Skip to main content


Bad Stress

“Bad is stronger than good.” 

Wait, bad is bad, right?

A Shortage of Trust

I wanted to complain about patients who complain, but guilt and common sense took over. I intended to declare the problem to primarily belong to the doctor, rather than the patient. To me, the solution to the patient’s consternation should begin and end with the source: me (you). My introspection, reasonings, and commandments were fine, but I kept running into the enigma of “Trust” – which can either be a speed-bump or chasm in our physician-patient relationships.

Best of 2022: I Need a Nemesis

A nemesis is so much more than the "enemy". Your nemesis defines what matters most to you and how you will overcome. Seth Godin once said, “Pick your enemies, pick your future”.

Best of 2022: Freeze Tag

A beloved childhood game I enjoyed was Freeze Tag. Players would run to avoid being tagged by the person who was “It”.  If you were tagged, you had to “freeze” in your spot until someone was brave enough to come un-tag you.  The game ends when everyone is frozen or if people quit. For over 2 years, I have been living in a real-life “Freeze Tag” game and able to dodge COVID19, until now. Sitting in my room symptomatic and frozen in isolation, I ruminated about my patients who had COVID19 and their experiences. I wanted to share with you three stories of three variants.

Best of 2022: Rheumatology Valentine

My uncle is going through medical hell.  As a committed iatrophobic (fear of doctors), any mention of phlebotomy, tests, needles or a clinic visit evokes flop-sweat.  Since being slapped with a cancer diagnosis, he has overcome a lot, and much to my surprise has bravely done so. When I asked how he has adapted so well to the medical onslaught he now leans into, his answer was quick and poignant.

The Best Prescription

The craziest question that you can ask any doctor is “what is your best therapy for __?”.    Crazy, because there are exponential answers, with factored layers that make each decision unique to that doctor. Each doctor has her own cha-cha-cha algorithm to a particular problem. The problem is, we each dance to a different cha-cha-cha tune in the practice of medicine.

More Than a Conference: Life’s Lessons

Conferences are held for the purposes of sharing ideas, developing new relationships, and collaborating on future research. The American College of Rheumatology (ACR) Convergence 2022 meeting embodies all these ideals by offering both in-person and virtual attendance options.

From the Archives: Rheumatology Dead Word Cemetery

I recently heard of a secondary school assignment wherein students were challenged to “bury” a word that was no longer useful or appropriate. Their exercise has now evolved into an unofficial RheumNow task force to retire diagnostic terms that have grown into misuse in rheumatology and medicine. How did we decide which words should perish? And by what criteria? Who has the final say?

ICYMI: Who is Your Glue?

I’ve often talked about the nurses in my clinic as being the glue, the clinic glue, my personal glue. Without them, the day and task would never go as well and just might crash and burn, if not for their steadying influence.

A Domain-Based Approach to the GRAPPA Psoriatic Arthritis Treatment Recommendations

With their publication in June 2022 (1), the 3rd iteration of the Group for Assessment of Psoriasis and Psoriatic Arthritis (GRAPPA) Treatment recommendations for Psoriatic Arthritis (PsA) may have set a record or sorts.

I Need a Nemesis

A nemesis is so much more than the "enemy". Your nemesis defines what matters most to you and how you will overcome. Seth Godin once said, “Pick your enemies, pick your future”.

A Rare Disease Doctor

Yesterday was national “Rare Disease Day” in the USA, with many tributes to the patients, doctors and researchers dedicated to these disorders.  Moreover, it was a great opportunity to shout about the many rare conditions that don’t often get enough press, praise or funding.