The urgency epidemic
I was in my office at 8 p.m. about a year ago. My back was hunched, phone in one hand and papers in the other, with twenty open tabs glaring at me from two adjacent monitors. I heard a nearby door shut and wondered, “Why is my colleague leaving so late?” Then it hit me: Have I thought of leaving yet?
If you asked me what I was doing …
Are you addicted to false urgency?
The brain is a pattern-seeking organ that continually organizes the world into a more predictable experience. Our first predictions arise out of early childhood and are predicated on messaging from primary caregivers. These are deeply buried in implicit memory meaning that much of what we anticipate from interactions lies outside of our awareness. Over the course of a lifetime, these guiding assumptions working in the background are continuously modified in …
How therapy helps uncover hidden patterns
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 …
Lessons on compassion and autonomy from One Flew Over the Cuckoo’s Nest
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 …
Why medicine needs a second Flexner Report
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, …
Drug giants face suit over hidden cancer risks
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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, …
How physicians can turn criticism into collaboration for better teamwork [PODCAST]
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 …
The ignored clinical trials on statins and mortality
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 …
Why awe may be the missing pillar of lifestyle medicine
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 …
A lawyer’s guide to physician side gigs
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 …
Inside the exam room: anxiety, trust, and medicine
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 …
Create your own financial vision for independence
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 …
Alice in Wonderland: the AI first health system
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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 …
How to transform your mindset by rewiring your brain with positive language [PODCAST]
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. …
What is a varicocele and how does it affect fertility?
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 …
How profit-driven hospitals fail long-term patient care
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. …
Complicity vs. protest: a doctor’s choice
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 …
How physician burnout and system reform are shaping the future of U.S. health care
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 …
How nature is inspiring the future of pain medicine
“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 …
Why doctors must fight for a just health care system
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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 …
Affordable postpartum hemorrhage solutions every OB/GYN can use worldwide [PODCAST]
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