I had been trying to write this story for a long time. The topic is so heavy that it took a great deal of courage and emotional strength to finally put it into words. This story is not about a patient; rather, it is about a caregiver.
I met Mrs. N. in 2020. She travelled from Gujranwala to Islamabad (a distance of 223 kilometers) to begin her treatment. Mrs. N. was …
Let’s talk about physician wellness.
Not the version that looks good in press releases or PowerPoint slides. I am talking about the lived, messy, heart-and-body version of wellness, the one that actually matters.
Because somewhere between the lavender oil diffusers and the “wellness committees,” the real meaning of physician well-being got lost. It has become a buzzword, something hospitals display proudly on banners and conference agendas, as if saying the word “wellness” …
Picture a “No Entry” sign or a speed limit. A simple red circle needs no translation for a driver in Tokyo, Tehran, or Toronto. That’s more than just convenience; it’s a global safety net.
But in health care, where a misunderstanding can be deadly, our communication hasn’t kept up. We still rely overwhelmingly on words, pages of dense text handed to patients who are stressed, exhausted, older, or struggling with a …
I recently attended a very large professional conference. In a rush to make it everywhere and yet feed myself, I was running to get breakfast before the sessions and spilled the majority of this much-desired coffee all over my shirt. Here I was, standing with an impressive, unmistakable, impossible-to-hide giant stain of dark liquid spreading across the front of my solid blue shirt and sleeve with nothing to hide it.
It …
As a pediatrician, I spent many years in a busy, at times hectic, mostly enjoyable practice before retiring and segueing into teaching. Now as an adjunct professor in pediatrics, I aspire to help future health care workers pursue a career in pediatrics.
I have often asked myself: Have I missed anything about the day-to-day of practicing pediatrics?
My answer was what I truly missed were the interactions I had with the children: …
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Triple board-certified physician in adult and geriatric psychiatry and addiction medicine, and the founder of The Aging Parent Coach Barbara Sparacino discusses her article “Why caring for a parent is hard for …
During my pediatrics rotation in my third year of medical school, the most important skill I learned was how to listen more carefully.
Children rarely have the language or power to fully articulate their needs. They are forced to rely on adults, systems, and institutions to advocate on their behalf. In pediatrics, that responsibility is not an abstract idea. It shows up in exam rooms where parents must choose to pay …
A patient stopped me in the hallway recently, not in an exam room, not seated, not “ready” for a clinical conversation. Just a human being catching me between visits and asking a question that felt heavier than any lab result:
“Doc, is this finally the thing that will work? Or is it just another trap?”
That question is the GLP-1 era in one sentence. And with the launch of oral Wegovy, it …
We owe patients a better explanation about food.
The food didn’t change. The world did, and our guidelines followed.
For many patients, dietary advice feels less like science and more like whiplash.
Their breakfast looks the same. Their milk is the same. Their daily habits are exactly where they left them. What shifts, sometimes violently, is the label we attach to it: healthy, unhealthy, recommended, discouraged.
Consider milk
For decades, we told patients to switch …
Few things scare parents faster than seeing blood where it doesn’t belong.
Maybe your child took a hard fall off a bike. Maybe there was a rough sports collision. Maybe it was a car accident, and everyone is still shaking. Then a nurse asks for a urine sample, or your child goes to the bathroom and you notice pink or red in the toilet.
Your mind immediately goes to the worst place.
As …
An excerpt from On All Sides of the Bed: One physician’s/CEO’s journey.
In the early summer of 2013, our hospital collided with a Black Swan.
Before Europeans discovered Australia, they were familiar only with white swans. The discovery of black swans overturned a long-held assumption. In business and risk theory, a “Black Swan” refers to a rare, unpredictable event with massive consequences, a concept popularized by Nassim Nicholas Taleb. For us, …
Human rights are understood to be universal and egalitarian. They are inalienable, indivisible, and grounded in a shared moral intuition: that human dignity deserves protection. One of the most widely accepted expressions of that intuition is the obligation to care for those who are physically or emotionally ill. Yet despite this near-universal belief, modern health care systems continue to struggle with a fundamental question: Is health care a human right, …
Voicemail has quietly become one of the most fragile points in outpatient care, not because clinicians or staff are failing, but because the system itself no longer fits the reality of modern health care.
Every day, patients call clinics with legitimate needs: appointment requests, medication questions, post-procedure concerns, insurance clarifications. When no one answers, they are routed to voicemail and asked to leave a message. From that moment on, the system …
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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 …
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Nationally recognized psychiatrist, internist, and addiction medicine specialist Muhamad Aly Rifai discusses his article “How deprescribing in psychiatry offers a path to safer care.” Muhamad explores the growing movement to reduce unnecessary …
Conventionally, medical malpractice is argued using inductive reasoning. There is nothing wrong with inductive reasoning. It is a component of critical thinking. However, it is just a component. Inductive reasoning is more subjective than objective and the influences of selection bias, avoidance bias, and confirmation bias are undetectable.
Deductive reasoning is also a component of critical thinking. It is not immune from these same biases; however, deductive reasoning is more robust …
I am not a doctor. I am a software developer who taught herself mobile development while working full-time and raising two kids. But I built a clinical simulation app used by medical students, and here is how I made sure it is actually clinically sound.
The credibility problem
When you don’t have an MD, you can’t rely on intuition or clinical experience. Every design decision has to be defensible, referenced, and auditable. …
When clinicians think about stroke recovery, attention often focuses on motor deficits, speech impairment, and the risk of recurrent cerebrovascular events. Cognitive outcomes, however, are frequently treated as secondary or inevitable consequences rather than primary targets of intervention. This oversight carries consequences. Post-stroke cognitive impairment (PSCI) is common, persistent, and one of the strongest predictors of long-term disability, institutionalization, and caregiver burden, yet it remains under-recognized in routine care.
As acute …
The years pass without ceremony.
They do not always announce themselves.
Sometimes they slip by like quiet weather,
like afternoons we cannot later recall
except by the way the light
once rested against a wall.
Time moves like autumn wind,
unannounced,
persistent,
tender in its own indifferent way.
A milkweed stands in a field,
having grown tall without noticing
the exact moment it became mature.
Its green has deepened,
its stem stiffened with understanding.
Now the wind arrives,
and the pods open
not in grief,
but in readiness.
Each …
“I don’t know” may be one of the most difficult phrases to both hear and admit. As a patient, fewer words can make you more anxious, and as a health care provider, fewer words can make you feel more powerless. As a whole, the medical community has fostered and embraced a culture of certainty, discouraging the phrase “I don’t know” because of the helplessness it can instill in patients and …
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