A few months ago, I met a woman who had stopped speaking at dialysis. She had grown quiet, worn thin by the rhythm of a system that seemed to talk around her but never truly to her. When she finally spoke to me, it was not about her labs or transplant status. It was a whisper — “Do you think I’ll make it in time?”
In that moment, she wasn’t asking …
Why transplant equity requires more than access
When I was a child, I watched a neighbor struggle after a stroke. He survived, but without rehabilitation he remained trapped in his disability, dependent on others for every task. That memory shaped my understanding of medicine: Survival alone is not enough. Patients deserve a chance to reclaim independence and dignity.
Years later, after completing medical training abroad, I came to the United States as an international medical graduate (IMG), determined …
An IMG’s story of exclusion in U.S. residency
Introduction
When I first arrived in North Carolina several years ago, I thought happiness would come easily. I had completed my medical education in Nepal, was ready to serve as a physician in the U.S. health care system, and carried the excitement of new beginnings. But I learned that happiness is not automatic—especially for physicians navigating American health care while maintaining their sense of purpose.
The transition from practicing medicine in Nepal …
The 4 foundations that sustain physicians through burnout and balance
Before making the case for evolving formal fellowships for physician anesthesiologists to conscientiously and systematically object to unnecessary health care, particularly unnecessary procedures, it is worth first exploring what constitutes “necessary.” Only then can we begin to regulate what may be considered “unnecessary.” Can physician anesthesiologists lead such academic and practical regulatory efforts, even amid potential conflicts of interest inherent in their role as anesthesia care providers?
This raises several important …
Should anesthesiologists object to unnecessary procedures?
Recently, The Hill published an op-ed purporting to be a measured critique of gender-affirming care for youth. In reality, it was a dangerous and misinformed piece of ideological propaganda cloaked in the language of academic concern and propped up by debunked claims and bad faith arguments.
Riffer, who has studied censorship, gender regulation, and the legislative targeting of LGBTQIA+ communities across the U.S., will say …
Ideology, not evidence, fuels the anti-trans agenda
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Physician Daryna Bahriy discusses her article “How Ukrainian doctors kept diabetes care alive during the war,” sharing how medical teams in western Ukraine adapted to protect vulnerable patients amid the chaos of …
How Ukrainian doctors sustained diabetes care during the war [PODCAST]
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]
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