January is named for the two-faced Roman god, Janus. His distinguishing feature was simultaneously looking back in reflection and forward in anticipation (imagery which pre-dated the Julian calendar by over a century)–a good choice for the first month of the new year . New Year’s Resolutions have existed in various forms from the time of the Ancient Babylonians (c. 2000 BCE), who would commit to returning borrowed tools in the new year,  through the middle ages, when knights

Large Language Models (LLMs) like ChatGPT, Claude, and Gemini have taken the world by storm over the past 2 years. I imagine almost everyone reading this newsletter has at least experimented with one LLM; probably many more of you have incorporated LLMs as efficiency tools broadly into your lives.  Digital dementia was coined by German psychiatrist Manfred Spitzer in 2012 as a phenomenon whereby the brain loses capacities when that brain’s owner relies excessively on technolo

Like most holidays, I'll be working this Thanksgiving. I don't have kids, so years ago I started volunteering for these shifts. It seemed like the right thing to do—give my colleagues with young children a chance to be home making memories with their family. It's become something of a tradition for me now, whether I'm in the ED, urgent care, or seeing palliative care patients. But here's something I've noticed over the years, something that's both heartening and revealing: pa

Over my nearly two-decade career in medicine, there’s been an insidious but undeniable shift in the way my physician, PA, and NP colleagues are referred to by those around us. Increasingly, and without much consideration for how clinicians feel about it, the term “provider” has displaced other more deferential or precise labels.   In my last clinical shift alone, here are a few phrases I overheard from various members of my well-intentioned clinical team: “Who is your provide

The brilliance of the HBO medical drama, The Pitt, has more layers than an onion. It's certainly helped to illustrate many of the problems within the U.S. healthcare system which are disproportionately felt by those who staff the nation's emergency departments. However, this is merely the most obvious impact of The Pitt's brilliant storytelling. The most recent data-driven revelation was the effect that the show has had on viewers in terms of getting them to reconsider (or pe

Joshua Russell, MD Introduction–When Pace is Personal As I approach another birthday, I have been thinking more about what my age means...

borrowing $300,000 and spending 12 years in school and training rather than earning and beginning to save for a home and retirement was a big financial risk, even in 2005. But how much more so is this the case now?