Busy physicians are moving so quickly we almost never stop long enough to acknowledge the subtle ways medicine reshapes us. But every physician I’ve ever coached, including myself, can name a moment when they didn’t quite feel like themselves. Maybe it was:
For decades, I practiced medicine as a dermatologist and dermatopathologist, serving patients and teaching medical students at UC Irvine. I believed I could recognize addiction when I saw it. I was always alert for signs, such as the patient whose story didn’t quite match the evidence, or whose habits hinted at something deeper.
When alcohol came up in conversation, I learned early to quietly double whatever amount the patient reported; experience …
“Explain a time you faced vaccine hesitancy and how you handled it.” As a fourth-year medical student applying for pediatric residency, this question came up often in interviews. It is an experience that almost every medical professional has encountered, even early in training. The first story that came to mind was from my newborn nursery rotation during my third year of medical school.
I met a first-time mother who had just …
A cesarean section, or C-section, is one of the most common surgeries in the United States. In 2023, 32.3 percent of live births were cesarean deliveries, while 67.7 percent were vaginal deliveries, according to the National Center for Health Statistics.
Pain during cesarean delivery under neuraxial anesthesia (regional anesthesia including spinal and epidural anesthesia) is a recognized clinical challenge and one that has received growing national attention. Recent media …
Before a doctor ever diagnoses a child with acute flaccid paralysis, the culprit leaves definitive clues in the sewer. At the Noguchi Memorial Institute for Medical Research, we spin bottles of wastewater in the centrifuge, pH-balance, and look for these clues. Their presence signals the return of an enemy we once thought we had defeated.
For decades, the world has rallied around the dream of eradication, the triumphant declaration that humanity …
A Guide and a Seeker walk into a bar.
The Seeker says, “I’m so glad I’m here, I’ve been searching far and wide for good beer to slake my thirst, and you, my Guide, have finally brought me here!”
The Guide says, “Ah, I know just the thing. I’ll get you some Dos Equis. A merchant’s representative told me it’s the most interesting beer in the world!”
The Guide tries to order a …
At the end of a clinic visit, the conversation often turns to lifestyle: eat healthier, exercise more, cut back on alcohol, sleep better. Patients nod, agree, and walk out the door.
And too often, little changes.
Why does advice that seems so straightforward rarely stick? The answer lies in the gap between medical instruction and human behavior.
The limits of good intentions
Research has shown that simply giving advice is rarely enough. A 2019 …
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Psychiatrist and author Arthur Lazarus discusses his article, “Finding integrity at the end of a career.” Arthur shares the poignant narrative of Dr. Raul Morales, a community internist facing retirement with a …
Medicine remembers data but forgets voices. I learned this between 1999 and 2003, when I was quietly fired and branded as someone who had “burned too many bridges.” That label was projection, not a critique of my science. My work within the national research network remains foundational to current clinical guidelines, and my training-grant application ranked near the top of all those submitted. Yet the whisper of “bridge-burning” became the …
Starting my training as an MD/PhD student at Yale, I expected long nights of memorizing biochemical pathways and drug mechanisms. I predicted challenging times learning how to care for patients in tough situations. But what I didn’t expect was just how difficult the current federal landscape would make this journey.
I felt this directly in early 2025. I came to Yale to study the health of LGBTQ+ populations. But when my …
Kidney stone disease remains one of the most common and painful conditions in urology, affecting millions worldwide each year. Global data show a continued rise in incidence (more than 100 million new cases in 2021) making prevention and long-term management a priority for both clinicians and patients. Despite significant advances in minimally invasive treatment, many patients still ask a familiar question: “Is there a natural remedy that can help …
Across conferences and journals worldwide, we repeat the same aspiration: Health care must shift from treating disease to promoting health. Yet most systems (regardless of country) remain architected around illness. Buildings, budgets, and workflows are still optimized for what happens after the body breaks down.
My perspective changed after speaking with a senior health care leader in Asia. He did not begin by discussing surgical innovation, emergency demands, or reimbursement challenges. …
The recent federal conviction of Done Global’s CEO, Ruthia He, and its clinical president, psychiatrist David Brody, on November 20, 2025, has brought long-standing concerns about virtual ADHD prescribing into undeniable focus. A San Francisco jury found both executives guilty of conspiring to distribute Adderall and other Schedule II stimulants, along with health care fraud and (for He) obstruction of justice. According to the Department of Justice, Done Global generated …
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If you’re managing metabolic disease for your patients, you’re also dealing with liver disease, whether you realize it or not. Metabolic dysfunction-associated steatotic liver disease (MASLD) affects up to 70 percent of patients who have type 2 diabetes or obesity, yet reliable, routine screening for liver disease is anything but commonplace.
I often wonder why that is. After all, the liver is arguably the most sensitive barometer of metabolic dysfunction, …
I’m not paranoid. And I don’t believe in conspiracy theories. But as a physician who has spent decades watching the pendulum of medical ethics swing back and forth, I can’t ignore the pattern emerging across public health and politics today. Some of what I’m seeing looks uncomfortably familiar. It looks like eugenics, not the caricature of white coats and calipers, but the quieter, policy-driven, values-encoded version that shaped America a …
15 years. That’s how long I’d been building my Facebook presence from grammar school friends to medical school colleagues, from former patients to the professional community I’d cultivated as a medical oncologist. Two years ago, I converted it to a business page to share evidence-based cancer information.
Then scammers stole my identity to sell fake cancer cures, and Facebook banned me while they stayed active.
The impersonation
It started with a message from …
We work in an impossibly depleted health care system and under impossibly high expectations of perfection from society. We hold our peers, our team members, our trainees, and most of all, ourselves to rigid, lofty ideals of flawlessness. By glorifying perfectionism in medicine, we have effectively dehumanized ourselves.
The oath we take is “Do No Harm.” It is not “Try your best to do no harm.” Is it appropriate to expect …
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Health care strategist Dana Y. Lujan discusses her article, “Grief and leadership in health care.” Dana shares her devastating personal story of losing both her son’s father and, six years later, her …
I check the submission website again. And again. Sometimes in the middle of the night, I find myself refreshing the page, hoping for a small update (a new status, a change in wording, a sign that my manuscript has moved from “under review” to “decision in process”).
For early-career researchers, this waiting game is familiar. We pour months, sometimes years, of effort into designing a study, collecting data, writing, revising, and …
Busy physicians seldom pause long enough to feel the weight or the wisdom of the year behind them.
We know the end of the year is approaching not because we’ve reflected, but because holiday coverage discussions have begun. Someone needs to work Thanksgiving. Someone has to take Christmas. Someone will miss the department party again.
You look at the schedule and realize: This year, it’s you.
And in that moment, something inside you …
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