There was a time — not too long ago — when I dreaded the start of each workweek.
I had spent years studying, training, and sacrificing sleep, time with family, and even my health to become a physician. I believed in the value of primary care and the importance of relationships with my patients. But somewhere along the way, the dream started slipping through my fingers. I wasn’t unhappy because of …
My journey to loving primary care again
Multiple sclerosis (MS) is an autoimmune-mediated neurodegenerative disease that affects approximately 2.8 million people worldwide, and its incidence has risen over the past decade. As health and wellness professionals who have cared for people living with MS, we have both witnessed the ever-evolving journey and the roller coaster of emotions, psychosocial impact, symptoms, and health challenges that people living with MS face. The muscle weakness that makes walking more …
How coaching transforms care for people with multiple sclerosis
“When doctors strike, patients die.” That phrase—flattened into certainty—gets tossed around like a moral verdict. It shows up in op-eds, comment threads, morning rounds. As if to say: there’s no argument. The matter’s settled. You swore an oath.
But what oath, exactly?
Most physicians are taught to revere the Hippocratic Oath, but few have read the original versions. It wasn’t universal. It wasn’t sacred scripture. It forbade surgery. It invoked Apollo and …
Why doctors striking may be the most ethical choice
For a long time, I was close-minded to the idea of vitamin supplementation as a meaningful part of mental health treatment. Like many in medicine, I saw it as misguided at best and more a part of wellness culture than real science. However, over time, I realized how often we mistake “That makes sense to me” for “That’s objectively true,” as we are prone to fall prey to our mental …
Integrating vitamin education in mental health care
Well before I was a physician, I was an art history major at Bowdoin College. Beneath towering pine trees, I spent much of my time in dim lecture rooms off the quad and in the quiet galleries of Maine’s art museums, studying paintings, sculptures, and photographs to understand not just what was being portrayed, but also what they revealed about the people, places, ideas, and defining events of their time. …
How photos shape drug stigma—and what we can do about it
Clinical trials are the cornerstone of progress in cancer treatment. Yet, paradoxically, the very patients these trials are designed to help often face the greatest obstacles to participation. While the concept of “patient-centered” clinical trials has been around for years, more than 20 percent of U.S. clinical trials fail to accrue a sufficient number of participants, forcing them to fold.
Why aren’t patients enrolling in clinical trials?
While there have …
From participants to partners: Rethinking clinical trial design
As a reproductive endocrinologist, I see countless patients who walk through my doors with quiet stories of loss—sometimes the loss of hope, sometimes the loss of time. But every year, there’s a particular group of gentlemen who share a strikingly similar history.
They come from different countries. Many grew up in regions where the measles-mumps-rubella (MMR) vaccine was unavailable or inconsistently administered. They had mumps as children, recovered, and thought nothing …
Mumps orchitis still causes infertility years after childhood
At first glance, medical school can be simplified to “drinking from a fire hose.” Endless Anki cards, color-coded notes, iPads filled with diagrams.
Cramming and regurgitation, funny acronyms and mnemonics. Obscure conditions. Buzzwords.
It feels like memorizing a ton of conditions and running through the routine steps of diagnosis, treatment, management, clinical investigations, and so on — until you can recite them in your sleep.
You’re buried in biochemical pathways, pathophysiology, and pharmacology, …
What it means to be a woman in medicine today
In medicine, one surprisingly heated debate doesn’t get much airtime: Should patients call their doctors by their first name?
It pops up often on medical forums. I’ve seen long threads dissect whether it’s disrespectful, whether it undermines authority, or whether it reflects a cultural shift in how we view physicians. Some doctors insist on “Doctor” as a matter of principle—status, respect, professionalism. Me? I appreciate being called Dr. Nadelson. It reflects the …
First-name familiarity improves doctor-patient connection
The United States and Japan, while separated by geography, language, and culture, share more in common than first meets the eye—particularly when it comes to health care. As post-war democracies that developed robust medical infrastructures in the latter half of the 20th century, both countries have grappled with similar challenges: Aging populations, rising costs, workforce burnout, and persistent health disparities. Yet their respective approaches—the U.S.’s pluralistic, market-driven model and Japan’s …
How Japan and the U.S. can collaborate for better health care
The transformation of care delivery is driven by value-based health care (VBHC). In addition to its cost-effectiveness and clinical efficiency, the success of VBHC depends upon its ability to exemplify empathy and equity. Usually disregarded in pursuing metrics, data, and integrated payments, these two pillars are indispensable for implementing a system that provides dignity and equity to all patients. Embedding empathy and equity into health care delivery is no longer …
Emphasizing empathy and equity in value-based health care delivery
As a surgeon, I’m trained to make decisions quickly—based on anatomy, evidence, and pattern recognition. But outside the OR, I’ve been thinking more deeply about something abstract yet everywhere: intelligence. What is it, really? And who or what gets to be called “intelligent”?
We often associate intelligence with humans—or more specifically, with traits like memory, logic, and verbal reasoning. The smarter someone is, we assume, the more they think like us. …
How AI, animals, and ecosystems reveal a new kind of intelligence
This past St. Patrick’s Day my daughter and I were listening to John Lennon’s Luck of the Irish. She wondered aloud whether people realized the phrase was meant to be ironic. Lennon certainly did, singing, “If you had the luck of the Irish, you’d be sorry and wish you were dead …” With Irish-born grandparents and Liverpool’s deep Irish roots, he understood the weight of the phrase, eight hundred years …
What it really means to be lucky: a doctor’s story of survival and resilience
As yet another tragic chapter unfolded in the intractable and ever-escalating Iran-Israel conflict, I found myself in the midst of conversations, intense, impassioned, and sometimes uncomfortably raw. The participants weren’t diplomats or scholars. They were ordinary people, men and women, brown and white, Jews and Arabs, Muslims and Christians, all fiercely devoted to their own perspectives, each convinced they were defending not merely an opinion but the truth.
One particularly striking …
How truth depends on where you stand and what you see
You see it before the final whistle blows. A boy—ten, or maybe nine—walks off the mat like he’s carrying bricks on his back. His face is red, his eyes damp. Waiting for him is his father, arms folded like a verdict. “You lost to that kid? You were up by two.” The boy opens his mouth, but nothing he says will be enough. The response is swift: a shake of …
Extreme weight cutting harms health and resilience in youth wrestling
Throughout my academic career I learned that medicine can be pursued through any major. Although the traditional path is through biology, as long as the correct prerequisites are taken, you are eligible to apply. As time went on, I began to think to myself, “Why isn’t there a common pre-med major?” This major would set students up to conquer the rigorous curriculum of medical school. Additionally, if students decide not …
The case for a standard pre-med major in U.S. universities
Lately, I have seen a few instances where physicians have been tricked by a term in their physician employment agreement that clearly does not mean what the physician thinks it means.
The most recent example came when I was negotiating a physician employment agreement, and the physician suggested verbiage concerning her scheduling. The physician suggested that we ask for language that the employer would develop a clinical schedule “after consultation with …
A physician employment agreement term that often tricks physicians
In the once-venerable corridors of our state’s flagship academic hospital, a slow-motion disaster is unfolding. White patients — yes, white patients, because that’s who’s leaving — are abandoning ship, hightailing it to the quieter, politer hospitals in “white” suburbs. Why? Because the “uniformly Mexican” staff — medical assistants, front desk drones, and nursing staff — treat customer service like it’s a foreign concept. And frankly, it is. Mexico isn’t exactly …
Why patients and doctors are fleeing flagship hospitals
I’ve taken some amazing vacations. Seriously—scenic, memorable, cool stuff. Travel has always been a top financial priority for me. It felt like one of the few things in life that reliably gave me joy and perspective.
And in many ways, I still believe in the value of taking time away. But over the past year, my perspective on why I take vacations—and what I’m actually hoping to gain—has changed in some …
The hidden reason your vacations never feel like enough
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Infectious disease physician Janet A. Jokela discusses her article, “Measles is back: Why vaccination is more vital than ever.” Recounting her own experience diagnosing a case in the 1990s, Janet contrasts that …
Confronting the return of measles and vaccine misinformation [PODCAST]
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