I remember the moment I understood I would have to write this story.
I was in Berlin with my girlfriend, wandering the city hand in hand, stopping for coffee near the Tiergarten with no real plan. We decided to visit the Jewish Hospital, the Jüdisches Krankenhaus. I had heard the name so many times in my family, and now I was just a few metro stops away.
We entered beneath the old …
Why do physicians write fiction?
While protein has dominated the nutrition conversation over the past decade, fiber is rapidly gaining ground as more consumers recognize its role in preventing disease and promoting overall well-being. From digestive health and weight management to heart health, blood sugar control, colon cancer prevention, and even reducing inflammation, the benefits are hard to ignore.
Yet most Americans average only 50 percent of optimal fiber requirements, with most consuming just 15 grams …
How to eat more fiber without the bloating
Whether the spread of bird flu to dairy cows, pigs, cats, dogs and seals or the spread of COVID-19 to deer, minks and zoo animals, the press is often mum about zoonotic viruses when they jump species.
Who, for example, knows that Ebola can spread to dogs, pigs and antelopes? Is non-reporting of virus activity to forestall panic or protect commercial markets?
The spread of animal viruses is caused by domestication, warfare, …
Why the press stays silent on zoonotic viruses
Years ago, when I was the only otolaryngologist in Columbia County, Pennsylvania, I treated a young boy with allergies. We had tested him, confirmed his sensitivities, and gotten him stable: a daily antihistamine, a nasal steroid spray, and allergy shots he received in my office. He was doing well. Then, at the end of one summer, he went back to school and fell apart. His controlled allergies flared. His asthma …
Your sinus infection may not be an infection
For more than three decades, I prescribed Schedule II stimulants to children and adolescents with ADHD. I did it carefully, consistently, and always within clinical standards. Yet throughout those years, I carried a quiet, persistent fear, not of harming patients, but of being misinterpreted by the Drug Enforcement Administration (DEA).
That fear wasn’t irrational. It was structural.
The DEA’s enforcement posture has long treated volume as suspicion, clinical judgment as potential misconduct, …
DEA fear is reshaping how doctors prescribe
After nearly four decades in medicine, I have become convinced that one of the greatest threats facing American health care is not a lack of scientific advancement. It is the growing imbalance between what our health care system excels at and what it often neglects.
Modern medicine has achieved extraordinary successes. We routinely save patients from heart attacks, strokes, severe infections, trauma, and many cancers. We transplant organs, replace joints, implant …
Why scientific medicine alone is not making us healthier
For many years, the medical establishment has argued, and in my view correctly, that addiction is a legitimate neurobiological condition that may often require long-term pharmacologic treatment, including with an opioid such as buprenorphine or methadone. This is not, in itself, a controversial stance. However, when the subject turns to pain, whether acute or chronic, many of the same institutions abruptly change their tone and, more importantly, their mindset. Pharmacologic …
The double standard at the heart of chronic pain treatment
Gen X (roughly 1965 to 1980) grew up as “latchkey kids” with no constant internet, more independence, figuring things out through trial and error. They often developed real resilience from facing hardships without much handholding. Gen Z (1997 to 2012) entered a world saturated with technology, social media, instant information, and a big emphasis on mental health. Many are thoughtful about emotional well-being but can be less practiced …
Youth online gambling is the new opioid crisis
Last week, KevinMD published my blog titled “The anticoagulant standard of care nobody tested.” This week I’ll continue with a discussion of patients who may have been harmed by anticoagulants.
In 2001, two co-authors and I initiated a systematic review of “Anticoagulants versus non-steroidal anti-inflammatories or placebo for treatment of venous thromboembolism.” The Cochrane Database of Systematic Reviews delayed publishing it until 2006. Because of the delays, Medscape General …
Heparin for acute coronary syndrome: a closer look
Subscribe to The Podcast by KevinMD. Watch on YouTube. Catch up on old episodes!
The same Robert Kennedy Jr. who sued Monsanto over glyphosate in 2017 is now defending an order to expand its production. What does a functional medicine physician do with that? Shiv K. Goel, …
MAHA has the right diagnosis and the wrong treatment plan [PODCAST]
A 32-year-old male is rushed to the ER. An hour ago, he was playing football with his friends, as he does every week. No smoking. Barely drinks. No family history anyone knew about. He is 32 years old, and his heart is attacking him. He is not an anomaly anymore. He is a pattern. According to an extensive study spanning 16 years, the rate of having a heart attack …
The hidden causes of heart attacks in young adults
I have delivered hundreds of babies. I have held the hands of women in their most terrifying and most joyful moments. I have spent my entire adult life becoming the kind of doctor who shows up, completely, compassionately, and without hesitation, for my patients. What I never imagined was that one day, bleeding and pregnant and alone in a call room at 21 weeks, I would be the one who …
Pregnant resident discrimination nearly cost me everything
Trust is often discussed in medicine as if it were mainly personal. Did the patient trust the clinician? Was the clinician empathetic? Did communication feel respectful? Did the patient feel heard? All of that matters. But it does not fully explain why trust breaks down in modern care.
Patients do not lose trust only when a clinician is rude, dismissive, or wrong. They lose trust when they leave an encounter without …
Trust in medicine is restored by method, not empathy
ADVERTISEMENT
In a Philadelphia courtroom this spring, a malpractice verdict unraveled in real time. A juror stood up during the reading of the verdict and said to the judge, “I think I misunderstood your question.” Moments later, when asked again if she agreed, she answered, “No, I do not.” What followed was confusion, re-polling, shifting answers, and ultimately a legally valid but deeply disturbing conclusion: The defendant physician was partly negligent, …
Why juries struggle with medical malpractice cases
The dream is always the same.
I’m pushing the ultrasound machine down a hospital hallway with an X-ray tech beside me. We’re on our way to do a portable exam when a voice crackles overhead: “Radiology to the ER. STAT.” She peels away toward the emergency department, and I turn back toward imaging alone. Then I can’t find my way back.
I step into elevators that open onto unfamiliar floors. I push …
Health care worker burnout doesn’t end at retirement
Most independent practices treat HIPAA as a documentation exercise. The policy binder sits on a shelf, the privacy notice is posted, the staff training certificate is in the file, and the assumption is that the practice is covered. Enforcement patterns over the last several years suggest a different exposure model. The settlements that reach small practices are rarely about the policies that were missing on paper. They are about the …
Why HIPAA settlements hit independent practices
I have written a couple of previous articles regarding pharmaceutical advertisements on TV and in print. I noted that they used glitz to sell their products, and that this was not helpful for patients, especially as many new products had potentially more severe side effects than older ones and were often of no greater effectiveness. The only significant difference was that newer products were more expensive.
The safety issue is of …
5 ways drug ads mislead patients on TV
I still hear my ventilator alarms in my sleep. But what stays with me is the silence.
For a long time, our ICU felt sealed off. No families. No clergy. No one at the bedside except us. When someone was dying at 2 a.m., it was machines, medication drips, and a screen propped up so a family could say goodbye from somewhere else.
We filled in the gaps. We had to. We …
ICU nursing did not return to normal after COVID
When the American Psychiatric Association formalized Section 7.3 of its Principles of Medical Ethics in 1973, it acted with a clear sense of urgency. Nine years earlier, the psychiatric profession had profoundly embarrassed itself in a partisan poll published by Fact magazine, where 1,189 psychiatrists, without any clinical examinations, labeled Republican presidential nominee Barry Goldwater “psychologically unfit.” The diagnoses were sloppy, weaponized, and defamatory.
The decayed fortress of silence
In response, the …
The Goldwater Rule and the cost of psychiatric silence
As a former Team USA figure skater with my own Olympic dreams, I couldn’t help but reflect on my own experience as an elite athlete while watching the Winter Olympics this year. With Match Day behind me and medical school graduation approaching, it is also time to dream of the future again.
In March, I matched into orthopedic surgery for residency, and I hope to complete a sports medicine fellowship to …
A letter to my future self, the team physician
Get free updates delivered free to your inbox.
