
We don’t always talk about guilt in medicine unless it’s framed as toxic or as a byproduct of impossible systems. But some guilt is earned. Some of it’s useful. The kind that nudges us when we’ve strayed from our values. And some is not.
What follows is a story out of several that came to mine from my own training after reading Dr. James Schindler’s piece, A Divine Slap. Mine wasn’t dramatic. B...

A thoughtful reader recently wrote in and asked me: “How did you build the strong relationships you have with specialists?”
At first, I wasn’t sure how to answer. My brain went to the tactical: referrals, shared patients, thank-yous. (These are still paramount. Doing your due diligence with workups, sending thoughtful referrals, and expressing appreciation to your partners in a patient’s care, ...

Years ago, I was leading a medical team in Southeast Asia after the tsunami. Infrastructure was gone, local health workers were either missing or tending to their own communities, and our team, hosted by a local NGO, was running long, hot, and emotionally heavy days.
One morning, something was off. Normally steady and cohesive, team members were sharp-edged, drained, disjointed. The local lead ...

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