Skip to main content


Yep I Want You To Accept This Reality


Ok, what day is it?  Friday?  Star date: March 27, 2020.

How's everyone doing? Everyone "coping" ok? Yeah, it's perfectly fine if you're not. But I would prefer if you were, so I'm going to try to help.

Before I get into it, it's time for the sakura (cherry blossoms) to spread their beauty in Japan. Unfortunately the traditional gatherings of friends underneath their blooms to meet for food and drink and good cheer (Hanami) is officially canceled due to COVID-19. But, we can still think about the meanings behind sakura and hanami.
In Japan the Sakura represents a time of renewal and optimism at the end of winter and start of spring, and remind us that life is short and beautiful. And since life is short and beautiful, no matter what's going on on the CNN news ticker (turn it off....really.....just turn the news off), we should fill it with meaningful time.

I'm going to first ask you to accept that shit sucks. It's going to suck for a while…
Recent posts

A Harsh Reality

Me again.

This post is going to suck.

On March 10, 2020 my gastroenterologist sounded the alarm to me about COVID-19. She told me to stop taking the train to work via a text conversation. I even tweeted about it, how I asked if she was blowing things out of proportion. Clearly she wasn't, but back then I hesitated and thought "what will others think if I do this now?" But I followed her advice. And now look where we are.
Today is March 23, 2020.

I have a lot of friends and colleagues who work in hospitals. A lot. Whether they're at the hospital I too work at but have the privilege to be "non-essential" and work from home or the people I've connected with at conferences or via Twitter. I know a lot of people in health care all over the world. My gastroenterologist, the one who sounded the alarm, is a close friend. Her husband, the head of pulmonology and intensive care at a major hospital in Chicago.

In my own department, we have a video-meeting (because…

So You Have IBD During a Pandemic


What's going on? Been pretty boring over here in Chicago.

Ok I don't need to elaborate on what the hell is going on in the world. We are being bombarded with information - some accurate, a lot inaccurate - about this pandemic. It's very easy to become completely overwhelmed by it all. We've been forced, pretty damn quickly, to completely overhaul our way of life for the greater good. To reduce the strain on our healthcare system of the sick and dying. And us humans are generally bad with rapid, monumental change that we really don't have a lot of say in. Our little reptilian brains do what they're supposed to do (prime us for fight or flight or freeze) but our advanced "thinking" parts of our brain have to interject with all sorts of unhelpful thoughts, thereby sending some of us off the rails.

Before we start, turn off the news. Seriously. In the days following 9-11 we found people who consumed more 24-hour news channel information were more lik…


The other day, someone who follows me on Twitter used the adjective “pushy” to describe my messages on the topic of mental heath and chronic digestive disease, specifically inflammatory bowel disease. I’m not going to out this person, because quite honestly I can’t remember his name. But I do remember where he works and what he does and let’s just say he’s not an outsider to the world of IBD medicine. At the time I laughed off the comment but as I reflect on the broader picture of my work and the work of my psychology colleagues and the patient advocates and anyone else attempting to bring some attention to the immense struggle that is life with IBD I’ve landed at a different emotion: anger.
I started in what is now called the field of Psychogastroenterology in 2005. The year Weezer put out the song most of us Gen X types cringe at, “Beverly Hills.”  Let that sink in. I’ve been in this space for 15 fucking years. I wrote my doctoral dissertation on stigma perceptions among patients wi…

Let's Talk About "All In Your Head"

If I had to vote for a phrase, just 4 short words, that cause more problems in our society than most others it would be these:
All in your head.
To hear these words as a person with medical symptoms brings about such a cascade of thoughts. Anything from "My doctor doesn't believe me" to "Are my symptoms really happening?" with corresponding emotions of anxiety, confusion, anger, even rage.
I spend a lot of time undoing the damage these 4 words can do in the patients I see. They've been told, either directly or indirectly, their disease is psychologically based. And that means it's really not that bad, that they should just get over it and move on. It's a running thread in most of the patients with any "functional" diagnosis I've seen, such as irritable bowel syndrome, but also appears in those with "organic" conditions - those diseases perceived as real like inflammatory bowel disease.
These 4 words are part of the fundamenta…

Medical PTSD

“It is just an illusion here on Earth that one moment follows another one, like beads on a string, and that once a moment is gone, it is gone forever.”  - Kurt Vonnegut, Slaughterhouse Five 
A few years ago, my gastroenterologist wanted me to have something called an esophageal manometry to better understand how my newly diagnosed eosinophilic esophagitis may have been affecting how the muscles in my esophagus were functioning.  I work with the guys who wrote the book on esophageal disease, and these guys do a lot of manometries. I know all about esophageal manometry.

My mind immediately went to images of a small bowel enteroclysis I'd had at least a decade prior. My body grew tense and it was almost as if I was back in that cold room with the cold metal table and the cold radiologist, who just didn't believe me when I told her how bad my gag reflex was before she placed a tube down my throat to inject my small intestines with barium.

It took what seemed like forever to get th…

Precision Patient

Precision medicine, or "a medical model that proposes the customization of healthcare, with medical decisions, treatments, practices, or products being tailored to the individual patient" is on fleek.

Or fire, or lit, because fleek is so 2017.

This is what happens when a Gen X'er tries to use the language of those under 25.

Online, at a conference, or even in your doctor's office, you've probably heard this buzzword. If you're an MD reading this, I'm sure you've heard this term used in various circles and may have even used it yourself with patients or in a presentation.

Precision medicine is exciting. Because, SCIENCE!

It seems every year, medical technology is advancing exponentially in how we understand disease and is going to save a lot of lives and reduce a lot of pain and suffering. How can you NOT be excited about precision medicine?

In my world of Crohn's disease, things like "therapeutic drug monitoring" and "biomarkers&quo…