Because Good Medicine Deserves Better Explanations
In 2012, telling a heart patient to cut carbohydrates could still get you labeled a heretic. Fat was the villain. Carbohydrates were the gospel. Medicine spoke in percentages and pyramids, not physiology. Calories were our currency, and balance was our creed. But the numbers on my desk told a different story.Triglycerides were falling, waistlines shrinking, … Read more
He was on the list for what we called a routine coronary angiography—possible PCI if needed.
Mid-sixties. Retired electrician. Lived alone. The kind of man who apologized when the nurse missed his vein.
“Bad veins, sorry,” he said, as if it were his fault.
The morning had gone smoothly. Five patients down, two to go. The rhythm of competence had settled in—steady, predictable, almost comforting…
“The physician must learn to bear the wounds of the heart.”— Ambroise Paré I used to think I could stay untouched by the pain I witnessed. That I could carry grief without absorbing it. That I could walk through medicine without it ever walking through me. No one practices medicine for long without being … Read more
Author’s note (2025 update) This article was originally published in 2017 and revised in 2021. It has now been updated and expanded for 2025 to include new clinical insights, refined explanations, and additional causes of chest pain. Chest pain is one of the most common—and most alarming—symptoms in medicine.In the United States, millions of people … Read more
He sits across from me, his file glowing on the computer screen. Numbers everywhere: cholesterol edging upward, blood pressure leaning north, a family tree littered with cardiac potholes.
He leans forward, eyes narrowing.
“So, doctor—what are my chances?”
I recite the liturgy: statins cut relative risk by about 25%, blood pressure control lowers stroke risk by 30–40%. Add them up, and the curves bend favorably.
He doesn’t look reassured.
“Yes, but will it happen to me—or not?”