F*ck fibromyalgia? No, f*ck diagnostic bias.
I’m in pain today, so please forgive the profanity. Pain has become a constant companion for me for several years now, though some days are worse than others.
I am also a pediatrician, which means I am one of the “nice doctors” who does not curse. I have never been particularly good at following that expectation outside of the exam room.
As I lay in a hospital …
Diagnostic bias almost cost me my life
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What if the cure for physician burnout isn’t a wellness workshop but a 10-minute exercise you can do alone in a quiet room? Brian Sayers is a rheumatologist in Austin, Texas, with nearly …
Why a rheumatologist asks every doctor to remember being six years old [PODCAST]
On November 22, 2025, Tatiana Schlossberg, a 35-year-old journalist and the daughter of Caroline Kennedy, announced that she was dying from a rare and particularly aggressive form of blood cancer called acute myeloid leukemia (AML). In a heart-wrenching essay in The New Yorker, she described having been diagnosed with the disease just a few hours after delivering a healthy baby girl and when she was seemingly in the prime of …
Can clonal hematopoiesis improve blood cancer screening?
If you are a child of the 1960s, chances are your mother or grandmother made some of your clothes from scratch. They would go to a fabric store, look through the hundreds of small packets of printed sewing patterns, and select their next project. The patterns were sheets of thin tissue paper containing outlines of how the fabric should be cut, with instructions on how to piece them together. My …
Finding meaning in medicine: Reconnecting with your childhood calling
For those who know me personally, you know that I have vitiligo. Vitiligo is an autoimmune disease affecting the skin, where there are patches of depigmentation (the skin appears white or pink). It is sometimes associated with other medical conditions.
I met someone recently and they said that they were curious about my skin. I am used to looks or questions and am happy to educate people about vitiligo, so I …
Living with vitiligo: Overcoming shame and control
Some illnesses do not storm the body to the brink of death. They don’t show up in emergency rooms or leave dramatic scans behind. Yet they quietly hollow a life from the inside, stealing ease, stealing spontaneity, turning ordinary days into endurance tests. Autoimmune disease and chronic pain often live in that space: not terminal, but relentless; not fatal, yet capable of dimming the world so deeply that survival becomes …
Sjogren’s, fibromyalgia, and the weight of invisible illness
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 …
The human element in clinical trials
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 …
The silent victories of medicine
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, …
A doctor’s struggle with burnout and boundaries
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. …
My rare disease was my greatest teacher
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 …
The 4 foundations that sustain physicians through burnout and balance
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 …
How shared language saved a patient from isolation
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), …
Clinical ghosts and why they haunt our exam rooms
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 …
Dedicated hypermobility clinics can transform patient care
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 …
Rediscovering the soul of medicine in the quiet of a Sunday morning
“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 …
Why being mistaken for a student is my secret weapon in medicine
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 …
Why stress and trauma are at the heart of autoimmune diseases [PODCAST]
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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 …
Telehealth under threat: Why Congress must act to save Medicare coverage [PODCAST]
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. …
The hidden cost of neglecting self-care: the autoimmune connection
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