Something is wrong with our health care system. Our country spends more per capita than any other developed nation, yet we have some of the worst health care outcomes. Rising costs are making health care prohibitive. Access to the system is becoming a growing concern. Medical care has become bureaucratic, bulky, and inefficient. I am a retired physician, a urologist, who has observed the health care system from outside medical …
What if the career you spent your life building, the one filled with achievement, purpose, and prestige, is now the cage you cannot escape? That question did not just haunt me; it held me back for years.
I was a successful urologist, specialized in advanced prostate cancer detection, robotic surgery, and men’s health. From the outside, I had it all: a thriving practice, financial security, a respected reputation, and a steady …
“It is, I think, not easy to exaggerate the importance of the informal social element in the promotion of science and learning.”
– Abraham Flexner, 1930
As stated by Mr. Flexner, the importance of the informal social element of science and learning is one of the key fundamentals of the hidden curriculum, a well-understood but unspoken rule in medical education and training. The hidden curriculum consists of the unspoken or implicit …
As a urologist, I consider myself an expert on the subject of prostate cancer. Here is a urologist’s view of a hypothetical announcement from a former U.S. president, five months after leaving office, of widespread high-grade metastatic prostate cancer.
Prostate cancer is the most common cancer in males. It begins as a cancer in the prostate, and with progression, metastatic disease occurs, primarily in the axial skeleton. Prostate cancer is known …
Prostate cancer treatment is evolving, and focal therapy is gaining relevance as part of that change.
For decades, patients and their physicians have had limited options: whole-gland treatments like radical prostatectomy or radiation, or active surveillance. But what about the men who fall somewhere in between? What about those who need more than monitoring, yet want to avoid the significant side effects associated with whole-gland therapy?
That is where focal therapy enters …
When a teenage boy develops sudden testicular pain, it should always be treated as an emergency. The most urgent concern is testicular torsion, where the spermatic cord twists and cuts off blood supply to the testicle. In these cases, every hour counts; waiting too long can mean permanent damage, loss of the testicle, and even future fertility problems.
Torsion happens most often in boys and adolescents because the testicles grow …
Most of us have done it: a new symptom pops up, and instead of calling a doctor, we type it into Google. In that moment, the internet feels like the fastest way to get answers. But when it comes to urology, a field where stigma, fear, and embarrassment often hold people back, the flood of conflicting or misleading information online can do more harm than good. That’s where digital health …
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Urologist Fara Bellows discusses her article “When recurrent UTIs might actually be bladder cancer.” Fara shares the story of a 91-year-old patient whose recurrent urinary infections masked an underlying bladder cancer diagnosis, …
Kidney stones are not only about what you eat or the genes you inherit. They are also about where you live and how hot it gets. Every summer, urologists notice the same pattern: as the temperature climbs, so do the visits for kidney stones. Because heat and humidity do not just make us sweat, they change how our bodies handle water and minerals. Dehydration concentrates the urine, crystals form more …
Varicocele is one of the most common findings in men being evaluated for infertility. Roughly 15 percent of all men have one, and the number climbs to about 40 percent among men with fertility problems. Yet despite how common it is, a varicocele remains a confusing diagnosis. Some men are told they need surgery right away, while others are advised to do nothing at all.
The truth is somewhere in between. …
Over the past decade, cycling has evolved from a sport into a full-fledged lifestyle. From weekend road warriors to dedicated commuters, millions of men around the world rely on their bikes for exercise, stress relief, and environmental consciousness. But a question often comes up in clinic rooms, whispered more than spoken aloud: “Is all this cycling hurting my fertility?”
It is a valid concern, especially for men trying to conceive. The …
As a urologist, I see recurrent UTI patients nearly every day, and most cases are routine: nasty bacterial infections that appear in the bladder every few months. However, a recent patient turned out to be the zebra rather than the horse. This particularly lovely woman was 91, an Italian immigrant, and was accompanied by her adult son, who helped provide history and translate as needed. She sat calmly on the …
It happens more often than people talk about: You go to the bathroom, and suddenly you notice red or brownish urine in the toilet bowl. Your heart skips a beat. Is it something you ate? Could it be serious? Should you wait or call your doctor?
If you ever see blood in your urine, don’t panic, but don’t ignore it either. That red color, whether it’s faint pink or dark like …
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Men don’t usually bring up prostate exams in casual conversation, and that silence is part of the problem.
Across clinics and exam rooms, we see it all the time: men who delay checkups until urinary symptoms become disruptive, or worse, when routine blood work turns into a cause for concern. The truth is, prostate screening isn’t about embarrassment or fear, it’s about staying one step ahead of issues that are common, …
I’ve taken some amazing vacations. Seriously—scenic, memorable, cool stuff. Travel has always been a top financial priority for me. It felt like one of the few things in life that reliably gave me joy and perspective.
And in many ways, I still believe in the value of taking time away. But over the past year, my perspective on why I take vacations—and what I’m actually hoping to gain—has changed in some …
Benign prostatic hyperplasia (BPH), commonly referred to as an enlarged prostate, is a highly prevalent condition affecting millions of men as they age. While it is not cancerous, its impact on daily life can be significant, causing lower urinary tract symptoms (LUTS) such as frequent urination, weak stream, urgency, or nocturia.
Over the past decade, treatment options for BPH have expanded considerably. In addition to medications and conventional surgery, there are …
“My PSA came back at 6.2 — does that mean I have cancer?”
It’s one of the most common and emotionally charged questions I hear in the clinic. The prostate-specific antigen (PSA) test, once celebrated as a breakthrough in early cancer detection, has become a double-edged sword. For many men, a slightly elevated PSA level is enough to trigger panic — and for some physicians, enough to trigger a biopsy.
But here’s …
An excerpt from Medicine is a Practice: The Rules for Healthcare Marketing.
“I’m late! I’m late! For a very important date!”
— The White Rabbit, Alice’s Adventures in Wonderland, Lewis Carroll
Lewis Carroll wrote about the tardiness of the White Rabbit in Alice’s Adventures in Wonderland in 1865. The problem of tardiness is older than the White Rabbit, and lack of punctuality plagues every profession and human interaction. Unfortunately, in the medical …
June is Men’s Health Month, an opportunity to spotlight the unique health challenges men face—and to change the way we talk about them. One of the most overlooked and under-discussed topics in men’s health? Fertility. It’s time to bring it to the forefront.
As a fellowship-trained urologist specializing in sexual medicine and male fertility, I’ve witnessed firsthand how male reproductive health is too often sidelined in conversations around family-building. For far …
“Happiness is the absence of striving for happiness.”
– Chuang Tzu
A hunter once lost his way deep inside the jungle while chasing a deer. He used all his navigation skills, but he did not find any way out of the jungle or food for several days. He started feeling so hungry that he could eat an entire elephant in one go. Disappointed, he lost all hope. And that is exactly when …
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