A few weeks ago, I delivered a baby in the morning and sat with a grandmother near the end of life that afternoon. I adjusted insulin for a patient I first helped quit smoking ten years ago. I counseled a teenager about to leave home for college. This is the joy of family medicine: walking with people through every stage of life. But too often, that joy is overshadowed by …
The backbone of health care is breaking
“If you are reluctant to ask the way, you will be lost.”
– Malay proverb
When I was struggling with burnout during training, I did not seek help.
Even when called into the office of the revered, stately, totally intimidating chair of the department, because he had “heard I was having trouble coping.”
Nope. I saw that as a sign that I needed to do a better job of hiding my lack of coping.
When …
Why doctors must ask for help before burnout escalates
An excerpt from Born to Heal: Medical Narratives Set to the Soundtrack of Classic Rock.
Dr. Evelyn Moore had always believed medicine was more than a profession; it was a calling. Not in the dramatic, messianic sense that some doctors held onto (where they saw themselves as saviors) but in the quiet, steady way a lighthouse stands guard over stormy waters. She was not there to rescue …
Why medicine is like a jazz solo
As a doctor working in a primary health care setting, it’s become routine, almost expected, to hear patients ask for a drip. Sometimes it’s after they’ve listed their symptoms, sometimes they say it right after walking in: “Doctor, please just give me drip.” And often, the complaints aren’t serious. It could be catarrh, a mild fever, or even plain tiredness.
At first, I didn’t understand it. I’d look at the patient’s …
Why so many patients ask for drips—and what doctors wish they knew
Since the fall of Roe v. Wade in 2022, the United States has been navigating a reproductive health crisis unlike anything in modern history. Now, in mid-2025, the picture is even more stark, and more urgent.
In the wake of the Dobbs decision, nearly 1 in 5 patients seeking abortion care, including care for miscarriage, have been forced to travel out of state. That is more than double the number from …
Reproductive care after Roe: Why silence is not an option
In some careers, your job is not something you do; it is something you are. Medicine, acting, and politics are intimate, high-visibility professions that blur the lines between personal identity and professional role. You are not just executing a skill; you are bringing your whole self into the room, exposed and accountable.
When things are going well, that visibility can feel exhilarating. You are recognized, affirmed, even admired. Your face becomes …
When your identity is your job: Why it’s dangerous in medicine
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Neurologist Vikram Madireddy discusses his article “How Japan and the U.S. can collaborate for better health care,” examining the parallels and contrasts between two of the world’s most influential health systems. Vikram …
How Japan and the U.S. can learn from each other to strengthen health care [PODCAST]
Whenever I bring up longevity medicine among some fellow physicians, I can almost hear the unspoken objections before anyone says a word. There is a pause, a sideways look, maybe even a faint smirk. If I could translate those silent expressions into captions, they would say:
“If people stop getting sick, will not we all be out of business?”
Let us stop right there. That is like saying restaurants would all go …
Will longevity medicine put doctors out of work?
I shadowed a neurologist recently. As a high school student on the cusp of applying to college, I thought I’d’ spend the day quietly observing: watching labs get ordered, hearing terms I’d Google later, maybe seeing the human side of medicine up close.
But nothing prepares you for watching someone slowly lose their chance at life—not because of their diagnosis, but because two parts of the medical system weren’t speaking to …
When doctors don’t talk: a silent failure in modern medicine
Grief is not a word most physicians would use to describe their day-to-day work. Stress? Absolutely. Burnout? Sadly too common. Exhaustion? Without question. But grief? That feels too tender, too vulnerable, too personal, too scary.
And yet, grief quietly saturates the practice of medicine and the existence of being a doctor.
Grief shows up most obviously in the loss of patients. Death coming sometimes suddenly, and sometimes after a long, protracted …
The many faces of physician grief
The landscape of medicine is evolving—and so are the roles of those who practice it. Today, more people are searching “how are doctors changing?”, “Why doesn’t my doctor have time to listen?”, or “Can doctors coach me instead of just treating symptoms?” These questions aren’t just valid—they’re vital.
For many of us in medicine, the traditional doctor-patient relationship no longer fits the needs of modern life. We’re not just being asked …
Why the doctor-patient relationship needs a redesign
Inland Southern California stands as one of the most diverse and rapidly growing regions in the United States. With a rich mix of cultures, ethnicities, and socioeconomic backgrounds, it also faces significant health disparities. From disproportionate rates of chronic diseases like diabetes and hypertension to barriers in accessing essential care, marginalized communities in the region continue to suffer the consequences of a health care system that often leaves them behind. …
Health equity in Inland Southern California requires urgent action
Imposter syndrome is not a personal failing. It is a conditioned mindset. A learned pattern. We are raised in a culture of hyper vigilance. We are taught to equate uncertainty with inadequacy. We are taught it is not OK not to know an answer. That being unsure is a failing.
We prepare relentlessly. We never let our guard down. Hypervigilance is our standard mode of operating. Self-judgment is an internal soundtrack. …
Imposter syndrome is not a personal failing
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Physician executive Carlos Nunez discusses his article “Why sleep is the missing pillar in modern health care,” emphasizing the urgent need to treat sleep as essential to overall wellness alongside diet and …
Why sleep must become a central pillar in modern health care [PODCAST]
I never thought much about my kidneys. I felt fine, I stayed active, and at 74 years old, I figured I was in pretty good shape. But kidney disease has a way of sneaking up on you. By the time most people find out they have it, they’re already in trouble. That could have been me—but thanks to the right care at the right time, I got a transplant before …
How early care saved my life from silent kidney disease
As an internist with a background in physics, I was taught to think in systems—to seek root causes, avoid assumptions, and apply data with precision. Early in my career, I practiced medicine exactly as I had been trained: Identify the diagnosis, follow the algorithm, apply evidence-based treatment. And in many cases, that worked.
But increasingly, I found myself caring for patients who didn’t fit cleanly into diagnostic boxes. Fatigue, brain fog, …
How functional medicine fills the gaps left by conventional care
The day I first watched ketamine lift a human being out of despair, I was standing in a quiet room at the National Institute of Mental Health. The fluorescent lights hummed, the monitor ticked, and a young adult who had been drowning for months came up for air. Hours, not weeks. That speed rewired me as much as it rewired their brain. In the early 2000s, most of us were …
A psychiatrist’s 20-year journey with ketamine
Historical, cultural, social, and political factors contribute to the disparities in reproductive health, making it a multifaceted and deeply rooted issue in the fabric of the United States. Historically, the legacy of slavery and the American eugenics movements established race-based medicine, systems, and stereotypes that continue to influence provider bias and patient mistrust, contributing to the ongoing inequities in reproductive health. Culturally, persistent stereotypes, particularly toward Black women, have led …
How racism and policy failures shape reproductive health in America
When I turned 50, I weighed 265 pounds. Over the next 12 years, through walking, yoga, and strength training, I lost 60 pounds and kept it off. But despite the discipline, I remained plagued by inflammation, pain, and sleep apnea.
Then last year, my doctor suggested tirzepatide (Zepbound), not just for weight loss but to treat my sleep apnea as well. That alternative diagnosis unlocked insurance coverage and led to a …
Why GLP‑1 drugs should be covered beyond weight loss
Funding from direct-to-consumer (DTC) “ask your doctor” drug ads has captured news media outlets and all but blocked important health stories like these. Read on.
1. “Hormone replacement therapy” (HRT) is back.
It is said that those who forget the past are doomed to repeat it, and nowhere is this more evident than the re-marketing of HRT to menopausal women who do not remember the first debacle (which increased the risk …
How drug companies profit by inventing diseases
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