of ethics is itself an ethical act that can carry responsibilities extending beyond …

Tobacco harm reduction changes the talk with your doctor

Edward Anselm, MD

August 5, 2026Aug 5, 2026

Until recently people who smoke cigarettes were presented with a simple choice: continue smoking and worsen the risk and severity of tobacco-related disease or make another quit attempt. The doctor would ask, “Do you believe that you are ready to quit smoking?” Both doctor and patient would be relieved when the answer was “no.” The doctor was given back some valuable time …

How specialists can handle difficult patients

Joan Naidorf, DO

August 5, 2026Aug 5, 2026

I recently had the opportunity to speak with a group of neurogastroenterologists who practice at a major referral center. These specialty physicians treat people with complex digestive disorders such as gastroparesis, abnormal motility, and irritable bowel disease. They also treat patients with illnesses categorized as “functional gastrointestinal disorders,” where no specific physical or lab abnormality can be identified. The people who have these disorders can get very frustrated and unhappy …

Adult-onset ADHD is a naming problem, not a new disorder

Nebyou Belay, MD

August 5, 2026Aug 5, 2026

"I've never really been able to focus, but it's only become a real problem in the last few years, since I started this job. Could I be evaluated for adult ADHD?" I hear a version of this request often, and…

“I’ve never really been able to focus, but it’s only become a real problem in the last few years, since I started this job. Could I be evaluated for adult ADHD?”

I hear a version of this request often, and it captures a confusion built into the term itself. “Adult ADHD” sounds like it names a condition that begins in adulthood, the way adult-onset diabetes or adult-onset asthma can. It doesn’t, …

Dance and brain health: a physician’s prescription

Geeta Maker-Clark, MD

August 5, 2026Aug 5, 2026

In many shamanic societies, if you came to a medicine person disheartened, dispirited, or depressed, they would ask one of four questions: When did you stop dancing? When did you stop singing? When did you stop being enchanted by stories? When did you stop being comforted by silence? I think about those questions often as a physician, and almost nothing I was trained to do begins with any of them.

Most …

Why doctors should read fiction, not just research papers

Matt Hasan, PhD

August 5, 2026Aug 5, 2026

A randomized controlled trial can tell us that a treatment reduces mortality by a measurable percentage. It cannot tell us what it feels like to receive that treatment, to wait for its results, or to watch someone you love decide whether to accept it. That gap, between what medicine measures and what patients actually experience, is where fiction has always done work that research papers cannot.

Consider Tolstoy’s The Death …

Gratitude in medicine: the people who carried me

Timir Banerjee, MD

August 5, 2026Aug 5, 2026

Reason I find that this exercise of thanking and expressing gratitude makes my journey to the land of the unknown joyful. I thought I should do this when I have a clear mind and good health. I am teaching the…

Reason

I find that this exercise of thanking and expressing gratitude makes my journey to the land of the unknown joyful. I thought I should do this when I have a clear mind and good health. I am teaching the residents now to understand its value. I am writing this now so that I am not too late to thank all those who helped transform my life. I want to …

Burnout blames the doctor for a broken system [PODCAST]