Author: Marcin Chwistek, MD

AI, Medical Humanities, Patient-Physician Relationship, Technology

From iPatient to aiPatient: Balancing Algorithms with Empathy

Fifteen years ago, Dr. Abraham Verghese introduced us to the concept of the “iPatient” – digital representations in electronic medical records that were commanding more physician attention than the actual humans in hospital beds. Today, we face something far more profound: the “AI Patient,” where artificial intelligence not only stores data but diagnoses conditions, generates treatment plans, and writes clinical notes. What’s striking is how … Continue reading From iPatient to aiPatient: Balancing Algorithms with Empathy

Unknown's avatarMarcin Chwistek, MD
Uncategorized

The Emotional Cost of Clarity

In palliative care, doing the right thing doesn’t always earn applause. Sometimes it gets you removed from the team. A recent JAMA article—”Why Good Palliative Care Clinicians Get Fired”—underscores the vulnerability of clinicians who communicate honestly about serious illness in a system that often treats dying as a failure. Even when delivered with skill and compassion, such honesty can provoke discomfort or resistance, revealing the … Continue reading The Emotional Cost of Clarity

Unknown's avatarMarcin Chwistek, MD
Medical Humanities, neuroscience

I Only Want What’s in Your Mind and Heart”: The Origins and Science of Total Pain in Oncology

So here’s the thing about pain: it’s complicated. Last weekend I was on call when my phone rang. It was an elderly woman in her 80s with advanced cancer that had been stable. Her chart said “pain well-controlled on optimized opioid regimen” – one of those clinical phrases we use that sometimes means everything and sometimes means nothing at all. She started talking about bone … Continue reading I Only Want What’s in Your Mind and Heart”: The Origins and Science of Total Pain in Oncology

Unknown's avatarMarcin Chwistek, MD
AI, Patient-Physician Relationship, Research Articles

The Paradox of Modern Cancer Care: Why Serious Illness Conversations Remain Elusive

Recently, I cared for a patient in his early 60s with advanced gastric cancer. When diagnosed months earlier, he had the standard “goals of care” conversation with his oncology team—focused primarily on treatment options, not his deeper values. His disease followed the unpredictable pattern so common in modern cancer care: treatment, stabilization, progression, and new treatment. Then, suddenly, everything changed. He deteriorated rapidly during hospitalization … Continue reading The Paradox of Modern Cancer Care: Why Serious Illness Conversations Remain Elusive

Unknown's avatarMarcin Chwistek, MD
neuroscience, Research Articles

The Jellyfish, the Poppy, and the Future of Pain Relief: A New Chapter Begins

Ancient Remedies and Modern Crises: The Poppy’s Legacy For centuries, humanity has sought relief from pain, and the poppy, with its potent analgesic properties, became deeply entwined with our history and culture. In 1805, a young German pharmacist’s apprentice, Friedrich Sertürner, refined this ancient remedy, isolating morphine and revolutionizing pain management. This breakthrough, however, paved the way not only for the widespread use of morphine … Continue reading The Jellyfish, the Poppy, and the Future of Pain Relief: A New Chapter Begins

Unknown's avatarMarcin Chwistek, MD
Medical Humanities, Research Articles

When Less is More: A Simple Solution to Complex Healthcare

While many healthcare institutions nationwide face challenges in enhancing goals-of-care discussions with seriously ill patients, an unexpectedly simple study from the VA demonstrated that a different approach could change how we think about these conversations. In 2013, at the Palo Alto VA Medical Center, Dr. Manali Patel proposed what seemed like an unlikely solution: What if individuals without medical training could assist veterans with advanced … Continue reading When Less is More: A Simple Solution to Complex Healthcare

Unknown's avatarMarcin Chwistek, MD
Essays, Medical Humanities, Patient-Physician Relationship

What If This Is the Best I’ll Ever Feel?

Im not afraid of dying, she said, smiling at me. I feel like Im on a runway, about to take off. Her words, spoken with such clarity by a woman facing two advanced cancers, have stayed with me. As a palliative care physician, I wish more patients felt empowered to face their mortality with such openness. But the truth is, we, as a society and … Continue reading What If This Is the Best I’ll Ever Feel?

Unknown's avatarMarcin Chwistek, MD
AI, Essays, Medical Humanities, Patient-Physician Relationship

AI and the Future of the Patient Narrative: The Rise of (a)iRecord

When Efficiency Trumped Narrative Here’s an odd thing about modern medicine: We have perfected the art of medical storytelling for over 4,000 years but have spent the last few decades systematically destroying it. Doctors have always been storytellers first, from ancient Egyptian scrolls to medieval Islamic physicians carefully documenting case histories. Until we decided efficiency mattered more than narrative. Today, we stand at another pivotal … Continue reading AI and the Future of the Patient Narrative: The Rise of (a)iRecord

Unknown's avatarMarcin Chwistek, MD
Research Articles

When Food Loses Its Appeal: Medicine’s New Understanding of Cancer’s Oldest Companion

The Chef’s Voice  I was driving home from clinic on a rain-soaked Monday when I heard something that made me pull over and listen. It wasn’t about medicine or cancer or the patients I’d just spent the day treating. It was chef Matty Matheson, who plays Neal Fak on the acclaimed TV show “The Bear,” being interviewed by Kara Swisher. “Food is an uncompromising love,” … Continue reading When Food Loses Its Appeal: Medicine’s New Understanding of Cancer’s Oldest Companion

Unknown's avatarMarcin Chwistek, MD
Cannabis, neuroscience, Research Articles

Hidden in Plain Sight: How Our Brain’s Endocannabinoid System Could Transform Pain Medicine

Opioids have a dual role in medicine, serving both as pain relievers and also their use may lead to addiction, complicating pain management conversations, especially for cancer patients. Recent research from Weill Cornell Medicine demonstrates a potential method to separate pain relief from addiction risk by manipulating brain compounds, offering hope for improved treatment strategies and quality of life. Continue reading Hidden in Plain Sight: How Our Brain’s Endocannabinoid System Could Transform Pain Medicine

Unknown's avatarMarcin Chwistek, MD