I have often heard people speak of numerology, weaving destinies around digits. They say that behind every event in a person’s life lies the hidden hand of numbers. I do not know if such beliefs hold scientific truth. Yet, in medicine, numbers certainly matter. Numbers fill our trial registers, power our statistics, shape our protocols. In research, life is reduced to codes, columns, and counts.
As a medical student, the jargon …
Some battles announce themselves with trumpets; others creep in silently, spreading their fire unseen. His battle was the latter. What began as a hidden spark in his muscles had grown into an inferno consuming his young body from within.
He was barely thirteen, a boy from Bihar, when fate dragged him into this fight. By the time he reached us, fever had bound him for three relentless weeks. His pulse was …
I had been hearing so much about burnout in medicine; and one day, I realized it had crept up on me. It began at my mother’s funeral, when an acquaintance, a former family friend, approached me asking me to examine her painful toe. I tried to avoid her, yet I could not say no. Through my grief and exhaustion, conditioned by years of striving to live a life of purpose, …
I was at one of the lowest points of my medical training. I had just finished my second-year exams. The stress had left me feeling hollow, anxious, and utterly drained. It was in this fragile state that my own body turned against me.
It started with a fever that would appear every evening. I told myself it was just the change of season. I took paracetamol and tried to ignore it. …
Introduction
When I first arrived in North Carolina several years ago, I thought happiness would come easily. I had completed my medical education in Nepal, was ready to serve as a physician in the U.S. health care system, and carried the excitement of new beginnings. But I learned that happiness is not automatic—especially for physicians navigating American health care while maintaining their sense of purpose.
The transition from practicing medicine in Nepal …
I was midway through a busy afternoon clinic when my pager erupted—an inpatient consult request. The case sounded messy: Chronic pancreatitis that had suddenly spiraled downward. A fresh, sizable mass sat in the pancreatic head; tumor markers were positive. Two endoscopic biopsies had failed, and surgery felt too risky for this frail patient. Cancer seemed the only plausible answer.
Rheumatology—my service—was called in because her ANA was weakly positive (1:40). In …
As a quadruple board-certified physician and a patient with a complex autoimmune disease, I live on both sides of the examination table. My professional life is about finding answers; my personal life has been about the agony of waiting for them.
This dual perspective makes it impossible to ignore a systemic problem in modern medicine: A class of diagnoses that live in the shadows. Seronegative Sjögren’s, mast cell activation syndrome (MCAS), …
Every week, I speak with patients who have spent years—sometimes decades—searching for answers. They’ve seen rheumatologists, neurologists, cardiologists, physical therapists, and more, trying to piece together a puzzle that no one provider seems to fully understand. Their symptoms are dismissed as anxiety, growing pains, or “just part of being flexible.” But the truth is often something far more complex: A connective tissue disorder like hypermobile Ehlers-Danlos syndrome (hEDS) or Hypermobility …
It is early Sunday morning—there’s the rare kind of quiet today that feels borrowed. My daughter is still asleep beside my wife, and the house is hushed in that golden stillness. I find myself flipping through the paper copy of The Rheumatologist’s “Best of 2024” supplement that had arrived earlier in the week—I just wanted a brief escape from medical records (and even more so, from studying).
Half-skimming, half-unwinding, I …
“Are you the medical student?” the resident asked me in between bites of his vegetable lo mein. We were in the hospital conference room, and I was sitting at the table by the projection screen while he was scarfing down a quick meal before the noon lecture. “Actually, I’m the attending,” I replied. He paused with fork in hand and turned beet red. “Sorry,” he murmured.
I couldn’t blame him for …
Doctors are worried, and rightly so. Recent rapid strides in artificial intelligence threaten to remove the need for doctors to a significant extent. There is an oft-discussed scenario that in the next two to three years, well-trained nurses or other mid-level providers, assisted by artificial intelligence, will be adequate to provide most medical care. So, are we going to see widespread unemployment among medical professionals?
The answer is complex. A recent …
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Join us as we dive into the complexities of autoimmune diseases with family physician Pamela Buchanan. Discover the profound connections between chronic stress, systemic inequities, and immune health, particularly for women and Black …
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Join us for a conversation with patient advocate Stephanie Marcovici as we explore the potential rollback of Medicare telehealth coverage in 2025. Stephanie shares her personal story and highlights the devastating impact this …
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Imagine your immune system as a vigilant guardian suddenly turning against the body it’s meant to protect. This is the reality of autoimmune diseases—a group of complex conditions where the immune system mistakenly attacks healthy cells, leading to chronic illnesses like multiple sclerosis, rheumatoid arthritis, and lupus.
A striking statistic reveals a sobering truth: 80 percent of autoimmune diseases occur in women, with an even more pronounced impact on Black women. …
Last week my nurse called me, weeping. A patient had called and abused her, threatened her, and said he would complain to authorities about her. This, because his insurance company had delayed his medication refill request by a week. My nurse was hurt; she answers patient queries and emails even on her days off. He is not the only one shouting at and threatening medical staff. In my 30-year career …
I didn’t know
when I placed my stethoscope on your chest,
listening,
that I was listening for the last time.
I didn’t know
that you said,
“when the doctor sees me, I will be fine.”
I wish I had held you longer.
If I had known it would be the last time,
I would have listened
to your heart
for a few more minutes.
I am sorry you had to go
too soon.
It still hurts so much when I lose,
and death steals
my patient.
Over …
I have a handicap placard. I appear healthy, and I walk a lot, but sometimes, the looks I get when I park in the designated handicap space are priceless because I am taking up a special parking spot for someone who is “sick.” “What gives?” they are thinking. “She doesn’t look sick!”
“It’s a big emotional load,” Dr. Sands says. “People are scowling at you because you took that handicapped parking …
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Join us for a conversation with Zachary Fellows, a rheumatologist who spent nearly four years in private practice navigating the complex intersection of obesity and rheumatic diseases. Zachary shares his journey from giving …
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We welcome Jennifer Obel, an oncology physician, who shares her personal journey of retiring from a fulfilling medical career due to Ehlers-Danlos Syndrome. Reflecting on the recent presidential debate and the health concerns …
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