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Physician wellness coach Jessica Singh discusses the article “Physician burnout: Finding peace in a broken health care system.” Jessica shares a powerful narrative of a grueling swing shift in a rural emergency …
Finding peace and reclaiming humanity within a broken health care system [PODCAST]
A patient in his 20s recently came to see me in a state of severe distress. He described feeling consumed by his thoughts, constantly anxious, unable to function, and deeply exhausted. His sleep had collapsed. His sense of identity felt lost. He was experiencing persistent passive suicidal thoughts, not because he wanted to die, but because everything felt overwhelming and unrelenting.
Within three days of starting low-dose lithium at 150 milligrams …
Low-dose lithium treats suicidal ideation safely
She was 16 the first time she noticed it. Milk. From her breasts. No pregnancy. No childbirth. No explanation. She told a provider. Labs were drawn. Her prolactin was elevated. She was told it was “not a big deal.” Over the years, multiple providers suggested she must be stimulating her nipples and advised her to stop. She insisted she was not. She felt embarrassed, dismissed, and increasingly reluctant to bring …
How diagnostic overshadowing delays hyperprolactinemia care
We have been calling it burnout. The word took decades to arrive, and then it was everywhere. It appears in journal editorials, hospital wellness initiatives, and continuing medical education (CME) modules on resilience. It has validated scales. It is now the official language of physician distress. It is not wrong. But it is incomplete. It describes something real: exhaustion, detachment, the slow erosion of meaning. But burnout describes how the …
Beyond physician burnout and understanding structural immiseration
I still remember the first time I saw what bullying in medicine could do to a physician in training. It was not loud at first. It was not always obvious. It came wrapped in authority, tone, pressure, and the quiet threat that a career could be damaged by people in power. A resident nearing her final year of dermatology training was being bullied by program leadership and others in the …
Confronting the reality of bullying in medicine today
The stethoscope has always been more than a tool for auscultation; it is a physical bond between two human beings that no government has the authority to sever. In early 2026, as the Iranian regime launched a brutal crackdown on its own citizens, we witnessed the most extreme test of this bond. When the state demanded that physicians become extensions of the secret police, our colleagues in Iran chose the …
Iranian physicians in 2026: a testament to medical courage
You tell me it is all in my head.
As though my head were a small room where false alarms
ring for sport,
like I have no better way to spend my time and life.
You hold films up to the light,
of bones and blood,
nothing cracked or out of place,
or a catastrophe waiting in the wings
that has earned a name in your stack of books.
My blood you have drawn
has traveled through your machines
and has …
A patient’s poem on invisible illness and trauma-informed care
These moments of hesitation keep happening to me. I recognize the harm. I can name it clearly. I have seen its effects over and over again with my patients. And yet, when the conversation turns to its cause, I hesitate. Not because I do not understand. Because I am supposed to stay neutral. Medicine has long held neutrality as a professional virtue. We are taught to rise above politics, to …
Why physician neutrality in the face of harm is a choice
In health care, we are trained to measure what we can quantify. We check blood pressure, glucose, cholesterol, and weight. We monitor lab trends and adjust medications. We look for numbers that confirm risk. What we do not routinely measure is whether a patient is living in a constant state of stress, even though the signs are often right in front of us.
In dentistry, those signs are hard to miss.
Over …
The hidden link between chronic stress and oral health
When I think about the defining trait physicians have, it is perseverance. Persistence in doing something despite difficulty or delay in achieving success. We work hard to get into medical school. If you do not get accepted the first time, you double down. You apply to more schools, take a course for the MCAT, brush up on interview skills, and pad your resume with more research. You explore less traditional …
Why resilience is not the cure for physician burnout
In the modern-day world, a physician’s daily routine is often a whirlwind of clinical data, digital notifications, and the latest diagnostic protocols. Yet, in the quiet moments between patients, I find myself returning to the teachings of a man who lived over a millennium ago: Ibn Sina, known to history as Avicenna.
While we often view the history of medicine as a linear climb from “darkness” to “enlightenment,” the Canon of …
Avicenna’s influence on modern medicine: a physician’s reflection
In 2002, prescribing risperidone meant fighting through layers of resistance. I had to argue with formulary doctors, armed with a special copy of the New England Journal of Medicine article where my own name was highlighted, just to gain permission. That was the level of scrutiny these drugs once demanded. The article itself was not obscure, it was a landmark trial demonstrating risperidone’s efficacy in children with autism spectrum disorders.
Yet …
The risks of direct-to-consumer pharmaceutical advertising and Big Pharma
Jonathan first met the health system on the floor of an emergency room.
He had drunk himself into a crisis, and the team did what they are trained to do: stabilize, monitor, and discharge. He got a lecture. He got a referral. He was given an AA meeting list. Then he got on with the long business of suffering.
For years, Jonathan bounced between moments of crisis and well-intentioned medical appointments that …
Occupational therapy in addiction recovery: Making daily life livable
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Most accounts of physician burnout begin with a familiar list: too many hours, too many clicks, too many patients, and not enough time. The diagnosis follows easily. Doctors are exhausted. Something inside them has been used up. Burned out. That explanation has the advantage of being familiar. It also has the potential to be incomplete. There is another way to understand what is happening, one that comes from an unlikely …
Why physician burnout is actually a loss of professional identity
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Integrative pediatrician Mary Wilde discusses the article “The pause medicine never taught us to take.” Mary discusses how medical training conditions clinicians to fear rest and prioritize a treadmill of servitude over …
Why physicians must reclaim their right to pause [PODCAST]
As a physician who treats people with chronic pain, stress-related illnesses, and the lasting physical effects of emotional trauma, I have begun seeing a deeply troubling pattern in my exam room. Parents arrive exhausted, anxious, and physically unwell. Their symptoms rarely come from one obvious injury or disease. Instead, they stem from an ongoing emotional battle taking place right inside their own homes: their teenager’s struggle with online gambling addiction. …
The hidden health crisis of teenage online gambling
The rise of artificial intelligence-generated profiles means that by 2028, globally, one in four job candidates will be fake, according to research and advisory firm Gartner. Once hired, an impostor can install malware to demand a ransom from a company, steal its customer data, trade secrets, or funds. That is one side of the coin. Here is the other: the fake recruiter. I have been receiving emails from recruiters …
How to spot artificial intelligence recruiters who target candidates from LinkedIn
In the sterile quiet of an exam room, a physician faces a patient recounting a history of profound trauma. To a layperson, the story is bone-chilling. To the seasoned clinician, it can occasionally and guiltily feel like data. We call it burnout or compassion fatigue, but biologically, it is something more fundamental. The human brain has a finite capacity for empathy.
Our neural circuitry evolved for small tribes, not for a …
Compassion fatigue in medicine: Why the brain numbs trauma
Emotional contagion and crowd psychology are powerful forces that shape human behavior in large gatherings. In India, where collective identity and reverence for public figures often run deep, emotional responses within crowds may take on added intensity. This reflection draws on an incident from Tamil Nadu to illustrate how collective emotion can sometimes override proportion and common sense, with implications for community safety and well-being.
This may sound amusing today, but …
The psychology of hero worship: When admiration overrides reason
An excerpt from Essential Psychopathology & Its Treatment. Copyright © 2026 by Mark D. Kilgus and Nicolas Badre. Used with permission from W. W. Norton & Company, Inc.
One can consider that psychiatric treatment occurs on three levels: biological, then psychosocial, and then moral-existential. First, if needed, the psychiatrist prescribes medication to rectify biological abnormalities. Second, the therapist facilitates psychotherapy to address psychosocial problems. Third, the therapist uses the clinician-patient …
The 3 levels of psychiatric treatment: biological, psychosocial, moral
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