An excerpt from Real Medicine, Unreal Stories, Volume 3.
The café was quiet, tucked between a shuttered bookstore and a yoga studio that only seemed to open during Mercury retrograde. It was the kind of place that didn’t advertise, which made it perfect for writers, wanderers, and today, two physicians who had long since discovered that stories, not stethoscopes, were the truest diagnostic tools.
Dr. Gary Handler stirred his coffee absentmindedly, …
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Board-certified pediatrician and certified coach Jessie Mahoney discusses her article, “Medicalizing burnout misses the real problem.” She argues that the health care industry’s current approach to physician burnout is failing because it …
It is time we talk about a critical, yet often overlooked, factor contributing to physician burnout: attention-deficit/hyperactivity disorder (ADHD), particularly in those with high IQs and a history of academic and professional success.
Many physicians, often driven and intellectually gifted, develop sophisticated coping mechanisms that mask their ADHD symptoms for years, even decades. Their high IQ can, paradoxically, compensate for executive function deficits, allowing them to excel in demanding environments like …
It is happening more often than most people realize. The same physicians who seem unshakable in the OR or clinic, the ones who handle chaos without blinking, are quietly scheduling therapy appointments. Not because they have “hit rock bottom” or cannot do their jobs anymore, but because they are realizing they do not have to slowly carry it all alone. Nor can they sustain this level of burnout anymore.
As a …
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Pediatrician and certified coach Jessie Mahoney discusses her article, “Why the future of medicine depends on leading from the heart.” Drawing from her experience leading a workshop for women cardiologists, she explores …
The truth is not hiding. We have known for decades what allows physicians to thrive and what erodes their well-being. The science has been published, the interventions described, and the solutions tested. What we face is not a crisis of knowledge; it is a crisis of action.
I was reminded of this recently when an emergency physician preparing a talk on wellness asked me for help. She wanted to share with …
Alzheimer’s disease is a ruthless thief, silently stealing the essence of our identities: our memories. It robs us of cherished moments, meaningful relationships, and the independence that makes life vibrant and fulfilling. Traditionally viewed as an inevitable consequence of aging or genetics, groundbreaking research now challenges this perspective, suggesting Alzheimer’s may actually be a form of metabolic disorder aptly coined Type 3 diabetes.
The concept of Alzheimer’s as Type 3 diabetes …
Ten years old and terrified, my patient sat curled in the chair, tears flowing, knees pulled to her chest, refusing to go to school for the third week in a row. Her parents looked exhausted. “We have tried everything. We don’t want to medicate her… but we can’t keep going like this.”
As a child and adolescent psychiatrist, I’ve had this conversation hundreds of times. Sometimes families walk in asking for …
Doctors are often praised for their resilience. It’s become a buzzword in medicine, touted as some catch-all antidote to physician burnout. It’s used in keynotes, wellness programs, recruitment ads, hospital HR emails—everywhere really. “Feeling burned out? Improve your resilience.” But I believe that this emphasis on resilience often misses the mark. Worse, it can subtly reinforce the idea that if you’re suffering, you’re not resilient enough.
But what if the problem …
As a physician, you’re trained to spot problems. You scan for risks, anticipate complications, and stay alert for what could go wrong. That mindset helps keep patients safe. However, over time, it can become automatic, even outside of work.
When your attention is always tuned to what’s missing or what might fail, it’s easy to lose sight of what’s going well. One physician I coached was deeply committed to his patients …
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Nationally recognized psychiatrist, internist, and addiction medicine specialist Muhamad Aly Rifai discusses his article, “How President Biden’s cognitive health shapes political and legal trust.” While carefully observing the ethical constraints of the …
My children’s Montessori teacher lost her son to suicide several years ago. When I heard of her son’s death, memories came flooding back. I recalled Tom’s upper school project in which he presented a hoverboard. This inspired much reverence and awe in my son, who later attempted the same. Tom’s mother had tended to my daughter’s bumps and scrapes on the playground and helped her learn phonics. I gathered the …
Introduction
The medical profession is grappling with a crisis of profound proportions. Burnout now affects nearly half of all practicing physicians. This is not merely dissatisfaction—it is emotional and moral exhaustion that undermines both physician wellbeing and patient safety. At its core, burnout signals a loss of connection to purpose, to colleagues, and to the healing relationship that defines medical practice.
Burnout manifests as emotional depletion, depersonalization of patients, and a diminished …
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Adjunct professor of psychiatry Arthur Lazarus discusses his article, “How inspiration and family stories shape our most meaningful moments,” which presents a moving fictional story excerpted from his book. The narrative centers …
Many of the physicians who come to my therapy practice share a quiet, painful fear. They’re already excellent clinicians. They know the medicine, stay up to date on the literature, and often find deep meaning in their work. But they’re worn down by the emotional toll of sitting with suffering day after day. They start to wonder: Why is this hitting me so hard when everyone else seems fine? Am …
A few years ago, I said something in a meeting that made the air go still.
“People don’t actually feel safe filing ‘safe’ reports.”
I said it to a room full of leaders from the quality and safety team, the very people tasked with building trust and accountability. They didn’t argue. They just didn’t believe me.
They pointed to the anonymous portal. The reporting dashboard. The just culture training modules. They cited infrastructure.
I …
As physicians, we are trained to care—for patients, colleagues, and our communities.
When it comes to caring for our own aging parents and ill family members, most of us find ourselves overwhelmed, overfunctioning, under-resourced, depleted, and isolated. More often than not, we find ourselves assigned the caregiving role—explicitly or implicitly—because we’re “the doctor in the family.”
We think our medical training should make caregiving easier. But the opposite is true. We know …
“It’s not just in your head.” For people living with complex PTSD (CPTSD), these words offer more than comfort—they offer scientific truth. Trauma doesn’t just scar the mind; it reshapes the brain. But so does healing.
The hidden epidemic of CPTSD
Unlike its better-known cousin PTSD, complex PTSD often emerges from prolonged, repeated trauma—domestic abuse, childhood neglect, trafficking, emotional captivity. And while DSM-5 only nods to it, millions silently live with its …
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Pediatrician and certified coach Jessie Mahoney discusses her article, “Why judgment is hurting doctors—and how mindfulness can heal.” She argues that the culture of medicine is steeped in judgment—from the language of …
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Nationally recognized psychiatrist, internist, and addiction medicine specialist Muhamad Aly Rifai discusses his article, “How deep transcranial magnetic stimulation is transforming mental health care.” He shares his experience with deep TMS (dTMS), …
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