Tag Archives: Education

Who is the Best?

surgeon waiting at the cross roads at patient's bedside


Patients often ask a question that seems simple but resists a clear answer: Who is the best doctor for me? Even if transparent outcomes data were widely available, the answer would remain uncertain. Because excellence in medicine is not confined to what can be measured.

In the end, what patients are really asking is something deeper. Not just who can perform a procedure, but who knows when to act, when to wait, and how to navigate uncertainty. These are not matters of technical skill alone, but of judgment—and judgment, ultimately, reflects character.

👉 Read the full essay on Substack:
Who is the Best?
https://henricolt.substack.com/p/who-is-the-best

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The Disease We Romanticized­—Then Forgot


There is a particular stillness in the faces of Amedeo Modigliani’s portraits. Elongated and instantly recognizable by their hollowed or pale blue eyes, with heads tilted like flowers resting on thin, swan-like necks, they now grace the walls of the world’s great museums. Many carry an unspoken fragility—a sense of life both vivid and already receding, much like their creator, who lived and died under the shadow of tuberculosis.

Tuberculosis was once so visible that its outward signs were aestheticized—what came to be known as “tubercular chic.” Today, the opposite has occurred. The disease has not disappeared, but rather receded from public awareness. Yet it remains the leading cause of death from a single infectious agent worldwide, affecting millions each year.

👉 Read the full essay on Substack:
The Disease We Romanticized—Then Forgot

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The Question Patients Cannot Answer

Physician torn between two worlds: patient care and data


Procedural medicine is built on the premise that skills can be seen, measured, and compared. Physicians who perform procedures are trained, above all, to intervene, and their success is often defined by dexterity, decisiveness, and outcomes. It is therefore natural that patients would want to choose their doctors based on published results of technical success. Yet, somewhat paradoxically, only a handful of specialties provide robust, publicly accessible, risk-adjusted outcomes that allow meaningful comparisons across institutions, and even fewer at the level of individual physicians.

In Interventional Pulmonology, where technological advances have expanded the ability to diagnose and treat complex airway diseases, this gap remains particularly evident. Patients who require these often life-altering or life-saving procedures are left without clear guidance on how to choose their physicians. The question they most want answered; Who is the best doctor for me? is one that medicine, despite its commitment to evidence and measurements, is not yet equipped to fully address.

👉 Read the full essay on Substack: The Question Patients Cannot Answer

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Rethinking Legacy Thinking

tree and books Rethinking Legacy Thinking


Legacy thinking is often described as a way of thinking about the future, especially when it involves leaving something behind for the next generation. Yet the same phrase can mean something quite different. Legacy thinking can also refer to the habit of staying anchored to the past. In this sense, it means hoping or presuming that habits and ideas that once worked will continue to work indefinitely.

In my experience as a physician, teacher, and writer, healthy legacy thinking transmits principles rather than habits. Principles endure even as methodologies, tools, and techniques evolve. Each new generation faces the challenge of deciding what should be preserved, what should be discarded, and what warrants adaptation.

For those interested in a contemplative examination of the subject, I explore these reflections more fully in a recent essay on Substack: https://henricolt.substack.com/p/rethinking-legacy-thinking

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The Physician’s Journey: Transitions, Burnout, and Reinvention

physician by river calmly thinking about professional transition and reinvention


Medicine is a profession marked by transitions, though we rarely name them as such. In this Substack essay, I reflect on burnout, not as a weakness, but as a signal that change is necessary before health care professionals collapse under the burdens of accumulated years, growing responsibilities, unfriendly work environments, and shifting systems.

As medicine enters an era increasingly affected by artificial intelligence and structural transformation, the ability to transition and even reinvent oneself is even more important than before. We are reminded that while tools and roles may evolve, the moral dimensions of medical practice remain. What endures is more than technical expertise, it is the human capacity to care, with judgment, presence, and compassion.

You can read the full essay on Substack here. https://henricolt.substack.com/p/the-physicians-journey-transitions

I welcome your reflections. 

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Anyone Can Be A Mentor

Doctor in white coat and stethoscope thinking. Two doctors in the background with a chart.


Mentorship is an essential part of professional and personal development. In medicine, it has been an especially dominate force, in part because of traditional apprentice-like training, but also because it has been a most opportune way for health care providers to learn to emulate certain behaviors and ways of thinking. It has also been a traditional vehicle for the transmission of knowledge. Authority descends from senior to junior physicians, to trainees, and students. Today, however, that alignment is less secure.

Technology puts information as well as world-class training tools and illustrated behaviors at the hands of virtually anyone almost immediately. Younger generations are often more adept at using new technologies than their senior colleagues. Traditions are questioned. Conventions demand justification based on more than experience alone. I’ve been thinking quite a bit about mentoring; about its good sides as well as its limitations and vulnerabilities, especially in an era of democratized knowledge and reversed mentoring.

For those interested in a contemplative examination of the subject, I explore these reflections more fully in a recent essay on Substack: Anyone Can Be a Mentor

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What Remains After a Patient Dies

: A solitary human figure seated in a dim, quiet interior space, facing soft light


I’ve written before on Colt’s Corner about resilience in medicine, mostly in the context of endurance, burnout, and recovery. Recently however, I found myself returning to the question from a different direction, less as a skill to be cultivated and more as an ethical stance based on human connection. 


After a recent lecture, several nurses and physicians spoke about what remains after a patient dies. They asked how one can resume work after facing therapeutic failures repeatedly or after suffering the emotional toll of sustained compassionate caregiving. Their questions led me to revisit resilience not as toughness, but as a form of presence that allows compassion without collapse. 

For those interested in a more contemplative examination of the subject, I explored these reflections more fully in a recent essay on Substack: What Remains After a Patient Dies.


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History of Pulmonary Medicine: From Antiquity to AI

history of pulmonary medicine shows evolution and AI


The history of pulmonary medicine is replete with famous names and milestone events that changed the face of medical science over centuries. From early empirical observations in ancient civilizations to Egyptian texts describing herbal treatments and surgical interventions, it is clear that humanity has suffered from lung disease since the days when Homo sapiens and its predecessors first walked the earth. What follows is not a comprehensive history, but some thoughts on how shifts in knowledge have shaped pulmonary medicine. 

Hippocrates and other Greek practitioners set guidelines for medical practice. They also defined and described many breathing disorders, not the least of which was phthisis, later known as consumption or pulmonary tuberculosis. They described and treated pleurisy and raised awareness about the potential contagiousness of what would ultimately be recognized as infectious lung diseases centuries before the discovery of germ theory.

After that, another Greek physician, Galen of Pergamon, who practiced in the Roman Empire in the second century CE, shaped the future of medicine for centuries. Although many of his findings rooted in anatomical studies and theoretical iterations of what ultimately became the humoral theory for disease needed to be revised or debunked, Galen was forward-thinking in the ways he tied symptomatology (medical semiology), the anatomical structure of the human body, and the external environment on the course of disease. He was among the first to suggest that air, water, and even emotional disturbances could have an adverse impact on human health and wellness.

New theories of medicine prospered only centuries later, when the Islamic physician Avicenna (Ibn Sina) published his Canon of Medicine and Book of Healing (11th century). The Renaissance, however, brought about some of the greatest changes and the abandonment of most antiquated Galenic theories regarding lung disorders. Anatomists/physicians such as Vesalius, who described the mechanics of respiration and demonstrated the principles underlying positive-pressure ventilation, and Michael Servetus, among the first to describe the pulmonary circulation (early to mid-16th century), were instrumental in building new foundations from which future discoveries in pulmonary medicine would be made.

From the 17th to the 20th century, new breakthroughs would occur particularly in the realms of microbiology, pharmacology, imaging studies, and physician concerns for public health. The discovery of oxygen and the physiology of respiration, accompanied by widespread adoption of Laennec’s stethoscope revolutionized bedside diagnosis and global thinking about the diagnosis, treatment, and prevention of pulmonary diseases. 

Concomitantly, advances in the diagnosis and management of infectious lung disease, the establishment of links between smoking and disorders such as lung cancer and COPD, and growing attention to occupational lung disease anchored pulmonary medicine as a social discipline.

Today, we have reached a new inflection point in the history of pulmonary medicine. Artificial intelligence is reshaping medical diagnosis and decision-making in ways that we cannot yet fully comprehend. Machine-learning algorithms already outperform traditional methods in image interpretation for lung nodules and interstitial lung disease. AI-assisted pathology and cytology promise laboratory expertise in even the most remote corners of the world. Tools combining large language models with genomic and gene-editing processes are accelerating discovery and assisting in earlier diagnosis and management of genetic disorders. Robotics and robotic-assisted bronchoscopy are penetrating the pulmonary procedures world at almost warp speed, providing higher diagnostic yields for lung cancer and other disorders by enabling better access to hard-to-reach peripheral nodules compared to traditional methods.

In the face of such rapidly changing times, our challenge is in finding ways to both embrace and harness computational power. While debates about the risks versus the advantages of AI in pulmonary medicine are helpful, we should also focus on how technological authority can go hand-in-hand with professional responsibility.

  • The Cambridge History of Medicine (2006). Eds. Roy Porter. Cambridge University Press.
  • Murray JF. A thousand years of pulmonary medicine: good news and bad. European Respiratory Journal 2001 17(3): 558-565; DOI: https://doi.org/10.1183/09031936.01.17305580.
  • Mahajan AK, Duong DK, Cortes J, et al. The Match 2 Study: Robotic Assisted Bronchoscopy with Integrated Imaging with Assessment of Digital Tomosynthesis (DT) and Augmented Fluoroscopy (AF): Three-Dimensional Accuracy as Confirmed by Cone Beam Computed Tomography (CBCT), Respiratory Medicine 2026. https://doi.org/10.1016/j.rmed.2026.108693.
  • Topol EJ. High-performance medicine: the convergence of human and artificial intelligence. Nat Med 2019;25(1): 44-56. 

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A New Home for My Writing

landscape stethoscope and ink pen announcement of new home for Henri Colt on Substack


I’m grateful you have been reading my work here, and I’m honored that so many of you around the world have viewed or downloaded educational materials from bronchoscopy.org in support of our shared educational mission.

I will continue to add to this website, and to post on Colt’s Corner.

For some time now, however, I’ve been thinking about where my longer, more reflective writing belongs. These include excerpts from my books, longer essays, short stories, and commentaries—reflections on medicine, philosophy, literature, science, art, and the fragile beauty of our shared lives.

I’ve begun publishing this work on Substack — a quieter space that allows for long-form writing and more direct conversation with readers. 

If you would like to continue reading there, 
you can find my work and subscribe here:
Subscribe on Substack

A recent essay:  On Friendship and Sudden Loss

Communication in Health Care: Patients and Providers

Effective communication in healthcare

 Communication in health care relies on a foundation of trust and psychological safety amid unexamined assumptions, non-dits (which is French for things left unsaid), potentially mismatched expectations, asymmetries of knowledge and power, vulnerability, unspoken emotional defenses, and differences in understanding or health care literacy. Perhaps this is why effective communication requires more than clarity of language. It also requires our attention to meaning, context, and subjective experiences, including the “emotional baggage” carried by all those involved in our conversations.

Whenever we communicate, we receive, transmit, and interpret both information and feelings. Psychological research shows that effective communication in health care is tied to perceived empathy, narrative coherence, and opportunities for all involved parties to be heard. Taking the time to sit at the patient’s bedside and avoiding potential distractions such as phone calls, computer screens, or unnecessary interruptions can be key to establishing rapport. In my experience, providers operating under time constraints, emotional strain, or institutional pressures have difficulty recognizing how fear, hope, and struggles tackling ambiguity or uncertainty adversely affect their patients’ understanding. They risk using technical jargon, matter-of-fact approaches, or paternalistic attitudes to rush through a conversation, disregard differences in health care literacy, or achieve a specific desired outcome. Hence, health care providers might subconsciously or intentionally distance themselves emotionally from their patients. The result is a potential undermining of a patient’s trust. Consequently, both caring and compassion are sacrificed on the altar of efficiency.  

Interprofessional communication between physicians, nurses, technicians, and allied health professionals also has its challenges. Healthy dialogue means overcoming real and perceived hierarchical barriers and role ambiguities. It means negotiating intergenerational differences, acknowledging differing professional identities grounded in diverse yet strangely singular training paradigms, and recognizing inward disengagement even when outward appearances signal agreement or a willingness to comply.

Overall, this introduces yet another layer of complexity to effective communication. Cultural expectations can vary significantly among trainees, mid-career professionals, and more senior practitioners. Intergenerational differences of opinion might exist regarding what constitutes competence and professionalism, for example, or how to communicate with respect to cultural diversity. Not everyone has similar views on the appropriateness of multitasking (it took me a while to realize that young people can remember and reflect on what I say even while scrolling through pictures and texts on their mobile phones), or on when to rely on narrative versus factual reasoning. 

Much more can be said about communication in health care. In future essays, I will briefly address dialogue between health care providers and administrators, conversations with patients’ families, and the challenge of effective communication with staff, other team members, and direct reports. I will also discuss communication failures and why I believe the observation and improvement of communication skills should be an integral part of competency—based training.