I was at one of the lowest points of my medical training. I had just finished my second-year exams. The stress had left me feeling hollow, anxious, and utterly drained. It was in this fragile state that my own body turned against me.
It started with a fever that would appear every evening. I told myself it was just the change of season. I took paracetamol and tried to ignore it. …
My rare disease was my greatest teacher
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Physician Jessie Mahoney discusses her article “Imposter syndrome is not a personal failing.” Jessie explains how self-doubt among physicians is less about individual weakness and more about a conditioned mindset reinforced by …
Why imposter syndrome is a systemic issue, not a personal flaw [PODCAST]
When you step into medical training, you’re often told, both implicitly and sometimes even explicitly, that certain parts of you don’t belong. Sensitivity, doubt, or even just being messy and human can feel like liabilities in a culture that prizes efficiency, certainty, control, and always “having the answer.” Many physicians I work with in therapy describe learning early on to “toughen up,” to silence the softer, more questioning sides of …
Reclaiming the human parts of a physician
Twenty years ago, when I started medical school, I had no idea that this would be my path. Coming from a research background in cancer biology and biophysics, I did not have much exposure or interest in integrative medicine. My path to practicing integrative and functional medicine and incorporating new modalities to my foundation as a general internist, was not linear, and not expected.
I was pregnant twice during my three-year …
My journey into integrative medicine started as a patient
In medicine, we’re trained to stay. To endure. To prove our worth by how much we can carry and how long we can carry it. Our roles become our identities. Our achievements and labels become scaffolds of self-worth. In medicine, stepping down is often labeled as a sign of weakness. So we hold on to roles even when they no longer fuel us. We are usually still doing the job …
Stepping down in medicine is an evolution
When I received an invitation to a webinar titled “Special Session on a New Autism Risk Test,” I expected a discussion on screening strategies or intervention innovations. Instead, when I researched the company and reviewed its website, I discovered a pitch for a punch-biopsy-based lab test marketed as a way to detect autism risk in newborns as early as two days after birth.
As a nurse practitioner who treats autistic patients, …
The ethics of marketing unproven autism tests
When we think about palliative care, our first instinct is to picture pain medications, symptom checklists, and clinical protocols. But for patients with terminal brain cancer, the reality is much more complex. As speech declines, as motor function deteriorates, and as identity itself feels threatened, the greatest need is not always more medicine; it is meaning, connection, and dignity.
In recent years, I have had the opportunity to study an ancient …
From Tokyo to Paris: Bringing the brushstrokes of healing to Western medicine
Not long ago, a 36-year-old man came to the emergency room with crushing chest pain. He had no significant medical history, exercised occasionally, and thought heart disease was something he would only need to worry about decades from now. To his disbelief, he was having a heart attack.
Stories like his are no longer rare. Cardiologists and emergency physicians are increasingly seeing patients in their thirties and forties presenting with acute …
Why younger patients are now showing up with heart attacks
We often see media headlines or articles about scientific and medical advancements promising imminent treatments or cures. I am not referring to advertisements that frequently masquerade as stories for naturopathic, homeopathic, or other unproven remedies, but rather those from supposedly reliable sources, such as CBS, Yahoo, or the Chicago Tribune.
Reporters or news writers often compose them, despite lacking training in science or medical reporting. They frequently make inappropriate assumptions and …
How to spot bad science in medical news
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Psychiatrist Muhamad Aly Rifai discusses his article “A psychiatrist’s 20-year journey with ketamine.” Aly recounts his first encounters with ketamine at the National Institute of Mental Health, where its rapid impact on …
A psychiatrist reflects on two decades of treating depression with ketamine [PODCAST]
On October 1, unless Congress acts, millions of Americans will lose access to telemedicine. A proven tool that has kept patients safe, doctors present, and costs down will vanish not because it failed, but because lawmakers failed to make it permanent. That would not just be bad policy. It would be malpractice by Congress.
I think of a patient of mine in northeast Georgia who lives 90 minutes from my clinic. …
Congress must make telemedicine permanent now
As a fertility specialist, recurrent implantation failure is one of the most difficult and heartbreaking problems we face. Over the last forty years, we’ve made tremendous improvements in both IVF protocols and lab techniques. A high-quality embryo may have up to a 70 percent chance of yielding a live birth. However, how do we approach the patient when high quality embryos are not taking? And what does the evidence really …
Why do high-quality IVF embryos fail?
Psychiatry, perhaps more than any other medical specialty, is a field defined by ambiguity. Unlike other branches of medicine, where diagnostic tests and standardized protocols guide treatment, psychiatry often operates in a landscape where clear-cut answers are rare. The psychiatrist’s primary tools are not scalpels or stethoscopes, but words, presence, and (most crucially) the self.
Psychological transference and countertransference: double-edged swords
Psychological transference and countertransference are central to the practice of psychiatry, …
The psychiatrist’s self as a clinical tool
More than 400 amputations happen in the U.S. daily. Not from gun violence, shark attacks, or car crashes, but from a disease that is easily diagnosed, preventable, and treatable, if caught early. Peripheral artery disease, or PAD, is a circulation problem in which narrowed arteries reduce blood flow to the limbs, most often the legs. More than 200 million people suffer from PAD, yet many aren’t even aware they have …
The silent disease causing 400 amputations daily
Here is what I have seen across two decades of admitting and managing patients on inpatient psychiatric units. People do not ask for a locked door when life is comfortable. They come to us when the ground drops out. Families arrive with the weight of sleepless nights in their faces. Emergency clinicians pass me the chart, then the baton, and sometimes the quiet plea that says please help this person …
The crisis in inpatient psychiatric care
After seventeen years of marriage, I found myself divorced, co-parenting, and facing two of life’s most daunting transitions at once: reentering the dating world and buying a new home. The reasons were many: parenting stressors, mid-life transitions, childhood wounds, and outside influences. There was no doubt that my career as a full-time, call-taking anesthesiologist also played a role. While the brutal 24-hour calls and 80-hour weeks were mostly behind me, …
Why can’t finding a doctor job be like Zillow?
Imagine your hospital’s entire IT operation grinding to a halt because of a snowstorm, cut fiber lines, or unstable internet connectivity. This is not a worst-case scenario for many rural health care providers; it is a regular reality. And it highlights just how fragile the digital infrastructure is in many parts of our country.
Across rural America, hospitals are losing physicians and fighting to stay open while serving communities …
The digital divide in rural health care
At the risk of sounding out of the times, I think back to how simple education was back in the day: attend lectures, take notes, read books (gasp), do any relevant flashcards or question sets, and repeat. Indeed, this formula is a functional strategy for many prior generations of doctors. For my own medical journey, now fifteen years in as an otolaryngology resident, this simple strategy has worked well enough.
The …
One doctor’s journey to making an AI study tool less corrosive to critical thinking
Introduction: a double-edged disruptor
Artificial intelligence (AI) has quickly insinuated itself and is transforming nearly every corner of modern life. Health care is no exception. With the rise of advanced chatbots, symptom checkers, and health-focused algorithms, patients now have 24/7 access to vast medical knowledge at their fingertips in seconds. The excitement is understandable: AI can demystify medical “doctor-speak” or jargon, suggest possible diagnoses and treatment options, and empower patients to …
Is it time to embrace augmented empathy while using artificial intelligence in health care?
All physicians lead, not just those with designated leadership titles, such as Medical Director, Department Chair, or Chief Medical Officer. Leadership is foundational to the doctor’s role.
Fortunately, leadership is a learned skill and improving physicians’ leadership skills can change how well we do our key job of taking care of patients. As physicians improve individual leadership skills the entire health care system will reap the benefits: nurses, technicians, administrators, finance …
Why physician leadership should be taught from day one of medical school
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