Psychiatry

Pilot mental health is a safety issue, not a stigma

Physician

April 28, 2026

You know what it feels like to keep working and pushing yourself when you are tired, distracted, or maybe even burned out. It’s common across professions, and we rarely speak about it openly. We almost never think of it as a safety issue. But for airline pilots, that silence can put hundreds of lives at risk.

That is why I believe this belongs in a conversation among clinicians. Medicine is often …

Bridging the gap in neurodevelopmental care and pediatrics

Ronald L. Lindsay, MD

Conditions

April 27, 2026

Long before I stood on collapsing bridges between DBP and NDD, I was the 1977 kid who intentionally derailed Bobby Jr.’s grand “seed money” scheme for free home heating oil for the poor, not out of mischief, but because there was no plan behind it. It was a hallucinogenic vision dressed up as strategy, with no capability for realization. Even then, I could not pretend something workable existed when it …

The hidden costs of delayed diagnosis and diagnostic ambiguity

Bita Ghatan

Conditions

April 26, 2026

One of the most damaging patterns in health care is also one of the most accepted: delayed diagnosis.

What stays with me is not only the diagnosis that came too late. It is everything that happened before it. The months. Sometimes the years. The symptoms that were minimized, misread, or explained away. The patient who was still struggling, but without enough clarity to move care forward. The family trying to function …

The true crime community is radicalizing kids online

Dexter Ingram & Matthew Turner, MD & Stephen Sandelich, MD

Physician

April 26, 2026

As physicians who regularly work with pediatric patients, and experts in counter-terrorism, we know firsthand the dangers that online radicalization poses to youth. Nihilistic violent extremism (NVE), which glorifies violence for the sake of violence, is on the rise globally. Many of these decentralized online networks, such as the 764 Network, specifically target children for recruitment. 764 has seen a sharp increase in popularity, and has become the …

What a tiny dog taught me about the nervous system

Carrie Friedman, NP

Conditions

April 24, 2026

Bree is an 11 1/2 year-old, 4.2-pound micro mutt who once lived on the streets of Long Beach. She eventually wound up at Long Beach Animal Care Services, where she sat in a crowded cold cement kennel with no bed, no blanket, no toys, and one very sick basset hound with parvovirus. Every dog in that kennel was scheduled to be euthanized on Christmas Eve 2014. If it weren’t for …

Why career pivots are a valid path in medical training

Whitney Black, MD

Physician

April 23, 2026

The medical students I work with are already starting to close doors. They are in their twenties, still in training, and they are already narrowing, already deciding which parts of themselves fit inside the life they are building toward. I recognize it because I did the same thing. I just did not realize it until much later. And no one told me there was another way to look at it. …

How to treat chronic pain and depression together

Kayvan Haddadan, MD

Conditions

April 23, 2026

As a physician who has spent years managing patients with persistent pain, I often encounter the same frustrating cycle. A patient arrives with unrelenting back pain that has lasted for months. They describe not just physical discomfort but a deepening sense of hopelessness, fatigue, and withdrawal from life. Is the pain causing the depression, or did underlying depressive symptoms amplify an initially manageable ache into something chronic and debilitating? It …

How research laboratory culture shapes mentorship in academic life

Rao M. Uppu, PhD

Conditions

April 23, 2026

Every research mentor eventually faces a difficult question: What, and who, will continue when the work is no longer theirs to carry forward?

We often speak about mentoring, yet the dilemma of mentorship is rarely addressed directly. Perhaps it lies at the intersection of responsibility and uncertainty. Mentorship is often imagined as guidance freely given, with apprenticeship unfolding naturally. In modern academic life, however, the laboratory is shaped not only by …

51 cases that reframe methylene blue serotonin syndrome

Steven E. Warren, MD, DPA

Meds

April 22, 2026

A patient walks into my office. She is 52, exhausted, brain-fogged, gaining weight, and six years into sertraline 100 mg. I mention methylene blue as a mitochondrial support at 10 mg orally.

She looks at me like I just suggested arsenic.

“My pharmacist said I can never take methylene blue because I am on an antidepressant. He said it causes serotonin syndrome.”

I hear this every week. And every week I have to …

Therapeutic alliance in psychiatry matters more than ever

Timothy Lesaca, MD

Conditions

April 22, 2026

Each May, during Mental Health Awareness Month, the health care industry releases its usual statements about access to care, workforce stress, and the enduring shadows of stigma. I usually read them between back-to-back appointments, staring at a screen full of diagnostic codes. The systemic issues are always important, yet, amidst the charts, the 20-minute med checks, and the rhetoric, there remains a more profound question I have to ask myself …

Ketamine therapy and the primacy of mind in modern medicine

Farid Sabet-Sharghi, MD

Meds

April 22, 2026

In the modern clinic, we often operate under an unstated a priori assumption that if a phenomenon is real, its primary explanation must be molecular. As a psychiatrist, I find this reductionist bias increasingly apparent in how we conceptualize “breakthrough” treatments like ketamine therapy for depression or chronic pain. When we discuss how ketamine works, the conversation almost instantly gravitates toward the neurotransmitter system, synaptic plasticity, glutamate surges, and the …

Leaving clinical practice for medical advocacy and purpose

Ronald L. Lindsay, MD

Physician

April 20, 2026

Two days after Christmas, I walked into a store and saw Easter Cadbury Eggs already on the shelves. Not a single mattress sale for Presidents’ Day in sight. Just a clean leap from tinsel to tulips, as if the world had quietly decided to skip the expected steps and sprint ahead. It struck me because that is exactly what my life feels like right now. For decades, I lived inside …

The human side of medicine in quiet clinical moments

Devina Maya Wadhwa, MD

Physician

April 19, 2026

From the outside, medicine is often imagined as a profession defined by urgency and dramatic turning points. People picture emergency rooms where rapid decisions determine outcomes, life-saving interventions performed under pressure, and moments when a physician’s action decisively alters the course of illness. These moments certainly exist, and they remain some of the most visible parts of medical practice, but they represent only a small fraction of what most physicians …

Why physical books matter in a social media world

Richard A. Lawhern, PhD

Tech

April 18, 2026

My wife and I recently spent a few days on vacation at a South Carolina beach. We took time to stroll on the sand, take naps, kick back, and read. However, in the last-minute rush to pack for our trip, I managed to leave my Kindle at home. Thus, I began the mental journey that resulted in this article.

My Kindle has been one of the nicest gifts my younger daughter …

How credentialing and culture impact physician mental health

Namit Choksi, MD, MBA, MPH, MPP

Physician

April 18, 2026

It is 3 a.m. and you are wide awake, not because of your overnight shift or a surgery you are prepping for, but because the stress you have been carrying for months will not let you sleep. You know you need help. You also know you probably will not ask for it. Somewhere in the back of your mind, a fear: that a mental health diagnosis could surface in your …

Why current solutions to physician burnout are failing

Bill Pressey

Conditions

April 18, 2026

After a decade of wellness programs, mindfulness apps, reduced shift lengths, scribes, and employee assistance programs, physician burnout rates are essentially unchanged. The AMA’s 2023 national survey found burnout affecting 45 percent of physicians, nearly identical to where we started. Burnout peaked at 62.8 percent in 2021, the highest ever recorded. Physicians still face double the burnout risk of other American workers. The well-intentioned people running these programs know they …

Natural disaster trauma requires mental health planning

Kevin

Conditions

April 15, 2026

Super Typhoon Sinlaku got the coverage it deserved, the satellite loops, the wind speed updates, the landfall reports over the Northern Marianas. Every wobble in the eye wall drew a headline. No one was talking about what was happening inside people’s bodies. I have sat with patients days after a storm passed, experiencing blood pressure that will not budge and hands that will not stop shaking, and the sky has …

How imposter syndrome affects high-achieving professionals

Ritu Goel, MD

Conditions

April 15, 2026

He had just been named a partner. The youngest in the firm’s history. The first thing he said when he sat down in my office was, “I think they made a mistake.” I have heard some version of this more times than I can count, from physicians, attorneys, founders, and C-suite executives. People whose resumes would make anyone’s jaw drop, yet who live with a persistent, quiet dread that someone …

Pharmacy closures threaten our entire public health system

Timothy Lesaca, MD

Physician

April 13, 2026

We turned pharmacies into the backbone of public health during coronavirus disease 2019 (COVID-19). Then we went back to paying them like retail stores. The result is what I think of as the pharmacy paradox. We expanded their role without changing the economics that sustain them. Now, across the country, those same pharmacies are closing, quietly and disproportionately in the communities that need them most.

In 2021, the corner drugstore ceased …

Pathogenesis of a medical startup: a physician’s diary of daring, doubting, and doing it anyway

Maxim Saksonov, MD, MBA

Physician

April 13, 2026

Intro

This is not a story of a 28-year-old successful serial entrepreneur, nor a work of personal development literature. It is rather an auto-dissection of a very regular and tired doctor who was arrogant enough to co-found a medical startup and become its chief executive officer (CEO) without having any qualifications for it whatsoever.

It is also not a story of great success (yet) merely because the journey is in its diapers …