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 …
Presidents are not immortal. But for much of American history, their bodies have been treated as state secrets, curated, concealed, and choreographed for public reassurance. When illness is hidden, the cost is not just clinical. It is geopolitical.
Warren G. Harding: collapse before the scandal
President Warren G. Harding died suddenly on August 2, 1923, at age 57, while touring the country on his “Voyage of Understanding.” He collapsed in San Francisco’s …
I put it on one night among tears and grief. It slid onto my skin like butter, like it was meant for me. It hugged my torso and clung to all the wrong places. The truth is, I had worn it before. I am unsure exactly when I last stopped wearing it. Unlike the donning of the letter, the removal is much quieter. I probably did not realize exactly when …
(Author’s note: This article has been a year in the making. Each time another mass shooting makes headlines, I think, this is the moment to speak, and then life intervenes. The opportunity to contribute meaningfully feels missed. But the cruelest irony is this: Wait ten more days, and there will be another tragedy to make the conversation relevant again. That, in itself, is the most heartbreaking fact of all.)
“Study my …
“To practice medicine,” a mentor once told me, “is to live with the tension between what you can do and what you should do.”
I didn’t understand him then. I do now. It is two in the morning in a Chicago hospital. The unit hums with fluorescent fatigue. A man in his fifties lies gasping for air, his lungs crowded by metastatic cancer. His chart lists “full code.” His daughter, sobbing …
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 …
As I sit breastfeeding a newborn and hastily switch to pump while the newborn (my fourth child) dozes, I have some thoughts that I think are particularly timely given concerns that are facing millions of families of young children in our country. Maternal and infant mortality continue to be worryingly high in the U.S., especially for women and children of color and in socially vulnerable areas of our country. The …
As a physician, I am trained to diagnose not just the presenting symptom but the underlying pathology. This is the same lens through which many of us in the medical community view the epidemic of American violence. For years, organizations from the AMA to the CDC have called it a public health crisis. This is not merely a metaphor; it is a clinical framework pioneered right here in Chicago by …
My wife, Kathy, had stage 4 end-stage renal disease. She was slowly dying, but never stopped living. Her resilience in managing peritoneal dialysis made travel possible, even with the logistical complexities involved. Ireland had long been on our bucket list, inspired by Kathy and Stephanie’s earlier visit while we lived in Peoria. With careful planning, we booked our flights using points out of Orlando, knowing the drive would minimize Kathy’s …
In 2025, Canada’s universal health care or Medicare system confronted a stark wake-up call. Many high-visibility service disruptions exposed the health care delivery model’s fragility and stress points. There were emergency room (ER) closures and specialty service interruptions.
In British Columbia, many hospitals repeatedly and increasingly closed their ERs for hours or days due to staffing shortages. The hospitals in large cities like Delta and Mission had multiple separate ER shutdowns. …
When I opened my dermatology practice 25 years ago, I used paper charts, a prescription pad, and a Dictaphone. Today, I use AI daily: for transcription, charting, and even reviewing complex labs. It’s certainly made my work more efficient.
But I’ve also seen something else: the erosion of trust between patients and physicians. I’m fortunate to practice independently, with the freedom to answer only to my patients, not a corporate boss. …
In Minot, I practiced a kind of pediatrics no flowchart could predict: improvised, airborne, and often surgical. Minot didn’t always follow the flowchart. One night, a toddler arrived in the emergency room, inebriated. Her father had given her vodka for teething pain, never imagining she’d swallow it. She did. She stopped breathing. I called a code and began CPR, ordering a blood alcohol level (BAL) and routine labs. Her BAL …
Racial diversity impacts health care delivery. North American nations like Canada and the U.S. are multi-racial. The U.S. addresses equity via programmatic and regulatory levers layered on a fragmented financing system: Medicaid, the Office of Minority Health’s National CLAS Standards for culturally appropriate services, and targeted maternal and community health initiatives. Nonetheless, persistent racial gaps in insurance, access, and outcomes underscore the limits of non-universal coverage, with maternal mortality for …
ADVERTISEMENT
Mrs. C is 80, frail, with heart failure and early dementia. The team has begun discussing an ICD. Her daughter wants “everything done.” The resident knows the evidence cold; he can recite the trial data, the ACC recommendations, and the mortality benefit. But he’s frozen at the bedside.
The gap we don’t talk about
Modern medical education does one thing brilliantly: It transmits knowledge. Today’s residents master more pathophysiology, more evidence, and …
I was not just a contributor. I was the pediatrician in the room, the one who translated clinical reality into research clarity, even when the system preferred abstraction.
From 1997 to 2003, I lived a six-year burst of energy: equal parts clinical invention, research precision, and institutional resistance. It was my Trinity Site: a catalytic moment where everything fused: rural care delivery, editorial rigor, and systems reform. The fallout still shapes …
The idea that medicine is a “calling” has been entwined deeply within our profession. From white coat ceremonies to recruitment posters featuring smiling doctors holding stethoscopes, we are told that to enter medicine is to answer a higher purpose. This framing is powerful. It inspires loyalty, fuels commitment, and builds identity. That is how the brainwashing begins as it also hides a dangerous truth: Labeling medicine as a calling has …
As a parent and a doctor of nearly four decades, I’ve often found myself navigating the rugged terrain of a dual existence: the life of a devoted physician, and the life of a dedicated parent. I have not always succeeded in both arenas. My wife and I both bear the weight of our professions, drawn into the noble yet demanding world of medicine. Our missions and ambitions, while fulfilling, have …
In the quiet moments of illness, I witness love and loss unfold.
I usually place the beds of relatively sick patients closest to my workstation. While I can monitor all the patients, except for a few female beds behind curtains, this arrangement helps me keep a closer eye on those who are more ill, particularly those receiving chemotherapy.
Directly in front of my counter lies a 50-year-old gentleman recently diagnosed with primary …
An excerpt from Held Together: A Shared Memoir of Motherhood, Medicine, and Imperfect Love.
Scott and I held hands as the last few minutes of waiting expanded to rival the anticipation of the days that had already passed. Two weeks ago at this same medical center, our perinatologist had performed a chorionic villus sampling, the procedure to collect the fragment of placenta that would determine our course. I had been …
For over forty years, I worked as a general and vascular surgeon. For the last ten of those years, I was employed under an RVU-based compensation model. That period is when my dissatisfaction with medicine truly began. Complex, life-saving operations were reduced to “productivity units.” The pressure was relentless, the system unforgiving.
And unlike primary care physicians, surgeons do not have the option of concierge or direct-pay models. We are necessarily …
Get free updates delivered free to your inbox.
