Blogs
Hydroxychloroquine for Everyone
Nearly 25 years ago, while lecturing on best therapies for rheumatoid arthritis (RA), I loudly stated that hydroxychloroquine was “useless” and, deservedly, I was “boo-ed” off stage. My point then was that rheumatologists needed to be aggressive, if not overly aggressive, in treating all RA patients. And my view was that HCQ was representative of under-treatment. I have reconsidered the use of HCQ in RA substantially in the last few years, based on its merit.
From DNA to PGA
I have been investigating the mechanisms of antinuclear antibody (ANA) expression in SLE since 1978. In this pursuit, I have followed the advice of my first division chief, Dr. Ralph Snyderman, a great academician. Ralph told me to identify a research focus and make it mine. I think I have done reasonably well in my mission so you can imagine my surprise (and excitement) when, for the Lupus 2025 meeting in Toronto, I was asked to conduct a Meet the Professor session on the Type 1 & 2 model for SLE.
The War Rheum
The effects on rheumatologists and their patients living in Ukraine largely have been unseen by the world. At ACR Convergence 2024, I met Dr. Marta Dzhus who practices at St. Michael's Clinical Hospital in Kyiv; she shared her story with me about the humanitarian crisis in rheumatologic care in Ukraine because of the ongoing war. Here is an excerpt of our conversation.
Rheum to Travel
One of the benefits of attending conferences aside from scientific exchange is meeting new people. At one symposium, I met a unique rheumatologist. This chance meeting turned into an interview, that turned into a blog. Holly Bastian, MD is a rheumatologist practicing without the restraints of being tied to a place. She is a nomadic rheumatologist, a rheum on the road who embodies Johnny Appleseed as she spreads her knowledge and skills to multiple places in need of rheumatologic services. This is her story.
Overlap Syndrome with ILD
How would you manage a patient with Overlap (anti-synthetase) syndrome, ILD, polyarthritis and myositis?
Gangsin: 갱신 Korean: refresh, renew, updated
Remaining status quo requires less effort than making a change. Over the last 20+ years, I have listened to thousands of patients confide their personal stories. Some remained paralyzed in their current state of distress, fearing new situations may be worse. I was one of them, until recently. In this final blog of my trilogy on self-discovery, I reveal my new life.
Chào: (Vietnamese: Goodbye/Hello)
One of the first words I was taught by my parents was “chào”. In Vietnamese, you say chào and bow when you greet someone or when you leave as a sign of respect. In my first blog about self-discovery, I detailed the burnout and why I left clinical practice. In this second blog of the trilogy, I wanted to share encounters with patients as I told them goodbye. While I received great advice when I started practice, no one ever talks about how hard it is to leave.
Karoshi - {Japanese 過労死: Death by Being Overworked}
Over the last few decades, Japanese workers were collapsing dead at their desks or committing suicide due to the high stress stemming from their jobs; Japan coined this phenomenon, “Karoshi.” In 2021, the World Health Organization and International Labour Organization issued a warning: working 55+ hours a week is a serious health hazard and increases the risk for death from heart disease and stroke. But since the pandemic, I see many colleagues working hard at the expense of their health, family life, mental and emotional well-being. I never thought I would be burned out because I had passion for my job.
Teaching and Academic Burnout
RheumNow recently highlighted a publication that reported about a third of physicians in academia intend to leave. To our colleagues in non-academic situations, this may seem incredibly high. I think an important contributor to the intention to leave academics is that something that used to be a benefit has now become a challenge: namely, teaching.