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Donald Kushner is a palliative medicine physician.

Bridging the gap between a chronic disease diagnosis and treatment

Donald Kushner, MD
Physician
April 21, 2026

Early in my career, I saved a man’s life, and he was not pleased. Mr. H came to see me for knee pain. With my training still fresh, I moved through a standard review of systems. When I asked about cardiac symptoms, he mentioned that for several weeks, walking more than a block caused chest pain that resolved with rest. The knee was forgotten. I explained the cardiac risk, ordered …

Read more…

Bridging the gap between a chronic disease diagnosis and treatment

Why symptom variability in chronic illness is not failure

Donald Kushner, MD
Physician
March 26, 2026

Every clinician has encountered this moment. A patient leans forward and says, “But doctor, I was fine yesterday.” The statement carries confusion, frustration, and sometimes quiet alarm. It also reveals an assumption deeply embedded in both medical culture and human cognition, that stability should look like consistency.

In clinical medicine, predictability is often mistaken for stability. We feel reassured when symptoms follow familiar patterns. Patients feel encouraged when treatments produce repeatable …

Read more…

Why symptom variability in chronic illness is not failure

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  • Most Popular

  • Past Week

    • Retirement isn’t the end of medicine, it’s a second act [PODCAST]

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